Red, gold and green: microbial contribution of Rhodophyta and other Algae to Green Turtle (Chelonia mydas) Gut Microbiome

The fitness of the endangered green sea turtle (Chelonia mydas) may be strongly affected by its gut microbiome, as microbes play important roles in host nutrition and health. This study aimed at establishing environmental microbial baselines that can be used to assess turtle health under altered future conditions. We characterized the microbiome associated with the gastrointestinal tract of green turtles from Guinea Bissau in different life stages and associated with their food items, using 16S rRNA metabarcoding. We found that the most abundant (% relative abundance) bacterial phyla across the gastrointestinal sections were Proteobacteria (68.1 ± 13.9% “amplicon sequence variants”, ASVs), Bacteroidetes (15.1 ± 10.1%) and Firmicutes (14.7 ± 21.7%). Additionally, we found the presence of two red algae bacterial indicator ASVs (the Alphaproteobacteria Brucella pinnipedialis with 75 ± 0% and a Gammaproteobacteria identified as methanotrophic endosymbiont of Bathymodiolus, with <1%) in cloacal compartments, along with six bacterial ASVs shared only between cloacal and local environmental red algae samples. We corroborate previous results demonstrating that green turtles fed on red algae (but, to a lower extent, also seagrass and brown algae), thus, acquiring microbial components that potentially aid them digest these food items. This study is a foundation for better understanding the microbial composition of sea turtle digestive tracts.info:eu-repo/semantics/publishedVersio

Red, Gold and Green: Microbial Contribution of Rhodophyta and Other Algae to Green Turtle (Chelonia mydas) Gut Microbiome

The fitness of the endangered green sea turtle (Chelonia mydas) may be strongly affected by its gut microbiome, as microbes play important roles in host nutrition and health. This study aimed at establishing environmental microbial baselines that can be used to assess turtle health under altered future conditions. We characterized the microbiome associated with the gastrointestinal tract of green turtles from Guinea Bissau in different life stages and associated with their food items, using 16S rRNA metabarcoding. We found that the most abundant (% relative abundance) bacterial phyla across the gastrointestinal sections were Proteobacteria (68.1 ± 13.9% “amplicon sequence variants”, ASVs), Bacteroidetes (15.1 ± 10.1%) and Firmicutes (14.7 ± 21.7%). Additionally, we found the presence of two red algae bacterial indicator ASVs (the Alphaproteobacteria Brucella pinnipedialis with 75 ± 0% and a Gammaproteobacteria identified as methanotrophic endosymbiont of Bathymodiolus, with <1%) in cloacal compartments, along with six bacterial ASVs shared only between cloacal and local environmental red algae samples. We corroborate previous results demonstrating that green turtles fed on red algae (but, to a lower extent, also seagrass and brown algae), thus, acquiring microbial components that potentially aid them digest these food items. This study is a foundation for better understanding the microbial composition of sea turtle digestive tracts.info:eu-repo/semantics/publishedVersio

Persistent dysphonia and constitutional syndrome. Laryngeal amyloidosis

Objetivo: describir un caso de amiloidosis laríngea que se define como una enfermedad por depósito de una determinada proteína, cuyo tratamiento si el diagnóstico no es precoz, puede ser muy incapacitante. Método: presentamos el caso de un paciente de 64 años con disfonía de años de evolución, su diagnóstico fue casual, pues la paciente nunca interpretó el cambio de su voz como patológico. Resultado: comentó pérdida de peso no cuantificada en los últimos meses. Se deriva a ORL que tras laringoscopia se aprecia aspecto granuloso en vestíbulo laríngeo por encima de las bandas ventriculares, sin aspecto neoplásico, pero que precisa biopsia, y posterior laringuectomía por hemorragia. Conclusiones: en la amiloidosis es esencial el diagnóstico precoz. El tratamiento debe ser individualizado, por lo que en estos pacientes son fundamentales el tratamiento de soporte y el manejo multidisciplinar, en especial en pacientes con afectación renal o cardiaca.Purpose: describe a case of laryngeal amyloidosis that is defined as a disease due to the deposition of a certain protein, whose treatment if the diagnosis is not early, can be very disabling. Method: here we present the case of a 64 year old patient with dysphonia of years of evolution, his diagnosis was casual, because the patient never interpreted the change of his voice as pathological. Results: commented on unquantified weight loss in recent months. ENT specialist is derived that after laryngoscopy a granular appearance is seen in the laryngeal vestibule above the ventricular bands, without neoplastic appearance, but that requires a biopsy, and subsequent laryngectomy due to hemorrhage. Conclusions: in early amyloidosis, early diagnosis is essential. The treatment must be individualized, so in these patients, supportive treatment and multidisciplinary management are fundamental, especially in patients with renal or cardiac involvement

