November 30th - December 2nd, 2018
Hilton Salt Lake City Center
255 S West Temple
Salt Lake City, UT 84101
For years Part III attendees have lamented, “So is that all there is? Can’t there be more? Although there are new articles, research, updates, literature critiques, and sarcasm (of course), the majority of this course will be problem solving, case management, mistakes to avoid, and tricks of the trade. The audience will consist of those with significant experience, questions, and issues which makes for an excellent experience for both me and participants, as we all learn from patients and ourselves. Extensive literature review in Parts I, II, & III have not allowed me to present all the interesting and complicated cases and situations that I have encountered in the last 15 years of practice. So bring your tough cases, comments, thoughts, and ideas and have another fun weekend with your talented peers. This will be a collection of the most talented and experienced physicians in this industry. Enjoy.
Part IV: Complexities of Hormone Replacement Therapy: An Evidence Based Protocol Review - December 2018
This course has been approved for 21 AMA PRA Category 1 Credits, 21 Nursing Contact Hours (21 pharmacologic hours), 21 Hours Pharmacy Credit (knowledge based).
All participants will receive an electronic and printed syllabus with their registration. The eSyllabus will be available for download at least one week prior to the course. An email notification will be sent when it is available for download and will include links and instructions. This early release provides an opportunity to download and review the materials prior to the course.
PLEASE NOTE: We request you download the material prior to the event as internet access in the meeting room may be limited. We will also have flash drives available for those that find this easier than downloading. The syllabus can be saved in Adobe Reader which allows participants to add "sticky notes" directly on the slide as the speaker is talking. THese notes can be saved permanently to your document. Other recommended applications include iBooks (for apple mobile devices) and iAnnotate (for mobile devices). Lastly, put perhaps most important for many of us, a printed syllabus is available with an option for good old fashioned note taking.
Prerequisites: Part I, II and III
One would think that 3 courses on HRT would be all that is needed to adequately practice BHRT. However attendees have requested that they want more, but with more complexity and problem solving as opposed to didactic. Hence Part IV.
Although there are new articles, research, updates, literature critiques, and sarcasm (of course), the majority of this course will be problem solving, case management, mistakes to avoid, and tricks of the trade. The audience will consist of those with significant experience, questions, and issues that make for an excellent experience for both me and participants as we all learn from patients and ourselves. Extensive literature review in Parts I, II, & III have not allowed me to present all the interesting and complicated cases and situations that I have encountered in the last 15 years of practice. I have included 60 of my most complex and problematic cases from the last 15 years but it will require you to have masterful understanding of Parts I, II, and III in order to understand the reasoning behind the treatment and management of these problematic cases.
First we will review the latest NAMS recommendations. It is a step in the right direction. However I will use the medical literature to, of course, prove to them what they should have said and done as opposed to their sole reliance on the WHI trial. It should be the summation of all available data that should dictate our treatment, not just one study. We will then review the evolution from testosterone causes prostate cancer to maybe it protects against cancer to now where we prescribe it to men with active cancer. Although commonly (incorrectly) thought to cause prostate cancer, estrogen has been a mainstay to treat and protect against prostate cancer. In fact it may be through aromatization that testosterone can protect against prostate cancer. We will also review at what level of estradiol results in a flip of the lipids that then become cardio-protective. Although it has been customary and fashionable to utilize aromatase inhibitors to block aromatization of testosterone to estrogen, the most recent study demonstrates using an AI increases gynecomastia, visceral and subq fat, cholesterol, and sexual dysfunction.
Please read the agenda and course outline for a more complete synopsis of topics and objectives. So bring your tough cases, comments, thoughts and ideas and have another fun weekend with your talented peers. This will be a collection of the most talented and experienced physicians in this industry. Caution: Part IV will be thought provoking, intense, and very complex. And just maybe you’ll be able to pass that Certification Exam.
Upon completion of this workshop, the health care professional will be able to:
1) Understand the benefit of MR-guided trans-rectal prostate biopsy and subsequent state of the art focal laser ablation of prostate cancer in comparison with other more problematic standard treatment modalities.
2) Integrate into your practice the Dynamic contrast Enhanced MRI with real time temperature mapping and tracer washout for accurate diagnosis and location of prostate CA.
3) Review prognosis and complications for radical prostatectomy, proton gun radiation therapy, brachytherapy, cryotherapy, HIFU, laser ablation, as well as costs.
4) Review management strategies and importance of testosterone utilization in prostate cancer survivors as well as literature support. How to be your patient’s advocate as no one else where explain all the ins and outs of the various available treatments.
5) Evaluate the association of testosterone and estradiol levels and the risk of developing prostate cancer. Should be raise, block, or administer estrogen based on the literature?
6) Based on the recent medical literature, physicians should be freed of any antiquated and unscientific restrictions that inhibit optimal treatment of their patients with testosterone, whether it is before or after prostate cancer diagnosis.
7) Appreciate that optimal thyroid levels are best as recent studies determine that high TSH levels are associated with increased arterial stiffness and plaque thereby increasing CVD risk.
8) Review the recent NAMS position statements that further distinguish the emerging differences in the therapeutic benefit-risk ratio between ERT & HRT at various ages and time intervals from onset of menopause.
9) Understand that high testosterone levels in women are associated with an increased risk of breast cancer. Also understand that studies show testosterone administration is protective against breast cancer and is apoptotic to cancer cells. This demonstrates that association does not prove causation and one should not extrapolate them to be the same.
10) High estrogen levels in men are associated with increased cardiovascular risk. However estrogen administration in men protects against heart disease and prostate cancer. This demonstrates another example where association does not imply causation.
11) Evaluate and discuss my 50 most difficult management cases involving HRT.
