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Background: Flexible endoscopy allows use of the vessel–tissue sealer Ligasure™ (Covidien, Massachusetts, USA) to perform diverticulotomy. Few studies have used this endoscopic approach in the uncommon disorder Zenker's diverticulum. The aim of the present study was to evaluate the effectiveness and safety of flexible endoscopy treatment assisted by Ligasure™. Methods: The single-center prospective and descriptive study included patients treated by flexible endoscopy using Ligasure™ for resection of Zenker’s diverticulum. Consecutive patients were included from March 2009 to April 2018. Patients were censored until the end of follow-up or death. Complications, symptoms before treatment, type of sedation, and number of interventions needed to resolve Zenker’s diverticulum were analyzed. Bleeding complications were considered when a case required a second endoscopy. Results: A total of 46 symptomatic patients with Zenker''s diverticulum were included in the final analysis (41.3% women, median age of 73.7 ± 11 years). The median follow-up period was 37.21 ± 28 months. Of all cases, 58.7% were considered small (< 3 cm). Solid or semi-solid food-related dysphagia was present in 55.6% of patients previously to the procedure. The technique was successful in a single procedure in 78.3% of cases. However, the success rate increased to 89.1% with a second procedure, and we had a complication rate of 4.3% with this technique. Most patients (79.66%) were managed as out-patients or with short (< 24 h) admission. Conclusion: In this large case series, treatment of Zenker''s diverticulum based on flexible endoscopy assisted by Ligasure™ was a safe and effective procedure with a high success rate in a few endoscopy sessions and low complication rate.

Resumen Objetivo Conocer las caracteristicas epidemiologicas, clinicas y terapeuticas de los pacientes con diagnostico de IC atendidos en atencion primaria de 2 zonas de salud de Albacete, Zona 5 A (caracteristicas de centro urbano) y Casas Ibanez (caracteristicas de centro rural), asi como destacar las principales diferencias entre ambos. Metodo Estudio descriptivo y transversal, correspondiente a la primera fase del estudio ALBAPIC. Se han registrado a todos los pacientes de la zona desde el 1 de enero del 2018 hasta el 30 de junio del 2019 que cumplieran el criterio de inclusion: tener diagnostico de IC en el programa TURRIANO (programa de consulta clinica en Atencion Primaria de Castilla-La Mancha). Se registraron las caracteristicas demografico-antropometricas y clinicas, los datos analiticos, las exploraciones diagnosticas complementarias, las pautas terapeuticas y las hospitalizaciones durante 12 meses previos a la inclusion. Se realizaron una exploracion fisica y controles electrocardiograficos y bioquimicos en la visita de inclusion. Resultados Han participado 384 pacientes diagnosticados de IC en ambas zonas de salud (161 en zona urbana y 223 en la rural). Edad media ± desviacion estandar 82,24 ± 10,51 anos (81,24 ± 9,59 anos en zona urbana y 83,37 ± 11 anos en rural, con diferencias significativas, p En relacion con la prevalencia de factores de riesgo cardiovascular, tenemos que la hipertension sobre todo y las dislipidemias son los mas frecuentes, existiendo diferencias segun el medio en el que viven. En el medio rural hay mayores tasas de cardiopatias (principalmente isquemicas y por valvulopatia). Los pacientes con IC tienen numero alto de enfermedades cronicas concomitantes, siendo entre 4 y 6 mas del 60% de los casos en el medio urbano y entre 1 y 4 en el medio rural. Aproximadamente, un 14% tiene tambien una enfermedad oncologica en el medio urbano frente a un 21% en el rural. Segun los datos de exploracion y analitica, las principales variables se encuentran aceptablemente controladas, estando peor controlados los parametros lipidicos en el centro rural. La media de farmacos prescritos por cada paciente fue de 6,3 en rural y 7,2 urbano. En cuanto a los tratamientos que estan tomando se observa que los diureticos y las estatinas son los mas utilizados tanto en el medio rural como urbano. Conclusiones Existe un aceptable control de los factores de riesgo cardiovascular en ambos medios, existiendo diferencias en cuanto a los metodos diagnosticos y tratamientos utilizados.

To know the epidemiological, clinical and therapeutic characteristics of patients with a diagnosis of HF treated in primary care of 2Health Areas of Albacete, Zone 5 A (characteristics of the Urban Center) and Casas Ibañez (characteristics of the Rural Center) as well as to highlight The main differences between the two.Descriptive and cross-sectional study, corresponding to the first phase of the ALBAPIC study. All patients in the area who met the inclusion criteria have been registered: Having a diagnosis of HF in the TURRIANO program (consultation program in Primary Care of Castilla la Mancha). Demographic-anthropometric and clinical characteristics, analytical data, complementary diagnostic examinations, therapeutic guidelines and hospitalizations were recorded for 12 months prior to inclusion. A physical examination and electrocardiographic and biochemical controls were performed at the inclusion visit.384 patients diagnosed with HF in both Health Zone (161 in urban areas and 223 in rural areas) have participated. Average age 82.24±10.51 years (81.24±9.59 years in urban areas and 83.37±11 years in rural areas with significant differences P.005, 54.3% are women (54% in urban areas and 54.7% in rural areas) We have an incidence of CI of 1% in urban areas and 1.8% in rural areas. The prevalence of CVRF has that hypertension above all and dyslipidemia are the most frequent, with differences depending on the environment in which they live. In the rural environment there are higher rates of heart disease. Patients with HF have a high number of concomitant chronic diseases, being between 4 and 6 more than 60% of cases in the urban environment and between 1 and 4 in the rural environment. Approximately 14% also have an oncological disease in the urban environment compared to 21% in the rural. According to the exploration and analytical data, the main variables are acceptably controlled, the lipid parameters in the rural center being worse controlled. The average number of drugs prescribed by each patient was 6.3 in rural and 7.2 urban. As for the treatments they are taking, it is observed that diuretics and statins.There is an acceptable control of cardiovascular risk factors in both media, there being differences in the diagnostic methods and treatments used.

