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Guidelines for the Preparation of Scientific Contributions to the Oncopedia Educational
Resource
These Guidelines are divided into 4 sections:
I. General information about the different types of submissions and their content
II. Specific directions for proper formatting of the different types of submissions
III. A style guide that addresses common usage questions and describes Oncopedia’s preferences
for scientific writing.
IV. Instructions for Oncopedia copyeditors
Section 1: General Information
I. What is the purpose of Oncopedia?
Oncopedia is a freely accessible interactive educational resource on Cure4Kids.org designed
for pediatric hematologists/oncologists, physicians, and other healthcare professionals who
provide care to children with cancer worldwide. Oncopedia’s purpose is to provide a forum
for education and interactive discussions on pediatric oncologic diseases. Oncopedia content
includes case reports, images, and chapters with content on specific diseaes.
II. Who can contribute to the scientific content on Oncopedia?
Any healthcare professional who provides care to pediatric patients with hematologic or
oncologic diseases may contribute content to Oncopedia.
III.
What types of contributions can be made to Oncopedia?
A. Case reports
Oncopedia case reports should include relevant and unique information about recent clinical
cases. Case reports should include descriptions of the presenting signs or symptoms of
disease, initial treatment, physical examination, biopsy and other diagnostic procedures, and
follow-up treatment. The documents can also include brief discussions of controversial issues
and relevant photographs or diagnostic images.
Educational objectives for case reports
 Give a brief history of the case, including details of discussions or treatment decisions
 Discuss treatment decisions for the particular case
 Review key features of the disease, including treatment controversies and how those
controversies might relate to treatment.
 Describe specific features of a disease as it occurred in the case report
B. Images
Image documents contain two types of information: text and diagnostic images or
photographs. The text in an image document is ideally two or three paragraphs long and
contains a short description of a sign or symptom of a disease. The text can also include
information on typical disease features and common treatments. The photographs or
diagnostic images in an image document should illustrate the information described in the
document text.
Educational objectives for images
 Give a short description of the disease feature, signs, or symptoms illustrated in the
document.
 Include a short explanation of the images included, with information about how aspects
of those images relate to the disease description or diagnosis.
 Include 2-5 images as examples of the aspect of the disease described in the document.
C. Chapters
Chapters are intended to be a review of disease history, epidemiology, pathology,
diagnosis and treatment. A chapter is not the place to discuss individual cases, but it can
be used to review common presenting signs, and may include discussions of disease
controversies or treatment in countries than the United States.




Educational objectives for chapters
Review epidemiology of disease on a global or regional scale.
Review pathology and diagnostic procedures
Review common treatment strategies and outcomes. Chapters may contain commentary
on disease controversies.
Contain information on disease treatment and outcomes in low-income countries (such
content is optional).
IV. Disclosure of conflict of interest
All authors must disclose any affiliations with organizations that to the author's
knowledge have a direct interest, particularly a financial interest, in the subject matter
discussed. Such affiliations include, but are not limited to, employment by an company,
ownership of stock, membership on a standing advisory council or committee, a seat on
the board of directors, or public association with a company or its products. Other areas
of real or perceived conflict of interest include receiving honoraria, consulting fees,
grants, or funds from such corporations or individuals representing such corporations.
When a case is accepted for posting, the editors will usually discuss with the authors the
manner in which such information is to be presented.
V. Protection of patients’ anonymity
It is the author’s responsibility to protect patient’s anonymity. Authors should mask
patients’ eyes, or, if the eye area is the focus of the illustration, the patient’s nose and
mouth; and they should remove patients’ names from figures.
A. Use of photographs in cases, images, and chapters
Photographs of clinical signs in patients may be included in Oncopedia images, cases, and
chapters, provided that appropriate consent has been given by the patient or the patient’s parents.
Photographs that show the patients’ faces can be edited to protect their anonymity by cropping or
blurring the eye and face area. If the clinical signs being shown involve the patient’s eyes, the
photo should be cropped to remove other areas of the face.
B. Identifiable patients in videos
Any video submitted to Oncopedia in which a patient’s face is visible must be submitted with a
signed copy of a consent form stating that the patient understands the video will be placed on the
internet for educational purposes. Videos that are used to show a clinical sign or feature of a
disease should be created without including the patient’s face if at all possible. Videos showing a
patient’s face will not be posted unless a consent form is on file at St. Jude.
Section 2: Formatting of Submissions
VI. Page setup for Case reports and Images
A. Page setup
There is a specific set of guidelines to follow to create a case document for Oncopedia.
These guidelines allow more space for adding text and images to the document. Page margins
should be set to 0.5”. Margins can be reset by choosing the page setup option from the File menu
in Microsoft Word. The font formatting for all text that is not a heading in Oncopedia case
documents is 12 pt Lucida Sans. Line spacing for all text that is not part of a heading or title
should be set to 1.5. This setting can be changed by choosing the paragraph option from the
Format menu in Microsoft Word.
B. Titles and headings
The title of the case should be centered at the top of the first page of the document. The
text formatting for the title should be 20 pt bold Lucida Sans. All section headings such as
Clinical Findings, Discussion, or References should be formatted in 16 pt bold italic Lucida Sans.
All headings within a section should be aligned with the left side of the page and should be
underlined. To underline, highlight the text of the heading and choose Borders and Shading
from the Format menu in Microsoft Word. This will open a Borders and Shading dialog box.
Choose the 1 ½ pt. line from the Width pull down menu, and choose paragraph from the pull
down menu under Apply to.
C. Biographical information
Biographical information for a document’s author should be placed on the first page of
the document directly after its title. The text of the biographical information should be formatted
in 12 pt Lucida Sans. Biographical information should be aligned with the left side of the page
and should include the author’s name and suffix, the name of the author’s hospital, the city and
country that in which hospital is located, and the date the case was added to Oncopedia. The
author’s department may be included with the name of the hospital, but it is not required
information. Each piece of information should be entered on a separate line.
Formatting biographical information in a document with a single author:
Format
Author’s first name surname, suffix:
Name of author’s hospital:
Hospital city, hospital country
Added to Oncopedia: MM/DD/YYYY
Example
John Smith, MD
Johns Hopkins Hospital
Baltimore, Maryland, United States
08/01/2008
Biographical information for cases with more than one author
Biographical information for all contributing authors should be placed in every
Oncopedia document directly after its title. The text of each biographical entry should be
formatted in 12 pt Lucida Sans. Biographical information should be aligned with the left side of
the page, and should include the name of each contributing author and the author’s suffix, the
name of the each author’s hospital, and the city and country in which that hospital is located. For
cases with more than one author at more than one hospital, separate entries should be made. Each
piece of information should be entered on a separate line. The date the case was added to
Oncopedia should be placed on the last line after the last biographical entry.
