Jose A. Cabero-Pérez

Background/Objectives: Fibromyalgia is a chronic pain syndrome influenced by both physical and psychological factors, but their interaction remains unclear. We evaluated tools combining physical and emotional dimensions to characterise fibromyalgia and assess associations with persistent physical symptoms (PPS) and the emotional distress in its clinical interpretation. Methods: This cross-sectional study included 1588 patients referred to the Pain Management Unit, Complejo Asistencial Universitario de León. Fibromyalgia cases had a prior diagnosis to referral using the 2019 ACTTION–American Pain Society Pain Taxonomy diagnostic criteria. At the first consultation, participants completed a standardized protocol including sociodemographic variables, a Central Sensitization Inventory Part B checklist of previously physician-diagnosed physical and psychological conditions, and the visual analogue scale for pain, the Modified Somatic Perception Questionnaire (MSPQ), and the Zung Self-Rating Depression Scale. The Distress and Risk Assessment Method (DRAM) was used to integrate MSPQ and Zung data. Results: Women had higher odds of fibromyalgia (p = 0.003). Fibromyalgia was associated with PPS (p < 0.001), with chronic fatigue predominating in women (p < 0.001) and neck injury/whiplash in men (p = 0.005). The MSPQ had the highest OR among the instruments evaluated (overall: p < 0.001; women: p < 0.001; men: p = 0.005). Fibromyalgia status differed by DRAM category (nominal model, p < 0.001), suggesting higher odds in the Depressive and Somatic categories compared with Normal. Conclusions: In our sample, sex was associated with fibromyalgia and PPS profiles; PPS profiles were also associated with fibromyalgia. The MSPQ appeared to be among the most informative instruments, and its integration with Zung through the DRAM may have potential utility for psychosomatic risk profiling in fibromyalgia, warranting further study.

Background: The optimal anaesthetic strategy for transcatheter aortic valve implantation (TAVI) remains debated. We compared perioperative characteristics and early outcomes according to anaesthetic regimen: conscious sedation (CS) versus general anaesthesia (GA).Methods: Prospective observational cohort of 35 consecutive adults undergoing TAVI at a tertiary hospital with CS or GA. We collected demographics, cardiovascular and anaesthetic variables, periprocedural complications, conversion from CS to GA, intensive care unit (ICU) and hospital length of stay, 30-day mortality, and patient-reported comfort assessed in the post-procedure period (visual analogue scale, VAS). Groups were compared using standard statistical tests.Results: GA was used in 24 patients (68.6%) and CS in 11. Median age was 82.5 (IQR 81.0-86.8) years in the GA group and 82.0 (79.0-86.0) years in the CS group. Conversion from CS to GA occurred in 15.4% of patients planned for CS. There were no significant between-group differences in baseline demographics, preoperative characteristics, cardiovascular or anaesthetic parameters, ICU or hospital length of stay, or 30-day mortality (p>0.05). Patient-reported comfort was high with both techniques at 24 hours post-procedure; however, at the same 24-hour time point, VAS scores indicated greater discomfort with GA both at rest (p=0.023) and after mobilisation (p=0.019), post-procedure.Conclusions: In this single-centre cohort, no significant differences were found in perioperative parameters or early outcomes between CS and GA for TAVI. However, a non-negligible risk of conversion from CS to GA should be anticipated. Patient comfort favoured CS.