Standards for
authors presenting unusual cases for publication in ELCANO
Version 2.1
English Version
Project supported by the Research, Technology
and Development Programme in
International Co-operation /Developing Countries of the European Union
The following standards for the presentation of unusual cases is based
on the fifth edition (1997) of the Minimum Requirements for Manuscripts sent to
Biomedical Journals of the International
Committee of Medical Journal Editors.
The publication of unusual cases will be over the Internet, and
therefore, it is necessary to provide all the relevant information on the
accompanying form.
This document gives information concerning the definition of unusual
cases to be included in the ELCANO library, patient’s confidentiality and
specific details on how to complete the form.
Clinical
cases suitable for electronic publication in ELCANO should meet the criteria of
one of the following categories:
q
Diseases rarely seen in clinical practice.
Indicators
of how unusual a disease is, can be:
- There are
no publications of the clinical case.
- There are
some publications of isolated clinical cases, but no systematic review exists.
- There have been reviews published about the disease
over time and/or from several hospitals, but these have become obsolete due to
the advances of medicine.
- The known
prevalence of the disease is lower than 1%.
Usual diseases
presenting with groups of unusual or atypical symptoms.
This category includes
diseases which are common in one of the two regions but unusual in the
other. A provisional list of these can
be found in the web page of ELCANO: http://www.imim.es/elcano
Patients with diseases,
unusual or not, who cannot be treated with the most usual therapy. This includes medical (allergies, previous
adverse effects to established treatments, etc.), and ethical (refusal of a
treatment for religious or moral grounds or other causes) restrictions.
Multiple
diseases in the same patient that fulfil the previous
conditions.
Clinical
cases where an error occurred in the diagnosis and/or treatment from which
there are lessons to be learned. Cases should not be considered
appropriate where the medical error is due to negligence as they do not
illustrate a scientific error from which the readers gain knowledge.
Readers
of primary sources need to know that what they are reading is original, unless
it is clearly stated that the article was published with the author's and
editor's consent. The basis for this
position is internationally regulated.
Most
scientific publications do not accept articles that have already been published
or that are in the process of being published either in print or
electronically. When an author submits
an unusual case for electronic publication, it must be stated in writing that
the case has not been published, or that it has already been accepted, or it is
in the process of publication in some journal.
In that case it must be shown that the author has obtained the consent
of the editor of the journal for electronic publication of the case. In the event of duplication of publication,
the author must accept responsibility.
The editor of ELCANO will decide on the publication or rejection of
cases submitted.
The
protection of the patient's confidentiality is a priority in the publication of
unusual cases. As such, all information
relating to the patient's identity must be omitted. The author should bear in mind that seemingly
innocuous data, such as the patient's initials, could lead to identification
and therefore, should never be included.
In
exceptional cases, where it is necessary to publish pictures with facial
features that could possibly identify the patient, the patient should be shown
the relevant material and written authorisation for
publication should be obtained from the patient.
It
is important to emphasise that information should
only be omitted if it could identify the patient, and that scientific data
should never be altered or falsified to protect the patient's identity.
In
clinical cases concerning medical errors, the National Editorial Board of
ELCANO has the discretion to eliminate any reference to the patient’s centre of
origin, the author or institution.
Reference to the country of origin will be included where this is
necessary for the scientific documentation of the case. In all other cases it will not be
included.
The
Editorial Board of ELCANO reserves the right to exclude all means of
identification of authors and centres if, in the
opinion of the editors, the reported case could result in litigation.
Any
conflict of interests, potential or real, on the part of any of the authors or
institutions involved should be declared explicitly to the editors of ELCANO.
The National Editorial Board of ELCANO will decide if it is necessary to
include the declaration of conflict of interests in the electronic publication
of the clinical case. This declaration
of conflict of interests includes - but is not limited to - commercial
relations with the pharmaceutical industry with clear implications in the
reported clinical case, membership of societies involved in the clinical case,
or where the authors is dependent on a centre where the patient has previously
been treated.
For
the ELCANO project, unusual cases should be submitted on the form designed for
that purpose. They can either be submitted on disk or in hard copy.
If
the case is presented electronically (disk), the format should be compatible
with word processor MS Word version 6.0 for MS Windows or in ASCII text format.
The final version should be submitted on disk together with a printed
copy.
A
clear name should be given to the file containing the case, and the disk
clearly labelled with the author's name, a brief
description of the case and the file name.
Detailed information relating to the software and hardware used should
be provided, especially in the case of ASCII text.
