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Biomedical subjects

J T Lear

Publications and source records attributed to J T Lear.

80 records · Page 5Linked to original sources
PubMed1994

A comparison of stress test referral rates and outcome between Asians and Europeans.

The Asian population is at greater risk from a myocardial infarction than their European counterparts. Fewer Asians are referred for coronary angiography. We studied referral rates for exercise stress testing following acute myocardial infarction in Asians and Europeans and also examined stress test outcome. A retrospective analysis was performed using hospital activity analysis data, ward admission book and stress test referral forms and reports. There were 962 acute myocardial infarctions with 90% being European. Fewer Asian patients were referred for stress testing (32.3% versus 45%, P < 0.001). Asian patients were more likely to have a positive test (42.9% versus 31.3%, P < 0.02). Fewer Asian patients completed the test (14.3% versus 31.3%, P < 0.001). Possible reasons for the decreased referral rates include communication difficulties and real or perceived poor exercise tolerance. More Asian patients should be referred for stress testing. Interpreters and information leaflets in multiple languages may help achieve this aim.

Aged↗
PubMed1993

Disruption caused by the house officer's bleep: a simple solution.

For a 'control' week, all bleep calls a surgical house officer received were charted without the nurses' knowledge and graded according to an arbitrary scale of usefulness. Also recorded were time of day, the person bleeping and whether the house officer was involved in patient care. A system was then tried in a later 'test' week, whereby only the nurse in charge would bleep the house officer and a board was placed on the house officer's own two wards where tasks could be written. Again all calls were recorded. This led to a decrease in inappropriate bleep calls from the nurses (58 per cent falling to 15 per cent p < 0.01) and a fall in numbers of nurses' bleep calls by two-thirds before 5 pm (p < 0.01). There was also a decrease in the number of bleeps when the house officer was directly involved in patient care (46 per cent falling to 28 per cent). The nurses in charge were agreeable to the changes. The entire study was repeated by another house officer with similar results. There has been little research on the disruption caused by the bleep and we believe that by this simple policy the house officers' day can be disrupted far less.

Medical Staff, Hospital↗
PubMedDate not supplied

Eruptive collagenomas of the skin: a case history.

We present a case of eruptive collagenomas of the skin in a young girl. The typical clinical features and histology of this rare condition are described. The differential diagnosis and other types of cutaneous collagenomas are briefly discussed. A biopsy is required to confirm the excessive mature collagen which predominates in these lesions.

Biopsy↗
PubMedDate not supplied

Pili annulati coincident with alopecia areata.

Pili annulati is a rare hair shaft abnormality of unknown pathogenesis which gives a gross beading effect. An association with alopecia areata has been reported. We present a 13-year-old girl who had alopecia areata and coincidentally was found to have pili annulati. Her mother also had pili annulati which had become more noticeable as her hair had become paler with age. We discuss the possible pathogenesis of pili annulati and relate that to the microscopic banding appearance of the hair shaft. We note the relevance of the condition becoming more apparent with age. We also discuss the probable coincidental association with alopecia areata.

Adolescent↗
PubMedDate not supplied

Myocardial infarction and thrombolysis: a comparison of the Indian and European populations on a coronary care unit.

We reviewed the ward admission notes of 211 Indian and 192 European patients admitted over a period of 12 months to a coronary care unit. More Indian patients had myocardial infarctions (34% vs 27%, p < 0.05); they were more likely to have diabetes mellitus (47% vs 14%, p < 0.001), but less likely to smoke (19% vs 67%, p < 0.001). Fewer Indian patients were treated with thrombolysis (49% vs 80%, p < 0.001), late presentation being the principal reason (62% vs 40%, p < 0.05). The referral rates for exercise stress testing and cardiac catheterisation were not significantly lower for Indian patients. The Indian patient admitted into a coronary care unit is more likely to have had a myocardial infarction and yet less likely to receive care comparable to that of his European counterpart.

Adult↗
PubMedDate not supplied

A comparison of risk factors for malignant melanoma, squamous cell carcinoma and basal cell carcinoma in the UK.

Cutaneous malignant melanoma (MM), squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) exhibit markedly different natural histories, but few studies have compared risk factors in individuals from a single population. Using logistic regression analysis in case and control groups, we assessed, the association of individual characteristics with MM (n = 240) and SCC (n = 184). We also compared differences in risk factors (eye/hair colour, skin type, smoking history, occupation, social class, tumour site) between MM/BCC and SCC/BCC. MM patients were more likely to have red/blonde hair and blue/green eyes than controls, and those with SCC more likely to have red/blonde hair, blue/green eyes, outdoor occupation, skin type 1 and to have smoked more. There were few differences in individual characteristics between the skin cancer groups, illustrating their non-specific nature. Tumour site, however, showed marked differences: MM patients were more likely to have a tumour on the trunk or limbs than BCC patients, while patients with SCC were more likely to have a tumour on the limbs. Reasons for this variation are unclear. The relatively weak effect of individual factors supports the view of a multifactorial disease and suggests that interactions between UV exposure and genetic predisposition may be more significant determinants of risk.

Adult↗