Talk:Grinker myelinopathy

This topic is being edited as an assignment in an undergraduate neurobiology course. The course is participating in the Wikipedia Education Program. The revised article will be posted by March 22, 2013. Please leave any comments on sources or information you would like to see on this topic.

Peer Edit
Because this is supposed to be an encyclopedia entry, I think that the page needs to be more descriptive or be linked to other pages. For example, people in science know what CO is but others won’t so this needs to be stated early (also be consistent, either use CO or use carbon monoxide – changes throughout the article). And what is hyperbaric? Etc… Symptoms also needs to be cleaned up grammatically. The diagnosis section should not start with “once other causes for dementia or hysteria have been eliminated etc…” because there is no flow to it and does not make sense. Content of causes section was done well – except for a few spelling errors. Ex: Demyleination should be demyelination. Also there is no information listed under the heading: Cerebral blood vessel damage. Alternative names should be put in the beginning along with history. You may also not need the history section considering it is in your introduction. Overall, the article was well written. It just needs to be re-read so that it flows better. KSirWillis (talk) 19:29, 4 April 2013 (UTC)

Author Response
Very good point about the links to other pages. We tried to link to other pages for potentially confusing terms if they weren't described in this article itself. We also ran through and cleaned up some of your other comments, including the consistency of phrasing and grammatical errors. We also removed the section of history because it merely repeated already given information. Instead, we gave alternative names its own section because it we believed it to be such an important and possibly confusing subject. Thank you for your criticism! --Riegern (talk) 03:27, 27 April 2013 (UTC)

Secondary Review
Overall, the article offers a good in-depth description of the disease. The article is easy to understand but also written in an academic tone. However, there are various typos and I would suggest that the author's re-read the article aloud in order to identify and correct these. Finally the "History" section seems a little out of proportion due to the extensive amount of information provided in the other sub topics. The history section should either be expanded upon or incorporated into another section.

Arakdpr (talk) 17:09, 3 April 2013 (UTC)

Author response
Thank you for your feedback. We have re-read the article and have hopefully caught all of our spelling and grammar errors. We also deleted the History section as it was just a repetition of what is stated in the introduction and because we did not find sufficient information to keep this as a sub section by itself.Ckbiology (talk) 03:23, 26 April 2013 (UTC)

Primary review
Overall the article is very good and provides plenty of information on the subject. At times the spelling/grammar was not correct throughout the article, review it a few times to make sure all of these errors are removed before the final draft.

There were also times when the wording could be a bit confusing to someone who does not have a background in science. Try to use simpler words to avoid any confusion. The opening sentence for the characterization section is confusing to me, both the wording and the purpose it serves for the rest of the article. As a previous reviewer said, there isn't anything under the Cerebral Blood Vessel Damage subsection in the causes section.

I think that for the most part you covered the areas that should be talked about in an article involving a disease (causes, diagnosis etc.). You also kept the article neutral in your explanations of all the involved topics.

As far as illustrations, you could include images of a damaged brain from hypoxia. You could also expand the history section and include a picture of Roy Grinker. I found both these topics through Google images.

The article I looked over was The Syndrome of Delayed Post-Hypoxic Leukoencephalopathy. It seems that you did a good job of covering what this article had to say on the subject. The only major thing that I saw was that the article you used had a fairly large section devoted to treatment and further direction to take while you didn't include any of this information. It would be a good idea to include this information to make your article more well rounded and complete.

Overall the entry you wrote is very good. With a few tweaks and additions you should be able to make an excellent article. Dotterson (talk) 22:44, 4 April 2013 (UTC)

Author response
Thank you for your thoughts and feedback. We have reviewed the article for spelling and grammar errors. We have added links and descriptions to the more technical terms to reduce confusion. We also went back and tried to simplify and clarify the opening of the characterization section. Another addition we made was to delete the cerebral blood vessel damage because we could not find sufficient sources for the topic. We could not find any pictures of Roy Grinker on the allowed cite for images for wikipedia, but we did find other images and added those to the article. After reviewing your peer review we decided to add the treatment section to the article. Ckbiology (talk) 23:23, 26 April 2013 (UTC)

Secondary Review
This article is well written and broad in scope. Having reviewed reference six "Clinical and Diagnostic Features of Delayed Hypoxic Leukoencephalopathy." the reference is paraphrased well and used appropriately in-text. An expansion in the relationship between Grinker's and myelin may be warranted

(ThrowTheBar2 (talk) 17:59, 7 April 2013 (UTC))
 * Grinker's Myelinopathy, also known as Anoxic Leukoencephalopathy[1] and delayed post-hypoxic leukoencephalopathy (DPHL),[2] is a rare disease of the Central Nervous System.
 * Link Central Nervous System to the Wiki article
 * Perhaps consider rephrasing the Prevention category
 * Most Wiki articles contain the History category at the beginning
 * Consider expanding it slightly

Author's response
Thank you for your review! It was very helpful, especially the link suggestions to Wikipedia article. The prevention category was replaced with a treatment and prognosis section to better describe the prevention of the disease. There was very little history about the disease in our sources so we decided to delete the section and instead mention the characterization in the introduction.

