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Abstract This paper analyzes ethno-racial residential segregation in two large metropolitan areas across the Global North and South: London (UK) and São Paulo (Brazil). Residential segregation is measured and mapped using global and local spatial segregation indices that portray different spatial dimensions across scales. To interpret results, the study adopted a relational approach that juxtaposes global figures and local variations of segregation, complementary dimensions of segregation (dissimilarity and exposure/isolation), multiple scales of segregation, and location patterns of different ethno-racial groups. Results indicate that London and São Paulo metropolitan regions have similar, although inverse, core-periphery patterns of ethno-racial segregation. The findings also revealed that segregation levels are higher for London than São Paulo across scales and dimensions, indicating that, against common assumptions, London is more ethno-racially segregated than São Paulo. These findings are discussed in the context of existing literature, exploring similarities and differences between ethno-racial segregation in the two metropolitan regions. The paper concludes with a discussion on the relevance of the comparative findings for segregation studies, and a reflection on future studies on urban segregation.

Resumo Este artigo analisa a segregação residencial do ponto de vista étnico-racial em duas grandes regiões metropolitanas localizadas no Sul e Norte Globais: Londres (Reino Unido) e São Paulo (Brasil). Utilizaram-se índices espaciais globais e locais para mapear e mensurar as diferentes dimensões espaciais e escalas da segregação étnico-racial nas duas metrópoles. O estudo adotou uma abordagem relacional para a interpretação dos resultados que justapõe resultados globais e variações locais da segregação, dimensões espaciais complementares (dissimilaridade e exposição/isolamento), múltiplas escalas geográficas e padrões de localização espacial dos diferentes grupos étnico-raciais. Os resultados indicam que as regiões metropolitanas de Londres e São Paulo apresentam padrões espaciais de segregação centro-periferia similares, mas inversos. Os resultados também relevaram que os níveis de segregação de Londres são mais altos do que os de São Paulo, indicando que contraintuitivamente Londres é mais segregada étnico-racialmente do que São Paulo. Esses resultados são discutidos no contexto da literatura, explorando as similaridades e diferenças entre as duas regiões metropolitanas. O artigo conclui com uma discussão sobre a relevância dos resultados e uma reflexão sobre a agenda futura para os estudos sobre a segregação urbana.

Resumen Este artículo analiza la segregación residencial desde un punto de vista étnico-racial en dos grandes regiones metropolitanas ubicadas en el Sur y el Norte Global: Londres (Reino Unido) y San Pablo (Brasil). Se usaron índices espaciales globales y locales para mapear y medir las diferentes dimensiones espaciales y escalas de la segregación étnico-racial en las dos metrópolis. El estudio adoptó un enfoque relacional para interpretar los resultados que yuxtapone resultados globales y variaciones locales de segregación, dimensiones espaciales complementarias (disimilaridad y exposición/aislamiento), múltiples escalas geográficas y patrones de ubicación espacial de diferentes grupos etnorraciales. Los resultados indican que las regiones metropolitanas de Londres y San Pablo presentan patrones espaciales similares, pero inversos, de segregación centro-periferia. Los resultados también revelaron que los niveles de segregación en Londres son más altos que en San Pablo, lo que indica que, contraintuitivamente, Londres está más segregada étnico-racialmente que San Pablo. Estos resultados se discuten en el contexto de la literatura, explorando las similitudes y diferencias entre las dos regiones metropolitanas. El artículo concluye con una discusión sobre la relevancia de los resultados y una reflexión sobre la agenda futura de estudios sobre segregación urbana.