Formatting biographical information in a document with multiple authors from the same hospital
1st Author’s first name surname, suffix
2nd Author’s first name surname, suffix
3rd Author’s first name surname, suffix
Name of hospital
Hospital City, Hospital Country
Added to Oncopedia: MM/DD/YY
John Smith, MD
Jane Smith, MD
Josh Smith, MD
St. Jude Children’s Research Hospital
Memphis, Tennessee, United States
08/01/2008
Formatting biographical information in a document with multiple authors from separate hospitals
1st Author’s first name surname, suffix
2nd Author’s first name surname, suffix
Name of hospital
Hospital ciy, hospital country
John Smith, MD
Jane Smith, MD
St. Jude Children’s Research Hospital
Memphis, Tennessee, United States
1st Author’s first name surname, suffix
Name of Hospital
Hospital ciy, hospital country
Added to Oncopedia: MM/DD/YY
Josh Smith, MD
Johns Hopkins Hospital
Baltimore, Maryland, United States
Added to Oncopedia: 02/18/2008
D. Figures
Figure titles should be formatted in 14 pt bold Lucida Sans and should be aligned with
the left side of the page. Any captions should be placed directly underneath the figure title and
one blank line should be used to separate the figure caption from the figure itself. Text for any
figure captions or descriptions should be formatted in 12 pt Lucida Sans.
The labeling of figures in Oncopedia should adhere to the original author’s labeling as
closely as possible. The document editor should add “Figure” labels only if such labeling helps
to facilitate formatting and flow within the document.
Spacing of figures within an Oncopedia document may vary depending on the length of
the document and the size and number of images. All images should be aligned with the left side
of the page and separated vertically by at least one blank line, though more space can be used if
it is available.
E. Reference sections for Case and Image documents
Cases and images
Reference citations should be numbered consecutively in the order in which they are
cited within a case or image document. Citation numbers should be inserted as superscript arabic
numerals immediately following the material they pertain to. Citation numbers may be repeated
out of numerical order after their first use in a text. Place arabic superscript numerals outside
periods and commas, inside colons and semicolons. When more than 2 references are cited at
one time, use a hyphen to join the first and last numbers of consecutive citations (e.g., 1-5); use
commas to separate other parts of a multiple citation (e.g., 1, 3-5, 7). References should be listed
in numerical order at the end of the document.
This is the current format for citing Oncopedia documents. It appears after the reference list at
the end of every Oncopedia document:
Please cite as:
Last name, First name. Document title, Oncopedia #007.
Released on Oncopedia: 01/23/2008.
URL: https://www.cure4kids.org/ums/oncopedia/case_detail/?id=
F. Case and Image footer
The following information should appear at the bottom of the last page of each
Oncopedia case document:
Provided by Oncopedia
Oncopedia℠ is a freely accessible interactive educational resource on
Cure4Kids.org designed for pediatric hematologists/oncologists, physicians,
and other healthcare professionals who provide care to children with cancer
worldwide. Oncopedia’s content is compiled using online submissions from
Cure4Kids users and may not reflect the views and opinions of Cure4Kids or St.
Jude Children’s Research Hospital. All material can be freely used and
downloaded for reference and educational purposes. For more information,
contact [email protected]. (Oncopedia is a service mark of St. Jude
Children’s Research Hospital.)
This information can be added to a document by using cut and paste. The paragraph should be
aligned with the left side of the page while the Oncopedia logo and the text “Provided by
Oncopedia should be centered on the page.
G. Formatting Power Point files for Case and Image documents
Title slide
The title slide is the first slide in the presentation and should contain the title of the case
as well as the names of all contributing authors. The text on the title slide should be formatted in
44 pt Century Gothic and should be centered on the slide.
Single author
If a case is submitted to Oncopedia by only one author, then only the name of the case
should be placed on the title slide for the presentation. The title should be aligned with the center
of the slide. Single author’s names are not placed on the title slide because the name will appear
in the lower left-hand corner of each slide in the presentation.
Multiple authors
If a case is submitted to Oncopedia by multiple authors, the names of all contributing
authors should be listed on the title slide, directly following the name of the case. The name of
the hospital should be placed at the end of the list of authors’ names. Both the name of the case
and the authors’ names should be centered on the slide. In the footer, only the name and hospital
of the primary author should be listed.
Image slide formatting
Images in PowerPoint presentations created for Oncopedia should be placed individually
on separate slides. Image slides should be labeled sequentially by figure (Figure 1, Figure 2, and
Figure 3) and the heading for each image slide should be formatted in 44 pt Century Gothic. Any
descriptive information should be placed directly underneath the heading and should be
formatted in 18 pt Century Gothic.
Example of an image slide heading:
Figure 1
Intracranial tumor
Final slide
The final slide in each presentation uploaded should be the pre-formatted slide containing
a short paragraph of information about Oncopedia and Cure4Kids. This slide is included in the
template presentations provided on Oncopedia and is preformatted, and so it should not require
any changes in formatting.
F. Chapters
There are two versions of Oncopedia chapters that must be maintained. The online
version of the chapter is the authoritative version. When creating a new online chapter the
developer should also create a word document with an exact copy of the online version of the
chapter. This word document will be used as the offline chapter master and will also be used to
create the printable .pdf copy of the chapter that will be uploaded in the final review area.
Chapter header
The chapter title, along with the names of the lead contributors should appear at the
center of the top of the first page of both the online and printable .pdf copies of the Oncopedia
chapters. The printable .pdf version of the chapter should also include the Oncopedia graphic in
the header of the first page.
The chapter title text should be formatted in 20 pt Lucida Sans font. The text of the
contributors names should be formatted in 16 pt Lucida Sans font. For the online version of the
chapter Arial and other san serif fonts or font families are acceptable.
Chapter sections
Oncopedia chapters are laid out in sections according to chapter content.The header text
for each chapter section should be formatted in underlined 16 pt Lucia Sans
Chapter sub-sections
The text of all subheadings within Oncopedia chapters should be formatted in italic 16pt
Lucida Sans.
Chapter organization
As with Oncopedia cases and images, citations in Oncopedia chapters should be
numbered consecutively with arabic numerals formatted as superscript text. Contributors should
use hyphens (e.g., 1-5) or commas (e.g., 1, 3) to list multiple citation numbers. (see Example
Chapter Section 2.0). Each Oncopedia chapter will be separated into sections by the lead chapter
author. The references within each chapter section will be numbered indepednantly. This means
that the referenc numbering for each section will begin with 1. Reference lists will be placed at
the end of each chapter section. Contributors may repeat the use of a citation number only within
a particular section.
To promote readability, chapter sections will be lettered alphabetically. The designated
letter for each section will be used to label all section subheadings, figures, and tables, as well as
the reference list for that section
A. Example Chapter Section 1.0
Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Cras luctus vestibulum est. Sed dictum
urna mattis pede. Sed accumsan dictum nulla. In nec lacus sit amet leo fringilla porttitor. Cras
rhoncus tortor ut urna.1 Quisque a est. Morbi sagittis, risus vel pharetra vestibulum, dolor odio
faucibus ipsum, nec posuere lacus neque non quam. Etiam rutrum. Aenean facilisis ultricies
mauris. Curabitur suscipit felis ac enim. Proin sagittis dignissim enim. Donec non purus id quam
congue mollis. Mauris augue lacus,2 commodo a, auctor non, venenatis et, diam. Nam in justo.
Ut vehicula felis at ante. Duis porttitor accumsan lacus. Suspendisse iaculis. Pellentesque
habitant morbi tristique senectus et netus et malesuada fames ac turpis egestas3.
