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k

ok, thanks for saying please and thanks. — Preceding unsigned comment added by SRLin (talk • contribs) 03:18, 11 August 2011 (UTC)

Hope you stay and edit with use. We are always looking for people interested in medicine.Doc James (talk · contribs · email) 04:01, 11 August 2011 (UTC)

Edit war

Please refrain from repeatedly undoing other people's edits, as you are doing in Circumcision. It appears you may be engaged in an edit war. The three-revert rule (3RR) prohibits making more than three reversions in a content dispute within a 24-hour period. Additionally, users who perform a large number of reversions in content disputes may be blocked for edit warring, even if they do not technically violate the three-revert rule. Rather than reverting, please discuss disputed changes on the talk page. Thank you. Garycompugeek (talk) 15:25, 6 August 2011 (UTC)

You did not even give me a link to where you reported me to ANI [1]. You where to have given me a warning before filling as well which was not done. Also I did not make MORE than 3 reverts in 24 hours. You have been reverted by two other editors. This is all rather disappointing... Doc James (talk · contribs · email) 18:33, 12 August 2011 (UTC)

HSP

Hi , Dr James ,

I need some advise from you or your friend.

My daughter aged 14 has been suffering HSP since she was 10 , her case recurrence very often almost 1 or 2 months , sometimes very mild and sometime very serious till she refuse to take food due to vomiting , sometimes we send her to a local specialist doctor who diagnose her HSP to put her on drip to avoid her from dehydration . We have been send her for a nephro doctor in Kuala Lumpur regularly on 2 months appointment to check on her urine for blood and protein contain and she was giving enalapril , the doctor manage to control her urine protein level to almost zero , but since last month her got attack again and the protein in urine increase . Doctor has confirmed lgA in blood cell .

Our concern was if this recurrence to often it may lead to kidney failure in long run which we are most fear of. Could you give us some advise on what to do or who to seek advise to prevent further damage on her kidney , is there any where to cure her sickness ?

Thanks a lot.

Lim WS Kuala Lumpur , Malaysia. Mobile phone no. +6019-3856827 E-mail  : alpha.wslim@gamil.com — Preceding unsigned comment added by 175.144.215.11 (talk) 03:08, 11 August 2011 (UTC)

I am not a specialist in this area of medicine and therefore am unable to comment. Best to see your doctor and direct this question at him or her.Doc James (talk · contribs · email) 18:26, 12 August 2011 (UTC)

What should I do?

Dear Dr.James

=I has sent message to you because i has occur ureteric stone. There are 4 mm calcium oxalate stone in my vesico-ureteric junction according Ultrasound result. I start to occur in colic pain in last 3 week(25.7.2011),But it (pain) took 2 day and spontaneously relieve. There is no other significant sign and symptoms.I have shown to urologist for this disease. Urologist said that stone pass spontaneously but need to take some medication. So I took uric acid 100mg od, Rowatinex 2 tds according to urologist prescription. But at last 2 day i felt transient mild colic attack in affected site (Right sided).There is no stone pass spontaneously till date. It is hard to feel about this mild pain in loin and groin.So what should i do?Urologist said no need to surgery or other treatment method rather than conservative management due to stone size. So what so i do?Please give me advice.

Thanks a lot,

with regards,

12.8.2011 Kyan sit thar Myanmar SouthEast Asia — Preceding unsigned comment added by 203.170.206.3 (talk) 16:21, 12 August 2011 (UTC)

We at Wikipedia are unable to give medical advice. You can however read our article on the topic kidney stone.Doc James (talk · contribs · email) 18:27, 12 August 2011 (UTC)

Sepsis Article

My mistake, I read the word as "sufficient". Corrected.

No worries that is sort off what I thought. Doc James (talk · contribs · email) 22:49, 12 August 2011 (UTC)

Pneumonia

After seeing your badge, I reviewed the pneumonia article and made a large number of revisions and corrections. Take a look!

http://en.wikipedia.org/w/index.php?title=Pneumonia&diff=444555096&oldid=443999524

Lumentec (talk) 23:54, 12 August 2011 (UTC)

Pneumonia (Continued...)

What kind of things do you plan on improving in the future? I would be glad to offer my help. Although you have much more technical knowledge in the area (this I'm sure of), I have an intimate knowledge of English grammatical rules which could prove to be helpful. I can also dig for good images to add to various parts of the page. Let me know.

