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Article ; Online: Intoxicação por carambola em pacientes com doença renal crônica

Pasqual Barretti

Jornal Brasileiro de Nefrologia , Vol 37, Iss 4, Pp 429-

da primeira descrição clínica à caramboxina

2015 Volume 430

Keywords	Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Portuguese
Publishing date	2015-12-01T00:00:00Z
Publisher	Sociedade Brasileira de Nefrologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Launching a CDMO in Brazil aiming to develop biopharmaceuticals for clinical trials

Rui Seabra Ferreira Junior / Marcelo Marcos Morales / Pasqual Barretti / Benedito Barraviera

Journal of Venomous Animals and Toxins including Tropical Diseases, Vol

2022 Volume 28

Abstract: Abstract The innovation timeline is expensive, risky, competitive, time-consuming, and labor-intensive. In order to overcome such challenges and optimize financial resources, pharmaceutical companies nowadays hire contract development and manufacturing ... ...

Abstract	Abstract The innovation timeline is expensive, risky, competitive, time-consuming, and labor-intensive. In order to overcome such challenges and optimize financial resources, pharmaceutical companies nowadays hire contract development and manufacturing organizations (CDMO) to help them. Based on the experience acquired first from the development of two biopharmaceuticals, the Heterologous Fibrin Sealant and the Apilic Antivenom, and more recently, during their respective clinical trials; the Center for the Study of Venoms and Venomous Animals (CEVAP) proposed to the Ministry of Health the creation of the first Brazilian CDMO. This groundbreaking venture will assist in converting a candidate molecule - from its discovery, proof of concept, product development, up to pilot batch production - into a product. The CDMO impact and legacy will be immense, offering service provision to the public and private sector by producing validated samples for clinical trials and academic training on translational research for those seeking a position in pharmaceutical industries and manufacturing platforms.
Keywords	Contract development and manufacturing organizations (CDMO) ; Translational research ; Clinical trials ; Good manufacturing practices (GMP) ; Biopharmaceuticals ; Arctic medicine. Tropical medicine ; RC955-962 ; Toxicology. Poisons ; RA1190-1270 ; Zoology ; QL1-991
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	SciELO
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: 7. Transfusão

Pasqual Barretti / Alvimar Gonçalves Delgado

Jornal Brasileiro de Nefrologia , Vol 36, Iss 1 suppl 1, Pp 29-

2014 Volume 31

Keywords	Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Portuguese
Publishing date	2014-03-01T00:00:00Z
Publisher	Sociedade Brasileira de Nefrologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Multifrequency bioimpedance by spectroscopy vs. routine methods in the management of hydration status in peritoneal dialysis patients

Fabiana Lourenço Costa / Nayrana Soares do Carmo Reis / Fabricio Moreira Reis / Rogério Carvalho de Oliveira / Silméia Garcia Zanati Bazan / Maryanne Zilli Canedo da Silva / Luis Cuadrado Martin / Pasqual Barretti

Frontiers in Medicine, Vol

A randomized control trial

2022 Volume 9

Abstract: BackgroundOverhydration (OH) is common in peritoneal dialysis (PD) and increases the cardiovascular risk. Multifrequency bioimpedance spectroscopy (BIS) has been proposed to estimate the hydration in dialysis. Our objective was to evaluate if BIS is ... ...

