The Voice of Podiatrists

Serving Over 11,000 Podiatrists Daily

March 26, 2009 #3,503 Publisher-Barry Block, DPM, JD

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GA Podiatrist Inspired to Make Annual Missions to Bosnia

Athens, GA podiatrist Frank DiPalma knew he wanted to have some sort of spiritual awakening when he made the trip to Medjugorje - a small town in Western Bosnia where people have had visions of the Virgin Mary. DiPalma found the experience he was looking for - but not where he thought he would.

Dr. Frank DiPalma examines a patient’s foot at Merciful Father’s House treatment center in Medjugorje, Bosnia-Herzegovina.

The pilgrimage DiPalma took with his wife earlier this month left him shocked at how rough life remains for people in rural parts of Bosnia and Herzegovina, the region in Southeastern Europe ravaged by more than three years of warfare a decade ago.

Treating patients in a rural clinic for less than a week convinced DiPalma to make an annual trip to the Balkans region to offer his medical services. Now, he's trying to convince colleagues to join him. DiPalma plans to return to Bosnia next year and he's already started recruiting colleagues, trying to talk the doctors he sees most often into joining him on the 2010 trip. DiPalma is also seeking donation of supplies and can be reached at fivetoes1946@aol.com

Source: Merritt Melancon, Athens Banner-Herald [3/20/09]

World-Renowned Research Professor Lectures at NYCPM

On Tuesday, March 24th, a large and enthusiastic audience of students and faculty at the New York College of Podiatric Medicine was privileged to attend a special preclinical lecture given by internationally-known molecular biologist James B. Hicks, Ph.D., Research Professor and Director of the Women’s Cancer Genomics Initiative at Cold Spring Harbor Laboratory, in Cold Spring Harbor, New York. In his lecture at NYCPM, given as part of the first-year molecular biology/molecular genetics course, and entitled “Genomic and Epigenomic Approaches to Cancer Diagnosis”, Dr. Hicks offered an overview of the role of chromosomal deletions and duplications in cancer and a look at some of his current research, in which he and colleagues are applying genome-wide microarray strategies to identify diagnostic and prognostic markers in breast, ovarian and cervical cancer.        

(L-R) Kenneth H. Astrin, PhD. S. William Sigler, Dr. Hicks; Michael J. Trepal, DPM; Eileen Daly Chusid, PhD., Louis L. Levine, and Stephen Alchermes, DPM

Dr. Hicks along with Dr. Gerald Fink, is best known for his work on yeast genetics and moveable DNA elements in the 1970’s and 1980’s. He discovered DNA transformation in yeast, and founded the yeast and plant groups at Cold Spring Harbor Laboratory, along with co-workers Jeff Strathern and Amar Klar, where they worked out the molecular details of mating type switching in yeast.

DOX / ACFAS  Drive Collects Over 2,000 Socks for Homeless

DOX Podiatry, a leading podiatry-specific electronic medical records and office management solutions, was the title sponsor of a recent sock drive held at the Annual Meeting of the American College of Foot and Ankle Surgeons in Washington, DC. The drive collected over 2,000 pairs of socks for the National Coalition for the Homeless.

(L-R) Dr. Mary E. Crawford, Dr. Bart Ripperger, President DOX Podiatry, Jennifer Leckman,  Megan Hustings, Dr. Marc A. Kravette, Stuart Finn, CEO, Dox Podiatry, and Dr. Michael D. Vaardahl

We believe it is everyone's responsibility to give back to our community.  Since our customers make their living by helping people's feet, we thought this is a perfect opportunity to give back,” said Stuart Finn, chief operating officer for DOX.

Query: Recurrent Verruca, Possible Carcinoma

My patient is a 58 y/o Hisp male, NIDDM with sensory distal polyneuropathy, previously underwent a left TMA in '04, 2/2 infection with full-thickness necrosis. Patient healed uneventfully and presented 3 yrs later with re-ulceration to TMA, a result of having a foreign body lodged in the shoe-void filler. Initially, he underwent CO2 laser ablation but presented during the post-op global period with minimal reoccurrence (per punch biopsy) and persistent ulceration. Patient underwent additional laser removal with exostectomy of 3rd met regrowth and application of GraftJacket.  Patient's GraftJacket then broke down with eventual re-infection of verruca and bacteria per biopsy/C&S.  

Recurrent Verruca, Possible Carcinoma

A local university has suggested topical Aldara and requested the previous path slides involving tissue biopsies showing verruca, wanting to r/o possible verruca carcinoma. They mentioned Bleomycin treatment, but if the lesion is carcinogenic, then surgery with possible radiation. Suggestions would be appreciated.

