A trans-Atlantic examination of haddock Melanogrammus aeglefinus food habits.

The food habits of Melanogrammus aeglefinus were explored and contrasted across multiple north-eastern and north-western Atlantic Ocean ecosystems, using databases that span multiple decades. The results show that among all ecosystems, echinoderms are a consistent part of M. aeglefinus diet, but patterns emerge regarding where and when M. aeglefinus primarily eat fishes v. echinoderms. Melanogrammus aeglefinus does not regularly exhibit the increase in piscivory with ontogeny that other gadoids often show, and in several ecosystems there is a lower occurrence of piscivory. There is an apparent inverse relationship between the consumption of fishes and echinoderms in M. aeglefinus over time, where certain years show high levels of one prey item and low levels of the other. This apparent binary choice can be viewed as part of a gradient of prey options, contingent upon a suite of factors external to M. aeglefinus dynamics. The energetic consequences of this prey choice are discussed, noting that in some instances it may not be a choice at all.

Quantifying alosine prey in the diets of marine piscivores in the Gulf of Maine.

The objectives of this work were to quantify the spatial and temporal distribution of the occurrence of anadromous fishes (alewife Alosa pseudoharengus, blueback herring Alosa aestivalis and American shad Alosa sapidissima) in the stomachs of demersal fishes in coastal waters of the north-west Atlantic Ocean. Results show that anadromous fishes were detectable and quantifiable in the diets of common marine piscivores for every season sampled. Even though anadromous fishes were not the most abundant prey, they accounted for c. 5-10% of the diet by mass for several marine piscivores. Statistical comparisons of these data with fish diet data from a broad-scale survey of the north-west Atlantic Ocean indicate that the frequency of this trophic interaction was significantly higher within spatially and temporally focused sampling areas of this study than in the broad-scale survey. Odds ratios of anadromous predation were as much as 460 times higher in the targeted sampling as compared with the broad-scale sampling. Analyses indicate that anadromous prey consumption was more concentrated in the near-coastal waters compared with consumption of a similar, but more widely distributed species, the Atlantic herring Clupea harengus. In the context of ecosystem-based fisheries management, the results suggest that even low-frequency feeding events may be locally important, and should be incorporated into ecosystem models.

You are what you eat, whenever or wherever you eat it: an integrative analysis of fish food habits in Canadian and U.S.A. waters.

The degree to which fish diet differs by season and area, particularly over broad scales, was examined for the first time in temperate, contiguous north-west Atlantic Ocean waters by comparing food habit data for 10 species of fishes collected concurrently during the spring and autumn surveys in the U.S.A. (Gulf of Maine proper and Georges Bank) and in the summer survey in Canada (western Scotian Shelf and Bay of Fundy). For most species, there was a general concurrence among the three seasons and four areas: summer diets had the same dominant prey items as spring and autumn diets. Although a suite of multivariate analyses did elucidate some differences in specific proportions of the diet for these species across seasons and areas, the main prey did not substantially change for most of these species. These results suggest that there are (1) minimal differences in diet across season for these species at these taxonomic resolutions, (2) there are minimal differences in diet geographically for these species and (3) differences across species, as expected, are important. Many fisheries ecosystem and multispecies models are dependent on food habit data, where resolving seasonal and spatial differences in diet remains an important consideration; however, the present work implies that amalgamated estimates of diet from seasonal surveys may be a reasonable approach when no finer seasonal resolution exists, as long as due diligence is exercised.

Functional feeding responses of piscivorous fishes from the northeast US continental shelf.

The functional feeding response forms of piscivorous fishes used in multispecies and ecosystem modeling have been questioned because they were mostly conjectural or solely based on laboratory studies. Here, we investigate the functional feeding response of seven species of piscivorous fishes on four species of their prey from the northeast US continental shelf using field data that spans 30 years. Our study confirmed that Holling's types II and III functional responses are the most common functional responses for piscivorous fishes in this region. However, our analyses also revealed that differences exist between piscivorous fishes' functional responses, and, therefore, combining functional responses of piscivores is probably not appropriate in multispecies and ecosystem modeling. In the absence of specific predator-prey functional responses, we suggest that, for cruising, actively attacking predators, a type II functional response is slightly preferable; for a sedentary, ambush predator, a type III functional response is slightly preferable; at low prey densities for a generic fish predator, a type III functional response should be used; and at moderate to high prey densities, either should work sufficiently. Because we have shown that the functional response of a particular predator to individual prey species varies, these relationships must be further evaluated as we continue to develop and employ multispecies and ecosystem modeling.

