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02/23/2024
PUBLISHED PODIATRISTS
From: Ivar E. Roth, DPM, MPH
I read the article quoting William Scherer, DPM and the need for diagnostic testing where he stated a 60% diagnostic confirmation rate for clinical nail fungus.
In my opinion, if it looks like fungus, it is fungus and really with a 60% confirmation rate, I believe that testing is a waste of time and money. I probably test 1% of my patients when I cannot get them better. Did testing help me with my treatment? Not really. If you feel the patient has fungus and they want the toes treated, I am not going to stop treatment if the diagnosis comes back negative as 98% of the time, I can clear up a fungus appearing nail despite what the diagnosis might be.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
Other messages in this thread:
11/15/2024
PUBLISHED PODIATRISTS
MI Podiatrist Publishes Book on Nutrition
Data scientist Mark Trudeau and podiatrist Sadegh Arab, DPM have co-authored “There’s a Food for That,” a guide that provides information on some of the different foods that can assist with treating the top 100 diseases and conditions affecting Americans.
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(L-R) Mark Trudeau and Dr. Sadegh Arab |
From TMA Publishing, the book provides targeted dietary recommendations to help readers prevent and manage common health issues like diabetes, hypertension, and allergies, among others, the authors said. Dr. Arab earned his podiatric medical degree from the Kent State University College of Podiatric Medicine. Presently, he is a staff member at Beaumont Hospital in Troy, Insight Surgical Hospital and Premier Surgical Center of Michigan.
Source: Sarah Wright, C & G News [11/13/24]
10/17/2024
PUBLISHED PODIATRISTS
FL Podiatrist Co-authors Paper in Wounds International
Richard Mann, DPM of Boca Raton, Florida, co-authored the scientific paper entitled "The beneficial effects of benfotiamine and methylcobalamin in the management of patients with polyneuropathy in Aruba: three case reports". The paper was recently published in the journal Wounds International 2024.
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Dr. Richard Mann |
The paper introduces the Mann Baratta Assessment Scale (MBAS), a quick and effective way to quantify a patient's perception with respect to any change in neuropathic symptoms they feel they have experienced since the initiation of therapy for peripheral neuropathy. The paper and a detailed description of the MBAS may be found here.
10/02/2024
PUBLISHED PODIATRISTS
NY Podiatrist Pens Second Novel
Elliot Udell, DPM has written his second novel titled It happened In Long Island: Antics of the Rich and Famous. The story centers on a Jewish girl from suburban Long Island, who gets a summer job working for one of the wealthiest, aristocratic, WASP families in America. Together with an Italian American girlfriend, they experience the antics of these people. Readers can see tennis matches, mansions, horse rides, romances, high society opera galas, and sailing excursions on the Long Island Sound. Behind all of this, however, is a milieu of racism, antisemitism, homophobia, xenophobia, and political corruption. Some of this bigotry is overt. In most cases, however, the hatred is subtle. Those guilty would be in complete denial.
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Dr. Elliot Udell |
The book is filled with romances that last forever and others that are mere summer flings. There are hysterically funny scenes, as well as scenes filled with sadness and loss. The book's climax is a famed international sailboat race where young and old from diverse economic, ethnic, and religious backgrounds join together despite petty prejudices and create a winning formula that defines American life.
09/05/2024
PUBLISHED PODIATRISTS
NY Podiatrists Publish Article in Journal of Perinatal Medicine
Father and son Rock G Positano, DPM, MPH and Rock CJay Positano, DPM, MPH of the Non-surgical Foot and Ankle Center at Hospital for Special Surgery in New York recently published an article in the Journal of Perinatal Medicine titled, "Common foot and ankle disorders in pregnancy: The role of diagnostic ultrasound".
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(L-R) Drs. Rock G and Rock CJay Positano |
Diagnostic ultrasound provides a safe and reliable method to assess the extent of bone, ligament, and tendon trauma, as well as circulatory and clotting derangements in the pregnant patient without the use of potentially dangerous exposure of x-rays to the developing fetus. This article is published in one of the most prestigious Ob/Gyn journals both nationally and internationally and demonstrates how podiatry has integrated and contributed to other disciplines such as diagnostic imaging radiology and perinatology.
