Talk:Gout/GA1

GA Review

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Reviewer: Casliber (talk · contribs) 13:25, 8 June 2010 (UTC)

Doctor I have this pain in my toe.... Okay, I will make straightforward copyedits as I go. Please revert if I accidentally change the meaning. I will jot queries below. Casliber (talk · contribs) 13:25, 8 June 2010 (UTC)

• podagra? Gosh, I don't remember that term...if obscure, I'd relegate to an etymology section.

The term is still in fairly common usage [1][2] Doc James (talk · contribs · email) 15:18, 8 June 2010 (UTC)

okay, point conceded Casliber (talk · contribs) 08:03, 9 June 2010 (UTC)

• The subsections in the Cause section can be amalgamated - it is too choppy as is. this source also mentions a high purine diet. Is this worth adding?

This 2004 paper clarified the purine link finding that well meat and seafood increase risk vegetables high in purines do not. Doc James (talk · contribs · email) 00:38, 9 June 2010 (UTC)

• acetylsalicylic acid --> surprise! why not just say aspirin...

This is the term much of the rest of the world still uses ( like the paracetamol / acetaminophen distinction ).Doc James (talk · contribs · email) 15:11, 8 June 2010 (UTC)

ditto. Casliber (talk · contribs) 08:03, 9 June 2010 (UTC)

• Other blood tests commonly performed are full blood count, electrolytes, renal function, thyroid function tests and erythrocyte sedimentation rate (ESR). This helps to exclude other causes of arthritis, most notably septic arthritis, and to investigate any underlying cause for the hyperuricaemia. - I'd think about adding how the tests differ - eg high WCC for SA etc. - needs refs too.

Yes I did not add this. Well these tests are commonly performed per emedicine the utility is questionable.Doc James (talk · contribs · email) 00:54, 9 June 2010 (UTC)

• EDTA, a chelating agent, increased uric acid excretion --> increases? this is just sorta hanging there - is this used much?

No it is almost never used except in the rare case of gout complicated by lead toxicity. I removed as the ref was a primary research study.Doc James (talk · contribs · email) 15:15, 8 June 2010 (UTC)

okay. Casliber (talk · contribs) 08:06, 9 June 2010 (UTC)

• In the Epidemiology section - any attribution of this increase to increased levels of obesity?

Added information and referenced. Doc James (talk · contribs · email) 00:28, 9 June 2010 (UTC)

• Given that Synovial fluid testing is tricky, explaining when one does a Synovial fluid test would be good. Casliber (talk · contribs) 08:11, 9 June 2010 (UTC)

• Maybe trawl through cochrane too. Stuff from there would be good to add. Casliber (talk · contribs) 08:20, 9 June 2010 (UTC)

Gone through Cochrane and added the couple things not already in the article.Doc James (talk · contribs · email) 03:02, 21 July 2010 (UTC)

Overall, the article seems a little..slim..but I am not sure what is missing. The prose is choppy and I will return to massage it, but need to sleep now. Casliber (talk · contribs) 14:03, 8 June 2010 (UTC)

• I've done some very tiny corrections, mainly singular <-> plural and punctuation, plus a couple of rephrasings - if I've altered the sense, please feel to revert. I'm left with the section Steroids and the sentence:
  • "Intra-articular steroids have also been found to be effective, however the risk of concurrent joint infection must be ruled out."
• I think I understand what it means, but it leaves me hanging, as if there's something missing. I'm sure it could express its meaning in a little more detail for dummies like me. --RexxS (talk) 17:44, 8 June 2010 (UTC)

I hope that clears it up a bit. Doc James (talk · contribs · email) 00:09, 9 June 2010 (UTC)

Yes, thanks James. It did mean what I thought, but I don't think it hurts to spell it out. I've made two tiny copyedits; hope those are ok. I can see why you wanted to link to intra-articular injection, as that's the precise medical term you'd use, I guess. Unfortunately intra-articular is just a redirect to joint, which isn't so helpful. We can't have an article on 'intra-articular' as it's an adjective, but someone could create wikt:intra-articular on wiktionary as a definition. It would probably be better if it was someone who knew what they were talking about (hint!). --RexxS (talk) 01:08, 9 June 2010 (UTC)

Joint injection of course - well spotted, James! --RexxS (talk) 01:16, 9 June 2010 (UTC)

• The Prophylaxis section needs to detail at what point one considers regular medication as prophylaxis.

