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Dive into the research topics where Ajácio Bandeira de Mello Brandäo is active.

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Featured researches published by Ajácio Bandeira de Mello Brandäo.


Clinical Transplantation | 2012

MELD scores with incorporation of serum sodium and death prediction in cirrhotic patients on the waiting list for liver transplantation: a single center experience in southern Brazil

Caroline Possa Marroni; Ajácio Bandeira de Mello Brandäo; Alexandre Wahl Hennigen; Claudio Augusto Marroni; Maria Lucia Zanotelli; Guido Cantisani; Sandra Cristina Pereira Costa Fuchs

To compare the accuracy of standard model for end‐stage liver disease (MELD) score with that of four MELD‐based scores incorporating serum sodium (SNa) to predict three‐ and six‐month mortality in cirrhotic patients after their placement on the waiting list for liver transplantation (LT). A cohort study was performed. Receiver operating characteristic (ROC) curves were generated for MELD, MELD incorporating SNa (MELD‐Na, MELD‐Na2), integrated MELD (iMELD), and MELD to SNa ratio (MESO) index to assess the predictive accuracy of these scores to determine three‐ and six‐month mortality. The c‐statistic (area under the ROC curve [AUC]) was used to determine predictive power and the Cox proportional‐hazard ratio to estimate death risk. We studied 558 patients. There was a statistically significant difference in the predictive accuracy of scores at three months (AUCs: MELD = 0.79 [95% CI = 0.72–0.87]; MELD‐Na = 0.84 [95% CI = 0.78–0.90]; MELD‐Na2 = 0.85 [95% CI = 0.80–0.91]; iMELD = 0.85 [95% CI = 0.80–0.90]; MESO = 0.81 [95% CI = 0.80–0.91]) and at six months (MELD = 0.73 [95% CI = 0.67–0.80]; MELD‐Na = 0.79 [95% CI = 0.73–0.84]; MELD‐Na2 = 0.80 [95% CI = 0.74–0.85]; iMELD = 0.80 [95% CI = 0.75–0.85]; MESO = 0.75 [95% CI = 0.69–0.81]) (p < 0.001). Death risk was independent of age and sex. Sodium‐modified MELD scores are able to more accurately predict three‐ and six‐month mortality among cirrhotic patients awaiting LT.


PLOS ONE | 2016

Alcohol Drinking Pattern: A Comparison between HIV-Infected Patients and Individuals from the General Population.

Maria Letícia Rodrigues Ikeda; Nêmora Tregnago Barcellos; Paulo Ricardo de Alencastro; Fernando Herz Wolff; Leila Beltrami Moreira; Miguel Gus; Ajácio Bandeira de Mello Brandäo; Flávio Danni Fuchs; Sandra Cristina Pereira Costa Fuchs

Background Alcohol consumption is highly prevalent in the general population and among HIV-infected population. This study aimed to compare the pattern of alcohol consumption and to describe characteristics associated with heavy alcohol consumption in individuals from the general population with patients infected with HIV. Methods Participants for this analysis came from a population-based cross-sectional study and from a consecutive sampling of patients infected with HIV. Participants aged 18 years or older were interviewed using similar questionnaires with questions pertaining to socio-demographic characteristics, alcohol consumption, smoking, physical activity, and HIV-related characteristics, among others. Blood pressure and anthropometric measures were measured using standardized procedures. Results Weekly alcohol consumption was more prevalent among individuals from the general population than HIV-infected patients: 57.0 vs. 31.1%, P<0.001. The prevalence of heavy episodic drinking was higher in the population sample as well: 46.1 vs. 17.0%, P<0.001. In the general population, heavy alcohol consumption was more prevalent in men. Cigarette smoking was independently associated with heavy alcohol consumption among HIV infected (Prevalence Ratio; PR = 5.9; 95%CI 2.6–13.9; P<0,001) and general population (PR = 2.6; 95%CI 1.9–3.0; P<0.001). Years at school were inversely associated with heavy alcohol consumption among HIV-infected patients and directly associated among participants from the general population, even after controlling for sex, age, skin color, and smoking. Conclusions Heavy alcohol consumption is more prevalent in the general population than among HIV-infected patients. Individuals aware about their disease may reduce the amount of alcoholic beverages consumption comparatively to healthy individuals from the general population.