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The nanostructured lanthanide-silica materials of the Ln-SiO2 type (Ln = La, Ce, Pr, Nd, Eu, Gd, Dy, Yb, Lu) were synthesized by the hydrothermal method at 100 °C, using cetyltrimethylammonium as a structural template, silica gel and sodium silicate as a source of silicon, and lanthanide oxides, with Si/Ln molar ratio = 50. The resulting materials were calcined at 500 °C using nitrogen and air, and characterized by X-ray diffraction (XRD), Fourier-Transform infrared absorption spectroscopy, scanning electron microscopy, thermogravimetry (TG), surface area by the BET method and acidity measurements by n-butylamine adsorption. The XRD and chemical analysis indicated that the SiO2 presented a hexagonal structure and the incorporation of lanthanides in the structure changes the properties of the Ln-SiO2 materials. The heavier the lanthanide element, the higher the Si/Ln ratio. The TG curves showed that the decomposition of the structural template occurs in the materials at temperatures below 500 °C. The samples showed variations in specific surface area, mean pore diameter and silica wall thickness, depending on the nature of the lanthanide. The incorporation of different lanthanides in the silica generated acid sites of varied strength. The hydrothermal stability of the Ln-SiO2 materials evaluated at high temperatures, evidenced that the properties can be controlled for application in adsorption and catalysis processes.

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Abstract Objective To describe a case of radiation-induced uterine carcinosarcoma 6 years after a cervical squamous cell carcinoma treatment, which imposed some diagnostic and management challenges. Case Report A 57-year-old woman with a history of pelvic chemoradiotherapy ~ 6.5 years before the event described in this study, following an International Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical cancer, presented with a cervical mass, involving the uterine cavity, the cervical canal and the upper two thirds of the vagina. The biopsy showed a poorly differentiated carcinoma, and a positron emission tomography (PET) scan excluded distant metastasis, although it was unable to define the origin of the tumor as either a new primary malignancy of the endometrium/cervix or as a cervical recurrence. Surgical staging procedure was performed, and the diagnosis was endometrial carcinosarcoma, FIGO stage IIB. The patient was not able to complete the adjuvant therapy, and the progression of the disease was remarkable. Conclusion The present case highlights one of the less common but more serious consequences of radiotherapy for cervical cancer, which has an increasing incidence in younger women, raising concerns about the long-termconsequences of its management.

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OBJECTIVE: To describe a case of radiation-induced uterine carcinosarcoma 6 years after a cervical squamous cell carcinoma treatment, which imposed some diagnostic and management challenges. CASE REPORT: A 57-year-old woman with a history of pelvic chemoradiotherapy ∼ 6.5 years before the event described in this study, following an International Federation of Gynecology and Obstetrics (FIGO) stage IIB cervical cancer, presented with a cervical mass, involving the uterine cavity, the cervical canal and the upper two thirds of the vagina. The biopsy showed a poorly differentiated carcinoma, and a positron emission tomography (PET) scan excluded distant metastasis, although it was unable to define the origin of the tumor as either a new primary malignancy of the endometrium/cervix or as a cervical recurrence. Surgical staging procedure was performed, and the diagnosis was endometrial carcinosarcoma, FIGO stage IIB. The patient was not able to complete the adjuvant therapy, and the progression of the disease was remarkable. CONCLUSION: The present case highlights one of the less common but more serious consequences of radiotherapy for cervical cancer, which has an increasing incidence in younger women, raising concerns about the long-term consequences of its management.

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Abstract Introduction: Takotsubo cardiomyopathy (TCM) is a stress-induced cardiomyopathy. It is characterized by an acute onset of symptoms and electrocardiographic abnormalities mimicking an acute coronary syndrome in the absence of obstructive coronary artery disease. Any anesthetic-surgical event corresponds to a stressful situation, so the anesthetic management of patients with TCM requires special care throughout the perioperative period. We describe the anesthetic management of a patient with a confirmed diagnosis of TCM undergoing segmental colectomy. Case report: Female patient, 55 years old, ASA III, with history of takotsubo syndrome diagnosed 2 years ago, scheduled for segmental colectomy. The patient, without other changes in preoperative evaluation, underwent general anesthesia associated with lumbar epidural and remained hemodynamically stable during the 2 h of surgery. After a brief stay in the Post-Anesthesia Care Unit, she was transferred to the Intermediate Care Unit (IMCU), with epidural analgesia for postoperative period. Conclusion: TCM is a rare disease which true pathophysiology remains unclear, as well as the most appropriate anesthetic-surgical strategy. In this case, through a preventive approach, with close monitoring and the lowest possible stimulus, all the perioperative period was uneventful. Because it is a rare disease, this report could help to raise awareness about TCM.

