Guide for Authors

Clinics of North America

Manuscript Guidelines for Authors

Welcome to the Clinics publishing program. Your contribution is greatly appreciated, and we look forward to working with you. All of the periodicals in the Clinics publishing program offer the medical, dental and veterinary practitioner comprehensive, clinical reviews of timely subjects, including diagnosis and therapy, new materials, and new technologies. Your contribution should be of genuine clinical interest and contain information that is well substantiated by your research, your clinical experience, and by reports in the literature.

These guidelines are provided to simplify manuscript preparation for you and to ensure that your article moves smoothly through the production process. Follow the instructions provided regarding article, table and figure preparation, and when complete, either e-mail or submit your manuscript (hard copy, disk, tables, figures and appropriate forms) to the Guest Editor by the agreed-upon deadline. Your manuscript will be forwarded to us after the Guest Editor's review of scientific content. The Guest Editor will contact you if any revisions are necessary.


  • Manuscripts must be typed double-spaced. This guideline includes all text, references, tables, and figure legends.
  • It is the author's responsibility to obtain permission and pay any fees for any borrowed, modified, or adapted text, tables, or figures from the copyright owner (usually the original publisher).
  • We cannot accept any manuscripts, figures, or tables that are unpublished and have been submitted to or are under consideration by any other publisher or publication.
  • It is the author's responsibility to provide publication-quality artwork (photos, drawings, etc).
  • Digital art must be submitted according to the guidelines.
  • You will be required to sign a Transfer of Copyright form (which will be sent to you via e-mail at a later date from Elsevier's production department) transferring copyright of your material to Elsevier. We will be unable to publish your article without this signed agreement.



• Submit your manuscript via e-mail unless requested to do otherwise by your Guest Editor.
• We prefer that articles are prepared using Microsoft Word, but we can convert most other program files.
• Save text, references, synopsis, figure legends, and tables all as one file.

Your title page must include the following information (see sample below):

• Title of article (the title should contain keywords to assist in online searches and reflect the Clinics specialty)
• Each author's name, degrees, academic or professional affiliation, city, and state (or country).
• E-mail address, mailing address, telephone number, and fax number of each coauthor.
• Clearly indicate the corresponding author, who will receive proof and reprints; if corresponding author is not indicated, materials will be sent to the first-named author.
• Statement acknowledging funding support, if applicable.
• Please supply 4-6 keywords which will be used to optimize search results. Words should address the diagnosis, treatment and patient characteristics if possible.
• Provide any financial disclosures and/or conflicts of interest for all authors (see section directly below). If none exist, indicate "The authors have nothing to disclose."


Authors should disclose any relationship with a commercial company that has a direct financial interest in the subject matter or materials discussed in their article or with a company making a competing product as follows:
• All funding sources supporting research that is the primary subject of discussion in the article should be acknowledged in a footnote on the title page of the manuscript, as should all institutional or corporate affiliations of the authors.
• Other relationships that might pose a conflict of interest, such as a paid consultancy, stock ownership or other equity interest, or patent-licensing agreements, should be disclosed in an acknowledgment placed at the end of the article before the references, where it will appear when the article is published.

For Clinics publications that offer optional CME/CE credit, all contributors will be required to disclose any professional or financial relationships relevant to the subject matter in their papers. Failure to comply with this request will jeopardize the publication of the author's paper. Contributors for these series will receive a disclosure form with their welcome packages.


• Text should be double-spaced in 10- or 12-point type with 1-inch margins.
• Number each page, starting with the title page.
• Indent paragraphs.
• Type heads consistently flush left throughout the article.
• Type reference numbers sequentially within brackets (no superscript necessary).
• Conclude article with a brief summary of its important points or objective.
• Acknowledge assistance of any colleagues or support staff in the preparation of article, if applicable.


• Double-spaced with 1-inch margins.
• List by number in the order in which used in the text (sequentially, not alphabetically).
• Use Index Medicus abbreviations for journals that are indexed; if a journal is not indexed, use full name.
• If more than three authors, cite first three and add "et al."
• If using reference managing software such as EndNote, Reference Manager or ProCite, choose the style for "Clinics of North America," or if unavailable, "JAMA," which most closely approximates Clinics style.
• Please include volume and page range whenever possible.
• For questions regarding formatting of other references not cited below, e.g., websites, e-mail, CDs, or databases, reference according to the AMA Manual of Style.

