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- RSV-Bacterial Co-Infection Is Associated With Increased Illness Severity in Hospitalized Children - Results From a Prospective Sentinel Surveillance StudyPublication . Torres, Ana Rita; Gaio, Vânia; Melo, Aryse; Lança, Miguel; Barreto, Marta; Lagoa Gomes, Licínia Isabel; Azevedo, Inês; Bandeira, Teresa; Lito, David; Guiomar, Raquel; Rodrigues, Ana Paula; VigiRSV groupDuring the autumn/winter respiratory syncytial virus (RSV) epidemics, bacterial co-infection is common and affects the disease severity. We aimed to understand the relationship between RSV-bacterial co-infections and clinical severity since the RSV seasonality change after COVID-19 pandemic. We conducted a prospective, sentinel surveillance study at 20 sites in Portugal in children under 2 years hospitalized with RSV, between April 21 and January 23. Effect of co-infection with potentially pathogenic bacteria (PPB) on the length of hospitalization and disease severity was investigated using multivariate linear and log-binomial regression models. Among 678 RSV hospitalizations, 67.4% occurred in children under 6 months and 15.3% in preterm; 20.4% tested positive for PPB; median length of hospitalization was 5 days (IQR: 3-7days). Children coinfected with PPB had a higher rate of ICU admission (29.7% vs. 3.5%, p < 0.001), resulting in more prolonged hospitalizations (7 vs. 5 days, p < 0.001) and a 13-fold risk of having severe disease (RR: 13.2, 95% CI:7.3-23.9). RSV-bacterial co-infection was associated with increased length of hospitalization and severe illness during off-season epidemics. This risk is probably overestimated, as laboratory testing for bacterial infections is usually higher in severely ill-appearing children. Measures to prevent outgrowth of pathogenic bacteria within the respiratory tract should be discussed.
- Measuring minerals in pseudocereals using inductively coupled plasma optical emission spectrometry: what is the optimal digestion method?Publication . Nascimento, Ana C.; Motta, Carla; Rego, Andreia; Delgado, Inês; Santiago, Susana; Assunção, Ricardo; Matos, Ana Sofia; Santos, Mariana; Castanheira, Isabel; .Pseudocereals have gained attention due to their adaptability to different climates, high nutritional value, and suitability for gluten-free and plant-based diets. However, a challenge lies in the necessary adaptations in the diet pathways, mainly due to the lack of matrix-matching metrological tools. To address this problem, we developed a classification system to support laboratory decisions without shaped Proficiency Testing (PT) or Certified/Standard References Material. This system evaluates method performance through limit of detection (LOD), maximum uncertainty, and statistical comparison. For that matter, the mineral contents (Cu, Mn, Fe, Zn, Mg, P, Ca, K, and Na) of quinoa (Chenopodium quinoa), amaranth (Amaranthus caudatus), and buckwheat (Fagopyrum esculentum) were determined, using three different digestion methods, including dry-ashing, microwave, and graphite block acid digestion. A decision was reached concerning the optimal digestion method to be employed, with the results classified into three categories: (i) “rejected if results failed in two categories; (ii) “use with caution” if results were not satisfactory in one category; or (iii) “accepted”, if the results passed in all the categories. The system efficacy was exemplified by the effectiveness of dry-ashing and graphite block acid digestion by comparison with microwave digestion. Neither dry-ashing nor graphite block acid digestion can be recommended as an alternative method to the microwave digestion method when all the prioritized nutrient minerals are understudied. Although the microwave method is preferable for multi-elemental analysis, it is possible to obtain, with caution, comparable results from all the digestion methods if a higher relative combined uncertainty is defined (target uncertainty < 11%) under the assumption that this is suitable for the study.