[Causes and incidence of traffic accidents caused by precipitous disorders of consciousness and illnesses of drivers. A one year study in Upper Austria and Salzburg]. / Ursachen und Häufigkeit von Verkehrsunfällen infolge anfallsartiger Bewusstseins- bzw. Gesundheitsstörungen der Lenker. Eine einjährige Erhebung in Oberösterreich und Salzburg.

It was attempted to make a survey of all traffic accidents due to sudden disturbances of health on behalf of drivers, being supported by the police of Upper Austria and Salzburg. Only 26 out of a total amount of 53.530 road accidents were made known but the cooperation with the police did not always seem to work too well. Only in the province of Salzburg did the number of these accidents correspond with the expected frequencies of 1.3%. Most of the drivers were internally sick, cardiovascular diseases prevailing. The danger of epilepsy is generally overestimated, that of diabetes and other internal diseases rather underrated. People in general good health were also seen causing accidents due to nausea. In such cases self-endangering is twice as common as the exposure of others to danger. In the majority of the incidents only damage to property resulted. In addition it became apparent, that accidents with damage to people occurred more often in the city than in rural areas, whereas fatalities and severe injuries were more common in the country than in cities.

Complications of insulin-dependent diabetes mellitus: management of insulin reactions and acute illness.

Occasional mild hypoglycemia is an unavoidable and usually acceptable side effect of intensive insulin therapy. Patients with insulin-dependent diabetes mellitus may have impaired glucose counterregulation, which may increase the risk of hypoglycemia and justify less ambitious glycemic goals. A conservative but flexible approach to the treatment of insulin reactions is appropriate in order to avoid hyperglycemia. Insulin requirements are often increased during acute illness, and frequent self-monitoring of blood glucose concentrations is necessary to determine the need for supplementation with regular insulin. Frequent supplementation, together with modification of diet and maintenance of fluid intake, should not only minimize the need for hospitalization but also prevent severe deterioration in glycemic control.

Case-control studies on the acute effects of coffee upon the risk of myocardial infarction: problems in the selection of a hospital control series.

In the course of evaluating the acute effect of caffeine-containing coffee on the risk of myocardial infarction (MI) among women 30-49 years of age, this study noted appreciable differences in coffee consumption among hospital patients admitted for illnesses not known to be related to coffee use. Among these potential controls, the coffee consumption of patients who had been compelled to hospital by conditions having an acute onset, such as fractures ("acute condition controls") was compared with that of patients admitted for chronic disorders ("chronic condition controls"). The proportion of drinkers of caffeine-containing coffee among 980 acute condition controls (65%) was significantly greater than that among 5835 chronic condition controls (58%) (p less than 0.01); by contrast, the proportion of drinkers of decaffeinated coffee was significantly greater among chronic condition controls (22%) than among acute condition controls (18%) (p less than 0.01). With regard to caffeine-containing coffee, other findings were that the frequency of drinking decreased with increasing contact with medical care in the year before admission; that patients who changed their consumption after discharge tended to give up coffee; and that the proportion of drinkers was greater among women in the community than among the hospital patients. These results suggest that relatively long-standing illness influences against drinking caffeine-containing coffee among women 30-49 years of age. They also suggest that there is an opportunity for overestimation of the relative risk of MI among coffee drinkers in hospital-based studies that use chronic condition controls.