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Joan Llibre

Publications and source records attributed to Joan Llibre.

3 recordsLinked to original sources
PubMed2004

Safety and efficacy of sevelamer in the treatment of uncontrolled hyperphosphataemia of haemodialysis patients.

BACKGROUND/AIM: The treatment of hyperphosphataemia is of major importance in the management of patients on dialysis. Traditional phosphate binders can be associated with undesirable effects. Recently, a new non-absorbable phosphate-binding polymer, sevelamer hydrochloride, has been available. Clinical information is scarce, and its cost could be a limiting factor for its wider use. No studies have evaluated its usefulness in uncontrolled hyperphosphataemic patients. METHODS: We identified 34 patients with a maintained serum phosphorus concentration >6.5 mg/dl and/or toxicity related to standard phosphorus-binding treatment (aluminium or calcium based). Sevelamer was added and titrated up fortnightly to achieve phosphorus control. Previous phosphate binders were decreased, whenever possible. The period of the study was 6 months. RESULTS: Thirteen patients (38%) dropped out because of side effects, mainly related to the gastro-intestinal tract. The efficacy analysis disclosed that the phosphorus concentration decreased from 2.39 +/- 0.48 to 1.84 +/- 0.48 mmol/l (p < 0.001). The mean dose of sevelamer was stabilised at 3.4 +/- 1.8 g/day. The amount of calcium- and aluminium-based phosphate binders could be decreased from 5.1 +/- 3.5 to 3.1 +/- 2.7 g/day (38% decrease) and from 2.4 +/- 1.5 to 1.5 +/- 1.7 g/day (36% decrease), respectively. The Ca x P product was significantly decreased from 5.83 +/- 1.19 to 4.36 +/- 1.12 mmol/l2 (p < 0.001). The total cholesterol concentration decreased from 4.34 +/- 0.9 to 3.98 +/- 0.9 mmol/l (p < 0.01) and the low-density lipoprotein cholesterol level from 2.61 +/- 0.98 to 2.20 +/- 0.77 mmol/l (p < 0.03). CONCLUSIONS: Sevelamer is an effective phosphate binder that allows a better serum phosphorus control, while allowing a decrease in the dose of calcium- and aluminium-based phosphate binders in these difficult patients. The drawbacks are the high intolerance rate and the price of the product.

Adult↗
PubMed1998

Synthesis and Characterization of the First Cyclic Monothioether Derivative of 1,2-o-Carborane and Its Reactivity toward Phosphine Transition Metal Complexes.

The first cyclic monothioether derivative of [C(2)B(9)H(12)](-) has been synthesized from 1-(SH)-1,2-C(2)B(10)H(11). Reaction of the latter with (n)BuLi and 1,3-dibromopropane leads to 1,2-&mgr;-(S(CH(2))(3))-1,2-C(2)B(10)H(10). Partial degradation leads to [7,8-&mgr;-(S(CH(2))(3))-7,8-C(2)B(9)H(10)](-). Reaction of [7,8-&mgr;-(S(CH(2))(3))-7,8-C(2)B(9)H(10)](-) with [PdCl(2)(PRR'(2))(2)] leads to different sets of compounds depending on the nature of R and R'. If R = R' = (t)Bu, a closo compound with one vertex occupied by "[Pd(P(t)Bu(3))(2)]" is obtained. When aryl groups are present in the starting phosphine complex, the zwitterionic non-metal-containing compounds are obtained. The crystal structure of one of them has been determined, and the compound has been proven to be 7,8-&mgr;-(S(CH(2))(3))-11-PPh(3)-7,8-C(2)B(9)H(9). The reaction of [7,8-&mgr;-(S(CH(2))(3))-7,8-C(2)B(9)H(10)](-) with [RhCl(PPh(3))(3)] leads to [Rh(7,8-&mgr;-(S(CH(2))(3))-7,8-C(2)B(9)H(10))(PPh(3))(2)]. An agostic B-Hright harpoon-up Rh interaction has been produced, identified by a (1)H{(11)B} NMR resonance at -4.78 ppm. In this instance the cluster is connected to "Rh" via the thioether and B(11)-H. The reaction of [7,8-&mgr;-(S(CH(2))(3))-7,8-C(2)B(9)H(10)](-) with [RuCl(2)(PPh(3))(3)] leads to a compound with two B-Hright harpoon-up Ru interactions. Contrarily to its noncyclic analogues, it seems that only one isomer has been obtained.

Journal Article↗