Talk:Ethylene glycol poisoning/GA1

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GA Review

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Protonk comments

Images

Sources

  • Sourcing format seems well done. I would recommend that if you have article links for articles with a doi or pubmed listing noted, they should be removed unless those links are to freely available versions. For example, "Utility of the Serum Osmol Gap in the Diagnosis of Methanol or Ethylene Glycol Ingestion" (fn 18) is not freely available so for most editors linking to it won't help--the pubmed listing provides an unambiguous and (presumably) permanent link to the article.
    • Removed instances of subscription only links

MOS

  • The lead should be expanded slightly. It currently covers all elements of the article but its coverage of some segments (specifically: Pathophysiology, Diagnosis and Treatment) should be expanded. I realize this article is short and that the lead as currently written flows well. I think the best way to solve this is to try to build one more paragraph into the lead that includes diagnosis and treatment and to include a more full description of Pathophysiology in the first paragraph of the lead (I don't think it is too much to at least note glycolic acid).
  • For measures of density in medical articles (e.g. mL/kg) is it common to use the conversion templates to give an english value in parenthesis? Just asking.
    • Spelt it out the first time it is used, hope this is what you meant
      • It was merely a question (though spelling it out helps): is wikipedia fully in the 21st century or is it still practice in MED articles to include Imperial units in parenthesis when we give SI measures? Protonk (talk) 05:17, 12 October 2008 (UTC)[reply]
  • The Only external link is already linked in a template. It might be worth it just to remove the section.
    • Removed section

Small issues

  • I don't think the second sentence in the lead should be cited. That material should be repeated in the body and citations in the lead should be limited to contentious statements and the rare case that quotes belong in the lead.
    • Removed, wasn't required, uncontentious
  • "Once thought innocuous,[2]..." This is intriguing to me. When was it thought innocuous? 100 years ago? 50 years ago? Was it treated like mercury and used in a manner we would view as horrifying today? Or was it simply not considered poisonous?
    • expanded it proposed use in the 30s
  • In the Toxicity section, the sentences should be rearranged to place the toxic dose information (both the numerical value and the poison control approximation) prior to the lethal dose information.
    • Rearranged
  • I would also consider merging the epidemiology section into the toxicity section. The elements in the epidemiology section referring to method of intake and connection to deaths would work well with the discussion of morbidity and the expected lethal dose. I understand that toxicity and epidemiology are logically distinct, but this is a suggestion.
  • "Because of its low vapor pressure and as it poorly absorbed through skin, ethylene glycol poisoning is uncommon following inhalational or dermal exposure." Consider breaking this into two sentences. Why, for the benefit of the reader who may read this in print or may not click away, does a low vapor pressure lead to it being unlikely that the compound will be inhaled?
  • Should the lead and the signs and symptoms section wikilink to Acute renal failure rather than Kidney Failure?
    • Linked to acute
  • In Pathophysiology: how long do each of the stages in the metabolic pathway take?
    • Added timeframes
  • Also in pahtophysiology: I would recommend rewriting this section (though mainly by rearranging sentences). I think the flow of this section should revolve around the symptoms the patient presents and the stages the chemicals move through. So as I see it the first sentence of the second paragraph belongs more properly with the first paragraph, where we discuss ethylene glycol itself. I'm not clear from this seciton which effects are contemporaneous and which can be largely considered to come before or after other events. If it the case where no clear timing for the pathways exists, then this rewrite might not work.
    • Rearranged
  • "an increase in the blood concentration of lactic acid occurs contributing to acidosis" Should we link to Lactic acidosis?
    • Linked
  • The article uses "renal failure" and "kidney failure" variously throughout. Is there a rule as to when one is to be used in certain cases?
    • Used kidney throughout
  • "Although the usefulness of gastric lavage has been questioned in poisoning situations." I would re-write this sentence so that it can stand alone.
    • Rewrote, unsure if it's much better
  • "As activated charcoal does not adsorb glycols, it is not indicated..." What does "it is not indicated" mean?
    • It is not recommend/doesn't work, rewrote
  • "...airway management with endotracheal intubation..." should this be piped to just read "intubation"?
    • Yes
  • ". Although its adverse effects include intoxication" is the "Although...<sentence about side effects>" a common turn of phrase in WP:MED articles?
    • Removed
  • "also require frequent blood ethanol level measurements and dosage adjustments to maintain a therapeutic ethanol concentration" Should we wikilink to Therapeutic index?
    • Yes
  • "Costing 1,000 United States dollars per gram" probably not necessary to spell that out. I think there is a currency conversion template somewhere.
    • Shortened it, will look for template
  • "Patients who present early to medical facilities and have prompt medical treatment typically..." have –> receive?
    • Changed to will have, hope that makes it clearer
  • Cerebral infarcts redirects to Stroke. It might be helpful to wikilink to the particular type of stroke caused by the poisoning or to just say "stroke" in the article.
    • Changed to stroke
  • The Epidemiology section doesn't seem to present a worldwide view on the subject. Are there studies in english as to the prevalence of ethylene glycol poisoning outside the US? Do chemical makers in Europe need to add Bitrex? In Australia?
    • Unfortunately there’s not a lot of information as most poison centers don't report like the Americans do, New Zealand has an annual report but no specific data on which chemicals are ingested,[1] The UK service also does not report specifics,[2] 2 Australian centers have a little information, will add them in.[3][4], will look into bitrex regulation worldwide
  • "In the United States, 3 states..." 3 should be spelled out.
    • Done

Overall

This is an informative, accurate and largely complete portrait of the subject. I worry that it is written with a med student in mind, rather than the general reader. Many of the terms used within the prose were written in the context of medical diagnosis and treatment. Words like "adversant", "perioral area"(which redirects to mouth, BTW) and "co-ingestant" wall the text off from the general reader. I don't think this is wholly inappropriate and I don't think that the article should be scrubbed of these terms where appropriate, but I feel that for a general encyclopedia, the authors should take care to determine when the precision of a word such as "diaphoresis" could be sacrificed for the less imposing "sweat". That concern, however, should not prevent this article from reaching GA status. I am placing this article on hold. Once a preponderance of the issues above have been fixed (please strike them out or respond below them individually), I will pass this article. Thank you. Protonk (talk) 04:53, 11 October 2008 (UTC)[reply]

  • I've passed the article. Thanks for the quick work. Congratulations. Protonk (talk) 05:57, 12 October 2008 (UTC)[reply]
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