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Article ; Online: The impact of coronavirus in Brazil: politics and the pandemic.

Ponce, Daniela

2020 Volume 16, Issue 9, Page(s) 483

MeSH term(s)	Betacoronavirus ; Brazil/epidemiology ; COVID-19 ; Coronavirus Infections/epidemiology ; Delivery of Health Care/organization & administration ; Humans ; Pandemics/legislation & jurisprudence ; Pneumonia, Viral/epidemiology ; Politics ; SARS-CoV-2
Keywords	covid19
Language	English
Publishing date	2020-07-16
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2490366-8
ISSN	1759-507X ; 1759-5061
ISSN (online)	1759-507X
ISSN	1759-5061
DOI	10.1038/s41581-020-0327-0
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Article ; Online: Strategies to Prevent Infections in Dialysis Patients.

Ponce, Daniela / Nitsch, Dorothea / Ikizler, Talat Alp

Seminars in nephrology

2024 Volume 43, Issue 5, Page(s) 151467

Abstract: Infections are the second leading cause of death among patients with end-stage kidney disease, behind only cardiovascular disease. In addition, patients on chronic dialysis are at a higher risk for acquiring infection caused by multidrug-resistant ... ...

Abstract	Infections are the second leading cause of death among patients with end-stage kidney disease, behind only cardiovascular disease. In addition, patients on chronic dialysis are at a higher risk for acquiring infection caused by multidrug-resistant organisms and for death resulting from infection owing to their likelihood of requiring treatment that involves invasive devices, their frequent exposure to antibiotics, and their impaired immunity. Vascular access is a major risk factor for bacteremia, hospitalization, and mortality among hemodialysis (HD) patients. Catheter-related bacteremia is the most severe central venous catheter (CVC)-related infection and increases linearly with the duration of catheter use. Given the high prevalence of CVC use and its direct association with catheter-related bacteremia, which adversely impacts morbidity and mortality rates among HD patients, several prevention measures aimed at reducing the rates of CVC-related infection have been proposed and implemented. As a result, a large number of clinical trials, systematic reviews, and meta-analyses have been conducted to assess the effectiveness, clinical applicability, and long-term adverse effects of such measures. Peritoneal dialysis chronic treatment without the occurence of peritonitis is rare. Although most cases of peritonitis can be treated adequately with antibiotics, some cases are complicated by hospitalization or a temporary or permanent need to abstain from using the peritoneal dialysis catheter. Severe and long-lasting peritonitis can lead to peritoneal membrane failure, requiring the treatment method to be switched to HD. Some measures as patients training, early diagnosis, and choice of antibiotics can contribute to the successful treatment of peritonitis. Finally, medical directors are key leaders in infection prevention and are an important resource to implement programs to monitor and improve infection prevention practices at all levels within the dialysis clinic.
MeSH term(s)	Humans ; Renal Dialysis/adverse effects ; Peritoneal Dialysis/adverse effects ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Peritonitis ; Anti-Bacterial Agents/therapeutic use ; Bacteremia/etiology ; Bacteremia/prevention & control ; Bacteremia/epidemiology
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2024-01-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604652-6
ISSN	1558-4488 ; 0270-9295
ISSN (online)	1558-4488
ISSN	0270-9295
DOI	10.1016/j.semnephrol.2023.151467
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Article ; Online: The role of peritoneal dialysis in the treatment of acute kidney injury in neurocritical patients: a retrospective Brazilian study.

Ponce, Daniela / Ramírez-Guerrero, Gonzalo / Balbi, André Luis

Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis

2024 , Page(s) 8968608231223385

Abstract: Background: Acute kidney injury (AKI) occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. AKI and its treatment, including acute kidney replacement therapy, can expose patients to a ... ...

