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RHODE ISLAND M Edical J Ournal RHODE ISLAND M EDICAL J ournaL DANIEL HALPREN-RUDER, MD, PhD JOHN R. LONKS, MD ANTHONY E. MEGA, MD FRED J. SCHIFFMAN, MD JON A. MUKAND, MD, PhD LYNN E. TAYLOR, MD MARIA A. MILENO, MD JENNIE E. JOHNSON, MD BRETT D. OWENS, MD RAMIN R. TABADDOR, MD JIE TANG, MD, MPH, MSc WEN-CHIH WU, MD, MPH RIMJ GUEST EDITORS of 2020 See story, page 21 DECEMBER 2020 VOLUME 103 • NUMBER 10 ISSN 2327-2228 URGENT RESOURCES FOR URGENT TIMES. In a pandemic, speed and access to information and You can access Coverys’ industry-leading Risk resources are vital. Management & Patient Safety services, videos, and staff training at coverys.com. Knowledge saves time, and you need all the time you can get to save lives. Introducing the COVID-19 Resource Center. All in one place, for our policyholders as well as for all Right here, right now, for you. healthcare providers. On our website, you’ll find the latest information and Thank you. For all that you are doing. You are our heroes, resources for important topics like: and we are here if you need us. • Telemedicine: including best practices and plain language consent forms • Links to infectious disease prevention guidance • Education and resources for healthcare providers on the front lines Medical Liability Insurance • Business Analytics • Risk Management • Education COPYRIGHTED. Insurance products issued by ProSelect® Insurance Company and Preferred Professional Insurance Company® RHODE ISLAND M EDICAL J OURNAL 7 COMMENTARY Reflections on 2020, the year of COVID RIMJ EDITORS A Pandemic-Inspired Transformation of Primary Care JEFFREY BORKAN, MD, PhD PAUL GEORGE, MD, MHPE ELI Y. ADASHI, MD, MS Turn Inward to Keep the Flame Burning ELIZABETH T. TOLL, MD 18 VINTAGE COMMENTARY These are the Times that Try Men’s Soles STANLEY M. ARONSON, MD 21 GUEST EDITORS Thanks to RIMJ’s Guest Editors of 2020 67 RIMS NEWS Are you reading RIMS Notes? Working for You 71 RIMJ AROUND THE WORLD Breckenridge, Colorado 72 SPOTLIGHT Through Plagues and Pandemics: The Evolution of Medical Face Masks KELLY PAN, ANUva GOEL LILIANA R. AKIN, SUTCHIN R. PATEL, MD, FACS 76 HERITAGE Planning a post-war, mid-century hospital in Kent County MARY KORR 3 RHODE ISLAND M EDICAL J OURNAL IN THE NEWS RI ‘pausED’ AND POISED 78 82 CHARTERCARE CARE@HOME to open two field hospitals to provide physician home care visits as COVID cases surge 83 POD E-CIGARETTES RI AMONG 4 statES 79 less harmful than regular cigarettes, picked by Pfizer for pilot program to new study finds study vaccine delivery, deployment 84 LUNG CANCER REPORT AMA STRENGTHENS POLICY 79 finds RI ranks as a Top 10 State for early to combat spike in national diagnosis, 5-year survival, surgery, screenings drug shortages and access to treatment NEW AMA POLICY 80 85 JAMA NETWORK recognizes racism as a Open article focuses on women’s public health threat access to healthcare AMA ANNOUNCES POLICIES 81 85 FataL OVERDOSES adopted on final day of special meeting in Rhode Island continue to rise AMA ADOPTS POLICY 82 86 LIFEspan CANCER INSTITUTE calling for continued telehealth services expands radiation therapy program to East Greenwich PEOPLE/PLACES METHODIUS G. TUULI, MD 87 88 KENT HOSPItaL named Executive Chief of receives Level 3 