User talk:Tekaphor

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[edit] Welcome!

Hello, and Welcome to the Wikipedia, Tekaphor! Thanks for the contributions over on the Chronic fatigue syndrome article. Here are a few perfunctory tips to hasten your acculturation into the Wikipedia experience:

And some odds and ends: Cite your sources, Civility, Conflict resolution, How to edit a page, How to write a great article, Pages needing attention, Peer review, Policy Library, Verifiability, Village pump, and Wikiquette; also, you can sign your name on any page by typing four tildes: ~~~~. Best of luck, Tekaphor, and most importantly, have fun! Ombudsman 16:28, 5 March 2007 (UTC)

Thanks - Tekaphor 09:13, 24 March 2007 (UTC)

[edit] CFS

Hi, I notice you've been doing some good work on chronic fatigue syndrome. At the moment the article reflects the very fragmented understanding of this condition in the medical research community, with little consensus. I have not made any major edits to that article, but I strongly feel that work is needed. I recently exchanged some views with Avb (talk · contribs), and it seems Thedreamdied (talk · contribs) and Sciencewatcher (talk · contribs) are also trying to take the article to another level. Obviously this is an emotional debate, and there is a lively online community that clearly does not accept certain hypotheses without a fight. I'll repeat here the points that I made to Avb:[1]

  • CFS is poorly defined. The systems that are in place (Oxford, Fukuda, Holmes, etc) are perceived as being inadequate.
  • There is no gold standard in the diagnosis of CFS. The complete lack of a useful diagnostic modality makes it almost impossible to generate a clinically homogenous population for an intervention (or even "natural history" trial).
  • There is a wide gap between what patients feel and what doctors can understand.
  • There are various schools of thought as to the pathogenesis. Some favour a psychiatric paradigm, while others find explanations in virology, autoimmune disease, endocrine causes and toxicology. These schools of thought are not well-defined, with members of the "psychiatric school" not excluding an organic cause and vice versa. I personally find myself in agreement with a hybrid approach (mental maladaption to a physical cause), but remain open-minded as to new perspectives.
  • There are a lot of people - probably too many - who claim they have found the cause of CFS (think of HHV6 and its incessant hype).

I'd love to hear your views on this, and am quite interested in generating some sort of a framework to make that article top-notch. JFW | T@lk 15:34, 19 March 2007 (UTC)

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Hi JFW. Thanks for your appreciation. I agree with all your points and that more work is needed on the article, although I am somewhat unsure about how exactly to significantly improve it. It may not currently be optimal, but until we have more definitive results from researchers, perhaps the best thing we can do for now is better represent these inadequacies/controversies/unknowns and improve the article in terms of wikipedia standards. I do have the following improvements or suggestions in mind though:
  • merging the diagnosis and symptom sections, with more comparative details about the different criterias (perhaps also with the section on "post-exertional symptom exacerbation" being moved as a symptom under the Canadian criteria) ...
  • a section on the overlap with other etiologies to rule out, plus a separate descriptive list on a another page as Thedreamdied suggests ...
  • upgrading/including the "controversies" section with more details about the "psychological vs physiological" debate (maybe it could be renamed too) ...
  • improving the references I have added (most are from news websites).
I would like to see some resolution between both "sides". I used to think CFS was mostly psychological but now I currently view it as mostly physiological, with a hybrid explanation seeming most likely. So while I tend to keep a critical eye on people's attempts at promoting ME/CFS as mostly psychological, I remain quite interested in this aspect and suspect it does play a secondary causal role. Similar to your example of mental maladaption to a physical cause, I think that the physical cause is some type of initial subtle biological weakness that snowballs when combined with certain stressors (psychological or otherwise), and that the mental maladaption goes hand in hand (may be partially caused or worsened by the biological weakness but may also contribute to it, hence the "snowballing"). - Tekaphor 10:07, 24 March 2007 (UTC)

When it comes to symptoms, we need a solid reference for each symptom. After all, it could be that a CFS patient has fatigue but also suffers from hay fever. It is tempting to attribute the hay fever to "immune dysfunction", ignoring the fact that 1/3 of the population suffers from this. One then needs to prove that it is more common in CFS patients. (This is just an example.)

Other syndromes to rule out: this is very much dependent on one's POV. The CDC list is deliberately short, but there are plenty of CFS message boards that will insist that every CFS patient should be tested for Pizza Disease (Margueritosis), while this is pointless of medical grounds apart from the fact that a small group of Margueritosis patients will occasionally feel tired. Do you want the short list (recommended by professional organisations) or the long list (pushed by patients' groups). Note that Margueritosis is a fictional diagnostic entity.

Controversies: it would be nice to have a good reference for this section.

