Archive for June, 2008

Publication is not the end of the process

June 30, 2008

At Cases Journal and Journal of Medical Case Reports, we encourage authors to report on any follow-up to their case reports. We also welcome you to ask questions, via posting a comment, if you would like to know more about any case report. In this way, publication of a case report is only the beginning of the process – we hope to open communication channels between authors and readers so that clinical experiences are shared more readily.

Richard Smith, Editor-in-Chief of Cases Journal, has today provided an update on his ‘Beijing cough‘ reporting on his return visit to the city. Read the comment online, and post your own comment if you have any questions about the case.

If you have published with JMCR or Cases Journal, let us know what has happened with the case since publication.

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Hydrocarbon pneumonitis caused by fire-eating

June 25, 2008

fire-eaterEfrosni Myloniki and colleagues, from Thessaloniki in Greece, report a case of a 16-year old boy  presenting with  dyspnea, cough, chest pain and fever after  fire-eating at a party.

A  chest  radiograph showed  infiltration  in  the  right  middle  lobe  which  was  diagnosed  as  aspiration pneumonia, and the patient was treated with antibiotics.

However, after five days, the patient’s condition deteriorated, and he was referred to a pulmonary clinic.

Spirometry revealed severe restriction of lung function, and a CT scan of the chest showed consolidation with an air bronchogram  in  the  right middle lobe, and areas of atelectasis and ground glass opacities in the middle and lower right lobes. Bronchoalveolar  lavage  fluid was hemorrhagic and  revealed cytoplasmic vacuolation of the macrophages,  lipid-laden  alveolar macrophages and neutrophilia.

These findings, and the use of liquid paraffin in the fire-eating routine, led the team to a diagnisis of hydrocarbon pneumonitis. The patient was treated successfully with systemic steroids and intravenous antibiotics.

Read the full case report for more details of the case, including images from the CT scans.

Motorcycling and pollution: an unusual cause of arrythmia?

June 5, 2008

26820967Published this week in Journal of Medical Case Reports is the unusual case of a 43-year-old motorcyclist who suffered cardiac extrasystoles and heart palpitations just two weeks after he began riding a lightweight motorbike to work. A diagnosis of premature ventricular complexes (PVCs) in bigeminy was made and the patient rested for two weeks. The PVCs  stopped during this period but resumed once he started using his motorbike on the same route to commute to work. With no other obvious explanation for the PVCs Dr Kent Emilsson suggests an association between air pollution and PVCs.

We already know of a worrying link between carbon monoxide from vehicles and ventricular arrhythmias, but so far previous reports are on patients with existing heart problems. To the best of the author’s knowledge this is the first report of this kind in relation to lightweight motorbike use.

For the full clinical information on this case, patient follow-up and how Dr Emilsson arrived at this conclusion please read his case report.

Professor Narayan speaks out on the pitfalls of case reporting

June 4, 2008

A leading Professor of Medicine, KM Venkat Narayan, today published an editorial on the pitfalls facing Cases Journal. He warns of the dangers of overlooking the “numerator phenomenon” – that by publishing case reports purely on what has been seen or experienced (the numerator), we will not always get a true sense of the problem. Professor Narayan recommends that “continuous caution will be needed to keep cases in perspective, in the absence of denominator information, and to not allow the emotive forces behind case reporting to singly or dominantly influence policy.

Narayan warns also of publication bias, and reminds potential authors that Cases Journal welcomes all cases – not only those that are clearly diagnosed, or on severe conditions.

Despite his words of warning, Professor Narayan has high hopes for our novel approach to case reporting: Cases Journal is a bold experiment in health journalism.  It can potentially help democratize the reporting of health and disease by widening the definition of cases to include those that matter not just to physicians but also to patients, their families, and to the community at large.”

You can share your opinions by posting a comment on this editorial. We look forward to hearing your thoughts.

Contribute to a BBC TV series

June 4, 2008

A new BBC TV series, Bizarre ER, tells the stories of survival of people involved in unusual accidents, or suffering unusual injuries and conditions.

The makers of the programme are particularly interested to hear from authors and readers of Journal of Medical Case Reports.

If you have handled an extraordinary case and would like to share it with the producers, please email Samantha Williams. They would initially only want to speak to you, and not with the patients. There would be no obligation to commit to the programme, and they are fully aware of the importance of patient confidentiality.

Share your point of view – post a comment

June 3, 2008

At Cases Journal and JMCR, we hope that publication of your case report won’t be the end of the process – we welcome readers to add their points of view by posting comments on the published article.
You might want to share your experience of dealing with a similar case, suggest an alternative diagnosis, or question the authors for more information on an aspect of their case.
Simply follow the ‘post a comment’ link at the right hand side of any article, and complete the simple form to share your point of view.

Sir Iain Chalmers, Editor of the James Lind Library, and others have already added their comments to Richard Smith’s editorial on the launch of Cases Journal, and we welcome your opinions too.