Lumentec (talk) 04:43, 13 August 2011 (UTC)

Reported for Warring

I have been trying to help add articles and images to the wiki for years and you have repeatedly reverted all edits I have made in good faith. I have used the discussion pages as required and have even responded to other user's request but you continue to follow me and revert my edits. I am finally calling foul and reporting you. I am tired of the petty wars. Shame on you for bringing down the quality of the WIKI with your childish behavior and personal vendettas. Davidandkimbenton (talk) 12:59, 13 August 2011 (UTC)

Helllo Jmh649. The editor has filed a complaint about you at WP:AN3#User:Jmh649 reported by User:Davidandkimbenton (Result: ). EdJohnston (talk) 14:08, 13 August 2011 (UTC)

Epilepsy Society

Hi James I would really appreciate your help. I am still trying to update our links /profile on Wikipedia.I have the following problems:

  1. Page for National Society for Epilepsy . I cannot get into the title and opening paragraph to edit. Our name has changed, as of this year, to Epilepsy Society and I would like to update.
  2. Epilepsy page. You say we are not a reliable source for referencing. We are the UK's leading national epilepsy medical charity working out of the renowned Chalfont Centre. All our work is verified by Professors John Duncan, Ley Sander and Sanjay Sisodiya who are part of Epilepsy Society, the National Hospital for Neurology and Neurosurgery and the Institute of Neurology University College London. We are already referenced on the page as are other chairties including Epilepsy Action. We are very keen to make information on our website available to those who are searching 'epilepsy' on Wikipedia. I am going to try editing the domain name again though you deleted it last time as this is just updating the info you have.
  3. I am also having trouble uploading our new logo to our Page (see point 1).

It would be really good to be able to talk to someone diret.

Many thanks

Nicola — Preceding unsigned comment added by Nicola Swanborough (talk • contribs) 12:24, 5 August 2011 (UTC)

James,
This is the "the free encyclopedia that anyone can edit", not the "the free encyclopedia that only people with access to a library of medical journals can edit". Nicola did not add unsourced or poorly sourced text; the text was already unsourced. Nor was the text incorrect or misleading; the text is fine. The sources used meet WP:RS and WP:V. The topic being sourced was not controversial or otherwise in need of only the highest quality sources. WP:MEDRS is a guideline on choosing the best medical sources one can access in order to meet WP:V and WP:NPOV policies. It is not designed to prevent people editing or improving Wikipedia when they only have access to lesser sources. The Epilepsy article is not some precious Featured Article or even a Good Article. It is in fact a rather poor article and much of it unsourced. The Epilepsy Society web pages are not "unreliable", though they aren't the best sources we can find. A better choice than their pages for a lay audience would be their For Professionals section, and in particular this set of articles outline a coverage of the topic that our own article would do well to emulate and draw from.
Your note on Nicola's user page that we use review articles is too narrow a requirement and actually inappropriate for a topic as huge as Epilepsy. The best sources for an article of this nature are professional books, though I'm sure there are many review articles that would help too. However, as I note above, the article currently would benefit from more reliable sources, not just the most reliable sources. -- Colin°Talk 14:02, 7 August 2011 (UTC)
There are a number of free review articles on this topic. One can request access from many people for others. One can get access to large parts of textbooks free on google books. Adding links to a site one runs is WP:COI. Just hoping to turn this user into a more productive editor.Doc James (talk · contribs · email) 03:56, 14 August 2011 (UTC)

James, replacing those weak sources with better ones is a much better response than just reverting edits. Thank you for doing this.

Wrt your "Their website has a please donate sign" comment, did you actually look at the source for this edit when you copied it from the Purple Day article? There's a great big "Donate" button on that page too. The Epilepsy Foundation is no different to the Epilepsy Society in this regard. And the link's actually broken so it doesn't support the text, or as you put it "This is bullshit and just generating work for someone else". And if we're concerned about websites wanting money off readers, then that applies to most journal links which want to extort $30 off me for a few sheets of paper. [I hope you take these comments in the humorous tone intended] Regards, Colin°Talk 08:34, 14 August 2011 (UTC)

Yes good point. :-) Doc James (talk · contribs · email) 15:02, 14 August 2011 (UTC)

Dear Sir, I am an Associate Professor of Cardiology in Baskent University, Konya, TURKEY. I have setup a BASIC ECG teaching website: www.metealpaslan.com, www.doktorekg.com

This site is both in English and Turkish.

