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Scientists Identify Genetic Links To High Blood Pressure
An international scientific study involving researchers from the University of Glasgow has identified eight common genetic differences which may increase the risk of high blood pressure.

Acute Heart Failure: Recognizing Signs And Symptoms
Although heart failure is a chronic condition, acute exacerbations are frequent and occur with serious complications; patients with heart failure and their families can help improve prognosis in acute events if they are taught to recognise the tell-tale signs of worsening condition and seek immediate medical help. "Any delayed recognition of these signs is associated with an increased rate of hospitalisation and complications, including mortality," says Professor Ferenc Follath from the University Hospital of Zurich, Switzerland.
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Senate GOP Could Use Procedural Tactics To Delay Sotomayor Hearings
Senate Minority Whip Jon Kyl (R-Ariz.), a member of the Senate Judiciary Committee, on Thursday said that the GOP has not ruled out the use of procedural tactics, such as a Republican boycott, to attempt to delay Supreme Court nominee Sonia Sotomayor"s confirmation hearing, Roll Call reports. Republicans have complained that the scheduled July 13 start date for the hearing does not give them enough time to review Sotomayor"s record. Kyl said that Republicans will try to negotiate with Senate Judiciary Committee Chair Patrick Leahy (D-Vt.) for more time if they feel they cannot meet the July 13 deadline (Stanton, Roll Call, 6/11). Leahy said that Sotomayor is entitled to be confirmed on the same timetable as Chief Justice John Roberts, who appeared before the Judiciary Committee less than two months after his nomination (Kivlan, CongressDaily, 6/11).Republican Senate aides say Judiciary Committee ranking member Jeff Sessions (R-Ala.) is not likely to make a final decision for several weeks on whether the GOP will try to delay the nomination. According to Roll Call, Sessions has sought to approach the issue "in a careful, measured way," though he has been critical of some of Sotomayor"s public statements. Roll Call reports that Republicans are apt to display an impartial stance on Sotomayor until the hearing starts, meaning that they likely will delay a decision on whether to stall the nomination until the last minute (Roll Call, 6/11).Sen. Dianne Feinstein (D-Calif.) said that Republican senators are stalling to give conservative groups more time to organize a campaign against Sotomayor that they hope will taint her nomination. Feinstein said that there are "groups out there who need more time for attacks and sound bites." She added, "This is a woman who is qualified, who is brilliant, and who worked her way up" (CongressDaily, 6/11).
Nutrition

Therapy Helps Improve Outcomes For Patients With Severe Sepsis

A preliminary study suggests that a therapy for severe sepsis or septic shock that included the use of an antibiotic-based "hemoperfusion" device to remove toxic products of bacteria from the blood in addition to conventional treatment resulted in a reduced risk of death and appeared to improve blood circulation and reduce organ dysfunction, according to a report appearing in the June 17 issue of JAMA. Severe sepsis and septic shock are common problems in the intensive care unit and carry a high risk of death. Endotoxin is one of the principal components of a form of bacteria, with high levels of endotoxin activity associated with worse clinical outcomes. Septic shock of intra-abdominal origin is often associated with high endotoxin levels. "Thus, it represents a condition in which endotoxin-targeted therapy may be of particular benefit," the authors write. Polymyxin B fiber column is a medical device designed to reduce blood endotoxin levels in sepsis. Reducing circulating endotoxin levels with polymyxin B (an antibiotic) hemoperfusion (the removal of toxins from the blood; blood filtering) could potentially improve patient clinical outcomes, according to background information in the article. Dinna N. Cruz, M.D., M.P.H., and Claudio Ronco, M.D., of St. Bortolo Hospital and the International Renal Research Institute Vicenza, Italy, and colleagues conducted a trial to determine whether polymyxin B hemoperfusion added to conventional medical therapy would improve clinical outcomes and survival compared with conventional therapy alone in patients with severe sepsis or septic shock who underwent emergency surgery for intra-abdominal infection. The randomized controlled trial (RCT) was conducted at 10 Italian intensive care units. Patients (n = 64) were randomized to either conventional therapy (n = 30) or conventional therapy plus two sessions of polymyxin B hemoperfusion (n = 34). "In this RCT of surgical patients with septic shock and severe sepsis induced by abdominal sepsis, polymyxin B hemoperfusion therapy was effective in improving 28-day [mortality was 32 percent (11/34) in the polymyxin B group vs. 53 percent (16/30) in the conventional therapy group] and hospital survival, blood pressure, vasopressor [an agent that increases blood pressure] requirement, and degree of organ failure ò€¦ when added to conventional medical treatment," the authors write. "Larger multicenter studies are indicated to confirm these encouraging findings in other patient populations. Furthermore, we advocate further studies to explore the use of newer assays for endotoxin activity both for patient selection, as well as guiding the number of hemoperfusion sessions." Editor"s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc. Editorial: International Differences in the Treatment of Sepsis - Are They Justified? In an accompanying editorial, John A. Kellum, M.D., of the University of Pittsburgh, and Shigehiko Uchino, M.D., of the Jikei University School of Medicine, Tokyo, write that the therapy used in this study is common in Japan, but not in the U.S. "This preliminary study is valuable as an example of "New Yorkers" testing a Japanese intervention. This kind of cross-community validation is refreshing and necessary but unfortunately only too rare. The results, although preliminary, suggest a number of interesting hypotheses and should provoke further study. This is essential given the significant ongoing problem that sepsis represents." American Medical Association (AMA)


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