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INTRODUCTION: Large Language Models (LLMs), such as the GPT model family from OpenAI, have demonstrated transformative potential across various fields, especially in medicine. These models can understand and generate contextual text, adapting to new tasks without specific training. This versatility can revolutionize clinical practices by enhancing documentation, patient interaction, and decision-making processes. In oncology, LLMs offer the potential to significantly improve patient care through the continuous monitoring of chemotherapy-induced toxicities, which is a task that is often unmanageable for human resources alone. However, existing research has not sufficiently explored the accuracy of LLMs in identifying and assessing subjective toxicities based on patient descriptions. This study aims to fill this gap by evaluating the ability of LLMs to accurately classify these toxicities, facilitating personalized and continuous patient care. METHODS: This comparative pilot study assessed the ability of an LLM to classify subjective toxicities from chemotherapy. Thirteen oncologists evaluated 30 fictitious cases created using expert knowledge and OpenAI's GPT-4. These evaluations, based on the CTCAE v.5 criteria, were compared to those of a contextualized LLM model. Metrics such as mode and mean of responses were used to gauge consensus. The accuracy of the LLM was analyzed in both general and specific toxicity categories, considering types of errors and false alarms. The study's results are intended to justify further research involving real patients. RESULTS: The study revealed significant variability in oncologists' evaluations due to the lack of interaction with fictitious patients. The LLM model achieved an accuracy of 85.7% in general categories and 64.6% in specific categories using mean evaluations with mild errors at 96.4% and severe errors at 3.6%. False alarms occurred in 3% of cases. When comparing the LLM's performance to that of expert oncologists, individual accuracy ranged from 66.7% to 89.2% for general categories and 57.0% to 76.0% for specific categories. The 95% confidence intervals for the median accuracy of oncologists were 81.9% to 86.9% for general categories and 67.6% to 75.6% for specific categories. These benchmarks highlight the LLM's potential to achieve expert-level performance in classifying chemotherapy-induced toxicities. DISCUSSION: The findings demonstrate that LLMs can classify subjective toxicities from chemotherapy with accuracy comparable to expert oncologists. The LLM achieved 85.7% accuracy in general categories and 64.6% in specific categories. While the model's general category performance falls within expert ranges, specific category accuracy requires improvement. The study's limitations include the use of fictitious cases, lack of patient interaction, and reliance on audio transcriptions. Nevertheless, LLMs show significant potential for enhancing patient monitoring and reducing oncologists' workload. Future research should focus on the specific training of LLMs for medical tasks, conducting studies with real patients, implementing interactive evaluations, expanding sample sizes, and ensuring robustness and generalization in diverse clinical settings. CONCLUSIONS: This study concludes that LLMs can classify subjective toxicities from chemotherapy with accuracy comparable to expert oncologists. The LLM's performance in general toxicity categories is within the expert range, but there is room for improvement in specific categories. LLMs have the potential to enhance patient monitoring, enable early interventions, and reduce severe complications, improving care quality and efficiency. Future research should involve specific training of LLMs, validation with real patients, and the incorporation of interactive capabilities for real-time patient interactions. Ethical considerations, including data accuracy, transparency, and privacy, are crucial for the safe integration of LLMs into clinical practice.
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BACKGROUND: Immunotherapy-based treatments have demonstrated high efficacy in patients with advanced and locally advanced non-small-cell lung cancer (NSCLC). BRAF mutations affect a small but significant fraction of NSCLC. The efficacy of these therapies in this subgroup of patients is unknown. MATERIALS AND METHODS: Plasma and tissue samples from 116 resectable stage IIIA/B NSCLC patients, included in NADIM and NADIM II clinical trials (NADIM cohort), and from a prospective academic cohort with 84 stage IV NSCLC patients (BLI-O cohort), were analyzed by next-generation sequencing. RESULTS: The p.G464E, p.G466R, p.G466V, p.G469V, p.L597Q, p.T599I, p.V600E (n = 2) BRAF mutations, were identified in four (3.45 %) samples from the NADIM cohort, all of which were cases treated with neoadjuvant chemoimmunotherapy (CH-IO), and four (4.76 %) samples from the BLI-O cohort, corresponding to cases treated with first-line immunotherapy (n = 2) or CH-IO (n = 2). All these patients were alive and had no evidence of disease at data cut-off. Conversely, patients with BRAF wild-type (wt) tumors in the BLI-O cohort had a median progression-free survival (PFS) of 5.49 months and a median overall survival (OS) of 12.00 months (P-LogRank = 0.013 and 0.046, respectively). Likewise, PFS and OS probabilities at 36 months were 60.5 % and 76.1 % for patients with BRAF-wt tumors in the NADIM cohort. The pathological complete response (pCR) rate after neoadjuvant CH-IO in patients with BRAF-positive tumors (n = 4) was 100 %, whereas the pCR rate in the BRAF-wt population was 44.3 % (RR: 2.26; 95 % CI: 1.78-2.85; P < 0.001). CONCLUSION: BRAF mutations may be a good prognostic factor for advanced and locally advanced NSCLC patients undergoing immunotherapy-based treatments.