In recent years, the Andújar-Cardeña Iberian Lynx Lynx pardinus population has grown both in number and in occupied surface area. This feline has spread into areas surrounding existing population nuclei and occupied new habitats including human-dominated areas and tree crops. Here we describe this colonization process and the evolution of the Iberian Lynx populations in the Olive Olea europaea groves that surround typical Lynx scrub habitats in Andújar-Cardeña. Our findings were obtained through radio-tracking, camera trapping and European Rabbit Oryctolagus cuniculus monitoring. Two colonized areas—Zocueca and Marmolejo-Montoro—were identified in which Olive cultivation is predominant. Since 2011, a total of 45 and 50 different individuals have been detected in Zocueca and Marmolejo-Montoro, respectively. At present, 19 individuals are known to live in Zocueca and 29 in Marmolejo-Montoro. The main cause of mortality is road-kills. Our results suggest that the Iberian Lynx is capable of colonizing human-modified areas such as agricultural land provided that they can support high-density Rabbit populations and the causes of non-natural mortality are minimized.

The creation of new populations through reintroductions in their former range is still necessary for the long-term conservation of the Iberian lynx (Lynx pardinus). A large-scale assessment of habitat suitability is a necessary prerequisite for evaluating the possibility of carrying out lynx reintroductions. We modelled habitat suitability for the Iberian lynx in the Iberian Peninsula using MaxEnt. Lynx presence data for 2010–2013 from Andujar-Cardeña and Doñana populations were used. Habitat variables were quantified using the CORINE Land Cover. This habitat suitability model predicted an environmentally suitable area of 87,747 km2, which represents 14.08% of the whole Iberian Peninsula. Of the total suitable habitat identified, 45% is located in a large continuous area in the south-western quadrant coinciding with the historical range of the species in the mid-20th century. However, there are also relevant patches mainly in the north-eastern quadrant. About 55% of the potential area suitable for the lynx falls outside protected areas. If Iberian lynx populations are to attain levels that will facilitate their long-term survival, it will be necessary to consider potential habitat for the species throughout the whole of the Iberian Peninsula.

The random encounter model, a method for estimating animal density using camera traps without the need for individual recognition, has been developed over the past decade. A key assumption of this model is that cameras are placed randomly in relation to animal movements, requiring that cameras are not set only at sites thought to have high animal traffic. The aim of this study was to define a correction factor that allows the random encounter model to be applied in photo-trapping surveys in which cameras are placed along tracks to maximize capture probability. Our hypothesis was that applying such a correction factor would compensate for the different rates at which lynxes use tracks and the surrounding area, and should thus improve the estimates obtained with the random encounter model. We tested this using data from a well-known Iberian lynx Lynx pardinus population. Firstly, we estimated Iberian lynx densities using a traditional camera-trapping design followed by spatially explicit capture–recapture analyses. We estimated the differential use rate for tracks vs the surrounding area using data from a lynx equipped with a GPS collar, and subsequently calculated the correction factor. As expected, the random encounter model overestimated densities by 378%. However, the application of the correction factor improved the estimate and reduced the error to 16%. Although there are limitations to the application of the correction factor, the corrected random encounter model shows potential for density estimation of species for which individual identification is not possible.

GEHEP-004 Study Group: María Dolores Ocete, Miguel Ángel Simón, Pilar Rincón, Sergi Reus, Alberto De la Iglesia, Isabel García-Arata, Miguel Jiménez, Fernando Jiménez, José Hernández-Quero, Carlos Galera, Mohamed Omar Balghata, Joaquín Primo, Mar Masiá, Nuria Espinosa, Marcial Delgado, Miguel Ángel von-Wichmann, Antonio Collado, Jesús Santos, Carlos Mínguez, Felícitas Díaz-Flores, Elisa Fernández, Enrique Bernal, José De Juan, José Joaquín Antón, Mónica Vélez, Antonio Aguilera, Daniel Navarro, Juan Ignacio Arenas, Clotilde Fernández, María Dolores Espinosa, María José Ríos, Roberto Alonso, Carmen Hidalgo, Rosario Hernández, María Jesús Téllez, Francisco Javier Rodríguez, Pedro Antequera, Cristina Delgado, Patricia Martín, Javier Crespo, Berta Becerril, Óscar Pérez, Antonio García-Herola, José Montero, Carolina Freyre, Concepción Grau., [Background & Aims] Most hepatitis C virus (HCV)-infected patients failing NS5A inhibitors develop resistance-associated substitutions (RASs). Here we report the use of resistance-guided retreatment of patients who failed prior NS5A inhibitor-containing regimens in the GEHEP-004 cohort. This is the largest direct-acting antiviral (DAA)-resistance cohort study conducted in Spain. We aim to provide indications on how to use resistance information in settings where sofosbuvir/velpatasvir/voxilaprevir may not be available., [Methods] GEHEP-004 is a prospective multicenter cohort enrolling HCV-infected patients treated with interferon (IFN)-free DAA regimens. Prior to retreatment, population-based sequencing of HCV NS3, NS5A and NS5B genes was performed. After receiving a comprehensive resistance interpretation report, the retreatment regimen was chosen and the sustained virological response (SVR) at 12 weeks after treatment completion (SVR12) was recorded., [Results] A total of 342 patients experiencing virological failure after treatment with sofosbuvir/ledipasvir±ribavirin (54%), sofosbuvir/daclatasvir±ribavirin (23%), or paritaprevir-ritonavir/ombitasvir±dasabuvir±ribavirin (20%) were studied. After a resistance report, 186 patients were retreated. An SVR12 was achieved for 88.1% of the patients who failed after sofosbuvir/ledipasvir±ribavirin, 83.3% of the patients who failed after sofosbuvir/daclatasvir±ribavirin, 93.7% of the patients who failed after paritaprevir-ritonavir+ombitasvir±dasabuvir±ribavirin., [Conclusions] In our study, we show how resistance-guided retreatment in conjunction with an interpreted report allows patients to achieve SVR rates close to 90%. We hypothesize that SVR rates may even be improved if resistance data are discussed between experienced virologists and treating clinicians. We believe that our data may be relevant for countries where the access to new DAA combination regimens is limited., [Lay summary] Hepatitis C infection can be cured with currently available antiviral agents. Only a small proportion of patients experience treatment failure, however, in absolute numbers, a high number of patients may require retreatment. Highly effective combinations of antivirals are also available for retreatment. However, these antivirals might not be available in resource-limited settings. Herein, we show how, by analyzing the cause of resistance, retreatment efficacy with old drugs can get very close to the efficacy of new drug combinations., This work was supported in part by grants from Fondo de Investigación Sanitaria (www.isciii.es) (PI15/00713), Plan Nacional de I+D+I and Fondo Europeo de Desarrollo Regional-FEDER (www.redes/redes/inicio) (RD16/0025/0040), Fundación Progreso y Salud, Junta de Andalucia (http://www.juntadeandalucia.es/fundacionprogresoysalud/es) (PI-0411-2014), and GEHEP-SEIMC (GEHEP-004).