References for A. Example Chapter Section
1
2
3
Ogdon D, O’Brien R, Patel A et al. Example of citation. Example publication. 2008;1(1):1-10.
Becksfort J, Patel A, Ogdon D. Example of citation. Example publication. 2008;1(1):1-10.
Ogdon D. Example of citation. 3rd edition. Memphis: Prestigious Publisher, 2008.
B. Example Chapter Section 2.0
Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Cras luctus vestibulum est. Sed dictum
urna mattis pede.1 Sed accumsan dictum nulla. In nec lacus sit amet leo fringilla porttitor. Cras
rhoncus tortor ut urna. Quisque a est. Morbi sagittis, risus vel pharetra vestibulum, dolor odio
faucibus ipsum, nec posuere lacus neque non quam. Etiam rutrum. Aenean facilisis ultricies
mauris. Curabitur suscipit felis ac enim. Proin sagittis dignissim enim. Donec non purus id quam
congue mollis. Mauris augue lacus, commodo a, auctor non, venenatis et, diam. Nam in justo. Ut
vehicula felis at ante. Duis porttitor accumsan lacus. Suspendisse iaculis.2-3 Pellentesque habitant
morbi tristique senectus et netus et malesuada fames ac turpis egestas.
References for B. Example Chapter Section 2.0
1
Patel A. Example of citation. Example Publication. 2008;1(1):1-10.
2
Becksfort J, Patel A, eds. Example book title. Memphis: Prestigious Publisher, 2008.
3
Ogdon D. Example title. Example Publication. 2008 1(1)1-10. Accessed online 01/01/2008.
www.cure4kids.org
VII. Reference citations
A. Titles in Reference Lists
The preferred style for reference citations is based on that recommended by the American
Medical Association Manual of Style.
 For book titles, use headline-style capitalization. Example: The Principles and Practice
of Medicine
 For journal article titles, use sentence-style capitalization (i.e., capitalize only the first
word in a title and any proper names). Example: Childhood and adolescent nonHodgkin lymphoma: new insights in biology and critical challenges for the future
 For the names of journals in which a referenced article appears, use Index Medicus
abbreviations with no italics and no periods within the abbreviated name. Example:
Pediatr Blood Cancer. 2005;45:753-69.
B. Reference formatting in Case and Image Documents
Citation format for journals
The required information for a journal citation in an Oncopedia document includes an author’s
surname and initials, article title, journal title, volume and issue numbers, and the year the article
was published. If there are ≤6 authors, list the names of all; if there are >6, list the names of the
first 3 followed by “et al.”
Example 1:
1st author’s surname and initial, 2nd author’s surname and initials, 3rd author’s surname and
initials. Title of publication. Year;volume number(issue number): page numbers.
1
Example 2:
1
Rivera GK, Quintana J, Villarroel M, et al. Transfer of complex frontline anticancer therapy to
a developing country: the St. Jude osteosarcoma experience in Chile. Pediatr Blood Cancer.
2008;50(6):1143-6.
Citation format for books
The required information for a book citation having one or more authors/editors includes the
authors’/editors’ surnames and initials, the full title of the book being cited, and the edition
number if listed and other than the first publication. For edited books, place the abbreviation
‘eds’ after the list of editors’ names. The city in which the book was published, the name of the
publisher, and year of publication for the edition being cited are also required pieces of
information.
Example 1: Authored book, first edition
Stern TA, Sekeres MA. Facing Cancer: A Complete Guide for People with Cancer, Their
Families, and Caregivers. New York: McGraw Hill, 2004.
Example 2: Edited book, 5th edition
Pizzo P, Poplack G, eds. Principles and Practice of Pediatric Oncology. 5th edition.
Philadelphia: Lippincott Williams and Wilkins, 2006.
Citation format for electronic documents
Citations of electronic documents should include the same information normally used in a
journal citation. When citing a website, use the website’s sponsoring organization as the author if
no other author information is available. The root URL of the website from which the author
retrieved the electronic document and the date of the last access should be included at the end of
the citation.
Example 1:
Sponsoring organization’s name. Title of publication. Accessed online 04/09/2008.
www.exampleurl.org
1
Example 2:
2
Centers for Disease Control. 2006/2007 Cancer Survivorship Fact Sheet. 2007. Accessed online
04/09/2008. www.cdc.gov
Example 3:
3
Dervieux T, Brenner TL, Hon YY, et al. De novo purine synthesis inhibition and antileukemic
effects of mercaptopurine alone or in combination with methodrexate in vivo. Blood.
2002;100(4):1240-7. Accessed online 04/09/2008. www.bloodjournal.org
Citing Cure4Kids Materials
When citing a Cure4Kids seminar please use the information provided for that seminar in the
references area. The current citation formation used on the Cure4Kids website is listed below:
Please cite this seminar as:
Pui, C., Campana, D. and Downing, J.Acute Lymphoblastic Leukemia: Recent Advances
Cure4Kids #1336. Released on Cure4Kids: 28 Jun 2007.
URL: https://www.cure4kids.org/seminar/1336/
Section 3: Style Guide
The purpose of this style guide is to improve the clarity, conciseness, precision, and overall
readability of the scientific information published in Oncopedia. This section focuses on some
elements of English language usage that serve that purpose.
VIII. Composing Titles
A. Composing titles for Oncopedia educational materials
 Titles should be brief and contain the key points of a contribution.
 Avoid subtitles whenever possible. For example, instead of “Synovial Sarcoma:
Pathology Features” write “Pathologic Features of Synovial Sarcoma”
B. Capitalization in titles
Use headline-style capitalization:
 Always capitalize the first and last words both in titles and subtitles and all other major
words (nouns, pronouns, verbs, adjectives, adverbs).

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Lowercase conjunctions that are ≤3 letters: and, but, or, nor.
Lowercase the article adjectives the, a, and an.
Lowercase prepositions that are ≤4 letters (in, on, to, by, for, with, etc.) except when they
are stressed or part of a Latin expression or a part of a proper name. Example: Progress
in In Vitro Fertilization at the Chicago Lying-In Hospital
For hyphenated compound words in a title, capitalize only the first element unless any
subsequent element is a proper noun or a proper adjective. Example: Outcome of
Children with Low-grade Cerebellar Astrocytoma: Long-term Complications and
Quality of Life
C. Punctuation in titles
 If a subtitle is needed, use a colon to separate the main title from the subtitle. Example:
Clear Cell Sarcoma of the Kidney: Case Report and Literature Review
 Use hyphens in compound modifiers. Examples: 7-year-old; hydroa vacciniforme-like;
non-Hodgkin lymphoma, post-laminar optic nerve invasion
D. Abbreviations in titles
 Do not use abbreviations in Oncopedia titles. Example: Instead of “Liver Dysfunction
During Induction Chemotherapy for ALL,” write “Liver Dysfunction During
Induction Chemotherapy for Acute Lymphoblastic Leukemia”
E. Spelling in titles
 Documents submitted to Oncopedia should use American rather than British spelling.
