Writing to Keep on Living: A Systematic Review and Meta-Analysis on Creative Writing Therapy for the Management of Depression and Suicidal Ideation.

PURPOSE OF REVIEW: The purpose of this review and meta-analysis was to explore the effectiveness of creative writing therapies for the management of depression and suicidal ideation. RECENT FINDINGS: Twenty one of the 31 reviewed studies showed that creative writing significantly improved depressive symptoms, while five studies suggested improvement in other symptoms. The results of meta-analyses showed that narrative writing significantly reduced depression compared to those in neutral writing or treatment as usual condition in both post intervention and follow-up. However, the number of studies exploring the effects of creative writing in suicidal ideation was too low to perform a meta-analysis. A structured and well-targeted intervention using creative writing could have beneficial results for the management of depressive symptoms. More studies are needed to explore the potential benefits of creative writing for reducing suicidal ideation.

Treatment of post-psychotic depression in first-episode psychosis. A systematic review.

BACKGROUND: Post-psychotic depression (PPD) after a FEP (first-episode psychosis) differs from other depressive symptoms in chronic schizophrenia in its aetiology, symptomatology, and prognostic implications. The objective was to search if any pharmacological or non-pharmacological interventions have proven to be effective on depressive symptoms after a FEP. METHODS: for this systematic review we systematically searched and screened PubMed for articles published from August 1975 to October 15, 2020, with the terms: treatment AND first-episode psychosis OR post-psychotic OR post-schizophrenic AND depression. RESULTS: we identified 139 articles of which 20 met the inclusion criteria. These interventions were then categorized into four subgroups (antipsychotics, antidepressants, psychological and miscellaneous). LIMITATIONS: this review has several limitations. The reviewed studies were heterogeneous as to assessments, interventions, and samples; furthermore, only one study had PPD in FEP as its primary outcome. CONCLUSIONS: to our knowledge, this is the first review of PPD in a FEP's treatment. PPD continues to be a diagnostic and therapeutic challenge. The available evidence for the use of treatment whether pharmacological or non-pharmacological is limited. However, certain approaches such as online therapy and treatment with n-3 polyunsaturated fatty acids (PUFA) show promising results. It could be of interest for future studies to focus not only on the treatment of PPD but also on the diagnostic heterogeneity of the sample and the adaptation of the content of the intervention to the individual.

Post-Psychotic Depression: An Updated Review of the Term and Clinical Implications.

BACKGROUND: Post-psychotic depression (PPD) is an important and frequent clinical phenomenon featuring controversial complexity in its nosological and aetiopathogenic cataloguing. OBJECTIVES: The main objective of this research was to review the published literature on PPD. The second objective was to indicate its clinical importance, either comorbid or as an entity of its own. To answer these questions, a historical review of the term is made and a search about the clinical, evolutionary, predisposal, and prognostic variables that characterize the PPD. METHODS: The international recommendations were followed according to the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses (PRISMA). The databases used were Web of Science and PubMed, with the deadline for the inclusion of articles in November 2019. The MeSH used were the following: "post" AND "psych *" AND "psich" AND "depr." RESULTS: The search resulted in 64 articles. Only 19 of these met the pre-specified inclusion criteria and were finally included in the review. One article found that reading this literature was added due to its relevance. Despite its high prevalence (around 30%), there is little research about the term PPD. Nevertheless, results show data to improve the description of the syndrome, revealing differential characteristics from other depressive symptoms in chronic psychosis due to its clinical implications. CONCLUSIONS: Coinciding with the latest classification manuals that do not include the term, there appears to be an abandonment of its use despite its high prevalence. Data suggest that PPD is a nosological entity different from a secondary effect to antipsychotics, the negative symptoms of psychosis, and other clinical disorders that combine psychotic and depressive symptoms such as bipolar disorder, schizoaffective disorder, or depression with psychotic symptoms. PPD also has differential characteristics concerning further depressive symptoms, especially important clinical implications such as higher suicide risk and poorer quality of life.

Social value of a set of proposals for the ideal approach of multiple sclerosis within the Spanish National Health System: a social return on investment study.

