User:Ksheka/Archive 1

Hello, Ksheka. My compliments on your recent cardiological additions. Could you tell something about your background? You a doctor, by any chance? I'm looking around to see if some medically qualified folks would be willing to pull the medical side of Wikipedia to a higher plane (the not-so-active WikiProject Medicine...) JFW 19:05, 4 Apr 2004 (UTC)

Sure. I'm a doctor, and interested in helping fill out the wikipedia's medical section. Mostly interested in Cardiology, since that's what I know best. Ksheka 12:33, Apr 6, 2004 (UTC)

Great. I'm trying to find some other docs to join in. So far, I've managed to contact User:Kd4ttc (a US gastroenterologist) and tried to get in touch with User:Alex.tan, who works in Singapore. When I've found a few more, I'll get in touch again; otherwise just scribble on my talk page... My main interests are endocrinology, haematology, gastroenterology, oncology and all those internal medicine things.
I see Wikipedia as a great way of learning as well; before I started on the article, I knew little about alpha 1-antitrypsin. JFW 10:15, 8 Apr 2004 (UTC)

PS Please see some preliminary documentation on User:Jfdwolff/WikiDoc!

Pesticide poisoning

Another page that needs work...I've been meaning to do more, particularly on the chronic poisoning section, but it would be better if a medically qualified person had major input. You seem to have the qualifications. Care to take a crack at it? I will be doing more on non-target organisms. Pollinator 12:18, 18 Apr 2004 (UTC)

Sounds kind of interesting. I'll keep it on my burner, and take a stab at it when I have some time. Right now I'm working on Cardiology and creating some of the articles that link from there. Ksheka 12:52, Apr 18, 2004 (UTC)

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Should the nonexistent Sudden_cardiac_death link on Long_QT_syndrome be to Cardiac_arrhythmia#SADS until it gets it's own page? Are they different things? You're the expert. Thanks. Munkee 02:55, 21 Apr 2004 (UTC)

I think that linking it to cardiac arrest is fine for now. As I mentioned in the Things to do section of user:ksheka, I'm planning on breaking up cardiac arrhythmia at some point. There's a lot of different things discussed in that page. Therefore it's probably not a good idea to link into that article. I'm pretty new to the wikipedia myself, but it doesn't seem like a good idea to link into a subsection of an article, since the subsection can easily change it's name, causing a dead link, right?

As for SADS, I'll have to research the terminology and figure out the distinctions between sudden cardiac death, sudden arrhythmic death, and cardiac arrest. As a quick check, it seems that SADS is just a sudden death due to one of the syndromes mentioned (Long QT, Brugada, etc). Eventually SADS is going to end up with it's own (small) page, I think. Ksheka 11:34, Apr 21, 2004 (UTC)

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Review request

Hi Ksheka, I've just expanded the myocarditis page. It's based mainly on the latest review in the NEJM, but that doesn't absolve me from petty mistakes and omissions... Any comments?
Sadly I've had no responses to my naming policy message. This might help in the [[heart attack]]/myocardial infarction debate. You know my position... Shall we ask the other Wikidocs??
JFW | T@lk 16:13, 26 Apr 2004 (UTC)

I'll definitely review the myocarditis article.

As for the naming convention discussion, I didn't know you started the ball rolling. I'll join the discussion there. As for the Myocardial Infarction move, I think we're stuck because of the naming convention issue.

One thing I was thinking about for the last few days is that the WikiDocs group needs some temp page somewhere where we can 1. bounce ideas off each other, 2. make general requests for reviews, 3. Ask specific questions regarding pages, 4. Enlist help from like-minded individuals.

Thanks Ksheka. I'll mention the "naming convention" issue on the talk page of "[[heart attack]]".
You're right about a WikiDoc. In the UK, doctors take breaks in the "mess" (is it the same in the USA?) How about I set up a "WikiDocMess" page? Or just the Talk page to WikiDoc?? The WikiDoc talk page is empty at the moment! JFW | T@lk 17:01, 26 Apr 2004 (UTC)

Hi Ksheka, compliments on your work on the doctors' mess.