Geriatric Emergency Obstetrics and Gynecology at Department Accreditation (GEDA) W&I, department chair at Brown 89 OBITUARIES ROBERT LEGARE, MD 87 Martin P. Feldman, MD receives healthcare Gerd Emma-Stina (Hallqvist) Grenander, MD professional award Alexander Adams McBurney, MD RWMC, FatIMA 87 Alberto S. Rubio, MD receive national quality awards Jack H. Ruddell, MD’21 4 DECEMBER 2020 VOLUME 103 • NUMBER 10 RHODE ISLAND Rhode Island Medical Society R I Med J (2013) M EDICAL J ournaL PUBLISHER 2327-2228 RHODE ISLAND MEDICAL SOCIETY 103 PRESIDENT CATHERINE A. CUMMINGS, MD IMAGES IN MEDICINE 10 PRESIDENT-ELECT 27 A Case of the Blue Finger – Achenbach Syndrome 2020 ELIZABETH B. LANGE, MD VICE PRESIDENT MICHAEL WOODS, BA; SADIA IFTIKHAR, MD December THOMAS A. BLEDSOE, MD Secretary CASE ReportS 1 KARA STavros, MD 29 Severe, Symptomatic Reinfection in a Patient with COVID-19 TREASURER VIJAIRAM SELvaraj, MD; KARL HERMAN, MD; Kwame-Dapaah-AFRIYIE, MD Kwame Dapaah-AFRIYIE, MD, MBA EXECUTIVE DIRECTOR 32 A Case of Interstitial Pneumonia with Features of Autoimmunity NEWELL E. WARDE, PhD RICHA NAHAR, MD; SUKRIT JAIN, MD; GERARDO CARINO, MD, PhD; BARRY S. SHEA, MD EDITORS-IN-CHIEF WILLIAM BINDER, MD 35 The Great Imposter: A Confusing Case of a Rare Renal Cell Carcinoma Edward FELLER, MD SOPHIA SONG, MD’23; Davis HARTNETT, MD’21; SyDNEY Tan, MD’21; ASSociate EDITOR JESSE HART, DO; JENNIFER JEREMIAH, MD, FACP KENNETH S. KORR, MD 38 Common Variable Immunodeficiency Presenting as EDITOR-IN-CHIEF EMERITUS Anti-GAD Cerebellar Ataxia JOSEPH H. FRIEDMAN, MD TODD NGUYEn, MD’21; MICHAEL McCAULEY, MD; Tao ZHENG, MD; SYED A. RIZVI, MD PUBLication StaFF MANAGING EDITOR 40 Takotsubo Cardiomyopathy and LV Outflow Tract Obstruction MARY KORR after Initiation of Novel Oral Chemotherapy [email protected] KARUPPIAH ARUNACHALAM, MD; SUBRAMANIAN GNANAGURUparaN, MD; GRAPHIC DESIGNER JOHN PAULOWSKI, MD, FACC MARIANNE MIGLIORI ADvertiSING ADMINIStrator CONTRIBUTIONS DULCINEIA COSME [email protected] 44 Initial Opioid Prescription and Number Needed to Harm LUKE BARRE, MD, MPH; MEGHAN McCORMICK, BS, MPH; JAMES V. McDONALD, MD, MPH 47 Physical Medicine and Rehabilitation in Rhode Island during the COVID-19 Pandemic TIMOTHY J. GENOVESE, MPH, MD’21; AlEXIOS CARAYANNOPOULOS, DO, MPH, FAAPMR, FAAOE, FFSMB; JOHN R. PARZIALE, MD 51 Lessons Learned from a Rhode Island Academic Out-Patient Lyme and Tick-Borne Disease Clinic MEGHAN L. McCARTHY, ScB; REBECCA REECE, MD; SARA E. VARGAS, PhD; JENNIE JOHNSON, MD; JENNIFER ADELSON-MITTY, MD; TIMOTHY FLANIGAN, MD 56 A Spatial Analysis of the Food Environment and Overweight and Obesity Among Rhode Island Youth ESMERALDA GUevara, MPH; MICHELLE L. ROGERS, PhD; RAUL SMEGO, MPH; RHODE ISLAND MEDICAL JOURNAL (USPS 464-820), a monthly publication, is MELISSA A. CLARK, PhD; ELISSA JELALIAN, PhD; PATRICK M. VIVIER, MD, PhD owned and published by the Rhode Island Medical Society, 405 Promenade Street, Suite A, Providence RI 02908, 401-331-3207. All PUBLIC HEALTH rights reserved. ISSN 2327-2228. Published 62 HEALTH BY NUMBERS articles represent opinions of the authors and do not necessarily reflect the official policy Accidental Drug Overdose Deaths in Rhode Island: of the Rhode Island Medical Society, unless January 1, 2016–July 31, 2020 clearly specified. Advertisements