h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

Hmmm... Almost none of the issues I raised have been addressed yet, and some of them were pretty significant.

For readability, the long paragraphs in the middle and end of the article could be separated from each other with a blank line (or if they weren't supposed to be separated, you could divide them up and make them easier to understand).

Sorry I've been neglecting this, I should* get some time tomorrow/Wednesday to give it some time to correct some of these points

2legs
So this is what is meant by Lupus. Hmmm. I'd heard of the complaint, but never really known what it was about.
Certainly an informative and well-written Entry, though I have to agree that it is way too long to take it all in easily at a sitting.

Friar Big Dawg's suggestions make sense to me - as a medical layman I found some of the technical uses of words unfamiliar (eg exacerbation) and some jargon non-translatable (particularly in the Skin Manifestation section)

Could you also take the *duck ransom* bit out of the title too. Entertaining though your motivation may be for the Entry may be it isn't germane to the Entry, for I am A Bear Of Very Little Brain and it confused me.
Actually I probably wouldn't have read the Entry without the hook of 'what has this got to do with ducks?'

Pimms

Sorry I've given it a bit more thought... It is hard to incorperate all your suggestions; Some of which would require including more, whilst several indicate (rather sensibably), that hte overall length needs to be reduced.
I'm thinking of removing the bit on Discoid Lupus, and possibly putting it ina seperate article, leaving this one to concentrate more on SLE. By doing this hopefully I can reduce the length enough to allow some of the extra things to be put in, and I can then edit some of the text and hopefully get it a bit more understandible and more easily readible. I'll give it a bash now

The duck ransom bit isn't needed any more, Zak made a break for freedom earlier in the week

Hurray! So how is he? Not too distressed after his ordeal?

He's fine and well

I'd keep a closer eye on his movements at the next meet

*checks watch

Hmmm... I'm not sure what the "checks watch" is about. Just a few posts above, you're saying that you're going to work on fixing a few things. There's no posting letting us know here in the thread that things have been fixed.

Taking a look at the entry, it does look like some things have been changed around a bit, but I'm not sure exactly what's been done. It still looks like it needs a lot of work.

If you don't post and let people know what you've done, then they don't know when to come back and take another look, and they don't know what specifically to look at. Just posting "checks watch" makes it sound like you're just sitting around waiting for the entry to be picked.

If you'll post and let us know what you've done, then I'll take another look at the entry.

Also, please note that the way you've formatted your user name makes the entry much less readable than it could be.

OK, sorry, I should have done that... I'll check through and post what bits I've changed and sort my name out... My post above was more me bookmarking it, as it had slippe dwon my conversations a bit...

Right.
The main things done to it are;
Introducin the criteria for diagnosis fromt eh American College of rhumatism (I've not got access to recent matterial from University as I'm not at university, it would be handy if someone could see if this is the most recent set of criteria as I know they are reviewed periodically).
Footnotes, for technical jargon (let us know if any more should be put in; I plan to add a few more to the diagnosis classification section shortly).
Immunology section (reduced in size and complexity ).
Introduction, (altered somewhat).
ANA and other serrological tests (Included infomration after peoples comments regarding faulse positive and negative results).
Mention of DLE and DIL in article (mainly removed; may contemplate writting a seperate guide entry at some point on DLE/DIL juvenile SLE ETC, having them all in the one article would probably make it too big, unmanagible and offputting for those reading it who haven't so much knowledge of the subject area).

tag; used for some of the lists of conditions/symptoms etc on teh page (is there a different way of doing such lists that is more appropiate?; I vaguely remember hearing something about some different Guide ML for different ordered lists...)

I've also altered a bit of the text elsewhere in places, just as I was working through it...

So what should be done next? I know its still miles from being near perfect....

I will take another look at the entry, but not until you sort out the mess with your user name (please!) -- it really does make the page pretty unreadable, especially since I use a laptop.

One thing I noticed offhand, however, is that the entry does seem to repeat itself in some places right now.

Let me know when the user name no longer takes over the page, and I will be back.

I think the username should be more managible now I noticed the tendancy for some repetiveness in the article... Not sure that i t is all a bad thing, but perhaps I could tallor id down a little; might help shorten the article...

Personally, I think the repetitiveness should be attended to -- as a reader, it makes me wonder -- wait, didn't I already read this section? Did I lose my place or something? What happened? It would also help with the length.

