Understanding and treating depression among cancer patients.

Cancer is a devastating disease. Awareness of this disorder tremendously impacts an individual's life, creating a host of changes to occur. Depression is one concern that many cancer patients experience. It is important to make an accurate and complete assessment of depressive symptoms. Furthermore, a heightened awareness of patients' culture and their perceptions is vital to their assessment, diagnosis, and treatment of depression. In cases of clinical depression, appropriate antidepressants prescribed along with the treatment for cancer are significant for the patient. Palliative counseling for patients and supportive counseling for their family are recommended as part of a treatment plan.

Influence of supplemental alfalfa quality on the intake, use, and subsequent performance of beef cattle consuming low-quality roughages.

Three experiments were conducted to evaluate influences of supplemental alfalfa quality on intake and use of low-quality meadow grass roughages (MG) by beef cattle. In Exp. 1, 15 steers (250 kg) were assigned to three treatments: 1) MG (5.2% CP), no supplement; 2) MG plus high-quality alfalfa (18.8% CP); and 3) MG plus low-quality alfalfa (15.2% CP). High- and low-quality alfalfa supplements were fed at .45 and .55% BW, respectively. Total DMI was greater (P < .01) for alfalfa-supplemented steers than for MG. Likewise, intake of digestible DM, DM digestibility (DMD), and ruminal ammonia level were greater (P < .01) for supplemented steers. In Exp. 2, 96 pregnant Hereford x Simmental cows (537 kg; body condition [BC] score 4.86) were assigned to the same treatments as in Exp. 1. For d 0 to 42, cows grazed on 19.1 ha of stockpiled MG (4,539 kg/ha; 6.8% CP), whereas, on d 43 to 84, cows received MG hay (5.2% CP). Supplemented cows gained more BW (P < .01), BC score (P < .01), and had heavier calf birth weight (P < .01) than nonsupplemented cows. However, there were no treatment effects (P > .10) on cow cyclicity, pregnancy rate, or calving interval. In Exp. 3, 90 pregnant Angus x Hereford cows (475 kg; BC score 4.59) were assigned to three treatments: 16.1%, 17.8% or 20.0% CP alfalfa supplement, with levels of .63, .55, and .50% of BW, respectively. Weight gain and BC score for the 84-d study displayed a quadratic response (P < .10), yet represented only 7 kg BW and .2 units of BC score. In conclusion, alfalfa hay supplementation was effective in increasing DMI and digestibility. However, alfalfa hay quality did not dramatically affect BW, BC score, and(or) calf birth weight, when fed on an isonitrogenous basis.

Early-vegetative tall fescue hay vs alfalfa hay as a supplement for cattle consuming low-quality roughages.

Two studies were conducted to evaluate high-quality tall fescue hay as a supplement to beef cattle fed low-quality roughages. In Exp. 1, 15 ruminally cannulated Hereford x Angus steers (average weight 390 kg) were blocked by weight and assigned randomly to one of three treatments: 1) tall fescue straw, no supplement; 2) tall fescue straw plus tall fescue hay supplement; 3) tall fescue straw plus alfalfa hay supplement. The 28-d digestion study consisted of 14 d of adaption, 6 d of intake data, and 6 d of collection of feces, respectively, with a 1-d ruminal sampling (d 27) and ruminal evacuations (d 28). In Exp. 2, 90 gestating Hereford x Angus cows were stratified by age and body condition and, within stratum, assigned randomly to three replications of the same treatments as described for Exp. 1. In both studies, a basal diet of tall fescue straw was fed with ad libitum access, alfalfa hay was fed at .4% BW, and tall fescue hay was fed at a level isonitrogenous with the alfalfa hay (.61% BW). In Exp. 1, DMI was at least 13% greater (P < .01) for supplemented steers than for nonsupplemented steers and was 12% greater (P < .10) for steers receiving supplemental tall fescue hay than for alfalfa hay-supplemented steers. Digestibility of DM was greater for supplemented steers than for nonsupplemented steers (P < .05) and, between supplement treatments, greater for tall fescue hay-supplemented steers than for alfalfa hay-supplemented steers (P < .10). Ruminal ammonia values peaked at 3 h after feeding and were higher for steers fed supplement treatments than for those fed the control treatment from just before feeding through 6 h after feeding (P < .10). In Exp. 2, supplemented cows gained more BW than nonsupplemented cows (P < .01), and the tall fescue hay-supplemented cows gained more BW (P < .10) than cows supplemented with alfalfa hay. Likewise, supplemented cows lost less condition (P < .01) than their nonsupplemented counterparts during the 84-d supplementation period, and cows receiving tall fescue hay supplement tended (P = .23) to lose less condition than cows receiving alfalfa hay supplement. No differences in calf growth were noted among treatment groups (P < .10). In conclusion, supplementation of high-quality tall fescue hay to cows fed low-quality forage diets seems to result in performance that is similar to or better than that of cows receiving alfalfa hay supplements when fed on an isonitrogenous basis.

