Simulated gastrointestinal digestion of polylactic acid (PLA) biodegradable microplastics and their interaction with the gut microbiota

The accumulation of microplastics (MPs) in the environment as well as their presence in foods and humans highlight the urgent need for studies on the effects of these particles on humans. Polylactic acid (PLA) is the most widely used bioplastic in the food industry and medical field. Despite its biodegradability, biocompatibility, and "Generally Recognized As Safe" (GRAS) status, recent animal model studies have shown that PLA MPs can alter the intestinal microbiota; however, to date, no studies have been reported on the possible gut and health consequences of its intake by humans. This work simulates the ingestion of a realistic daily amount of PLA MPs and their pass through the gastrointestinal tract by combining the INFOGEST method and the gastrointestinal simgi® model to evaluate possible effects on the human colonic microbiota composition (16S rRNA gene sequencing analysis) and metabolic functionality (lactic acid and short-chain fatty acids (SCFA) production). Although PLA MPs did not clearly alter the microbial community homeostasis, increased Bifidobacterium levels tended to increase in presence of millimetric PLA particles. Furthermore, shifts detected at the functional level suggest an alteration of microbial metabolism, and a possible biotransformation of PLA by the human microbial colonic community. Raman spectroscopy and field emission scanning electron microscopy (FESEM) characterization revealed morphological changes on the PLA MPs after the gastric phase of the digestion, and the adhesion of organic matter as well as a microbial biofilm, with surface biodegradation, after the intestinal and colonic phases. With this evidence and the emerging use of bioplastics, understanding their impact on humans and potential biodegradation through gastrointestinal digestion and the human microbiota merits critical investigation.

P-648 Intramuscular progesterone as a rescue therapy for optmized luteal phase support in patients with low progesterone levels during elective euploid single embryo transfer

Study question

Does the addition of intramuscular progesterone(P) may improve the clinical outcomes of FET cycles in cases of low serum P levels before embryo transfer?

Summary answer

Intramuscularly P may correct the potentially harmful effects associated with low serum P levels during the luteal phase in FET cycles performed under HRT.

What is known already

Compelling evidence suggests that during FET, P levels measured on the mid-luteal phase may impact pregnancy outcomes, indicating that regardless of uterine P levels, a minimum level of serum P is required to enhance clinical outcomes. Up to one-third of patients under HRT using intravaginal micronized progesterone during FET cycles may present inadequate serum P levels, which may decrease the live birth rate in up to 32% when compared to patients with adequate serum P levels. Thus, the individualization of the LPS according to P monitoring may be necessary to overcome the deleterious effect of low P levels before FET.

Study design, size, duration

A retrospective cohort study was conducted between August 2019 and June 2021. Patients undergoing elective single embryo transfer (eSET) of euploid day 5 or day 6 blastocysts with own oocytes were included in the study. During the study period, 305 patients fulfilled the inclusion criteria.

Participants/materials, setting, methods

In patients presenting with serum P levels <9.2 ng/mL on the day before the ET, 1 mg/day of intramuscular P was added as a rescue therapy on the day of the ET and was maintained until the blood pregnancy test was completed; this represented the rescue LPS (rLPS) group. The clinical outcomes of rLPS group were compared to those patients with adequate serum P levels that maintained the LPS with vaginal micronized P (tLPS group).

Main results and the role of chance

During the study period, 305 patients fulfilled the inclusion criteria. There were 198 patients (65%) with adequate serum P levels that maintained the LPS with vaginal micronized and oral P (tLPS group), while 107 patients (35%) presented with low P levels in which a rescue intramuscularly administered P was added on the day of the embryo transfer (rLPS). When comparing the groups, there was no statistical difference in terms of maternal age, BMI, endometrial thickness before starting the P administration, estradiol and P levels in the proliferative phase, E levels in the luteal phase. There was a statistically significant difference in P levels on the day before the embryo transfer when comparing the tLPS and rLPS groups (13.6±6.2 ng/mL and 7.5±1.9 ng/mL, respectively; P<0.0001). No significant difference was observed in the clinical outcomes when comparing the tLPS and rLPS. The pregnancy rates were 73.7% and 72.0% (aOR=0.91, 95% CI 0.54–1.55; P=0.74), clinical pregnancy rates were 69.2% and 68.2% (aOR=0.96, 95% CI 0.58–1.55; P=0.86), and ongoing pregnancy rates were 65.7% and 64.5% (aOR=0.95, 95% CI 0.58–1.55; P=0.84) in the tLPS and rLPS respectively. The multivariate logistic regression did not identify any independent factor related to the ongoing pregnancy rate.