09/03/2024
PUBLISHED PODIATRISTS
FL Podiatrist and Renowned Chef Launch Revolutionary Cookbook
Jenneffer Pulapaka, DPM and Chef Hari Pulapaka, a dynamic husband-and-wife duo, have announced the release of their groundbreaking cookbook, The Heart Healthy Plant-Based Cookbook. This innovative culinary guide offers over 100 delicious recipes to improve vascular health, lower blood pressure, and support cardiac recovery.
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(L-R) Hari Pulapaka and Dr. Jenneffer Pulapaka |
With Dr. Pulapaka's medical expertise and Chef Pulapaka's culinary artistry, this cookbook provides a roadmap to a healthier lifestyle.
07/23/2024
PUBLISHED PODIATRISTS
IN Podiatrist Writes Children's' Book
Jason Grove, DPM, a podiatrist at Trinity Health in Mishawaka, IN and father of seven, is the author of the children's book Monster's Mustard. Dr. Grove says he had always wanted to write a book and after encouragement from his wife and kids, he decided to go for it.
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Dr. Jason Grove |
Monster's Mustard is about the challenges children face with relationships and the journey of friendship between the two main characters, Monster and Ram.
Source: WSBT [7/20/24]
05/02/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS)
From: Pete Harvey, DPM
KUDOS to Dr. Kor!
His book could not be published at a better time.
NEVER FORGET!
Pete Harvey, DPM, Wichita Falls, TX
05/01/2024
PUBLISHED PODIATRISTS
IN Podiatrist Publishes Book Honoring Holocaust Survivors
In an effort to chronicle the lives of his parents (Eva and Mickey Kor), both Holocaust survivors, and how they positively impacted so many including their son, Alex Kor, DPM from Danville, Indiana and his co-author, Graham Honaker have released their book entitled, A Blessing, Not a Burden:My Parent's remarkable Holocaust Story and My Fight to Keep Their Legacy Alive.
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Dr. Alex Kor |
In an effort to motivate, inspire, and combat hate in our world, the book will also emphasize why knowledge of this terrible history cannot be forgotten and is even more important for medical providers considering that Dr. Kor's mother was one of Dr. Josef Mengele's twins experimented on at Auschwitz.
04/01/2024
PUBLISHED PODIATRISTS
CA Podiatrist Publishes New Study in Scientific American
Kevin Kirby, DPM of Sacramento, California has published an article in Scientific American entitled "Evolutionary Future of the Fingers and Toes.” In his anthropological research paper, he postulates, "For thousands of years, humans have been putting on their shoes using their index finger as a shoehorn - and in some kind of Darwinian way we’ve adapted, and the index finger in a couple of thousand years, it's going to look like a shoehorn."
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Click on photo to view short video |
In this video, Dr. Kirby postulates that because the index finger has been used to assist in putting on shoes, it will eventually assume the shape of a shoehorn. Not all podiatrists agree. Bryan Markinson, DPM, Chief of Podiatry, Department of Orthopedic Surgery, Icahn School of Medicine at Mount Sinai cautioned Dr. Kirby, “when predicting evolutionary changes, Curb Your Enthusiasm.”
Source: April Fools News [4/1/24]
03/15/2024
PUBLISHED PODIATRISTS
ME Podiatrist Surpasses 5,000 Article Reads on ResearchGate
Todd O’Brien, DPM of Orono, Maine has recently surpassed 5,000 article reads on ResearchGate. His publications have primarily focused on foot surgery, diagnostic devices, and the diabetic foot. Dr. O'Brien is currently affiliated with the Mason Lab at the University of Maine working on a novel technique for measuring bone density.
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Dr. Todd O’Brien |
ResearchGate is an online network of over 25 million researchers from around the globe. Researchers use the platform to share and discover research. Founded in 2008, its mission is to connect the world of science and make research open to all.
03/01/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1C
From: John Lanthier, DPM
Will Dr. Roth write up and publish his treatment protocols for these dystrophic nails so that the professional community may evaluate their success and efficacy, or will this be a trade secret? This is not meant to be sarcasm but a general question so that our patients can benefit from these protocols, as benefiting the public is the true nature of a profession.
John Lanthier, DPM, Sudbury Ontario, Canada
Editor's note: This topic is closed.
