User talk:Dr. Imbeau

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 * Wizardx 09:44, 26 March 2006 (UTC)

Dental amalgam controversy
Hi Dr. Imbeau. I noticed your edits to Dental amalgam controversy and wanted to point to two relevant Wikipedia policies: neutral point of view and the three revert rule. I hope you see how a selective presentation of facts designed to argue one point of view in an intro section of an article might not be in the spirit of neutral point of view. Also, please stop re-adding the info to the amalgam article for now, as you are in violation of the three revert rule. If you like, please discuss the changes on the article's talk page. If you continue to revert the article and re-add the changes in violation of the rule, I will report the incident to an administrator. - Jersyko &middot;talk 02:42, 28 March 2006 (UTC)
 * I'm not the ultimate judge of what is and is not POV. However, the following sentence from Wikipedia's NPOV policy is highly relevant in this situation, and I hope you consider it when editing: "Debates are described, represented, and characterized, but not engaged in."  I have reported your fifth reversion of the dental amalgam controversy article as a violation of the three revert rule. -  Jersyko &middot;talk 02:59, 28 March 2006 (UTC)
 * Hi. You have made five reverts in the past 24 hours to the article Dental amalgam controversy.  This places you in violation of the three revert rule.  I ask you to please stop reverting to your version and attempt to work out the issue on the article's talk page.  If you continue to revert the article rather than discussing the issue, you may be blocked from editing wikipedia.  Thanks.  -- Vary | Talk 04:22, 28 March 2006 (UTC)

The Swedish ban was already mentioned in the article text. I moved the link from the intro to the text, but removed the mention of it in the intro. If we're going to have a conversation about this, I imagine that Vary would appreciate it if it continued on the article's talk page instead of on her talk page. - Jersyko &middot;talk 23:38, 28 March 2006 (UTC) Please post any further messages about the amalgam controversy on the article's talk page instead of my or Vary's talk page. Thanks. - Jersyko &middot;talk 01:28, 30 March 2006 (UTC)
 * You make a good point about the article's limited geographic scope in the intro. Thanks for explaining it, it failed to cross my mind.  I'll correct it. -  Jersyko &middot;talk 23:48, 28 March 2006 (UTC)
 * Another good point. Please post other messages about the article on its talk page.  We can continue any discussion regarding the article there. -  Jersyko &middot;talk 00:09, 29 March 2006 (UTC)

Anonymous editing
The John Siegenthaler controversy actually was a big deal around here a few months ago. It was certainly a shame that the information about Mr. Siegenthaler was on Wikipedia for so long. However, instead of merely editing the information, the person who discovered the article, in his quest to discredit Wikipedia, publicized the information. The same applies to Mr. Siegenthaler himself--he could have but chose not to edit out the false information himself. Once it was brought to the attention of the larger community, the information was gone within moments. This is true for most vandalism and outright falsity on Wikipedia, and our technology for fighting vandalism is actually improving daily. To answer your question about anonymous editing, while it would certainly substantially reduce vandalism, disallowing anonymous editing would elminate a lot of excellent contributions that anonymous editors would otherwise make. For every incident of vandalism by an anon, there are several positive contributions by other anons. A required registration process would likely discourage a lot of these people from contributing. I would oppose a move to require registration for this reason, as would, I imagine, a large majority of Wikipedians (this debate has occurred before in the community, though I don't have the link right now). Yes, that means that there is more work for those of us who would like to rid Wikipedia of vandalism, but as I said, the technology (especially vandalism bots) is getting better daily and the number of positively-contributing Wikipedians is also growing. Regarding my own identity, while I don't reveal my name on my userpage per se, the description of myself on my page is accurate and I reveal more than enough information so that anyone with a phone or internet access can discover my identity with relative ease. When my article is published in the University of Memphis Law Review in a few days, this will become even easier. In any event, may I ask why you asked this question on my talk page? Thanks. - Jersyko &middot;talk 04:10, 19 April 2006 (UTC)


 * Dear Jersyko: I posted it on your talk page because it is a separate topic and I did not know of any article with a discussion on this going on of which you were part. It is also link to the same issue that was raised before but deemed irrelevant to the topic at hand at the time. Regarding anons, as you call them, I see your point. I guess there are advantages and disadvantages to anonymity. However in the world in general anonymity is not, in my view, a big advantage. If someone feels the need to make an anonymous contribution, one would have to ask why. If there is no fear or constraint on freedom of speech than there is no reason for anonymity. Of course that is IF as sadly the reality is somewhat different.... Maybe Mr. Siegenthaler had ulterior motives but some of the points he raised were valid and confirmed by Mr. Wales. Wikipedia is obviously still evolving.

