Soil nematode abundance and functional group composition at a global scale.

Soil organisms are a crucial part of the terrestrial biosphere. Despite their importance for ecosystem functioning, few quantitative, spatially explicit models of the active belowground community currently exist. In particular, nematodes are the most abundant animals on Earth, filling all trophic levels in the soil food web. Here we use 6,759 georeferenced samples to generate a mechanistic understanding of the patterns of the global abundance of nematodes in the soil and the composition of their functional groups. The resulting maps show that 4.4 ± 0.64 × 1020 nematodes (with a total biomass of approximately 0.3 gigatonnes) inhabit surface soils across the world, with higher abundances in sub-Arctic regions (38% of total) than in temperate (24%) or tropical (21%) regions. Regional variations in these global trends also provide insights into local patterns of soil fertility and functioning. These high-resolution models provide the first steps towards representing soil ecological processes in global biogeochemical models and will enable the prediction of elemental cycling under current and future climate scenarios.

Consenso de expertos sobre la eficacia clínica y directrices sobre la terapia de oxígeno transdérmico continuo para la cicatrización de las heridas complejas o difíciles de cicatrizar.

INTRODUCTION: Oxygen is pivotal for wound healing. Its lack or hypoxia can delay this process, especially in individuals with comorbidities, potentially resulting in complex or hard-to-heal wounds. The Colombian Association of Diabetes (ACD) and the Colombian Association of Internal Medicine (ACMI) collaborated with a diverse group of experts to provide recommendations on the efficacy and best practices of continuous transdermal oxygen therapy (TOTc) in the care of such wounds. METHOD: A modified Delphi technique was employed to obtain controlled feedback and responses. Experts from various disciplines engaged in reviewing and discussing numerous relevant scientific studies, focusing on the role of TOTc in treating chronic ulcers. RESULTS: Continuous transdermal oxygen therapy has proven to be an effective and safe treatment for chronic and/or hard-to-heal ulcers. This therapy directly addresses the wound's oxygen deficiency, providing an environment conducive to healing. Significant benefits were observed, including the acceleration of the healing process, wound size reduction, and an enhancement in patient quality of life. Its efficacy was found across various ulcer etiologies, underscoring its therapeutic versatility. CONCLUSIONS: Continuous transdermal oxygen therapy is effective and safe for treating chronic and hard-to-heal ulcers. It's crucial to address each case individually and through a multidisciplinary approach to maximize this therapy's benefits. Both evidence and clinical experience back its utility across a variety of ulcer etiologies.

RESUMEN: Introducción: El oxígeno es esencial en la cicatrización de heridas. Su ausencia o hipoxia puede retrasar este proceso, especialmente en individuos con comorbilidades, lo que podría resultar en heridas complejas o de difícil cicatrización. La Asociación Colombiana de Diabetes (ACD) y la Asociación Colombiana de Medicina Interna (ACMI) se unieron con un grupo diverso de expertos para brindar recomendaciones sobre la eficacia y práctica de la terapia de oxígeno transdérmico continuo (TOTc) en el cuidado de estas heridas. Método: Se utilizó la técnica Delphi modificada para obtener respuestas y retroalimentación controlada. Expertos de diversas disciplinas participaron en la revisión y discusión de numerosos estudios científicos relevantes, centrados en el papel de la TOTc en el tratamiento de úlceras crónicas. Resultados: El oxígeno transdérmico continuo ha demostrado ser una terapia eficaz y segura en el tratamiento de úlceras crónicas y/o de difícil cicatrización. Esta terapia aborda directamente la deficiencia de oxígeno en la herida, proporcionando un entorno propicio para la curación. Se observaron beneficios significativos, incluyendo aceleración del proceso de cicatrización, reducción del tamaño de la herida y mejora en la calidad de vida del paciente. Se encontró eficacia en diversas etiologías de úlceras, subrayando su versatilidad terapéutica. Conclusiones: La terapia de oxígeno transdérmico continuo es eficaz y segura para tratar úlceras crónicas y de difícil cicatrización. Es vital abordar cada caso de manera individualizada y mediante un enfoque multidisciplinario para maximizar los beneficios de esta terapia. La evidencia y experiencia clínica respaldan su utilidad en diversas etiologías de úlceras. Palabras clave: Terapia de oxígeno transdérmico continuo, Oxígeno, Pie diabético, Cicatrización de heridas, Cuidado de heridas, Úlceras vasculares, Lesiones por presión, Hipoxia, Infección.

