Background: In addition to fatigue, pain is the most frequent persistent symptom in cancer survivors. Clear guidelines for both the diagnosis and treatment of pain in cancer survivors are lacking. Classification of pain is important as it may facilitate more specific targeting of treatment. In this paper we present an overview of nociceptive, neuropathic and central sensitization pain following cancer treatment, as well as the rationale, criteria and process for stratifying pain classification. Material and methods: Recently, a clinical method for classifying any pain as either predominant central sensitization pain, neuropathic or nociceptive pain was developed, based on a large body of research evidence and international expert opinion. We, a team of 15 authors from 13 different centers, four countries and two continents have applied this classification algorithm to the cancer survivor population. Results: The classification of pain following cancer treatment entails two steps: (1) examining the presence of neuropathic pain; and (2) using an algorithm for differentiating predominant nociceptive and central sensitization pain.Step 1 builds on the established criteria for neuropathic pain diagnosis, whileStep 2 applies a recently developed clinical method for classifying any pain as either predominant central sensitization pain, neuropathic or nociceptive pain to the cancer survivor population. Conclusion: The classification criteria allow identifying central sensitization pain following cancer treatment. The recognition of central sensitization pain in practice is an important development in the integration of pain neuroscience into the clinic, and one that is relevant for people undergoing and following cancer treatment.

Controversies exist concerning the frequency of early epileptic seizures in different types of stroke. The aim of this work was to analyze the incidence of epileptic seizures at the onset of stroke, the factors related to seizures, and the prognosis of such seizures. A total of 1,000 patients included in a prospective data bank of cerebrovascular diseases in Girona were studied. Cranial CT scans were carried out in 90.5 % of the series. Fifty patients (5 %) had epileptic seizures at the onset or during the first 48 h of stroke. When the lesions involved the cortical region of the cerebral lobes, seizures occurred in 15.6% of the hemorrhages, 19.2% of the hemorrhagic infarcts and 6.2% of the ischemic infarcts (p = 0.02). The incidence of seizures was similar in superficial ischemic infarcts of thrombotic or embolic origin. Thirty-two percent of patients with seizures and 19 % of those without seizures died during hospitalization (p = 0.02). Epileptic seizures did not constitute an independent predictive factor of bad prognosis in the multiple regression analysis after adjusting the model for age, lesion extent and loss of consciousness. In conclusion, epileptic seizures at the onset of stroke are more frequent in hemorrhagic lesions. Their incidence is greater in large superficial lesions that reduce the level of consciousness and cause cerebral herniation, these being the factors leading to poor outcome.

Aims and Objectives:To investigate what factors influence caregiver strain in informal caregivers just before inpatients are discharged.Background: Previous research has investigated the risk factors related to the burden on caregivers in different clinical contexts. However, the findings from studies analysing these factors just before inpatients are discharged are uncertain.Design: A cross-sectional study design. Methods:The study involved 100 inpatients and 100 informal caregivers from seven different hospital units. Sociodemographic, clinical, functional and cognitive factors of inpatients-caregivers, and caregiver strains were recorded. Descriptive, bivariate correlation and multiple regression analyses were performed.Results: Caregivers of inpatients at risk of ulcers had significantly higher scores of strain. Dependency in activities of daily living scores and cognitive status scores were statistically inversely proportional to caregiver strain. Almost 27% of total variance of caregiver strain was due to dependency in activities of daily living.Conclusions: Caregiver strain was mainly associated with those situations in which the hospitalised patients presented the risk of ulcers, dependency and cognitive disorders, with dependency in activities of daily living being the factor that most influenced informal caregiver strain.Relevance to clinical practice: Dependency in activities of daily living, among other risk factors, should be evaluated at an early stage, monitored and controlled by hospital nursing staff. These strategies could protect and promote the well-being and quality of life of informal caregivers during patient hospitalisation and after discharge. caring for a relative (Jagannathan et al., 2014;Zarit, Todd, & Zarit, 1986). According to the general theory of stress, caregivers have to face stressful factors mediated by psychological processes. These mechanisms influence the emotional impact, perception of social support, coping strategies and family. The interaction between stressors and coping strategies may cause the caregiver to perceive an overload with negative consequences on his or her health (Hsiao & Tsai, 2015;L opez-Alonso & Moral-Serrano, 2005;Zarit et al., 1986).Caregiver strain may be defined as the stress or burden experienced by informal caregivers as a consequence of their caregiving role (Panganiban-Corales & Medina, 2011). | BACKGROUNDAlthough the estimated prevalence of caregiver strain varies in the literature, most studies have reported high levels of strain (Bradshaw et al., 2013;Oosterveer, Mishre, Van Oort, Bodde, & Aerden, 2014). Many predictors can influence the manner in which caregivers react and feel as a result of their role (Ain et al., 2014;Berg et al., 2005). Several studies state that caregiver strain depends on multiple sociodemographic, clinical, contextual or environmental factors (Berg et al., 2005;Blake & Lincoln, 2000;Bugge, Alexander, & Hagen, 1999;Hung et al., 2012) that probably contribute independently to this problem (Santos-Garc ıa & De la Fuente-...

Reduced functional capacity is a common characteristic of fibromyalgia (FMS). We aimed to investigate the relationship between functional status and body mass index (BMI) in a population with and without FMS. A pilot case–control study was performed in 34 women with FMS and 22 healthy controls which were classified according to their BMI. The main outcome measures were: Balance (MiniBestest, One Leg Stance Test), functional mobility (Timed up and Go), physical disability (Health Assessment Questionnaire Disability Index), spinal range of motion (Spinal Mouse), level of physical activity at work (Leisure Time Physical Activity Instrument), and home and leisure time (Physical Activity at Home and Work). Statistical differences were observed between overweight/obese healthy controls and women with FMS for several indicators of functional capacity. FMS patients reported worse dynamic (p = 0.001) and static balance (right: p = 0.002, left: p = 0.001), poorer functional mobility (p = 0.008), and higher levels of physical disability (p = 0.001). Functional status is altered in FMS women compared to the healthy control group, independently of nutritional status; therefore, BMI is unlikely to play a main role in functional capacity indicators in postmenopausal FMS women. Only dynamic balance seems to reduce the obesity status in this population.