EUROPEAN SOCIETY OF PREVENTIVE,
REGENERATIVE AND ANTI-AGING MEDICINE

ESAAM

Certification Course:

ESAAM Clinical Training Course. Preventive, Anti-Aging, Regenerative Medicine

Scientific Director: Prof., Dr., Dr. med. Michael Klentze

Co-Director: Prof., Dr., Dr. med. Claus Muss

Teaching Faculty: To be confirmed

Course Description

This one-week intensive course aims to prepare Medical Doctors to understand the science of aging and advance the clinical skills in utilizing scientific tools to prevent and treat aging disorders; to examine emerging trends and the latest developments in regenerative biomedical technology. The course includes 6 months mentorship program for up to 10 clinical cases for each student.

Medical Doctors regardless of specialties, with an interest in anti-aging and regenerative medical practice would benefit from the course. This is especially advantageous considering the increasing demand for the medical profession to provide anti- aging services.

This course is organized by ESAAM. Upon completion of the course and exam, students will be awarded a Certificate of Competence in Preventive, Anti-Aging and Regenerative Medicine or a Certificate of Competence in Anti-Aging Aesthetic Medicine, endorsed by the European Society of Preventive Anti-Aging Medicine (ESAAM) in association with world authorities and anti-aging & regenerative medicine organizations.

FEE (suggested €3,500), includes

- Seven-day intensive physical course with lunches and coffee breaks, examination and Certification.

- Course Material & CD

- On line course modules

- 6 months e-mentoring for up to 10 clinical cases

- Course material and subjects

INTRODUCTION

Introduction to ESAAM Clinical Training Course - Reasons for doing, Course Objective, Board Exam by ESAAM.

DEMOGRAPHIC AND SOCIAL ASPECTS OF AGING

Overview in epidemic changes in health systems of Europe, Asia & America. Medical economics and Prevention. Concepts of Primary, secondary and tertiary prevention. Prevention in the hospital and medical practice. Evaluation of health projects, Terms of epidemiology, Interpretation of scientific data. Biostatistics, Prevention and Anti-aging medicine an investment in to the future.

MECHANISMS OF AGING

The theories of aging, focus on: Neuroendocrine, Genetic Control, Free-Radical, Wear & Tear, Crosslinking and Immunological. Evolutionary and novel theories.

Biology and genetics: Telomerase measurements and importance regarding towards aging. Interventions to extend aging in lower animals, mammals, primates and humans. The importance of caloric restriction, and its mimetics. Important aging pathways in energy metabolism. Learn Sirtuin effects, and its mimetics. Mitochondrial aging and its effect on energy metabolism, muscle metabolism and sarcopenia.

Biopeptide regulation

BRAIN AGING

Normal Brain Aging: brain volume shrinkage, lab methods and imaging. Dementia, Alzheimer’s Disease (Incl. prevention, genetics, diagnosis and treatments), Vascular brain aging and how to prevent, Ischemic stroke, test battery to identify vascular and non-vascular brain aging, Parkinson Disease, Stem cell treatment of neurodegenerative Diseases, Hormonal effects on cognition and emotion.

Hormesis, neuronal stress response, and Indispensable Soma Hypothesis.

HISTORY TAKING AND PHYSICAL EXAMINATION

Personalised medicine, Unique disease principle.

Using language appropriate for each patient. Eliciting the patient’s chief complaint as well as a complete list of the patient’s concerns. Obtaining a patient’s history in a logical, organized, and thorough manner, covering the history of present illness; past medical history); preventive health measures; social, family, and occupational history; and review of systems.

Demonstrating proper hygienic practices whenever examining a patient. Demonstrate consideration for the patient’s feelings, limitations, and cultural and social background whenever taking a history and performing a physical exam.

Performing a physical examination for a patient in a logical, organized, respectful, and thorough manner, giving attention to the patient’s general appearance, vital signs, and pertinent body regions.

BIOMARKERS

Biomarkers of aging and detection of chronic aging diseases. Serum, saliva, urine tests for detection of hormones and metabolites. Proteomics, genomics, polymorphisms. Evidence based methods to prevent and treat chronic aging disorders.

