Post-Hospital Syndrome: A New Challenge in Cardiovascular Practice

AbstractThe image of the hospital representing the modern medicine and its diagnostic and therapeutic advances becomes more evident in the face of an aging population and patients with multiple comorbidities requiring highly complex care. However, recent studies have shown a growing number of hospital readmissions within 30 days after discharge. The post-hospital syndrome is a new clinical entity associated with multiple vulnerabilities that contribute to hospital readmissions. During hospitalization, the patient is exposed to different stressors of physical, environmental, and psychosocial natures that trigger pathophysiological and multisystemic responses and increase the risk of complications after hospital discharge. Patients with a cardiac disease have high rates of readmission within 30 days. Therefore, it is important for cardiologists to recognize the post-hospital syndrome since it may impact their daily practice. This review aims at discussing the current scientific evidence regarding predictors and stressors involved in the post-hospital syndrome and the measures that are currently being taken to minimize their effects.

Analysis Treatment Guideline versus Clinical Practice Protocol in Patients Hospitalized due to Heart Failure

Background: Despite the availability of guidelines for treatment of heart failure (HF), only a few studies have assessed how hospitals adhere to the recommended therapies. Objectives: Compare the rates of adherence to the prescription of angiotensin-converting enzyme inhibitor or angiotensin II receptor blockers (ACEI/ARB) at hospital discharge, which is considered a quality indicator by the Joint Commission International, and to the prescription of beta-blockers at hospital discharge, which is recommended by national and international guidelines, in a hospital with a case management program to supervise the implementation of a clinical practice protocol (HCP) and another hospital that follows treatment guidelines (HCG). Methods: Prospective observational study that evaluated patients consecutively admitted to both hospitals due to decompensated HF between August 1st, 2006, and December 31st, 2008. We used as comparing parameters the prescription rates of beta-blockers and ACEI/ARB at hospital discharge and in-hospital mortality. Results: We analyzed 1,052 patients (30% female, mean age 70.6 ± 14.1 years), 381 (36%) of whom were seen at HCG and 781 (64%) at HCP. The prescription rates of beta-blockers at discharge at HCG and HCP were both 69% (p = 0.458), whereas those of ACEI/ARB were 83% and 86%, respectively (p = 0.162). In-hospital mortality rates were 16.5% at HCP and 27.8% at HCG (p < 0.001). Conclusion: There was no difference in prescription rates of beta-blocker and ACEI/ARB at hospital discharge between the institutions, but HCP had lower in-hospital mortality. This difference in mortality may be attributed to different clinical characteristics of the patients in both hospitals.

On the stepwise and disciplined engineering of adaptive service-oriented applications

Magdeburg, Univ., Fak. für Informatik, Habil.-Schr., 2010

Best-Practice - Mobile Testing Viewing mobile usability studies with the example of an eyetracking study in the retail sector

Today, usability testing in the development of software and systems is essential. A stationary usability lab offers many different possibilities in the evaluation of usability, but it reaches its limits in terms of flexibility and the experimental conditions. Mobile usability studies consider consciously outside influences, and these studies require a specially adapted approach to preparation, implementation and evaluation. Using the example of a mobile eye tracking study the difficulties and the opportunities of mobile testing are considered.

Hypermodelling : next level software engineering with data warehouses

Magdeburg, Univ., Fak. für Informatik, Diss., 2013

Energieeffizienz in Gebäuden durch innovative Gebäudetechnik, Durchgängiges Engineering von Gebäudesystemen

Aufbauend auf den Arbeiten von Prof. Dr. Müller (Hochschule Wismar) wird am Beispiel eines Fachklinikums mit Forschungslaboratorien eine Methode und Struktur der integrierten Planung zur Gebäudetechnik und Gebäudeautomation vorgestellt. Die linear integrierte Planung der HOAI wird aufgelöst in einen auf mehreren Varianten basierenden Planungsablauf, der durch die variablen Kriterien Energieeffizienz und Ökonomie zu einer optimierten Gesamtlösung führt.

Verwendung von Merkmalen im Engineering von Systemen

Magdeburg, Univ., Fak. für Elektrotechnik und Informationstechnik, Diss., 2015

Algorithm engineering for expression dag based number types

Magdeburg, Univ., Fak. für Informatik, Diss., 2015

Einfluss der Gravitation auf humane Chondrozyten : Tissue Engineering des Knorpels

Universität Magdeburg, Univ., Dissertation, 2015

National Aquaculture Development Plan / prepared by the Joint Subcommittee on Aquaculture of the Federal Coordinating Council on Science, Engineering and Technology.

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Resum de la tasca realitzada al Center Biomedical Engineering (CBE) del Massachussets Institute of Technology (MIT). Juliol-Agost 2005

Estudi elaborat a partir d’una estada al Center Biomedical Engineering (CBE) del Massachussets Institute of Technology (MIT), durant els mesos de juliol i agost del 2005. S’investiga una metodologia amb l’objectiu d’obtenir biomaterials que puguin actuar de bastida en la interfície os/cartílag, afavorint la diferenciació i creixement cel·lular de cartílag ossificat que pugui actuar d’unió entre l’articulació i l’os. S’experimenta una metodologia per a establir quins són els péptids afavoridors de la formació de teixit ossi utilitzats en materials d’hidroxiapatita. Es conclou que la tecnologia desenvolupada permet disposar d’una plataforma per assajar l’estudi del signaling sobre cèl·lules embrionàries, que permeti desenvolupar materials amb més capacitat diferenciadora.

Thermal tests on the LISA pathfinder engineering model

Report for the scientific sojourn carried out at Albert Einstein Institut in Germany, from April to July 2006.