Resumo Introdução: A miocardiopatia takotsubo (MT) é uma miocardiopatia induzida pelo estresse. Caracteriza-se por um início agudo de sintomas e alterações eletrocardiográficas que mimetizam uma síndrome coronária aguda na ausência de doença arterial coronária obstrutiva. Qualquer evento anestésico-cirúrgico corresponde a uma situação de estresse, pelo que a abordagem anestésica dos doentes com MT exige um cuidado especial em todo o período perioperatório. Descrevemos a abordagem anestésica de uma doente com diagnóstico confirmado de MT submetida a colectomia segmentar. Caso clínico: Paciente do sexo feminino, 55 anos, ASA III, com antecedentes de síndrome de takotsubo diagnosticada havia dois anos, encaminhada para colectomia segmentar. A paciente, sem outras alterações na avaliação pré-operatória, foi submetida a anestesia geral associada a epidural lombar e manteve-se hemodinamicamente estável durante as duas horas do procedimento cirúrgico. Após uma breve permanência na Unidade de Cuidados Pós-Anestésicos foi transferida para a Unidade de Cuidados Intermédios (UCIM) com analgesia peridural para o pós-operatório. Conclusão: A MT é uma doença rara, cuja verdadeira fisiopatologia continua por esclarecer, assim como a estratégia anestésico-cirúrgica mais apropriada. Nesse caso, por causa de uma abordagem preventiva, com monitoração rigorosa e o menor estímulo possível, todo o perioperatório decorreu sem intercorrências. Sendo uma doença rara, o seu relato poderá contribuir para o avanço do conhecimento sobre a MT.

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INTRODUCTION: Takotsubo cardiomyopathy (TCM) is a stress-induced cardiomyopathy. It is characterized by an acute onset of symptoms and electrocardiographic abnormalities mimicking an acute coronary syndrome in the absence of obstructive coronary artery disease. Any anesthetic-surgical event corresponds to a stressful situation, so the anesthetic management of patients with TCM requires special care throughout the perioperative period. We describe the anesthetic management of a patient with a confirmed diagnosis of TCM undergoing segmental colectomy. CASE REPORT: Female patient, 55 years old, ASA III, with history of takotsubo syndrome diagnosed 2 years ago, scheduled for segmental colectomy. The patient, without other changes in preoperative evaluation, underwent general anesthesia associated with lumbar epidural and remained hemodynamically stable during the 2hours of surgery. After a brief stay in the Post-Anesthesia Care Unit, she was transferred to the Intermediate Care Unit (IMCU), with epidural analgesia for postoperative period. CONCLUSION: TCM is a rare disease which true pathophysiology remains unclear, as well as the most appropriate anesthetic-surgical strategy. In this case, through a preventive approach, with close monitoring and the lowest possible stimulus, all the perioperative period was uneventful. Because it is a rare disease, this report could help to raise awareness about TCM.

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Mature cystic teratomas, or dermoid tumors, are the most common benign ovarian neoplasms in young women. Malignant transformation is rare, and occurs in less than 2% of the cases. The heterogeneous histological composition of these tumors may be responsible for the occasional elevation of various tumor markers, such as Ca19-9 and Ca125. We describe one case of mature cystic teratoma in a 50-year old woman with the second highest level of Ca19-9 (8922.76 UI/mL) described in the literature. We concluded that abnormal levels of Ca19-9 are not necessarily associated with ovarian malignancy, and may lead to unnecessary medical intervention and patient anxiety. Therefore, the clinical features, imaging studies and antigen testing should be interpreted carefully, and should not limit the surgical approach.

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Abstract Mature cystic teratomas, or dermoid tumors, are the most common benign ovarian neoplasms in young women. Malignant transformation is rare, and occurs in less than 2% of the cases. The heterogeneous histological composition of these tumors may be responsible for the occasional elevation of various tumor markers, such as Ca19-9 and Ca125. We describe one case of mature cystic teratoma in a 50-year old woman with the second highest level of Ca19-9 (8922.76 UI/mL) described in the literature. We concluded that abnormal levels of Ca19-9 are not necessarily associated with ovarian malignancy, and may lead to unnecessary medical intervention and patient anxiety. Therefore, the clinical features, imaging studies and antigen testing should be interpreted carefully, and should not limit the surgical approach.