OBJECTIVE: The objective of this study was to determine the long-term clinical outcome and persistence of hepatitis B surface antigen (HBsAg) loss after discontinuation of treatment. BACKGROUND: The prognosis of patients with chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs) who discontinue treatment after loss of HBsAg remains largely unknown, particularly in White patients. PATIENTS AND METHODS: We analysed a cohort of patients with CHB who discontinued NA treatment after loss of HBsAg. A total of 69 patients with hepatitis-B-e antigen-positive or hepatitis-B-e antigen-negative CHB with undetectable HBsAg during NA treatment were included after discontinuation of treatment, and followed up for a median period of 37.8 months (interquartile range: 23.8-54.6 months). RESULTS: At the end of follow-up, none of the patients showed spontaneous reappearance of HBsAg and only one patient had detectable hepatitis B virus DNA (22IU/ml). Another patient negative for HBsAg and anti-HBs developed hepatitis B virus reactivation without elevated transaminases after treatment with corticosteroids and vincristine for dendritic cell neoplasm, 38 months after withdrawal of the antiviral treatment. Regarding clinical outcome, a patient with cirrhosis developed hepatocellular carcinoma, 6.6 years after discontinuing treatment. None of the patients had hepatic decompensation or underwent liver transplantation. CONCLUSION: HBsAg clearance after discontinuing NAs in patients with CHB is persistent and associated with good prognosis. The risk for developing hepatocellular carcinoma persists among patients with cirrhosis.

Resumen Objetivo Analisis de situacion de la insuficiencia cardiaca en una zona de salud y evaluacion de criterios de calidad. Metodo Estudio observacional transversal de los pacientes diagnosticados de insuficiencia cardiaca mediante historia clinica en el programa informatico «Turriano». Se analizan las variables: comorbilidades, control de factores de riesgo cardiovascular (FRCV), tratamientos, numero de enfermedades cronicas e ingresos. Tambien se analiza el grado de adherencia terapeutica para farmacos en relacion con la insuficiencia cardiaca mediante la determinacion del cociente entre el porcentaje de farmacos prescritos y el de farmacos retirados de farmacia, segun el programa de prescripcion de Turriano. El estudio consiste en un ciclo de mejora o ciclo evaluativo, siguiendo la metodologia propuesta por Palmer para evaluar la calidad de la asistencia ambulatoria. Resultados Se incluyo a 161 pacientes, con una edad media de 81,24 anos; un 54,6% eran mujeres. Las dolencias asociadas eran hipertension arterial (95%), diabetes (42,2%), dislipidemias (8,9%), obesidad (49,1%) y neoplasias (13,7%). Un 62,2% tenian diagnosticado algun tipo de cardiopatia: el 29,2% cardiopatia isquemica, el 46,6% arritmias cardiacas y el 20,5% valvulopatias. Mas del 60% tenian entre 4 y 6 enfermedades concomitantes. En cuanto a los FRCV, se observa un aceptable control. Un 70% tomaban tratamiento de diureticos, un 32 y un 35% inhibidores de la enzima conversora de la angiotensina y antagonistas del receptor de la angiotensina II. Mas del 20% han tenido 1-2 ingresos en el ultimo ano, con descompensacion cardiaca como principal causa. Hubo un 16% de mortalidad. Conclusiones Los pacientes con insuficiencia cardiaca tienen importante numero de enfermedades cronicas concomitantes, si bien hay un aceptable control de los FRCV.

Objective To analyse the heart failure situation in a health area, as well quality criteria. Method Cross-sectional observational study of patients diagnosed with heart failure by collecting data from their clinical history in the “Turriano” computer program. The variables analysed were, comorbidities, control of cardiovascular risk factors, treatments, number of chronic diseases, and admissions. The level of adherence to drugs in relation to heart failure by determining the ratio between the percentage of prescribed drugs and drugs withdrawn from pharmacy is also analysed using the Turriano prescription program. The study consisted of an improvement cycle or evaluative cycle, following the methodology proposed by Palmer to evaluate the quality of ambulatory care. Results A total of 161 patients were included, with a mean age of 81.24 years, and 54.6% were women. Almost all of them (95%) had disease associated high blood pressure, including diabetes 42.2%, dyslipidaemia 8.9%, obesity 49.1%, and cancer 13.7% Some type of heart disease was diagnosed in 62.2% of patients with 29.2% ischaemic heart disease, 46.6% cardiac arrhythmias, and 20.5% valve diseases. More than 60% had between 4 and 6 concomitant diseases. An acceptable control is observed as regards the cardiovascular risk factors. Diuretic treatment was taken by 70%, with 32% and 35% taking angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists. More than 20% have had 1–2 admissions in the last year, with cardiac decompensation being the main cause. There was 16% mortality. Conclusions Patients with heart failure have a significant number of chronic concomitant diseases, although there is an acceptable cardiovascular risk factors control. There are quality criteria that can be improved.

[Abstract] A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) α-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of “extra-target” RAS suggests the need for RAS screening in all three DAA target regions. Ministerio de Economía y Empresa; IDI-20151125 Ministerio de Ciencia, Innovación y Universidades; SAF SAF 2017-87846-R

