Learn from the Leaders http://blog.promedicacme.com Promedica International CME Thu, 02 Oct 2008 23:27:20 +0000 http://wordpress.org/?v=2.1 en Challenging Case Presentation on Hyperhidrosis Management http://blog.promedicacme.com/2008/10/02/challenging-case-presentation-on-hyperhidrosis-management/ http://blog.promedicacme.com/2008/10/02/challenging-case-presentation-on-hyperhidrosis-management/#comments Thu, 02 Oct 2008 23:18:26 +0000 Fritz J. Baumgartner, MD http://blog.promedicacme.com/2008/10/02/challenging-case-presentation-on-hyperhidrosis-management/ A 20 year old US serviceman in the Marines presents with massive palmar, plantar, and axillary hyperhidrosis impairing his ability to perform his duties and posing a danger in critical situations. How should this patient be managed? Should topical anticholinergic agents be applied to his palms, feet and underarms as an initial treatment? At what point and which anatomic location should injection of Botulinum A toxin be considered first line? What are the roles of oral anticholinergic medications, sedatatives, or psychotropic medications in management of this disorder? How labor-intensive is ionotophoresis before significant results are evident? At what point should thoracoscopic sympathectomy be considered, and should it be a last resort or considered first line treatment? What sympathectomy level gives the best results with the least side effects?

Dr. Baumgartner welcomes you to comment on your own experiences with treating this debilitating disorder.

]]> http://blog.promedicacme.com/2008/10/02/challenging-case-presentation-on-hyperhidrosis-management/feed/ Debates and Cross Fires on Controversial Topics in Beverly Hills http://blog.promedicacme.com/2008/08/26/debates-and-cross-fires-on-controversial-topics-in-beverly-hills/ http://blog.promedicacme.com/2008/08/26/debates-and-cross-fires-on-controversial-topics-in-beverly-hills/#comments Tue, 26 Aug 2008 21:01:43 +0000 Drs. Gregory P. Fontana and Raj Makkar http://blog.promedicacme.com/2008/08/26/debates-and-cross-fires-on-controversial-topics-in-beverly-hills/ Is the current evidence in support of percutaneous coronary intervention for the treatment of unprotected left main stem disease?  Current guidelines indicate coronary artery bypass grafting is the standard of care.  Should the use of drug-eluting stents in “off-label” cases be discouraged and good surgical candidates with unprotected left main coronary artery disease undergo surgical revascularization?  Is CABG really proven to perform better than PCI in this subset of patients and is CABG to be recommended in all good surgical candidates? 

The current status of Drug Eluting Stents will be debated and addressed in Cross Fires with Surgeons, Cardiologists and Interventional Cardiologists at the World Renowned “Controversies and Advances in the Treatment of Cardiovascular Disease: The Eighth in the Series” symposium to be held September 4-5, 2008 in Beverly Hills, California.

]]> http://blog.promedicacme.com/2008/08/26/debates-and-cross-fires-on-controversial-topics-in-beverly-hills/feed/ Announcing the Release of the Interventional Cardiology 2008 DVD Teaching Program! http://blog.promedicacme.com/2008/08/15/announcing-the-release-of-the-interventional-cardiology-2008-dvd-teaching-program/ http://blog.promedicacme.com/2008/08/15/announcing-the-release-of-the-interventional-cardiology-2008-dvd-teaching-program/#comments Fri, 15 Aug 2008 18:39:11 +0000 Promedica International CME http://blog.promedicacme.com/2008/08/15/announcing-the-release-of-the-interventional-cardiology-2008-dvd-teaching-program/ The highly anticipated CME accredited Interventional Cardiology 2008 DVD Teaching Program has been released and is now available for purchase. This educational series offers a comprehensive approach to percutaneous management of structural heart disease and coronary and peripheral vascular disease. The international format of the program includes esteemed faculty from five continents.  This provides a uniquely global perspective by illustrating the cutting-edge procedures taking place both within and outside of the United States. 

The live teaching sessions featured on the DVDs have been produced using a distinctive Studio Enhancement process to optimize the educational experience.  Click here to view the scientific program listing, CME accreditation and designation information and to purchase your copy today!

]]> http://blog.promedicacme.com/2008/08/15/announcing-the-release-of-the-interventional-cardiology-2008-dvd-teaching-program/feed/ DVDs of ACTS 2007 Live Surgical Teleconference for 15 CME Hours of Credit! http://blog.promedicacme.com/2008/04/21/dvds-of-acts-2007-live-surgical-teleconference-for-15-cme-hours-of-credit/ http://blog.promedicacme.com/2008/04/21/dvds-of-acts-2007-live-surgical-teleconference-for-15-cme-hours-of-credit/#comments Mon, 21 Apr 2008 23:32:50 +0000 Promedica International CME http://blog.promedicacme.com/2008/04/21/dvds-of-acts-2007-live-surgical-teleconference-for-15-cme-hours-of-credit/ We are excited to announce that a set of 8 DVDs of the ACTS 2007 symposium is now available on our website for purchase and CME credit. This DVD collection was filmed using the latest state-of-the-art HDTV technology and contains six live cases, didactic lectures from internationally known leaders in the field and video presentations showcasing advancing techniques and technology as they were presented in May.

Focus was placed on the most recent advances in the surgical treatment of Heart Valve and Coronary Artery Disease, Chronic Atrial Fibrillation and Diseases of the Aorta with emphasis on less invasive approaches, including percutaneous techniques. This DVD set is designed for cardiologists, cardiac surgeons, interventional cardiologists, internists, perfusionists and health care professionals involved in the field of coronary artery disease.

