_238px.jpg?id=62580&typ=s){kind=logo}
Why is the SSIF Award such an important initiative for Serono Symposia International Foundation?
Medical education has never been more important than today so the SSIF Board of Directors feel that it is important to focus on the true core of medical education - the people who are doing excellent work in teaching and making sure that the medical profession receives the best possible continuing education.
For that reason the SSIF Board of Directors decided to establish this prestigious award that will recognize and reward excellence in medical education.
The first year of the award will honour excellence in education in reproductive medicine, and we are privileged to be working with the Executive Committee of ESHRE. The award will be formally announced and opened at this year's ESHRE meeting in Rome, and the winner will receive his or her award at the ESHRE meeting in 2011.
What will the winner of the award receive?
We are trying to find an individual with wide-ranging talents and great potential to be involved in the future of medical education, so we have created three components to the award. First, the winner will receive a trophy, a beautiful object that they will be able to display as a constant reminder of the recognition they have received. Secondly, as a contribution to their ongoing work, they will receive a cash award of €10.000. And finally, they will become a member of the SSIF Advisory Committee.
Who is eligible to apply for the award and how will the candidates be assessed?
If I try to imagine the kind of person who will win this award, I think of someone who is young but already making a significant impact in medical education. They will be 35-50 years old and will already have been teaching as a lecturer or professor. They will be active at live educational events, where they may be organizing meetings and speaking or tutoring. They will also be sharing their academic work with a good track record of publications in journals and books. Most importantly, I see this person as forward looking and innovative: they will have been active in online courses and developing new approaches to continuing medical education.
When will the award be presented?
Applications for the award will be received between 27 June and 31 December 2010 and the winner will be presented with his or her award at the ESHRE meeting in June 2011.
Will there be more awards in the future?
The Serono Symposia International Foundation Award will take place each year. The first award is for excellence in reproductive medicine, and in subsequent years will recognize achievements in other therapeutic areas.
More information about the SSIF Award 2011
Panama City, Panama; March 25-27, 2010
The second session, which focused on genetics and the physiological role of LH in human reproduction, was opened by Claus Yding Andersen from Denmark who discussed the physiology of reproduction and LH and FSH genetics. Sandro Esteves from Brazil gave a talk on the relevance of LH 'window' in reproductive cycles, underling the concept that a therapeutic LH window exists during follicular phase. LH concentrations below a threshold are associated with inadequate E2 production whereas concentration above a ceiling might be detrimental to follicular development. This concept is supported by several studies and should be used when considering LH supplementation in reproductive cycles.
The third session aimed to describe the currently available tools to improve ovarian stimulation. Maria Bustillo from USA opened this session with a very interesting lecture on ovarian reserve and the markers utilized to discern it. The specificity and sensitivity of basal early follicular serum gonadotropin (FSH and LH) and estradiol levels, serum inhibin B levels, antimullerian hormone (AMH) levels as well as ultrasound assessment of antral follicular count were carefully analyzed. Administration of supplements such as L-arginine, human growth hormone and other ovarian stimulatory agents and schemes, together with the results that might be expected, were also discussed. Mark Leondires from USA discussed optimization of the use of GnRH agonists and antagonists in ovarian stimulation: protocol choice should be decided according to baseline patient characteristics and previous stimulation records, when available. By tailoring the use of GnRH agonist and antagonist the goal is to optimize the stimulation outcomes, oocyte quality, endometrial receptivity, patient satisfaction and pregnancy rates.
