RHODE ISLAND M EDICAL J OURNAL SPECIAL SECTION INFECTIOUS DISEASES GUEST EDITOR BRIAN T. MONTAGUE, DO, MPH JanuaRy 2015 VOLUME 98 • NUMBER 1 ISSN 2327-2228 Your records are secure. Until they’re not. Data theft can happen to anyone, anytime. A misplaced mobile device can compromise your personal or patient records. RIMS-IBC can get you the cyber liability insurance you need to protect yourself and your patients. Call us. 401-272-1050 IN COOPERATION WITH RIMS-IBC 235 PROMENADE STREET, SUITE 500, PROVIDENCE RI 02908 MEDICAL PROFESSIONAL/CYBER LIABILITY PROPERTY/CASUALTY LIFE/HEALTH/DISABILITY RHODE ISLAND M EDICAL J OURNAL 17 Public-private Partnerships, Programs Target Infectious Diseases in RI BRIAN T. MONTAGUE, DO, MPH GUEST EDITOR ID B. Montague, DO A I N 18 Tuberculosis Control in RI: Maintaining Control Cover: Produced by the Efforts in the Context of Declining Incidence National Institute of Allergy and Funding for Tuberculosis Programs and Infectious Diseases (NIAID), this digitally-col- BRIAN T. MONTAGUE, DO, MPH; NICOLE E. ALEXANDER- orized scanning electron SCOTT, MD, MPH; UTPALA BANDY, MD, MPH; JAIME micrograph (SEM) depicts COMELLA, MPH; AWEWURA KWARA, MB.CHB, MPH a grouping of red-colored, N. Alexander- U. Bandy, MD rod-shaped Mycobacterium Scott, MD tuberculosis bacteria, which 22 Tuberculous Meningitis in Child Born in the US to cause tuberculosis (TB) in Immigrants from a Tuberculosis-Endemic Country human beings. ERIC J. CHOW, MD, MS, MPH; ELIZABETH TOLL, MD; BRIAN T. MONTAGUE, DO, MS, MPH; NICOLE ALEXANDER- SCOTT, MD, MPH; ERIN VAN SCOYOC, MD, MPH 26 Monitored Viral Load: A Measure of HIV Treatment C. Beckwith, MD P. Chan, MD Outcomes in an Outpatient Setting in Rhode Island FRANCINE TOUZARD ROMO, MD; FIZZA S. GILLANI, PhD; PETER ACKERMAN, MD; AADIA RANA, MD; ERNA M. KOJIC, MD; CUrt G. BECKWITH, MD 31 Addressing the Increasing Burden of Sexually Transmitted Infections in Rhode Island E. Chow, MD T. Flannigan, MD PHILIP A. CHAN, MD; JUSTINE MAHER, DANIELLE POOLE, NICOLE ALEXANDER-SCOTT, MD; R. BOBBY DUCHARME, GAIL YATES, STACEY BENBEN, AMY NUNN, ScD; JAIME COMELLA, MPH; UTPALA BANDY, MD; BRIAN T. MONTAGUE, DO, MPH; ERNA KOJIC, MD; KIMBERLE CHAPIN, MD; TIMOTHY P. FLANIGAN, MD 35 Tick-Borne Illness In Rhode Island – How Big A Problem Is It? E. Kojic, MD A. Kwara, MB REBECCA REECE, MD; ERIC CHOW, MD; AADIA RANA, MD; ERNA M. KOJIC, MD; TIMOTHY P. FLANIGAN, MD 38 Outpatient Parenteral Antibiotic Therapy in an Academic Practice in Rhode Island FRANCINE TOUZARD ROMO, MD; BRIAN RESNICK, PA; MILDRED PEREZ-CIOE; ERNA M. KOJIC, MD; TIMOTHY P. FLANIGAN, MD; CUrt G. BECKWITH, MD A. Rana, MD E. Van Scoyoc, MD RHODE ISLAND M EDICAL J OURNAL 8 COMMENTARY Brain Treatments and Creativity JOSEPH H. FRIEDMAN, MD January 1920: The Beginning of Nationwide Sobriety STANLEY M. ARONSON, MD Marijuana Use in Athletics DAVID B. STOLL, MD, FACP 15 RIMJ AROUND THE WORLD We are read everywhere: Tehran and Isfahan, Iran 59 RIMS NEWS Working for You Why You Should Join RIMS 63 SPOTLIGHT Q & A with Carol T. Lewis, MD Creating a Medical Home for Refugee Kids at Hasbro MARY KORR 72 PHYSICIAN’S LEXICON The Compulsion to Do Away With Anonymity STANLEY M. ARONSON, MD 74 HeritaGE 100 Years Ago – Dr. Harriet Alleyne Rice of Newport: The struggles of an African-American physician MARY KORR RHODE ISLAND M EDICAL J