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Biomedical subjects

K J McIntyre

Publications and source records attributed to K J McIntyre.

12 recordsLinked to original sources
PubMed1992

The 1990 contract: have patients noticed?

We carried out a questionnaire survey in a Semi-urban General Practice in Renfrewshire to evaluate patients' knowledge and understanding of changes to General Practitioner services six months after implementation of 'The 1990 Contract'. The survey assessed the point prevalence of patients' knowledge in an opportunity sample. A total of 237 patients attending morning surgery during one week in September 1990 were asked to complete a short questionnaire. Despite 38% of respondents declaring they were aware of the changes, only 10% of the respondents showed evidence of understanding of the changes. There was a lack of perceived usefulness of Well Person Checks despite a relatively good understanding of what this involves. Most of the recent changes in General Practice were perceived as being useful or extremely useful to patients after they had been explained. It is suggested that further publicity with careful targeting and explanation is required before the public can make appropriate and effective use of these changes.

Contract Services↗
PubMed1991

Essential thrombocythemia in young adults.

Essential thrombocythemia is typically a disorder of adults in the sixth or seventh decade of life and is characterized by frequent thrombohemorrhagic complications. In young patients, the optimal management of complications is controversial. We studied 56 young adults (33 female and 23 male patients) with a diagnosis of essential thrombocythemia. The mean duration of follow-up was 4.68 years. The mean platelet count at diagnosis was 1,328,000/mm3. Platelet aggregation studies in 21 patients demonstrated hypoaggregation to epinephrine; spontaneous platelet aggregation was present in 4. At diagnosis, 39 patients were asymptomatic, and thrombocytosis was discovered incidentally. Throughout follow-up (up to 20 years), 24 patients remained asymptomatic. Thrombotic complications developed in 24 patients; they were life-threatening in only 3. The most common vaso-occlusive symptoms were migraine headache (in 12 patients) and erythromelalgia (in 3). Minor hemorrhagic complications occurred in six patients, and none was life-threatening. Serious complications (one cerebral and two myocardial infarctions) occurred in three patients, all of whom recovered. Two deaths occurred, neither of which was attributable to essential thrombocythemia. The treatment regimens used were chemotherapy in 9 patients, antiaggregating agents in 7, radioactive phosphorus in 1, the newer platelet-lowering agent anagrelide in 10, and only observation in 29. No treatment-related acute leukemias developed. This series of young patients with essential thrombocythemia, the largest to date, demonstrates a low incidence of life-threatening complications and a favorable long-term prognosis. Therapeutic recommendations should remain conservative, and potential leukemogens should be avoided unless serious complications develop. Anagrelide may be useful in young patients with thrombocythemia who are symptomatic.

Adolescent↗