Background: The normal left ventricle shows a systolic wringing motion with clockwise rotation at the base and counterclockwise rotation at the apex. Purpose: The aim of the present study was (1) to assess left ventricular (LV) contraction and relaxation in patients with chronic heart failure (CHF), and (2) to evaluate the effect of medical therapy on LV contraction -relaxation behavior. Methods: Magnetic resonance was used to examine LV motion by labeling specific LV regions in three planes (myocardial tagging). Twenty-three subjects were included, nine healthy controls and 14 CHF patients. Cardiac motion was determined from the deformation of a rectangular grid in a basal and apical plane. CHF patients were put on triple therapy with ACE-inhibitors, h-blockers and spironolactone. Follow-up examination (n=9) was performed after 6 months. Results: In controls, systolic rotation was À9.5F2j at the base and +3.3F1j at the apex. In CHF patients, rotation was reduced both at the base (À3.4F2j, P<0.01) and the apex (+0.9F3j, P<0.05). Similarly, regional ejection fraction (REF) was reduced in CHF patients both at the base and the apex. Medical therapy was associated with an improvement in REF, but systolic rotation improved only at the base (À4.6F2j, P<0.05). Conclusions: Systolic wringing motion with clockwise rotation at the base and counterclockwise rotation at the apex is maintained in CHF although reduced. Heart failure treatment is associated with an improvement in REF, whereas rotation improved only at the base, but not at the apex. Thus, there is an uncoupling between regional shortening and rotation in CHF patients.

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially lifethreatening, immune-mediated adverse reactions characterized by widespread erythema, epidermal necrosis, and detachment of skin and mucosa. Efforts to grow and develop functional international collaborations and a multidisciplinary interactive network focusing on SJS/TEN as an uncommon but high burden disease will be necessary to improve efforts in prevention, early diagnosis and improved acute and long-term management. SJS/TEN 2019: From Science to Translation was a 1.5-day scientific program held April 26-27, 2019, in Vancouver, Canada. The meeting successfully engaged clinicians, researchers, and patients and conducted many productive discussions on research and patient care needs.

[Reb Zevi] saw and realized that the business was leading [Reb Issachar] astray, that he was being distracted by it and was distracting others, until finally he felt like one tugged by a distorted idea, a senseless bit of sophistry or vain embellishment, like one who becomes increasingly bogged down as he trudges from one pilpul to the next, from one piece of vanity to the next, until it finally drags him into a morass from which he can never emerge.

Background. Adolescents have an increased risk of preterm birth (PTB) and sexually transmitted infections (STIs). We examined the prevalence and impact of STIs (gonorrhea, chlamydia, and trichomonas) on PTB and chorioamnionitis in pregnant adolescents. Methods. This retrospective cohort study utilized the first pregnancy delivered at an urban hospital among patients≤19 years old over a 5-year period. Poisson regression with robust standard errors was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of the association between STIs and PTB (<37 weeks) and chorioamnionitis identified by clinical or placental pathology criteria. Results. 739 deliveries were included. 18.8% (n=139) of births were preterm. The overall prevalence of STIs during pregnancy was 16.5% (Chlamydia trachomatis: 13.1%, n=97; Trichomonas vaginalis: 3.7%, n=27; and Neisseria gonorrheae: 3.1%, n=23). Detection of C. trachomatis, T. vaginalis, or N. gonorrheae was not associated with increased PTB. While infection with N. gonorrheae and C. trachomatis did not increase the likelihood of any chorioamnionitis, infection with T. vaginalis significantly increased the likelihood of any chorioamnionitis diagnosis (aPR 2.19, 95% CI 1.26-3.83). Conclusion. In this adolescent population with a high rate of PTB, in whom most received appropriate STI treatment, we did not find an association between STI during pregnancy and an increased rate of PTB. However, an infection with T. vaginalis was associated with an increased likelihood of chorioamnionitis. Early detection of STIs may prevent adverse pregnancy outcomes. Continued vigilance in STI screening during pregnancy, including consideration of universal Trichomonas vaginalis screening, is merited in this high-risk population.

The question of the role of women in Holocaust Studies has been raised in the last decade with increasing eloquence and urgency. This article considers the role of women in Holocaust films. It argues that in numerous major cinematographic representations of the Holocaust (e.g., The Holocaust, Schindler's List, Europa Europa, Shoah ) women are portrayed as vicarious victims of the Holocaust. They suffer as the wives and mothers of men who are directly involved in the war as refugees, camp inmates, or resister. Often female characters are marginalized and stereotyped as sexual objects, or as emotional reflectors. They are often ignorant of or indifferent to the political complexity and the threat of the war. This article questions these stereotypes and the ideology that undergirds them.