Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study protocol.

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, https://www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5000 richly phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.

A comparative study among catalytic wet air oxidation, Fenton, and Photo-Fenton technologies for the on-site treatment of hospital wastewater.

The feasibility of catalytic wet air oxidation, intensified homogeneous Fenton and heterogeneous Photo-Fenton systems for the treatment of real hospital wastewater has been investigated. Wastewater samples were collected from a hospital sewer, during a weekly monitoring program, and fully characterized. Up to seventy-nine pharmaceuticals, including mostly parent compounds and some of their transformation products, were analyzed. Catalytic wet air oxidation allowed the complete removal of several pharmaceutical groups, but it did not allow to eliminate analgesics/anti-inflammatories and antibiotics, whose average removal was around 85%. Intensified Fenton oxidation was the most efficient process for all the drugs removal with an almost complete reduction of the initial pharmaceutical load (99.8%). The heterogeneous Photo-Fenton system reached a 94.5% reduction of the initial pharmaceutical load. The environmental risk of the treated samples by the hazard quotient (HQ) method was also evaluated. Fenton oxidation was the most effective system with a final ∑HQ of 5.4. Catalytic wet air oxidation and Photo-Fenton systems achieved total ∑HQ values of 895 and 88, respectively. This fact was related to the presence of refractory antibiotics in the treated catalytic wet air oxidation samples. On the opposite, the Photo-Fenton system provided the elimination of most pharmaceutical pollutants that pose a high environmental risk such as antibiotics. Simplified cost estimation was finally performed as a preliminary approach of the economy of the three oxidation processes for the hospital wastewater treatment.

Predicting Deprotonation Sites Using Alchemical Derivatives.

An alchemical transformation is any process, physical or fictitious, that connects two points in the chemical space. A particularly important transformation is the vanishing of a proton, whose energy can be linked to the proton dissociation enthalpy of acids. In this work we assess the reliability of alchemical derivatives in predicting the proton dissociation enthalpy of a diverse series of mono- and polyprotic molecules. Alchemical derivatives perform remarkably well in ranking the proton affinity of all molecules. Additionally, alchemical derivatives could be use also as a predictive tool because their predictions correlate quite well with calculations based on energy differences and experimental values. Although second-order alchemical derivatives underestimate the dissociation enthalpy, the deviation seems to be almost constant. This makes alchemical derivatives extremely accurate to evaluate the difference in proton affinity between two acid sites of polyprotic molecule. Finally, we show that the reason for the underestimation of the dissociation enthalpy is most likely the contribution of higher-order derivatives.

How predictive could alchemical derivatives be?

The chemical space contains all possible compounds that can be imagined. Its size easily equals the number of fundamental particles in the observable universe. Rational design of compounds aims to find those sectors of the chemical space where compounds optimize a set of desired properties. Then, rational design demands tools to efficiently navigate the chemical space. Ab initio alchemical derivatives offer the possibility to navigate, without empiricism, the energy landscape through alchemical transformations. An alchemical transformation is any process, physical or fictitious, that connects to points in the chemical space. In this work, those transformations are constructed as a perturbative expansion of the energy with respect to perturbations in the stoichiometry. The response functions of that expansion are what is called alchemical derivatives. In this work we assess how effective alchemical derivatives are in predicting energy changes associated to changes in the composition. We do this by including in the expansion, for the first time, electrostatic, polarization and electron-transfer effects. The system we chose is one that challenges alchemical derivatives because none of these effects dominates its behavior. The transmutations studied here correspond to substitutional doping of Al13 with up to four atoms of Si, Al13-nSin. Two types of transformations are considered, those in which the number of electrons remains constant and those in which the number of electrons also changes. It is found that contrary to what has been reported before, polarization cannot be neglected. If polarization is not included, alchemical derivatives fail to predict the change of energy and the relative energy between isomers. For isoelectronic substitution of four or more atoms, the perturbative approach collapses because the strength of the perturbation becomes too strong to guarantee convergence of the series. It is shown, however, that if only one atom is mutated at a time, alchemical derivatives rank pretty well the isomers of Al13-nSin according to their energy. In the case of non-isoelectronic transformations, it is observed that the series rapidly diverges with increasing number of electrons. In this situation, it becomes more important to keep the degree of transmutation of the parent system small.