Let us know if you have any concerns about the changes we made or how we interpreted your suggestions. Thanks again for the review!Alphabetfood (talk) 00:13, 27 April 2013 (UTC)

Primary Review
Overall, this article is well written and easy to understand. First I have some small suggestions after reading through the article.


 * In Symptoms, there are two grammar mistakes that need correcting. In Diagnosis, "event" needs and "s". Under Causes, Pathophysiology is spelled wrong.
 * Also in the Symptoms paragraph, I would suggest linking myocardial infarction to its Wikipedia page. There are some other circumstances where links could be added as well: leukoencephalopathy, hypoxia, basal ganglia, anoxia, demyelination, necrosis, oligodendrocytes, and hyperbaric medicide. As a general rule, I would suggest including a link to any science or medical term that has a page. This will help people with no science background understand what you are talking about without deviating from the relevant topic. The links provided were well done. I checked all the links, and they all connect to a page.
 * As was suggested above, I would also recommend being consistent with CO vs. carbon monoxide.
 * The Cerebral Blood Vessel Damage section has nothing in it and should probably be deleted.
 * If there is more information on the History of the disease that would be a great thing to include. If not, I would delete that section as it is already stated in the introduction.
 * Your first source is only cited once at the very beginning. If that specific name is found in another source you might consider using that source instead and deleting your first source altogether.

I verified source number 3, "Delayed postanoxic encephalopathy: a case report and literature review". This is an acceptable secondary source. In the introduction, you say Grinker characterized the disease in 1925. However, the only thing this source says is that he reported the first case in 1926. I noticed in the History section you used different sources for this information. You may want to add one of the sources (7 or 8) to this sentence because the information given is not coming from source 3 as far as I can tell. Everything else referenced looks good, but I think you could add more from this source to the History section to complete it.

Overall, this is a well written article. However, it could use more simplification in parts. There are a lot of terms that make it difficult to understand for anyone without a medical background. Adding more links will help that, but also just re-reading the article out loud would be beneficial. Make sure everything is perfectly clear to someone who has not researched the topic. The article looks verifiable, everything is well cited and the article I looked at is correctly referenced. The coverage is broad and answers any questions a reader may have when looking up the disease. The only addition I would suggest again, is in the History section. The article remains neutral, nothing stands out as being opinionated, or controversial. A picture should be added. There have been some suggestions already. A picture of Roy Grinker would be good, or maybe a visual of the brain and the affected regions.

Great job overall, I enjoyed learning about Grinker myelinopathy! 8712NeuroBio (talk) 19:21, 7 April 2013 (UTC)

Author Response
Thank you for the review! It was actually very helpful. We took into account pretty much all of it. The spelling mistakes and grammar mistakes that you mentioned in the beginning of your review were taken care of. We also went ahead and linked everything that we thought was confusing or too technical to its respective Wikipedia article. I definitely think that it helped clear up our article a lot. We switched CO to carbon monoxide and linked it a few times to provide more detailed coverage of the material. The history section was deleted. The first source was used in other places throughout the article, but not cited. As a solution, I added this citation to additional pieces of information in the article that were taken from this particle source.

As far as the different dates in which Grinker categorized the disease, we originally posted 1925 because this was the most common date sited. To solve the issue of contradicting references I included a both dates, and the respective sources that stated them. We thought this was a better option than choosing one or the other. We included another source along with three for the mentioning of the date of Grinker's categorization to make their reference to this date more clear. In the reference 3, when talking about Grinker's myelinopathy, the authors mention that "Since the original Grinker's case (1925) a large number of identical cases has been reported". This is the sentence in reference 3 that lends support the original characterization in 1925.

We tried looking for a picture on the Wikipedia database for Roy Grinker but were not lucky enough to find one. We had trouble finding one without a copyright that could be submitted to Wikipedia. We did, however, add pictures. These were mostly related to the neuroimaging used to diagnose the disease.