Abstract	BackgroundOverhydration (OH) is common in peritoneal dialysis (PD) and increases the cardiovascular risk. Multifrequency bioimpedance spectroscopy (BIS) has been proposed to estimate the hydration in dialysis. Our objective was to evaluate if BIS is superior than control based on clinical assessment plus single-frequency bioimpedance (SF-BIA) on the fluid control and intermediate cardiovascular outcomes.MethodsRandomized controlled study in adult PD patients, with a 9-month follow-up, allocated into two groups: control and BIS. Data were collected from medical records. SF-BIA and BIS, laboratory exams, ambulatory blood pressure monitoring, echocardiography (ECHO), and pulse wave velocity (PWV) were evaluated. The BIS data were available to the medical team only in BIS group.Results34 patients completed the study, 17 in each group. At the endpoint the BIS group had a significant (p < 0.05) greater proportion of patients with OH/extracellular water (OH/ECW%) ≤ 15% than the control (94.1% vs. 52.9%), and a lower OH mean (2.1 ± 1.6 vs. 0.9 ± 1.1 L). The control group has a significant increase in the tumor necrosis factor alpha median concentration from baseline to six [11.9 (6.0–24.1) vs. 44.7 (9.4–70.6) pg/ml] and 9 months [11.9 (6.0–24.1) vs. 39.4 (27.9–62.6) pg/ml], and in the N-terminal fragment of pro-B-type natriuretic peptide median [239 (171.5–360.5) vs. 356 (219–1,555) pg/ml]. For cardiovascular parameters, BIS group presented a significant reduction in radial PWV [7.7 (6.9–9.2) vs. 6.5 (5.5–8.4) m/s] at 9 month, while in the control presented a significant increase in mean central systolic blood pressure (BP) (106.8 ± 11.2 vs. 117.6 ± 16.5 mmHg) and in central diastolic BP (90.4 ± 9.8 vs. 103.3 ± 12.5 mmHg) at 9 months. The left ventricular mass (LVM)/body surface presented a significant reduction in the control (109.6 ± 30.8 vs. 101.2 ± 28.9 g/m2) and BIS group (107.7 ± 24.9 vs. 96.1 ± 27.0 g/m2) at 9 months.ConclusionThe results suggest BIS is superior than the clinical evaluation plus SF-BIA for the ...
Keywords	peritoneal dialysis ; overhydration ; chronic kidney disease ; inflammation ; electrical bioimpedance ; cardiovascular diseases ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Peritoneal dialysis modality transition and impact on phosphate and potassium serum levels.

Daniela Peruzzo / Murilo Guedes / John W Larkin / Guilherme Yokoyama / Taynara Lopes Dos Santos / Roberto Pecoits-Filho / Silvia Carreira Ribeiro / Alfonso Ramos / Pasqual Barretti / Thyago Proença de Moraes / BRAZPD Investigators

PLoS ONE, Vol 16, Iss 10, p e

2021 Volume 0257140

Abstract: Peritoneal dialysis (PD) modalities affect solute removal differently. However, the impacts of switching PD modalities on serum levels of biomarkers of different sizes are not known. Our objective was to analyze whether a change in the PD modality ... ...

Abstract	Peritoneal dialysis (PD) modalities affect solute removal differently. However, the impacts of switching PD modalities on serum levels of biomarkers of different sizes are not known. Our objective was to analyze whether a change in the PD modality associates with the levels of two routine biochemical laboratories. In this multicentric prospective cohort study. we selected all patients who remained on a PD modality for at least 6 months and switched PD modality. Patients were also required to be treated with the same PD modality for at least 3 months before and after the modality change. The primary outcome was change in potassium and phosphate serum levels. We identified 737 eligible patients who switched their PD modality during the study. We found mean serum phosphate levels increased during the 3 months after switching from CAPD to APD and conversely decreased after switching to from APD to CAPD. In contrast, for potassium the difference in the mean serum levels was comparable between groups switching from CAPD to APD, and vice versa. In conclusion, CAPD seems to be as efficient as APD for the control of potassium serum levels, but more effective for the control of phosphate serum levels. The effect of a higher removal of middle size molecules as result of PD modalities in terms of clinical and patient-reported outcomes should be further explored.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Fatigue in incident peritoneal dialysis and mortality

Murilo Guedes / Liz Wallim / Camila R Guetter / Yue Jiao / Vladimir Rigodon / Chance Mysayphonh / Len A Usvyat / Pasqual Barretti / Peter Kotanko / John W Larkin / Franklin W Maddux / Roberto Pecoits-Filho / Thyago Proenca de Moraes

PLoS ONE, Vol 17, Iss 6, p e

A real-world side-by-side study in Brazil and the United States.

2022 Volume 0270214

Abstract: Background We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods We conducted a side-by-side study from two of incident PD patients in Brazil and the United ... ...