OURNAL IN THE NEWS NURSING CENTER 64 65 $20M INNOVATION AWARD to occupy from CMS awarded to RI South St. Landing 66 PROVIDENCE VA expands in New Bedford HEART/VASCULAR 65 CENTER 66 LOAN REPAYMENT planned by applications available Southcoast at DOH PEOPLE/PLACES LAWRENCE AUBIN 67 69 WOMEN & Infants named Lifespan recognized for Leapfrog safety, chairman of board quality award CHarterCARE 67 69 IVONILDE BURGESS, RN appoints Schindel CEO wins DAISY Award URI COLLEGE OF PHARMACY 69 70 MARINA TOULOU-SHAMS, PHD recognized for licensure awarded $2M grant achievements 70 WILLIAM SIKOV, MD addresses breast cancer symposium EDWARD DONNELLY, MD 69 joins Newport Neurology 71 OBITUARY Anthony T. Carrellas, MD JanuaRy 2015 VOLUME 98 • NUMBER 1 RHODE ISLAND Rhode Island Medical Society R I Med J (2013) 2327-2228 M EDICAL OURNAL PUBLISHER J 98 RHODE ISLAND MEDICAL SOCIETY 1 WITH SUPPOrt FROM RI DEPT. OF HEALTH 2014 PRESIDENT January PETER KARCZMAR, MD 5 PRESIDENT-ELECT RUSSELL A. SETTIPANE, MD VICE PRESIDENT CONTRIBUTIONS SARAH J. FESSLER, MD 43 Pediatric Refugees in Rhode Island: Increases in BMI Percentile, secretary BRADLEY J. COLLINS, MD Overweight, and Obesity following Resettlement TREASURER JESSICA H. HENEY, MD; CAMIA C. DIMOCK, MD; JOSE R. POLANCO, MD JENNIFER F. FRIEDMAN, MD, PhD; CAROL T. LEWIS, MD IMMEDiate PAST PRESIDENT ELAINE C. JONES, MD 48 Treating Children at Urgent Care Centers: EXECUTIVE DIRECTOR A Qualitative Study to Determine How Providers Perceive NEWELL E. WARDE, PhD Managing Pediatric Patients THERESE L. CANARES, MD; LINDA BROWN, MD, MSCE; REBECCA M. SLOTKIN; EDITOR-IN-CHIEF ARIS GARRO, MD, MPH JOSEPH H. FRIEDMAN, MD associate EDITOR SUN HO AHN, MD EMERGENCY MEDICINE RESIDENCY CPC EDITOR EMERITUS STANLEY M. ARONSON, MD 54 A Broken Heart: A Woman with Chest Pain and an Abnormal ECG COUrteNEY MACKUEN, MD; WILLIAM BINDER, MD PUBLication StaFF MANAGING EDITOR MARY KORR PUBLIC HEALTH [email protected] 57 Vital Statistics GRAPHIC DESIGNER MARIANNE MIGLIORI COLLEEN A. FONTANA, STATE REGISTRAR ADVertisinG STEVEN DETOY SARAH STEVENS [email protected] EDITORIAL BOARD STANLEY M. ARONSON, MD, MPH JOHN J. CRONAN, MD JAMES P. CROWLEY, MD EDWARD R. FELLER, MD JOHN P. FULTON, PhD PETER A. HOLLMANN, MD KENNETH S. KORR, MD RIMJ Mission Statement MARGUERITE A. NEILL, MD The Rhode Island Medical Journal (RIMJ), published by the Rhode Island Medical Society, is an FRANK J. SCHABERG, JR., MD independent, monthly, electronic publication which aims to reflect the views and purposes of the LAWRENCE W. VERNAGLIA, JD, MPH entire medical community of Rhode Island. NEWELL E. WARDE, PhD We see the Journal as a vehicle aimed at the practicing physicians of Rhode Island – whether they are in private practice, on the staff of the state’s hospitals or as part of the many colleges and universities of the state. It offers a venue for them to express their clinical or investigative RHODE ISLAND MEDICAL JOURNAL findings, and for the academic faculty to publish their clinical or research results. It also serves (USPS 464-820), a monthly publication, is as a platform for local medical students, resident physicians and fellows to contribute to the owned and published by the Rhode Island Medical Society, 235 Promenade Street, Suite medical literature while honing the rudiments of medical writing. 