do not im- ply sponsorship or endorsement by the Rhode BENJAMIN D. HALLOWELL, PhD; HEIDI R. WEIDELE, MPH; Island Medical Society. RACHEL P. SCAGOS, MPH © COPYRIGHt 2013–2020, RHODE ISLAND 66 Vital Statistics MEDICAL SOCIETY, ALL RIGHTS reserved. ROSEANN GIORGIANNI, DEPUTY STATE REGISTRAR 5 Ready for Tomorrow Keep moving toward your goals with HUB. When you partner with us, you’re at the center of a vast network of healthcare industry experts who help practices like yours prepare for the unexpected with: ý Medical liability and business insurance to protect your practice, your reputation and your assets ý Employee benefits that help you navigate change and support your people ý Personal insurance and wealth management to help you protect your home and family For more information about our tailored solutions, visit, hubinternational.com/rimed Put our resources to work for you. Daniel Nissi, LIA 800-649-9111 [email protected] Advocacy | Tailored Insurance Solutions | Peace of Mind Commentary Reflections on 2020, the year of COVID Rhode Island Medical Journal Editors MARY KORR RIMJ MANAGING EDITOR 7 Farewell, 2020. As Charles Dickens (1812–1870) began and personal expe- 11 in A Tale of Two Cities, set in London and Paris during riences during the the French Revolution of 1789–1799: COVID-19 pandemic, EN and hopes for a better It was the best of times, it was the worst of times, 2021, with safe and it was the age of wisdom, it was the age of foolishness, efficacious vaccines it was the epoch of belief, it was the epoch of incredulity, and therapeutics on it was the season of Light, it was the season of Darkness, the horizon. In the spirit of the Print shows Charles Dickens seated at desk it was the spring of hope, it was the winter of despair… holiday season this in his study. [LibrarY OF CONgress] 2020 has truly been a “Dickensian” year, as SARS-CoV-2 month, I know I speak engulfed the world. for all the editors in echoing the words of Tiny Tim, in In this collective commentary, RIMJ editors share patient Dickens’ A Christmas Carol: “God bless us, every one!” v On the Frontlines WILLIAM BINDER, MD CO-EDITOR-IN-CHIEF Sixty minutes into a recent shift not overlook a life-threatening disorder, one must consider the in the emergency department, I was worst-case scenario. At baseline this approach is taxing; during spent. We had three codes: a 52-year- a pandemic, it is exhausting. We normally discharge our stress old woman with a ventricular fibrilla- outside of work. However, options are limited during the pan- tion arrest, and two septuagenarians presenting from home in demic. Combined with the uncertainty of whether one’s inev- asystole, followed by a young man with a fatal gunshot wound itable exposure to Sars-CoV-2 will result in an asymptomatic to the head after an argument at a carwash, as I later read in infection or a lethal cytokine storm, or somewhere in between, the Providence Journal. The violence was not isolated – two half way into a typical shift most of us are depleted and drained. weeks earlier I attempted to resuscitate a young man with a It is a complex calculus to consider when to hang up the stab wound to “the box” and recently a colleague of mine per- spikes, and I vacillate.
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