Jump to content

Talk:Rheumatoid arthritis

Page contents not supported in other languages.
From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by 14.200.91.233 (talk) at 09:45, 1 October 2017 (EGCG vs GTE). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

WikiProject iconMedicine: Dermatology / Translation / Genetics B‑class High‑importance
WikiProject iconThis article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine articles
BThis article has been rated as B-class on Wikipedia's content assessment scale.
HighThis article has been rated as High-importance on the project's importance scale.
Taskforce icon
This article is supported by the Dermatology task force.
Taskforce icon
This article is supported by the Translation task force (assessed as High-importance).
Taskforce icon
This article is supported by the Medical genetics task force.
Note icon
This article was a past Medicine Collaboration of the Week.

Additions

User:Drsoumyadeepb. Here and here, the following were added:

  • In 2017, a subset of pathologically expanded 'T peripheral helper' cells has been found to drive B cell mediated action in synovium of seropositive RA cells.[1]
  • However the dominant TNF theory is being challenged by newer studies which show that a combined synovial IL-21 and TNF production mechanism induces bone and cartilage destruction in RA matrix metalloproteinase production by fibroblast-like synoviocytes.[2]
  • A clinical trial published in 2017 found that Sirukumab, a human monoclonal antibody that selectively binds to the interleukin-6 cytokine improves signs and symptoms and was well tolerated in patients with active rheumatoid arthritis who did not respond to anti-TNF drugs or other biological agents.[3][4]


Additionally, the following:

  • More than 75% of women with rheumatoid arthritis have symptoms improve during pregnancy but might have symptoms worsen after delivery.[5] Methotrexate and leflunomide are teratogenic (harmful to foetus) and not used in pregnancy. It is recommended women of childbearing age should use contraceptives to avoid pregnancy and to discontinue its use if pregnancy is planned.[6][7] Low dose of prednisolone, hydroxychloroquine and sulfasalazine are considered safe in pregnant persons with rheumatoid arthritis.

Was replaced with: Patients with RA do not have decreased fertility.[8] Women of childbearing age having RA are recommended to use contraceptives to avoid pregnancy and to discontinue its use if pregnancy is planned.[6][7] There is no evidence on increase in maternal and fetal deaths which can be attributed to RA .Cite error: The <ref> tag has too many names (see the help page). Methotrexate and leflunomide are teratogenic (harmful to foetus) and not used in pregnancy.Low dose of prednisolone, hydroxychloroquine and sulfasalazine are considered safe in pregnant persons with rheumatoid arthritis.Biologics should be stopped as soon as pregnancy is discovered.[8]

References

  1. ^ "Pathologically expanded peripheral T helper cell subset drives B cells in rheumatoid arthritis". Nature. 542: 110–114. doi:10.1038/nature20810. Retrieved 14 March 2017.
  2. ^ [Synovial IL-21/TNF-producing CD4+ T cells induce joint destruction in rheumatoid arthritis by inducing matrix metalloproteinase production by fibroblast-like synoviocytes "Synovial IL-21/TNF-producing CD4+ T cells induce joint destruction in rheumatoid arthritis by inducing matrix metalloproteinase production by fibroblast-like synoviocytes"]. Journal of Leukocyte Biology. doi:10.1189/jlb.5A0516-217RR. Retrieved 14 March 2017. {{cite journal}}: Check |url= value (help)
  3. ^ Aletaha, Daniel. "Efficacy and safety of sirukumab in patients with active rheumatoid arthritis refractory to anti-TNF therapy (SIRROUND-T): a randomised, double-blind, placebo-controlled, parallel-group, multinational, phase 3 study". The Lancet. doi:10.1016/S0140-6736(17)30401-4. Retrieved 14 March 2017.
  4. ^ "Sirukumab effective in patients refractory to anti-TNF therapy". Nature Reviews Rheumatology. Retrieved 14 March 2017.
  5. ^ Shah, Ankur. Harrison's Principle of Internal Medicine (18th ed.). United States: McGraw Hill. p. 2738. ISBN 978-0-07174889-6.
  6. ^ a b Amy M. Wasserman (2011). "Diagnosis and Management of Rheumatoid Arthritis". American Family Physician. 84 (11): 1245–1252. PMID 22150658.
  7. ^ a b DiPiro, Joseph T., Robert L. Talbert, Gary C. Yee, Gary R. Matzke, Barbara G. Wells, and L. Michael Posey (2008) Pharmacotherapy: a pathophysiologic approach. 7th ed. New York: McGraw-Hill, ISBN 978-0-07-147899-1.
  8. ^ a b "Pregnancy and rheumatoid arthritis". PMID 16864922. {{cite journal}}: |access-date= requires |url= (help); Cite journal requires |journal= (help)
  • Ref 1 is PMID 28150777, a primary source
  • Ref 2 is PMID 27733582, a primary source
  • Ref 3 is PMID 28215362 , a primary source
  • Ref 4 is PMID 28250460 is a "research highlight"; this is not a reliable secondary source per MEDRS
  • Refs 5, 6, and 7 were already in the article and are fine
  • Ref 8 is PMID 16864922, which is indeed a review but an 11 year old one, which fails WP:MEDDATE; also per its website the journal is published by Medip Academy which is a predatory publisher. This source is not OK. We also don't write "patients", we write "people", per MEDMOS.

