Mútua Terrassa

Introduction: Muscle function is influenced by hydroelectrolytic mechanisms that regulate cellular volume beyond isolated plasma electrolyte concentrations. However, the role of integrated hydration and electrolyte regulation profiles in muscle function among older adults remains insufficiently understood. Objective: To identify which physiological domains of hydroelectrolytic regulation are most strongly associated with muscle strength and functional performance in community-dwelling older adults. Methods: A cross-sectional study was conducted in 96 community-dwelling individuals aged ≥ 70 years. Markers of cellular hydration and membrane integrity were assessed using bioelectrical impedance analysis, together with first-morning fasting plasma and urinary sodium and chloride concentrations. Principal component analysis (PCA) was applied as a data-driven approach to identify latent domains of coordinated hydroelectrolytic regulation. Associations between component scores and handgrip strength and Timed Up and Go (TUG) were examined using two sequential multivariable regression models: Model 1 adjusted for sex and fat-free mass index (FFMI); Model 2 additionally adjusted for age, hypertension, and diuretic use. Results: Three principal components were retained, explaining 77.5% of total variance: PC1 (renal-cellular domain), PC2 (plasma electrolyte domain), and PC3 (cellular volume domain). For handgrip strength, Model 1 showed significant associations for PC3 (β = 0.152; p = 0.025) and PC1 (β = 0.180; p = 0.050). In Model 2, only PC3 remained independently associated (β = 0.146; p = 0.036). For TUG, Model 1 showed associations for PC1 (β = -0.262; p = 0.049) and PC3 (β = -0.238; p = 0.015). In Model 2, PC1 (β = -0.308; p = 0.019) and PC2 (β = -0.190; p = 0.046) remained independently associated, whereas PC3 was not. Conclusions: Maximal force production appears primarily associated with cellular volume regulation, whereas functional performance reflects broader multi-compartmental hydroelectrolytic integration involving renal and plasma domains. These findings suggest that multidimensional hydration profiling may complement isolated biochemical markers in the functional assessment of older adults, warranting validation in longitudinal studies.

<h3>Background and Importance</h3> Evaluating the appropriateness of antineoplastic treatment (AT) during end of life care is essential to ensure patient well-being and optimise healthcare resources. <h3>Aim and Objectives</h3> To describe and analyse the use of AT in oncology patients during their last phase of life. <h3>Material and Methods</h3> An observational retrospective study was conducted including oncology patients who received AT in 2024 at our centre. Variables collected included demographics (age, sex, ECOG), diagnosis, treatment characteristics (type, intention, line, duration), and mortality-related data (initiation of AT within 30 days prior to death (30DPD), follow-up by the palliative care unit (PCU), emergency or hospital admissions within the 30DPD, cause and place of death, and ongoing AT within 30 or 14 days of death). Descriptive statistics were applied. <h3>Results</h3> A total of 158 patients (62% male; median age 69 years, IQR 15) were included. The most common diagnoses were lung (29.8%), digestive (24%), and breast (12%) cancer. Treatments received were chemotherapy (70.2%), immunotherapy (22.2%), and targeted therapies (11.4%); 94.3% were administered with palliative intent. PCU follow-up occurred in 54.4% of patients. AT was administered within 30DPD in 25.9% (41/158) and within 14 days in 9.5%. New treatments were initiated within 30DPD in 8.9% of cases, mostly as first-line therapy (65%). ECOG ≥2 was reported in 39% of patients. Median number of treatment cycles was two (IQR 3). The main causes of death were disease progression (93.7%) and infectious complications (3.8%). Emergency visits occurred in 77.2% of patients within 30DPD, with 68.3% requiring hospital admission. Death occurred at home (36.2%), long-term care facilities (40.4%), or hospitals (23.4%). <h3>Conclusion and Relevance</h3> The proportion of patients receiving AT within 14 days of death (9.5%) was below the 10% threshold described in the literature, but initiation of new treatment within 30DPD (8.9%) exceeded the recommended 2%. These findings highlight possible inappropriate resource use, with high rates of emergency care. PCU follow-up (54.4%) was near optimal (55%). ECOG status and limiting treatment lines may help refine decision making in end of life oncology care. <h3>References and/or Acknowledgements</h3> 1. <b>DOI:</b> 10.1200/JCO.24.00542; 2. <b>DOI:</b> 10.1200/JCO.2004.08.136; 3. <b>DOI:</b> 10.1093/jjco/hyn031; 4. <b>DOI:</b> 10.3390/cancers15133349 <h3>Conflict of Interest</h3> No conflict of interest

Anal cancer is rare but increasingly common, currently accounting for 2% of all digestive neoplasms. Some 50% of anal cancers are diagnosed at the localized stage, 29% as locoregional disease, and 12% as metastatic disease. When clinical suspicion of anal cancer exists, histological confirmation, correct local staging with MRI and distant staging with thoraco-abdominal CT, and management by a multidisciplinary team are mandatory. Chemoradiotherapy with 5-FU and mitomycin C (MMC) is the standard of care for early and locally advanced disease, while combination chemotherapy with a platinum-containing compound and taxanes is the treatment of choice for metastatic disease.

Level of Education (LoE) is widely used as an indicator of cognitive reserve and is associated with risk of dementia. The aim of the present study was to know the influence of the LoE on cognitive function (CF) in patients with Parkinson´s disease (PD). Controls and PD patients from the Spanish cohort COPPADIS with a disease duration from symptoms onset ≤ 5years, who were recruited from January/2016 to November/2017 (baseline visit; V0) and evaluated at 2 (V2), 4 (V4) and 5 (V5) years of follow-up were included. Regarding LoE, patients were classified as with primary, secondary and university education. CF was assessed using the Parkinson´s Disease Cognitive Rating Scale (PD-CRS). General linear model (GLM) repeated measure was used to test for changes in the CF. A p value ≤ 0.005 was considered significant. Three hundred and ninety-nine PD patients (61.9 ± 8.9years old; 58.4% males) and 207 controls (61 ± 8.3years old; 49.8% males) were included. From V0 to V5, significant differences were observed in PD patients in global and fronto-subcortical (p < 0.0001 in all visits) between LoE groups but not in posterior-cortical (p > 0.05 in all visits) CF. LoE was associated with the change from V0 to V5 in the PD-CRS total score and fronto-subcortical sub-score (p < 0.0001) in PD patients but not in controls. After adjustment for many covariates, primary education was not a predictor of PD dementia (PD-CRS < 65) at V5 (OR = 3.31; p = 0.194). Cognitive function in Parkinson's disease is influenced by the level of education.