É assim mesmo. Amanhã é outro dia! | Entrevista com Angel Vianna concedida a Marina Magalhães e Juliana Ribeiro

Angel and Klauss Vianna are important researchers of the body and gesture in Brazil. Since the 1950s, with the School and the Ballet Klauss Vianna, in Belo Horizonte, they have influenced many generations, strongly contributing with the artistic and pedagogical fields. In this interview, Angel Vianna presents the highlights of her trajectory in dance and it's interface with theater and therapeutics, focusing on Grupo Teatro do Movimento, a dance company founded in Rio de Janeiro in the 70s and considered to be one of the first contemporary dance companies in the city. The text reveals Vianna’s thinking and her creative processes towards dance.Angel y Klauss Vianna son importantes investigadores sobre el cuerpo y el gesto en Brasil. Desde la década de 1950, con la Escola y el Ballet Klauss Vianna, en Belo Horizonte, han influido en varias generaciones, contribuyendo fuertemente al entorno artístico y pedagógico. En esta entrevista, Angel Vianna presenta los principales puntos de su trayectoria en la danza y su interfaz con el teatro y el área terapéutica. Vianna se enfoca en el Grupo Teatro do Movimento, una compañía de danza fundada en Río de Janeiro en la década de 1970, considerada una de las compañías precursoras de danza contemporánea de la cuidad. El texto revela el pensamiento de Vianna y sus procesos creativos con la compañía de danza.Angel e Klauss Vianna são importantes pesquisadores sobre o corpo e o gesto no Brasil. Desde a década de 1950, com a Escola e o Ballet Klauss Vianna, em Belo Horizonte, vêm influenciando várias gerações, contribuindo fortemente com o meio artístico e pedagógico. Nesta entrevista, Angel Vianna apresenta os principais pontos de sua trajetória na dança e sua interface com o teatro e a área terapêutica, focando no Grupo Teatro do Movimento, companhia de dança fundada no Rio de Janeiro na década de 1970, considerada uma das companhias precursoras da dança contemporânea carioca. O texto revela o pensamento de Vianna e de seus processos criativos junto à companhia de dança

International Liver Transplantation Society Global Census:First Look at Pediatric Liver Transplantation Activity Around the World

Background. Over 16 000 children under the age of 15 died worldwide in 2017 because of liver disease. Pediatric liver transplantation (PLT) is currently the standard of care for these patients. The aim of this study is to describe global PLT activity and identify variations between regions. Methods. A survey was conducted from May 2018 to August 2019 to determine the current state of PLT. Transplant centers were categorized into quintile categories according to the year they performed their first PLT. Countries were classified according to gross national income per capita. Results. One hundred eight programs from 38 countries were included (68% response rate). 10 619 PLTs were performed within the last 5 y. High-income countries performed 4992 (46.4%) PLT, followed by upper-middle- (4704 [44·3%]) and lower-middle (993 [9·4%])-income countries. The most frequently used type of grafts worldwide are living donor grafts. A higher proportion of lower-middle-income countries (68·7%) performed ≥25 living donor liver transplants over the last 5 y compared to high-income countries (36%; P = 0.019). A greater proportion of programs from high-income countries have performed ≥25 whole liver transplants (52.4% versus 6.2%; P = 0.001) and ≥25 split/reduced liver transplants (53.2% versus 6.2%; P &lt; 0.001) compared to lower-middle-income countries. Conclusions. This study represents, to our knowledge, the most geographically comprehensive report on PLT activity and a first step toward global collaboration and data sharing for the greater good of children with liver disease; it is imperative that these centers share the lead in PLT.</p

