Resumo: O objetivo do artigo é apresentar as motivações e as formas de algumas ações caracterizadas como indisciplina, praticadas por tripulantes de embarcações luso-brasileiras quando os navios encontravam-se ancorados. O recorte temporal concentra-se na segunda metade do século XVIII e, em que pese a profusão de fontes existentes, trata-se de um período pouco estudado pela historiografia. Em meio às diversas formas de insubmissão às normas e às tentativas de impor um controle disciplinar aos homens do mar, foram abordados dois temas recorrentes nas fontes e na bibliografia: as deserções e suas possíveis causas e os distúrbios envolvendo os marinheiros em terra.

Abstract: The objective of the article is to present the motivations and forms of some actions characterized as indiscipline, practiced by crew members of Portuguese-Brazilian vessels when the ships were anchored. The temporality is concentrated in the second half of the 18th century, which, despite the profusion of sources, it is a period with few historiographical studies. Considering the various forms of non-submission to the rules and the attempts to impose disciplinary control on seafarers, two recurring themes were studied in the sources and in the bibliography: desertions and their possible causes and riots involving sailors on land.

RESUMEN El artículo aborda algunos aspectos de las prácticas religiosas de marineros en sus desplazamientos por el Atlántico en la época moderna. Apunto especificidades en las prácticas religiosas de mareantes lusos y, cuando fue posible, presento información sobre españoles, ingleses y holandeses. El análisis se dedica particularmente al culto mariano y de los santos católicos. Los conflictos por las expresiones exteriores de la religión se presentan como evidencias de la cultura marítima en transformación a lo largo del período recortado. Para eso, se analizaron fuentes como las narraciones de viajeros desde el siglo XVI y los registros de las tripulaciones de los barcos portugueses en los siglos XVIII y XIX.

ABSTRACT The article addresses some aspects of sailors' religious practices during their trips across the Atlantic in the modern age. I highlight the specificities of the religious practices of Portuguese sailors, as well as of Spanish, English, and Dutch sailors, when information was available. The analysis focuses particularly on the cult of the Virgin Mary and the Catholic saints. The conflicts arising from the external manifestations of religion are presented as evidence of the transformation of maritime culture during the period. The sources used for the study were travelers' diaries since the 16th century and registries of crew members of Portuguese ships in the 18th and 19th centuries.

RESUMO O artigo aborda alguns aspectos das práticas religiosas de marinheiros em deslocamentos pelo Atlântico na época moderna. Aponto especificidades nas práticas religiosas de mareantes portugueses e, quando possível, apresento informações sobre espanhóis, ingleses e holandeses. A análise dedica-se particularmente ao culto mariano e dos santos católicos. Os conflitos em torno das expressões exteriores da religião são apresentados como traços da cultura marítima em transformação ao longo do período recortado. Para isso, foram analisadas fontes tais como os relatos de viajantes desde o século xvi e os registros de matrículas de tripulações de navios portugueses nos séculos XVIII e XIX.

Resumo Este estudo apresenta os registros de matrículas de navios mercantes que saíram de Lisboa entre a segunda metade do século XVIII e as primeiras décadas de século XIX. Destaco o potencial dessa fonte para estudos sobre circulação dos marítimos. Entre outros temas, a fonte permite: um inventário de cargos e funções a bordo; estabelecer o tempo de experiência e a idade dos indivíduos quando começavam nas profissões marítimas; relacionar tipos de embarcações, rotas, tamanho da tripulação e tempo de viagem; estabelecer as diferenças de naturalidade, condição social, idade, treinamento e experiência dos marinheiros.

Abstract: This study presents the Enrollment Records of merchant ships that left Lisbon between the second half of the 18th century and the first decades of the 19th century. I highlight the potential of this source for studies about circulation of seafarers. Among other topics, this source allows one: to make an inventory of positions and functions on board; to establish individuals’ time of experience and age when they enrolled in professions of the sea; to establish relationships among types of vessels, routes, crew size and travel time; to establish the differences of naturalness, social condition, age, training and experience of the seamen.