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Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Mutación , Proteínas Proto-Oncogénicas B-raf , Humanos , Carcinoma de Pulmón de Células no Pequeñas/genética , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/terapia , Proteínas Proto-Oncogénicas B-raf/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/mortalidad , Neoplasias Pulmonares/terapia , Femenino , Masculino , Persona de Mediana Edad , Anciano , Estadificación de Neoplasias , Pronóstico , Adulto , Estudios Prospectivos , Inmunoterapia/métodos , Biomarcadores de Tumor/genética , Anciano de 80 o más Años , Metástasis de la NeoplasiaRESUMEN
OBJECTIVES: The S-REAL study aimed to assess the effectiveness of durvalumab as consolidation therapy after definitive chemoradiotherapy (CRT) in a real-world cohort of patients with locally advanced, unresectable stage III non-small cell lung cancer (LA-NSCLC) included in a Spanish early access program (EAP). METHODS: In this multicentre, observational, retrospective study we analysed data from patients treated in 39 Spanish hospitals, who started intravenous durvalumab (10 mg/kg every 2 weeks) between September 2017 and December 2018. The primary endpoint was progression-free survival (PFS). Secondary endpoints included patient characterization and adverse events of special interest (AESI). RESULTS: A total of 244 patients were followed up for a median of 21.9 months [range 1.2-34.7]. Median duration of durvalumab was 45.5 weeks (11.4 months) [0-145]. Median PFS was 16.7 months (95% CI 12.2-25). No remarkable differences in PFS were observed between patients with programmed cell death-ligand 1 (PD-L1) expression ≥ 1% or < 1% (16.7 versus 15.6 months, respectively). However, PFS was higher in patients who had received prior concurrent CRT (cCRT) versus sequential CRT (sCRT) (20.6 versus 9.4 months). AESIs leading to durvalumab discontinuation were registered in 11.1% of patients. CONCLUSIONS: These results are in line with prior published evidence and confirm the benefits of durvalumab in the treatment of LA-NSCLC patients in a real-world setting. We also observed a lower incidence of important treatment-associated toxicities, such as pneumonitis, compared with the pivotal phase III PACIFIC clinical study.
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Anticuerpos Monoclonales , Carcinoma de Pulmón de Células no Pequeñas , Quimioradioterapia , Neoplasias Pulmonares , Humanos , Carcinoma de Pulmón de Células no Pequeñas/terapia , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Masculino , Femenino , Neoplasias Pulmonares/terapia , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/mortalidad , Estudios Retrospectivos , Anciano , Persona de Mediana Edad , España , Anticuerpos Monoclonales/uso terapéutico , Adulto , Anciano de 80 o más Años , Antineoplásicos Inmunológicos/uso terapéutico , Estadificación de Neoplasias , Supervivencia sin Progresión , Quimioterapia de Consolidación , Antígeno B7-H1/antagonistas & inhibidoresRESUMEN
Objectives: The aim of the study was to ascertain the percentage of Spanish lung cancer cases that would fulfil the lung cancer screening inclusion criteria recommended by the United States Preventive Service Task Force (USPSTF) in 2013 and 2021. Methods: A cross-sectional study was carried out. All lung cancer cases registered in the Thoracic Tumor Registry with data on date of birth, date of diagnosis, smoking habit, number of pack-years and time elapsed since smoking cessation were included. Results: The study included 15 006 patients diagnosed with lung cancer in Spain between 2016 and 2022. Eligibility to participate in screening increased from 53.7% to 63.5% (an increase of 9.8%) according to the 2013 and 2021 recommendations, respectively. The percentage of eligible men rose by 9.2 percentage points with the 2021 versus 2013 recommendations, whereas this rise was 11.5 percentage points in women. Under the 2021 recommendations, 36.6% of women and 5.3% of men would not have fulfilled the screening inclusion criteria due to being never-smokers; 14.9% of women and 11.0% of men would not have fulfilled the age criterion; and 27.0% of ex-smokers among women compared to 35.6% among men would not have been eligible due to >15â years having elapsed since smoking cessation. Conclusions: In Spain, over one-third of lung cancer cases could not be detected through screening, by virtue of not meeting the most recent inclusion criteria stated by the USPSTF. The degree of fulfilment in a potential nationwide screening programme should be analysed, with the aim of establishing inclusion criteria in line with each country's context.