[COVID-19-associated lung weakness (CALW): Systematic review and meta-analysis]. / Debilidad pulmonar asociada a COVID-19 (DPAC): revisión sistemática y metaanálisis.

Objectives: To assess mortality and different clinical factors derived from the development of atraumatic pneumothorax (PNX) and/or pneumomediastinum (PNMD) in critically ill patients as a consequence of COVID-19-associated lung weakness (CALW). Design: Systematic review with meta-analysis. Setting: Intensive care unit (ICU). Participants: Original research evaluating patients, with or without the need for protective invasive mechanical ventilation (IMV), with a diagnosis of COVID-19 who had developed atraumatic PNX or PNMD on admission or during their hospital stay. Interventions: Data of interest were obtained from each article and analysed and assessed by the Newcastle-Ottawa Scale. The risk of the variables of interest was assessed by data derived from studies including patients who developed atraumatic PNX or PNMD. Main variables of interest: Mortality, mean ICU length of stay and mean PaO2/FiO2 at diagnosis. Results: Data were collected from 12 longitudinal studies. Data from a total of 4,901 patients were included in the meta-analysis. A total of 1,629 patients had an episode of atraumatic PNX and 253 patients had an episode of atraumatic PNMD. Despite finding significantly strong associations, the high heterogeneity between studies means that interpretation of the results should be made with caution. Conclusions: Mortality of COVID-19 patients was higher in those who developed atraumatic PNX and/or PNMD compared to those who did not. The mean PaO2/FiO2 index was lower in patients who developed atraumatic PNX and/or PNMD. We propose to group these cases under the term CAPD.

Type of household firearm ownership and firearm suicide among adolescents, 1976-2018.

After declining steadily for almost two decades, the rate of firearm suicide among adolescents (aged 15-19 years) has increased nearly every year since 2007. At the same time, overall levels of household firearm ownership have been declining. In this paper, we examined whether and how types of firearms in the homes of adolescents have changed over time, and the extent to which such changes are associated with trends in firearm suicides among adolescents. Our analyses focused on understanding these trends among Black and White male and female adolescents to better understand longstanding race-gender differences in firearm ownership and firearm suicide. With combined data from the General Social Survey (GSS) and the National Center for Health Statistics (NCHS), the findings show that handgun ownership in Black and White households increased over the last four decades, while overall levels of firearm ownership declined. Increases in handgun ownership were predictive of increased firearm suicide rates among White adolescents, especially among males. We found no significant relationship between firearm suicide among Black adolescents and firearm ownership among Black households, regardless of gun type, which is potentially unsurprising given that firearm ownership is substantially lower in Black households compared to White households. Possibly reflecting race and gender differences in household gun ownership, our findings also show that rates of firearm suicide were lower for Black and female adolescents and highest for White male adolescents. Taken together, these findings provide new evidence on the relationship between trends in firearm ownership and adolescent firearm suicide and address important questions about the influence of race and gender for understanding firearm suicide among adolescents.

Implementation of a neonatal donation protocol in the neonatal intensive care unit: A single-center experience.

BACKGROUND: Lack of specific protocols for neonatal donation contributes to the rarity of neonatal donors. In this study, we evaluate the impact of the implementation of a neonatal donation protocol in our NICU. METHODS: In this single-center study, we conducted a retrospective chart review of neonatal deaths in our NICU from January 2013 to January 2022. The study was divided into two periods: before and after the implementation of a neonatal donation protocol. The referral rates of potential neonatal donors to the OPO in the two periods were compared using the chi-square test. A p value < .05 was considered statistically significant. RESULTS: Sixty-four infants were reviewed. Seven (10.9%) met the inclusion criteria for potential neonatal donors after DCC. The referral rate of potential neonatal donors increased from 2.5% to 16.7% after the implementation of this protocol (p = .041), and one infant (4.1%) became an effective heart-valve donor. CONCLUSION: The implementation of a local neonatal donation protocol could have contributed to increase the referral rate of potential neonatal donors in our NICU. Following the implementation of a local neonatal donation protocol, we were able to perform a heart-valve donation for the first time in our unit.

Effectiveness of telemedicine psychoeducational interventions for adults with non-oncological chronic disease: A systematic review.

