Talk:Gastroschisis

Copyvio
Original article text taken from MedlinePlus Medical Encyclopedia (public domain) —Preceding unsigned comment added by Wouterstomp (talk • contribs) 17:16, 3 November 2005 (UTC)

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 * I have removed all of the information that was copied verbatim from the MedlinePlus website, leaving content that was added originally by other Wikipedia editors. Should you encounter a similar problem in the future, have a look at Wikipedia's stance on copyright violations to see what your options are. In general, simply blanking the article will not achieve your goal. Cheers. --P e ruvianLlama(spit) 21:51, 8 September 2006 (UTC)

Error
I do not really know how to edit or contribute to wikipedia but i found what i think is an error on the gastroschisis page- it says the etiology is failure of folds to form in the abdominal wall but that is the etiology of omphalocele- according to uptodate.com gastroschisis occurs secondary to vascular accident leading to the disruption of the normal development of the abdominal wall. i could be wrong, but im doing a presentation on it and ive been researching. thanks to anyone who can act on this!:-) —Preceding unsigned comment added by 129.98.42.122 (talk) 02:39, 11 July 2008 (UTC)

Error
My daughter was born with Gastroschisis and I thought you should know that there is NO KNOWN REASON for why GASTROSCHISIS is caused. The other diseases you have on this site have almost nothing to do with Gastroschisis. Besides them all haveing to do with the stomach. Your confusing people by telling them there is a known reason for this disease when in fact, there is not. TerraLeeB (talk) 16:15, 28 July 2008 (UTC) TerraLeeB

Actually, there are some studies that DO say it's genetic, but I'm not qualified to say which ones are actually useful, and which ones are crap. That's why I've put a Citation Required mark by the statement that it's genetic. Xrobau (talk) 04:54, 9 September 2008 (UTC)
 * You actually put the Citation Required mark by the statement that it is congenital - as per the linking article, a congenital disorder is any acquired before birth, whether it be by genetics, accident, a pathological agent, or whatever. I moved your citation required back a word to be next to "inherited" which appears to be where you intended it. I did one heck of a doubletake when I saw that someone wanted a citation for this being congenital :D Syndaryl (talk) 15:37, 20 November 2008 (UTC)

The Royal Women’s Hospital in Victoria, Australia believes that Gastroschisis occurs in about 1 in 5 -10,000 live births. It appears to occur more frequently in women who are less than 20 years of age. It may also be more common in women who smoke and use drugs such as cocaine. Also a friend of my studying medicine in the Royal College of Surgeons in Dublin in Ireland also concurs with this theory.

During the 4th to 5th week of embryonic development the embryo, which has been a flat disk, folds in four directions: up and down and right and left sides. Each fold converges at the site of the umbilicus with the side folds forming the sides of the abdominal wall.

Gastroschisis is thought to occur because of interruptions to the blood supply or blood vessels which supply the muscles of the abdominal wall during the period of abdominal wall development. Walter Ramsbottom —Preceding comment added by 86.41.110.115 (talk) 14:59, 13 August 2008 (UTC)

In May 2011, ABC TV (Australian Broadcasting Corporation) reported on a Gastroschisis cluster in northern NSW and southern Queensland. The figures reported there are way, way higher than what is quoted in the article. Although there was no conclusion as to the causes, a link was made to agricultural spraying. Not only are the figures so much higher there, but for babies made in spring, the numbers are higher still. It is too easy to say 'it's genetic', because it means that nobody can or must do anything to investigate.

Not mentioned on TV, just two things that come to my mind: 1. Reading up on Aspartame, artificial sweetener, suggests this cannot be excluded as a contributor. 2. The increased percentage of IVF babies is never correlated to increase in birth defects. This is unscientific. 144.136.177.12 (talk) 06:28, 22 May 2011 (UTC)

US incidence trend
Without objection, I will add this CDC link to the article. Lfstevens (talk) 17:54, 28 October 2014 (UTC)

WP:SELFCITE primary source
and now have added content about a new primary source  three times now:
 * dif
 * dif
 * dif