CHEMICAL REACTIONS IN CELL METABOLISM

Krebs Cycle, Apoptosis, Free Radicals, Inflammation, Glycation, Methylation, Acetylation, Oxidation.

LABORATORY MEDICINE

Terms of assessment Laboratory medicine; Introducing different new lab techniques (blood spot test; saliva spot technique, urine spot technique), LTT Melisa, functional immunological panels (Natural killer cell function, Tumor killing test, Pro-Inflammatory cytokine status). Il2-R-Test, Human Bio monitoring, Laboratory evaluation.

Concepts of detoxification (phase related detoxification) Total Glutathione-S- transferase activity, GST μ, GST p1, GST M1, P1, T1, p 450 cytochrome activity, caffeine clearance, basics and clinical applications

Assessment of oxidative stress, Intracellular Glutathione levels, NF-kappa ß, Antioxidative capacity, lipid peroxidation, 8-0H-Desoxyguanosine, Superoxide dismutase, Glutathione peroxidase.

Test in functional nutritional medicine: Breath gas analysis, genetic proof of LCT-gene mutation, hereditary fructose intolerance (genetic test). Anti-transglutaminase in stool & serum samples, genetic determination for Celiac disease (HLADQ 2,HLADQ 8).

Neurostress: Catecholamines (Adrenaline, Noradrenaline, Dopamine), Glutamine, GABA, Serotonin, Cortisol profile in saliva and urine. Assessment of neurodegeneration by advanced lab techniques: Biomarkers: S100, Apo E, MBP-Peptides, MOG-Peptides.

Mitochondrial Medicine: Citrulline, Nitrotyrosine, Measuring mitochondrial activity, Acid base balancing according to Sander, Kryptopyrrol in urine samples.

Cardiovascular risk assessment: ADMA, homocysteine, Lp(a), oxidized LDL, Vitamin C levels, sCRP

PHYSIOLOGICAL RESPONSE TO INFLAMMATORY PATHWAYS

NFkB, AP-1 Pathways, MMPs, DNA Regulation, RNA Transcription, Protein Synthesis, Mitochondrial Mutations. Basics of the immunology. Aging Immune system including practical clinical parameters of assessment, Inflammaging, Silent inflammation impact on Th1/Th2 Regulation. Impact of neurostress on different aspects of the Immune system, methods of diagnosis & treatment. Mitochondrial Medicine, Prophylaxis & Treatment of mitochondrial deficiency. NK cells and NK cell activity. Apoptosis.

KEY CLINICAL TOOLS FOR PREVENTION & ANTI AGING

Health, what is health. Time-related dysfunction as ageing.

Intervention objective for risk reduction of CVD, stroke, cancer, metabolic syndrome. Evidence based methods to prevent most common aging-associated diseases.

Senolytics etc.

IMMUNE AGING & CLINICAL DETOX

Immunessence, Inflammaging, Auto-Immune Diseases, Loss of CD-4 Cell, CD-95 Cell and NK Cell Activity, Heavy Metals, Cancer Virusload, CFS, Chelation and Immune Therapy.

CARDIOVASCULAR AGING

CV Diseases, Polymorphisms, Lipid Metabolism, Intervention for Therapy. Primary Prevention, Secondary Prevention, Apop- tosis Pathways in Endothel Disease. Cardiovascular Risk Factors Genetic Control in Men and Women; and Nutritional Response.

Epidemiologic changes and risk factors that are associated with ischemic stroke. Evaluate the efficacy and safety of thrombolytic therapy in ischemic stroke.

Blood pressure management, using the current understanding of the pathophysiology of acute ischemic event. Therapeutic strategies for primary and secondary stroke prevention based on risk factor assessment and current literature. The role of vascular and neuroprotective agents in managing stroke. Develop and justify prevention and treatment plans for stroke-related complications, using the available literature.

Record and interpret an ECG. Interpret serum markers of myocardial injury (biomarkers). Interpret a complete blood count.

Interpret chest x-ray findings. Interpret arterial blood gas measurements. Interpret serum electrolyte measurements.

LEARNING OBJECTIVES FOR CORONARY SYNDROMES

Evaluate the evidence for and against using C-reactive protein (CRP), lipoprotein Phospholipase A2 (Lp-PLA2), and cystatin C as risk stratification tools in a patient with ACS.