This site has hundreds of high quality images which are completely free to download and use by public.

I think that many ECGs in my website will be helpful for emdical students and other healthcare workers.

Regarding some ECG topics in the wikipedia.org, I tried to edit several of them and I tried to give External Links to my website.

But after a few attempt, the wikipedia.org blocked me.

Please examine my website. I hope you will find it useful.

How can I make more people be aware of my non-profit basic ECG teaching website? Can you help me to stop the wikipedia.org's blockage on my adding new external links to my website.

By the way, if you have any e-mail groups, can you tell them about my website.

Thank you very much. Very Truly Yours Dr. Mete Alpaslan — Preceding unsigned comment added by Doktorekg (talk • contribs) 05:38, 13 August 2011 (UTC)

If you are willing to release these images under a creative commons 3.0 license we can upload them here at Wikimedia Commons[2]. They can than be added to the appropriate Wikipedia page with attribution to the author and your site. We however are unable to add your site as an external link. It would also be preferable to have the water marks removed from the images. Doc James (talk · contribs · email) 16:23, 13 August 2011 (UTC)

Pneumonitis

The refs to dorlands do not work. Do you know how to correct them? Doc James(talk · contribs · email) 22:32, 13 August 2011 (UTC)

Hello, and thank you. I did not add the refs to Dorlands. I agree that they do not work as internet connexions per se, but paper copies exist (somewhere... like libraries and so on) and I judged that the citations have some merit in priore modo, while imperfect. (Hope I am saying this clearly, let me know if not.) The Dorland site is registration/PIN protected. I do not know of a work around as to internet access for Dorlands. I would prefer a better citation than this and I will see if I can find one. I ascribe to the concept of verifiability.FeatherPluma (talk) 22:46, 13 August 2011 (UTC)

I have a copy at home. Will follow up when I get their. I have look at some journal sources and am unable to find a concise definition of pneumonitis in a review.Doc James (talk · contribs· email) 23:02, 13 August 2011 (UTC)

Thanks for taking it on. Perhaps the edits I have provided will address the issue that was raised by several people on the disc page. I defer to you as my round of edits is presently completed.FeatherPluma (talk) 23:26, 13 August 2011 (UTC)
Thanks for the help. Will continue to work on trying to get this article to GA status over the next few weeks.Doc James (talk · contribs · email) 23:28, 13 August 2011 (UTC)

Strong warning

Just saying, that was a strong warning you dished out to User:24.60.33.124. It is an anon account which means that different people probably edited between January and August. The warning I gave to him was for the same thing that you were warning him for (you just rolled back before me). Effectively, he is on his first warning. Rabbitfang 03:51, 14 August 2011 (UTC)

Yes did get a double warning but did make two poor edits. Doc James (talk · contribs · email) 03:52, 14 August 2011 (UTC)

Struck Comment

Did you strike the right comment on the TM article.Thought I'd check so there was no confusion in the future in that discussion.I(olive (talk) 23:18, 14 August 2011 (UTC))

Thanks been having problems with chrome.Doc James (talk · contribs · email) 01:09, 15 August 2011 (UTC)

Arbitration

FYI, you've been dicussed here.Anythingyouwant (talk) 09:32, 15 August 2011 (UTC)

:)

Thanks for your appreciation. I'm blown away by the richness of info on brain structure, chemistry, etc. to which I can make no technical input - so it's nice to think I might be of some use, even if of a rather nit-picking kind - it all helps to make this astounding project better. - and yes - I can do grammar, & I'm glad to have the links to wiki resources, thank you. Fentlehan (talk) 21:03, 15 August 2011 (UTC)

No worries and again welcome to the project. Doc James (talk · contribs · email) 21:10, 15 August 2011 (UTC)

UMich photos

I saw your post over on Wikimedia Commons and found the UMich website to be quite a treasure trove of excellent freely licensed photos. I don't know how to do batch uploads or I would do it myself but I did start adding some of the more useful photos into various articles. They unfortunately have a prominent watermark but they are a great addition in any case. The Graves' article had been looking for a good photo of proptosis and lid retraction for a while. Warfieldian (talk) 01:51, 16 August 2011 (UTC)

The Signpost: 15 August 2011

This should be added to tonsil stones..

