Talk:Natalizumab/Archive 1

message: Is using the generic name for a drug as the title of the article perhaps a standard and
universally followed  WP convention? If so, then this article is properly titled, though I'm trying 
to figure out how to make the generally known name a little more prominent in the first sentence) .
If it's not the universal or almost universal convention, I'm going to argue the point.
I did change the cryptic section heading "PML" DGG 23:06, 4 October 2006 (UTC)
replies: text: Yes, it is – see Naming of drug pages. Anyway, Tysabri redirects here, so anyone typing "Tysabri" in the search box will be brough to this article. Fvasconcellos 15:55, 5 October 2006 (UTC)
replies: text: Title should be the generic name -- Samir धर्म 02:21, 6 October 2006 (UTC)
thread_title: generic name

message: Is this notable for the Tysabri topic?
http://mugglenet.com/app/news/show/689
Subsequently, and following an outcry from MS organisations and personalities such as Ms Rowling, in both England and Scotland the Governments decided to reimburse Tysabri in cases of "highly-active" RRMS. At the start of 2008, the funding was becoming available.io-io (talk) 00:44, 21 January 2008 (UTC)
thread_title:  Jo! 

message: Anyone have an idea why the pharmacology of this drug gets so little emphasis, while a rare brain disease and return to market get such big play in the article?  Dr. Holland, Kd4ttc 15:03, 24 July 2007 (UTC)
replies: text: I'm a writer, not an MD, so I can't improve it much further.  Hopefully some medical/pharmaceutical editor will flesh out the pharmacology.  --CliffC 01:22, 26 July 2007 (UTC)

text: I have added mechanism-of-action text directly from the FDA labelio-io (talk) 00:45, 21 January 2008 (UTC)
thread_title: Why is there such an odd balance in this article?

message: Initial improvement in health-related quality of life (measured by SF-36) is sustained when the drug is continued for a total duration of 48 weeks:  JFW | T@lk 18:43, 2 December 2007 (UTC)
thread_title: HRQOL in Crohn's

message: References 5 and 6 on the current page ([5] New Data on Natalizumab Demonstrate Significant Improvement in Cognitive Function in Patients With Multiple Sclerosis. Doctor's Guide and [6] New Pharmacoeconomic Data On TYSABRI® Demonstrate Significant Reduction In Steroid Use And Hospitalizations In Patients With Multiple Sclerosis) are sourced to news services.  I've looked a bit on pubmed but found nothing published in medically reliable sources that says the same thing, does anyone have citations for these statements?  They justify the statements "maintained cognitive function,[5] reduced the use of steroids and hospitalization[6]"; the other statements in the paragraph I tracked down pubmed journals for, but these ones I'm either not looking in the right spot or haven't been reported yet.  WLU (talk) 01:01, 10 March 2008 (UTC)
replies: text: I note you are asking these questions, but also you seem to have already shortened the section, summarily removing the Oct'07 Report to ECTRIMS that N "significantly increases the proportion of disease-free patients with MS". However, this Discussion has received input from others, including Garrondo who has contributed hugely to the Treatment of multiple sclerosis page, recently honored as a Wiki feature, and he has described the fact that sometimes you cannot find a better source. We will have to see if can find better citations for you, so that these secondary clinical trial results in MS symptoms can reach a wider audience, but you have to repect the Discussion. And please don't label a news release as "drug company material" when it clearly describes a poster or presentation at a leading Neurology conference....io-io (talk) 01:59, 10 March 2008 (UTC)
replies: text: I have found and inserted an additional 4 abstract citations from the AAN (American Association of Neorolgy) annual meeting. On this basis I have restored at least 1 of the proven benfits that you had unilaterally deleted. Also, as no-one has contradicted my previous position stated above that this Wiki Page needs to have some balance restored, I have added bold-face paragraph headings in order to direct the reader to these proven claims of what N definitively prevents and achieves...io-io (talk) 02:53, 10 March 2008 (UTC)
replies: text: Bold claims are addressed below - balance should be found by expanding sections, not SHOUTING at the reader.  WP:MOSBOLD has more information.  The lead could also be expanded to place more emphasis on benefits - I have done so, but only for a limited number of improvements (basically the ones I remember, but probably the most significant; though the lead should not enumerate every single benefit the most significant should be there).  IO, please note that I am trying to do what I think is best for wikipedia, based on my experience on the project.  I am not trying to smear or worsen the name of natalizumab.  Please assume good faith that I am doing the best I can.  I understand parity of sources; lacking a pubmed journal a conference presentation or publication from the drug's producer is adequate.  But if such a journal is available, it is a superior source that I would prefer to cite, per WP:MEDRS.  WLU (talk) 11:58, 11 March 2008 (UTC)
replies: text: OK, I will assume good faith. I would point you to the WP:PILLARS and where it says that "Perfection is not required". Also WP:LOP states: "Every policy, guideline or any other rule may be ignored if it hinders improving Wikipedia." Take for example Bupropion, note how it's page departs rigid formatting into various conditions (perceived/symptomatic, and not diseases per se), some for which it is not approved. Also, the issue of how to present these trial results has been "Talked" for a week now, and two other informal WP:3O have come down on the side of more information about what N does, than what was presented hereto.....(separate issue: I believe now that, out of the 7 or 8 medical presentations, only 1 is uniquely sourced from a company news release)....io-io (talk) 00:20, 12 March 2008 (UTC)
replies: text: addendum - earlier, I had proposed bullet-points below...would do later...io-io (talk) 00:23, 12 March 2008 (UTC)
thread_title:  Refs 5 and 6 

