Two patients with hepatitis B virus infection and myocarditis are reported. The implicated pathogenesis was an immune complex mechanism in one patient. Both patients presented with heart failure and arrhythmia which were controlled with conventional medical therapy. Echocardiography played an important role for early detection of left ventricular dysfunction. The efficacy and safety of corticosteroid therapy is still conjectural. Acute hepatitis B infection should be a differential diagnostic consideration in the etiology of acute myocarditis.
Consumers can influence ecological patterns and processes through their trophic roles and contributions to the flow of energy through ecosystems. However, the diet and associated trophic roles of consumers commonly changes during ontogeny. Despite the prevalence of ontogenetic variation in trophic roles of most animals, we lack an understanding of whether they change consistently across local populations and broad geographic gradients. We examined how the diet and trophic position of a generalist marine predator varied with ontogeny across seven broadly separated locations (~ 750km). We observed a high degree of heterogeneity in prey consumed without evidence of spatial structuring in this variability. However, compound specific isotope analysis of amino acids revealed remarkably consistent patterns of increasing trophic position through ontogeny across local populations, suggesting that the roles of this generalist predator scaled with its body size across space. Given the high degree of diet heterogeneity we observed, this finding suggests that even though the dietary patterns differed, the underlying food web architecture transcended variation in prey species across locations for this generalist consumer. Our research addresses a gap in empirical field work regarding the interplay between stage-structured populations and food webs, and suggests ontogenetic changes in trophic position can be consistent in generalist consumers.
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