São Paulo, city-region: constitution and development dynamics of the São Paulo macrometropolis
This article deals with the emergence of the city-region in São Paulo (Brazil), called ‘macrometropolis’, and highlights some of the challenges facing this new territorial or spatial configuration in terms of globalisation and governance. It also stresses the productive changes that gave rise to it and sheds light on the constituent dynamics of the macrometropolis at different scales. The article affirms that metropolitan problems can no longer be interpreted without taking into account the new determinants of the macrometropolis of São Paulo, which implies considering the interaction of the metropolis with other urban centres bearing social, economic and environmental singularities.
Trapped by the land? Change and continuity in the provision of social housing in Brazil
Despite economic growth, institutional strengthening, improved regulatory frameworks for urban land markets and availability of subsidized financial resources for social housing, Brazilian urban development policy has continued to face challenges in providing access to housing for low-income groups in general, and families earning up to three minimum salaries in particular. In this article, we argue that state spatial policies have been severely weakened by the lack of leverage over urban land markets. In that respect, the renewed rolled-out developmental state that has followed the neoliberalization of spaces in the 1990s, as reflected in the Statute of the City, the creation of the Ministry for Cities and the launch of federal housing finance programmes represent advances, but have not been able to trigger structural change in the production of urban space.
Pharmacokinetics of Mivacurium Isomers and Their Metabolites in Healthy Volunteers after Intravenous Bolus Administration
Background Previous studies report the pharmacokinetics of mivacurium isomers after an infusion using venous blood sampling. Although the extent of the mivacurium arterial‐venous gradient is not known, the sampling site is likely to influence mivacurium pharmacokinetic parameters because the drug is rapidly metabolized as it traverses the circulation. The objectives of this study were (1) to determine the pharmacokinetics of mivacurium isomers in healthy persons after intravenous bolus administration using intensive arterial blood sampling, and (2) to characterize the formation and elimination of mivacurium metabolites in human plasma. Methods Eight persons classified as American Society of Anesthesiologists physical status 1 or 2 who were scheduled to undergo elective surgery under balanced anesthesia received 0.15 mg/kg mivacurium chloride as an intravenous bolus. Arterial blood samples were collected every 10 s during the first 2 min and at frequent intervals for 4 h thereafter. Plasma concentrations of mivacurium isomers and their metabolites were determined by two stereoselective high‐performance liquid chromatographic methods coupled with fluorometric detection and noncompartmental pharmacokinetic parameters. Results Mean elimination half‐lives of the trans‐trans, cis‐trans, and cis‐cis isomers were 2.4, 2, and 28.5 min, respectively, with corresponding mean plasma clearances of 29.2, 45.7, and 6.7 ml [center dot] min‐1 [center dot] kg‐1. The volumes of distribution at steady state of the trans‐trans, cis‐trans, and cis‐cis isomers were 0.047, 0.054, and 0.189 l/kg, respectively. Plasma concentrations of monoester and alcohol metabolites peaked 25 s (median) after mivacurium injection, with half‐lives in the range of 90 min, except for the cis alcohol metabolite, which was only negligibly and transiently formed. Conclusions Substantial hydrolysis of mivacurium isomers by cholinesterases was confirmed by the rapid appearance of mivacurium metabolites in plasma. The intensive arterial sampling proved to be critical for the trans‐trans and cis‐trans isomers because the area under the curve between 0 and 2 min accounted for 75% and 86% of the total, respectively.