Manic episode and excessive consumption of licorice as an expression of a metabolic disorder

Se presenta un caso de pseudohipoaldosteronismo inducido por consumo excesivo de regaliz en una paciente con un episodio maníaco. Se ha revisado la fisiopatología, atendiendo a la evolución de la paciente por la persistencia de la hipopotasemia, así como el diagnóstico diferencial de este cuadro clínico. Pese a su gravedad potencial, su tratamiento es sencillo y eficaz. Desde nuestro campo de actuación, la atención en la anamnesis es la clave para el diagnóstico y el tratamiento, dado que la modificación de uno de los hábitos actuales de la paciente podría haber evitado, no el ingreso por manía, pero sí la evolución tórpida de las alteraciones electrolíticas levesWe present a case of pseudo-hypoaldosteronism induced by excessive consumption of licorice in a patient with a manic episode. The pathophysiology has been reviewed, taking into account the evolution of the patient due to the persistence of hypokalemia, as well as the differential diagnosis of this clinical picture. Despite its potential severity, its treatment is simple and effective. From our field of action, attention in the anamnesis is the key to diagnosis and treatment, since the modification of one of the patient’s current habits could have prevented, not admission due to mania, but the torpid evolution of electrolyte disturbances

Parsonage Turner syndrome an underdiagnosed pathology in the painful shoulder

Se presenta un caso de dolor en miembro superior derecho secundario al Síndrome de Parsonage Turner, una patología muy poco frecuente, de etiología desconocida, que se manifiesta fundamentalmente como una neuritis del plexo braquial. En este caso clínico se revisan las distintas fases de este síndrome, así como su diagnóstico y tratamiento. Desde atención primaria, el médico debe considerar esta patología en el diagnóstico diferencial del hombro doloroso, especialmente en aquellos casos que cursen con afectación neuromuscular, puesto que, el diagnóstico es fundamentalmente clínico presentando en la mayoría de los casos un buen pronóstico con remisión clínica completa y sin secuelas.We present a case of superior right limb pain secondary to the Parsonage Turner Syndrome, a rare disease with an unknown etiology which manifests mainly as a brachial plexus neuritis. In this case we review the different stages of this syndrome, its diagnosis and treatment. In Primary Care, the physician must consider this pathology in the differential diagnosis of shoulder pain, because its diagnosis is mainly clinical presenting in most of cases a good prognosis with complete clinical remission and no sequelae

Aortic dissection. The diagnostic challenge in out-of-hospital health care

Se presenta un caso de dolor torácico asociado a debilidad de ambos miembros inferiores secundaria a una disección aórtica, una patología poco frecuente, que puede debutar de múltiples formas clínicas, caracterizada por una elevada morbimortalidad. En este caso clínico se revisa la clínica más frecuentemente asociada a esta patología, el diagnóstico y las complicaciones derivadas de su tratamiento, destacando la necesidad de un diagnóstico precoz. El médico de urgencias debe estar familiarizado con esta enfermedad, considerándola en el diagnóstico diferencial de todo aquel paciente que consulte por dolor torácico.We present a case of chest pain associated with lower limbs weakness secondary to acute aortic dissection, an uncommon illness, that can debut in various ways presenting a high morbimortality. In this case we review the most common symptoms associated to this clinical entity, its diagnosis and complications related to its treatment, underlining the importance of an early diagnosis. The emergency physician must be familiarized with this pathology, in order to, consider it in the differential diagnosis of every patient that consult for chest pain

Parasites of the Reintroduced Iberian Lynx (Lynx pardinus) and Sympatric Mesocarnivores in Extremadura, Spain.

The Iberian lynx (Lynx pardinus) is one of the most endangered felid species in the world. Conservation efforts have increased its population size and distribution and reinforced their genetic diversity through captive breeding and reintroduction programmes. Among several threats that the Iberian lynx faces, infectious and parasitic diseases have underlined effects on the health of their newly reintroduced populations, being essential to identify the primary sources of these agents and assess populations health status. To achieve this, 79 fresh faecal samples from Iberian lynx and sympatric mesocarnivores were collected in the reintroduction area of Extremadura, Spain. Samples were submitted to copromicroscopic analyses to assess parasite diversity, prevalence, and mean intensity of parasite burden. Overall, 19 (24.1%, ±15.1-35.0) samples were positive for at least one enteric parasite species. Parasite diversity and prevalence were higher in the Iberian lynx (43.8%) compared with the others mesocarnivores under study (e.g., the red fox Vulpes vulpes and the Egyptian mongoose Herpestes ichneumon). Ancylostomatidae and Toxocara cati were the most prevalent (15.6%) parasites. Obtained results revealed that Iberian lynx role as predator control might have reduced parasite cross-transmission between this felid and mesocarnivores due to their decreasing abundances. Surveillance programs must include regular monitoring of this endangered felid, comprising mesocarnivores, but also domestic/feral and wild cat communities.This research was funded by the European Union through its LIFE project Life + IBERLINCE (LIFE + 10NAT/ES/570) “Recuperación de la distribución histórica del lince ibérico (Lynx pardinus) en España y Portugal”. R. T. Torres is funded by national funds (OE), through FCT—Fundação para a Ciência e a Tecnologia, I.P., in the scope of the framework contract foreseen in the numbers 4, 5, and 6 of the article 23, of the Decree-Law 57/2016, of 29 August, changed by Law 57/2017, of 19 July. Thanks are due to FCT/MCTES for the financial support to CESAM (UIDP/50017/2020 + UIDB/50017/2020) and CIISA Project UIDB/00276/2020 through national funds.S