Brazilian Journal of Infectious Diseases | 2011

Absence of occult hepatitis B among blood donors in southern Brazil

Fernando Herz Wolff; Sandra Cristina Pereira Costa Fuchs; Ajácio Bandeira de Mello Brandäo

BACKGROUNDnOccult hepatitis B virus (HBV) infection is characterized by the detection of HBV DNA in serum and/or in liver in the absence of detectable hepatitis B surface antigen (HBsAg). The reported prevalence of occult hepatitis B varies markedly among populations and according to the sensitivity of the HBV DNA assay. The aim of the present study was to describe the prevalence of occult hepatitis B among HCV-infected and non-infected blood donors in Porto Alegre, Southern Brazil, using a highly sensitive real time polymerase chain reaction (PCR) method.nnnMETHODOLOGYnBetween 1995 and 1997 a sample of 178 blood donors with two positive anti-HCV ELISA tests were consecutively selected as cases, and 356 anti-HCV negative donors were selected as controls. Blood donors were randomly selected from eight blood centers in Porto Alegre, Southern Brazil, representative of the whole blood donor population. Blood samples were kept at 70ºC and defrosted for the first time for the analysis of this report. Tests previously performed in the laboratory using the same real time PCR for HBV DNA had sensitivity for detecting as low as 9 copies/mL. Among 158 blood samples from HBsAg-negative blood donors, five were anti-HBc positive, 53 tested positive for anti-HCV and 105 had anti-HCV negative. The samples analysis was performed in duplicate and all blood samples tested negative for HBV DNA.nnnCONCLUSIONnThe result reflects a very low prevalence of occult hepatitis B in our setting.


Clinical Transplantation | 2018

Dobutamine stress echocardiography, myocardial perfusion scintigraphy, invasive coronary angiography, and post-liver transplantation events: Systematic review and meta-analysis

Jonathan Soldera; Fábio Camazzola; Santiago Rodríguez; Ajácio Bandeira de Mello Brandäo

The impact of coronary artery disease on the clinical course of patients enrolled for liver transplantation (LT) has changed over the years as these patients become older and sicker. The purpose of this systematic review and meta‐analysis was to investigate the value of dobutamine stress echocardiography (DSE), myocardial perfusion scintigraphy (MPS), and invasive coronary angiography (ICA) in predicting cardiac events post‐LT in cirrhotic patients. A literature search was conducted using Scopus, Web of Science, EMBASE, MEDLINE (via PubMed), BIREME (regional medical library of the Pan American Health Organization), LILACS (Latin American and Caribbean Health Sciences Literature), Cochrane Library for Systematic Reviews, and OpenGrey Repository (www.opengrey.eu) electronic databases. A total of 322 records were retrieved for DSE, 90 for MPS, and 149 for ICA. In the final analysis, 11 records for DSE, 7 for MPS, and 8 for ICA were included. The relative risk and confidence interval for major adverse cardiac events were 30.2 (2.8‐325.4) for DSE, 2.6 (1.09‐6.1) for MPS, and 2.1 (1.0‐2.3) for ICA, while the relative risk and confidence interval for all‐cause mortality was 4.7 for DSE (1.8‐12.0), 2.7 (1.25‐5.9) for MPS, and 1.5 (0.89‐3.2) for ICA. In conclusion, this meta‐analysis found that DSE, MPS, and ICA do not satisfactorily predict increased risk of perioperative MACE or all‐cause mortality among cirrhotic patients listed for LT, among small and heterogenous studies.


Clinical Transplantation | 2016

Cost-effectiveness of whole-body bone scans in the pre-liver transplant assessment of patients with hepatocellular carcinoma in Southern Brazil.

Santiago Rodríguez; Giácomo Balbinotto Neto; Guillermo Kiss; Ajácio Bandeira de Mello Brandäo

Bone metastases (BM) are rare in patients with early‐stage hepatocellular carcinoma (HCC). In many centers, liver transplantation (LTx) policies require patients with HCC to undergo bone scans (BSs).