References: give me a list of references to chase. This is usually easy. Use the name of the first author and the year (and the journal) and feed it into PubMed. I usually get it quickly. JFW | T@lk 08:55, 25 March 2007 (UTC)

You made a few more good suggestions. So far I have replaced the several news site references in that section with those from PubMed. I also divided the section up into relevant subsections and slightly reworded some of the text. - Tekaphor 06:26, 26 March 2007 (UTC)

Well done on your recent contributions, such as the Occ Med (London) citation on the epidemiology. Could you suggest (on the article's talkpage) which sections could be trimmed or removed? JFW | T@lk 14:08, 3 May 2007 (UTC)

[edit] Improving CFS/ME Article

Hi, I've noticed you recently made a contribution or regularly contribute to Chronic Fatigue Syndrome. I recently nominated it as the Wikipedia:Improvement Drive. I feel that it needs urgent improvement, and if you agree please vote at the Improvement Drive project page. Thanks! Thedreamdied 02:08, 3 April 2007 (UTC)

[edit] Email

If you activated your Wikipedia email I could send you a message. JFW | T@lk 21:48, 20 May 2007 (UTC)

Done. - Tekaphor 10:28, 23 May 2007 (UTC)

[edit] CFS Neuro Endocrinology

Placed some comment on your CFS research page. Would be interested in your comment on article i attempted to post y'day Jagra

[edit] Medicine Collaboration of the Month

 Thank you for your support of the Medicine Collaboration of the Week.
This week Ascending cholangitis was selected.
Hope you can help…


NCurse work 17:29, 16 October 2007 (UTC)

[edit] Anti-oxidants

Hi Tekaphor, a certain editor is reverting edits regarding anti-oxidants in CFS on spurious grounds. Firstly as unreliable source here which I had overturned on the WP RSN here, and now as Fringe theory, which I sure could be easily overturned. Rather than continue his edit war I have posted a Discussion on anti-oxidants and seek a consensus on the Talk page for an replacement section. Jagra 03:20, 5 November 2007 (UTC)

[edit] Sleep deprivation and emotional instability

You may find this interesting [`http://www.medscape.com/viewarticle/564867?src=rss] Sleep deprivation and emotional instability "This is the first set of experiments that demonstrate that even healthy people's brains mimic certain pathological psychiatric patterns when deprived of sleep." How is this for attitude on CFS, as if there were not enough problems? Seasons Regards Jagra (talk) 03:06, 23 December 2007 (UTC)

Hi Jagra, interesting article, and rather obvious too!
You might be interested in this news article, "Researchers Reverse Effects Of Sleep Deprivation".
Belated seasons regards - Tekaphor (talk) 00:35, 13 January 2008 (UTC)

[edit] CFS Articles

Hi Tekaphor.

Thought you might want to check this out

https://online.sagepub.com/cgi/register?registration=FTNov2007-34

You can get free access to all their journals (and there is a lot of them) until end of November. I am currently working my way through them. (A tip: search for "chronic fatigue", not "chronic fatigue syndrome", you get a bit more chaff, but also a broader and more interesting range of results.)

Two particularly interesting studies (of considerable relevance to the CFS article discussions) that I have found so far are:

Retrospective Measurement of Childhood Sexual Abuse: A Review of Instruments. Hulme PA, 2004. Complete abstract:

In this comprehensive review of retrospective childhood sexual abuse (CSA) instruments, instruments from studies published between 1986 and 2001 are examined according to administration method, number and specificity of questions, CSA operational definitions, psychometric properties, and the use of scales. It was found that both self-administered and interview instruments range from the vagueness of a single question to the preciseness of multiple, specific questions. Furthermore, the review demonstrated that CSA instruments generally lack standardization. Many are developed for one time use and others modified when reused. Descriptive CSA instruments have been preferred by researchers and primarily used to measure CSA dichotomously. However, little consensus exists as to how to operationally define CSA. One positive trend is the development of scales that measure CSA as an interval-level variable, allowing for more extensive psychometric data to be collected.

Daily physical activities of patients with chronic pain or fatigue versus asymptomatic controls. A systematic review. van Weering M, et al, 2007. From the abstract:

Conclusions: Results reported in the literature with respect to the activity level of patients with chronic pain or fatigue compared with controls were too heterogeneous to give sufficient evidence and were not conclusive.

Some food for thought.

Catch you later.

Bricker 04:41, 15 November 2007 (UTC)

[edit] IBS

Hi,

I'm just about to fix the pubmed id, just leave it for a minute as I keep hitting against an edit conflict with you. WLU (talk) 14:29, 9 December 2007 (UTC)

the problem is it should be pmid = 23536653; that is, it should be lower case (may not matter) and an equal sign. You forgot the equal sign. WLU (talk) 14:30, 9 December 2007 (UTC)
I eventually figured it out, a simple mistake! From previous experience, the upper case doesn't matter. Good work on moving the study to a more appropriate place, I wasn't really sure where it should have gone so I just added it where similar studies were mentioned. Regards - Tekaphor (talk) 03:14, 10 December 2007 (UTC)

[edit] Thanks for CFS work on case definition

In the rush of events, both on Wikipedia and in my personal life, I think I forgot to acknowledge properly your work on the problems with the patient selection criteria in the Issues with the definitions/criteria section. Much appreciated.

Bricker (talk) 05:32, 13 December 2007 (UTC)

[edit] Wikiproject, anyone?

The work on splitting the main article brought to attention the need for a place for coordination as well as a lot of outlying articles in need of attention by the same community of editors.

While there is no official consensus on a name and not yet a permanent location, there is a project page presently stashed at: User:Strangelv/MEproject. Thank you for your work and consideration. -- Strangelv (talk) 07:19, 26 April 2008 (UTC)

Thanks, I'll take a look. - Tekaphor (talk) 08:27, 26 April 2008 (UTC)