Obeticholic acid (OCA) was recently approved as the only on-label alternative for patients with primary biliary cholangitis (PBC) with intolerance or suboptimal response to ursodeoxycholic acid (UDCA). However, few data are available outside clinical trials.To assess the effectiveness and safety of OCA in a real-world cohort of patients with non-effective UDCA therapy.Open-label, prospective, real-world, multicentre study, enrolling consecutive patients who did not meet Paris II criteria, from 18 institutions in Spain and Portugal. Effectiveness was assessed by the changes in GLOBE and UK-PBC scores from baseline. POISE and Paris II criteria were evaluated after 12 months of OCA . Liver fibrosis was evaluated by FIB-4 and AST to platelet ratio index (APRI).One hundred and twenty patients were eligible, median time since PBC diagnosis 9.3 (4.0-13.8) years, 21.7% had cirrhosis, and 26.7% received had previous or concomitant treatment with fibrates. Seventy-eight patients completed at least 1 year of OCA. The Globe-PBC score decreased to 0.17 (95% CI 0.05 to 0.28; P = 0.005) and the UK-PBC score decreased to 0.81 (95% CI -0.19 to 1.80; P = 0.11). There was a significant decrease in alkaline phosphatase of 81.3 U/L (95% CI 42.5 to 120; P 0.001), ALT 22.1 U/L (95% CI 10.4 to 33.8; P 0.001) and bilirubin 0.12 mg/dL (95% CI 0 to 0.24; P = 0.044). FIB-4 and APRI remained stable. According to the POISE criteria, 29.5% (23 out of 78) achieved response. The adverse events rate was 35%; 11.67% discontinued (8.3% due to pruritus).This study supports data from phase III trials with significant improvement of PBC-Globe continuous prognostic marker score among OCA-treated patients with good tolerability.

Background & Aims: Clinical trials evaluating second-generation direct-acting antiviral agents (DAAs) have shown excellent rates of sustained virologic response (SVR) and good safety profiles in patients with chronic hepatitis C virus (HCV) genotype 1 infection. We aimed to investigate the effectiveness and safety of two oral DAA combination regimens, ombitasvir/paritaprevir/rito navir plus dasabuvir (OMV/PTV/r + DSV) and ledipasvir/sofosbuvir (LDV/SOF), in a real-world clinical practice. Methods: Data from HCV genotype 1 patients treated with either OMV/PTV/r + DSV +/- ribavirin (RBV) (n = 1567) or LDV/SOF +/- RBV (n = 1758) in 35 centers across Spain between April 1, 2015 and February 28, 2016 were recorded in a large national database. Demographic, clinical and virological data were analyzed. Details of serious adverse events (SAEs) were recorded. Results: The two cohorts were not matched with respect to baseline characteristics and could not be compared directly. The SVR12 rate was 96.8% with OMV/PTVr/DSV +/- RBV and 95.8% with LDV/SOF +/- RBV. No significant differences were observed in SVR according to HCV subgenotype (p = 0.321 [OMV/PTV/r + DSV +/- RBV] and p = 0.174 [LDV/SOF]) or degree of fibrosis (c0.548 [OMV/PTV/r/DSV +/- RBV] and p = 0.085 [LDV/SOF]). Only baseline albumin level was significantly associated with failure to achieve SVR (p < 0.05) on multivariate analysis. Rates of SAEs and SAE-associated treatment discontinuation were 5.4% and 1.7%, in the OMV/PTV/r + DSV subcohort and 5.5% and 1.5% in the LDV/SOF subcohort, respectively. Hepatocellular carcinoma (HCC) recurred in 30% of patients with a complete response to therapy for previous HCC. Incident HCC was reported in 0.93%. Conclusions: In this large cohort of patients managed in the real-world setting in Spain, OMV/PTV/r + DSV and LDV/SOF achieved high rates of SVR12, comparable to those observed in randomized controlled trials, with similarly good safety profiles. Lay summary: In clinical trials, second-generation direct-acting antiviral agents (DAAs) have been shown to cure over 90% of patients chronically infected with the genotype 1 hepatitis C virus and have been better tolerated than previous treatment regimens. However, patients enrolled in clinical trials do not reflect the real patient population encountered in routine practice. The current study, which includes almost 4,000 patients, demonstrates comparable rates of cure with two increasingly used DAA combinations as those observed in the clinical trial environment, confirming that clinical trial findings with DAAs translate into the real-world setting, where patient populations are more diverse and complex. (c) 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Grupo para el Estudio y Modelización Epidemiológica de la Hepatitis C en España (GEMEHCE).

Habitat selection models for woodland species usually consider forest attributes derived from land cover maps, such as an area covered by forests or distance to forest edge, but canopy cover is less frequently used as a predictor. We evaluated the effect of including forest canopy cover data in habitat selection models for woodland species using the endangered Iberian lynx as a case study. We considered four canopy cover classes for both conifer and broadleaved forests, together with other land cover predictors, and analyzed a large telemetry (GPS-GSM collars) dataset. The model that included forest canopy cover outperformed, both in predictive power and in conservation management insights, the model that only used forest area. The effect of forest canopy cover on lynx habitat selection was especially strong for broadleaved forests; an increased tree cover in these forests consistently translated into significantly lower selection probabilities. Open broadleaved forests were found to clearly be the most preferred habitat. By contrast, the habitat model without canopy cover data indicated that broadleaved forests were significantly less preferred than shrublands and mountain olive groves, which may mislead conservation management actions. We conclude that habitat selection models for woodland species should consider forest canopy cover as a relevant candidate predictor as it can capture important factors influencing habitat use, such as understory vegetation abundance or prey availability. Recent developments on remote sensing technologies will increase the availability of spatially continuous information on canopy cover, facilitating a more widespread use of vegetation structural variables in habitat modeling and hence improving the conservation planning value of these models.

The feline immunodeficiency virus is a lentivirus that infects felids worldwide. It may induce a profound immunodysfunction in domestic cats, while wild felids seem less prone to disease. During routine health check monitoring of the endangered Iberian lynx populations, 465 samples from 311 individuals were tested between 2004 and 2017. All of them tested negative for molecular detection of provirus. Similarly, only one adult male tested positive for FIV antibodies by means of both ELISA and immunoblot. This lack of contact contrasts with the seropositivity detected in other wild felid species, mainly in Africa and the Americas, and confirms that the Iberian Peninsula is not an FIV-endemic area. To prevent a potential disease spreading, the seropositive individual was kept captive for 22 months and remained FIV antibody-positive and antigen-negative during this period. After evaluating potential risks, it was re-introduced to nature. Among other possibilities, this Iberian lynx could have cleared an FIV infection. Moreover, we found 0% qPCR prevalence in 84 feral cats sampled in the area between 2012 and 2016.

