Background/Objectives: The optimal protein dose for critically ill cancer patients, especially for muscle mass preservation and survival, remains unclear. This study evaluated whether a higher protein intake, compared to usual intake, was associated with improved clinical outcomes in this population. Methods: This was a prospective analysis of critically ill adult cancer patients admitted to an oncological intensive care unit (ICU). Patients were initially assigned to receive protein prescriptions of either 1.5 or 2.0 g per kilogram per day (g/kg/day), but due to common limitations in achieving prescribed targets in this setting, a prespecified per-protocol analysis was conducted. After three days of exclusive nutritional therapy, patients were reclassified into two groups based on actual protein intake: >1.5 g/kg/day (higher intake group, IG) and ≤1.5 g/kg/day (usual intake group, CG). The primary outcome was muscle mass preservation, measured by quadriceps muscle thickness (QMT) via ultrasound on days 1, 7, and 14. Secondary outcomes included ICU survival, hospital and ICU length of stay, mechanical ventilation duration, dialysis requirement, and 60-day survival. Results: From June 2019 to September 2023, 117 patients were included. Following the planned interim analysis, the study was stopped after meeting the Pocock criterion for ICU survival (p = 0.0013). After reclassification, 68.4% (n = 80) were in the IG and 31.6% (n = 37) in the CG. ICU stay was similar (both medians 13 days), but the IG had shorter hospital stays [21.0 vs. 27.5 days, p = 0.020], less QMT loss, and improved ICU (HR = 0.31, 95% CI 0.15–0.64), hospital (HR = 0.43, CI 0.23–0.80), and 60-day survival (HR = 0.43, CI 0.23–0.80), along with shorter ventilation duration (HR = 0.54, CI 0.30–0.99). Conclusions: Higher protein intake (>1.5 g/kg/day) was associated with better muscle mass preservation and improved clinical outcomes in critically ill cancer patients.

Category: Nutrition/Metabolism Introduction: According to the National Cancer Institute, 704 thousand new cases of cancer are expected in Brazil for each year of the 2023-2025 triennium.() Malnutrition in cancer patients is common and largely multifactorial due to the direct and indirect effects of the tumor, treatments performed and psychological factors.() Objective: To verify whether, in patients admitted to the ICU, a protein intake target of 2.0g/kg/day compared to a conservative protein intake target of 1.5g/kg/day may be associated with kidney

Feedback is a formative assessment model that regulates the teaching-learning process, continuously providing the student with parameters so that they can understand how they are progressing towards acquiring skills. The objective was to identify the evidence available in the literature about the role of feedback as a learning tool in medical residency. This is an integrative review in the PubMed and Scopus databases, of articles from studies developed on this topic, published in English, Portuguese or Spanish, with no defined publication date. After the search strategy, 11 articles were included that address the use of learning and feedback tools. Feedback is a powerful tool for teaching-learning within the scope of medical residency, it offers opportunities for self-reflection, stimulates trust in the relationship between resident and preceptor, allows the review of actions and the improvement of the quality of the service offered by actors in medical scenarios. in-service training. In order to take advantage of feedback as an evaluation method, those involved must pay attention to the elements that make up effective feedback, such as objectivity, specificity, opportunity, bidirectionality, affectivity, care and sensitivity.