The Voice of Podiatrists

Serving Over 9,000 Podiatrists Daily

December 09, 2007 #2,761 Editor-Barry Block, DPM, JD

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NY Podiatrist Educates on Diabetes at UN

Andrew Rubin, D.P.M spent yesterday presenting to an audience at the United Nations on the dangers of diabetes and its affects on the extremities. There are over 7,000 people employed at the United Nations New York Headquarters, many of whom are either affected by the disease or know someone who is.

Dr. Andrew Rubin

For over 10 years Andrew Rubin, a podiatrist at Jamaica Hospital Medical Center and Chairman of the Queens Chapter of the American Diabetes Association, has worked to empower patients with information about diabetes.

“Presenting at the United Nations was a remarkable opportunity. Working in one of the most ethnically diverse counties in the country, Queens County is a microcosm of the United Nations and what it represents.” says Dr. Rubin.

VA Podiatrists Collect 2,000 Pairs of Slippers for Needy

Soles4Souls Inc., the charity dedicated to providing free footwear to needy people around the world, announced today that they would deliver 2,000 pairs of Christmas slippers to needy children in the Appalachian area in Virginia. Dr. Lenord Horwitz, a podiatrist in Bluefield, Virginia, said that the Foot Pain Center will coordinate the effort with regional non-profit and civic organizations to deliver the slippers in time for the holidays.

Dr. Lenord Horwitz (L) and Dr. Sam Scott (R)

"We are excited that Soles4Souls is able to make this contribution to families in Appalachian communities," he said. "Dr. Sam Scott, the staff at the Foot Pain Center and myself are delighted to work with Soles4Souls to bring a little more joy to these families for the holidays," he said.

"Dr. Horwitz and Dr. Scott are perfect examples of Americans helping their communities," said Paul Wilson, President of Soles4Soles, Inc.. "Without help from individuals and caring companies like the Foot Pain Center, we couldn't reach these people effectively."

North Lake Hospital Closes

HCA's TriStar Health System announced on Tuesday, Dec. 5 the suspension of all services at Northlake Medical Center in Tucker, Georgia effective December 15, 2006. The hospital's emergency department will close at Noon on December 8. Over the past five years, the hospital has experienced steadily declining inpatient volumes, high employee turnover rates along with difficulty in recruiting employees, and continuing financial losses.

The famed podiatric residency program, as well as The Podiatry Institute will relocate to DeKalb General Hospital, located about four miles away.

Source: DeKalb News [12/6/06]

House Votes to Cancel 2007 Medicare Pay Cuts

The House of Representatives on Friday overwhelmingly approved legislation that extends popular tax breaks, opens up the Gulf of Mexico to new oil and gas drilling and cancels a scheduled pay cut for doctors who treat the elderly under Medicare.

The House voted 367-45 for the legislation, one of the few remaining bills the Republican-led Congress hopes send to President George W. Bush before adjourning. House members were expected to quickly take up a companion trade bill that will be joined with the tax measure and sent to the Senate.

The bill, which will cost the federal treasury about $40 billion over five years, extends tax breaks for research and development and other popular causes, cancels a Medicare pay cut for doctors next year.

Source: Reuters [12/8/06]

Query: High Ankle Sprain

"High ankle sprain" seems to be the 'de rigeur" sports injury of this decade. Please advise on the diagnosis, treatment and prognosis of this injury.

Robert Teitelbaum, DPM, Naples, FL

Query: Schwannoma

I have a 60 Year old male with a greatly enlarged 5th toe. The biopsy came back as a schwannoma (neurilemoma). Has anybody seen one of these on the foot other than associated with an interdigital neuroma?

Art Hatfield, DPM, Long Beach, CA

RE: Neuroma Release Vs. Excision (Ben Pearl, DPM)
From: Steven H. Goldstein, DPM

This presentation is one in which cryosurgery for the treatment of Morton's neuroma is worth considering. Minimally invasive, no sutures, almost no downtime, My success rate with one treatment is between 80-90%.