A holistic option is the use of Apple Cider Vinegar (ACV). An ACV mixture of 2 Table Spoons of Apple Cider Vinegar mixed with 8 oz of Water can be used to break up the stones and neutralize bacteria. The mixture should be gargled for 30 seconds to a minute. This mixture is also safe drink and is reported to have other benefits. The gargling is not necessary for other treatments of ACV but for Tonsil Stones it is recommended as it will help reach the Crypts and clean the affected areas in the mouth. It is important to also rinse the mouth with water after gargling the mixture as the vinegar can affect the coating of the teeth causing increased sensitivity. The Apple Cider Vinegar, which has acidic properties and other cultures that are believed to have additional health benefits, is reported to work by restoring PH balance in the body and reacting against the bacteria and other elements that cause the stones to form.

Sources: http://www.applecidervinegarhealth.com/vinegar-remedies/tonsil-stones/ http://altmedicine.about.com/od/applecidervinegardiet/a/applecidervineg.htm

I also use this treatment and have for many years. My mother showed me and she from hers. It has basis. I have also listed sources above.

Where are the sources for the other treatments — Preceding unsigned comment added by 72.244.167.226 (talk) 23:47, 16 August 2011 (UTC)

Removal of external link for MS article

I noticed that you removed the external link to the MS Resource Center at MedMerits. (http://www.medmerits.com/index.php/center/multiple_sclerosis_center). I guess you thought that the link was of little value. I just wanted to point out that MedMerits provides some of the most comprehensive MS articles available to the general public. The articles are licensed from MedLink, the online reference that practicing neurologists pay $400/year to access. The content may be too technical for many, but it is an invaluable resource for those who want to read detailed, professional-grade clinical articles (as opposed to the dumb-down stuff usually made available to the public).

Rgbwiki (talk) 17:52, 18 August 2011 (UTC)

Regarding Whiplash Article

Dear Dr.James Heilman This is Terry Chou

I am a UBC summer research assistant at the CIPRD Whiplash Prevention Program. My supervisor Dr.marc White and I are currently working on updating the whiplash article on wikipedia with more current knowledge. Thank you for correcting my preliminary article as I kind of did it without figuring out how to add references.

My article is currently been reviewed by Professor Doug Romilly. After he is done, I'll put it on the site and hope you can point out my errors.

Thank you

Best Regards, Terry Chou — Preceding unsigned comment added by Yhchou.8 (talk • contribs) 16:51, 19 August 2011 (UTC)

Content/refs in Pertussis article

Hi, I saw that you did some MAJOR cleanup in the Pertussis article- it's much appreciated! I saw one place though where you made some edits I didn't quite follow. In Prevention/adverse effects http://en.wikipedia.org/w/index.php?title=Pertussis&action=historysubmit&diff=432632214&oldid=432632011 you snipped a bit with unsourced claims, and one with a cited reference with the reason: "ref needed". The second statement was misworded (genetic drift causing antigen change is a far more likely culprit) but the cited ref seems to support the underlying premise- that the vaccine may be losing its effectiveness. Is the ref (New Scientist) not a reliable source? Would it be helpful to find a ref from a less sensational rag? Or is this simply inaccurate information based on poor data- not worth verifying or disproving? I don't have any stake here; just trying to get a better sense of how WP editors think and work, so I can be more useful to WP myself. --Raduga (talk) 17:46, 19 August 2011 (UTC)

The paper quoted does not seem to support very well the conclusions of new scientist. http://www.cdc.gov/eid/content/16/2/297.htm Doc James (talk · contribs · email) 18:23, 19 August 2011 (UTC)

Horse Lisa

Was that funny? 70.137.150.187 (talk) 06:48, 20 August 2011 (UTC)

No idea to what you refer. Doc James (talk · contribs · email) 16:13, 20 August 2011 (UTC)

re account, I know. But I rarely edit. The 70.137.x.x in Alprazolam are all me. Regarding horse Lisa, I made the joke: Next you come with an experiment on ONE single rat, who volunteered, or on our horse Lisa, which was the only experimental animal on our institute, on which we had to make all our experiments. It since died. - In response to your primary source with a very small study on volunteers, which had a funny design IMO. 70.137.130.120 (talk) 17:19, 20 August 2011 (UTC)

Yes I have not suggested we use said source anywhere. The problem is if you have a review in 2004 that states no report has been published showing tolerance and if in 2007 a poor quality report on one rat is published the 2004 statement is dated. Poor wording on their part IMO. If we just state "uncommon" or "rare" I think this would be better... Doc James (talk · contribs · email) 17:22, 20 August 2011 (UTC)

