Genetic and Phenotypic Evaluation of European Maize Landraces as a Tool for Conservation and Valorization of Agrobiodiversity.

The ECPGR European Evaluation Network (EVA) for Maize involves genebanks, research institutions, and private breeding companies from nine countries focusing on the valorization of maize genetic resources across Europe. This study describes a diverse collection of 626 local landraces and traditional varieties of maize (Zea mays L.) from nine European genebanks, including criteria for selection of the collection and its genetic and phenotypic diversity. High-throughput pool genotyping grouped the landraces into nine genetic groups with a threshold of 0.6 admixture, while 277 accessions were designated admixed and likely to have resulted from previous breeding activities. The grouping correlated well with the geographic origins of the collection, also reflecting the various pathways of introduction of maize to Europe. Phenotypic evaluations of 588 accessions for flowering time and plant architecture in multilocation trials over three years confirmed the great diversity within the collection, although phenotypic clusters only partially correlated with the genetic grouping. The EVA approach promotes conservation of genetic resources and opens an opportunity to increase genetic variability for developing improved varieties and populations for farmers, with better adaptation to specific environments and greater tolerance to various stresses. As such, the EVA maize collection provides valuable sources of diversity for facing climate change due to the varieties' local adaptation.

Chemical Profile and Biological Activities of Brassica rapa and Brassica napus Ex Situ Collection from Portugal.

This study aimed to analyse the chemical profile and biological activities of 29 accessions of Brassica rapa (turnips) and 9 of Brassica napus (turnips and seeds) collections, maintained ex situ in Portugal. HPLC-HRMS allowed the determination of glucosinolates (GLS) and polyphenolic compounds. The antioxidant and antimicrobial activities were determined by using relevant assays. The chemical profiles showed that glucosamine, gluconasturtiin, and neoglucobrassin were the most abundant GLS in the extracts from the turnip accessions. Minor forms of GLS include gluconapoleiferin, glucobrassicanapin, glucoerucin, glucobrassin, and 4-hydroxyglucobrassin. Both species exhibited strong antioxidant activity, attributed to glucosinolates and phenolic compounds. The methanol extracts of Brassica rapa accessions were assessed against a panel of five Gram-negative bacteria (Enterobacter cloacae, Escherichia coli, Pseudomonas aeruginosa, Salmonella enterica subsp. enterica serovar, and Yersinia enterocolitica) and three Gram-positive bacteria (Bacillus cereus, Listeria monocytogenes, and Staphylococcus aureus). The extracts exhibited activity against S. enterica and S. aureus, and two showed inhibitory activity against E. coli and Y. enterocolitica. This study provides valuable insights into the chemical composition and biological properties of Brassica rapa and Brassica napus collections in Portugal. The selected accessions can constitute potential sources of natural antioxidants and bioactive compounds, which can be used in breeding programs and improving human health and to promote healthy food systems.

Towards a practical threat assessment methodology for crop landraces.

Crop landraces (LR), the traditional varieties of crops that have been maintained for millennia by repeated cycles of planting, harvesting, and selection, are genetically diverse compared to more modern varieties and provide one of the key components for crop improvement due to the ease of trait transfer within the crop species. However, LR diversity is increasingly threatened with genetic erosion and extinction by replacement with improved cultivars, lack of incentives for farmers to maintain traditional agricultural systems, and rising threats from climate change. Their active conservation is necessary to maintain this critical resource. However, as there are hundreds of thousands of LR and millions of LR populations for crops globally, active conservation is complex and resource-intensive. To assist in implementation, it is useful to be able to prioritise LR for conservation action and an obvious means of prioritisation is based on relative threat assessment. There have been several attempts to propose LR threat assessment methods, but none thus far has been widely accepted or applied. The aim of this paper is to present a novel, practical, standardised, and objective methodology for LR threat assessment derived from the widely applied IUCN Red Listing for wild species, involving the collation of time series information for LR population range, LR population trend, market, and farmer characteristics and LR context information. The collated information is compared to a set of threat criteria and an appropriate threat category is assigned to the LR when a threshold level is reached. The proposed methodology can be applied at national, regional, or global levels and any crop group.

