Abstract Objective To assess obstetric/puerperal/neonatal outcomes in an inflammatory bowel disease (IBD) population and to analyze disease characteristics that may be associated to adverse outcomes. Methods Retrospective descriptive analysis including 47 pregnant women with IBD (28 with Crohn's disease – CD and 19 with ulcerative colitis – UC) who delivered between March 2012 and July 2018 in a tertiary hospital. We reviewed clinical records to extract demographic information, previous medical history, disease subtype, activity, severity, treatment, and obstetric, puerperal, and neonatal outcome measures. Results Obstetric and neonatal complications (composite outcomes) occurred in 55.3% and 14.6% of the IBD population, respectively, and were more frequent in UC patients. Preterm birth (PTB), preeclampsia, anemia, low birth weight (LBW), and neonatal death were also more frequent in UC patients. The rate of postpartum hemorrhage (PPH) was 14.9%, and it was higher in CD patients. Women with active IBD had more obstetric/neonatal adverse outcomes (fetal growth restriction and LBW in particular) and cesarean sections. Patients with medicated IBD had less obstetric/neonatal complications (PTB and LBW in specific) and cesarean sections but more PPH. Conclusion Women with IBD may have an increased risk of obstetric/puerperal/neonatal adverse outcomes. Ulcerative colitis patients had more obstetric and neonatal complications, whereas PPH was more frequent if CD patients. Other disease characteristics were considered, which allowed a better understanding of their possible influence. Although more research is needed, this work reinforces the importance of adequate surveillance to allow prompt recognition and treatment of complications.

Resumo Objetivo Avaliar os desfechos obstétricos/puerperais/neonatais em uma população com doença inflamatória intestinal (DII) e analisar as características da doença, que podem estar associadas a desfechos adversos. Métodos Análise descritiva retrospectiva incluindo 47 gestantes com DII (28 com doença de Crohn – DC e 19 com retocolite ulcerativa – RCU) que deram à luz entre março de 2012 e julho de 2018 em um hospital terciário. Revisamos os registros clínicos para extrair informações demográficas, histórico médico prévio, subtipo da doença, atividade, gravidade, tratamento e medidas de resultados obstétricos, puerperais e neonatais. Resultados As complicações obstétricas e neonatais (desfechos compostos) ocorreram em 55,3% e 14,6% da população com DII, respectivamente; e foram mais frequentes em pacientes com RCU. Nascimento prematuro (PTB), pré-eclâmpsia, anemia, baixo peso ao nascer (BPN) e óbito neonatal também foram mais frequentes em pacientes com RCU. A taxa de hemorragia pós-parto (HPP) foi de 14,9% e foi maior em pacientes com DC. Mulheres com DII ativa tiveram mais desfechos obstétricos/neonatais adversos (restrição de crescimento fetal e BPN em particular) e cesarianas. Pacientes com DII medicada tiveram menos complicações obstétricas/neonatais (PTB e BPN em específico) e cesarianas, mas mais HPP. Conclusão Mulheres com DII podem ter um risco aumentado de desfechos adversos obstétricos/puerperais/neonatais. As pacientes com RCU apresentaram mais complicações obstétricas e neonatais, enquanto a HPP foi mais frequente em pacientes com DC. Outras características da doença foram consideradas, o que permitiu uma melhor compreensão de sua possível influência. Embora mais pesquisas sejam necessárias, este trabalho reforça a importância de uma vigilância adequada para permitir o reconhecimento e o tratamento imediatos das complicações.

