Talk:Hyperhidrosis/Archive 1

This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.

I am writing to document the recurring issues with the "external links" section of the hyperhidrosis page. This is an effort to make clear the type of links that meet Wikipedia's criteria and those that do not.

Per Wikipedia’s spam policy, http://en.wikipedia.org/wiki/Wikipedia:Spam, links added to promote a product are not appropriate. Linking to a specific page on a website that might offer hyperhidrosis treatment information is not an exception, regardless of the quality of that information. This must be so, as anyone trying to sell such hyperhidrosis remedies would simply add such a page to their site in the hopes of creating a spam doorway to promote their products. Wikipedia is not a tool to be manipulated for the purpose of promoting products.

Moreover, there have been issues with blog sites being listed as run by non-profit organizations. These blog sites have the distinct appearance of being spam doorways that link to product websites. Simply put, they are sham facades that are built with the single purpose of directing traffic to product sites. This methodology is deceptive and it is a clear violation of Wikipedia policy.

It should also be noted that each and every time a particular product promotion link was added, another “non-profit” blog site was added by the same user. Moreover, there is no clear ownership or authorship attributable to this blog. I have requested verification that this blog is in fact run by a certified Section 501 C non-profit organization. These requests were never answered.

Lastly, the same user who has repeatedly added spam links has also committed two other notable activities:

1. They remove the link to sweathelp.org, the website of the certified Section 501(C) non-profit organization for the hyperhidrosis community, each and every time, never noting an editorial reason

2. They removed talk page comments from me and other users (JakeIHHS on 20:30, 8 November 2007 (UTC) ) asking why the sweathelp.org was removed.

It is clear that this individual does not want a link to sweathelp.org, nor do they want any record of their behavior or other users’ requests for the link to be preserved. This is malicious to those who come to the Wikipedia page in search of help for a truly significant medical condition. I could not fathom someone removing the link to the American Cancer Society page from the Wikipedia cancer article, but this individual seems to think that it is OK to do to the hyperhidrosis community.

I ask that all concerned please be vigilant for inappropriate behavior on the hyperhidrosis page. In particular, please be attentive to the “External Links” area.

Tim Carter Pedrera 02:32, 1 December 2007 (UTC)

Here's some information that I have removed from the Atropine page. It should probably be re-integrated on this page: --Mdwyer 17:17, 4 January 2006 (UTC)

An article on eMedicine (http://www.emedicine.com/derm/topic893.htm) reports:

"Systemic agents used to treat hyperhidrosis include anticholinergic medications. Anticholinergics such as propantheline bromide, glycopyrrolate, oxybutynin, and benztropine are effective because the preglandular neurotransmitter for sweat secretion is acetylcholine (although the sympathetic nervous system innervates the eccrine sweat glands). The use of anticholinergics may be unappealing because their adverse effect profile includes mydriasis, blurry vision, dry mouth and eyes, difficulty with micturition, and constipation."

I just copyedited this article (a lot) to remove its commercial feel, some content from there might want to be merged here. SailorfromNH 00:55, 9 March 2006 (UTC)

"....but this hyperactivity may in turn be caused by abnormal brain function." What does this mean? Can this be specified? Source?

The temperature regulation part of the brain, hypothalamus I believe it's called.

Please see

Why people like you get into semantics for no reason when you could actually contribute in some meaningful way really makes me question your motives. Someone who "suffers" from an ailment does not need to be in pain, or even inconvienced by the illness. All that is implied by "suffering" in this context is that they have the illness. Now, the problem with your term "patients" implies that they are seeking treatment, when they may in fact have the illness and are not seeking any medical treatment at all, so they therefore are not patients. Also, you refer to this condition as "very controllable", are you a doctor? are you basing that off of your professional medical experience? I had no idea you've been studying hyperhidrosis for 30 years and have first hand knowledge that there are ways that stop 100% of the symptoms! You should probably tell someone because there are alot of people out there still suffering with the condition who would love to hear your miracle cures. Diabetes is also very controllable, we should change the diabetes article to explicitly state that no one suffers from diabetes either, they're just "patients of diabetes". —Preceding unsigned comment added by 64.230.84.24 (talk • contribs) 05:17, December 6, 2007 (UTC)