Pilot Randomized Controlled Trial of an Educational Video for CAR T-Cell Therapy Recipients.

BACKGROUND: CAR T-cell therapy has transformed the treatment of hematologic malignancies, but it is complex and challenging to convey to patients. Educational video interventions are efficacious for improving patient knowledge about cancer therapeutics and informing their care preferences, yet no educational videos have been evaluated in CAR T-cell therapy. METHODS: We conducted a randomized controlled trial comparing an educational video versus usual care in adults (age ≥18 years) with hematologic malignancies receiving CAR T-cell therapy at Massachusetts General Hospital. Intervention participants watched a 13-minute video depicting how CAR T-cell therapy works, logistics, toxicities, prognosis, recovery, and approaches for dealing with prognostic uncertainty. The primary outcome was feasibility (≥60% enrollment rate). Secondary outcomes included acceptability (≥80% reporting comfort with the video), patients' knowledge about CAR T-cell therapy (10-item test), and self-efficacy (Communication and Attitudinal Self-Efficacy Scale-Cancer), decision satisfaction (Decision Conflict Scale), psychological distress (Hospital Anxiety and Depression Scale), and preference for CAR T-cell therapy. RESULTS: We enrolled 79% (80/101) of eligible patients. Of that group, 91% (30/33) reported being very or somewhat comfortable watching the video, and 94% (31/33) would definitely or probably recommend the video. At 1 month, participants in the video arm reported higher self-efficacy (mean difference [MD], 9.2 [95% CI, -4.0 to 22.3]; Cohen's d, 0.32), decision satisfaction (MD, 2.5 [95% CI, 0.7-4.2]; Cohen's d, 0.67), and lower anxiety (MD, -0.8 [95% CI, -2.5 to 0.7]; Cohen's d, 0.26) compared with participants in the usual care arm. At 1 week, both arms reported high preferences for CAR T-cell therapy (video arm, 94% [33/35]; usual care, 84% [27/32]). CONCLUSIONS: We found that an educational video for patients receiving CAR T-cell therapy was feasible and acceptable. The educational video demonstrated promising preliminary effects on patient self-efficacy and decision satisfaction and warrants further study.

Monitoring Genetic Erosion of Aromatic and Medicinal Plant Species in Alentejo (South Portugal).

The main goal of this work was to study the genetic erosion risk of plants with aromatic, medicinal and gastronomic applications in Portugal, particularly in the Alentejo region. The target species were coriander (Coriandrum sativum L.), hart's pennyroyal (Mentha cervina L.) and pennyroyal (Mentha pulegium L.). The methodology involved direct observations and surveys (2002/2003 and 2011). The GE formula applied in Hammer's studies was used to estimate genetic erosion. The main factors causing genetic erosion were the primary drivers of biodiversity loss: habitat loss, invasive species, and overexploitation influenced by human intervention such as the clearing of watercourses, vegetation control, grazing and desertification. The results indicate a reduction in individuals per species in Alentejo, with a net erosion loss of 11% for M. pulegium, 32% for M. cervina and 33% for C. sativum. The overall loss of accessions (genetic erosion risk) was higher in cultivated accessions (33%) than in wild accessions (11%), with an annual genetic erosion rate of 3.7% and 1.2%, respectively. The annual risk of genetic erosion for M. pulegium accessions collected in a natural habitat was 0.6%, which is much lower than the 3.7% for M. cervina. These results consolidate the importance of collecting and conserving genetic resources.

Chemical Variability of the Essential Oils from Two Portuguese Apiaceae: Coriandrum sativum L. and Foeniculum vulgare Mill.