Is the reason to switch relevant?

57763]. AS is supported by a doctoral grant from “Fundação para a Ciência e Tecnologia” (SFRH/BD/108246/2015).Background: To investigate whether the reason to discontinue the first TNF inhibitor (TNFi) affects the response to the second TNFi in axial spondyloarthritis (axSpA). Methods: Patients with axSpA from the Rheumatic Diseases Portuguese Register (ReumaPt), who discontinued their first TNFi and started the second TNFi between June 2008 and May 2018, were included. Response was assessed by the Ankylosing Spondylitis Disease Activity Score (ASDAS) clinically important improvement (ASDAS-CII), major important improvement (ASDAS-MI), low disease activity (ASDAS-LDA), and inactive disease (ASDAS-ID). The reason for discontinuation of the first TNFi was defined, according to ASDAS-CII as primary failure (no response ≤ 6 months), secondary failure (response ≤ 6 months but lost thereafter), adverse events, and others. The association between the reason for discontinuation of the first TNFi and response to the second TNFi over time was assessed in multivariable generalized equation (GEE) models. Results: In total, 193 patients were included. The reason for discontinuation of the first TNFi did not influence the response to the second TNFi, according to the ASDAS-CII. However, a difference was found with more stringent outcomes, e.g., there was a higher likelihood to achieve ASDAS-ID with the second TNFi for patients discontinuing the first TNFi due to secondary failure (OR 7.3 [95%CI 1.9; 27.7]), adverse events (OR 9.1 [2.5; 33.3]), or other reasons (OR 7.7 [1.6; 37.9]) compared to primary failure. Conclusion: Patients with axSpA with secondary failure to their first TNFi, compared to those with primary failure, have a better response to the second TNFi according to stringent outcomes.publishersversionpublishe

going beyond BASDAI

This work was supported by a Research Grant from the InvestigatorInitiated Studies program of Merck Sharp & Dohme (Grant No. 56078). The sponsor did not interfere with the study question, analysis or interpretation of results. AS is supported by a doctoral grant from Fundação para a Ciência e Tecnologia (Foundation for Science and Technology) (SFRH/BD/108246/2015).OBJECTIVES: To compare definitions of high disease activity of the Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) in selecting patients for treatment with biologic disease-modifying antirheumatic drugs (bDMARDs). METHODS: Patients from Rheumatic Diseases Portuguese Register (Reuma.pt) with a clinical diagnosis of axial spondyloarthritis (axSpA) were included. Four subgroups (cross-tabulation between ASDAS (≥2.1) and BASDAI (≥4) definitions of high disease activity) were compared regarding baseline characteristics and response to bDMARDs at 3 and 6 months estimated in multivariable regression models. RESULTS: Of the 594 patients included, the majority (82%) had both BASDAI≥4 and ASDAS ≥2.1. The frequency of ASDAS ≥2.1, if BASDAI<4 was much larger than the opposite (ie, ASDAS <2.1, if BASDAI≥4): 62% vs 0.8%. Compared to patients fulfilling both definitions, those with ASDAS ≥2.1 only were more likely to be male (77% vs 51%), human leucocyte antigen B27 positive (79% vs 65%) and have a higher C reactive protein (2.9 (SD 3.5) vs 2.1 (2.9)). Among bDMARD-treated patients (n=359), responses across subgroups were globally overlapping, except for the most 'stringent' outcomes. Patients captured only by ASDAS responded better compared to patients fulfilling both definitions (eg, ASDAS inactive disease at 3 months: 61% vs 25% and at 6 months: 42% vs 25%). CONCLUSION: The ASDAS definition of high disease activity is more inclusive than the BASDAI definition in selecting patients with axSpA for bDMARD treatment. The additionally 'captured' patients respond better and have higher likelihood of predictors thereof. These results support using ASDAS≥2.1 as a criterion for treatment decisions.publishersversionpublishe

Fifth European Dirofilaria and Angiostrongylus Days (FiEDAD) 2016

Peer reviewe