Degradation kinetics of sugars (glucose and xylose), amino acids (proline and aspartic acid) and their binary mixtures in subcritical water: Effect of Maillard reaction.

A systematic kinetic study was conducted in subcritical water medium in the temperature range from 150 to 200 °C for pure glucose, xylose, proline and aspartic acid as well as binary mixtures of sugars + amino acids to understand the reaction kinetics and interactions among biomass components and to discern the influence of Maillard reaction (MR) on the overall reaction kinetics. The main degradation products identified for glucose and xylose were the respective dehydration products, hydroxymethyl furfural and furfural, yielding an increasing solid residue with temperature (15.9 wt% at 200 °C) with an augmented heating value. The degradation of sugars and amino acids in binary systems was faster compared to pure compounds due to MR and the production of dehydration products was delayed when considering total sugar conversion. Higher relative reactivity in MR was observed for xylose over glucose showing also higher antioxidant activity.

Presiones de la vía biliar en pacientes con y sin colelitiasis

Introducción: El reflujo de enzimas pancreáticas hacia la vía biliar extra-hepática y la vesícula biliar es un fenómeno anormal que tiene un rol en la litogénesis y carcinogénesis. Debido a que la presión de la vía biliar depende entre otros factores, de las presiones del esfínter de Oddi. La disfunción de éste se vería reflejada en presiones elevadas de la vía biliar en pacientes con colelitiasis. Objetivo: El objetivo de este estudio es el de medir las presiones de la vía biliar extra-hepática en pacientes con y sin colelitiasis y relacionarlas con la presencia de reflujo pancreáticobiliar. Material y Método: Se diseñó un estudio pros-pectivo de casos y controles. La muestra está constituida por todos los pacientes operados con gastrectomía total por cáncer gástrico estadios I y II durante 30 meses. La medida de resultado primaria fue establecer diferencias en las presiones de la vía biliar entre pacientes con y sin colelitiasis. Resultados: Las presiones de la vía biliar extra-hepática en pacientes con colelitiasis fueron más elevadas (16,9 mmHg) que en los pacientes sin colelitiasis (3,3 mmHg) (p < 0,0001). Estas presiones se correlacionan con la presencia de amilasa y lipasa en la bilis de la vesícula; se encontraron niveles elevados de enzimas pancreáticas en pacientes con colelitiasis (p < 0,0001). Conclusiones: Las presiones de la vía biliar en pacientes con colelitiasis fueron, significativamente, mayores comparadas con las presiones de la vía biliar en pacientes sin colelitiasis. En los pacientes con colelitiasis, la presión elevada de la vía biliar se asocia a la presencia de reflujo pancreáticobiliar.

Background: The reflux of pancreatic enzymes into the bile duct and the gallbladder is an abnormal phenomenon that plays a role in lithogenesis and carcinogenesis. Because the pressure of the common bile duct depends on the pressures of the sphincter of Oddi, its dysfunction would be reflected in an increase in the pressure of the common bile duct in patients with cholelithiasis. Aim: The objective of this study was to measure the pressures of the common bile duct in patients with and without cholelithiasis and to relate them to the presence of pancreatobiliary reflux. Material and Method: A prospective case-control study was designed. The universe was constituted by all patients undergoing total gastrectomy for gastric cancer stages I and II during 30 months. The primary outcome measure was to establish differences between common bile duct pressures in patients with and without cholelithiasis. Results: Common bile duct pressures in patients with gallstones showed a significant elevation (16.9 mmHg) compared to patients without gallstones (3.3 mm Hg) (p < 0.0001). These pressures correlated with the levels of amylase and lipase in gallbladder bile; higher levels were found in patients with gallstones compared to patients without gallstones (p < 0.0001). Conclusions: Common bile duct pressure in patients with cholelithiasis was significantly higher compared to patients without cholelithiasis leading to pancreatobiliary reflux.

Treatment of hereditary amyotrophic lateral sclerosis.