AIM: To evaluate the effectiveness of telemedicine psychoeducational interventions (PIs) in adult patients on the clinical management of chronic non-oncological diseases compared with another therapeutic option or no treatment. DESIGN: Systematic review of randomized controlled trials. DATA SOURCES: Six databases were searched between January 2011 and August 2021. REVIEW METHODS: A systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Study selection, quality appraisal and data extraction were conducted independently by two reviewers. A third arbiter was available if discrepancies. RESULTS: A total of 719 articles were reviewed and 17 studies met the inclusion and quality criteria. The included studies related to smoking, chronic pain, obesity and mental illness. Most interventions were based on cognitive behavioural theory. Most of the included studies (12/17, 70.5%) showed improvements in health and significant reductions in anxiety, pain and depression with variable effect sizes. Patients reported a high satisfaction rate and indicated lectures or self-report writings as helpful in their recovery compared with more interactive items. Only financial incentives demonstrated greater adherence. A specific intervention format or complementary professional support was not associated with health outcomes. CONCLUSIONS: Telemedicine PIs are a safe and effective option for the clinical management of adults with chronic diseases. Future longitudinal studies are needed to assess the impact of these interventions on chronic physical and mental disease, evaluating the quality of life, morbidity and mortality. IMPACT: The results reinforce the telemedicine PIs with effects on clinical management similar to those of the face-to-face modality and can be carried out in a safe environment for patients at a lower cost to the health system. These conditions make them suitable for comprehensive care in the epidemiological COVID-19 context with the highest safety conditions for the patients and professionals.

Pulmonary nodules in a patient with Crohn's disease.

We report a case of a 42 year-old-woman who presented cough, diarrhea, bilateral cavitated pulmonary nodules in the radiography and a colonoscopy suggestive of Crohn's disease. Before the beggining of treatment, IGRAs were positive. This case was a diagnosis challenge between Crohn's disease and intestinal tuberculosis. Eventually, the diagnosis of Crohn's disease with pulmonary involvement was given, which is an unusual extraintestinal manifestation.

Complete Mesocolic Excision and D3 Lymphadenectomy versus Conventional Colectomy for Colon Cancer: A Systematic Review and Meta-Analysis.

BACKGROUNDS: Previous systematic reviews suggest that the implementation of 'complete mesocolon excision' (CME) for colon tumors entails better specimen quality but with limited long-term outcomes. We performed a meta-analysis to compare the pathological, perioperative, and oncological results of CME with conventional surgery (CS) in primary colon cancer. METHODS: Embase, MEDLINE and CENTRAL databases were searched using Medical Subject Headings for CME and D3 lymphadenectomy. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: A total of 18,989 patients from 27 studies were included. Postoperative complications were higher in the CME group (relative risk [RR] 1.13, 95% confidence interval [CI] 1.04-1.22, I2 = 0%), while no differences were observed in terms of anastomotic leak (I2 = 0%) or perioperative mortality (I2 = 49%). CME was associated with a higher number of lymph nodes harvested (I2 = 95%), distance to high tie (I2 = 65%), bowel length (I2 = 0%), and mesentery area (I2 = 95%). CME also had positive effects on 3- and 5-year overall survival (RR 1.09, 95% CI 1.04-1.15, I2 = 88%; and RR 1.05, 95% CI 1.02-1.08, I2 = 62%, respectively) and 3-year disease-free survival (RR 1.10, 95% CI 1.04-1.17, I2 = 22%), as well as decreased local (RR 0.35, 95% CI 0.24-0.51, I2 = 51%) and distant recurrences (RR 0.71, 95% CI 0.60-0.85, I2 = 34%). CONCLUSIONS: Limited evidence suggests that CME improves oncological outcomes with a higher postoperative adverse events rate but no increase in anastomotic leak rate or perioperative mortality, compared with CS.

Low sensitivity of conventional fungal agars in fungemia by Rhodotorula mucilaginosa: description of two cases.

BACKGROUND: Although most bloodstream yeast infections are caused by Candida spp., infections by rare or less common species have increased in recent years. Diagnosis of infections caused by these species is difficult due to the lack of specific symptoms and adequate diagnostic tools. CASES PRESENTATION: We describe two cases of fungemia by Rhodotorula mucilaginosa within a few months of each other, in a secondary Spanish hospital. In both cases, diagnosis was challenging. Blood subcultures in conventional fungal media were persistently negatives and the use of non-conventional fungal media was essential for isolating the yeasts and achieving a correct diagnosis. 1-3 beta-D-glucan detection and a panfungal PCR assay were helpful techniques to confirm the diagnosis CONCLUSION: It is highly important to establish an early diagnosis for fungemia. The process is challenging because often non-specific symptoms are presents. When yeasts grow in blood cultures other genera than Candida spp. could be the cause of infection. Patient risk factors should be assessed to incorporate alternative culture media and the available rapid diagnostic test, in order to provide an early recognition of the pathogen.

