a b s t r a c t a r t i c l e i n f o Keywords:Critically ill Nutritional risk Modified NUTRIC score Effectiveness Cultural validation Purpose: Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score. Materials: National, multicenter, prospective, observational study conducted in 15 polyvalent Portuguese intensive care unit (ICU), during 6 months. Adult patients were eligible. Those transferred from another ICU or readmitted, brain dead at admission, and with length of ICU stay (LOS) of 72 hours or less were excluded. NUTRIC score was calculated at admission; scores ≥5 represent a high nutritional risk. Main outcome was mortality from all causes at 28 days after admission to the ICU; LOS and days without mechanical ventilation (days free of MV) were secondary outcomes. Results: From 2061 admissions, 1143 patients were considered, mostly males (n = 744, 64.7%) with median (P 25 -P 75 ) age of 64 (51-75). Patients at high nutritional risk were 555 (48.6%). High NUTRIC score was associated with longer LOS (P b .001), less days free of MV (P = .002) and higher 28-day mortality (P b .001). The area under the curve of NUTRIC score ≥5 for predicting 28-day mortality was 0.658 (95% CI, 0.620-0.696). NUTRIC score ≥5 had a positive predictive value 32.7% and a negative predictive value 88.8% for 28-day mortality. Conclusions: Almost half of the patients in Portuguese ICUs are at high nutritional risk. NUTRIC score was strongly associated with main clinical outcomes.

Patients with AD showed a significant thickness reduction in global and temporal superior quadrants in pRNFL and in superior pericentral and peripheral sectors of RT. These findings may reflect a peripapillary and retinal changes characteristic of AD, suggesting the importance of SD-OCT as a potential adjuvant in early diagnosis of AD. Further studies are needed to understand which retinal layers and macular sectors are more useful as potential ocular biomarker over time in AD.

a b s t r a c t a r t i c l e i n f o Keywords:Critically ill Nutritional risk Modified NUTRIC score Effectiveness Cultural validation Purpose: Characterize the nutritional risk of critically ill patients with the modified NUTrition Risk in the Critically ill (NUTRIC) score. Materials: National, multicenter, prospective, observational study conducted in 15 polyvalent Portuguese intensive care unit (ICU), during 6 months. Adult patients were eligible. Those transferred from another ICU or readmitted, brain dead at admission, and with length of ICU stay (LOS) of 72 hours or less were excluded. NUTRIC score was calculated at admission; scores ≥5 represent a high nutritional risk. Main outcome was mortality from all causes at 28 days after admission to the ICU; LOS and days without mechanical ventilation (days free of MV) were secondary outcomes. Results: From 2061 admissions, 1143 patients were considered, mostly males (n = 744, 64.7%) with median (P 25 -P 75 ) age of 64 (51-75). Patients at high nutritional risk were 555 (48.6%). High NUTRIC score was associated with longer LOS (P b .001), less days free of MV (P = .002) and higher 28-day mortality (P b .001). The area under the curve of NUTRIC score ≥5 for predicting 28-day mortality was 0.658 (95% CI, 0.620-0.696). NUTRIC score ≥5 had a positive predictive value 32.7% and a negative predictive value 88.8% for 28-day mortality. Conclusions: Almost half of the patients in Portuguese ICUs are at high nutritional risk. NUTRIC score was strongly associated with main clinical outcomes.

IntroductionThe purpose of this study was to measure and to compare macular choroidal thickness (CT) between patients with mild Alzheimer's disease (AD), patients without AD, and elderly patients.MethodsCT was measured manually in 13 locations at 500-μm intervals of a horizontal and a vertical section from the fovea. Linear regression models were used to analyze the data.ResultsFifty patients with a diagnosis of mild AD (73.1 years), 152 patients without AD (71.03 years), and 50 elderly without AD (82.14 years) were included. In the AD patients, CT was significantly thinner in all 13 locations (P < .001—comparing with age-match group), and comparing with the elderly group, a more pronounced difference was found in two locations temporal to the fovea.DiscussionPatients with AD showed a significant choroidal thinning even when compared with elderly subjects. The reduction of CT may aid in the diagnoses of AD, probably reflecting the importance of vascular factors in their pathogenesis.

The associations between enteric pathogenic parasites and growth in infants in São Tomé were explored using a refined anthropometric approach to recognize early growth faltering. A birth cohort study was conducted with follow-up to 24 months of age. Microscopic examination for protozoa and soil-transmitted helminths was performed. Anthropometric assessments included: z-scores for weight-for-length (WLZ), length-for-age (LAZ), weight (WAVZ) and length velocities (LAVZ), length-for-age difference (LAD), and wasting and stunting risk (≤−1 SD). Generalized additive mixed effects regression models were used to explore the associations between anthropometric parameters and enteric parasitic infections and cofactors. A total of 475 infants were enrolled, and 282 completed the study. The great majority of infants were asymptomatic. Giardia lamblia was detected in 35.1% of infants in at least one stool sample, helminths in 30.4%, and Cryptosporidium spp. in 14.7%. Giardia lamblia and helminth infections were significantly associated with mean decreases of 0.10 in LAZ and 0.32 in LAD, and of 0.16 in LAZ and 0.48 in LAD, respectively. Cryptosporidium spp. infection was significantly associated with a mean decrease of 0.43 in WAVZ and 0.55 in LAVZ. The underestimated association between subclinical parasitic enteric infections and mild growth faltering in infants should be addressed in public health policies.