Control of Visceral Leishmaniasis in Latin America—A Systematic Review

Visceral leishmaniasis is a vector-borne disease characterized by fever, spleen and liver enlargement, and low blood cell counts. In the Americas VL is zoonotic, with domestic dogs as main animal reservoirs, and is caused by the intracellular parasite Leishmania infantum (syn. Leishmania chagasi). Humans acquire the infection through the bite of an infected sand fly. The disease is potentially lethal if untreated. VL is reported from Mexico to Argentina, with recent trends showing a rapid spread in Brazil. Control measures directed against the canine reservoir and insect vectors have been unsuccessful, and early detection and treatment of human cases remains as the most important strategy to reduce case fatality. Well-designed studies evaluating diagnosis, treatment, and prevention/control interventions are scarce. The available scientific evidence reasonably supports the use of rapid diagnostic tests for the diagnosis of human disease. Properly designed randomized controlled trials following good clinical practices are needed to inform drug policy. Routine control strategies against the canine reservoirs and insect vectors are based on weak and conflicting evidence, and vector control strategies and vaccine development should constitute research priorities

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)

Venous vascular reconstruction of a robotically procured right kidney with two renal veins transplanted into a pediatric recipient

BACKGROUNDRight versus left kidney donor nephrectomy remains a controversial topic in renal transplantation given the increased incidence of right kidney vascular anomalies and associated venous thrombosis. We present the case of a 3-year-old pediatric recipient with urethral atresia and end-stage kidney disease who received a robotically procured living donor right pelvic kidney with two short same-size renal veins and a short ureter.METHODSWe utilized a completely deceased iliac vein system (common iliac vein with both external and internal veins) to extend the two renal veins. Due to the distance between both renal veins, the external iliac vein was anastomosed to the upper hilum renal vein, and the internal iliac vein was anastomosed to the lower hilum renal vein. The donor's short ureter was anastomosed to the recipient's ureter end-to-side.RESULTSThe patient had immediate graft function and there were no post-operative complications. Renal ultrasound was unremarkable at 48 hours post-transplant. Serum creatinine was 0.5 mg/dL at 3 months post-transplant.CONCLUSIONWe demonstrate the successful transplantation of a robotically procured right pelvic donor kidney with two short renal veins using a deceased donor iliac vein system for venous reconstruction without increasing technical complications. This technique of venous reconstruction can be used in right kidneys with similar anatomical variations without affecting graft function

Water Demand Prospects for the Irrigation in São Francisco River

Regional expansion of irrigated agriculture causes a growth in foodstuff production in the country, minimizes risks for the farmer and strengthens foodstuff security for future generations. However, at the same time, it has a damaging effect on water availability, via demands for water use, which may intensify situations of microregional water scarcity . The TERM-BR was used in order to simulate expansion scenarios in irrigated areas, aiming at verifying the impact of such an expansion in the use of water for 2025. Scenarios were adapted for the National Plan for Water Resources (PNRH) and simulations were carried out for areas deemed potentially suitable for irrigation based on the MI study (2014). Irrigated agriculture was separated from dry farming in terms of differential productivity. The Climate Water Balance (CWB) was estimated for Northeastern States in order to compare regional water supply and demand. Results for the simulation suggest that the greater impact on the GDP, investment and use of regional families would take place in the state of Mato Grosso, in the Midwest region of the country. The comparative result of the CWB and the TERM-BR simulation for states in the Northeastern region point to potential hydric problems in the states of Alagoas and Pernambuco in particular

O que pode um corpo? O método Angel Vianna de conscientização do movimento como um instrumento terapêutico What can a body do? The Angel Vianna method of awareness of movement as a therapeutic instrument