Abstract	Background We tested if fatigue in incident Peritoneal Dialysis associated with an increased risk for mortality, independently from main confounders. Methods We conducted a side-by-side study from two of incident PD patients in Brazil and the United States. We used the same code to independently analyze data in both countries during 2004 to 2011. We included data from adults who completed KDQOL-SF vitality subscale within 90 days after starting PD. Vitality score was categorized in four groups: >50 (high vitality), ≥40 to ≤50 (moderate vitality), >35 to <40 (moderate fatigue), ≤35 (high fatigue; reference group). In each country's cohort, we built four distinct models to estimate the associations between vitality (exposure) and all-cause mortality (outcome): (i) Cox regression model; (ii) competing risk model accounting for technique failure events; (iii) multilevel survival model of clinic-level clusters; (iv) multivariate regression model with smoothing splines treating vitality as a continuous measure. Analyses were adjusted for age, comorbidities, PD modality, hemoglobin, and albumin. A mixed-effects meta-analysis was used to pool hazard ratios (HRs) from both cohorts to model mortality risk for each 10-unit increase in vitality. Results We used data from 4,285 PD patients (Brazil n = 1,388 and United States n = 2,897). Model estimates showed lower vitality levels within 90 days of starting PD were associated with a higher risk of mortality, which was consistent in Brazil and the United States cohorts. In the multivariate survival model, each 10-unit increase in vitality score was associated with lower risk of all-cause mortality in both cohorts (Brazil HR = 0.79 [95%CI 0.70 to 0.90] and United States HR = 0.90 [95%CI 0.88 to 0.93], pooled HR = 0.86 [95%CI 0.75 to 0.98]). Results for all models provided consistent effect estimates. Conclusions Among patients in Brazil and the United States, lower vitality score in the initial months of PD was independently associated with all-cause mortality.
Keywords	Medicine ; R ; Science ; Q
Subject code	310
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical and microbiological factors predicting outcomes of nonfermenting gram-negative bacilli peritonitis in peritoneal dialysis

Ana Claudia Moro Lima dos Santos / Rodrigo Tavanelli Hernandes / Augusto Cezar Montelli / Aydir Cecília Marinho Monteiro / Thais Alves Barbosa / Carlos Henrique Camargo / Adriano Martison Ferreira / Alessandro Lia Mondelli / Maria de Lourdes Ribeiro de Souza da Cunha / Pasqual Barretti

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 9

Abstract: Abstract Peritonitis due to gram-negative bacilli (GNB), particularly nonfermenting GNB (NF-GNB), is a serious complication of peritoneal dialysis with a low resolution rate. Beyond the patient’s condition, microbiological properties such as ... ...

Abstract	Abstract Peritonitis due to gram-negative bacilli (GNB), particularly nonfermenting GNB (NF-GNB), is a serious complication of peritoneal dialysis with a low resolution rate. Beyond the patient’s condition, microbiological properties such as antimicrobial resistance, biofilm production and other virulence factors can explain the poor outcomes. This study aimed to evaluate the influence of patient condition, microbiological characteristics, including biofilm production, and treatment on peritonitis outcome. We reviewed the records of 62 index episodes caused by NF-GNB that occurred between 1997 and 2015 in our center. The etiologies were species of Pseudomonas (51.6%), Acinetobacter (32.2%), and other NF-GNB (16.1%). There was a high (72.9%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low resolution rate (< 45%) among the episodes attributable to them. Preexisting exit-site infection was independently associated with nonresolution. No other factor, including biofilm production, was associated with the outcome. The higher in vitro susceptibility of Pseudomonas compared to other NF-GNB that presented a similar resolution rate suggests that bacterial virulence factors such as biofilms can act in concert, thereby worsening the outcome.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2021-06-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Peritoneal dialysis modality transition and impact on phosphate and potassium serum levels

Daniela Peruzzo / Murilo Guedes / John W. Larkin / Guilherme Yokoyama / Taynara Lopes dos Santos / Roberto Pecoits-Filho / Silvia Carreira Ribeiro / Alfonso Ramos / Pasqual Barretti / Thyago Proença de Moraes / on behalf of the BRAZPD Investigators

PLoS ONE, Vol 16, Iss

2021 Volume 10

Abstract	Peritoneal dialysis (PD) modalities affect solute removal differently. However, the impacts of switching PD modalities on serum levels of biomarkers of different sizes are not known. Our objective was to analyze whether a change in the PD modality associates with the levels of two routine biochemical laboratories. In this multicentric prospective cohort study. we selected all patients who remained on a PD modality for at least 6 months and switched PD modality. Patients were also required to be treated with the same PD modality for at least 3 months before and after the modality change. The primary outcome was change in potassium and phosphate serum levels. We identified 737 eligible patients who switched their PD modality during the study. We found mean serum phosphate levels increased during the 3 months after switching from CAPD to APD and conversely decreased after switching to from APD to CAPD. In contrast, for potassium the difference in the mean serum levels was comparable between groups switching from CAPD to APD, and vice versa. In conclusion, CAPD seems to be as efficient as APD for the control of potassium serum levels, but more effective for the control of phosphate serum levels. The effect of a higher removal of middle size molecules as result of PD modalities in terms of clinical and patient-reported outcomes should be further explored.
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Abordagem da oclusão trombótica dos cateteres de longa permanência dos pacientes em hemodiálise

Marcela Lara Mendes / Pasqual Barretti / Tricya Nunes Vieira da Silva / Daniela Ponce

Jornal Brasileiro de Nefrologia , Vol 37, Iss 2, Pp 221-

uma revisão narrativa

2015 Volume 227

Abstract: Resumo Atualmente, cateteres venosos permanentes (CVCp) estão se tornando cada vez mais uma alternativa de acesso vascular de longa permanência para pacientes nos quais o acesso arteriovenoso não pode ser confeccionado, sendo a oclusão trombótica ... ...

