Talk:Chylothorax

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Someone who is better versed might want to consider this paper that leads with "Post-operative chylothorax can be cured by a medium-chain triglyceride (MCT)-rich diet" but to allow for more fat soluble vitamins.--Stageivsupporter (talk) 20:14, 29 December 2014 (UTC) [1] Legendary source that can get this to GA[reply]

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Removed mention of Gorham syndrome

Removed, as Gorham's disease is an extremely rare condition, and within those with it, only subset have chylothorax. David notMD (talk) 11:40, 12 March 2019 (UTC)[reply]

GA Review

This review is transcluded from Talk:Chylothorax/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: Bryanrutherford0 (talk · contribs) 03:11, 28 September 2019 (UTC)[reply]

GA review (see here for what the criteria are, and here for what they are not)
  1. It is reasonably well written.
    a (prose, spelling, and grammar): b (MoS for lead, layout, word choice, fiction, and lists):
    After some copyediting, the article is generally at an acceptable prose standard and complies with the required section of MoS, excepting layout: the "See also" section contains only one link, which is also the very first wikilink in the text of the article, but MOS:NOTSEEALSO says that "As a general rule, the 'See also' section should not repeat links that appear in the article's body." The entire "See also" section should be removed, unless there's some other related topic that needs to be added.
    Some notes: In the lead section, the third-to-last sentence ("It results from..." ) seems to be largely a duplicate of the second ("It results from..."); the third-to-last should be eliminated, and any content not already present in the earlier sentence can be edited into that sentence. In the section "Causes", the sentence "Two thirds of chylothoraces are seen on the right side of the chest" doesn't seem to me to say anything about the causes of chylothorax; I would move it to the section on "Symptoms and signs", or perhaps the section on "Mechanism". The sentence at the end of that paragraph about classification according to output also doesn't seem to relate to "Causes", but since there's no "Classification" section, maybe this is the best available place for this information?
    Is there a reason why none of the cancers listed in the beginning of "Non-traumatic causes" is wikilinked? If it wasn't a conscious decision, then they should probably all link to the relevant articles; the same goes for the list of infectious causes further down the paragraph. In the second sentence of "Diagnosis", I don't understand the use of the word "obligates", but that may a piece of radiology jargon I'm not familiar with? In "Treatment", pleuroperitoneal shunting sounds an awful lot like a surgical treatment to me, but it's currently listed as a conservative non-surgical treatment? Also, wouldn't it make better sense to list conservative treatments before surgical interventions, since the sources say that's the sequence in which they should be attempted?
    I'm not grasping the logic used to decide when "percent" is used and when '%' is used; if there isn't some good reason to use one at times and the other at others, then it should be made consistent throughout. I don't think lymphedema belongs in the "Complications" section of the infobox, considering that it's a complication not of chylothorax but of one of its possible treatments (thoracic duct ligation); instead, there should probably be the same complications as those listed in the "Complications" section of the body.
     Done TylerDurden8823 (talk) 18:48, 5 October 2019 (UTC)[reply]
    The prose is now much, much better; great work! A last note: in the final paragraph of "Diagnosis", there's got to be a way to combine the two sentences about long-chain fatty acid levels in the thoracentesis fluid into one simpler and more professional sentence. -Bryan Rutherford (talk) 22:01, 7 October 2019 (UTC)[reply]
    I think this last issue is now resolved but let me know if you think it still needs more work. If so, I'll try again. TylerDurden8823 (talk) 07:19, 11 October 2019 (UTC)[reply]
  2. It is factually accurate and verifiable.
    a (reference section): b (citations to reliable sources): c (OR): d (copyvio and plagiarism):
    The article has a reference section and citations to reliable published sources. I don't see any sign of plagiarism from online sources; the matches from Earwig's tools are stock technical phrases, and I think all the paraphrasing is original enough.
    The article has a "Citation needed" template already in it, and I've added a second, along with a "Clarify" for the phrase "In early times", which needs to be clarified and backed with a citation. In "Causes", the source from SAGES doesn't support the article's definition of "high-output" chylothorax; more fundamentally, that source appears to be an article on a non-peer-reviewed wiki run by SAGES and doesn't look like a reliable source by Wikipedia's standards to me. In "Mechanism", clarify the reason most chylothoraces present on the right side. In the same section, clarify that up to 3 L of chyle may drain into the pleural space daily (not just cumulatively).