"The condition is very controllable": the author of this statement reveals his, or her, ignorance by writing it. My Hyperhidrosis was triggered overnight some nineteen years ago by treatment I was undergoing for a different ailment. It has proved entirely uncontrollable with medication and my case is deemed unsuitable for surgery, or Botox, as it covers too large an area of skin. As a result I have been left with Agoraphobia in addition to Hyperhydrosis. I have an another, life-threatening condition, but it hasn't affected my life nearly as much as my severe sweating. I wouldn't normally write these words, but I cannot bear to see such ill-informed opinions in black and white. (JS) —Preceding unsigned comment added by 212.84.100.135 (talk) 21:31, 13 February 2008 (UTC)

Hi. I have been trying to add an external link to the hyperhidrosis article. I believe I have read the guidelines on editing and on external links and have understood them. I have operated in good faith and according to the rules by adding the name of and link to the International Hyperhidrosis Society -- a non-profit dedicated to providing information to those that suffer from hyperhidrosis. There are no sales on the site. The site keeps getting removed from the external links. I just tried again, this time without the specific website name. I am not trying to do something against the rules. Yes the link gets removed every time I put it there. Any ideas? Did I miss something? Additionally, there was a message for me regarding a post on a Torah article. I did not make such a posting. Any ideas on that would be appreciated as well. Thank you.JakeIHHS 20:30, 8 November 2007 (UTC)

Jake,

There are many people trying to make a quick buck from the unfortunate people who suffer from this condition. That being the sad state of things, someone (or group) has been constantly removing the link to the International Hyperhidrosis Society and replacing it with a link to “www.megadry.com/excessive-sweating-info.html”. This is obvious spamming of the wikipedia page.

I’ve been asked to look into the constant vandalism of the wikipedia page (an important resource for the entire hyperhidrosis community). I’ll do my best, but if anyone else sees that “www.sweathelp.org” is removed, please add it back. And please remove the link to “www.megadry.com/excessive-sweating-info.html” if the spammers return. —Preceding unsigned comment added by Tim Carter Pedrera (talk • contribs) 03:24, November 27, 2007

Acupuncture is not a medical procedure, period. --76.224.86.43 (talk) 04:54, 27 December 2007 (UTC)

Sure it is. It's just not a conventional medical practice.

Improve me

] 13:31, 27 December 2007 (UTC)

The deletion was made because the data was illogical. Of course one may sweat during heavy exercise, however, hyperhidrosis does not refer to heavy exercise. Hyperhidrosis is diagnosed based on the premise that heavy sweating occurs while one is not in a hot area or exercised. Mike 1:20, 19 February 2008

I added a Section of people with Hyperhidrosis. I only know of Ahman Green, but aif anyone else know of anyone else with Hyperhidrosis, please add them. Blackmachismo131 (talk) 22:41, 20 June 2008 (UTC)

The armpits picture and sweaty hands diagram are both pointless and aside from being graphical don't add anything to the article. I can't remove them because the article is protected. Can anyone help? 217.132.150.164 (talk) 10:22, 27 July 2008 (UTC)

I think they might be helpful to some readers, if we could get an English translation and write useful captions. WhatamIdoing (talk) 23:05, 27 July 2008 (UTC)

I agree with the anonymous user. The pictures should be removed.

