February 6, 2017
|When we are no longer able to change a situation, we are challenged to change ourselves.
-- Viktor Frankl
|In this Issue|
10,000 U.S. Seniors Die Within Week of ER Discharge Every Year: Study
May be due to gaps in medical knowledge about which patients need more attention, researcher says
THURSDAY, Feb. 2, 2017 (HealthDay News) -- Each year, about 10,000 generally healthy U.S. Medicare patients die within seven days of discharge from a hospital emergency department, a new study contends.
"We know that hospitals vary a lot in how often they admit patients to the hospital from the ED [emergency department], but we don't know whether this matters for patient outcomes," said lead researcher Dr. Ziad Obermeyer.
He is a staff physician in the Brigham and Women's Hospital department of emergency medicine in Boston.
"The variation in outcomes that we observed may be linked to gaps in medical knowledge about which patients need more attention from physicians," Obermeyer said in a hospital news release.
Geography and socioeconomics may also play a role, he said, adding that "access to resources varies dramatically across hospitals."
The analysis of more than 16 million ER visits showed that the most common causes of death in the following week were heart disease and chronic obstructive pulmonary disease (COPD), said Obermeyer, who is also an assistant professor at Harvard Medical School.
But another major cause was overdose from opioid painkillers like Oxycontin, Percocet and Vicodin, mostly after ER visits for pain and injuries, the study found.
Most of these deaths occurred among patients seen at hospitals that admitted few patients from the ER. Policymakers often regard these hospitals as models due to their low costs, the researchers noted.
However, deaths occurred far less often among patients seen at large, university-affiliated ERs with higher hospital admission rates and higher costs. This was so even though patients at these ERs tended to be less healthy upon arrival at the ER, the study authors said.
Patients at greatest risk for death included those with confusion, shortness of breath or generalized weakness. The researchers found that those with chest pain had a much lower risk of death.
The study looked at ER visits made by seniors between 2007-12 across the United States. It did not include patients with known serious illnesses or diagnoses of life-threatening conditions in the ER, any one over 90, or those receiving palliative care.
"There's a lot of policy interest in reducing unnecessary admissions from the ED," Obermeyer said in a hospital news release.
Obviously, not all patients can or should be admitted to the hospital, he noted.
"But we need to focus on admitting the right patients, rather than admitting more or less," he said. "I'm optimistic that advanced analytics and better data will help physicians with these kinds of decisions in the future."
The results were published Feb. 1 in the journal BMJ.
The American College of Emergency Physicians has more on emergency care.
Better Sleep Could Mean Better Sex for Older Women
Study found links between too little shuteye and less sexual satisfaction, especially around menopause
WEDNESDAY, Feb. 1, 2017 (HealthDay News) -- A more satisfying sex life may be only a good night's sleep away for women over 50, new research finds.
Researchers led by Dr. Juliana Kling of the Mayo Clinic in Scottsdale, Ariz., tracked data from nearly 94,000 women aged 50 to 79.
The investigators found that 31 percent had insomnia, and a little more than half (56 percent) said they were somewhat or very satisfied with their sex life.
But too little sleep -- fewer than seven to eight hours a night -- was linked with a lower likelihood of sexual satisfaction, the findings showed.
"This is a very important study since it examines a question which has tremendous potential impact on women's lives," said Dr. Jill Rabin, who reviewed the findings. She's co-chief of the Women's Health Program at Northwell Health in New Hyde Park, N.Y.
Age played a key role in outcomes. For example, the study found that older women were less likely than younger women to be sexually active if they slept fewer than seven to eight hours per night.
Among women older than 70, those who slept fewer than five hours a night were 30 percent less likely to be sexually active than women sleeping seven to eight hours, Kling's team found.
The findings highlight how crucial sleep is to many aspects of women's health, medical experts said.
"Seven hours of sleep per night will improve sexual satisfaction and has been shown to increase sexual responsiveness," said Dr. JoAnn Pinkerton, executive director of The North American Menopause Society.
Besides putting a damper on sex lives, she said, poor sleep is also tied to an array of health issues, such as "sleep apnea, restless legs syndrome, stress and anxiety." Other health problems linked to insomnia include "heart disease, hypertension [high blood pressure], arthritis, fibromyalgia, diabetes, depression and neurological disorders," Pinkerton added.
Dr. Steven Feinsilver directs sleep medicine at Lenox Hill Hospital in New York City. He reviewed the new findings and stressed that they can't prove cause and effect. "It certainly could be possible that many underlying problems -- for example, illness, depression -- could be causing both worsened sleep and worsened sex," he noted.
Rabin agreed, but said there's been "a paucity of studies" looking into links between sleep and sexual health, especially during menopause.
"We know that obstructive sleep apnea and sexual dysfunction are positively correlated," she said. "Other factors which may lead to a decreased sleep quality include: a woman's general health; various life events, which may contribute to her stress; chronic disease; medication; and degree and presence of social supports, just to name a few," Rabin explained.
And, "in menopause, and due to the hormonal transition, women may experience various symptoms which may impact the duration and quality of their sleep patterns," Rabin added.
"We and our patients need to know that quality sleep is necessary for overall optimum functioning and health, including sexual satisfaction, and that there are effective treatment options -- including hormone therapy -- which are available for symptomatic women," she said.
The study was published online Feb. 1 in the journal Menopause.
The U.S. National Institute on Aging has more about sexuality later in life.
Health Tip: Strength Training Is For Seniors, Too
How it may help older people
(HealthDay News) -- Strength training isn't just for younger folks who want to bulk up.
The American Council on Exercise explains that seniors may benefit from:
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