Methadone therapy.

Diabetic patients are exposed to higher risk of morbidity and mortality. However, it is difficult to define this in advance and to predict the degree of inability for work. The risk is depending on type of diabetes, age of manifestation, age of the patient course and duration of the disease and mainly from glycemic control. Educational programs may markedly ameliorate the overall situation and decrease of risk of late complications which may threat kidney, eyes, nerves and the cardiovascular system. However, it is an erroneus notion that most diabetics may be crippled by complications of their disease which may result in unwarranted bias against them in both work and leisure activities. Most diabetics may undertake any occupation or hobby, of course with some exceptions when hypoglycemia due to insulin or hypoglycemic agents represents risk for themselves and other persons. Those patients may not serve as pilots and cannot hold public service vehicle driving licences. They should not take over the supervision in power-stations etc. Ordinary driving licences can be held by diabetic patients if on insulin or not, provided that they are otherwise physically fit and do not suffer from blackouts. From many studies it is known that the rate of accidents is not higher with respect to diabetic patients than in the normal population. Life assurance premiums are often raised by amounts which depend on the result of a medical examination but it is very important that the judgement is not made on the basis of a single checkup at a given time. To get information about the presence or development of late complications which have a very broad spectrum it is necessary to have insight into the course of the metabolic disorder and the tendency of worsening or amelioration.

Cause of Death↗

PubMed1997

[Fat embolism--a too infrequently determined pathoanatomic diagnosis].

In 1993, pulmonary fat embolism occurred in 92 cases (17%) out of 527 clinical autopsies. It was found in 62% of patients who had suffered bone fractures, in 9% with soft tissue surgery and in 53% after resuscitation; non-traumatic fat embolism was present in 6% of the cases. The comparison group of 50 persons with lethal polytrauma revealed pulmonary fat embolism in 52% of the cases. Bone-marrow embolism and microthrombi accompanied fat embolism of the lungs; furthermore some of the persons with pulmonary fat embolism also expressed minor degrees of renal (55%) and cerebral (25%) fat emboli. A retrospective analysis of the clinical data revealed no specific symptoms: a so called fat embolism syndrome had not been discovered clinically in any of the cases with histologically proven fat embolism. The significance of pulmonary fat embolism as a cause of death with regard to histological and clinical findings is discussed.

Cause of Death↗