Template:Did you know nominations/Charles S. Bryan

The following is an archived discussion of the DYK nomination of the article below. Please do not modify this page. Subsequent comments should be made on the appropriate discussion page (such as this nomination's talk page, the article's talk page or Wikipedia talk:Did you know), unless there is consensus to re-open the discussion at this page. No further edits should be made to this page.

The result was: promoted by Yoninah (talk) 19:13, 29 June 2019 (UTC)

Charles S. Bryan

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Charles S. Bryan

... that Charles S. Bryan (pictured) and Bill Stone worked out how to avoid toxic doses of penicillin in people with kidney failure?
- ALT1:... that ...?

Reviewed: Hu Jinqing

Created by Whispyhistory (talk) and Philafrenzy (talk). Nominated by Whispyhistory (talk) at 22:35, 22 May 2019 (UTC).

New enough. Long enough. QPQ done. NPOV observed. Earwig and spot-checking found no close paraphrasing issues, copyright violations or plagiarism. Well-cited throughout. Hook is interesting enough. AGF on the Annals of Internal Medicine source, as I can only read part of it, but the interview appears to support it. Well-cited throughout. Photo is suitably licenced for the main page. Edwardx (talk) 10:31, 10 June 2019 (UTC)

Came to promote, but I'm trying to understand the hook, which is a little vague, and the article ditto, and I'm not sure the first source cited in the article's hook sentence mentions this, and I can't get to the second and third sources. What exactly did they do? Hook says "worked out how to avoid toxic doses" per the hook, and "worked out how to give the maximum dose of penicillin to a person in kidney failure, who otherwise might develop toxic levels of penicillin in their blood" per the article? Do any of the sources say anything specific at all, like it's a procedure, or a method, or a dosage schedule, or a formulation, or what? --valereee (talk) 20:30, 20 June 2019 (UTC)

It seems clear enough to me. Ref 2 quotes him as saying: "One day a question arose on the wards about the disposition of penicillin in patients with renal failure, the scenario being a patient who was twitching and stuporous and feared to be near death. Nobody could figure out what was going on because all of his basic parameters were reasonably controlled. We believed that we had his infection under control. We wondered if it were the penicillin. We stopped the penicillin and he woke up and made a full recovery. We asked how one might give penicillin to a patient with renal failure to assure, for example, the bacteriologic cure of meningitis or endocarditis and achieve the same blood level as in a normal person receiving 24 million units of penicillin daily. It turned out nobody had done that, even though it had been shown in 1942 by Charles Rammelkamp and Chester Keefer that excretion of penicillin is markedly slowed in renal failure. With a nephrologist, Bill Stone, I worked it out." Published in an article in The Annals of Internal Medicine which no doubt contains more technical detail, but the basic point is clear I think. Philafrenzy (talk) 20:58, 20 June 2019 (UTC)

Thanks @Philafrenzy: and @Yoninah:, correct...yes..there is a formula they worked out...written in the original paper. If someone has kidney failure and an infection, and you treat them with the same dose of penicillin as with someone with normal kidney function, there is risk of penicillin toxicity as the penicillin is excreted more slowly when kidneys are not working properly. Bryan and colleague developed a formula to adjust the dose in order to treat the infection and avoid penicillin toxicity. The hook sounds ok to me. It is probably his most significant achievement. I have the full original paper but on me until next week. Whispyhistory (talk) 07:05, 21 June 2019 (UTC)

Would the source support this:

ALT1 ... that Charles S. Bryan (pictured) and Bill Stone developed a formula to prevent penicillin toxicity in people with kidney failure?

To me that reads less vague than "worked out how to". --valereee (talk) 11:47, 21 June 2019 (UTC)

It's just a more complicated way of saying the same thing and adds nothing. We should go with the original which is easy to read, factually accurate, supported by the sources, and crystal clear. Philafrenzy (talk) 12:03, 21 June 2019 (UTC)