On the aortic valve stenosis page, there is mention of hypertrophic obstructive subaortic stenosis. Is this identical to HOCM, but differing in terminology? JFW | T@lk 16:28, 27 Apr 2004 (UTC)

There's a bit of terminology confusion: Hypertrophic obstructive cardiomyopathy (HOCM), and apical hypertrophic cardiomyopathy (nonobstructive hypertrophic cardiomyopathy, (article)) are subtypes of hypertrophic cardiomyopathy (HCM).

HOCM used to be known as Idiopathic hypertrophic subaortic stenosis (IHSS). The term IHSS is going out of fashion. I'm not sure why, but my guess is that it's not technically a sub-valvular stenosis that causes the outflow tract gradient. In stead, it's a combination of the pulling of the mitral valve anterior leaflet into the outflow tract during ventriclar systole and the asymetric hypertrophy of the interventricular septum, causing a dynamic outflow tract gradient.

By the way, I took a look at aortic valve stenosis page, and have doubts as to the ownership of the images on the page. They look like images in a text book I saw somewhere. If I come across the images again, I'mm bring it up.

Damn. I might as well just write the articles on HCM... :-) Ksheka 17:42, Apr 27, 2004 (UTC)

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Is WikiDoc moving?

Please follow this link for some information.
JFW | T@lk 12:29, 3 May 2004 (UTC)

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Mitral valve prolapse

Thanks for your recent message on Talk:Mitral valve prolapse about the inaccuracy of the Mitral valve prolapse page. The references I used to write the original text of the article were dated, so I was pleased to find your comments about the recent review of MVP. I've just made a bold attempt to rewrite the article incorporating the new findings, and would be very appreciative if you would check the article for accuracy. Thanks! --Diberri | Talk 20:22, May 3, 2004 (UTC)

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Featured article

Very good for nominating acetaminophen as a featured article. Medical topics have been very much underrepresented in features. Acetaminophen is indeed very good. I've self-nominated imatinib as well; revolutionary drug. On the talk page you'll see why it might affect cardiology in the future!!
Could you tell me who introduced the boxes with the molecular structure. I've been writing a lot of drug articles, (pioglitazone, cerivastatin) and might want to add the box to those as well.
JFW | T@lk 09:14, 9 May 2004 (UTC)

PS Are you writing amiodarone sometime? Touches on thyreotoxicosis and hypothyreodism (and hepatitis and pulmonary fibrosis!)

I'll be working on amiodarone in the near future. (Probably this week some time.) I seem to be hitting a lot of the antiarrhythmic agents. :-) As for the molecular structure boxes, I created those. I actually took the box from Columbia university, and tweaked it to what I needed. Someone else changed the code for the box, but it displays the same. I've used the same boxes on all the pictures I add. I really don't like the default image layout of the wiki. :-( Ksheka 11:54, May 9, 2004 (UTC)

Brilliant. We might actually revive WikiProject Drugs! Not that I'm a pharmacologist... You've done some very good stuff. I've made an amiodarone image (it is called Image:amiodarone.png).
JFW | T@lk 20:44, 9 May 2004 (UTC)

As mentioned, I started working on this. I took the image off this page, since I'm using it in the amiodarone article. Ksheka 02:00, May 16, 2004 (UTC)

EMLA and Angiography

Hi Ksheka. Just checking... you can't use EMLA to catheterise a femoral artery can you? I've always assumend that a s/c local anesthetic injection would be need --e 01:30, 11 May 2004 (UTC)

You can use anything. I'm not sure if the patient would appreciate it, however. :-) You're right, though. While the skin layer's important because of the number of sensory nerves at that level, it's important to numb the deeper nerves as well, with a subcutaneous injection. At my institution, subcutaneous lidocaine is a very popular agent. Ksheka 02:12, May 11, 2004 (UTC)

Thanks - i just deleted a ref to angio in topical local anaesthesia - but wanted to make sure! btw - no idea about your ST segment and class III ageents question. I agree with you from first principles for what it's worth but have no references! --e 03:50, 11 May 2004 (UTC)

