Exercise and health: Dose and response
Over the past 60 years, an enormous body of data has demonstrated that exercise is good for health. Recently, however, there has been concern that repetitive intense exercise may have deleterious cardiovascular effects. To evaluate this possibility, the author has reviewed the health response to exercise, with particular attention to the body's minimum daily requirement and to the maximum amount that is safe and effective. The American Journal of Medicine
(11/2015) Share: 
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Online cognitive training promotes mental health
Online cognitive training could promote ability to reason in the elderly. United Kingdom researchers studied over 2,000 adults older than 60 years for six months. Increased abilities in reasoning were seen as soon as six weeks. Additional benefits were also seen in the six-month period, and those with age-associated impairment showed the same pattern of gained benefits as those unimpaired. This could prove to be a cost-effective way to promote mental health and stave off progression of deterioration in mental abilities. Journal of the American Medical Directors Association
(11/2015) Share:
Lower urinary tract complaints in older men
The prevalence of lower urinary tract symptoms (LUTS) increases as men age. Some common LUTS are urinary urgency, hesitancy, intermittency, straining and nocturia. The authors studied ~1,200 men in an outpatient setting who complained of LUTS. Among all the symptoms, nocturia was the most common complaint. Nocturia is diagnosed when the individual wakes at night one or more times to urinate. The causes of nocturia can be several-fold and include diabetes mellitus, diabetes insipidus, and bladder and prostate dysfunction. Often, simple behavioral modification such as limiting the amount of fluid intake before bedtime can help with symptoms. Physicians should discern the most bothersome symptom and tailor evaluation and therapy accordingly. Urology
(11/2015) Share:
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Inpatient PPI use tied to infection, death risk
A study in the Journal of General Internal Medicine found that proton-pump inhibitors, frequently prescribed in hospital settings to prevent stomach bleeding, may be linked to greater mortality from hospital-acquired infections. The study used a simulation based on inpatient data to explore risk, finding that those who start PPIs while hospitalized have a 90% higher risk of death, while patients who previously took PPIs and continue during a hospital stay have 79% increased risk. Patients taking PPIs may develop pneumonia or Clostridium difficile infection. United Press International
(11/10) Share:
Intensive blood-pressure reduction boosts vascular protection, review finds
Intensive blood-pressure lowering significantly reduces major cardiovascular events, stroke, myocardial infarction, albuminuria and progression of retinopathy, according to a review of 19 trials including almost 45,000 participants. "This review and meta-analysis provides clear evidence of the benefits of more intensive blood-pressure lowering, including in high-risk patients whose systolic blood pressure is lower than 140 mm Hg," the researchers wrote. The findings were published in The Lancet. Medscape (free registration)
(11/6), Reuters
(11/9) Share:
Depression in diabetes ups mortality, CVD, kidney disease risks
Diabetes patients with depression had a 20% increased risk for incident kidney disease, 24% increased risk for incident coronary heart disease, 35% increased risk for incident stroke and 25% increased risk for all-cause mortality, according to a study presented at Kidney Week 2015. Researchers evaluated over 3 million veterans with a mean age of 65 and also found an association between depression and inflammation. Medscape (free registration)
(11/10) Share:
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Survey reveals hospitals' efforts to "humanize" patient experience
A survey by Vocera Communications' Experience Innovation Network revealed the increasing interest of US health systems and hospitals in "humanizing" data to better understand patient experiences, fears and concerns. According to the report, many providers have implemented monitoring and management platforms to keep track of patients' grievances and complaints, but they still have trouble aligning safety, experience and quality strategies to address them. The report also found that health care organizations employ three times as many people for quality and safety measures as they do for improving patient experience. Healthcare IT News
(11/5) Share:
ACOs on a successful trajectory despite some setbacks
Some accountable care organizations have dropped out of Medicare's Pioneer and Shared Savings programs, causing concern among industry observers, but growing pains are to be expected as the nation's health system transitions to a value-based model, writes Gordon Norman, a senior health management consultant at Towers Watson. Indeed, some ACOs that have left the Medicare programs remain committed to the accountable care model and have chosen other options that involve either less risk or different metrics, write Mark McClellan, S. Lawrence Kocot and Ross White. BeckersHospitalReview.com
(11/6), Health Affairs Blog
(11/4) Share:
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