Nanoscale Fe/Ag particles activated persulfate: optimization using response surface methodology.

This work studied the bimetallic nanoparticles Fe-Ag (nZVI-Ag) activated persulfate (PS) in aqueous solution using response surface methodology. The Box-Behnken design (BBD) was employed to optimize three parameters (nZVI-Ag dose, reaction temperature, and PS concentration) using 4-chlorophenol (4-CP) as the target pollutant. The synthesis of nZVI-Ag particles was carried out through a reduction of FeCl2 with NaBH4 followed by reductive deposition of Ag. The catalyst was characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM) and Brunauer-Emmett-Teller (BET) surface area. The BBD was considered a satisfactory model to optimize the process. Confirmatory tests were carried out using predicted and experimental values under the optimal conditions (50 mg L-1 nZVI-Ag, 21 mM PS at 57 °C) and the complete removal of 4-CP achieved experimentally was successfully predicted by the model, whereas the mineralization degree predicted (90%) was slightly overestimated against the measured data (83%).

Accelerating Oxygen-Reduction Catalysts through Preventing Poisoning with Non-Reactive Species by Using Hydrophobic Ionic Liquids.

Developing cost-effective electrocatalysts for the oxygen reduction reaction (ORR) is a prerequisite for broad market penetration of low-temperature fuel cells. A major barrier stems from the poisoning of surface sites by nonreactive oxygenated species and the sluggish ORR kinetics on the Pt catalysts. Herein we report a facile approach to accelerating ORR kinetics by using a hydrophobic ionic liquid (IL), which protects Pt sites from surface oxidation, making the IL-modified Pt intrinsically more active than its unmodified counterpart. The mass activity of the catalyst is increased by three times to 1.01 A mg(-1) Pt @0.9 V, representing a new record for pure Pt catalysts. The enhanced performance of the IL-modified catalyst can be stabilized after 30 000 cycles. We anticipate these results will form the basis for an unprecedented perspective in the development of high-performing electrocatalysts for fuel-cell applications.

Natural magnetite as an effective and long-lasting catalyst for CWPO of azole pesticides in a continuous up-flow fixed-bed reactor.

The global occurrence of micropollutants in water bodies has raised concerns about potential negative effects on aquatic ecosystems and human health. EU regulations to mitigate such widespread pollution have already been implemented and are expected to become increasingly stringent in the next few years. Catalytic wet peroxide oxidation (CWPO) has proved to be a promising alternative for micropollutant removal from water, but most studies were performed in batch mode, often involving complex, expensive, and hardly recoverable catalysts, that are prone to deactivation. This work aims to demonstrate the feasibility of a fixed-bed reactor (FBR) packed with natural magnetite powder for the removal of a representative mixture of azole pesticides, recently listed in the EU Watch Lists. The performance of the system was evaluated by analyzing the impact of H2O2 dose (3.6-13.4 mg L-1), magnetite load (2-8 g), inlet flow rate (0.25-1 mL min-1), and initial micropollutant concentration (100-1000 µg L-1) over 300 h of continuous operation. Azole pesticide conversion values above 80% were achieved under selected operating conditions (WFe3O4 = 8 g, [H2O2]0 = 6.7 mg L-1, flow rate = 0.5 mL min-1, pH0 = 5, T = 25 °C). Notably, the catalytic system showed a high stability upon 500 h in operation, with limited iron leaching (< 0.1 mg L-1). As a proof of concept, the feasibility of the system was confirmed using a real wastewater treatment plant (WWTP) effluent spiked with the mixture of azole pesticides. These results represent a clear advance for the application of CWPO as a tertiary treatment in WWTPs and open the door for the scale-up of FBR packed with natural magnetite.

Reusable adsorbent of magnetite in mesoporous carbon for antibiotic removal.