Limitations, reasons for caution

A control group comprising patients with low P levels that did not receive any intervention is lacking. However, we believe it would be unethical to neglect evidence from previous studies suggesting that low P levels might reduce reproductive outcomes in this group of patients.

Wider implications of the findings

Although previous clinical studies concluded that low luteal P levels before FET might impact clinical outcomes, we observed that intramuscular P administration starting on the day of euploid blastocyst ET, as a novel rescue therapy, can lead to comparable results to those achieved in patients presenting with adequate P levels.

Trial registration number

-

P–037 Influence of sperm selection by microfluidic device on outcomes of in vitro fertilization cycles

Study question

Does sperm selection by a microfluidic sperm-sorting device improve laboratory outcomes of intracytoplasmic sperm injection cycles?

Summary answer

The ZyMōtTMdevice seems a good alternative to the conventional swim-up technique, possibly increasing progressive sperm motility post processing and blastulation rate.

What is known already

It is well-known that high levels of sperm DNA fragmentation negatively impact not only early embryonic development but also embryo genome activation. Microfluidic technologies for processing sperm samples selection such as the ZyMōtTM device have been developed to sort sperm with lower rates of sperm DNA fragmentation in order to improve in vitro fertilization (IVF) outcomes. Moreover, it offers several advantages: working with very small volume samples, high sensitivity and low reaction times, automatic sample treatment and analysis, among others. However, the real benefits on the clinical and laboratory outcomes of IVF cycles is yet to be determined.

Study design, size, duration

We performed a retrospective study including 126 seminal samples processed between May 2019 and December 2020. These samples belong to 63 infertile couples that underwent 2 consecutive IVF cycles using the swim-up technique in the first cycle (n = 63) and the ZyMōtTM device in the second (n = 63). The oocytes of the female partners were recovered and inseminated, and the embryonic culture was carried out until the blastocyst stage, when the quality of these embryos was analyzed. Participants/materials, setting, methods: A total of 118 seminal samples from 59 couples were included. Four couples were excluded due to insufficient seminal volume / concentration (2) or absence of mature oocytes recovered (2). Laboratory outcomes were evaluated including semen parameters post processing, as well as fertilization, cleavage, blastulation (blastocyst among cleavage stage) and top-quality blastocyst rates. Continuous variables were analyzed by paired Student’s t-test or Wilcoxon signed-rank test, as appropriate. Differences were considered significant when p-value < 0.05.

Main results and the role of chance

We did not find any difference in the percentage of non-progressive sperm motility [0 (0–33%) vs. 0 (0–10%); p = 0.063] and immotile sperm [0 (0–70%) vs. 0 (0–80%); p = 0.095] post processing when comparing the swim-up technique with the ZyMōtTM device. Likewise, no significant differences were detected regarding fertilization [83% (0–100%) vs. 89% (0–100%); p = 0.104] and cleavage [100% (0–100%) vs. 100% (80–100%); p = 0.217] rates in both groups. Nevertheless, there was a significant difference in the percentage of progressive sperm motility [100% (20–100%) vs. 100% (10–100%); p = 0.012] post processing, as well as blastulation [37% ± 0.32 vs. 50% ± 0.3; p = 0.031] and top-quality blastocyst [13.5% (0–100%) vs. 33% (0–100%); p = 0.009] rates, favoring the ZyMōtTM device.

Limitations, reasons for caution

The retrospective design and the small sample size make the study prone to bias. Furthermore, we do not have data on sperm DNA fragmentation pre and post processing. Clinical outcomes were not evaluated due to insufficient statistical power, since embryo transfer has not yet been accomplished in several patients.

Wider implications of the findings: Besides the ZyMōtTM device has been indicated as a new tool to potentially improve laboratory and clinical IVF outcomes, it offers the advantage of being safe, fast, easy-to-use and less influenced by human errors. Further well-designed prospective studies are needed to prove its cost-effectiveness.