For
the printed copy white paper (216x279 mm) or ISO-A4 (212x297 mm) should be
used.
All
sections of the form must be in double space and preferably in Times New Roman
font, size 12.
The
title of the case, clinical report, discussion, bibliographical references,
acknowledgements and figures, should all begin on separate pages.
Figures with pathological
images can be sent as photographs (black and white, or colour)
no smaller than 13 x 18 cm, or as slides of 25 x 35 mm. The diagrams, graphics and drawings should
be originals on pages DIN-A4 (212x297 mm).
Charts
and figures will be inserted in the relevant section (Clinical information or
Discussion) preferably created in MS Word 6.0.
Permission
for the reproduction of any published material that could identify patients
should always be included.
The first page will contain:
The receiving centre of
ELCANO will allocate each case a number which will be communicated to the
author. This should then be quoted as
the reference number for any future correspondence relating to the case.
The
receiving centre will complete this on receipt of the case for evaluation by
the National Editorial Board.
Relates to the National Editorial Committee of ELCANO.
Any
case to be included must meet the criteria set out by the project. Any individual case can fall within more than
one of the categories. It is possible
therefore, that a case could be of low prevalence, also have unusual
restrictions in treatment, and at the same time constitute an example of a
medical error to be avoided in similar cases.
The
full names of authors must be stated in the following format - first name,
initial of the middle name, surname.
There
is no limit to the number of authors that submit a clinical case. However, all the people designated as
authors should fulfil certain requirements. Each author should have participated enough
in the work to assume public responsibility for its content.
To
be credited as an author, a person should have contributed to the
a)
writing of the unusual case or the critical revision
of an important part of it, and
b)
approval of the final version to be published.
Requirements
of (a) and (b) must be fulfilled without exception. Merely participating in the gathering of the
data does not justify being given credit as an author. Each part of the unusual case that affects
the main conclusions will be the responsibility of at least one of the
authors.
The
editors of ELCANO can request the authors to justify the inclusion of each
individual in the list of authors.
The
name identifying the place of the authors' work should be stated. Where the authors work in different centres they will be identified by a number in parenthesis,
before the author's name as well as before the place of work. The official name of the place of work
should always be used to assure consistency with other publications and ELCANO.
The name of the place of work should be written in the official language of the
country. The translation of the official
names of services, departments, health centres or
institutions must be avoided.
Hepatic Transplant Unit. Department of General Surgery. St. Mary’s Hospital. London.
Servicio de Cirugia General y
Digestiva. Departamento de Cirugía.
Hospital Universitari del Mar. Universitat
Autònoma de Barcelona.
The
full postal address, telephone number (including dialling
codes and extension numbers), fax and email of the author responsible for
correspondence should be given.
The
name of the country where the patient has been treated should be given.
The
summary must contain a brief description of the case, with sufficient
information to illustrate the unusual aspects of the case. It should not exceed 250 words. This brief description will be the text used
in the index of ELCANO to identify the case.
The
Editorial Committee of ELCANO reserves the right to amend the description
proposed by the authors, without previous consultation with them.
The
clinical report consists of History, Physical Exam, Laboratory Tests, Imaging
Techniques, Endoscopy, Other tests, Diagnosis,
Treatment, Evolution and Final outcome.
Some
sections of the form include sub-sections.
Where there is no information available for a sub-section, it should be
left blank. Where it is known that a
test was not carried out (which affects the diagnosis or treatment) it should
merely say "Not carried out."
The
‘History’ section in the clinical report includes age, sex and place of origin
of the patient. Reasons for the
consultation, description of onset of the disease and the patient's admission
to hospital should be detailed.
All
relevant personal, social, family, allergic, medical and surgical histories and
addictions should also be specified, together with any other facts that are
relevant to the case in question.
Current
or recent medication should also be included, specifying the doses, generic
names and trademark.
The
vital signs should be stated: pulse in beats per minute, systolic and diastolic
arterial tension in millimetres of mercury (mmHg),
respiration rate in breaths per minute and temperature in degrees Celsius. Other relevant data should be written in the
corresponding sections.
If
an examination is not carried out, merely state "Not carried
out". In the case of normal
examination, state "
These
will be presented in the form of a table (in MS Word), in three columns: the
name of the test, the value in the patient, and normal values for the test. More lines can be added to the existing
table if necessary.