message: Acknowledging comments just received from WLU on my Talk page, and I believe the appropriate place for them is here as the Discussion is daily ongoing:
:" Please review MOS:CAPS (in particular Wikipedia:Manual_of_Style_(capital_letters)#Section_headings) and WP:HEAD for restrictions and formatting of capital letters and section headings on wikipedia " 
I will review and address later ....input welcome of course from others on all topics....io-io (talk) 23:41, 10 March 2008 (UTC)
replies: text: Addressed the issue of capital letters in the sub-section headings...io-io (talk) 00:34, 11 March 2008 (UTC)
replies: text: Per WP:ITALICS and WP:MOSBOLD, I've removed the use of italics and bold where not necessary.  I've also collapsed the number of subheadings in the MS section to a single sentence listing the effects of N on MS patients (per WP:UNDUE, giving each its own section places excessive emphasis on each finding when there's no real need to have a sub-section for every single effect), re-wrote to avoid quotation, re-added the information on antibodies (as it's referenced in a peer-reviewed journal and a valid inclusion on the page), added the mechanism of action and the mention of its withdrawal and re-approval to the lead per WP:LEAD.  The lead should summarize the main information in the body text below proportionate to the coverage in the body, and I think I've captured the sub-headings and contents appropriately.  Please note that citation templates are used extensively in the referencing;  should be used when it is a web-based link only, there are also  when published in a peer-reviewed journal and  for conferences.  I am not against information that supports the effectiveness of natalizumab, but the page should be encyclopedic - all information that can be included, should be included.  Give me references about N being good or bad, I'll add both.  Most of these changes are to standardize the page against other wikipages and primarily against the manual of style.  Given this is a publicly editable encyclopedia, the only touchstones we have for uniform formatting are the MOS, policies and guidelines and that is what I try to edit by.  Please let me know if I have made any errors per these guidelines.  WLU (talk) 11:48, 11 March 2008 (UTC)
replies: text: Others in the Discussion have pleaded that above all else, what the drug actually does, should be clear. That has been the problem. I have no time now, but propose bullet-points....io-io (talk) 18:53, 11 March 2008 (UTC)
replies: text: What do you believe is missing?  I have edited the lead twice (MS and CD) to show the benefits to those diseases, given a reference or specific suggestion, I could add more.  WLU (talk) 18:56, 11 March 2008 (UTC)
replies: text: What is missing is the clarity - these are the results that distinguish it in MS; these are what patients (and doctors, even from a technical sense, because symptom improvement is a reasonably reliably surrogate that the drug is working clinically) need to see, above all else, on the Page - this would be a Wiki improvement as I described in talk-section above, and that is why I propose bullet-points...io-io (talk) 00:27, 12 March 2008 (UTC)
thread_title:  Manual of style (further comments from WLU) 