This appears very much to be a violation of WP:SELFCITE based on the username (the study is from Univ of Illinois) and this is a primary source and per WP:MEDRS we base content on reviews. Please discuss. Thanks. Jytdog (talk) 19:18, 15 June 2015 (UTC)


 * Jytdog--
 * first off, I am clearly new to the editing process here.. threatening to block me from editing is unnecessary. As I said, I am a current medical student working at Children's Hospital of Illinois. My supervisor is Dr. Edmund Yang, a highly respected national voice on gastroschisis. I have attempted to add a snippet to the article about the correlations between spontaneous onset of labor and length of stay, a snippet that I believe flows well while expanding thoughts already presented. I am aware that this info does not come from a review article, but the editing rules also allow for highly respected opinions outside of review articles, which I believe is a category Dr. Yang falls into. Let me know what I am missing here. If the point of Wiki is not to stay up to date with new, widely accepted information... then what is the point? Illini0910 (talk) 19:24, 15 June 2015 (UTC)
 * I am glad the edit note about blocking got your attention, since you ignored that same warning of a possible block in the edit warring notice I gave you twice, at both your Talk pages (you apparently didn't read it). Before we begin, please read the section of our COI guideline called Writing about yourself and your work which includes a discussion of WP:SELFCITE and then reply here. Thanks. Jytdog (talk) 19:26, 15 June 2015 (UTC)


 * Jytdog--
 * I neither wrote or participated in the study, merely acknowledging it. I do not go to medical school at University of Illinois or at any of the medical schools that sponsored this research. I apologize for not noticing your warnings, like I said I've never edited. I read the MEDRS:


 * Ideal sources for biomedical content includes literature reviews or systematic reviews published in reputable medical journals, academic and professional books written by experts in the relevant field and from a respected publisher, and medical guidelines or position statements from nationally or internationally recognised expert bodies. Primary sources should generally not be used for medical content. Many such sources represent unreliable information that has not been vetted in review articles, or present preliminary information that may not bear out when tested in clinical trials.


 * As I said, I believe this leaves the door open to primary articles published by a field of experts (I listed 6 of them on the journal entry I posted). Again, not trying to be disruptive in any way, this is my first attempted edit to Wiki. Illini0910 (talk) 19:57, 15 June 2015 (UTC)


 * I am sorry that you cannot see your conflict of interest here, as you are writing about your supervisor. The section I cited says "You should not create or edit articles about yourself, your family, or friends.".  In other words, people you are close to. With regard to MEDRS, please do not WP:Wikilawyer - yes we are guided by policy and guideline - their letter but most importantly their spirit.    Please know that in Wikipedia there is WP:NODEADLINE; you have not provided any reason not to wait until this original research paper is discussed by others in the field, in a review article. We want more than anything for our content to be reliable, and one thing we look for is to see how original  research, like what is discussed in this source, is treated by others in the field.  We are not cutting edge - we are reliable.  All you are saying is This Guy is Really Great and Wikipedia Should Add Content Right Away About His Research Every Time He Publishes, which is not true of anyone. The pressure seems entirely COI driven. We can wait and see if others think - others may weigh in soon. Jytdog (talk) 20:01, 15 June 2015 (UTC)


 * Fair enough, I'm not quite sure what I've done to warrant the talk down, but thanks. I just met Dr. Yang last week.. would certainly not classify him as a "person I'm close to". Following a thorough lit review, I simply noticed a weakness in the Wiki article which six experts in the field (one of which I have met) directly addressed. Apparently I completely misunderstood how this site works, I won't try to add anything again in the future. Thanks! Illini0910 (talk) 20:11, 15 June 2015 (UTC)
 * No reason to stomp your feet and walk away! You are new here and like I said, others may a different perspective than me. And please know that there is a community of editors who work on health related content and are always striving to improve their quality.  If you stuck around a bit longer, our standard of using review articles would start to make a lot of sense to you.  Anyone can edit, right?  And you know that there zillions of journals, and even the best journals sometimes publish really crappy research that never gets cited, right?  So we have people who want to add content that all kinds of dietary supplements or other woo treats this or that disease; people from companies wanting to advertise their products, researchers looking to promote their own research - who wall want to cite original research papers like this one.  Holding sourcing to the high bar of reviews is one of the main things that keeps a lot of garbage out of Wikipedia.  We need a very good reason to lower that bar.  Doesn't that make sense to you? Jytdog (talk) 20:25, 15 June 2015 (UTC)