I think we agree. But you understand why I brought poor Lisa into play. Can you do the edit? And no, the 70.137s are a whole stable full of my idiot clones at work, bitching and moaning over the bad state of the Wikipedia article. ;) 70.137.130.120 (talk) 17:34, 20 August 2011 (UTC) 70.137.130.120 (talk) 17:34, 20 August 2011 (UTC)

Talk:Kidney stone/GA1

This review is over two months old now. If there are outstanding issues then best to fail now. Jezhotwells (talk) 22:20, 22 August 2011 (UTC)

The Signpost: 22 August 2011

PTSD article comment re: image

Thanks for showing up in this dispute. None of the other regular contributors have yet appeared, which, of course, suggests that they lack strong feelings about the issues (assuming they even noticed it!). I, too think it should be kept. It makes a strong statement, and one that needs to be made, I have clearly asserted, in the discussion.

I also like my idea for a graph, but think it would really go best in the article body. I think that's the first place I'll put it. Either way, I'm not in favor of dropping the image. I just keep seeing the cover of JAMA - a generic cover with some piece of fine art on it. What I've done with this image certainly has ample precedent there, I think. Tom Cloyd (talk) 08:09, 23 August 2011 (UTC)

Yes agree. Illustrating psychological conditions is hard. Dealing with the same things at the ADHD article among a few others. No images is perfect but I believe they do add to the article.Doc James (talk · contribs · email) 09:40, 23 August 2011 (UTC)

I am new to Wikipedia and somewhat confused as to why you are removing the external link to the MS Resource Center at MedMerits. Did you look at the content on the site? The MS articles at MedMerits exceeds anything else that is freely available online. They are both comprehensive and authoritative, written by top neurologists. (The articles are licensed from MedLink, whose editorial board reads like the who’s-who of neurology; clinicians pay $400 a year for access to the complete content library).

Can you please provide some indication of why you think this content is not useful for Wikipedia readers? I just don’t see why you think that links to databases summaries and abstracts are of interest, but links to full-length clinical articles are not. Or perhaps you feel that the links violate some Wikipedia policy? Your feedback would be appreciated.

Rgbwiki (talk) 00:00, 19 August 2011 (UTC)

Does not appear to add anything over what Wikipedia already contains. Doc James (talk · contribs · email) 01:12, 19 August 2011 (UTC)

Rgbwiki, I feel your pain. I have been a victim of Jmh649's censorship as well. He is NOT an unbiased editor, but rather a hack that removes links without reading the content. Too bad really, the wiki is just what the censors want to present, not really open sourced. A lot of good material is not allowed. Davidandkimbenton (talk) 23:36, 23 August 2011 (UTC)

Your reversion

From TM research article talk page: "Doc I'd suggest you revert yourself. I will ask for neutral admin guidance on this issue if you fail to. I may be wrong on this but its with out merit to change content while that content is under discussion on a NB. A neutral admin could help me determine what is appropriate." Thanks for allowing the NB process to play out in a neutral fashion. (olive (talk) 21:45, 24 August 2011 (UTC))

Yes I think it is an excellent idea to get some more admins involved. Feel free to post at ANI. Doc James (talk · contribs · email) 21:52, 24 August 2011 (UTC)
Posted here.(olive (talk) 22:48, 24 August 2011 (UTC))

pneumonia

the sentence just reads really rough, especially the "but can also be caused by irritants or unknown causes" I was trying to smooth out the language is all. :D Je.rrt (talk) 04:54, 26 August 2011 (UTC)

by review do you mean

By review do you mean a recent reference for my addition of the bronchopulmonary hygiene as a management tool for pneumonia? Je.rrt (talk) 23:41, 26 August 2011 (UTC)

Yeahbut . . .

. . . does the article have enough links pertaining to chikdren with Type 1? If there is any point at all to useful links, I would think a kid-related link list would make sense. Is there any problem with the quality of the links? There's certainly a problem with the formatting. I haven't done this kind of list before, but I'm working on this one. I'd like to see it in unless there's a stronger reason than "we have enough." -- Jo3sampl (talk) 19:52, 27 August 2011 (UTC)

Have added dmoz Wikipedia is not a collect of external links while this site specializes in them. Consider adding the EL there... Doc James (talk · contribs · email) 20:06, 27 August 2011 (UTC)

thanks for the welcome!