500, Providence RI 02908, 401-331-3207. In addition, it offers the opportunity for medical professionals to make the community aware All rights reserved. ISSN 2327-2228. Published of testing or clinical expertise that may not be widely known, even within our small state. And articles represent opinions of the authors and finally, RIMJ is a forum where allied health professions such as local schools of public health, do not necessarily reflect the official policy of the Rhode Island Medical Society, unless pharmacy and nursing may share their concerns and aspirations as the business of health care clearly specified. Advertisements do not im- takes on new and unanticipated challenges. ply sponsorship or endorsement by the Rhode Island Medical Society. Joseph H. Friedman, MD Sun Ho Ahn, MD Stanley M. Aronson, MD Advertisers contact: Sarah Stevens, RI Medical Editor-in-Chief Associate Editor Editor Emeritus Society, 401-331-3207, fax 401-751-8050, [email protected]. HavingHaving thethe rightright risk managementmanagement program is IMPORTANT Cover your risk withwith CoverysCoverys EveryEvery day,day, you’reyou’re exposed to risk. That‘s whywhy youyou should join the 25,000 physicians,physicians, dentists and allied healthcare professionals andand more thanthan 500 hundredhundred hospitals,hospitals, healthhealth centers andand clinicsclinics that choose Coverys for medical professional liability insurance and risk management. We bring the experience, fi nancial strength, support services, and strategic insight to protect you andand your practice.practice. Get Coverys.Coverys. Because it’s veryvery important. www.coverys.com 800.225.6168800.225.6168 ProSelectProSelect Insurance CompanyCompany commentary Brain Treatments and Creativity JOSEPH H. FRIEDMAN, MD [email protected] 8 9 EN A COLLEAGUE WROTE AN the antipsychotic drugs haze-induced Xanadu, or Timothy Leary article on brain disease that cause movement and his LSD “trips.”) It seems unlikely and creativity which disorders, tend to slow to me, on the face of it, that drugs induce brought up an interesting people down, both in creativity, although I do admit it is point that I had never con- their movements and in plausible. More likely, drugs suppress sidered seriously, namely, their thinking. In fact, in anxiety, or increase activity by com- the potential side effect the “early” days of psy- bating depression, leading to increased of reducing creativity in chopharmacology, animal and more considered expression of patients who we put on testing for anti-schizo- already-present thoughts, but this is brain-active drugs. The phrenic drugs focused on certainly not an evidence-based opin- article focused on people the drug’s ability to slow ion, and the bottom line is the bottom who suffered from mental the animals and make line. If drug X helps someone to write illness (Can J Psychiatry 2011;56;132) them less inquisitive. Likewise the pre- a great poem, create a dance, or solve but there’s no reason the point doesn’t sumed benefit of frontal lobotomies was some problem, then who can argue? carry over to any brain disorder. While reduced agitation, often reduced move- The interesting question that arises many of us are familiar with the eccen- ment in general, probably due largely to in the article is whether certain medi- tricities of friends or relatives with apathy.