Tan | 39

04:40, 28 October 2008 (UTC)

Quoted from the article: "[...] more serious consequences than just hyperhidrosis.". The use of the word "just" is subjective (implying that hyperhidrosis itself isn't serious, which depends on a case-by-case basic of the persons having hyperhidrosis) and does not add anything to this sentence. Please remove the word "just" from this sentence (can't seem to edit the page myself). 85.159.97.1 (talk) 10:40, 18 August 2008 (UTC)

Please add an inter-language link, "ja:多汗症", underneath nl:Hyperhidrose. Nikm (talk) 23:13, 22 October 2008 (UTC)

•  Done Icewedge (talk) 00:14, 23 October 2008 (UTC)

I entered 2 external links, one of them the Forum for people who have had ETS, the surgery this article promotes to give an insight into the reality of the side-effects these people end up with - after and elective surgery...(http://etsandreversals.yuku.com/directory), and a blog site where articles from medical journals regarding the various effects (side-effects?) of sympathectomy are published. (http://sympathectomy.blogspot.com/) Both are relevant to the article that seems to promote the surgical procedure. The 2 external sites left are also sites that advertise this surgical procedure (often without warning of the possible adverse outcomes). The 2 sites I added had no commercial interest, they are set up so that people can find out more about the surgery and can get a more balanced view. I am concerned that the 2 external links have been removed because it would hurt the commercial interest of a selct group who advocate the procedure. I would like an explanation why the links were removed and would like them reinstated.Porcelina81 (talk) 21:27, 28 December 2008 (UTC)

Hi Porcelina,

Your links were removed because they directly violate Wikipedia's

WP:ELNO

#11. I will remove them again. I ask that you not reinsert them.

Also, in general, your work is largely unsourced, and it will also need to be removed. You must not write from your own personal experience. You must find a published source that directly supports your information.

Finally, Wikipedia does not use ALL CAPS to emphasize words. The goal is a dispassionate, formal tone. WhatamIdoing (talk) 19:02, 29 December 2008 (UTC)

Oh, and since you'll likely want to know: I removed the rat study from the "chemical surgery" section because it uses an entirely unrelated chemical, and doesn't actually make any claims for translation to practical side effects in humans. WhatamIdoing (talk) 19:24, 29 December 2008 (UTC)

I have, once again, removed Porcelina81's blog and chat boards from the external links list. I ask that all editors watching this page help enforce Wikipedia's rules about

inappropriate external links, which clearly and directly prohibit both of these types of links. (See items #10 and #11 in the list.) WhatamIdoing (talk

) 23:20, 18 January 2009 (UTC)

I also ask that you stop inserting links to a well known ETS surgeon's website, whom you describe as having developed a revolutionary technique. How would you know?! You also added him as a reference/authority on the subject. As the results of his work can not be considered scientific evidence and have not been reviewed by independent research, it also constitutes personal experience and nothing more. Science needs to be science based, and so far there is overwhelming evidence that sympathectomy has many - undisclosed - side-effects.Porcelina81 (talk) 02:44, 19 January 2009 (UTC)

This article seems to wander back and forth between being reasonably neutral on the point of surgical treatment to being firmly opposed to it. At the risk of being long-winded, let me start at the beginning:

Purpose of Wikipedia: Wikipedia requires that we don't provide "the answer" to patients: we're

But there is no evidence that supports the surgery. That's the point. The fact that the surgeons who offer the elective procedure say that it is effective, safe etc, is not evidence and should not be presented as such on wiki. This page should be science based, and I would like to see the scientific evidence presented. Claims from doctors are not satisfactory, not even when it is presented by a majority - all of whom provide the surgery. You are suggesting to review 'papers' presented by doctors based on their own experience. I strongly disagree that this should or could be considered scientific evidence. How could it be? And I am also concerned that you - I suspect - consider the research into the effects of the surgery to be "experimental literature". They are independent studies that publish the results of their observations. ETS surgeons do not study and do not apply rigorous testing and questioning of their technique. So I think there is a problem with your definition of what constitutes 'science', 'evidence' or 'study'.Porcelina81 (talk) 02:51, 19 January 2009 (UTC)

Ok. I'll preface this by saying that my clinical experience is definitely not in this area, so I'm speaking purely about the article itself.

First of all, I think WP:Assume good faith could stand a little airing here. The goal is not to promote any one theory, but to provide a solid encyclopedia article for the general reader (including patients, medics, and insurance salespeople). I suggest no-one edit the article at all for a few days, take a breath and get some perspective.