Here are some other issues I noticed this time through:

Your info on the gender ratio is out of date -- there's actually quite a bit known about why it's more common in women. In fact, going through the entry, there are several sections where the info is about 10 years out of date, and out of date in a way in which that it seems I can tell either what source you were using, or what source your sources were using (i.e., all of the out of date bits seem as if they were researched from DuBois' textbook, but from the early 90s edition, or from the multitudes of other books that were written and used that textbook as their primary source). Regardless, that source has since been updated. If you're looking for something that does a good job of translating all of this into more userfriendly language, Daniel Wallace's book (his one for patients, not the DuBois textbook, which Wallce is the current author/editor on) does a superb job.

The epidemiology section is currently very choppy. I would either try to string it together more fluidly into a coherent paragraph, or make into even choppier bullet points. While an incidence rate of 40 per 100,000 would look good in an academic paper, it's not very user friendly for this kind of audience -- I would sooner go with the inverse of 1 in 2500, which I think most people can grasp easier.

There are lots of things under the header of lupus nephritis that have nothing to do with nephritis.

As I pointed out back in the beginning, the heavier treatments aren't just for nephritis -- they're for organ involvement and systemic disease in general -- they're given to people with SLE-related anemia, CNS involvement from SLE, liver disease from SLE, lung disease from SLE, etc. You've tagged on a sentence at the end of the section, but that doesn't really do it justice -- instead, the whole section should really be about treating more severe manifestations of SLE, which happens to include lupus nephritis.

"The most common clinical features include

photosensitive skin rash
fever
polyarthritis
Kidney disease
Liver disease
Central nervous system
The Heart "

Can I point out that CNS and the heart are not clinical features, but organ systems that everyone has? And since you go into clinical features down below twice more, it's rather repetitive to have it here, especially since there's not room to define what you mean by these terms.

The way in which the entry is currently organized is a little confusing in some parts -- here's what I would suggest:

Intro -- define SLE as an autoimmune disease, this would essentially include what you currently have under "immunological features". I would get rid of what you currently have in the intro about "clinical features", as it's both confusing and misleading, not to mention repetitive.

Next, I would go into Symptoms: I would start out with your paragraph from the intro, saying that not everyone has all symptoms, etc. Now, what you currently have on symptoms in the entry is very uneven -- you have a paragraph on skin symptoms, a paragraph on nephritis, but really nothing on anything else. I would actually have a little less on the skin and kidneys, and a little more on everything else. I might consider formatting it as a bulletted list, by organ systems -- skin, kidneys/urologic, GI/hepatic, cardiovascular, respiratory, hematologic, reproductive, CNS, etc. I would think a sentence or three would be sufficient for each.

At the end of this section, I'd tack on the bit about disease course and progression, although I think you could tighten up what you currently have into about 2 sentences.

From there I'd go into Diagnosis: A lot of the information in the beginning part of the diagnosis section could be pared down. I'd go straight to the ACR criteria, then have a bit explaining what the lab tests are (what's an ANA test, etc.), and a bit about differential diagnosis (wanting to rule out RA and thyroid conditions).

From there into treatment: I'd separate treatment into 1) symptomatic tx (i.e., NSAIDs), 2) milder disease (antimalarials), 3) organ-involving or systemic disease (immunosuppressants). I don't know that I would bother to list out the names of immunosuppressants used, as the entry would too quickly be out of date -- there are new drugs being used with SLE all the time, cellcept is a new one I know of.

It's probably also worth mentioning that there are also other chronic conditions that are also commonly comorbid with SLE, and that these need to be treated separately from SLE for patients to get well properly -- including fibromyalgia, depression, and reflux.

That's all for this go around.

Mikey

Oh, also -- the first sentence says the disease is "of unknown origin". Now, while we don't know *everything* about it's origin, we do know a decent amount, just as we've learned about autoimmune diseases in general. For example, we know there's a genetic predisposition involved, but that on top of the genetic predisposition there needs to be some kind of "trigger" later in life, generally of infectious or environmental origin.

Oh, and I would also add to the introduction a short sentence delineating SLE from discoid, drug-induced, and neonatal lupus. Wouldn't need to take much in the way of length or complexity -- just to mention that there are other forms, but that this entry is about the systemic type.

Any progress?

If you're feeling overwhelmed, I would be willing to lend a hand on this one.

I'm, I'm procrastinating a lot at the moment Well, I've been doing all this job application stuff I'll give it a go this weekend, see if I can get something done (I did a bit last weekend), if I've come up with nothing by Monday, then I'd more than appreciate the help I might get a go at it this afternoon actually, see what I can muster,