Response to Treatment

1. Title Authors Associated institutions Intervention Introduction • The introduction should be brief tell why the case is important and why it is being reported (for • example, because it adds to the understanding of a clinical problem). For the sake of brevity, • cite a few recent review articles rather than many individual studies. Case reports usually • respond to one of the following generic topics, but use specific information from the case being • presented. • An unexpected association between diseases or symptoms. (For example, AIDS came to be recognized, in part, because Kaposi's sarcoma and Pneumocystis carinii pneumonia were reported in homosexual men in 1981.) • An unexpected event in the course of observing or treating a patient. (The transdermal absorption of nitroglycerin and its dilating effect on blood vessels came to be understood after a physician reported headache in a patient who handled TNT powder in his daily work.) • 3) Findings that shed new light on the possible pathogenesis of a disease or an adverse effect. • 4) Unique or rare features of a disease. • 5) Unique therapeutic approaches. Describe all therapeutic interventions conducted during the course of treatment. Provide the results of only relevant examinations and laboratory tests, usually those with positive results. List the laboratory's ranges of normal values for any unusual tests performed. Response to Treatment Describe the outcome of treatment including final diagnosis. Discussion Significance/Uniqueness of Case The purpose of the discussion is to explain anything that isn't clear in the case description and to offer interpretations of findings. It’s also the spot to indicate why the intervention used for your case was different from similar cases reported previously. Make clear any important point that isn't explained in the case descriptions. For example, if you reported that liver enzymes were elevated but no significant liver dysfunction was found, tell the reader in the discussion section why the enzymes were elevated. Also discuss implications for the field. Use the literature to establish any previous work related to your research question. Make clear to your reader whether this is the first ever reported, or how many have been reported previously. The essential characteristic of a publishable case report is educational value. After all, nobody is going to change the way they practice medicine based upon one case report. In addition, it is not true that a report must tell of a unique finding. Some case reports are published because they support the findings of previously published cases or because they are useful reminders of an important point in diagnosis or treatment. Patient Description Conclusions Describe the patient including gender, age, height weight, BMI, social history (including tobacco and alcohol use), use of illegal substances, medication being used, notable results of physical examination and laboratory tests, and differential diagnosis or diagnoses considered, just to name a few. When in doubt, think about the patient information you would like to know as background information and provide it in this section. Don’t go overboard; we don’t need to know how many toilets are in the patient’s primary residence. Give all of the basics, and add the specifics important to the case. Remember: When writing up your case report, refrain from using any identifying data, such as date of birth, date of service, patient name/initials or medical record number. Do not use case when referring to a person - a case is an instance of disease, a patient is a person. The big finish, where you get to blow your audience away with your final, pithy comment. This should be brief, three sentences tops. If you’re at a loss for words, you can either do a combined Discussion/Conclusions section, or just do a conclusions section that reiterates the importance of your case. References Don’t Be Constrained by These Headings While it is a nice thing to include references, if you’re crunched for space, these are the first things to go. If the choice is between including a really good looking graph or the references, ditch the references and show the graph. Every case is different, so don’t feel like you have to mash your round pegs to fit into the template’s square holes. Add sections and headings as are dictated by your case. Charts/Graphs/Pictures For most of your audience, this section will hold the most interest, and will also be the biggest attention-grabber for the casual passer-by. They may not care for your title of “A Rare Case of Okra Toxicity in Bexar County” but the full color 3D CT of a tortured liver will suck them right in. Remember: Any pictures which contain patient identifiers (i.e., facial shots, unusual tattoos) will require a signed release form from the patient. Check with the GRMERC Research Department for more information.