Understand the lipoprotein fractions and interpret them. Design a treatment protocol for arteriosclerotic risk patients. Understand the importance of fibrinogen, s-CRP and develop treatment strategies to reduce these inflammatory markers. Non – statin treatments for LDL reduction

BONE AGING

Cartilage and Sarcopenia, Aged-Related Loss of Anabolism. Falls.

MUSCULAR SKELETAL DISEASE PREVENTION INCLUDING OESTEOARTHRITIS

Common presentations of pain. Prevention strategies for pain and dysfunction in common musculoskeletal conditions including benefits and risks of lifestyle factors, physical activity, minimising immobility and avoiding of specific risks. Know the wide range of musculoskeletal conditions

Understand that the early diagnosis and management of common general practice musculoskeletal presentations. How to make assessments and pronouncements on musculoskeletal injuries that affect the patient and their legal outcomes. The effect of chronic pain on sleep.

Outline the principles involved in evaluating the efficacy of treatments for musculoskeletal conditions, including alternative or complementary therapies. Chronic disease self-management.

Natural treatment for joint and bone. Musculoskeletal treatments with herbs and herbal pain management. Steroidal drugs and side effects. Hormonal treatment in musculoskeletal disorders. Know the sarcopenia problem in aging. Effect of hGH on muscular skeletal system. Effects on estrogens on bone density. Genetic risk factors for osteoporosis. Stem cell treatments for joint problems.

NEUROPHYSIOLOGY

Neurodegeneration: Parkinson, Alzheimer, MCD, Chronic Stress Diagnosis, Depression Detection, Intervention, Serotonin, Melatonin, 5HTP Deficiency, Sleep Disturbance.

METABOLIC SYNDROME

Metabolic Syndrome & Signal Pathways: G-Protein Pathways, Thyrosin Kinase, Akt, Serine Kinase, Mitochondrial Effects, Insulin Pathways and Clinical Intervention. Beta Cell Dysfunction in the Development of Type 2 Diabetes. Clinical Deficiency and Therapy.

OBESITY, METABOLIC SYNDROME, INSULIN RESISTANCE AND DIABETES PREVENTION

Discuss with patients and families the importance of lifestyle. Diet and exercise, in the management of diabetes. Develop treatment plans in the context of each patient's life, environment, and culture. Teach and motivate patients to monitor blood glucose at home

NUTRITION AND WEIGHT MANAGEMENT

Health professionals should understand their own attitudes to obesity, the etiology and pathophysiology of increasing body fatness and appreciate the importance of prevention and intervention where the condition is established. Obesity management.

Building capacity and capability of practitioners to deliver behaviour change at Individual and population level is key to achieving weight management targets. Prevention through Exercise & Nutrition.

ENDOCRINOLOGY

Aging Male, LHRH-LH-Testicles, PADAM Diagnosis, HRT Treatment, When & Why, Safe Testosterone Treatment, Risks & Benefits.HGHRH-HGH-IGF-1-Ghrelin, GHRH, Insulin, Metabolic Syndrome, Adiponectin, Leptin, Neuropeptide Y, Nuclear Receptors Stimulation and Replacement. ACTH–Adrenals (DHEA, Cortisol and Melatonin). Chronic Stress, Burnout and Fatigue. Thyroid: TSH, T3, T4, Deiodeinase, Melatonin, Nuclear Receptors.

Female HRT - Knowledge of Studies, Safe Hormone Therapy, Breast Cancer Risk, Polymorphism Regulating Pathways. Female BHRT – PMS, Pre-Menopause and Post-Menopausal.

Regenerative Medicine

How hormones control the activities of the female reproductive organs and the development of female secondary sex characteristics. The physiology governing the menopausal transition. Circulating hormone levels. Endocrine changes during female life.

Symptoms of estrogen deficiency, estrogen dominance, progesterone deficiency, androgen deficiency in women. Effects of female hormones on brain, skin, bone, immune system, TH1/Th2 ratio, allergies, pregnancy

MALE HORMONAL CHANGES

Evaluation and monitoring of Hormone Supplementation. Male HRT and Andropause.