message: The current reference 4, , is to a conference poster that has not yet happened (note the date is for April 15th, 2008).  Is this normal?  Is this kosher?  I understand that research is done months in advance of publication and I've always been confused by the  template and would love some informed opinions on this.  WLU (talk) 15:50, 11 March 2008 (UTC)
replies: text: "Is this normal? Is this kosher? " - Its normal that abstracts get published based in advance upon the paper. The asbtract is a fact now, the presentation is a scheduled fact, and nothing else is really relevant...io-io (talk) 18:56, 11 March 2008 (UTC)
replies: text: Here - http://en.wikipedia.org/w/index.php?title=Natalizumab&diff=197490362&oldid=197486843 - which your edit descritption lists as "adding a conference citation" - there are now 1 less proven N benefit with conference citation than before, because deleted is "(N has been shown to)... reduce the severity of MS, http://www.abstracts2view.com/aan2008chicago/view.php?nu=AAN08L_P04.169}}"? (found here - http://www.abstracts2view.com/aan2008chicago/index.php - if needed to verify). Would assume accidental, but if not, please provide justification....io_editor (talk) 17:11, 23 March 2008 (UTC)
thread_title:  Unpresented conference 

message: Note discussion on AN/I:  Wikipedia:Administrators%27_noticeboard/Incidents#Natalizumab.  WLU (talk) 20:18, 12 March 2008 (UTC)
thread_title:  Noticeboard discussion 

message: I created a new page, challenge-dechallenge-rechallenge, 'cause there is no page on it, and I believe it is the appropriate medical testing protocol referred to in the contraindications section.  Could any doctors confirm (and expand?) WLU (talk) 23:10, 12 March 2008 (UTC)
thread_title:  New link 

message: The above section in the article doesn't actually contain any physical or chemical properties. Its content should be merged into the rest of the article, and what's already adequately covered removed altogether. Fvasconcellos (t·c) 02:39, 13 March 2008 (UTC)
replies: text: I believe I did so adequately, I moved it into mechanism of action and invisibled the properties heading.  WLU (talk) 13:23, 13 March 2008 (UTC)
thread_title:  Physical and chemical properties 

message: I re-ordered the page per Wikipedia:Manual_of_Style_%28medicine-related_articles%29#Drugs - history should actually be first, unlike disease pages.  I believe User:Jfdwolff had re-ordered the history to the former section (the end, just before see also) and I thought it was because I had mis-read the MOS article.  However, given the discussion above and re-examining MEDMOS, I think it is warranted that the history section go at the top.  Wolff - if I missed out on the reason for the move, please let me know so we can discuss.  WLU (talk) 17:21, 13 March 2008 (UTC)
replies: text: What User:Jfdwolff actually wrote when he moved the History section to the end was something entirely different - that he considered it minimally relvant today......regardless of what MEDMOS says, few drug pages have the history first, if indeed they even have a history section...but dont take my word for it, instead that can be seen here - http://en.wikipedia.org/w/index.php?title=Natalizumab&diff=191920442&oldid=191684328 .....io-io (talk) 22:42, 13 March 2008 (UTC)
replies: text: "History", in this case, usually refers to the drug discovery and development process, and to events preceding modern pharmacological use in humans. The events occurring after approval of natalizumab are probably better covered under the WP:MEDMOS heading "Legal status", since they deal with regulatory events rather than "history" per se. In which case they would appear later in the article. That's my 2 cents. MastCell Talk 22:53, 13 March 2008 (UTC)
replies: text: History=drug development, Legal status is licensing/withdrawal/relicensing/restricted issuing issues - moved as per WP:MEDMOS#Drugs. David Ruben  Talk  01:22, 17 March 2008 (UTC)
thread_title:  History move 