12) Learn current approaches to manage vaginal bleeding, DUB, and endometrial hyperplasia.
13) Recent medical evidence seems to counter everything that you have learned in regards to preventing prostate cancer.
14) Review medical studies demonstrating the various mechanisms of estrogen’s ability to stop prostate cancer growth.
15) Androgen deprivation therapy in men results in higher cardiovascular mortality and metabolic complications and this can be prevented by simply administering estrogen.
16) Traumatic Brain Injury affects quality of life by pituitary dysfunction: When and how to test and not miss it.
17) Evaluate recent literature demonstrating the mechanism by which synthetic progestins increase breast cancer development through the production of the RANKL protein.
18) Utilize dual intravaginal therapy to maximize the effect on atrophic vaginitis, chronic UTI, incontinence, and sexual dysfunction.
19) Review the historical perspective that pieces together the studies to understand the complexities in the NAMS recommendation for HRT.
20) Review a fun and entertaining article that puts in perspective the often distorted, oversimplified, over-exaggerated, and simply wrong conclusions from the WHI investigators.
21) Evaluate abnormal lab tests and various symptoms in complex and confusing cases.
22) Evaluate exactly when to use estrogen in premenopausal women and when not to use it: Anovulation vs. amenorrhea.
23) Identify different types of estrogen and progesterone and when to prescribe each.
24) Review various scenarios that dictate when to switch to alternate forms of HRT, based on history, BMI, risks, and compliance.
25) Hair loss in women: Current approach to reverse hair loss.
26) Understand various alternatives in testosterone administration in women.
27) Review when to switch from oral to transdermal estrogen; when to switch from transdermal to oral estrogen.
28) Current approach to preventing CVD in women with Syndrome W (X).
29) How to treat the vagina with pills, patches, rings, and things.
30) Review of management strategies for progesterone intolerance.
31) HRT review, myths, updates, alternatives when the usual routine doesn’t work.
32) Update on diagnosis, treatment, and prevention of prostate cancer. Should we be prescribing estrogen to men instead of blocking it.
33) Review management strategies for estrogen intolerance.
34) Evaluate the best prevention and treatment for incontinence and UTI, from wet to dry and dry to wet. Prevention is the key before use of drugs or surgery.
35) Current recommendations from NAMS for HRT and ERT and how they differ from past recommendations. Oh how the pendulum swings.
36) Review the history as to why the world believes testosterone causes prostate cancer.
37) Further review the data demonstrating that E2 is the best estrogen but not the safest.
38) Review the work up for elevated PSA and that doesn’t mean biopsy and what to do when the biopsy is negative.
39) How to design a study of T3 to make sure that it fails.
40) A literature review of spironolactone and its BBW.
41) Discuss the most recent FDA BBW for testosterone as it pertains to MI, CVA, and DVT.
42) Review dosing and administration of tranexamic acid to stop your patients from bleeding.Register
7:30 AM - 8:00 AM
8:00 AM - 9:00 AM
9:00 AM - 10:00 AM
10:00 AM - 10:15 AM
10:15 AM - 11:15 AM
11:15 AM - 12:15 PM
12:15 PM - 1:15 PM
1:15 PM - 2:15 PM
2:15 PM - 3:15 PM
3:15 PM - 3:30 PM
3:30 PM - 4:30 PM
4:30 PM - 5:30 PM
5:30 PM - 6:30 PM
Dr. Neal Rouzier is a pioneer in the bio identical hormone replacement field, practicing almost since its inception in the early 1990’s. He has dedicated his life’s work to uncovering the medical literature that supports safe and effective protocols for unique and personalized patient care. He is the Director of the Preventive Medicine Clinics of the Desert, specializing in the medical management of aging and preventive care for men and women. He has treated more than 2,000 patients with natural hormone replacement therapy and is recognized as a renowned leader and expert in the field. Additionally, Dr. Rouzier is the author of Natural Hormone Replacement for Men and Women: How to Achieve Healthy Aging. He has over 16 years of experience as an educator and practicing physician, and 29 years of Emergency Medicine experience at Queen of the Valley Hospital in West Covina, CA.
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Hilton Salt Lake City Center
255 S West Temple
Salt Lake City, UT 84101
Room Block Rate $169.00
Room block rate expires on November 8, 2018
Call 1-800-Hiltons for reservations, group name worldlink medical / CME educational seminar
Initial Enrollment - $1,295.00
Discounted Price - $1,195.00
*If Registered By Friday November 5, 2018
Part II Graduate - $675.00
Staff Member (MA, RN, Office Mgr) - $675.00
If cancellation is received more than 3 weeks in advance a full credit can be applied to your account for future use. If less than 3 weeks a $350.00 cancellation fee applies and the balance will be applied as a credit to a future event.
AMA PRA Category 1 Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Foundation for Care Management (FCM) and Worldlink Medical. The Foundation for Care Management is accredited by the ACCME to provide continuing medical education for physicians.
FCM designates this educational activity for a maximum of 20 AMA PRA Category 1 CreditsTM.
Physicians should only claim credit commensurate with the extent of their participation in this activity.The ACCME defines a “Commercial Interest” as any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.
The Foundation for Care Management is an approved provider of continuing nursing education by the Western Multi-State Division (WMSD), Approver of Continuing Nursing Education an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. 20 Nursing contact hour(s).
The Foundation for Care Management is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Program # 0347-9999-18-003-L01-P Objectives appropriate for pharmacists. This activity is 20 Contact Hours Pharmacy Credit. *This CME is Knowledge Based (K). Initial release May 4, 2018back to top
Hilton Salt Lake City Center
255 S West Temple
Salt Lake City, UT 84101