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February 16, 2022 ACFAS.org | FootHealthFacts.org | JFAS | FASTRAC | Contact Us

News From ACFAS


Last Call for Austin
Registration is in the final days for ACFAS 2022 in Austin February 24-27. Don’t miss the chance to celebrate 80 years of advancing the profession together in person by registering at acfas.org/Austin before February 22. After February 22, registration will move to on-site registration only.

Remember if you register on site, you will still need to abide by ACFAS’ health and safety protocols and show a proof of vaccination OR a negative COVID test.

We hope to see everyone in Austin!
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Countdown to ACFAS 2022
We’re looking forward to gathering in person in Austin for the 2022 Annual Scientific Conference! Here are some things to remember to make sure you are ready to roll by the time you arrive.
  • Download the ACFAS 2022 mobile meeting app.
  • Check the weather before you pack your bags for Austin.
  • Check your airline/airport COVID-19 safety protocols and be sure to pack extra face coverings.
  • Proof of vaccination or negative COVID-19 test is required for ACFAS 2022. To make registration go as smooth as possible, please follow the instructions ACFAS emailed to you for you to upload your proof of vaccination or negative test before you arrive.
  • Watch your email inbox for badge information. You will print your badge onsite in Austin at Registration.
  • Stop by the Exhibit Hall to meet vendors, network with your colleagues over lunch, and check out the poster display.
  • Stay connected with us throughout the meeting by following #ACFAS2022 on social media.
  • Reconnect with colleagues and friends at the Premier Connection Opening Event.
  • Always wear your badge for food, beverage service and security. This includes during all sessions, in the Exhibit Hall and other events.
  • Share your feedback with us after each session you attend by evaluating each through the 2022 mobile app.
  • Enjoy Texas Charm and all Austin has to offer!
Visit acfas.org/Austin for more information about this year’s meeting.
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Download the ACFAS 2022 App
Access everything ACFAS 2022 has to offer before landing in Austin with the 2022 mobile app. Download the app and you’ll find:
  • your pre-selected sessions,
  • the full conference schedule,
  • a listing of manuscripts,
  • the ability to evaluate session,
  • exhibitor directory,
  • important meeting alerts & announcements,
  • convention center maps,
  • live social media feeds,
  • and more!
Download the app by visiting core-apps.com/dl/acfas2022 or by searching for ACFAS in your phone's app store. Instructions and login information will be emailed to you prior to the conference. You can also find your login information on the third panel of your conference badge.
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ACFAS Regions Support Local Student Scholars
Congratulations to the 2022 ACFAS Region Scholars! Each Student Scholar earned a scholarship from his or her respective ACFAS Region in recognition of their strength as a podiatric medical student, future promise as a foot and ankle surgeon, and appreciation for their leadership of their local ACFAS Student Club on their school’s campus. Funds are used to support their travel to the ACFAS Annual Scientific Conference on an annual basis. If you see them in Austin next week, please be sure to congratulate them:

Big West Region: Dylan Mariano, AZPod ‘24

Great Lakes Region: Alexis Peters, Kent State '24

Midwest Region: Megan Palmer, DMU '24 and Taha Mahmood, Scholl '25

Northeast Region: Paul Jicman, NYCPM '23

Pacific Region: Youssef Moustafa, CSPM '24 and Donya Rabadi, WesternU '25

Southeast Region: Sheena Cherukara, Barry '24

Tri-State Region: Jacklyn Zvonar, Temple '24
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Foot and Ankle Surgery


Analysis of Return to Play After Modified Broström Lateral Ankle Ligament Reconstruction
Research was held to ascertain the rate of return to preinjury activity level among physically active patients following the modified Broström procedure (MBP) for recurrent lateral ankle instability. Subjects had undergone a primary MBP by one surgeon over six years and had a minimum 24 months of follow-up. Of the 59 patients who satisfied inclusion criteria, 41 (69 percent, 20 men and 21 women) participated in a phone interview. Results indicated that 22 (54 percent) resumed their prior level of activity and their mean age was 27.2 years, versus 25.1 years among nonreturners. Most patients (88 percent) were satisfied with surgery and the overall outcome, while seven of the 19 nonreturners (37 percent) observed ankle-related reasons for not returning and 12 (63 percent) cited non–ankle-related reasons. The mean preinjury and postoperative Tegner score for returners was 6.8, and seven of 14 high-level athletes with preinjury Tegner scores = 8 returned to their preinjury activity level. For high-level athletes who did not resume previous activity levels, the mean postoperative Tegner score was 6.6, and only one (7 percent) listed an ankle-related reason for not returning.

