Kjempeform
| This user is a student editor in Western_Michigan_University_Homer_Styker_MD_School_of_Medicine/MEDU_9330_-_Expanded_WikiProject_Medicine_(June_1,_2020_-_June_28,_2020) . |
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editHello, Kjempeform, and welcome to Wikipedia! My name is Shalor and I work with Wiki Education; I help support students who are editing as part of a class assignment.
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If you have any questions, please don't hesitate to contact me on my talk page. Shalor (Wiki Ed) (talk) 16:15, 1 June 2020 (UTC)
Peer review
editHi Fatima, I think your article reads very well. I'll list some minor style critiques below.
- Consider linking "autosomal recessive" in the intro paragraph as well. I have seen other articles link the same word each time it first appears under a subheading.
- Consider placing "Heme is a component of hemoglobin which carries oxygen in red blood cells." after first sentence.
- Consider linking "heme synthesis" to the "synthesis subheading" of "Hemoglobin A" article
- In text citations are generally after the period.
- Consider linking the entire word rather than the abbreviation for ALAD and ALA.
- ALA dehydratase deficiency is a rare cause of hepatic porphyria, meaning that excess porphyrins originate from the liver rather than the bone marrow as in erythropoietic porphyrias[2]. (Add comma after porphyria)
- Under Signs and Symptoms, consider the following format (after typing it out I think I like yours better but here it is anyway):
The clinical presentation of ADP includes a wide range of neurologic and gastrointestinal symptoms. During acute attacks, neurologic symptoms can resemble those encountered in acute intermittent porphyria. Patients can also experience abdominal cramping, vomiting, and constipation. These gastrointestinal symptoms can result in failure to thrive and poor weight gain in children. Other clinical features of an acute attack include a rapid heart beat, high blood pressure, and respiratory difficulties.
Acute attacks can last for weeks and may be called "neurovisceral" attacks due to the associated neurological complications. Patients have reported numbness and tingling in the extremities, seizures, burning pain, poor coordination, inability to move muscles voluntarily, and psychological disturbances. Psychosis is rare but has been reported in severe instances.
ADP may present during early childhood or as late as adulthood. The severity and onset of symptoms in each patient is dependent on their level of ALAD enzyme function. The higher the ALAD enzyme activity, the fewer symptoms a person will exhibit and the later they will present. Decreased ALAD enzyme activity will result in an earlier presentation with more severe symptoms.
- Consider linking failure to thrive
- A defective gene responsible for the disorder is located on an autosome, and two copies of the defective gene (one inherited from each parent) are required in order to be born with the disorder. (Deleted "This means a")
- Consider including a sentence about parents being "carriers" and what that means or linking to "genetic carrier"
- I think you may only need to cite once after you list the risks in conditions where both parents are carriers.
- To make a diagnosis "of ADP"
- Consider rephrasing to: All reported cases of ADP have been in males which is a feature that separates ADP from other porphyrias. However, the probability of ADP is theoretically the same in both males and females.
- This sentence was not clear to me: Avoiding physical and psychological stressors including certain drugs has been shown to limit the reoccurrence of attacks.
I'm assuming the drugs cause physical stress, but consider rephrasing.
- Consider referencing the drugs that should be avoided earlier in the article (for example, in the signs and symptoms section).
- One major edit you can consider is adding a Pathophysiology or Causes subheading and include the following information in some manner along with how the heme synthesis pathway is relevant:
Many triggers have been identified for acute ADP attacks including fasting, a low carb diet, dehydration, alcohol intake, the use of estrogen or progesterone, certain drugs, and other mental and physical stressors. Inducers of the CYP-450 enzymes are drugs that should therefore be avoided in patients with ADP. Drugs included in this category are anti-convulsants like phenytoin and carbamazepine, and other drugs like barbiturates, St. John's wort, and rifampin.
Overall, I think it's well done and very accessible to readers. Hope this helps. MendozaLine99 (talk) 17:40, 22 June 2020 (UTC)
- Thank you MendozaLine99 for all of those edits! I've incorporated some of your feedback into my article. I made sure to site all of the intext citations after the periods. I also rephrased the sentence about stressors that can trigger the ADP attacks and made it into two separate sentences for clarity.