Background and Aims: This study aims to evaluate the role of an advanced endoscopist to study the entire colon after an incomplete colonoscopy. Methods: All patients with an elective incomplete colonoscopy performed under deep sedation in our department between January 2010 and October 2016 were included. Patients with a colonic stenosis, an inadequate bowel preparation, or a colonoscopy performed without deep sedation were excluded. Included patients were followed up to evaluate if and what type of subsequent examinations (colonoscopy by an advanced endoscopist, single-balloon enteroscopy [SBE], and/or CT colonography) was performed to complete the study of the entire colon. Lesions found during these subsequent examinations were also recorded. Results: Ninety-three patients had an incomplete colonoscopy, with no diagnosis of colorectal cancer (CRC) and a high-risk polyp rate of 5.4% (n = 5). Seventy-seven patients with incomplete colonoscopies underwent subsequent examinations, namely CT colonography in 45.5% (n = 35), colonoscopy by an advanced endoscopist in 53.2% (n = 41), and SBE in 13% (n = 10). In the 49 patients who performed either colonoscopy (n = 39) or SBE (n = 10) by an advanced endoscopist, the cecal intubation rate was 100%, and high-risk polyps were found in 26.5% (n = 13) and CRC in 4.1%. CT colonography revealed findings consistent with polyps and CRC in 22.9% (n = 8) and 2.9% (n = 1) of the cases, respectively. Colonoscopy was further repeated in 6 patients with suspected polyps in CT colonography, confirming the initial diagnosis in 5 patients. Conclusions: Colonoscopy by an advanced endoscopist achieved cecal intubation in all patients, representing a good choice after an incomplete colonoscopy.

Introdução/Objetivo: O presente estudo pretende avaliar o papel de um endoscopista avançado no estudo do cólon após colonoscopia incompleta (CI). Material: Incluíram-se todos os doentes com CI eletiva realizada por especialista, sob sedação profunda entre janeiro de 2010 e outubro de 2016. Excluíram-se doentes com estenose cólica, colonoscopia com preparação inadequada e/ou sem sedação. Avaliaram-se os exames subsequentes (colonoscopia por endoscopista avançado, enteroscopia assistida por monobalão [EAB] e colonografia virtual [CV]) realizados para completar o estudo do cólon e as lesões diagnosticadas. Resultados: Incluíram-se 93 CI, que detetaram pólipos de alto risco em 5.4% (n = 5) e não identificaram carcinoma colorretal (CCR). Realizou-se um segundo exame em 82.8% (n = 77) dos doentes, designadamente, a CV, colonoscopia por endoscopista avançado e EAB em 45.5% (n = 35), 53.2% (n = 41) e 13% (n = 10), respetivamente. Nos 49 doentes que realizaram colonoscopia (n = 39) ou SBE (n = 10) por endoscopista avançado, a taxa de entubação cecal foi de 100%, detetando-se pólipos de alto risco em 26.5% (n = 13) e CCR em 4.1%. Na CV observaram-se achados compatíveis com pólipos em 22.9% (n = 8) e CCR em 2.9% (n = 1) dos casos. A colonoscopia foi subsequentemente realizada em 6 doentes com suspeita de pólipos na CV, confirmando-se o diagnóstico em 5 doentes. Conclusão: A entubação cecal foi conseguida em todos os doentes submetidos a colonoscopia realizada por endoscopista avançado representando uma boa opção no estudo subsequente do cólon após uma CI.

Background: Virtual chromoendoscopy (VC) in small bowel capsule endoscopy can improve the visualization and characterization of different small bowel lesions (SBLs). There are few studies of its usefulness in the Given® system, and there is no evidence yet of its utility in the MiroCam® system. Aim: The aim of this study was to evaluate whether VC can improve the characterization of SBLs with the MiroCam® system. Methods: Twenty-two patients were selected, in which 100 elementary lesions were identified, including erosions (n = 45), ulcers (n = 17), and angioectasias (n = 38). For each lesion identified, images were captured without chromoendoscopy (normal image [NI]) and with chromoendoscopy modes 1 (color mode [CM] 1), 2 (CM2), and 3 (CM3). A score from 1 to 4 was assigned to each image, in which a better evaluation of the characteristics and limits of the lesion was classified in ascending order, where 1 is the worst and 4 the best evaluation. The scores of the various modes were compared with Kendall’s tau-c coefficient. Results: The average scores attributed to the photographs in NI, CM1, CM2, and CM3 were 3.83, 2.89, 1.85, and 1.43, respectively (tau-c = -0.75, p < 0.001). Evaluating the elementary lesions independently, the average scores for modes NI, CM1, CM2, and CM3 were 3.83, 2.92, 1.86, and 1.38 (tau-c = -0.77, p < 0.001) for erosions, respectively; 3.87, 2.96, 1.76, and 1.40 (tau-c = -0.80, p < 0.001) for ulcers, respectively; and 3.81, 2.82, 1.87, and 1.50 (tau-c = -0.71, p < 0.001) for angioectasias, respectively. Conclusions: VC using the CMs available in the Miro-Cam® system has not proven useful for a better assessment of any of the SBLs.