Examples: liter vs. litre, anesthesia vs. anaesthesia, leukemia vs. leukaemia, judgment
vs. judgement
F. Numbers in titles (and elsewhere)
 Arabic numerals should be used to express numbers in most circumstances. Example:
Metastatic Neuroblastoma in a 3-Month-Old Infant
 Spell out numbers that begin a title or subtitle. Example: Six Cases of Retinoblastoma
in 5-Year-Old Children
 Spell out ordinals (first, second, third, etc.).
IX. Language Use
A. Grammar
1.
Verbs
Active versus Passive Voice Verbs
Use the active voice as much as possible. Sentences using active voice verbs are usually less
wordy and more direct than those using passive voice constructions.
In the active voice, the grammatical subject of the sentence does the acting. In the passive voice,
the grammatical subject is acted on. Passive voice verbs contain some form of the verb “to be”
(is, are, was, were, etc.) followed by a past participle.
Examples:
Active voice: Physicians gathered data from 5000 patients. “Physicians” is the grammatical
subject, and “gathered” is the active voice verb.
Passive voice: Data were gathered by physicians from 5000 patients. “Data” is the grammatical
subject, and “were gathered” is the passive voice verb consisting of “were” (the past tense, plural
form of “to be”) plus “gathered” (the past participle form of “to gather”).
Passive voice is appropriate when the actor is unknown or should not be emphasized. Methods
sections of papers often use passive voice since the focus is on what was done, not who did it.
Examples:
The 6-year-old child was referred to our clinic after surgery for acute abdominal pain.
The patient was extubated after resolution of neutropenia.
2.

Nouns and pronouns used as subjects of verbs
The use of “I” or “we” was once thought to be too “subjective” for a scientific
publication, but that idea about writing style has given way to an emphasis on clear,
concise, and vigorous writing. Avoiding the use of first-person pronouns can lead to
awkward, wordy, or unclear sentences.
Instead of: It was decided to include retuximab in the rescue therapy.
Revise to: We decided to include retuximab in the rescue therapy.

3.
Subject-verb agreement and placement
Grammatical subjects and verbs must agree in number: a singular subject requires a
singular verb form, and a plural subject requires a plural verb form. Sentences are
usually clearer and easier to read when the grammatical subject is placed close to the verb.
Note: When a modifying phrase comes between the subject and verb, it does not affect
the number (either singular or plural) of the subject.
Examples:
The patient, along with his parents, after consultation with the health care team, makes the
decision. [Singular subject and singular verb. Note that “along with his parents” is a
prepositional phrase and is not part of the grammatical subject of the verb.]
The patient and his parents make the decision after consolation with the health care team. [Plural
subject and plural verb. Note that the coordinating conjunction and joins “patient” and “parents”
and thus the subject of the sentence is plural.]
B. Punctuation
1.
Commas
 Use a comma to separate main clauses joined by a coordinating conjunction (and, but, or).
Examples:
The boy’s right eye was proptotic, but his vision was clear.
Other biochemical parameters were normal, and there was no evidence of tumor lysis syndrome.

Use a comma before the coordinating conjunction that precedes the last term in a series
of 3 or more items.
Examples:
The tumor had invaded the left maxillary sinus, soft tissues, and bilateral pterygomaxillary
fossae.
Peripheral blood count, hepatic and renal function tests, and uric acid levels were normal.
2.
Periods
Periods precede ending quotation marks and superscript reference citations.
C. Spelling
1.
American spellings
 Documents submitted to Oncopedia should use American rather than British spelling.
Examples: liter vs. litre, anesthesia vs. anaesthesia, leukemia vs. leukaemia,
judgment vs. judgement
2.
Hyphenated terms
The following is a guide to the use of hyphens.
Adjective + noun: Use hyphens in adjectival compound terms coming before and modifying a
noun: e.g., low-density lipoprotein, a middle-class family (but “the family was middle class”)
Age terms: “a 3-year-old child” (hyphenate all such age terms whether they are used as
adjectives or nouns)
Noun + participle: contrast-enhanced ultrasound (but “the ultrasound was contrast enhanced”)
Prefix + proper noun: non-Hodgkin disease
Prefix “non”: Generally no hyphen is used with this prefix: e.g., nontender, nonsignificant. Do
hyphenate when it appears before a proper name or before another hyphenated term, e.g., noninsulin-dependent diabetes.
Prefixes “ex-“ and “self”: Always hyphenated
Letters used as modifiers in scientific terms: hyphens are used when the terms are adjectival,
e.g., beta-cell dysfunction (but “defects in the beta cell”)
Adverb “well”+ participle or adjective: well-established practice (but “the practice is well
established”)
D. Terminology
1.
Eponymous terms
Eponymous terms
A transition toward use of the nonpossessive form of eponymous terms is taking place in the
scientific literature. To ensure consistency among the documents published on Oncopedia,
authors are asked to:
 Use the nonpossessive form of eponymous terms. That is, write the personal name
without an apostrophe or an apostrophe plus s at the end. Examples: Wilms tumor,
Burkitt lymphoma, Langerhans cell histiocytosis
 Capitalize only the person’s surname, not other terms (such as tumor or lymphoma) that
follow it.
2.
Terms for patients
Do not refer to a patient as a case. A case is a particular instance of a disease. A patient is a
particular person who is receiving medical care.
Instead of: A 12-year-old case of mediastinal enlargement and respiratory distress …
Revise to: A 12-year-old patient with mediastinal enlargement and respiratory distress …
3.
Terms for children
Referring to Children
Avoid using male(s) and female(s) as nouns. Refer to boys and girls.
Instead of: A seven-year-old female was treated…
Revise to: A 7-year-old girl was treated…
Instead of: An 11 year-old patient was referred…. The patient was treated….
Revise to: An 11-year-old boy was referred…. He was treated….
4.
Other “preferred” terms
x-ray: Always hyphenate and use lower case.
Tru-Cut: The manufacturer uses a hyphen and upper case. Preferred terminology is “Tru-Cut
needle biopsy.”
resectability: Use of this term should be limited to the context of assessing possible removal of a
tumor.
neuroblastoma stages: According to the International Neuroblastoma Staging System, the
stages are: stage 1, stage 2A, stage 2B, stage 3, stage 4, and stage 4S. (See:
http://www.cancer.gov/cancertopics/pdq/treatment/neuroblastoma/HealthProfessional/page4)
incisional biopsy: This term refers to a biopsy in which only a sample of the suspicious tissue is
cut into (incised) and removed for purposes of diagnosis. A incisional biopsy is in contrast to an
excisional biopsy in which an entire lesion is removed.
flow cytometric information: “information obtained by flow cytometric methods”
Section 4. Guidelines for Oncopedia Copyeditors
Oncopedia is part of Cure4Kids, a Web site dedicated to the continuing medical
education of health professionals who care for pediatric patients around the world. Materials in
Oncopedia focus on the clinical presentation and treatment of hematologic and oncologic
diseases in children. The intended audience is international. By following the guidelines and
pointers below, Oncopedia copyeditors will help improve the communication of important
scientific information to readers from around the world. Please submit any questions not
answered by this document to Dorothy May at [email protected].
Keep it simple
The physicians and health care professionals who consult the materials on Oncopedia are
medically very knowledgeable, but some of them may be much less familiar with the subtleties
of English language usage. For this reason, the preferred writing style in Oncopedia materials is
simple and direct.