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PURPOSE: Obesity is a growing health problem that affects a high percentage of the population. In podiatry context, few studies have addressed obesity because most pedobarographic systems are unable to bear the weight of patients with obesity, making it difficult to examine and manage these patients. The objective of this study was analyzed the sociodemographic characteristics, quality of life, foot disorders, and pedobarographic parameters of patients with extreme obesity who are candidates for bariatric surgery and determine the changes after weight loss post-surgery. MATERIALS AND METHODS: We conducted a foot examination, a pedobarographic study using a Podoprint® pressure platform, and a quality of life questionnaire (EQ-5D) on 23 patients with extreme obesity and analyzed the changes 12-18 months after surgery in 11 of them. RESULTS: We observed foot disorders, high plantar pressure, greater rearfoot contact, flat footprint, asymmetries, and alterations in toe contact. Almost 73.9% of participants said they had foot pain, 56.5% said they had impaired mobility, and more than 40% said they had limitations in carrying out daily activities and suffered from anxiety. After weight loss, we observed improved quality of life; more foot disorders; changes in total contact area, plantar pressures, barycenter, contact time, and footprint; decreased pain perception, walking problems and anxiety situations. Moreover, medication decreased, but they need to take more vitamins and calcium. CONCLUSION: Weight loss improved the quality of life of the participating patients but altered their foot disorders. All parameters need regular reassessment to detect changes and modify initially prescribed treatments.
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Cirugía Bariátrica , Derivación Gástrica , Obesidad Mórbida , Humanos , Calidad de Vida , Presión , Obesidad Mórbida/cirugía , Obesidad/complicaciones , Obesidad/cirugía , Pérdida de PesoRESUMEN
Growth alterations have been described in patients operated on for oral clefts. The purpose of this work was to analyze the craniofacial and palate morphology and dimensions of young adults operated on for oral clefts in early childhood in Spain. Eighty-three patients from eight different hospitals were divided into four groups based on their type of cleft: cleft lip (CL, n = 6), unilateral cleft lip and palate (UCLP, n = 37), bilateral cleft lip and palate (BCLP, n = 16), and cleft palate only (CPO, n = 24). A control group was formed of 71 individuals. Three-dimensional (3D) digital models were obtained from all groups with an intraoral scanner, together with cephalometries and frontal, lateral, and submental facial photographs. Measurements were obtained and analyzed statistically. Our results showed craniofacial alterations in the BCLP, UCLP, and CPO groups with an influence on the palate, maxilla, and mandible and a direct impact on facial appearance. This effect was more severe in the BCLP group. Measurements in the CL group were similar to those in the control group. Cleft characteristics and cleft type seem to be the main determining factors of long-term craniofacial growth alterations in these patients. Prospective research is needed to clearly delineate the effects of different treatments on the craniofacial appearance of adult cleft patients.
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Labio Leporino , Fisura del Paladar , Adulto Joven , Humanos , Preescolar , Labio Leporino/epidemiología , Labio Leporino/cirugía , Fisura del Paladar/epidemiología , Fisura del Paladar/cirugía , España/epidemiología , Estudios Prospectivos , Cefalometría , MaxilarRESUMEN
The aim of this study was to determine if the ability to rotate mental imagery influenced the comprehension of graphs in economics. A sample of 140 Business Administration undergraduates familiar with economic analysis using graphs were administered the Measure of the Ability to Rotate Mental Images (MARMI). Moreover, participants completed an ad hoc graph comprehension test consisting of six exercises of increasing difficulty with graphs developing the IS-LM model described in conventional macroeconomic textbooks. Both the ability to rotate mental imagery and graph complexity (the number of quadrants in each graph) were found to significantly influence the number of correct graph comprehension responses.