This study aims to evaluate the feasibility of an innovative reusable adsorbent through adsorption-degradation sequence for antibiotic removal from water. The magnetite/mesoporous carbon adsorbent was prepared using a two-step method of (i) in situ impregnation of magnetite precursor during resorcinol formaldehyde polymerization and (ii) pyrolysis at elevated temperature (800 °C). XRD spectra confirmed that magnetite (Fe3O4) was the only iron oxide species present in the adsorbent, and thermogravimetric analysis revealed that its content was 10 wt%. Nitrogen sorption analysis showed that Fe3O4/carbon features a high fraction of mesopores (> 80 vol.%) and a remarkable specific surface area value (246 m2 g-1), outstanding properties for water treatment. The performance of the adsorbent was examined in the uptake of three relevant antibiotics. The maximum adsorption uptakes were ca. 76 mg g-1, ca. 70 mg g-1, and ca. 44 mg g-1 for metronidazole, sulfamethoxazole, and ciprofloxacin, respectively. All adsorption curves were successfully fitted with Langmuir equilibrium model. The regeneration of adsorbent was carried out using Fenton oxidation under ambient conditions. After three consecutive runs of adsorption-regeneration, Fe3O4/carbon maintained its performance almost unchanged (up to 95% of its adsorption capacity), which highlights the high reusability of the adsorbent.

[Features of acute myocardial infarction among aged patients]. / Infarto agudo al miocardio en el adulto mayor: características clínicas, evolución hospitalaria y a 5 años plazo.

BACKGROUND: Among aged patients, acute myocardial infarction has more complications and there is a tendency to underuse proven treatments. AIM: To report the features of acute myocardial infarction among aged patients. MATERIAL AND METHODS: Analysis of a registry of patients with acute myocardial infarction admitted to a coronary unit. For the purposes of analysis, patients aged 65 years or more were selected. Follow up was made consulting medical records, calling patients by telephone or consulting death records at the National Identification Service. RESULTS: A total of 1.358 patients were admitted in the study period with a diagnosis of acute myocardial infarction and 580 (43%) were aged 65 years or more. On admission, this age group had a higher frequency of hemodynamic instability and anterior wall infarctions. Reperfusion therapy and beta blockers were used less commonly in this group. Hospital mortality among patients younger or older than 65 year was 8 and 25%, respectively (p < 0.01). Among aged patients, five years mortality was 33%. CONCLUSIONS: Among aged patients, acute myocardial infarction has a higher risk profile on admission, is usually undertreated and has higher mortality than younger subjects.

Photo-Fenton oxidation of cylindrospermopsin at neutral pH with LEDs.

Cylindrospermopsin (CYN) is a potent cyanobacterial toxin found in freshwaters worldwide. In this work, the feasibility of the photo-Fenton process under neutral pH using light emitting diodes as irradiation source for the removal of this hazardous cyanotoxin from freshwater was investigated. The impact of the kind of iron chelating agent (ethylenediamine-N, N'-disuccinic acid vs. ethylenedinitrilotetraacetic acid) as well as the effect of the main operating conditions viz. H2O2 dose, Fe(III) load, initial CYN concentration, and Fe(III):EDDS molar ratio on the performance of the process was systematically evaluated. EDDS was selected as the most appropriate iron chelating agent considering the kinetics of the process and the environmental impact (Vibrio fischeri and Artemia salina). Under optimized conditions ([H2O2] = 30 mg L-1; [Fe(III)] = 5 mg L-1; Fe(III):ligand = 1:0.5 (molar ratio)), complete removal of CYN was achieved in 15-min reaction time. Furthermore, the catalytic system showed to be effective in real water matrices (river and reservoir waters) spiked with CYN. Although the presence of inorganic ions (mainly HCO3-/CO32-) and dissolved organic carbon decreased the oxidation rate of CYN due to scavenging reactions and iron coordination, respectively, complete elimination of the cyanotoxin was achieved in all cases. The fate of EDDS along the process was also evaluated to demonstrate that the catalytic system investigated, apart from its effectiveness, warrants the complete absence of residues after reaction. Therefore, the proposed system constitutes a promising method for cyanotoxin treatment either as a drinking water treatment step in conventional plants or as a potential remediation strategy in the natural environment.

The importance of the Andes in the evolutionary radiation of Sigmodontinae (Rodentia, Cricetidae), the most diverse group of mammals in the Neotropics.

