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It does not require great powers of observation to note the pervasiveness of Nazi Germany in contemporary U.S. cultural and political discourse. For better or worse, the discursive landscape is saturated with depictions of and references to Hitler, the Holocaust, and the Gestapo—an obsession visible everywhere, from the progressive left to the far right, from TV shows to Twitter feeds to video games. The allure of using the Third Reich as a rhetorical weapon may seem obvious enough in a hyperpartisan political climate, but the resonance of that historical period clearly extends well beyond politics. Indeed, National Socialism now functions as an all-purpose conceptual barometer that can be applied to conversations about all sorts of subjects. Over the past few years, scholars have sought to shape such discussions with an unusually heavy outpouring of projects that explore correlations between Nazi Germany and the United States. What they rarely address, however, is why Americans are so prone to invoking the Third Reich as a framework for thinking about life in their own country to begin with. No less important to consider are the implications of how that trend has taken on such a wide-ranging salience and sense of urgency lately. With these questions in mind, Bradley Nichols (History, University of Missouri) convened an interdisciplinary roundtable, composed not only of historians, but also scholars of U.S. politics and culture. He invited Jens-Uwe Guettel (History, Penn State University), Sabine Hake (Germanic Studies, University of Texas), Emanuela Kucik (English and Africana Studies, Muhlenberg College), Alexandra Minna Stern (English, University of California, Los Angeles), and S. Jonathan Wiesen (History, University of Alabama at Birmingham) to share their insights and reflect on the issues at stake. 1. The recent upsurge of scholarly interest in the relationship between Nazi Germany and the United States has mirrored a heightened level of popular curiosity in the topic. How do we explain the timing of this conjuncture? What, if anything, sets it apart from the long-standing current of fascination with parallels linking the two countries? Is there something unique going on here that transcends other overlaps in focus between academia and the public (past or present)?

Background The diagnosis of pulmonary arterial hypertension requires right heart catheterization (RHC) which is typically performed via proximal venous access (PVA). Antecubital venous access (AVA) is an alternative approach for RHC that can minimize complications, decrease procedural duration and allow for immediate patient recovery. A direct comparison between the two procedures in patients with pulmonary hypertension (PH) is lacking. Objectives To determine the feasibility, safety, and adoption rates of AVA-RHC as compared with ultrasound-guided PVA in a subpopulation of patients with PH. Methods All patients who underwent RHC for evaluation of PH between December 2014 and March 2017 at a single large academic medical center were included in this study. Demographic, procedural and outcomes data were retrieved from the medical records. Results In total, 159 RHC were included (124 AVA, 35 PVA). The duration of RHC was significantly shorter in the AVA compared with PVA group (53 (IQR 38–70) vs. 80 (IQR 56–95) min, respectively, p

Physicians in the intensive care unit face a myriad of ethical dilemmas involving end-of-life care, yet they receive only minimal training about their jurisprudential obligations, and misconceptions about legal responsibilities abound. In particular, significant uncertainty exists among critical care physicians as to ethical and legal obligations for terminally ill patients. This paper presents 3 hypothetical cases to elucidate the medical, ethical, and legal considerations in common end-of-life situations encountered in the intensive care unit.

Pulmonary arterial hypertension (PAH) is a common consideration when patients have unexplained signs of cardiopulmonary disease. Guidelines have been issued regarding diagnosis and management of this condition. Since multiple conditions can mimic components of PAH, the clinician should think about the patient's total clinical condition before diagnosing and categorizing it. Proper evaluation and etiologic definition are crucial to providing the appropriate therapy. This review offers a case-based guide to the evaluation of patients with suspected PAH.

Convex endobronchial ultrasound transbronchial needle aspiration (C-EBUS-TBNA) has become an essential modality for diagnosis and staging of hilar, mediastinal, and central pulmonary lesions. A Trans-thoracic pleural biopsy is the accepted practice for diagnosing pleural nodules. However, the diagnostic yield of a pleural biopsy is limited and surgical procedures pose a greater risk. We report a unique case of using a C- EBUS scope for the diagnosis of pleural nodules and mediastinal lymph node metastasis in a man with metastatic renal cell carcinoma.