Introdução: A cromoendoscopia virtual na capsula endoscópica (CE) tem como principal intuito melhorar a visualização e caracterização de diferentes lesões do intestino delgado. Existem poucos estudos da sua utilidade no sistema Given®, não existindo contudo evidência da sua utilidade no sistema MiroCam®. Objetivos: Avaliar a utilidade da cromoendoscopia virtual na caracterização de lesões elementares do intestino delgado no sistema MiroCam®. Métodos: Avaliados 22 doentes, nos quais foram identificadas 100 lesões elementares, nomeadamente erosões (n: 45), úlceras (n: 17) e angiectasias (n: 38). Para cada lesão identificada, foram captadas imagens sem cromoendoscopia (imagem normal), e com cromoendoscopia nos modos 1 (color mode 1), 2 (color mode 2) e 3 (color mode 3). Atribuída a cada imagem uma pontuação de 1 a 4, na qual uma melhor avaliação das características e limites da lesão se encontra classificada de forma crescente, sendo que 1 corresponde à pior e o 4 à melhor avaliação. As pontuações dos vários modos foram comparadas pelo coeficiente de correlação de Kendall tau-c. Resultados: A pontuação média atribuida às fotografias nos modos imagem normal (NI), color mode 1 (CM1), color mode 2 (CM2) e color mode 3 (CM3) foi respectivamente 3.83, 2.89, 1.85 e 1.43 (tau-c = -0.75, p < 0.001). Avaliando as lesões elementares independentemente, os scores médios para os modos NI, CM1,CM2 e CM3 foram: 3.83, 2.92, 1.86, 1.38 (tau-c = -0.77, p < 0.001) para erosões; 3.87, 2.96, 1.76, 1.40 (tau-c = -0.80, p < 0.001) para úlceras; 3.81, 2.82, 1.87, 1.50 (tau-c = -0.71, p < 0.001) para angiectasias. Conclusões: A cromoendoscopia virtual não se revelou útil para uma melhor avaliação de qualquer uma das lesões elementares.

Background: Obesity is an increasing worldwide problem associated with a vast number of comorbidities. Decreasing body weight by only 5-10% has been shown to slow and even prevent the onset of obesity-related comorbidities. Between pharmacological therapy and bariatric surgery a great variety of endoscopic techniques are available, the most common being intragastric balloon (IGB). The purpose of this study was to assess the safety, tolerance, and kinetics of IGBs in weight loss. The kinetics of weight loss were evaluated in 2 different contexts and phases: after the IGB’s removal and after follow-up that varied between 6 and 12 months. Successful weight loss was defined as ≥10% weight loss after 6-12 months. Methods: The study included 51 patients who had undergone Orbera® IGB placement between September 2014 and February 2016. Inclusion criteria were age between 18 and 65 years; body mass index (BMI) 28-35 with severe obesity-related disorders; or BMI 35-40. The IGB was removed 6 months later. All patients were followed for a minimum period of 6-12 months. Results: Of 51 patients, 16 were excluded (7 due to intolerance) and 35 patients entered the study, of which 83% were followed for more than 6-12 months. The average weight loss (WL) and % excess WL (%EWL) after 6 months of treatment were 11.94 kg and 42.16%, respectively. At 6-12 months, after removal of the IGB, the mean WL was 8.25 kg and %EWL was 30.27%. Nineteen patients attained a WL of ≥10% the baseline value at IGB removal and 12 maintained their weight below this threshold during the 6-12 following months. Conclusions: After temporary IGB implantation in overweight or obese individuals, a WL that was ≥10% of weight at baseline was achieved in 54.3% and sustained at 6-12 months in 41.4% of participants. IGBs are an attractive intermediate option between diet and exercise programs and bariatric surgery. In general, IGB placement is a safe and well-tolerated procedure.