Coriandrum sativum L. and Foeniculum vulgare Mill. are two aromatic and medicinal Apiaceae species commonly grown in Portugal, whose essential oils (EOs) are used in the food, pharmaceutical, and cosmetics industries. The present study evaluated EOs isolated from the fruits and vegetative aerial parts (VAPs) of 11 samples of Coriandrum sativum L. and from the fruits of 19 samples of Foeniculum vulgare Mill. The plant material was grown in experimental fields, after collection from several regions of mainland Portugal. The EOs were isolated by hydrodistillation and analyzed by gas chromatography and gas chromatography-mass spectrometry. The coriander EOs analysis evidenced two main clusters, with the first containing the fruits' EOs dominated by linalool (60-73%), γ-terpinene, and α-pinene and the second with the VAPs' EOs, which showed 2-trans-decenal (37-63%) and n-decanal (13-30%) as the main compounds. The fennel EOs analysis revealed two well correlated clusters, the first dominated by estragole (34-76%) and fenchone (16-30%) and the other dominated by trans-anethole (37-56%) and fenchone (14-34%). The present data suggest coriander EOs' chemical descriptors as linalool for the fruits' EOs and 2-trans-decenal with n-decanal for the VAPs' EOs. For the fennel fruit EOs, the putative descriptors were trans-anethole and estragole, with variable fenchone content. The gathered data reinforce the relevance of clarifying variability of these species' EOs, particularly when considering aromatic and medicinal plants with such a wide range of applications.

Oral Health in migrants children in Melilla, Spain.

Numerous developing countries' socioeconomic and political issues resulted in a significant migratory phenomenon, which poses a health burden for the nations that receive migrant populations. Often, the greatest age group of migrants is children and teens. Oral problems are one of the most common reasons that immigrants in the receiving nations visit the healthcare system. Cross-sectional research was conducted on children and teenagers housed at the Temporary Stay Center for Immigrants (CETI) of the Autonomous City of Melilla (Spain) with the aim of identifying the state of the oral cavity of these group of migrants. Information on the condition of the research group's oral cavity was gathered using the World Health Organization's standards. The research comprised all of the children and teenagers who were enrolled in the CETI for a defined period of time. A total of 198 children were assessed. It was determined that 86.9% of the youngsters were of Syrian descent. There were 57.6% males and a 7.7 (±4.1) average age. The average caries index for children under the age of six was dft =6.4 (±6.3), and for children aged six to eleven, it was 7.5 (±4.8), taking into account both the temporary and permanent dentition, and for children aged twelve to seventeen, it was 4.7 (±4.0). A total of 50.6% of children between the ages of 6 and 11 needed extractions, compared to 36.8% of children under the age of 6. The population under study had a significant incidence of sextants where bleeding occurred during periodontal probing (mean 3.9 (±2.5)), according to an examination of the community periodontal index (CPI). It is crucial to study the oral cavity status of refugee children when designing intervention programs to improve their oral health and provide health education activities that favour the prevention of oral diseases.

Oral Health Status in a Group of Roma Children in Seville, Spain.

The Spanish gypsy community is widely integrated among the rest of the Spanish population due to a coexistence that dates back centuries. Despite this integration, they are at risk of marginalization, the child population clearly being a vulnerable group. In terms of social and health inequalities, ethnic minorities in general, and the gipsy minority in particular, in many cases do not achieve equity with the rest of the population. Regarding health in general and, more specifically, oral health, this fact can be perceived, although it has not been evidenced by any epidemiological study of oral health in the Andalusia region. OBJECTIVE: Identify the oral health status through an epidemiological survey of the population of gipsy children in the city of Seville. METHODS: The WHO (World Health Organization) criteria for oral health surveys were used in the study with children aged 6 to 13 years carried out in two Seville schools located in neighborhoods with a high percentage of gypsy population (Polígono Norte and Sur of the city of Seville). RESULTS: The final sample consisted of 108 children in whom the DMF (decay-missing-filled index) for primary dentition was 5.0 + -3.1 for the 6-9 year-old age group and the DMFT (Decayed, Missing, and Filled Teeth) for the 10-13 year-old group was 4.5 + -3.3. The frequency of brushing was low, with a significant percentage of children not brushing their teeth (42.3%). The striking feature is that 26.9% of children had never visited the dentist despite their basic dental care being covered by the regional government. CONCLUSIONS: The children studied present high levels of caries compared to the rest of the Spanish population, as well as very low levels of oral hygiene. Given the lack of success of existing oral health programmes among this population, a different intervention is needed, taking into account the idiosyncrasies of the gipsy community.

