A 2 X 2 factorially arranged trial was conducted to compare effects of implant (zeranol) and frame size on weight and compositional gain, and plasma hormone concentrations. Angus, Charolais X Hereford and Hereford X Angus yearling steers (34 steers averaging 270 kg body weight) were randomly assigned to treatments of small (SF) vs large frame (LF) and implant (I) vs no implant (NI). Steers were implanted at 0 and 97 d and individually fed an 81% whole shelled corn and 11.5% corn silage-based diet (dry basis) for a 175-d period. Shrunk weights and body measurements for frame size determination were taken initially and at approximately 28-d intervals; blood was collected via venipuncture at 14-d intervals for analyses of insulin (IN), triiodothyronine (T3), thyroxine (T4) and glucose concentrations. Steers were also counted in a whole body counter for measurement of 40K content and prediction of whole body protein and fat. The I steers showed an improvement (P less than .05) in daily gain regardless of frame size for the total trial. The I LF steers required 18% more dry matter to attain higher daily gain for 97 to 175 d; I steers were more efficient (P less than .05) at converting dry matter to gain during 0 to 97 d and 0 to 175 d. Daily fat deposition was increased (P less than .05) in I steers, while protein deposition was not affected by I. Plasma IN concentrations were numerically elevated (P less than .10) in I steers regardless of frame size, during the initial 97 d. Implant did not influence (P greater than .10) plasma T3, T4 and glucose concentrations regardless of frame size. Steers responded differently to zeranol implant over time regarding plasma T4 concentrations (P less than .003). Steers differing in frame size responded similarly in rate of gain, in feed conversion and in patterns of plasma insulin concentrations to zeranol implants.

Fifty-eight episodes of catheter-related sepsis in 21 patients receiving home parenteral nutrition were retrospectively studied. Of 81 organisms isolated from the blood, 59% were Gram-positive cocci, 25% were Gram-negative bacilli, and 16% were yeast. Attempts to treat bacterial infections at home with antibiotic therapy while the catheter remained in place were made; fungal isolation resulted in immediate hospitalization and catheter removal. Gram-negative infections more often resulted in eventual hospitalization (92%) and catheter removal (50%) than Gram-positive infections (57% hospitalization and 23% catheter removal). Empiric therapy with 1 g of cefazolin intravenously every 12 hr was successful in only 33% of episodes caused by coagulase-negative staphylococci, whereas vancomycin was successful in 62%. Sensitivity testing was not a reliable guide for antibiotic choice for treatment of these infections. Cefazolin, 1 g, intravenously every 12 hr was successful in only 25% of Gram-negative episodes treated empirically with this regimen. We conclude that our home parenteral nutrition patients should be hospitalized for a few days upon presentation with a catheter infection for clinical evaluation and aggressive antibiotic therapy. Vancomycin is the preferred drug for treatment of catheter-related infections caused by coagulase-negative staphylococcus.

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The authors describe a children's mental health unit (CMHU) in a general hospital and cite the need for short- and intermediate-term children's psychiatric facilities within the community. They point out the special need for psychiatric inpatient units for the 3-13 age group and note that in their CMHU the average length of stay and patient turnover ratio compare favorably with adolescent units, which they attribute to the emphasis on diagnosis and treatment rather than long-term rehabilitation.