Whatever you do at a pedicure salon, do not let the pedicurist turn on the bubbles in the foot baths. "The jets in the whirlpool bath can harbor bacteria and fungus," says Manhattan podiatrist Dr. Jacqueline Sutera. Sutera estimates that she sees about 10 to 12 patients a week who come in with fungal or viral infections, like warts and athlete's foot, caused by build-up in whirlpool foot baths. If the skin is cut by accident during a pedicure, you can also get bacterial infections by coming into contact with bacteria from previous customers. She recommends finding a salon that uses pipeless foot baths or individual bath liners to further avoid cross-contamination with previous clients. Plus, make sure that your salon runs a sanitization cycle for the required minimum of 10 minutes between each client.
Dr. Jacqueline Sutera
Some salons might be using UV lights to sanitize tools -- you know, those machines that look like toaster ovens (not autoclaves, which kill 100 percent of infective organisms using high pressure and steam). But Dr. Sutera says that popping tools into one of those isn't a great way to sterilize. "It’s a six-hour process to sterilize instruments," she says. "You have to get them at really, really high temperatures; you have to soak them in different solutions; they have to be scrubbed. So putting them in that little toaster oven in between clients for a few minutes? I don't think that that's really doing much."
Source: Rebecca Adams, Huffington Post [3/24/14]
INTERNATIONAL PODIATRISTS IN THE NEWS
Indian Podiatrist Discusses New Techniques for Treating Charcot Foot
The Global Diabetic Foot Conference (DFcon 2014) concluded earlier this week in Los Angeles. U.S. Citizen News Service (CNS) had an opportunity to interact with one of the key faculty members and experts on Indian approach to saving limbs of people who are living with diabetes. Dr. Ajith Kumar Varma is a Professor and Diabetic Lower Limb and Foot and Ankle Reconstructive Surgeon, in the Department of Endocrinology, Diabetic Lower Limb and Podiatric Surgery, at Amrita Institute of Medical Sciences and Research Centre, Kochi.
Dr. Ajith Kumar Varma
Podiatric surgeons at Amrita Institute of Medical Sciences and Research Centre, Kochi, India have devised the novel ‘Amrita Sling Technique’ of fixation and stabilization of the foot and ankle in deformed Charcot arthropathy. Over 400 such surgeries have been performed at this Institute during the last seven years with excellent results. Sometimes, the foot and ankle bones in Charcot’s disease are so extensively damaged that conventional reconstruction becomes impossible, and a below-knee amputation is the only solution. To prevent these amputations in such severely destroyed foot bones, the doctors at the Institute have devised a technique of replacing these bones with artificial prosthetic bones made of polymethyl methacrylate (PMMA). More than 200 such PMMA prosthesis surgeries of forefoot, mid-foot, and hind-foot bones have been done with excellent results and without any complications.
Source: Shobha Shukla, Citizen News Service [3/24/14]
INTERNATIONAL PODIATRISTS IN THE COMMUNITY
Aussie Podiatrist is Woodchopping Champion
If you lose a couple of toes during a woodchopping competition, having Brent Smith next to you can't hurt. The 6-foot-5 woodchop champion, who began competing at the age of nine, is also a podiatrist. Smith spreads his time between training on the family property at Holbrook, teaching at Charles Sturt University, and doing more training at home, where he has a small setup.
Brent Smith (Photo: Goulburn Murray)
On Monday afternoon, he was training hard at his home, getting ready for a tilt at the world title at Sydney's Royal Easter Show. Smith says he enjoys not only the social aspect of competition, but also learning about different timbers and types of saws and axes when travelling the world for competition.
Source: Nick Fogarty, ABC [3/25/14]
Antibiotics and Conservative Surgery for Diabetic Osteomyelitis Yield Similar Results
No prospective trials have been carried out comparing antibiotic treatment alone with primarily surgical treatment in patients with diabetes and foot osteomyelitis. The aim of the current study was to compare the outcomes of the treatment of diabetic foot osteomyelitis in patients treated exclusively with antibiotics versus patients who underwent conservative surgery, following up the patients for a period of 12 weeks after healing.
Conclusions: Antibiotic therapy and surgical treatment had similar outcomes in terms of healing rates, time to healing, and short-term complications in patients with neuropathic forefoot ulcers complicated by osteomyelitis without ischemia or necrotizing soft tissue infections.
