Talk:Mesoamerican nephropathy

Selected Citation Herbicide - Logical Problem
Error in logical conclusion and refering to political opposition and questions about its scientific evidence for the Herbicide Glyphosate as cause for deadly epidemic of kidney disease,. The citation as evidence in the context of Chronic Kidney Disease for Sri Lanka’s government caused an "on hold" for the decision to ban the top-selling Monsanto herbicide glyphosate. Scientific evidence for Glyphosat was published in context of cancer in March 2015 by the International Agency for Research on Cancer (IARC), an intergovernmental agency forming part of the World Health Organization of the United Nations, published a summary of their forthcoming monograph on glyphosate, and classified glyphosate as "probably carcinogenic in humans" (category 2A) based on epidemiological studies, animal studies, and in vitro studies. It noted that there was "limited evidence" of carcinogenicity in humans for non-Hodgkin lymphoma. The IARC classifies substances for their carcinogenic potential, and "a few positive findings can be enough to declare a hazard, even if there are negative studies, as well." Unlike the BfR, it does not conduct a risk assessment, weighing benefits against risk. .

Logical Error: Glyphosate does not cause Chronic Kidney disease, so there is not a problem with the application of Glyphosate. The decision to ban Glyphosate or to allow the application in Sri Lanka is in the governmental domain of regulation of agrochemicals and comparing risks and benefits. The logical error is located before in the actual decision making to ban in the scientific logical reasoning from Glyphosate to the risk factors for diseases (including Cancer).

--Bert Niehaus (talk) 08:29, 27 September 2018 (UTC)

Citation Needed
In the article the statement "...or agents have also been brought to the chart of possibilities as a culprit for this unusual form of kidney damage." in the "summary of current scientific evidence" needs a as marked "citation needed". Removed that sentence mentioning "other possibilities" and recommend to add evidence from peer-reviewed journals and mention scientific contributions to the article rather than make a statement about "other possibilities". "citation needed" for this part of the sentence is from June 2014, so the uncited "other possibilities" part of the sentence will be removed. --Bert Niehaus (talk) 07:09, 27 September 2018 (UTC)

Multifactorial Disease and Precautionary Principle
The disease CKDu or CKDnt (non-traditional causes) are regarded as multifactorial prevalent. The high number of cases of CKDu mesoamerica is mentioned. Reading the article seems to have an underlying conclusion "no evidence - no action needed beyond scientific clarification of causes".

Citation Wikipedia Article: "To date, CKDu (MeN) causes remain undetermined and debatable; nothing can be ruled out".

At least mentioning the "precautionary principle" may be helpful for a neutral point of view especially for medical decision making. Medical decision making is performed very often under "uncertainty" especially when causes cannot be clarified fully under time constraints or due to access to lab facilities in an emergency case. With a multifactorial set of risk factors currently a main factor cannot be addressed. The precautionary principle addresses multiple risk factors and tries to implement risk mitigation strategies even if the causes remain unclear (i.e. workflow optimization, minimize exposure to agrochemical, reduce self-medication, mitigate dehydration during exhausting work, ...). --Bert Niehaus (talk) 09:14, 2 October 2017 (UTC)

Comment: Logical Problem in Arguments
Multifactorial problem. Assume that a disease is definitely caused by A,B,C. The disease will develop if at least 2 risk factors are present in a certain region.
 * A,B prevalence of disease in region 1
 * B,C prevalence of disease in region 2
 * C,A prevalence of disease in region 3

All regions 1,2,3 do not have a single risk factor A,B or C in common (intersection). So logically we cannot conclude, because A is as risk factor not present in region 2, A is not a relevant risk factor. But arguments in article seem to follow that line. Corrected this logical error in section about multifactorial problem.

The same logical error seems to be present in section "Cultural pattern" or the underlying line of arguments should be clarified!

--Bert Niehaus (talk) 12:59, 2 October 2017 (UTC)

Comment: The problem with a "global approach (CKDu/CKDnt)" without certainty
1.- This Wikipedia page is devoted to Mesoamerican nephropathy (MeN) only. 2.- To date, MeN has not been demonstrated to be the same disease as CINAC in Sri Lanka or other endemic nephropathies around the globe. Although the idea of a global nephropathy is attractive, we are far from concluiding they are all the same entity. 3.- Mixing/extrapolating studies, reports, findings from CINAC to MeN should be done with caution. 4.- Sri Lank endemic Nephropathy (CINAC) should be further discussed in a different wikipedia page, unless new evidence arises showing both to be the same entity.

--gtrab (gtrab) 12:59, 2 October 2017 (UTC)

(+) Support for comment gtrab of not mixing Sri Lanka and other endemic nephropathies with MeN.

A root page nephropathy can branch to the child pages
 * Mesoamerican Nephropathy,
 * Sri Lank endemic Nephropathy (CINAC),

The disease can be different from the medical perspective, but the progression of the disease could share the same common risk factors. To what extend the precautionary principle will be applied in a standard medical workflow and a huge number of cases, should be added. The root page can define the "generic approach to the unknown" listing risk factors e.g. dehydration, self-medication, work flow management, exposure to chemicals, Risk Literacy,... that are known to be nephrotoxic or have an negative impact on the kidney function.

The logical error in scientific arguments of multifactorial problems is an problem not only present in the current article so a I would create learning resource on Wikiversity on that topic and refer to permanent link of this article to learn about logical errors in scientific arguments.

Thank you for comment gtrab

--Bert Niehaus (talk) 09:51, 3 October 2017 (UTC)

External links modified (January 2018)
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