Filomena Pietrantonio has completed her medical degree from Catholic University of the Sacred Heart of Rome and she has completed residencies in Internal Medicine (Catholic University of Sacred Heart, Rome), Clinical Psicology (University “Sapienza” of Rome) and Cardiology (Torvergata University of Rome). She is co-Director in internal Medicine Department in S. Eugenio Hospital in Rome. She has published 28 papers in reputed journals and has been serving as an editorial board member of International Journal of Community & Family Medicine.
Background: Chronic diseases are the major cause of death (59%) and disability, (46%) of global disease burden. According to the\r\nFuture Hospital Commission of the Royal College of Physicians, Medical Division (MD) will be responsible for all hospital medical\r\nservices from emergency to specialist wards focusing on the management of acute medical patients.\r\nMethods: To better manage polypathological patients requiring hospitalization, we propose the hospital counterpart of Chronic Care\r\nModel (CCM), the Acute Complex Care Model (ACCM). Target population is acutely ill complex and poly-pathological patients\r\n(AICPPs), admitted to hospital and requiring continuous monitoring and high technology resources. Th e mission is to improve\r\nthe AICPPs management through pre-defi ned intra-hospital tracks and a global, multidisciplinary, patient centered approach. Th e\r\nACCM leader is internal medicine specialist (IMS) who summarizes health problems, establishes priorities and restores health\r\nbalance in AICPPs. Admitted patients, evaluated according to validated criteria, should be allocated in High Dependency Areas\r\n(HDAs) to receive more frequent clinical and nursing monitoring than in ordinary wards, even if less than in Intensive Care Unit.\r\nACCM advantage is patient safety, thanks to a more favorable nurse/patients ratio, quicker responses to changes in clinical conditions\r\nand more functional allocation of resources.\r\nResults: Preliminary data collected in two Rome MD (50 patients) showed: Mean age 73 years, more than 4 active comorbidities, need\r\nof continuous monitoring, high technology resources, an average of 4 urgent investigations and 2 specialists consultations performed\r\nduring the fi rst 72 hours from admission.\r\nConclusions: Epidemiological transition leading to a progressive increase in “chronically unstable” patients needing frequent\r\nhospitalizations, enhances the role of hospital IMS. ACCM represents a practical response to this epochal change of roles.
Filomena Pietrantonio has completed her Medical degree from Catholic University of the Sacred Heart of Rome and has completed Residencies in Internal\r\nMedicine (Catholic University of Sacred Heart, Rome), Clinical Psychology (University “Sapienza” of Rome) and Cardiology (Torvergata University of Rome). She\r\nis the Co-Director in Internal Medicine Department in Sant’Eugenio Hospital in San Francisco, USA. She has published 28 papers in reputed journals and has been\r\nserving as an Editorial Board Member of International Journal of Community & Family Medicine.
Background & Aim: International guidelines demonstrate the importance of nutrition and lifestyle as risk factors in chronic diseases\r\n(CD). In order to validate the INS fi rst realized through a pilot study in the race Strafadoi Lazio, the same questionnaire (CRF) was\r\nadministered to a total of 157 athletes during 3 races in 2014.\r\nMethods: CRF was realized to identify, through a composite index, modifi able risk factors in causing CD taking into account: Weight,\r\ndiet and physical activity. Weight was measured using BMI according to the WHO stratifi cation, physical activity as weekly frequency\r\nand average activity duration. Foods were evaluated qualitatively enhancing their eff ect on metabolism and food combination.\r\nResults: INS was calculated by multiplying: Nutrition index, BMI index and physical activity index. Maximum INS value is 0.92\r\nstratifi ed in 4 ranges between 0.01 and 0.92 (very low - low high - very high ). Th e athlete sample, selecting individuals with normal\r\nBMI, doing regularly exercise and following balanced diet, shows high INS value: 0.47-0.69 (75% of the sample) and very high value:\r\n0.69-0.92 (23%). INS seems to be direct correlate with physical activity index (moderate direct correlation: 0.756) and less linked to\r\nnutritional index (0.408) and to BMI Index (0.472).\r\nConclusions: Th e INS is the fi rst composite index that combines nutritional status with other factors such as BMI and diet. Th e\r\nvalidation shows how it can be able to relate adequately to fundamental health determinants and can be a useful tool in evaluation of\r\nCD risk factors.