Is Fat Absorbed through the Peritoneum?

A 10% fat solution (Liposyn) was infused (50 mi/kg) into the peritoneal cavity of four normal rabbits and left for five hours. Changes in the intraperitoneal volume were measured by using the radioactive albumin dilution technique. After an initial ultrafiltration, which peaked at one hour, the solution began to be absorbed and approximately 30% of the initial volume was removed at five hours. At the end of the infusion, dialysate fat concentration decreased to 85% of the initial value but the absolute amount absorbed was approximately 40% of the infused amount. Plasma total fat increased from 0.16 ± 0.03 to 1.35 ± 0.49 g/100 ml and plasma triglycerides increased from 94.7 ± 57.5 to 1247.8 ± 6.46 mg/100 ml. We observed no histological changes in the liver of the rabbits and the transmission electron microscopy demonstrated passage of lipid droplets into the mesenteric interstitium. The presence of droplets in micropinocytotic vesicles indicates that at least some of the lipid is transported through the cell by vesicular diacytosis. Our data indicate that fat emulsion is absorbed through the peritoneum slowly as the infused volume is absorbed. Under these conditions the solution cannot be used as a dialysis solution, but may be used for total parenteral nutrition in patients with normal kidney function who have no vascular access.

Population trends in European rabbits and other wildlife of central Australia in the wake of rabbit haemorrhagic disease

Before the establishment of rabbit haemorrhagic disease (RHD) in central Australia in May 1996, a program was instituted to monitor its impacts at six localities broadly distributed across the region. At these sites, population trends in rabbits and other wildlife were studied over a 2.5-year period. Rabbit populations declined by approximately 85% following establishment of RHD at the sites, and had not recovered 22 months later. More varanid lizards were detected on our survey plots 12–22 months after RHD than during the preceding period. Although numbers of dingoes and wedge-tailed eagles varied during the study, significant population reductions were not detected in either species in the wake of RHD. Significant population changes were not detected in red foxes, feral cats, red kangaroos, small mammals, or other raptor species.

Warren ripping: its impacts on European rabbits and other wildlife of central Australia amid the establishment of rabbit haemorrhagic disease

The impacts of warren ripping on European rabbits and other wildlife were studied at four sites in central Australia over a 2.5-year period. At each site, treated (ripped) and untreated plots were established. On the treated plots, warrens were ripped over an area of 20–140 km2. Rabbit haemorrhagic disease (RHD) became established in central Australia during the study. There were fewer rabbits on ripped plots compared with untreated plots both before and after the establishment of RHD. There was also less sign of exotic predators (red foxes and feral cats) on ripped plots. The amount of dingo sign observed and the number of peregrine falcons, brown falcons, kites and goshawks combined and kestrels and hobby falcons combined changed with time but no treatment effect was detected. No consistent treatment effect was detected for red kangaroos, varanid lizards, small mammals or other raptor species.

Randomized trial of nurse-assisted strategies for smoking cessation in primary care

BACKGROUND

Brief advice to stop smoking from general practitioners (GPs) has been repeatedly shown to increase smoking cessation by a small, but measurable amount. Some studies have suggested that adding more intensive interventions to brief advice may increase its effectiveness, but it is unclear whether this is true in general practice.

AIMS

To determine whether brief advice from a doctor together with counselling and follow-up from a trained practice nurse is more effective than brief advice alone in helping people to stop smoking.

METHODS

The design was a randomized controlled trial. Four hundred and ninety-seven general practice patients aged older than 18 years and smoking at least one cigarette per day in six general practices in Oxfordshire, Berkshire, and Buckinghamshire were randomized to one of two interventions: brief verbal or written advice from a GP plus extended counselling and follow-up from a trained practice nurse; brief advice from a GP alone. The primary outcome was sustained abstinence from smoking at three and 12 months. A secondary outcome was forward movement in the stages of change cycle.

RESULTS

The proportion showing sustained abstinence was 3.6% in the extended counselling group, and 4.4% in the brief advice group (difference = -0.8%; 95% confidence interval = -4.3% to 2.6%). Seventy-four (30%) of those randomized to extended counselling actually took up this offer. No significant progression in stages of change was detected between the two groups.

CONCLUSIONS

In unselected general practice patients who smoke, brief advice from a GP combined with intensive intervention and follow-up by a practice nurse is no more effective than brief advice alone.

The career outcomes for doctors completing general practice vocational training 1990-1995

BACKGROUND

While much has been published about the career outcomes of doctors who completed general practice vocational training prior to 1990, no evidence is currently available about those who have qualified since that time.

AIM

To obtain information about the career paths of doctors who had completed general practice vocational training since 1990, and to compare the results with previously published data.

METHOD

Postal questionnaire survey of all doctors completing vocational training during the period 1990-1995 in three regions of the United Kingdom. The study examined current work status, career path since completion of training, desire for and experience of part-time training, degree of difficulty in choosing and following a career, and the degree to which certain factors impeded career choice.

RESULTS

The overall response rate was 64.8%, although there was a significant difference between the response rates for men and women. While virtually all responders were employed, with the majority working in general practice, women were significantly less likely than men to be working as principals in general practice, for all cohorts. These results were very similar to those cohorts described in earlier studies. The career paths of doctors only became stable after about four years. Of those working in general practice, about 20% found it difficult to choose their career, and about 10% found it difficult to follow their career. Out-of-hours work was the major factor impeding career choice.

CONCLUSION

Although they are taking longer to reach, the final career destinations of doctors completing vocational training since 1990 are no different from those of earlier cohorts.

Population Maintenance of Lucilia-Cuprina (Wiedemann) in the Arid Zone

For 3 years numbers and species of blowflies breeding in carcasses and on live merino sheep were studied at the University of New South Wales Arid Zone Research Station at Fowlers Gap, to determine which species initiated blowfly strike on sheep and how Lucilia cuprina (Wiedemann) maintained its population throughout the year; particularly whether it could complete its life cycle on carcasses. Larvae taken from struck sheep showed L. cuprina to be the dominant species in >87% of strikes. Native calliphorids, Calliphora nociva Hardy, Calliphora augur (Fabr.), and Calliphora stygia (Fabr.) were present in about 7% of strikes sampled, usually in association with L. cuprina. In a regularly inspected small mob (c. 70) of sheep, incidence of covert strike was higher than incidence of overt strike, supporting the view that a grazier's estimate of flystrike in the flock would almost always be an underestimate. On carcasses, the secondary strike native blowfly, Chrysomys rufijacies (Macquart), was produced in very large numbers. Some native primary strike Calliphora spp. were produced from some carcasses in the colder months, but no L. cuprina was produced from either small or large carcasses (sheep, kangaroos, rabbits) at any time. However, larvae of L. cuprina were recovered from live sheep at all times of the year, indicating that L. cuprina is an obligate parasite of live sheep in the arid zone.