Corridors are usually delineated as areas of minimum cumulative resistance to movement through a resistance surface and characterized by their effective distance (accumulated resistance along the least-cost path). The results of these assessments depend on resistance values, which are typically derived from the inverse of habitat suitability models or from presence data of individuals within their home ranges, rather than from data on dispersal or exploratory movements. Evaluate the extent to which corridor delineation and effective distance estimates may vary depending on whether home range locations or dispersal data are used to characterize species habitat selection and landscape resistance to movement. We analyzed a large telemetry dataset (GPS collars) for the endangered Iberian lynx. We modeled corridors and effective distances three ways: (1) considering only GPS locations within home ranges, (2) considering only locations in dispersal or exploratory movements outside home ranges, and (3) considering all locations together. Delineated least-cost corridors followed similar trajectories and sometimes overlapped in the three models. The estimated effective distances were 42 % lower in the dispersal-based model than in the model based solely on home range use. Models derived exclusively from locations within home ranges may provide lower connectivity estimates than models derived from dispersal locations, affecting estimates of resistance to move between habitat areas, even when the most likely movement routes are similar. Although dispersal data are costly to gather, they potentially provide more realistic assessments of the actual isolation of populations in heterogeneous landscapes.

At the turn of the 21st century, Lynx pardinus) individuals were found to occur in Southern Spain. Research conducted when the species was that scarce identified Mediterranean scrubland as its breeding habitat. In recent years, the population has grown both in number of individuals and occupied surface. Here, we describe the use of olive tree plantations with low scrub density as breeding habitats by the Iberian lynx. Our results suggest that habitats that were formerly considered as non-suitable, such as agricultural land, could indeed host Iberian lynx breeding territories in areas with low scrubland coverage if wild rabbits are abundant.

Los esfuerzos de conservacion sobre las poblaciones del amenazado lince iberico (Lynx pardinus) y la reintroduccion de ejemplares para expandir las poblaciones hacia sus areas de distribucion historica hacen necesario evaluar la potencialidad del territorio para albergar poblaciones estables y para facilitar el movimiento de individuos entre ellas. Con este objetivo, se han analizado 43 897 localizaciones proporcionadas por collares GPSGSM de 48 linces en Andalucia. Las localizaciones se clasificaron en dos grupos segun el estado de comportamiento de los animales (territorial/dispersivo), aplicando a cada grupo una funcion de seleccion de recursos para determinar la probabilidad de seleccion de cubiertas forestales y no forestales, caracterizadas mediante el Sistema de Informacion de Ocupacion del Suelo para Andalucia (escala 1:10 000) y el Mapa Forestal de Espana (escala 1:50 000). Los resultados indican mayor plasticidad de individuos dispersivos en el uso de las cubiertas respecto a los ejemplares territoriales. Permiten identificar areas con elevada calidad del habitat fuera de zonas de distribucion actual, asi como una permeabilidad al movimiento relativamente baja alrededor de la poblacion Donana-Aljarafe. La cartografia empleada no mejora sin embargo el ajuste de modelos similares con cartografias de menor resolucion espacial y tematica. Los analisis realizados muestran la influencia del estado de comportamiento de los individuos en el uso del territorio y la importancia de seleccionar cartografia adecuada a los objetivos del estudio. Al tiempo sugieren areas preferentes para establecer medidas de gestion del territorio ocupado por las actuales y posibles futuras poblaciones y de los paisajes heterogeneos que las separan.

According to literature, female Iberian lynx (Lynx pardinus) start reproducing at 3 years of age. In more recent years, females breeding at 2 years have been recorded in wild populations. Here, however, we describe the first breeding record for a one-year-old female Iberian lynx. This finding was obtained by camera-trapping data, provided by the yearly monitorization of the species that is carried out across its distribution area. A litter of two lynx kittens was found at the south-east limit of the Andujar-Cardena population. Two camera-traps were set up near the den to identify the breeding female. Photographs obtained confirmed that the breeding female had already been identified the previous year at less than 3 months of age. The case reported here of a yearling female breeding is the first ever from historical distribution range of the species, and as such, is an exceptional event in the reproduction of the Iberian lynx.

Chronic hepatitis C virus infection is usually asymptomatic. The severity of the hepatic lesion in these patients at diagnosis varies and, from the histopathologic point of view, most have mild disease. A series of factors have been described that correlate with the progression of fibrosis in patients with mild fibrosis: age at diagnosis, the duration of the infection, male sex, HIV coinfection, transaminase levels during follow-up, alcohol consumption, metabolic factors such as diabetes and overweight, necroinflammatory activity in the initial biopsy, and the degree of steatosis. In patients with genotype 1 hepatitis C infection, the standard treatment has been pegylated interferon and ribavirin. However, response rates are markedly increased by concomitant use of first-generation protease inhibitors, boceprevir or telaprevir. In patients with moderate fibrosis, these drugs are well tolerated, in addition to being effective. Currently, dual therapy should be reserved for patients with good baseline predictive factors of response and/or contraindications for treatment with telaprevir or boceprevir. In patients with genotypes other than genotype 1, the standard treatment continues to be the combination of pegylated interferon and ribavirin, although the development of new direct-acting antiviral agents such as sofosbuvir and simeprevir will change the strategies used in these patients. The decision to wait for the new treatments is complex because their release date is unknown; likewise, their high cost will limit the possibilities for their use.

Cryobanking somatic foetal cells acquire much relevance in endangered species for biodiversity conservation purposes. Such cells could be later used to reintroduce the lost genes into the breeding pool, by inducing pluripotency and/or nuclear transfer if necessary. Since requirements for preserving foetal cells are not always the same as for adult ones, we evaluated the cryosensitivity of foetal skin cells in comparison with adult ones from the critically endangered Iberian lynx. Responses to cryoinjury were analyzed in both thawed cell types by means of cell viability and functionality (by analyzing their membrane integrity, metabolic activity, glycosaminoglycan content and proliferative activity). Freezing media included the permeating cryoprotectant Me 2 SO, either alone or along with the non-permeating cryoprotectant sucrose at 0.1 or 0.2 M. When Me 2 SO was the only cryoprotectant, survival rate fell in thawed foetal cells to 54 ± 4% (against 89 ± 6% for thawed adult ones) and both proliferative and metabolic activities remained significantly lower than values for thawed adult cells. However, the combination of sucrose (both 0.1 as 0.2) and Me 2 SO in foetal cells significantly increased their survival rates (to 71 ± 4% and 73 ± 5%, respectively), proliferative activities (partially at day 7 and completely at day 14 after thawing) and metabolic activities. Our findings clearly show a difference between foetal and adult cells concerning their cryopreservation sensitivity and requirements, as well as their recovery time after thawing. These results are of relevance for the cryopreservation of foetal and adult cells from the Iberian lynx and could be also useful for other mammals.