Thanks for the welcome, its nice to see positive things on my talk page lol. I am a RT and I started editing because all of the Respiratory therapy articles were really, really bad. I havent been able to stop yet, this is fun and an interesting way to gain extra information to store in my brain Je.rrt (talk) 21:15, 27 August 2011 (UTC)

Online Ambassadors: Time to join pods

Hello! If you're planning to be an active Online Ambassador for the upcoming academic term, now is the time to join one or more pods. (A pod consists of the instructor, the Campus Ambassadors, and the Online Ambassadors for single class.) The Memorandum of Understanding (MOU) explains the expectations for being part of a pod as an Online Ambassador. (The MOU for pods in Canada is essentially the same.) In short, the role of Online Ambassadors this term consists of:

  • Working closely with the instructor and Campus Ambassadors, providing advice and perspective as an experienced Wikipedian
  • Helping students who ask for it (or helping them to find the help they need)
  • Watching out for the class as a whole
  • Helping students to get community feedback on their work

This replaces the 1-on-1 mentoring role for Online Ambassadors that we had in previous terms; rather than being responsible for individual students (some of whom don't want or help or are unresponsive), Online Ambassadors will be there to help whichever students in their class(es) ask for help.

You can browse the upcoming courses here: United States; Canada. More are being added as new pods become active and create their course pages.

Once you've found a class that you want to work with—especially if you some interest or expertise in the topic area—you should sign the MOU listing for that class and get in touch with the instructor. We're hoping to have at least two Online Ambassadors per pod, and more for the larger classes.

If you're up for supporting any kind of class and would like me to assign you to a pod in need of more Online Ambassadors, just let me know.

--Sage Ross - Online Facilitator, Wikimedia Foundation (talk) 16:33, 19 August 2011 (UTC)

PS: There are still a lot of student articles from the last term that haven't been rated. Please rate a few and update the list!

A pod suggestion for you: Physiology for Public Health

Hi Doc! I'm in the process of trying to find Online Ambassadors to support each of the classes for this coming term, and I thought you'd be a good fit for this one: Wikipedia:United_States_Education_Program/MOU/sign#Physiology_for_Public_Health. If you're up for it, please check out the Memorandum of Understanding (linked above) which sketches the expectations for Online Ambassadors this term, and then you can sign on to class and get in touch with the professor.

--Sage Ross - Online Facilitator, Wikimedia Foundation (talk) 14:32, 25 August 2011 (UTC)

Thanks for the heads up. I have a friend and prof who teaches at Yale. Will see if he is also interested in getting involved. Doc James (talk · contribs · email) 01:17, 29 August 2011 (UTC)

Bio-Identical Hormone Replacement Therapy

Hello, I have recommended this article for resolution. All I want is a fair representation of the information from both sides. The talk page shows a history of frustration with accomplishing this. I think it is time it gets done. Nutritiondr (talk) 02:13, 29 August 2011 (UTC)

You are free to bring appropriate references to the talk page to be discussed. Doc James (talk · contribs · email) 02:51, 29 August 2011 (UTC)

"Perifular" fullness

Hi James, I recently came across the wording "bilateral perifular fullness" in the caption of File:RSV.PNG in the Bronchiolitis article, and in the file description page itself. Don't you mean "perihilar" fullness? Cheers, Fvasconcellos (t·c) 23:30, 29 August 2011 (UTC)

I sure do. A typo... Doc James (talk · contribs · email) 00:18, 30 August 2011 (UTC)

The Signpost: 29 August 2011

Mediation request

It appears that the dispute you were having at Gabapentin has been resolved. If you are still interested in pursuing the mediation request, please so indicate on the mediation page. If no one says they want to continue by 20:00 UTC September 2, 2011, we will close the mediation as unneeded. Regards, TransporterMan (TALK) 19:35, 31 August 2011 (UTC)

I have missed recent changes. Let me look. --Doc James (talk · contribs · email) 01:07, 1 September 2011 (UTC)

Whipple disease

I agree that review material is to be preferred as citable material on WP. However use of primary material is permitted under the WP guidelines. Additionally the citation of primary material is extensive on pages relating to medicine in WP.DrMicro (talk) 21:26, 1 September 2011 (UTC)