Estimating exposure to neighborhood crime by race and ethnicity for public health research.

BACKGROUND: Police-reported crime data (hereafter "crime") is routinely used as a psychosocial stressor in public health research, yet few studies have jointly examined (a) differences in crime exposure based on participant race and ethnicity, (b) differences in measures of crime exposure, and (c) considerations for how exposure to police is captured in police-recorded crime data. We estimate neighborhood exposure to crime and discuss the implications of structural differences in exposure to crime and police based on race and ethnicity. METHODS: Using GPS coordinates from 1188 participants in the Newborn Epigenetics Study, we estimated gestational exposure to crime provided by the Durham, North Carolina, Police Department within (a) 800 m and (b) the Census block group of residence. We controlled for non-overlapping spatial boundaries in crime, Census, residential, and police data to report crime spatial (crime per km2) and population (crime per 1000 people per km2) density. RESULTS: We demonstrate dramatic disparities in exposure to crime based on participant race and ethnicity and highlight variability in these disparities based on the type of crime and crime measurement method chosen. CONCLUSIONS: Public health researchers should give thoughtful consideration when using police-reported crime data to measure and model exposure to crime in the United States, as police-reported data encompasses joint exposure to police and crime in the neighborhood setting.

Adaptive governance and coping strategies in the Yucatan Peninsula coasts facing COVID-19.

The COVID-19 pandemic has abruptly transformed all social structures around the world, and coastal zones where tourist and fishing activities take place is no exception. Due to the sanitary measures, restrictions to travel and lock down periods, the tourist sector has been one of the economic sectors most affected by this health and economic crisis. However, it is not the only sector to have been affected, the fisheries sector, being highly dependent on the export market, has also suffered the consequences of this crisis. In this article, we aim to identify the main characteristics and key aspects of the fishing and tourist sectors in the states of Yucatan and Campeche, in Mexico, under pandemic dynamics. What are the organizational and governance structures that have been developed in response to this world phenomena? To answer this question, we conducted phone interviews and reviewed governmental and community actions. Results show that individual survival strategies prevail as a response to COVID-19, over community or governmental actions. There was limited coordination among the different governance structures, between the community and governmental levels. However, this crisis has also been a period of learning and innovation to implement adaptive governance structures to build resilience and a "new normal social reality".

Employment and Health Among Recently Incarcerated Men Before and After the Affordable Care Act (2009-2017).

Objectives. To explore whether and how the Affordable Care Act (ACA) affects the relationship between employment and health insurance coverage, health care utilization, and health outcomes among recently incarcerated men aged 18 to 64 years in the United States.Methods. With data from the National Survey on Drug Use and Health (NSDUH), we used a difference-in-differences approach to compare changes in outcomes by employment status among recently incarcerated men.Results. Uninsurance declined significantly among recently incarcerated men after ACA implementation. As the uninsured rate of unemployed men fell below that of their employed counterparts, the ACA helped to fully eliminate the effect of employment on insurance coverage among recently incarcerated men. The employment gap in diabetes widened after ACA implementation as unemployed men saw significant increases in diagnosed diabetes. Employment disparities in hospital visits, diagnosed hypertension, and reported mental illness also declined in the period following ACA implementation, but these changes were not statistically significant.Conclusions. These findings highlight how the ACA, by providing a new route to health care, reduces the confounding forces associated with employment that are linked to both incarceration and health.

Efficacy and safety of a novel nitric oxide generator for the treatment of neonatal pulmonary hypertension: Experimental and clinical studies.

Persistent pulmonary hypertension of the newborn (PPHN) is a complex pathology resulting from a failure of the post-natal reduction in pulmonary vascular resistance leading to hypoxemia. The standard therapy is inhaled Nitric Oxide (NO) improving oxygenation but its availability is limited, especially in hospitals with restricted financial resources. We evaluated the efficacy and safety of a new device generating NO (TAS + PLUS), in three experimental piglet models of pulmonary hypertension (PH), and we later tested its application in a pilot study of newborn patients suffering from PPHN. Piglets with experimentally induced PH showed a decrease in pulmonary arterial pressure (PAP) after breathing NO. Both acute and chronic exposure of piglets and rats did not cause any adverse effect in blood gas levels and biological parameters. A pilot study including 32 patients suffering from PPHN showed an increase in oxygen saturation (SatO2) and partial pressure of oxygen in arterial blood (PaO2) leading to a decrease of Oxygenation Index (OI) after compassionate treatment with NO from TAS + PLUS device. The device showed effectiveness and safety both in experimental PH and in the clinical setting. Therefore, it represents an excellent alternative for PPHN management in conditions where commercial NO is unavailable.