Steven H. Goldstein, DPM, Livingston, NJ, Stevefootdr1@cs.com

RE: Silicon Injections (Jim Fisher, DPM)
From: Carl Solomon, DPM, Barry Mullen, DPM

To me it makes no difference whether atrophic sub-Q fat is replaced by injections of saline, silicon, collagen, or whatever. The sub-Q that I’ve seen, and remember reading about is “…distinctly divided into lobules of varying size and shape, separated by partitions of fibrous connective tissue” (Bloom and Fawcett: A Textbook of Histology, 8th Ed, W,B, Saunders Co.). So that being said, how can the injection of an amorphous fluid glob of ANYTHING, substitute for the well organized network of fat cells contained within the fibrous septae which keep everything in place. Why should it surprise us that these injections are almost guaranteed to fail in the long term as pressure from any bony prominence will eventually push an amorphous fluid out of the way?

Carl Solomon, DPM, Dallas, TX, cdsol@BaylorHealth.edu

I've always been somewhat skeptical and miffed as to exactly how sub metatarsal head injected Silicon can remain within that plantar fat pad area without ultimately succumbing to the same pre-existing shearing and compression forces that led to the original fat pad atrophy/displacement in the first place? Logic dictates that anything implanted would and should be subject to the same forces that the implant is attempting to replace.

Clinicians should be prepared to deal with the potential harmful effects that migrated Silicon creates to the foot and remote organ systems. We should all recall what occurs when silicon implants fail where the decomposed silicon, created by the same compressive forces that caused the original 1st MTP cartilage destruction, created a "detritic synovitis" in several cases. I don't recall any major systemic effects or organ system breakdown, yet, I do recall that Dr. Balkin reported modest success with his injectable silicon modality, on many occasions, and in more than 1 scientific publication, while I don't seem to recall that he experienced any major complications. So, how well can one really expect this concept to work...and how safe is it? Clinicians would be well advised to ascertain these facts by reviewing all of the pre-existing literature on this topic before implementing this treatment modality to properly ascertain what the true risk-benefit ratio is.

Barry Mullen, DPM, Hackettstown, NJ, YAZY630@aol.com

PRACTICE FOR SALE – NEW YORK

20 Year practice by-the-sea in beautiful Long Beach, NY. Excellent Terms. E-mail seashell554@aol.com or (516) 432-7300.

ASSOCIATE POSITION – NEW YORK CITY

Looking for an enthusiastic well-trained foot and ankle surgeon to join busy Manhattan/Brooklyn practice leading to partnership. Candidate must have completed a minimum two-year surgical residency program, demonstrate qualities of self-motivation and have impeccable skills in forefoot and rearfoot surgery. Package includes malpractice ins. health ins. plus salary. Terms negotiable. Email Manfootcare@aol.com or call 917-756-3686

ASSOCIATE POSITION--PHOENIX SUBURB

Attractive opportunity for enthusiastic, proficient, and personable associate. Well-established modern practice with multiple newer spacious offices, technology and equipment. Solid referral base, close to hospitals, knowledgeable certified staff. 22% MCR. Practice and surgical center partnership potential opportunity. Prefer 24-36+ PSR. Send CV: AZpodassociate@aol.com

ASSOCIATE POSITION - LOS ANGELES/SOUTH BAY AREA

Multi-office, multi-doctor, well-established practice near the beach cities. Seeking a board eligible/certified PSR-24 or PSR-36 trained foot and ankle surgeon. Well-rounded practice requiring knowledge in biomechanics, pediatrics, sports medicine, diabetic wound care, trauma, and reconstructive foot and ankle surgery. Full-time position available immediately with generous compensation and benefits, including malpractice, and health insurance. Two-year commitment required with partnership opportunity. Send CV to akemfoot@sbcglobal.net or fax to (310) 838-0227.

ASSOCIATE POSITION - CENTRAL CALIFORNIA

Central California multi-location practice looking for PSR-36 associate leading to partnership. PSR-36 trained podiatrist with great opportunity for reconstructive surgical practice. Practice has Medicare-approved surgery center. Must have excellent interpersonal skills. Excellent salary and incentive. Respond to: westsidefoot@yahoo.com

ASSOCIATE POSITION- MEMPHIS, TN

30 year-old, high volume, multi-office practice in Memphis, looking for 24-36 PSR trained individual. Good opportunity for reconstructive surgery and wound care. No nursing homes or weekends. Potential partnership opportunity. Contact Footdok4@gmail.com.

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