Keep Them Safe

On May 29, 2014, President Obama hosted a Healthy Kids and Safe Sports Concussion Summit at the White House to address the growing risk of concussion in youth sports.  More than 200 invited guests attended, and the overall recommendation and emphasis were on the need for future research on head injuries and safety for the nation’s young athletes.  The president highlighted the millions of dollars in research commitments from the National Collegiate Athletic Association, Department of Defense, National Football League and National Institute of Standards and Technology.

The Normal Heart

A recent film on Home Box Office deals with the story of the beginning of the AIDS epidemic in New York City in the early 1980s.  Having grown up in the Big Apple and having spent many years during the 1980s in medical school and residency taking care of patients with HIV/AIDS, the movie  took me back to an earlier decade when the lack of medical knowledge, fear of the unknown and significant prejudice in our nation against homosexuals were common.  It made me wonder about the current status of HIV/AIDS in our own state.

First (Worst) In the Nation?

Last week, the New Hampshire Department of Insurance presented information about worker’s compensation medical costs in the Granite State.  This information came from the National Council on Compensation Insurance, or NCCI, which gathers data, analyzes industry trends and prepares objective insurance rate and loss cost recommendations from 35 states.

Tommy, Can You Hear Me?

Spring is finally here, and Little League baseball players throughout the Granite State are oiling up their baseball gloves, taking swings in the batting cages and finally running around the infield.  Pitchers are staring intently at the catcher’s mitt, ready to strike out another Casey at the plate.  But a cautionary tale came our way from Major League Baseball last week from Miami via Tampa via Santa Clara, Cuba, about the limits of even the greatest young prospects.

Forget Me Not

This past Mother’s Day, my father’s wife told my brother and me that our dad was forgetting her name as well as having some other short-term memory difficulties.  He is in his early 80s and for years has tried to put up a good front, telling anyone who asked that the weather was great and life was copasetic.  However, the truth was that he has been slowing down his activity over the past few years, decreasing his interactions with other people and never telling his doctors what was really going on.  The concern, of course, is whether this is an early Alzheimer’s presentation or just an older man being stubborn and perhaps in denial.  As we assessed all the clinical information from a thousand miles away, it made sense to review the current research and treatment options for Alzheimer’s disease.

Do No Harm

On the evening of April 29, 2014, inside the Oklahoma State Penitentiary in McAlester, Okla., convicted murderer Clayton D. Lockett was being put to death by lethal injection.  However, his vein that was allowing intravenous access collapsed before the full extent of the chemicals being used for the execution entered his body.  Eyewitnesses have reported that Mr. Lockett was still conscious 34 minutes after the execution began, and, at that point, the procedure was aborted.  Mr. Lockett eventually died of a heart attack one hour after the chemical infusion began.  There has been much discussion during the past week that Mr. Lockett, in effect, was tortured before dying.  See the NPR blog and CNN story.

Faster May Be Better

Last week a friend of the family suffered an ischemic stroke while talking to her children.  She developed difficulty speaking, had a right facial droop and right arm weakness.  She was taken to the local acute care hospital, had imaging studies to check for bleeding in the brain and, after a few days, was discharged home.  As I was told about her situation, a media story was released concerning recommendations about acute stroke management.  It related a series of articles from the Journal of the American Medical Association, discussing early management of stroke and the impact on decreasing disability.

The Pain Puzzle

On April 22, 2014, the Food and Drug Administration’s Center for Drug Evaluation and Research held a scheduled meeting of the Anesthetic and Analgesic Drug Products Advisory Committee (AADPAC).  One of the main issues discussed and voted on concerned the proposed drug Moxduo, which is developed by QRxPharma and is a combination pain medication made up of morphine sulfate and oxycodone hydrochloride.  The proposed indication was for “the management of moderate to severe acute pain where the use of an opioid analgesic is appropriate.”  The “Combination Rule,” which is part of the FDA regulations under 21 CFR 300.50, states that:

Now Hear This...

Phyllis Frelich, the Tony Award-winning actress in 1980 for her lead role in “Children of a Lesser God,” died earlier this week at the age of 70.  As New England and America remembers the victims and survivors of the Boston Marathon bombing and embraces the awareness of disability issues that have been so significant this past year, the passing of Ms. Frelich can refocus awareness of people who are deaf or hard of hearing, and the limitations that can be exceeded if willpower and acceptance are in large supply.  Read The Washington Post story here.

18 Wheels Are Safer Than 4?

For physicians who see patients for commercial driver certifications, May 21, 2014, is going to be an important day for you.  Beginning that day, patients who need to have a commercial driver examination and license will need to be seen by a Certified Medical Examiner (CME) who is registered and certified through the National Registry of Certified Medical Examiners.  See the FMCSA regulations.

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