Talk:Thyrotoxic periodic paralysis

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Featured article Thyrotoxic periodic paralysis is a featured article; it (or a previous version of it) has been identified as one of the best articles produced by the Wikipedia community. Even so, if you can update or improve it, please do so.
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Sources[edit]

More possible sources:
Circéus (talk) 23:46, 8 November 2010 (UTC)

Those are case reports. As per WP:MEDRS I will stick to secondary sources while expanding this article. JFW | T@lk 15:19, 9 November 2010 (UTC)

I thought they did present interesting separate facts, particularly on its etiology, as the article sticks to a fairly narrow definition of the causes of the thing, but admittedly I'm not medical specialist. I'm familiar with various areas of biology and medical translation, but I'll happily leave evaluation of sources to those more experienced than me. Circéus (talk) 17:21, 9 November 2010 (UTC)
Excessive thyroid hormone administration is mentioned in the reviews and has been included. I am yet to include the ECG changes mentioned in both Kung and Pothiwala. With regards to the extasy, the explanation is plausible but it is an isolated report that should be cited in a review before being notable for inclusion. I agree that they are interesting, and thank you for pointing them out. JFW | T@lk 18:12, 9 November 2010 (UTC)
Actually, my original list included the articles you were listing (I like to use "article citing this") XD. I'm not particularly trying to defend them. I did not expect the discussion to happen at all: I was mistaking the article for a quick stub that the original author would probably not come back to. Circéus (talk) 20:42, 9 November 2010 (UTC)
That's okay. I'm enjoying a particularly quiet spell on the job, and having found some sources I will continue to expand it until I can submit it for peer review or GA candidacy. JFW | T@lk 22:24, 9 November 2010 (UTC)
I'm never entirely clear about the expected level of review for GA, so I don't hang around GAN, but if you ever want to get a Peer Review for FAC, feel free to drop me a note. Circéus (talk) 22:58, 9 November 2010 (UTC)

() Thanks. JFW | T@lk 12:49, 10 November 2010 (UTC)

Expert input[edit]

If you get the article to the point that you want some COI-laden expert input then let me know (I won't actually touch the article since I'm biased). A couple quick points:

  • If you mention the KCNE3 findings you should also mention this paper from Betrand Fontaine's group.
  • The CaV1.1 findings are SNPs, not actually mutations (to my knowledge no one's ever shown that they affect channel expression or physiology).

--Dpryan (talk) 23:50, 9 November 2010 (UTC)

Thank you. The Sternberg paper is technically a primary source, so I will currently stick to reviews/secondary sources. I take your points about the SNPs and will change the wording accordingly. Please make any further modification you feel necessary, or provide advice, because I am a clinician and the article would still benefit from a biochemistry/physiology perspective. JFW | T@lk 08:27, 10 November 2010 (UTC)
Thanks for pointing me to doi:10.1016/j.neuron.2010.10.008. This is a great secondary source and will be a useful way of introducing the Kir2.6 findings also. I note that there is no article on Kir2.6/KCNJ18, and it might be an idea to generate a stub. JFW | T@lk 12:49, 10 November 2010 (UTC)

Another review[edit]

doi:10.4065/​80.1.99 appears to be another review, in Mayo Clin Proc, but it contains virtually no additional information on superficial reading. JFW | T@lk 20:37, 10 November 2010 (UTC)

Epidemiology[edit]

Should there be an image in this section? I do not see one there... Doc James (talk · contribs · email) 11:41, 19 November 2010 (UTC)

It's a globe with Japan coloured in. JFW | T@lk 18:02, 20 November 2010 (UTC)
It comes up now. Doc James (talk · contribs · email) 20:54, 20 November 2010 (UTC)

Comments[edit]

  • There is only one cardiac arrhythmias and that is asystole the rest are dysrythmias. Not sure we need to define each term as people can just click on the blue links.
  • Any nonselective B blocker can used used not just propranolol.

Doc James (talk · contribs · email) 11:47, 19 November 2010 (UTC)

The word "arrhythmia" is correct in my mind and is widely used here. Contractions are rhythmic (as in a musical rhythm) or they are lacking rhythm. I certainly try to briefly define a concept when first introducing it, so readers don't need to click on each bit of medical jargon when mentioned.
The papers I have cited tend to mention propranolol. Which other nonselective β-blockers did you have in mind? JFW | T@lk 18:04, 20 November 2010 (UTC)
Yes arrythmia is still frequently used. Have no strong feeling regarding this. It does seem that propranolol has been the only one studied. This paper however simply states non selective B blockers Lin SH (2005). "Thyrotoxic periodic paralysis". Mayo Clin. Proc. 80 (1): 99–105. PMID 15667036.  Unknown parameter |month= ignored (help) Doc James (talk · contribs · email) 20:56, 20 November 2010 (UTC)
I decided not to use Lin's paper, although it makes the same points as the others. I will simply expand as you suggested. JFW | T@lk 21:37, 20 November 2010 (UTC)
I have used it to clarify a few things. Definitely an interesting condition. Never seen a case myself. Lin's paper is nice as it is freely available. Doc James (talk · contribs · email) 21:42, 20 November 2010 (UTC)
Fair enough. Kung is free too. JFW | T@lk 23:17, 20 November 2010 (UTC)

GA Review[edit]

This review is transcluded from Talk:Thyrotoxic periodic paralysis/GA1. The edit link for this section can be used to add comments to the review.

