Annals of Life Insurance Medicine: 1964 Volume II by H. Jecklin (auth.)

By H. Jecklin (auth.)

One thousand unselected sufferers with asthma were up for a normal interval of eleven years, with extremes of 33 years and 3 years. the typical interval from the 1st signs to the date of follow-up was once 20.6 years within the 562 men and 22.3 years within the 438 ladies, with extremes of seventy two years and 3 years. due to the fact that during the research no modifications have been came across among the sexes, they've been grouped jointly. phrases used, equivalent to bronchial asthma, continual bronchitis, formative years bronchitis, age of onset, etc., were rigorously outlined, as have the descriptions of intermittent and non-stop bronchial asthma. the current nation of the sufferers has been categorized as A (good), B (fair), C (poor), and D (dead). Early age of onset (before sixteen) and intermittent bronchial asthma have been linked and had a extra beneficial analysis, whereas the adolescence bronchitic had a greater outlook than the grownup bronchitic. Intermittent and non-stop bronchial asthma were in comparison. The occurrence of bronchitis before everything was once greater within the non-stop team, and the tendency to strengthen bronchitis through the years (present in all asthmatics) used to be additionally higher within the non-stop staff. people with bronchitis have been in a lot poorer healthiness on follow-up than these without.

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Finally, we can of course distinguish between acute and chronic nephritis (see SARRE 1962 for details of differential diagnoses). The prognosis of long-term compensated chronic nephritis is favourable over years and decades as the statistics have shown. As I have demonstrated elsewhere, it can exist for many years without impairing the capacity for work. There are many cases where the patient does not even notice it provided the blood pressure has not reached a high level and the function of the kidneys is normal or is only reduced by very gradual degrees (serum urea under 60 mg 010).

For the reasons explained in the foregoing paragraphs it is unwise to base the final rating on only one blood pressure reading. Where more than one reading is available, a "rating average" should be computed on the following lines: (a) Usually ignore all blood pressure readings taken more than five years prior to the date of the current medical examination. (b) Form the averages (arithmetic means) of the blood pressures taken on any one day. These may be called the daily averages. The Underwriting of Blood Pressure Abnormalities 35 (c) Form the average (arithmetic mean) of the daily averages for the past three months.

E. the extra mortality to be assessed should be somewhere between the basic and optimal ratings. 5. 1. 1. Repeat blood pressure examinations (a) General situations in which repeat examinations are called for: In the interest of correct underwriting and in view of the considerable variability of blood pressure readings, even over short periods, repeat blood pressure examinations are desirable, sometimes necessary, in a number of situations, for example the following: (i) There may be an indication that the examining doctor tends to understate or overstate blood pressure readings.

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