Heart attack

Please take a look at [[heart attack]], see what you think. JFW | T@lk 12:43, 14 May 2004 (UTC)

Thanks. Ksheka 01:39, May 15, 2004 (UTC)

Pulmonary hypertension

Pulmonary hypertension was a requested article (by whom???) and someone dumped an article from the Merck reference into the database. Surely we can do a lot better than that! What do you think of the present pseudo-stub??? JFW | T@lk 21:03, 23 May 2004 (UTC)

PS You might even have a pretty ECG showing right-ventricular strain!

Ummm..... I may have requested Pulmonary hypertension as a part of the expansion of the index on Cardiology to cover all of cardiovascular medicine. (see Talk:Cardiology) I certainly didn't put it on any list of requested topics, though... I'm more the type to write the article out myself and then ask for help. :-) I'll try to take a look at it this week. I want to focus some time on Vascular resistance, and it sort of is an adjacent topic, so it all works out. Ksheka 22:14, May 23, 2004 (UTC)

I didn't just copy it out of the Merck manual, I only found the Merck article after I'd written it! It was intended just to be a brief outline that someone else could fill in, someone more knowledgeable that is.  ;-) The area I probably know most about is anatomy, so if you think there is something more appropriate I could contribute to then please let me know. --Lacrimosa 08:04, 26 May 2004 (UTC)

I didn't mean to imply that it was a copy. I read your version, and it was a good effort. Another good medical text that is available free online is harrison's online. I use it a lot when I write these sort of articles. I hope you're not offended. Ksheka 10:10, May 26, 2004 (UTC)

No, not at all. I was just looking for something to do when I saw it in the request list. I think I'll stick to areas I know more about in future though. ;) --Lacrimosa 10:48, 26 May 2004 (UTC)

Well, I've done my $0.02 on pulmonary hypertension. In this week's NEJM there's a whole article on the incidence of chronic thromboembolic PH after an episode of pulmonary embolism. Yum.
I also saw the "stub warning" (on MediaWiki:Opentasks) for restenosis. I added some stuff, but I trust there's much more to it, and a future interventional cardiologist might be interested!! JFW | T@lk 16:51, 28 May 2004 (UTC)

on categories

I just resurrected your question on Wikipedia talk:WikiProject Clinical medicine. You might want to put category:cardiology on articles you edit having to do with cardiology. It all seems to be an evolving aspect of Wikipedia. It is supposed to allow for the creation of automated lists, but we'll see.... - Nunh-huh 02:22, 1 Jun 2004 (UTC)

Thanks. I was getting frustrated, since the wiki was going down whenever I was trying to commit an edit. It seems that things have settled down for a while. Ksheka 10:19, Jun 1, 2004 (UTC)

Nifedipine

Hi Ksheka, I started nifedipine. I'll try to produce an image. Was I correct that it's a dihydropirine? JFW | T@lk 09:59, 11 Jun 2004 (UTC)

Of course you're right. :-) (Look here) Really, Calcium channel blocker should be expanded a bit to give the different types of calcium channel blockers. A few years ago, the drug reps. used to talk about the different tissue penetrance of the different calcium channel blockers, but it turned out that it really didn't matter. We used to have a poster on our wall here in the hospital which had all the classes of calcium channel blockers and the different effects of them. Haven't seen it in 4-5 years, though. :-( Now-a-days, they talk about different tissue penetrance of ACE inhibitors. I still think it makes no difference. :-) Ksheka 11:04, Jun 11, 2004 (UTC)

tetralogy

Someone "merged" Blue Baby Syndrome with Tetralogy of Fallot: I separated them again, since it's not a one-to-one mapping, but they would benefit from your attention, especially the former! - Nunh-huh 19:51, 16 Jun 2004 (UTC)

Atrial flutter

I noticed that you included Cardioversion as a treatment for a-fib and not for atrial flutter. I have come across cardiologists who cardioverted several a-flutter patients, some of which required ICDs as a permanent solution. What have you yourself come across in your practice relating to this. (BTW, I'm not a cardiologist, or even an MD. Just an interested pre-med.  ;-) )