Association of Fluid Overload With Clinical Outcomes in Critically Ill Children With Bronchiolitis: Bronquiolitis en la Unidad de Cuidados Intensivos Pediátricos (BRUCIP) Study.

OBJECTIVES: Increasing evidence supports the association of fluid overload with adverse outcomes in different diseases. To our knowledge, few studies have examined the impact of fluid balance on clinical outcome in severe bronchiolitis. Our aim was to determine whether fluid overload was associated with adverse clinical outcomes in critically ill children with severe bronchiolitis. DESIGN: Descriptive, prospective, multicenter study. SETTING: Sixteen Spanish PICUs. PATIENTS: Severe acute bronchiolitis who required admission from October 2014 to May 2015 were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Total fluid intake and output were prospectively recorded during PICU assistance. Fluid balance was measured at 24, 48, and 72 hours after PICU admission. A total of 262 patients were enrolled; 54.6% were male. Median age was 1 month (interquartile range, 1-3 mo). Patients had a positive fluid balance during the first 4 days of PICU admission, reaching a neutral balance on day 4. A positive balance at 24 hours in patients admitted to the PICU with severe bronchiolitis was related with longer stay in PICU (p < 0.001), longer hospital stay (p < 0.001), longer duration of mechanical ventilation (p = 0.016), and longer duration of noninvasive ventilation (p = 0.0029). CONCLUSIONS: Critically ill patients with severe acute bronchiolitis who present a positive balance in the first 24 hours of PICU admission have poorer clinical outcomes with longer PICU and hospital length of stay and duration of invasive and noninvasive mechanical ventilation.

The Institutional Determinants of Health Insurance: Moving Away from Labor Market, Marriage, and Family Attachments under the ACA.

For more than a century, the American welfare state required working-age adults to obtain social welfare benefits through their linkages to employers, spouses, or children. Recent changes to U.S. healthcare policy prompted by the Patient Protection and Affordable Care Act (ACA), however, provide adults with new pathways for accessing a key form of social welfare-health insurance-decoupled from employers, spouses, and children. Taking advantage of this fundamental shift in the country's system of social welfare provision, I use data from the National Survey on Drug Use and Health (NSDUH) to explore patterns of health insurance coverage from before and after the ACA became active in 2014. The results show that the salience of labor market, marriage, and family attachments as pathways to coverage significantly declined in the first three years following passage of the ACA. By providing adults with a new route to coverage decoupled from their institutional attachments, the ACA helped narrow health insurance inequalities across gender, race and ethnicity, and education. Given the strong association between health insurance and health outcomes, the results from this study raise important questions about the centrality of institutional attachments for our knowledge of health inequalities.

Silence Speaks: The Relationship between Immigration and the Underreporting of Crime.

Scarce in criminological literature is an exploration of whether crime reporting varies geographically. Yet, there are substantive reasons to believe not only that the percentage of crimes reported to the police varies across jurisdictions, but also that crime reporting can be explained by ecological characteristics. Drawing upon data from both the National Crime Victimization Survey and the census, this study examines the relationship between immigration and the likelihood that crimes are reported to the police. Results indicate that crime reporting is inversely related to increases in the rates of noncitizens and foreign-born residents within a metropolitan area, and that the negative effect is greater for violence than for property crime. Implications for policing and public safety are discussed.

PANLAR Consensus Recommendations for the Management in Osteoarthritis of Hand, Hip, and Knee.

OBJECTIVE: The objective of this consensus is to update the recommendations for the treatment of hand, hip, and knee osteoarthritis (OA) by agreeing on key propositions relating to the management of hand, hip, and knee OA, by identifying and critically appraising research evidence for the effectiveness of the treatments and by generating recommendations based on a combination of the available evidence and expert opinion of 18 countries of America. METHODS: Recommendations were developed by a group of 48 specialists of rheumatologists, members of other medical disciplines (orthopedics and physiatrists), and three patients, one for each location of OA. A systematic review of existing articles, meta-analyses, and guidelines for the management of hand, hip, and knee OA published between 2008 and January 2014 was undertaken. The scores for Level of Evidence and Grade of Recommendation were proposed and fully consented within the committee based on The American Heart Association Evidence-Based Scoring System. The level of agreement was established through a variation of Delphi technique. RESULTS: Both "strong" and "conditional" recommendations are given for management of hand, hip, and knee OA and nonpharmacological, pharmacological, and surgical modalities of treatment are presented according to the different levels of agreement. CONCLUSIONS: These recommendations are based on the consensus of clinical experts from a wide range of disciplines taking available evidence into account while balancing the benefits and risks of nonpharmacological, pharmacological, and surgical treatment modalities, and incorporating their preferences and values. Different backgrounds in terms of patient education or drug availability in different countries were not evaluated but will be important.

