In elderly patients who have hepatic diseases, antiepileptic drugs that are not metabolized in the liver, such as levetiracetam, are preferred; in patients with moderate and severe renal failure, carbamazepine and valproic acid are the preferred antiepileptic drugs. Phenytoin, fosphenytoin, carbamazepine, oxcarbazepine and lamotrigine should not be prescribed in elderly patients with cardiac conduction abnormalities or a history of ventricular arrhythmia. While the majority of antiepileptic drugs interact with other drugs, hepatic enzymes and plasma proteins, a few newer antiepileptic drugs are free from such interactions (e.g., gabapentin, levetiracetam and tiagabine), which make them suitable candidates for elderly patients. However, in order to make further recommendations regarding the choice and dosing regimens of antiepileptic drugs in elderly patients, more extensive clinical research in this specific population is necessary.
Introduction/Objective. Tarsal dislocations are rare injuries. Usually, they
are caused by high energy trauma. Depending on the type of dislocation,
surgical treatment or closed reduction is used. In this study, 13 patients
are presented with the aim to analyze the type of feet dislocations, their
treatment and outcome. Methods. Tarsal dislocation cases treated in the
University Hospital in Foca were analyzed during the period from 2009 to
2016. All the cases were clinically and radiographically examined and
monitored on control examinations at least three years. The mobility of
joints was measured and pain existence was estimated by visual analog scale.
Results. All 13 patients with tarsal dislocation were male. Four patients
were treated surgically (two patients with tarsometatarsal and one with
cuboid and navicular dislocation) and other patients had non-surgical
treatment. In ten patients, an excellent functional result has been achieved
and in two patients with tarsometatarsal dislocation a good functional
result. In one patient with cuboidal dislocation satisfactory functional
result has been achieved. Conclusion. Out of the 13 reviewed patients with
tarsal dislocations, functional results were rated excellent in ten
dislocations, good in two, and satisfactory in one. Diagnosis and treatment
of foot dislocations are demanding, but with adequate treatment of these
injuries, a favorable functional outcome can be expected.
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