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Comprensión , Imágenes en Psicoterapia , Humanos , RotaciónRESUMEN
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Humanos , Femenino , Persona de Mediana Edad , Colangitis/complicaciones , Colangitis/microbiología , Hemorragia Gastrointestinal , Aneurisma Falso/etiología , Aneurisma Falso/diagnóstico por imagen , Arteria Hepática/diagnóstico por imagen , Arteria Hepática/patología , Tomografía Computarizada por Rayos X , AngiografíaRESUMEN
We read with interest the article by Guido Villa-Gómez, Manuel Alejandro Mahler and Dante Manazzoni "A new case of pseudoaneurysm of the right hepatic artery secondary to laparoscopic cholecystectomy". A 57-year-old cholecystectomized female was admitted due to abdominal pain with an analytical pattern of cholestasis and liver enzyme alterations, with cholangitis that progressed to septic shock of a biliary origin with gradual anemia and hypotension.
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Aneurisma Falso , Colangitis , Colecistectomía Laparoscópica , Hemobilia , Aneurisma Falso/complicaciones , Aneurisma Falso/diagnóstico por imagen , Colangitis/etiología , Colangitis/cirugía , Femenino , Hemobilia/diagnóstico por imagen , Hemobilia/etiología , Arteria Hepática/diagnóstico por imagen , Humanos , Persona de Mediana EdadRESUMEN
No disponible
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Humanos , Masculino , Anciano , Aneurisma/diagnóstico por imagen , Aneurisma/etiología , Arteria Hepática/diagnóstico por imagen , Arteria Hepática/patología , Síndrome del Ligamento Arcuato Medio/complicaciones , Síndrome del Ligamento Arcuato Medio/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Arteria Hepática/cirugía , Aneurisma/cirugíaRESUMEN
INTRODUCTION: The objective of this study was to analyze the survival of patients with lung cancer by TNM stage in the 4-year periods 2003-2006, 2007-2010 and 2011-2014, treated in the Basque Health Service, and to compare this with survival in an equivalent sample of the general population. METHODS: A retrospective observational design was applied to cases from the Hospital Cancer Registry of Euskadi. A cohort of 11,635 patients had complete data for the following variables: TNM stage, age, sex, histology, date of diagnosis, vital status and date of death. Relative survival and Cox and parametric regression models were used to assess changes in survival. RESULTS: The lung cancer 5-year survival probability decreased with increasing stage, from 50-65% in patients with stage I disease to 2-3% in those with stage IV disease. Comparing patients diagnosed from 2011-2014 and 2003-2006, we found that survival improved: (a) the risk of death (hazard ratio) in 2003-2006 was 1.66 for stage I, 1.51 for stage II, 1.21 for stage III, and 1.10 for stage IV; (b) the 5-year relative survival increased from 11.0% to 17.8% in the period 2011-2014; and (c) the years of life lost decreased significantly from 2003-2006 to 2011-2014, varying between 6.16 (stage I) and 16.21 (stage IV). CONCLUSIONS: Survival from lung cancer by stage in the Basque Country has lengthened significantly across all disease stages. Nonetheless, since we estimated that lung cancer patients still have significantly lower mean survival times than the general population, there is a need for more research to improve these outcomes.
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Neoplasias Pulmonares/mortalidad , Sistema de Registros , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , España/epidemiología , Tasa de SupervivenciaRESUMEN
We present the case of a 74-year-old man, with a history of residual schizophrenia, who underwent abdominal-pelvic CT with intravenous contrast, due to abdominal acute pain, that showed a stenosis at the origin of the celiac trunk and a large aneurysm of the hepatic artery, secondary to a mediam arcuate ligament syndrome, of the diaphragm was observed.
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Aneurisma , Síndrome del Ligamento Arcuato Medio , Dolor Abdominal , Anciano , Aneurisma/complicaciones , Aneurisma/diagnóstico por imagen , Arteria Celíaca/diagnóstico por imagen , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/etiología , Arteria Hepática/diagnóstico por imagen , Humanos , Masculino , Síndrome del Ligamento Arcuato Medio/diagnóstico por imagenRESUMEN
No disponible
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Humanos , Femenino , Adulto , Neoplasias Hepáticas/diagnóstico por imagen , Angiomiolipoma/diagnóstico por imagen , Imagen por Resonancia MagnéticaRESUMEN
In relation to the article published by Ortiz S et al. (1), we have recently seen a 37-year-old female who presented to the Emergency Department with pain in right hypochondrium and a mild increase in transaminase levels. An ultrasound was performed that showed a large 13-cm tumor in the right hepatic lobe, which was heterogeneous with hyperechogenic and anechoic areas.