Resumo Os teratomas maduros císticos do ovário, ou tumores dermoides, são as neoplasias benignas mais frequentes em mulheres jovens. A sua transformação maligna é rara, e ocorre emmenos de 2% dos casos. A composição histológica heterogénea destes tumores pode ser responsável pela ocasional elevação de marcadores tumorais, como o Ca19-9 e o Ca125. Descrevemos umcaso de teratoma maduro cístico do ovário numa paciente de 50 anos com o segundo valor mais elevado de Ca19-9 (8922,76 UI/mL) descrito na literatura. Concluímos que níveis anormalmente elevados de Ca19-9 não estão necessariamente associados a tumores malignos, e podem conduzir a intervenções médicas desnecessárias e contribuir para o aumento da ansiedade da paciente. Portanto, as características clínicas, os estudos imagiológicos e os marcadores tumorais devem ser interpretados cuidadosamente, e não devem limitar o tipo de conduta cirúrgica.

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OBJECTIVE: To evaluate the accuracy of fetal weight prediction by ultrasonography labor employing a formula including the linear measurements of femur length (FL) and mid-thigh soft-tissue thickness (STT). METHODS: We conducted a prospective study involving singleton uncomplicated term pregnancies within 48 hours of delivery. Only pregnancies with a cephalic fetus admitted in the labor ward for elective cesarean section, induction of labor or spontaneous labor were included. We excluded all non-Caucasian women, the ones previously diagnosed with gestational diabetes and the ones with evidence of ruptured membranes. Fetal weight estimates were calculated using a previously proposed formula [estimated fetal weight = 1687.47 + (54.1 x FL) + (76.68 x STT). The relationship between actual birth weight and estimated fetal weight was analyzed using Pearson's correlation. The formula's performance was assessed by calculating the signed and absolute errors. Mean weight difference and signed percentage error were calculated for birth weight divided into three subgroups: < 3000 g; 3000-4000 g; and > 4000 g. RESULTS: We included for analysis 145 cases and found a significant, yet low, linear relationship between birth weight and estimated fetal weight (p < 0.001; R2 = 0.197) with an absolute mean error of 10.6%. The lowest mean percentage error (0.3%) corresponded to the subgroup with birth weight between 3000 g and 4000 g. CONCLUSIONS: This study demonstrates a poor correlation between actual birth weight and the estimated fetal weight using a formula based on femur length and mid-thigh soft-tissue thickness, both linear parameters. Although avoidance of circumferential ultrasound measurements might prove to be beneficial, it is still yet to be found a fetal estimation formula that can be both accurate and simple to perform.

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Objective To evaluate the accuracy of fetal weight prediction by ultrasonography labor employing a formula including the linear measurements of femur length (FL) and mid-thigh soft-tissue thickness (STT). Methods We conducted a prospective study involving singleton uncomplicated term pregnancies within 48 hours of delivery. Only pregnancies with a cephalic fetus admitted in the labor ward for elective cesarean section, induction of labor or spontaneous labor were included. We excluded all non-Caucasian women, the ones previously diagnosed with gestational diabetes and the ones with evidence of ruptured membranes. Fetal weight estimates were calculated using a previously proposed formula [estimated fetal weight = [1] 1687.47 + (54.1 x FL) + (76.68 x STT). The relationship between actual birth weight and estimated fetal weight was analyzed using Pearson's correlation. The formula's performance was assessed by calculating the signed and absolute errors. Mean weight difference and signed percentage error were calculated for birth weight divided into three subgroups: < 3000 g; 3000-4000g; and > 4000 g. Results We included for analysis 145 cases and found a significant, yet low, linear relationship between birth weight and estimated fetal weight (p < 0.001; R2 = 0.197) with an absolute mean error of 10.6%. The lowest mean percentage error (0.3%) corresponded to the subgroup with birth weight between 3000 g and 4000 g. Conclusions This study demonstrates a poor correlation between actual birth weight and the estimated fetal weight using a formula based on femur length and mid-thigh soft-tissue thickness, both linear parameters. Although avoidance of circumferential ultrasound measurements might prove to be beneficial, it is still yet to be found a fetal estimation formula that can be both accurate and simple to perform.

