Thursday, June 27

 


PRESIDENT'S ADDRESS

8:00-8:30:


Nicholas Bird, MD, FUHM

BirdNicholas WEB NEW
Overview
: Provide an overview of activities, plans, and outcomes from initiatives carried out by UHMS home office, officers and committees. 

Objectives:

  • Name two of the position statements published in the last year.
  • Describe what the UHMS has done to improve its editorial review process

About Dr. Bird:  Dr. Nicholas Bird is a regional medical director for Duke Urgent Care and am board-certified in both family medicine and undersea and hyperbaric medicine. He split my time between clinical practice and administrative responsibilities, and he have a passion for improving health care delivery to optimize patient access, education and outcomes. Prior to joining the Duke medical staff, he was the chief medical officer and CEO of Divers Alert Network and an internationally recognized expert on diving injuries, accidents and medical treatment. Outside of work, he enjoy traveling, and diving the warm waters of the world. He has been a PADI SCUBA instructor for more than 25 years. He also enjoy reading Clive Cussler novels, cooking, and golfing, when time permits. He live in Durham with his wife, Kim. They have three children, a grandson, and a crazy Jack Russell terrier.


Controversies in the Hyperbaric Management of Late Radiation Injuries

 
8:30-9:00:


Late Radiation Tissue Injury Below the Clavicles: Considerations with IMRT and the Fibroatrophic Model
John Feldmeier, DO

Feldmeier Pic OfficialIn this session, Dr. Feldmeier will join with Dr. Robert Marx to address several recent articles calling into question the role of hyperbaric oxygen in treating LRTI’s (Late Radiation Tissue Injuries). While Dr. Marx will concentrate on the application of Hyperbaric Oxygen to osteoradionecrosis (ORN) of the mandible and maxilla and soft tissue injuries of the head and neck, Dr. Feldmeier will concentrate on injuries to organs and tissues below the clavicle. Special emphasis will be given to radiation cystitis and proctitis. The technique of modern radiation therapy targeting including IMRT (Intensity Modulated Radiation) will be briefly discussed. A recently proclaimed and popular model of delayed radiation injury is called the Fibroatrophic Model. It de-emphasizes vascular damage as the major contributor to LRTI. This model will be discussed from 2 perspectives: 1. Its validity and 2. Even if accepted in part or in toto, how a strong case for the use of hyperbaric oxygen can be made. At the conclusion of both Dr. Marx’s and Dr. Feldmeier’s plenary sessions, a panel discussion will occur.

About Dr. Feldmeier: Dr. Feldmeier received his D.O. degree from The Philadelphia College of Osteopathic Medicine in 1979 with USAF sponsorship and completed residency training in Radiation Oncology at the University of Texas Health Science Center at San Antonio, Texas in 1985. He received a fellowship certificate from the USAF Hyperbaric Medicine Fellowship Training Program at Brooks Air Force Base in San Antonio, Texas and was a staff physician there from 1980 to 1982. Dr. Feldmeier was simultaneously the Chief of Radiation Oncology and Chairman of the Hyperbaric Medicine Department at Wright-Patterson Air Force Base Medical Center in Dayton, Ohio before separating from the USAF in 1985. Dr. Feldmeier has served as the Chief of Radiation Oncology at the University of Texas Health Science Center in San Antonio, Grace Hospital in Detroit, MI and the Chairman of Radiation Oncology at the University of Toledo Medical Center from which he retired in 2013 with the award of Professor Emeritus. Dr. Feldmeier has authored numerous publications in both radiation oncology and hyperbaric medicine. He has been the editor of the Undersea & Hyperbaric Medical Society (UHMS) Hyperbaric Oxygen Therapy Committee Report. He served as review editor of Undersea and Hyperbaric Medicine. He is a Fellow of Undersea and Hyperbaric Medicine and Past- President of the UHMS. He currently co-chairs the UHMS Research Committee. He is a Fellow of the American College of Radiation Oncology.   He is a medical consultant to International ATMO. He is the only physician in the U.S. board certified in both Radiation Oncology and Undersea and Hyperbaric Medicine. 

 9:00-9:30:

Answering the criticism and challenges to HBO2 in the treatment of radiated patients
Robert Marx, DDS

Marx 

 

 

About Dr. Marx:  Robert E. Marx, DDS, is Professor of Surgery and Chief of the Division of Oral and Maxillofacial Surgery at the University of Miami Miller School of Medicine as well as Chief of Surgery at Jackson South Community Hospital in Miami. He is well known as an educator, researcher, and innovative surgeon. Dr. Marx has pioneered new concepts and treatments for pathologies of the oral and maxillofacial area as well as new techniques in reconstructive surgery, including stem cell therapies. 
     His many prestigious awards, including the Harry S. Archer Award, the William J. Giles Award, the Paul Bert Award, the Donald B. Osbon Award, and the Daniel Laskin Award, attest to his accomplishments and commitment to the field of oral and maxillofacial surgery. 
      His textbook “Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment” has won the American Medical Writers Associations Prestigious Book of the Year Award. His other textbooks, “Platelet Rich Plasma: Dental and Craniofacial Applications,” “Tissue Engineering,” “Oral and Intravenous Bisphosphonates Induced Osteonecrosis” and an “Atlas of Bone Harvesting” have been best sellers. He is also a writer of fiction medical mystery novels. His first publication “Deadly Prescription” is currently an Amazon best seller.

