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Welcome to the doctor's mess! There are only a few rules:
1. Don't shout, remain civil and treat eachother with respect.
2. Please wash any cups you use and clean up, let's not make a mess out of this mess!
3. The 7 o'clock news always has priority on the tv, except when The Simpsons are on.



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Gastroenteritis articles cluster

Re the request for help with Rotavirus (see above), I notice there is a large cluster of closely related pages with overlapping content:

Norovirus is notable for not having much content overlapping with other pages. --Una Smith 00:37, 1 December 2007 (UTC)[reply]

I think gastritis and enteritis have individual merits, because there are many causes of each that are unrelated to the clinical syndrome of gastroenteritis (e.g. regional enteritis, atrophic gastritis). Bacterial gastroenteritis can probably be merged in the GEitis article without loss of information.
The ORS page has individual merits.
Diarrhea has at least 100 causes, from cholera to hyperthyroidism and back again to carcinoid and laxative abuse. It can stand on its own merits.
I totally agree that infectious gastroenteritis-related content should all be moved to one article. I'll see if I can lend a hand. JFW | T@lk 22:52, 1 December 2007 (UTC)[reply]
I don't propose a wholesale merge of all these pages, but most would benefit from moving around some of their content. If Gastritis and Enteritis are not merged with Gastroenteritis, then the distinctions between them need to be made clearer. --Una Smith 00:11, 2 December 2007 (UTC)[reply]
There is more discussion of this on Talk:Gastroenteritis. --Una Smith 00:27, 2 December 2007 (UTC)[reply]
I totally agree that we need to make this clearer. JFW | T@lk 09:48, 2 December 2007 (UTC)[reply]

I have added still more articles in this cluster for cleanup. See Talk:Gastroenteritis. ----Una Smith 14:45, 4 December 2007 (UTC)[reply]

Rotavirus is improving steadily, but would benefit from some fresh eyes, particularly lay readers' eyes. Please take a look, comment on Talk:Rotavirus, or jump right in and edit Rotavirus. --Una Smith (talk) 03:46, 12 December 2007 (UTC)[reply]

  • Rotavirus is being groomed for FAC soon; before it appears as a Featured Article it would be really good if related, supporting pages were cleaned up. --Una Smith (talk) 17:59, 26 December 2007 (UTC)[reply]
  • Gastroenteritis needs some attention. An anonymous editor is making some strange edits and incorrectly attributing vandalism to me. --Una Smith (talk) 23:56, 2 January 2008 (UTC)[reply]

Sudden death

Tagging some articles WPMED, I noticed Sudden death is a redirect to a disambig page, and the only medical link there is to Sudden cardiac death. Wikipedia needs an article on Sudden death (medicine). Anyone here care to take a stab at it? --Una Smith (talk) 16:02, 26 December 2007 (UTC)[reply]

Initially, sudden death was about the phenomenon in sport, and I spent a very long time changing the links.
I think the terms "sudden death" and "sudden cardiac death" are used interchangeably. Does anyone think there are other conditions that need mentioning under this header? Otherwise we can just redirect sudden death (medicine) to sudden cardiac death. JFW | T@lk 16:35, 26 December 2007 (UTC)[reply]
On Talk:Sudden cardiac death there is mention of a list of 15 causes of sudden death other than sudden cardiac death. --Una Smith (talk) 18:07, 26 December 2007 (UTC)[reply]
I agree with the contributor there (and therefore with you, Una) that we ought to perhaps list diseases that can rapidly lead to death, but that list is actually almost limitless (overwhelming sepsis, visceral perforation, status epilepticus, ruptured aortic aneurysm, etc). Unless a reliable source can be found that lists the most important causes sensibly, I cannot find grounds for an independent article. The alternative would be to mention on sudden cardiac death that postmortem examination should be performed to exclude other causes of sudden death, such as the causes mentioned on the talkpage and by myself above. Again, for such an addition a good source is needed. JFW | T@lk 22:34, 26 December 2007 (UTC)[reply]
This discussion rather proves my point, which is not that we need a list, but that we need an article defining "sudden death" in the medical sense. (If someone wants to start an exhaustive list, that would be List of causes of sudden death.) Sudden cardiac death really does not suffice. I am looking for a link to use from causes of sudden death, so that it is not necessary to explain on each linking page that the condition in question is a medical emergency on the order of "Call 911!" or worse. --Una Smith (talk) 23:55, 26 December 2007 (UTC)[reply]
I think the problem, as JFW has alluded to, is that "sudden death" is not really a medical term outside of the specific instance of sudden cardiac death. Surely we can indicate, briefly and pointedly, that a condition requires emergent care and may be rapidly fatal without creating a page defining the term "sudden death" (which in this context is essentially self-explanatory)? MastCell Talk 04:35, 27 December 2007 (UTC)[reply]
That's okay, because Wikipedia is not really a medical encyclopedia. "Emergent care" isn't defined in Wikipedia, by the way. And how rapid is "rapidly"? --Una Smith (talk) 04:58, 27 December 2007 (UTC)[reply]
Well, you previously defined "rapidly" as "within an hour". As I said, the list is potentially endless and hard to verify. I agree that Wikipedia is not a medical encyclopedia, and we should try to avoid giving the impression that it is. At the same time, creating articles with non-standard titles (feeling tired with red blotches on your legs or headache with vomiting) will do nobody any service.
I stand by my view that listing a few diseases that rapidly progress to death in sudden cardiac death would be useful, provided a reasonably accurate source can be found. JFW | T@lk 08:01, 27 December 2007 (UTC)[reply]
I'll second JFW and MastCell here regarding the usage of sudden death == sudden cardiac death. Una Smith, since you say you don't want to "explain on each linking page that the condition in question is a medical emergency," maybe medical emergency would be a more directly connected page? Antelan talk 08:25, 27 December 2007 (UTC)[reply]

Ginger and cancer

Ovarian cancer could use some attention; it is accumulating text about that new miracle cancer treatment, a dab of ginger. The same text appears on Ginger. --Una Smith (talk) 05:15, 27 December 2007 (UTC)[reply]