From the article of the same title
Orthopaedic Journal of Sports Medicine (02/02/22) May, Nolan R.; Driscoll, Matthew; Nguyen, Shawn; et al.
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Functional Outcomes and Complications of Tibial Lengthening Using Unilateral External Fixation and Then Plating. A Prospective Case Series
A study evaluated the functional outcomes and complications of tibial lengthening via unilateral external fixation followed by plating. The 11 enrollees were people of short stature or leg length discrepancy of more than 3 centimeters, whose average age at time of surgery was 25.89 years. External fixators in this study were Muller's frame or Nhan's frame. Included were 18 tibias that were lengthened and then plated. Average tibial lengthening was 6.89 ± 1.25 centimeters (21.87 percent ± 6.59 percent). Functional results were excellent in seven patients and good in four patients, while pin-track infection occurred in three tibias. One case of superficial infection occurred, while 12 legs (66.7 percent) developed ankle equinus after removing the external fixator. Four legs with severe equinus deformity received treatment with percutaneous tendo-Achilles lengthening while valgus deviation occurred in eight tibias, peroneal nerve neuropraxia occurred in two legs during distraction and distal migration of the fibula head occurred in four legs.

From the article of the same title
Annals of Medicine and Surgery (02/01/22) Vol. 74 Nguyen, Luong Van; Le, Doan Van
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Treating Hallux Valgus Associated Metatarsus Adductus by Minimally Invasive Surgery: A Simple Solution for a Difficult Problem
A new study aimed to assess a minimally invasive surgical procedure that addresses hallux valgus accompanied by metatarsus adductus. The results of 20 patients (21 feet) that underwent a newly developed percutaneous osteotomy procedure of the lesser metatarsal bones were retrospectively analyzed. At a one-year follow-up the mean hallux valgus angle, inter-metatarsal angle and the metatarsal angle were reduced by 31.62, 3.86 and 14.69, respectively. The mean American Orthopaedic Foot and Ankle Society for 15 feet available improved by a mean of 44.53, while patient satisfaction rates were high. Patients endured mild to moderate midfoot pain during the first few weeks post-surgery, which abated when union occurred. No cases of lesser metatarsal nonunion have been observed.

From the article of the same title
Journal of Foot & Ankle Surgery (02/01/22) Alon, Burg; Rutenberg, Tal Frenkel; Meir, Nyska; et al.
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Practice Management


Four Tips to Curbing Rising Costs and Staffing Shortfalls
Medical networks and smaller practices must contend with spiraling inflation costs and staffing shortages due to waves of COVID cases. There are approaches can help ameliorate the situation and ease workloads. Deploying virtual medical assistants to assume more of the burdensome ancillary, non-clinical and personal tasks can free up clinical staff to focus on more vital responsibilities. Also helpful is the removal of electronic medical record charting backlogs, which can improve workflow and boost revenue. Remote medical scribes can record accurate notes in real time so charts can be finished quickly and rigorously. A third suggestion is to use quality coding to increase reimbursements, which can play a role in optimizing the revenue cycle. Adopting telemedicine as a permanent feature, especially in rural areas, is the fourth and final tip.

From the article of the same title
Medical Economics (02/07/22) Ciesla, Terry
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How to Identify a Malicious Email
Medical practices should be aware of the forms malicious emails take and follow best practices recommended by the US Cybersecurity and Infrastructure Security Agency (CISA). Inconsistencies in spelling, email addresses and domain names can signal bad intentions, as can unsolicited links or attachments. Poorly written emails are automatically suspect, while generic greetings like "valued customer" and vague signatures can flag malicious emails. Emails instilling a sense of pressure or urgency are automatically a warning sign, and legitimate organizations will also not ask for sensitive information. CISA-advised practices include checking previous communications or reaching out to companies directly when uncertain of an email's legitimacy and avoiding using contact information connected to the request. Practices also should never provide internal information about their organization unless certain that an individual has the proper authority to access it, and they should not share personal or financial data via email or respond to requests for this information. Practices are recommended to install and maintain anti-virus software, firewalls and filters to reduce malicious emails, as well as employ their email and Web browser's anti-phishing features or contract with a third party for greater security. Finally, practices should enforce multi-factor authentication.

From the article of the same title
Physicians Practice (02/04/22) Greevy, Hoala
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Health Policy and Reimbursement


Biden Administration Moves to Rev Up Support for Nominee Califf to Head FDA
The Biden administration is stepping up efforts to put its candidate of choice, Robert M. Califf, at the helm of the US Food and Drug Administration (FDA), even as opposition to his nomination mounts. The cardiologist garnered GOP support when he was installed as FDA director in 2016 under then-President Obama. Califf was considered a shoo-in for the position under Biden, but Republicans and even some Democrats are speaking up against the candidate, particularly his stance on medical abortions and his past ties to the pharmaceutical industry, which some Democrats find uncomfortably cozy, as well as FDA's perceived weak regulation of opioids.