03/01/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1B
From: Elliot Udell, DPM
Drs. Scherer and Bakotic say that 59.4% of nails studied are positive for mycosis. Dr. Markinson, who tests prior to initiating treatment, finds it to be 85%, and Dr. Roth feels that he can return "ugly" nails to normal without the need for any testing. Oddly, everyone is correct. The one proverbial "elephant" in the room that is missing is the psychology of what brings patients with thick, yellow, odorous nails into podiatric offices. It's not to find a pathogen. It's to get a better cosmetic result for their feet or eliminate pain. If isolating a pathogen will help, then testing should be done. In our office, we side with Dr. Markinson and send specimens to the lab prior to treatment.
If Dr. Roth has a technique that will treat all dystrophic and mycotic nails, he will make patients happy and he should publish his technique so that all podiatrists and patients can benefit from his findings. Most of us would gladly try his technique on patients, especially those suffering from recalcitrant nail conditions.
Elliot Udell, DPM, Hicksville, NY
03/01/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1A
From: Brett Ribotsky, DPM
Three observations/comments I need to make on this topic:
1) Incredible accolades should go to Dr. Scherer for being the most published podiatrist ever on onychomycosis, including winning three Stickel awards. Currently, this paper written with Dr. Gupta (The world authority on onychomycosis) should be acknowledged, and respected by all of us.
2) I am shocked that Dr. Markinson, who is a podiatric expert on dermatolgy, could not find 5 to 10 minutes out of his day to read the article that Drs. Scherer/Gupta authored.
3) To Dr. Roth, I am incredibly excited on what you may have discovered. I’m willing to offer you $10 million plus royalties for the right to distribute this product, should it prove its success unequivocally. Onychomycosis is the number one disease in the world and should your treatment algorithm be reproducible and successful, it may be a greater invention than insulin.
Brett Ribotsky, DPM, Fort Lauderdale, FL
02/29/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1 B
From: Ivar Roth, DPM, MPH
I would like to state my findings and observations concerning the comments by the esteemed doctors Scherer and Bakotic. They wrote that 50% of dystrophic nails are, in fact, onychomycosis and that onychodystrophy can have varying etiologies, both infectious (fungal and bacterial) and non-infectious (microtrauma, psoriasis, lichen planus, melanonychia, etc.). They state that is the precise reason why laboratory confirmation prior to definitive pharmaceutical therapy is recommended.
Unfortunately, while what they state is accepted dogma in the academic world, the reality is I have found that by using my treatment for “ugly” nails, whether fungal or onychodystropic, the fact remains that they almost all can be cured to perfectly normal nails. This is why I stated the testing does not matter anymore and is a waste of time and money.
I will offer as proof photos of my patients' nails to PM News so everyone can see for themselves. I will send in dystropic 2nd and 5th toenails that everyone says is from micro-trauma and very deformed nails that until now most docs would say are impossible to treat. I hope our profession takes note and gets behind the idea that what was once dogma concerning “ugly” nails is no longer true.
Ivar E. Roth, DPM, MPH, Newport Beach, CA
02/29/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1 A
From: Bryan C. Markinson, DPM
Dr. Scherer's article, which I have not yet read, as summarized in PM News, reported a 59.4% positivity rate for clinically diagnosed onychomycosis. In this very large sample of cases, I am sure there are variables that were very difficult to control. For example, specimen collection techniques are so varied that I am certain this was a factor in the end results. However, I fully understand and support wholeheartedly the point of the study...it's NOT all onychomycosis.
Laboratories publicly promising that they will find it and the expectations from practitioners that they must find it has not helped our collective...
Disclosure: Dr. Markinson is Senior VP for Podiatric Medical Education at Sagis Dx.
Editor's note: Dr. Markinson's extended-length letter appears here.
02/28/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1 B
From: William P Scherer, DPM, MS, Wayne L. Bakotic, DO
Dr. Ivar Roth may indeed have subjective success in treating onychomycosis without laboratory testing; however, this is certainly not the case universally. Essentially, all dermatology and podiatry peer-reviewed literature on this topic have demonstrated that only '50% of dystrophic nails are, in fact, onychomycosis. Visual assessment by a physician, while an essential part of a patient encounter, is unreliable at discerning an accurate etiology of the nail changes observed, as demonstrated by multiple referenced studies. The level of precision required to render an accurate and proper diagnosis of onychomycosis is best obtained through laboratory confirmation following appropriate clinical evaluation.