Sample citations:Journal article
12. Simpkins H, Schoaf F, Katz J, et al. An acute granular lymphoid leukemia: a case report. Hum Pathol 1987;18:93-9.

Clinics article
18. Aron DN, Crowe DT. Upper airway obstruction. Surg Clin North Am 1999;46:1224-45.

Chapter in a single-authored book
5. Haeney M. Antibody deficiency. In: Introduction to clinical immunology. London: Butterworth; 1985. p. 64-87.

Chapter in a multi-authored book
3. Krane SM, Near RM. Connective tissue. In: Smith LJ Jr, Their SO, editors. Pathophysiology: the biological principles of disease, 2nd edition (International Textbook of Medicine, vol 1). Philadelphia: WB Saunders; 1985. p. 611-26.

Proceedings papers
24. Bell LM, Alpert G, Gorton-Slight P. Skin colonization of hospitalized and nonhospitalized infants with lipophilic yeast [abstract 519]. In: Programs and abstracts of the 25th Interscience Conference of Antimicrobial Agents and Chemotherapy. Minneapolis: 1985, p. 186-8

Works in Progress and Personal Communications
Insert in text, in parentheses, any mention of personal communications or unpublished observations:

...(John Hones, MD, City, State, personal communication, May 1999)...
• Personal communications should not be included in the reference list.
• Information attributed to "personal communication" in your manuscript should not be inflammatory or libelous or cause embarrassment to anyone, including the source, when it is published.


Provide a brief summary (approximately five sentences) of your article for the table of contents. Be advised that the synopsis is often used by indexing services such as PubMed as the abstract for the article.


The generic or nonproprietary name of a drug should be used, with the proprietary or trademark name included in parentheses at first mention, e.g., trimethoprim-sulfamethoxazole (Bactrim; Septra). The manufacturer's name, superscript ®, and superscript are not necessary.

Trademark names of equipment and materials should be provided when appropriate, and the manufacturer's name and address (city, state, country if necessary) should be included in parentheses immediately following; e.g., Velcro tourniquet (Velcro USA, Inc., Manchester, NH).


Be aware of the difference between tables and lists. Tables must be at least two columns and their purpose is to show relationships between data; lists are enumerations. Submitted "tables" that are actually lists will be converted to lists according to Elsevier house style.

• Number tables consecutively throughout text; do not combine numbering with figures.
• All tables must be called out in order at least once in the text (e.g., Table 1).
• Compose each table on a separate page at end of the manuscript.
• Provide a title at the top of each table.
• Provide the appropriate credit line at the bottom of all borrowed, modified, or adapted tables (see "Guidelines for Permissions").
• Obtain permission for all borrowed, modified, or adapted tables (see "Guidelines for Permissions").


We encourage you to use original figures and tables to illustrate your article. When it is necessary to borrow figures or tables from other publications, authors are urged to consider using material originally published by Elsevier or one of Elsevier's imprints: Academic Press, Butterworth-Heinemann, Cell Press, Churchill Livingstone, Excerpta Medica, Hanley & Belfus, The Lancet, Mosby, Pergamon, and WB Saunders. Elsevier also offers access to an online image library,, from world renowned medical illustrator Frank Netter. The images range from anatomical drawings to clinical disease states to new therapeutic technologies. To borrow any figures or tables from Elsevier/Netter, contact the in-house Clinics editor.

If you provide artwork for your article, all figures should be high resolution and sharp in detail. Please note that all costs for figure preparation are assumed by the author. Art will not be reproduced in color unless an arrangement has been made with the Clinics editor prior to the submission of the manuscript. Please submit only figures that are not under consideration for publication elsewhere.