Abstract	Background: Acute kidney injury (AKI) occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. AKI and its treatment, including acute kidney replacement therapy, can expose patients to a secondary greater brain injury. This study aimed to explore the role of peritoneal dialysis (PD) in neurocritical AKI patients in relation to metabolic and fluid control, complications related to PD and outcome. Methods: Neurocritical AKI patients were treated by PD (prescribed Kt/V = 0.40/session) using a flexible catheter and a cycler and lactate as a buffer. Results: A total of 58 patients were included. The mean age was 61.8 ± 13.2 years, 65.5% were in the intensive care unit, 68.5% needed intravenous inotropic agents, 72.4% were on mechanical ventilation, APACHE II was 16 ± 6.67 and the main neurological diagnoses were stroke (25.9%) and intracerebral haemorrhage (31%). Ischaemic acute tubular necrosis (iATN) was the most common cause of AKI (51.7%), followed by nephrotoxic ATN AKI (25.8%). The main dialysis indications were uraemia and hypervolemia. Blood urea and creatinine levels stabilised after four sessions at around 48 ± 11 mg/dL and 2.9 ± 0.4 mg/dL, respectively. Negative fluid balance and ultrafiltration increased progressively and stabilised around 2.1 ± 0.4 L /day. Weekly delivered Kt/V was 2.6 ± 0.31. The median number of high-volume PD sessions was 6 (4-10). Peritonitis and mechanical complications were not frequent (8.6% and 10.3%, respectively). Mortality rate was 58.6%. Logistic regression identified as factors associated with death in neurocritical AKI patients: age (odds ratio (OR) = 1.14, 95% confidence interval (CI) = 1.09-2.16, Conclusion: Our study suggests that careful prescription may contribute to providing adequate treatment for most neurocritical AKI patients without contraindications for PD use, allowing adequate metabolic and fluid control, with no increase in the number of infectious, mechanical and metabolic complications. Mechanical ventilation, positive fluid balance and intracerebral haemorrhage were factors associated with mortality, while patients with nephrotoxic AKI had lower odds of mortality compared to those with septic and ischaemic AKI. Further studies are needed to investigate better the role of PD in neurocritical patients with AKI.
Language	English
Publishing date	2024-01-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	645010-6
ISSN	1718-4304 ; 0896-8608
ISSN (online)	1718-4304
ISSN	0896-8608
DOI	10.1177/08968608231223385
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Article: The impact of coronavirus in Brazil: politics and the pandemic

Ponce, Daniela

Nat Rev Nephrol

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #652561
Database	COVID19

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Article ; Online: Infectious and mechanical complications in planned-start vs. urgent-start peritoneal dialysis: a cohort study.

Müller, João Victor Costa / Ponce, Daniela

Jornal brasileiro de nefrologia

2022 Volume 45, Issue 1, Page(s) 27–35

Abstract: Background: Few studies have compared the infectious and mechanical complications seen in planned-start and urgent-start peritoneal dialysis (PD) patients.: Objectives: To compare the incidence and etiology of mechanical and infectious complications ... ...

Abstract	Background: Few studies have compared the infectious and mechanical complications seen in planned-start and urgent-start peritoneal dialysis (PD) patients. Objectives: To compare the incidence and etiology of mechanical and infectious complications in patients offered planned- and urgent-start PD and assess potential differences in patient survival and time on PD. Methods: This retrospective cohort study included patients with chronic kidney disease on planned- and urgent-start PD seen from 2014 to 2020 and compared them for mechanical and infectious complications, clinical outcome, death rates, and need to switch to hemodialysis. Results: Ninety-nine patients on planned-start PD and 206 on urgent-start PD were included. Incidence of exit-site infection (18.9 vs. 17.17%, p=0.71) and peritonitis (24.27 vs. 27.27%, p=0.57) were similar between patients, while pathogens causing peritonitis were different, although non-fermenting Gram-negative bacilli were more commonly seen in the planned-start PD group. Leakage as a mechanical complication and hospitalization were more common among patients needing urgent-start PD (10.68 vs. 2.02%, p=0.0085 and 35.44 vs. 17.17%, p=0.0011, respectively). Patient survival was similar between groups. Cox regression found an association between death and age (HR=1.051, 95% CI 1.026-1.07, p=0.0001) and albumin (HR=0.66, 95% CI 0.501-0.893, p=0.0064), and between peritonitis and a diagnosis of diabetes (HR=2.016, 95% CI 1.25-3.25, p=0.004). Conclusion: Patient survival and time on PD were similar between the planned- and urgent-start PD groups, while leakage was more frequently seen in the urgent-start PD group. Death was associated with lower albumin levels and older age, while peritonitis was associated with diabetes.
MeSH term(s)	Humans ; Cohort Studies ; Retrospective Studies ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/complications ; Time Factors ; Diabetes Mellitus ; Peritoneal Dialysis/adverse effects ; Peritonitis/etiology ; Peritonitis/complications
Language	Portuguese
Publishing date	2022-06-25
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2057873-8
ISSN	2175-8239 ; 2175-8239
ISSN (online)	2175-8239
ISSN	2175-8239
DOI	10.1590/2175-8239-JBN-2021-0287en
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Article: Jealousy, sexism, and romantic love myths: the role of beliefs in online dating violence.