BACKGROUND: Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease that in many cases produces disability, having a high impact in patients' lives, reducing significantly their quality of life. The aim of this study was to agree on a set of proposals to improve the current management of MS within the Spanish National Health System (SNHS) and apply the Social Return on Investment (SROI) method to measure the potential social impact these proposals would create. METHODS: A Multidisciplinary Working Team of nine experts, with representation from the main stakeholders regarding MS, was set up to agree on a set of proposals to improve the management of MS. A forecast SROI analysis was carried out, with a one-year timeframe. Data sources included an expert consultation, a narrative literature review and a survey to 532 MS patients. We estimated the required investment of a hypothetical implementation, as well as the potential social value that it could create. We calculated outcomes in monetary units and we measured intangible outcomes through financial proxies. RESULTS: The proposed ideal approach revealed that there are still unmet needs related to MS that can be addressed within the SNHS. Investment would amount to 148 million € and social return to 272 million €, so each euro invested could yield almost €2 of social return. CONCLUSIONS: This study could guide health interventions, resulting in money savings for the SNHS and increases in patients' quality of life.

Antimicrobial activity of poly(3,4-ethylenedioxythiophene) n-doped with a pyridinium-containing polyelectrolyte.

In spite of p-doped conducting polymers having been widely studied in the last decades and many applications having been developed, studies based on n-doped conducting polymers are extremely scarce. This fact is even more evident when it comes to conducting polymers n-doped with polycations, even though polyanions, such as poly(styrenesulfonate), are often used to obtain p-doped conducting polymers. In this work poly(pyridinium-1,4-diyliminocarbonyl-1,4-phenylene-methylene chloride), abbreviated as P(Py-1,4-P), has been used to prepare n-doped poly(3,4-ethylenedioxythiophene) (PEDOT) electrodes by applying a reduction potential to a de-doped PEDOT film in a P(Py-1,4-P) water solution. The utilization of this cationic polyelectrolyte as an n-dopant agent results in drastic superficial changes, as is observed by comparing the morphology, topography and wettability of p-doped, de-doped and n-doped PEDOT. Cytotoxicity, cell adhesion and cell proliferation assays, which have been conducted using epithelial and fibroblast cell lines, show that the amount of P(Py-1,4-P) in the re-doped PEDOT films is below that required to observe a cytotoxic harmful response and that n-doped PEDOT:P(Py-1,4-P) films are biocompatible. The non-specific bacteriostatic properties of n-doped PEDOT:P(Py-1,4-P) films have been demonstrated against E. coli and S. aureus bacteria (Gram-negative and Gram-positive, respectively) using bacterial growth curves and adhesion assays. Although the bacteriostatic effect is in part due to the conducting polymer, as is proved by results for p-doped and de-doped PEDOT, the incorporation of P(Py-1,4-P) through the re-doping process greatly enhances this antimicrobial behaviour. Thus, only a small concentration of this cationic polyelectrolyte (∼0.1 mM) is needed to inhibit bacterial growth.

Are commercial sweet cherry rootstocks adapted to climate change? Short-term waterlogging and CO2 effects on sweet cherry cv. 'Burlat'.

High CO2 is able to ameliorate some negative effects due to climate change and intensify others. This study involves the sweet cherry (Prunus avium) cultivar 'Burlat' grafted on the 'Mariana 2624', 'Adara' and 'LC 52' rootstocks. In a climate chamber at two CO2 concentrations, ambient (400 µmol mol-1 ) and elevated (800 µmol mol-1 ), the plants were submitted to waterlogging for 7 d, followed by 7 d of recovery after drainage. Waterlogging drastically decreased the rate of photosynthesis, significantly endangering plant survival, particularly for the 'LC 52' and 'Adara' rootstocks. 'Mariana 2624' was also clearly affected by waterlogging that increased lipid peroxidation and the Cl- and SO42- concentrations in all the studied plants. Nevertheless, CO2 was able to overcome this reduction in photosynthesis, augmenting growth, increasing soluble sugars and starch, raising turgor and regulating the concentrations of Cl- and SO42- , while lowering the NO3- concentration in leaves of all the studied rootstocks. In concordance with these results, the proline levels indicated a more intense stress at control CO2 than at high CO2 for waterlogged plants. 'Mariana 2624' was more resistant to waterlogging than 'Adara', and both were more resistant than 'LC 52' in control CO2 conditions; this clearly enhanced the chance of survival under hypoxia.

Fruit quality of sweet pepper as affected by foliar Ca applications to mitigate the supply of saline water under a climate change scenario.