None of this is OK. Jytdog (talk) 17:34, 15 March 2017 (UTC)[reply]

You have also reverted without discussion.Editing wikipedia has become so much difficult because of editors who threaten without discussion and when the same is done to them they coerce citing rules. . I quit Wikipedia. Thanks Drsoumyadeepb (talk) 18:00, 15 March 2017 (UTC)[reply]

See above, which I posted before I removed this batch of content the 2nd time. Editing Wikipedia has become more difficult, but that is because articles are reaching decent quality and we have good strong guidelines and policies in place to keep them that way and make them even better. It is hard to improve articles. But why quit? Why not learn to edit per WP:MEDRS and WP:MEDMOS instead? Jytdog (talk) 18:05, 15 March 2017 (UTC)[reply]
User:Drsoumyadeepb this is a major medical condition. There are lots and lots of excellent sources. We as medical experts should be using them as we are best positioned to know what they are and how to find them. Doc James (talk · contribs · email) 00:18, 16 March 2017 (UTC)[reply]
I am sorry to see Drsoumyadeepb frustrated, but I think I recognize the pattern from my own experience; this is an academic writing style is somewhat out of place on WP. Because citation of high-quality primary sources is routine (expected!) in scientific publication, it can be hard for an academic to adapt to WP:MEDRS, WP:MEDMOS, and other WP standards. That said, these are WP standards for good reason (and there are processes for appeal if one wants to try that route). I hope that, after a pause, you will return to contribute further. — soupvector (talk) 03:07, 16 March 2017 (UTC)[reply]

Dear Jytdog, soupvector , Doc James I see that Wikipedia has successfully converted it into a rule-book throwing organisation without application of any common sense and etiquette. Rules exist to facilitate and not hinder and is not superseded by common-sense : 1. If a new patho-physiological mechanism is discovered which challenges previous dogma , do we wait for a decade till a review article comes up. (I hope everyone knows the pace at which science moves from bench to text book and then to implementation). This is what happened for the new "combined synovial IL-21 and TNF production mechanism ".. I have clearly stated that this is an emerging theory and readers would be smart enough to understand that. 2. I have edited the RA article extensively , including information almost all the secondary sources in this article which Jytdog is throwing at me now. I know the wiki rules well. I edit the article based on information needs of patients and so it is important to address information on - What is the evidence on this new drug Sirukumab (in this case only a single trial is available and systematic reviews are not likely to be available for next few years)? If I have RA does my fertility decrease ?If i get pregnant does it increase the risk of maternal death or foetal death ? Do I stop or not stopping drugs I am taking, how does it affect my symptom ? For pregnancy, a good editor would use his sense and either try to find better sources to refine the article.(Doc James mentions apparently there are plenty !) . Instead Wikipedia editors, revert edits(without discussion) and then "troll" other editors by posting weird notices declaring war on the talk page. I can clearly see a pattern and the motivation, is to increase edit counts without actually contributing to better quality information being available. Editors with high edit counts, treat wikipedia as their personal fiefdom , reverting and threatening others at their free will without any consequences .Why threaten banning  ? Do I have to throw a rule book to stop online trolling ?By the way there is one which defines trolling as "nonconstructive edits to Wikipedia with the intent of provoking an angry reaction in other userss )" https://en.wikipedia.org/wiki/Wikipedia:Vandals_versus_Trolls#Trolls . So i am taking the advice "don't feed the trolls" and quitting wikipedia. Drsoumyadeepb (talk) 05:57, 16 March 2017 (UTC)[reply]

I suppose if you are unable to conform to community norms when editing you may not be happy here, but that would be a shame. -Roxy the dog. bark 07:51, 16 March 2017 (UTC)[reply]
We may wait a couple of months for it to be covered in a review article. This is how we prevent stuff like the liberation procedure from misleading people, we wait for evidence of wider acceptance by the scientific community.
Here is a review on sirukumab [1] Doc James (talk · contribs · email) 14:19, 16 March 2017 (UTC)[reply]

Infectious cause.. maybe

User:Autoimmunity rev, about this and this -- there was already content in the Research section about this. And even the Smolen ref makes it clear that the association is suggested, not confirmed. It still belongs in research. I added the quote from Smolen and have moved the content to the Research section and blended it with what was already there, in these diffs. Jytdog (talk) 00:18, 5 April 2017 (UTC)[reply]

reversal "we do not empty sections"

This reversal of a Good faith edit with the rather pompous pluralis maiestatis editsummary "we do not empty sections" makes no sense to me. I am restoring it. --Wuerzele (talk) 14:52, 19 July 2017 (UTC)[reply]

Edits

There are issues with these edits[2]

  • Onset is usually middle age per [3]
  • The prevalence of 0.5 to 1% is NOT from 2016 per[4]
  • Not sure why definition was removed from ?
  • This text "such as cigarette smoking and silica exposure influence manifestation of the disease." is not supported by the associated reference
  • Methotrexate is also often given by injection.
  • Not seeing were the cost of biologics is brought up in the source
  • Per WP:MEDMOS we use "Signs and symptoms" rather than "Symptoms and signs"
  • No idea why the map of deaths per million was moved to the section on vaccination

Doc James (talk · contribs · email) 17:20, 19 July 2017 (UTC)[reply]

EGCG vs GTE

Per my undo (of the deletion), the reviews provided specifically refer to EGCG (not just Green Tea Extracts) and even name it as such in their titles. Here's another separate review on EGCG for RA again that can be added too: [1]. I'm fine for the text to be modified to "Green tea extract and EGCG" if preferred, since EGCG is one of the components of green tea extracts. There's no point in just deleting it, since there's a vast number of studies and reviews all showing the same thing. Just update the wording if it's so concerning. The vast majority of other non-EGCG specific studies of GTEs contain EGCG as well anyway, having most of the same effect (although higher EGC to EGCG ratios result in a bit lower EGCG absorption/bioavailability).

  1. ^ https://arthritis-research.biomedcentral.com/articles/10.1186/ar2982
Retrieved from "https://en.wikipedia.org/w/index.php?title=Talk:Rheumatoid_arthritis&oldid=803239787"