message: MEDMOS / drugs - http://en.wikipedia.org/wiki/Wikipedia:MEDMOS#Drugs - guides that Drug pages be written - "For example, a long list of side effects is largely useless without some idea of which are common or serious. It can be illuminating to compare the drug with others in its class...." Accordingly:
- Multiple Sclerosis DMD class
*Avonex - mention of liver side effects confined to single sentence in the middle of "Overview" section, despite Primetherapeutics; no mention of PML, even though the 2 patients who got PML in the N trials were on Avonex; no mention of any safety issues in the lead.
*Rebif - same as above, (with the exception that PML has not been linked to it).
*Betaseron - speaks only of beneficial effects, liver issues not mentioned anywhere
*Glatiramer acetate - issues are confined to a single section; nothing in lead
*Mitoxantrone - side effects in sngle section; despite absolute limit on usage due to cumulative heart damage - no mention in lead
- Crohns Disease DMD class
*Infliximab - despite black box and multiple FDA warnings, safety issues confined to a single section, and nothing in lead. Although linked with PML, this is not even mentioned. Article is generally glowing, which it should, given the versatility.
*Adalimumab - despite black box and FDA warnings, safety issues confined to a single section, and nothing in lead.
- Drugs linked to PML
*Rituximab - despite black box and multiple FDA warnings, safety issues including PML confined to a single section. Nothing in lead. Interesting becase this is the best hope for a PPMS treatment.
*Chemotherapy - obviously countless die from it's toxocity, but no mention of safety is lead. Immunosuppression and myelosuppression titles a sub-section.
*Corticosteroids - this is class of drugs with inevitable serious side-effects - but nothing in lead, and very little mention on page - no meniton of PML anywhere.
*Tacrolimus - thousands die post-transplant from immune suppression, but no mention of safety is lead. Immunosuppresion following transplantation titles a sub-section.
*Avonex - see above.
- Conclusion - of 11 comparables, none of their Wiki pages seem close to the layout of the N page - this supports my thesis of WP:NPOV / WP:UNDUE problems.....io-io (talk) 20:01, 22 March 2008 (UTC)
replies: text: Again, I think further conversation on this point is wasting everyone's time and energy, and I recommend that we stop the discussion.  Perhaps we can revisit it at a much later date.  WhatamIdoing (talk) 20:21, 22 March 2008 (UTC)
replies: text: WhatamIdoing is accurately reporting the views of a pretty broad consensus here, and I think his suggestion to revisit at a much later date is a reasonable one. Antelantalk 20:28, 22 March 2008 (UTC)
replies: text: OK, say for the world within Wiki, it's true, better keep the status quo. But the world outside Wiki, what about that world, it doesn't matter? can it wait?.....io_editor (talk) 21:04, 22 March 2008 (UTC)
replies: text: I think you've done a good job of compiling that list. Instead of posting that here, however, why not remedy the problem and add in appropriate adverse event information into the other articles? That will be a boon to the encyclopedia. Antelantalk 21:11, 22 March 2008 (UTC)
replies: text: Recall Occam's razor? From their many contributors, no-one has expressed an opinion that any of those pages have WP:NPOV / WP:undue problems....io_editor (talk) 23:38, 22 March 2008 (UTC)
replies: text: Occam's razor - do not postulate plurality unnecessarily. Here, it is necessary to postulate plurality. Id est, there are several (plural) articles lacking in relevant adverse events. If there are sources to back what you've said, then those articles need to be updated. Would you like to work with me on improving them? Antelantalk 23:47, 22 March 2008 (UTC)
replies: text: because: 1) No opinion there of WP:NPOV / WP:undue problems...2) Still other serious progressive diseases affirm same WP:NPOV standard...3) I am wiki-busy/backlogged...4)Why are we here?...5)The outside Wiki world need not wait when WP:undue has grave consequences....io_editor (talk) 01:21, 23 March 2008 (UTC)
replies: text: You need to stop speaking in policy code. I don't see how NPOV/UNDUE are relevant to the fact that other articles are lacking in information. I'm offering help to you - you have identified articles that are lacking in info on adverse events. I'm willing to help you add those adverse events. Now, please feel free to reply to me on my talk page or here, though this is not truly a relevant place for this discussion, on the condition that you actually want to help bring these other articles up to par. Antelantalk 01:41, 23 March 2008 (UTC)
replies: text: sticking to N subject; suggest confirm relevance to the outside-wiki world by reading: http://www.msrc.co.uk/index.cfm?fuseaction=show&pageid=2396 (hope you understand implications) - before pursuing those tactics....io_editor (talk) 02:05, 23 March 2008 (UTC)
replies: text: Improving Wikipedia articles is now a "tactic"? I'm sorry you're not interested in working with me to improve other articles. Better luck in the future, Antelantalk 03:00, 23 March 2008 (UTC)
replies: text: already comitted to working on 1 of them; in others I dont see anything mis-leading; suggest if you see WP:undue issues, bring them up on their own talk pages; only issue that belongs here is N....io_editor (talk) 16:28, 23 March 2008 (UTC)
thread_title:  "compare the drug with others in its class" - per MEDMOS 