Essential Oils from Origanum vulgare subsp. virens (Hoffmanns. & Link) Ietsw. Grown in Portugal: Chemical Diversity and Relevance of Chemical Descriptors.

Origanum vulgare L. is a well-known aromatic and medicinal plant, whose essential oil (EO) has recognised flavouring and medicinal properties. In this study, Origanum vulgare subsp. virens (Hoffmanns. & Link) Ietsw. EOs, isolated from accessions grown in experimental fields, were evaluated. The plant material was grown from rooted cuttings or nutlets (fruits), originally collected in 20 regions in mainland Portugal and harvesting for EO isolation was performed in two years. EOs were isolated by hydrodistillation and analysed by gas chromatography and gas chromatography-mass spectrometry, for EO quantification and identification, respectively. EO yields ranged from <0.05-3.3% for rooted cuttings, with oregano samples obtained in Portalegre and Alandroal, respectively. Ninety-one compounds were identified, mainly grouped in oxygen-containing monoterpenes and monoterpene hydrocarbons. EO agglomerative cluster analysis evidenced two main clusters, with the first subdivided into four subclusters. From the obtained data, the putative O. vulgare subsp. virens chemotypes are carvacrol, thymol and linalool, with γ-terpinene, p-cymene, cis- and trans-ß-ocimene also contributing as these EOs chemical descriptors. The comparison between the present data and a survey of the existing literature on Portuguese O. vulgare reinforces the major variability of this species' EOs and emphasises the importance of avoiding wild collections to obtain a defined chemical type of crop production of market relevance.

Tracing Back the History of Pepper (Capsicum annuum) in the Iberian Peninsula from a Phenomics Point of View.

The Iberian Peninsula was the place where pepper (Capsicum annuum) entered Europe and dispersed to other continents but was also an important secondary center for its diversification. The current work evaluated the phenotypic diversity existing in this region and investigated how that evolved from Capsicum native areas (Mexico and Andean Region). For that purpose, the high-throughput phenotyping tool Tomato Analyzer was employed. Descriptors related to size and shape were the most distinctive among fruit types, reflecting a broad diversity for Iberian peppers. These traits likely reflected those suffering from more intensive human selections, driving the worldwide expansion of C. annuum. Iberian peppers maintained close proximity to the American accessions in terms of fruit phenomics. The highest similarities were observed for those coming from the southeastern edge of the Peninsula, while northwestern accessions displayed more significant differences. Common fruit traits (small, conical) suggested that Portuguese and Spanish landraces may have arisen from an ancient American population that entered the south of Spain and promptly migrated to the central and northern territories, giving rise to larger, elongated, and blocky pods. Such lineages would be the result of adaptations to local soil-climate factors prevailing in different biogeographic provinces.

Occurrence and seasonality of Campylobacter spp. in Portuguese dairy farms.

The growing idea that natural products are better for consumption is creating behaviors that can lead to food safety problems and an increase of healthcare costs. One of the trending products is raw milk, which in some countries is sold by vending machines outside dairy farms. Campylobacteriosis is the most common gastrointestinal infection in humans in the European Union since 2005. Several outbreaks have been associated with the consumption of raw milk contaminated with Campylobacter spp. In the present study, the occurrence and seasonality of Campylobacter spp. in raw cow's milk were determined. Other samples from the dairy farm environment were also analyzed to understand the possible routes of contamination. The study was conducted from November 2020 to September 2021 in randomly selected dairy farms located in northern Portugal. One liter of milk was collected from bulk cooling tanks transported to the laboratory and analyzed within 24 h. Campylobacter spp. detection and identification were performed using real-time PCR methodology and confirmation followed ISO standards. From 100 dairy farms evaluated, the occurrence of Campylobacter spp. was estimated at 4.0 % in raw cow's milk samples. In the samples from the environment of the farms, only contaminated fecal samples were found, corresponding to an occurrence of 4.2 %. Positivity was observed in summer months. The results of this study indicate the potential risk of campylobacteriosis after the consumption of raw milk. Consumers who seek raw milk for health reasons should be aware of the risk, especially if they belong to vulnerable groups. Moreover, it raises the question of how climate change will impact food safety, suggesting that routine surveillance for zoonotic pathogens should be implemented in dairy farms.