BACKGROUND: Sweet pepper fruit quality disorders have been related mainly to an unbalanced nutrient supply and non-optimal growth conditions. Increases in the atmospheric CO2 concentration ([CO2 ]) have been associated with a reduction of transpiration, which can affect calcium (Ca) uptake as it is linked closely to water uptake. We investigated whether foliar application of Ca can counterbalance the effects of saline water and elevated [CO2 ]. RESULTS: High CO2 favoured generative growth instead of vegetative growth. Foliar Ca supply did not affect the marketable yield, but reduced the total yield when combined with salinity and 400 µmol mol-1 CO2 . Salinity affected negatively the total yield but this was overcome when CO2 was applied. The B and K concentrations were reduced by foliar Ca application, while Ca and Mn were increased at 400 µmol mol-1 CO2 . Salinity increased the Mn, Cl, and Na concentrations, regardless of the [CO2 ], and decreased K at 800 µmol mol-1 CO2 . The total protein was affected negatively only by elevated [CO2 ], and the total free amino acid concentration was reduced by all treatments. CONCLUSION: The effect of Ca application differed according to the other treatments applied. This procedure should be optimised to overcome future climate impacts on fruit quality. © 2017 Society of Chemical Industry.

Two minuses can make a plus: waterlogging and elevated CO2 interactions in sweet cherry (Prunus avium) cultivars.

The increase in the ambient concentration of CO2 and other greenhouse gases is producing climate events that can compromise crop survival. However, high CO2 concentrations are sometimes able to mitigate certain stresses such as salinity or drought. In this experiment, the effects of waterlogging and CO2 are studied in combination to elucidate the eventual response in sweet cherry trees. For this purpose, four sweet cherry cultivars ('Burlat', 'Cashmere', 'Lapins and 'New Star') were grafted on a typically hypoxia-tolerant rootstock (Mariana 2624) and submitted to waterlogging for 7 days at either ambient CO2 concentration (400 µmol mol-1 ) or at elevated CO2 (800 µmol mol-1 ). Waterlogging affected plants drastically, by decreasing photosynthesis, stomatal conductance, transpiration, chlorophyll fluorescence and growth. It also brought about the accumulation of proline, chloride and sulfate. Nonetheless, raising the CO2 supply not only mitigated all these effects but also induced the accumulation of soluble sugars and starch in the leaf. Therefore, sweet cherry plants submitted to waterlogging were able to overcome this stress when grown in a CO2 -enriched environment.

[Uveitis: Study of 109 cases]. / Uveítis: estudio de 109 casos.

PURPOSE: Analyse and describe the anatomical and etiological classification, clinical and epidemiological characteristics and most frequent symptoms of uveitis cases in our population. PATIENTS AND METHOD: Descriptive, retrospective observational study of uveitis cases treated in the Ophthalmology Department of Virgen del Rocío University Hospital in 2021. The demographic and clinical characteristics were studied. RESULTS: A total of 109cases of uveitis were studied, 46 men and 63 women, with a mean age of 45.43±16.11 years. The most frequent symptoms were pain (74.31%), hyperemia (73.39%) and blurred vision (65.14%). The most frequent anatomical classification was anterior (55.96%), followed by panuveitis (18.35%), posterior (12.84%) and intermediate uveitis (7.34%). Regarding etiology, most uveitis were idiopathic (42.99%), followed by non-infectious (38.32%) and finally infectious (18.69%). CONCLUSIONS: In southern España, the characteristics of uveitis are similar to other studies in Western countries.

Use of new technologies for the promotion of physical activity in patients with mental illness: A systematic review.

BACKGROUND: Physical exercise is an underutilized tool for the management of mental disorders. New technologies have made a breakthrough in health care, and one of its possible applications (apps) could be that of customizing exercise programs for special populations, such as patients with mental disorders. However, the app of the so-called e-health to mental health care is still limited. AIM: To know the efficacy of apps to promote physical activity in patients with mental disorders. METHODS: We conducted a systematic review of the PubMed and Embase databases with the aim of exploring the use of new technologies for the enhancement of physical exercise in patients with a psychiatric illness. Following the selection process, 10 articles were included in the review. RESULTS: The most commonly used devices in this type of intervention are wearable devices and web platforms. Good results in terms of effectiveness and acceptability were obtained in most of the studies. CONCLUSION: Our findings suggest that the use of new technologies in mental health represents a feasible strategy with great potential in clinical practice.

Psychotic symptoms associate inversely with social support, social autonomy and psychosocial functioning: A community-based study.

