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Powered by TCPDF (www.tcpdf.org) case reports 2017; 3(1) Editorial: CASE REPORT: ACTIVE PROGRESSIVE BASED ON CLINICAL PRACTICE LEARNING (APB-C) Arturo José Parada Baños M.D. Universidad Nacional de Colombia Faculty of Medicine Department of Obstetrics and Gynecology Bogotá, – Colombia https://doi.org/10.15446/cr.v3n1.65433 CASE REPORTS Clinical case reports date back to 1600 B. or intervention, or describe some event that C., when Egyptian papyri first described inju- is unknown (8). ries or disorders of the head and the back (1). APB-C learning is an apprentice-centered Likewise, cases reported by Hippocrates, 460 strategy that not only considers students as B.C (2), or the first uterus (3) and face trans- apprentices, but also considers any health plants (4) can be found in the literature, as well professional who progressively builds critical, as cases on the recent Zika epidemic and its autonomous, and creative thinking in an open relation to microcephaly (5). All of them have and malleable way, according to the context, greatly contributed to the evolution of medical and based on new research works. It also science during different periods, both in re- includes professionals with an analytical and search and learning processes. resolute capacity to apply this knowledge Case reports can be considered as scientific in a specific way to each new clinical case publications that represent the simplest form received and, with the potential to broaden of research in the clinical area (6); however, their knowledge and experience finding new they are the evidence of what actually happens meanings. In the context of APB-C learning, in each case. That its usefulness is purely a clinical case report represents a situation investigative is debatable. Case reports have that encourages knowledge, because it not a low profile in relation to the classification of only seeks to solve a problem, but also is, other scientific works, but their contribution to sometimes, the tip of the iceberg for new the understanding of history (1), meaningful knowledge. learning of medicine and a more humanized When the author of a clinical case report view of health care is evident (7). incorporates new knowledge into the cogni- Regardless of the current discussion on tive structure of the professionals who read the hierarchical place of case reports as a it, a meaningful learning process arises, in scientific evidence, it is clear that it has always which each reader gives a personal meaning been present in medical literature, not only to the new acquired knowledge. This way, because of its scientific value, but because relationships with their cognitive structure are it has always been a part of medical learning. established and new theoretical and method- The medicine learning process has evolved, ological elements (9) for teaching-learning moving from positivist and behaviorist the- processes of future research appear. oretical strategies to the current cognitive, One of the most relevant contributions of constructivist and socioconstructivist learning case reports, and the reason why they are still processes. These approaches have allowed an valid today, is the cognitive dynamics generat- active progressive based on clinical practice ed when meaning is given to new knowledge, (APB-C) learning, leaving passive knowledge since it could be integrated or diverge from acquisition processes behind and fostering previous knowledge about a specific topic or active, progressive, participatory and integra- pathology. This active and progressive dynamic tive processes for logical and constructive motivates new ventures in scientific research reasoning based on each clinical case. Cases or learning processes in medicine. are the essence of clinical medicine, even Case reports have been proposed as a more when they report a new disease, are gateway for undergraduate and graduate stu- rare and little known, show a new treatment dents, as well as for professors and research- CASE REPORT: ACTIVE PROGRESSIVE BASED ON CLINICAL PRACTICE LEARNING (APB-C) ers, to take their first steps into the world of REFERENCES medical literature. This position is not entirely shared by the author of this editorial, since 1. Nissen T, Wynn R. The history of the case re- case reports of all kinds have been produced port: a selective review. JRSM Open. 2014;5 throughout history, and have been submitted by (4):2054270414523410. doi: http://doi.org/b8fd. new professionals or experts and researchers 2. Abu Kasim NH, abdullah BJJ, Manikam J. of medical science who allow themselves to The current status of the case report: Terminal or be astonished by new knowledge and want viable?. Biomed Imaging Interv J. 2009;5(1):e4. doi: http://doi.org/bhpnr2. to share it. 3. Fageeh W, Raffa H, Jabbad H. Transplanta- The ability to recognize that which gener- tion of the human uterus. Int J Gynaecol Obstet. ates new meaning as learning is what allows 2002;76(3):245-51. many authors to detect a case to report and 4. Siemionow M, Papay F, Alam D, Bernard S, to share it, leaving aside the amount of ex- Djohan R, Gordon C, et al. Near-total human perience they have. If a case is significant face transplantation for a severely disfigured patient enough for an author, it might be significant in the USA. The Lancet. 