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Shock Therapy (shock + therapy)
Selected AbstractsWill Gradualism Work When Shock Therapy Doesn't?ECONOMICS & POLITICS, Issue 1 2003Vivek H. Dehejia When shock therapy is politically infeasible, will gradualism work? This paper takes up this question by: (i) building a political economy model in which it makes sense; (ii) stating the relevant political economy constraint rigorously; and (iii) analyzing the question in the context of a neoclassical model of adjustment, based on Mussa (1978). The paper answers the question in the affirmative, thus contributing to the scientific and policy literature on the economic analysis of policy reform. [source] Painless Shock Therapy: More Than Just an Attempt to Square the Circle?JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2007GIUSEPPE BORIANI No abstract is available for this article. [source] Long-Term Incidence of Malignant Ventricular Arrhythmia and Shock Therapy in Patients with Primary Defibrillator Implantation Does Not Differ from Event Rates in Patients Treated for Survived Cardiac ArrestJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 5 2005ULRICH BACKENKÖHLER M.D. Introduction: Recent trials have demonstrated benefit of prophylactic defibrillator (ICD) implantation compared to conventional treatment in high-risk patients. However, many patients have rare or no sustained arrhythmias following implantation. Our study addresses the question, whether patients with prophylactic defibrillator implantation have a lower risk for life-threatening ventricular tachycardia (VT) or ventricular fibrillation (VF) compared to sudden cardiac death (SCD) survivors. Methods and Results: Over 7 years we enrolled 245 patients. Occurrence of spontaneous sustained VT/VF resulting in adequate ICD treatment was the endpoint. Incidence, type, and treatment of sustained arrhythmia in 43 previously asymptomatic ICD recipients (group B) were compared to data of 202 survivors of imminent SCD (group A). All patients had severely impaired left ventricular ejection fraction (<45%). Group B patients had long runs (>6 cycles, <30 s) of VT during Holter monitoring and inducible sustained arrhythmia. Incidence of rapid VT and VF (cycle length <240 ms/heart rate >250 bpm) after 4 years (35% in both groups, P = ns) and adequate defibrillator therapies (57% vs 55%, P = ns) were similar in both groups after univariate and multivariate analysis. Cumulative mortality tended to be lower in group B compared to group A, but the difference was not statistically significant. Conclusion: During long-term follow-up, incidence of sustained rapid ventricular arrhythmia in prophylactically treated patients is as high as that of SCD survivors. Benefit from defibrillator implantation for primary prevention (group B) appears to be comparable to that for survived cardiac arrest (group A). [source] The Political Economy of Shock TherapyJOURNAL OF ECONOMIC SURVEYS, Issue 1 2002John Marangos The collapse of the centrally administered economies gave rise to a transition process towards economic systems based on market relations. Nevertheless, the transition process is not restricted to the economic field. The political and ideological aspects of the transformation are fundamental. As such an analysis of the shock therapy model requires the exposition of what I define the primary elements of the shock therapy model which are: 1) The body of economic analysis used by the shock therapy model. 2) What structure of society the shock therapy model desires to achieve? 3) The speed of the reforms. 4) The political structure consistent with the model. 5) The consistent ideological structure. After the identification of the primary elements of the shock therapy model the next'step'is to identify secondary elements, the desired changes with respect to: 1) 'Price liberalisation,stabilisation. 2) Privatisation. 3) Institutional structure. 4) 'Monetary policy. 5) Fiscal policy. 