Ginger as a treatment is right up there with marshmallow fluff. Thanks for the note. Antelan talk 06:16, 27 December 2007 (UTC)[reply]
Ah, good old-fashioned skepticism... Brings tears to my eyes... Seriously, when there are further studies (i.e. in vivo ones, maybe even on people some day), this may certainly warrant a mention. Fvasconcellos (t·c) 20:10, 27 December 2007 (UTC)[reply]

Ketogenic diet: unwarranted page moves

I would like some help from project members, and specifically an admin who can undo some unwarranted page moves. User:OccamzRazor has moved Ketogenic diet to Ketogenic diet (epilepsy) and has rewritten some of the latter to reflect his POV. This long-established article is now a dictdef with a couple of newspaper links about cancer. Please see my discussion at User talk:OccamzRazor#Ketogenic diet. I would like the article moved back (there is nothing of merit at the current version of Ketogenic diet). I can repair the links and revert some of the recent edits once this is done. Thank you. Colin°Talk 10:32, 27 December 2007 (UTC)[reply]

The move may be reasonable if the page was mainly on the epilepsy diet, but the stub that is now standing it its place is hopeless. It bears noting that the popular (and reasonably effective) Atkins diet is also ketogenic. JFW | T@lk 14:30, 27 December 2007 (UTC)[reply]
The category "ketogenic diet" may encompass aspects of the Atikins and other low carb diets. The noun "ketogenic diet" is exclusively used as a medical therapy, and its main indication is refractory epilepsy in children.
Wikipedia:Naming conventions nutshell: "Generally, article naming should prefer what the greatest number of English speakers would most easily recognize, with a reasonable minimum of ambiguity, while at the same time making linking to those articles easy and second nature." A Google or PubMed search will confirm that the medical therapy should be the main topic of the ketogenic diet article.
My problem is that I believe it requires an admin to move the page (with all its history) back to the proper place. Copy/paste is explicitly discouraged. Colin°Talk 15:45, 27 December 2007 (UTC)[reply]

We have two options available to us. I have asked OccamzRazor (talk · contribs) to reconsider his move. I'm quite willing to move the page back when he has aknowledged that. You are correct with regards to WP:NC, but I want to see if he disputes this. JFW | T@lk 16:56, 27 December 2007 (UTC)[reply]

External links on Rotavirus

Could someone fix the external link template at the end of the article? I can't get the ICD 10 code to go to the right WHO webpage :-( --GrahamColmTalk 15:37, 27 December 2007 (UTC)[reply]

Appears to have been fixed by Una Smith. Colin°Talk 19:57, 27 December 2007 (UTC)[reply]
Indeed. By the way, nice work on this, Graham. Fvasconcellos (t·c) 20:03, 27 December 2007 (UTC)[reply]
Another illustration (public domain) of seasonal variation is here, showing the US national trend. Graham's UK peak is in January; the US national peak is in March. This could develop into an interesting paragraph, if similar data is available for other regions. --Una Smith (talk)
The US is a big country, the national peak is in March, but I remember reading a paper (which I can't find at the moment), some years ago, that clearly showed how rotavirus infections spread like a wave across the US which followed the progression of the US winter. The authors included either or Mary Estes or Roger Glass or Al Kapikian or all three. I'll search for it in the morning. The data and graph that Una wants in this paper.[1]--GrahamColmTalk 21:27, 27 December 2007 (UTC)[reply]
Here are US regional peaks; not a lot of evidence there for a wave. What is this (geographic?) "progression of the US winter"? —Preceding unsigned comment added by Una Smith (talk • contribs) 22:49, 27 December 2007 (UTC)[reply]

This is the paper I was trying to remember,[2] but perhaps this discussion belongs on the Rotavirus discussion page?--GrahamColmTalk 11:15, 29 December 2007 (UTC)[reply]

  1. ^ Cook SM, Glass RI, LeBaron CW, Ho MS (1990). "Global seasonality of rotavirus infections". Bull. World Health Organ. 68 (2): 171–7. PMID 1694734. {{cite journal}}: |access-date= requires |url= (help)CS1 maint: multiple names: authors list (link)
  2. ^ Turcios RM, Curns AT, Holman RC; et al. (2006). "Temporal and geographic trends of rotavirus activity in the United States, 1997-2004". Pediatr. Infect. Dis. J. 25 (5): 451–4. doi:10.1097/01.inf.0000214987.67522.78. PMID 16645512. Retrieved 2007-12-29. {{cite journal}}: Explicit use of et al. in: |author= (help)CS1 maint: multiple names: authors list (link)

Triumph

I am pleased to report that every article in WikiProject Medicine's automatically assessed articles category has been manually reviewed. The category is now empty, and I'll be getting back to my usual list of unassessed articles soon. WhatamIdoing (talk) 20:28, 27 December 2007 (UTC)[reply]

That is brilliant. Compliments to the reviewers. Perhaps you could report here quickly which important articles are in serious need of improvement? JFW | T@lk 20:54, 27 December 2007 (UTC)[reply]
The WPMED Quality vs Importance table shows over 50 articles of Top importance with quality below GA. Most (all?) of the 50 are listed here. --Una Smith (talk) 22:54, 27 December 2007 (UTC)[reply]

I think these Top-rated articles are in the most embarrassing state:

None of them rate above a good start, and unprotected sex is actually a stub -- and not even a good stub, just a plain old didn't-get-finished-with-this stub.

As for the B-class articles in this category, what they really need is a proper Good Article review. I didn't rate any article higher than B unless some other project had previously rated it higher than B, so some of the articles doubtless deserve higher quality ratings than they have now.

It would be great if someone (or several someones) would take a quick look at the whole list of Top-rated articles and downgrade anything that seems weird. I suspect that for any given topic, we haven't always picked the single best article to represent it. For example, Pregnancy was only "High" until a few minutes ago, and it might be fair to demote pregnancy test to "merely" High. We might also want to choose either Anatomy or Human anatomy for the Top rating instead of listing both.

I have been thinking about the proportion of articles which ought to be considered Top importance. While some of our current Tops may need to move down the line a bit, I've been thinking that a review of the High-level articles is also in order, with an eye to picking things that might be particularly popular with our readers or fundamental to medicine. We could probably promote 25 or possibly even 50 "High" articles to Top without compromising the utility of the list.

