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Our data confirm previous studies indicating the good effectiveness of ECT irrespective of age. We also found an excellent tolerability profile in the elderly in our patient sample. There was no mortality, and only transient and no life-threatening adverse events occurred.

Our study supports the hypothesis that inducting anaesthetic agents have a different impact on seizure duration, ictal and postictal electrophysiological indices and clinical efficacy of ECT. Compared to thiopental, which has been established as a standard anaesthetic during ECT, also the modern anaesthetic propofol is a suitable inducting agent.

Our study supports the hypothesis that inducting anaesthetic agents have a different impact on seizure duration, ictal and postictal electrophysiological indices and clinical efficacy of ECT. Compared to thiopental, which has been established as a standard anaesthetic during ECT, also the modern anaesthetic propofol is a suitable inducting agent.

Zolpidem, a non-benzodiazepine hypnotic, acts selectively via the alpha(1)-subunit of GABA(A) receptors at therapeutic doses. It is therefore thought to lack both benzodiazepine properties such as anxiolysis, anticonvulsion, muscle relaxation, and side effects such as dependency. We report a case of severe dependency of zolpidem taken because of percieved myorelaxation in a patient with multiple sclerosis and paraspasticity. The observations in the patient described here suggest that zolpidem looses alpha1-receptor selectivity at higher doses, thereby leading to the same risks and benefits such as benzodiazepines. This should be taken into account by doctors when prescribing higher doses. Zolpidem may improve symptoms of spasticity in high doses via affection of GABA alpha2-receptor and alpha3-receptor subunits.

Zusammenfassung: Ziel der Arbeit war es, die Art und Häufigkeit von vorgeworfenen tierärztlichen Diagnose-und Befunderhebungsfehlern bei der Hufrehe darzustellen und deren Beurteilung durch sachverständige Gutachter zu untersuchen. Zu diesem Zweck wurden 22 Gutachten, die sich mit dem Vorwurf des tierärztlichen Fehlers bei der Diagnostik der Hufrehe befassen, deskriptiv statistisch ausgewertet. Die Gutachten stammen aus den privaten Archiven von 4 Gutachtern, die langjährige Erfahrung auf dem Gebiet der Pferdeorthopädie besitzen. Am häufigsten wurde dem Tierarzt das Nichterkennen bzw. die Fehlinterpretation von klinischen (36,4 %) und röntgenologischen (36,4 %) Befunden vorgeworfen. Weitere Kritikpunkte waren unterlassene klinische (9,1 %), röntgenologische (13,6 %) und weiterführende diagnostische (4,5 %) Untersuchungen. In 13 von 22 Fällen (59,1 %) erwiesen sich die Vorwürfe der Patientenbesitzer gegen den Tierarzt gemäß der Beurteilung der Gutachter als nicht gerechtfertigt. In 9 Fällen (40,9 %) bestätigten die Gutachter den Vorwurf des Diagnoseund/oder Befunderhebungsfehlers. In jeweils 3 Fällen beanstandeten die Gutachter die Fehlinterpretation von klinischen (33,3 %) und rönt-genologischen (33,3 %) Befunden, in 2 Fällen (22,2 %) eine unterlassene klinische Untersuchung und in 1 Fall (11,1 %) eine unterlassene röntgenologische Untersuchung. Zur Vermeidung von Diagnose-und/oder Befunderhebungsfehlern bei der Hufrehe sind eine systematische klinische Untersuchung, eine standardisierte röntgenologische Untersuchung sowie die Kenntnis der unterschiedlichen Symptomatik in den einzelnen Krankheitsstadien der Hufrehe essentiell. Die differentialdiagnostische Abgrenzung der Hufrehe zu ähnlichen Krankheitsbildern wie dem der Pododermatitis kann im Anfangsstadium dennoch schwierig sein. Ein hohes aber tendenziell vermeidbares Risiko für den Tierarzt bergen Dokumentationsversäumnisse, die im Ernstfall als Befunderhebungsfehler gewertet werden können, welche der Tierarzt rechtlich zu vertreten hat.Schlüsselwörter: Hufrehe / Diagnose / Diagnosefehler / Befunderhebungsfehler / Gutachten / Schadenersatz / Haftpflicht Veterinary diagnostic errors and errors in assessment of findings in laminitis -An evaluation of 22 expert opinions Aim of this study was to determine the type and frequency of alleged veterinary diagnostic errors and errors in assessment of findings in laminitis and to examine their evaluation by experts. For this purpose, 22 expert opinions that deal with the accusation of veterinary errors in the diagnostic of laminitis were evaluated descriptively. The expert reports come from the private archives of 4 renowned experts, who have long years of experience in the field of equine orthopaedics. Most commonly veterinarians were accused of non-recognition or misinterpretation of clinical (36.4 %) and radiographic (36.4 %) findings. Other criticisms included omitted clinical (9.1%), radiographic (13.6 %) and additional diagnostic (4.5 %) examinations. In 13 of 22 cases (59.1%) the patient owners' allegations agai...

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Introduction: The effectiveness of electroconvulsive therapy (ECT) in pharmacotherapy resistant major depression and schizophrenia has been shown for all age groups. Nevertheless, age specific side effects such as greater cognitive impairment and higher somatic risks due to medical comorbidities and concomitant medication may be limiting factors in geriatric patients. Methods: We retrospectively evaluated 4457 treatments in 380 patients. Clinical variables, treatment modalities, ictal and postictal neurophysiological parameters were analysed. For modelling the influence of age on these varibles of interest, linear regression models, if necessary logistic regression models, were performed (statistical software package R 2.8.1). Results: We found a considerable clinical improvement over all age groups. Higher severity of disease at admission came up with a better clinical response. In comparison of the whole patient sample versus the elderly over the age of 60, there were no significant differences in need and number of concomitant psychotropic, but in medical co-medication. Ictal and postictal EEG parameters were only in part predictive for clinical outcome, but age had a significant influence on most of them. Cardiovascular side effects and cognitive disturbances were more frequent in the elderly but were only transient, and in most cases there was no need for any specific treatment. Conclusions: The outcome results show excellent effectiveness and tolerability of ECT in all age groups. The very old are more prone to adverse events, but nonetheless tolerate ECT well and are likely to benefit.