As a copyeditor, your goal is make the text clear and understandable so that the audience
of readers can grasp the author’s intended meaning on their first reading. Remember that
Oncopedia materials are written by medical professionals, and your job is not to revise their text
to make it sound more academic or scientific as you might do for a document to be submitted for
peer review and journal publication.
For copyeditors of Oncopedia, the advice to “Keep it simple” particularly applies to word
choice, sentence structure, and paragraph organization.
Word choice
Your first objective is to make sure the words used are correct and unambiguous (see
Pointers 1 and 2). To be sure that a medical term that is unfamiliar to you is being correctly used,
check a medical dictionary or do an online search. Doing so will also help you find typos or
misspellings. You should not revise medical terms that are correctly used in the original
document, but you should clarify any use of jargon (see Pointer 3). Simplify word choice
whenever possible, without changing the meaning of the original text (see Pointer 4 below). Edit
text so that it is written in plain English without any unnecessary words (see Pointer 5).
Sentence structure
To improve the readability of sentences, you should keep a few principles in mind.
 English sentences are built on a few basic patterns, all of which have a subject (noun or
pronoun) and a predicate (verb).
 The easiest-to-read sentences are those that have a readily identifiable subject and verb.
 The subject should be near the beginning of the sentence.
 The subject and verb should be fairly close together (i.e., not separated by multiple
prepositional phrases or other modifiers).
 The “action” of the sentence should be in the verb.
These principles should guide you in the revisions you make to simplify sentence
structure and clarify meaning (see Pointers 6-11). Another tactic to improve clarity is to revise
overly long sentences. How long is “overly long”? Generally, look for sentences longer than 3
printed lines or containing multiple clauses that separate the subject and verb. They may need to
be divided into 2 (or more) shorter sentences.
Paragraph structure
A paragraph is a number of sentences on a single topic. A good paragraph has three important
characteristics: clarity, coherence, and completeness.
Clarity: It is clearest to have only one message per paragraph.
Coherence: A well-structured paragraph begins with a clear statement of its central idea—what
is called the topic sentence. Subsequent sentences should support the idea expressed in the topic
sentence and should be logically connected to it and to each other.
Completeness: The topic (central idea) should be fully addressed, but unrelated ideas should be
moved elsewhere. If a paragraph has more than one main idea, you need to divide the paragraph.
When you do so, make sure each of the new paragraphs has a clearly expressed topic and
adequate supporting details.
Just as sentences should follow one another logically within a paragraph, so too should
paragraphs follow logically from one to the next.
Pointers for copyeditors
Many of the following pointers come from the classic text on effective writing: Strunk and
White’s The Elements of Style, a book that copyeditors should reread often. Others are taken
from various books on scientific writing style, including the AMA Manual of Style and Essentials
of Writing Biomedical Research Papers.
1.
Never presume the meaning or spelling of an unfamiliar term. And never rely solely on
spellchecking software. A word may be spelled correctly and still be the wrong word for
the context.
Original:
Questions about how exercise effects wait loss lead us to this experiment.
[Note: Spellcheck software will not pick up the 3 errors in word choice or
spelling illustrated in this sentence.]
Revision:
Questions about how exercise affects weight loss led us to this experiment.
2.
Put statements in positive form. Instead of saying what is not, say what is.
Original:
“It is not very often easy to determine…”
Revision:
It is usually hard to determine …
3.
Use definite, specific, concrete language.
Original:
The abdominal examination was benign.
Revision:
The findings of the abdominal examination were within normal limits.
4.
Use simple words: sweaty, not diaphoretic; use, not utilize or employ; end, not terminate;
stop, not discontinue; walk, not ambulate; chew, not masticate.
5.
Omit needless words. Avoid useless introductory clauses (e.g., It will be noted that …).
Original:
It has rarely been the case that any mistake has been made.
Revision:
Few mistakes have been made.
To be avoided
At this point in time
A portion of
A considerable portion of
A majority of
In order to treat
First of all; Firstly
Whether or not
Preferable
Now; at present
Some
Many
Most
To treat
First
Whether
6.
Express co-ordinate ideas in similar form. This principle, that of parallel construction,
requires that expressions similar in content and function be outwardly similar.
Original: Formerly, science was taught by the textbook method, but now the laboratory
method is employed. [Note: Here you have 2 independent clauses joined by
the coordinating conjunction but. The 2 clauses should have parallel
construction.]
Revision: Formerly, science was taught by the textbook method, but now it is taught by
the laboratory method.
7.
Be sure that the sentence’s subject and predicate make sense together.
Original:
The patient had no liver or spleen.
Revision:
The liver and spleen were not palpable.
8.
Make sure that the subject and verb agree in number.
Original:
The esophagus, stomach, and duodenum of each rabbit was examined.
[Note: Although “rabbit was” sounds right, the subject of the verb is
plural.]
Revision:
The esophagus, stomach, and duodenum of each rabbit were examined.
9.
Check agreement of subjects and helping verbs. [A helping, or auxiliary, verb is used
with a main verb to form a verb phrase. For example, passive voice verbs are formed with
some form of the verb “to be” plus the past participle of the main verb, e.g., was minced.]
Original:
The tissue was minced and the samples incubated. [Note: tissue is singular
but samples is plural.]
Revision:
The tissue was minced and the samples were incubated.
10.
Put the action of the sentence in the verb. If the action of a sentence is expressed by the
main verb, the sentence is direct and easy to understand.
Original:
A progressive decrease in the death rate occurred. [The grammatical
subject of the sentence is decrease and the verb is occurred.]
Revision:
The death rate decreased progressively. [The grammatical subject is death
rate and the verb is decreased.]
11.
Use the active voice. The active voice is more direct and vigorous than the passive voice,
and it usually takes fewer words.
Original:
Severe pain was reported by the patient.
Revision:
The patient reported severe pain.
B. Example Revisions
Supplement to Guidelines for Copyeditors
To illustrate the key editing principles outlined in our Guidelines for Copyeditors, we are
providing this supplement. It contains commentary on (and further revision of) five Oncopedia
documents that were copyedited by the Editage team. The yellow highlighting and “tracked
changes” identify revisions made by the Editage team.
Example 1
Issues addressed in this example:
 Word Choice
 Sentence Structure
We present the case of a 12-year-old patient who was referred to our hospital for mediastinal
enlargement and respiratory distress. At arrival, his condition was poor, requiring almost
immediate mechanical ventilation.
Comment: Note that the editing here doesn’t shorten or simplify the original. The wording is less
vigorous than that of the original. In the original the patient is the subject of both
sentences, an appropriate style for a case report.
Revision: A 12-year-old boy was referred to our hospital because of a mediastinal enlargement
and respiratory distress. He arrived in poor condition and required almost immediate
mechanical ventilation.
An anterior mediastinal mass and left supraclavicular adenopathy were evident (Figure 3, white
arrow). This series of pictures shows massive airway compression and lateralization of the upper
airway (black arrows). Immediately after intubation, small incisional biopsy of the
supraclavicular adenopathy was carried out, and on the basis of the findings, lymphoblastic
lymphoma was diagnosed.
