The Voice of Podiatrists

Serving Over 9,500 Podiatrists Daily

June 08, 2007 #2,956 Editor-Barry Block, DPM, JD

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Mildred W. Butterworth, PMAC 90

Mildred W. Butterworth, 90, of Mankato died June 2, 2007. In 1957, she became a medical assistant in the office of Dr. William Perendy, retiring in 1986. She was co-founder and past president of Minnesota State Association of Podiatric Medical Assistants, past president of the American Association of Podiatric Assistants and Board Member Emeritus at the time of her death. In 1981 she was elected to membership in “The World’s Who’s Who of Women.”

Mildred W. Butterworth

She was active in the Lakeside Extension Club, Rebekah Lodge #142, and the National Association of Rocketry. While a member of the Rebekah Lodge she was awarded the Decoration of Chivalry. Mildred had an outstanding record in civic as well as fraternal organizations.

PM Policy is to recommend that memorial donations be made to the APMA Educational Foundation Student Endowment Fund, 9312 Old Georgetown Rd., Bethesda, MD 20814.

Source: Mankato Free Press (MN), [6/6/07]

Fungal Infections From Nail Salons Can be Costly: IL Podiatrist

Dr. Elizabeth Hofmeister, a podiatrist at Prairie Rock Foot and Ankle Clinic, which has offices in Manteno and Manhattan, IL said she has seen three or four nail infections in the past six or seven months where the patient suspected she picked up the problem at a nail salon. This is not to say that Hofmeister or her patients were able to confirm their suspicions, but the patients reported that the infections turned up after a pedicure, Hofmeister said.

Dr. Elizabeth Hofmeister

A bad nail fungus infection -- one that takes up the entire nail -- will take nine months to a year to clear up, Hofmeister said. If the infection is only a spot on the nail, it might clear in four months to six months; it varies depending on how fast people's nails grow. Treatment takes so long because the medication cures the infection by assuring the new nail doesn't become infected, too. The fungus is cleared once all the infected nail has grown out.

Topical medication can range in price from $15 to $100 per bottle. Depending on the number of infected nails, someone will typically go through two bottles before the infection clears, Hofmeister said. A three-month supply of oral medication would range between $600 and $700. None of those figures includes a doctor's visit.

Source: Jaclyn Youhana, The Daily Journal [6/3/07]

Lavery to Receive Pecoraro Prize at ADA Annual Scientific Meeting

Larry A. Lavery DPM, MPH, of Georgetown, TX has been selected to be the second podiatrist to receive the prestigious Pecoraro Prize (Lawrence Harkless, DPM was the first). The Pecoraro Prize of the American Diabetes Association was instituted in the memory of the late Roger Pecoraro MD, a pioneering researcher in epidemiological aspects of diabetic foot care and in the diagnosis and the management of foot infection.

Dr. Larry A. Lavery

In recognition of his work, the Pecoraro Lectureship was founded by the American Diabetes Association and is given on the occasion of the Annual Scientific Sessions of the American Diabetes Association. The lecture will be delivered by Dr. Lavery on the afternoon of Saturday June 23rd at the ADA Annual Scientific Sessions at the McCormick Convention Center, Chicago, IL.

Dr. Lavery is a professor in the department of Surgery at Scott and White Hospital and Texas A&M Health Science Center College of Medicine. Dr. Lavery’s research group has published 130 peer reviewed scientific papers, and they have received more than $6M in research funding from the National Institute of Health, Veterans Administration, American Diabetes Association, American Podiatric Medical Association, American College of Foot Surgeons and industry. Dr. Lavery is the past chair of the American Diabetes Association Foot Care Council and the American Public Health Association Foot Section. He is on the editorial board for Diabetes Care.

P4P Gains Not Significantly Greater: Study

A program offering financial incentives to hospitals did improve outcomes for heart attack patients, but those outcomes weren’t significantly better than for patients at hospitals that did not participate in the program, according to a study in the June 6th issue of the Journal of the American Medical Association.

Researchers at Duke University Medical Center, Durham, NC, studied whether some of the hospitals participating in a CMS pilot project launched in 2003 showed more improvement in certain process measures and outcomes for treatment of heart attack than hospitals not in the program. The study analyzed data for 105,383 patients treated between July 2003 and June 2006 at 54 hospitals in the CMS program and 446 control hospitals. The researchers found significant improvement at both pay-for-performance and control hospitals with no significant difference in the rate of improvement between the two hospital groups.

The researchers concluded that although they did not find significantly stronger improvement in hospitals participating in the voluntary pay-for-performance program, they also did not find evidence that pay-for-performance had an adverse impact on processes that were not subject to financial incentives. The researchers also noted that the study is one of the first to evaluate the CMS pay-for-performance pilot, and additional studies are needed to determine the optimal role of pay-for-performance initiatives.

Source: Cinda Becke, Modern Healthcare [6/6/07]

Query: Fibromyxoid Sarcoma

Last month, I had the unexpected experience removing a mass on a heel that I thought was a simple plantar fibroma. To my surprise, the mass was much more extensive and a lot bigger than planned. The path report came back a low grade fibromyxoid sarcoma. He was immediately sent for further evaluation and treatment. Has anyone else had a similar experience and what was the prognosis?

Doug Mason, DPM, Freeport, IL

RE: Erythromelalgia with Hyderhydrosis (Birute Balciunas, DPM)
From: Elliot Udell, DPM

Erythromelalgia is a rare condition. I have treated three patients in 27 years of practice with this condition. One of my patients was so severe that he used to drive with a bucket of ice in his car so that he could dip his feet in a hurry during a sudden attack. When he had an attack his feet would turn lobster red and he felt like they were on fire. In all three cases changes in shoe gear did not affect the symptoms. Since the patient described does not have the problem while wearing golf shoes, could this problem be biomechanical?

One theory is that erythromellgia is a serotin uptake problem and the pathology in the foot is similar to the pathology that causes clinical depression in the brain. A group of physicians from Mt. Sinai Hospital in NYC published a paper many years ago showing that Serototin uptake Inhibitors can alleviate the symptoms. I have since used this treatment with success. I start the patients on low dosages of Zoloft and gradually go to therapeutic levels. Lyrica, which is also a Serotonin uptake inhibitor, might also work.

Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

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