Clinical Transplantation | 2015

Validation of the “Metroticket” model in a cohort of patients transplanted for hepatocellular carcinoma in southern Brazil

Adriana Machado; Guillermo Kiss; Lucas Ernani; Claudio Augusto Marroni; Maria Lucia Zanotelli; Guido Cantisani; Carlos Thadeu Schmidt Cerski; Gabriela Perdomo Coral; Ajácio Bandeira de Mello Brandäo

This retrospective study evaluated the ability of the Metroticket model to predict five‐yr post‐transplant survival in patients with hepatocellular carcinoma (HCC) based only on explant data. Five‐yr survival after transplant was estimated using the Metroticket Calculator, and observed survival was calculated using the Kaplan–Meier method. Metroticket‐predicted survival was compared between deceased and surviving patients using the Mann–Whitney test. The accuracy of Metroticket estimates in discriminating between these two patient groups was assessed using the c‐statistic. Median patient age (n = 109) was 55.7 yr, and 72.5% of the sample were men. Metroticket‐predicted and observed post‐transplant survival at five yr was 71.1% and 58.7%, respectively. Predictions were calculated using the explant data of the 64 survivors and 45 deceased patients. Median five‐yr survival was 72.9% in the former and 69.7% in the latter. The c‐statistic of the Metroticket model for distinguishing surviving from deceased patients was 0.55. In this cohort, the Metroticket model was unable to accurately predict five‐yr post‐transplant survival based only on explant data.


Arquivos De Gastroenterologia | 2015

ASSOCIATION BETWEEN MURINE DOUBLE MINUTE 2 - T309G polymorphism and recurrence of hepatocellular carcinoma after surgical treatment

Uirá Fernandes Teixeira; Andréa Gomes Coelho Izaguirre; Mayara Christ Machry; Carlos Thadeu Schmidt Cerski; Ajácio Bandeira de Mello Brandäo; Paulo Roberto Ott Fontes

BACKGROUNDnDiscovery and incorporation of biomarker panels to cancer studies enabled the understanding of genetic variation and its interference in carcinogenesis at molecular level. The potential association between single nucleotide polymorphism (SNP) 309 and increased development of tumors, such as hepatocellular carcinoma, has been subject to several studies. This is the first study on this association conducted in Brazil.nnnMETHODSn62 cases of cirrhotic patients with hepatocellular carcinoma surgically treated by partial hepatectomy (HPT) or by liver transplantation (LTX) from 2000 to 2009 at Santa Casa Hospital Complex, in the city of Porto Alegre, were retrospectively analyzed. Tumor samples from surgical specimen were collected and prepared for study in paraffin blocks.nnnRESULTSnOverall survival was 26.7 months in the HPT group and 62.4 months in the LTX group (P <0.01). Overall tumor recurrence was 66.7% in the HPT group (10/15) and 17% in the LTX group (8/47) (X²=13.602, P <0.01). Alpha-fetoprotein levels >200ng/mL, microvascular invasion and histological grade were associated with tumor recurrence (P <0.01). Recurrence rates in each surgical group and analysis of factors associated with tumor recurrence, when stratified for each genotypic pattern, were both not statistically significant.nnnCONCLUSIONnG/G genotype was not associated with tumor recurrence after surgical treatment and it did not show any correlation with other prognostic factors.


Journal of Epidemiology and Community Health | 2011

SP2-9 Diagnostic criteria of lipodystrophy in HIV-infected patients

P R de Alencastro; S C Fuchs; Fernando Herz Wolff; Maria Letícia Rodrigues Ikeda; Ajácio Bandeira de Mello Brandäo; Nêmora Tregnago Barcellos

