Monitoring waterborne pathogens in surface and drinking waters : are water treatment plants (WTPs) simultaneously efficient in the elimination of enteric viruses and fecal indicator bacteria (FIB)?

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).Monitoring the quality of water is a requisite to prevent outbreaks related to waterborne diseases, predominantly caused by pathogens like enteric viruses, usually transmitted via the fecal-oral route. This study aimed to survey a group of enteric viruses (Enterovirus, Norovirus genogroups I and II, and hepatitis A virus) in two surface water sources of drinking water, also intending to evaluate the extent of their elimination in the two water treatment plants (WTPs) involved in drinking water production. Correlations between these viruses and fecal indicator bacteria (FIB) were also evaluated. Positive samples for viral RNA were recurrently found by reverse transcription quantitative PCR (RT-qPCR) and quantified, in genomic copies per liter (gc/L) of sampled water. Viral RNAs were detected in 14 out of 27 samples of surface water, and 21 out of 36 samples of drinking water, NoV II having been the most frequently detected in both (0–78.6 gc/L and 0–12.5 gc/L, respectively). Both WTPs showed variable efficacies in the elimination of viral RNA. Only one correlation was found with FIB, between NoV II and intestinal enterococci. These results recommend the monitoring of enteric viruses over time and their inclusion in the mandatory analysis of water quality.This research was funded by the Empresa Portuguesa das Águas Livres (EPAL) and the Foundation for Science and Technology (FCT) Portugal through a Ph.D. grant to D. Salvador (PDE/BDE/114582/2016) and financial support to CESAM and ISAMB (FCT/MCTES projects UIDP/50017/2020+UIDB/50017/2020 and UIDB/04295/2020, respectively) through national funds.info:eu-repo/semantics/publishedVersio

Study of the Potential of Water Treatment Sludges in the Removal of Emerging Pollutants

This research was funded by CENSE through the Portuguese Foundation for Science and Technology (FCT; UIDB/04085/2020) and through a PhD grant for Rita Dias (SFRH/BD/148793/2019). The authors are also indebted to EPAL AdVT for their financial support to this project. This work was also supported by the Associate Laboratory for Green Chemistry-LAQV, which is financed by national funds from FCT/MCTES (UIDB/50006/2020). Maria Bernardo acknowledges Norma Transitoria DL57/2016 Contract (FCT/MCTES).Presently, water quantity and quality problems persist both in developed and developing countries, and concerns have been raised about the presence of emerging pollutants (EPs) in water. The circular economy provides ways of achieving sustainable resource management that can be implemented in the water sector, such as the reuse of drinking water treatment sludges (WTSs). This study evaluated the potential of WTS containing a high concentration of activated carbon for the removal of two EPs: the steroid hormones 17β-estradiol (E2) and 17α-ethinylestradiol (EE2). To this end, WTSs from two Portuguese water treatment plants (WTPs) were characterised and tested for their hormone adsorbance potential. Both WTSs showed a promising adsorption potential for the two hormones studied due to their textural and chemical properties. For WTS1, the final concentration for both hormones was lower than the limit of quantification (LOQ). As for WTS2, the results for E2 removal were similar to WTS1, although for EE2, the removal efficiency was lower (around 50%). The overall results indicate that this method may lead to new ways of using this erstwhile residue as a possible adsorbent material for the removal of several EPs present in wastewaters or other matrixes, and as such contributing to the achievement of Sustainable Development Goals (SDG) targets.publishersversionpublishe

Complete blood count parameters as biomarkers of retinopathy of prematurity: a Portuguese multicenter study

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Purpose: To evaluate complete blood count (CBC) parameters in the first week of life as predictive biomarkers for the development of retinopathy of prematurity (ROP). Methods: Multicenter, prospective, observational study of a cohort of preterm infants born with gestational age (GA) < 32 weeks or birth weight < 1500 g in eight Portuguese neonatal intensive care units. All demographic, clinical, and laboratory data from the first week of life were collected. Univariate logistic regression was used to assess risk factors for ROP and then multivariate regression was performed. Results: A total of 455 infants were included in the study. The median GA was 29.6 weeks, and the median birth weight was 1295 g. One hundred and seventy-two infants (37.8%) developed ROP. Median values of erythrocytes (p < 0.001), hemoglobin (p < 0.001), hematocrit (p < 0.001), mean corpuscular hemoglobin concentration (p < 0.001), lymphocytes (p = 0.035), and platelets (p = 0.003) of the group of infants diagnosed with ROP any stage were lower than those without ROP. Mean corpuscular volume (MCV) (p = 0.044), red blood cell distribution width (RDW) (p < 0.001), erythroblasts (p < 0.001), neutrophils (p = 0.030), neutrophils-lymphocytes ratio (p = 0.028), and basophils (p = 0.003) were higher in the ROP group. Higher values of MCV, erythroblasts, and basophils remained significantly associated with ROP after multivariate regression. Conclusion: In our cohort, the increase in erythroblasts, MCV, and basophils in the first week of life was significantly and independently associated with the development of ROP. These CBC parameters may be early predictive biomarkers for ROP.Open access funding provided by FCT|FCCN (b-on). This work was supported by the Laboratório de Genética and the Instituto de Saúde Ambiental (ISAMB) of the Faculdade de Medicina of Universidade de Lisboa and the Instituto de Investigação Científica Bento da Rocha Cabral. The writing of the manuscript was also supported by funds from Fundação para a Ciência e a Tecnologia to ISAMB (ref. UIDB/04295/2020 and UIDP/04295/2020). This work was also part of a doctoral project funding by the company CUF with a PhD grant in Medicine awarded in 2021 and by the Portuguese Society of Ophthalmology with a PhD grant awarded in 2019.info:eu-repo/semantics/publishedVersio