Zacharia Facaros, DPM, Fountain Valley, CA
 

Query: Crazy Things Runners Do to Shoes

I was wondering if any of you had pictures of the crazy things runners do to their shoes to get through a race, like cutting a hole at the 1st MPJ to create room for their bunion deformity. I need some pictures for an upcoming project.
 
David B. Williams, DPM, El Paso, TX
 

RE: Botox for Hyperhydrosis (Stephen Kinard, DPM)
From: Bob Kornfeld, DPM

I have recently used Botox on a patient with a 12 year history of recalcitrant plantar fasciitis who was also post-fasciotomy which failed to relieve his symptoms. One injection of Botox and he is now pain free. I purchased the vial directly from Allergan and there was no issue with it being used off-label.

Bob Kornfeld, DPM, Lake Success, NY, holfoot153@aol.com

RE: Sural Nerve Biopsy (Lee C. Rogers, DPM)
From: Elliot Udell, DPM, Allen Mark Jacobs, DPM

I acknowledge Dr. Rogers for stating: "The sural nerve biopsy should never be the first investigation in someone with diabetes and signs of nerve dysfunction."
 
Biopsies have their time and place in the practice of medicine, but with any treatment for any condition, we have to weigh its benefits versus its risks. Doing sural nerve biopsies or even epidermal nerve fiber density biopsies on every diabetic patient with peripheral neuropathy could do more harm than good. This is because when peripheral neuropathy is coupled with vascular disease, patients are subject to wounds that don't heal. We all know this. The inducement of iatrogenic wounds via biopsy into every diabetic  patient with peripheral neuropathy could cause many people to develop ulcerations and infections, which could lead to amputations. The benefits of the data gleaned from these tests would rarely, if ever, alter the course of the treatment. 
 
Elliot Udell, DPM, Hicksville, NY, Elliotu@aol.com

The suggestion by Dr. Rogers that sural nerve biopsy is preferable to epidermal nerve fiber density testing was not totally accurate with regard to safety.
 
Dahlin, et al. (Acta Neurologia Scandanavia 118 (3) 2008 noted that because of persistent pain and parasthesia following sural nerve biopsy, 66% (16/24) of patients stated that they would never undergo such testing again.
 
The IENFD study is excellent for the diagnosis of neuropathy. If histologic, histochemical, or immunologic studies are necessary, then sural nerve biopsy may be preferred. Properly performed, IENFD testing may establish length, dependent from other europathic processes. Bako laboratories provides this service.
 
Allen Mark Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net

RE: PM News Marks Issue #3,500 & 15th Anniversary
From: Marlene Reid, DPM

I also want to offer my congratulations to Barry Block on his 3500th issue this week!  We all know that PM News is an important way our profession interacts and stays in touch. I hope you will all join me in making a contribution in his honor to the APMA Educational Foundation! With the economy the way it is and the scholarship fund growth based on endowment investments, this year is an important year to give.
 
Marlene Reid, DPM, Naperville, IL, mreiddpm@yahoo.com

RE: Mitch Pokrassa, DPM

There are a few who knew Mitch better than I did, but as a 30 year member of the Baja Project for Crippled Children I had the opportunity to spend much time with him. Mitch was a private person and he did not often talk about himself, but it was obvious that he had a love for foot surgery and taking care of patients.  He had a stroke several years ago that resulted in enough disability that his insurance policy allowed him to retire, but podiatry was Mitch's life and after a year he came back into practice. Although he cut back on his surgical load in the States, he continued to travel with our group to Mexico, Honduras, and El Salvador, often for a week at a time. He moved a step slower, but still took on very difficult cases. We would often be in the OR for over 10 hours with only minimal breaks. He always kept his complaints to a minimum. 
 
We often dealt with very complex reconstructive case in very primitive situations. His rule was “do no harm” and he stuck to it. He was very resourceful at getting the job done, in spite of equipment limitations. It was a pleasure to scrub with him and watch how he taught the residents, always guiding them along, never hammering them. Perhaps the best part of working with Mitch was that he was always very approachable. You could ask him for advice regarding any aspect of a tough case and he would make suggestions without your ever feeling belittled. I, for one, have lost a mentor.
 