Currently, only four molecules can be prescribed for amyotrophic lateral sclerosis (ALS), of which only one is approved worldwide for this indication, riluzole. Although progress in the therapeutic field remains unsatisfactory, we have to notice that genetics have undergone impressive improvements over the last three decades and, by extension, our knowledge of ALS cases linked to a pathogenic mutation that accounts for 10% of all cases (either sporadic or familiar) and is currently called hereditary ALS (hALS). In many neurological diseases treatment targeting pathogenic genes have significatively improved the natural profile of the disease: this is perfectly illustrated for familial amyloid neuropathy and spinal muscular atrophy. Because of these findings and the urgent need to find a cure for ALS, many trials have focused on familial ALS targeting the four most important genes linked to the disease: C9orf72, SOD1, TARDBP and FUS. We propose in this review an update on the perspectives of treatment that may be available in mid-term in hALS and will discuss in the last part the potential consequences for asymptomatic relatives of patients with a hALS and for ALS patients.

Therapeutic news in ALS.

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by death of motor neurons in the cortex and the spinal cord. This loss of motor neurons causes progressive weakness and amyotrophy. To date, the median duration of survival in patients with ALS, from first symptoms to death, is estimated to be 36 months. Currently the treatment is limited to two options: riluzole which prolongs survival for a few months and edaravone which is available in only a few countries and also has a small impact on disease progression. There is an urgent need for more effective drugs in this disease to significantly improve progression. Over the last 30 years, all trials have failed to find a curative drug for ALS. This is due, partially, to the heterogeneity of the clinical features and the pathophysiology of motor neuron death. We present in this review the various treatment options currently being developed for ALS, with an emphasis on the range of therapeutic approaches being explored, from old drugs tested in a new indication to innovative drugs obtained via biotechnology or gene therapy.

Subcritical water as hydrolytic medium to recover and fractionate the protein fraction and phenolic compounds from craft brewer's spent grain.

The valorization of the brewer's spent grain (BSG) generated in a craft beer industry was studied by subcritical water hydrolysis in a semi-continuous fixed-bed reactor. Temperature was varied from 125 to 185 °C at a constant flow rate of 4 mL/min. Biomass hydrolysis yielded a maximum of 78% of solubilized protein at 185 °C. Free amino acids presented a maximum level at 160 °C with a value of 55 mg free amino acids/gprotein-BSG. Polar amino acid presented a maximum at lower temperatures than non-polar amino acids. The maximum in total phenolic compounds was reached at 185 °C. This maximum is the same for aldehyde phenolic compounds such as vanillin, syringic and protocatechuic aldehyde; however, for hydroxycinnamic acids, such as ferulic acid and p-coumaric, the maximum was obtained at 160 °C. This allows a fractionation of the bioactive compounds. Subcritical water addresses opportunities for small breweries to be incorporated within the biorefinery concept.

Loperamide exerts a direct bactericidal effect against M. tuberculosis, M. bovis, M. terrae and M. smegmatis.

Tuberculosis (TB) is caused by Mycobacterium tuberculosis. TB is highly prevalent, characterized by the constant occurrence of drug-resistant cases, and confounded by the incidence of respiratory disease caused by non-tuberculous mycobacteria (NTB). Expanding the spectrum of drugs for the treatment of TB is indispensable. Loperamide, an antidiarrhoeal drug, enhances immune-driven antimycobacterial activity, and we aimed to evaluate its bactericidal activity against M. tuberculosis, Mycobacterium bovis BCG, Mycobacterium terrae and Mycobacterium smegmatis. Loperamide exhibited an inhibitory effect against all mycobacterial species tested, with MICs of 100 and 150 µg ml-1 . Thus, loperamide is a mycobactericidal drug with potential as adjunctive therapy for TB and NTB infections.

The multiple faces of encephalitis: Antibody profile in a case series of autoimmune encephalitis in Bogotá, Colombia.

There is a lack of population based studies of autoimmune encephalitis (AE) in Latin American countries, especially in Colombia. The aim of this study is to characterize patients with AE managed in three centers in Bogotá-Colombia, emphasizing on antibody profile. We conducted a retrospective case-series study, including 9 patients. The most prevalent antibody found was NMDAR, followed by LGI1. Some distinguishing features included: faciobrachial dystonia and hyponatremia in LGI1, a younger age and good outcome in NMDAR, a notable response to steroids in anti TPO-Thyroglobulin, a cerebellar syndrome associated with Anti-Yo, and epilepsy with insomnia in CASPR2.

Successful treatment of intractable epilepsy with ketogenic diet therapy in twins with ALG3-CDG.