This article is well done. The only thing that I would change would be to add the references more densely (not leaving more than one unreffed sentence between refs). This makes it easier for maintenance and if further content is added down the road. Reviewer: Doc James (talk · contribs · email) 08:30, 22 November 2010 (UTC)

I seem to recall that we had a similar discussion on Talk:Pneumothorax. As far as I know, it is not necessary to link every sentence if all sentences together concern themselves with the same point. Is there a policy on this? JFW | T@lk 10:13, 22 November 2010 (UTC)
No policy on this that I am aware of. Just that the page will get less harassment and will be easier to keep uptodate if more refs. Will leave it up to you. Doc James (talk · contribs · email) 10:19, 22 November 2010 (UTC)
Thanks very much! Will have a look and see which sentences seem to be hanging in the air without sourcing. JFW | T@lk 10:31, 22 November 2010 (UTC)

Passed[edit]

On the above note:

1. Well written?:

Prose quality:
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:
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:

Overall:

Pass: - Doc James (talk · contribs · email) 06:14, 13 August 2010 (UTC)

Working towards FA[edit]

Including WP:WIAFA here for reference:


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I'm going to start preparing this article for FAC, because I think it illustrates the concept well and there are no real loose ends (unless one wanted to include even more detail). JFW | T@lk 15:30, 16 December 2010 (UTC)

All images are PD and from Commons. I have not created or uploaded any new images for this article. JFW | T@lk 15:48, 16 December 2010 (UTC)

History of periodic paralysis[edit]

It turns out to be quite hard to find the original references for the first descriptions of periodic paralysis. http://www.whonamedit.com/synd.cfm/927.html lists Musgrave (1700), Cavaré (1853) and Carl Friedrich Otto Westphal (1885). Many older sources mention Cavaré, and some mention Musgrave. Few actually provide a reference, but it seems to have been in Gaz Med Toulouse. Any further suggestions on how to retrieve the reference are welcome. Until then I will need to stick with what we know, which is Fontaine's historical observation. JFW | T@lk 23:43, 19 December 2010 (UTC)

Here and in the genereviews article is some more info on Musgrave's description. --WS (talk) 12:03, 20 December 2010 (UTC)
And with a little more digging, here is the original report: [1] (Philosophical Transactions of the Royal Society (20:257 July 1698). --WS (talk) 12:38, 20 December 2010 (UTC)

Any idea how to get hold of Cavaré's report? JFW | T@lk 14:14, 20 December 2010 (UTC)

No, can't find it, but the full reference is: "Cavaré: Observation d'une paralysie général du sentiment et du mouvement affectant le type intermittent, Gaz. méd. de Toulouse 38, 1853.". It seems that this is the first report of familial periodic paralysis, and that the Musgrave report is about an isolated case (of which the diagnosis might be debatable).--WS (talk) 15:02, 20 December 2010 (UTC)
It might make more sense to list that as ==Further reading== than as a reference. WhatamIdoing (talk) 04:40, 21 December 2010 (UTC)
Most of it would be most relevant in the history section of periodic paralysis rather than here. --WS (talk) 21:00, 21 December 2010 (UTC)
I do think we need to say something about how the concept of periodic paralysis came to be recognised, as before 1927/1931 the link with thyroid disease was unknown. I agree that devoting an entire paragraph to the finer details of these reports may be WP:WEIGHT. JFW | T@lk 01:42, 22 December 2010 (UTC)

The current version looks good to me.--WS (talk) 09:04, 23 December 2010 (UTC)

Thank you. Would you mind offering your support on the FAC page? JFW | T@lk 21:34, 23 December 2010 (UTC)
Just haven't had the time to critically read the whole article. I have a lot more time directly after Christmas, and my guess is it will definitely get my support :-) --WS (talk) 00:06, 24 December 2010 (UTC)
Splendid, enjoy the holidays. JFW | T@lk 00:33, 24 December 2010 (UTC)

Potassium replacement[edit]

From "Treatment", paragraph 1: "Administration of potassium rapidly improves the muscle weakness and prevents complications." It is unclear if the administration of potassium is rapid, or if the improvement in muscle weakness is rapid. Axl ¤ [Talk] 10:58, 12 January 2011 (UTC)

