Translational Medical Research Commons^™

An American Medical Economics Phenomenon, Richard Guthmann Md, Mph

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on his own experience with medical economics-driven phenomena in healthcare.

Social Determinants May Limit The Success Of Pcsk9 Inhibitors, An Effective Treatment For Hyperlipidemia In Statin-Intolerant Patients, Abigail C. Kuplicki

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Moriarty PM, Thompson PD, Cannon CP, et al. Efficacy and safety of alirocumab vs ezetimibe in statin-intolerant patients, with a statin rechallenge arm: The ODYSSEY ALTERNATIVE randomized trial. J. Clin. Lipidol. 2015;9(6):758-769. https://doi.org/10.1016/j.jacl.2015.08.006

for a statin-intolerant patient with hyperlipidemia.

Renal Disease Rehabilitation And Delaying Dialysis, Spencer Brown, Natalie Sterner

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Greenwood SA, Koufaki P, Mercer TH, et al. Effect of exercise training on estimated GFR, vascular health, and cardiorespiratory fitness in patients with CKD: a pilot randomized controlled trial. Am J Kidney Dis. 2015;65(3):425-434. https://doi.org/10.1053/j.ajkd.2014.07.015

for a patient with non-dialysis CKD interested in slowing the progression toward necessary dialysis.

Slow Surgical Correction Affects More Than Just The Bowels, Emilia M. Clementi

Clinical Research in Practice: The Journal of Team Hippocrates

Reflection on how delayed colostomy reversal affects a patient's mental and physical well-being.

Uptitrating Mycophenolate Mofetil Therapy In A Patient With Lupus Cerebritis Doesn’T Increase Risk Of Infection Compared To Cyclophosphamide, Gautham Pavar

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Appel GB, Contreras G, Dooley MA, et al. Mycophenolate mofetil versus cyclophosphamide for induction treatment of lupus nephritis. J Am Soc Nephrol. 2009;20(5):1103-1112. https://doi.org/10.1681/ASN.2008101028

for a patient with neuropsychiatric lupus.

Stigma And Patient-Controlled Analgesia: Trust Is The Essential Ingredient Of Successful Patient Education In The Patient-Doctor Relationship, Trey D. Vanaken

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Van Beers EJ, Van Tuijn CFJ, Nieuwkerk PT, et al. Patient-controlled analgesia versus continuous infusion of morphine during vaso-occlusive crisis in sickle cell disease, a randomized controlled trial. Am J Hematol. 2007;82(11):955-960. https://doi.org/10.1002/ajh.20944.

for a patient with recurrent vaso-occlusive crisis secondary to Sickle Cell Disease.

Early Closure Of Colostomy From Abdominal Trauma May Be Beneficial In Otherwise Healthy Patients, Nicole Xu

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Khalid MS, Moeen S, Khan AW, Arshad R, Khan AF. Same admission colostomy closure: a prospective, randomised study in selected patient groups. Surgeon. 2005;3(1):11-14. https://doi.org/10.1016/s1479-666x(05)80004-6

for a patient with loop transverse colostomy due to trauma

Evaluating The Use Of Cheaper, Less Effective Medications In Patients With Cost-Based Medication Nonadherence, Muneer F. Hasso

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Sangaralingham LR, Sangaralingham SJ, Shah ND, Yao X, Dunlay SM. Adoption of Sacubitril/Valsartan for the Management of Patients With Heart Failure. Circ Heart Fail. 2018;11(2):e004302. https://doi.org/10.1161/circheartfailure.117.004302

for a patient with low medication adherence rates due to the high out-of-pocket costs of newer medications.

Motivational Interviewing May Resolve Vaccine Hesitancy, Scott L. Baughan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Gagneur A, Lemaître T, Gosselin V, et al. A postpartum vaccination promotion intervention using motivational interviewing techniques improves short-term vaccine coverage: PromoVac study. BMC public health. 2018;18(1):811. https://doi.org/10.1186/s12889-018-5724-y

for a juvenile patient with a caregiver who is skeptical about the safety of routine vaccinations.

Buprenorphine/Suboxone Is Safe In Pregnancy: Substance Use And Stigma In The Healthcare Professions, Blake S. Sanford

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Mullins N, Galvin SL, Ramage M, et al. Buprenorphine and Naloxone Versus Buprenorphine for Opioid Use Disorder in Pregnancy: A Cohort Study. J Addict Med. 2020;14(3):185-192. https://doi.org/10.1097/ADM.0000000000000562

for a woman with opioid use disorder during pregnancy.