As for your own identity I am not trying to find it at all and have no need to.--Dr. Imbeau 05:25, 20 April 2006 (UTC)

Proposal to merge Stephen Barrett, Quackwatch, and NCAHF article
I have started three separate proposals to merge these three articles. The discussion for each amalgamation of the merge begins here. I would appreciate you taking the time to give your thoughts for each proposal. Thanks. Levine2112 06:49, 28 September 2006 (UTC)

Osteoporosis
Hi, the discussion you added re biphosphonates and jaw necrosis was interesting to read, but I thought it misplaced in the osteoporosis article:
 * it is about a side-effect to specific class of agents (vs treatment for osteoporosis as a whole), whole sale moving it Biphosphonates seemed the most appropriate action. I wondered whether to make a short mention/redirect for this or create a new brief "Side effects of treatment" section...
 * However the reference clearly indicates that this relatively rare problem is overwhelmingly (94%) due to intravenous use in some cancer patients, so just moving the information to biphosphonates seem the correct course of action.
 * Biphosphonates already mentioned this side effect and with same reference, so I briefly incorporated some of the points raised in your original addition to osteoporosis and copyedited (clearly no need duplicate mechanism of biphosphonate action under this one of their side-effects).David Ruben Talk 11:47, 30 September 2006 (UTC)

Thanks for reply, Yes of course some mention of BP & ONj needs be made and currently exists in wikipedia - the issue is were on wikipedia and how extensively. Given the effect is almost entirely for iv rather than oral administration, that suggests in the BP article not OP. Unless 6% of this rare condition is generally clearly accepted as being of major risk for oral BP treatment, then I suspect it is overall a trivial point as far as the OP article is concerned (ie statistically trivial, not of course trivial to an affected patient). NPOV requires mention of major and significant minor POV, but not trivial ones. I think mention in the OP article is therefore not indicated, especially as the far commoner gastrointestinal side-effects of oral BP use is not mentioned there at all.

Importantly ONj is already mentioned in the BP article using the same reference as you had used in the OP article (was that your insertion or another editor having found the same reference useful). I feel the extent of coverage of ONj is about right, in that it is proportionate to the risk of ONj as compared to the other side-effects mentioned (in fact mention of ONj has almost twice the length of GI side-effects, which are the far commoner risks and major reason for patients discontinuing drugs in this class).

If discussion of ONj needs be much more extensive (remember this is a general encylopdia), then I suspect it would not warrent being in either OP or BP article, but perhaps a new article of its own. Does ONj occur as a result of other drugs, are there a substantial number of research studies on this (or just the one already used), what is the management of the condition. I note that Woo et al suggested holding off bisphosphonates until necessary dental work first completed. However if a patient has a rapidly rising life-threateningly dangerous calcium level, then delay in giving BPs is not an option - what is done to then minimise the risk of ONj in such cases ? I worry though that discussing in an article answers to any of these points in great detail may be beyond the scope of a mere (although very good) encyclopedia.

So if the condition is notable enough for further expansion, then a new article is probably the way to proceed (title should be Osteonecrosis of the jaw, or Jaw osteonecrosis but this seems awkward). You clearly have the far greater knowledge on this, so I leave it to you - but if you need any help with proofreading, copyediting, citation markup etc please do let me know. :-) Yours David Ruben Talk 02:32, 1 October 2006 (UTC)

Osteonecrosis of the jaw
re Osteonecrosis of the jaw wow ! Showed up my lack of knowledge (above) on the topic :-) What's your professional background (merely curious - absolutely no obligation to add anything to your user page) ? I've had a brief go at some copyediting and a litte adjustment of the section headers. For a quick read, it is a nice article for myself as a doctor. It will need further wikilinks to terms, splitting up of long paragraphs and sub-section headers in due course, plus an adjustment in tone for a wider readership - sorry :-( - see Talk:Osteonecrosis of the jaw for further constructive suggestions :-) Again great creation of a really well cited article :-) David Ruben Talk 14:07, 3 October 2006 (UTC)

