In medical practice today, diabetic ketoacidosis results in a fatal outcome for 10% of patients, and in the hyperosmolar non-ketoacidosis syndrome 50% die. Thrombotic complications account for a considerable proportion of the deaths of these patients and cerebral manifestations are characteristic of their hyperosmolar state. A strategy which leads to improved management and survival of these severely decompensated patients remains to be found. Recommendations for management of these patients are presently controversial because the aetiology of their cerebral disturbance is ill-defined. This thesis describes novel alterations in blood from patients with ketoacidosis which are particularly associated with the development of the hyperosmolar state. The combination of these abnormalities with other factors present, leads to an unique summated effect on the flow properties of blood during severe diabetic decomposition. Subsequently impaired perfusion could therefore account for the depressed conscious level, strokes and fatal thrombotic phenomena commonly associated with diabetic ketoacidosis. The biochemical alterations underlying the blood abnormalities were studied both in humans and in animals with severe diabetic ketoacidosis. The findings which emerged from the study are particularly relevant to planning treatment and monitoring the pathophysiological response of vital tissue in these patients. It is possible that we can reduce the mortality of these serious medical conditions and improve the outlook for the diabetic individual if we elucidate the underlying pathophysiological changes and adjust treatment accordingly.

Bakgrund: Hjärtinfarkt bedöms vara den ledande dödsorsaken världen över. Trots att fler män än kvinnor insjuknar i hjärtinfarkt är dödligheten bland kvinnor högre. Bilden av hjärt- kärlsjukdom har länge präglats av ett manligt perspektiv vilket är en livshotande inställning som leder till att kvinnors symtom inte tas på allvar. Syfte: Syftet med studien var att beskriva kvinnors upplevelser av symtomen vid hjärtinfarkt. Metod: En litteraturöversikt där elva  artiklar från databaserna CINAHL Complete och PubMed granskats och analyserats. Resultat: De vanligaste symtomen hos kvinnor med hjärtinfarkt var smärta, fatique, andningspåverkan, gastrointestinala besvär och kroppstemperaturförändringar. Många kvinnor hade svårt att förstå och relatera sina symtom och blev inte tagna på allvar i vården. Det fanns en tydlig frustration då symtomen i många fall inte överensstämde med de symtomförväntningar som fanns. Slutsats: Litteraturöversikten lyfter fram kvinnors symtom vid hjärtinfarkt och bidrar till att skapa en förståelse för kvinnans tankemönster vid vårdsökandet. Hjärtinfarkt ska inte baseras på kön utan på kliniska fynd. Genom att vidga en större förståelse för hur kvinnor tolkar sina symtom kan vårdpersonal förbättra utgången för kvinnor med hjärtinfarkt. / Background: Myocardial infarction is considered to be the leading cause of death worldwide. Although the number of cases is higher in men, the mortality rate is higher amongst women. The image of cardiovascular disease has long been characterized by a male perspective, which is a life-threatening attitude that leads to women's symptoms not being taken seriously. Aim: The aim of this study was to describe women’s experiences of myocardial infarction symptoms. Method: A literature study where eleven articles from the databases CINAHL Complete and PubMed were reviewed and analyzed. Results: The most common symptoms in women with myocardial infarction were pain, fatigue, respiratory distress, indigestion and body temperature changes. Many women had a hard time understanding and relating their symptoms to cause and were hence not taken seriously in care. There was a clear frustration as the symptoms in many cases did not match the expectations that existed. Conclusion: This literature review highlights women’s symptoms of myocardial infarction and helps to create an understanding of the woman's thought patterns when seeking care. Assessment of myocardial infarction should not be based on gender but on clinical findings. By broadening a greater understanding of how women interpret their symptoms, healthcare professionals can improve the outcome for women with myocardial infarction.