The rise and fall of legislative service organisations in the united states congress

Book synopsis: The abolition of Legislative Service Organisations by the 104th Congress (1995–96) constituted one of its earliest achievements. Although political dissensus had surrounded the role and activities of LSOs throughout their institutional existence, the Republican victory in the 1994 congressional elections was the critical factor prompting their abolition. Prior reform attempts had faltered upon the Democratic party's post‐1954 dominance of the House of Representatives and the diffuse representational and institutional benefits which LSOs conferred upon their members. However, when, under a new Republican majority, the perceived costs of LSOs were held to exceed their benefits, the organisations were rapidly terminated. The abolition of LSOs lends new and additional support to scholars who emphasise the continued salience of party to congressional politics in the United States

B-type natriuretic peptide concentrations and myocardial dysfunction in critical illness

B-type natriuretic peptide (BNP) is the first biomarker of proven value in screening for left ventricular dysfunction. The availability of point-of-care testing has escalated clinical interest and the resultant research is defining a role for BNP in the investigation and treatment of critically ill patients. This review was undertaken with the aim of collecting and assimilating current evidence regarding the use of BNP assay in the evaluation of myocardial dysfunction in critically ill humans. The information is presented in a format based upon organ system and disease category. BNP assay has been studied in a spectrum of clinical conditions ranging from acute dyspnoea to subarachnoid haemorrhage. Its role in diagnosis, assessment of disease severity, risk stratification and prognostic evaluation of cardiac dysfunction appears promising, but requires further elaboration. The heterogeneity of the critically ill population appears to warrant a range of cut-off values. Research addressing progressive changes in BNP concentration is hindered by infrequent assay and appears unlikely to reflect the critically ill patient's rapidly changing haemodynamics. Multi-marker strategies may prove valuable in prognostication and evaluation of therapy in a greater variety of illnesses. Scant data exist regarding the use of BNP assay to alter therapy or outcome. It appears that BNP assay offers complementary information to conventional approaches for the evaluation of cardiac dysfunction. Continued research should augment the validity of BNP assay in the evaluation of myocardial function in patients with life-threatening illness