BACKGROUND: Population-based studies exploring psychotic symptoms (PS) show that their prevalence in the community is higher than previously thought. Psychosocial functioning and social support are poorer among people presenting clinical and subclinical PS. AIMS: We aimed to estimate the prevalence rate of PS in Andalusia and to explore the association between PS and psychosocial functioning, social support and social autonomy in a Southern European population. MATERIAL AND METHODS: This is a cross-sectional study. We undertook multi-stage sampling using different standard stratification techniques. Out of 5496 households approached, we interviewed 4507 (83.7%) randomly selected participants living in the autonomous region of Andalusia (Southern Spain). The Spanish version of the MINI International Neuropsychiatric Interview was used to elicit PS. We also gathered information on socio-demographic factors, suicidality risk, psychosocial functioning, social support and social autonomy. RESULTS: The overall prevalence of PS was 6.7% (95% CI: 5.99-6.45). PS were associated with lower age (OR 0.975; 95% CI (0.967-0.983); p < .0001), female gender (OR = 1.346; 95% CI (1.05-1.07) p = .018), not living in a rural area (OR = 0.677; 95% CI (0.50-0.90) p = 0.009), lower social support (OR = 0.898; 95% CI (0.85-0.94) p < .0001), lower scores on social autonomy (OR = 0.889; 95% CI (0.79-1.00) p = .050), having an increased suicidality risk score (OR = 1.038; 95% CI (1.005-1.07); p = .023) and having lower scores on psychosocial functioning (OR = 0.956; 95% CI (0.95-0.96); p < 0.0001). CONCLUSIONS: Social outcomes seem to be strongly inversely associated with PS in spite of presumed higher levels of social support among Southern European cultures.

Obesity and overweight among children and adolescents with bipolar disorder from the general population: A review of the scientific literature and a meta-analysis.

There is substantial evidence of the high prevalence of obesity (OB) and overweight (OW) and their association with increased medical and psychiatric burden among adults with bipolar disorder (BD). However, little is known regarding its prevalence among young people with BD, other than the risk from psychotropic medication, which has been the focus of research in this population. We present a systematic review and meta-analysis of the literature on prevalence and correlates of OB and OW children and adolescents with BD using a different perspective than impact of medication. Four studies met inclusion criteria. The prevalence of OB in children and adolescents with BD was 15% (95% CI 11-20%). We observed a higher prevalence of OB in comparison to the general population. Different studies found significant associations between OB, OW, and BD in young populations including non-Caucasian race, physical abuse, suicide attempts, self-injurious behaviours, psychotropic medication, and psychiatric hospitalizations.

Short-Term Waterlogging in Citrus Rootstocks.

Changes in climate are provoking flooding events that cause waterlogging in the fields. Citrus are mainly cultivated in areas with a high susceptibility to climate change. Therefore, it is vital to explore their responses to these events to anticipate future challenges by means of genetic improvement of the commercial rootstocks. In this experiment, three popular commercial rootstocks, namely 'Cleopatra' (C. reshni Hort. Ex Tanaka), C. macrophylla, and 'Forner Alcaide no. 5' (Citrus reshni Hort. Ex Tanaka × Poncirus trifoliata), were evaluated after being submitted to short-term waterlogging and a period of recovery of 7 days in each case. Photosynthesis rate and stomatal conductance decreased in 'Cleopatra', while in the other two genotypes they were maintained (C. macrophylla) or restored after recovery ('Forner Alcaide no. 5''). Relative water content and chlorophylls also decreased in 'Cleopatra'. This indicates a deeper effect of flooding in 'Cleopatra', which suffered changes during flooding that were also sustained during the recovery phase. This did not occur in the other two rootstocks, since they showed signs of recovery for those parameters that decreased during waterlogging.

Comparison of Four Systems to Test the Tolerance of 'Fortune' Mandarin Tissue Cultured Plants to Alternaria alternata.