message: An interesting property of natalizumab, and possibly even a therapeutic mechanism, it is ability of mobilising haematopoietic stem cells (CD34+ mononuclear population) from the bone marrow:  JFW | T@lk 10:46, 25 March 2008 (UTC)
replies: text: I enquired today of colleagues if this had any significance, and apparently the drug will be trialled in multiple myeloma. Nothing on the clinicaltrials.gov site however.io_editor (talk) 01:50, 27 March 2008 (UTC)
thread_title:  Stem cells 

message: Reference #1 - from NEJM - withdrawal by Biogen -http://content.nejm.org/cgi/content/full/353/4/432
Reference #2 - FDA approval history - subsequent "re-approval" was actually a "supplemental"  (Biological License); original License was in place - http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Label_ApprovalHistory#apphist   ....io_editor (talk) 01:17, 29 March 2008 (UTC)
thread_title:  FDA did not withdraw Tysabri nor cancel it's License 

message: There were 3 PML cases; of which 2 died. Only in full-blown Aids is PML usually seen, and is usually fatal due to the absence of an immune system.  So how did these patients die? 
 1. http://content.nejm.org/cgi/content/full/353/4/375?ijkey=b24b4864c7f8f2c41bcc31d8e021ff52b2f40430
 2. http://content.nejm.org/cgi/content/full/353/4/369?ijkey=f3eceb18a94aa8b54237f55ba4a7286c8f4e071f
 3. http://content.nejm.org/cgi/content/full/353/4/362
What all 3 had in common were 2 things:
 1. con-committant drugs (avonex in 2 "MS" patients; and in the CD patient, not simultaneous but was
 already chronically immuno-suppressed - had already low lymphocyte counts due to prior immuran and infliximab).
 2. a bungling period 3 to 5 months of PML mis-diagnosis before death or partial recovery (in one
 case of course the mis-diagnosis of a brain tumor continued for 2 years post-mortem). In this 3 to 5
 months of PML mis-diagnosis, all 3 received massive amounts of powerful immuno-suppressive medications - all
 for the wrong issues.
Treatment of PML in these non-Aids cases appears possible - http://archneur.ama-assn.org/cgi/content/abstract/64/2/169 - ....io_editor (talk) 01:33, 29 March 2008 (UTC)
thread_title:  the PML deaths 

message: By "original diagnosis", 2 is the answer; 1 died, 1 lived. However, a few months after the NEJM simultaneously published the case histories, it published a pair of letters (presumably, among many) which, to the embarrassment of the authors, cast doubt on the MS diagnosis of both patients - http://content.nejm.org/cgi/content/full/353/16/1744 - rather than explain all that, and for those who have no NEJM access, here is a full copy, minus the references -
<<<<<" To the Editor: According to the established definition of multiple sclerosis, the condition in the patient described by Kleinschmidt-DeMasters and Tyler (July 28 issue) should not have been diagnosed as multiple sclerosis. Apart from the unusual clinical findings, no oligoclonal bands were detected in two separate examinations of the cerebrospinal fluid, and repeated magnetic resonance imaging (MRI) scans obtained over the course of several years showed new and enlarging, but never enhancing, lesions. The most convincing argument against a diagnosis of multiple sclerosis is the neuropathology: no lesions that are characteristic for multiple sclerosis were detected. The patient described by Langer-Gould et al. in another article in the same issue may also raise concern about the diagnosis of at least "typical" multiple sclerosis. One to two oligoclonal bands in the cerebrospinal fluid would have to be considered negative, and repeated MRI scans would not show enhancing lesions. Therefore, it does not seem appropriate to conclude that patients with multiple sclerosis may be at risk for progressive multifocal leukoencephalopathy (PML) owing to treatment with natalizumab and interferon beta-1a. Is it possible to misdiagnose subclinical nonfatal cases of PML as multiple sclerosis in patients who are not obviously immunosuppressed? Further investigations of JC virus infections should extend our knowledge of this scenario. 
Thomas Berger, M.D., M.Sc. 
Florian Deisenhammer, M.D., M.Sc. 
Innsbruck Medical University 
A-6020 Innsbruck, Austria
Dr. Berger reports having received unrestricted research-grant support, lecture fees, and consulting fees from Berlex, Biogen-Idec, Sanofi-Aventis, Schering, and Serono; and Dr. Deisenhammer, unrestricted research-grant support, lecture fees, and consulting fees from Biogen-Idec, Schering, and Serono.">>>>>  (Io-Editors's note - this means almost all the MS DMD maker/ competition)
-------------------------------------------------------------------------------
 