The Andean mountains stand out for their striking species richness and endemicity that characterize many emblematic Neotropical clades distributed in or around these mountains. The radiation of the Sigmodontinae subfamily, the most diversified mammalian group in the Neotropics, has been historically related to Andean orogenesis. We aim to evaluate this interplay between geological processes and biological responses through the diversification dynamics, the biogeographical history, and the range evolution of the subfamily. For these, we built the most comprehensive phylogeny and gathered 14,836 occurrences for the subfamily. We identified one shift in the speciation rate in the genus Akodon, which suffered their Andean radiation after the arrival of non-Andean ancestors. Our biogeographic analyses show multiple dispersal paths throughout the evolution that allowed this subfamily to colonize all Neotropics. The Northern Andes and Central-Southern Andes were the most important sources of diversity. In addition, the Central-Southern Andes were the most relevant sink, receiving the highest number of lineages. The Andean region exhibited higher speciation and turnover rates than non-Andean regions. Thus, our results support the crucial role of the Andean Mountains in the Sigmodontinae radiation, acting as a "macroevolutionary cradle" and "species attractor" for several sigmodontine lineages at different times, and as a "species pump" becoming the biogeographic source of multiple widely distributed neotropical lineages. Then, complex macroevolutionary dynamics would explain these rodents' high extant Andean diversity and their wide distribution in the Neotropics.

Latin American Trans-ancestry INitiative for OCD genomics (LATINO): Study Protocol.

Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder. Worldwide, its prevalence is ~2% and its etiology is mostly unknown. Identifying biological factors contributing to OCD will elucidate underlying mechanisms and might contribute to improved treatment outcomes. Genomic studies of OCD are beginning to reveal long-sought risk loci, but >95% of the cases currently in analysis are of homogenous European ancestry. If not addressed, this Eurocentric bias will result in OCD genomic findings being more accurate for individuals of European ancestry than other ancestries, thereby contributing to health disparities in potential future applications of genomics. In this study protocol paper, we describe the Latin American Trans-ancestry INitiative for OCD genomics (LATINO, www.latinostudy.org). LATINO is a new network of investigators from across Latin America, the United States, and Canada who have begun to collect DNA and clinical data from 5,000 richly-phenotyped OCD cases of Latin American ancestry in a culturally sensitive and ethical manner. In this project, we will utilize trans-ancestry genomic analyses to accelerate the identification of OCD risk loci, fine-map putative causal variants, and improve the performance of polygenic risk scores in diverse populations. We will also capitalize on rich clinical data to examine the genetics of treatment response, biologically plausible OCD subtypes, and symptom dimensions. Additionally, LATINO will help elucidate the diversity of the clinical presentations of OCD across cultures through various trainings developed and offered in collaboration with Latin American investigators. We believe this study will advance the important goal of global mental health discovery and equity.

A new isomer of C20 and a way to a new C240.

Here we show that the dynamic simulation of a molecular collision can give insight into new molecular species. In this way, a new stable isomer of C(20) (IV) has been found. It is planar with pentagonal form. This isomer is high in energy compared to the three most stable previously known isomers of C(20): cage (I), bowl (II) and ring (III). Most interestingly, we show that using this new isomer it is possible to construct a macrobucky C(240) (V) that is also stable. The electronic structure of this new isomer of C(240) is very different from properties of the C(240) fullerene. Contrary to the C(240) fullerene, in the new isomer the π electrons are localized.

[Primary angioplasty for acute myocardial infarction with an anomalous origin of right coronary artery: report of one case]. / Angioplastía primaria en infarto agudo al miocardio en arteria coronaria derecha con origen anómalo: caso clínico.

Anomalous origin of coronary arteries is a rare anatomical defect and its association with acute myocardial infarction is unusual. We report a 58-year-old male with ST-Segment elevation. Myocardial infarction of the inferior wall caused by a total occlusion on the proximal third of an anomalous right coronary artery, that was effectively treated with primary angioplasty with stent placement. The patient had a favorable outcome and is asymptomatic after five years of follow up.

Insights into the degradation of microplastics by Fenton oxidation: From surface modification to mineralization.

