Talk:Pleurothotonus

Non-peer review

Hey guys, great job so far! It looks like you are closing in on the finished product, so here are a few suggestions as you continue:

• Make sure you don't switch back and forth between the two names for the disease (pleurothotonus and pisa syndrome). Try to pick one and go with it for the rest of the article
• You may go into too much detail in the intro. Try to pare it down to the most critical information and then save the detail for the subsections.

Good luck! Stempera (talk) 22:30, 5 December 2011 (UTC)

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Thanks for your comments! I went through the article and changed pleurothotonus to Pisa syndrome so the naming is more consistent. I also moved some of the information in the intro pertaining to symptoms to the appropriate subsection.

patelbq (talk) 20:50, 7 December 2011 (UTC)

Peer Review

Hey guys, this article was really interesting! I had no idea there were negative effects from antipsychotic drugs. There were just a few small things I noticed about structure, grammar, etc. In the history section, you reference the discovery by Ekbom. I would link to a page about Ekbom or at least put his first name (if he has one!). I would also insert a clarifying sentence to say that neuroleptics and antipsychotics are synonymous. Also in the history section, I would use the phrase "induced by" her dementia rather than "induced from." In the section about ziprasidone, the second sentence isn't a complete sentence. Sorry if those are too picky! One more quick thing: if possible, try to elaborate on the treatment and medication section. The see also section was very helpful! This article looks really good and I definitely learned about something I had never heard of! Cassianp (talk) 17:21, 13 November 2011 (UTC)

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Thanks for your comments! We went through and fixed the problems you pointed out and we will definitely try to find more information on treatment and medication. patelbq (talk) 19:44, 06 December 2011 (UTC)

Peer Review

I found this article very informative, but I did come across a small issue while I was reading it. There are a few topics such as dystonia and presenile dementia that I was not familiar with so I had to stop and see what they are. An internal link to these pages would be helpful. I checked and Wikipedia pages do exist for these two topics. There is also a minor typo in the last paragraph of the history section- "ad" should be "and." Also, I know there probably aren't many additional graphics existing for this topic on Wikimedia, but perhaps adding a picture of one of the drugs that was mentioned would to the page a little. Another suggestion about the causes section: where it says, "Tricyclic antidepressant, psychoactive drug, and antiemetic drug," if you change the links by adding, for example, "|psychoactive drugs," after the actual page name in the internal link code, this sentence would be more grammatically correct. One last thing I noticed, on the top of the page there is a box that says your page is an orphan, so I would suggest going to related pages and creating links to your own page, even if it's just under a "See Also" section. Great job! Mdac927 (talk) 22:00, 14 November 2011 (UTC)

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Thank you for your review! I've looked through the article and made changes based on your suggestions and corrections. However, I don't understand what you're trying to tell me when you point out the changes I should make to the causes section. Besides that I have addressed all your comments. Kiki522 (talk) 17:13, 7 December 2011 (UTC)

Peer Review

This article is very interesting and informative! The introduction section provides a great overview and the history section is extensive and interesting. It says in the article that prolonged exposure to antipsychotic drugs is the primary cause, but all three cases in the history section say that the syndrome developed quickly. I’m just curious if you read anywhere if this is because the dosage in these cases was so high that it caused the syndrome to develop quickly or if the patients were at an elevated susceptibility because of their sex and/or age.

The bullet format in the causes section is great and helps to break up the article. The case study section is great, but does have some typos that would be helpful to proofread. Also, it would be interesting to expand on the research section if possible. If there is any research behind they hypotheses you mention for possible causes (a dopaminergic-cholinergic imbalance or a serotonergic or noradrenergic dysfunction) that would be helpful to provide. Also, it says that the article is an orphan, so if you find another page to which you could link this one that would be good. The links from this article to others are great and very helpful. Great so far!

Horowitr (talk) 04:21, 15 November 2011 (UTC)

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Thanks for your suggestions! I looked into your comment on the difference in onset of symptoms and was unable to find anything due to the little knowledge about the underlying the pathology and biochemistry of Pisa syndrome. I did include a clarifying sentence in the article stating that the onset of symptoms varies depending on the drug and patient. I went through and fixed the typos and also linked our article to others so it is no longer an orphan. I will definitely try to find more info to incorporate about pisa syndrome research, but the field seems to be pretty scarce unfortunately.

patelbq (talk) 18:13, 07 December 2011 (UTC)

Unfortunately I am having no luck finding a relevant or useful image on any of the public domains listed on the image policy wikipedia page.

patelbq (talk) 22:21, 07 December 2011 (UTC)

Peer Edit

The general introduction and history is rock solid. I believe there is no improvement for that section. This is nit picking, but the "Causes" section about the drugs seems redundant. You mention drugs and the types of the drugs in your paragraph section, but mention it in the list again. Maybe, for more fluidity, you can just list the drugs in that table you made and erase the types of the drugs from the first paragraph.

