As we have already explained elsewhere, today's medicine is at a changing point. We are witnessing a paradigm shift that will transform medicine from an exclusive containment of symptoms into a true science of health optimization. 21st century medicine is based on 4 pillars and for this reason in the US it is called 4P medicine:
- Predictive: the possibility to use advanced molecular and genomic tools to study individual risk to develop diseases much before any symptom or clinical manifestation arises.
- Preventive: once the risk factors have been identified, a personalized preventive plan can be develop and will include nutrition, nutraceuticals, phytochemicals, drugs, psychological interventions and exercise.
- Personalized: each intervention is shaped on individual characteristics and not only on being part of a category of individuals with similar symptoms as it is today when a physician makes a diagnosis.
- Participatory: the new medicine is based on a partnership between physician and patient, a long term alliance for the preservation of health in which the patient actively participates in all therapeutic choices.
In order to make operational such form of medicine, it‘s necessary to embrace a methodological revolution which starts from the very concept of diagnosis. Today to make a diagnosis means to position in the same prefixed pathological categories different patients having similar symptoms and manifestations. This is an unavoidable and necessary procedure during an acute episode, when one wants to reach quickly a decision on the best therapeutic approach but doesn't work for chronic conditions or in the field of prevention. In fact to make diagnosis in such a way means to eliminate the subjectivity of the individual and not to take into account that similar manifestations can have totally different origins and mediators.
ISMERIAN's check-up is founded precisely on these concepts and aims to reach the following clinical objectives:
1. Not to simply determine the presence or absence of disease but to evaluate current health status;
2. To determine physio-pathological trends and patterns that can, with time, develop into diseases;
3. To study the biochemical and molecular condition of the subject in order to analyze the very first signs of imbalances and not wait for symptoms;
4. To study the genomic profile of the person in order to understand his or her basic risk;
5. To study the lifestyle and environment where the person lives and to help make them less harmful;
6. To measure levels of stress, capacity to manage emotions and cognitive performance in order to optimize mental functions;
7. To develop a long term complete preventive/therapeutic plan to reduce to the minimum the risk to develop diseases and complications;
8. To use a multimodal therapy in which ones seeks to obtain the maximum result with the less invasive intervention starting with lifestyle changes and enlarging to nutraceuticals and phytochemicals and to synthetic drugs only one the other interventions have not worked sufficiently.
Medical history of the patient
When one books a check-up at ISMERIAN he/she will receive a medical questionnaire of about 25 pages in which many questions are asked about current and past health, lifestyle and family history. The questionnaire will be used as a basis for the discussion with the doctor, moment in which the most important issues will be reviewed in depth. The day of the examination the patient is also asked to bring all old clinical documentation. Sometimes the documents are many but our staff will make copies and include them in your files as this represent vital information used to better understand the specific condition and the effect of previous therapies.
Biochemical and genomic tests
The questionnaire is also used to decide which laboratory exams are necessary for the patient. ISMERIAN adopts an in depth approach to laboratory exams and genomics in which the tests are not done simply on the basis of current symptoms. Therefore on our patients we routinely carry out complete hormonal profiles, inflammatory markers, oxidative stress measurement, concentration of vitamins but we also include all classic biochemistry parameters. The exams are not read only on the basis of norm ranges (most often very wide) but on optimal values as reported in the scientific literature. This allows building a map of pre-pathological trends that is used to develop a long-term preventive programme. Moreover today we can study the genomic predispositions towards several chronic diseases and we can define in a more precise manner the risk to develop several diseases including several forms of cancer, diabetes, osteoporosis, Alzheimer's and Parkinson's disease..
"Head to toe" medical evaluation and determination of biological age
During our check-up the physical examination is done "head to toe", going through every single area, checking for early signs of pathology, hormonal imbalances and vitamin deficiencies. Body composition is also analyzed to determine percentage of fat, lean body mass and water and their distribution throughout the body. Through a battery of functional tests including hearing, vision, lung function, reflexes and memory, biological age of the subject is measured. Differently to chronological age, biological age is an expression of how the organism functions and of how fast it's aging in respect to the average population.
Functional test and fitness evaluation
Our check-up is enriched with a number of advanced functional tests that measure important physiological parameters such as maximum oxygen consumption, basic metabolic rate and heart rate variability which is used to evaluate the balance between sympathetic and parasympathetic nervous system and levels of fatigue of the organism. In the field of fitness we also determine posture, motor control and strength. Among these tests also the Space Curl, originally developed for training astronauts, which allows testing motor control in 3 dimensions.
Pyshco-physiological testing
Psycho-physiology is the science studying the response of different body districts to different emotional conditions of stress or relaxation. It basically allows working in a scientific manner on the mind-body interaction in order to optimize psycho-physical resources, stress management, mental performance and to reduce bodily symptoms related to psychological tension. Also we dedicate a lot of attention to cognitive functionality, memory and attention which are evaluated with a number of specific software. Psycho-physiological tests are carried out in a "mind room", a specific environment enabling relaxation and concentration.
Personalized report and preventive therapeutic programme
The information collected during the check-up is analyzed and integrated with the results of the lab exams. This information is used to prepare a personalized report in which we underline the results obtained and the areas needing a therapeutic approach. The intervention is multi-modal and integrated and includes medical, psychological and exercise interventions. The medical therapy includes a nutritional plan, food supplements, phytonutrients and, when needed, drugs. A follow-up programme is also proposed in order to monitor results.
Logistics and timing
The check-up is entirely taking place at our institute and lasts from 5 to 7 hours. If the person comes in from far away we can organize his or her stay in a nearby hotel which can also provide transportation. It is possible and advisable to book also 1 hour of personal session with our trainers and psychologist in order to receive a correct introducing to the techniques that will be proposed in the fields of physical exercise, stress reduction and emotional management.
What are the benefits?
We provide an integrated form of medicine working on the complex networks connecting the different systems of the organism. For the patient this translates into a better management of health characterized by:
- Personalized prevention based on individual genomic and biochemical characteristics
- Correction of body weight
- Improvement of mobility and muscular endurance
- Improvement of aerobic performance
- Prevention of falls and improved proprioceptive control
- Reduction of back problems
- Increased in vitality and slowing down of aging
- Reducing of stress and better emotional balance
- Improved mental performance
- Regularization of metabolic and hormonal processes
- Aesthetic improvement
- Optimal management of menopause and andropause
- Optimal management of menstrual irregularities and functional hormonal imbalances
Moreover the check-up is the best way to access advanced and integrated therapies for those people affected by a chronic-degenerative diseases such as cardiovascular diseases, diabetes, stroke, hypertension, osteoporosis, osteoarthritis, autoimmune diseases and Alzheimer's.
Dr.Filippo Ongaro
Medical Director
ISMERIAN-Institute for Regenerative and Anti-Aging Medicine