 * First, welcome to Wikipedia! Second, the COI issue can be managed by finding an unrelated primary source. That leaves the question of primary/secondary, which MEDRS addresses. This discussion has mostly circled around the COI question. Indeed, if a point is controversial and has received little reaction from others, it really does not belong here. I have carefully avoided examining the claim or its sourcing, and thus can't comment on that, but at least it has not engaged my bias. Lfstevens (talk) 23:45, 15 June 2015 (UTC)

bs
Newborns are often smaller for gestational age due to their abdomen not expanding because the bowels (and sometimes other organs) are outside of the body.+ynoPERITONEUMcovr?81.11.230.70 (talk) 18:14, 6 March 2016 (UTC)

source needed
You have a typo. The source says [40]. You'll want to fill that out. --David Tornheim (talk) 21:27, 22 July 2016 (UTC)

Embryology Section
The embryology section does not have any sources, and I plan to add some while also expanding on the content. Jonathan Bell (talk) 18:30, 28 June 2017 (UTC)

Intro Section
The introduction needs more updated sources. I plan to add more appropriate sources and content. Jonathan Bell (talk) 15:29, 29 June 2017 (UTC)

Hi Jytdog. I made some edits on the Gastroschisis page which have all now been deleted. I note on your guidelines page that you prefer secondary sources. I can understand why this is doubtless in order to ensure that your articles are only based on the best available evidence.

The review article by Moore from the Canadian Government is a highly reputable secondary source, as is the narrative review article by Reece.

The papers by Mastroiacovo and Tanna were published in the British Medical Journal and represent registry reports from national birth registries so this would seem to be reliable data.

Data presented by the CDC at https://www.cdc.gov/ncbddd/birthdefects/features/gastroschisis-key-findings.html shows dramatic increases in gastroschisis in US 5 states in recent years. Moreover the rate of gastroschisis increase is well known to have increased in many nations in recent times. The CDC reference is to a paper by Martin, which is a large primary source based on a review of the experience in 15 US states so it would appear to be reasonable to include that source also. It does not make sense to allow reference to CDC page but not to the source that CDC reference.

Similarly the reference by PROPEL is a Canadian Government source based on whole population survey and would appear to be reputable, roughly equivalent to the CDC in that country. Its status as evidence would be equivalent to that of the Moore report.

The CDC graph (referenced above) shows dramatic increases in the rates especially in younger people. This clearly leaves open the possibility that younger people are preferentially exposed to an environmental toxin.

Again the paper by Bassil is a whole Canadian nation report done at fine geographical resolution clearly showing evidence of micro-clustering of the incidence of gastroschisis in that nation.

The website report by Meldrum-Hanna is a website only, but again confirms the Canadian finding of evidence of occurrence of gastroschisis in a geographically defined location. Moreover the area around Wadeville is area of New South Wales in Australia is in the very epicentre of Australia's national cannabis use. Whilst the use of a website does not strictly fit within the evidence based guidelines you have mentioned above it is common knowledge that many Wikipedia sites often refer to website URL's.

Again the Laughon report shows a doubling of the rate of gastroschisis in North Carolina in just the three years from 1997-2000. This report was published in the very eminent and reputable Journal of Perinatology. Whilst not a secondary source it is reliable. Moreover it is unheard of that the incidence of a major malformation doubles in so short a time, an issue which as the authors rightly remark raises the question of exposure to an environmental toxin.

In short the evidence base for gastroschisis is obviously changing, as is acknowledged both by the Wikipedia website and the CDC page referred to above based on the Martin paper. At present that Wikipedia page does not indicate this. The remarks it that the incidence "may be increasing", which does not do justice to the evidence.