This work aims at evaluating the fate of microplastics (MPs) along Fenton oxidation. For such goal, realistic MPs (150-250 µm) of five representative polymer types (PET, PE, PVC, PP and EPS) were obtained from commercial plastic products by cryogenic milling. Experiments (7.5 h) were performed under relatively severe operating conditions: T = 80 °C; pH0 = 3; [H2O2]0 = 1000 mgL-1 (15 doses, 1 every 0.5 h); [Fe3+]0 = 10 mgL-1 (5 doses, 1 every 1.5 h). Slight MPs weight losses (∼10%) were achieved after Fenton oxidation regardless the MP nature. Nevertheless, oxidation yield clearly increased with decreasing the particle size given their higher exposed surface area (up to 20% weight loss with 20-50 µm EPS MPs). Clearly, MPs suffered important changes in their surface due to the introduction of oxygenated groups, which made them more acidic and hydrophilic. Furthermore, MPs progressively reduced their size. In fact, they can be completely oxidized to CO2, as demonstrated in the oxidation of PS nanoplastics (140 nm), where 70% mineralization was achieved. The nature of the plastic particles had a relevant impact on its overall oxidation, being more prone to be oxidized those polymers which contain aromatic rings in their structures (EPS and PET) compared to those formed by alkane chains (PE, PP and PVC). In the latter, the presence of substituents also reduced their oxidation potential. Remarkably, possible leachates released along reaction were more quickly oxidized than the MPs/NPs, so it can be assumed that these dissolved compounds would be completely removed once the solid particles are eliminated. Notably, the leachates obtained upon MPs oxidation were more biodegradable than the released from the fresh solids. All this knowledge is crucial for the understanding of MPs oxidation by the Fenton process and opens the door for the design and optimization of this technology either for water treatment or for analytical purposes (MPs isolation).

[Angioplasty compared to thrombolysis as the initial reperfusion therapy in acute myocardial infarction]. / Terapia de reperfusión en infarto agudo al miocardio: Comparación entre trombolisis endovenosa y angioplastía coronaria.

BACKGROUND: Primary angioplasty is superior to intravenous thrombolysis as reperfusion therapy for acute myocardial infarction. AIM: To compare the results of available reperfusion strategies for initial management of acute myocardial infarction during hospitalization and 5 years follow up. PATIENTS AND METHODS: Historical cohort study from a prospective registry of patients admitted with acute myocardial infarction to our center. Patients treated with primary angioplasty were identified and were then matched by age, sex and date of event with patients treated with throm-bolysis. The clinical outcomes were compared including hospitalization and 5-years follow-up. RESULTS: From March 1993 to August 2001, 98 patients were treated with primary angioplasty and matched with 98 thrombolyzed patients. The groups were comparable. Compared to thrombolysis, angioplasty had a higher success rate (68 and 91% respectively), resulted in less complications and reduced mortality (11 and 2% respectively), required less revascularization procedures and shorter hospital stay (17 and 13 days, respectively). During the follow-up of survivors, no differences in events or additional mortality were detected at 1 or 5 years. CONCLUSIONS: Primary angioplasty is superior as treatment in terms of achieving success and reducing mortality during hospitalization. Evolution after hospitalization is independent of initial therapy.

[Sub capsular splenic hematoma in a sickle cell trait carrier. Case report]. / Hematoma subcapsular esplénico en paciente portador de rasgo falciforme.

Drepanocytic anemia is an uncommon hereditary disease in Chile. The heterozygous state of drepanocytic anemia or "sickle trait" has a frequency of 8% among Afro-Americans. A small number of patients carrying hemoglobin S are homozygous, with clinical manifestations of hemolytic anemia and thrombotic disease. Sickle trait is usually asymptomatic. We report a 59-year-old male who presented an acute abdominal pain and dyspnea while staying at high altitude. Six days later, an angio CAT scan showed the presence of a subcapsular splenic hematoma that was managed conservatively. Sickle cell induction with sodium metabisulphite was positive. Hemoglobin electrophoresis confirmed the sickle trait.

Adsorption of micropollutants onto realistic microplastics: Role of microplastic nature, size, age, and NOM fouling.