And finally, on the articles I've assessed: While I've rated articles according to my understanding of the guidelines, I don't pretend to have provided the One True Assessment™ and will not be offended by (or even notice) changes. However, if you find anything that's wildly out of line and it seems to have my name on it (or if you just want to be reassured that your opinion is as valuable as anyone else's), then I'd be happy to hear about it on my talk page. WhatamIdoing (talk) 01:14, 28 December 2007 (UTC)[reply]

Thanks for that, WhatamIdoing. Unprotected sex needs urgent redirection to safe sex, which provides much more context and deals with the relevant topic comprehensively. I totally agree that anatomy, physiology, pathology and articles about the main medical specialties are in need of improvement. JFW | T@lk 01:28, 28 December 2007 (UTC)[reply]
I merged Unprotected sex into Safe sex. --Una Smith (talk) 03:29, 28 December 2007 (UTC)[reply]
Quality is probably judged quite accurately but we need to look at priority: I don't think we have our priorities straight, especially if you consider the commonest keywords on search engines are probably diabetes and all conditions related to gynecology (such as vaginal infection) and pediatrics. I think we should be more aware of our position on search engines, and were possible article titles should match likely keywords, plus priority should go to popular health searches. --Steven Fruitsmaak (Reply) 01:57, 28 December 2007 (UTC)[reply]
I agree. Could someone build an index to medical articles by priority (=importance)? That would be somewhat helpful here. --Una Smith (talk) 03:29, 28 December 2007 (UTC)[reply]

I would be thrilled to have other people involved in restructuring the importance lists. Do you need something beyond the main category for Medicine articles by importance? If you just want to see a list of what's been rated (or isn't yet rated, which includes 3700 stubs and the 1750 entirely unassessed articles which are on my target list), then the existing category structure is probably what you're looking for. WhatamIdoing (talk) 05:48, 28 December 2007 (UTC)[reply]

The problem with importance categories is that they are not subdivided by quality. :-) So, for example, to find the one article rated Top and Stub I estimate its relative position in the articles-by-quality index by adding the row totals for FA, A, GA, and B, and dividing by 400. That gives me a rough idea which index page to look on. In some cases, it would be helpful to have a parallel index of articles-by-importance. --Una Smith (talk) 15:23, 28 December 2007 (UTC)[reply]

In theory, CatScan will let you find articles which are in any two categories. In practice -- some days it works for me, and some days it doesn't. I think it silently gives up if it can't get a response from WP quickly enough. WhatamIdoing (talk) 19:30, 28 December 2007 (UTC)[reply]

Opinions on importance must be guided by an overarching principle. Is an important article (1) a "big killer", (2) a popular search term on Google, (3) a common chronic but non-lethal disease, (4) something weird & horrible? I have previously felt that we should have very good articles on cancer, heart disease, stroke etc, but I agree with Steven that most people will be looking for high-quality content on how to treat their acne, stop getting vaginal candidiasis or find something to take them through the day when they've got a headache. With most of us being either medical students or practising doctors, it is easily forgotten that mouth ulcers may be more debilitating than community-acquired pneumonia. Perhaps a hierarchy of importance would need to take into account both the popularity of the subject and their impact on health in general. JFW | T@lk 08:11, 28 December 2007 (UTC)[reply]

You might want to take a look at our official importance scale. Generally your instincts are on target: Ratings are the intersection between what average, non-medical people want to read about medicine (sex, kids, and the common cold), and what we think average, non-medical people should want to read about medicine (hypertension, heart disease, and the fact that those "whole wheat" fried doughnuts aren't technically a health food). My own assessments additionally reflect my POV that

  • individual people who impact on modern medicine is smaller than Galen's was on pre-modern medicine,
  • organizations whose impact on worldwide medicine is smaller than the FDA's,
  • anatomy that isn't familiar to the average 12 year old, and
  • medical signs and terms which are related primarily to a single specialty

are basically unimportant. (You aren't required to cooperate with my biases, but you might find the official scale interesting.) WhatamIdoing (talk) 08:48, 28 December 2007 (UTC)[reply]

Herpes zoster again

The article failed its FAC and perhaps we should reflect on why we couldn’t get this right. The disease is very well understood, not controversial and not new, yet we still managed to get embroiled in arguments, distracted by trivia and mess up, (me included). I did not nominate the article but if I had I would be very disillusioned with Wikipedia today. Yes, the article was flawed, but nothing that could not be fixed. What went wrong? My two English pennies worth. We were treading on each others toes, me on Colin’s in particular, because it became too crowded. Some were clearly learning about the disease whilst editing and not before and, for example, mistaking herpes zoster for a virus when it is a disease. We were fiddling with syntax when we should have been checking the references, (where the big problems were) and we weren’t using the discussion page enough. We were being too bold and, to my amazement, the nominator never contributed or questioned what was happening. As medics, my view is, (and I know this will make me unpopular), we have an obligation to research a subject that we don’t already know well, before leaping in. I’m not talking about the odd typo of course, we went in, me more than most, took the article apart and tried to put it back together in a completely chaotic fashion. Ideally, and this is with benefit of hindsight, we should have coordinated our efforts and given each other the space to work. Say, let person A sort out any WP:MOS problems because they are good at it, then ask member B to sort out any problems with the discourse because they are a good critic, then ask person C to approve the clinical stuff and person D to check the virology. Lastly ask anyone known for writing first-rate prose to give it a good polish. I know this might sound complicated but this is how a team works. I noticed last night that, despite all our hard work, someone put a clean-up template at the top of the article! Oh my. I might be getting the wrong angle on this, being new to Wikipedia, so I am happy to stand to correction but please don’t shoot the messenger.--GrahamColmTalk 17:55, 28 December 2007 (UTC)[reply]