Comment: Note that the copyeditor replaced some one-syllable words with longer words or
terms (soon/immediately; done/carried out). A sentence written in active voice was
revised and put into passive voice and new wording added (“the diagnosis was
lymphoblastic lymphoma” was rewritten as “on the basis of the findings,
lymphoblastic lymphoma was diagnosed”). Perhaps the editor intended to make the
writing sound more scientific. But for educational purposes, the simpler language is
preferable.
This condition is an oncological emergency caused by massive airway compression [1]. General
anesthesia should be avoided in such cases because of the high risk of airway compression.
However, in the presented case, the child had to be intubated because of imminent respiratory
failure, and therefore a diagnostic procedure could be carried out simultaneously. In cases
wherein anesthesia can be avoided, obtaining a specimen for diagnosis could be challenging, and
bone marrow aspiration (which was negative in this case) or cytology of effusions should be the
initial approach to obtain a tissue sample for diagnosis.
Comment: Terms such as however, therefore, and wherein can be confusing to readers for whom
English is not their native language.
Revision: This condition is an oncological emergency caused by massive airway compression
[1]. Usually, general anesthesia should be avoided in such cases because of the high
risk of airway compression. But this child had to be intubated because of imminent
respiratory failure and so that a diagnostic procedure could be done at the same time.
When anesthesia can be avoided, obtaining a specimen for diagnosis could be
challenging. Bone marrow aspiration (which was negative in this case) or cytology of
effusions should be the initial approach to obtain a tissue sample for diagnosis.
In cases wherein diagnosis is not possible and the risk associated with anesthetization is high
because of airway compression, a brief course of corticosteroids helps in reducing the mass and
allows a safe biopsy.
Comment: Note that the edits raise the reading level (i.e., complexity) by introducing less
familiar or longer terms (e.g., wherein, associated with, anesthetization). It isn’t clear
whether “helps in reducing the mass and allows a safe biopsy” means the same thing
as the original “will help to reduce the mass and perform the biopsy safely.”
However, lymphoblastic lymphoma may be highly sensitive to corticosteroids and tumor
manifestations may disappear; hence, such patients should be evaluated very carefully in order to
proceed with biopsy at an appropriate time.
Comment: This 3-line sentence could be shortened to improve readability. Replacing “in a
timely fashion” with “at an appropriate time” doesn’t save any words and may, in fact,
change the author’s intended meaning or emphasis. The phrase “in a timely fashion”
means “in a reasonable, appropriate amount of time.”
Revision: Lymphoblastic lymphoma can be very sensitive to corticosteroid treatment, and
tumor manifestations may disappear. For this reason, patients should be carefully
evaluated so that biopsy can be performed in a timely fashion.
Tumor lysis may also complicate the course of these patients, and fluid administration should be
carefully monitored to avoid fluid overload and further worsening of respiratory conditions. Due
to these reasons, aggressive hyperhydration is poorly tolerated by such critical patients [2].
Comment: There’s an opportunity to break up overly long sentences here.
Revision: Tumor lysis may also complicate the course of these patients. Administration of
fluids should be carefully monitored to avoid overload and further worsening of
respiratory conditions. Aggressive hyperhydration is poorly tolerated by these
critically ill patients [2].
Example 2
Issues addressed in this example:
 Word Choice
 Sentence Structure
We present 2 cases of germ cell tumor in the head and neck area. The first case (Figures 1–4) is a
21-month-old patient with a tumor in the maxillary/parotid area that rapidly developed within 2
weeks and resulted in right facial palsy.
Comment: Do not refer to a patient as a case. A case is a particular instance of a disease. A
patient is a particular person who is receiving medical care.
Revision: We report 2 cases of …. In the first case example, the patient was a 21-month-old
who had a tumor in the maxillary/parotid area that rapidly developed (in 2 weeks) and
led to right facial palsy (Figures 1-4).
Physical examination revealed a left parotid tumor protruding into the oral cavity and causing
difficulties in deglutination, nasal occlusion, and palsy of the III, IV, VI, VII, and XII cranial
nerves.
Comment: The author’s original wording “tumor in the left parotid area” may be easier to read
because of the use of the prepositional phrase as a modifier. Generally, you want to
avoid stacking up modifiers in front of noun (as in left parotid tumor). Also, the
original “swallowing difficulties” is more immediately understandable than
“difficulties in deglutination.” I would break up the sentence so that you have 2
shorter sentences instead of 1 long one.
Revision: The physical exam revealed a tumor in the left parotid area that protruded into the
oral cavity. It caused problems in swallowing, nasal occlusion, and palsy of the III, IV,
VI, VII, and XII cranial nerves.
Thereafter, an incisional biopsy was performed that revealed an endodermal sinus (yolk sac)
tumor.
Comment: Keep the writing style as simple as possible. Avoid terms like “thereafter,” which
complicate the style. Choose the shortest, simplest verb that comes the correct
meaning. Eliminate unnecessary words.
Revision: Incisional biopsy showed an endodermal sinus (yolk sac) tumor.
Peripheral blood count, hepatic and renal function tests, and uric acid levels were normal.
The lactate dehydrogenase activity (LDH) level was 669, the beta human choriogonadotropin (βhCG) level was less than 5, and the serum alpha-fetoprotein (AFP) level was 37.520. [Note: See
Editor’s Note #1.]
Comment: I don’t have access to the Editor’s Note, but if it asks about the spelling out of terms, I
would agree that does need to be done. But there’s no reason to repeat the verb “was”
and to make the statement more wordy than the original.
Head and neck contrast-enhanced CT scan (Figures 1–4) showed a heterogeneous solid mass
localized in the left parapharyngeal space. The tumor had invaded the left maxillary sinus, soft
tissues, and bilateral pterygomaxillary fossae. The mass crossed the midline and extended to the
contralateral maxillary sinus, base of the skull, and esphenoidal sinus along with an extension
into the extradural space in the temporal fossa.
Comment: The last sentence in the passage above has a lot of information for the reader to
process at once. I’d break it up.
Revision: The mass crossed the midline and extended to the contralateral maxillary sinus, base
of the skull, and esphenoidal sinus. It also extended into the extradural space in the
temporal fossa.
The second case is a 4-year-old girl with an orbital tumor in the eye who was referred to us from
another institution. An extent-of-disease evaluation showed no evidence of disease elsewhere;
hence, a surgical biopsy was carried out.
Comment: See notes above about referring to a patient as a case and about using adverbs like
“hence” and “therefore.” Remember that the purpose of these case reports is
educational, and so elevating the prose style can be counterproductive. For that reason,
I would advise the copyeditor to avoid substituting longer terms for perfectly
acceptable shorter ones. There’s no need to replace “done” with “carried out.”
Revision: The second case report concerns a 4-year-old girl referred to our institution because
an orbital tumor. Evaluation of the extent of disease showed no evidence of cancer
elsewhere, and so a surgical biopsy was done.
A CT scan and an MRI scan (Figures 5–8) revealed the presence of an extensive mass in the left
orbit with an extension into the central nervous system (CNS). The pathological diagnosis was
mixed germ cell tumor with choriocarcinoma components.
Comment: Changing “showed” to “revealed the presence of” adds words without improving
clarity.
