Adipose derived MSC's hold great promise for regenerative medicine. The use of culture expanded MSC's to treat critical limb ischemia and help patients avoid amputation will be discussed. Before and after photos of treated limbs and vascular studies will be reviewed.

The presentation will give an introduction into the procedure, how it has evolved into a clinical setting over four years, and where its medical benefits and limitations lie. It will conclude with what the outcome of such clinical research has been.

4 Year follow-up reporting on successful retreatment of refractory angina by the use of minimally invasive delivery of stem cells.

The use of bone marrow aspirate concentrate to treat type II and type I diabetes will be discussed. Serum glucose and H1AC levels before and after treatment will be highlighted.

The results of a 5-year study of the use of BMAC and two different preparations of mesenchymal stem cells to treat lumbar disc bulges will be presented. Before and after high filed MRI's will be reviewed as well as patient reported outcomes will be reviewed.

We conducted a study to investigate the feasibility, safety, and clinical outcome of patients with Ischemic Cardiomyopathy treated with Autologous Angiogenic and Cardio- Regenerative Progenitor cells (ACRPC's) in a prospective fashion. Both in world scientific literature as well as our experience in greater than 300 patients there is evidence of sustained improvement in the ejection fractions of patients treated with ARPC's. Animal experiments, not only show improvement in cardiac function, but also engraftment and differentiation of ACRPC's into cardiomyocytes as well as neo-vascularization in infracted myocardium. In our human clinical experience the process has shown to be safe as well as effective. This study suggests that ACRPC's can improve the ejection fraction in patients with severely reduced cardiac function with benefits sustained to six months. The goal of this presentation is to facilitate understanding of the different types of stem cells, Identifying the therapeutic benefits of stem cells, and applying current treatments to patient populations.

Emotional stress, pain, and insomnia are known to contribute to the detrimental effects of aging on the body and increase the risk for medical morbidity (e.g., metabolic syndrome, obesity) and mortality. This workshop will cover the theoretical aspects, empirical evidence, and practical applications for three psychosocial techniques for treating these conditions: hypnosis for pain management, cognitive behavioral coaching for stress management and insomnia and mindfulness meditation for emotional stress. The workshop will be a unique blend of didactic information, clinical case discussions, and experiential components so that participants will be able to 1) complete assessments for emotional stress, pain, and insomnia, and 2) understand the application of these alternative medicine techniques (hypnosis, cognitive-behavioral coaching, and meditation) for their patients. By learning techniques that mitigate against the detrimental effects of stress on the brain, participants will be able to help their patients better benefit from medical interventions.

Overview of the definition and assessment of acute and chronic pain and underlying psychoneuroimmunological mechanisms. Including a tutorial on theory and application of hypnotic techniques for managing pain. A combination of didactic and experiential audience components will be utilized. 

 

Objectives: 1) Neuropsychological assessment strategies will be discussed for emotional stress and insomnia; 2) Stress management techniques combining cognitive behavioral theory with practical applications including combining with medical interventions for stress and insomnia will be discussed; and 3) Empirical evidence for efficacy and neurobiological mechanisms of therapeutic action will re reviewed. Finally, the psychological theory and neurobiological underpinnings associated with the “placebo effect” and how physicians can optimize this effect in motivating client adherence in their medical clinics will also be covered.

In this day and age, new delivery systems are being offered due to the rapid acceleration of new active ingredients that have specific targets on the skin. Per Jon Packer, president of Centerchem..."If what you put on the skin doesn't get to the intended locations, it certainly won't have the desired activity". The right delivery of an ingredient can make even hard-to-use ingredients easier to formulate. For instance, when delivering peptides, liposomal systems are sometimes important since  not all peptides are stable. We are finding that liposomal encapsulation can be a solution to this issue..yet if we want a cosmetic active to support collagen synthesis, we need to bring it to the dermis in order for it to perform.  Learn some of the new delivery systems, and  how the importance of them will provide you the TRUE efficacy of active ingredients to reach the results your trying to obtain.