And ... all of those necessary steps could have happened before FAC, with collaboration from the nominator. I'm as disappointed as you are, but for different reasons, which are best understood by looking at the FAC for lung cancer. I wonder if the Medicine WikiProject has clear standards? Also, I suggest a review of the path taken to FA by Polio and autism: both collaborative, done pre-FAC and successful. SandyGeorgia (Talk) 18:07, 28 December 2007 (UTC)[reply]
I knew nothing about Herpes zoster being nominated for FAC until it was spotted on the FAC page and brought to our attention here. The nominator did not ask us for help before or during the FAC, nor told us about the FAC. I agree that too much writing was and still is being done without reading the sources. That is a very common fault on Wikipedia. Editing others' writing, I failed to check sources adequately, but on the other hand it should not be necessary to check sources as completely as required on Herpes zoster. Re team work, a top down team may function in an organized manner, but Wikipedia functions in a bottom up manner. The dynamics are very different. In the case of this FAC, I think Herpes zoster should have been promptly withdrawn by its nominator or rejected by the FAC committee. That would have saved many of us the frustration of trying to fix the article on an "emergency" basis, lest it somehow pass FAC and become a Featured Article in its current state. --Una Smith (talk) 21:42, 28 December 2007 (UTC)[reply]
The "FAC committee" (sic) can't "reject" a nomination that garnered support from the Medicine Project: the "FAC committee" judges consensus, and several Medicine Project members supported the nomination before others began to uncover issues. SandyGeorgia (Talk) 21:57, 28 December 2007 (UTC)[reply]
Okay, I get it. The "consensus" on the FAC page refers to the opinions of those who express an opinion. Some of the early opinions of support were eventually revised. Would it be uncool to contact those users and ask them to review their opinion? I consider the opinions to be strictly personal; in what sense had Herpes zoster "garnered support from the Medicine Project" (sic)? --Una Smith (talk) 22:09, 28 December 2007 (UTC)[reply]

By the way, I think a clean-up tag on Herpes zoster is entirely appropriate, simply to let readers know that the article is currently unstable. The clean-up tag is a signal to readers, to recruit those who are interested in helping and send others away. I am sorry that some editors view the tag as somehow derogatory or a demerit. --Una Smith (talk) 21:52, 28 December 2007 (UTC)[reply]

Graham, the nominator Orangemarlin has been around for three years, and has 10,000 edits under his belt. The nomination failed IMO due to lack of preparation and a misunderstanding of what level of detail and quality is expected at FAC. Don't beat yourself up (or anyone else) that he might be "disillusioned with Wikipedia today" because we failed him. I originally thought, like you, it could be polished at FAC, but it became apparent that the article was so fundamentally flawed (at policy level, not dashes and commas) that I stopped believing it could be fixed in time. Let me also be quite clear that I thought you behaved like a gentleman throughout, only once quite accidentally stepped on my toes. Sure, there was some friction between some editors and the rush didn't help that. I'd like to think we can work together, at a leisurely pace, again.
I fully agree with you about research and I hope I wasn't guilty of making ignorant edits. I actually made very few edits to the article during FAC: some initial work on the refs; a very little copyediting; a revised paragraph on lysine (subsequently dropped, which I'm more than OK about); and a few reverts when I felt a rushed, non-discussed, edit had made the text worse. My preference when reviewing an article that someone else has invested in, is to make only superficial edits and to ask them, the expert, to clarify or improve the text where I see deficiencies. I don't expect all my suggestions to be implemented but was frankly disappointed at the lack of response by the nominator. In effect, Graham and other project members stepped into that gap and did their best.
This wikiproject should help with the final steps of taking an article to FAC. Some of our project members have free access to the sources used, and the training to understand them. I hope in future those abilities are used to give an article a thorough checkover prior to FAC. Yes, I feel I and others wasted a lot of time polishing prose that ultimately bore no resemblance to the quoted sources. I wish I'd spotted that earlier.
I'm not sure of the necessary for demarcation of roles, though if two people are trying to do the same thing at the same time in a hurry, they'd better be best of pals. It would sure be nice to have your ABCD talents working as a team. I don't quite follow Una's top-down/bottom-up argument. The best FACs I've seen recently involved essentially one hard-working and responsive subject expert who brought the article so far, deeply cared for the subject, and was supplemented by folk trying to help him or her improve it, but being respectful of that investment. I agree with Una that working under "emergency" conditions was stressful and the initial support it received didn't help relieve that pressure.
The key is preparation and patience. Colin°Talk 21:58, 28 December 2007 (UTC)[reply]
Wise words indeed, and ones I need to reflect on. Thanks guys.--GrahamColmTalk 22:17, 28 December 2007 (UTC) Time for bed.[reply]

I am glad that we are holding this "post-mortem". Already it has given me some new things to think about. --Una Smith (talk) 00:08, 29 December 2007 (UTC)[reply]

Bulged disc/neck/shoulder pain/no one knows

My husband has been going to doctors, had an MRI, had X-rays, and they can't figure out what is wrong with his shoulder/neck area. He is in so much pain, and they can't put their finger on it. Chiropractor and family doctor haven't figured it out yet. Any thoughts on what it could be? He was in a motorcycle accident about 10 years ago, and has a large scar on his shoulder blade if that means anything. Thank you68.79.97.243 (talk) 01:51, 29 December 2007 (UTC)[reply]

I'm sorry that your husband is in pain. However, this page won't attract much useful help; it's primarily about which medicine-related articles need some editing work. May I suggest that you post your question at the reference desk instead? WhatamIdoing (talk) 02:09, 29 December 2007 (UTC)[reply]
Folks, if if this were your concern, how would you use Wikipedia to answer it? Where would you start looking? How about Neck pain? Imagine for a moment you are this reader, who may be struggling to express her questions. Her husbands' doctors seem to have ruled out local physical causes of pain, which leaves what alternatives? Some come to my mind immediately: Referred pain and (ahem) zoster sine herpete and/or Postherpetic neuralgia. Can you see how Neck pain could be improved, to help this reader (and others) find answers to her questions? --Una Smith (talk) 17:11, 29 December 2007 (UTC)[reply]

I agree neck pain needs decluttering, including removal of the horible second person lecturing ("your pain", "do this, get that"). But I think 68.79.97.243's poor husband may need further support from his physicians. Until the diagnostic machine from Crichton's Andromeda Strain becomes a reality, none of us here can conduct a musculoskeletal and neurological examination on him. JFW | T@lk 20:40, 29 December 2007 (UTC)[reply]

Fate of "Unprotected sex"

The article Unprotected sex was until recently just two definitions for the term. 1)Sex without protection from STDs and 2)Sex without protection from pregnancy. The two different definitions are generally used in entirely different contexts.