Background and Aims Yellow nail syndrome is a rare disorder involving characteristic nail changes, lymphedema and chronic respiratory symptoms. Currently there is no definitive treatment and there have been no prospective randomised controlled trials evaluating the available options. In order to strengthen the literature on this topic, we present the case of a 67-year-old man with YNS and a detailed review of current treatment options. Methods We included 40 articles for the final review according to their relevance with the subject. Results Data for use of the commonly chosen therapies for YNS remains inconclusive, with small studies and case reports showing mixed results of efficacy. Conclusion Although the date indicates that it is reasonable to recommend a trial of conservative therapy including vitamin E, antibiotics and compression stockings before pursuing more aggressive or invasive modalities, larger scale studies are required to determine the true efficacy of all treatment options.

Introduction: The United States experienced a postpandemic outbreak of H1N1 influenza in 2013-2014. Unlike the pandemic in 2009 clinical course and outcomes associated with critical illness in this postpandemic outbreak has been only sparsely described. Methods: We conducted a retrospective analysis of all patients admitted to the Medical Intensive Care Unit with H1N1 influenza infection in 2009-2010 (pandemic) and 2013-2014 (postpandemic). Results: Patients admitted in the postpandemic period were older (55 ± 13 vs. 45 ± 12, P = 0.002), and had a higher incidence of underlying pulmonary (17 vs. 7, P = 0.0007) and cardiac (16 vs. 8, P = 0.005) disease. Mechanical ventilation was initiated in most patients in both groups (27 vs. 21, P = 1.00). The PaO 2 /FiO 2 ratio was significantly higher in the pandemic group on days 1 (216 vs. 81, P = 0.0009), 3 (202 ± 99 vs. 100 ± 46, P = 0.002) and 7 (199 ± 103 vs. 113 ± 44, P = 0.019) but by day 14 no difference was seen between the groups. Rescue therapies were used in more patients in the postpandemic period (48% vs. 20%, P = 0.028), including more frequent use of prone ventilation (10 vs. 3, P = 0.015), inhaled vasodilator therapy (11 vs. 4, P = 0.015) and extracorporeal membrane oxygenation (ECMO) (4 vs. 2, P = NS). No significant differences in mortality were seen between the two cohorts. Conclusions: Compared to the 2009-2010 pandemic, the 2013-2014 H1N1 strain affected older patients with more underlying co-morbid cardio-pulmonary diseases. The patients had worse oxygenation indices and rescue modalities such as prone ventilation, inhaled epoprostenol and ECMO, were used more consistently as compared to the 2009 pandemic.

Background Glucocorticoids (GC) are considered first-line therapy for treating sarcoidosis, but there are few data about the adverse consequences of GC. Although there are several steroid-sparing medications available for treatment, a large proportion of patients are treated with prolonged courses of GC. The toxicities of GC in sarcoidosis populations have not been carefully evaluated. Methods We performed a retrospective cohort study of all newly diagnosed sarcoidosis patients who had the entirety of their medical care in a single health system. We analyzed the time to development of a composite toxicity end-point, including diabetes, hypertension, weight gain, hyperlipidemia, low bone density and ocular complications of GC using Cox proportional hazards analysis. Results One hundred and five patients were ever treated with GC, whereas 49 were not treated during a median follow-up of 101 months. GC-treated patients developed 1.3 ± 1.1 toxicities during therapy, versus 0.6 ± 1.0 in the non-treated group. After adjustment for age, gender, race and preexisting conditions, the hazard ratio for ever-treated patients was 2.37 (1.34–4.17) for the composite end-point. Age and the presence of preexisting conditions also were associated with reaching the end-point. Similar effects were seen when analyzed for cumulative GC dose and for duration of GC use. For individual end-points, weight gain (HR 2.04) and new hypertension (HR 3.36) were associated with any use of GC. Conclusions Our data suggest that GC are associated with clinically important toxicities in sarcoidosis patients, associated with both the cumulative dose and duration of treatment.