The β-HCG level was 15400. Both the patients were treated with intensive chemotherapy that
included etoposide, cisplatin, and ifosfamide. A good initial response was noted in both patients.
Comment: Note that “both” means “the two together” and using it in the first sentence implies
that the 2 children were treated together.
Revision: Each patient received intensive chemotherapy with etoposide, cisplatin, and
ifosfamide. Both children had a good initial response to treatment.
Gonadal and extragonadal germ cell tumors are infrequent in childhood, constituting
approximately 1% of all cancers diagnosed in children less than 15 years.
Comment: There are unnecessary changes here, changes that complicate the prose style. Also,
when talking about age, the correct usage is “younger than” not “less than.”
Revision: Gonadal and extragonadal germ cell tumors are rare in children. In children younger
than 15 years, they account for about 1% of cancer diagnoses.
Of all germ cell tumors, 5% are located in the head and neck region. However, endodermal sinus
tumors of the head and neck, exclusively in the CNS, are uncommon. The prognosis of children
with endodermal sinus tumors is dependant on early diagnosis and aggressive adjuvant therapy.
Comment: Note that revising “exclusive of” to “exclusively in” changes the meaning. Perhaps
the copyeditor’s revision is the correct wording, but I would think a query to the
author is needed here. Note also that in the last sentence a more precise wording
might add “favorable” before “prognosis.”
Revision: Of all germ cell tumors, 5% are located in the head and neck region. Endodermal
sinus tumors of the head and neck, exclusive of the CNS, [Editor’s Note: Please
verify that this wording is correct, or did you mean “exclusively in the CNS”? are
uncommon. A favorable prognosis for children with endodermal sinus tumors
depends on early diagnosis and aggressive adjuvant therapy.
However, recent evidence has suggested that tumors at this location have a poor outcome. The
neck area may also be a site for metastasis. Since a tumor is usually not suspected,
serum marker levels for its diagnosis are not determined and the diagnosis is attained
by carrying out a biopsy, as carried out in the present 2 cases.
Comment: You can provide a logical transition between the preceding sentence and the first one
here without using “however.” It is acceptable to start a sentence with “but.”
Revision: But it should be noted that recent evidence suggests head and neck tumors often have
a poor outcome. The neck may also be a site for metastasis. Tumors of the head or
neck are rarely suspected in children, and so serum markers usually are not used to
make a diagnosis. Most often, the diagnosis is based on the results of a biopsy, as was
done in the cases described here.
Example 3
Issues addressed in this example:
 Sentence Structure
 Word Choice
A 9-year-old boy was referred for progressive fatigue, dyspnea, and headache.
There was no history of fever and chest pain. At presentation, he had marked pallor,
diffuse nontender lymphadenopathy, widespread petechiae, several large bruises,
and hepatosplenomegaly with mediastinal enlargement on an x-ray film.
Comment:
The sentence beginning “At presentation” is not written in parallel
construction.
Revision:
At presentation, he had marked pallor, diffuse nontender
lymphadenopathy, widespread petechiae, and several large bruises. Xray showed hepatosplenomegaly with mediastinal enlargement.
He had an oxygen saturation of 94–95% and did not require supplementary oxygen.
The initial laboratory examination findings were as follows: leukocyte count,
480,000 mm³; hemoglobin concentration, 10.5 g/dl; and platelet count, 100,000
mm³ Further, other biochemical parameters, particularly renal and liver function
tests, were normal, and there was no evidence of tumor lysis syndrome.
Comment:
You don’t need both “further” and “other.” Omit “further.” Note that
“parameters” is a catch-all, often vague term. Use of “measures” or
“measurements” might be more precise.
A peripheral blood smear (May–Grunwald Giemsa stained) showed numerous
blast forms, i.e., the L1-L2 type.
Comment:
It’s not clear why “i.e.” [abbreviation meaning “that is”] is used here.
Was the author’s meaning “numerous lymphoblasts that were
classified L1 and L2”?
The initial treatment comprised intravenous hydration at 3000 ml/(m²·day),
alkalinization with sodium bicarbonate, and allopurinol.
Comment:
“The initial treatment comprised…” could be more simply stated.
Revision:
We began intravenous ….
The results confirmed the diagnosis of acute lymphoblastic leukemia (ALL), and
the cells were identified as T cell leukemia precursors on the basis of CD 3, CD 5,
CD 8, and CD 7 expression on the cell surface. Cytogenetic evaluation disclosed a
normal karyotype.
The patient received leukoapheresis twice without any complications; his
symptoms disappeared thereafter.
Comment:
You might simplify the last sentence.
Revision:
… complications, and his symptoms disappeared.
He was treated with a BFM-based [Note: See Editor’s Note #1.] protocol for ALL
(IC BFM 2002).
After the second leukoapheresis, his leukocyte count was 200,000 mm³,
hemoglobin concentration was 8.5 g/dl, and platelet count was 63,000 mm³.
Discussion
In acute leukemia, hyperleukocytosis is a sign associated with the development of
intravascular thrombi composed of leukemic cells (leukostasis) in the lungs and
brain, which may lead to pulmonary and cerebral infarctions and death.
Comment:
Break up this long sentence.
Revision:
Hyperleukocytosis is associated with the development of intravascular
thrombi. These thrombi are composed of leukemic cells (leukostasis)
in the lungs and brain that can lead to pulmonary and cerebral
infarctions and death.
Clinically significant hyperleukocytosis occurs when the WBC count is >300,000
mm³ in the patients with ALL [Note: Please check the change.] and occurs in 9–
13% of children with ALL. Only few pediatric cases of ALL and pulmonary
leukostasis have been reported.
Comment:
If you add “only” you need to say “Only a few…” but adding that
wording isn’t necessary. Keep it simple.
Revision:
Few cases of ALL and pulmonary leukostasis in children have been
reported.
Studies have shown that complications of hyperleukocytosis in children with ALL
are relatively rare. Leukoreduction may be reserved for patients with extremely
high leukocyte counts (>400,000 mm³) and patients who have leukostasis-related
complications at presentation.
Implications for developing countries:
In patients with a persistent leukocyte count of ≤300,000, it is preferable to aim at
gradual cytoreduction with prednisone in order to avoid the possible complications
of the procedure (pheresis or exchange transfusion), which is invasive, expensive,
and has limited availability in few hospitals; complications, if occur, may delay the
initiation of chemotherapy. [Note: Please check the change.]
Comment:
This 6-line sentence needs to be broken up to make it easier to follow.
I’m not sure that my interpretation of the author’s intended meaning is
correct, but my revision does illustrate the editing principle of shorter,
less complicated sentences.
Revision:
In patients whose leukocyte count is always ≤300,000, gradual
cytoreduction with prednisone is the preferred approach. This
approach is to avoid the possible complications of pheresis or
exchange transfusion. Those procedures are invasive, expensive, and
have limited availability in many hospitals. Complications of those
procedures may delay the initiation of chemotherapy.
Leukoreduction by apheresis remains a useful tool in acute hyperleukocytosis in
selected cases.
Example 4
Issues addressed in this example:
 Word Choice
 Sentence Structure
Problems are frequently encountered when implantable catheters are used in pediatric oncology
patients.