Two editors here believed the article should be redirected to safe sex and one performed the merge. In the diff of the merge one sees that sites discussing fertility awareness were used to support the statement "safe sex practices can be used as a form of family planning". The editor obviously misunderstood; fertility awareness is commonly used to enable unprotected sex without risk of pregnancy. Fertility awareness can be used as a method of family planning, but it has nothing to do with safe sex. It is overwhelmingly used in stable monogamous relationships where not using a condom is generally not considered "unsafe", thus the preference for the term "unprotected" instead of "unsafe" to refer to the lack of birth control use.

This merge deleted that usage of the term "unprotected sex" from Wikipedia. I'm also not sure that someone typing "unprotected sex" into Wikipedia is going to be happier arriving at safe sex and not bareback (sex).

There seems to be long-term dissatisfaction with "unprotected sex" as an article (see its talk page), so I propose two alternatives:

  • Make unprotected sex a disambiguation page to bareback (sex), safe sex, and fertility awareness, or
  • Make "unprotected sex" a soft redirect to the Wiktionary entry (which doesn't currently exist, but I'm willing to create it if this option is accepted).

I hope this is the correct place to bring this up - it was suggested to me on my talk page. Any thoughts on my proposals would be appreciated. LyrlTalk C 16:22, 29 December 2007 (UTC)[reply]


Thanks, Lyrl. I think we all agree that Unprotected sex was an unsatisfactory article. I considered making it a disambig page, but decided the topic would be better addressed within the context of Safe sex, which is why I did the merge. However, in some respects Safe sex has a rather limited POV. On Talk:Safe sex I have mentioned some aspects of safe sex that are missing from the article. The discussion here brings up yet another aspect:

"Fertility awareness can be used as a method of family planning, but it has nothing to do with safe sex. It is overwhelmingly used in stable monogamous relationships where not using a condom is generally not considered "unsafe", thus the preference for the term "unprotected" instead of "unsafe" to refer to the lack of birth control use."

Fertility awareness can be used both to avoid pregnancy and to achieve pregnancy. Also, if one member of a couple has an STD, then unprotected sex is unsafe sex. Such a couple might use safe sex practices except when trying to conceive, and use fertility awareness to limit their use of unprotected hence unsafe sex. --Una Smith (talk) 16:58, 29 December 2007 (UTC)[reply]

Re the dab idea, 1)Sex without protection from STDs and 2)Sex without protection from pregnancy imply the disambig would be:

  • Sex without protection from STDs: contrast to safe sex
  • Sex without protection from pregnancy: contrast to birth control

That is a rather awkward disambig. --Una Smith (talk) 17:17, 29 December 2007 (UTC)[reply]

For a disambiguation page, I had more in mind:
Unprotected sex may refer to:
  • Bareback (sex), any type of penetrative sexual act without the use of a condom.
  • Sexual activity that is not safe sex.
  • In discussions of fertility awareness, sexual intercourse without any use of birth control.
That's an interesting observation about fertility awareness and a discordant couple trying to conceive. I'm really not sure a citation could be found for that, however, and just us agreeing it's a possible use is original research. I don't believe the "no birth control" definition of unprotected sex fits into the "safe sex" article, so a merge leaves it deleted from Wikipedia.
If you believe the disambiguation page is a bad idea, how about a soft redirect to Wiktionary? LyrlTalk C 17:20, 30 December 2007 (UTC)[reply]
I am on the fence re a disambiguation page, but opposed to a redirect to Wiktionary. Re HIV discordant couples trying to conceive, here is just one of many web citations. That is why I prefer the merge into Safe sex. --Una Smith (talk) 20:08, 30 December 2007 (UTC)[reply]
Thanks for the link, that's interesting that advice like that is common. Sad that so many couples have to make such choices.
Back to the merge, though, I have two objections. First, unprotected sex is most commonly used to mean barebacking. In this sense, safe sex is the opposite of what most people are looking for when they type "unprotected sex" into Wikipedia. Second, the "no birth control" usage is commonly used in relationships where sex without a condom is not considered "unsafe". I'm just not able to wrap my mind around including a discussion of birth control and pregnancy risk in an article where the stable introduction (prior to your edits) talked only about STDs and ended with the statement, "Although safe sex practices can be used as a form of family planning, the term refers to efforts made to prevent infection rather than conception."
What are your objections to the disambig and soft redirect options? You had stated earlier that you thought the disambiguation page would be awkward, did my formatting suggestion address any of that? Are you OK with the three links I included, or do you think one or more should be changed? LyrlTalk C 23:09, 30 December 2007 (UTC)[reply]

I just noticed, "fertility awareness is commonly used to enable unprotected sex without risk of pregnancy." I certainly hope things like this aren't getting into any article on Wikipedia, unless "without risk of pregnancy" is commonly undertood to mean, "with a 20% annual risk of pregnancy." Antelan talk 23:12, 30 December 2007 (UTC)[reply]

With a significantly lower risk than random unprotected intercourse. If the couple understands and has the motivation to follow the rules, a risk of less than 1% per year. The actual article goes into the detail of perfect use and typical failure rates, I skipped over those details in this discussion to try to focus attention on my point that safe sex and unprotected sex can be unrelated topics, depending on how the terms are being used. LyrlTalk C 00:29, 31 December 2007 (UTC)[reply]
It appears that we are getting our numbers from widely diverging sources. My concern about those numbers isn't really germane to your point in posting here, though, so I'll back off. Antelan talk 00:44, 31 December 2007 (UTC)[reply]
Antelan, could you be conflating fertility awareness with the (rudimentary) rhythm method? --Una Smith (talk) 07:11, 31 December 2007 (UTC)[reply]
Probably not. Problems with instruction (particularly among the self-taught) and compliance (it is not a suitable method for couples without the discipline to maintain accurate records and abstain or use barrier methods for a significant portion of each cycle) result in high pregnancy rates in some populations. I believe 20% was the failure rate found by the U.S. National Survey of Family Growth and cited in the 17th edition of Contraceptive Technology. LyrlTalk C 18:37, 31 December 2007 (UTC)[reply]