Alternaria brown spot is a severe disease that affects leaves and fruits on susceptible mandarin and mandarin-like cultivars, and is produced by Alternaria alternata. Consequently, there is an urge to obtain new cultivars resistant to A. alternata, and mutation breeding together with tissue culture can help shorten the process. However, a protocol for the in vitro selection of resistant citrus genotypes is lacking. In this study, four methods to evaluate the sensitivity to Alternaria of mandarin 'Fortune' explants in in vitro culture were tested. The four tested systems consisted of: (1) the addition of the mycotoxin, produced by A. alternata in 'Fortune', to the propagation culture media, (2) the addition of the A. alternata culture filtrate to the propagation culture media, (3) the application of the mycotoxin to the intact shoot leaves, and (4) the application of the mycotoxin to the previously excised and wounded leaves. After analyzing the results, only the addition of the A. alternata culture filtrate to the culture media and the application of the mycotoxin to the wounded leaves produced symptoms of infection. However, the addition of the fungus culture filtrate to the culture media produced results, which might indicate that, in addition to the mycotoxin, many other unknown elements that can affect the plant growth and behavior could be found in the fungus culture filtrate. Therefore, the application of the toxin to the excised and wounded leaves seems to be the most reliable method to analyze sensitivity to Alternaria of 'Fortune' explants cultured in vitro.

Psychosis and Dandy-Walker syndrome: a case report and review of the literature.

Dandy-Walker syndrome (DWS) is a group of brain malformations which sometimes present with psychotic symptoms. We present the case of a patient diagnosed with Dandy-Walker variant who presented with schizophrenia-like psychosis. A man in his 30s was admitted to an acute psychiatric unit presenting with persecutory delusions, auditory hallucinations and violent behaviour. The MRI performed showed the typical alterations of Dandy-Walker variant: vermian hypoplasia and cystic dilatation of the fourth ventricle. He also suffered from mild intellectual disability. After being treated with olanzapine 10 mg/d for a month, his psychotic symptoms greatly improved and he was discharged. In conclusion, DWS may cause psychosis through a dysfunction in the circuit connecting prefrontal, thalamic and cerebellar areas. The association between these two conditions may contribute to the understanding of the aetiopathogenesis of schizophrenia.

Mutants of Citrus macrophylla rootstock obtained by gamma radiation improve salt resistance through toxic ion exclusion.

Salinity is one of the biggest challenges that need to be faced in crop production. Citrus is highly sensitive to salt stress and obtaining rootstocks with improved resistance to salinity is key for the citrus growing industry. In this study, five mutants of Citrus macrophylla rootstock, obtained through gamma radiation and in vitro pre-selected for their resistance to salinity, were irrigated with a solution containing 100 mM of NaCl. After 8 weeks of exposure, the mutants were evaluated for their performance (growth, visual leaf damage) and chlorophyll, proline, starch, soluble sugars and ion contents to determine their degree of resistance to this salinity level. In the saline conditions assayed, all the mutants showed better performance and less leaf damage than Citrus macrophylla. Our data suggest that this improved resistance to salinity was based on their capacity to accumulate less Na (MM4B and MMN1) or Cl- (MM1A, MM4A and MM3B). Besides having the lowest Cl- content, the mutants MM1A, MM4A and MM3B, had the highest NO3- concentrations in salinity. Furthermore, mutants did not show chlorophyll degradation and showed less leaf damage and acceptable plant growth. Other parameters including proline and soluble sugars, did not prove decisive in the salinity resistance of these genotypes.

In Vitro Plant Evaluation Trial: Reliability Test of Salinity Assays in Citrus Plants.

Salinity is one of the major abiotic stresses affecting crops worldwide, and breeders are urged to evaluate new genotypes to know their degree of tolerance to this selective agent. However, obtaining a number of plants high enough to make the evaluation can prove to be a long and laborious process which could be overcome by using tissue culture techniques. In the present study, the reliability of tissue culture evaluations is called into question through two parallel experiments, in vitro and ex vitro, using Citrus macrophylla and four mutants thereof, previously selected by their different behavior to salinity, as a plant material. Plants were subjected to salinity for 8 weeks in both in vitro (80 mM NaCl) and ex vitro (100 mM NaCl) experiments, and differences with plants grown in control conditions without salt were analyzed. After the experiments, length, leaf damage, shoot dry weight, chlorophylls and ions were measured in both conditions and experiments. As a result, it was demonstrated that tissue culture is a reliable tool to determine whether a genotype is tolerant to salinity or not, since plants of the same genotype responded in a similar way to salinity in both experiments. Henceforth, in vitro evaluations can be employed to test genotypes in a very early stage and using very little time and space. However, genotypes that showed the biggest or lowest changes when cultured in salinity were not always the same in both experiments. Thus, only ex vitro experiments can be performed if the goal is to compare genotypes and see which genotype is the most or least resistant to salinity.

The social return on investment of a new approach to heart failure in the Spanish National Health System.