At the beginning of that section, I mentioned that atrial flutter can be treated the same as atrial fibrillation. Maybe it should be made more obvious that the treatment options for atrial fibrillation can also be used in atrial flutter. Ksheka 00:07, Jul 19, 2004 (UTC)

Ahhh, I'm sorry that I didn't catch that. Perhaps a simple copy from one section to the other would suffice. Thanks for the reply. --G3pro 18 July 2004

==Hello== (Moved from top of page) Hi Ksheka. I'm very new to WikiPedia, so I will ask your patience in advance if I should inadvertantly break any conventions... (such as: I wasn't sure where to put this note, but I've settled on the top here...)

Anyway, I was surprised to see the entry on Acetaminophen claim that "Prior to the creation of acetaminophen, the only anti-pyretic agent available was cinchona bark."

I have always understood that Aspirin is also an effective (though no longer in favor, due to possible serious side effects) antipyretic. In fact, the WikiPedia entry on Aspirin says that "Hippocrates, a Greek for whom the Hippocratic Oath is named, wrote in the 5th century BC about a bitter powder extracted from willow bark that could ease aches and pains and reduce fevers."

So, my question is, how are these statements to be reconciled?

I have no formal medical training, so I will certainly defer to you or others who know more.

And, I'll take this opportunity to thank you for your contribution to this wonderful endeaver!

 - Richard Geiger - rmg@foxcove.com

Welcome to the Wiki. Tell you the truth, I haven't been contributing much for the last month, but I'm somewhat back. You are right about Aspirin being an antipyretic. My guess is that it wasn't really used much as such in the western world??? (*shrug*) Ksheka 00:05, Jul 19, 2004 (UTC)

Atrial Fibrillation

Thanks for the addition on AF, that part about sructural heart disease. If a patient has coronary artery disease but normal LVEF and no wall motion abnormalities, does he require warfarin for AF? Any references?Mehrenberg 18:46, Jul 29, 2004 (UTC)

Reference added to text, with slight corrections in the text. The actual reference I am using is table 14, which is on page 25 of the .pdf file (page 1255 of the journal). Ksheka 02:21, Jul 30, 2004 (UTC)

As an aside, the table (and the text as well) is not clear. For instance: Individuals with coronary artery disease (CAD) should be on a beta blocker, if tolerated. However, the definition of hypertension defines any individual that is on an anti-hypertensive medication (ie: a beta-blocker) as being hypertensive. Therefore, individuals with CAD are being treated with beta blockers, and get the diagnosis of hypertension. Based on that and the table I mentioned above, individuals with CAD should be treated with coumadin (since hypertension is a risk factor for thromboembolism). I really can't see which patients fall into the category of atrial fibrillation, coronary artery disease, but no risk factors for thromboembolism. *strug*. Ksheka 02:29, Jul 30, 2004 (UTC)

LMWH

Hi Ksheka, I see you're sailing the anticoagulant seas! I'm planning to read up on heparin-induced thrombocytopenia and create a page on it, and expand on the heparinoids in general. I can't seem to find an explanation of the difference between HIT type 1 and 2. Have you heard of the distinction (and does it matter?) JFW | T@lk 09:39, 8 Sep 2004 (UTC)

There is a big difference between HIT 1 and HIT 2. HIT 2 is immune-mediated HIT. This means that the longer heparin is given, the further down the platelet levels go. Also, platelet levels tend to go lower and thrombosis is a problem. One of my colleagues described HIT 2 as one of the most thrombogenic states in existance. See these pages (1, 2) for a bit about the distinction. Ksheka 10:18, Sep 8, 2004 (UTC)

Could you provide your colleague's reference? I'm curious. In the stuff I'm reading (mainly by T.E. Warkentin, a Canadian world-renowned HIT expert) HIT is always immune-mediated with antibodies against PF4-heparin complexes. Is HIT1 simply the benign thrombocytopenia form, or is there more to it?? JFW | T@lk 18:17, 9 Sep 2004 (UTC)