BACKGROUND: Congenital disorders of glycosylation (CDG) is a heterogeneous group of congenital metabolic diseases with multisystem clinical involvement. ALG3-CDG is a very rare subtype with only 24 cases reported so far. CASE: Here, we report two siblings with dysmorphic features, growth retardation, microcephaly, intractable epilepsy, and hemangioma in the frontal, occipital and lumbosacral regions. RESULTS: We studied two siblings by whole exome sequencing. A pathogenic variant in ALG3 (NM_005787.6: c.165C > T; p.Gly55=) that had been previously associated with congenital glycolysis defect type 1d was identified. Their intractable seizures were controlled by ketogenic diet. CONCLUSION: Although prominent findings of growth retardation and microcephaly seen in our patients have been extensively reported before, presence of hemangioma is a novel finding that may be used as an indication for ALG3-CDG diagnosis. Our patients are the first reported cases whose intractable seizures were controlled with ketogenic diet. This report adds ketogenic diet as an option for treatment of intractable epilepsy in ALG3-CDG.

Advances in disease-modifying pharmacotherapies for the treatment of amyotrophic lateral sclerosis.

INTRODUCTION: To date, riluzole and edaravone are the only two drugs that have successfully passed clinical trials for the treatment of Amyotrophic Lateral Sclerosis (ALS). Unfortunately, both drugs exhibit very modest effects. Most other drugs have failed at phase III to show significant effects in phase III when tested in larger cohorts. This pattern necessitates improvements in the approach to ALS pharmacotherapy. AREAS COVERED: The authors discuss the two approved drugs, as well as several examples of drug candidates whose clinical trials did not demonstrate efficacy in phase III. Post-hoc analyses reveal that future clinical trials should include disease-staging procedures, longer-term trials to correctly assess survival, genetic studies of participants to aid in stratification, and more similarity between the protocols on preclinical models and clinical trials. Finally, they discuss the trials in process that demonstrate some of these suggestions and improvements. EXPERT OPINION: The approval of riluzole and edaravone was essentially a desperate attempt to provide urgent pharmacotherapy to the ALS community. To evolve toward more efficient therapies, we must conduct clinical trials with optimal stratification based on rapid/slow progressors and cognitive decline. Pharmaco-metabolomics should allow for the identification of biomarkers that are adapted for a given drug.

Microencapsulation of rice bran oil using pea protein and maltodextrin mixtures as wall material.

In this work, the encapsulation of rice bran oil extracted using supercritical CO2 has been studied. In the first stage, the emulsification process by high pressure homogenization was studied and optimized. The effect of the working pressure (60-150 MPa), the composition of the carrier (mixtures of pea protein isolate (PPI) and maltodextrin (MD), from 50 to 90% of PPI) and the carrier to oil ratio (2-4) on the emulsion droplet size (EDS) was studied. To minimize the EDS, moderate pressures (114 MPa), a carrier composed mainly by PPI (64%) and carrier to oil ratios around 3.2 were required. The emulsion obtained in the optimal conditions (EDS = 189 ± 3nm) was dried using different technologies (spray-drying, PGSS-drying and freeze drying). The supercritical CO2 based drying process (PGSS) provided spherical particles that resulted in the smallest average size (but broader distribution) and lower encapsulation efficiency (53 ± 2%).

Hernia incisional en laparotomía de McBurney: complicaciones de una hernia inusual / Incisional hernia after McBurney incision: complications of an unusual hernia

Resumen Introducción Actualmente, la mayoría de las series que hablan sobre hernia incisional, no mencionan hernias incisionales en laparotomías de McBurney. La incidencia reportada de hernia incisional en esta laparotomía varía entre 0,7% y 2%. Aún más escasas son las publicaciones sobre sus complicaciones. El objetivo del presente reporte de casos es el de discutir el diagnóstico, tratamiento y resultados de dos pacientes operados en nuestra institución por hernia de McBurney complicada. Reporte de Casos: Se describen 2 pacientes femeninos de 68 y 65 años de edad que fueron operadas de urgencia por hernia incisional en laparotomía de McBurney complicada. La evolución postoperatoria fue diferente en ambas y una de ellas falleció. Discusión Se discuten los factores de riesgo para el desarrollo de estas hernias, el diagnóstico y tratamiento. Además, se discute la importancia de la apendicectomía laparoscópica para la prevención de estas hernias. Conclusiones Las complicaciones de la hernia en laparotomía de McBurney, las cuales son severas y potencialmente letales, se diagnostican tardíamente debido al retraso en la presentación y en el diagnóstico. La amplia utilización de la cirugía laparoscópica para la apendicectomía seguramente reducirá aún más la incidencia de este tipo de hernia durante los próximos años.