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Angiomiolipoma/diagnóstico por imagen , Neoplasias Hepáticas/diagnóstico por imagen , Adulto , Angiomiolipoma/patología , Femenino , Humanos , Neoplasias Hepáticas/patología , Imagen por Resonancia MagnéticaRESUMEN
Objetivo: Determinar la eficacia de una intervención (Time In) para reducir el dolor y mejorar los síntomas psicológicos en personas con dolor crónico. Diseño: Ensayo clínico aleatorizado con grupo control y con 3 mediciones realizadas a lo largo de 3 meses. Emplazamiento: Granada. Participantes: Un total de 40 mujeres mayores de 18 años con una historia de dolor crónico (más de 6 meses de duración). La captación fue en la Asociación de Fibromialgia de Granada (AGRAFIM). Intervenciones: Time In es un trabajo sensoriomotriz que combina procedimientos biomecánicos fisioterapéuticos y estrategias psicológicas. Se planificó una sesión semanal de 3h de duración y el total del programa se desarrolló durante 5 semanas seguidas. Mediciones principals: Variables dependientes: puntuaciones de las escalas Brief Pain Inventory (BPI-S), Short-Form Health Survey (SF-12), Symptom Check List-90-R (SCL-90-R) y Clinical Outcome in Routine Evaluation (CORE-OM). Variables independientes: información sociodemográfica, historial clínico y grupo de intervención o control. Resultados: Se observaron diferencias significativas entre grupo control y grupo intervención de gran parte de las escalas utilizadas en las mediciones postintervención y seguimiento. Así pues, se obtuvieron puntuaciones medias significativamente inferiores en la intensidad, interferencia y zonas de dolor, calidad de vida, síntomas psicológicos y cambio de comportamiento. Se observaron resultados similares en las puntuaciones de d Cohen "muy importantes" en la intensidad del dolor (d = -1,01, d = -0,97) y la interferencia del dolor (d = -0,85, d = 0,74), con un porcentaje de mejoría del 21 al 30%. Conclusiones. La intervención Time In reduce el dolor y mejora los síntomas psicológicos en pacientes con fibromialgia, lo que redunda en una mejor calidad de vida
Objective: To assess the effectiveness, on people with chronic pain, of an intervention (Time In) designed to reduce pain and to improve psychological symptoms. Design: A randomized clinical trial with a control group, taking three measurements over three months. Setting: Granada, Spain. Participants: A sample of 40 women aged 18 or older with a history (over 6 months) of chronic pain. The recruitment was in the Fibromyalgia Association of Granada, Spain (AGRAFIM). Interventions: Time In is a sensorimotor intervention that combines biomechanical physiotherapeutic procedures and psychological strategies. A weekly session of 3h was planned and the total of the program was developed during five weeks. Main measurements: Independent variables: sociodemographic information, clinical history and Time In intervention. Dependent variables: Brief Pain Inventory (BPI-S), Short-Form Health Survey (SF-12), Symptom Check List-90-R (SCL-90-R) and Clinical Outcome in Routine Evaluation (CORE-OM). Results: Significant differences were observed between control group and intervention group of most of the scales used in postintervention and follow up measurements. Thus, significantly lower mean scores were obtained in intensity, interference and areas of pain, quality of life, psychological symptoms and behavioural change. Similar results were observed on d Cohen scores. They were 'very important' on intensity of pain (d = -1.01, d = -0.97) and interference of pain (d = -0.85, d = -0.74), with an improvement percentage from 21% to 30%. Conclusions: Time In intervention reduces pain and improves psychological symptoms in patients with fibromyalgia; this results in a better quality of life
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Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Dolor Crónico/terapia , Modalidades de Fisioterapia , Estudios de Casos y ControlesRESUMEN