Images

 * The most important issue is one of the license - as for articles, any image must generally be under a GFDL (e.g. if self made). Most US governament material is free to use (but not all, and this includes much of material at NIH). So finding a suitable image is generally the hard part. As a final issue, there are no specific rules about using pictures of patients, but doctors are under their own professional codes of conduct (i.e. liable in their own territories if confidentiality is breached) - so as for any medical publication, if it is your picture of one of your patients, then you should have obtained the necessary (written) consent.
 * Images generally should not be too large (100-200 kb and 400kb max) else they may take a long time to load for those of us with dial-up. Large imaes should be displayed as thumbnails (see below)
 * Give the image a suitable name on your hard disc - I think spaces are allowed, but I always replace spaces with underscore '_'.
 * Goto Uploading images to read more, then proceed to http://en.wikipedia.org/wiki/Special:Upload
 * Click on the Browse button to locate the file on your hard disc
 * In the Summary box enter any details on source of image and a description of what it is - as a minimum remember to sign teh entry with 4 tildes ~ ~ ~ ~
 * Don't forget to then select suitavle option from drop-down Licensing - an inapproipriate license will mean the image is rapidly deleted within a few days.
 * Click on the upload button.

To insert an image into an article use. However you will need to use some optional parameters to resize the image and align it on the page (parameters separated by teh pipe character - "|" ). The "thumb" parameter shows a boxed thumbnail at various "px" pixel widths (generally around 200 is a good size), finally left (or right or center) the image. Finally free text parameter interpreted as a caption - see Images for more info.

Hence  

Gives:

Whilst   (without the thumbnail box)

Gives:

David Ruben Talk 03:14, 4 October 2006 (UTC)

Image tagging for Image:Bisphosphonate associated ONj after a dental extraction.jpg
Thanks for uploading Image:Bisphosphonate associated ONj after a dental extraction.jpg. The image has been identified as not specifying the source and creator of the image, which is required by Wikipedia's policy on images. If you don't indicate the source and creator of the image on the image's description page, it may be deleted some time in the next seven days. If you have uploaded other images, please verify that you have provided source information for them as well.

For more information on using images, see the following pages:
 * Image use policy
 * Image copyright tags

This is an automated notice by OrphanBot. For assistance on the image use policy, see Media copyright questions. 05:05, 5 October 2006 (UTC)


 * Sorry the warning template can't directly be used to provide the information by substituting the template name of "no copyright holder" for the journals URL address :-)
 * i.e. can't switch for  but I quite understand why you might have thought this is what was being sought.
 * Templates when actively being used (as apposed to jumping to the templates definition pages) have curly brackets. Hence Template:template's name is a link to the page setting up a template, but to actually insert & use a template within another page one uses " ".
 * What is needed is a section header of " ==License== " followed by one of the specific image copyright tags (see Category:Image copyright tags). The alternative is to reload the image ensuring one selects from one of the drop-down options from the Licensing box, which will do this for one automatically. If you wish to manually add a suitable template then:
 * (if the uploader releases the rights),
 * (if another user released his/her rights), or.
 * If the work is PD for another reason, check the copyright tag page or use . David Ruben Talk 08:04, 5 October 2006 (UTC)


 * Ah if issued under "Public issue" but without any clear copyright notice, then I suspect (c) remains with the journal (truely free material generally has an explictly stated GFDL or equivalent) - have you a full URL address to the page where the image is used (not to the actual image file, but to the article from within which you 1st saw the image) and I'll see, but I suspect the warning tags need be restored for the image to be routinely removed :-( David Ruben Talk 08:16, 5 October 2006 (UTC)


 * re "I have some from my own case that I am planning to upload. Can I upload them in a way that I can post them in the article without giving others the right to use them for any other purpose" - No. GFDL grants right for anyone else to make use of the image or even alter the image (provided only that they acknowledge also released under GFDL and preserving any original copyright notices). You retain the original copyright but under GSDL release the rights for others to make free use of the material, but you can't then regain control who then makes use of the image or how they use it (they could publish the photo in their own book, provided it also under GFDL - so unlikely anyone would wish to do so). You could of course release a relatively low-resolution version of your own photos making them only suitable for monitor screen viewing (or small sized print out) and so prevent anyone from being able to add it to their collection of images used in their own projected presentation slides (but don't add any direct (c) notice onto the image itself, e.g. as a watermark, as that is seen as restricting GFDL usage). David Ruben Talk 09:07, 5 October 2006 (UTC)


 * The full link to letter was http://www.mja.com.au/public/issues/183_10_211105/letters_211105_fm-3.html and there is a clear copyright notice at the very bottom of that page - sorry. David Ruben Talk 09:07, 5 October 2006 (UTC)

Thanks David. I have removed the image so that should take care of it. I obviously missed the notice at the bottom. I will get there :-)Dr. Imbeau 10:11, 5 October 2006 (UTC)

