Talk:Heyde's syndrome

I chose to re-write this article to improve readability, detail of information,breadth of coverage, and the use of supporting citations.

I am not a specialist in this area, but I am a biomedical researcher and I choseto make these changes to the Wikipedia entry as part of a literature review ofmy own. Specific potentially controversial changes and additions are listedbelow.

As I am not a specialist in this area, it is quite possible that I made somemistakes in my edits to this page, although I worked very hard to avoid that. Ifyou discover a mistake, or more likely a statement that you disagree with,please feel free to make a change, but also clearly document your reasoning inthis talk section. I will be monitoring this page and making edits in the weeksand months to come, and I will carefully review and alter all changes if I feelthey are unsupported by the literature, unless you provide a clear andcompelling reason in this talk section.Michael Dacre (talk - contribs - email) 21:09, 25 June 2015 (UTC)Reply

I expanded the existing diagnosis section maintaining all of the content that wasalready there. This is the section I am least comfortable with. My knowledge ofthe subject comes from an extensive literature review, an includes no clinicalexperience. My discussion of diagnosis is based on my understanding of thepathophysiology. If any actual physicians are able to edit this section toinclude a more experienced and well rounded point of view, I would reallyappreciate it.

I left the the first sentence unchanged other than to add a citation, I changedthe second sentence to use the word 'noted' instead of 'described', as theletter by Dr. Heyde merely notes the association in a small number of hispatients and requests input, it does not describe the condition at all norprovide any evidence for the association.

I chose to add a history section due to the controversial nature of this diseasesince its description by Edward Heyde in the 50s. For a while there wasconsiderable debate as to whether the association was even real, and thepossible cause remained open until very recent years.

This section is intentionally incomplete as I left out the several possibleexplanations proposed in earlier years that were easily dismissed by laterresearch.

I moved 'Diagnosis' to be after 'Pathophysiology'section based on my observation of WikiProject Medicine featured articles.

This section can be rolled into 'Diagnosis', and is not present in the majorityof WikiProject Medicine featured articles

The previous first paragraph of the pathophysiology section is a historical noteand not a discussion of the current understanding of the pathophysiology of thisdisease. I therefore moved it to 'History' and merged it with the firstparagraph there.

The second sentence of the pathophysiology section was written like a historysection also, I chose to expand the discussion of the pathophysiology greatly,and to do so in an encyclopedic fashion, rather than in the historical fashionpreviously. I retained all of the information in the original sentence however.

Rather than repeatedly refer to Heyde's syndrome, I made the choice toexplicitly state 'the association between gastrointestinal bleeding and aorticstenosis'. This is much more long winded, but I feel that it is much clearer fora lay audience.

I could not find any prognostic data on Heyde's syndrome in specific, only dataon IA and AS, so I left this section out.Michael Dacre (talk - contribs - email) 21:09, 25 June 2015 (UTC)Reply

This article refers to von Willebrand's and angiodysplasia interchangably despite the fact that these are totally different diseases.Michael Dacre (talk - contribs - email) 21:41, 22 June 2015 (UTC)Reply

I tried to clarify the introductory paragraph by removing the bit about where the syndrome got its name (I moved that info to the history section). Here's the original introduction:

In 1953, Dr Edward C. Heyde described a syndrome of aortic valve stenosis associated with gastrointestinal bleeding from angiodysplasia in the colon.

Cheers! --Diberri | Talk 21:06, Apr 19, 2004 (UTC)

Currently, wikipedia is coming across as suggesting that the 2003 paper suddenly and somewhat unexpectedly clarified the underlying pathophysiology. In fact, several lines of evidence started to be developed in the late 1970's, and gradually came together, such that the hypothesis was clearly presented in the early 1990's, and received substantial corroboration from many sources over the next decade. In fact, the 2003 article credits much of that work. The elucidation of this syndrome "took a village." I'll see if I can find a nice secondary source review of how this developed, but readers are cautioned that the chronology was a little less simple than might be inferred from the current wording. FeatherPluma (talk) 04:00, 10 November 2011 (UTC)Reply

doi:10.1056/NEJMcibr1205363 JFW | T@lk 19:34, 7 February 2013 (UTC)Reply

The association is far from complete. vWD IIa probably promotes angiogenesis of angiodysplasias. doi:10.1111/bjh.12272 JFW | T@lk 23:29, 7 December 2014 (UTC)Reply

doi:10.1093/ageing/afp019 - review from a geriatric perspective.

doi:10.1111/jocs.12131 - cardiac surgery perspective. JFW | T@lk 23:34, 7 December 2014 (UTC)Reply

User:Ozzie10aaaa: You put many requests for 'medical references' without any clarification or edit summary. Please provide your rationale for me. With one exception that I intend to remove shortly, everything in this article is substantiated by medical review, and primary sources are provided for clarification of individual points. Many sources are quite old, but this is not an actively researched syndrome, and so they are still absolutely current. In cases where they are not current, they support single statements that describe the work done by that article, and not the pathophysiology or diagnosis. Again with one exception, I do not understand any of your requests. Can you please enlighten me? Michael Dacre (talk - contribs - email) 08:23, 7 July 2015 (UTC)Reply

Michael Dacre ...no problem.......irrespective of primary or secondary, the sources are dated (references #1,4,5,6,7,9,14,15 (have place inline citations...the History section is exempt)--Ozzie10aaaa (talk) 20:10, 6 July 2015 (UTC)....this is what I had placed due to the fact that they where dated (old) and generally should be replaced with newer ones, if you find difficulty in finding any newer ones just remove the tag (I will have a shot at PubMed to find a few),,,feel free to ping me with any question,,,thanks--Ozzie10aaaa (talk) 17:30, 7 July 2015 (UTC)Reply

Thanks Ozzie10aaaa; I am editing the article right now and I will try to clean up the older references; I think I am too attached to my non-Wikipedia style of citing primary literature. I have found a few newer reviews that I am going to use to edit the text right now. Do you think I should just delete older references entirely, or simply add the newer reviews to the list? Also, if I am using reviews only, as seems to be Wikipedia policy, should I be citing less often? When I made wrote most of this content I cited often and mixed newer reviews supporting entire paragraphs with older literature supporting single sentences in those paragraphs. Should I just cite less and only have the reviews supporting larger chunks of text? Thanks again for all of your help :-) Michael Dacre (talk - contribs - email) 17:37, 7 July 2015 (UTC)Reply

no problem,,,,the first ref we decided to leave in....im looking for the rest (before deleting make sure you have a replacement reference) usually I go 1-2 sentences per references, everyone is different,.....remember you can use GOOGLE books and position statement (FDA,NHS,NIH,WHO,HHS,) --Ozzie10aaaa (talk) 17:39, 7 July 2015 (UTC)Reply

PS....Michael Dacre...[1] [2][3] [4] [5] ...see if these help,,i will keep looking--Ozzie10aaaa (talk) 17:57, 7 July 2015 (UTC)Reply

Thanks Ozzie10aaaa, I think that I have addressed all of the major citation issues now. When you have time, if you can make sure it all looks ok, that would be fantastic. Thanks again for all of your help Michael Dacre (talk - contribs - email) 20:45, 9 July 2015 (UTC)Reply