Abstract	Resumo Atualmente, cateteres venosos permanentes (CVCp) estão se tornando cada vez mais uma alternativa de acesso vascular de longa permanência para pacientes nos quais o acesso arteriovenoso não pode ser confeccionado, sendo a oclusão trombótica complicação mecânica comum. Essa complicação pode ocasionar mudanças frequentes dos locais de cateter, eliminando os sítios vasculares. Este estudo teve como objetivo realizar uma revisão narrativa do manejo da oclusão trombótica de CVCp na população em HD. O tratamento da trombose de CVC consiste em infusão de solução salina ou na administração de trombolíticos como plasminogênio tecidual ativado, reteplase ou uroquinase. Há poucos estudos sobre o uso de alteplase em CVCp obstruídos na população em diálise, e todos eles relatam sucesso entre 80 a 95% dos casos com uso de trombolítico na dose de 1 mg/ml. Por tratar-se de medicamento de custo elevado, estudos sugerem que a criopreservação e o fracionamento da alteplase tornam o uso financeiramente viável.
Keywords	cateteres venosos centrais ; falência renal crônica ; obstrução do cateter ; unidades hospitalares de hemodiálise ; Diseases of the genitourinary system. Urology ; RC870-923 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Language	Portuguese
Publishing date	2015-06-01T00:00:00Z
Publisher	Sociedade Brasileira de Nefrologia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Phenotypic and Molecular Characterization of Nonfermenting Gram-Negative Bacilli Causing Peritonitis in Peritoneal Dialysis Patients

Ana Cláudia Moro Lima dos Santos / Aydir Cecília Marinho Monteiro / Thaís Alves Barbosa / Danilo Flávio Moraes Riboli / Carlos Henrique Camargo / Adriano Martison Ferreira / Alessandro Lia Mondelli / Augusto Cezar Montelli / Rodrigo Tavanelli Hernandes / Maria de Lourdes Ribeiro de Souza da Cunha / Pasqual Barretti

Pathogens, Vol 11, Iss 218, p

2022 Volume 218

Abstract: 1) Background: Peritonitis due to nonfermenting Gram-negative bacilli (NF-GNB) is a dramatic complication of peritoneal dialysis (PD) with bad outcomes. Previous studies of PD-related peritonitis due to Pseudomonas species have shown a low-resolution ... ...

Abstract	(1) Background: Peritonitis due to nonfermenting Gram-negative bacilli (NF-GNB) is a dramatic complication of peritoneal dialysis (PD) with bad outcomes. Previous studies of PD-related peritonitis due to Pseudomonas species have shown a low-resolution rate, without a high resistance rate to antipseudomonal antibiotics. This suggests that bacterial virulence factors can act and influence peritonitis evolution. This study aimed to describe the microbiological characteristics of NF-GNB causing PD-related peritonitis and analyze their influence on the outcome. (2) Methods: We analyze the 48 isolates from NF-GNB peritonitis, which were stored in our culture collection regarding bacterial resistance, biofilm, and other virulence factors’ production, and clonal profile. Additionally, we collected data on treatment and outcomes from patients’ clinical registers. (3) Results: The etiologies were species of Pseudomonas (50%), Acinetobacter (36%), and other NF-GNB (14%). There was a high (75%) proportion of biofilm producer lineages. The in vitro susceptibility rate of Pseudomonas spp. to amikacin, ciprofloxacin, and ceftazidime was significantly greater than that of Acinetobacter spp. and other species; however, there was a similar low-resolution rate (<45%) among the episodes attributable to them. Pseudomonas species have a polyclonal profile, while we found a clone of five multiresistant Acinetobacter baumannii over an 8-year interval (2000–2008), which suggest an origin from the healthcare environment. (4) Conclusions: We are not able to identify any predictor of outcome, but it is possible that biofilm and others virulence factors can act in concert and contribute to the bad outcome.
Keywords	peritoneal dialysis ; peritonitis ; biofilm ; antimicrobial resistance ; Pseudomonas ; Acinetobacter ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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