Adapting Agriculture to Climate Change: A Synopsis of Coordinated National Crop Wild Relative Seed Collecting Programs across Five Continents.

The Adapting Agriculture to Climate Change Project set out to improve the diversity, quantity, and accessibility of germplasm collections of crop wild relatives (CWR). Between 2013 and 2018, partners in 25 countries, heirs to the globetrotting legacy of Nikolai Vavilov, undertook seed collecting expeditions targeting CWR of 28 crops of global significance for agriculture. Here, we describe the implementation of the 25 national collecting programs and present the key results. A total of 4587 unique seed samples from at least 355 CWR taxa were collected, conserved ex situ, safety duplicated in national and international genebanks, and made available through the Multilateral System (MLS) of the International Treaty on Plant Genetic Resources for Food and Agriculture (Plant Treaty). Collections of CWR were made for all 28 targeted crops. Potato and eggplant were the most collected genepools, although the greatest number of primary genepool collections were made for rice. Overall, alfalfa, Bambara groundnut, grass pea and wheat were the genepools for which targets were best achieved. Several of the newly collected samples have already been used in pre-breeding programs to adapt crops to future challenges.

Portuguese wild hop diversity assessment by fast SNP genotyping using high-resolution melting.

A set of seven SNP markers was used to evaluate the genetic diversity of wild Portuguese hops in comparison with commercial cultivars. A collection of 110 wild genotypes and 33 cultivars was characterized by a high-resolution melting analysis of short amplicons targeting SNP loci. Most of the 143 genotypes (75%) could be differentiated. Phylogenetic analysis showed three main clusters, one included almost exclusively (98%) wild accessions, being the others constituted of both wild and commercial genotypes. The study of population genetic structure placed the accessions into three genetic units, being one exclusively of Portuguese genotypes. The study showed the great biodiversity of the Portuguese hop germplasm and the notable differences (FST = 0.163, p<0.00001) from commercial hops. Results support the usefulness of the use of these seven markers for hop discrimination, with the fast and high-throughput HRMA technique for allele calling and contribute to the affirmation of the high richness breeding potential of Portuguese wild hops.

Evaluation of Antimicrobial Resistance of Different Phylogroups of Escherichia coli Isolates from Feces of Breeding and Laying Hens.

Animal and food sources are seen as a potential transmission pathway of multi-drug resistance (MDR) micro-organisms to humans. Escherichia. coli is frequently used as an indicator of fecal contamination in the food industry and known as a reservoir of antimicrobial resistance genes (ARGs). Microbial contamination as a major outcome for the poultry and egg industry and is a serious public health problem. In the present study we performed the quantification of ß-glucoronidase positive E. coli in 60 fecal samples of breeding and laying hens collected in Portugal in 2019. Phylogenetic and pathotypic characterization, antimicrobial susceptibility, and detection of resistant extended-spectrum ß-lactamase (ESBL) genes were assessed. The phylogenetic and pathogenic characterization and detection of ESBL genes were assessed by real-time PCR and antimicrobial susceptibility was evaluated using the disk diffusion method. Overall, E. coli quantification was 6.03 log CFU/g in breeding hens and 6.02 log CFU/g in laying hens. The most frequent phylogroups were B1. None of the isolates was classified as diarrheagenic E. coli (DEC). In total, 57% of the isolates showed MDR and 3.8% were positive for ESBL. Our study highlights that consumers may be exposed to MDR E. coli, presenting a major hazard to food safety and a risk to public health.