View a video clip from the DVDs below.

To purchase the set of 8 DVDs, click here.

]]> http://blog.promedicacme.com/2008/04/21/dvds-of-acts-2007-live-surgical-teleconference-for-15-cme-hours-of-credit/feed/ Important Updates on the Ross Procedure http://blog.promedicacme.com/2007/09/28/important-updates-on-the-ross-procedure/ http://blog.promedicacme.com/2007/09/28/important-updates-on-the-ross-procedure/#comments Fri, 28 Sep 2007 20:38:37 +0000 William F. Northrup III, MD http://blog.promedicacme.com/2007/09/28/important-updates-on-the-ross-procedure/ The Ross procedure has been set aside by some surgeons because of unpredictable long-term autograft function reported in some series.  We believe that there are important technical reasons for these results, which can be modified.  Professor Yacoub has identified the critical success factors for a predictable life-long lasting functional autograft, which he will share with us at our live teleconference in October.  Moreover, he has data to suggest that the Ross Procedure, if done correctly, can restore expected survival.  If so, it is now the second valve operation, along with mitral valve repair to have this capability. 

William F. Northrup III, MD

]]> http://blog.promedicacme.com/2007/09/28/important-updates-on-the-ross-procedure/feed/ The Clinical Use of Stem Cells for the Treatment of Heart Failure http://blog.promedicacme.com/2007/09/19/the-clinical-use-of-stem-cells-for-the-treatment-of-heart-failure/ http://blog.promedicacme.com/2007/09/19/the-clinical-use-of-stem-cells-for-the-treatment-of-heart-failure/#comments Wed, 19 Sep 2007 15:10:34 +0000 Federico Benetti, MD http://blog.promedicacme.com/2007/09/18/the-clinical-use-of-stem-cells-for-the-treatment-of-heart-failure/ Rosario, Argentina 

5 million patients suffer from heart failure in EEUU, 500,000 new patients every year, and the expected survival is 35% (class3/4) at 5 years .The current treatment options include medications, cardiac resynchronization therapy, destination VAD therapy and cardiac transplantation.

In March 2003 we started the first clinical trial to compare patients with an OPCAB operation alone vs. OPCAB plus autologous stem cells (CD 34+ CD45-) implanted by direct surgical application.  At 6 months, we found that the second group improved their ejection fraction more than 30% compared with the patients that received OPCAB alone. In the next series, we used direct surgical application of autologous stem cells (CD 34 + CD 45 -) not only by sternotomy but also minimally invasively through a scope.  Additionally in January 2005 we did another trial in 10 patients where we used for the first time direct surgical implantation of embryofetal stem cells between 5 to 12 weeks of gestation.

The operative mortality for the 29 patients that received autologous stem cells from different approaches was 1 patient. In the embryofetal group, the operative mortality was zero.

In the long term at 4 years, the mortality for the autologous group was 4 patients: 3 from cardiac causes and 1 from pulmonary infection. The initial average EF was 30% and, at 4 years, 38% for the ischemic patients and 27% and 36% for the patients with idiopathic cardiomyopathy. The survival at 4 years was 90% for the total series.  

In the group of patients who received embryofetal stem cells, the initial mortality was 0 % and in the long term 4 patients died: 3 for cardiac causes and 1 from diabetes complications The average initial EF was 26% and at 2 years and 7 months increased to 37% The survival is 60%.

In conclusion, direct surgical stem cell implantation is an alternative for heart failure patients.  Both types of cells work, apparently for different mechanisms:  the autologous cells by a paracrine effect and angiogenesis and the embryofetals by making new cells (in 4 of the embryofetal cell patients we achieved total remodeling of the ventricle in 3 months).

More studies are needed to confirm these initials observations and learn more about the type of cell in each situation, but without doubt we can say that both improve myocardial function and cellular activity. Surgical epicardical injection in the beating heart also improves the clinical symptoms of angina and heart failure, is safe and non-arrhythmogenic with sustained improvements of the EF in the long term. In conclusion, we think that direct surgical injection of stem cells is an alternative for many patients with heart failure.

]]> http://blog.promedicacme.com/2007/09/19/the-clinical-use-of-stem-cells-for-the-treatment-of-heart-failure/feed/ Learn From the Leaders http://blog.promedicacme.com/2007/09/19/learn-from-the-leaders/ http://blog.promedicacme.com/2007/09/19/learn-from-the-leaders/#comments Wed, 19 Sep 2007 15:00:17 +0000 Promedica International CME http://blog.promedicacme.com/2007/09/18/learn-from-the-leaders/ Over the years, we at Promedica International CME have been privileged to work with the world’s leading physicians as Program Directors and Faculty to produce major educational activities to help improve the quality of healthcare you can offer your patients. Now we are delighted to add to your educational opportunities through this unique web blog entitled “Learn from the Leaders”.  We hope you will appreciate the following opportunities:

  • Learn about emerging techniques and technologies at an early stage, directly from the source.                                 
  • Share comments and ask questions in an informal environment
  • Discover new ideas years before they can be published in the journals
  • A forum for sharing tips and subtle nuances of techniques

 We are proud to launch “Learn from the Leaders” with Dr. Federico Benetti sharing his clinical experience to date using stem cells for the treatment of heart failure.

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