2009;374(9685):203-9. for others as well. Then a literature review is doi: http://doi.org/cznvb8. initiated, although few cases out of hundreds 5. Mlakar J, Korva M, Tul N, Popović M, Pol- are actually published; what is meaningful jšak-Prijatelj M, Mraz J, et al. Zika Virus and new for an author, may not be for other Associated with Microcephaly. N Engl J Med. professionals. 2016;374:951-8. doi: http://doi.org/f8cm38. 6. Delgado-Ramírez, MB. What is the value of Historically, this type of articles have shown continuing to publish case reports? Rev Colomb a complete picture of clinical practice, which Anestesiol. 2017 [cited May 20 2017];45(S1):1- evidences the differential empathic process 3. Available from: https://goo.gl/87BT5Y. between the attending professional and his 7. Agha R, Rosin RD. Time for a new approach to patients, showing the comprehensive knowl- case reports. Int J Surg. 2010;8(5):330-2. doi: edge that is described in the narrative of the http://doi.org/b3trp6. case. Currently, this comprehensiveness in 8. Romaní-Romaní F. Reporte de caso y serie case presentation is increasingly strengthening de casos: una aproximación para el pregrado. due to the CARE guidelines (consensus-based CIMEL Ciencia e Investigación Médica Es- development of guidelines for reporting clinical tudiantil Latinoamericana. 2010 [cited May 18 cases) (10), which allow for greater scientific 2017];15(1):46-51. Visitado el 18 de mayo de validity and a comprehensive and holistic view 2017. Available from: https://goo.gl/x1cuXd. of each case presentation. 9. Ponce V. El aprendizaje significativo en la inves- tigación educativa en Jalisco. Revista Electrónica Writing and analyzing clinical case reports Sinéctica. 2004 [cited May 20 2017];24:21-9. should be part of the APB-C learning strategies Available from: https://goo.gl/. for undergraduate and graduate students, as well 10. Gagnier JJ, Kienle G, Altman DG, Moher as for practicing professionals, additionally to D, Sox H, Riley D, et al. The CARE Guideli- historical, academic and humanistic interest gen- nes: Consensus-based Clinical Case Reporting erated by the cognitive-constructivist processes Guideline Development. Glob Adv Health Med. of meaningful learning and scientific research. 2013;2(5):38-43. doi: http://doi.org/b8fs. Case Reports 2017; 3(1) https://revistas.unal.edu.co/index.php/care/article/view/58625 ENVENOMATION CAUSED BY THE BITE OF THE SNAKE BOTHRIECHIS SCHLEGELII. REPORT OF TWO CASES IN COLOMBIA Palabras clave: Bothriechis schlegelii; Mordeduras de serpientes; Coagulación sanguínea; Colombia. Keywords: Bothriechis schlegelii; Snake bites; Blood coagulation; Colombia. Mario Galofre-Ruiz, MD, MSc Tox Centro de Información de Seguridad sobre Productos Químicos CISPROQUIM Consejo Colombiano de Seguridad Bogotá D.C. – Colombia Corresponding author [email protected] Phone number.: (057)3157261026 CASE REPORTS ABSTRACT brown and black), helps it mimic its surround- ings. It has prehensile tail, and from two to four The bite by snakes of the Bothriechis genus is small superciliar scales, in the way of “eye- common in certain areas of Colombia such as lashes”. It feeds on baby birds, lizards, frogs the Coffee-growing Region. Due to their arbo- and rodents, inhabits tropical forests and corn real habits and defensiveness, these snakes and coffee crops, at altitudes ranging from 0 usually bite farmers in their upper limbs and to 2600 m; the viper reaches the highest alti- face. In Colombia, the incidence of accidents tude in Colombia (2,3). caused by these snakes has not been accu- In the regions in which it inhabits, it is also rately estimated yet because of deficiencies in known as cabeza de candado, granadilla, ví- recording this type of cases, as well as of the bora de tierra fría, víbora de pestañas, ya- ignorance on this reptile by health personnel ruma, veinticuatro, guacamaya, víbora rayo, working in its area of influence. mortiñera, colgadora and grano de oro (these This paper describes two cases of bites by B. are different names to refer to this snake in schlegelii occurred in Colombia during 2015. diverse regions of Latin America) (2,4). The first case is about a 55-year-old man who B. schlegelii extends from southern Mexi- was bitten on the left hand, and subsequent- co, throughout Central America, to the east of ly developed paresthesia and edema until the Venezuela, and in the Pacific through Costa forearm, with no other findings; the patient un- Rica, Panama, El Salvador and Ecuador (5).