In particular there is no mention of the involvement of cannabis on the Wikipedia page, whereas this is often mentioned in the medical and scientific literature on this malformation. The data above is all consistent with the increasing exposure particularly of young people to an environmental toxin which is becoming more common internationally, and particularly in parts of Canada and New South Wales. In fact a large state-wide report from Hawaii in 2007 reported a relative incidence in babies born to cannabis exposed mothers of 23.11 time (95% confidence interval 4.69 to 69.34; Forrester, Journal of Toxicology and Environmental Health, 2007; 70: 7-18).

Whilst the Wikipedia page at present mentions the potential involvement of tobacco and alcohol there is no mention of other drugs which have now been linked by many studies. It is of concern that the literature clearly indicates that fathers who are exposed to cannabis - and likely also other drugs - can also produce with major malformations.

It does not seem right that young people are being afflicted by this serious condition, and not being warned. As such what is required is a large and careful study to combine all of these different aspects and come up with a synthetic and unified answer which places each of the known risk factors in their relative place and informs the public of their relative role.

This service has been conducted by the Skarsgard article. This paper is written from Canada which obviously contains demographic "hot spots" for gastroschisis. This is important as many papers on this subject contain only low frequencies both of the malformation and of its risk factors. Studies conducted in environments of low prevalence are both well known and widely acknowledged to return false negative and misleading answers. This paper placed these various risk factors in perspective and thus performed an invaluable service to global public health.

In summary I can understand why Wikipedia have the rules of evidence relating to secondary sources to ensure the quality of the evidence which is presented. However it is clearly evident to any observer that the dataset in this disorder is changing rapidly and affects especially young people. Without question the "Wikirules" are somewhat flexible and allow a certain latitude in their interpretation. I would ask you to please consider the above observations which paint a uniform and concerning picture of the environmental safety of the culture into which our young are being born across the globe. The gastroschisis literature is large and rich, and is not well reflected at present on the Wikipedia page.

Of particular concern I recently showed the evidence presented here and described above to one of the top Professors of Public Health at New York's Mailman School of Public Health, one of the top public health schools in the world and she was very concerned indeed. She found the data both compelling and concerning. She was especially concerned at the apparent geographic coincidence in the rates of gastroschisis presented by Moore with the rates of cannabis use in Canada shown by PROPEL. This fits especially with the evidence of micro-clustering in Australia, Canada and presumably also in Hawaii and North Carolina.

I await your further review and consideration with particular interest.Blueheeler.oz (talk) 18:14, 11 September 2017 (UTC)
 * We use recent, secondary sources per WP:MEDRS - you cited a bunch of primary sources and constructed a mini-review here in Wikipedia. We don't do that here.  Please see the definitions of "primary" and "secondary" at WP:MEDDEF.  You might also find this thing on my user page helpful: User:Jytdog. Jytdog (talk) 18:17, 11 September 2017 (UTC)


 * Sorry Jytdog. Most of the cited sources are reviews.  And state or multi-state level epidemiological findings.  Most are quite recent.  Some of the references used can also be referred to indirectly via other authoritative reviews written in major journals such as New England Journal of Medicine.  The same points can be made via referencing reviews.  I am concerned that you might be taking a blanket approach and applying your standards selectively.Blueheeler.oz (talk) 21:00, 11 September 2017 (UTC)


 * Hi Jytdog, As mentioned earlier Moore wrote a review for the Canadian equivalent of the relevant CDC department which deals with infant abnormalities. Her review mentions that gastroschisis has been shown to be three times higher after maternal cannabis exposure.  The Wikipedia page presently mentions implication of both tobacco and alcohol in causality.  As the Moore review is both a review article and a CDC-equivalent publication please explain why this reference is not acceptable to Wikipedia???


 * I am unclear about the basis for your taking exception to the mention of cannabis, given the present implication of tobacco and alcohol.  I would be grateful if you could please clarify.


 * The present Wikipage mentions at points three and four that vascular accidents are thought be one leading theory of the causes of gastroschisis. An authoritative review by Dr. Nora Volkow, Director of the National Institute of Drug Abuse, part of NIH, published in the New England Journal of Medicine (2014; 371: 879, doi: 10.1056/NEJMc1407928), mentions that cannabis is associated with major vascular catastrophes such as stroke and heart attack.  As she is obviously a leading world authority, publishing a review, in the world’s leading medical journal, please explain why Dr Volkow’s work is not acceptable as a source for referencing in Wikipedia in relation to this heading???