Second, I think where there has been shown to be some contention, we must be careful about statements like "It is generally considered" and "most patients are satisfied", especially where the evidence review citing such things is based on "observational evidence". I'm not saying it isn't perfectly true, just that we should be careful how we use the source.

Third, we have to be just as careful about sweeping statements like "there is no evidence". I'd like to see scientific evidence presented too Porcelina81, but I think all of us should suspend judgement in the meantime, don't you?

Finally, I think it's essential that we avoid the blog sites and the forums here. There is just no way to turn them into credible sources, and that goes for any number of sources I'd like to cite as well in my own articles! It's hard work, but we really must find a way to use

third-party published sources wherever possible, and to reference them directly. Cheers, Basie (talk

) 03:15, 19 January 2009 (UTC)

Porcelina81, I realize that this goes against your personal view, but here's the summary:

• Wikipedia considers any recent article in a reputable, peer-reviewed journal to be a good source.
• Within the large group of articles that meet that basic requirement, Wikipedia considers
  primary sources
  (case studies, case series, original reports on experiments, and more).

This means that Wikipedia believes that major reviews like

PMID 17720429

.

Furthermore, and very importantly, anything in humans with the specific condition trumps any experiment done in humans with some other condition, anything done in other animals, or anything done in a test tube. So let us compare Wikipedia's rules to some of the references that you seem to favor and which concern me:

1. an experimental surgery in dogs from 1973
2. a case report (single patient)
3. a review about a different condition
4. a small, short-term randomized controlled trial
5. PMID 6614039
   , which is a 25-year-old case study (single patient) of a different disease
6. a dictionary definition for the word syncope
7. Experimental measurement of 12 patients
8. PMID 5972550
   , published in 1966 (yes: forty-two years ago, as if surgery has not advanced even slightly since then)
9. PMID 7364866, a 1980 report, in none of the patients apparently had hyperhidrosis, and half were having major bypass surgery
10. [http://www.ispub.com/ostia/index.php?xmlFilePath=journals/ijs/vol18n1/lumbar.xml A review], but in an advertising-filled internet-only "journal" that has no reputation and isn't listed at MedLine
11. A 1998 editorial (not a proper scientific paper) about patients with
    causalgia
    (an unrelated disease)

Do you understand why I think these sources fail to meet Wikipedia's standards for reliable sources? WhatamIdoing (talk) 22:56, 19 January 2009 (UTC)

I strongly protest agianst you inserting Reisfeld's paper where he talks about his own experience with patients after lumbar sympathectomy. There is no way to verify any claims/statements in his article and because of the obvious bias should not be considered as evidence. Please stop making claims that there is now evidence that lumbar sympathectomy does no cause sexual dysfunction, impotency and retrograde ejaculation, or if you do, please cite a credible, independent source/study with no interest in the findings - not Reisfeld please. Your insistence of including him on this page and attempting to show him as someone with a superior technique and results to other surgeons is still advertising. I have no doubt that you have an interest in Reisfeld's work. Your objections are not valid. The articles you object to are from the British Medical Journal, Oxford University Press, and the one that you call not credible because it appears in the Internet Journal of Surgery has an extensive reference list, also from controlled trials, British Medical Jounal and so on. A controlled trial is not credible to you when it does not agree with your agenda, but Reisfeld's obviously biased self-congratulatory article is good evidence. Please drop the double standards. Reisfeld is not better than the others who push this surgery. I know few of his patients who became disabled as the result of this surgery. And when I say disabled I am not using it as a metaphor. Porcelina81 (talk) 00:39, 20 January 2009 (UTC)

I agree that Reisfeld is not the best source, and I am not adding that link to the article. I am, however, adding a link to a strong study that appears to represent the common views of the relevant experts, and I am suggesting that you read the paper before reverting it. WhatamIdoing (talk) 03:15, 20 January 2009 (UTC)

Source #1

Now let's take your sources one at a time:

1: An experimental surgery in five dogs from 1973.

You claim that this dog experiment proves "Some patients have also been shown to experience a cardiac sympathetic denervation, which results in a 10% lowered heartbeat during both rest and exercise."