This discussion arose over the inclusion of material concerning the inclusion of material on epidemiology (that the organism was an environmental one, that it was more common in sewage workers as might be expected from an orofaecal transmission), the inclusion of a small number of rare presentations including a case of cocoon syndrome where the diagnosis was life saving, and some material on the associated abnormalities of the immune system. Although the fact that this organism is an environmental organism that occasionally causes disease and is spread by the orofaecal route is included in the more recent reviews, the remaining material while validly published and acceptable according to WP instructions is not included in such a review. That is all there is to this. DrMicro (talk) 21:37, 1 September 2011 (UTC)

"Reliable primary sources may occasionally be used with care as an adjunct to the secondary literature, but there remains potential for misuse. For that reason, edits that rely on primary sources should only describe the conclusions of the source, and should describe these findings clearly so the edit can be checked by editors with no specialist knowledge. In particular, this description should follow closely to the interpretation of the data given by the authors or by other reliable secondary sources. Primary sources should not be cited in support of a conclusion that is not clearly made by the authors or by reliable secondary sources, as defined above"

This is a quote from the WP guidance. While reliable secondary sources are ideal this does not exclude the use of primary sources in addition - a position that is adopted in the majority of pages relating to medicine. DrMicro (talk) 22:20, 1 September 2011 (UTC)

If I may also quote one of the Five Pillars of WP;

"Wikipedia does not have firm rules. Rules in Wikipedia are not carved in stone, and their wording and interpretation are likely to change over time. The principles and spirit of Wikipedia's rules matter more than their literal wording, and sometimes improving Wikipedia requires making an exception to a rule."

DrMicro (talk) 22:28, 1 September 2011 (UTC)

Re consensus: it appears that the consensus is that primary sources may be included even in featured articles. To illustrate this point I refer to the article on rotavirus on the featured list of medical articles. I chose this example only because I know something about this topic.

A brief perusal of the references in the article reveals a number of primary source citations. Since this is but one example which I believe to be reasonably typical of such articles (a point on which I admit I could be wrong: from a sample of one it is difficult to draw statistically valid inferences) and one that have been reviewed by scores if not hundreds of editors who have found that inclusion of such material is reasonable practice.

If this example is insufficient I doubt that it will be difficult to provide other examples where primary source material is cited in articles that have been reviewed many many times. Given the number of editors involved in reviewing these articles and the support of the explicit statement in the the WP guidance, I believe that it is correct to say that the consensus is that properly cited and utilized primary source articles may be (and perhaps should be) included and that a blanket ban on such material is an error.

If such material is to be removed the burden on the editor wishing to remove it is to show that it:

(1) fails to describe the conclusions of the source (2) fails to describe these findings clearly so the edit can be checked by editors with no specialist knowledge (3) that the description fails to follow closely to the interpretation of the data given by the authors or by other reliable secondary sources (4) that the edit does not support of a conclusion that is not clearly made by the authors or by reliable secondary sources

It is my opinion that a re examination of the edits and the sources cited will show that none of the above criteria were met.

In sum it is my belief that the inclusion of primary source material is (1) permitted under the rules of WP (2) that this is common practice even in featured articles and (3) that hundreds if not thousands of editors have approved the inclusion of such material in wikipedia. Furthermore deletion of such material should only be done for approved indications including but not limited to those listed above. DrMicro (talk) 10:10, 2 September 2011 (UTC)

Thank you for your kind words. I would like to hope that your opinion is shared with other editors on this site.

I do take issue however with your misstatement. I did not say nor intend to imply that primary sources were 'better' that reviews. What I did say is that they may be included and have been included in a number of featured articles. That they may be included in articles is clearly stated in the guidance on WP from which I have quoted extensively in support of this position.

If it is your opinion that this material should be removed or the article should be downgraded from its current status may I quote you on this on the discussion page? DrMicro (talk) 10:35, 2 September 2011 (UTC)

I would also like to take issue with your statement that you have written the articles on gout and dengue fever. The record shows that these articles were started in 2002. You wikipedia history suggest that you became active here in 2008, six years after the articles were started. The first recorded wikepedian writing on gout was PierreAbbat. The first recorded editor on dengue fever was an IP address. The first identifiable editor was Mav. In both cases you do appear to have been an active contributor but so also have hundreds of other editors. To make such a statement as you did would appear to claim credit for the work of many others.