From the article of the same title
Washington Post (02/05/22) Roubein, Rachel; McGinley, Laurie
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Program to Cut Student Debt Sticks Some With Even More
Healthcare workers in the National Health Service Corps. work in places where medical providers are in short supply in return for aid repaying their student loans, but pandemic-related job disruptions have put a growing number of workers in violation of their contracts and exposed them to heavy fines. This threatens to push them even deeper into debt. Participants who lose their jobs and cannot find others that qualify owe the government $7,500 for every month left in their contracts, plus interest, currently in excess of 9 percent. Complicating the situation is the fact that clinics and positions that are eligible under one program may not qualify under another. Penalties are written into the law, leaving Congress with the authority to rewrite them. The penalties are clearly indicated in the contracts and specified in guidelines to the programs, and the cohort of participants who suspended their contracts rose to 11 percent in fiscal 2020 from 7.5 percent in fiscal 2019.

From the article of the same title
Wall Street Journal (02/09/22) Smith, Rebecca; Ballhaus, Rebecca
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States Move to Protect Hospital Patients from Heavy Medical Debt
At least 10 states pushed through laws last year to restrict hospital billing practices and offer patients more assistance in avoiding massive medical debts. Some of the measures mandate that facilities provide financial aid to low-income patients, according to a summary published in the Journal of the American Medical Association, while others target aggressive debt-collection behavior. Medical bills easily account for the greatest share of debt in collections, according to a separate study the journal reported last summer. Census Bureau estimates based on 2017 data, meanwhile, suggest nearly one-fifth of US households have medical debt. While federal laws, including the Affordable Care Act and the new No Surprises Act offer some relief, consumer advocates and some state legislators agree that additional steps are needed to close gaps in these protections.

From the article of the same title
Wall Street Journal (02/07/22) Mathews, Anna Wilde
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Medicine, Drugs and Devices


Amazon rolls out its telehealth service nationwide
Amazon announced that it is unveiling its telehealth service, Amazon Care, nationwide. The program features virtual-care visits, free telehealth consultations and fee-based in-home visits from nurses for testing and vaccinations. Since its initial launch in the Seattle area in 2019, the service has evolved into more of a primary care service. Amazon also intends to introduce its in-person care in 20 cities later this year, including San Francisco, Miami, New York City and Chicago. The in-person services are currently available in eight cities. The company expects that Amazon Care's mix of virtual and in-person care will be able to draw employers from other providers. To this end, the service will need to ensure health insurance-network coverage. Health insurance companies already work with existing providers like Dr. on Demand and Teladoc to provide telehealth services, but they are also offering their own virtual primary care plans. For instance, Anthem just broadened its virtual primary care services in 11 states.

From the article of the same title
CNBC (02/08/22) Palmer, Annie; Coombs, Bertha
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Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients with Type Two Diabetes
A multinational, Phase III study explored whether adding a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GLP-1) receptor agonist to insulin therapy would improve outcomes in people with uncontrolled type two diabetes. The sample population included 475 adults whose blood glucose levels were persistently high despite treatment with daily insulin glargine, with or without metformin. Following randomization, 116 participants received 5 mg of subcutaneous tirzepatide once per week, 119 received 10 mg weekly, 120 received a 15-mg dose, and 120 received a placebo. The primary endpoint — change in blood glucose level at 40 weeks compared with baseline levels — was measured at -2.11, -2.40, -2.34 and -0.86, respectively, for the four treatment cohorts. In addition to significantly improved glycemic control vs. placebo, tirzepatide was associated with a greater reduction in body weight. Patients were down a mean 5.4 kg, 7.5 kg and 8.8 kg, respectively, with the three tirzepatide doses compared with a 1.6-kg drop in the control group. Overall, the study authors added, adverse events documented with tirzepatide use—primarily gastrointestinal problems that resolved over time—were in line with the known safety profile of tirzepatide and GLP-1 receptor agonists.

From the article of the same title
Journal of the American Medical Association (02/08/22) Vol. 327, No. 6, P. 534 Dahl, Dominik; Onishi, Yukiko; Norwood, Paul; et al.
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FDA Raises Concerns About China-Developed Drugs
Federal regulators are likely to pause approval for several new medicines developed in China over concerns about the quality of studies conducted primarily in that country and whether the results can apply to patients in the United States. The move could derail the plans of drugmakers such as Eli Lilly and Novartis, which had expected to generate billions of dollars in sales from bringing the Chinese medicines to the United States. At issue is the quality of the studies assessing China-developed drugs, according to US Food and Drug Administration (FDA) officials. Richard Pazdur, director of FDA's cancer-drugs division, said FDA has more flexibility to accept China-only clinical data for diseases that are less common in the United States than in Asia, such as. He also said he was worried that the Chinese studies used obsolete study designs that do not directly demonstrate whether the China-developed drug works as well as similar drugs approved in the United States in recent years.

From the article of the same title
Wall Street Journal (02/09/22) Loftus, Peter
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, AACFAS


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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

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