Flexner Report 3.0—Structurally Competent Healthcare, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

The editor advocates to formalize the addition of “Medical Social Sciences” as a basic science in our Schools of Medicine and “Clinical Decision Science” as the corollary clinical practice discipline: a “Flexner Report 3.0."

Professionalism And Moral Injury In A Capitalist Healthcare System, James Peter Meza Md, Phd, Kassem Soufan Md, Michael Francis Do, Abbass Berjaoui Md

Clinical Research in Practice: The Journal of Team Hippocrates

Professionalism cautions against profit while capitalism exists for profit. This case is a structural analysis of capitalism in a clinical setting that reveals physicians to be simultaneously wage laborers and professionals. Capitalism generates profit. Professionalism views profit as a conflict of interest that erodes trust in the doctor-patient relationship. Managing these conflicting values causes moral injury for physicians, which is a driver of physician burnout.

Mechanical Thrombectomy For Intermediate Risk Pulmonary Embolism, James Peter Meza, Marissa Costello Md, Angela Moughni Md, Nicholus Yee Md

Clinical Research in Practice: The Journal of Team Hippocrates

An informed consent article using a set of publications to develop an informed consent conversation for a patient with an acute pulmonary embolism being considered for pulmonary artery thrombolysis.

I Finally Understand How Applying The Fagan Nomogram Can Change Medical Decision-Making, David Salvatori, Do

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the case that changed his opinion on the efficacy of the Fagan nomogram.

Thymic Stromal Lymphopoietin Participates In The Host Response To Intra-Amniotic Inflammation Leading To Preterm Labor And Birth, Tomi Kanninen, Li Tao, Roberto Romero, Yi Xu, Marcia Arenas-Hernandez, Jose Galaz, Zhenjie Liu, Derek Miller, Dustyn Levenson, Jonathan M. Greenberg, Jonathan Panzer, Justin Padron, Kevin Theis, Nardhy Gomez-Lopez Phd

Medical Student Research Symposium

Objective: To determine if bacteria (Ureaplasma parvum and Sneathia spp.) associated with intra-amniotic infection can trigger the induction of cytokine Thymic stromal lymphopoietin (TSLP) in human amnion epithelial cells (hAECs) in vitro.

Material or subjects: Amniotic fluid and chorioamniotic membrane (CAM) were collected from women with sPTL who delivered at term (n=30) or preterm without intra-amniotic inflammation (n=34), with sterile intra-amniotic inflammation (SIAI, n=27), or with intra-amniotic infection (IAI, n=17). Amnion epithelial cells (AECs), Ureaplasma parvum, and Sneathia spp. were also utilized.

Methods: The expression of TSLP, TSLPR, and IL-7Rα was evaluated in amniotic fluid or CAM by …

Implicit Bias And Stigma Theory In Clinical Practice: Developing “Habits Of Mind” For Clinical Inquiry, James Peter Meza

Clinical Research in Practice: The Journal of Team Hippocrates

The editor introduces a new article type in this issue, Translational Social Science, and reflects on the social theory required to perceive and counteract implicit bias.

Stigma Is A Very Real Part Of Clinical Practice, Aaron Rivkin

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on avoiding stigmatizing language in clinical practice.

Bioprosthetic Reoperative Aortic Valve Replacement In Patients Under 50, Aisha Kazeem

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Chan V, Lam BK, Rubens FD, et al. Long-term evaluation of biological versus mechanical prosthesis use at reoperative aortic valve replacement. J Thorac Cardiovasc Surg. 2012;144(1):146-151. https://doi.org/10.1016/j.jtcvs.2011.08.041

for a patient considering reoperative aortic valve replacement.

Renal Replacement Therapy Could Be Initiated In Patients With Severe Aki, Regardless Of Age And Critical Condition, El Hussain Shamsa

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Meersch M, Küllmar M, Schmidt C, et al. Long-Term Clinical Outcomes after Early Initiation of RRT in Critically Ill Patients with AKI. J Am Soc Nephrol. Mar 2018;29(3):1011-1019. https://doi.org/10.1681/asn.2017060694

for a critically ill elderly patient with severe acute kidney injury.

The Effect Of Medical Respite Services On Hospital Readmissions For Those Experiencing Homelessness, Kendrick Belardo

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Kertesz SG, Posner MA, O’Connell JJ, et al. Post-Hospital Medical Respite Care and Hospital Readmission of Homeless Persons. J Prev Interv Community. 2009;37(2):129-142. https://doi.org/10.1080/10852350902735734

for a patient experiencing homelessness.