According
to the international convention (The New England Journal of Medicine IF Unit
Conversion Guide, Michael Laposata, MD PhD. Robquet Print Ltd.,
This
section describes the imaging techniques used, the date of the examination and
all technical characteristics where relevant, as well as the specialist's
report. If an image is sent for
publication, it should be indexed in the text as "Figure NN" (using
Arabic numbers) and should be numbered consecutively in order of appearance in
the text. The description of each image
should be included in the chart of Figures.
Endoscopy examinations should be included in this section. The
full endoscopy report should be given including
pathological and histopathological findings. If the study has images to be included in
the case, they should be treated as stated in the previous section.
Additional Studies
Other tests and examinations not included in the
previous sections should be described.
The
diagnosis should be clearly stated for the case in question. This section should also include the
diagnosis of associated conditions as well as the main diagnosis. The final diagnosis must be certain and
confirmed. Clinical cases with
uncertain or speculative diagnosis will not be included in ELCANO.
The
pharmacological treatment must include the doses, schedules, generic name and
trademarks of the medications used in the patient's treatment.
The
surgical treatments must be specified in detail with a clear description of the
techniques used, avoiding the use of eponyms (it is
better to say "cephalic duodenum pancreatectomy
with pyloric preservation" than "modified Whipple’s operation").
A
description of the sequence of clinical events with which the patient presented
must be made, including different symptoms, laboratory examinations, imaging
tests and treatment.
This
section is especially useful in complex cases where new pathologies or
complications appear during the course of diagnosis or treatment. Further
tables can be included to specify a further series of laboratory tests or
imaging explorations, etc.
The
author must take special care in this section, to provide only facts about the
case, and not enter into any discussion or justification of the strategies
undertaken, as these issues must be dealt with in the Discussion section.
Clear
reasons why the case is unusual must be given in this section. As such it is important that information
concerning prevalence or incidence should be included.
In
order to maximise the educational potential of each
case it is important that the discussion should highlight any improvements that in
hindsight could have been made in diagnosis and therapy.
It
is also important to include any bibliographical references concerning all
aspects of the case, debatable points in diagnosis, treatment and prognosis,
together with evidence to support the treatment undertaken.
References
should be numbered consecutively following the order in which they are first
mentioned in the text. References in
illustrations should be identified with Arabic numbers in parenthesis, and
should be numbered in the text where the illustration is first mentioned
References
must be based on the format used by the National Library of Medicine of the
Summaries
of papers must not be included as references; "unpublished observations”,
"unpublished communications" and "personal communications"
should also not be quoted as references, but reference to written communication
may be included in the text (in parenthesis).
Articles accepted for publication but not yet in print should be
included in the references, with the title of the journal followed by the words
"In press". Articles
submitted to a journal but not yet accepted should be mentioned in the text as
"unpublished observations" (in parenthesis).
A
series of examples follow:
Include
the name of all the authors where there are six or less; if there are seven or
more, quote the first name of the six followed by "et al"
You CH, Lee KY, Chey RY, Mengar R. Electrogastrographic
study patients with unexplained nausea, bloating and vomiting. Gastroenterology
1980 Aug; 79(2):311-4.
If
the journal uses continuous page numbering throughout a volume, the month and
number may be ommitted.
You CH, Lee KY, Chey RY, Mengar R. Electrogastrographic
study patients with unexplained nausea, bloating and vomiting. Gastroenterology
1980;79:311-4.
The
Coffee drinking and cancer of pancreas (editorial). BMJ 1981;283:628.
Massone L, Borghi
S, Pestarino A, Piccini R, Gambini C. Localisations palmaires purpuriques de la dermatite herpétiforme. Ann Dermatol Venerol 1987;114:1545-7.
Magni F, Rossoni
G, Berti F. BN-52021 protects guinea-pig form heart
anaphylaxis. Pharmacol Res Commun 1988;20 Suppl
5:75-8.
Gardos
G, Cole JO, Haskell D, Marby D, Paine SS, Moore P. The natural history of tardive dyskinesia. J Clin Psychopharmacol 1988;8(4 Suppl):31S-37S.
Hanly C. Metaphysics and
innateness: a psychoanalytic perspective. Int J Psychoanal 1988;69(Pt 3):389-99.
Edwards L, Meyskens F,
Levine N. Effect of oral isotretinoin on dysplastic nevi. J Am Acad
Dermatol 1989;20(2 Pt
1):257-60.
Baumeister AA. Origins
and control of stereotyped movements. Monogr
Am Assoc Ment Defic 1978;(3):353-84.