The need to provide invasive mechanical ventilatory support to patients with myocardial infarction and acute left heart failure is common. Despite the large number of patients requiring mechanical ventilation in this setting, there are remarkably few data addressing the ideal mode of respiratory support in such patients. Although there is near universal acceptance regarding the use of non-invasive positive pressure ventilation in patients with acute pulmonary oedema, there is more concern with invasive positive pressure ventilation owing to its more significant haemodynamic impact. Positive end-expiratory pressure (PEEP) is almost universally applied in mechanically ventilated patients due to benefits in gas exchange, recruitment of alveolar units, counterbalance of hydrostatic forces leading to pulmonary oedema and maintenance of airway patency. The limited available clinical data suggest that a moderate level of PEEP is safe to use in severe left ventricular (LV) dysfunction and cardiogenic shock, and may provide haemodynamic benefits as well in LV failure which exhibits afterload-sensitive physiology.

In the 1960s and 1970s two controversies forced Rotary clubs to address the issue of complicity during the Holocaust. One emerged from a West German Rotarian’s attempts to publish an honest account of his organization’s concessions to National Socialism in the 1930s. The second ensued upon the nomination of an Austrian former Nazi to the Rotary International presidency. Both events unleashed intense discussions in the United States and elsewhere, pitting those who felt that the Holocaust must never be forgotten against those who saw camaraderie and forgiveness as more important than historical memory. These debates revealed “transnational” memory at work. Rotarians’ and the wider public’s response to these controversies transcended geographical boundaried, bringing Americans, Europeans, and others together to contemplate the moral legacies of Nazism and the Holocaust.

OBJECTIVE. Children and adolescents with newly diagnosed hypertension undergo various tests to define the cause and target organ consequences of the elevated blood pressure. We tested the hypothesis that the diagnostic yield of individual components of the currently recommended assessment does not justify performance for all patients with mild-to-moderate hypertension. METHODS. A retrospective chart review was conducted of patients who were referred between July 2002 and June 2007 for mild-to-moderate hypertension, defined as maximum blood pressure at ≥95% + 20/10 mmHg. The assessment included history and physical examination, nutritional assessment, urinalysis, biochemical and fasting lipid profile, renal ultrasound, echocardiogram, and 24-hour ambulatory blood pressure monitoring. RESULTS. A total of 249 patients were identified, and charts for 220 (88%) were available for review. There were 156 boys and 64 girls aged 13.3 ± 4.4 years. BMI was 26.1 ± 6.7 kg/m2, and 143 (65%) had a BMI of ≥90%. Results of urinalysis and serum biochemical testing were clinically normal in all cases. Among those with a lipid profile, 59 (42%) had total cholesterol values of >170 mg/dL, and 26 (19%) had severe hypercholesterolemia (>200 mg/dL). Renal sonography revealed findings plausibly associated with hypertension in 14 (8%) patients; 4 (2%) had renovascular abnormalities. Yield of echocardiography was 17%. On ambulatory blood pressure monitoring, 47 (60%) children had systolic readings of >95% at least 20% of the time, and 28 (36%) had diastolic readings of >95% at least 20% of the time. CONCLUSIONS. For children and adolescents with mild-to-moderate hypertension, on the basis of a cutoff of 5% to 20% abnormal results to define a useful test, the initial evaluation can range from a serum cholesterol level and ambulatory blood pressure monitoring to a panel that consists of a fasting lipid profile, renal ultrasound, echocardiogram, and ambulatory blood pressure monitoring. Additional assessment should be guided by specific clinical features and the nature of the patient population.

Yellow nail syndrome is a rare disorder involving characteristic nail changes, lymphedema and chronic respiratory symptoms. Currently there is no definitive treatment and there have been no prospective randomised controlled trials evaluating the available options. In order to strengthen the literature on this topic, we present the case of a 67-year-old man with YNS and a detailed review of current treatment options.We included 40 articles for the final review according to their relevance with the subject.Data for use of the commonly chosen therapies for YNS remains inconclusive, with small studies and case reports showing mixed results of efficacy.Although the date indicates that it is reasonable to recommend a trial of conservative therapy including vitamin E, antibiotics and compression stockings before pursuing more aggressive or invasive modalities, larger scale studies are required to determine the true efficacy of all treatment options.