6) International trade and Foreign Aid. 7) 'Social policy. The analytical framework developed makes possible to understand the shock therapy model from a new and more enlightening perspective. We are better able to comprehend the complexities involved and the disagreements about the reform process. [source] Shock therapy: a history of electroconvulsive treatment in mental illnessACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2010Martin Balslev Jørgensen No abstract is available for this article. [source] Congenital Short QT Syndrome and Implantable Cardioverter Defibrillator Treatment:JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 12 2003Inherent Risk for Inappropriate Shock Delivery Introduction: A congenital short QT interval constitutes a new primary electrical abnormality associated with syncope and/or sudden cardiac death. We report on the initial use of implantable cardioverter defibrillator (ICD) therapy in patients with inherited short QT interval and discuss sensing abnormalities and detection issues. Methods and Results: In five consecutive patients from two unrelated European families who had structurally normal hearts, excessively shortened QT intervals, and a strong positive family history of sudden cardiac death, ICDs were placed for primary and secondary prevention. Mean QT intervals were 252 ± 13 ms (QTc 287 ± 13 ms). Despite normal sensing behavior during intraoperative and postoperative device testing, 3 of 5 patients experienced inappropriate shock therapies for T wave oversensing 30 ± 26 days after implantation. Programming lower sensitivities and decay delays prevented further inappropriate discharges. Conclusion: The congenital short QT syndrome constitutes a new clinical entity with an increased risk for sudden cardiac death. Currently, ICD treatment is the only therapeutic option. In patients with short QT interval and implanted ICD, increased risk for inappropriate therapy is inherent due to the detection of short-coupled and prominent T waves. Careful testing of ICD function and adaptation of sensing levels and decay delays without sacrificing correct arrhythmia detection are essential. (J Cardiovasc Electrophysiol, Vol. 14, pp. 1273-1277, December 2003) [source] Psychosocial Aspects of Patient-Activated Atrial DefibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 8 2003Andrew R.J. Mitchell M.R.C.P. Introduction: The atrial defibrillator empowers patients to cardiovert themselves from atrial arrhythmias at a time that is socially and physically acceptable, thereby preventing hospitalization. The long-term psychosocial effects of repeated use of the patient-activated atrial defibrillator at home are unknown. Methods and Results: Eighteen patients underwent placement of the Jewel AF atrial defibrillator for persistent atrial fibrillation only. All patients performed manually activated cardioversions at home under self-administered sedation. Automatic shock therapies were disabled. Hospital Anxiety and Depression Scale and Multidimensional Health Locus of Control questionnaires were obtained before implant. All patients completed questionnaires 1 year after device implant and at long-term follow-up. The spouse or partner of each patient was interviewed to identify positive and negative aspects of manual cardioversion at home. The baseline patient scores for both anxiety (5.7 ± 2.7) and depression (3.4 ± 2.3) fell within the predefined range of normality. At 1 year, there was no significant change in anxiety (4.9 ± 3.7, P = 0.39) or depression (2.4 ± 1.8, P = 0.06). At long-term follow-up (mean 28 months), a total of 377 patient-activated cardioversions were performed out of hospital (median 15 per patient). Scores for anxiety (6.0 ± 4.0, P = 0.70) and depression (3.2 ± 2.5, P = 0.68) remained unchanged. Conclusion: During long-term follow-up, patient-activated cardioversion using the atrial defibrillator was not associated with increased anxiety or depression. The procedure was well tolerated by patients and their partners, offering an acceptable treatment option for patients with recurrent persistent atrial fibrillation. (J Cardiovasc Electrophysiol, Vol. 14, pp. 812-816, August 2003) [source] Will Gradualism Work When Shock Therapy Doesn't?ECONOMICS & POLITICS, Issue 1 2003Vivek H. Dehejia When shock therapy is politically infeasible, will gradualism work? This paper takes up this question by: (i) building a political economy model in which it makes sense; (ii) stating the relevant political economy constraint rigorously; and (iii) analyzing the question in the context of a neoclassical model of adjustment, based on Mussa (1978). The paper answers the question in the affirmative, thus contributing to the scientific and policy literature on the economic analysis of policy reform. [source] Implantable Cardioverter Defibrillators: Do Women Fare Worse Than Men?JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 9 2009Gender Comparison in the INTRINSIC RV Trial Introduction: Due to limited enrollment of women in previous trials, there is a paucity of data comparing outcome and arrhythmic events in men versus women with implantable cardioverter defibrillators (ICDs). Methods and Results: We analyzed outcome of patients in the INTRINSIC RV (Inhibition of Unnecessary RV Pacing with AV Search Hysteresis in ICDs) trial