Abstract Aim: This study aimed to evaluate the acute supplementation effects of capsaicin, caffeine, and the combined capsaicin plus caffeine on total volume (total repetitions x weight lifted), rate of perceived exertion (RPE), and side-effects on resistance training. Methods: Eleven men (21.5 ± 2.1 years, 1.75 ± 0.08 m, 79.64 ± 10.1 kg), trained in resistance training (experience of 4.5 ± 2.6 years, weekly frequency 5 ± 0.8 days) were recruited. This was a crossover, randomized, double-blind study. Each volunteer went through four experimental conditions: supplemented with capsaicin (12 mg), caffeine (400 mg), capsaicin plus caffeine (12 mg and 400 mg, respectively), or placebo. After supplementation, the volunteers completed four sets of back squats until failure, at 70% of one-repetition maximum, with 90 s of rest interval between sets. RPE was registered at the end of each set. Volunteers were asked about the occurrence of side effects, right after exercise and 24 h after supplementation. Results: No significant differences were found (p > 0.05) in total volume between placebo (5505.2 ± 810.7 kg), capsaicin (6010.0 ± 1067.0 kg), capsaicin plus caffeine (5885.1 ± 1219.3 kg), and Caffeine (5628.6 ± 894.4 kg). No significant differences were found in RPE (p > 0.05) between the experimental conditions. The effect size of the total volume was small in capsaicin and capsaicin plus caffeine (d = 0.62 e d = 0.47, respectively), and trivial in the caffeine condition (d = 0.15). Conclusion: The supplementation failed to influence resistance training performance as well as had no effects on increasing the total volume or reducing RPE.

Introdução: A falência hepática aguda (ALF) é uma doença rara com potenciais altas taxas de mortalidade. Pretendeu-se estudar a epidemiologia recente da ALF numa das regiões portuguesas de transplante hepático (LT). Materiais e Métodos: Coorte retrospectivo incluindo 34 doentes com ALF consecutivamente admitidos na Unidade de Cuidados Intensivos (ICU) do Hospital Curry Cabral (Lisboa, Portugal) entre Outubro de 2013 e Dezembro de 2016. Resultados: A idade mediana foi 49 (31-67) anos e 21 (62%) doentes eram do sexo feminino. As etiologias não-paracetamol ocorreram em 29 (85%) doentes. Na admissão na ICU, a encefalopatia hepática grau 3-4 desenvolveu-se em 10 (29%) doentes; a ventilação mecânica invasiva, os vasopressores e a técnica de substituição da função renal foram usados em 8 (24%), 7 (21%) e 5 (15%) doentes, respectivamente; os critérios King’s College Hospital (KCC) foram cumpridos por 16 (47%) doentes. Entre os 15 (44%) doentes não transplantados, 11 (73%) morreram durante a estadia hospitalar. Entre os 19 (56%) doentes transplantados, 4 (21%) morreram durante a estadia hospitalar. Os KCC não se associaram com a mortalidade hospitalar (p = 0.97), mas associaram-se significativamente com o LT (p = 0.008). Conclusões: Num coorte de doentes com ALF português, as etiologias nãoparacetamol predominaram. A mortalidade hospitalar foi significativamente menor nos doentes transplantados.

Background and Aims: Acute liver failure (ALF) is a rare disease with potentially high mortality rates. We aimed to study the recent epidemiology of ALF in one of the Portuguese liver transplant (LT) regions. Methods: We assessed a retrospective cohort including 34 consecutive patients with ALF admitted to the intensive care unit (ICU) of Curry Cabral Hospital (Lisbon, Portugal) between October 2013 and December 2016. Results: The median age (IQR) was 49 (31-67) years, and 21 (62%) of the cohort were female. Nonparacetamol etiologies were found in 29 patients (85%). On ICU admission, grade 3-4 hepatic encephalopathy developed in 10 patients (29%); invasive mechanical ventilation, vasopressors, and renal replacement therapy were required for 8 (24%), 7 (21%), and 5 (15%) of the patients, respectively; the King’s College criteria (KCC) were fulfilled by 16 patients (47%). Of the 15 (44%) nontransplanted patients, 11 (73%) died during their hospital stay. Of the 19 (56%) transplanted patients, 4 (21%) died during their hospital stay. KCC were not associated with hospital mortality (p = 0.97), but they were significantly associated with LT (p = 0.008). Conclusions: In a Portuguese cohort of patients with ALF, non-paracetamol etiologies were predominant. Hospital mortality was much lower amongst transplanted patients.