AIMS: We aim to agree on a set of proposals to improve the current management of heart failure (HF) within the Spanish National Health System (SNHS) and apply the social return on investment (SROI) method to measure the social impact that these proposals would generate. METHODS AND RESULTS: A multidisciplinary working team of 16 experts was set up, with representation from the main stakeholders regarding HF: medical specialists (cardiologists, internal medicine physicians, general practitioners, and geriatric physicians), nursing professionals, health management professionals, patients, and informal caregivers. This team established a set of proposals to improve the management of HF according to the main areas of HF care: emergency and hospitalization, primary care, cardiology, and internal medicine. A forecast-type SROI method, with a 1-year time frame, was applied to measure the social impact resulting from the implementation of these proposals. The required investment and social return were estimated and summarized into a ratio indicating how much social return could be generated for each euro invested. Intangible returns were included and quantified through financial proxies. The approach to improve the management of HF consisted of 28 proposals, including the implementation of a case management nurse network, standardization of operational protocols, psychological support, availability of echocardiography machines at emergency departments, stationary units and primary care, early specialist visits after hospital discharge, and cardiac rehabilitation units, among others. These proposals would benefit not only patients and their informal caregivers but also the SNHS. Regarding patients, proposals would increase their autonomy in everyday activities, decrease anxiety, increase psychological and physical well-being, improve pharmacological adherence and self-care, enhance understanding of the disease, delay disease progression, expedite medical assessment, and prevent the decrease in work productivity associated with HF management. Regarding informal caregivers, proposals would increase their quality of life; improve their social, economic, and emotional well-being; and reduce their care burden. The SNHS would benefit from shorter stays of HF patients at intensive care units and reduction of hospitalizations and admissions to emergency departments. The investment needed to implement these proposals would amount to €548m and yield a social return of €1932m, that is, €3.52 for each euro invested. CONCLUSIONS: The current management of HF could be improved by a set of proposals that resulted in an overall positive social return, varying between areas of analysis. This may guide the allocation of healthcare resources and improve the quality of life of patients with HF.

Inducing mutations in Citrus spp.: Sensitivity of different sources of plant material to gamma radiation.

Gamma radiation represents an alternative for improving genotypes for which breeding through hybridization involves many difficulties because of their complex reproductive biology, as in the case of citrus. In this study in vitro and ex vitro mutagenesis was induced by gamma radiation in several citrus species ('Alemow' and sour orange as citrus rootstocks, lemon cv. 'Fino 49' and 'Verna 51', mandarin cv. 'Nova' and lime cv. 'Bearss'). Three different sources of materials - seeds, budwoods and nodal segments - from in vitro explants, were tested. Seeds and budwoods were germinated or induced to sprout, and de novo regeneration was obtained from in vitro nodal segments from which preexisting buds were previously removed. Budwoods were tested in summer and winter in order to assess their capacity for mutation and further sprouted in different seasons. Seeds were seen to be more resistant to gamma radiation (LD50 of 127 Gy in 'Alemow and 156 Gy in sour orange) than budwoods (LD50 about 50 Gy for all cultivars) and nodal segments (LD50 about 25 Gy for both lemon cultivars), the last being the most sensitive material tested. Similar LD50 were found for budwoods collected in winter and summer for all the genotypes. All the tested plant material can be considered suitable for gamma irradiation, although budwood is the most widely available and tissue culture material needs the highest degree of expertise.

Genetic Transformation in Peach (Prunus persica L.): Challenges and Ways Forward.

Almost 30 years have passed since the first publication reporting regeneration of transformed peach plants. Nevertheless, the general applicability of genetic transformation of this species has not yet been established. Many strategies have been tested in order to obtain an efficient peach transformation system. Despite the amount of time and the efforts invested, the lack of success has significantly limited the utility of peach as a model genetic system for trees, despite its relatively short generation time; small, high-quality genome; and well-studied genetic resources. Additionally, the absence of efficient genetic transformation protocols precludes the application of many biotechnological tools in peach breeding programs. In this review, we provide an overview of research on regeneration and genetic transformation in this species and summarize novel strategies and procedures aimed at producing transgenic peaches. Promising future approaches to develop a robust peach transformation system are discussed, focusing on the main bottlenecks to success including the low efficiency of A. tumefaciens-mediated transformation, the low level of correspondence between cells competent for transformation and those that have regenerative competence, and the high rate of chimerism in the few shoots that are produced following transformation.