Nationwide access to endovascular treatment for acute ischemic stroke in portugal

Publisher Copyright: Copyright Ordem dos M dicos 2021.Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitalspublishersversionpublishe

Acesso a Tratamento Endovascular para Acidente Vascular Cerebral Isquémico em Portugal

Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and Methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.Introdução: A aprovação do tratamento endovascular para o acidente vascular cerebral isquémico obrigou à reorganização dos cuidados de saúde em Portugal. Os nove centros que realizam tratamento endovascular não estão distribuídos equitativamente pelo território, o que poderá causar acesso diferencial a tratamento. O principal objetivo deste estudo é realizar uma análise descritiva da frequência e métricas temporais do tratamento endovascular em Portugal continental e seus distritos. Material e Métodos: Estudo de coorte nacional multicêntrico, incluindo todos os doentes com acidente vascular cerebral isquémico submetidos a tratamento endovascular em Portugal continental durante um período de dois anos (julho 2015 a junho 2017). Foram colhidos dados demográficos, relacionados com o acidente vascular cerebral e variáveis do procedimento. Taxas de tratamento endovascular brutas e ajustadas (ajuste indireto a idade e sexo) foram calculadas por 100 000 habitantes/ano para Portugal continental e cada distrito. Métricas de procedimento como tempo entre instalação, primeira porta e punção foram também analisadas. Resultados: Foram registados 1625 tratamentos endovasculares, indicando uma taxa bruta nacional de tratamento endovascular de 8,27/100 000 habitantes/ano. As taxas de tratamento endovascular entre distritos variaram entre 1,58 e 16,53/100 000/ano, com taxas mais elevadas nos distritos próximos a hospitais com tratamento endovascular. O tempo entre sintomas e punção femural entre distritos variou entre 212 e 432 minutos. Conclusão: Portugal continental apresenta uma taxa nacional de tratamento endovascular elevada, apresentando, contudo, assimetrias regionais no acesso. As métricas temporais foram comparáveis com as observadas nos ensaios clínicos piloto

Mengovirus as Process Control Virus in the Monitoring of Genomic RNA and Infectivity of Enteric Viruses in Water Matrices

The present study, developed in the scope of a survey to monitor enteric viruses in natural surface water and drinking water sources, addressed the suitability of mengovirus to assess viral recovery rates at two steps of the water sampling process. In a pilot campaign comprising two samples from each type of water source, when mengovirus was added after the filtration/primary concentration step, the recovery rates of viral RNA were higher than 18% and identical for both water matrices. In a one-year sampling campaign, where mengovirus was present along the whole sample processing (addition in the filtration/primary concentration step), significantly different recovery rates were observed between water matrices: usually higher than 1% in drinking water and under 1% in surface water. The results suggest the first stage of the water sampling process and the type of water matrix are the most influential factors for viral RNA recovery. This study also addressed and evidenced mengovirus replication and titration in Vero E6 cultures and showed infectious mengovirus to be recovered from samples of both types of water matrix. These results anticipate a more comprehensive applicability of mengovirus as a process control virus in the monitoring of viruses in water, extended to viral infectivity

Characterization of Five Portuguese Wastewater Treatment Plants: Removal Efficiency of Pharmaceutical Active Compounds through Conventional Treatment Processes and Environmental Risk

Due to the high consumption and incorrect disposal of pharmaceutical active compounds (PhACs), they are recognized as contaminants of emerging concern. Wastewater treatment plants (WWTPs) may be inefficient in removing PhACs, therefore discharging them into surface waters. The removal efficiencies of five WWTPs located in the south of Portugal (Alentejo) were evaluated in 2020. Twenty-six PhACs were analyzed in wastewater influents, effluents, and surface waters, upstream and downstream of the WWTPs by solid-phase extraction (SPE) and ultra-performance liquid chromatography coupled with tandem mass detection (UPLC-MS/MS). The most representative PhACs in influents were acetaminophen, caffeine, naproxen, ibuprofen, and diclofenac with minimum-maximum concentrations of 49–225 µg/L, 26–46 µg/L, 5.9–13 µg/L, 5.2–22 µg/L, and 1.3–2.5 µg/L, respectively. For effluents, it was acetaminophen, caffeine, and diclofenac with minimum-maximum concentrations of 0.054–7.8 µg/L, 0.084–4.8 µg/L, and 0.28–3.3 µg/L, respectively. The highest removal efficiencies were observed for acetaminophen, sulfadiazine, cortisone, testosterone, metoprolol, and propranolol (100%). The lowest removal efficiencies were observed for carbamazepine (2.7%) and diclofenac (−13.2%). The risk quotient of sulfamethoxazole and diclofenac were higher than 1 for receiving waters, indicating they probably pose high risks to aquatic organisms