The fourth session, entitled 'How to optimize ovarian stimulation' was opened by Peter Humaidan from Denmark who focused his presentation on poor and low responders and the use of exogenous LH supplementation. According to his data, several studies have addressed the effect of recombinant LH supplementation; the results of some of these studies indicate that two subgroups of normogonadotropic patients seem to particularly benefit from the addition of LH activity to the stimulation protocol: patients older than 35 years and those with an initial poor response to rFSH. Possible biological reasons for this beneficial effect were discussed within the lecture. Antonio Gutierrez from Mexico gave a talk on ovarian stimulation in PCOS and high responders; he underlined that women with PCOS are at greater risk of developing ovarian hyperstimulation syndrome (OHSS) and that the miscarriage rates following IVF treatment is increased in women with PCOS. Immature oocytes retrieved from antral follicles of unstimulated PCOS ovaries via the trans-vaginal approach, and subsequently matured and fertilized in vitro, might present many clinical advantages by avoiding OHSS risks. Therefore, he concluded, in vitro maturation might be a promising alternative to conventional IVF in PCOS patients. Luigi Devoto from Chile discussed the potential role of androgens in ovarian stimulation. Day after day, scientists are performing many pharmacological and molecular studies which have demonstrated the key role of androgens in follicular growth and of primordial follicles and recruitment. The current findings undoubtedly provide the rationale for initiating new approaches in ovulation induction treatments based in the observation that pharmacological supplementation of androgens could improve treatment outcomes. The keynote lectures was given by William Kearns, from USA, who discussed pros and cons of genetics and proteomics in preimplantation diagnosis. Pre-implantation genetic diagnosis (PGD) identifies genetic abnormalities in preimplantation embryos prior to embryo transfer and showed to be efficacious in improving pregnancy rates in many patient sub-groups, but some risks are related to the methodology. Proteomics is, on the other hand, a non-invasive procedure which provides information about embryos' 'metabolic performance'. It represents a promising, additional tool to assess viability of pre-implantation embryos.
The final session of the event aimed to identify other factors influencing ART outcomes, particularly endometrial receptivity. The first speaker of this session was Paulo Serafini from Brasil who reminded the audience of the criteria to be used for uterine receptivity assessment and to understand the potential, predictive role of this receptivity. From USA, Mark Leondires focused his presentation on how to improve endometrial receptivity in stimulated cycles. After underlining the importance of a specific evaluation of the uterus and endometrial cavity as an essential aspect of improving uterine receptivity he presented the evaluation of pathologies potentially affecting uterine functionality, such as myomas and polyps that should be properly treated for a correct understanding of uterine receptivity. The final speaker of this session was Josè Franco Jr from Brasil who gave a talk about the effects of LH on endometrium and corpus luteum during the ovarian stimulation. The final part of this conference was a very interesting round table entitled 'Role of habits and environment on ovarian stimulation strategies'. Claus Yding Andersen analyzed the impact of diet and weight on reproduction. Obesity, in fact, is often associated with increased risk of concomitant pathologies (diabetes, hypertension, cardiovascular diseases, etc) and therefore obese women experience many reproductive problems. A proper diet and weight reduction strategies could be counselled to these subjects prior to infertility treatments. Antonio Gutierrez from Mexico presented some scientific evidence of the effects of smoking and alcohol consumption on fertility outcomes. Maria do Carmo Borges from Brasil discussed her studies evaluating the effects of pollutants on reproductive outcomes. These studies, coming from a long survey of the population living in the metropolitan area of Rio de Janeiro, showed that people exposed to the most prevalent organ-chlorine compounds as well as lead and cadmium presented abnormalities in both follicular or seminal fluids with severe consequences on their fertility. The round table was concluded by Corinne Palatchi from Mexico who talked about psychological distress and reproductive issues. Distress typically refers to negative stressors and it impacts patients with a complex interplay between mind and body. Major areas affected by stressors that have traditionally been recognized are self esteem and body image, sexuality and intimacy, relationship with partners and family. Current researches in this field try to focus on the causes behind discontinuation of infertility treatment and treatment perseverance, where drop outs are associated with psychological factors, instead of paying attention to the relationship between stress or depression and pregnancy outcomes. A round table session concluded this scientific event with a stimulating discussion between the audience and the faculty. Many questions were raised and many points were debated from personal experience. Evidence and data from different countries, and different approaches to infertility treatment were shared in this session, allowing attendees to increase their knowledge and improve their clinical understanding.
Beaune, France; May 28-29, 2010
The first session began with an outstanding lecture by Martin Matzuk from USA who presented his recent results on basic research between cumulus cell-oocyte communication and infertility outcomes. His group had demonstrated the importance of the bi-directional paracrine communication between the oocyte and the granulosa cells. The evidence of this existing crosstalk will, in the near future, lead to improvements in the process for oocyte selection.
The second session was emphatically entitled 'The seven wonders of ovarian stimulation' and was aimed at providing an overview of all the parameters currently being taken into consideration to manage patients presenting insufficient ovarian responsiveness: androgens, aromatase inhibitors, metformin, mini hCG administration, LH, GnRH to trigger ovulation and estrogen in the luteal phase.