To the Editor: Kleinschmidt-DeMasters and Tyler described a patient with multiple sclerosis and PML that developed after she received natalizumab treatment. However, some of the findings in this patient are uncommon in multiple sclerosis. The absence of contrast enhancement in the MRI studies that were performed — almost a rule in patients with PML — is uncommon in multiple sclerosis. The lack of intrathecal synthesis of IgG is unusual in multiple sclerosis, although it is frequent in PML. Moreover, an autopsy study found no multiple sclerosis plaques but only PML lesions. Therefore, the pathological findings did not support a diagnosis of multiple sclerosis, which raises some questions. Can initial PML mimic multiple sclerosis? Was PML the only disease in this patient? To our knowledge, PML with a relapsing–remitting course has not been described. To clarify whether PML may have a relapsing–remitting course, it is necessary to study the cerebrospinal fluid in patients with relapsing neurologic disorders to rule out this disease. This seems particularly important for patients with suspected multiple sclerosis with atypical findings, such as early mental symptoms or an absence of oligoclonal bands. If it is demonstrated that PML can have an initial relapsing–remitting course, the risks of natalizumab treatment should be reevaluated. 
José C. Álvarez-Cermeño, M.D. 
Jaime Masjuan, M.D. 
Luisa M. Villar, Ph.D. 
Hospital Ramón y Cajal 
28034 Madrid, Spain 
Note that these letters raise the possibility that, not only did one or both patients never had MS, but may have had "sub-clinical" PML. Perhaps in recognition of this (because the anomaly was raised at the FDA Advisory Committee Hearings - reference available), patients "who already have PML" are contra-indicated on the label for N treatment....io_editor (talk) 13:23, 29 March 2008 (UTC)
replies: text: In actual practice, both in all trials and in 2 years of widespread availability, no MS patient (real or disgnosed) has contracted PML while on N alone - http://www.biogenidec.com/site/tysabri-information-center.html (by Dec '07, there were 21,000 MS patients on N)....io_editor (talk) 14:16, 29 March 2008 (UTC)

text: Their long-winded excuses, for failing to note the strange diagnosis in their single-patient paper, doesnt help ths page much - but here is part of their conclusion - "we believe it is unlikely that a chronic indolent or relapsing–remitting form of PML was the sole disease that this patient had" - all the more remarkable given that all they had was an autopsy....io_editor (talk) 16:32, 29 March 2008 (UTC)
thread_title:  How many "real" MS patients on N (and Avonex) got PML? 

message: N mentioned twice, including general descriptions of efficacy and safety - http://doc.mediaplanet.com/projects/papers/Multiplesclerosis.pdf
- notice that PML & Deaths are not mentioned at all - io_editor (talk) 17:24, 29 March 2008 (UTC)
replies: text: So an article by the New York Times isn't appropriate, but an advertisement in the London Times is? Antelantalk 17:47, 29 March 2008 (UTC)
replies: text: I have alreaady dealt with the NYT - even this month they think N is "back in clinical trials" and appear to borrow the term "the sixth drug is Tysabri"  http://query.nytimes.com/gst/fullpage.html?res=9C03E0DC123BF937A35750C0A96E9C8B63&sec=&spon=&pagewanted=2 - from the Wikipedia (Multiple sclerosis page) -  but to call the London Times piece an advertisement is intellectually dishonest because there is no other a way that a national MS society can advance its agenda in so prominent a manner, and what they write reflects their policies...io_editor (talk) 18:53, 29 March 2008 (UTC)
replies: text: No, to call it an advertisement is intellectually and in all other ways candid, since an advertisement is what that is. The fact that a robust and respected institution took out the advertisement doesn't change the fact that it is an advertisement. Antelantalk 19:04, 29 March 2008 (UTC)
replies: text: Well, if you have a point relative to N - any point at all - say what it is. I will leave it you and others to determine which has more relevance to encyclopedic-writing on N - this 12-page ad by the "robust and respected institution" or the current NYT article which appears to borrow from Wiki itself, and and get other basic facts wrong....io_editor (talk) 19:22, 29 March 2008 (UTC)
thread_title: Today's MS Society (UK) 12-page pull-out on MS in London Times