Hi Ksheka, I've written up heparin-induced thrombocytopenia now. Could you review it for factual inconsistencies and/or provide references that you see fit? JFW | T@lk 08:11, 11 Oct 2004 (UTC)

I'll try to get to it soon, but no promises for now. My Cardiovascular Board Examination is in three weeks. After that I will be much more active in the wikipedia. I've been acruing a lot of key references to cardiovascular topics (including low molecular weight anticoagulation regimens), that I can add when I have time. Ksheka 11:02, Oct 11, 2004 (UTC)

Good luck with your "boards"! I'm warming to the promise of more Ksheka on Wikipedia. I have recently twiddled with ECG as well, as my registrar told me I needed to update my ECG reading :-} JFW | T@lk 11:08, 11 Oct 2004 (UTC)

While I have your attention, is there anywhere I can get info about showing short videos on the wikipedia? I've got a beautiful echocardiogram of hypertrophic cardiomyopathy that I can legally upload (I'm stripping out all patient and hospital information). Each video is 5-10 seconds (should be shown in a loop to simulate constant motion), and I think I have the programs necessary to change the format to whatever is necessary. For hypertrophic cardiomyopathy, I would like to add a total of 3 or 4 video clips (And associated still images), showing systolic anterior motion of the mitral valve and asymetric septal hypertrophy. Also, if it goes smoothly, I can access echocardiograms and coronary angiograms of normal individuals and various other conditions and procesures, such as atrial septal defect, ventricular septal defect, myocardial infarction, etc. I'm kind of itching to add some of these to the wiki, with the first one to be ready by the middle of November. Ksheka 01:14, Oct 12, 2004 (UTC)

I'm not sure which video format is encouraged on Wikipedia. For sound it's Ogg Vorbis. JFW | T@lk 08:44, 12 Oct 2004 (UTC)

List of publications in medicine

Hi,

JFW suggested that I'll contact you regarding List of publications in medicine. The list should contain the important publications in many subtopics in medicine. As I see it, the list should help people learn quickly new topics and the major achievements in it. Look at List of publications in computer science for an example of such a mature list. Unfortunately, I don't have any medical knowledge. Can you help and contribute to the list? Thanks, APH 06:29, 19 Sep 2004 (UTC)

Hello. Thanks for the line. My feeling is that while there are many individual medical articles of import (100+ per year), they can only be described in the context of previous articles. Because of this, I believe that scientific articles should be referenced in articles, and should be done so just like journal articles refer to each other. Each wikipedia article should be like a review article on the subject that strives to bring understanding of the topic to the lay person.

As an example, one of the most influential articles that came out in the last couple years in the field of cardiology is Madit 2, which threatens to bankrupt the entire health care industry of the United States with it's implication that anyone with coronary heart disease and decreased ejection fraction should receive an implantable cardioverter-defibrillator. Of course, this study has to be taken into the context of MUSTT and Madit 1, which also involved placing ICDs in individuals. Also, the response by CMS is very important, and cannot easily be explained without going into the cost burden that MADIT 2 places on the government (a one-time cost of > $250 billion, with yearly expenditures of about 10% of that).

Rather than just putting these studies in a list, I feel we are better served by mentioning them in the text of articles on myocardial infarction and implantable cardioverter-defibrillator, since people that read those articles would be most interested in the above mentioned studies and in the text of the articles, mention of the controversy can be made.

Since different pharmeaceutical companies sponser studies based on their drugs, there are many controversies that are not easy to explain in a list format. For instance, the 4S trial advocates the use of simvastatin in individuals with heart disease as a form of secondary prevention. However, the A to Z study showed increased complications due to high-dose simvastatin, whlie other studies have shown good tolerance of atorvastatin (a competing medication).

These issues make me feel that we would be doing a disservice by just listing studies, and that giving a history of the treatment of each disease process would be much more interesting to the individual. This history can be done as a segment of each article (For example, a history of the treatment of hypercholesterolemia can be part of the article on hypercholesterolemia).