Trial registration number

Not applicable

Motility and cell shape roles in the rheology of growing bacteria cultures

Cell shape, size and self-motility appear as determinant intrinsic cell factors in the rheological behavior of living bacterial cultures during the growth process. In this work three different species were considered due to their differences on these intrinsic characteristics: two different strains of Staphylococcus aureus - strain COL and its isogenic cell wall autolysis mutant, RUSAL9 - both non-motile and Escherichia coli and Bacillus subtilis - both presenting intrinsic motility. In situ real-time rheology, was used to characterize the activity of growing bacteria, under steady-shear conditions, in particular the viscosity growth curve was measured, for a constant shear flow rate, presenting for all studied cultures, different and rich flow curves. These complex rheological behaviors are a consequence of two coupled effects: the cell density continuous increase and its changing interacting properties, where cell size and shape and intrinsic motility are major players.

Specific protocols of controlled ovarian stimulation for oocyte cryopreservation in breast cancer patients

Background

Fertility preservation is an important concern in breast cancer patients. In the present investigation, we set out to create a specific protocol of controlled ovarian stimulation (cos) for oocyte cryopreservation in breast cancer patients.

Methods

From November 2014 to December 2016, 109 patients were studied. The patients were assigned to a specific random-start ovarian stimulation protocol for oocyte cryopreservation. The endpoints were the numbers of oocytes retrieved and of mature oocytes cryopreserved, the total number of days of ovarian stimulation, the total dose of gonadotropin administered, and the estradiol level on the day of the trigger.

Results

Mean age in this cohort was 31.27 ± 4.23 years. The average duration of cos was 10.0 ± 1.39 days. The mean number of oocytes collected was 11.62 ± 7.96 and the mean number of vitrified oocytes was 9.60 ± 6.87. The mean estradiol concentration on triggering day was 706.30 ± 450.48 pg/mL, and the mean dose of gonadotropins administered was 2610.00 ± 716.51 IU. When comparing outcomes by phase of the cycle in which cos was commenced, we observed no significant differences in the numbers of oocytes collected and vitrified, the length of ovarian stimulation, and the estradiol level on trigger day. The total dose of follicle-stimulating hormone and human menopausal gonadotropin administered was statistically greater in the group starting cos in the luteal phase than in the group starting in the late follicular phase.

Conclusions

Our results suggest that using a specific protocol with random-start ovarian stimulation for oocyte cryopreservation in breast cancer patients is effective and could be offered to young women undergoing oncologic treatment.

Rotational tumbling of Escherichia coli aggregates under shear

Growing living cultures of Escherichia coli bacteria are investigated using real-time in situ rheology and rheoimaging measurements. In the early stages of growth (lag phase) and when subjected to a constant stationary shear, the viscosity slowly increases with the cell's population. As the bacteria reach the exponential phase of growth, the viscosity increases rapidly, with sudden and temporary abrupt decreases and recoveries. At a certain stage, corresponding grossly to the late phase of growth, when the population stabilizes, the viscosity also keeps its maximum constant value, with drops and recoveries, for a long period of time. This complex rheological behavior, which is observed to be shear strain dependent, is a consequence of two coupled effects: the cell density continuous increase and its changing interacting properties. Particular attention is given to the late phase of growth of E. coli populations under shear. Rheoimaging measurements reveal, near the static plate, a rotational motion of E. coli aggregates, collectively tumbling and flowing in the shear direction. This behavior is interpreted in the light of a simple theoretical approach based on simple rigid body mechanics.

Shaping up operando spectroscopy: Raman characterization of a working honeycomb monolith

An operando reactor cell for honeycombs to study the effect of conformation on structure–activity relationships by surface Raman spectroscopy and gas-phase analysis.

Development of a versatile experimental setup for the evaluation of the photocatalytic properties of construction materials under realistic outdoor conditions