     Done TylerDurden8823 (talk) 19:50, 5 October 2019 (UTC)[reply]
  3. It is broad in its coverage.
    a (major aspects): b (focused):
    The article achieves broad coverage of the topic, with a brief discussion of classification and sections discussing symptoms, causes, mechanism, diagnosis, treatment, prognosis and epidemiology. It struggles, however, to maintain focus on the topic without straying into excessive or tangential detail; one example is the inclusion in the section "Non-traumatic causes" of the fact that "Recently, there are fewer cases of chylothorax caused by lymphoma," which is much too narrow a detail for this article and should be removed. The "Diagnosis" section doesn't need so much detail about the mechanics of a lymphangiography or a nuclear lymphoscintigraphy. In "Conservative treatment", the discussion of the radiation dosage needed to treat a malignant chylothorax is another unnecessary detail.
    A bigger problem is the parts of the article that are written in a voice of instruction, as if to advise a physician managing a case. The second paragraph of "Diagnosis" also includes too much advice for lab technicians and should be rewritten in an encyclopedic voice. Likewise, the second paragraph of "Treatment" also reads like a how-to manual, advising what "should be done"; this, too, needs to be rewritten in an encyclopedic voice.
     Done TylerDurden8823 (talk) 19:50, 5 October 2019 (UTC)[reply]
  4. It follows the neutral point of view policy.
    Fair representation without bias:
    The article treats the topic in a suitably neutral tone, not e.g. overblowing its significance.
  5. It is stable.
    No edit wars, etc.:
  6. It is illustrated by images and other media, where possible and appropriate.
    a (images are tagged and non-free content have fair use rationales): b (appropriate use with suitable captions):
    The images are relevant, helpful and informative, and they have appropriate licenses.
  7. Overall:
    Pass/Fail:
    The major and pervasive prose and tone issues and the presence of valid cleanup templates make this article close to a quick-fail, but I've tried to tidy up the prose and point out the largest issues that need to be addressed to bring this to the GA standard. I'm putting it on hold for the standard seven days, and it will need to see large changes in that time to not be failed. -Bryan Rutherford (talk) 22:21, 30 September 2019 (UTC)[reply]
     Done Bryanrutherford0 I have further adjusted the prose and addressed the above issues so this should help. I believe I have addressed all of the above points and I have also added a few secondary sources to further strengthen the article. If anything more is needed, please let me know and I will make additional adjustments. Thanks! TylerDurden8823 (talk) 19:50, 5 October 2019 (UTC)[reply]
    Tremendous progress, with a rescue from an editor who didn't nominate! Very impressive! Only a handful of much smaller issues remain, and then this article should now be able to meet the GA standard. -Bryan Rutherford (talk) 22:01, 7 October 2019 (UTC)[reply]
    @TylerDurden8823: I really appreciate you jumping in to try to save this nomination! Do you think you'll be able to respond to the remaining concerns soon? It's very close to passing! -Bryan Rutherford (talk) 17:01, 10 October 2019 (UTC)[reply]
    Yes, I believe I can. Please stand by... TylerDurden8823 (talk) 04:58, 11 October 2019 (UTC)[reply]
    The only remaining issues are with the "Complications" entry in the infobox, as noted in section 1 of the review above, the explanation of why chylothoraces are more likely on one side than the other, as noted in section 2, the "Citation needed" spot you've just marked, and the excessive detail about radiation therapy, as noted in section 3. Thanks for your work! -Bryan Rutherford (talk) 16:04, 11 October 2019 (UTC)[reply]
    I have addressed most of these. I am still searching for a high-quality reference to support why chylothoraces are more likely to occur on the right side. Stay tuned! TylerDurden8823 (talk) 05:39, 12 October 2019 (UTC)[reply]
    Reviewing the Nair, Petko & Hayward source, section 7 has a better explanation of this than the article currently contains: "The course of the thoracic duct explains why injury to the duct above the level of the fifth thoracic vertebra usually produces left-sided chylothorax and injury below that level, a right-sided chylothorax. Half of all chylothoraces are right-sided, one-third are left-sided, and the remainder are bilateral." That's already the source cited at the end of that paragraph here; let's replace the current claim in "Mechanism" with a paraphrased summary of the information in that source, and this will be ready to promote. -Bryan Rutherford (talk) 14:02, 12 October 2019 (UTC)[reply]
     Done. I have adjusted the mechanism section. Please let me know if anything else is needed. TylerDurden8823 (talk) 05:33, 14 October 2019 (UTC)[reply]
    And with that, the article meets the standard and is approved for GA! Thanks for your work, TylerDurden8823! -Bryan Rutherford (talk) 14:10, 14 October 2019 (UTC)[reply]