I accept that is is your opinion that featured articles should only include secondary sources. This does not appear to be the majority view here - a point I will conceed is very difficult to prove. I make this statement based on a brief perusal of the references of a number randomly chosen of featured articles. It may well be that in the future the concensus will concur with your opinion but at the moment this appears to be a minority opinion.DrMicro (talk) 10:47, 2 September 2011 (UTC)

Your last question is an excellent one. It is a question that probably should be asked of a wider audience that just between ourselves. The question is not whether or not secondary sources should be treated as more reliable - they may not be but are usually - but rather whether or not primary sources should be cited seperately. Perhaps there should be reflists for primary sources and a second one for secondary? In this way the reader can judge for herself whether or not to trust the authority cited. There may be better alternatives that you and I have not even thought of. DrMicro (talk) 10:53, 2 September 2011 (UTC)

Thank you for the correction to the statement.DrMicro (talk) 10:56, 2 September 2011 (UTC)

I have examined the list of featured medical articles. On the top row there are the following articles: Acute myeloid leukemia, Alzheimer's disease, Anti-tobacco movement in Nazi Germany, Asperger syndrome, Autism, Frank Macfarlane Burnet, Cerebellum, Chagas disease. I have examined the references in each one. All without exception include primary sources. According to the criteria you have proposed all of these should be removed from the featured article list. While there may be some basis for your argument I am inclined to the view that removing all these articles for this reason alone is unlikely to be uncontrovertial. DrMicro (talk) 11:10, 2 September 2011 (UTC)

I confess that I do not understand that last phrase "health claims". If this refers to treatment(s) than I would agree entirely with you. There are too many alternative methods of treatment proposed with little basis in fact and such matters should be included if supported by reliable citations based on reviews and similar. The matter that caused this discussion related to the prevalence of a particular organism in stool samples. I am unclear on whether this would fall under your newly proposed category of 'health claims'. DrMicro (talk) 11:19, 2 September 2011 (UTC)

The disease in question is considered rare. For this reason unusual case reports such as the one cited may help alter the perception of the disease. At present routine culture for Whipple's organism is not done for infected hip joints. It is considered difficult to isolate this organism in primary culture. There is on going debate about using PCR in addition to the current methods of bacterial isolation in clinical laboratories. I believe that the majority are in favour but very few do this in practice probably for cost reasons. There are a number of cases where nothing is isolated despite the obvious presence of infection. It may be that more than a few of these are due to this organism. We simply don't know. Personally I would consider such a case notable enough to make mention of it in a review.DrMicro (talk) 11:35, 2 September 2011 (UTC)

To the best of my present knowledge no. That having been said I have not examined sufficient reviews to formulate a definitive opinion on whether or not this is in fact the case. Perhaps you may wish to step up to the plate? DrMicro (talk) 11:43, 2 September 2011 (UTC)

Your last comment raises an excellent point: should case reports be citable even in rare diseases with a known cause? This I think I will post to the forum you suggested earlier.DrMicro (talk) 12:09, 2 September 2011 (UTC)

I have posted the two points raised here to the page you suggested to see what if any opinions exist on these matters. DrMicro (talk) 12:23, 2 September 2011 (UTC)

Thank you for agreeing with me. These are questions that reasonable people may disagree on. Given that WP is a forum where people will disagree - and not always reasonably - it seemed sensible to seek additional views and discussion on these matters. I hope I have stated the questions in the forum in a such a fashion to allow for reasoned discussion.DrMicro (talk) 13:15, 2 September 2011 (UTC)

chronic urticaria diagnosis

Dr. Heilman,

Good evening. My name is Carmelo Spatazza. For nearly the last 4 years, I have suffered from chronic (daily) hives that exactly resemble [[3]]. I cannot pinpoint the triggers (i.e.; heat, water, stress, or other allergens) as this happens at any given time, day or night, even when I am sleeping. I have suffered allergies since I was child, however most of those allergies subsided a decade ago. I must also add that I have been treated in the past for extreme stress, something that has yet to be controlled. These hives have gone from the occasional annoyance to an everyday acceptance. When I came across the aforementioned image you posted, and the fact that you are an MD, I had to inquire. I hope that this is not out of line. In any case, if you have any advice for me, it would be truly appreciated. I can be reached via email carmelo.spatazza at gmail.com. Thanks very much for your time and expertise.

Sincerely,

Carmelo Spatazza — Preceding unsigned comment added by 50.88.6.129 (talk) 02:48, 2 September 2011 (UTC)

If you have had hives for more than 6 weeks would advice that you see a dermatologist who one would expect would do a panel of laboratory tests as there are some rare but potentially treatable causes of chronic hives.Doc James (talk · contribs · email) 09:06, 2 September 2011 (UTC)
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