The interest on outdoor photocatalytic materials is growing in the last years. Nevertheless, most of the experimental devices designed for the assessment of their performance operate at controlled laboratory conditions, i.e., pollutant concentration, temperature, UV irradiation, and water vapor contents, far from those of real outdoor environments. The aim of the present study was the design and development of an experimental device for the continuous test of photocatalytic outdoor materials under sun irradiation using real outdoor air as feed, with the concomitant fluctuation of pollutant concentration, temperature, and water vapor content. A three-port measurement system based on two UV-transparent chambers was designed and built. A test chamber contained the photoactive element and a reference chamber to place the substrate without the photoactive element were employed. The third sampling point, placed outdoors, allowed the characterization of the surrounding air, which feeds the test chambers. Temperature, relative humidity (RH), and UV-A irradiance were monitored at each sampling point with specific sensors. NO x concentration was measured by a chemiluminescence NO x analyzer. Three automatic valves allowed the consecutive analysis of the concentration at the three points at fixed time intervals. The reliability of the analytical system was demonstrated by comparing the NO x concentration data with those obtained at the nearest weather station to the experimental device location. The use of a chamber-based reaction system leads to an attenuation of NO x and atmospheric parameter profiles, but maintaining the general trends. The air characterization results showed the wide operating window under which the photoactive materials should work outdoors, depending on the traffic intensity and the season, which are reproduced inside the test chambers. The designed system allows the measurement of the photoactivity of outdoor materials or the comparison of several samples at the same time. The suitability of the system for the evaluation of the DeNO x properties of construction elements at realistic outdoor conditions was demonstrated. The designed experimental device can be used 24/7 for testing materials under real fluctuations of NO x concentration, temperature, UV irradiation, and relative humidity and the presence of other outdoor air pollutants such as VOCs, SO x , or NH3. The chamber-based design allows comparing a photocatalytic material with respect to a reference substrate without the photoactive phase, or even the comparison of several outdoor elements at the same time.

Living bacteria rheology: population growth, aggregation patterns, and collective behavior under different shear flows

The activity of growing living bacteria was investigated using real-time and in situ rheology-in stationary and oscillatory shear. Two different strains of the human pathogen Staphylococcus aureus-strain COL and its isogenic cell wall autolysis mutant, RUSAL9-were considered in this work. For low bacteria density, strain COL forms small clusters, while the mutant, presenting deficient cell separation, forms irregular larger aggregates. In the early stages of growth, when subjected to a stationary shear, the viscosity of the cultures of both strains increases with the population of cells. As the bacteria reach the exponential phase of growth, the viscosity of the cultures of the two strains follows different and rich behaviors, with no counterpart in the optical density or in the population's colony-forming units measurements. While the viscosity of strain COL culture keeps increasing during the exponential phase and returns close to its initial value for the late phase of growth, where the population stabilizes, the viscosity of the mutant strain culture decreases steeply, still in the exponential phase, remains constant for some time, and increases again, reaching a constant plateau at a maximum value for the late phase of growth. These complex viscoelastic behaviors, which were observed to be shear-stress-dependent, are a consequence of two coupled effects: the cell density continuous increase and its changing interacting properties. The viscous and elastic moduli of strain COL culture, obtained with oscillatory shear, exhibit power-law behaviors whose exponents are dependent on the bacteria growth stage. The viscous and elastic moduli of the mutant culture have complex behaviors, emerging from the different relaxation times that are associated with the large molecules of the medium and the self-organized structures of bacteria. Nevertheless, these behaviors reflect the bacteria growth stage.

Photocatalysis for continuous air purification in wastewater treatment plants: from lab to reality

The photocatalytic efficiency of TiO(2)-SiMgO(x) plates to oxidize H(2)S was first evaluated in a flat laboratory reactor with 50 mL min(-1) synthetic air containing 100 ppm H(2)S in the presence of humidity. The use of the photocatalyst-adsorbent hybrid material enhanced the photocatalytic activity in terms of pollutant conversion, selectivity, and catalyst lifetime compared to previous H(2)S tests with pure TiO(2) because total H(2)S elimination was maintained for more than 30 operating hours with SO(2) appearing in the outlet as reaction product only after 18 h. Subsequently, the hybrid material was successfully tested in a photoreactor prototype to treat real polluted air in a wastewater treatment plant. For this purpose, a new tubular photocatalytic reactor that may use solar radiation in combination with artificial radiation was designed; the lamp was turned on when solar UV-A irradiance was below 20 W m(-2), which was observed to be the minimum value to ensure 100% conversion. The efficient distribution of the opaque photocatalyst inside the tubular reactor was achieved by using especially designed star-shaped structures. These structures were employed for the arrangement of groups of eight TiO(2)-SiMgO(x) plates in easy-to-handle channelled units obtaining an adequate flow regime without shading. The prototype continuously removed during one month and under real conditions the H(2)S contained in a 1 L min(-1) air current with a variable inlet concentration in the range of tens of ppmv without release of SO(2).