The following figure formats are acceptable for publication (only one copy is necessary):

• Electronic file formats of JPG, TIF, EPS, PDF or PSD
• PowerPoint files and figures embedded in Word documents
• Halftone or color images (clinical photos, radiographs, MRIs) must have a resolution of at least 300 dpi, line art must be at least 1200 dpi, and combination art must be at least 600 dpi.
• Original line drawings
• Black-and-white or color glossy prints
• Computer-generated laser-quality prints
• Camera-ready copy of a borrowed figure
• 2" x 2" slides

Details of figure submissions:
• Number each figure consecutively as it appears in the text. Do not combine numbering of figures with numbering of tables.
• Refer to each figure by number in the text (e.g., Fig. 1).
• Digital file names must match figure number in text.
• Crop digital images to show desired clinical information or indicate any crop marks on border of hard copy of figure or photocopy of figure.
• Add any labels (A, B, etc.), arrows, or other markings using appropriate software or provide a photocopy of figure with changes noted.
• If providing hard copy figures, label the backs of all figures with author's name and figure number, using a very soft pencil or label. Indicate "top" of illustration.
• If multi-part figures must be placed in a specific arrangement, please indicate your preferences in your manuscript. Layout changes are not possible once an article has been typeset.
• The publisher is obligated to mask eyes or other identifiable features of a patient in a photograph from whom a release has not been verified (see "Patient Photograph Release Forms").


• Type double-spaced with 1-inch margins on a separate page.
• Explain each part of multi-part figures, using capital letters A, B, C, etc.
• Explain any labels, arrows, arrowheads, or other markings on the figures.
• Provide a complete credit line at the end of the legend of each borrowed figure.
• Obtain permission for any borrowed or courtesy figures (see "Guidelines for Permissions").


• We encourage authors to submit multimedia files (movies, animations, audio), which will be published online with the electronic version of the article. Multimedia files should be submitted together with your manuscript and should be complete and final when submitted. To ensure that your material is usable, it must be provided in one of our recommended file formats:
• Video files should be submitted in a format that offers as high a resolution as possible. MPEG files are the preferred format for movies. (Specifically, MPEG-1 or MPEG-2 files are required.) We also accept MOV and AVI files. GIF files are our preferred format for animation of rasterised (pixel-based) images. For audio submissions, we accept WAV and MP3 files. The recommended upper limit for the size of a single multimedia file is 10 Mb.
• Supplementary multimedia files should be referred to in the text in the same way as figures and tables (e.g., See Movie 1)


If you need to borrow, modify or adapt a table or figure from another source, you must obtain permission and pay any fees requested from the original source. Copyright law prevents us from publishing borrowed material without proper written permission, so it is important that you seek permission while you are preparing your manuscript.

• Note that you as the author are responsible for proper use and attribution of all borrowed material in your article, including your own work that has been previously published.
• If you have not obtained permission by the time your article is submitted for publication, borrowed material may have to be withdrawn.


Any form of expression, upon creation, including personal letters, unpublished tables, and committee recommendations, whether published or not, requires permission for its use or reuse. In order to publish anything that has been published or posted online elsewhere, we need to know the copyright status. Copyright is, most simply, the right to make a copy. Copyright is automatic for any original work upon publication, regardless of whether or not there is a copyright notice attached to the work. "Publication" can include books, journals, maps, websites, conference presentations, product brochures - if this image has appeared in public in the past, we need to know how, where and when this occurred. Even if the material is in the public domain or is the author's own work, we need to know if it has been published in the past to ensure that proper credit is given.Text
You may make "fair use" of borrowed text without permission. Whether a use is "fair" depends on a variety of factors, including what percentage of the original material is used, how much of your work is composed of borrowed material, and whether the potential market or value of the original source will be adversely affected. To be "fair," proper credit must be given and material should not be used misleadingly. Ordinarily, use of 300 words or less from an average book chapter will be considered fair use, but it could be considered unfair use if, for example, the 300 words constitute a large percentage of the original article or chapter. If you are unsure, the safest course is to request permission. Notify the Elsevier editor as early as possible if you think permission is needed. You must seek permission to quote from a poem or song lyric and for verbatim use of dictionary definitions.

Public domain
Anything first published in the United States before 1923 and all other material in the public domain do not require permission. Included in the public domain are United States Government publications (including material authored by United States Government employees within the scope of their employment) and any work on which the copyright has expired.

Anything first published in the United States before 1923 and all other material in the public domain do not require permission. Included in the public domain are United States Government publications (including material authored by United States Government employees within the scope of their employment) and any work on which the copyright has expired.