Source: José Luis Lázaro-Martínez, Javier Aragón-S ánchez, Esther García-Morales, Diabetes Care 2014;37(3):789-795. via Medscape, Via Dr. David Secord
Obviously, many things can cause cramping, but you must rule out nerve entrapment of both the common fibular nerve and tibial nerve in the soleal sling. This can be done by assessing for a Tinel's sign and provocation.
We have had many doctors indicate that they see a 15-20% increase in the efficacy of their laser treatments when their patients diligently use a SteriShoe sanitizer. When we have asked how they quantify this, it’s a bit of a guess. With that said, we know the fungus is in the shoes.
Novartis’s Lamisil study showed that the fungus is in the carpets and showers. While that may be true, we don’t spend 8-12 hours a day in one spot on our carpet or in our shower; however, we do spend 8-12 hours a day in our shoes. Every step compresses the sock, squeezing the fungus-laden sweat between the foot and the shoe.
It’s important that any protocol for onychomycosis not forget about the shoes. Socks end up in the washing machine, but shoes do not. The shoes need to be sanitized. Telling patients to throw out their shoes has one big problem – when will they contaminate their new shoes? Lysol and other chemicals, other than not being testing in shoes, pose health risks and contain warnings about use on clothing and contact with skin. A study with the SteriShoe sanitizer was published in JAPMA in the July/Aug 2012 issue. The article cites several other articles indicating that footwear is contaminated.
Disclosure: Shoe Care Innovations, Inc. is the manufacturer of the SteriShoe sanitizer.
Having just returned from the American Academy of Dermatology's annual meeting in Denver, this is what I learned. None of the lasers currently available work to cure onychomycosis. I asked a few questions to drill down on this topic. The result is that they (the collective masters) feel we're still a few years away from having a laser or a light source that works. The feeling was that photodynamic therapy (medication + light source) would be the first to the market with good results. Two new topicals (from Anacor and Valeant) have some good data, but nothing so far is a home run.
Dr. Musser asked for advantages and disadvantages. I'll give you one big disadvantage. If you do not do plaster slipper casts, then there is really nothing that separates you from chiropractors, physical therapists, pedorthists, or the shoe store salesman who does a scan. It does not matter which scanner you use. They all make you run-of-the-mill and..... beige. Let the slings and arrows fly, especially from those of you who don't want to get your hands dirty, or those of you who have "trained" your office staff to handle the mundane stuff, or those of you who failed to master the art of casting.
I enjoyed the three-year program. Unfortunately, the plan to have more grads was questionably calculated. In California, the old CCPM had approximately 100 students per class with a podiatric hospital and fully functioning orthotic lab. Now, we have two schools in California with approximately 100 students or less in total, and no hospital or orthotic lab in either.
I cannot believe that anyone in our profession could possibly vote for the 3-year podiatry curriculum. Before I looked at the results, I thought the voting would be less than 1%. First of all, as one of my colleagues stated, there is way too much to learn for even four years. Also, for those of us who have been around for over 40 years, if you think we were looked down upon by our medical colleagues and the general public in the past, this would be a public relations disaster, not to mention a credentialing disaster for hospitals, etc.
One viable alternative would be a 6-year college/podiatry degree program like Hopkins and several medical schools have, or at least I know had in the past. This would especially be a viable alternative for schools affiliated with undergraduate schools like Temple. Also, we're the only profession that is trying to force every graduate into becoming a surgeon with a 3-year residency to even get a license in most states. This is extremely detrimental and costly to the students wishing to provide for patients needing other types of care, and for our profession in general.
I'm shocked and saddened to learn of Keith Springer's passing. My heartfelt condolences to the entire Springer family. Not only was Keith an excellent teacher, he was a genuinely nice guy, conducted himself with class, and was always easily approachable to students. I greatly enjoyed his mentorship. May he rest in peace.
Barry Mullen, DPM, Hackettstown, NJ
I wish to offer my deepest condolences to Dr. Springer's family at this time. Dr. Springer was a wonderful and well respected professor at the New York College of Podiatric Medicine. I will always remember him as a great teacher, and I am grateful to have had the opportunity to be taught by him.
May his family experience peace to bring them comfort, courage to face the days ahead, and loving memories to hold in their hearts.
Kathy Reilly Fallon, DPM, Armonk, NY
MEETING NOTICES - PART 1
RESPONSES/COMMENTS (YOU CAN'T MAKE THESE THINGS UP)
I chuckled at Dr. Kittay’s note and was reminded of the movie, The In-Laws, with Michael Douglas and Albert Brooks. Brooks plays a podiatrist who finds himself in hilarious circumstances such as those described by Dr. Kittay. Such an episode can only be humorous after the fact and everyone is okay. I enjoyed the story.