Abstract P2-06-05: p27 Expression in Hormone Sensitive Breast Carcinomas, Prior and after Short Term Hormone Treatment: A Prospective Placebo Double-Blind Study

Background: Mutations in genes that regulate the cell cycle are found in most human cancers. In addition, there are other cell cycle genes, including those encoding p27, that contribute to tumor progression but are rarely mutated. p27 is a member of the Cip/Kip family of cyclin-dependent kinase inhibitors and it is present in high levels in quiescent cells, but its levels decline when cells proliferate in response to mitogenic signals. Various functions have been attributed to p27, including promotion of apoptosis and regulation of drug resistance. p27 is functionally inactivated in most of human cancers through enhanced p27 proteolysis, sequestration by cyclin D/cdk complexes, and by cytoplasmic mislocalization. There is evidence from preclinical studies that p27 is essential for cell cycle arrest by tamoxifen and other antiestrogenic drugs.

Objectives: To compare the expression of nuclear and cytoplasmic p27, cyclin D1, Ki-67, p53, HER2/ErbB2, ER and PR in hormone sensitive invasive ductal carcinomas (IDC) in postmenopausal women, prior and after tamoxifen and anastrozole in a short term treatment. Methods: Seventy one patients were enrolled in this study and fifty-eight were elegible for analyses. All patients had palpable ER-positive IDC (stage II and III) and were double-blind randomized in a prospective placebo controlled study with short term hormone treatment (HT) groups for twenty-six days prior to surgical treatment: Anastrozole 1mg/day (n= 18), Placebo (n=25) and Tamoxifen 20mg/day (n= 15). Pre and post HT samples were disposed in tissue micro array blocks and submitted to immunohistochemical assay. Biomarkers status (nuclear and cytoplasmic p27, cyclin D1, Ki-67, p53, HER2/ErbB2, ER and PR) were obtained comparing each immunohistochemical evaluation of pre and post-surgery samples using semi-quantitative Allred's method for nuclear biomarkers, and scored based on a four-point intensity based system: negative (no stain), weakly positive (1+), mild positive (2+) and strongly positive (3+). Statistical analysis were performed using the GEE (General Estimation Equations) and ANOVA tests with significant p ≥0.05. Results: The patients mean age was 66.25 ± 9.95 years. The mean tumor size was 4.0 ± 1.06 cm. There was no statistically significant correlation between nuclear p27 expression and tumor size or histologic grade. Before HT, 38 (62.5%) patients had positive nuclear p27 expression, 5 (8.6%) patients had positive cytoplasmic p27 expression, and after treatment their expression was increased in all groups. There was a positive correlation between Ki-67, cyclin D1, p53 and nuclear p27 prior to HT. After HT, there was a positive correlation between Ki-67, cyclin D1, p53, HER2/ErbB2, ER, and nuclear p27.

Conclusions: There was an increment of nuclear and cytoplasmic p27 after short term treatment, regardless of the drug used. The positive correlation between nuclear p27 and poor prognostic markers was unexpected.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-06-05.

Kinetics of denitrification using sulphur compounds: effects of S/N ratio, endogenous and exogenous compounds

The influence of different sulphur to nitrogen (S/N) ratios on the specific autotrophic denitrification activity was studied in batch experiments using thiosulphate and nitrate as substrates. Transitory accumulations of nitrite were observed for assays with S/N ratios of 3.70 and 6.67 g/g, probably due to the higher specific reduction rate of nitrate compared to that of nitrite. Nitrite was the main end product when S/N ratios of 1.16 and 2.44 g/g were tested. The effects of endogenous (NO(3)(-),NO(2)(-),S(2)O(3)(2-)and SO(4)(2-)) and exogenous compounds (acetate and NaCl) on the specific denitrifying activity of the sludge were tested. Nitrite and sulphate did exert clear inhibitory effects over the process while thiosulphate, acetate and NaCl did not have strong effects at the concentrations tested. Similar experiments also showed that sulphur was not a suitable electron donor for these microorganisms, but sulphide was used successfully.