This session closed with a very interesting lecture by Bart Fauser from The Netherlands who described the present tailored strategies aimed at overcoming the 'one fits all approach' and render ovarian stimulation safer and more efficient over time.
A brilliant keynote talk was then given on transcriptomics by Dagan Wells from UK; he overviewed the latest methods of chromosome testing and showed the most up-to-date evidence coming from ongoing clinical studies using these techniques.
The last two sessions were dedicated to the existing relationship between obesity and reproduction, and cancer and reproduction. Nick Finer from UK impressed the audience by presenting recent data on how weight loss associated with an appropriate diet in obese women could greatly improve menstrual regularity, ovulation and finally pregnancy outcomes. On the other side Francois Olivennes, from France and Scientific Organizer of the meeting, highlighted how the recent successes in cancer treatment increase the number of patients requesting assisted reproductive techniques. His lecture analyzed the balance between concerns and benefits of proposing ovarian stimulation to this kind of patients and tried to identify potential protocols to be chosen in such subjects.
The brilliant final panel discussions and the high levels of participant involvement showed that this was again a very successful meeting.
Rome, Italy; June 26, 2010
The symposium began with two stimulating lectures. In the first, Allan Templeton (UK) reviewed the epidemiology of infertility, which underlined the current low rate of fertility in Europe. The second, by Jorge Chavarro (USA), examined the influence of nutrition and lifestyles on reproductive function. The following speakers were Manuela Simoni (Italy), who focused on main genetic markers influencing the reproductive function, genotypes and polymorphisms associated with male infertility and abnormal ovarian response, whilst Frank Broekmans (Netherlands) discussed several ovarian reserve tests (FSH, AFC, AMH) which have been shown to be accurate predictors of poor response. The session was concluded by Michael Alper (USA) who presented a list of practical recommendations on how to increase patient compliance and reduce drop out from treatment.
In the second session, many crucial aspects of ovarian stimulation were addressed including individualization of stimulation regimens and treatment strategies for poor responders. Speakers provided an overview and analysis of practical solutions for OHSS management that allow selection of well-defined goals for ovarian response stimulation and identification of personalized treatments.
The third part of the Symposium focused on some of the most up-to-date laboratory procedures implemented in ART. Jason Barritt (USA) opened the session by examining the current methods for pre-implantation embryo selection. His conclusions confirmed that the combination of microscopy evaluation, genetic testing, protein analysis and metabolic profiling provide a balance of information useful for embryo selection. Noriko Kagawa (Japan) introduced a brief history of cryopreservation techniques in IVF, and then went provided a detailed description of vitrification procedures, focusing on how to maintain the viability of the vitrified oocytes. Finally, she discussed the safety of the open cooling system in order to avoid potential virus contamination during oocytes storage in liquid nitrogen.
The final lecture, by Jacques Donnez (Belgium), addressed the management of fertility preservation in patients undergoing cancer treatments and showed the results of orthotopic reimplantation of cryopreserved ovarian tissue with thirteen live births finally reported. Therefore, as a result of recent advances in ovarian tissue cryobanking, fertility preservation is now a reality for patients whose reproductive function is threatened by radiotherapy or chemotherapy.
The lively participation of the audience in the final panel discussion confirmed that this symposium provided participants with a state-of-the-art knowledge of the key aspects of assisted reproduction, and was an ideal introduction to the scientific sessions of the ESHRE Congress.
Rio de Janeiro, Brazil; May 21-22, 2010
The second session was opened by Bonaventura Casanova (Spain) replacing Celia Oreja-Guevara (Spain) who had to decline to participate in the meeting. Using illustrative images, he reviewed the role of MRI and other advanced imaging examinations in MS. The other two lectures of this session were delivered by two Brazilian speakers, Marco Lana-Peixoto and Regina Papais-Alvarenga, who addressed the geographical distribution, pathophysiology and clinical management of NMO. Marco Lana-Peixoto focused particularly on the role of the antibodies anti-aquaporins in pathogenesis, and Regina Papais-Alvarenga highlighted the differences between the NMO forms observed in Asia and Latam.
