Medical Education Commons^™

Transanal Irrigation Is More Beneficial In Symptomatic Management Of Neurogenic Bowel Disease Than Conservative Bowel Management, Chi-Lan Tran

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Christensen P, Bazzocchi G, Coggrave M, et al. A Randomized, Controlled Trial of Transanal Irrigation Versus Conservative Bowel Management in Spinal Cord–Injured Patients. Gastroenterology. 2006;131(3):738-747. https://doi.org/10.1053/j.gastro.2006.06.004

Upper Vs. Lower Extremity: Does The Site Of Steroid Injection Have A Different Effect On Blood Glucose Levels In Patients With Diabetes?, Emilyn Anderi

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Twu J, Patel N, Wolf JM, Conti Mica M. Impact of variation of corticosteroid dose, injection site, and multiple injections on blood glucose measurement in diabetic patients. J Hand Surg Am. 2018;43(8):738-744. https://doi.org/10.1016/j.jhsa.2018.06.005 for a patient with diabetes and osteoarthritis.

Changing Guidelines: Recommendation Of Early Peanut Introduction For Prevention Of Peanut Allergy In Infants With Severe Eczema, Alexandra H. Zetye

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. New Eng J Med. 2015;372(9):803-813. https://doi.org/10.1056/nejmoa1414850

Endovascular Branch Fenestration And/Or Stenting May Be A Viable Treatment Option For Lower Limb Malperfusion Due To Acute Type B Aortic Dissection, Matthew Henry

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Norton EL, Williams DM, Kim KM, et al. Management of acute type B aortic dissection with malperfusion via endovascular fenestration/stenting [published online September 30, 2019]. J Thorac Cardiovasc Surg. 2019. https://doi.org/10.1016/j.jtcvs.2019.09.065

Do Atypical Antipsychotics Trigger Manic Switching In Patients With Bipolar I Disorder?, Hilary P. Stevenson Md, Phd

Clinical Research in Practice: The Journal of Team Hippocrates

A 22-year-old newly diagnosed patient with bipolar is discussing with her doctor the safety of starting an atypical antipsychotic as part of her treatment plan for depression. The patient was recently diagnosed with bipolar disorder after years of ups and downs making school and her relationship especially difficult. After seeking out a university student health psychiatrist for a severe depressive episode she was prescribed an antidepressant, which within a few weeks triggered a manic episode that required hospitalization. Since that time she has been compliant with her medications but has fallen into another depressive episode. Her psychiatrist encourages her to …

Behavioral Therapy Is A Viable Treatment Option For Children And Adolescents With Trichotillomania, Elizabeth Nesbitt

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Franklin ME, Edson AL, Ledley DA, Cahill SP. Behavior therapy for pediatric trichotillomania: a randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2011;50(8):763-771. https://doi.org/10.1016/j.jaac.2011.05.0091 for a patient with trichotillomania.

Janus Kinase Inhibitors May Be An Effective Treatment To Reduce Skin Depigmentation In Vitiligo, Shannon E. Lohman

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Rothstein B, Joshipura D, Saraiya A, Abdat R, Ashkar H, Turkowski Y, Sheth V, Huang V, Au SC, Kachuk C, Dumont N, Gottlieb AB, Rosmarin D. Treatment of vitiligo with the topical Janus kinase inhibitor ruxolitinib. J Am Acad Dermatol. 2017 Jun;76(6):1054-1060.e1. https://doi.org/10.1016/j.jaad.2017.02.049 for a patient with worsening vitiligo.

Mindfulness Therapy Is An Effective Adjunctive Treatment For Adolescents Living With Hiv, Samantha Rea

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Webb L, Perry-Parrish C, Ellen J, Sibinga E. Mindfulness instruction for HIV-infected youth: a randomized controlled trial. AIDS Care. 2018;30(6):688–695. https://doi.org/10.1080/09540121.2017.1394434

Inpatient Motivational Interviewing For Adolescent Type 1 Diabetics With Poor Glycemic Control Is Ineffective, Andrew L. Roberts

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Wang Y-C, Mackenzie M, Nakonezny PA, et al. A randomized controlled trial comparing motivational interviewing in education to structured diabetes education in teens with type 1 diabetes. Diabetes Care. 2010;33(8):1741-1743. https://doi.org/10.2337/dc10-0019.

Addition Of An Anti-Staphylococcal Beta Lactam To Standard Antibiotic Therapy Does Not Decrease 90-Day Mortality Of Mrsa Bacteremia Versus Standard Therapy Alone, Monica Hessler

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Tong SYC, Lye DC, Yahav D, et al. Effect of vancomycin or daptomycin with vs without an antistaphylococcal β-lactam on mortality, bacteremia, relapse, or treatment failure in patients with MRSA bacteremia: a randomized clinical trial. JAMA. 2020;323(6):527–537. https://doi.org/10.1001/jama.2020.0103 for a patient with multiple comorbidities including heart failure, severe aortic regurgitation, aortic aneurysm and intellectual disability being treated for MRSA bacteremia who is intubated in the ICU.

