PubMed Health⌕ Search

Biomedical subjects

M L Hefti

Publications and source records attributed to M L Hefti.

At least 19 recordsLinked to original sources
PubMed1990

[Life expectancy and risk assessment in decreased glucose tolerance (subclinical diabetes)].

The term Impaired Glucose Tolerance (IGT) has replaced the term Subclinical Diabetes (SD). It corresponds to a grey zone between normal glucose tolerance (GT) and diabetic glucose intolerance which by definition can be determined only by an oral glucose tolerance test. Pathogenetically, and impaired glucose tolerance constitutes a risk factor for the formation of atherosclerosis and in about 30% of cases represents a pre-stage of diabetes mellitus. No mortality statistics are as yet available for insureds with impaired glucose tolerance. We may, however, assume with good reason that their relative mortality lies between the comparable values of insureds with normal glucose tolerance and those with type 2 diabetes. The relative mortality of type 2 diabetes is calculated on the basis of the American Medical Impairment Study 1983 and the Swiss Re study on diabetes mellitus and the relative mortality of insureds with impaired glucose tolerance is then determined on that basis. Finally, a possible course of action for the risk assessment of applicants with impaired glucose tolerance is proposed and the expected extra mortality rates are given.

Adolescent↗
PubMed1988

[Principles of risk assessment in the life insurance industry as exemplified by ulcerative colitis].

This report addresses physicians whose work lies outside the field of life insurance and especially its particular type of risk assessment. It attempts to clear up some typical misconceptions arising between attending physicians and the medical consultant working in life insurance. Taking as an example the life insurance application of a man with conservatively treated ulcerative colitis, risk assessment procedure from the viewpoint of life insurance is analyzed on the basis of the Swiss Reinsurance Company rating guidelines. Attention is drawn to the specific features of prognosis assessment in life insurance compared with that in medical practice or at the bedside. The concepts of mortality and extra mortality are defined and that of mortality compared with the concept of survival rate. The example of the colitis patient is used to show why the extra mortality observed by life insurers can be markedly above that indicated by epidemiologists and clinicians, and why a practically normal 5-year survival rate and significantly increased mortality need not be mutually exclusive. The statistical basis for the mortality assumptions of life insurers is exemplified by the Medical Impairment Study 1983 published in autumn 1987, which gives an average extra mortality of 162% for insured persons who had ulcerative colitis at the time of policy issue.

Adult↗
PubMed1981

Intramural pseudodiverticulosis of the esophagus: report of seven cases and literature review.

Seven cases of esophageal intramural pseudodiverticulosis (EIPD) are presented and compared with 46 cases previously reported. EIPD is mainly a disease of older age with a 3:2 predominance of male patients. The radiologic appearance of EIPD shows great variation in localization and severity of visible changes. Radiologic examination is far more sensitive than endoscopy in diagnosing EIPD. The most effective therapy for EIPD is dilatation of strictures, leading to amelioration or disappearance of symptoms in over 90% of cases. Visible pseudodiverticula may persist after therapy, even in symptom-free patients.

Age Factors↗
PubMed1977

[Dissolution of gallstones by chenodeoxycholic acid].

A 2-year prospective study with chenodeoxycholic acid (CDCA) (750 mg per day) was performed in 34 asymptomatic patients with radiolucent gallstones. 17 patients dropped out before completion of the trial. In 5 cases (29%) the stones dissolved and in 5 additional cases they decreased in size, while in 2 cases (13%) they increased in size during treatment. Favorable criteria for dissolution were round stones without edges and fissures on radiological appearance and a stone diameter of less than 1 cm. In 3 cases drug-induced nausea or diarrhea were so pronounced that treatment could not be continued. CDCA treatment also caused a significant rise in SGPT for at least one year. Thus, CDCA is at best moderately effective in a highly selective group of patients with gallstones.

Aspartate Aminotransferases↗