Prevalência de maloclusão em dentição decídua nos alunos do ensino pré-escolar do concelho de porto de mós (portugal) / Prevalence of malocclusion in deciduous dentition in preschool students in the municipality of Porto de Mós (Portugal) / Prevalencia de maloclusión en dentición temporal en preescolares del municipio de Porto de Mós (Portugal)

Introdução:A maloclusão é considerada a segunda doença oral mais comum em crianças e jovens adultos. É importante saber identificar estas alterações de forma a permitir um adequado desenvolvimento da oclusão.O diagnóstico de um desenvolvimento anormal na dentição decídua é relevante para a prevenção e quando necessáriouma intervenção precoce. Objetivo:O objetivo deste estudo transversal foi avaliar a prevalênciade maloclusão em crianças com dentição decídua e relacionar com diferentes parâmetros.Metodologia:Observaram-se 300 crianças de ambos os sexos, com idades compreendidas entre os 3 e os 6 anos. A recolha de dados foi realizada a partir do exame clínico comkits de observação(espelho bucal básico descartável,sonda descartável, babador,luvas e sacos descartáveis), sob luz natural e na cadeira escolar, no Agrupamento de Escolas de Porto de Mós, Distrito Sanitário de Leiria. Analisaram-se as seguintes características: Tipo de arco de Baume, espaços primatas, diastemas, apinhamento, relação distal dos segundos molares decíduos, relação canina, sobremordida e sobressaliência, mordida anterior e posterior.Resultados:A prevalência de maloclusão registradafoi de 67,7%, verificando-se ser mais baixa aos seis anos, sem apresentar diferenças significativas em ambos os sexos. A sobressaliência foi a maloclusão mais prevalente (42,7%) nas crianças observadas, seguida da mordida aberta anterior (23,3%). Registrou-seumaelevada prevalência de maloclusão nas crianças com arco de Baume tipo II, sem diastemas ou espaços primatas, com apinhamento, degrau distal, classe II canina ou desvio da linha média para a direita.Conclusões:Verificou-se existir uma elevada prevalência de maloclusão nas crianças do agrupamento de escolas do Concelhode Porto de Mós, estando relacionada com diferentes parâmetros oclusais (AU).

Introduction:Malocclusion is considered a second mostcommon oral disease in children and young adults. It is important to know how to identify these changes in order to allow proper development of the occlusion.The diagnosis of anabnormal development in primary dentition is relevant for prevention and when necessary, early intervention.Objective:The aim of this cross sectional study was to evaluate the prevalence of malocclusion in children with deciduous dentition and relate this prevalence with sex, age and with different occlusal parameters.Methodology:300 children of both sexes, aged between 3 and 6 years were observed. Data collection was carried out from the clinical examination using observation kits, in schools, in the Group of schools of Porto de Mós, Health District of Leiria. The following characteristics were analyzed: Baume arc Type, spaces, diastemas, crowding, the deciduous second molars distal relation, canine relationship, Overbite and overjet, anterior and posterior bite.Results:The recorded prevalence of malocclusion was 67.7%, was lower at six years old, without any differences in both sexes. The overjet was the most prevalent malocclusion (42.7%) in the observed children. There was a high prevalence of malocclusion in children with type II Baume arch, without spaces or primate spaces, with distal step, canine class II or with the middle line shifted to the right.Conclusions:There there was a high prevalence of malocclusion in children of the schools in the municipality of Porto de Mós, and is related to the different occlusal parameters (AU).