This work aims at evaluating the role of nature, size, age, and natural organic matter (NOM) fouling of realistic microplastics (MPs) on the adsorption of two persistent micropollutants (diclofenac (DCF) and metronidazole (MNZ)). For such goal, four representative polymer types (polystyrene (PS), polyethylene terephthalate (PET), polypropylene (PP) and high-density polyethylene (HDPE)) were tested. MPs were obtained by cryogenic milling of different commercial materials (disposable bottles, containers, and trays), and fully characterized (optical microscopic and SEM images, FTIR, elemental analysis, water contact angle and pHslurry). The micropollutants hydrophobicity determined to a high extent their removal yield from water. Regardless of the MP's nature, the adsorption capacity for DCF was considerably higher than the achieved for MNZ, which can be related to its stronger hydrophobic properties and aromatic character. In fact, aromatic MPs (PS and PET) showed the highest adsorption capacity values with DCF (~100 µg g-1). The MP size also played a key role on its adsorption capacity, which was found to increase with decreasing the particle size (20-1000 µm). MPs aging (simulated by Fenton oxidation) led also to substantial changes on their sorption behavior. Oxidized MPs exhibited acidic surface properties which led to a strong decrease on the adsorption of the hydrophobic micropollutant (DCF) but to an increase with the hydrophilic one (MNZ). NOM fouling (WWTP effluent, river water, humic acid solution) led to a dramatic decrease on the MPs sorption capacity due to sorption sites blocking. Finally, the increase of pH or salinity of the aqueous medium increased the micropollutants desorption.

Overview of toxic cyanobacteria and cyanotoxins in Ibero-American freshwaters: Challenges for risk management and opportunities for removal by advanced technologies.

The increasing occurrence of cyanobacterial blooms worldwide represents an important threat for both the environment and public health. In this context, the development of risk analysis and management tools as well as sustainable and cost-effective treatment processes is essential. The research project TALGENTOX, funded by the Ibero-American Science and Technology Program for Development (CYTED-2019), aims to address this ambitious challenge in countries with different environmental and social conditions within the Ibero-American context. It is based on a multidisciplinary approach that combines ecology, water management and technology fields, and includes research groups from Chile, Colombia, Mexico, Peru and Spain. In this review, the occurrence of toxic cyanobacteria and cyanotoxins in freshwaters from these countries are summarized. The presence of cyanotoxins has been confirmed in all countries but the information is still scarce and further monitoring is required. In this regard, remote sensing or metagenomics are good alternatives at reasonable cost. The risk management of freshwaters from those countries considering the most frequent uses (consumption and recreation) has been also evaluated. Only Spain and Peru include cyanotoxins in its drinking water legislation (only MC-LR) and thus, there is a need for regulatory improvements. The development of preventive strategies like diminishing nutrient loads to aquatic systems is also required. In the same line, corrective measures are urgently needed especially in drinking waters. Advanced Oxidation Processes (AOPs) have the potential to play a major role in this scenario as they are effective for the elimination of most cyanotoxins classes. The research on the field of AOPs is herein summarized considering the cost-effectiveness, environmental character and technical applicability of such technologies. Fenton-based processes and photocatalysis using solar irradiation or LED light represent very promising alternatives given their high cost-efficiency. Further research should focus on developing stable long-term operation systems, addressing their scale-up.

[A vacuum assisted closure system in complex wounds: a retrospective study]. / Sistema de cierre asistido por vacío en heridas complejas. Estudio retrospectivo.

INTRODUCTION: Vacuum-assisted closure (VAC) therapy is a dynamic and non-invasive system for improving wound healing. This novel therapy is based on applying air suction at a controlled sub-atmospheric pressure. The most important benefits of this therapy include, a reduction in the wound area together with induction of new granulation tissue formation, effective wound cleansing (removal of small tissue by suction), and the continuous removal of wound exudate. The aim of this study was to describe our experience with VAC therapy for complex wounds. MATERIAL AND METHOD: We retrospectively evaluated our experience with VAC therapy between April 2007 and August 2008. We employed a "suprafascial" VAC system and an open abdomen VAC system. Descriptive statistical techniques were applied and percentages and means were calculated. RESULTS: VAC therapy was applied in 20 patients, of whom 16(80%) had abdominal complex wounds, and 4(20%) in other locations. We employed a "suprafascial" VAC system in 17 patients (85%) and an "intra-abdominal" VAC system in 3 patients (15%). Two patients (10%) developed fistula during "intra-abdominal" VAC therapy (urinary and enteric) but the closure was achieved before therapy was finished. Mean hospital stay was 38.3 days (7-136). No mortality was directly due to the VAC system. Two patients (10%) died due to their septic condition and the rest are still alive. Mean therapy length was 29.17 days (1-77) in the "suprafascial" group and 18 days (7-49) in the "intra-abdominal" group. Average costs were 3197.97 euro (119.1-10780.25) per patient. CONCLUSIONS: VAC therapy can improve and accelerate abdominal wound healing also in the presence of infection and bowel fistula.