The conservation of endangered species requires accurate data, and knowledge of cause-specific mortality rates is one of the most important issues. In recent years, conservation programs for the critically endangered Iberian lynx Lynx pardinus have been developed on the basis of mortality data derived 30 years ago from the small Donana population. Thus, there is an urgent need for an update of mortality rates and causes in both populations (Sierra Morena and Donana). Here we use radio-tracking information from the whole range of the Iberian lynx to quantify mortality rates and identify their causes. Between 2006 and 2011, we radio-tagged 78 Iberian lynxes from its two remaining populations (39 from Sierra Morena and 39 from Donana). Mortality events were evaluated to identify causes, and cause-specific annual mortality rates (AMR) were obtained using the nonparametric cumulative incidence function estimator. Overall, AMR was estimated at 0.16 ± 0.05 (0.19 ± 0.09 in Sierra Morena and 0.12 ± 0.07 in Donana). Disease was the main cause of mortality both for the whole population and the Donana population. Poaching was the main cause of mortality in Sierra Morena. Our results suggest that the best strategy for conserving this species is to focus action on decreasing the fatal effect of disease and poaching. Given the possible existence of an underlying inbreeding-mediated immunosuppression, genetic management aimed at increasing the genetic diversity of this population is also recommended.

Emergent diseases may alter the structure and functioning of ecosystems by creating new biotic interactions and modifying existing ones, producing cascading processes along trophic webs. Recently, a new variant of the rabbit haemorrhagic disease virus (RHDV2 or RHDVb) arguably caused widespread declines in a keystone prey in Mediterranean ecosystems - the European rabbit (Oryctolagus cuniculus). We quantitatively assess the impact of RHDV2 on natural rabbit populations and in two endangered apex predator populations: the Iberian lynx (Lynx pardinus) and the Spanish Imperial eagle (Aquila adalberti). We found 60–70% declines in rabbit populations, followed by decreases of 65.7% in Iberian lynx and 45.5% in Spanish Imperial eagle fecundities. A revision of the web of trophic interactions among rabbits and their dependent predators suggests that RHDV2 acts as a keystone species, and may steer Mediterranean ecosystems to management-dependent alternative states, dominated by simplified mesopredator communities. This model system stresses the importance of diseases as functional players in the dynamics of trophic webs.

As human populations increase and overlap with snow leopards, conflicts will undoubtedly occur. In some cases, there will likely be the need to translocate individuals to supplement or restore lost or endangered populations. Therefore, capacity to capture, handle, manage, rehabilitate, and release snow leopards will be important to future management initiatives. A series of case studies represents efforts to restore wild populations or return captive felids to the wild. On the basis of these, we outline procedures and lessons learned that may be applicable in addressing future snow leopard management issues. NABU (German Nature Conservation Union) began working in Kyrgyzstan in 1994 and on Issyk-Kul Biosphere Reserve’s Project Snow Leopard in 1999. The anti-poaching team “Gruppa Bars” was established in 2001 to detain poachers and provide public outreach. In 2002, NABU opened the Snow Leopard Rehabilitation Center in Issyk-Kul District to care for (and release when possible) confiscated and injured snow leopards.

Capture–recapture analysis of camera trap data is a conventional method to estimate the abundance of free-ranging wild felids. Due to notorious low detection rates of felids, it is important to increase the detection probability during sampling. In this study, we report the effectiveness of attractants as a tool for improving the efficiency of camera trap sampling in abundance estimation of Iberian lynx. We developed a grid system of camera stations in which stations with and without attractant lures were spatially alternated across known Iberian lynx habitat. Of the ten individuals identified, five were detected at stations with no attractant (blind sets), and nine, at the lured stations. Thirty-eight percent of blind set station’s independent captures and 10 % of lured station’s independent captures resulted in photographs unsuitable for correct individual identification. The total capture probability at lured stations was higher than that obtained at blind set stations. The estimates obtained with blind set cameras underestimated the number of lynxes compared to lured cameras. In our study, it appears that the use of lures increased the efficiency of trail camera captures and, therefore, the accuracy of capture–recapture analysis. The observed failure to detect known individuals at blind set camera stations may violate capture–recapture assumptions and bias abundance estimates.

Over the last 20 years surveys of the population of the Iberian lynx Lynx pardinus in Doñana National Park and its surroundings in Spain have produced estimates of a total population of 50–60 in fragmented patches. The population was estimated to be 26 adults in 2002–2003. Use of camera trapping and other field methods during 2004–2008 allowed us to determine the abundance of the lynx and to estimate demographic statistics. Estimated annual abundance of adult and subadult lynxes averaged 38 individuals (range 35–43). Although the population exhibited a continuous distribution it was concentrated in three major areas, including Doñana National Park, with an average area occupied of 620 km2. Our results suggest that the Doñana Iberian lynx population now has a different structure from that in the 1990s and in particular a more continuous spatial distribution. These results indicate an improved, but not secure, scenario for the population. The continuous geographical distribution suggests the population is currently less vulnerable to extinction than 10 years ago. Conservation actions now need to focus outside Doñana National Park on the reconversion of pine plantations into original Mediterranean scrubland habitat, and the continuity and intensification of ongoing restocking with rabbits in fenced areas.