Hypoxia vs hypoxia (Medical)
Dear User:Srice13, thanks for fixing the link to the better article on hypoxia on the osteoporosis of the jaw article. Would redirecting to Hypoxia(Medical) be an easier solution ? That way anyone linking to hypoxia would automatically be redirected to hypoxia (medical)... :-) Dr. Imbeau 02:45, 11 October 2006 (UTC)
 * Dr. Imbeau: Thank you for your interest in disambiguation and your authorship to a great article!!! Most of the articles (65+) that I encountered working the on the Hypoxia page did point to Hypoxia (medical), so perhaps that should have been left as the primary page. (Note: I didn't create it, I only encoutered it working on dab There were a number of articles that referred to Hypoxia (environmental), so the dab page is not without some value. It has been an interesting experience working on the dab project, as I have had a great quantity of exposure to the number of ways that we (English speakers) re-use terms on a regular basis. I double-checked the page to which you referred, and it points to the proper destination, so we are safe in this case. An interesting consequance of the wiki project is the proof of the old saying that one should never assume (ass-u-me). ;-) I am hopeful that this tool (wikipedia) will evolve the capability to assist expert authors in the selection of the most appropriate page. Until then, we will all be victims of multiple uses of the same word for drastically different concepts, and the ability of a single individual to be bold and demand a broader definition of a term that seems unambiguous.Srice13 04:47, 11 October 2006 (UTC)


 * Srice13 thank you for your kind comments on the article osteonecrosis of the jaw. Authors like to name things so the same thing can be named different words or different things, the same word which causes confusion. The same is true for osteonecrosis of the jaw where various forms are given various names and ONj being currently mostly associated with the adverse effects of bisphosphonates when in fact ONj has been around long before bisphosphonates. Again thanks and keep up the good work !Dr. Imbeau 08:23, 11 October 2006 (UTC)

ONj & BP mention in latest BMJ & BNF
Thought it would interest you to know about 2 recent publications that may (should) increase UK awareness. See Talk:Osteonecrosis of the jaw. Yours David Ruben Talk 00:06, 15 November 2006 (UTC)

Survey request
Hi,

I need your help. I am working on a research project at Boston College, studying creation of medical information on Wikipedia. You are being contacted, because you have been identified as an important contributor to one or more articles.

Would you will be willing to answer a few questions about your experience? We've done considerable background research, but we would also like to gather the insight of the actual editors. Details about the project can be found at the user page of the project leader, geraldckane. Survey questions can be found at geraldckane/medsurvey. Your privacy and confidentiality will be strictly protected!

The questions should only take a few minutes. I hope you will be willing to complete the survey, as we do value your insight. Please do not hesitate to contact me or Professor Kane if you have any questions.

Thank You, BCeagle0312 (talk) 14:01, 19 July 2008 (UTC)

proposing new section for ONJ article
I am new to using Wikipedia, so excuse me if I have not figured out the correct way to address adding content to an article. One thing I have observed is that the worst way is to just insert the new content on the page. I agree with those comments about the quality of the ONJ page and feel that our content works with, and extends, the information of the article. I am posting the content below. I look forward to hearing back from you. Thank you again. Medradar (talk) 15:36, 25 August 2008 (UTC)

I am working with a group called the Research on Adverse Drug events And Reports group (RADAR) headed by Dr. Charles Bennett, MD PHD with Northwestern University. Edwards, Beatrice J, M.D, one of the members of our team has been studying the rise of cases of ONJ and has a paper coming out for publication in the near future. Rather than just posting content to the excellent Wiki article on ONJ, and studying how Wiki works and protocol for changes, it seemed that the best way to see about adding this content to the ONJ article would be to present to the people who largely created the content. You can see more about us at our website with the Cancer Center at Northwestern at RADAR. You can contact Dr. Edwards at [mailto:bje168@northwestern.edu Dr. Beatrice Edwards] or reply back to me as I am handling the web and wiki development for RADAR. Below is the content as provided by Dr. Edwards. You can also email me at [mailto:paul@medradar.org Paul] Medradar (talk) 22:16, 24 August 2008 (UTC)

Timeline of introduction of bisphosphonate zoledronate and increase in reports of Osteonecrosic of the Jaw
The first three cases of bisphosphonate-associated osteonecrosis of the jaw were spontaneously reported to the FDA by an oral surgeon in 2002, with the toxicity being described as a potentially late toxicity of chemotherapy. (12) In 2003 and 2004, three oral surgeons independently reported to the FDA information on 104 cancer patients with bisphosphonate-associated osteonecrosis of the jaw seen in their referral practices in California, Florida, and New York.(13,14, 25) These case series were published as peer-reviewed articles- two in the Journal of Oral and Maxillofacial Surgery and one in the Journal of Clinical Oncology. Subsequently, numerous instances of persons with this ADR were reported to the manufacturers and to the FDA. By December 2006, 3607 cases of persons with this ADR had been reported to the FDA and 2227 cases had been reported to the manufacturer of intravenous bisphosphonates.