This is a primary source, which is already weak. It is seriously outdated. It involves no humans, and canine neurology is not exactly like humans. None of the dogs had the relevant condition (hyperhidrosis), because dogs can't sweat (see previous statement).

This source does not comply with Wikipedia's standards for

reliable sources in medicine-related articles

. It must therefore be removed.

Do you agree to have this one source removed as not complying with Wikipedia's standards, or would you like to ask the

the reliable sources noticeboard to arbitrate the concerns about this source? WhatamIdoing (talk

) 03:15, 20 January 2009 (UTC)

There are many problems with the article, but the world will not end if it sits in its current state for a little while. Can we take a breath, please? Basie (talk) 03:29, 20 January 2009 (UTC)

Porcelina81, your recent change of the link didn't work, so I'm reverting to a functional link. Please respond to my detailed analysis of reference #1 in this list. WhatamIdoing (talk) 17:43, 20 January 2009 (UTC)

There is a lot of material/studies and research from the 50s up to the 80s and so on into hte effects of the sympathectomy. Of course it was not included to illustrate sweating or lack of it, it was an article illustrating cardiac denervation after sympathectomy...I thought that would be clear. I also added more studies, for example the Holter changes that looked at humans who had hyperhidrosis and underwent sympathectomy to treat the condition. That article was concluded with the sentence: "Consistently spectral analysis variables significantly changed after bilateral surgery but showed no right-sided dominance. Little effect of sympathectomy was found on the QT interval, which tended to decrease after bilateral sympathectomy. CONCLUSIONS: Patients should be informed of the bradycardia resulting from sympathectomy." Te article also describes how the test was done. It is something that is measurable, if you like tangible evidence and I can not see how or what kind of bias could be in this article. It seems very straightforward to me. Feel free to remove the dog study, however the article from 2002: Holter changes resulting from right-sided and bilateral infrastellate upper thoracic sympathectomy are relevant and significant and should be included. I will also add the Goldstein study, who did a controlled trial including patients after ETS for HH, that showed the upper-thoracic symathectomy denervates the heart. Porcelina81 (talk) 07:14, 21 January 2009 (UTC)

I think you're referring to this, and I agree it looks like a good source:

• Abraham P, Berthelot J, Victor J, Saumet JL, Picquet J, Enon B (2002). "Holter changes resulting from right-sided and bilateral infrastellate upper thoracic sympathectomy". Ann. Thorac. Surg. 74 (6): 2076–81.
  PMID 12643398. {{cite journal}}: |access-date= requires |url= (help); Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link
  ).

I suspect the Goldstein study you refer to may be this one:

• Moak JP, Eldadah B, Holmes C, Pechnik S, Goldstein DS (2005). "Partial cardiac sympathetic denervation after bilateral thoracic sympathectomy in humans". Heart Rhythm. 2 (6): 602–9.
  PMID 15922266. Retrieved 2009-01-21. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link
  ).

Obviously, feel free to edit this section and grab the {{cite journal}} references for use in the article. Cheers, Basie (talk) 11:32, 21 January 2009 (UTC)

Porcelina81, Wikipedia requires that we use up-to-date evidence in medicine-related articles. Reports from several decades simply aren't good enough.

These new sources are much better than the dog surgery, although they are still

secondary sources

. I realize that as an amateur researcher, you want to read the study methods, but that's not actually what Wikipedia's policies recommend. Articles need to be based upon secondary sources. Why don't you look for reviews and textbooks? If this is a widely accepted side effect (and I have no reason to imagine that it's not), then finding what Wikipedia considers to be the ideal type of source should be no trouble at all. In the meantime, perhaps you'd be willing to remove the dog study, and replace it with one of the better sources.

Also, Wikipedia does not make patient-care recommendations. Ever. Therefore, the statement that patients should be informed of a particular side effect must be removed. WhatamIdoing (talk) 21:05, 21 January 2009 (UTC)

It appears that you aren't able to justify how a 33-year-old study in dogs meets Wikipedia's standards, so I am removing that study from the article. The statement it was associated with has other refs behind it, so the statement itself can stay (for now, at least). WhatamIdoing (talk) 02:17, 27 January 2009 (UTC)

Source #2

It's time to move on to the next one.