Creating tables and figures from data
If you have created your own figures or tables using data from another source, no permission is necessary, and the credit line should read, "Data from (complete reference)."

Tables and charts
Ideas and facts are not subject to copyright, only the original expression of those ideas and facts; this is why you can reference someone else's research without asking permission.

A table or chart that is simply an arrangement of data or a list is not subject to copyright. If there is some original expression, such as full sentences or a particularly creative table design, permission is needed. If you aren't sure, apply for permission. As a general rule, apply for permission for any previously published graphic representation of data - pie charts, bar charts, graphs - even when the graph is not particularly original.

Permission is always required for borrowed figures, even if they have been adapted or modified. In the latter case, specific permission to adapt or modify must be obtained, and the credit line should begin, "Adapted from (complete reference)." If you are using your own unpublished photographs, releases must be obtained from all identifiable patients (see "Patient Photograph Release Forms"). If you are using previously unpublished photographs obtained from a colleague, the credit line should read "Courtesy of..." followed by the colleague's name, academic degree, and location. If you are using original artwork and the artist has retained copyright, you must obtain permission for its use. If you are borrowing previously published artwork, you must ascertain whether the publisher or the artist holds the copyright and obtain permission from the appropriate party.

Samples of credit lines for tables and figures
• Some copyright holders require specific wording for credit lines; please follow their instructions.
• Please do not list a reference number in place of a credit line.
• When referencing a borrowed figure, add only the page where the figure was found, not the page range.

Fully borrowed (permission necessary)
From Lawrence TJ. The hepatorenal syndrome. Am J Gastroenterol 1989;28:475, with permission.

Modified or adapted (permission necessary)

From Lawrence TJ. The hepatorenal syndrome. Am J Gastroenterol 1989;28:475, with permission.

Modified or adapted (permission necessary)

Adapted from Epstein AE, Stanley JG, Morris TB. Hematologic abnormalities associated with HIV disease. Blood 1990;125:615, with permission.

Created using data from other sources (no permission is necessary)

Data from Brenner WN, Bauer HH. Long-term survival following heart-lung transplantation. Arch Surg 1988; 89:339-45.

Courtesy of an individual (verbal confirmation required)

(Courtesy of Steven J. Thompson, MD, Los Angeles, California.)

Courtesy of a company (permission is necessary)

(Courtesy of Medco Inc, Denver, Colorado.)

Product photos
If you take an original picture of a piece of equipment, you do not need permission from the manufacturer to publish that photo. If, however, you want to republish an image from a manufacturer's website, advertisement or brochure, then you need permission from the publisher of that material (usually the manufacturer.)

Museum and archival materials
An exact reproduction of an image in the public domain is also in the public domain. This means that a museum cannot claim that it holds the rights to such an image. Note that this only applies to exact reproductions, such as a photographic reproduction of a painting. If the image was created or first published after 1923, it is probably protected by copyright.


To obtain permission from Elsevier or one of Elsevier's imprints (Academic Press, Butterworth-Heinemann, Cell Press, Churchill Livingstone, Excerpta Medica, Hanley & Belfus, The Lancet, Mosby, Pergamon, and WB Saunders):
• Fill out the online form at:
• Or email

Many major publishers are now using "Rightslink" through the Copyright Clearance Center ( For publishers using "Rightslink," you will need to establish an online account. You will then be able to apply for permission. Some helpful tips:
• For "Type of usage" choose option closest to "Use in a journal"
• If asked if usage is for-profit or non-profit, it is always for-profit unless "STM signatory" is also an option. Please choose "STM signatory" whenever possible, to avoid unnecessary fees.
• If you are asked for "number of figures" the correct response is the amount of figures you are borrowing, not individual figure numbers.
• Click button for "Quick Price" to see the fee, if there is one.
• If asked for a "PO number" use volume and issue number
• Retain all emails/approvals and forward to the in-house Clinics editor

Most other publishers have online systems to apply for any reuse of text, figures, and tables. Please use their online system to apply. To locate a publisher:
• For a partial list of permission contacts and information sources, please see below.


