Left Ventricular Diastolic Dysfunction in the Intensive Care Unit: Trends and Perspectives

Heart failure with a normal or nearly normal left ventricular (LV) ejection fraction (HFNEF) may represent more than 50% of heart failure cases. Although HFNEF is being increasingly recognized, there is a relative lack of information regarding its incidence and prognostic implications in intensive care unit (ICU) patients. In the ICU, many factors related to patient's history, or applied therapies, may induce or aggravate LV diastolic dysfunction. This may impact on patients' morbidity and mortality. This paper discusses methods for assessing LV diastolic function and the feasibility of their implementation for diagnosing HFNEF in the ICU

Literary Politics of the New Deal

Sean McCann, Gumshoe America: Hard-Boiled Crime Fiction and the Rise and Fall of New Deal Liberalism. Durham, NC: Duke University Press, 2000. Pp viii, 370. $64.95 (cloth),$21.95 (paperback). Michael Szalay, New Deal Modernism. American Literature and the Invention of the Welfare State. Durham, NC: Duke University Press, 2000. Pp. 343. $59.95 (cloth),$19.95 (paper). Literary critics often like to think of themselves as detectives, seeking out underlying motives in fact patterns that have no obvious meaning or a meaning that is all too obvious. They particularly like to revise existing accounts of such fact patterns and to show that a latent meaning, missed by earlier critics, has just been waiting for its moment and its interpreter to appear. With the current dominance of historicist scholarship in literary studies, literary critics are also anxious to distinguish themselves from run-of-the-mill historians. Sherlock Holmes complains that Watson sees but does not observe; he scoffs at the authorities who are excellent at amassing facts, though they do not always use them to advantage. Like Holmes, literary critics attempt with their keen gazes to discern patterns of thought and motive that seem to escape mere historians, those Watson-like amassers of fact. Among broadly historicist scholars of literature, one of the most compelling and prestigious types of pattern to identify is an underlying metaphor or analogy that seems to shape a particular era of literary and cultural history. The critic Walter Benn Michaels struck gold when, in Our America, he identified the nativist modernism of the 1920s and claimed to show that apparently cosmopolitan writers of that era, such as Fitzgerald, Hemingway, Faulkner, and Cather, were in fact obsessed with racial and textual purity. No one writes any longer of a Victorian Frame of Mind or an Elizabethan World Picture, but critics still aspire to summarize a generation\u27s mindset, preferably in a counterintuitive, revisionist way. The two books under review, both indebted to some degree to Michaels\u27s work, aim to define the literature of the 1930s and 1940s in terms of debates surrounding the New Deal. They both undertake to draw analogies between the literary concerns of poets and novelists and contemporary political and economic debates. These analogies seldom rely specifically on the social history of the period or the stated political opinions of the authors under consideration. Rather, both Sean McCann and Michael Szalay boldly describe persistent patterns of thought that they claim are shared by writers, politicians, and social thinkers. McCann explores the reworking of the tensions inherent in twentieth-century liberalism through the genre of detective fiction. Szalay attempts to demonstrate the persistence of an actuarial imagination throughout the literature and social theory of the period and to trace the pattern of an underlying analogy between literature and insurance