Introduction The prevalence of lipodystrophy ranges from 2 to 84% and the range of findings stems from differences between the populations studied and lack of standardised diagnostic criteria. The diagnosis of lipodystrophy is based on changes in body fat distribution with or without medical confirmation, objective measures of circumferences and skin folds or quantification of adiposity by dual emission x-ray absorptiometry (DEXA) CT scan or MRI. Objective Establish diagnostic criteria for lipodystrophy and evaluate the prevalence of lipodystrophy among men and women with HIV/AIDS. Study design Cross-sectional survey was conducted in HIV-infected patients of both genders, aged 18u2005years or older who sought to confirm the diagnosis or treatment in a reference service for HIV/AIDS for the period June 2006 to December 2008. Results 1240 patients with HIV infection were invited to participate. Among the signs that contributed most to the detection of lipoatrophy, include hollow cheeks, reduced fat on the face, buttocks and arms. To lipohypertrophy the biggest contributor was an increase in fat in the abdomen, abdomen bigger than usual and increased waist circumference. Men were more often lipoatrophy (p=0.049) and women lipohypertrophy (p<0.001). Conclusion This study identified high rates of self-reported signs of lipodystrophy were significantly associated with that objective measures. The differences between men and women do not represent a formal test validation, but the analysis comparing objective measures confirms the importance of using specific questions about changes in the distribution of fat in their accompaniment.


Journal of Epidemiology and Community Health | 2011

SP4-37 Metabolic syndrome prevalence and population attributable risk among HIV/AIDS patients: comparisons between NCEP-ATPIII, IDF and AHA/NHLBI criteria

P R de Alencastro; S C Fuchs; R R de Oliveira; F H Holff; Maria Letícia Rodrigues Ikeda; Ajácio Bandeira de Mello Brandäo; Nêmora Tregnago Barcellos

Background Metabolic syndrome comprises a set of aggregated risk factors, which increase the risk of cardiovascular disease and type 2 diabetes mellitus, and changes in the abnormality criteria account for differences in prevalence rates and in the population attributable risk. Objectives Verify the prevalence of metabolic syndrome according to the NCEP-ATPIII, IDF and the AHA/NHLBI, and the impact of each component on the diagnostic of metabolic syndrome among HIV-infected adults. We also estimated the HIV-infected population with metabolic syndrome by Brazilian regions. Methods This cross-sectional study enrolled HIV infected patients from a HIV/AIDS reference Center in southern Brazil. Metabolic syndrome was identified according to the NCEP-ATPIII, IDF and AHA/NHLBI criteria, using standardised questionnaire and blood testing. Results A sample of 1240, out of 1295, HIV-infected patients was enrolled. Males were on average older, more educated, and had shorter time since the HIV diagnosis. The population attributable risk (PAR) for waist circumference explained 80% of the prevalence among men and women (AHA/NHLBI criteria). Triglycerides had the highest impact on prevalence of metabolic syndrome according to all criteria, independently of age, skin colour and HAART use, among men. The southern and south regions of Brazil had the highest population of subjects HIV-infected with metabolic syndrome. Conclusions In this large sample of HIV infected patients, the overall prevalence of metabolic syndrome, under either classification, was noticeable and the AHA/NHLBI definition accounted for the highest prevalence. The largest population HIV-infected with metabolic syndrome is concentrated in the southern and south of Brazil.


Einstein (São Paulo) | 2017

Ventilatory support and hospital stay after liver transplant in cirrhotic patients with hepatopulmonary syndrome

José Leonardo Faustini Pereira; Lucas Homercher Galant; Eduardo Garcia; Luis Henrique Telles da Rosa; Ajácio Bandeira de Mello Brandäo; Claudio Augusto Marroni

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Claudio Augusto Marroni

Universidade Federal de Ciências da Saúde de Porto Alegre

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Sandra Cristina Pereira Costa Fuchs

Universidade Federal do Rio Grande do Sul

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Maria Letícia Rodrigues Ikeda

Oklahoma State Department of Health

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Nêmora Tregnago Barcellos

Oklahoma State Department of Health

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Carlos Thadeu Schmidt Cerski

Universidade Federal do Rio Grande do Sul

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Gabriela Perdomo Coral

Universidade Federal de Ciências da Saúde de Porto Alegre

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Guido Cantisani

Universidade Federal do Rio Grande do Sul

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Guillermo Kiss

Universidade Federal do Rio Grande do Sul

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Maria Lucia Zanotelli

Universidade Federal do Rio Grande do Sul

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Santiago Rodríguez

Universidade Federal de Ciências da Saúde de Porto Alegre

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