Septic Shock Better Controlled With Earlier Administration Of Norepinephrine, Steve Durham

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Elbouhy MA, Soliman M, Gaber A, Taema KM, Abdel-Aziz A. Early use of norepinephrine improves survival in septic shock: earlier than early. Archives of Medical Research. 2019;50(6):325–332. https://doi.org/10.1016/j.arcmed.2019.10.003.

One-Stage And Two-Stage Breast Reconstruction Have No Meaningful Difference In Patient Quality Of Life, Amer Mansoor

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising Negenborn VL, Young-Afat DA, Dikmans REG, et al. Quality of life and patient satisfaction after one-stage implant-based breast reconstruction with an acellular dermal matrix versus two-stage breast reconstruction (BRIOS): primary outcome of a randomised, controlled trial. Lancet Oncology. 2018;19(9):1205-14. https://doi.org/10.1016/s1470-2045(18)30378-4.

Antiviral Prophylaxis May Not Provide Benefit In Patients With Posner-Schlossman Syndrome, Patrick Lee

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Chee SP, Jap A. Cytomegalovirus anterior uveitis: outcome of treatment. Br J Ophthalmol. 2010 Dec;94(12):1648-52. https://doi.org/10.1136/bjo.2009.167767 for a patient on antiviral prophylaxis for recurrent episodes of Posner-Schlossman Syndrome.

Covid-19, Colleagues, Confusion, And Conversations, Nathanael R. Sanchez M.D., Katherine S. Lee , M.D., Karen Weaver M.D.

Clinical Research in Practice: The Journal of Team Hippocrates

During the COVID-19 pandemic, doctors in a community hospital reflect on their decision-making regarding treatment options for COVID-19. Whether to use hydroxychloroquine is the treatment discussed in most detail.

When Rationing Becomes Part Of Clinical Decision-Making, Christopher A. Hopper, Mitra Bahaee

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical practice-based reflection on Noack DP, Newton G. Compared to maximal current management standards, oscillating positive expiratory pressure devices have not been shown to improve clinically relevant outcomes in COPD patients with acute exacerbation. Clin. Res. Prac. 2017;3(2):eP1516. doi: 10.22237/crp/149886732.

Clinical Decision Science Suggests Different Research Questions Need To Be Asked Related To Informed Consent, John K. Geddes

Clinical Research in Practice: The Journal of Team Hippocrates

The author examines the literature relating to informed consent for early cardiac catheterization to treat Non-ST-segment elevation acute coronary syndrome, and considers whether Clinical Decision Science might provide new directions for applying the clinical research literature.

Valbenazine Has A Small But Meaningful Benefit For Tardive Dyskinesia, Joseph Friedli, Ryan Quick, Reem Sobh, Samantha Cowing

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of

Hauser RA, Factor SA, Marder SR, et al. KINECT 3: A Phase 3 Randomized, Double-Blind, Placebo-Controlled Trial of Valbenazine for Tardive Dyskinesia. Am J Psychiatry. 2017;174(5):476-484. https://doi.org/10.1176/appi.ajp.2017.16091037

and

Factor SA, Remington G, Comella CL, et al. The Effects of Valbenazine in Participants with Tardive Dyskinesia: Results of the 1-Year KINECT 3 Extension Study. J Clin Psychiatry. 2017;78(9):1344-1350. https://doi.org/10.4088/JCP.17m11777

exploring the efficacy of a newer therapy for tardive dyskinesia, and describing recommendations for a patient with acute medical problems and longstanding tardive dyskinesia.

Clinical Decision Science Emphasizes Unique Social Context In A Way That Evidence-Based Medicine Does Not, Karen Weaver Md, Michelle Diebold Md, Zeinab Rizk Md, Ghada Mustapha Md, Wafa Algahmi Md, Aaron Rivkin Md, Nicholus Yee Md, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

INTRODUCTION: The ideal of evidence-based medicine includes the integration of clinical experience and patient values with research evidence. We introduce clinical decision science, a new framework that includes patient social context to demonstrate this integration, which has been absent from evidence-based medicine sources. METHODS: This is an observational study comparing published articles within the domains of clinical decision science and evidence-based medicine. In a standardized manner, investigators identified and counted instances of social interaction within the publications. RESULTS: Publications of Clinical Decision Science had a higher number of markers of social interaction per paper and greater proportion of papers that …

From The Editor: Defining The Scholarship Of Clinical Decision Science, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

The Editor refines the focus of the journal to a new area of scholarship, Clinical Decision Science, exploring how the complex interacting aspects of clinical care are described, understood, shared, and explained in the context of the doctor-patient relationship.

First Aid First: Implementation And Evaluation Of A Community-Based First Aid Training Course, Luke Wesemann

Medical Student Research Symposium

In 2018, medical students at Wayne State University School of Medicine (WSUSOM) created a first aid training initiative called First Aid First (FAF). FAF is a comprehensive community-based training program that teaches lifesaving skills tailored for Detroit. The objective of this initiative was to improve the confidence and basic first aid skills of those who attend trainings.