The next session was opened by Oliver Neuhaus (Germany) who defined the target of pharmacological treatment within the MS pathophysiologic mechanisms. Then Bonaventura Casanova delivered his second lecture reviewing the knowledge that supports the early initiation of MS treatments, and Miguel Angel Macías (Mexico) discussed two main topics in his lecture: criteria directing the choice of pharmacological treatments in MS, and patient compliance as a determinant of success. He concluded by highlighting the relevance of health care professionals/patient interaction as a key factor for treatment success. The introduction of new drugs and advancement in knowledge of the pathophysiology of MS are suggesting the use of innovative therapeutic schemes, such as induction or combination protocols, as an alternative to the 'classic' escalation approach. Oscár Fernández presented an overview of currently available and new options for MS treatment. Txomin Arbizu (Spain) and Arnoldo Soto (Venezuela) completed the session by reviewing the contents of the Spanish and the Latam Consensus Conferences, respectively.
Jorge Correale (Argentina) started the second day of the symposium by introducing the new therapeutic targets that the drugs expected in the near future are aimed at. Giancarlo Comi (Italy) and Edgardo Cristiano (Argentina) discussed, respectively, new oral and injectable drugs. The future scenarios of MS treatment were completed by Antonio Uccelli (Italy) and Oscár Fernández who delivered two elegant lectures on the use of stem cells. The success of the meeting was confirmed by the level of interest shown by the audience in the two panel discussions that closed the symposium.
Both panel sessions – the first on the advances in pathophysiology and diagnosis of MS, and the second on treatment algorithms – were very stimulating for the audience and led to lively discussions.
Barcelona, Spain; June 1-3, 2010
The already well balanced program, is fine tuned and improved, year by year, for every new meeting, based on comments collected form participants and feedback from the Scientific Organizers and SSIF. The 2010 Preceptorship included four outstanding Keynote Speeches (KNS), delivered by Hartmut Weckerle (Germany), Eva Hvrdova (Czech Republic), Giancarlo Comi (Italy) and Xavier Montalban (Spain). They were dedicated, respectively, to the alterations of immune system function that characterize multiple sclerosis pathogenesis, the optimization of the use of currently available drugs, and to the future oral and injectable therapies. Each of these KNS provided participants with outstanding reviews of the topic based on up-to-date literature, data and speakers’ own experience.
Among the many excellent lectures, are noteworthy the ones by José Carlos Álvarez-Cermeño (Spain) on CSF analysis, by Mar Tintoré (Spain) on MS diagnosis and differential diagnosis, by Angelo Ghezzi (Italy) on juvenile MS and by Jaume Sastre-Garriga (Spain) on symptoms management. Alan Thompson (UK) skilfully chaired the panel discussion on 'cognition in MS' which involved Iris Katharina Penner (Switzerland), who reported interesting evidence on the relationship between cognitive disorders and MRI, Jaume Sastre-Garriga, who addressed the treatment, and Francisco Pérez Mirallez (Spain), who presented a case study.
The whole meeting was characterized by a lively interaction between participants and faculty. In particular, the working groups on case studies provided the opportunity to discuss clinical practice issues, such as MS management and pregnancy, symptoms’ relapses management and efficacy and safety of drugs used in MS. The MS Preceptorship program confirms the need for a multidisciplinary approach in MS management, since physicians, researchers, psychologists, nurses and rehabilitators are included in the faculty. Moreover, the visits to the Cem-Cat premises give the opportunity to see how and where all these healthcare professionals share the complex management of MS patients.
In 2008, the MS Preceptorship was the first SSIF meeting where a role play with a real patient on adherence management was included, since when, it has been one of the most appreciated sessions. In the 2010 Preceptorship, a new patient was invited to interact with Jaume Sastre-Garriga in the simulation of some key aspects of the patient/physician interaction. The session offered the opportunity to discuss with participants the differences and similarities in this interaction, according to cultural and social characteristics specific of the countries of origin of participants.
Berlin, Germany; June 22, 2010
A satellite symposium held during the 20th ENS (European Neurological Society) Meeting
The first lecture, delivered by Heinz Reichmann (Germany), addressed the role of mitochondrial dysfunction in PD. Mitochondrial dysfunction is definitely a relevant mechanisms in PD, but many aspects have to be clarified, including, firstly, whether it is the cause or the consequence of other pathophysiological mechanisms of the disease. The speaker delivered an exhaustive overview of the evidence available on mitochondrial dysfunction in PD, starting from the defect of complex I, one of the members of the metabolic cascade located on the mitochondrial membrane, and going through the other hypothesized mitochondrial alterations almost all related to gene defects.