Introduction Currently, most series over incisional hernia do not mention this hernia occurring in McBurney's laparotomy. The reported incidence for this type of hernia is 0.7% to 2%. Even more scarce are publications regarding its complications. The purpose of this report is to discuss the diagnostic, treatment and outcomes of two patients operated on our institution for complicated McBurney´s hernia. Report of Cases: Two female patients 68 and 65 years-old operated on emergency grounds for complicated incisional hernia over a McBurney´s incision are described. Postoperative evolution was different in both cases and one of them died. Discussion We discuss risk factor for this specific incisional hernia development, its diagnosis and treatment. Besides, the importance of laparoscopic appendectomy was stressed. Conclusions Complicated incisional hernia over McBurney's incision is an infrequent severe clinical condition habitually diagnosed late. The widespread utilization of laparoscopic appendectomy will reduce even more the incidence of this kind of hernia within the next few years.

Perforación traumática aislada de la vesícula biliar: revisión de la literatura actual con reporte de un caso / Isolated gallbladder perforation following blunt abdominal trauma: literature review and case report

Resumen Introducción La lesión de la vesícula biliar secundaria a trauma abdominal cerrado constituye un evento infrecuente de perforación traumática de ella, de presentación tardía. Objetivo Revisar la literatura científica actualmente disponible y además describimos un caso. Materiales y Método Utilizando la plataforma PubMed se buscan las siguientes palabras clave: " Blunt abdominal trauma ". Se seleccionan las series con lesiones de la vesícula biliar: " Traumatic gallbladder rupture". Se seleccionan los reportes de lesiones aisladas de la vesícula biliar: " Isolated gallbladder rupture ". Se seleccionan los reportes de presentación tardía de lesiones aisladas de la vesícula biliar: " Delayed presentation of isolated gallbladder rupture ". Resultados De todas estas publicaciones se seleccionan las que a criterio de los autores son relevantes para el presente caso. Discusión La mayoría de las perforaciones de la vesícula biliar se producen en vesículas sanas de paredes delgadas distendidas por el ayuno o el consumo de alcohol. No existe una presentación clínica clásica. Los estudios imagenológicos son inespecíficos y se llega al diagnóstico definitivo durante la exploración quirúrgica. El tratamiento de esta lesión es la colecistectomía. Conclusiones El diagnóstico no es fácil, pero la resolución es relativamente simple y el pronóstico es bueno. El presente caso ilustra este tipo de lesiones en pacientes con trauma abdominal cerrado.

Introduction Gallbladder injury secondary to blunt abdominal trauma is a rare event. Aim Review the current available scientific literature and describe a case. Materials and Method Using the PubMed platform, the following keywords were searched: "Blunt abdominal trauma". Series with gallbladder lesions were selected: "Traumatic gallbladder rupture". Reports of isolated lesions of the gallbladder were selected: "Isolated gallbladder rupture". Reports of late presentation of isolated lesions of the gallbladder were selected: "Delayed presentation of isolated gallbladder rupture". Of all these publications, those that were relevant to the present case were selected according to the criteria of the authors. Case report A 20 years-old male patient suffered an abdominal trauma two weeks before presentation at our Institution. He underwent an exploratory laparotomy showing bilious content and a gallbladder perforation over the peritoneal wall as an isolated injury. Discussion Most isolated gallbladder perforations occur in healthy gallbladders with thin walls and distended because fasting or alcohol consumption. There are no classical clinical features to diagnose this specific injury and radiologic studies are nonspecific. Definitive diagnosis is often reached during surgery as it was with our patient. Recommended treatment is cholecystectomy. Conclusions This case illustrates this unique kind of gallbladder injury in patients with blunt abdominal trauma. A clear diagnosis is not easy however, the treatment is simple and prognosis is good.

