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Abstract Background Brucella spp. isolation is increasingly reported in cetaceans, although associated pathologies, including lesions of the musculoskeletal and nervous systems, are less frequently described. Concerning the nervous system, Brucella sp. infection causing meningitis, meningoencephalitis or meningoencephalomyelitis have been extensively reported in striped dolphins (Stenella coeruleoalba), and less frequently in other cetacean species. Case presentation A juvenile female common bottlenose dolphin (Tursiops truncatus) was found stranded alive in Lanzarote (Canary Islands, Spain) in 2005, but died shortly after. On physical examination, the dolphin showed a moderate body condition and was classified as code 2 (fresh dead) at the time of necropsy. The main gross findings were severe multiorgan parasitism, thickened and congested leptomeninges, and (sero)fibrino-suppurative and proliferative arthritis of the shoulder joint. Histopathological examination revealed the distinct features of a sub-acute systemic disease associated with Cetacean Morbillivirus (CeMV) infection. However, brain lesions diverged from those reported in systemic CeMV infection. This led to suspect that there was a coinfecting pathogen, based on the characteristics of the inflammatory response and the lesion distribution pattern in the central nervous system. Brucella sp. was detected in the brain tissue by PCR and Brucella antigen was demonstrated by immunohistochemistry in the brain and shoulder joint lesions. Conclusions The zoonotic potential of marine mammal strains of Brucella has been demonstrated both in natural and laboratory conditions. In this study, PCR detected Brucella sp. in the brain of a common bottlenose dolphin stranded in the Canary Islands; the dolphin was also co-infected with CeMV. This is the first detection of Brucella sp. infection in a stranded cetacean in this archipelago. Therefore, we stress the importance of taking adequate measures during the handling of these species to prevent the transmissions of the infection to humans.

Abstract Background Peripheral neuropathies are a common complication in patients with diabetes. Changes in nerve function and central pain processing can be quantified by assessing pain thresholds and pain modulation mechanisms. Aim To summarise the literature which compares pain thresholds and pain modulation mechanisms in people with diabetes without neuropathies, with non-painful diabetic neuropathies and with painful diabetic neuropathies, and in people without diabetes. Methods A systematic review and meta-analysis will be conducted. Terms related to diabetes, pain thresholds and pain modulation mechanisms will be combined in a structured search in MEDLINE, CINAHL, EMBASE, the Cochrane Library, SPORTDiscus, Web of Science and PEDro. Publications on adults (18 years and older) with diabetes and at least one pain threshold measure following thermal, mechanical or electrical stimuli and/or at least one pain modulation mechanisms (temporal summation or conditioned pain modulation) with a comparison group will be considered. There will be no restriction regarding language or year of publication. One investigator will screen records based on title and abstract (ESS). Two independent investigators (ESS and MC) will select full-text papers and assess risk of bias using a modified Downs and Black checklist. Potential disagreements will be resolved with a third investigator (LB). One investigator (ESS) will extract all data and a second investigator (MS) will extract data for 20% of the papers to verify accuracy of the process. A sensitivity analysis for publication bias will be conducted. Discussion This systematic review and meta-analysis will summarise the evidence on pain threshold profiles and pain modulation mechanisms in people with diabetes without and with neuropathies (both painful and non-painful). This will provide more insight in the clinical presentation and progression of diabetic neuropathies. Systematic review registration PROSPERO CRD42018088173

Abstract Background In the last 20 years, Cetacean Morbillivirus (CeMV) has been responsible for many die-offs in marine mammals worldwide, as clearly exemplified by the three dolphin morbillivirus (DMV) epizootics of 1990–1992, 2006–2008 and 2011 that affected Mediterranean striped dolphins (Stenella coeruleoalba). Systemic infection caused by DMV in the Mediterranean has been reported only during these outbreaks. Results We report the infection of five striped dolphins (Stenella coeruleoalba) stranded on the Spanish Mediterranean coast of Valencia after the last DMV outbreak that ended in 2011. Animal 1 stranded in late 2011 and Animal 2 in 2012. Systemic infection affecting all tissues was found based on histopathology and positive immunohistochemical and polymerase chain reaction positive results. Animal 3 stranded in 2014; molecular and immunohistochemical detection was positive only in the central nervous system. Animals 4 and 5 stranded in 2015, and DMV antigen was found in several tissues. Partial sequences of the DMV phosphoprotein (P), nucleoprotein (N), and hemagglutinin (H) genes were identical for Animals 2, 3, 4, and 5, and were remarkably different from those in Animal 1. The P sequence from Animal 1 was identical to that of the DMV strain that caused the epizootic of 2011 in the Spanish Mediterranean. The corresponding sequence from Animals 2–5 was identical to that from a striped dolphin stranded in 2011 on the Canary Islands and to six dolphins stranded in northeastern Atlantic of the Iberian Peninsula. Conclusions These results suggest the existence of an endemic infection cycle among striped dolphins in the Mediterranean that may lead to occasional systemic disease presentations outside epizootic periods. This cycle involves multiple pathogenic viral strains, one of which may have originated in the Atlantic Ocean.