Again, we appreciate your thoughtful review and let us know if you have any concerns with our changes. Alphabetfood (talk) 00:03, 27 April 2013 (UTC)

Note from an Author
It may be too late to post this but the goal of this article was to describe the disease in terms of theorized causes and pathologies. Unfortunately, for this article, not much can be found in the form of secondary sources. Most of the information is based off of case studies and the disease is very poorly understood. Each author even seemed to use a different name when they described the disease. Some of the information from some articles contradicts the information in others. In these cases, we took the information from the article that seemed to describe the information best. Alphabetfood (talk) 20:57, 7 April 2013 (UTC)

Secondary Review
This article is very well written, but also very intense. I suggest trying to add as much clarification as possible. I think that it would also be a good idea to add a picture in the category entitled, "Neuroimaging." I learned a lot from this article, but I found myself re-reading information in order to try and understand it better. I think that more links should be added as well. P meyer9614 (talk) 04:35, 8 April 2013 (UTC)

Author response
Thank you for the feedback. We tired to clarify anything in depth and added links to further enhance understanding. We took your suggestion and added a picture in the Neuroimaging section as well.Ckbiology (talk) 03:26, 26 April 2013 (UTC)

Secondary Review
Great job on the article. I found the flow of the article was smooth, and was also “dumb-down” enough that an average person/patient would be able to understand. I would suggest adding in a picture here or there to improve some sections or clarify what may be explained.

Here are some things I noticed that can be changed or improved:

-The symptoms upon onset {h}ave been known to include apathy- forgot the “h”

-Cerebral blood vessel damage section doesn’t have any content in it?

-reword: One way to prevent the likelihood of Grinker's myelinoopathy occurring is standard or hyperbaric oxygen after carbon monoxide poisoning

-Expectation and recognition will also lead to an earlier and more accurate and appropriate use of health care services – find a different word for “expectation”

Caseymunger (talk) 17:25, 8 April 2013 (UTC)

Author Response
We appreciate your thoughts and helpful comments. We added pictures to give a visual reference and clarify certain sections. The 'h' was added and the 'Cerebral Blood Vessel' section was deleted. Proper re-wording and grammatical errors you suggested were revised. Dkoallpro (talk) 21:58, 26 April 2013 (UTC)

Secondary Review
Overall the article is very well written and organized. The information given is sufficient to its topic and stays within its range. I would possibly recommend putting a link on some words that the typical non-scientist reader may not comprehend. (Like Leukoencephalopathy) There were a couple grammar and structure errors that were seen.

-	In the symptoms section on the first line the word “ave” should be “have”.

-	The sentence saying “Once other possible causes for dementia or hysteria have been eliminated Grinker's myelinopathy is diagnose” should have a comma after eliminated.

Also, the referencing was good and properly placed. However, the second paragraph in the section titled Cerebral blood vessel damage could use a reference. Since it is telling how this evidence is supported, a reader may want to look more into that.MinnieMee (talk) 18:10, 8 April 2013 (UTC)

Author response
Thanks for your helpful comments and feedback and we took your advice. The'h' and the comma was added as suggested. The 'Cerebral Blood Vessel' section was deleted as well. Dkoallpro (talk) 22:03, 26 April 2013 (UTC)

Primary Review
Overall this was a well-written article. There is a good overview of the disease and with the seemingly limited amount of information available you have made a concise summary that would be useful to a reader that needs a base knowledge of the subject. You did a good job remaining neutral on the subject, especially in the causes section where you outlined a specific counterargument to a theory. There were, however, a few problems I encountered and I will offer a few suggestions.


 * More links out to other pages in the introduction, the text itself implies some post knowledge of the subject. Without a source of information some terms could mean nothing to the reader without a little research, links would provide easy access to that info (words like leukoencephalopathy, CNS, and white matter in particular)
 * Under the symptoms subheading there is a period after pseudobulbar palsy that needs to be removed, maybe link out to demyelination
 * The information under the subheading “The direct toxicity of carbon monoxide” needs to be reworded a little for the sake of clarity and grammatical correctness. Specifically the sentences “This results in lesions to a great deal of subcortical cerebral white matter but leaving axons, U- fibers, and perivascular myelin mostly untouched. “  and “Support against this theory stems from the ability to replicate these lesions by using nitrogen-induced hypoxia and hypotension in cats and the onset of this disease in individuals who experienced acute hypoxia without CO poisoning.”
 * Others have mentioned it but the subheading cerebral blood vessel damage has nothing under it so info should be added or the heading should be removed
 * Maybe show an MRI or CT scan image

The source I reviewed was source 6, Clinical and Diagnostic Features of Delayed Hypoxic Leukoencephalopathy. The source was secondary and from a reputable journal and the section of text that cited it did stay consistent with the content of the source. There was some information in the source about MRI imaging from case studies that could possibly be used to add to the neuroimaging section.IJWMarq (talk) 01:38, 9 April 2013 (UTC)