based on gender. Women comprised 19% (293/1530) of the INTRINSIC RV population. Compared with men, women were less likely to have coronary disease, ischemic cardiomyopathy, and hyperlipidemia, and were more likely to have congestive heart failure and diabetes. Women were less likely to receive beta blockers and ACE inhibitors, and more likely to receive diuretics. Over 10.8 ± 3.5 months of follow-up, unadjusted mortality was higher in women than men (6.8% vs 4.1%, P = 0.04). Heart failure hospitalizations occurred in 7.9% of women versus 5.7% of men (P = 0.13). After adjustment for baseline differences and drug therapy, there was no significant difference in mortality between men and women. Adverse events were observed more often in women. There were no gender differences in the percentage of patients receiving appropriate or inappropriate ICD shocks. Conclusions: In INTRINSIC RV, women receiving ICDs differed from men regarding baseline characteristics and drug therapy. After adjusting for baseline differences and medical therapy, there were no differences in heart failure hospitalization, survival, or ICD shock therapy during follow-up. Apparent undertreatment of heart failure and greater frequency of adverse advents in women receiving ICDs warrant further investigation. [source] Two Hearts and One DefibrillatorJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 10 2004PETER OTT M.D. A patient who had undergone heterotopic heart transplantation and placement of an implantable cardioverter defibrillator in his native heart underwent generator change. Defibrillation testing induced ventricular fibrillation in his donor heart. To prevent this potentially lethal complication, defibrillator shock therapy must be synchronized to the donor heart R wave. [source] The Political Economy of Shock TherapyJOURNAL OF ECONOMIC SURVEYS, Issue 1 2002John Marangos The collapse of the centrally administered economies gave rise to a transition process towards economic systems based on market relations. Nevertheless, the transition process is not restricted to the economic field. The political and ideological aspects of the transformation are fundamental. As such an analysis of the shock therapy model requires the exposition of what I define the primary elements of the shock therapy model which are: 1) The body of economic analysis used by the shock therapy model. 2) What structure of society the shock therapy model desires to achieve? 3) The speed of the reforms. 4) The political structure consistent with the model. 5) The consistent ideological structure. After the identification of the primary elements of the shock therapy model the next'step'is to identify secondary elements, the desired changes with respect to: 1) 'Price liberalisation,stabilisation. 2) Privatisation. 3) Institutional structure. 4) 'Monetary policy. 5) Fiscal policy. 6) International trade and Foreign Aid. 7) 'Social policy. The analytical framework developed makes possible to understand the shock therapy model from a new and more enlightening perspective. We are better able to comprehend the complexities involved and the disagreements about the reform process. [source] Organizational Learning and Productivity: State Structure and Foreign Investment in the Rise of the Chinese CorporationMANAGEMENT AND ORGANIZATION REVIEW, Issue 2 2005Doug Guthrie abstract Over the two and a half decades of economic reform in China, two types of Chinese firms have consistently outperformed their peers. In the 1980s, it was the firms at the lower levels of the industrial hierarchy, the township and village enterprises that were closely monitored by local governments. In the 1990s and beyond, the top performers have been those Chinese firms that have formal relationships with foreign investors. While many studies on the economic reforms in China have focused on the hardening of budget constraints and the transfer of technology from foreign to Chinese firms, I focus here on the stability created by relationships with local government offices and with powerful foreign investors. Where advocates of shock therapy have argued that a rapid transition to market institutions was the best path to building a market economy, I argue that the successful practices of the market are learned gradually over time, and the Chinese firms that are stabilized by attention from local government offices and relationships with foreign investors are well-positioned to successfully navigate China's emerging markets. A quantitative analysis of 81 firms in industrial Shanghai and three case studies help illuminate the mechanisms behind these relationships. [source] | |||||||||||||