[Assessment and prognostic evaluation of chronic and recurrent arrhythmias].
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The marked improvement during recent years in prognosis for patients with insulin-dependent diabetes mellitus (IDDM), has also had actuarial consequences. In the article is described the development in prognosis over the past 60 years, based (inter alia) on findings in almost 3,000 IDDM patients with onset during the period, 1933-1972, and referred to the Niels Steensens Hospital in Denmark.
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BACKGROUND: The mortality results of policies on insured lives with elevated blood pressure have been the subject of several studies since the early 20th century. This study, which began with issues of 1989, utilizes data from the Impairment Study Capture System (ISCS). Data are also compiled for impairments other than elevated blood pressure in the ISCS for the same study period. A comparison of these 2 sets of data shows the relative severity of elevated blood pressure compared to all other impairments combined. The determination of elevated blood pressure was made on the basis of risk classification due to lack of specific blood pressure readings. METHODS: Mortality results are actual to expected ratios based on the SOA 1990-95 Select Basic Table. The companies participating in this study have completed 3 steps: (1) agreement to have individual reports to the MIB included in the ISCS file; (2) submission of additional policy information, not on the MIB report; and (3) update of in-force status annually. Reports do not include personal identifying information. RESULTS: Based on the limited amount of data contributed by relatively few companies, there has been considerable improvement since earlier studies in mortality among insureds with elevated blood pressure. Some possible reasons for this include: (1) fewer smokers--there were fewer smokers in the population and hence applying for insurance during the period covered by this study as compared to earlier studies; (2) improved treatment, patient awareness and adherence to regimen--a wider variety of medications and current treatment practices compared to treatment in the 1970s and early 1980s may have influenced results. Compared to prior studies, it is likely that more insureds with elevated blood pressure first noted on the insurance examination subsequently have received treatment. In addition, those with elevated blood pressure have become more aware of the importance of adhering to their medication regimen and improving other adverse risk factors; (3) improvement in the treatment of related medical conditions. CONCLUSION: The results of this study must be interpreted with caution. The volume of data is not substantial, and the results may not be representative of non-contributing companies. Going forward, it is hoped that more companies will agree to participate such that future studies will produce data and results of greater utility.
Kawasaki disease is currently the leading cause of acquired heart disease in children in the United States and Japan. The case of an 18-year-old insurance applicant is used to review the pathogenesis, complications, treatment and prognostic implications of this disorder.
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After a brief passage on the reliability and special features of the most important liver values, this paper deals with the diseases of the liver most frequent in everyday rating practice from the angle of specific laboratory patterns and enzyme processes, putting emphasis on prognostic aspects. Special mention is made of the most recent diagnostic findings in the field of virus hepatitis. Furthermore, the influence of alcohol on the liver values is explained in detail. In a résumé, GPT, Gamma-GT and cholinesterase are regarded as sufficient for classifying almost 98% of all diseases of the liver, the limited significance of liver values as "functional parameters" being stressed, however.
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