Gemcitabine plus cisplatin repeating doublet therapy in previously treated, relapsed breast cancer patients.

PURPOSE: To determine the safety and efficacy of gemcitabine plus cisplatin for patients with relapsed adenocarcinoma of the breast. PATIENTS AND METHODS: Previously treated patients with adenocarcinoma of the breast received cisplatin (30 mg/m(2)) plus gemcitabine (1,000 mg/m(2)) on days 1, 8, and 15 of each 28-day cycle, which was changed after patient no. 12 to cisplatin (30 mg/m(2)) plus gemcitabine (750 mg/m(2)) days 1 and 8 of each 21-day cycle. RESULTS: Of 30 patients, three (10%) had complete and 12 (40%) had partial responses, for an overall response rate of 50%. Two objective responses were observed among the four patients accrued after relapse that followed high-dose/stem-cell therapies. The median time to progression was 14 weeks. The median time to progression for objective responders was 23.5 weeks, with a range of 8 to 68 weeks. Toxicities included grades III and IV neutropenia in 13%, anemia in 6%, thrombocytopenia in 31%, grade III nausea in 4%, and grade II peripheral neuropathy in 2% of 151 treatment cycles. Moderate alopecia occurred in four patients. There were no treatment-related deaths. CONCLUSION: Cisplatin plus gemcitabine is active and tolerable for patients with relapsed breast cancer. Responses observed in previously treated patients, including high-dose/stem-cell failures, indicate activity in otherwise drug-refractory patients.

History and overview of comprehensive interdisciplinary breast centers.

The comprehensive interdisciplinary breast center represents a model for delivering breast care in an efficient and cost-effective manner. It is a better way of caring for women with breast disease and allows for an interdisciplinary treatment by various specialists working and communicating with each other. The center allows for incorporation of new programs and innovations of care. As breast cancer care undergoes further changes, the comprehensive breast center facilitates progress and serves as a model for other disease-specific interdisciplinary programs. The evolution of breast centers and types of models are reviewed, and key factors of success are outlined in this article.

A breast cancer care report card. An assessment of performance and a pursuit of value.

The transition to managed care raises concerns about the resulting quality of care. The report card, a publicly released, standardized report on quality, has received widespread acceptance as a method to evaluate physician performance. Current report cards provide insufficient information to allow purchasers of health care to assess accurately the performance of professionals who provide breast care. To overcome these limitations, we propose an expanded report card on breast cancer care. Mammographers and general surgeons would assess an independent series of at least 100 consecutive cases of newly diagnosed breast cancer. Mammographers would determine the percentage of invasive cancers < 15 mm detected on screening mammograms in asymptomatic women aged 50 to 74 years. Surgeons would determine the percentage of combined stages 0 and 1 breast cancers detected and the percentage of patients receiving breast-conserving surgical therapy. Performance targets are set at 60% for invasive cancers < 15 mm detected on screening mammography, 60% for combined stage 0 and 1 breast cancers, and 50% for patients receiving breast-conserving therapy.

Benign breast disease.

Benign breast disease is common with an estimate of over half the female population at sometime seeking medical attention for a breast problem. The clinician must prove that the woman with a breast problem (ie, tenderness, lump, discharge) does not have a malignancy. This is done using a history and physical examination and, when indicated, mammography, ultrasonography, ductography, fine needle aspiration biopsy, or excisional biopsy. A comprehensive breast center allows for an efficient and cost-effective workup for women with a breast problem. In this context, benign breast disease and preinvasive breast cancer is presented.

Improved mammographic accuracy.

Use of ancillary imaging studies to evaluate suspicious screening mammograms can improve their positive predictive value for detecting malignant lesions. In 1989 8181 screening mammograms were performed at the breast evaluation center at Memorial Hospital Medical Center in Long Beach. A total of 670 patients were called back for magnification views or ultrasonographic evaluation, and 92 of these patients underwent surgical biopsy. There were 42 cancers diagnosed, yielding an accuracy rate of 46%.

5-Flourouracil in hepatocellular carcinoma: report of twenty-one cases.

Twenty-one patients with biopsy-proven hepatocellular carcinoma were treated with oral or intravenous 5-Fluorouracil according to a randomized treatment schedule. Twenty-one patients were evaluable for response and toxicity. The two groups were comparable in distribution of pretreatment characteristics. There were no objective responses in either group. This is the largest reported group of patients with hepatocellular carcinoma treated with 5-Fluorouracil. Toxicity occurred in 46% of patients treated, but was tolerable. In contrast to previous reports, we have found that weekly 5-Fluorouracil given orally or intravenously is not of significant value in the treatment of hepatocellular carcinoma.