This lecture discuss how younger and older women can surgically and non surgically beautify their torso and will represent the dissemination of the quintessential aspects of our text, and also how it is applicable to a clinician’s optimal medical practice. There will be a discussion of super cross-training regimens which involves weight training, the running of sprints, ballet exercises, free dancing, yoga stretches, and Taekwondo conditioning protocols. In addition, there will be a review how the over-activation of CRH engenders a compromised aesthetic appearance.  Moreover, we will also discuss the importance of optimal hormonal modulation as well as heuristic dietary regimens. Furthermore, the Zen Beauty approach to female torso enhancement likewise educates a woman how to ameliorate her body’s inner energy dynamics. We will be presenting what are the latest innovations in surgical body sculpturing such as water-assisted liposuction and how this technology can be blended with laser protocols to induce propitious skin tightening. Many cosmetic practitioners are now successfully transferring undesirable subcutaneous adiposity into a woman’s breasts. We will be demonstrating that the aesthetic field of female torso beautification represents a synergistic integration of many facets of optimal medicine.

This lecture discus the application of pigment into the skin in the form of Permanent Makeup, how it differs from Tattoo and the latest rules and regulations from the FDA. Implications for use and contra indications, along with up-to-date information on equipment and pigments.

Low power radio frequency is the process of using electrical resistivity to selectively thermocoagulate small, cosmetically unacceptable blood vessels using microbursts of high-frequency electrical energy delivered into the vessel via a hair-thin probe. The energy is converted to heat instantly, coagulating the blood and collapsing the vessel wall, yet leaving the outer layers of the skin unaffected. Some of the benefits of this unique new technology include instant results, minimal discomfort, no need for topical anesthetic and works for any skin type without risk of burns.

Medical practitioners are now utilizing a plethora of fascinating protocols to aesthetically improve the facial appearance of the aging phenotype. Many plastic surgeons and dermatologists are employing non-invasive procedures which increase facial volume and mitigate the deleterious effects of facial aging. Thus, they are becoming less inclined to perform highly invasive surgical protocols. Currently, clinicians are injecting adipose cells with high concentrations of stem cells into the face, and this restores youthful volume to the facial structure. Recently, we have implanted autologous adipose stem cells with the body’s own platelet derived growth factors throughout the facial dermis. Moreover, we have demonstrated that this innovative cosmetic strategy induces increased facial volume as well as exquisite epidermal/dermal aesthetic rejuvenation. Other clinicians have likewise shown that a patient’s own autologous growth factor attenuate facial deep furrows and beautifies the epidermal complex. This protocol may eventually replace the need for exogenous fillers. Furthermore, this lecture will also review how topical growth factors when combined with non-invasive laser strategies can rejuvenate the aging face and torso.

 

We will also be reporting on our most recent aesthetic stem cell research which involves the use of adipose cells to re-create the youthful facial scaffold as well as an additional sequence of dermal and subdermal injections throughout the facial surface with adipose stem cells and platelet-derived growth factors for superb textural epidermal remodeling.  

Overview of the available facial fillers on the US market (including Restylane, Juvederm, and Radiesse). Clinical applications of each filler material will be discussed. Additionally, clinical applications of Botox/Dysport will be discussed.

This lecture discuss the use of bimatoprost as a means of enhancing hair growth. What are the concerns and side effects? Are the side effects permanent or reverseable? Can we use non-prescription solutions to create the same effect? If so, what are the alternatives, how effective are they and what could be any possible contra indication or side effects?

Overview of the changes of the aging face (including facial bones, soft tissue changes, and skin changes). Discuss factors that may accelerate the aging process such as sun exposure, hormonal changes, thinning of the skin, and cigarette smoking. Discussion of non-surgical treatment which includes anti-aging skincare, skin resurfacing treatment, facial fillers and injectables, as well as dental procedures. 

(includes complimentary breakfast)
Non-CME symposium sponsored by MedQuest Pharmacy 

The impact of stress on health cannot be understated. Physicians need to understand the impact and physiology of stress vs. the normal response to stress and how stress effects the cardiovascular system and insulin resistance function. Clinicians will be instructed as to what evidence based tests are appropriate to measure the physiologic response to stress, TSH and how to identify and treat adrenal dysfunction and thyroid dysfunction. 

