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At least 1,387 records · Page 77Linked to original sources
PubMed1998

Mortality in rheumatoid arthritis: experience in four clinical series compared with the experience in the 1983 medical impairment study.

BACKGROUND: Survival curves and decimal Standardized Mortality Ratios (SMRs) were reported in 1994 for four clinical series of patients with Rheumatoid Arthritis (RA), with use of a common data processing system. It was felt to be desirable to compare the excess mortality observed in clinical patients with the excess mortality found in substandard policyholders with RA in the 1983 Medical Impairment Study. RESULTS: The weighted mean SMR was 2.25 for the male RA patients and 2.42 for the females. Although similar in magnitude to the percentage male and female Mortality Ratios (MRs) in the 1983 Medical Impairment Study, the derived Excess Death Rate (EDR) was higher for the clinical RA patients, despite the lower select mortality versus the population mortality, even after adjustment for difference in mean age between the clinical and insurance series. CONCLUSION: The higher EDR in four clinical series of RA patients probably reflects a higher proportion of more severe cases, who are declined for insurance or do not accept a highly rated offer.

Adult↗
PubMed1998

Underwriting implications of premalignant disease.

The study of premalignant disease may hold the promise of cancer prevention and, in some cases, this potential is already being realized. In other instances, however, increased risk of mortality and morbidity has been identified without clear data to guide treatment. This series reviews the current state of information about premalignant disease from the perspective of diagnosis, treatment and underwriting risk. The first article will focus on prostatic intraepithelial neoplasia.

Aged↗
PubMed1998

Chronic eosinophilic pneumonia.

Chronic eosinophilic pneumonia (CEP) belongs to a group of syndromes manifested by pulmonary infiltrates with peripheral eosinophilia (PIE syndromes). The role of the eosinophil as a destructive agent in CEP is discussed. The degree of manifested eosinophilia at the time of diagnosis, the frequency of relapses of pneumonia, the response to steroid therapy, the status of current physical and x-ray findings, and especially the trend in pulmonary function data, all appear to be critical factors in determining the potential mortality risk of CEP cases.

Adrenal Cortex Hormones↗
PubMed1999

[Medical risk assessment at the turn of the century. International developments and trends--exemplified by some typical changes].

This article analyses the effects that the increasing amount of medical information available today can have on risk assessment, using examples taken from the fields of serological laboratory diagnosis (HIV, Hepatitis C) and sonographic and molecular genetic examination methods. In general, it can be said that new methods of diagnosis help achieve a more exact and refined prognosis, although their results cannot always be implemented consistently, especially in so-called borderline cases. The second section provides a detailed analysis of access to and availability of medical information in proposal forms, drawing on experience gained from the most important markets.

Diagnostic Techniques and Procedures↗
PubMed1998

5-year survival after bone marrow transplantation for aplastic anemia.

The International Bone Marrow Transplant Registry reported experience from 179 transplant teams worldwide on patients treated with bone marrow transplantation for severe aplastic anemia. The cohort consisted of 470 patients (283 male, 187 female), mean age 20 years, who received an HLA-identical sibling bone marrow transplant for aplastic anemia between 1988 and 1992. The etiology of aplastic anemia was usually idiopathic, with a small number of cases caused by hepatitis or toxin exposure. Congenital aplastic anemia was not considered. Expected mortality was based on the United States 1992 Total Population Mortality Table. Additional data were obtained from the author.

Adolescent↗
PubMed1998

Comparative mortality in cerebral palsy patients in California, 1980-1996.

BACKGROUND: The large database of the California Department of Developmental Services provides a data source for mortality rates in persons with mental retardation by age, sex, severity, cause and associated conditions. This study involves patients with a diagnosis of cerebral palsy. RESULTS: After a table of demographic data, four tables are used to show detailed age-related observed and expected mortality rates for Cerebral Palsy patients by sex and a severity factor that divides the patients into two groups of approximately equal size. The factor used was quadriplegia (all four limbs involved in motor dysfunction). Spasticity was the predominant feature of the motor dysfunction. CONCLUSION: Excess mortality was moderate in the less severe Cerebral Palsy patients, but was higher in those with quadriplegia (overall EDR--Excess Death Rate--about 6 per 1000 and 16 per 1000, respectively). In less severe cases EDR was higher at ages 1-4 years, the almost constant to age 49, then rose with advancing age. In case with quadriplegia EDR decreased in childhood and young adults to a relatively stable minimum at ages 25-49, then increased at older ages. There was little sex difference in EDR.

Activities of Daily Living↗
PubMed1998

Medical underwriting on the eve of the millennium.

This article discusses the effects of the profusion of medical data on daily underwriting and then attempts to derive conclusions as to future developments in this field. Whereas the volume of medical information is constantly increasing, access to this information is in many cases being rendered difficult as a result of a highly critical attitude to the insurance industry on the part of applicants and medical practitioners. The second part of this article looks more closely at the handling of medical information and makes reference in this regard to the experience of insurance medical officers and directors of underwriting departments in the most important international markets.

Confidentiality↗
PubMed1998

Psoriatic arthritis.

Arthritis of various types can occur as a manifestation of psoriasis, and is classified as one of the seronegative spondyloarthropathies. Progression of psoriatic arthritis can be predicted by both clinical and biochemical markers. In some cases, mortality may be adversely effected.

Adult↗