Objetivo Avaliar a precisão da determinação ultrassonográfica da estimativa de peso fetal recorrendo apenas a parâmetros lineares (comprimento do fémur - FL - e espessura de tecido mole a meio da coxa fetal - STT), no período precedente ao parto. Métodos Realizamos umestudo prospectivo que incluiu gestações simples de termo, comfeto cefálico, nas quais o parto ocorreu nas 48h seguintes à avaliação ecográfica. A inclusão no estudo foi feita nomomento de admissão ao bloco de partos para cesariana eletiva, indução do trabalho de parto ou trabalho de parto espontâneo. Foram excluídas todas as grávidas não caucasianas, com diagnóstico de diabetes gestacional ou evidência de rotura de membranas. A estimativa de peso fetal foi calculada através de uma fórmula previamente publicada [estimativa de peso fetal = [1]1687,47 + (54,1 x FL) + (76,68 x STT). A relação entre o peso real e o peso estimado foi analisada através da correlação de Pearson. O desempenho desta fórmula foi avaliado através do cálculo da percentagem de erro absoluto e não absoluto. Os recém-nascidos foram divididos em3 grupos consoante o peso real: < 3000 g; 3000 g - 4000 g; e > 4000 g; para cada grupo foi calculada diferençamédia entre a estimativa de peso e o peso real e a percentagem de erro associada. Resultados Incluímos 145 casos no estudo, cuja estimativa de peso e peso real se correlacionaram significativamente, apesar do valor de correlação ser pouco elevado (p < 0,001; R2 = 0,197). Globalmente, a percentagem de erro absoluto foi 10,6%. A percentagem de erro mais baixa correspondeu ao grupo com peso real entre 3000 g e 4000 g. Conclusões Comeste estudo demonstramos uma correlação fraca entre o peso real e a estimativa de peso fetal ultrassonográfica, quando calculada combase numa fórmula que usa o comprimento do fémur e a espessura de tecido mole a meio da coxa fetal, ambos parâmetros lineares. Ainda que a exclusão de parâmetros circunferenciais no cálculo da estimativa de peso fetal se venha a provar benéfica, esta não parece ser uma fórmula simultaneamente simples e precisa no cálculo da estimativa de peso fetal.

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Objective: To evaluate the integrity of the apical seal in root filled teeth following immediate post space preparation and after eight days.Methods: Forty extracted single-rooted human teeth were instrumented and filled, using lateral condensation technique, with gutta-percha and Sealapex® sealer (Kerr-Sybron, Scafati, Italy). The teeth were randomly assigned to four groups: group I (GI) with seventeen teeth (immediate post space preparation), seventeen in group II (GII) (delayed post space preparation) and three teeth in each control group, group III (GIII) positivecontrol and group IV (GIV) negative control. In GI and GII, the post space was prepared with ProTaper Universal® retreatment files (Dentsply/Maillefer, Ballaigues, Switzerland). After the post space preparation, all specimens were coated, except for two apical millimeters, immersed inmethylene-blue dye for eight days, and then sectioned longitudinally. The extent of staining was examined under a stereomicroscope. Results: In GI there was an average apical leakage of 7,42 mm, while in GII it was 6,82 mm. There were no statistically significant differences between groups I and II (p>0.05). Conclusion: The timing of post space preparation, in teeth filled with Sealapex® sealer (Kerr-Sybron, Scafati, Italy), did not affect the apical sealing ability.