Greater than one-third of adult Americans have abnormal liver enzymes and most of these elevations are believed to be due to nonalcoholic fatty liver disease or NAFLD. NAFLD occurs most commonly in late middle age, but an increasing number of children and adolescents are affected by NAFLD. NAFLD is typically regarded to be the hepatic manifestation of obesity and the metabolic syndrome, but recent data implicate environmental toxins in NAFLD. NAFLD may progress to cirrhosis and liver cancer, but it also appears to be a risk or exacerbating factor for cardiovascular disease. The pathogenesis of NAFLD is complex but includes oxidative stress, mitochondrial dysfunction, pro-inflammatory cytokines, insulin resistance and intestinal barrier dysfunction. Weight loss is the mainstay of therapy, but recent studies indicate a role for the antioxidant, Vitamin E.

Turmeric is one of the hottest supplements on the market today. The clinical applications from decreasing inflammation to decreasing the incidence of Alzheimer disease, and the role that turmeric plays in cancer will be discussed during the presentation. The issue of instability and the rapid oxidation of this raw material along with the real science and current clinical trials will be reviewed. 

Open to all attendees and includes a complimentary lunch

Featuring John E. Adams, Cenegenics President and Chief Executive Officer

It is commonly accepted fact that hormones can cause cancer, thanks to the WHI trial. Any mention of hormones suddenly brings fear of cancer, no matter what the hormone. Most of the world’s literature supports harmful effects of medroxyprogesterone (MPA). Nevertheless, a plethora of data and studies demonstrate that many hormones protect against the cancers we so often fear. This review will put to rest the commonly held notion that all hormones cause cancer as some definitely do and many absolutely do not. The purpose of this review is to review the medical literature in regards to which hormones cause cancer and which are protective against cancer based on our medical literature. This presentation will provide literature for both physicians and patients so that they come to understand optimal replacement of hormones decreases overall morbidity and mortality from cardiovascular disease, musculoskeletal disease, and cancer. Finally we will review the pathophysiology of cancer protection via hormones and their effect on up regulation of genes, decrease in visceral fat, and production of protective proteins.

Antioxidant, antiangiogenesis and immune enhancement treatments may facilitate current classical treatments in fighting cancer. There are an increasing number of scientific publications that  show nutritional supplements play important roles in counteracting the formation and propagation of cancer. These supplements include the following: Acetyl L-Carnitine (ALC), Alpha Lipoic Acid (ALA), Coenzyme Q10 (CoQ10), Curcumin with Peperine, Genistein, Lentinan, N-AcetylCysteine (NAC), Resveratrol, selenium, Vitamin B Complex, Vitamin C, Vitamin E  and zinc.   These ingredients have been demonstrated, either individually or collectively, to have antioxidant, anti-angiogenesis, and immune stimulation properties. Furthermore, the scientific literature supports direct cancer cell cytotoxicity for Curcumin, Geinstein and NAC. The Formulation component activities are supported by over 13,000 references in the scientific literature (PubMed.com) and over 1,200 clinical trials (clinicaltrials.gov). From the literature there is evidence that some of the antiangiogenesis components affect the majority if not all pathways of angiogenesis when used in combination. Furthermore, Curcumin, Genistein and NAC actually stimulate the in vivo production of natural antiangiogenic compounds which include Angiostatin, Endostatin and Thrombospotin 1. All of the above components play a role in serving as either water or lipid soluble (able to cross the blood-brain barrier) antioxidants. Curcumin, Genistein, Resveratrol, Lentinen, NAC, zinc, selenium and the B and C vitamins all stimulate the immune system. Except for ALC and CoQ10, the other components show anti-inflammatory activity. ALC, Resveratrol along with the B and C vitamins are helpful in treating fatigue.

 

The components that help protect the brain and promote nerve regeneration include ALA, CoQ10, Resveratrol, NAC, selenium, zinc and the B and C vitamins. Limited clinical studies with the supplements have resulted in positive outcomes in late stage disease patients. In conclusion, effective prevention and treatment for diseases such as cancer, heart disease and immune deficiency will require multiple compounds. The safety and efficacy of these components on an individual component basis are the targets for a number of clinical trials. However, treating them as nutritional supplements may allow a multicomponent approach for the prevention and complementary treatment of cancer. 

