Clean lungs at a price. Do smoking-related deaths save the nation money?
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Monoclonal gammopathy of undetermined significance is not a benign condition. There is a significant increase in mortality associated with the risk of development of multiple myeloma and related disorders.
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HIV infection and AIDS pose special challenges to employers. Myriad laws affect how the employer must respond when an applicant or employee is infected with HIV or is ill due to AIDS. An overall compliance strategy should include thorough knowledge of those laws and a policy on HIV and AIDS, put in place before a crisis occurs.
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BACKGROUND: The Cystic Fibrosis Foundation has been collecting mortality and other data on cystic fibrosis patients from over 100 U.S. clinical centers since 1966, and publishes annual reports of the data. Cystic fibrosis is an important autosomal recessive genetic disease, affecting multiple body systems, with disability and early mortality as very common complications. RESULTS: Observed data by age in the 1994 and 1995 REports are compared with the earliest Registry experience. 1966-1972, after age-matching observed with expected mortality in the U.S. population. Observed and expected results are given in four tables of comparative mortality. CONCLUSION: Excess mortality as a rate difference has shown a marked decrease during this time period, ranging from 96% at age 0-1 to 52% at ages 20-25 years. This can be attributed to improvements in medical treatment.
BACKGROUND: Long-term outcome of patients treated with a St. Jude prosthetic heart valve was reported by investigators in Lausanne, Switzerland. This article quantifies the mortality and morbidity implications of single or multiple heart valve replacement. RESULTS: After hospital discharge, mortality ratios were highest for duration 5-10 years, roughly comparable in patients who received a single valve, and generally higher in those who received both an aortic and a mitral valve prosthesis. Outcome varied with preoperative myocardial function, but there was no survival difference among subjects with a history of stenotic, regurgitant, or mixed lesions. Postoperative complications included embolism, anticoagulant-related hemorrhage, stroke, prosthesis thrombosis, endocarditis, prosthesis dysfunction, hemolytic anemia, and reoperation. CONCLUSIONS: This study indicated that overall mortality experience was fairly comparable in patients who received a single St. Jude prosthetic heart valve and less favorable in those who received multiple valves. Long-term morbidity rates following insertion of a St. Jude prosthetic heart valve were high.
Survival following treatment of breast cancer may be estimated through the recognition of various prognostic factors. The Case Study presented here calls attention to several of these factors. The reliability and relative value of these prognosticators are discussed. Recommendations are offered for the practical application of prognostic information in the determination of expected mortality.
Proposed legislation to limit the use of genetic test results in insurance underwriting has appeared with increasing frequency at the state and federal level. The proponents seek to protect consumers from unfair discrimination by insurers. Can we not develop a proactive approach, acknowledging that we do not need to do prospective testing while we assert that we must retain the current status of equivalency of information between the underwriter and the applicant?
Gamma-glutamyltransferase (GGT) is a highly sensitive but poorly specific liver enzyme commonly used to detect hepatobiliary disease and possible alcohol abuse. Isolated elevations of this enzyme may be due to biochemical anomalies rather than the presence of pathology.
Insurers and their support organizations are among the largest collectors and users of personally identifiable information in the United States, yet little attention has been focused historically on the implications of insurers' information practices to individuals' privacy. Moreover, these practices are virtually opaque from the subject individual's point of view--in other words, individuals do not realize the full implications to their privacy when they enter into relationships with insurers. Thus, individuals may be at a disadvantage from a privacy protection standpoint in dealing with insurers. This paper analyzes insurers' information practices from a privacy protection perspective and suggests several areas that need improvement.
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