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FEBRUARY 2023    Volume 106, Number 1

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Editor-in-Chief
William Binder, MD

Associate Editors
Kenneth S. Korr, MD
George Bayliss, MD

Managing Editor
Mary Korr

Graphic Designer
Marianne Migliori

Contact
william_binder@brown.edu
mkorr@rimed.org

FOR AUTHORS
Author Guidelines
Copyright Transfer
Financial Disclosure
Commentary Guide
Letters to the Editor Guide
Images in Medicine Guide
Videos in Medicine Guide
 

CASE REPORTS
Methylphenidate Reversal of Executive Dysfunction in a Patient with Bi-Frontal Lobe Glioblastoma
Jake McGillion-Moore; Prakash Sampath, MD; Eric T. Wong, MD

A Case of Pneumocystis jirovecci in a Patient with Non-Small Cell Lung Cancer
Treated with Immunotherapy

Pranavi Sanka, MD; Andrew Hsu, MD

Cyanide Poisoning and Lactate in Smoke Inhalation
J. Austin Lee, MD, MPH; Christina Matulis, MD

IMAGES IN MEDICINE
A Bicuspid Aortic Valve with Aberrant Coronary Anatomy
Kenneth N. John, MD; Geoffrey Hayward, MD; Tzong-Huei H. Chen, MD

VIDEOS IN MEDICINE
Bilateral Asterixis Associated with Supratherapeutic Carbamazepine and Ammonia Levels
Ahmed Wahbe, MD‘23; Umer Akbar, MD


Watch VIDEO 1 [0:14]


Watch VIDEO 2 [0:10]

PATHOLOGY REPORT
Modified Method to Perform Autopsy Safely During the COVID-19 Pandemic
Weibiao Cao, MD; Katelyn Dannheim, MD

RESEARCH REPORTS
BNT162b2 and mRNA-1273 Vaccine Effectiveness against SARS-CoV-2 and Variants in the Urban Underserved Population
Chien-Hsiang Weng, MD, MPH; Sheng Zhou, MD, ScM; Andrew Saal, MD, MPH;
Mallory Hafferty; Daniel C. McGuire; Philip A. Chan, MD, MS

Older Adult Pedestrian Injury in Rhode Island, 2017–2020
Niralee Shah, MD, ScM; Michael J. Mello, MD, MPH; Julie R. Bromberg, MPH, CCRP;
Stephanie Lueckel, MD,
ScM

PILOT STUDIES
Reasons for Use of Electronic Cigarettes, Cigars, and Hookah in Pregnant Women in Rhode Island: A Preliminary Study
Natasha A. Sokol, ScD; Anna Alikhani, MSW, MPH; Nancy C. Jao, PhD; Eva Sharma, PhD;
Laura R. Stroud,
PhD

Where’s My Doctor? The Impact of the Primary Oncologist’s Visit with Their Hospitalized Patients
Brianna R. Bakow, MD; Fred J. Schiffman, MD; Anthony E. Mega, MD

CONTRIBUTIONS
Calls of Despair: An EMS Perspective on Suicide and Overdose in Rhode Island during COVID-19
James L. Thorndike, BS, EMT-B; Carolina Roberts-Santana, MHA, DHSc;
Jason Rhodes, MPA, AEMT-C; Kenneth A. Williams, MD, FACEP, FAEMS

Impact of a Quality Improvement Initiative on Increasing Height Measurement Among Children with Medical Complexity
Jessica Hoffen, MD-ScM’23; Allison Brindle, MD

Comparing Effectiveness of Remote-learning Formats for Resident Physician Didactics
Julia K. Shinnick, MD; Jennifer L. Narvaez, MD;
Christina Raker,
ScD; E. Christine Brousseau, MD

Robotic Spine Surgery in Rhode Island
Eren O. Kuris, MD; George M. Anderson, BS; Daniel Alsoof, MBBS; Camilo Osorio, MD;
Benjamin Stone, BS; Bryce Basques, MD; Alan H. Daniels, MD

COMMENTARY
Perspectives on the Art of Scientific and Medical Writing
Roland Hammond, MD; Joseph H. Friedman, MD; Kenneth S. Korr, MD; George Bayliss, MD; Mary Korr; William Binder, MD

