We determined to survey the general practice population regarding their attitudes to and knowledge of osteoporosis as a baseline prior to publication of national guidelines for the management of osteoporosis. All 2515 general practitioners registered in the 10 Health Authorities of the North Thames region, London, UK were surveyed by a postal questionnaire. Responses relating to epidemiology, public health and education on osteoporosis were analyzed. The overall response was 1153 (46%). General practitioners who responded were younger, predominantly female and in group practice. There is considerable awareness of the importance of preventing osteoporosis. General practitioners are active in identifying groups at risk, particularly those who are aged 40 years and older. A prevention strategy for osteoporosis is viewed as effective. However, two thirds of general practitioners remain unconvinced about the efficacy of drug therapy. Education on osteoporosis is considered inadequate. General practitioners would welcome further information on management issues and access to osteoporosis services. In conclusion, educational initiatives will be important both at undergraduate and postgraduate levels to increase awareness and knowledge of osteoporosis. General practitioners are aware of the public health impact of this condition and express a preference for educational material of direct relevance to the care of their patients. Therefore better cooperation between primary and secondary care should lead to ways of breaking down barriers to change in clinical practice and promoting fully integrated care of patients with osteoporosis.

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The lipid composition of salivary glands from male and female lone star ticks, Amblyomma americanum, was investigated at progressive stages of tick feeding. The amounts of fatty acids from both phospholipid and neutral lipid fractions increased dramatically during the initial stage of feeding and peaked in partially fed females weighing 100-250 mg. Percentage compositions of myristic (14:0) and palmitic acid (16:0) decreased, but stearic (18:0), oleic (18:1), linoleic (18:2), and arachidonic acid (20:4) increased during tick feeding. Arachidonic acid, the precursor to eicosanoids including the 2-series of prostaglandins, increased from 1.3% of all fatty acids in salivary glands from unfed female ticks to 8.2% in salivary glands from fully engorged female ticks. Arachidonic acid was found in the triglyceride fraction of unfed and fed virgin females but only in phosphatidylcholine and phosphatidylethanolamine from salivary glands of other fed female ticks. Comparisons between fed and unfed male ticks and fed/virgin, fed/mated, and unfed females demonstrate that feeding is necessary for accumulation of arachidonic acid in salivary gland phospholipids.

Analysis of lipids in salivary glands of the lone star tick, Amblyomma americanum, demonstrated that arachidonic acid (20:4, n-6) comprises 8% of all fatty acids identified by gas chromatography. The occurrence of arachidonic acid and other C20 polyunsaturated fatty acids in tick salivary glands was confirmed by gas chromatography-mass spectrometry. Arachidonate is located entirely in the phospholipid fraction and is associated exclusively with phosphatidylcholine (PC) and phosphatidylethanolamine (PE). Salivary glands stored and frozen for several months had a similar lipid composition as freshly dissected salivary glands, with the exception of a small amount of free arachidonic acid and an increase in lysophosphatidylcholine. Incubation of salivary gland homogenates with snake venom phospholipase A2 showed that most saturated fatty acids are esterified in the sn-1 position of PC and PE, with the unsaturated fatty acids in the sn-2 position. Approximately 75% of arachidonic acid is in the sn-2 position of PC and PE, adding support to the hypothesis that arachidonic acid is released into the cytoplasm after activation of a phospholipase A2 for subsequent metabolism to prostaglandins and/or other eicosanoids.

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