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Biomedical subjects

S Fahy

Publications and source records attributed to S Fahy.

At least 19 recordsLinked to original sources

Lithium use in octogenarians.

OBJECTIVES: To assess the tolerability and side-effect profile of lithium use in a group of octogenarians attending a specialized lithium clinic. METHODS: This is a cross-sectional study looking at all patients of eighty years and over attending a lithium clinic. Charts were examined to assess renal function, thyroid function and level of side-effects during their course of lithium treatment in order to assess the tolerability of this medication in octogenarians. RESULTS: Twelve patients of 80 years and over (with an average age of 83.6 years) were taking lithium for an average period of 53.7 months. They had a mean serum level of 0.42 mmol/l. No patient had to discontinue lithium therapy because of side-effects, even though some patients did develop transient abnormalities of renal function. One patient developed diabetes insipidus. One female patient developed hypothyroidism. CONCLUSIONS: Lithium was well tolerated and was administered safely to this cohort of octogenarians. Monitoring of serum lithium levels and kidney and thyroid function should preferably be done in the setting of a specialized lithium clinic.

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Discontinuation of lithium augmentation in an elderly cohort.

OBJECTIVES: To observe the effects of gradual discontinuation of lithium augmentation therapy in a group of patients over the age of 65 years and to measure the rate of relapse and to identify any factors which would predict relapse. METHODS: This was a naturalistic study involving 21 patients who were on lithium augmentation and whose lithium was discontinued for a variety of clinical reasons. In most cases lithium was tapered and discontinued over a period of 2-12 weeks. Demographic and other variables were collected at baseline and compared between those who remained well and those that subsequently relapsed. RESULTS: Eleven patients (52.4%) relapsed following discontinuation of lithium augmentation. Those who relapsed had been on lithium for significantly longer than those who remained well off lithium (p = 0.007). There was a trend towards more hospital admissions in the relapse group (p = 0.062). CONCLUSIONS: When lithium augmentation therapy is discontinued in elderly depressives over half of these patients relapse. A longer duration of prediscontinuation lithium treatment and more hospital admissions appear to be associated with increased risk of relapse.

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Unilateral papilloedema in a 12 year old girl--a surprising diagnosis.

A previously well 12 year old girl presented with diminished visual acuity and haziness of her left eye. Her examination confirmed visual loss in her left eye and significant disc blurring on fundoscopy. Extensive investigations including computerised tomography of the brain and orbit were normal. Her serum angiotensin converting enzyme (ACE) levels were elevated and subsequent Kveim test was positive confirming the diagnosis of ocular sarcoidosis. She did respond to a course of systemic steroids and over the following 3 years her eye signs and symptoms did correlate well with the ACE level. To date she has not had any systemic or respiratory symptoms. Thus sarcoidosis should be considered in the differential diagnosis of ocular pathology of unexplained aetiology.

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