To investigate the effect of concomitant conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) with adalimumab or infliximab on maintaining serum drug and clinical outcomes after the first year of treatment in patients with rheumatoid arthritis (RA). Second, to assess the influence of methotrexate (MTX) dose on these outcomes. Ninety-two patients with RA starting infliximab (n = 67) or adalimumab (n = 25) tumor necrosis factor inhibitor (TNFi) with available drug levels and clinical improvement assessment (European League Against Rheumatism [EULAR] response) after 12 months were included. Patients were grouped according to concomitant csDMARD use: (i) TNFi monotherapy; (ii) TNFi+MTX; (iii) TNFi with csDMARDs other than MTX (TNFi+OD). Patients receiving MTX were also classified by dose as < 15 mg/week (TNFi+MTX<15) and ≥ 15 mg/week (TNFi+MTX≥15). Logistic regression analyses were employed. More TNFi+MTX patients had circulating serum TNFi at 12 months (71% TNFi+MTX vs. 20% TNFi+OD vs. 9% TNFi monotherapy). Of these, the probability of maintaining serum TNFi levels was twice (OR 2.3; p = 0.06) than that of patients without MTX. However, statistically significant results were observed only for the highest MTX dose (OR 4.9; p = 0.02). Most patients achieving good EULAR response were treated with TNFi+MTX (81%). The probability of achieving this response was three times higher in patients within the TNFi+MTX group (OR 3.4; p = 0.03); however, no differences were found with regard to MTX dose. The persistence of serum TNFi and the probability of achieving clinical response are influenced by MTX but not by OD in patients with RA treated with infliximab or adalimumab.
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Adalimumab/uso terapéutico , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Infliximab/uso terapéutico , Metotrexato/uso terapéutico , Adalimumab/sangre , Anciano , Antirreumáticos/sangre , Quimioterapia Combinada , Femenino , Humanos , Infliximab/sangre , Modelos Logísticos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
OBJECTIVE: To assess the effectiveness, on people with chronic pain, of an intervention (Time In) designed to reduce pain and to improve psychological symptoms. DESIGN: A randomized clinical trial with a control group, taking three measurements over three months. SETTING: Granada, Spain. PARTICIPANTS: A sample of 40 women aged 18 or older with a history (over 6 months) of chronic pain. The recruitment was in the Fibromyalgia Association of Granada, Spain (AGRAFIM). INTERVENTIONS: Time In is a sensorimotor intervention that combines biomechanical physiotherapeutic procedures and psychological strategies. A weekly session of 3h was planned and the total of the program was developed during five weeks. MAIN MEASUREMENTS: Independent variables: sociodemographic information, clinical history and Time In intervention. Dependent variables: Brief Pain Inventory (BPI-S), Short-Form Health Survey (SF-12), Symptom Check List-90-R (SCL-90-R) and Clinical Outcome in Routine Evaluation (CORE-OM). RESULTS: Significant differences were observed between control group and intervention group of most of the scales used in postintervention and follow up measurements. Thus, significantly lower mean scores were obtained in intensity, interference and areas of pain, quality of life, psychological symptoms and behavioural change. Similar results were observed on d Cohen scores. They were 'very important' on intensity of pain (d=-1.01, d=-0.97) and interference of pain (d=-0.85, d=-0.74), with an improvement percentage from 21% to 30%. CONCLUSIONS: Time In intervention reduces pain and improves psychological symptoms in patients with fibromyalgia; this results in a better quality of life.
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Terapia Conductista/métodos , Dolor Crónico/psicología , Dolor Crónico/terapia , Modalidades de Fisioterapia , Actividades Cotidianas , Adulto , Anciano , Biorretroalimentación Psicológica/métodos , Estudios de Casos y Controles , Lista de Verificación , Dolor Crónico/fisiopatología , Intervalos de Confianza , Retroalimentación Sensorial/fisiología , Femenino , Fibromialgia/fisiopatología , Fibromialgia/psicología , Fibromialgia/terapia , Encuestas Epidemiológicas , Humanos , Persona de Mediana Edad , Manejo del Dolor/métodos , Dimensión del Dolor , Calidad de Vida , Factores Socioeconómicos , España , Estadísticas no Paramétricas , Evaluación de Síntomas , Resultado del TratamientoRESUMEN
This article describes and illustrates the case of an adult patient with clinical symptoms of constitutional syndrome, postprandial discomfort and a mass in the left lateral abdominal region caused by a gastric intussusception with a fundal adenoma as the head of the invagination. The intussusception was diagnosed by MRI (magnetic resonance imaging).