This article explores the self-understanding of West German business leaders in the aftermath of the Second World War and the Holocaust. It argues that business leaders were never silent about the ...

This article situates industrialists in an ongoing discussion about the ‘Americanization’ of West Germany by focusing on business leaders' interest in public relations and human relations during the l950s. It portrays industrialists' adoption of putatively ‘American’ techniques of publicity and factory relations as an attempt to make peace with workers, while simultaneously overcoming a legitimacy crisis born of their complicity in nazi crimes. Despite their interest in American PR, many industrialists could not hide their fears of American popular culture. Industrialists therefore crafted an image of America as economically modern but intellectually bankrupt. They juxtaposed this ambivalent view of America with indigenous discourses about ‘the factory community’ and company paternalism that had been present during the Weimar Republic and the Third Reich. Ultimately, against the backdrop of the Cold War, industrialists were able to adapt to liberal democracy and ‘protect’ their workers from communism by amalgamating American and German models of labour relations.

In 1973 Yad Vashem, the international organization commemorating Holocaust martyrs and heroes, extended its highest honors to one of Germany's most influential business leaders. Berthold Beitz, head of the Krupp Foundation in Essen, was declared one of “the righteous among the nations” and was inducted into a very small group of individuals who had risked their lives to rescue Jews during the Third Reich. As a young manager in German-occupied Galicia, Beitz had been considered a rising star in the firm of Karpaten Öl. A trustee acting on behalf of the board of directors, Beitz was in a key position to witness the brutality of the SS in occupied Poland. In 1943, as he began to suspect his government's murderous intentions, Beits grew determined to risk his career, and possibly his life, to protect Jews from a tragic fate. Through various means of trickery and bargaining with the SS, Beitz took under his wing both young and old, skilled and unskilled, and employed them in scattered oil installations in eastern Galicia, ultimately protecting many of them from deportation and probable death in Belzec.

Many important works in the field of consumer studies focus on the United States and post-World War II Western Europe, with the former often cast as the paradigmatic example of consumer society. Notwithstanding the disruptions of the Great Depression and less-severe business cycles, these societies offer plentiful images of bustling stores, widening economic opportunities, and the emergence of politicized citizen-consumers. The unique violence of the movements – whether manifested in the militant machismo of Benito Mussolini or the genocidal thrust of National Socialism – sets fascism apart from other twentieth-century developments. This article addresses some of the questions that emerge from a consideration of fascism and consumption, focusing in particular on National Socialist Germany, where consumption served a uniquely harsh end. It explores how Nazism envisioned the function of buying, selling, and consuming; the extent to which consumption was shaped by the state's ideological priorities; Nazi visions of consumption; realities of consumption and marketing in the Third Reich; and the debate on consumption and consent.

It is tempting to associate consumption exclusively with democracy. Many important works in the field of consumer studies focus on the United States and post-World War II Western Europe, and the former is often cast as the paradigmatic example of consumer society.1 We tend to assume that economic opportunity and wide access to goods and services depend on a basic level of political openness and plurality.2 Consumption, however, is not limited to democratic settings. It has also existed under fascist dictatorships, which have used shopping and leisure opportunities to bind their populations to their political visions and to inspire them toward hard work and sacrifice.3 Historians have found the relationship between National Socialism and consumption particularly intriguing, for in his quest to build a racially pure “people’s community” (Volksgemeinschaft.), Adolf Hitler appeared to be moving in the opposite direction from the United States.4 The Nazi leadership welcomed certain features of consumer society—like modern manufacturing, advertising, and retailing technologies—but rejected the social and political expressions that came to be associated with mass consumption: cultural hybridity, the commercialization of public life, and opportunities for activism among self-conscious consumers.5