Patients attitudes towards sleep disturbances during chemotherapy.

Sleep disturbances are among the most distressing symptoms in cancer: they often co-occur with fatigue, pain and psychological distress. Despite the negative impact on quality of life, patients rarely seek help for managing their sleep disturbances. This paper presents the results of a multicentre observational study on patients' attitudes towards their sleep problems. The study also investigates symptom correlates. Patients responded to a semi-structured interview and completed the following questionnaires: Pittsburgh Sleep Quality Index; Brief Fatigue Inventory; Hospital Anxiety and Depression Scale; and European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life QLQ-C30 Questionnaire (QLQ-C30). Four hundred and three cancer patients were enrolled in the study. Bad sleepers constituted 66% of the sample. Thirty-eight per cent of them had not turned to any professional to solve their sleep disturbances because they had various beliefs about the importance of the problem and the possibility to be treated. The main correlates of sleep disturbances were psychological distress, reduced physical functioning and reduced overall quality of life. In conclusion, there is a need to sensitise patients to actively search for a solution to their sleep disturbances so they can be solved along with other co-occurring symptoms. Doctors could also be encouraged to dedicate more attention to routinely asking cancer patients about eventual sleep disturbances.

Nociceptive inputs transmission in Huntington's disease: a study by laser evoked potentials.

The aim of the present study was to evaluate pain perception and evoked responses by laser stimuli (LEPs) in mild not demented Huntington's Disease (HD) patients. Twenty-eight HD patients and 30 control subjects were selected. LEPs were obtained by four scalp electrodes, (Fz, Cz, referred to the nasion; T3, T4, referred to Fz), stimulating the dorsum of both hands. All patients were also evaluated by somatosensory evoked potentials (SEPs) by median nerve stimulation. Only 3 patients referred pain of arthralgic type. Laser pain perception was similar between HD patients and controls. An abnormal N2, P2 and N1 latency increase was evident in the majority of HD patients. LEPs features were similar between patients taking and not taking neuroleptics. The N2 and P2 latencies, showed a negative correlation with functional score and Mini Mental State Examination, and a positive correlation with the severity of hyperkinetic movements. A delay in nociceptive input processing emerged in HD, concurring with the main features of the disease, in absence of clinical evidence of abnormalities in pain perception. The dysfunction of pain signals transmission in HD may induce sub-clinical changes of sensory functions, which may probably interfere with sensory-motor integration and contribute to functional impairment.

Post-traumatic Growth in the Italian Experience of Long-term Disease-free Cancer Survivors.

Cancer survivors often report post-traumatic growth. Since culture influences the development of post-traumatic growth, the aims of this study were to measure the prevalence of post-traumatic growth in Italian long-term disease-free and treatment-free cancer survivors (≥5 years) and explore the relationship between post-traumatic growth and sociodemographic and clinical variables. Three hundred sixty long-term disease-free and treatment-free cancer survivors were assessed with Post-traumatic Growth Inventory (PTGI), Brief COPE and Multidimensional Scale of Perceived Social Support (MSPSS). Mean age was 58.6 years, and mean survival was 11 years (range 5-32). The PTGI average total score was higher in younger survivors, in those without comorbidities, in survivors engaged in physical activity. Positive correlation between PTGI and Brief COPE and between PTGI and MSPSS were found. The variables more associated with post-traumatic growth were age, comorbidity, physical activity and two coping subscales. The prevalence of post-traumatic growth in this sample of cancer survivors was lower than previous studies. We discussed some possible explanations, including the consideration that cultural differences may affect the development of post-traumatic growth in cancer survivors. Having less comorbidities, receiving social support from friends, having the ability to adaptively cope and engaging in physical activity were found to be strongly associated with post-traumatic growth.