Ksheka 17:23, Sep 19, 2004 (UTC)

As an aside, I really like using superscripts within articles and numbered references at the end of the articles (in a references section) to list all the references. It keeps things organized and lets individuals that want to look at the references find them all easily (without hunting for them throughout the article). For instance, look at this article. Ksheka 17:41, Sep 19, 2004 (UTC)

The description section can be used in order to explain the context and the impact of the article. We can add a reference to a wiki article that will explain more on each such publication. As for your last comment, I think that listing the papers and not using references is preferred. Usually there is no connection between the publications so I think that it is better to discuss them separately. I added Madit 2 to the list of publication. Can you verify that what I wrote is correct and extend it?

thanks, APH 07:05, 21 Sep 2004 (UTC)

You'll like this

Hi Ksheka. You'll like this new page: James Herrick. I've also written about the history of the ECG. I'm sure you'll have something to add! JFW | T@lk 23:38, 19 Oct 2004 (UTC)

Videos...

Hi, I wrote most of the (still tentative) video policy. I replied to you on the Village pump about videos. Basically, I'd be interested in experimenting with your video to see if we can encode it in Theora format. --Robert Merkel 03:30, 30 Oct 2004 (UTC)

Thanks. I'll contact you in a week or so to email you the video files. I'm taking a fairly important exam this coming wednesday and thursday, and won't be able to work on it at all at least until next weekend, and I have to blacken out the patient and hospital information (part of the agreement in putting them on the internet.) Unfortunately, the only format I can get these videos out of our database is in the MS-MPEG4 v2 codec. I think I have the necessary software to transcode it to something else. If not, I'll find out next weekend. :-) Ksheka 01:32, Oct 31, 2004 (UTC)

When you edit to remove the identifying data, please use the "lightest" recompression you can find, even if this makes the files much bigger. Every time we recompress, we screw things up a little more... For quality purposes, it'd be better if you didn't have to edit and recompress at all, but obviously you can't go round sending non-anonymized patient data to some bloke on the net... --Robert Merkel 11:04, 31 Oct 2004 (UTC)

Not a problem. I'll talk to the guys that created the AVI (who are on contract from the hospital) to see about getting uncompressed copies of the video, but I'm not holding my breath. :-) Ksheka 21:13, Oct 31, 2004 (UTC)

Question about vascular resistance

(Moved from the top of the talk page...)

Hello, Ksheka. I am new to the Wikipedia and I haven't yet registered. I am a doctor and I have been reading some of the articles that you and your colleagues have created. [I have also tinkered with a few :-) ].

I am concerned by the reference ranges that you quote on vascular resistance. Is the format that you use (median plus/minus range) considered appropriate by the medical/Wiki community? Also, I think that your range for pulmonary vascular resistance is on the low side. I accept that there is a degree of variation in ranges used by different units, especially for pulmonary vascular resistance, but the one that you use is not representative. 148.197.5.19 16:50, 3 Nov 2004 (UTC)

I'll take a look at it again. The great thing about a wiki is that if you feel it's incorrect, just change it! (And add a note on the talk page with the reference your using, if appropriate. :-) ) I usually put numbers in mean ± standard deviation, but I'll check what I did on the vascular resistance page. I suppose giving a range for normal is another way to do it (and may be easier to read in some instances.) Ksheka 19:27, Nov 4, 2004 (UTC)

I have a username now (Axl). When I read your table in vascular resistance, I didn't realise that the 'error' represented the SD. Therefore the range corresponds to only 68% of 'normal' values. Have a look at the table in arterial blood gas. In my opinion, this is a more useful table. Also, I dislike the term 'normal range'. It implies that values inside the range are normal, while values outside the range are abnormal. With a 95% CI, this is clearly not the case. I much prefer the term 'reference range'. The clinician refers to the range and then interprets the result alongside other clinical findings. If you have no strong objection, I'll change the entry, along the lines of the table in arterial blood gas. Axl 18:43, 5 Nov 2004 (UTC)

Flecainide

Hi Ksheka, I'm unsure of what to do with flecainide. This was initially cobbled together from online sources by User:AAAAA, who wanted a "very complete page on flecainide", but was shot down as a copyvio. I spent some time rewriting it, but ran out of energy and patience while being harried by other users to remove all copyvio content.