Carcinoma escamocelular del canal anal metastásico en un paciente con VIH tratado con quimiorradioterapia concomitante. Reporte de un caso y revisión de la literatura / Metastatic anal canal squamous cell carcinoma in a patient with HIV treated with concomitant radiotherapy chemo. Case report and literature review

Resumen El carcinoma del canal anal es responsable de hasta el 4% de los casos de cáncer de colon, recto y ano; el tipo histológico más común es el carcinoma escamocelular. Una proporción no despreciable de pacientes se presenta con enfermedad metastásica al momento del diagnóstico. En estos estadios, el pronóstico es pobre y su tratamiento usualmente se basa en quimioterapia paliativa con cisplatino y 5-fluorouracilo, con tasas de supervivencia que no superan el 30% a 5 años. Algunos estudios recientes han sugerido que el tratamiento multidisciplinario con quimiorradiación, que se brinda en estadios más tempranos de la enfermedad, podría mejorar la supervivencia en un grupo seleccionado de pacientes. A continuación, presentamos el caso de un paciente masculino de 54 años con carcinoma escamocelular del canal anal con compromiso metastásico extenso y con VIH atendido en una institución especializada en el manejo de cáncer, en el cual se logró remisión completa de la enfermedad luego del manejo con quimiorradioterapia concomitante con mitomicina C y 5-fluorouracilo y se mantiene en remisión después de cerca de 4 años de haberse suspendido el tratamiento. Se discute el caso y se revisa la literatura al respecto.

Abstract Anal canal carcinoma is responsible for up to 4% of all cases of colon, rectum and anus cancer. The most common histological type is squamous cell carcinoma. A non-negligible proportion of patients have metastasized by the time of diagnosis. In these stages the prognosis is poor, and treatment is usually based on palliative chemotherapy with cisplatin and 5-fluorouracil. Five year survival rates do not exceed 30%. Some recent studies have suggested that multidisciplinary chemoradiotherapy (chemotherapy combined with radiation therapy) in earlier stages of the disease could improve survival for a select group of patients. We present the case of a 54-year-old male patient with squamous cell carcinoma of the anal canal with extensive metastasis who also had HIV. He was treated at an institution specializing in cancer treatment where complete remission of the disease was achieved after treatment with chemoradiotherapy with Mitomycin C and 5-fluorouracil. He remains in remission four years after discontinuation of treatment. We discuss the case and review the literature.

Semillas de 125I en la localización de lesiones no palpables en pacientes con cáncer de mama / 125I radioactive seed localization for non-palpable lesions in breast cancer

OBJETIVO: El marcaje de lesiones no palpables en cáncer de mama mediante semillas de 125I es una alternativa al arpón quirúrgico. El objetivo de este trabajo es presentar los resultados obtenidos con el uso de semillas de 125I frente a la que era la técnica de referencia en nuestro centro, el arpón quirúrgico. MATERIAL Y MÉTODO: Estudio longitudinal prospectivo en el que se incluyen pacientes con diagnóstico anatomopatológico de cáncer de mama, con lesiones no palpables, candidatas a tratamiento quirúrgico primario en las que se realizó marcaje con semilla de 125I (2016-2018) y con arpón (2015-2016). Se realizó análisis histopatológico de la pieza quirúrgica determinando la existencia de bordes afectos. Se calculó el volumen de la pieza quirúrgica. RESULTADOS: Se incluyeron un total de 146 pacientes, 95 a las que se les realizó tumorectomía guiada con semilla de 125I y 51 con arpón. El volumen cubo medio de las piezas resecadas fue de 135,67cm3 vs.190,77cm3 (p = 0,017). El volumen ortoedro fue de 58,75cm3 vs.80,60cm3 (p = 0,003). Once de las pacientes marcadas con semillas presentaron afectación de bordes (11,6%) frente a 7 (13,2%) del grupo arpón (p = 0,084). Se realizó reescisión en 9 de las pacientes marcadas con semillas y en 7 del grupo arpón (p = 0,49). CONCLUSIÓN: El uso de semillas de 125I es factible en la localización de lesiones no palpables de mama, con una baja tasa de reintervención y volúmenes de piezas quirúrgicas significativamente inferiores a los obtenidos con arpón

AIM: Marking of non-palpable breast lesions with 125I radioactive seeds is an alternative to the use of the surgical wire. The objective of this work is to present the results that we have obtained using radioactive seed localization compared to the reference technique in our center, the wire localization of non-palpable breast lesions. MATERIAL AND METHOD: Longitudinal prospective study that includes patients with histological diagnostic of breast cancer, with non-palpable lesions that are candidates to primary surgical treatment by radioactive seed localization (2016-2018) and by wire localization (2015-2016). Histological analysis of the surgical specimen was performed determining the status of surgical margins. The volume of the surgical specimen was calculated. RESULTS: A total of 146 patients were included, 95 who underwent surgery by radioactive seed localization and 51 by wire localization. The mean cube volume of the specimens were 135.67cm3 vs.190.77cm3 (p = 0.017), respectively. Eleven patients who underwent surgery by radioactive seed localization showed affected margins of the specimen (11.6%), versus 7 (13.2%) of wire localization group (p = 0.084). Reintervention was performed in 9 of the patients marked with seeds and in 7 marked with wires (p = 0.49). CONCLUSION: The use of 125I radioactive seeds is feasible in non-palpable breast lesions, with a low rate of reintervention and volumes of surgical specimens significantly lower than those obtained by wire localization