[Branched chain amino acid diseases]

The authors present 19 cases of branched-chain AA catabolism disease: 9 Maple Syrup Urine Diseases, 6 Methylmalonic Acidemias, 2 Propionic Acidemias, 1 case of 3-OH-3-methylglutaryl-CoA-lyase deficiency and another of 2-methyl-ketoacetyl-CoA-thiolase deficiency. Fifteen are early neonatal forms and in 4 the onset occurred later. Fifteen patients (78.9%) needed one or several extra-corporal procedures either in the initial acute phase or during relapse. Fifteen patients presented several metabolic relapses, sometimes fatal (3 children). Global mortality was 26.3%, that is 5/19 patients: 4 children with neonatal forms, one with a later onset. Eleven patients (57.9%) had an IQ/DQ > or = 80: only 46.6% of the neonatal forms obtained these results, in contrast with all the late onset forms. Of the survivors, 9 (64.2%), presented a residual neurologic condition. The correct diagnostic and treatment procedures are defined and the need to consider the existence of these diseases at any age, particularly in the neonatal period, is stressed.

[Percutaneous valvuloplasty of congenital pulmonary stenosis in adults over 50 years of age]

The authors report three cases of congenital pulmonary stenosis in adults over 50 years of age treated by percutaneous balloon valvuloplasty. Three symptomatic women aged 74, 80 and 51, had systolic pressure gradients ranging from 107 to 113 mmHg between the right ventricle and pulmonary artery. After valvuloplasty with two balloons or one trefoil balloon, the transvalvular pressure gradient fell to 25 to 30 mmHg. It was only 14 mmHg in one patient controlled after one year's follow-up. The cardiac index was initially decreased and did not change very much immediately after the procedure, increasing from 1.68 1/m2/mn to 1.77 1/m2/mn. The pulmonary valve surface area increased from 0.22 to 0.43 cm2. There were no complications and in one patient, reviewed two years later, the clinical improvement was maintained. Percutaneous valvuloplasty is indicated in severe and/or poorly tolerated pulmonary stenosis. With the 10 other previously reported cases of patients over 50 years of age, the procedure was successful in 12 out of 13 patients (92%). In these patients of 51 to 80 years of age, the systolic pressure gradient between the right ventricle and pulmonary artery was reduced from 112 +/- 46 mmHg to 43 +/- 26 mmHg (-62%). Slight pulmonary regurgitation appeared in 5 out of 9 cases. Valvuloplasty was usually well tolerated and there were no fatalities. There were no signs of restenosis in 5 cases controlled 10 days to 1 year after dilatation. In the future, systematic Doppler echocardiographic examinations should help comparison of cardiac haemodynamics before, immediately after valvuloplasty and at long-term.(ABSTRACT TRUNCATED AT 250 WORDS)

[Ceroid-lipofuscinosis: ultrastructural study of 8 cases]

The authors studied the clinical and ultrastructural features of 8 cases of Neuronal Ceroid-Lipofuscinosis (NCL). Five cases of the late-infantile type and 3 cases of the juvenile type. The clinical diagnosis of all cases was confirmed by the electron microscopy analysis of the peripheral blood lymphocytes and biopsy material from the skin, palpebral conjunctiva, skeletal muscle and rectal mucosa. Our observations agree with previous reports concerning the predominance of curvilinear bodies in the cells of the late infantile type, and fingerprint-like structures in those of the juvenile type. The finding of parallel tubular arrays and NCL inclusions associated in the same lymphocyte (frequently in the same vacuole) suggests that those structures could be related to the metabolic error of NCL. Ultrastructural examination of microbuffycoats of peripheric blood lymphocytes is a simple, time-saving and reliable method that allows specific confirmation of a clinical diagnosis of Neuronal Ceroid-Lipofuscinosis.

A case of GM1 gangliosidosis type I

A six-month-old female gypsy child, the daughter of second degree cousins, born after a full-term pregnancy and normal delivery, is described. There was generalized neonatal edema. Abnormalities included psychomotor retardation from birth and progressive appearance of facial dysmorphism, organ enlargement, axial hypotonia, hypertonia in limbs, myoclonic jerks, optic atrophy and bilateral cherry-red spots. The diagnosis of GM1 type 1 gangliosidosis was confirmed by biochemical, enzymatic and ultrastructural findings.

[Phenylketonuria--physical and mental development of phenylketonuric children subjected to early treatment]

The Authors present the first clinical and laboratory assessment of 6 children with PKU, diagnosed and treated early, as a result of the application of the Early Diagnosis Programme in the southern part of the country, from April 1984 to November 1986. The main protein source used in the feeding of these patients was a phenylalanine-free mixture of amino-acids, with an excellent tolerance.