His untimely death is a true loss to many of us as well as many children who will not have the benefits of his skills

Jack Reingold, DPM, Solana Beach, CA

PODIATRIST NEEDED FOR MIAMI-DADE COUNTY

Multi office practice needs doctor of podiatry for full time and/or part time for private office, clinics, and nursing homes. Great opportunity to grow with and unlimited income potential. Offices in Miami, Hialeah, Westchester, and Cutler Ridge. Email to feetdoctor@aol.com

ASSOCIATE POSITION – VICTORIA, CANADA

Beautiful Victoria, B.C. Canada on the ocean, fast growing area. Associate for multi-office full scope practice. Licenser exam to be given in June 2009. Reply to dr.cole@shaw.ca

ASSOCIATE POSITION NEW YORK

Podiatrist needed for private clinic setting in N.Y.C.  All RFC, no stress, $40+/hr. Great opportunity to earn some easy extra money. For more info. And details call (917) 880-6639 or e-mail: hansfeet@aol.com

PRACTICE FOR SALE - FLORIDA—CENTRAL/SOUTH

Turn-key operation grossing $570,000 annually based on one full-time doctor. Great opportunity for growing the top-line. Surgery is only 14% of the professional man-hours; it can significantly increase income. Medicare makes up 64% of revenues. Seller will assist with transition. Call 863-688-1725, ask for Chas.

ASSOCIATE WANTED - FLORIDA

Associate needed for a dynamic multi-doctor practice in the Tampa Bay area. Partnership opportunity for the right candidate. Preference given to a PSR 24+ resident completing their education this spring/summer, and must have a Florida license. Well-established practice, high tech with EMR and digital x-rays, with specialties in sports medicine, surgery and wound care. No nursing homes or HMO's. Excellent hospital privileges available. Choose an area of practice concentration that you are passionate about and enjoy a lifestyle for yourself and your family that is second to none. E-mail: kimvelez@tampabay.rr.com
 

ASSOCIATE POSITION - CHANDLER/GILBERT/PHOENIX, ARIZONA

Seeking a well-trained, ethical and hard working graduate of a PSR 24+/36 Residency to join our growing multi-location practice. This is a practice with a nice mix of 35% surgery/trauma, 20% diabetic/wounds, 25% biomechanics, 20% pediatric. ER Call. Opportunity for partnership at 2 surgery centers. Very modern offices with EMR, U/S, Digital X-Ray, ESWT, Vascular Testing Machine. Excellent referral base, and a well-trained staff. Board eligible/certified a plus. Competitive salary, bonus structure, benefits. Please e-mail CV and references to FootAnkleAZ@aol.com

OFFICE SPACE/ MRI RENTAL – NYC, LI   
 
Turn-key space available, daily, monthly; East 60th off Park Ave, East 22nd St. off 3rd Ave, and Plainview Long Island. JACHO-certified operating rooms available, as well as all surgical equipment and anesthesia. Extremity MRI Rental. Stark compliant. All exams read by board certified radiologist. Call for details. 516 476-1815

ASSOCIATE POSITION - CHICAGO AREA

Join one of the most successful, long-established podiatry practices in the Chicago area, with excellent salary and benefits. We have an immediate opening for a full-time podiatrist in a multi practice location in Chicago. Must have two years of surgical residency. Please e-mail resume to f-massuda@footexperts.com

CASE CONSULTING

Dennis Shavelson, DPM is now accepting referrals of difficult cases involving biomechanics, surgical complications, non-healing wounds diagnostic and treatment dilemma’s and subtalar stenting from DPM’S. Full reporting with second opinion only, rapid return after care and assumption of care options. Medicare and Out-of-Network Only. (212) 288-3668 or drsha@lifestylepodiatry.com 

PRACTICE FOR SALE - CENTRAL FL

Practice sale, in beautiful, high quality of life, growing area; 2000 sf bldg. fully equipped/ designed for podiatry; excellent location, features & exposure; near hospital, wound and HBO center. Great opportunity for expansion; good insurance climate. 352-357-7499 / E-mail: windnwave@earthlink.net

PRACTICE FOR SALE-SOUTHEAST MICHIGAN-BRIGHTON

Great opportunity. Established 11 years. Excellent location. Large illuminated sign on busy main road. Mid to high income growth area.  Supplies, furniture, and equipment included: X-Cell X-Ray w Hope Autoprocessor, Pelton-Crane Autoclave, Parks Lab, Bircher, Burton Floor Light, OR with Lighting, bone instruments and power equipment, Midmark Chairs. Quality 1,350 sf build-out. convenient parking. Must sacrifice. Call (248) 565-5266. Docpod@aol.com

NEEDED CHICAGO -- NW IND & BALTIMORE/WASHINGTON, DC PODIATRISTS

Home Physicians, a medical group specializing in house calls is looking to hire podiatrists in Chicago, Northwest Indiana, and Baltimore, MD. Full and part-time positions are available. Competitive Compensation including malpractice. Contact Scott Schneider. Phone-773-342-4201 FAX 773-486-3548-E-Mail sschneider@homephysicians.com Visit our website

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