The Use Of Cold Dialysis Solution In Reducing Fatigue In An End-Stage Renal Disease Patient, Justin Pawloski

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Sajadi M, Gholami Z, Hekmatpour D, Soltani P, Haghverdi F. Cold dialysis solution for hemodialysis patients with fatigue ‐ a cross‐over study. Iranian Journal of Kidney Diseases. 2016;10(5):319‐24.

for a patient with sickle cell disease.

Self-Administered Opat (S-Opat) Is A Potential Cost-Effective Equivalent Option For Uninsured Patients Requiring Opat, Joshua Brady

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Bhavan KP, Brown LS, Haley RW. Self-Administered Outpatient Antimicrobial Infusion by Uninsured Patients Discharged from a Safety-Net Hospital: A Propensity-Score-Balanced Retrospective Cohort Study. PLoS Med. 2015;12(12): e1001922. https://doi.org/10.1371/journal.pmed.1001922

for a patient with fungal peritonitis requiring OPAT.

Cystic Fibrosis Transmembrane Conductance Regulator Modulation May Improve Intestinal Inflammation In Adults With Cystic Fibrosis, Lauren G. Culver

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Ooi CY, Syed SA, Rossi L, Garg M, Needham B, Avolio J, Young K, Surette MG, Gonska T. Impact of CFTR modulation with Ivacaftor on Gut Microbiota and Intestinal Inflammation. Sci Rep. 2018 Dec 13;8(1):17834. https://doi.org/10.1038/s41598-018-36364-6

for a patient with cystic fibrosis experiencing small bowel obstruction.

Partial Outpatient Oral Antibiotic Treatment Of Infective Endocarditis Is Non-Inferior To Inpatient Intravenous Antibiotic Therapy, Nicholas J. Murphy

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Iversen K, Ihlemann N, Gill SU, et al. Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis. N Engl J Med. 2019; 380:415-424. https://doi.org/10.1056/NEJMoa1808312

for a patient with infective endocarditis and intravenous drug use with desire to leave the hospital.

Baclofen As A Helpful Alternative In Treatment Of Painful Paroxysmal Attacks From Trigeminal Neuralgia, Samantha Ryan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Fromm GH, Terrance CF, Chattha AS. Baclofen in the treatment of trigeminal neuralgia: double-blind study and long-term follow-up. Ann Neurol. 1984;15(3):240. https://doi.org/10.1002/ana.410150306

for a patient with paroxysmal attacks from trigeminal neuralgia who is unable to take carbamazepine.

Indwelling Pleural Catheterization Maximizes Functionality And Quality Of Life In Management Of Recurrent Malignant Pleural Effusions, Avinash Ramkissoon

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Davies HE, Mishra EK, Kahan BC, et al. Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleural effusion: The TIME2 randomized controlled trial. J Am Med Assoc. 2012;307(22):2383-2389. https://doi.org/10.1001/jama.2012.5535

for the management of recurrent malignant pleural effusions in a patient with metastatic renal cell carcinoma.

Exploring Alternative Treatment Options For A Patient With Heavy Menstrual Bleeding And Mistrust Of The Healthcare System, Rachel A. O'Dell

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Tinelli A, Gustapane S, D’Oria O, Licchelli M, Panese G. Nutraceuticals in fibroid management after ulipristal acetate administration: An observational study on patients’ compliance. International Journal of Gynecology and Obstetrics; 2022;156(1):133-138. https://doi.org/10.1002/ijgo.13692

for a patient with chronic, symptomatic anemia with menorrhagia and uterine fibroid.

The Importance Of Stigma Theory For Clinical Decisions Related To Diabetic Foot Amputations, Rachael Garcia, Callie Bartkowiak, Alison Nesbitt Do

Clinical Research in Practice: The Journal of Team Hippocrates

The authors examine the unconsidered impact of social stigma theory on the shared clinical decision-making process for a patient with foot osteomyelitis and MRSA bacteremia facing the prospect of an amputation.

Understanding How Social Determinants Of Health Are Integrated Within Clinical Decision Science, James Peter Meza Md, Phd, Nicholus H. Yee Md

Clinical Research in Practice: The Journal of Team Hippocrates

The editors reflect on the effect of Social Determinants of Health in Clinical Decision Science on questions of efficacy and effectiveness.

The Decision I Never Thought I Would Have To Make, Mary Nixon

Clinical Research in Practice: The Journal of Team Hippocrates

A brief essay on how the COVID pandemic has changed how we think about medicine and our patients.