Structural changes of a protein extract from apple with polyphenoloxidase activity obtained by cationic reversed micellar extraction induced by high-pressure carbon dioxide and thermosonication.

Polyphenoloxidase from apple was extracted and further concentrated by cationic reversed micellar extraction. Previous to reversed micellar extraction a crude protein extract was obtained using AG2-X8 as adsorbent of phenolic compounds and the detergent Triton X-100. Forward and backward extraction conditions were optimized by using dodecyl trimethyl ammonium bromide as surfactant in the organic phase. Optimization was carried out to obtain the highest value of PPO activity recovery and the purification fold at the different experimental conditions. Under the optimum extraction conditions, PPO activity recovery was 99% and purification fold reached a value of 17, showing that reversed micellar extraction was a good technique as a first step to concentrate on a targeted enzyme. After removing some impurities by centrifuge ultrafiltration, the protein extract with PPO activity was treated by pressurized carbon dioxide and thermosonication achieving residual PPO activity values of 16 ± 3 and 9 ± 1%, respectively. Quenching experiments by iodide performed in the non-treated extract and in the treated extracts revealed conformational changes of this protein fraction reflected in the greater exposure of the fluorophore to the quencher.

125I radioactive seed localization for non-palpable lesions in breast cancer. / Semillas de 125I en la localización de lesiones no palpables en pacientes con cáncer de mama.

AIM: Marking of non-palpable breast lesions with 125I radioactive seeds is an alternative to the use of the surgical wire. The objective of this work is to present the results that we have obtained using radioactive seed localization compared to the reference technique in our center, the wire localization of non-palpable breast lesions. MATERIAL AND METHOD: Longitudinal prospective study that includes patients with histological diagnostic of breast cancer, with non-palpable lesions that are candidates to primary surgical treatment by radioactive seed localization (2016-2018) and by wire localization (2015-2016). Histological analysis of the surgical specimen was performed determining the status of surgical margins. The volume of the surgical specimen was calculated. RESULTS: A total of 146 patients were included, 95 who underwent surgery by radioactive seed localization and 51 by wire localization. The mean cube volume of the specimens were 135.67cm3 vs. 190.77cm3 (p=0.017), respectively. Eleven patients who underwent surgery by radioactive seed localization showed affected margins of the specimen (11.6%), versus 7 (13.2%) of wire localization group (p=0.084). Reintervention was performed in 9 of the patients marked with seeds and in 7 marked with wires (p=0.49). CONCLUSION: The use of 125I radioactive seeds is feasible in non-palpable breast lesions, with a low rate of reintervention and volumes of surgical specimens significantly lower than those obtained by wire localization.

One-day point prevalence of healthcare-associated infections and antimicrobial use in four countries in Latin America.

BACKGROUND AND AIMS: Experience in the region shows that in some countries there is very good surveillance of Healthcare-associated infections (HAIs) in health services, but there is no national data consistently in all countries. Therefore, we set to estimate the total burden of HAIs and antimicrobial use in acute care hospitals in Brazil, Venezuela, Mexico, and Colombia using the one-day point prevalence methodology. METHODS: The survey was conducted between June and July 2016. In each ward or unit, HAIs and antimicrobial use data were collected on a single day by a trained team of researchers. Also, for each patient, we collected data on risk factors for infections. RESULTS: One out of ten individuals surveyed had at least one healthcare-associated infection (HAI). Pneumonia and surgical site infections were the most relevant among the surveyed countries. Most of the surveyed participants, regardless of their HAI status, received antibiotics except the individuals managed in Brazil. Carbapenems and third-generation Cephalosporins were among the most frequently used antibiotics. CONCLUSION: Our results add to WHO's recent efforts to understand HAIs prevalence and antibiotic consumption in low and middle-income countries, of which we studied three that were not included in their last report.