Introducción: La maloclusión se considera la segunda enfermedad bucal más común en niños y adultos jóvenes. Es importanteidentificar estos cambios para llograr un adecuado desarrollo de la oclusión. El diagnóstico precoz deldesarrollo anormal en la dentición temporal es relevante para la prevención y cuando sea necesario una intervención temprana. Objetivo: El objetivo de este estudio transversal fue evaluar la prevalencia de maloclusión en niñoscon dentición temporal y relacionarla con diferentes parámetros. Metodología: Fueran observados 300 niños de ambos sexos, con edadesentre los 3 y los 6 años. La recogida de datos del examen clínico se realizó mediante kits de observación, en un entorno escolar, en el Grupo Escolar dePorto de Mós, Distrito Sanitariode Leiria. Se analizaron las siguientes características: tipo de arco de Baume, espaciosprimates, diastemas, apiñamientos, relación distal de los segundos molares deciduos, relación canina, sobremordida horizontal y vertical, mordida anterior y posterior. Resultados: La prevalencia de maloclusión registrada fue de 67,7%, la cual resultó ser menor a los seis años, sin mostrar diferencias significativas en ambos sexos. El overjet fue la maloclusión más prevalente (42,7%) en los niños observados, seguida de la mordida abierta anterior (23,3%). Hubo una alta prevalencia de maloclusión en niños con arco de Baume tipo II, sin diastemas ni espacios de primates, con apiñamiento, paso distal, canino clase II o desviación de la línea media hacia la derecha.Conclusiones: Se encontró que hayuna alta prevalencia de maloclusión en niños dela comunidad escolar del municipio de Porto de Mós, y que se relaciona,con diferentes parámetros oclusales (AU).

Vitamin D in dysphagic patients who have undergone endoscopic gastrostomy for long-term enteral feeding / Vitamina D en pacientes con disfagia sometidos a gastrostomía endoscópica percutánea para una nutrición enteral de larga duración

OBJECTIVE: Vitamin D plays a major role in biological processes. Its deficiency is associated with increased morbidity and mortality. Patients who have undergone endoscopic gastrostomy (PEG) present with protein-energy malnutrition, and may be at risk for Vitamin D deficiency, due to their age, less sunlight exposure and lower dietary intake. We aimed to determine the prevalence of hypovitaminosis D in PEG-patients, its change under PEG-feeding, and its relationship with serum proteins and risk factors for Vitamin D deficiency. METHODS: This was a prospective observational study, over 4 weeks, after gastrostomy. Data were collected at the initial PEG procedure (T0), and after 4 weeks (T1). Initial evaluation included age, gender, underlying disorder, NRS-2002, BMI, serum albumin, transferrin and Vitamin D. At T1 we assessed Vit. D, albumin, and transferrin. Vitamin D was performed with Electrochemiluminescence through Elecsys 2010 assay. Patients were fed with blended homemade meals. RESULTS: 200 patients (118 males), 22-92 years of age, were studied. There were initial low values for Vit. D (181), albumin (96), transferrin (121), and BMI (124). A correlation was found between Vit. D and serum albumin (r=0.49, p = 0.005) but not with transferrin (r=0.26, p = 0.195). At T1 the subgroup who had Vit. D levels assessed (n=48) was part of the initial study group maintained low levels of Vitamin D despite nutritional intervention. CONCLUSION: We recommend systematic Vitamin D supplementation of PEG fed patients using homemade meals or at least screening for hypovitaminosis D as a routine part of their care

OBJETIVO: La vitamina D desempeña una función muy importante en los procesos biológicos. Su insuficiencia se asocia a una mayor morbimortalidad. Los pacientes que se han sometido a una gastrostomía endoscópica percutánea (GEP) presentan desnutrición proteinicocalórica y pueden correr riesgo de padecer insuficiencia de vitamina D, debido a su edad, menor exposición solar y menor ingestión alimentaria. Nuestro objetivo consistió en determinar la prevalencia de hipovitaminosis D en pacientes sometidos a GEP, su cambio en el contexto de la alimentación a través de GEP y su relación con las proteínas séricas y los factores de riesgo asociados a la insuficiencia de vitamina D. MÉTODOS: Se trató de un estudio observacional y prospectivo de cuatro semanas tras la gastrostomía. Se recogieron datos al inicio de la intervención de GEP (T0) y tras 4 semanas (T1). El análisis inicial incluyó edad, sexo, afecciones preexistentes, NRS-2002, IMC, seroalbúmina, transferrina y vitamina D. En el punto temporal T1, analizamos la vitamina D, albúmina y transferrina. La vitamina D se interpretó utilizando electroquimioluminiscencia mediante Elecsys 2010. RESULTADOS: Se estudió a 200 pacientes (118 varones) con edades comprendidas entre 22 y 92 años. Al inicio, se detectaron niveles bajos de vitamina D (181), albúmina (96), transferrina (121) y un IMC bajo (124). Se halló una correlación entre la vitamina D y la seroalbúmina (r=0,49; p = 0,005), pero no con la transferrina (r=0,26; p = 0,195). En el punto temporal T1, el subgrupo en el que ya se habían analizado niveles de vitamina D (n=48), que formó parte del estudio inicial, mantuvo niveles bajos, a pesar de la intervención nutricional. CONCLUSIÓN: Recomendamos un suplemento sistemático de vitamina D a los pacientes alimentados a través de GEP con comidas caseras o, al menos, la detección de hipovitaminosis D como parte habitual de su tratamiento