Objetivo: Avaliar o selamento apical em dentes desobturados imediatamente após a obturação radicular e desobturados oito dias depois, para a colocação de retentor intra-radicular. Métodos: Quarenta dentes unirradiculares, foram instrumentados manualmente e obturados pela técnica de condensação lateral com cones de gutaperchae cimento Sealapex® (Kerr-Sybron, Scafati, Italy). Foram aleatoriamente distribuídos em 4 grupos. Grupo I (GI) 17 dentes - desobturaçãoimediata; Grupo II (GII) 17 dentes - desobturação tardia; Grupo III (GIII) 3 dentes - controle positivo; Grupo IV (GIV) 3 dentes - controle negativo.Para a desobturação (GI e GII) foram utilizados instrumentos mecanizados de retratamento ProTaper Universal® (Dentsply/Maillefer, Ballaigues,Switzerland). Após desobturação, os dentes foram impermeabilizados com esmalte, exceto nos 2 milímetros apicais, foram imersos em soluçãode azul-de-metileno durante 8 dias e seccionados longitudinalmente. Com o auxílio de uma lupa ?Wild Makroskop M420? foi realizada a leitura da infiltração. Resultados: No GI, obteve-se infiltração apical média de 7,42 mm e no GII de 6,82 mm. Estas diferenças não foram estatisticamente significativas (p>0,05). Conclusão: O momento de desobturação para a colocação de retentores intra-radiculares, de dentes obturados com cimento Sealapex® (Kerr-Sybron, Scafati, Italy), não afetou o selamento apical.

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Os traumatismos dentários constituem, na atualidade, uma das principais causas da procura pelo cirurgião-dentista. O objetivo deste artigo é apresentar um caso clínico de traumatismo dental, abordando as diferentes reações pulpares dos dentes afetados e uma proposta de tratamento. Foram identificados dois tipos distintos de respostas pulpares ocorridas em dentes que foram sujeitos a um mesmo traumatismo (dente 21 e 11). Após o exame clínico e radiográfico, foi feito o diagnóstico diferencial entre lesão periapical no dente 21 e a imagem radiolúcida do orifício do nervo nasopalatino. Foi diagnosticado necrose pulpar no dente 21, sem lesão periapical e polpa viva no dente 11, apresentando este reabsorção interna e externa da raiz. Foi realizado o planejamento com indicação de tratamento de canal dos dentes 21 e 11, bem como a restauração estética dos mesmos com recurso de técnicas de clareamento interno e externo. O tratamento seleccionado mostrou um ótimo resultado estético com um custo relativamente baixo. O follow-up de dois anos permitiu confirmar o êxito e a longevidade do tratamento proposto.

Presently, dental trauma is one of the main causes for seeking a dental surgeon. The present paper presents a case report of dental trauma, addressing the different pulp reactions of the affected teeth and a treatment plan. The authors identified two distinct types of pulp reactions in teeth (tooth 21 and 11) subject to the same trauma. After clinical and radiographic examination, the differential diagnosis between periapical lesion on tooth 21 and radiolucency of the nasopalatine foramen was performed. Pulpal necrosis, without periapical lesion, was diagnosed in tooth 21, and live pulp in tooth 11, with internal and external root resorption. A treatment plan was designed, which included root canal treatment of teeth 21 and 11, as well as aesthetical restoration of both using internal and external bleaching techniques. This treatment resulted in optimal aesthetic outcome with relatively low cost. The 2-year follow-up confirmed the success and longevity of the treatment.

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Os autores revisaram a literatura quanto ao tratamento cirúrgico utilizado para fístula mamária, observando índice de recidiva significativamente elevado. Descrevem técnica cirúrgica pessoal que resultou em baixo índice de recidiva e bom resultado estético. A fístula mamária foi descrita por Zuska e cols. (1951), porém Atkins (1953) descreveu com detalhes a sua apresentaçäo e tratamento. Trata-se de doença de evoluçäo crônica näo relacionada à funçäo d lactaçäo e que ocorre com mais frequência entre 30-40 anos

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Os autores apresentam um caso de carcinoma adenóide cístico da mama, o qual é um tumor maligno similar a tumores de glândulas salivares, brônquios, próstata e glândulas lacrimais. É caracterizado por uma combinaçäo de tecidos glandular, estromal e de membrana basal. De acordo com Haagensen, representa o mais raro e o menos maligno dos carcinomas de mama, correspondendo a aproximadamente 0,1 por cento dos tumores malignos de mama, e apresenta excelente prognóstico. O tratamento de escolha referido na literatura é a mastectomia. No presente caso, a paciente foi tratada por mastectomia e dissecçäo axilar. Dezesseis linfonodos foram retirados, todos sem neoplasia. No seguimento a paciente apresentou-se bem, sem sinais de recorrência.

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