MIGUEL A. SIMON,∗ JOSE M. GIL-SANCHEZ,† GEMA RUIZ,† GERMAN GARROTE,† EMIL B. MCCAIN,‡§ LEONARDO FERNANDEZ,† MARCOS LOPEZ-PARRA,† EVA ROJAS,† RAFAEL ARENAS-ROJAS,† TERESA DEL REY,† MARIBEL GARCIA-TARDIO,† AND GUILLERMO LOPEZ∗∗† ∗Consejeŕia de Medio Ambiente de la Junta de Andalucia. c/ Doctor Eduardo Garcia-Trivino Lopez, 15. 23009 Jaen, Spain †Agencia de Medio Ambiente y Agua de Andalucia. c/ Johan Gutenberg s/n, Isla de la Cartuja 41092 Seville, Spain ‡Iberus Medio Ambiente S.L., Avda. Granada 35 PI: 1 Pt: A. 23003 Jaen, Spain §Parque Natural Sierra de Andujar. Cercado del Cipres. Camino de los Rubiales s/n 23740 Andujar (Jaen), Spain

Celsior solution (CS) is a high-sodium, low-potassium, low-viscosity extracellular solution that has been used for liver graft preservation in recent years, although experience with it is still limited. We performed an open-label randomized active-controlled trial comparing CS with the University of Wisconsin solution (UW) for liver transplantation (LT), with a follow-up period of 5 years. Adult transplant recipients (n = 102) were prospectively randomized to receive either CS (n = 51) or UW (n = 51). The two groups were comparable with respect to donor and recipient characteristics. The primary outcome measure was the incidence of postreperfusion syndrome (PRS). Secondary outcome measures included primary nonfunction (PNF) or primary dysfunction (PDF), liver retransplantation, and graft and patient survival. Other secondary outcome measures were days in the intensive care unit (ICU) and the rates of acute rejection, chronic rejection, infectious complications, postoperative reoperations, and vascular and biliary complications. In all, 14 posttransplant variables revealed no significant differences between the groups. There were no cases of PNF or PDF. The incidence of PRS was 5.9% in the CS group and 21.6% in the UW group (P = 0.041). After reperfusion, CS revealed greater control of serum potassium (P = 0.015), magnesium levels (P = 0.005), and plasma glucose (P = 0.042) than UW. Respective patient survivals at 3, 12, and 60 months were 95.7, 87.2, and 82.0% for the CS group and 95.7, 83.3, and 66.6% for the UW group (P = 0.123). While retaining the same degree of safety and effectiveness as UW for LT, CS may yield postliver graft reperfusion benefits, as shown in this study by a significant reduction in the incidence of PRS and greater metabolic control.

Bernal V, Pascual I, Lanas A, Esquivias P, Piazuelo E, Garcia-Gil FA, Lacambra I, Simon MA. Cardiac function and aminoterminal pro-brain natriuretic peptide levels in liver-transplanted cirrhotic patients. Clin Transplant 2012: 26: 111–116. © 2011 John Wiley & Sons A/S. Abstract: Background: Cirrhosis is associated with structural and functional abnormalities of the heart. We examined the evolution of these abnormalities after liver transplantation (LT). Methods: Sixty cirrhotic patients, without cardiovascular disease, were included. Clinical data, echocardiography, and aminoterminal pro-brain natriuretic peptide (NT-proBNP) levels were analyzed before and after transplantation. Healthy controls (n = 25) were included for reference. Results: Before transplantation, cirrhotic patients had higher left atrium diameter, left ventricular (LV) mass index, and ejection fraction than controls. After transplantation, LV mass index increased (105 ± 31 vs. 119 ± 35 g/m2; p

This work presents a Biological Resource Bank generated as a complementary supporting tool for the reproduction and the in situ and ex situ conservation of the Iberian lynx. In its design we prioritized the preservation of a maximum of the current genetic and biological diversity of the population, and the harmless collection of the samples. To provide future reproductive opportunities through any possible technique, we processed and cryopreserved germinal cells and tissues from dead animals, 7 males and 6 females, as well as somatic cells and tissues from 69 different individuals. This somatic cell reserve reflects a very important fraction of the population biodiversity which, furthermore, will allow the development of a wide variety of studies that can be easily extrapolated to the majority of the population. We have developed a new non-destructive method to isolate cells with stem-cell-like properties. If considered convenient in the future, and after proper research, such cells could permit therapeutic applications and perhaps be a good source to be used in somatic cell nuclear transfer. Samples of whole blood and its derivatives, hairs, urine and feces from many different individuals were also preserved. Proper storage of such samples is required to allow epidemiological studies to be performed for the testing of different etiological hypotheses or, in general, to develop any bio-sanitary study to improve conservation strategies within the natural habitat. This work describes the main aspects involved in the practical implementation of the Iberian lynx Biological Resource Bank, as a model that could be useful for the development of similar banks for other endangered species.

The feline leukemia virus (FeLV) is a retrovirus that affects domestic cats all over the world. Its pathogenic effects generally include anemia, immunosuppression or tumors. Dissemination over populations is linked to cat sociality, because the virus is transmitted by direct contact. Although the domestic cat is its common host, FeLV infection has also been described in some wild felids. In the Iberian lynx Lynx pardinus, some sporadic FeLV infection cases have been reported since 1994, but an outbreak with the involvement of several animals has never been described until now. During spring 2007, an FeLV outbreak hit the Do ˜

The Iberian Lynx Conservation Breeding Program follows a multidisciplinary approach, integrated within the National Strategy for the Conservation of the Iberian lynx, which is carried out in cooperation with national, regional and international institutions. The main goals of the ex situ conservation programme are to: (1) maintain a genetically and demographically managed captive population; (2) create new Iberian lynx Lynx pardinus free-ranging populations through re-introduction. To achieve the first goal, the Conservation Breeding Program aims to maintain 85% of the genetic diversity presently found in the wild for the next 30 years. This requires developing and maintaining 60–70 Iberian lynx as breeding stock. Growth projections indicate that the ex situ programme should achieve such a population target by the year 2010. Once this goal is reached, re-introduction efforts could begin. Thus, current ex situ efforts focus on producing psychologically and physically sound captive-born individuals. To achieve this goal, we use management and research techniques that rely on multidisciplinary input and knowledge generated on species' life history, behaviour, nutrition, veterinary and health aspects, genetics, reproductive physiology, endocrinology and ecology. Particularly important is adapting our husbandry schemes based on research data to promote natural behaviours in captivity (hunting, territoriality, social interactions) and a stress-free environment that is conducive to natural reproduction.

