The Voice of Podiatrists

Serving Over 14,000 Podiatrists Daily

November 16, 2012 #4,614 Publisher-Barry Block, DPM, JD

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Diabetes Now Considered ‘A National Epidemic’ In The Bahamas

Diabetes is now considered a “national epidemic” in The Bahamas and is the fifth-leading cause of death for all ages locally with a rate of 29.2 deaths per 100,000 persons annually, Minister of Health, Dr. the Hon. Perry Gomez said Tuesday. A symposium, held under the theme: “Diabetic Foot 101: Saving Legs, Saving Lives,”  addressed five key areas to which the Ministry of Health was “committed,” Dr. Gomez said.

Dr. Monique Mitchell (R) attaches World Diabetes Day pin to the Bahamas Minister of Health (Photo: Patrick Hanna)

These include discussions on diabetic peripheral neuropathy; comprehensive foot examinations; healing diabetic foot ulcers, and treating diabetic foot infections. The Diabetic Foot, is It Worth Saving,  was also included in the discussions. Presenters included Drs. Frederick Smith, nephrologist; Monique Mitchell, podiatrist; James Iferenta, emergency medicine; Dr. Delton Farquharson, surgeon, and Dr. Desmond Bell, CEO of the Save A Leg, Save A Life Foundation.

Source: Matt Maura, Caribseek News [11/14/12]

AAPPM Board of Trustees Adds IL Podiatrist as Newest Trustee

The AAPPM has announced the addition of its newest Trustee: Melissa Lockwood, DPM. In her new leadership role, Dr. Lockwood already has volunteered to chair the AAPPM Membership Development Committee and also serve as the Board Liaison to the AAPPM vendor members.  

Dr. Melissa Lockwood

Dr. Lockwood is entering her fourth year of private practice in Bloomington, IL. She is a graduate of OCPM and the University Hospitals of Cleveland residency program and has been a member of the AAPPM since 2007. She currently spearheads the Academy’s New Member Tracks.

PA Podiatrist Becomes 80th President of PPMA

On November 10, 2012, Joseph Pasquino, DPM was elected new President  of the Pennsylvania Podiatric Medical Association, during the House of Delegates Banquet at the Radisson Hotel Valley Forge, King of Prussia, PA. Dr. Pasquino’s inaugural makes him the 80th president of the Association, which was started in 1909.

Dr. Joseph Pasquino

Dr. Pasquino is Clinical Assistant Professor at Temple University School of Podiatric Medicine, Department of Podiatric Medicine and Orthopedics. He is a Fellow of the American Professional Wound Care Association and Diplomate of the American Board of Lower Extremity Surgery, Podiatric Surgery and Medicine. He serves as the Pennsylvania state coordinator for the APMA PAC and is Rotation Director for the University of Pittsburgh Medical Center’s Podiatric Residency Program. 

NV Podiatrist Honored for Promoting Diabetic Foot Care

November is Diabetes Awareness Month, and at the November 7, 2012 Las Vegas City Council meeting, the Council recognized the value to the community of the "Lions Hunt for Diabetic Peripheral Neuropathy (DPN) Free Foot Screening Program. Mayor Pro Tem Stavros Anthony gave the Council and audience an overview of how the partnership of the Lower Extremity Amputation Prevention (LEAP) Alliance and the Las Vegas Summerlin Lions club is helping to prevent serious diabetic foot complications and amputations due to DPN.

Dr. Lawrence Rubin (Right, Front) Receives Proclamation

Lion Dr. Larry Rubin and Lion Grant Roelf each accepted proclamations from the Council signed by Mayor Goodman and all councilmen making November 7, 2012, Summerlin Lions Club and LEAP Alliance Day in Las Vegas. LEAP Alliance director, Lawrence M. Rubin, DPM, is working with Lions Clubs throughout the country to provide this program in collaboration with local podiatrists.

Source: Las Vegas-Summerlin Lions Club

OK Podiatrist to Speak at Lunch-and-Learn Event

 A lot could go awry in the process of walking 115,000 miles. That’s the distance the average person, engaging in non-strenuous activity, walks in a lifetime. Enid podiatrist Dr. E. Alex Lebrija will be the featured speaker at a Thursday Senior Life Network lunch-and-learn event at Oakwood Mall.