In the age-management approach to medicine one of the biggest hurdles is motivating the patient to change certain behaviors. As a society we have become spectators in our health as a opposed to active participants. We must motivate our patients through education to take an active role in their health, exercise, diet and cessation of certain abusive behaviors. Statistically less than 10% will make changes that will benefit them and decrease their risk of life threatening diseases, and improve the quality of their lives. We must use all available tools to accomplish this task education, personal challenges and even simple encouragement.

Functional medicine, focusing on biochemical individuality, provides physicians with an understanding of the underlying causes of patient complaints and also a view of factors that change before diseases manifest. Participants will learn how cutting-edge diagnostic tools provide the information for exploring biochemical individuality of patients within the construct of nutritional biochemisty, functional medicine, and the gene environment. This presentation is designed to instruct physicians and healthcare professionals on methods for integrating functional medicine to optimize the health and well-being of patients, including case studies and practical methods for incorporating functional medicine into their clinical practice.

 

Using pharmacokinetic parameters we will discuss the dosing and variations between dosage forms of bio-identical hormone replacement therapies. Topical transdermal creams and gels vs. oral preparations, vaginal preparations vs. suppositories are all drug delivery considerations when prescribing bHRT.

 

 

(includes complimentary breakfast)
Non-CME symposium sponsored by T.A. Sciences 

Optimizing our patients' health requires a comprehensive review of their history, a physical exam, and appropriate testing. There are many available testing options and the physician should be able to reliably measure and adjust a patient's medical management accordingly. However, there are known limitations to testing hormones giving great variability and ultimately, as physicians, we are treating the patient and not the laboratory values. 

A critical evaluation of laboratory testing, both by blood and saliva, shall be discussed so that the clinician can understand subtle changes in these values that could represent less than optimal cellular function.  In addition to the general chemistries and CBC, other specific serum tests will be critically examined, such as, homocysteine, fibrinogen, ferritin, Plac-2, and hormone levels. For example, homocysteine discussions will not only include its place in cardiovascular and cerebrovascular disease but shall be expanded to demonstrate its elevation or low value interpretations that could represent difficulties with DNA transcription. A review of cellular physiology will ensue including the Kreb’s Cycle because of its extreme importance for our biochemistry. Saliva testing for both sex hormones and adrenal function will also be discussed. The attendee will obtain a good handle as to the optimal values expected for sex, age and patient history as opposed to the normal values reported out by the laboratories. Direction for this lecture will be to help the practitioner to be able to utilize this information for immediate access and usage in his/her daily practice towards the development of new sets of treatment protocols.  

Sexual Dysfunction is a pervasive problem which is infrequently addressed in a traditional medical setting. Additionally, pharmaceutical options for treatment of this condition are scant, particularly for women. In this discussion, we will review the primary etiologies of male and female sexual dysfunction. Clinical case studies will be presented to provide attendees with clinically relevant information which they can apply in their clinical practices. In addition to discussing basic hormone replacement as one treatment option for sexual dysfunction, we will also review the adjuvant compounded treatment options.

Growth hormone (GH) is an anabolic hormone released from the anterior pituitary that regulates somatic growth.  Indirectly, and clinically most significant, GH stimulates the production of insulin-like growth factor-I (IGF) in the liver (endocrine action) and in peripheral tissue states of growth hormone (GH) and testosterone deficiency have been detected among a proportion of HF patients, which usually is not addressed.  Patients with idiopathic dilated cardiomyopathy (DCM) who present with HF have lower levels of circulating GH and IGF compared to healthy controls. Similar low baseline levels of GH and IGF were found in patients with moderate HF caused by myocardial ischemia. Of interest, others unveiled contradictory results, elevated levels of GH in patients with HF.  Because the elevated levels of GH were not all immunologically functional, low levels of IGF existed in these patients lending to the term ‘growth hormone resistance’. This phenomenon occurs primarily in HF patients with coexistent cardiac cachexia. Preliminary data on GH therapy in patients with heart failure for symptom improvement is promising, however, further large randomized control trials are warranted before definitive conclusions can be drawn.