WE ARE READ EVERYWHERE
Charles M. Schulz Museum and Research Center, Santa Rosa, California

RIMS NEWS  
Working for You: RIMS advocacy activities

In the News     [8-page pdf]
Study shows pharmacists can safely, effectively start treatment for patients with opioid use disorder

American Lung Association report gives Rhode Island mixed grades for tobacco control policies

Reed joins Hasbro Children’s Hospital & American Cancer Society to celebrate Childhood Cancer STAR Reauthorization Act signed into law

RI Delegation announces $2M to boost local vaccination efforts

Encompass Health announces plans to build a 50-bed inpatient rehabilitation hospital in Johnston

Behavioral health organizations announce charity hockey event for summer 2023

Butler, Brown launch study aimed at developing methods for early, accurate Alzheimer’s diagnosis

Officials discuss fentanyl crisis to plan effective solutions to stop manufacturing, trafficking and distribution

RI leaders, coalition com-memorate 50th anniversary of Roe v. Wade
Call for the passage of the Equality in Abortion Coverage Act (EACA

BCBSRI expands access to urgent and pediatric behavioral healthcare services

Women and Infants Hospital, General Biomics form collaborative clinical agreement to study the role of the human microbiome in diseases of infants in the NICU

People/Places    [3-page pdf]
APPOINTMENTS
Gyan Pareek, MD, named Chief of Urology at Lifespan, Brown

Thomas D. Wold, DO, joins Kent Hospital as Chief Medical Officer

Peter Markell, CPA, named Executive Vice President & Chief Financial Officer for Lifespan

Eric B. Newton, MD, named University Gastroenterology’s next president

Nejat Zeyneloglu, MD, named Chief Medical Officer at W&I

Michael Lee, MD, named Medical Director of Kent Hospital at Home

Recognition
Stephen Salloway, MD, receives Leon Thal award for Alzheimer’s Research

Alan A. Wartenberg, MD, recognized by Continental Who’s Who

Westerly Hospital’s medical laboratory awarded re-accreditation by CAP

OBITUARIES    [2-page pdf]
Frances Phillips Conklin, MD
MARY DESPINA LEKAS, MD,
DSc
Chafic Sebastian Raad, MD

 
RHODE ISLAND MEDICAL JOURNAL (USPS 464-820), a monthly publication, is owned and published by the Rhode Island Medical Society, 405 Promenade Street, Suite A, Providence RI 02908, 401-331-3207. All rights reserved. ISSN 2327-2228. Published articles represent opinions of the authors and do not necessarily reflect the official policy of the Rhode Island Medical Society, unless clearly specified. Advertisements do not imply sponsorship or endorsement by the Rhode Island Medical Society.

© Copyright 2013–2023, Rhode Island Medical Society, All rights reserved.

 

VIDEOS IN MEDICINE
Bilateral Asterixis Associated with Supratherapeutic Carbamazepine
and Ammonia Levels
Ahmed Wahbe, MD‘23; Umer Akbar, MD

A 65-year-old man with a 10-year history of complex partial epilepsy and hypertension, was admitted to the hospital for dysarthria, dizziness, and gait ataxia, which began gradually approximately 1 week prior to presentation. His seizures had been well controlled on carbamazepine 800 mg in the morning, 600 mg in the evening, and phenobarbital 64.8 mg twice daily. His examination revealed scanning dysarthria, slowed saccades, mild bilateral dysmetria in the arms, no nystagmus, and bilateral hand asterixis (Video 1). Given the subacute onset of his brainstem/cerebellar symptoms, stroke was initially suspected, and ruled out with an MRI brain, which showed few scattered white matter hyperintensities and no acute findings. His blood work revealed a normal comprehensive metabolic profile, including LFTs, complete blood count, and carbamazepine level of 26 (therapeutic range 4–12 UG/ML), phenobarbital level 23 (15–40 UG/ML), and ammonia 57 (range 2–50 UMOL/L). After two days of holding carbamazepine, the level fell within the therapeutic range and his asterixis resolved (Video 2).

Video 1

Video 2

Video links: [1] https://vimeo.com/772119716 and [2] https://vimeo.com/772129122

 

 

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