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At least 955 records · Page 53Linked to original sources
PubMed1997

[Traumatic splenic rupture--fatal increase in thrombocytes after splenectomy].

A patient with CMGM developed after traumatic splenectomy a severe thrombocytosis up to 4 millions. 25 days after the accident he died of acute right heart failure caused by vascular occlusion of lung vessels due to thrombocyte aggregations. According to the regulations of professional cooperatives in Germany the death is caused by the occupational accident. A bereaved pension will be payed. For the private life insurance the blood disease is with 33% partial responsible for the fatal development and reduces the payment. According to german penal law the death of the victim will tighten the punishment, if someone else is guilty for the accident. A professional error on the part of a doctor is not provable.

Accidents, Occupational↗
PubMed1997

Nonalcoholic fatty liver (NASH syndrome).

Nonalcoholic steatohepatitis (NASH) is the term used for a common form of fatty liver presenting in adults with varied clinical manifestations. The most common presentation is asymptomatic elevation of liver enzymes (AST or SGOT and ALT or SGPT), which can be discovered incidentally in the course of an annual checkup, life insurance examination, or as part of surrogate screening before blood donation. At the other end of the clinical spectrum is the patient with complications from cryptogenic cirrhosis, who also shows a lack of evidence of alcohol as an etiological factor in pathogenesis. Clinical associations of probable relevance include gender (female), obesity, diabetes, and hyperlipidemia, but many patients do not conform to any of these stereotypes (e.g., young men of normal weight with normal fasting glucose and lipid levels). Liver biopsy confirms the diagnosis of NASH, the association of steatosis with an inflammatory response being the sine qua non for the condition and "creeping fibrosis" being a variable but possibly sinister feature. Newer imaging techniques may provide convincing evidence of steatosis, but they give little insight into ongoing fibrosis, and liver biopsy therefore remains the gold standard. The mainstay of treatment remains judicious weight loss coupled with positive dietary advice, including the ingestion of adequate but not excessive vitamins. After initial encouraging data. the assessment of ursodeoxycholic acid currently being studied under randomized controlled conditions is eagerly awaited.

Adult↗
PubMed1998

Screening for hemochromatosis: phenotype versus genotype.

Hereditary hemochromatosis is one of the most common inherited disorders among Caucasians of European ancestry. Malregulation of iron absorption from the duodenum eventually leads to iron overload. Although the time required to become iron loaded is variable, it is clear that most homozygotes will eventually become symptomatic. The clinical manifestations can be prevented by prophylactic phlebotomy therapy. Screening young populations is therefore a key to the prevention of disease-related morbidity. Protocols based on the phenotype of high transferrin saturation already exist. The recent identification of a candidate gene for hemochromatosis now allows for a potential genetic screen. Both the phenotypic and the genotypic methods of screening have inherent advantages and disadvantages. Iron-depletion therapy of homozygotes before the development of disease-related morbidity results in normal longevity. National initiatives for hemochromatosis screening will prevent morbidity by identifying and treating young, healthy homozygotes. Healthy, iron-depleted homozygotes should be eligible for health and life insurance at standard rates. Furthermore, healthy homozygotes would make ideal blood donors.

Genetic Testing↗
PubMed1997

Health insurance reform legislation.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA), enacted on August 21, 1996 (Public Law 104-19), provides for improved access and renewability with respect to employment-related group health plans, to health insurance coverage sold in connection with group plans, and to the individual market (by amending the Public Health Service Act). The Act's provisions include improvements in portability and continuity of health insurance coverage; combatting waste, fraud, and abuse in health insurance and health care delivery; promoting the use of medical savings accounts; improving access to long-term care services and insurance coverage; administrative simplification; and addressing duplication and coordination of Medicare benefits.

Career Mobility↗
PubMed1997

[Epilepsy and suicide--a new evaluation. Prevalence and classification of methods].

According to a criticism of all findings results that an early and progressing successful medical and psychosocial therapy will help to reduce respectively to prevent suicide. Certainly the risk is still insignificant higher than on the average of general population but doesn't come to the three- or five-fold as constantly repeated in the past. The uncertain number of attempts of suicides is at least comparably high in epileptics and general population. The described facts give permission to more founded statements with respect to the prognosis of epilepsies and should be taken into consideration by contracting for life-insurances, especially if seizure-control persists or is to be expected within a reasonable space of time.