In addition, I had trouble understanding how the drugs caused the symptoms. Does the drugs effect some area of the brain causing degeneration? You can trying giving a little more biochemical aspect of how the drugs cause this syndrome. This will allow readers to see the mechanism how the syndrome develops.

The addition of picture to add to your explanation may not be bad. This can be really helpful in the symptom part of the section and quite possible explaining the biochemical effect of the drugs. One symptom I'm talking about is the trunking spine you guys mentioned. "http://www.scielo.br/img/revistas/anp/v66n4/a26fig01.jpg"

Bcneuro (talk) 04:12, 16 November 2011 (UTC)

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Thanks for your input! I cleaned up the causes to make it less redundant. Unfortunately, we were unable to find any information regarding the biochemistry/mechanism of the syndrome since it affects such a wide variety of individuals and not much research has been done. I will definitely go through the public domains given on wikipedia and try to find a picture to add.

patelbq (talk) 21:54, 07 December 2011 (UTC)

Peer Review

This is a very interesting topic and I found your article to be very intelligible and concise in explaining the syndrome. I agree with other reviewers in that your Introduction and History sections are definitely the strongest. Though this may be a personal preference, it might be a good idea to consider putting the History section directly following the Symptoms section simply because it may be good to first have an understanding about the causes and symptoms of the syndrome, and then looking back at the history and case studies which have contributed to characterizing pleurothotonus.

Another suggestion I would offer is to consider expanding upon why asymmetric brain functions and neural transmission appear to be the underlying mechanisms for Pisa syndrome. What experimental evidence has suggested these mechanisms? Also, you should probably cite this point that you make in the Causes section about dopaminergic-cholinergic imbalance and a serotonergic/noradrenergic dysfunction, even though you already cited it in the intro paragraph.

A final observation is that Treatment and Medication section could include explicitly hypothesized reasons as to why reduction of drug dosage or anticholineric drugs have been observed to be effective method by which to reduce the symptoms of the syndrome.

Overall really good work and very informative! I look forward to reading the final version. Michjkelley (talk) 06:13, 16 November 2011 (UTC)

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Thanks for your comments! We moved the history section to the end (before further research) so that should be easier to understand. We would love to expand on the underlying mechanisms of Pisa syndrome, but we have been unable to find articles with detailed experimental research, if any at all. There seems to be very little known about the actual pathological and biological causes of Pisa syndrome. Most articles we found explicitly state symptoms and how they can be treated but they do not detail how/why these treatments work.

patelbq (talk) 22:32, 07 December 2011 (UTC)

Peer Review

This is a very good article! It flows quite well following a strong introduction and history section, which set the tone of the article nicely. One quick note on the introduction-the word "antipsychotic" is not hyphenated when hyperlinked but is later hyphenated. This should be consistent throughout the article.

The beginning of the Causes section, specifically, within the sentence "Tricyclic antidepressant, psychoactive drug, and antiemetic drug are some of the few other drugs...", needs a few changes. Each of the types of drugs listed need to be pluralized: Tricyclic antidepressants, psychoactive drugs, and antiemetic drugs etc. Because these are the types and not the names of drugs, they should be pluralized.

I noticed that throughout the article, the phrase "Pleurothotonus, or Pisa Syndrome", is used. Because it is established immediately in the introduction that these are synonymous, it does not need to be continually repeated. This is nit-picky, but picking one and being consistent with this throughout the rest of the article and across the rest of the sections will help the article flow a little better!

The addition of the case studies gave a deeper understanding about the interactions between the various drugs and the onset of the disease, which was very interesting and valuable. Overall, this article was very nicely presented. Very well written! Kelseyfish1189 (talk) 17:44, 16 November 2011 (UTC)

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We went through and fixed everything you pointed out, thanks for your comments! patelbq(talk) 19:32, 06 December 2011 (UTC)