Better - but is there evidence they are overprescribed? underprescribed?

• If Prevention is prevention of acute gout, then surely this is partly synonymous with prophylaxis?

• If these medications are being used chronically at the time of the attack they should not be - just sits there a bit and sounds a bit like a how-t segment. Could do with a reword.

• Lead is slim. I'd place classical presentation in lead too.

• The intake of dairy products, purine rich vegetables, and the total protein intake do not affect the occurrence - I think this is best expanded a little - as in they were implicated in gout but later discounted.

• Urate lowering measures should be increased until serum uric acid levels are below 360 µmol/L (6.0 mg/dL) - I note David Ruben's comment. If this is not commonly done in practice, should be mentioned.

Sorry about delay - been busy. Casliber (talk · contribs) 08:33, 19 June 2010 (UTC)

Have attempted to address the above points. Doc James (talk · contribs · email) 09:53, 19 June 2010 (UTC)

I can see Cas' point that Prophylaxis could be considered prevention, but it's also true that it can be considered treatment, since it is only initiated following one or two attacks. I think the reader would be just as well off, no matter which section it is in. I've done a quick copyedit for obvious typos. etc. I haven't done a thorough check of the refs as it takes ages, but I'd be happy to do that at some point if requested. From a stylistic view, I think it has too many short sentences, so is a bit too "abrupt" for my taste; I feel that sentences read badly when I find "however" part-way through a sentence (as a concession to the pedants who insist it shouldn't be the first word) - I keep feeling the need to put commas around it. Nevertheless, none of that should affect the ability of the article to pass GA – they're just pointers for the future. --RexxS (talk) 20:26, 19 June 2010 (UTC)

Still reads more like a succinct medical manual than an encyclopedia article. I noted something else above. I will do some copyediting some more. Casliber (talk · contribs) 14:40, 20 June 2010 (UTC)

Okay then, this is a BBC page written for the general reader. I am not recommending using it directly but it has some pointers to some other information worth either including or discounting/refuting.

• Link between gout and subsequent renal problems

• famous gout sufferers (I am dubious of the BBC article's list, but maybe there are some out there that have some degree of solid sourcing (?)) - okay nevermind about this one

• Discussing exogenous purines' role in metabolism.

• what might bring on an acute attack in a chronic sufferer.

• "Gout sufferers are also at greater risk of developing kidney stones, high blood pressure, kidney disease, diabetes mellitus, high levels of triglycerides, and atherosclerosis or hardening of the arteries." - from the BBC article

• the Sydenham description is also good for the history section.

I think I have addressed most of these concerns. Not of big fan of section on famous people who have had this disease especially since it is so common.Doc James (talk · contribs · email) 09:39, 28 July 2010 (UTC)

1. Well written?:

Prose quality: -still a bit choppy but not a deal-breaker if comprehensiveness addressed.

Manual of Style compliance:

2. Factually accurate and verifiable?:

References to sources:

Citations to reliable sources, where required:

No original research:

3. Broad in coverage?:

Major aspects: - queries listed above.

Focused:

4. Reflects a neutral point of view?:

Fair representation without bias:

5. Reasonably stable?

No edit wars, etc. (Vandalism does not count against GA):

6. Illustrated by images, when possible and appropriate?:

Images are copyright tagged, and non-free images have fair use rationales:

Images are provided where possible and appropriate, with suitable captions:

• Images need WP:ALT text.

Overall:

Pass or Fail: - on hold currently. Casliber (talk · contribs) 13:42, 22 June 2010 (UTC) pass

Alt text

Alt text added for each image; feel free to improve it. --RexxS (talk) 16:09, 23 June 2010 (UTC)

If you could give me a week to address the above. Away from home for a bit.Doc James (talk · contribs · email) 19:37, 23 June 2010 (UTC)

No problem. I will try and chip in as well. I feel it is worth taking some time and doing right. Casliber (talk · contribs) 20:41, 23 June 2010 (UTC)

I am going to be out of country until July 15th and internet access / time will be limited. Will continue when I get home.Doc James (talk · contribs · email) 17:04, 28 June 2010 (UTC)

I have it watchlisted James, and I'll do my best to fix/respond to anything brought up in the meantime. --RexxS (talk) 19:27, 28 June 2010 (UTC)