[Rare disease in the age of artificial intelligence.] / Ammalarsi di una patologia rara in tempi di intelligenza artificiale.

INTRODUCTION: The text examines the impact of artificial intelligence (AI) in the context of rare diseases, exploring how patients turn to AI resources for health information, especially in situations where doctor-patient communication is limited. The article features the case of a doctor specializing in clinical psychology and psychotherapy, diagnosed with thymoma and Good's syndrome, who uses AI resources during his illness. METHODS: The capabilities of five chatbots based on Large Language Models (LLMs), such as GPT-3.5, GPT-4, Bing Chat, Google Bard, and Anthropic Claude are explored. The AIs were queried on various aspects of the disease, from pre-diagnosis and diagnosis to therapeutic, psychological, and caregiver management issues. The responses were evaluated by five experts based on criteria such as: accuracy, relevance, coherence, clarity, practical utility, ethical considerations, empathy, and capacity to respond to questions and concerns. RESULTS: The results indicate consistency in the evaluators' assessments, with generally high scores across all dimensions. Particularly, systems like Bard and GPT-4 received high ratings in terms of information accuracy and the ability to respond to questions and concerns. Bing and Claude were appreciated for their empathy and tone. Overall, the AI systems' responses were considered appropriate, respectful of ethics and privacy, and useful in the clinical context. DISCUSSION: The article emphasizes the importance of understanding the reliability and precision of responses provided by AI systems in the clinical field. Although these systems offer high-quality responses, there is significant variability in their performance. Healthcare professionals must be aware of these differences and use such tools cautiously. AI can provide support in some aspects of care but cannot replace genuine human empathy and understanding. Integrating AI into clinical practice presents potential but also challenges, particularly the possibility of providing incorrect information. CONCLUSIONS: The AI systems demonstrate the ability to provide useful advice on clinical and psychological issues, but their use requires caution. It is crucial to distinguish the benefits of AI for patients from the challenges it presents for healthcare professionals. As AI technology continues to evolve, it is essential that its integration into the clinical field is accompanied by continuous research and evaluations, to ensure safe and effective use in the healthcare sector.

Illusionist techniques as a complement to psychological support for children with cancer.

Magic and illusionism may be a potentially valid resource for children with cancer, as a complement to more traditional psychological support approaches. This study considered the psychological interviews conducted with patients with cancer <10 years of age from January to December 2019. We classified the reasons why consultations were performed and the specific situations when psychologists adopted illusionist techniques. Overall, 96 children (age 4-10 years, median 7) received psychological interventions. Magic techniques were used in 30 patients: in 15 cases to support communication and relations, in 9 as a diversion, and in 2 each for physical therapy and rehabilitation, humour therapy, and psychotherapy. This preliminary descriptive experience suggests that the use of magic tricks might be helpful in providing support for communication and relations, as well for compliance and rehabilitation, for children with cancer. More analytical studies are needed to provide quantitative assessment of the efficacy of such an approach.

[Healing magic. Illusionistic techniques supporting communication and relationship between children and adolescents.] / Magie che curano. Tecniche illusionistiche a supporto della comunicazione e della relazione tra clinici e pazienti bambini e adolescenti.

In the training of the doctors, even specialists, training courses are generally not available for communication and for the relationship with patients in developmental age. Some techniques such as illusionistic techniques are increasingly described in the scientific literature as tools that can be used in the areas of care and rehabilitation. In this work, clinical experiences are presented on the use of illusionism techniques in clinical consultation with patients suffering from organic pathologies, based on a review of the scientific literature.

[Continuity and school reentry support of patients with serious diseases: experiences in pediatric oncology.] / Il supporto alla continuità scolastica nella cura multidisciplinare dei pazienti con patologie gravi: esperienze in oncologia pediatrica.

Dealing with a serious illness always implies, and particularly for a child, important physical and psychological stresses. If on the one hand, the adult could have adaption's resources which allow him to deal with the illness's implications, on the other hand, for a child, the interference of the disease with growing steps may cause serious problems. For this reason, the clinicians and the family have to support the educational and social continuity of the child's interactions. The school experience, in fact, helps and supports the psychological and social development of the patient. This article has the aim of describing the experiences of the authors considering the Italian legislation, discussing the scientific literature and the approaches and resources which can be used in order to maintain the children within their school career. The experiences of the authors have been collected in the Paediatric Unit of an oncology's hospital. However, these experiences may be useful also in other contexts where children are being treated for different diseases.

[Conflict and divorce management in the field of pediatric care. Experience in pediatric oncology.] / Gestione della conflittualità e della separazione genitoriale. Esperienze in oncologia pediatrica.

Divorces and separations have become more frequent over the last 20 years and for this reason they are issues of great importance with possible effects on medical treatments. Conflicts between the adults frequently affect the children involved in the separation of their parents. If, on the one hand, the parental conflict is a hard and distressing experience for the whole family, on the other hand this situation gets even more complicated if a child is affected by a serious illness. Since there is a lack of studies about the management arrangements of these situations, this article aims to illustrate the experiences gained in a pediatric ward of a big oncology hospital and the appropriate multidisciplinary management arrangements. These experiences, however, can be applied also in other contexts where children are being treated and where the conflict between parents can either produce different difficulties in the performance of the therapy or prejudice the child's serenity.