Introdução: A obesidade, problema crescente, está associada a um grande número de comorbilidades. A redução do peso corporal em apenas 5-10% mostrou-se eficaz na melhoria e até na prevenção do aparecimento de comorbilidades relacionadas com a obesidade. Entre a terapia farmacológica e a cirurgia bariátrica, temos disponíveis uma grande variedade de técnicas endoscópicas, sendo a mais comum a colocação de balão intragástrico (BIG). O objectivo do estudo foi avaliar a segurança, tolerância e cinética da perda de peso do BIG. A cinética da perda de peso foi avaliada em dois momentos e contextos distintos: após a remoção do balão e depois do periódo de follow-up (PFU), que variou entre 6-12 meses. Eficácia definida como perda de peso 10% após PFU de 6-12 meses. Métodos: O estudo incluiu 51 pacientes que colocaram Orbera® BIG entre setembro de 2014 e fevereiro de 2016. Os critérios de inclusão foram: idade entre 18-65 anos, IMC 28-35 com comorbilidades relacionadas com obesidade e IMC 35-40. O BIG foi removido passados 6 meses. Todos os doentes foram acompanhados por um período minino de 6-12 meses (PFU). Resultados: Dos 51 doentes considerados, 16 foram excluidos (7 por intolerancia) e 35 entraram no estudo, dos quais 83% foram seguidos durante PFU. A perda de peso média (PPM) e % de excesso de peso perdido (EPP) na altura de remoção do BIG foi de 11.94 kg e 42.16%, respetivamente; após PFU, a PPM foi de 8.25 kg e o EPP foi 30.27%. Dezanove alcançaram uma perda de peso na altura de remoção de BIG e 12 mantiveram o seu peso abaixo deste limiar após o PFU. Conclusões: Após a colocação temporaria do BIG em pacientes com excesso de peso ou obesidade, foi alcançado uma perda de peso superior a 10 em 54.3% na altura de remoção do BIG e sustentada após periodo de follow-up de 6-12 meses em 41.4% dos doentes. Os BIG são uma alternativa intermédia atractiva entre dieta/exercicio fisico e cirurgia bariátrica. Em geral é um procedimento seguro e bem tolerado.

ABSTRACT Aim: the aim of this study was to determine predictive factors for an incomplete capsule endoscopy and an inadequate small-bowel preparation in capsule endoscopy. Methods: predictive factors for an incomplete capsule endoscopy were evaluated. Therefore, all patients with incomplete examinations performed between June 2009 and February 2016 were retrospectively included and compared with all patients with complete procedures performed between January 2014 and February 2016. Predictive factors of an inadequate small-bowel cleanliness were assessed. Therefore, the subset of patients that underwent capsule endoscopy between January 2014 and February 2016, including incomplete examinations, were evaluated. Small-bowel cleanliness was evaluated according to a quantitative index and a qualitative evaluation scale. Data with regard to patient and capsule endoscopy was analyzed. Results: 31 incomplete and 122 complete capsule endoscopies were included in the analysis of predictive factors for an incomplete capsule endoscopy. The degree of dependency (OR = 4.67; p = 0.028), performance of a capsule endoscopy in hospitalized patients (OR = 4.04; p = 0.006) and prior abdominal surgery (OR = 3.45; p = 0.012) were independent predictive factors of an incomplete procedure. 130 patients were included in the analysis of predictive factors for an inadequate small-bowel cleanliness. The mean quantitative index value was 7.3 (s.d. ± 2.3); 41.6% and 58.5% of capsule endoscopies were classified as poor-fair and good/excellent respectively, according to the qualitative evaluation. Independent predictive factors for an inadequate preparation according to the quantitative index included male gender (Beta = -0.79; p = 0.028), small-bowel transit time (Beta = -0.007; p < 0.0001) and cardiac disease (Beta = -1.29; p = 0.001). Associated factors according to the qualitative evaluation included male gender (OR = 0.406; p = 0.027) and small-bowel transit time (SBTT) (OR = 0.993; p < 0.0001). Conclusion: inpatient status, higher degrees of dependency and abdominal surgery are predictive factors for an incomplete capsule endoscopy; male gender and higher small-bowel transit time are predictive factors for an inadequate cleanliness.