The value of serial lung ultrasound (LUS) in patients with COVID-19 is not well defined. In this multicenter prospective observational study, we aimed to assess the prognostic accuracy of serial LUS in patients admitted to hospital due to COVID-19. The serial LUS protocol included two examinations (0–48 h and 72–96 h after admission) using a 10-zones sequence, and a 0 to 5 severity score. Primary combined endpoint was death or the need for invasive mechanical ventilation. Calibration (Hosmer–Lemeshow test and calibration curves), and discrimination power (area under the ROC curve) of both ultrasound exams (SCORE1 and 2), and their difference (DIFFERENTIAL-SCORE) were performed. A total of 469 patients (54.2% women, median age 60 years) were included. The primary endpoint occurred in 51 patients (10.9%). Probability risk tertiles of SCORE1 and SCORE2 (0–11 points, 12–24 points, and ≥25 points) obtained a high calibration. SCORE-2 showed a higher discrimination power than SCORE-1 (AUC 0.72 (0.58–0.85) vs. 0.61 (0.52–0.7)). The DIFFERENTIAL-SCORE showed a higher discrimination power than SCORE-1 and SCORE-2 (AUC 0.78 (0.66–0.9)). An algorithm for clinical decision-making is proposed. Serial lung ultrasound performing two examinations during the first days of hospitalization is an accurate strategy for predicting clinical deterioration of patients with COVID-19.

Background: Bad dietary habits and sedentary lifestyles alter body composition, increasing disease risk. Methods: We conducted a prospective, comparative, longitudinal observational study among nursing students from Complutense University of Madrid. Data were collected in two periods: before exams (January 2024) and during exams (May 2024). Body composition was assessed via bioimpedance (Beurer BF 1000), dietary habits through the modified Kidmed survey, and physical activity using the IPAQ. Results: During exam preparation, fat mass significantly increased (25.43% to 28.79%, p = 0.016), muscle mass significantly decreased (39.70% to 36.20%, p < 0.001), and visceral fat rose notably (2.34 to 3.52, p < 0.001). Students exhibiting poor dietary quality increased (54.2% to 80.0%, p < 0.001), vigorous physical activity dramatically decreased (84.7% to 11.1%, p < 0.001), and sedentary time increased significantly (408.24 to 543.61 min/day, p < 0.001). Conclusions: Our findings suggest dietary deterioration and reduced physical activity during exams adversely affect students’ body composition.

Background: Surgical patients often experience nutritional imbalances due to their underlying condition and the forthcoming surgical procedure. These imbalances can increase the risk of post-operative complications. To mitigate such risks, a comprehensive nutritional assessment—also known as morphofunctional assessment—should be conducted. This includes evaluating body composition (muscle and fat mass), muscle strength, and functional capacity. Methods: We conducted an observational, prospective, pre-post interventional study involving 138 patients undergoing major elective surgery. Each patient received a morphofunctional assessment and an individualized prehabilitation program, including nutritional supplementation, physical exercise, and comorbidity optimization for 21 days before surgery and one month afterward. Outcomes were assessed through bioimpedance (muscle mass), muscle ultrasound (QRF thickness), dynamometry (strength), and visceral fat ultrasound (fat reduction). Results: The patient’s morphofunctional assessment and subsequent nutritional and physical exercise optimization performed during the month before surgery in the prehabilitation consultation led to an increase in muscle mass (measured by bioimpedance analysis, p = 0.001), and muscle ultrasound, (QRF thickness: p < 0.001) and dinamometry (muscle strength: p = 0.014); a reduction in preperitoneal visceral fat thickness (reduction p < 0.001); and an improvement in the patients’ nutritional status, with a decrease in malnutrition rates (64.8% vs. 31.8%). As a result, post-operative complications were effectively prevented (p < 0.001). Conclusions: Pre-operative patient optimization by means of a prehabilitation program led to increased muscle strength, improved muscle mass, reduced complication rates, and shorter hospital stays. In addition, patients maintained their quality of life and functional capacity following surgery.