I object to a soft redirect because, as this discussion illustrates, the meaning of the term "unprotected sex" is complex enough to need explanation here, not in Wiktionary. I also object to limiting Wikipedia articles to "common" meanings, ignoring other meanings verified in reliable sources. After some thought about this, I now also object to a disambiguation page. As Talk:Bareback (sex) shows, "bareback" and "unprotected" are not equivalent. And Lyrl asserts (and I agree) that "unprotected sex" and "unsafe sex" are not equivalent. Hence, a disambiguation page would not be appropriate. "Unprotected sex" might be unsafe sex, or safe sex, depending on the circumstances. So now I think "unprotected sex" belongs in a section on Safe sex, or on its own page that is not a stub. To break this impasse, it might help to research the history of the use of these terms. --Una Smith (talk) 07:11, 31 December 2007 (UTC)[reply]

Looking at the above discussion, I think disambiguation is exactly what the awkward title unprotected sex should become, and I take back my previous opinion that it should redirect to safe sex. It depends completely on protection from what exactly. From STIs? From pregnancy? From birth defects (if the male is taking finasteride or thalidomide for some reason, or the female is on tuberculosis treatment or warfarin)? We need a short page that disambiguates between those various meanings in a sensible way. I see no problem mentioning barebacking there. If we start a whole new article that simply rehashes all the meanings I've mentions we'll end up with duplication. JFW | T@lk 07:36, 31 December 2007 (UTC)[reply]
Let's try it. See Unprotected sex now. --Una Smith (talk) 16:16, 31 December 2007 (UTC)[reply]
Looks pretty good. I did have a couple of comments I pulled from MoS:DAB, "Each bulleted entry should, in almost every case, have exactly one navigable (blue) link" and "The link should be the first word or phrase in each entry." We can't comply exactly with the first-word rule on all the pages being linked to, but a grammatical phrase can be started with the bareback link, at least.
The link to thalidomide confused me - is sex without a condom dangerous for someone whose partner is taking that drug?
I'm not sure the links to specific barrier methods meet the manual of style guideline "Keep in mind that the primary purpose of the disambiguation page is to help people find the information they want quickly and easily. These pages are not for exploration, but only to help the user navigate to a specific article." The current last line might just be dropped from the page?
I appreciate all the thought Una has put into this. I hope this feedback is helpful. LyrlTalk C 18:37, 31 December 2007 (UTC)[reply]
The "first word" style does not apply here, because the link titles are not variants of the dab title. --Una Smith (talk) 19:49, 31 December 2007 (UTC)[reply]
Following the lead of WhatamIdoing, I've continued discussion on this topic at Talk:Unprotected sex#Drugs. LyrlTalk C 13:30, 1 January 2008 (UTC)[reply]

Vitamin C on Citizendium

Anyone else noticed and/or consider it problematical that the Vitamin C article on the supposedly more authoritative Citizendium is being largely written by an ex-Wikipedia editor who exhibited a strong pro-megadosage alignment here? The Citizendium piece - currently at draft stage - has a distinctly polemical edge to its general historical section, and its links focus heavily on sources that would be viewed as partisan here. 86.155.205.144 (talk) 18:30, 29 December 2007 (UTC)[reply]

Good luck dealing with this Paulingite. I'm afraid we can do little about problems on Citizendium. JFW | T@lk 20:42, 29 December 2007 (UTC)[reply]
Isn't it interesting, though, that a more authoritative, accurate, and neutral representation of the state of the art can be achieved via controlled chaos (Wikipedia), as opposed to Citizendium's approach? Of course, entrusting the Vitamin C article to an editor with a chip on his shoulder about "the costs in terms of suffering and early deaths of the lack of conscience of many scientists in the life sciences", who was unable to work within the constraints of verifiability, neutrality and collaboration on Wikipedia, probably does not help matters. MastCell Talk 20:37, 30 December 2007 (UTC)[reply]
To be fair to Citizendium, the article hasn't yet been approved; but that it's been allowed to develop so far, even as a draft, with such blatant bias isn't a good sign. Anyhow, just a heads-up for anyone interested. 217.44.18.22 (talk) 00:27, 1 January 2008 (UTC)[reply]

Ryke Geerd Hamer / classification & background

Hi! That article is quite disputed. I would be glad, if somebody could classify it, and if somebody could write some lines about the aura of incompetence around some doctors of medicine (one female psychiatrist told me, that in psychiatry being correct is not essential -- although I would expect that it is essential that a victim of a hate crime gets another treatment than somebody who has imaginative enemies... especially I would think, that it is essential, that the violence doesn't continue in the psychiatric ward... but nobody listened to me...), so that the user can understand, why patients might decide to have severe pain instead of morphine... Maybe some notes about a grievance system within the health care system would be useful, too... And some notes about the usefulness of psychotherapy in case of an oncological diagnosis... --Homer Landskirty (talk) 19:52, 31 December 2007 (UTC)[reply]

Given the sheer volume of problematic WP:BLP information in that article, are there any reliable independent secondary sources in English? MastCell Talk 20:05, 31 December 2007 (UTC)[reply]
In a quick seach I just found this: http://www.ncbi.nlm.nih.gov/pubmed/15702221 (seems to be an abstract of a longer article)... --Homer Landskirty (talk) 20:37, 31 December 2007 (UTC)[reply]
A biographical article should not be the place for generalisations about a profession. This rubbish about an "aura of incompetence" is not encyclopedic - this always remains between the practicioner and his regulating body. There are good and bad doctors like there are good and bad rocket scientists, politicians and streetsweeps.
Whichever psychiatrist told you about "being correct", you seem to have misinterpreted it. The point is not about the treatment people get (which should be equal whatever a person's background), but the level of accuracy that can be achieved in psychiatry. It is well known that several psychiatrists will reach different conclusions in the same patient. But the same phenomenon exists mutatis mutandis in other branches of medicine. Radiologists, pathologists and neurophysiologists will disagree with colleagues over a certain proportion of their cases - because nothing in life is 100% (apart perhaps from death and taxes). JFW | T@lk 20:51, 31 December 2007 (UTC)[reply]

more details about that man and his victims: [1] and here [2] and here [3] —Preceding unsigned comment added by 87.122.80.78 (talk) 17:03, 4 January 2008 (UTC)[reply]

Participant welcome

Hi all,

could anyone create a little Project welcome message for new editors who add themselves to Wikipedia:WikiProject Medicine/Participants, so that people watching that page can welcome newcomers and point them to essential resources like this talk page, collaboration, WP:MEDMOS, Portal:Medicine, ...

