RESUMO
Few reports assessed endothelial activation biomarkers in kidney allograft biopsies using immunohistochemistry. This retrospective cohort study evaluated the association between posttransplant outcomes and the immunohistochemistry expression of Caveolin-1, Von Willebrand Factor (Vwf), and T-Cadherin in for-cause biopsies diagnosed as interstitial fibrosis and tubular atrophy of unknown etiology. Samples with antibody-mediated changes were excluded. The patients were followed for 3 years after the biopsy or until graft loss/death. Seventy-one (71) samples from 66 patients were included. Eighteen (25.4%) patients lost their grafts, mainly due to chronic rejection (33.3%). Caveolin-1 and T-Cadherin were not associated with graft loss. Vwf had good accuracy in predicting graft failure (AUC 0.637, 95% CI 0.486 to 0.788 P =0.101). The presence of more than 10% of Vwf positivity in the microvasculature (Vwf >10%) was associated with reduced death-censored graft survival (58.2% vs. 85.4% P =0.006), and this result was also observed in the subgroup presenting mild interstitial fibrosis (ci=1) (65.7% vs. 88.6% P =0.033). The multivariate analysis showed that Vwf >10% was an independent risk factor for graft loss (HR=2.88, 95% CI 1.03 to 8.02 P =0.043). In conclusion, Vwf might be an additional tool to predict allograft outcomes in kidney transplant recipients with interstitial fibrosis and tubular atrophy of unknown etiology, probably reflecting immune endothelial activation.
Assuntos
Nefropatias , Transplante de Rim , Humanos , Aloenxertos/patologia , Atrofia/patologia , Biópsia , Caveolina 1 , Fibrose , Rejeição de Enxerto/diagnóstico , Rim/patologia , Estudos Retrospectivos , Fator de von Willebrand , Imuno-HistoquímicaRESUMO
Objective to analyze the temporal trend of Web Food and Nutrition Surveillance System (SISVAN Web) coverage of children under 5 years old in the Northern Region of Brazil between 2008-2017. Methods this was an ecological time series study with data from SISVAN Web; coverage annual percentage change (APC) was estimated using the Prais-Winsten regression model. Results SISVAN Web coverage in the Northern Region in 2008 and 2017 was 12.2% and 37.9%, respectively, with a rising trend (APC=14.2% - 95%CI 10.9;17.6); the states and health regions showed similar trends; Acre was the state with the highest APC (17.3% - 95%CI 13.6;21.1). Conclusion there was a rising trend in SISVAN Web coverage in the Northern Region as a whole, in all its states and in all its health regions.
Assuntos
Transtornos da Nutrição Infantil/epidemiologia , Estado Nutricional , Vigilância em Saúde Pública/métodos , Brasil/epidemiologia , Pré-Escolar , HumanosRESUMO
Objetivo: analisar a tendência temporal da cobertura do Sistema de Vigilância Alimentar e Nutricional Web (Sisvan Web) em menores de 5 anos de idade da região Norte brasileira, no período de 2008 a 2017. Métodos: estudo ecológico de séries temporais, com dados do Sisvan Web; a variação percentual anual (VPA) da cobertura do sistema foi estimada pelo modelo de regressão de Prais-Winsten. Resultados: na região Norte, as coberturas do SISVAN Web em 2008 e 2017 foram de 12,2% e 37,9%, respectivamente, com tendência crescente (VPA=14,2% - IC95% 10,9;17,6); os estados da região e respectivas regionais de saúde apresentaram tendências semelhantes; o Acre foi o estado que apresentou maior VPA (17,3% - IC95% 13,6;21,1). Conclusão: houve tendência crescente da cobertura do Sisvan Web na região Norte do país, assim como em todos os seus estados e regionais de saúde.
Objetivo: analizar la tendencia temporal de la cobertura del Sistema de Vigilancia Alimentaria y Nutricional (SISVAN Web) en niños menores de 5 años en la Región Norte de Brasil entre 2008-2017. Métodos: estudio ecológico de series temporales con datos del SISVAN Web; el porcentaje de variación anual (PVA) de cobertura se estimó mediante el modelo de regresión de Prais-Winsten. Resultados: en la Región Norte, la cobertura del SISVAN Web en 2008 y 2017 fue de 12,2% y 37,9%, respectivamente, con una tendencia creciente (PVA=14,2% - IC95% 10,9;17,6); los Estados y las Regionales de Salud presentaron resultados similares; Acre fue el Estado con el PVA más alto (17,3% - IC95% 13,6;21,1). Conclusión: hubo una tendencia creciente en la cobertura del SISVAN Web en todos los Estados y Regionales de Salud de la Región Norte entre 2008 y 2017.
Objective: to analyze the temporal trend of Web Food and Nutrition Surveillance System (SISVAN Web) coverage of children under 5 years old in the Northern Region of Brazil between 2008-2017. Methods: this was an ecological time series study with data from SISVAN Web; coverage annual percentage change (APC) was estimated using the Prais-Winsten regression model. Results: SISVAN Web coverage in the Northern Region in 2008 and 2017 was 12.2% and 37.9%, respectively, with a rising trend (APC=14.2% - 95%CI 10.9;17.6); the states and health regions showed similar trends; Acre was the state with the highest APC (17.3% - 95%CI 13.6;21.1). Conclusion: there was a rising trend in SISVAN Web coverage in the Northern Region as a whole, in all its states and in all its health regions.