I have now truncated all material not reviewed by me, but the page needs some TLC from someone who has (unlike me) worked with the drug and knows the actual issues. Would you mind having a look? JFW | T@lk 17:35, 18 Nov 2004 (UTC)

I haven't had much use for flecainide. All I really know about is the results of the CAST trial and it's use in the Brugada syndrome and AVRD. I added that stuff and a references section.

One thing - Please don't convert the reference numbers into # symbols. It's a pet peeve of mine, but if someone needs to rearrange the reference numbers and theres a lot of reference numbers, things get confusing real fast. Ksheka 03:11, Nov 19, 2004 (UTC)

OK, I won't mess with the references. We'll have to wait until MediaWiki supports footnotes...

Your help with Flecainide is appreciated. Sadly, it has received negative attention due to its copyvio problems, and I'm trying to convince User:MattKingston to stop making a fuss. JFW | T@lk 09:49, 19 Nov 2004 (UTC)

Okay. I just read the disecussion page of Flecainide. Given the seriousness of the vio, I'll give some more effort over the next couple days to fixing up the page. I'm pretty sure I have some free time this weekend. Ksheka 11:24, Nov 19, 2004 (UTC)

Thanks for your flecainide work, Ksheka. PS did you get my email? JFW | T@lk 01:03, 21 Nov 2004 (UTC)

Article Licensing

Hi, I've started a drive to get users to multi-license all of their contributions that they've made to either (1) all U.S. state, county, and city articles or (2) all articles, using the Creative Commons Attribution-Share Alike (CC-by-sa) v1.0 and v2.0 Licenses or into the public domain if they prefer. The CC-by-sa license is a true free documentation license that is similar to Wikipedia's license, the GFDL, but it allows other projects, such as WikiTravel, to use our articles. Since you are among the top 1000 Wikipedians by edits, I was wondering if you would be willing to multi-license all of your contributions or at minimum those on the geographic articles. Over 90% of people asked have agreed. For More Information:

• Multi-Licensing FAQ - Lots of questions answered
• Multi-Licensing Guide
• Free the Rambot Articles Project

To allow us to track those users who muli-license their contributions, many users copy and paste the "{{DualLicenseWithCC-BySA-Dual}}" template into their user page, but there are other options at Template messages/User namespace. The following examples could also copied and pasted into your user page:

Option 1

I agree to [[Wikipedia:Multi-licensing|multi-license]] all my contributions, with the exception of my user pages, as described below:

{{DualLicenseWithCC-BySA-Dual}}

OR

Option 2

I agree to [[Wikipedia:Multi-licensing|multi-license]] all my contributions to any [[U.S. state]], county, or city article as described below:

{{DualLicenseWithCC-BySA-Dual}}

Or if you wanted to place your work into the public domain, you could replace "{{DualLicenseWithCC-BySA-Dual}}" with "{{MultiLicensePD}}". If you only prefer using the GFDL, I would like to know that too. Please let me know what you think at my talk page. It's important to know either way so no one keeps asking. -- Ram-Man (comment| talk)

Unverified images

Hi! Thanks for uploading the following image:

• Image:Dofetilide.png

I notice it currently doesn't have an image copyright tag. Could you add one to let us know its copyright status? (You can use {{gfdl}} if you release it under the GNU Free Documentation License, {{fairuse}} if you claim fair use, etc.) If you don't know what any of this means, just let me know at my talk page where you got the images and I'll tag them for you. Thanks so much. [[User:Poccil|Peter O. (Talk, automation script)]] 05:49, Dec 11, 2004 (UTC)

P.S. You can help tag other images at User:Yann/Untagged_Images. Thanks again.

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There's a few more images without tags.