--Steven Fruitsmaak (Reply) 21:21, 31 December 2007 (UTC)[reply]

New collaboration of the fortnight

I'm sorry for the late update, but I didn't want to choose a new collaboration until the reconstrution process is finished. So we should start the new year with focusing on the Rhabdomyolysis article. Happy new year and thank you for your important and valuable contribution to the medical part of our encyclopaedia. I hope we can work together in 2008 as well. NCurse work 22:02, 31 December 2007 (UTC)[reply]

Thanks Berci. I think most us will have something to contribute to rhabdomyolysis. From the discussions (now archived) I think there was consensus that MCOTW needed overhaul, but there is no consensus as to what needed to happen. So I agree that we might as well continue trying... JFW | T@lk 00:45, 1 January 2008 (UTC)[reply]

High stubs

I went through all ~40 articles rated High and Stub, and demoted many of them from High or promoted them from Stub. A few I think deserve special attention:

Short list for improvement:

Merge into / reorganize wrt others:

--Una Smith (talk) 05:54, 1 January 2008 (UTC)[reply]

Stethophone and several other stubs have been merged into Stethoscope. --Una Smith (talk) 16:43, 1 January 2008 (UTC)[reply]

Fetal screening has been merged into Prenatal diagnosis (which needs cleanup). --Una Smith (talk) 17:05, 2 January 2008 (UTC)[reply]

Stethoscope is now rated Start. --Una Smith (talk) 17:05, 2 January 2008 (UTC)[reply]

The table and index have been updated, and these articles are listed here. --Una Smith (talk) 18:30, 8 January 2008 (UTC)[reply]

Medical advice

Why is medical advice a simple redirect to physician? I think that something more like legal advice would be appropriate. WhatamIdoing (talk) 20:18, 1 January 2008 (UTC)[reply]

I agree. --Una Smith (talk) 14:55, 2 January 2008 (UTC)[reply]

Vasoconstriction

Factors that trigger vasoconstriction are of exogenous origin, i.e. medication, endogenous, i.e. as a response from the body itself and others.

Isn't the use of endogenous as an example of exogenous a contradiction? 201.230.69.224 (talk) 17:50, 2 January 2008 (UTC)[reply]

That appears to be a copyediting error. Please be bold and fix it. --Una Smith (talk) 18:24, 2 January 2008 (UTC)[reply]

İt says adenosine is a vasoconstrictor it is not it i vasodilator,there is a table kind thing on the page and lists the adenosine as vasoconstrictor.Docteur (talk) 21:56, 3 January 2008 (UTC)

Please be bold and fix it. --Una Smith (talk) 15:03, 4 January 2008 (UTC)[reply]

Common cold nominated for GA

Common cold has been nominated for good article status. Comments (and improvements) solicited. Regards—G716 <T·C> 04:11, 3 January 2008 (UTC)[reply]

Infectious diarrhea needs cleanup

Help would be appreciated. --Una Smith (talk) 04:43, 3 January 2008 (UTC)[reply]

Emmanuelm, again

Our friend User:Emmanuelm has reinserted his "soft redirects" into tumor and neoplasia articles again. Several editors disagreed with his zero-consensus decision to discourage expansion of those articles a few weeks ago. I have restarted the talk page discussion on Talk:Neoplasia. Does anyone have a suggestion for making this stop on a more permanent basis? WhatamIdoing (talk) 20:00, 3 January 2008 (UTC)[reply]

One constructive solution would be to clean up both of those pages. --Una Smith (talk) 15:58, 4 January 2008 (UTC)[reply]

I discussed these points in the talk page of Neoplasia. Emmanuelm (talk) 20:04, 8 January 2008 (UTC)[reply]

Dysmetria article

On the dysmetria page it is stated that: "Hypermetria describes undershooting intended position and hypometria describes overshooting intended position". As far as I'm aware, hypermetria means 'too much movement' which would imply the overshooting of the intended position. Hypometria implies a lack of movement, which results in undershooting. In other words: shouldn't those two descriptions be switched? —Preceding unsigned comment added by 86.82.49.207 (talk) 12:01, 4 January 2008 (UTC)[reply]

Yes, they should. Please go right ahead and do it. --Una Smith (talk) 15:01, 4 January 2008 (UTC)[reply]
I did it myself. --Una Smith (talk) 16:06, 4 January 2008 (UTC)[reply]

The article appears to be a cut and paste job from somewhere else, so there may be a copyvio problem. Also, it needs wikilinks throughout. --Una Smith (talk) 16:06, 4 January 2008 (UTC)[reply]

Acoustic Neuroma (Vestibular Neuroma): Treatment outcomes

The Acoustic Neuroma article discusses the two available courses of treatment (microsurgery and radiotherapy), but does not discuss available literature on treatment outcomes. While a surgical procedure is a 'success' if the neuroma is removed, to the patient, post-surgery consequences are extremely important, and are not discussed to any great extent, but should be.

There appears to be conservative bias towards microsurgery in this article. The very high proportion of microsurgery patients that experience post-operative disability, long recovery periods, hearing loss and facial nerve damage, including pain and numbness of facial muscles should be taken into account in recommending treatment, especially since radiosurgery results appear to be improving and post operative complications are few.

Current literature seems to recommend microsurgery in cases where the neuroma is very large in size, growing rapidly or both and threatening imminent injury to the patient -- in that case, radiosurgery is not indicated as it is likely to produce short term post procedure swelling.

However, in many cases, the long recovery period, risk of facial nerve damage and hearing loss can be a very significant factor to most patients, especially if it interferes with future employment or activity. Radiosurgery is an important treatment alternative and may be the only reasonable course of treatment for those with slow growing, relatively small neuromas. Rarkm (talk) 15:54, 4 January 2008 (UTC)[reply]

Go right ahead. That article needs work. So do the related articles below. --Una Smith (talk) 16:24, 4 January 2008 (UTC)[reply]

I would, but I'm not a medical professional and have no medical training -- my interest is subjective (I have this condition, unfortunately). I have been perusing as much of the literature as is available on the net, and have been struck by the distinctly binary points of view offered by those that do traditional microsurgery and those that do radiosurgery. It's the 'when all you have is a hammer, everything looks like a nail' problem. However, if noone steps forward with better credentials, I'll take a crack at it. Rarkm (talk) 04:06, 10 January 2008 (UTC)[reply]

Fibromyalgia Pathophysiology

The intro to Fibromyalgia includes this statement cited from Rheum Int, specifically here:

"Though recognized as an independent clinical syndrome, the pathophysiology behind fibromyalgia may actually be secondary to several clinical entities, ranging from a mild, idiopathic inflammatory process in some individuals, to a somatoform disorder resulting from clinical depression in others, with probable overlaps in between. Current diagnostic criteria are insufficient to differentiate these entities."