PD is one of the diseases were cell therapy was considered to be promising from the early stages of the development of this procedure, but it is also a field where hopes related to this approach have been over-emphasized.
Roger Alistair Barker (UK) addressed the topic of stem cell therapies in PD in a very balanced way. ‘The best way to go through the topic is by answering some questions’ said the speaker at the beginning of his lecture. He listed challenging and provocative questions giving answers referred to data and experimental evidences. The choice of the right cells to be transplanted and the way they should be ‘prepared’ for the ‘mission’ of restoring substantia nigra dopaminergic function, the need to clarify if the aim of cellular therapy in PD should be only to restore substantia nigra dopaminergic function, and the lack of standardization in research protocol design are some of the problems that must be solved to avoid the contradictory results seen in clinical trials to date. Roger Alistair Barker answered ‘no’ to the final question which was: ‘so will stem cell therapies be used in PD in the near future?’. In his opinion more well designed studies are needed.
‘To speak about the future, let’s start from the past’ said Thomas Gasser (Germany) opening his lecture and reviewing the history of knowledge of PD genetics. The speaker focused particularly on sporadic PD which he depicted as the basis of the ‘iceberg’ of PD patient population because of its epidemiologic dimension. In this form of the disease the knowledge of the effects of genetic defects and environmental factors on the pathogenesis and their interaction are far from clearly defined. In particular, Thomas Gasser pointed out that it was important to identify low-frequency genetic variants with intermediate effects on PD development in order to clarify the role played by these two etiologic factors. Concluding his talk, the speaker said that the final result that can be envisaged for genetic studies in PD is to provide the basis for an efficacious individualized treatment.
Milan, Italy; April 23-24, 2010
The first session provided participants with an updated overview of basic mechanisms of autoimmunity, starting from the role of innate immunity alterations. Cecilia Garlanda (Italy) introduced the most relevant physiologic mechanisms of innate immunity and clearly depicted some of the steps that change the fundamental mechanisms of defense in pathogenetic mechanisms of autoimmune diseases that damage cells and tissues. She focused particularly on pentraxins and the primary cytokines interleukin 1 and Tumor Necrosis Factor. The following lecture by Ruggero Pardi (Italy) addressed the role of adhesion molecules in leukocyte trafficking, which was depicted using informative images and videos. Upon completion of the first session, three protagonists of the pathophysiology of autoimmune diseases, effector T cells, B cells and regulatory T cells, were introduced by three excellent speakers: Sergio Romagnani, Vito Pistoia and Maria Grazia Roncarolo, all Italian scientists renowned in this field.
Sessions two, three and four were focused on three different autoimmune diseases and were designed to provide a complete overview of their genetics, pathophysiology and therapy. David Hafler (USA) reported the recent achievements in multiple sclerosis (MS) genetics, pointing out relationships between some allelic variations and alterations of immune system function which increase susceptibility to MS. A number of meta-analyses of genomewide studies are producing stimulating evidence, but the complexity of geneenvironment interactions in the pathogenesis of MS leaves many questions unanswered. Marco Furlan (Italy) was a last minute replacement for Hans Peter Hartung (Germany), who was unable to join the meeting because of the flight troubles, but covered the topic of MS pathophysiology, exhaustively addressing both the inflammatory mechanisms that determine the damage and the repair mechanisms. The balance between damage and repair determines the progression of the disease, but the real problem is the prolonged sub-clinical phase of the progression. This is a phase, the speaker claimed, that is very important in the subsequent evolution of the disease, but which risks being undetected and untreated, making MS management much more difficult in the following years. This concept ideally introduced Giancarlo Comi’s talk which reviewed present and future therapies, delivering these main messages: individualize treatment, treat early because drugs are more efficacious and tackle inflammation before it induces irreversible damages.
In the following session, dedicated to type 1 diabetes (T1D) Francesco Cucca (Italy) reported literature and his own group’s data on genetics of the disease and Georgia Fousteri (USA), a collaborator of Matthias von Herrat (USA), delivered an excellent lecture on the pathophysiology of T1D including the interesting concept of “fertile field” determined by viral infection which opens the way to autoimmune aggression against β-cell. She also presented some intriguing proposal for new therapeutic approaches.
