Background Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student‐ and trainee‐led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre‐specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non‐selective cyclo‐oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.

This article presents the first reconstruction of the relationship between conscience and empire in the Portuguese World between 1500 and 1650. It shows to what extent the foundation of the Mesa da Consciência (“Board of Conscience”), a royal council of theologians devoted to issues like war, commerce, conversion, and slavery, shaped the imperial ideology. In this context, “conscience” emerged as a keyword in the political vocabulary, reflecting the importance of moral theology for the political language in which the empire was conceived. It not only bolstered the hegemony of theologians but also encouraged the emergence of a missionary casuistry, which became increasingly independent of the central authorities in the kingdom and in Rome. Under the Habsburg domination (1580-1640) this system was dismantled and theologians lost their centrality at court. After the Restoration of 1640 some of the old institutions were recovered in name, but the old interconnection between politics and moral theology was not re-installed.

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O objetivo do presente artigo é fazer uma incursão na história conectada dos dois grupos mais discriminados do império português da época moderna, dando particular atenção ao caso da sociedade colonial brasileira: os ameríndios e os negros africanos escravizados. Essa história é resultante de uma complexa teia formada por causas de diversas naturezas. Examinamos aqui três delas: o juízo acerca da capacidade de trabalho, a influência do paradigma antijudaico e o debate sobre a salvação da alma dos ameríndios e dos negros africanos. Palavras-chave: Discriminação -hierarquias sociais -escravidão Amerindian and Black African slaves: a connected history Discrimination theories and models in the Portuguese Empire (ca. 1450-1650)This article aims to move toward a connected history of the two more discriminated groups in the early modern Portuguese Empire, with special regard to Brazilian colonial society: the enslaved Amerindians and Black Africans. Entangled factors marked that history. Three of them are here considered: the judgment about working capacity, the influence of anti-Judaism and the debate on the eternal salvation of Amerindians and Black Africans. Keywords: Discrimination -social hierarchies -slavery 1 Artigo recebido e aprovado para publicação em julho de 2010. Escravidões conectadas: trabalho e hierarquiaVou partir de dois documentos escritos com cerca de um século de distância um do outro. Trata-se em ambos os casos de uma interpelação, feita ao rei de Portugal por colonos residentes no Brasil, sobre a questão do trabalho dos escravos.Havia passado cerca de sete anos da chegada do primeiro governador geral, D. Tomé de Sousa (1549-1553), quando autoridades municipais e moradores portugueses de Salvador da Bahia dirigiram a D. João III o específico e fundamentado pedido de uma autorização do rei para armar navios a serem enviados para São Tomé e Cabo Verde a fim de dar início a um singular comércio de escravos: índios tupinambás em troca de negros africanos "da Guiné". A alegação era que estes últimos eram muito mais úteis e confiáveis do que os nativos ("os naturais"). Argumentava-se que um uso maior de escravos africanos levaria "muito proveito ao povo, serviço a Vossa Alteza com o aumento das suas remdas e seguridade da terra".3 Voltarei a tratar das opiniões etnográficas dos colonos da Bahia. No entanto, o que interessa primeiro é observar como, em lugares e épocas diferentes, podemos encontrar ecos de uma percepção análoga, o que demonstra o segundo documento a ser examinado.Em meados do século XVII, a região setentrional do Maranhão não tinha mais do que uma colonização embrionária. Numa consulta de 1639, a Mesa da Consciência e Ordens, tribunal régio especialmente incumbido de dirimir ou prevenir as controvérsias causadas pela intervenção da coroa em matérias de natureza