This statement has been repeatedly removed by one individual b/c he states that it is "controversial."

My recollection was that the American College of Rhemotology issued a very similar statement in times past. Is this statement truly controversial, or am simply misinterpreting medical consensus? Djma12 (talk) 04:16, 6 January 2008 (UTC)[reply]

Is this individual providing any mainstream sources that dispute that the ACR article? Antelan talk 05:01, 6 January 2008 (UTC)[reply]
No, he is not. He simply states that he finds it "dubious". Djma12 (talk) 14:08, 6 January 2008 (UTC)[reply]
The solution is simple: find a source for the disputed statement, and cite the source. --Una Smith (talk) 15:05, 6 January 2008 (UTC)[reply]
The burden, of course, will be on the person who thinks that this source exists. Not saying that I doubt it exists, because I simply don't know, but I am saying that Djma12 should certainly not be expected to bear this burden. Antelan talk 17:20, 6 January 2008 (UTC)[reply]

Totally agree with Antelan that the burden of proof should always be on the party claiming that there is a "controversy". Everything in medicine can be regarded as a controversy of some form or description. The Rheum Int paper fairly accurately describes current thinking about the enigmatic condition that fibromyalgia is (together with all those related syndromes). Obviously this is controversial, because all conditions that overlap with FM (such as chronic fatigue syndrome, multiple chemical sensitivity etc etc) are "controversial". But then the use of antibiotics in bronchitis is "controversial", or the existence of Brugada syndrome. JFW | T@lk 21:29, 6 January 2008 (UTC)[reply]

Heck, on Wikipedia the fact that HIV causes AIDS is apparently "controversial". :) I agree with the earlier comments, but would just add that the sentences listed at the top of the thread by User:Djma12 contain some heavy-duty medicalese. I'm not in favor of unecessarily dumbing things down, but is this material described more accesibly elsewhere in the article? MastCell Talk 22:02, 6 January 2008 (UTC)[reply]
I can try to make the intro a little more accessible if that will help :-) Djma12 (talk) 02:14, 7 January 2008 (UTC)[reply]
  • There is an RFC on this issue on the Fibromyalgia discussion page if anyone would like to contribute. Djma12 (talk) 02:26, 7 January 2008 (UTC)[reply]

RfC on Talk:Biopsychiatry controversy

An RfC has been created on Talk:Biopsychiatry controversy on the subject: "Is the majority viewpoint of the psychiatric profession, and particularly of the psychiatric research community, that the biopsychiatric model of psychiatry is, by and large, accepted or rejected?" Comments from editors involved in this article/project may prove useful. HrafnTalkStalk 06:49, 6 January 2008 (UTC)[reply]

"Functional"

The medical term "functional" is something that many patients do not understand, and as yet it is also not well explained on Wikipedia. --Una Smith (talk) 17:24, 9 January 2008 (UTC)[reply]

Cynically, jfdwolff commented: are you suggesting doctors do understand? JFW | T@lk 18:31, 9 January 2008 (UTC)[reply]

Thyroid hormone resistance

Anyone in the mood to tidy up a recent addition to thyroid hormone resistance. I looked at it, realised it was potentially useful, but then lost the will to do anything potentially complicated. JFW | T@lk 21:55, 9 January 2008 (UTC)[reply]

Felt sorry for you, then started to actually read the turgid soul-sapping article promoting idea of T3 deficiency as cause fibromyalgia and chronic fatigue syndrome ... deletion seemed a simple approach, but suspect might just breach WP:NPOV, WP:OWN, WP:AGF and everything else we hold dear :-) Lets see how far I can get (I doubt very far)....David Ruben Talk 01:50, 10 January 2008 (UTC)[reply]
No apparent PubMed hits to directly support 3 doctors views as boldly as the edits suggest. Totally lacks citations from reliable sources to verify, and even if this addressed then WP:UNDUE weight applies to length of this. see Talk:Thyroid hormone resistance#January 2008 edits. For now I've moved to its own section of Thyroid hormone resistance#Claims of cause of fibromyalgia and chronic fatigue syndromes and suitably tagged, but in all honesty might be better removed and placed into talk page to be discussed & worked-up, to be then promptly précised-down :-) David Ruben Talk 02:55, 10 January 2008 (UTC)[reply]
Did you notice that, according to one of the sources, the 8th International Workshop on Resistance to Thyroid Hormone was held in October 2007 on San Miguel in the Azores? I think priority one is for us to attend the next meeting (in Ibiza?) and go from there. We need to be educated on the subject, after all. MastCell Talk 04:03, 10 January 2008 (UTC)[reply]
Hey sounds good to me, certainly an improvement on past wikimeetup locations :-) But what to call it on my year performance assessment - Wikidays or holipedia clearly not work-related, certainly wikiference less suspect than conpedia ? David Ruben Talk 23:25, 10 January 2008 (UTC)[reply]

Relevant articles indexed on PubMed are very recent, so I expect there are more, still newer articles not yet indexed on PubMed. So, apart from medical conference junketing, the first step is to add citations, then read the cited articles for verification / clarification. Ask the editor who added the text to go back and add citations? --Una Smith (talk) 05:09, 10 January 2008 (UTC)[reply]

It appears that the information was added by an anonymous editor who was describing her (his?) personal experience/beliefs. I don't really think we'll be able to get useful sources from the editor. I doubt that we'd even be able to successfully contact the editor. WhatamIdoing (talk) 06:21, 10 January 2008 (UTC)[reply]

WhatamIdoing is hitting the nail on the head. I left a message on Mr Anon's talkpage asking for some further copyediting and so on. Evidently nothing happened. Thanks to David and also to Arcadian for quickly sourcing a whole load of stuff. JFW | T@lk 22:12, 10 January 2008 (UTC)[reply]

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