Appearance of the hymen in prepubertal girls.

The recent increase in requests for genital examinations in girls who may have been sexually abused has necessitated detailed information not previously available on normal anatomy of the prepubertal girl. This study was undertaken to document the genital anatomy of 211 girls between the ages of 1 month and 7 years who presented for well child care or nongynecologic complaints and who had no history of sexual abuse. Each child's genitalia was examined and photographed, with findings reported reflecting those observed photographically. The study population consisted of 36% blacks, 33.6% white non-Hispanics, 29.9% Hispanics, and 0.5% Asians. Subjects had a mean age of 21 +/- 20.6 (SD) months. Extensive labial agglutination sufficient to obscure the hymen was noted in 5% (10/211) and partial agglutination in an additional 17% (35/211). A significant difference was noted in hymenal configuration by age, with a fimbriated hymen the most common type (46%) in infants aged 12 months or younger and a crescentic hymen the most common (51%) in girls older than 24 months (P less than or equal to .001). No significant difference was noted in hymen configuration by race. Hymenal bumps (mounds) were observed in 7%, hymenal tags in 3%, vestibular bands in 98%, longitudinal intravaginal ridges in 25%, and external ridges in 15% of subjects in whom the anatomy under study could be visualized. Hymenal notches (clefts) occurred superiorly and laterally on the hymenal rim but none were found inferiorly on the lower half of the hymen. A narrow rounded hymenal ring with a transection was observed in only 1 (0.5%) of 201 subjects and was not considered a normal finding.(ABSTRACT TRUNCATED AT 250 WORDS)

Factors affecting isolation and identification of Haemophilus vaginalis (Corynebacterium vaginale).

The rate of isolation of organisms resembling Haemophilus vaginalis (Corynebacterium vaginale) from vaginal specimens was not significantly affected by anaerobic versus carbon dioxide incubation atmospheres or whether specimens were inoculated on isolation media immediately after collection or after a delay of 6 h. Forty-one clinically isolated strains were provisionally divided into 30 H. vaginalis strains and 11 H. vaginalis-like (HVL) strains based on morphological and growth characteristics. The H. vaginalis strains were less reactive in API-20A identification test strips, (Analytab Products, Inc.) using Lombard-Dowell broth, than in a modified basal medium that contained proteose peptone no. 3 (Difco). The numbers and kinds of substrates fermented by 30 clinical and 2 reference strains of H. vaginalis varied among conventional, API, Minitek (Baltimore Biological Laboratory), and rapid buffered substrate fermentation systems. A greater number and variety of carbohydrates were fermented by the 11 HVL strains more consistently in all four test systems. Analysis of volatile and nonvolatile fermentation end products by gas-liquid chromatography did not reveal significant differences between the H. vaginalis and HVL strains. However, the latter group grew in peptone-yeast extract-glucose broth, whereas the H. vaginalis strains did not grow without the addition of starch to peptone-yeast extract-glucose. All of the reference and clinical strains were similar in their susceptibilities to a variety of antimicrobial compounds except sulfonamides, which inhibited the HVL strains and bifidobacteria but not the H. vaginalis strains. Sulfonamide susceptibility or resistance corresponded in part to the H. vaginalis and HVL-bifidobacteria strain reactions on selected conventional fermentation substrates. Susceptibility or resistance to sulfonamides and metronidazole in conjunction with fermentation tests is described to aid in the separation of H. vaginalis from other possibly unrecognized biotypes of H. vaginalis or other vaginal bacteria that presumptively resemble the organism. A human blood medium known as V agar was also of considerable value in distinguishing H. vaginalis from HVL strains, because only the H. vaginalis strains produced diffuse beta-hemolysis on V agar.

Tellurite reduction test to aid in the recognition of Corynebacterium vaginale.

Corynebacterium vaginale (Haemophilus vaginalis) does not reduce potassium tellurite. When a 1% aqueous solution of tellurite is added to starch agar plates previously inoculated with vaginal discharge material, other starch-fermenting and most non-starch-fermenting bacteria rapidly reduce tellurite to produce black or gray colonies. This test is a useful adjunct to methods for rapid presumptive identification of C. vaginale. C. vaginale is more susceptible to tellurite inhibition than a variety of other gram-positive bacteria.