Peer Review

Hello guys! I picked to read this article because of its fabulous, dinosaur-sounding title Anyways, just a disclaimer, I am an English major also, so I have some copyedits for you as well as regular old comprehension comments. First off, “Pleurothotonus, or commonly known as Pisa Syndrome” should be switched to more commonly known as or also known as. Or is not correct in this context. Next, this sentence is a bit confusing and I think it should be split in two because it has too many clauses: “It is characterized by dystonia, abnormal and sustained involuntary muscle contraction, which may cause twisting or jerking movements of the body or a body part”. Conversely, you could instead delete the description of dystonia since you do have a link to it. Next, something I observed throughout the entire article is that the linking is not done correctly. You only ever place links at the end of paragraphs, when really they should be almost at the end of every sentence (since everything you wrote is not your own, I assume). Furthermore, throughout the article, you alternatively refer to Pisa syndrome or pleurothotonus without picking one or the other. Save for that first sentence, I would consistently use one of the names (seems like Pisa syndrome is the one most commonly used through the rest of the article). Also, Pisa syndrome should not be capitalized on the syndrome. That is inconsistent throughout the article. Next, this sentence is far too long: “Although Pisa Syndrome develops most commonly in those undergoing long-term treatment with anti-psychotics, it has been reported less frequently in patients receiving other medications, such as an acetylcholinesterase inhibitor, in those with other diseases causing neurodegeneration, and in those who are not receiving any medication”. I think it should be split into two far more straightforward sentences. For example: Pisa syndrome develops most commonly in those undergoing long-term treatment with anti-psychotics. However, it has also been reported in in patients receiving other medications, such as an acetylcholinesterase inhibitor, in those with other diseases causing neurodegeneration, and in those who are not receiving any medication. This sentence is a little messy as well: “Females and older patients with organic brain changes predominantly develop Pisa Syndrome and symptoms generally disappear after discontinuation of the anti-psychotic drug”. I would change it to: Pisa syndrome predominantly develops in females and older patients with organic brain changes. Symptoms generally disappear after discontinuation of the anti-psychotic drug. On a side note, what is an organic brain change? Perhaps this should be explained a bit further. Next, in the main body of the article, History should not be first (this is according to an editor who worked on my Wikipedia article). This editor moved it to the very end just before Research directions (that is, a section that deals with future research). In the History section, this sentence is missing a period: “These symptoms proved to be the making of a new dystonic reaction, which was termed pleurothotonus or the Pisa syndrome”. Also, I believe you meant tilting in this sentence: “However, within the first few days the patient began to exhibit a titling to right upon walking”. Furthermore, I would switch this sentence: “The patient also experienced a pulling away from her direction of walking and a difficulty to turn”. Difficulty to turn should be difficulty turning. Next, perhaps this is due to the placement of the History section, but I would like some explanation of the drugs and why the patients in the History section were treated with these particular drugs. Also, “original normal state” should just be original state or normal state. When you say a 63-year-old woman “posed as the second patient”, I think posed is not the right word you are looking for. It implies that she is faking the symptoms. I would just say something like: The second patient to exhibit pleurothotonus was a 63-year-old woman who also underwent methylperone treatment. Also, I’ve noted that the syndrome seems to be mainly present in older women (as you said earlier). Is there a reason for that? I would expand on this if you can. Next, I think you mean as instead of ad in this sentence: “As more cases of the syndrome come about, research has discovered that the switching of drug treatments is being debated ad a possible inducement of the disease”. The use of implicated is not correct in this sentence: “Based on the drugs that caused Pisa syndrome, it has been implicated that the syndrome may be due to a dopaminergic-cholinergic imbalance or a serotonergic or noradrenergic dysfunction.” Instead you should write it has been suggested (and cite by whom). Prior to this sentence, I had no idea that there is a drug-resistant Pisa syndrome: “For the development of Pisa Syndrome that is resistant to anticholinergic drugs, it has been considered that asymmetric brain functions or neural transmission may be the underlying mechanism for it”. This needs to be cleared up. Also, while the Leaning Tower of Pisa connection is interesting, it needs to be mentioned earlier or not at all. Furthermore, I’m not sure that linking to that is relevant in this article, which is biology-based. (Wikipedia has rules about linking that can be reviewed). Next, “Oculogyric crisis” should be crises; and “a 77 year old” needs dashes (77-year-old) in the Case studies section. Finally, your subtitles should not be capitalized beyond the first word (i.e. Further Research should be Further research). This needs to be corrected throughout the article. Overall, I really enjoyed the Case studies section; it added a bit of colorful background. Anyways, good luck with everything! — Preceding unsigned comment added by Fowlerta (talk • contribs) 15:51, 16 November 2011 (UTC)

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Thank you for the detailed response! It was very helpful. I went through and fixed most if not all of the things you pointed out. I added clarification on what organic brain changes are and also moved the placement of the history section, so thank you for that!

patelbq (talk 22:19, 07 December 2011 (UTC)