Author Response
Thanks for the very thorough criticisms! We realized the lack of links between other pages could lead to confusion and be detrimental to conveying the information we wanted to. We attempted to either clear up potentially difficult terms in the article itself and/or link the reader to a more illustrative page on the subject. We also noted the lack of visual information left the reader wanting and attempted to show some images to further clarify our topic. More generally, we reread and reworded much of the article in order to make our ideas more clear and understandable, as there were multiple grammatical and logical errors to rectify. We chose not to include the case studies provided by the source, as it more or less was just a more specific example of the broader symptoms we had already described in the article and thought that it would not add much to the reader's understanding of the MRI technique's helpfulness. We tried to address your other points though- thanks for your help! --Riegern (talk) 03:33, 27 April 2013 (UTC)

Primary Review
I enjoyed reading and learning about Grinker Myelinopathy and after reading through Wikipedia's criteria for a "good article" here are a few suggestions to consider when revising:


 * Add in a picture to go along with the article, whether it be Roy Grinker or there are several images on Google I found that display brain-images of patients with this disease.


 * I liked how you explained most of the science definitions that non-science individuals may not recognize. For example, when you describe hypoxic episode in the Onset section. However, it be great to also provide insight into the effects of some symptons such as extensive hemispheric demyelination and the degeneration of the basal ganglia.


 * As mentioned in previous primary review, Cerebral blood vessel damage section has no information contained in it.


 * You could add the history section to the introduction

I verified Source #4 entitled, "Delayed Neurological Deterioration After Anoxia" authored by Fred Plum, etc. This article was used when discussing Cerebral Edema. I found that the article came from a credible site (JAMA Internal Medicine). I thought it did a great job of summarizing the information found within the article, especially on page 6 of 8, in the PDF form of the article. If you would like to expand on this section you may add in how this edema has the unique property of being, at least initially, a wholly intracellular process (pg. 6 of the article). Additionally, the fact that edema after injury is at its maximum by the 2nd-4th day I found to be an interesting fact while reading the article.

I like how the article is to the point and maintains neutral viewpoints as it has no bias that is prevalent within the article. I would just make some minor adjustments to the article with the help of suggestions from reviewers as well as add an image to enhance the article. Cdrellishak (talk) 01:46, 9 April 2013 (UTC)

Author's response
Thank you for your great review! We took into account a great deal of your suggestions. We added two pictures in reference to the neuroimaging used to diagnose the disease. Unfortunately, we could not include pictures form Google images as they were mostly copyrighted and would have to be submitted to Wikipedia. The cerebral blood vessel damage section was removed, as was the history section. There was not enough information in the literature for a proper description of either section. In reference to describing the intracellular component of edema, we decided against this. It is a great idea but we thought it would deviate too much from the main topic of the Wikipedia article. As a compromise, we linked this topic to its own Wikipedia page in the hopes that readers who wish to find more information on the topic will look up the topic through the link. Thank you for the compliments and the review, let us know if you are uncomfortable with any of the changes we made.

Alphabetfood (talk) 00:20, 27 April 2013 (UTC)

Faculty Review
Nicely written. I did go through and make some minor edits. Mostly they were incorrect capitalization of words. I think how you listed the alternative names is useful.

I think the causes section may be the most confusing. If I understood what you wrote, it mainly occurs after a period of hypoxia due to a variety of insults (carbon monoxide, drug overdose or a vascular incident). In addition to the lack of oxygen these insults may also result in cerebral edema. I edited the pathophysiology section to reflect this. Then the second paragraph on carbon monoxide toxicity may be better rewritten about hypoxia in general including how carbon monoxide deprives the brain of oxygen. The entire paragraph needs re-writing; it is not understandable the way it is. This was mentioned in one of your primary reviews but you did not address it in your response to the review or make any changes to these sentences. That same reviewer told you of a small typo (extra period) that you also did not fix. Remember, the reviews were done to enhance the article so you should be careful to look them over thoroughly.

This sentence in the treatment section makes no sense to me "If remediation is impossible or fails, the addition and application of redeeming strategies is reasonable and adjustment of type and/or scheudle of post-DPHL roles may be needed." I have removed it. If you want to add it back you need to make it more coherent. I also removed "Electroconvulsive therapy can sometimes be considered for refractory depression following a suicidal attempt with carbon monoxide poisoning or drug overdoses." because this is not treatment for Grinker's myelinopathy but rather the underlying depression that may have led to a suicide attempt, correct?

In the prognosis section you are confusing severity with recovery time. They are likely related but not necessarily the same. I edited this portion to make it more clear. Check to see if it still reads correctly according to the references you used.MMBiology (talk) 21:38, 7 May 2013 (UTC)