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Biomedical subjects

A I O'Neill

Publications and source records attributed to A I O'Neill.

5 recordsLinked to original sources
PubMed1995

Lupus anticoagulant in the elderly may be associated with both quinine and quinidine usage.

Thirty-one patients aged over 60 yrs and with lupus anticoagulant (LA) were reviewed for their drug intake. Twenty-three (73%) were taking cinchona alkaloids, 10 (32%) quinine for night cramps, 11 (35%) quinidine for cardiac arrhythmia and 2 (6%) were taking both. These frequencies of drugs usage differed significantly from age and sex matched controls (p < 0.001). Five patients had features suggestive of the antiphospholipid syndrome. Repeat testing showed persistent LA activity in all but 2 of 5 patients in whom the relevant drug had been ceased. This is the first description of a possible causal association between LA and quinine therapy.

Aged↗
PubMed1992

Mild bleeding disorders. A clinical and laboratory study.

OBJECTIVE: To investigate in-vitro haemostasis in subjects with symptoms suggesting a mild bleeding disorder. DESIGN: A prospective study in which an extensive range of in-vitro tests were applied unselectively. SETTING: Patients were referred from community-based practices and hospital outpatient services. PATIENTS: Ninety-three consecutive patients were examined. Hospital patients with severe illness were excluded. CLINICAL FEATURES: Patients presented with easy bruising (68%), epistaxis (12%), excessive operative bleeding (7%), menorrhagia (4%), haematuria (3%), dental bleeding (1%) and bleeding from other sites (5%). In no instance was the bleeding life threatening. OUTCOME MEASURES: Results of laboratory tests for patients presenting with the symptoms of a mild bleeding disorder were compared with the results for a healthy reference group. RESULTS: Abnormal results of in-vitro tests were found in 53% of the subjects. Thirteen per cent had a prolonged bleeding time, of whom the majority had abnormal results of other in-vitro tests. Von Willebrand's disease was diagnosed in 7% of patients, although only half of these had a prolonged bleeding time. CONCLUSIONS: Abnormal results of in-vitro tests were prevalent among subjects with symptoms of mild bleeding disorder. Easy bruising was as powerful a clue as any other bleeding manifestation to the presence of an abnormal in-vitro test result.

Bleeding Time↗
PubMed1992

Automation of the Kaolin Clotting Time.

An automated Kaolin Clotting Time (KCT) has been developed to simplify screening for the Lupus Anticoagulant (LA). The assay is performed on the ACL300 Research coagulation analyser, but may be modified for other centrifugal analysers. Automation of the KCT allows up to 17 delta KCT (delta KCT) screens (Gibson J, Starling E, Date L et al. Simplified screening procedure for detecting lupus inhibitor. J Clin Pathol 1988; 44: 226-31) or 2 full Exner curves (Exner T, Rickard KA, Kronenberg H. A sensitive test demonstrating lupus anticoagulant and its behavioural patterns. Br J Haematol 1978; 40: 143-51) to be performed in one test cycle. An automated and manual delta KCT screen was performed on 17 patients with a previously diagnosed LA, 41 hospital patients having routine coagulation studies and 37 blood donors. In addition, 11 patients on full-dose heparin and 12 patients with stable warfarin anticoagulation were tested. The correlation between the automated delta KCT and the manual delta KCT was 0.958 (p less than 0.001). A full Exner curve was performed on 5 of the patients with a LA and 1 blood donor which demonstrated that the automated KCT produced results entirely comparable with the manual method. The automated KCT is a quick, inexpensive approach to screening patients for the presence of LA.

Blood Coagulation Tests↗
PubMed1991

A comparison of five devices for the bedside monitoring of heparin therapy.

Five instruments were tested for their capacity to monitor heparin therapy on whole blood at the bedside. The instruments were 512 Coagulation Monitor (Ciba-Corning), Thrombotrack (Nycomed), Automated Coagulation Timer (Hemotec), Hemochron-ACT and Hemochron-APTT (International Technidyne Corporation). Fifty subjects with various levels of heparinisation were tested on each instrument and were also assayed for antithrombin III, fibrinogen, haematocrit, platelet count and plasma heparin level. The results were compared with a reference APTT performed on the Automated Coagulation Laboratory 300R (Instrumentation Laboratories). The Hemochron-ACT correlated least well. The Hemotec and Thrombotrack were unsuitable in a clinical setting because of pipetting requirements, although the Thrombotrack did correlate well with the reference parameters. The 512 Coagulation Monitor was the simplest to use, but its maximum response corresponded to the midpoint of the reference APTT therapeutic range. The Hemochron-APTT was simple to use, had an adequate response range and correlated well with reference parameters.

Blood Coagulation Tests↗