We aimed to assess publication speed of manuscripts submitted to general medical journals and to explore the link with various author, paper and journal characteristics. In this retrospective study of bibliometric data we retrieved 45 randomly selected papers published in 2016 from each of the highest impact factor journals of general internal medicine (n = 9) and primary care (n = 9). Only journals reporting submission and publication dates were included. The following data were extracted: first author (gender, place of affiliation, number of publications), paper (submission and publication dates, online publication, open access, number of authors, number of participants, study design, study results) and journal characteristics (impact factor, number of papers published). We computed for each paper the submission-to-acceptance, acceptance-to-publication and submission-to-publication times. We performed linear regression with random effects models to identify the associations with predictors, adjusting for intra-cluster correlations. A total of 781 papers were included. The overall median submission-to-acceptance time was 123 days (interquartile range 111, min 1, max 922), acceptance-to-publication time 68 days (interquartile range 88, min 2, max 802) and submission-to-publication time 224 days (interquartile range 156, min 24, max 1034). In multivariate analysis, online publication was strongly associated with reduced submission-to-publication time (difference: − 93 days, p value < 0.001). This study provides insight into the submission-to-acceptance, acceptance-to-publication and submission-to-publication times in general medical journals. Researchers interested in reducing publication delays should focus on journals with online publication.

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BackgroundSevere leptospirosis occurs mainly in a tropical environment and includes icterus, acute renal failure and hemorrhages. These bleedings, which are mainly a consequence of acute homeostatic disturbances, can also reveal simultaneous diseases. Coinfections with other tropical diseases have been previously reported during leptospirosis. To our knowledge, invasive amebiasis, which can induce gastrointestinal bleedings, has never been described in the course of severe leptospirosis.Case presentationIn this report, we describe a case of a 60 year-old man living in Reunion Island (Indian Ocean, France) admitted to our intensive care unit for severe Leptospira interrogans serovar icterohaemorrhagiae infection with neurological, renal, liver and hematological involvement. Two lower gastrointestinal bleedings occurred 7 and 15 days after admission. The first episode was promoted by hemostatic disturbances while the second bleeding occurred during low-dose heparin therapy. Colonoscopy revealed a pseudo-tumoral inflammatory mass of the recto-sigmoid junction. Histological examination found trophozoites inside mucinous exudate suggestive of Entamoeba histolytica. Amoebic serology was strongly positive whereas careful detection of cysts or trophozoites on saline-wet mount was negative in three consecutive samples of stools. Amoxicillin followed by metronidazole therapy, combined with supportive care, led to an improvement in the clinical and biological patient’s condition and endoscopic appearances.ConclusionClinicians should be aware that gastrointestinal bleeding during severe leptospirosis could not solely be the consequences of hemostatic disturbances. Careful endoscopic evaluation that may reveal curable coinfections should also be considered.

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