2. a case report (single patient)

You claim that this case report involving a single patient proves, "Some patients have also been shown to experience a cardiac sympathetic denervation, which results in a 10% lowered heartbeat during both rest and exercise."

This is a

Since no one has attempted to defend this source, I have removed it. WhatamIdoing (talk) 05:44, 24 February 2009 (UTC)

Source #3

Next source:

3. a review about a different condition (

PMID 10432334

)

Since no one has attempted to defend this source, I have removed it. WhatamIdoing (talk) 21:04, 1 April 2009 (UTC)

Source #4

4. Influence of Endoscopic Thoracic Sympathectomy on Baroreflex Control of Heart Rate in Patients with Palmar Hyperhidrosis has already been removed.

Source #5

5.

PMID 6614039

, "Simultaneous treatment of Raynaud's phenomenon and orthostatic hypotension"

This paper reports on a single patient, treated in 1983. This patient did not have hyperhidrosis. This source is therefore irrelevant. I am therefore removing it. If you think that this source is important to an article about hyperhidrosis, please explain your reasoning here. WhatamIdoing (talk) 21:04, 1 April 2009 (UTC)

Sources #6 through #10

These sources have already been removed. WhatamIdoing (talk) 21:11, 1 April 2009 (UTC)

Source #11

11. A 1998 editorial (not a proper scientific paper) about patients with

causalgia

This source is used to support the assertion, "ETS side effects have been described as ranging from trivial to devastating."

This editorial paper focuses on an entirely unrelated condition involving significant, complex, intractable pain. It's not reasonable to assume that side effects seen in these patients are the same as side effects seen in people with hyperhidrosis. This source, and its attendant statement (unless we can produce other sources that suggest this is a generally applicable statement), should therefore be removed. WhatamIdoing (talk) 21:15, 1 April 2009 (UTC)

WhatamIdoing, you exchanged Reisfeld's article for another one - equally poor quality. It is not a study, it is a general statement of the surgeon offering the procedure, thus can be suspect of bias. There is no reference to any test, measurement or any form of investigation the surgeon would have done. Please apply the rigor you demand of others to yourself and your articles. Please remove it, it does not qualify for publication. Porcelina81 (talk) 19:28, 21 January 2009 (UTC)

Porcelina81, I wonder if we could speak of sources specifically by name and year (for example, Abraham02)? Rather than "your source", "his source", "the source you added". I say this not only because I get confused about which one we're speaking of, but also because it takes the personal feeling out of it. Once the sources have been added to the article they don't belong to anyone in particular, and we can either keep them there or remove them based on their quality and suitability.

"Please apply the rigor you demand of others to yourself and your articles" is a borderline personal attack and unnecessary here. All that needs to be said is that you have doubts about the quality of the source, mention its name and date and we can talk about it. Cheers, Basie (talk) 21:10, 21 January 2009 (UTC)

Porcelina81, the standards you list above are not required by Wikipedia. They are your own personal standards, and the personal standards of individual editors are irrelevant on Wikipedia. For example, Wikipedia routinely accepts peer-reviewed articles published in medical journals, even though these are very frequently written by physicians that offer whatever treatment they report on. Wikipedia actually prefers some kinds of sources that summarize results instead of laying out methodology. I, um, also assume from your other comments that you haven't read the entire paper?

As to the Rieger paper (provided by another editor, BTW) not meeting the same standards that I demand of you:

• it's peer-reviewed
• it's published in the last five years,
• it's published in a widely respected medical journal, and
• it involves the exact procedure in the exact patient population that is discussed.

It's only limitation is that it's primary literature instead of a secondary source; on the other hand, I've found no secondary sources that contradict it (and I have looked). So which point of Wikipedia's standards do you think it fails? WhatamIdoing (talk) 21:27, 21 January 2009 (UTC)

This is an archive of past discussions. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.