Pete Harvey, DPM, Wichita Falls TX
Wait a minute. The bride’s sister was 14 months pregnant?
Philip J. Shapiro, DPM, Ormond Beach, FL
MEETING NOTICES - PART 2
ASSOCIATE POSITION - CENTRAL FLORIDA
Associate wanted for well-established practice in central Florida. Multi Physician Practice – Multi Practice Locations Competitive Salary and Benefits. Experienced support staff. Excellent opportunity for a promising future. To apply please go to www.yourcareerinpodiatry.com
ASSOCIATE NEEDED- CONNECTICUT
Position available for a board certified or qualified individual who has an emphasis on DM foot care and is comfortable with all surgical aspects of forefoot, rearfoot and ankle surgery. Excellent opportunity for a surgeon. Competitive salary and benefits offered and a perfect community to raise a family. fax resume to email@example.com
FULL-TIME ASSOCIATE POSITION – FLORIDA PANHANDLE
Immediate position available for hard-working, motivated individual in a well-established practice. Equal mix of primary care and surgery. Excellent opportunity to get on all insurance panels. Board qualified/Certified with ABPS preferred. Competitive salary and benefit package. Please email CV and letter of interest to firstname.lastname@example.org.
ASSOCIATE POSITION - HUDSON VALLEY REGION, NY
Hudson Valley Foot Associates has a great opportunity available! We’re a high-volume, diversified, multi-office group practice utilizing state-of-the-art modalities. Great growth for a personable and motivated DPM. Please visit www.hvfa.com and forward cover letter with CV to email@example.com.
ASSOCIATE POSITION - KENTUCKY
Immediate opening for palliative/general podiatric care provider in established clinics, nursing home and assistive living settings in beautiful Southern Kentucky. Travel involved, but transportation provided along with ability to provide a wide range of clinical care including DME. Board certification not mandatory, but must be eligible for KY state license. Base salary with incredible bonus opportunity/full benefits. Join Kentucky’s largest and most respected podiatric group. Email CV and letter of interest to: firstname.lastname@example.org
PRACTICE FOR SALE - SOUTHWEST FL
Multilocation multidoctor practice in beautiful Southwest Florida. Practice has grossed over seven figures consistently and currently shows 10-15% growth in revenues with increase in new patients and patient visits. EHR is already implemented with meaningful use criteria met. Practice has been professionally evaluated by Provider Resources. Only serious inquiries to this email address. This is a great practice in Paradise and a good opportunity for the right doctor or doctors. Email to: email@example.com
ASSOCIATE POSITION - ATLANTA SUBURB
Immediate associate position available. PSR 24/36, ABPS certified/qualified for high volume surgical practice. State of the art practice with on-site accredited surgical center, physical therapy and MRI. Full hospital privileges available. Send inquiry and CV to: firstname.lastname@example.org.
FULL-TIME ASSOCIATE POSITION- SOUTHERN CALIFORNIA
Well established 65 year old practice looking for full time associate upon completion of a 36-month residency. Salary and full benefits including medical and malpractice included. Purchase opportunity available after probationary period. Full scope modern practice with 2 office locations. Great opportunity. Please email your CV to email@example.com
PODIATRISTS WANTED – NORTHERN CALIFORNIA
Podiatrists wanted for fully managed practice in skilled nursing facilities in the following areas: 1. Chico and Meadowood 2. Sacramento 3. Fresno – local and up to one hour south. Send CV and area of interest to:ZBUBBLESZ@aol.com
ASSOCIATE POSITION - SOUTHERN CALIFORNIA
Very busy, two location group practice seeking a full-time, self-motivated and hard-working podiatry associate. Competitive salary offered. Please email CV to: firstname.lastname@example.org
ASSOCIATE POSITION- NORTH CAROLINA - GREENSBORO/TRIAD AREA
Busy, state-of-the-art group practice seeking full time associate. PSR 24 or above training preferred. Excellent opportunity for a highly motivated and ethical applicant. Competitive income and benefit package. Hospital privileges available. Board certified/qualified applicant, send CV and letter of interest to email@example.com
PM News Classified Ads Reach over 15,500 DPMs and Students
Whether you have used equipment to sell or are offering an associate position, PM News classified ads are the fastest, most-effective way of reaching over 15,500 DPMs. for details, click here or write to: firstname.lastname@example.org or call (718) 897-9700 for details. For commercial or display ads contact David Kagan at (800) 284-5451
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