Ramírez-Carrasco, Daniela / Ferrer-Urbina, Rodrigo / Ponce-Correa, Felipe

Frontiers in psychology

2023 Volume 14, Page(s) 1212737

Abstract: With the massification of the Internet and social networks, a new form of dating violence called cyber-violence has emerged, which involves behaviors of control, humiliation, intimidation and threats towards the partner or ex-partner. Using a non- ... ...

Abstract	With the massification of the Internet and social networks, a new form of dating violence called cyber-violence has emerged, which involves behaviors of control, humiliation, intimidation and threats towards the partner or ex-partner. Using a non-probabilistic sample of 1,001 participants aged 18 to 25 years, the present study used an
Language	English
Publishing date	2023-09-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2023.1212737
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Article ; Online: Long QT syndrome - Bench to bedside.

Ponce-Balbuena, Daniela / Deschênes, Isabelle

Heart rhythm O2

2021 Volume 2, Issue 1, Page(s) 89–106

Abstract: Long QT syndrome (LQTS) is a cardiovascular disorder characterized by an abnormality in cardiac repolarization leading to a prolonged QT interval and T-wave irregularities on the surface electrocardiogram. It is commonly associated with syncope, seizures, ...

Abstract	Long QT syndrome (LQTS) is a cardiovascular disorder characterized by an abnormality in cardiac repolarization leading to a prolonged QT interval and T-wave irregularities on the surface electrocardiogram. It is commonly associated with syncope, seizures, susceptibility to torsades de pointes, and risk for sudden death. LQTS is a rare genetic disorder and a major preventable cause of sudden cardiac death in the young. The availability of therapy for this lethal disease emphasizes the importance of early and accurate diagnosis. Additionally, understanding of the molecular mechanisms underlying LQTS could help to optimize genotype-specific treatments to prevent deaths in LQTS patients. In this review, we briefly summarize current knowledge regarding molecular underpinning of LQTS, in particular focusing on LQT1, LQT2, and LQT3, and discuss novel strategies to study ion channel dysfunction and drug-specific therapies in LQT1, LQT2, and LQT3 syndromes.
Language	English
Publishing date	2021-01-22
Publishing country	United States
Document type	Journal Article
ISSN	2666-5018
ISSN (online)	2666-5018
DOI	10.1016/j.hroo.2021.01.006
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Article ; Online: Comparative analysis of patients' survival on hemodialysis vs. peritoneal dialysis and identification of factors associated with death.

Vicentini, Carolina Aparecida de Almeida / Ponce, Daniela

Jornal brasileiro de nefrologia

2022 Volume 45, Issue 1, Page(s) 8–16

Abstract: Introduction: There are several studies comparing the outcomes of patients treated with peritoneal dialysis (PD) and hemodialysis (HD), and most are divergent.: Methods: This is a cohort study that followed patients with incident PD and HD in a ... ...

