Diagnosis of a leak after a SG required a greater index of suspicion in order to perform an early diagnosis. Sepsis control and nutritional support are the cornerstones of this treatment. Evolution is characterized by longer periods of time that are necessary in order to wait until the leak closes. Management must be tailored to each patient.

No abstract

Some subsets of pediatric sarcoma patients have very poor survival rates. We sought to determine the feasibility and efficacy of allogeneic HSCT (alloHSCT) in pediatric sarcoma populations with <25% predicted overall survival. Patients with ultra-high risk Ewing’s sarcoma family of tumors (ESFT), alveolar rhabdomyosarcoma or desmoplastic small round cell tumor received EPOCH-fludarabine induction, a cyclophosphamide/fludarabine/melphalan preparative regimen and HLA matched related peripheral blood stem cells. Thirty patients enrolled; 7 did not undergo alloHSCT due to progressive disease with diminishing performance status during induction. All 23 alloHSCT recipients experienced rapid full donor engraftment, with no peri-transplant mortality. Five of 23 alloHSCT recipients (22%) remain alive (overall survival of 30% by Kaplan-Meier analysis at 3 years), including 3 of 7 (42%) transplanted without overt disease (median survival 14.5 vs. 29.0 months from alloHSCT for patients transplanted with vs. without overt disease, respectively). Among the 28 patients who progressed on the study, the median survival from date of progression was 1.9 months for the 7 who did not receive a transplant compared to 11.4 months for the 21 transplanted (p=0.0003). We found prolonged survival after post-transplant progression with several patients exhibiting indolent tumor growth. We also saw several patients with enhanced anti-tumor effects from post-transplant chemotherapy (objective response to pre-transplant EPOCH-F was 24% vs. 67% to post-transplant EOCH), however this was associated with increased toxicity. This largest reported series of alloHSCT in sarcomas demonstrates that alloHSCT is safe in this population, and that patients undergoing alloHSCT without overt disease show higher survival rates than reported using standard therapies. Enhanced chemo- and radio-sensitivity of tumors and normal tissues was observed post-transplant.

No abstract

Atlantic Menhaden Brevoortia tyrannus is an economically and ecologically important forage fish in the western Atlantic Ocean. In the Chesapeake Bay, its recruitment has been low since the late 1980s, prompting questions on how environmental factors may affect its productivity. Growth is an important component of production, but causes of spatial and temporal variability in growth of age‐0 Atlantic Menhaden are not fully understood. Our objective was to quantify the effect of temperature on spatial and temporal variability in growth of age‐0 Atlantic Menhaden in Chesapeake Bay. We analyzed data on mean length and temperature for years 1962–2011 from nine regions of Chesapeake Bay. We developed a linear model that relates mean total length of Atlantic Menhaden to cumulative growing degree‐days (GDDs) in Chesapeake Bay and validated the model using data that were withheld from the initial parameter estimation. The temperature threshold that best described variability in growth was 14°C, a temperature substantially higher than the physiological threshold for growth. The GDD model explained almost 80% of the variability in mean length over time (within and among years) and among regions. In a model validation exercise, it accurately predicted mean length in tributary subregions of the bay not included in the original model fitting. The GDD model requires only temperature data to effectively predict growth, making it simpler to apply than models requiring more complex approaches. Received August 22, 2013; accepted May 30, 2014