Well, not too rapid (as it would invite arrhythmias when the K+ hits the right atrium)! The improvement of the weakness is rapid. Thanks for your grammar fixes and clarifications. I may need to revise my "en-4" status on WP:BABEL. JFW | T@lk 11:23, 12 January 2011 (UTC)
I guessed that rapid potassium administration might do that. ;-) I'll clarify the sentence. Axl ¤ [Talk] 09:14, 13 January 2011 (UTC)

Prevalence & incidence[edit]

What are the prevalence and incidence? Axl ¤ [Talk] 10:13, 13 January 2011 (UTC)

Don't think these figures are available. The sources don't give them anyway. JFW | T@lk 12:18, 13 January 2011 (UTC)

The French[edit]

The French have translated this article almost verbatim, and it has achieved GA status on the French Wikipedia. We can probably regard that as a compliment. JFW | T@lk 07:44, 20 February 2011 (UTC)

Swap medical jargon with plain English[edit]

The text reads e.g. "Thyrotoxic periodic paralysis (TPP) is a condition featuring attacks of muscle weakness in the presence of hyperthyroidism (overactivity of the thyroid gland). Hypokalemia (a decreased potassium level in the blood) is usually present during attacks. The condition may be life-threatening if weakness of the breathing muscles leads to respiratory failure, or if the low potassium levels lead to cardiac arrhythmias (irregularities in the heart rate)."

Shouldn't the encyclopedic style NECESSITATE to put medical jargon into parenthesis, and lift the common language explanations up. Like this:

"Thyrotoxic periodic paralysis (TPP) is a condition featuring attacks of muscle weakness in the presence of overactivity of the thyroid gland (hyperthyroidism). A decreased potassium level in the blood (hypokalemia) is usually present during attacks. The condition may be life-threatening if weakness of the breathing muscles leads to respiratory failure, or if the low potassium levels lead to cardiac irregularities in the heart rate (arrhythmias)."

My mother tongue is not English, but hopefully you can understand what I mean.

This comment is not particularly aimed at this article, but any article that has even a sligthest touch of medicine. TWx4eABO5y (talk) 20:51, 21 June 2011 (UTC)

There are various ways of doing this. The "medical jargon" is the most precise terminology, while the information between brackets explains that terminology in lay terms. There is no reason why the reader cannot, through reading the article, acquire a basic understanding of the relevant terminology. I dare even say that continuous use of lay language runs the risk of dumbing things down excessively. Stylistically, if the term "hyperthyroidism" is used repeatedly, then it should be explained on first use; it would be strange, however, if you put the technical term between brackets but continued to use it as the main term. (I would hate to have to repeatedly use "overactivity of the thyroid gland".) JFW | T@lk 21:09, 21 June 2011 (UTC)
This article is generally informative, but I agree with TWx4eABO5y's sentiments. Consistently parenthesizing multi-word appositive phrases for jargon seems crude and makes for an awkward read. I think it would better to do the converse; that is, to swap jargon with plainer English and enclose the jargon term in parentheses after a brief definitional phrase in common language. The improvement is clear in TWx4eABO5y's example. (To address JMW's concern above: the jargon, and not the appositive, could then be used in subsequent references to the concept.) Ultimately, there are many better ways to indicate the meaning of a new term than simply enclosing appositives (or the jargon they define) in parentheses. A wider variety of appositional techniques seems like the best remedy here.
In my opinion, the stylistic concern above is an example of a slightly broader lack of accessible writing in this article. More background information and context in the article -- particularly in the lead -- would help improve that. Fluidly incorporating appositives and background context into the first appearance of a term of scientific jargon (even elementary jargon) is an important tactic. For example, most lay readers will not know what the thyroid is or does, and even those with background in the biological sciences may benefit from a refresher. Considering its centrality in this article, a sentence of definition and context would probably due. Making the diction simpler and less clinical -- again, particularly in the lead -- would also help the vast majority of readers.
In my experience writing the article on homologous recombination, a similarly advanced topic in biology, I found the most difficult part by far was trying to make the article accessible. A greater degree of hand-holding with terms and concepts is a big departure from the style used in textbooks and journals, but it is a necessary road-bump for an encyclopedia with an audience that includes not only university students and researchers but also the general interested public. Emw (talk) 03:45, 22 June 2011 (UTC)

Missed this[edit]

More about Kir2.6 - doi:10.1681/ASN.2012010046 JFW | T@lk 12:05, 11 May 2016 (UTC)

doi:10.1007/s12020-012-9777-x JFW | T@lk 12:07, 11 May 2016 (UTC)
doi:10.1038/nrendo.2011.58 JFW | T@lk 12:07, 11 May 2016 (UTC)