Pre- and post-test surveys were used to measure knowledge, confidence and skill level. The survey data gathered from March 2018-October 2019 consisted of 5 Likert scale questions for self-evaluation component and 23-25 multiple choice questions, number depending on time of administration due to …

Evaluation Of The Impact Of Social Collaborations On Sexual And Reproductive Health Knowledge, Lucki Word, Jaila Campbell, Manar T. Edriss, Destiny Stroman, Jewel Evans, Melanie Hanna-Johnson, Md, Anil N. F. Aranha, Phd

Medical Student Research Symposium

Introduction: Developments in technology, such as the popularity of mobile devices and social media outlets, have enhanced the ability of individuals to communicate. Currently, search engines allow for easy exploration of information related to every topic of interest. Our study purpose was to evaluate the impact of technological and social collaborations on sexual and reproductive health knowledge (SRHK).

Methods: A 50-item survey instrument, integrating factors of sociodemographics, number/type of social collaborations, technological communication use, and SRHK, was developed to assess familiarity with sexual and reproductive health perceptions. The survey was provided to consenting patients in an ambulatory, primary care setting. …

Medical Student Perspectives On Opioid Use Disorders: An Innovative Mat Waiver Training Integration During Im Clerkships, Michael Garmo, Rafael Ramos, Katherine Palmer Loveluck, Kaycee Ching, Irvin Lein, Jody Chou, Aaron Szpytman, Eva Waineo Md, Diane L. Levine Md

Medical Student Research Symposium

The opioid epidemic in the US has become a major issue in healthcare. In 2017, there was an estimated 72,306 drug overdose related deaths and Emergency Departments (ED) nationally saw a 30% increase in opioid related overdoses.

Innovative programs can help ensure patients are offered optimal treatment options. Most primary care physicians self-report they lack the skills to identify and appropriately treat substance abuse disorders (SUDs). Studies have suggested that the best solution is to improve medical school curricula, which translates to better educated future physicians. Unfortunately, due to timing and exposure constraints, most medical school programs do not provide …

In Clinical Practice, Patients Have Names, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

In order to better reflect this robust description of clinical practice, we have initiated the use of pseudonyms for patients in our publications.

Managing A Conflict-Related, Open Fracture With Drug-Resistant Infections: The Case Of A Wounded Syrian Refugee In The Hashemite Kingdom Of Jordan, Alex Green

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Uruc V, Ozden R, Duman IG, Dogramaci Y, Yengil E, Karapinar S, Karakus A, Kalaci A. Major musculoskeletal injuries and applied treatments in the current conflicts in Syria. Acta Medica Mediterranea. 2014;30(3):637-644.

Fondaparinux Is An Effective Alternative To Other Non-Heparin Anticoagulants In The Treatment Of Heparin-Induced Thrombocytopenia, Allan J. Brazier Jr.

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Kang M, Alahmadi M, Sawh S, Kovacs MJ, Lazo-Langner A. Fondaparinux for the treatment of suspected heparin-induced thrombocytopenia: a propensity score-matched study. Blood. 2014;125(6):924-929. doi: 10.1182/blood-2014-09-599498.

Amantadine Minimally Improves Arousal In Patients With Severe Traumatic Brain Injury, Michelle Eventov

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Giacino JT, Whyte J, Bagiella E, et al. Placebo-Controlled Trial of Amantadine for Severe Traumatic Brain Injury. New England Journal of Medicine. 2012;366(9):819-826. doi: 10.1056/nejmoa1102609.

Reflection: Reducing Long-Term Mortality In Suicidal Adolescents, Nina R. Bihani

Clinical Research in Practice: The Journal of Team Hippocrates

A transformative method to reducing mortality in suicidal adolescents involves a novel approach of educating and empowering their loved ones.

Reduced Doses Of Direct Oral Anticoagulation Are Safe In Atrial Fibrillation Patients With Mild Thrombocytopenia, Matthew Gross

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Janion-Sadowska A, Papuga-Szela E, Łukaszuk R, et al. Non–Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation and Thrombocytopenia. Journal of Cardiovascular Pharmacology. 2018;72(3):153-160. doi: 10.1097/fjc.0000000000000607

Nsaid Use Increases Risk Of Miscarriage In Early Pregnancy, Leigh Durudogan

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Li D, Ferber J, Odouli R, Quesenberry C. Use of nonsteroidal anti-inflammatory drugs during pregnancy and the risk of miscarriage. Am J Ob Gyn. 2018; 219(3): 275.e1–275.e8. doi: 10.1016/j.ajog.2018.06.002.

Fecal Microbiota Therapy In Recurrent And Refractory Clostridium Difficile Infections Has Been Associated With Positive Results In Immunocompromised Patients, Eric Applebach

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Kelly CR, Ihunnah C, Fischer M, et al. Fecal microbiota transplant for treatment of Clostridium difficile infection in immunocompromised patients. The American Journal of Gastroenterology, 2014;109(7):1065-71. doi: 10.1038/ajg.2014.133