9:30-10:00: Panel discussion


Physiology and Science in Hyperbaric Medicine


4:00-4:
30:


Stem cells and hyperbaric oxygen therapy
Stephen Thom, MD

Thom picThe first scientific papers reporting effects of hyperbaric oxygen therapy (HBOT) on stem cell biology were published just 12 years ago and now they number over 100. This presentation will summarize the latest data on stem cell physiological responses to HBOT. Oxygen acts as a critical regulator of stem cells, and HBOT has a variety of effects on stem cell mobilization dynamics, metabolism, engraftment, and can influence paracrine roles with tissue repair. Some effects appear with the initial HBOT exposure while others develop when repeated hyperoxia-normoxia cycling occurs. Mechanisms and data on clinical utilization will be presented, as well as current questions and future directions.

About Dr. Thom: Dr. Thom received his MD and PhD (microbial physiology) degrees from the University of Rochester in 1981. He served as professor of emergency medicine and chief of hyperbaric medicine at the University of Pennsylvania for 27 years and in July 2013 took a position at University of Maryland. He is a practicing emergency medicine physician and also carries out research in several areas. He is lead/senior author on over 130 peer reviewed papers and 40 reviews or textbook chapters on oxygen and other gas toxicities. Research interests include the role of stem cells in diabetic wound healing and cell responses to hyperoxia, pathophysiology of decompression sickness, carbon dioxide and carbon monoxide (CO). His lab group was the first to describe vasculogenic stem cell mobilization by hyperbaric oxygen therapy and he currently directs projects to assess the role of stem cells in diabetic skin wound healing. He was president of the UHMS from 1996-1998, and chair of the hyperbaric oxygen therapy committee from 1991-1993.  Dr. Thom has been the recipient of the Albert R. Behnke award of the UHMS in 1996 and 2008, the Paul Bert award from UHMS in 2007, the Edgar End award of the Gulf Coast Chapter of the UHMS in 1988, and the C. Longoni award from the Italian Undersea and Hyperbaric Medical Society in 1998.

4:30-5:00:

Research that We Need to do in the Field of Hyperbaric Medicine and Some Thoughts on How to Achieve this Goal
John Feldmeier, DO (Co-chairman of the UHMS Research Committee)

Feldmeier Pic OfficialIt is no surprise to our membership that as a discipline, hyperbaric medicine has not achieved a consistently successful track record in accomplishing research to further advance the application of our treatment modality or even for that matter to firmly solidify those indications that we accept as “Approved.” CMS and commercial insurers are actively involved in removing re-imbursements for pharmaceuticals, devices and procedures unless their proponents can make a solid argument for their benefit based on good and adequate science. It is likely that payments for our clinical efforts are going to be put under even greater scrutiny unless new and corroborating science is done and published with a quality that is readily acceptable to payors and potential referring physicians alike. As a small field, we do not have the luxury of large sums of money available to support the conduct large research protocols involving randomized controlled trials. We can, however, learn from the major cooperative oncologic trial groups and employ registries to achieve the necessary quality of science. A number of promising new applications deserve scrutiny and some of our long-standing indications need better support. This talk will be designed to identify several areas where research must be done for the good of our patients and our discipline and will consider some methods by which these studies can be accomplished.

About Dr. Feldmeier: Dr. Feldmeier received his D.O. degree from The Philadelphia College of Osteopathic Medicine in 1979 with USAF sponsorship and completed residency training in Radiation Oncology at the University of Texas Health Science Center at San Antonio, Texas in 1985. He received a fellowship certificate from the USAF Hyperbaric Medicine Fellowship Training Program at Brooks Air Force Base in San Antonio, Texas and was a staff physician there from 1980 to 1982. Dr. Feldmeier was simultaneously the Chief of Radiation Oncology and Chairman of the Hyperbaric Medicine Department at Wright-Patterson Air Force Base Medical Center in Dayton, Ohio before separating from the USAF in 1985. Dr. Feldmeier has served as the Chief of Radiation Oncology at the University of Texas Health Science Center in San Antonio, Grace Hospital in Detroit, MI and the Chairman of Radiation Oncology at the University of Toledo Medical Center from which he retired in 2013 with the award of Professor Emeritus. Dr. Feldmeier has authored numerous publications in both radiation oncology and hyperbaric medicine. He has been the editor of the Undersea & Hyperbaric Medical Society (UHMS) Hyperbaric Oxygen Therapy Committee Report. He served as review editor of Undersea and Hyperbaric Medicine. He is a Fellow of Undersea and Hyperbaric Medicine and Past- President of the UHMS. He currently co-chairs the UHMS Research Committee. He is a Fellow of the American College of Radiation Oncology.   He is a medical consultant to International ATMO. He is the only physician in the U.S. board certified in both Radiation Oncology and Undersea and Hyperbaric Medicine.