Microsoft Word - Vieira Editorial 2015.docx


	
  

Vol	
  3,	
  No	
  1	
  (2015)	
  
ISSN	
  2167-­‐8677	
  (online)	
  

DOI	
  10.5195/d3000.2015.39	
  	
  

	
  

	
  

	
  

http://dentistry3000.pitt.edu	
  

	
   New	
  articles	
  in	
  this	
  journal	
  are	
  licensed	
  under	
  a	
  Creative	
  Commons	
  Attribution	
  4.0	
  United	
  States	
  License.	
  

	
  
This	
  journal	
  is	
  published	
  by	
  the	
  University	
  Library	
  System,	
  University	
  of	
  Pittsburgh	
  as	
  part	
  of	
  its	
  D-­‐Scribe	
  Digital	
  Publishing	
  Program	
  and	
  is	
  cosponored	
  
by	
  the	
  University	
  of	
  Pittsburgh	
  Press.	
  

Rescuing	
  Case	
  Reports	
  
Alexandre	
  Rezende	
  Vieira	
  
	
  
Editor	
  in	
  Chief	
  
Department	
  of	
  Oral	
  Biology,	
  University	
  of	
  Pi4sburgh	
  School	
  of	
  Dental	
  Medicine,	
  Pi%sburgh	
  PA,	
  USA	
  
	
  

	
  

	
  

	
  

	
  

	
  

	
  

Cita%on:	
  Vieira	
  AR.	
  (2015)	
  Rescuing	
  Case	
  Re-­‐
ports.	
  Den!stry	
  3000.	
  1:a001	
  
doi:10.5195/d3000.2015.39	
  
Received:	
  November	
  25,	
  2015	
  
Accepted:	
  	
  November	
  26,	
  2015	
  
Published:	
  	
  December	
  18,	
  2015	
  
Copyright:	
  ©2015	
  Vieira	
  AR.	
  This	
   is	
  an	
  open	
  ac-­‐
cess	
  ar!cle	
   licensed	
  under	
  a	
  Crea-ve	
  Commons	
  
A!ribu!on	
  Work	
  4.0	
  United	
  States	
  License.	
  
Email:	
  arv11@pi$.edu

	
  

	
   This	
  issue	
  of	
  Dentistry	
  3000	
  
features	
  a	
  series	
  of	
  case	
  reports	
  that	
  
have	
  particular	
  emphasis	
  on	
  condi-­‐
tions	
  that	
  appear	
  to	
  be	
  aggregating	
  
in	
  families.	
  The	
  decision	
  to	
  empha-­‐
size	
  case	
  reports	
  aims	
  to	
  address	
  
several	
  areas	
  of	
  concern.	
  

	
   One	
  of	
  the	
  consequences	
  of	
  
the	
  shift	
  towards	
  evidence-­‐based	
  
practice	
  is	
  the	
  assumption	
  that	
  case	
  
reports	
  are	
  very	
  weak	
  evidence	
  in	
  
the	
  hierarchy	
  of	
  research	
  evidence,	
  
since	
  they	
  bring	
  information	
  that	
  
has	
  not	
  been	
  rigorously	
  tested.	
  
Conversely,	
  this	
  shift	
  has	
  created	
  a	
  
high	
  value	
  for	
  randomized	
  clinical	
  
trials,	
  for	
  that	
  very	
  reason:	
  the	
  im-­‐
plementation	
  of	
  testing	
  by	
  rigorous	
  
scientific	
  means.	
  It	
  is	
  interesting	
  to	
  
say	
  the	
  least	
  to	
  realize	
  that	
  increas-­‐
ingly,	
  randomized	
  clinical	
  trials	
  
have	
  become	
  divorced	
  from	
  normal	
  
patient	
  populations	
  by	
  their	
  insist-­‐
ence	
  on	
  inclusion	
  of	
  patients	
  de-­‐
fined	
  by	
  narrow	
  criteria	
  and	
  ab-­‐
sence	
  of	
  comorbidities.	
  It	
  is	
  also	
  in-­‐

teresting	
  to	
  realize	
  that	
  the	
  original	
  
definition	
  of	
  evidence-­‐based	
  prac-­‐
tice	
  that	
  included	
  clinician	
  experi-­‐
ence	
  and	
  characteristics	
  of	
  individ-­‐
ual	
  patients	
  as	
  well	
  as	
  sound	
  re-­‐
search	
  evidence	
  in	
  the	
  decision-­‐
making	
  process	
  has	
  been	
  hijacked	
  
[1]	
  to	
  the	
  point	
  that	
  to	
  be	
  consid-­‐
ered	
  valid	
  evidence,	
  the	
  evidence	
  
needs	
  to	
  be	
  derived	
  from	
  research,	
  
eliminating	
  the	
  need	
  to	
  consider	
  
both	
  the	
  clinician	
  experience	
  or	
  the	
  
patient	
  characteristics.	
  