• Image:Action potential.png
• Image:Action potential Class III.png
• Image:Action potential Class Ia.png
• Image:Action potential Class Ib.png
• Image:Action potential Class Ic.png

Thanks for uploading them. --[[User:Ricky81682|Ricky81682 (talk)]] 21:33, Dec 19, 2004 (UTC)

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Also:

• Image:Common Flutter-Zoom.png RedWolf 23:29, Dec 23, 2004 (UTC)
• Image:Common Flutter.png RedWolf 23:30, Dec 23, 2004 (UTC)
• Image:Phenacetin.png RedWolf 21:56, Dec 30, 2004 (UTC)

Image source

Thank you for uploading Image:Aortic Stenosis - Hemodynamic Pressure Tracing.png. Its copyright status is unclear, so it may have to be deleted. Please leave a note on the image page about the source of the image. Thank you. --Ellmist 06:05, 13 Mar 2005 (UTC)

Image:Aortic Stenosis - Hemodynamic Pressure Tracing.png

Image deletion warning

The image Image:Aortic Stenosis - Hemodynamic Pressure Tracing.png has been listed at Wikipedia:Possibly unfree images. If the image's copyright status cannot be verified, it will be deleted. If you have any information on the source or licensing of this image, please go there to provide the necessary information.

Burgundavia (✈ take a flight?) 05:34, May 24, 2005 (UTC)

Image:Aortic dissection - Echocardiogram - Longitudinal view - Color.jpg

Image deletion warning

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Burgundavia (✈ take a flight?) 05:35, May 24, 2005 (UTC)

WPW

Great job, Ksheka! What I am missing still is something on the syndrom's etiology. I went to the doctor today because of Lyme borreliosis and they have found this heart defect. Could it be caused by the infection? Thanks. --Eleassar my talk 14:35, 27 July 2005 (UTC)

Category

Added your userpage to category physicians. Hope you don't mind. --Nomen Nescio 09:37, August 27, 2005 (UTC)

Paid Editing Project

Hi: My name is Tess and I work for a global independent research firm in New York. I am interested in hiring you for a Wikipedia editing project, based on your technology and medical experience and expertise. I attempted to email you through your user page. If you received it, please read it over and contact me with any questions. If you did not receive this email, please let me know and I would be more than happy to tell you more about this project. (You can call 512-651-1797 or email tfurman@glgroup.com). Thank you and I hope to hear from you soon! Tess - Gerson Lehrman Group 19:30, 28 September 2005 (UTC)

Emergency department

I wonder if you would consider supporting Emergency department at Wikipedia:Article improvement drive, to raise the profile of medicine on the wikipedia. The ED is a key area where the public receive emergency care, but the current article is very inadequate--File Éireann 23:27, 10 November 2005 (UTC)

Leave your suggestions for the page draft

Hi
Could you please review this draft I've prepared for "dilated cardiomyopathy" section, and give your suggestions? Talk:Dilated_cardiomyopathy
Thanks
huji 13:43, 23 November 2005 (UTC)

Echocardiogram images

Hi there Ksheka, I just realized that the beautiful echocardiograms you placed on mitral valve prolapse have been deleted by a bot determined to purge any potentially unfree images. I realize you haven't been around these parts in a while, but I figured I'd drop you a note and let you know. Plus, it'd be great if you could find those images and upload them once more -- this time with a {{gfdl}} or similar tag so they aren't deleted again. Cheers, David Iberri (talk) 23:02, 10 January 2006 (UTC)

Image Tagging Image:Hypertrophic Cardiomyopathy - Intraventricular Pressure Tracing.png

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Thanks for uploading Image:Hypertrophic Cardiomyopathy - Intraventricular Pressure Tracing.png. I notice the 'image' page currently doesn't specify who created the content, so the copyright status is therefore unclear. If you have not created this media yourself then you need to argue that we have the right to use the media on Wikipedia (see copyright tagging below). If you have not created the media yourself then you should also specify where you found it, i.e., in most cases link to the website where you got it, and the terms of use for content from that page.

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