The International Myeloma Foundation's web-based survey included 1203 respondents, 904 patients with myeloma and 299 with breast cancer and an estimate that after 36 months, osteonecrosis of the jaw had been diagnosed in 10% of 211 patients on zoledronate and 4% of 413 on pamidronate.(26) A population based study in Germany identified more than 300 cases of osteonecrosis of the jaw, 97% occurring in cancer patients (on high-dose intravenous bisphosphonates), and 3 cases in 780,000 patients with osteoporosis for an incidence of 0.00038%. Time to event ranged from 23-39 months and 42-46 months with high dose intravenous and oral bisphosphonates. (35) A prospective, population based study by Mavrokokki et al. estimated an incidence of osteonecrosis of the jaw of 1.15% for intravenous bisphosphonates and 0.04% for oral bisphosphonates. Most cases (73%) were precipitated by dental extractions. In contrast, safety studies sponsored by the manufacturer reported bisphosphonate associated osteonecrosis of the jaw rates that were much lower. Although the majority of cases of ONJ have occurred in cancer patients receiving high dose intravenous bisphosphonates, almost 800 cases have been reported in oral bisphosphonate users for osteoporosis or Pagets disease. In terms of severity most cases of ONJ in oral bisphosphonate users are stage 1-2 and tend to progress to resolution with conservative measures such as oral chlorhexidine rinses.



LAY DEFINITION Osteonecrosis of the jaw is a condition that results in death of segment os the jaw bone. More commonly it has been reported in cancer patients with extensive malignant disease who require high dose intravenous bisphosphonates to halt skeletal metastatsis (93% of cases). It has been most commonly reported in patiuets with multiple myeloma, breast and prostate cancer, although it has also been reported in other types of cancer. The incidence increases with the duration of bisphosphonate therapy and may be as high as 10-15% after 3 years of therapy. Lesions may be extensive and may require oral antibiotic care, in general aggressive surgical intervention is avoided. In rare cases have jaw bone grafts been necessary. Occasionally ONJ will be a chronic indolent condition leading to hospitalization and disability. ONJ has also been described in oral bisphosphonate users (for osteoporosis or Paget’s disease) although at much lower rates (< 1:10,000). ONJ lesions in these patients also appear to be smaller and respond well to local care progressing to complete healing. Predisposing factors: cancer, use of chemotherapy or glucocorticoids, radiation therapy to the head and neck region, diabetes mellitus, smoking, periodontal disease Precipitating factors: dental trauma or dental extraction Medradar (talk) 22:16, 24 August 2008 (UTC)


 * Medradar, the lay description is problematic in that the lead-in ought to be of this sort of simpler introduction to the topic. I've moved it for now out to Talk:Osteonecrosis of the jaw, for others to see how to make use of this.
 * Secondly the main history w.r.t. bisphosphonates is a sub-part of the overall history of ONj which extends back long before bisphosphonates ever invented. The actual details, whilst can be a sub-section of the main history, probably needs current details untangling to prevent duplication.
 * The references manually provided above (eg "(35)") need specifying - are these numbers those of references in the existing wikipedia article, or from the paper you seek to publish (in which case need to be specified). Finally if the latter, then how much of a copy&paste job is this from the original paper, i.e. is there any possibility this is a copywrite violation ? David Ruben Talk 19:27, 5 January 2009 (UTC)


 * PS Dr. Imbeau, I spent today dealling with the "worried well" over article in one of UKs major daily papers from the 2nd January stating a newly discovered link between bisphosphonates and ONj !  Also gave wildly unbalanced coverage space to whether they do, or do not cause cancers. The Daily Wail (sorry should be Daily Mail) is long looked down upon by doctors for scaremongering health stories. Anyway, I was confidently able to tell patients that I was well aware of the link, that not "new" and advice of getting prior dental check-up or work done been part of my practice for sometime. Looking back on the article though, I was somewhat surprised that been as long ago as 2 years - how time flies :-) David Ruben Talk 19:27, 5 January 2009 (UTC)

ArbCom elections are now open!
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