Comment:
The revision introduced 2 passive voice constructions: “are encountered” and “are
used.” You should use active voice as much as possible.
Revision:
Implantable catheters frequently cause problems in children undergoing cancer
treatment.
An accurate diagnosis of the condition can usually be attained by performing only a simple
radiological procedure with contrast enhancement.
Comment:
The author’s use of “problem” should be kept since it links to the preceding
sentence where “problems” are first mentioned. I also think the revision, which
moved the word only, changed the meaning
Revision:
Identifying the specific problem usually requires a simple radiological procedure
that includes contrast enhancement.
This series of pictures shows the radiological appearance of some of the most frequently
encountered problems associated with intravenous implantable catheters.
Comment: This sentence can be shortened.
Revision: These radiographs illustrate some of the most common problems associated with
implantable catheters.
Example 5
Issues addressed in this example:
 Word Choice
 Sentence Structure
 Paragraph Structure
Presented herein is a case of a 3-year-old male patient who was referred to our hospital because
of persistent fever for 3 weeks and a tumor at the left superior maxillary level.
Comment: By introducing more complex language, these edits make the text harder to read
rather than easier. I would recommend shorter sentences and simpler terms.
Revision: A 3-year-old boy was referred to our hospital. He had fever that had lasted 3 weeks
and a tumor at the left superior maxillary level.
The family had first consulted a dentist who diagnosed an asuppurative dental condition and
administered amoxicylin-clavulanic acid therapy. The patient showed a torpid outcome with
persistent fever, tumor enlargement, and pain aggravation.
Comment: Note that “asuppurative” is not a word (at least I can’t find it). So instead of “an
asuppurative” the correct edit would be “a suppurative”. The term “torpid outcome”
is not one in common use, if one can trust a Google search, and so a simpler
description of the boy’s condition would be helpful.
Revision: The boy had first seen a dentist who diagnosed a suppurative dental condition. The
dentist treated the boy with amoxicylin/clavulanic acid., but he did not improve. His
fever continued, the tumor got larger, and his pain worsened.
Because there was no improvement in his condition, the family brought him to our center, where
he was admitted with the diagnosis of facial and abdominal tumor.
Comment: Shorter, more direct sentences are preferable.
Revision: The family then brought him to our center where the diagnosis was facial and
abdominal tumor.
Physical examination findings (see video): You can see a malnourished patient with an acute
phase of a chronic illness, with a predominantly left-sided facial tumor infiltrating the gums.
Comment: This might be shortened.
Revision: Physical exam (see video): Malnourishment is obvious as is a predominantly leftsided facial tumor in the boy’s gums.
He had dyspnea due to upper airway obstruction and could not close the mouth and swallow.
Comment: Although “dyspnea” is the medical term, “difficulty breathing” may be more
immediately understood.
Revision: Obstruction of the boy’s upper airway made it hard for him to breath. He was unable
to close his mouth and swallow.
The right eye was proptotic without loss of visual acuity. The abdomen was distended because of
a tumor that was not well circumscribed. The boy was unable to walk for a few days, and he
experienced headaches without vomiting.
Comment: Again, one might use shorter, simpler sentences.
Revision: The boy’s right eye was proptotic, but his vision was clear. His abdomen was
distended because of a tumor that was not well-circumscribed. He had been unable to
walk for a few days. He had headaches but no vomiting.
Laboratory findings:
Peripheral blood count: white blood cell count, 14,000/mm³ (neutrophils, 60%; blast cells,
absent); hemoglobin level, 11.4 g/dl; platelet count, 418,000/mm³
Uric acid level was 8.5 mg/dl; and lactic dehydrogenase level was 4200 U/l. Renal and liver
function tests; levels of Ca, P, and Mg; and coagulation test were all normal. HIV serology was
negative.
Bone marrow aspiration findings: normal.
Images:
CNS and facial computed tomography (CT) scan show massive destruction of the facial bones
and a tumor occupying the upper airway and protruding into the cranial vault (arrow in the
fossa media). The patient was assessed as CNS+. See Figures 1 and 2
Multiple biopsies of the facial tumor were performed by an otolaryngologist.
Diagnosis: Burkitt’s lymphoma.
Comment: For uniformity of spelling of eponymous terms, Oncopedia omits the possessive form
of the proper name. So this would be “Burkitt lymphoma.”
Treatment:
The patient was administered a BFM-based protocol for B cell malignancies, following which he
developed severe acute lysis syndrome with acute renal failure (albeit dialysis was not required)
during the pre-phase when he received dexamethasone and cyclophosphamide.
Comment: Note that this sentence is 4 lines long. That much information in a single sentence can
lead to confusion or misreading.
Revision: The patient’s treatment began with a BFM-based protocol for B-cell malignancies.
During the early phase of that treatment he received dexamethasone and
cyclophosphamide, and he developed tumor lysis syndrome. He had acute renal
failure, but dialysis was not needed.
Involvement of the facial bones by Burkitt’s lymphoma is common in endemic areas; however, it
is relatively rare, less than 5% of all Burkitt’s lymphoma cases, in nonendemic areas.
Comment: Could this be simplified?
Revision: In endemic Burkitt lymphoma, involvement of the facial bones is common. But in
sporadic or immunodeficiency-related Burkitt lymphoma, such involvement is rare
(less than 5% of cases).
In these regions, Burkitt’s lymphoma involves the head by affecting the Waldeyer ring or the
orbit (1).
Comment: The meaning of “regions” is ambiguous. Does my revision reflect the author’s
intended meaning?
Revision: When sporadic or immunodeficiency-related Burkitt lymphoma does involve the head,
the Waldeyer ring or the orbit is usually affected (1).
It usually presents as a localized disease, and the outcome is favorable with contemporary
treatment.
Comment: The meaning of “It” is unclear as is “contemporary treatment.” Is this sentence
talking about a Burkitt lymphoma that can be treated with good results?
In this case, however, the child presented with advanced disease, probably due to the delay in
diagnosis.
Comment: To simplify style, avoid terms like “however” and use as few words as possible.
Revision: In this case, the child’s disease was advanced, probably as a result of delayed
diagnosis.
The reason why endemic Burkitt’s lymphoma involves the orofacial bones predominantly in
endemic areas is not known. The relationship between Burkitt’s lymphoma and Epstein Barr
virus and malaria in endemic areas may partially explain this association.
Comment: The more logical place for these 2 sentences about endemic Burkitt lymphoma would
be where that topic is first discussed.
In all cases, particularly in those with an uncommon presentation and extensive disease such as
our case, HIV infection should be ruled out.
Comment: Does “In all cases” mean “In all cases of facial tumor” or “In all cases of Burkitt
lymphoma” or something else? Does “HIV infection should be ruled out” mean “the
patient should be tested for HIV infection”?
Revision: For cases of Burkitt lymphoma, particularly when there are uncommon signs and
symptoms or extensive disease, the patient should be tested for HIV infection.
CNS involvement of the lymphoma, i.e., parameningeal involvement, as seen in this case, is a
life-threatening complication.
Comment: Can this sentence be shortened?
Revision: Parameningeal involvement of the lymphoma, as seen in this patient, is a lifethreatening complication.