Contrapondo-se à educação tradicional da dança, quando esta trabalhava corpo e movimento padronizados, o método Angel Vianna de Conscientização do Movimento começou a ser desenvolvido no ensino do balé clássico - e posteriormente da expressão corporal - que considerasse o corpo e o movimento na sua singularidade. Esse modo original e autêntico de lidar com o corpo acabou direcionando a Conscientização do Movimento para uma utilidade também terapêutica, sendo aplicada em diversas áreas de atuação no campo da saúde. Porém, apesar de a Conscientização do Movimento ter demonstrado consistência e eficácia, sua aplicação terapêutica ainda se dá na primazia da experiência, carecendo de uma formalização dos fundamentos teórico-conceituais que a sustente enquanto método de trabalho terapêutico para a área da saúde. O objetivo principal deste artigo foi propor uma possível formalização dos fundamentos teórico-conceituais que orientam a Conscientização do Movimento no campo da saúde. A pesquisa parte de nossa própria experiência, além da utilização do método filosófico-conceitual que nos permite desconstruir crenças cristalizadas e propor uma concepção mais ampliada do processo saúde-doença. Consideramos que uma terapêutica como o método Angel Vianna de Conscientização do Movimento pode, via corpo, contribuir para a integração do psicossoma, ampliando a saúde do indivíduo enquanto capacidade normativa e criativa. Entretanto, mesmo sendo uma prática corporal que se faz potente em vários âmbitos por sua própria experiência, percebemos que o fato de ser formalizada sem cair em reducionismos ou cristalizações pôde trazer ainda mais vitalidade à sua aplicação terapêutica.<br>In contrast with the traditional dance teaching, in which dance held together standardized body and movement, the Angel Vianna method of Awareness of Movement began its development for the teaching of classical ballet - and afterwards of body expression - that considered body and movement in its singularity. This original and authentic method of dealing with the body turned the Awareness of Movement also useful from a therapeutic viewpoint, applied to several areas in the health field. However, despite the fact that over the years the Awareness of Movement showed consistency and efficacy, its therapeutic application still occurs only through experience, lacking formalization of the theoretical-conceptual foundations that could give support to it as a therapeutic method in the health area. So our main objective in this paper was to propose a possible formalization of the theoretical-conceptual foundations that guide the Awareness of Movement in the health field. The research starts with our own experience, and uses the philosophical-conceptual method that allows us to demolish crystallized beliefs and propose a broader conception of the process health-illness. We believe that a therapeutic like the Angel Vianna method of Awareness of Movement can, through the body, help integrate the psycho-soma, amplifying the individual's health in its normative and creative capacity. Although this method is a body practice that makes itself powerful in several aspects from its own experience, we found that its formalization, without falling in reductionisms or crystallizations, could bring an even greater vitality to its therapeutic application

Creating a Single Inflow Orifice From Living Donor Kidney Allografts With Multiple Renal Arteries

Multiple renal arteries (MRA) are often encountered during living-donor kidney transplantation (LDKT), requiring surgeons to pursue complex renovascular reconstructions prior to graft implantation. With improvements in reconstruction and anastomosis techniques, allografts with MRA can be successfully transplanted with similar outcomes to allografts with a single renal artery. Here, we describe in detail various surgical techniques for reconstruction of MRA grafts with the intent of creating a single arterial inflow. We retrospectively reviewed the medical records of all LDKT recipients with laparoscopically procured MRA kidneys between March 2008 and July 2021. Recipient and donor characteristics, operative data, type of reconstruction, and recipient outcomes were analyzed. The primary outcomes were the incidence of developing delayed graft function (DGF) and/or a vascular or urological complication within 12 months post-transplant. Seventy-three LDKT recipients of MRA donor allografts were evaluated. Two renal arteries (RA) were encountered in 62 allografts (84.9%) and three RA in 11 allografts (15.1%). Renal artery reconstruction was performed in 95.8% (70/73) of patients. Eighteen different reconstruction techniques of MRA were utilized, the most common being side-to-side anastomosis in allografts with two RA ( = 44) and side-to-side-to-side anastomosis in allografts with three RA ( = 4). Interposition grafting was performed in seven cases (9.6%). A single ostium was created in 69 cases (94.5%), and the median warm ischemia time was 27 (range 20-42) minutes. None of the patients developed DGF or post-operative vascular or urological complications. Median creatinine at 3, 6, and 12 months post-transplant remained stable at 1.1 mg/dl. With a median follow-up of 30.4 months post-transplant, only one graft failure has been observed-death-censored graft survival was 98.6%. Complex reconstruction techniques to create a single renal artery ostium for graft implantation anastomosis in allografts with MRA show acceptable warm ischemic times, with no increased risk of post-operative vascular or urological complications