Onychodystrophy can have varying etiologies both infectious (fungal and bacterial) and non-infectious (microtrauma, psoriasis, lichen planus, melanonychia, etc.), which is the precise reason why laboratory confirmation prior to definitive pharmaceutical therapy is recommended. Additionally, terbinafine resistance, which requires laboratory evaluation to identify, is an omnipresent issue with a current rate >5% in those with confirmed onychomycosis in the U.S., although the rates overseas are far higher and increasing. It is for these stated reasons that laboratory confirmation, no matter which laboratory or testing methodology is chosen, is recommended by the CDC, American Academy of Dermatology, British Association of Dermatologists, and others. Our recently published paper with 96,293 samples supports and reinforces these recommendations. It goes without saying that the accurate characterization of nail pathology utilizing evidence-based medicine, no matter the etiology, allows for individualized treatment plans that ultimately result in improved patient outcomes and overall satisfaction.
Disclosure: Drs. Scherer and Bakotic are affiliated with Bako Diagnostic Labs.
William P Scherer, DPM, MS, Delray Beach, FL, Wayne L. Bakotic, DO, Alpharetta, GA
02/28/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1 A
From: Ivar Roth, DPM, MPH
Thanks Dr. Jacobs for your comments. With my concierge practice, I take the time to treat each patient personally and follow them up very carefully. When I say follow-up for fungus nail treatments, I include a 3 month follow-up as well as a 12 month at no charge. Since the patients paid significant funds, we have a high number that return for their follow-up appt. We take photos 100% of the time at each visit during the treatment and with follow-ups. I have spent over 2 decades trying to cure fungus toenails, and I can say with great pride that I have achieved that goal. I have successfully treated thousands of patents now. When I say cured, I mean cured. I use a 4-step process.
The first step is using a laser or lasers which I have developed a proprietary protocol for. It took me years to figure out what settings and times to use. The second step is meticulous...
Editor's note: Dr. Roth's extended-length letter can be read here
02/27/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1 B
From: Kathleen Neuhoff, DPM, Robert Kornfeld, DPM
Dr. Jacobs, I have a cash-only practice and have never claimed “possession of advanced skills and knowledge not understood or provided by the rest of us mortals.” Sweeping generalization or just bias?
Kathleen Neuhoff, DPM, South Bend, IN
While I can neither support nor refute Dr. Roth’s claims to a 98% success rate treating onychomycosis without a culture, I do take offense to Dr. Jacobs’ short, off-the-cuff condemnation of those of us who do not accept insurance. A lot was said in those couple of sentences. First of all, in a profession with a long history of struggles (which continue to this day), the last thing we need is someone coming along and dividing the profession into “them” and “us”. This same thing happened back when...
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
02/27/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS) - PART 1 A
From: Elliot Udell, DPM
Dr. Roth is correct, both he and most of our colleagues can diagnose and treat onychomycosis without the need for expensive lab testing. There is a practice management perspective on this. In our geographic area, some insurance companies will not pay for a topical and/or oral antifungal agent unless there is lab proof that the patient has mycotic toenails. Many years ago, our state podiatry society and possibly even the APMA fought this battle and convinced many insurance companies that a doctor's clinical assessment is good enough without the need for lab testing.
Unfortunately, we are seeing cases cropping up where an insurance company will require prior authorization and will reject the prescription unless they see documented lab proof that the patient has fungal nails. A recent example is where an insurance company demanded lab proof to approve an RX of oral terbinafine. McKesson charges $7.98 for a bottle. Even with the add-on to have a pharmacist make it up, there is no way that the insurance company is making a profit by making us order a lab test.
Elliot Udell, DPM, Hicksville, NY
02/26/2024
RESPONSES/COMMENTS (PUBLISHED PODIATRISTS)
From: Allen Jacobs, DPM
Dr. Ivar Roth claims a 98% cure rate for onychomycosis. He does so sans any diagnostic testing. Given the fact that Dr. Roth has informed our profession that he provides his patients with by far the highest cure rates for onychomycosis ever reported, would he be so kind as to share his therapeutic regimen with our profession in order that we might provide our patients with the same benefit. Quite frankly, I have serious doubts regarding his claim. If true, he has achieved the Nobel Prize of podiatry, as his most recent bombastic claim runs diametric to all published medical literature on the subject.
