Background: Insomnia, defined as a difficulty in initiating or maintaining sleep, is a relevant medical issue. Benzodiazepines (BZDs) are commonly prescribed to treat insomnia. Two phases characterize human sleep structure: sleep with Non-Rapid Eye Movement (NREM) and sleep with Rapid Eye Movement (REM). Physiological sleep includes NREM and REM phases in a continuous cycle known as “Sleep Architecture.” Objective: This systematic review summarizes the studies that investigated BZDs changes on Sleep Architecture. Methods: The article’s selection included human clinical trials (in English, Portuguese, or Spanish) only, specifically focused on BZDs effects on sleep architecture. PubMed, BVS, and GoogleScholar databases were searched. Results: Findings on BZDs effects on sleep architecture confirm an increase in stage 2 of NREM sleep and a decrease in time of stages 3 and 4 of NREM sleep with a reduction in time of REM sleep during the nocturnal sleep. Conclusion: Variations in NREM and REM sleep may lead to deficits in concentration and working memory, and weight gain. The increase in stage 2 of NREM sleep may lead to a subjective improvement of sleep quality with no awakenings. BZDz should be prescribed with zeal and professional judgment. These patients should be closely monitored for possible long-term side effects.

We conclude that the PC-18 extract may be effective for the treatment of CRF in patients with a variety of solid tumors. A conditioning effect, which was observed in patients who had a beneficial effect of PC-18 on CRF, may explain the better than expected fatigue scores of the placebo-treated patients.

Objective To evaluate the perception of oncology patients and their caregivers upon diagnosis and beginning of the therapy and during palliative care.Methods A cross-sectional study at the oncology and palliative care outpatients clinics of the Faculdade de Medicina do ABC . Clinical and demographic data from patients and their caregivers were collected and questionnaires regarding the elements considered important in relation to the treatment were applied.Results We enrolled 32 patients and 23 caregivers that were initiating treatment at the oncology outpatient clinic, as well as 20 patients and 20 caregivers at the palliative care clinic. Regarding the patients treated at the oncology clinic, the issues considered most important were a physician available to discuss the disease and answer questions (84%), trust in the physician (81%), and a physician with accessible language (81%). For their caregivers, the following issues were considered extremely important: trust in the medical team that treats the patients (96%), and the same medical team taking care of their relatives (87%). As to patients treated at the palliative care clinic, trust in the physician (83%), to be with people considered important to them (78%), and to be treated preserving their dignity (72%) were considered extremely important. For their caregivers, to receive adequate information about the disease and the treatment’s risks and benefits (84%), and sincere communication of information about the disease (79%) were considered extremely relevant.Conclusion Confidence through good communication and consistency in care were fundamental values to achieve satisfaction among caregivers and patients with cancer during all the course of disease development.

e20680 Background: Paullinia cupana (guaraná) is an Amazonian plant that has been previously shown to be effective in treating chemotherapy-related fatigue (CRF) in patients with breast cancer. We aimed to evaluate the efficacy of a purified dry extract of P. cupana (PC-18) in patients with various solid tumors treated with chemotherapy. Methods: We included 40 patients with solid tumors who showed increases in their Brief Fatigue Inventory (BFI) questionnaire scores after one week of systemic chemotherapy. PC-18 was administered at 37.5 mg by mouth two times per day (PO bid), starting after one week of chemotherapy, for three weeks (induction phase). Patients who had an improvement in or stabilization of their BFI scores were randomized to receive either PC-18 at the same dose or placebo for the following three weeks (maintenance phase). Results: After PC-18 treatment, the BFI fatigue scores improved or stabilized in 36 out of the 40 patients (mean BFI score difference = 2.503; 95% CI: 1.716 – 3.375, P = 0.0002). Three weeks after randomization (16 patients on PC-18 and 17 on placebo), we observed no significant differences in the BFI, FACIT, HADS, and PSQI scores between patients randomized to PC-18 versus placebo. Conclusions: We conclude that the PC-18 extract is effective for the treatment of CRF in patients with a variety of solid tumors. A conditioning effect, which was observed in patients with early positive effects of PC-18 on CRF, may explain the better than expected fatigue scores of the placebo-treated patients.

Posttraumatic stress disorder (PTSD) can be defined by symptomatic cognitive, behavioral, somatic, and affective perpetuation resulting from a psychologically traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks involving the traumatic event, avoidant behaviors, hypervigilance, and sleep disorders, causing a functional impact in the social, occupational, and interpersonal spheres, with significant loss of quality of life for patients. [1][2][3][4] Studies on the epidemiological relevance differ regarding the prevalence of the disorder. A study based on data from the World Health Organization stated that the lifetime prevalence of PTSD in the general pop-