(1) Background: Prehabilitation programs improve patients’ functional capacity before surgery by enhancing physical activity, nutrition, and psychological well-being, thereby reducing postoperative complications, hospital stays, and readmissions. We propose a centralized model led by an advanced practice nurse and internist to minimize consultations and reduce costs. (2) Methods: We studied 211 patients in a tertiary hospital in Madrid, with 135 enrolled in the centralized prehabilitation program and 76 in standard care (control). We compared complications, hospital stays, blood transfusions, and consultations, estimating costs using public pricing from Madrid’s healthcare authorities. (3) Results: The centralized model significantly reduced blood transfusions (p = 0.014), postoperative complications (p < 0.001), and hospital stays (p = 0.004), leading to annual savings of EUR 593,453.00. (4) Conclusions: A centralized surgical prehabilitation model decreases complications, hospital stays, readmissions, and consultations compared to standard care, significantly reducing healthcare costs.

Background: Emergency laparotomy (EL) carries high morbidity and mortality relative to elective abdominal surgery. While Enhanced Recovery After Surgery (ERAS) principles improve outcomes in elective care, their translation to emergencies is inconsistent. The emergency department (ED) provides a window for rapid risk stratification and pre-optimization, provided that interventions do not delay definitive surgery. Methods: We conducted a PRISMA-ScR–conformant scoping review to map ED-initiated, ERAS-aligned strategies for EL. PubMed, Scopus, and Cochrane were searched in February 2025. Eligible sources comprised ERAS guidelines, systematic reviews, cohort studies, consensus statements, and programmatic reports. Evidence was charted across five a priori domains: (i) ERAS standards, (ii) comparative effectiveness, (iii) ED-feasible pre-optimization, (iv) risk stratification (Emergency Surgery Score [ESS], frailty, sarcopenia), and (v) oncological emergencies. Results: Thirty-four sources met inclusion. ERAS guidelines codify rapid assessment, multimodal intraoperative care, and early postoperative rehabilitation under a strict no-delay rule. Meta-analysis and cohort data suggest ERAS-aligned pathways reduce complications and length of stay, though heterogeneity persists. ED-feasible measures include multimodal analgesia, goal-directed fluids, early safe nutrition, respiratory preparation, and anemia/micronutrient optimization (IV iron, vitamin B12, folate, vitamin D). Sarcopenia, frailty, and ESS consistently predicted adverse outcomes, supporting targeted bundle activation. Evidence from oncological emergencies indicates feasibility under no-delay governance. Conclusions: A minimal, ED-initiated, ERAS-aligned bundle is feasible, guideline-concordant, and may shorten hospitalization and reduce complications in EL. We propose a practical framework that links rapid risk stratification, opportunistic pre-optimization, and explicit continuity into intra- and postoperative care; future studies should test fidelity, costs, and outcome impact in pragmatic emergency pathways.

Background: Sarcopenia is a progressive muscle disorder commonly associated with aging and chronic diseases. It has been linked to worse clinical outcomes and increased vulnerability during acute illness. However, its prevalence in emergency department (ED) populations remains underexplored. This study aimed to evaluate the presence of sarcopenia among ED patients using ultrasound, determine its relationship with underlying comorbidities, and assess its association with in-hospital complications. Methods: We conducted a prospective, observational, cross-sectional study at the Infanta Cristina University Hospital (Madrid, Spain) from January to May 2024. A total of 150 patients aged 18 years and older who presented to the ED were assessed for sarcopenia using rectus femoris ultrasound. Sociodemographic, clinical, and laboratory variables were collected. A multivariate logistic regression model was used to identify independent predictors of in-hospital complications. Patients were followed for 30 days to evaluate outcomes. Comparisons were made between diagnostic groups and sarcopenia indices. Results: The mean age of the cohort was 70.7 years (SD 18.15), and 52% were male. Neurological diseases were associated with the highest degree of sarcopenia (mean Y-axis: 0.93 cm), followed by digestive (1.05 cm), hematological (1.05 cm), and cardiovascular diseases (1.08 cm). Patients who developed in-hospital complications had lower mean muscle thickness values compared to those without complications (1.08 cm vs. 1.24 cm; p < 0.05). Sarcopenia was significantly correlated with the presence of comorbidities and poor clinical outcomes. Conclusions: These findings support the integration of sarcopenia screening protocols into emergency care and highlight the need for studies exploring early nutritional or rehabilitation interventions targeted at high-risk patients.