Lecture provides insight into the signs and symptoms of growth hormone deficiency we see in our patient population. In addition, the lecture will cover the recent changes in the prescribing information that the pharmaceutical industry has made which now require the use of provocative testing to accurately diagnose growth hormone deficiency. An overview of the approach I use in my practice for diagnosing and treating growth hormone deficiency will also be discussed.   

From the human genoma project conclusion, a post-genomic era has started, which represents an ideal match with tailored nutraceuticals, thus leading to a nutrigenomics evolution. Nutrigenomics mainly aims at studying genetic and epigenetic interactions with a nutrient as to lead to a phenotype change and therefore to the cell metabolism, differentiation or apoptosis. Such assessments has to be in line with consistent markers identification, both directly connected (functional factors) to the process to be modified as well as indirectly associated (indicators). In this context, it is of paramount importance aiming the integration into medical practice of new clusters of genomic test and possibly microbiome tests too aimed to predict risk assessment and better management. This would play a definite role in general good health conditions as well as in the potential reduction of disease risk occurrence within a synergistic-integrated approach in established therapeutic regimens.

The rise in hormonal-related cancers is a concern to both practitioners and patients. We all know it is better to "prevent" a cancer than try to treat a cancer but the tools to assess our patients for their "risk" for an estrogen-related cancers has eluded us until recently.  We are now able to assess for and measure the amount of exposure to "estrogen mimicker" molecules within the body, evaluate the way the body metabolizes estrogen into the various categories of metabolites (whether they would be protect or harmful.....much the same way we evaluate the fractionation of a lipid profile).  We are also able to identify genetic polymorphisms (in addition to BRCA 1 and 2) in terms of assessing the risk associated with problems with detoxification and elimination of xenoestrogens and estrogen metabolites. The accumulation of these "carcinogenic metabolites" increase the risk of cancers but research has shown that in the world of "nutri-genomics", various nutrients can have an extremely positive effect on modulation of  stimulation of estrogen receptors IF WE KNOW WHAT THE PROBLEM IS. The purpose of this lecture is to review the physiology of estrogen metabolism, the availability of genetic testing associated with estrogen metabolism and detoxificiation, and the nutrients that have been shown to produce positive effects in terms of lowering the "total estrogenic burden" in the body and thereby reducing the risk of hormonal-related cancers. 

For more than ten years, with the help of over 40 correspondents throughout the world, The Los Angeles Gerontology Research Group (GRG) has maintained a list of the World's Oldest Living People or Supercentenarians (persons 110 or older) on its Internet website (www.grg.org). We have come to be regarded by the international media (AP, UPI, and Reuters) as the world authority on this list due to our rigorous criteria for validating claims. In particular, we require three independent forms of documentation (Birth Certificates, Marriage Certificates, and PhotoID's) before adding someone  to our tables. Although the number of persons on the list goes up and down several times a week, we currently cite 73 Supercentenarians (71 Females: 2 Males) on our list (called Table E). The Supercentenarian ResearchFoundation (SRF), which we founded three years ago with the aim of sequencing the DNA Supercentenarians, has performed nine autopsies to uncover why these rare individuals die when they do, and how they escape from conventional diseases written on Death Certificates (Heart Disease, Cancer, Stroke, Diabetes, and Alzheimer's Disease). The common disease process for most of them is called Senile TTR Amyloidosis.  Two of them died of pneumonia. We have now begun the process of tissue sampling of families of Supercentenarians throughout the US and will begin sampling European Supercentarians in 2011.

 

  

(additional registration required – non CME)

 

This one day certification in the essential knowledge in the collection of stem cells is taught by pre-eminent experts in the field of cell-based medicine. Ranging from a general overview of the clinical uses of stem cells to best practices in the collection of stem cells, this training session is intended for licensed physicians who are interested in bringing cell-based medicine into their clinical practice. This course provides a critical introduction to the therapeutic options of stem cells and essential knowledge on the proper techniques for their effective collection.