Background Hepatitis B virus (HBV) reactivation in patients with resolved HBV infection (HBsAg negative, antiHBc positive) is uncommon, but potentially fatal. The role of HBV prophylaxis in this setting is uncertain. The aim of this study was to compare the efficacy of tenofovir disoproxil fumarate (TDF) prophylaxis versus close monitoring in antiHBc-positive, HBsAg-negative patients under treatment with rituximab (RTX)-based regimens for hematologic malignancy. Methods PREBLIN is a phase IV, randomized, prospective, open-label, multicenter, parallel-group trial conducted in 17 hospitals throughout Spain. Anti-HBc-positive, HBsAg-negative patients with undetectable HBV DNA were randomized to receive TDF 300 mg once daily (Group I) or observation (Group II). The primary endpoint was the percentage of patients showing HBV reactivation during 18 months following initiation of RTX treatment. Patients with detectable HBV DNA (Group III) received the same dose of TDF and were analyzed together with Group I to investigate TDF safety. Results Sixty-one patients were enrolled in the study, 33 in the TDF treatment group and 28 in the observation group. By ITT analysis, HBV reactivation was 0% (0/33) in the study group and 10.7% (3/28) in the observation group (p = 0.091). None of the patients in either group showed significant differences in liver function parameters between baseline and the last follow-up sample. TDF was generally well tolerated and there were no severe treatment-related adverse events. Conclusion In patients with hematological malignancy and resolved hepatitis B infection receiving RTX-based regimens, HBV reactivation did not occur in patients given TDF prophylaxis.

Fundamento Analizar la efectividad y el coste de 2 estrategias en el tratamiento de la infeccion por H. pylori en la ulcera peptica, en atencion primaria. Pacientes y metodo Se incluyeron pacientes consecutivos con diagnostico endoscopico de ulcera peptica e infeccion por H. pylori asignados aleatoriamente a una de dos estrategias: a) tratamiento durante 7 dias con omeprazol, metronidazol, tetraciclina y subcitrato de bismuto (pauta «cuadruple»), y si este fracasaba, tratamiento con omeprazol, amoxicilina y claritromicina durante 7 dias (OCA7), y b) tratamiento con la pauta OCA7, y si este fracasaba, cruce a pauta «cuadruple». El punto de analisis era la erradicacion 8 semanas despues de completarse el tratamiento. Tras valorar costes directos e indirectos (euros, 1997) se hizo un analisis de coste-efectividad fundado en un arbol de decision. Se proporcionan los intervalos de confianza del 95%. Resultados Tras evaluar a 255 pacientes, se incluyeron 97: 48 pacientes se asignaron a la estrategia a y 49 a la b. Por intencion de tratar se obtuvo la erradicacion en el 72,9% (IC del 95%: 58,2–84,7) con la estrategia a y en el 91,8% (IC del 95%: 80,4–97,7) con la estrategia b (p Conclusiones La estrategia de administrar OCA7 como terapia inicial y OTBM7 para los fracasos resulta la mas eficiente. La variable que determina la eficiencia en el tratamiento de la infeccion por H. pylori en atencion primaria es la eficacia.

Cryobanking skin samples permit preserving a maximum of genetic representation from the population biodiversity. This is a relevant aspect for threatened species, potentially menaced by an epizooty and from which it is difficult to obtain gametes. As a first step for properly cryobanking skin samples of a given species, the optimal conditions of culture and freezing have to be studied by covering a broad range of possibilities. This paper presents, for the first time, a systematic study of such conditions for the Iberian lynx (Lynx pardinus). To that end, we have analyzed twenty different culture conditions and fifteen different freezing solutions for skin explants, as well as three freezing solutions for isolated cells derived from them. The culture conditions included both two different culture strategies and several combinations of nutritional supplements and mitotic agents. For the freezing solutions, we have considered different concentrations of the permeating cryoprotectant dimethyl sulfoxide (Me(2)SO) either alone (5%, 7.5%, 10%, 12.5% and 15% v/v for explants, 10% for isolated cells) or along with the non-permeating cryoprotectant sucrose (0.1 or 0.2M). Our results have been analyzed through several quantitative parameters and show that only thawed explants cryopreserved in Me(2)SO (10%) either alone or with sucrose (0.2M) presented similar properties to those in optimal fresh cultures. In addition, for these freezing conditions, isolated thawed cells also presented high survival rates (90%) and percentages of cellular functionality (85%). These results, focussed on the most endangered felid in the world, could be also useful for other threatened/endangered species., This work was financed through projects from the Consejería de Medio Ambiente de la Junta de Andalucía-Universidad Miguel Hernández (CONSEMEDAMAND1.05X), BanCaja-Universidad Miguel Hernández (BANCAJAUMH.03X) and Diputación de Alicante (DIPU2.04X).

Based on both radio-tracking and photo-trapping data, we present in this paper the first evidence of a non-parental male infanticide in the Iberian lynx. This paper is focused on the behaviour of 3 Iberian lynxes [one resident male (RM); one resident female (RF), and one incoming male (IM)] of the Donana population, recorded in the spring of 2007. The first two animals were monitored by radio-tacking and the third one by camera trapping. During the mating season of 2007, RM and RF were the only adult lynxes detected in the area. In February, a new incoming adult male was first spotted within RF’s territory. In March, RM was found dead due to a Feline Leukaemia Virus infection. A few days later RF cubs were found dead, and the evidences collected point out to a case of infanticide committed by IM. More research on this type of behaviour is necessary, since it can represent a relevant threat to population reproductive success and increasing rate. Based on this event, when a replacement of males takes place during the first three months of lactation in the vicinity of a reproductive female home-range, the cubs could suffer a potential infanticide event. Conservation managers should take this into account by increasing cub surveillance or by considering cub removal for captive breeding.

The Iberian lynx is the most endangered felid species. During winter/spring 2006/7, a feline leukemia virus (FeLV) outbreak of unexpected virulence killed about 2/3 of the infected Iberian lynxes. All FeLV-positive animals were co-infected with feline hemoplasmas. To further characterize the Iberian lynx FeLV strain and evaluate its potential virulence, the FeLV envelope gene variable region A (VRA) mutant spectrum was analyzed using the Roche 454 sequencing technology, and an in vivo transmission study of lynx blood to specified-pathogen-free cats was performed. VRA mutations indicated weak apolipoprotein B mRNA editing enzyme and catalytic polypeptide-like cytidine deaminase (APOBEC) restriction of FeLV replication, and variants characteristic of aggressive FeLV strains, such as FeLV-C or FeLV-A/61C, were not detected. Cats exposed to FeLV/Candidatus Mycoplasma haemominutum-positive lynx blood did not show a particularly severe outcome of infection. The results underscore the special susceptibility of Iberian lynxes to infectious diseases.