• Copies of permission requests/approvals and patient releases should be enclosed with your manuscript with the originals kept for your files. To ensure correct attribution of borrowed figures and tables, include a photocopy of the page on which the borrowed material appears. Please also include a copy of the original legend. This is particularly important because of the possibility that the source you are using may refer to yet another party. If this is the case, you must request permission from the original source of the material.
• Include a copy of the signed permission form for each borrowed figure or table.
• Include a copy of the signed permission form for any borrowed text over 300 words.


• If above not yet available, send a copy of your permission request (with a copy of signed, completed original to follow directly to Clinics Editor).


Any photos of identifiable patients need signed releases from the patient or, in the case of minors, from the patient's parent or legal guardian. Any full face or full profile images are considered identifiable. If you wish to use a patient photo and a release is not available, the patient's identity will need to be obscured, either through cropping the figure or covering the eyes with a black bar. The in-house Clinics editor only needs verification that you have signed releases; you do not have to supply the signed releases.

Photos of people in public places, large groups, or engaged in normal daily activities (such as a technician operating a piece of machinery) do not require releases.

If you do not have your own form or a form provided by your institution, we suggest that you use the following wording on your letterhead:

I, [patient's name], give permission to [your name] to take and reproduce photographs in connection with my diagnosis, care, and treatment, including surgical procedures, and authorize that such photographs may be a part of the physician's files or medical record. I also authorize the physician to use and publish these photographs at his or her discretion in the medical literature and otherwise for research purposes, provided that I shall not be identified by name in any such publication or use.

Patient or Legal Guardian Signature__________________________ Date _________________________________


• Your article will be typeset and copy edited for grammar, punctuation, house style, and format. When this process is complete, an e-mail message will be sent to the corresponding author which will provide a link to the typeset manuscript (in PDF format) and author queries. Review of proof allows the author to answer all queries and make any corrections necessary.
• We ask that these proofs be returned within 48 hours. Corrections received after that time may not be included.
• Please keep in mind that only essential changes can be made on the page proof. Any lengthy changes in your manuscript should be sent to the Clinics Editor before typesetting.


Diagnosis and Management of Pneumonia in the Elderly

William F. Smith, MD,a,b and Ellen J. Lewis, MD, PhDc

aProfessor of Medicine, Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina; and
bDirector, Medical Intensive Care Unit, Medical University of South Carolina Medical Center, Charleston, South Carolina
cAssociate Professor of Medicine and Chief, Program in Geriatric Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

This work was supported by Grant No. HL23456 from the National Institutes of Health.

The authors have nothing to disclose.

Keywords: pneumonia, pneumococcus, elderly, geriatric

a,bCorresponding author forproof and reprints:

William F. Smith, MD
Division of Pulmonary and Critical Care Medicine
Medical University of South Carolina
171 Ashley Avenue
Charleston, SC 29425
(803) 792-3000
(803) 123-4567 (fax) (email)

cCoauthor(s) address(es):

Ellen J. Lewis, MD, PhD
Department of Internal Medicine
University of Pennsylvania
School of Medicine
36th and Hamilton Walk
Philadelphia, PA 19104
(215) 898-4211
(215) 123-4567 (fax) (email)

Links for permissions
To get permission to republish, follow the guidelines of the original publisher of your source content. The main websites and permissions sites for many publishers are listed below. Click on the name of the publisher to be taken to the main site, or click on the following link to go to the permissions page. If you are unsure who publishes the book or journal where your content is found, try searching for the title on Google. PubMed, a service of the National Library of Medicine, is a useful source for finding out more about specific journal articles.


AMA journals:

American Psychiatric Publishing:

American Psychological Association:

Datatrace: Email requests to

Lippincott, Williams & Wilkins:

McGraw Hill:

New England Journal of Medicine:



World Health Organization (WHO):

Publishers that use Rightslink:

Blackwell Publishing Ltd. (UK)
British Medical Journal Publishing Group Ltd. (UK)
The Journal of Bone & Joint Surgery (JBJS)
The National Academies Press
Nature Publishing Group
Oxford University Press (UK)
SAGE Publications
Springer SBM
AAAS (American Association for the Advancement of Science)
American Psychological Association
Taylor & Francis
Wolters Kluwer/Lippincott Williams and Wilkins

Updated January 2010