Session four was dedicated to Crohn’s Disease with three excellent speakers. Carl Anderson (UK) reported the outcomes of several studies aimed at defining the genes involved in susceptibility to the disease and pointed out that some of them are in common with other autoimmune diseases. Claudio Fiocchi (Italy) delivered an outstanding lecture on pathophysiology, claiming that one of the main difficulties that gastroenterologists have to face in deciphering Crohn’s pathogenesis is related to the different role that intestinal flora can play in each patient. Paolo Gionchetti (Italy) closed the session reviewing current approaches to Crohn’s Disease with a particular focus on the risk/benefit balance.
In the last Session Riccardo Troncone (Italy), Virginia Pascual (USA) and Salvatore Albani (USA) provided overviews on other autoimmune diseases such as, respectively, coeliac disease, systemic lupus erythematosus (SLE) and rheumatic diseases. The first speaker drew attention to the intriguing analogies between T1D and Coeliac Disease, since in both diseases a contact between an environmental factor (protein or virus) induces a reaction of the immune system which leads to the development of an autoimmune disease in subjects with genetic predisposition. He also showed how this predisposition depends on some genes detected in the genetic background of several different diseases and coeliac disease and T1D share both HLA and non-HLA related genes. Virginia Pascual provided a detailed review of the genetic background of SLE pathogenesis and in particular of the role played by some immune cells. The last speaker reported exciting outcomes of research, performed by his group, aimed at inducing immune system tolerance to treat autoimmune diseases. By the end of the meeting it became clear that the challenge of organizing such a highlevel meeting across different clinical areas had been achieved because the event had offered a unique opportunity for experts in different diseases to discuss lines of research and protocols of management that have several common features because they share the underlying objective of tackling autoimmune mechanisms.
Rome, Italy; May 21-22, 2010
Chaired by Murray Kopelow, Chief Executive of the Accreditation Council for CME (ACCME), and Bernard Maillet, Union of European Medical Specialists (UEMS) Secretary General, it has representatives of the CME systems of France, Germany, UK, Canada, Italy, Bulgaria, Finland, Spain and USA. Many new ideas were discussed during this 9th Rome Group meeting which will be developed in the coming months, especially relating to future strategies for Continuing Medical Education (CME) and for Continuing Professional Development (CPD).
Furthermore the members agreed on the creation of a major visibility for the Rome Group activities, with an official web presence supported by Serono Symposia International Foundation starting 2011. In addition, considering the important results and documents developed by the Rome Group in recent years and the group’s increased visibility, the members discussed some possible options to open the forum to observers interested in the meeting activities. Over the past few years the Rome Group has developed a consensus paper, underlining the basic values that are common to all CME programs which must be implemented effectively, including quality, absence of commercial bias and validity of educational content.
This was the first time in the history of CME that a group of leading countries actually met and defined a list of principles for medical education. The Group has also developed three other official documents: 'Standards for Commercial Support', 'Distance-learning CME guidelines' and the 'Glossary on CME'. All these documents have been endorsed by all the members.
Reproductive Medicine
2nd International Symposium on Gene, Environment, Lifestyle Interaction in Human Reproduction
August 27, 2010 - August 28, 2010; Malmö, Sweden
Endometrium and embryo implantation: the hidden frontier
September 24, 2010 - September 25, 2010; Lyon, France
IVF Preceptorship: Current practice in the 21st century
October 7, 2010 - October 8, 2010; Madrid, Spain
Challenging issues in ART
November 12, 2010 - November 13, 2010; Barcelona, Spain
Treating the ovary to obtain better eggs
November 26, 2010 - November 26, 2010; Montreal, Canada
Neurology
MS Academia 2010
October 12, 2010 - October 12, 2010; Gothenburg, Sweden
MS Nurse 2010
October 12, 2010 - October 12, 2010; Gothenburg, Sweden
Biological basis of progressive MS
November 6, 2010 - November 6, 2010; Montreal, Canada
Multiple Sclerosis: Future Treatments and New Goals
November 12, 2010 - November 13, 2010; Vienna, Austria