Danoek
K. Skiing in and through the history of medicine. Nord Medicinhist Arsb 1982:86-100.
Ronne Y. Ansvarsfall.
Blodtransfusion till fel patient. Vardfacket 1989;13:XVI-XXVII.
Spargo PM, Manners JM. DDAVP and open heart surgery (letter). Anaesthesia
1989;44:363-4.
Shishido A. Retraction notice:
Effect of platinum compounds on murine lymphocyte mitogenesis (Retraction of Alsabti
EA,
Alsabti
EA,
Piccoli A, Bossatti
A. Early steroid therapy in IgA neuropathy: still an
open question (comment). Nephron 1989;51:289-91. Comment on: Nephron
1988;48:12-7.
Kobayashi Y, Fujii K, Hiki
Y, Tateno S, Kurokawa A, Kamiyama
M. Steroid therapy in IgA nephropathy: a
retrospective study in heavy proteinuric cases (see
comments). Nephron 1988;48:12-7.
Comment in: Nephron 1989;51:289-91.
Schofield A. The CAGE questionnaire and psychological health (published
erratum appears in Br J Addict 1989; 84:701). Br J Addict 1988;83:761-4.
Colson JH, Armour WJ. Sports
injuries and their treatment. 2nd rev ed.
Diener HC, Wilkison
M, editors. Drug-induced headache.
Virginia Law Foundation. The medical and legal implications of AIDS.
Weinstein L,
Vivian VL, editor. Child abuse and neglect: a medical community
response. Proceedings of the First AMA National Conference on
Child Abuse and Neglect; 1984 Mar 30-31;
Harley NH. Comparing radon daughter dosimetric and risk models. In: Gammage
RB, Kaye SV, editors. Indoor air and human health. Proceedings of the Seventh Life Sciences Symposium; 1984 Oct 29-31;
Akutsu
T. Total heart replacement device.
Rensberger B, Specter B. CFCs may be
destroyed by natural process. The Washington Post 1989 Aug 7;Sect
A:2(col 5).
Toxic Substances Control Act: Hearing on S776 Before
the Subcomm. on the
Environment of the Senate Comm. on Commerce, 94th Congr., 1st Sess. 343
(1975).
Ectasia. Dorland´s illustrated medical dictionary. 27th de.
The Winter´s Tale: act5, scene1, lines 13-16. The complete works of William Shakespeare.
Lillywhite HB, Donald JA. Pulmonary blood flow regulation in an aquatic snake. Science. In press.
A
minimum of 3 and a maximum of 10 key words should be included to help with
indexing the case. For this purpose,
the terms of the Medical Subject Headings (MeSH) list
of the Index Medicus should be used. For any new terms that do not yet appear in MeSH, common expressions should be used.
In
the ELCANO project, the word “figures” refers to graphs and images
(photographs). These must be numbered
consecutively in order of appearance in the text of the report.
On
the final page of the form is a table where a description must be given for
each image that accompanies the case.
In
the first column of the table the name of the figure appears (Figure
"NN") which must correspond with its citation in the text of the clinical
report or discussion.
In
the second column, there should be a description of the figure. This description will be the title of the
figure that will appear next to it in the WEB PAGE of ELCANO.
In
the third column, the name of the file containing the image must be quoted (if
the author submits a digitised image). Otherwise, it should be left blank and the
ELCANO centre to which the image is submitted will digitise
it and complete this section.
Images
should be sent as slides (25 x 35 mm) or photographs on glossy paper in black
and white or colour (minimum of 13 x 18 cm). The
patient’s name should never be included in the picture. Any letters, numbers, symbols or arrows
should be clear, uniform and contrasted in all the slides; and should be large
enough to remain legible after the slide has been digitised.
The
number of the figure and the first author's name should be written in pencil on
the slide or on the reverse of the picture.
The top edge of the slide should be indicated with an arrow.
If the image has already been published, the
original source will be acknowledged and authorisation
in writing to reproduce it will be presented.
This permission is necessary, independent of who is the author or
editor; the only exception being for documents within the public domain.
If
the pictures are microscopic enlargements, tint and augmentation should be
quoted at the foot of
the figure.
If
photographs of patients are used, these should not be identifiable. The editorial Committee of ELCANO reserves
the right to alter images to ensure complete confidentiality for the patient. In any case where it is impossible to hide
the patient's identity and at the same time maintain the scientific content of
the image (especially in images showing some facial features),
the Editorial Committee of ELCANO will request an informed consent in writing
from the patient for each image.