Translational Medical Research Commons^™

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.

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.

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.

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

Intravenous Iodinated Contrast Is Not Associated With Acute Kidney Injury In Adult Patients With Nephrotic Syndrome, Andrew Bacyinski

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Tao SM, Kong X, Schoepf UJ, et al. Acute kidney injury in patients with nephrotic syndrome undergoing contrast-enhanced CT for suspected venous thromboembolism: a propensity score-matched retrospective cohort study. European Radiology. 2018;28(4):1585-1593. doi: 10.1007/s00330-017-5109-0

Carvedilol Is Not Superior To Metoprolol For Heart Failure Patients When Given At Equivalent Doses, Adam Gorman

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Lazarus DL, Jackevicius CA, Behlouli H, et al. Population-Based Analysis of Class Effect of β Blockers in Heart Failure. The American Journal of Cardiology 2011;107(8):1196-1202. doi: 10.1016/j.amjcard.2010.12.017.

Weighing Harms, Benefits, And Alternatives For A Young Man With A Recent Flare Of Ulcerative Colitis, Louise B. Welsh

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Sandborn WJ, Su C, Sands B, et al. Tofacitinib as Induction and Maintenance Therapy for Ulcerative Colitis. N Engl J Med. 2017 May 4;376(18):1723-1736. doi: 10.1056/NEJMoa1606910

Thrombosis Prevention In Atrial Fibrillation With Concomitant Cirrhosis: Oral Anticoagulation May Not Be Worth The Risks, Madeline Berschback

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Kuo L, Chao TF, Liu CJ, et al. Liver cirrhosis in patients with atrial fibrillation: Would oral anticoagulation have a net clinical benefit for stroke prevention? J Am Heart Assoc. 2017;6(6):e005307. doi: 10.1161/jaha.116.005307

Andexanet Alfa Is An Effective Reversal Agent For Factor Xa Inhibitors In Patients That Develop Intracranial Hemorrhage, Joseph Friedli

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Connolly SJ, Milling TJ, Eikelboom JW, et al. Andexanet alfa for acute major bleeding associated with factor Xa inhibitors. N Engl J Med. 2016;375(12):1131-1141. doi: 10.1056/NEJMoa1607887.

Cannabidiol Is Beneficial In Management Of Drug-Resistant Dravet Syndrome, Nikita Desai

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Devinsky O, Cross H, Laux L, et al. Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome. N Engl J Med. 2017;376(21):2011-2020. doi: 10.1056/NEJMoa1611618.

Agenesis Of The Corpus Callosum Is Associated With Developmental Delay And Intellectual Disability, Quinton J. Mandle

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Romaniello R, Marelli S, Giorda R, et al. Clinical characterization, genetics, and long-term follow-up of a large cohort of patients with agenesis of the corpus callosum. Journal of Child Neurology, 2016;32(1):60-71. doi: 10.1177/0883073816664668.

Ranolazine Decreases Weekly Anginal Episodes In Patients With Chronic Stable Angina And Type 2 Diabetes, Hisham Kaddurah

Clinical Research in Practice: The Journal of Team Hippocrates

The author reflects on the meaningful difference between statistical and clinical significance.

Tevar Should Be Considered In Select Patients With Uncomplicated Stanford Type B Aortic Dissection, Mordechai G. Sadowsky

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Nienaber CA, Kische S, Rousseau H, et al. Endovascular repair of type B aortic dissection: long-term results of the randomized investigation of stent grafts in aortic dissection trial. Circ Cardiovasc Interv, 2013;6(4):407-16. doi: 10.1161/circinterventions.113.000463.