Abstract	Introduction: There are several studies comparing the outcomes of patients treated with peritoneal dialysis (PD) and hemodialysis (HD), and most are divergent. Methods: This is a cohort study that followed patients with incident PD and HD in a planned and unplanned way, in a dialysis unit of the HCFMB from 01/2014 to 01/2019, until the outcome. We collected clinical and laboratory data. The PD and HD groups, death and non-death outcomes, were compared using the chi-square test for categorical variables and t-test, or Mann-Whitney test for continuous variables. Kaplan Meier curve and log-rank test were used for survival. Multivariate analysis was performed using the Cox regression. The significant difference was p < 0.05. Results: We had 592 patients, 290 treated by HD and 302 by PD. The mean age was 59.9 ± 16.8, with a predominance of males (56.3%), the main underlying disease was diabetes (45%); 29% of the patients died. There was no difference in the survival of patients treated by HD and PD. The oldest age (1.018 (95% CI 1.000-1.037; p=0.046)) was identified as a risk factor for death, while the highest number of infection-free days (0.999 (95% CI 0.999-1.000; p=0.003 )) as a protective factor. Conclusion: The analysis reinforced that the survival of patients on HD and PD was similar. Higher age and shorter infection-free time were associated with death.
MeSH term(s)	Male ; Humans ; Adult ; Middle Aged ; Aged ; Female ; Renal Dialysis/adverse effects ; Cohort Studies ; Kidney Failure, Chronic/complications ; Kaplan-Meier Estimate ; Peritoneal Dialysis/adverse effects ; Retrospective Studies ; Risk Factors
Language	Portuguese
Publishing date	2022-05-04
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2057873-8
ISSN	2175-8239 ; 2175-8239
ISSN (online)	2175-8239
ISSN	2175-8239
DOI	10.1590/2175-8239-JBN-2021-0242en
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Article ; Online: Pneumocystis

Rojas, Diego A / Ponce, Carolina A / Bustos, Adriel / Cortés, Vicente / Olivares, Daniela / Vargas, Sergio L

Journal of fungi (Basel, Switzerland)

2023 Volume 9, Issue 4

Abstract: Inflammation and mucus hypersecretion are frequent pathology features of chronic respiratory diseases such as asthma and COPD. Selected bacteria, viruses and fungi may synergize as co-factors in aggravating disease by activating pathways that are able to ...

Abstract	Inflammation and mucus hypersecretion are frequent pathology features of chronic respiratory diseases such as asthma and COPD. Selected bacteria, viruses and fungi may synergize as co-factors in aggravating disease by activating pathways that are able to induce airway pathology.
Language	English
Publishing date	2023-04-07
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2784229-0
ISSN	2309-608X ; 2309-608X
ISSN (online)	2309-608X
ISSN	2309-608X
DOI	10.3390/jof9040452
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Article ; Online: Peritoneal dialysis and acute kidney injury in acute brain injury patients.

Ramírez-Guerrero, Gonzalo / Husain-Syed, Faeq / Ponce, Daniela / Torres-Cifuentes, Vicente / Ronco, Claudio

Seminars in dialysis

2023 Volume 36, Issue 6, Page(s) 448–453

Abstract: Acute kidney injury (AKI) is a heterogeneous syndrome with multiple etiologies. It occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. In this scenario, AKI alters the kidney-brain axis, ... ...

Abstract	Acute kidney injury (AKI) is a heterogeneous syndrome with multiple etiologies. It occurs frequently in the neurocritical intensive care unit and is associated with greater morbidity and mortality. In this scenario, AKI alters the kidney-brain axis, exposing patients who receive habitual dialytic management to greater injury. Various therapies have been designed to mitigate this risk. Priority has been placed by KDIGO guidelines on the use of continuous over intermittent acute kidney replacement therapies (AKRT). On this background, continuous therapies have a pathophysiological rationale in patients with acute brain injury. A low-efficiency therapy such as PD and CRRT could achieve optimal clearance control and potentially reduce the risk of secondary brain injury. Therefore, this work will review the evidence on peritoneal dialysis as a continuous AKRT in neurocritical patients, describing its benefits and risks so it may be considered as an option when deciding among available therapeutic options.
MeSH term(s)	Humans ; Renal Dialysis ; Peritoneal Dialysis/adverse effects ; Renal Replacement Therapy ; Acute Kidney Injury/etiology ; Acute Kidney Injury/therapy ; Brain Injuries/complications ; Brain Injuries/therapy
Language	English
Publishing date	2023-03-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1028193-9
ISSN	1525-139X ; 0894-0959
ISSN (online)	1525-139X
ISSN	0894-0959
DOI	10.1111/sdi.13151
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