SummaryA prospective study was completed of 30 shocked patients admitted consecutively to an intensive therapy unit; the majority of the patients had shock of septic origin. Measurements were made of whole blood lactate together with mean arterial pressure, hourly urine volume and core: peripheral temperature difference ut the start of treatment and 3 and 24 hours later. Serial lactate measurements were better at predicting outcome than single measurements. However, lactate measurements were much less valuable than serial measurements of the simple haemodynamic variables.

A composite statistical analysis was made of the results from four trials comprising patients undergoing upper abdominal operations. It revealed a marked correlation between the neuroticism score as measured by a personality inventory before operation and the percentage vital capacity impairment found after operation. Neuroticism correlated also with pain as measured by a visual analogue scale. The vital capacity impairment and subjective pain readings were interrelated and both neuroticism and vital capacity impairment were related to the chest complication rate. Personality assessment before operation can identify one group of patients who will have marked pain and limitation of vital capacity after operation.

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Epidemiological studies have consistently suggested an aetiological relationship between certain dietary constituents, faecal bile acid (FBA) concentration and colorectal cancer. This study was designed to examine the effect of the dietary manipulation of fat and fibre on tumour induction and on various faecal characteristics in Albino Swiss rats. A total of 232 animals were maintained on one of four different diets for 4, 20 and 28 weeks respectively. The diets were classified as high fat high fibre, low fat high fibre, high fat low fibre and low fat low fibre. The groups were further sub-divided according to the administration of systemic azoxymethane (10 mg/kg per week) or saline over 12 consecutive weeks. The high fat low fibre diet was associated with the highest risk for tumour production and the low fat high fibre diet with the lowest risk. Statistically significant differences between all the diets were noted with the exception of a comparison between the high fat high fibre and low fat high fibre diets. The highest total concentration of free FBA was found in the faeces from animals fed low fibre containing diets. The results show a clear influence of both fat and fibre on tumour induction while, in this model, fibre was the principle determinant of faecal bile acid concentration.

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