Diagnosing hormonal imbalance; which test to prescribe (biochemical, SNP, serum/saliva/urine). Personalized HRT, minimize side effect and risk. Hormonal control of the female reproductive cycle and of the male and female sexual behavior. Mechanisms of endocrine hypofunction and hyperfunction.

Effects of a deficiency in growth hormone (GH). The relationship between GH and insulin-like growth factors (IGFs)

The mechanisms and GH disorders that result from poorly controlled diabetes mellitus, treatment with adrenal glucocorticosteroid hormones, and malnutrition. Treatment options for GH deficiencies, effects and side effects. Tests for GH deficiency

DHEA

CANCER AND PREVENTIVE ONCOLOGY

Cancer Pathways and Prevention. Cancer Dormancy and Vessel Formation, Oncology (Mainstream and Alternative): Breast, Prostate, Melanoma. Polymorphisms and Genomic Approach to Cancer Treatment. Proteomics, PET for Early Clinical Diagnosis/Detection of Urinary Cancer, Prostate Cancer.

New advances in the field of biomarker discovery. The role of microbiome and how it helps in maintaining a healthy host- microbiota relationship to prevent susceptibility for cancer development. Tumour markers.

ADVANCES IN BIOTECHNOLOGY, BIOMEDICAL SCIENCES AND REGENERATIVE MEDICINE

Modern Preventive Medicine Using Genetic Techniques. Stem cells - Theory and Practice for Prevention and Treatment of Age Related Diseases.

SEXUAL DYSFUNCTION

Sexuality and ageing

Aesthetic Medicine

DIET, EXERCISE AND OVERALL FITNESS

Nutrition in long term conditions such as diabetes, coronary heart disease or chronic kidney disease, arthritis, back and knee joint problems, palliative care, substance misuse, neurological conditions, physical activities including sports, etc.

Basis of nutritional science, physiology of digestion, hormones regulating hunger (leptin cycle etc.) and energy balancing. Diets in industrialized countries. Difference between ancestral diets and present nutritional habits, evaluation of food supply, food sources of micronutrients, principles of supplementation.

Nutritional recommendations, Energy balance, Assessment of proper nutritional supply,

Macronutrients compounds of nutrition: fats, proteins, carbohydrates, water, fat related compounds, essential fatty acids, Understanding fats and oils, Omega 3: Omega 6 fatty acids, phospholipids, Choline and lecithin, Natural food sources (vegetables and fruits, meat, milk and dietary products, fish, cereals, salt)

Brain food, implications in neurodegenerative disease, Micronutrients in the Prevention and Therapy of Disease. Probiotics/ Essential trace elements (Zinc, Copper, Molybdenium, Chromium, Iodine, Selenium, Fluoride) Minerals (Calcium, Magnesium, Potassium, Iron)

Accessory nutrients: Coenzyme Q 10, Fiber supplementations, Lipoic acid, S- adenosylmethione (SAM)

SKIN AGING

Understanding and Developing Aesthetic/Cosmetic Treatment Plan to Complementing an Anti-Aging Program. Analysis of Facial Anatomy and the Aging Face.

CLINICAL TOOLS IN AESTHETIC MEDICINE

Cosmeceuticals, Mechanical and Chemical Peels, Botox, Fillers, Mesotherapy, Laser, IPL, Thread Lifting, Hair Restoration.

BOTOX & FILLERS

Botulinum Toxin Pharmacology for Rebalancing the Muscles of Facial Expression. Fillers for Facial Aesthetic Enhancement and Volume Restoration. Complication Management and Successful Botox & Filler Practice. Various Application and Injection Techniques: How to do Botox/Filler for the Upper Face.

How to do Botox/Filler for the Lower Face. Creating Youthful Perioral and Periocular Region.

Injection for the Nasobial and Melomental Fold Correction. Lip Augmentation, Tear Through Region, Volume Restoration.

MESOTHERAPY FOR AESTHETIC & FUNCTIONAL ANTI-AGING

Indications and contra-indications; pharmacological formula selection for best results; techniques and application sites.

For upper body aesthetic: mesohair for alopecias, mesotox, face & neck rejuvenation, photoaging, wrinkles, mesolift, mesoglow. For lower body aesthetic: cellulite, localized fats, stretch marks, venous. For functional anti-aging: pain management, rheumatology, sports medicine, vascular pathologies.

EXAMINATION