	
   This	
  scenario	
  has	
  steadily	
  
declined	
  opportunities	
  for	
  scholars	
  
to	
  publish	
  case	
  reports.	
  It	
  was	
  
through	
  short	
  case	
  reports	
  that	
  for	
  
the	
  first	
  time,	
  trisomy	
  of	
  chromo-­‐
some	
  21	
  was	
  linked	
  to	
  Down	
  syn-­‐
drome	
  [2],	
  or	
  that	
  Down	
  syndrome	
  
would	
  associate	
  with	
  leukemia	
  [3].	
  
Almost	
  simultaneous	
  reports	
  in	
  
Germany	
  and	
  Australia	
  led	
  to	
  tha-­‐
lidomide	
  to	
  be	
  identified	
  as	
  the	
  
cause	
  of	
  phocomelia	
  in	
  newborns	
  
[5].	
  Or	
  a	
  1981	
  report	
  of	
  five	
  cases	
  

that	
  for	
  the	
  first	
  time	
  described	
  a	
  
syndrome	
  that	
  was	
  soon	
  to	
  be	
  
known	
  as	
  AIDS.	
  The	
  report	
  conclud-­‐
ed:	
  "The	
  above	
  observations	
  sug-­‐
gest	
  the	
  possibility	
  of	
  a	
  cellular-­‐
immune	
  dysfunction	
  related	
  to	
  a	
  
common	
  exposure	
  that	
  predisposes	
  
individuals	
  to	
  opportunistic	
  infec-­‐
tions."	
  The	
  bottom	
  line	
  is	
  that	
  case	
  
reports	
  can	
  provide	
  insight	
  to	
  im-­‐
portant	
  problems	
  that	
  deserve	
  fur-­‐
ther	
  study.	
  

	
   Finally,	
  writing	
  case	
  reports	
  
is	
  a	
  good	
  exercise	
  for	
  young	
  profes-­‐
sionals	
  in	
  training	
  and	
  can	
  serve	
  as	
  
an	
  important	
  tool	
  to	
  teach	
  a	
  number	
  
of	
  skills	
  from	
  appreciation	
  and	
  the	
  
ability	
  to	
  critically	
  evaluate	
  infor-­‐
mation	
  to	
  generate	
  hypothesis	
  driv-­‐
en	
  questions	
  that	
  deserve	
  further	
  
exploration.	
  This	
  issue	
  brings	
  a	
  
number	
  of	
  case	
  reports	
  authored	
  by	
  
young	
  professionals	
  and	
  emphasize	
  
the	
  genetic	
  etiology	
  of	
  oral,	
  dental,	
  
and	
  craniofacial	
  conditions.	
  



Rescuing	
  Case	
  Reports	
  

Vol	
  3,	
  No	
  1	
  (2015)	
  	
  	
  	
  DOI	
  10.5195/d3000.2015.39	
  

	
  http://dentistry3000.pitt.edu	
  
2	
  

	
   Dentistry	
  3000	
  will	
  contin-­‐
ue	
  to	
  publish	
  original	
  case	
  reports	
  
and	
  support	
  the	
  scholarly	
  develop-­‐
ment	
  of	
  dental	
  professionals	
  both	
  
young	
  and	
  experienced.	
  

References	
  

1.	
  Evidence-­‐based	
  case	
  reports.	
  Bol-­‐
ton	
  J.	
  J	
  Can	
  Chiropr	
  Assoc	
  v.58(1);	
  
2014	
  Mar	
  PMC3924510	
  

2.	
  [Chromosomic	
  diagnosis	
  of	
  mongo-­‐
lism].	
  Lejeune	
  J,	
  Turpin	
  R,	
  Gautier	
  M.	
  
Arch	
  Fr	
  Pediatr.	
  1959;16:962-­‐3.	
  
French.	
  PMID:14415503	
  

3.	
  Inheritance	
  of	
  an	
  Abnormal	
  Chro-­‐
mosome	
  in	
  Down's	
  Syndrome	
  (Mon-­‐
golism)	
  with	
  Leukemia.	
  German	
  JL,	
  
Demayo	
  AP,	
  Bearn	
  AG.	
  Am	
  J	
  Hum	
  
Genet.	
  1962	
  Mar;14(1):31-­‐43.	
  
PMID:17948467	
  

4.	
   Recognition	
  of	
  thalidomide	
  
defects.	
  Smithells	
  RW,	
  Newman	
  CG.	
  J	
  
Med	
  Genet.	
  1992	
  Oct;29(10):716-­‐23.	
  
PMID:1433232	
  

5.	
  Pneumocystis	
  pneumonia-­‐-­‐Los	
  An-­‐
geles.	
  Centers	
  for	
  Disease	
  Control	
  
(CDC).	
  MMWR	
  Morb	
  Mortal	
  Wkly	
  
Rep.	
  1981	
  Jun	
  5;30(21):250-­‐2.	
  
PMID:6265753