Female↗
PubMed2002

Hypertrophic cardiomyopathy: risk factors for life and living benefits insurance.

BACKGROUND: The clinical course of hypertrophic cardiomyopathy (HCM) is highly variable. Patients may remain asymptomatic throughout life, develop progressive and ultimately fatal heart failure, or die prematurely due to sudden death. This article reviews Western and Asian literature on HCM, including recent studies of large, regionally based cohorts that reflect the full spectrum of disease. The intent is to estimate HCM-related morbidity and mortality rates in the general population and identify risk factors for life and living benefits insurance. RESULTS: Clinical studies have identified risk factors that are associated with a higher incidence of sudden death, such as non-sustained ventricular tachycardia, left ventricular wall thickness, and family history of sudden death. For many of these factors, there was a nonlinear relationship between mortality risk and the number of risk factors (ie, each additional risk factor was associated with a disproportionately greater risk of sudden death). Natural history studies of patients with HCM reported total HCM-related mortality rates of 1.8% per year for ages 5 to 15 years, 1.0% to 1.5% for ages 16 to 65, 3.9% for ages 66 to 75, and 4.7% for ages above 75 years. Sudden death rates varied from 0.5% to 1.5% per year for most age groups, with children and adolescents experiencing sudden death rates near the top of this range. With regard to morbidity, patients progressed from New York Heart Association functional class I or II to III/IV at a rate of 1% to 2% per year, with higher progression rates in people aged 65 years or older. Risk varied with genotype and was generally similar in Western and Asian populations. CONCLUSION: Despite improvements in diagnosis and treatment, HCM is still associated with considerable morbidity and mortality.

Adolescent↗
PubMedDate not supplied

[The problem of private insurance for patients with epilepsy (author's transl)].

324 epileptics were questioned about their approach to private insurance. Only 9,26% of them were covered by a life or accident insurance policy: 3,70% had life insurance, 3,70% accident insurance and 1,86% both. None of the patients had declared his disability to the insurance company. In 6,17% of the 324 epileptic cases an insurance policy had been taken out by their parents. In comparison about 35% of the Italian population in general are insured. A questionnaire was sent to 20 insurance companies; only 5 of them replied, saying that as far as accidents were concerned, they considered epileptics uninsurable. As for life insurance, policies can be contracted at increased premiums, according to the individual case (including the severity of the illness). Physicians must give epileptics fuller information about their insurance plans because, if their illness is detected after an accident, they will find themselves not covered by insurance. Government intervention is called for with the setting-up of special funds for this purpose.

Cost Control↗
PubMed1993

Employment and insurance for young adults with congenital heart disease.

OBJECTIVE: To determine the life and health insurability and employability of young adults with congenital heart disease. DESIGN: Questionnaire study. SETTING: Cardiac department of a tertiary referral hospital for children. PATIENTS: Young adults 18-30 years old with a variety of congenital heart defects, both simple and complex, including postoperative patients. MAIN OUTCOME MEASURES: Availability of insurance at normal or high rates, with or without special conditions or exclusions. Prospects for employment. RESULTS: Questionnaires were sent to eight large life insurance companies, five health insurance companies and, 15 employers, and 26 replies were received (93%). The consensus for life insurability was that young adults with mitral valve prolapse without regurgitation, postoperative ductus arteriosus, and aortic coarctation were insurable at standard rates. Those with any of the other heart defects listed were either insurable at high rates, or in the case of many lesions, not insurable at all. The consensus for health insurance was that insurance was available, but with complete exclusion of benefit for the cardiac disorder. Employment prospects were good for those with simple defects, but poorer for those with complex lesions. CONCLUSIONS: Prospects for insurance and employment for young adults with complex congenital heart lesions are poor. Inconsistencies found in insurance and job policies may be due to lack of appropriate guidelines for the outcome of young adults with corrected and uncorrected congenital heart disease.

Adolescent↗
PubMed1991

Life after mandatory insurance: Hawaii providers tide a new wave.

While the nation looks to universal access laws as a solution to hospitals' rising costs of caring for the uninsured, laws covering all workers are standard operating procedure in Hawaii. The state's mandatory insurance law was meant to reduce hospitals' indigent-care losses, but losses have continued to mount at some facilities. Despite the overall benefits of the law, Hawaiian hospitals struggle just like their mainland counterparts to survive.

Evaluation Studies as Topic↗