The Pilates method and cardiorespiratory adaptation to training.

Although all authors report beneficial health changes following training based on the Pilates method, no explicit analysis has been performed of its cardiorespiratory effects. The objective of this study was to evaluate possible changes in cardiorespiratory parameters with the Pilates method. A total of 45 university students aged 18-35 years (77.8% female and 22.2% male), who did not routinely practice physical exercise or sports, volunteered for the study and signed informed consent. The Pilates training was conducted over 10 weeks, with three 1-hour sessions per week. Physiological cardiorespiratory responses were assessed using a MasterScreen CPX apparatus. After the 10-week training, statistically significant improvements were observed in mean heart rate (135.4-124.2 beats/min), respiratory exchange ratio (1.1-0.9) and oxygen equivalent (30.7-27.6) values, among other spirometric parameters, in submaximal aerobic testing. These findings indicate that practice of the Pilates method has a positive influence on cardiorespiratory parameters in healthy adults who do not routinely practice physical exercise activities.

The value of lipopolysaccharide binding protein for diagnosis of late-onset neonatal sepsis in very low birth weight infants.

OBJECTIVE: To assess the accuracy of lipopolysaccharide binding protein (LBP) for diagnosing late-onset neonatal sepsis (LONS) in very low birth weight (VLBW) infants. STUDY DESIGN: Observational, prospective study. We assessed the diagnostic performance of LBP in 26 suspected LONS episodes among 54 patients. Proven and probable LONS episodes were recorded according to established criteria. Receiver operating characteristic curve analysis was performed to evaluate LBP's ability to predict LONS. RESULTS: LONS was diagnosed in 17 of 26 episodes. LBP levels were significantly higher in confirmed LONS episodes (P<0.001). The area under the curve of LBP was 0.89. A cut-off of 17.5 µg/mL had a sensitivity of 94.1%, a specificity of 77.8%, a positive predictive value of 88.9% and a negative predictive value of 87.5%. CONCLUSIONS: Serum LBP measurement may be useful as an additional tool in the evaluation of suspected LONS in VLBW infants.

Should arm span or height be used in calculating the BMI for the older people? Preliminary results.

AIMS AND OBJECTIVES: To consider using arm span rather than height for calculating the body mass index, as a parameter that offers greater long-term stability, for the nutritional assessment of persons aged over 65 years. BACKGROUND: The body mass index presents certain drawbacks for the nutritional screening of older people suffering malnutrition or at risk of malnutrition, due to the anthropometric changes that occur with increasing age, especially the progressive loss of height. DESIGN: Observational, cross-sectional study, using nonprobabilistic convenience sampling, with anthropometric measurements and nutritional screening in older men and women, divided into two groups: (1) aged 65-75 years and (2) aged over 75 years. METHODOLOGY: Height and arm span were measured to calculate two separate indices of body mass: body mass index (weight/height) and body mass index.1 (weight/arm span). Nutritional screening was conducted using the Mini Nutritional Assessment Short-Form, which includes the body mass index as an anthropometric measure. RESULTS: Our results reveal statistically significant differences between the two indices, for the sample analysed. Body mass index.1 classifies a larger number of older people as suffering malnutrition and fewer as being at nutritional risk. When this new index is used, there is a displacement of the subjects at risk, thus increasing the number considered at risk of malnutrition and in need of appropriate therapeutic intervention. Therefore, the use of body mass index.1 would enable more people suffering malnutrition, who would otherwise remain untreated, to be attended. CONCLUSIONS: As arm span, as an anthropometric measure, remains unchanged over time, it could be used instead of height, as an alternative index (body mass index.1) to the conventional body mass index. Further research is needed to determine the association between body mass index.1 and clinical status parameters to determine optimum cut-off points. RELEVANCE TO CLINICAL PRACTICE: This study describes the greater stability of body mass index.1 with respect to body mass index for nutritional screening, and the resulting benefits for nutritional monitoring and intervention for older people.