Dr. Edward (Alex) Lebrija

Lebrija, a Fellow of the American College of Foot and Ankle Surgeons and member of the American Board of Podiatric Surgery and the American Podiatric Medical Association, specializes in rearfoot reconstruction, limb salvage procedures, total ankle replacement, trauma, and general podiatry. He is board certified in rearfoot reconstruction, ankle surgery, and foot surgery.

Source: Enid Eagle and News [11/13/12]

IL Podiatrist Develops Ankle Arthrodesis Nail

Officials at MedShape, Inc. have introduced the first surgical use of the DynaNail Ankle Arthrodesis Nail, an intramedullary (IM) nail that contains an innovative internal nickel titanium (NiTiNOL) element. The product represents a breakthrough in that it is the first IM nail to harness the shape memory properties of NiTiNOL, which up to now has been impeded from clinical use due to various technological challenges ranging from basic materials science to manufacturing and device design. After receiving 510(k) clearance from the U.S. Food and Drug Administration, DynaNail was successfully used in an ankle arthrodesis procedure performed by Doug Pacaccio, DPM, at Valley West Community Hospital in Chicago, IL.

Dr. Doug Pacaccio

"I was impressed with the performance of the DynaNail device," says Dr. Pacaccio, who is a co-founder of MedShape. "The nail sustains compression across the joint like an external fixator, but because it is inserted like traditional IM nails, it reduces operating time significantly." DynaNail is expected to become an effective alternative to external fixators for treating limb salvage procedures, as the NiTiNOL compressive element gives the nail unique properties over traditional IM nails. Compression across the joint is important for not only ensuring the joint bones remain in close apposition, but also in promoting healing.
 
Source: Today's Medical Developments [11/15/12]

U.S. Docs Gain Ground on Health IT, But Other Countries Lead

The U.S. is not alone among high-income nations in its efforts to push health information technology use to primary-care providers, according to results of a recent survey by the Commonwealth Fund. Nor is the U.S. alone in its struggle to achieve interoperability of systems and the free exchange of healthcare information, the surveyors found.

A "high percentage" of the nearly 8,500 physicians surveyed across the 10 nations covered by the survey "reported that they did not routinely receive timely information from specialists or hospitals," while feedback loops providing physicians with data about their own performance "varied notably" between countries, according to a report, "A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology, Less in Other Areas," appearing online in the policy journal Health Affairs

Source: Joseph Conn,  Modern Healthcare [11/15/12]

Query: Pea-Sized Plantar Fibroma

A 17 year old high school track athlete presented with a painful pea-sized plantar fibroma on the proximal 1/3 of the medial PF band. This was caused by stepping on a large gauge nail last Jan. 2012. Only in the past 2-3 months did the fibroma show up. The challenge will be accommodating the fibroma in a track spike. I am looking into the verapamil patch for her and have started accommodative padding to see how that helps her. As small as it is, would anyone recommend removal? 

David Kahan, DPM, Sacramento, CA

Query: HBOT Oversight

What experiences have PM News readers had in providing oversight for hyperbaric O₂ therapy (HBOT) for lower extremity disorders?

Eric Goldenberg, DPM,  Daytona Beach, FL

RE: Tenosynovitis (Scott Hughes, DPM)
From: J E Schiller, DPM, Robert Kornfeld, DPM

Have you considered RSD, a frequently missed diagnosis?

J E Schiller, DPM, Cleveland, OH, Joan.Schiller@UHhospitals.org

Whether this is tenosynovitis or not, the first question I would ask after 4 years is why hasn't this patient's injury healed? In my opinion, an ultra-sound over a large area may miss something. I agree that an MRI would be a better diagnostic tool. That said, does she have any medical history that needs to be taken into account? Is she overweight? A smoker? It would be prudent to look at any immune burdens, inflammatory issues and pedal blood flow. This is a patient who may be a surgical disaster since what prevented her foot from healing in the first place may place a challenge on the healing of the surgical trauma.
 
Challenging patients need to be addressed in a far more comprehensive way than just the foot pathology. Functional medicine provides answers for why a patient is struggling to heal. These issues need to be discovered. Then, supportive therapies designed to enhance efficiency of cellular repair and detoxification would be the best approach.
 
Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com

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