It is interesting how those who write in to PM News who maintain a cash-only practice, claim procession of advanced skills and knowledge not understood or provided by the rest of us mortals. There is apparently great power in the green poultice. Please Dr. Roth, share your discovery of the Holy Grail. Publish your results for critical examination.
Allen Jacobs, DPM, St. Louis, MO
02/22/2024
PUBLISHED PODIATRISTS
FL Podiatrist Published in Journal of Fungi
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Dr. William Scherer |
In this retrospective cohort study, they assessed confirmatory laboratory testing results with matching clinical diagnoses with 96,293 nail specimens submitted during a 9-month period from 2022 to 2023. Despite the risk of mis-diagnosis, confirmatory laboratory testing is under-utilized and their results support the use of it for toenail pathology when there is a clinical diagnosis of onychomycosis.
02/16/2024
PUBLISHED PODIATRISTS
IN Podiatrist Writes Memoir of Loss of Daughter to Drugs
Wanting to prevent others from enduring the excruciating agony of watching their son or daughter succumb to drug or alcohol abuse, Mann Spitler, III, DPM wrote Manda’s Beast: A True Life Addiction Story to Help Parents Protect Their Sons and Daughters from Self-Abuse with Drugs.
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Dr. Mann Spitler, III |
In a heart-wrenching memoir, he shares Manda’s haunting journey into the “beast” of heroin addiction, culminating in her tragic death at age 20 from a self-administered lethal dose. This guide was lovingly crafted with kids and teens in mind, with the preventive measures that he and his wife Phyllis wish they had taken.
Source: Amazon.com
12/18/2023
PUBLISHED PODIATRISTS
NC Podiatrist is Guest Editor of Wound Central
Steven Kravitz, DPM was recently honored with being the guest editor of the October issue of Wound Central. This peer-reviewed journal is dedicated to research and treatment in the U.S. and Canada. In addition, his article "Sclerotherapy, Literature Review, Complications, and Case Presentation" was published in the September issue of the Journal of Wound Care.
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Dr. Steven Kravitz |
Dr. Kravitz currently lectures on utilizing positive ions and advanced polymers to destroy biofilm and control pathogens without causing toxicity. His latest article on this topic is expected to be submitted within the next eight weeks.
12/01/2023
PUBLISHED PODIATRISTS
MA Podiatrist Co-Edits Limb Salvage Publication
Sara Rose-Sauld, DPM, a podiatrist in the Foot and Ankle Division of the Orthopaedic Department at Massachusetts General Hospital (MGH), has co-edited the recently published text, The Massachusetts General Hospital Approach to Transcatheter Arterialization of the Deep Veins for Advanced Limb Salvage.
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Dr. Sara Rose-Sauld |
Dr. Rose-Sauld is a 2016 graduate of Barry University School of Podiatric Medicine. She came to MGH after completing her residency at Palmetto General Hospital in Hialeah, Florida in 2019. She holds a Harvard Medical School appointment as an associate professor. Since joining MGH, she has integrated herself into the vascular services department of the Wound Care Center, bringing needed podiatric expertise to the wound care program. She is a founding member of the MGH LEAPP program.
11/08/2023
PUBLISHED PODIATRISTS
MD Podiatrists Publish 2nd Edition of Foot Book
The Foot Book: The Complete Guide to Caring for Your Feet and Ankles (2nd Ed) by Jonathan D. Rose, DPM and Vincent J. Martorana, DPM is written by leading experts with decades of experience in podiatry. This new edition of The Foot Book covers everything you need to know to care for your feet. It addresses the entire foot, inside and out, describing in plain English its anatomy and biomechanical operations.
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(L-R) Drs. Jonathan Rose and Vincent Martorana |
The second edition also:
Provides an overview of common and rare foot injuries and syndromes
Includes information on alignment and balance problems, heel pain, skin and toe conditions, flat feet, arthritis, and more
Offers guidance on medications, exercises, stretches, inserts, therapy, and surgery
Explains how to select the right footwear and provides shoe recommendations
Covers foot issues in children, athletes, people with diabetes, and people with nerve or vascular problems
Includes links to supplemental videos that guide you through stretching, flexibility, and strengthening exercises
Illustrated with nearly 100 images, The Foot Book walks you through tips and practices that are essential to caring for your feet.
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