Effectiveness of dutasteride in a large series of patients with frontal fibrosing alopecia in real clinical practice.

BACKGROUND: Dutasteride has been proposed as an effective therapy for frontal fibrosing alopecia (FFA). OBJECTIVES: We sought to describe the therapeutic response to dutasteride and the most effective dosage in FFA compared with other therapeutic options or no treatment. METHODS: This was a retrospective observational study including patients with FFA with a minimum follow-up of 12 months. Therapeutic response was evaluated according to the stabilization of the hairline recession. RESULTS: A total of 224 patients (222 females) with a median follow-up of 24 months (range 12-108 months) were included. The stabilization rate for the frontal, right, and left temporal regions after 12 months was 62%, 64%, and 62% in the dutasteride group (n = 148), 60%, 35%, and 35% with other systemic therapies (n = 20), and 30%, 41%, and 38% without systemic treatment (n = 56; P = .000, .006, and .006, respectively). Stabilization showed a statistically significant association with an increasing dose of dutasteride (88%, 91%, and 84% with a weekly treatment of 5 or 7 doses of 0.5 mg [n = 32], P < .005). Dutasteride was well tolerated in all patients. LIMITATIONS: Limitations included the observational and retrospective design. CONCLUSIONS: Oral dutasteride was the most effective therapy with a dose-dependent response for FFA in real clinical practice compared with other systemic therapies or no systemic treatment.

Vitamin D in dysphagic patients who have undergone endoscopic gastrostomy for long-term enteral feeding.

OBJECTIVE: Vitamin D plays a major role in biological processes. Its deficiency is associated with increased morbidity and mortality. Patients who have undergone endoscopic gastrostomy (PEG) present with protein-energy malnutrition, and may be at risk for Vitamin D deficiency, due to their age, less sunlight exposure and lower dietary intake. We aimed to determine the prevalence of hypovitaminosis D in PEG-patients, its change under PEG-feeding, and its relationship with serum proteins and risk factors for Vitamin D deficiency. METHODS: This was a prospective observational study, over 4 weeks, after gastrostomy. Data were collected at the initial PEG procedure (T0), and after 4 weeks (T1). Initial evaluation included age, gender, underlying disorder, NRS-2002, BMI, serum albumin, transferrin and Vitamin D. At T1 we assessed Vit. D, albumin, and transferrin. Vitamin D was performed with Electrochemiluminescence through Elecsys 2010 assay. Patients were fed with blended homemade meals. RESULTS: 200 patients (118 males), 22-92 years of age, were studied. There were initial low values for Vit. D (181), albumin (96), transferrin (121), and BMI (124). A correlation was found between Vit. D and serum albumin (r=0.49, p=0.005) but not with transferrin (r=0.26, p=0.195). At T1 the subgroup who had Vit. D levels assessed (n=48) was part of the initial study group maintained low levels of Vitamin D despite nutritional intervention. CONCLUSION: We recommend systematic Vitamin D supplementation of PEG fed patients using homemade meals or at least screening for hypovitaminosis D as a routine part of their care.