 * An authoritative Review by Dr. Nora Volkow, Director of the National Institute of Drug Abuse, part of NIH, published in the JAMA (2017; 317 (2): 129-130, doi: 10.1001/jama.2016.18612) mentions that cannabis exposed babies are small for dates and smaller for gestational age and have a higher rate of prematurity. Since cannabis obviously induces an impairment of tissue growth in the whole baby, as gastroaschisis babies are often small for dates as mentioned in your article, and as failed tissue growth to close the hole in the abdominal wall is relevant to gastroschisis, please explain why this review article by a world figure in addiction medicine is not acceptable as a Wikipedia reference???


 * The two papers cited in the British Medical Journal were reviews of the experience of national registries so would be analogous to CDC sources. They show a rise in many registries of two- to three- fold in recent decades.  Since they are review articles published in a leading medical journal please explain why these reviews are not acceptable as Wikipedia reference sources???


 * The review article by Reece cited in Mutation Research mentions a cellular theory whereby cannabis can interfere with cellular growth potentially explain all the above findings because tetrahydrocannabinol interacts directly with key proteins on the microtubules which form the “train tracks” which chromosomes run along during cellular division. This review refers to an important paper by Tortoriello G.  (EMBO Journal 2014, 33: 668-685).  This reference is also cited by Dr Volkow in the above cited review (Volkow N.D., New England Journal of Medicine 2014; 371: 879, doi: 10.1056/NEJMc1407928).  As both these reviews were published in recognized journals please explain why this important finding is not acceptable as a reference for Wikipedia???  ?Blueheeler.oz (talk) 09:13, 12 September 2017 (UTC)
 * Can you provide a link to the pubmed entry for the review you are talking about?
 * This is a "letter" not a review Doc James  (talk · contribs · email) 15:42, 12 September 2017  (UTC)


 * Blueheeler.oz, No one can help you if you do not stop arguing, actually read WP:MEDDEF, and ask about anything there that you do not understand. Almost everything you wrote above about sourcing is incorrect. You have not been using "secondary sources" as we define them here. Jytdog (talk) 18:33, 12 September 2017 (UTC)


 * Hi Doc James. You asked for a PubMed link for the review I am talking about.  Could you please specify which of the reviews I mentioned you are referring to?  Thanks.Blueheeler.oz (talk) 20:05, 12 September 2017 (UTC)
 * Any of them. Doc James  (talk · contribs · email) 22:01, 12 September 2017 (UTC)
 * Thanks Jytdog. Here is the comment in the link to which you referred. "A secondary source in medicine summarizes one or more primary or secondary sources, usually to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies. Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations."  Most of the sources cited in the larger comment from me yesterday fit this criterion exactly.  I would be so grateful if you could please explain your position.  I am not clear as to why you feel that the reviews cited are unacceptable.Blueheeler.oz (talk) 20:09, 12 September 2017 (UTC)
 * There are links in the actual content you copied and pasted. please read literature reviews and systematic reviews; the sources you have cited are neither. Most of them were what we call "primary sources" as defined in MEDDEF .Jytdog (talk) 22:46, 12 September 2017 (UTC)

examples..
 * Torfs - PMID 7974254 - primary source from 1994 (very much too old) (cited twice)
 * Weinsheimer - PMID 18485958 - primary source from 2008 (too old)
 * Tanna - PMID 12480852 - primary source from 2002 (too old)
 * Mastroiacovo - PMID 16484273 - primary source from 2006 (too old) (and just a letter to the editor)
 * Kirby - PMID 23969795 - primary source from 2013
 * Bassil PMID 27348112 - primary source from 2016
 * Meldrum news from 2011 - no good.
 * Loughon PMID 12774135 - primary source from 2003 (too old)

-- Jytdog (talk) 23:02, 12 September 2017 (UTC)
 * Thanks Jytdog. So NOT a single review article :-( Doc James  (talk · contribs · email) 23:25, 12 September 2017 (UTC)