ABSTRACT Objective To describe of the translation from English to Portuguese and adaption process of subitems of the Functional Assessment of Cancer Therapy – Multiple Myeloma. Methods In the first phase, translations from English into Portuguese of two subitems of Functional Assessment of Cancer Therapy – Multiple Myeloma were performed. Subsequently, a consensus and back translation were conducted, and, finally, translation and back translations were reviewed by four independent bilingual experts. In the second phase, the translated subitems were applied, along with a questionnaire, to 10 native Portuguese speakers patients with multiple myeloma. Results There was a recognition of the translation process in its first version applied to 10 patients with multiple myeloma, whose reported no difficult to understand the translated and validated instrument. Patients also did not find the content irrelevant or offensive, and they did not suggested changes. Conclusion The subitems of the Functional Assessment of Cancer Therapy – Multiple Myeloma were translated from English into Portuguese following the proposed methodology and there was not need of readjustments. This process allowed this instrument of quality of life, which is widely known to be beneficial in the management of patients with multiple myeloma, to be used among our population.

RESUMO O Consenso Brasileiro de Nutrição em Transplante de Células-Tronco Hematopoiéticas: Idoso foi elaborado com a participação de nutricionistas, médicos nutrólogos e médicos hematologistas de 15 centros brasileiros referência em transplante de células-tronco hematopoiéticas, com o objetivo de salientar a importância do estado nutricional e da composição corporal durante o tratamento, bem como as principais características relacionadas à avaliação nutricional do paciente. As intenções, ao se estabelecer o consenso, foram aprimorar e padronizar a terapia nutricional durante o transplante de células-tronco hematopoiéticas. O consenso foi aprovado pela Sociedade Brasileira de Transplante de Médula Óssea.

ABSTRACT The Brazilian Nutritional Consensus in Hematopoietic Stem Cell Transplantation: Elderly was elaborated by nutritionists, nutrologists and hematologists physicians from 15 Brazilians reference centers in hematopoietic stem cell transplantation, in order to emphasize the importancy of nutritional status and the body composition during the treatment, as well as the main characteristics related to patient’s nutritional assessment. Establishing the consensus, we intended to improve and standardize the nutritional therapy during the hematopoietic stem cell transplantation. The Consensus was approved by the Brazilian Society of Bone Marrow Transplantation.

JUSTIFICATIVA E OBJETIVOS: Pouquíssimas são as publicações sobre a síndrome de amplificação dolorosa no idoso (SAD), a despeito da sua importância para aqueles indivíduos, pois pode ter múltiplas consequências no envelhecimento. O objetivo deste estudo foi relatar um caso de SAD no idoso; representada pela fibromialgia (FM), descrevendo sua abordagem diagnóstica e seu manuseio terapêutico, bem como apresentar uma revisão bibliográfica do assunto. RELATO DO CASO: Paciente do gênero feminino, 73 anos, há 4 anos iniciando um quadro de moderada dor muscular difusa, rigidez matinal fugaz, anedonia, tristeza, ansiedade, importante fadiga e distúrbio do sono. Inicialmente, diagnosticada polimialgia reumática, assim, vinha fazendo uso regular de prednisona, apesar de progressiva piora da sua capacidade funcional e qualidade de vida (QV). Há um ano, no nosso serviço, foi revisto o diagnóstico, e verificado tratar-se de SAD, espectro da FM. Suspendeu-se, então, a prednisona e orientado terapia não farmacológica com programa de autogerenciamento em dor, e farmacológica multimodal com analgésicos não opioide o clonixinato de lisina e opioide o tramadol, e um modulador da dor, a duloxetina. Após 6 meses de tratamento verificou-se grande melhora na dor, sono, depressão, ansiedade, capacidade funcional e QV. CONCLUSÃO: É de suma importância o diagnóstico correto e uma intervenção terapêutica adequada nos casos de SAD, especialmente tratando-se da população idosa e da FM, a qual apresenta características peculiares naquela população. Há grandes probabilidades de melhora sintomática, funcional, e na QV dos idosos com SAD ao se atentar aos diagnósticos diferenciais, bem como ao se introduzir terapêuticas adequadas.

BACKGROUND AND OBJECTIVES: There are very few publications on pain amplification syndrome in the elderly (PAS), in spite of its importance for them, because it may have multiple consequences during aging. This study aimed at reporting a case of PAS in the elderly represented by fibromyalgia (FM), describing its diagnostic approach and therapeutic management, and at presenting a literature review on the subject. CASE REPORT: Female patient, 73 years old, with moderate diffuse muscle pain, fleeting morning stiffness, anhedonia, sadness, anxiety, major fatigue and sleep disorders for four years. She was initially diagnosed as rheumatic polymyalgia and was under regular prednisone in spite of the progressive worsening of her functional capacity and quality of life (QL). One year ago her diagnosis was reviewed by our service and we confirmed it was PAS, spectrum of FM. Prednisone was then withdrawn and non-pharmacological therapy was indicated with pain self-management program; multi-176 modal pharmacological therapy was also instituted with non-opioid (lysine clonixinate) and opioid (tramadol) analgesics and a pain modulator (duloxetine). Six months later there has been major pain, sleep, depression, anxiety, functional capacity and QL improvement. CONCLUSION: Accurate diagnosis and adequate therapeutic intervention are paramount for PAS cases, especially in the elderly population with FM, which has unique characteristics in such population. There are major probabilities of symptomatic, functional and QL improvement in the elderly with PAS if we pay attention to differential diagnoses and introduce adequate therapies.

JUSTIFICATIVA E OBJETIVOS: A osteoartrose (OA) é a artropatia mais comum e uma das principais causas de dor crônica na população idosa, podendo levar a grande incapacidade funcional nestes indivíduos. Objetivando o tratamento da dor em idosos com OA de joelho utilizou-se o clonixinato de lisina (CL) e avaliou-se a sua efetividade. MÉTODO: Estudo clínico e duplamente encoberto, aleatório e placebo controlado com 109 idosos com dor associada à OA de joelho. Os participantes foram divididos em dois grupos: Grupo CL e P (placebo) que receberam comprimidos para uso três vezes ao dia por 30 dias. Realizadas avaliações iniciais, após 15 dias e ao final do estudo, quanto à intensidade de dor em repouso, ao movimento inicial, à deambulação e à compressão articular; necessidade de analgesia complementar, rigidez matinal; incapacidade funcional associada à dor, aderência, tolerabilidade e avaliação global do tratamento. RESULTADOS: O CL reduziu significantemente a dor ao início do movimento e à deambulação já nos primeiros 15 dias, redução de 30% da dor protocinética e de 31,6% à deambulação, mas os melhores resultados ocorreram com 30 dias, quando as reduções foram de 42,3% e 45,5%, protocinética e à deambulação, respectivamente. A analgesia complementar foi significantemente menor com o CL: 2,6% e 9,5%, grupos CL e P, respectivamente. Não ocorreram diferenças entre os grupos para rigidez matinal e incapacidade funcional. Houve grande aderência e tolerabilidade. A avaliação global foi favorável para o CL, sendo excelente ou boa em 50%. CONCLUSÃO: O clonixinato de lisina foi efetivo no tratamento da dor associada à osteoartrite de joelho em idosos.

BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) is the most common arthropathy and one of the major causes of chronic pain in the elderly population, which may lead to major functional incapacity of these individuals. Aiming at treating pain of elderly patients with knee OA, we have used lysine clonixinate (LC) and have evaluated its effectiveness METHOD: Randomized, double-blind, placebo-controlled clinical trial with 109 elderly patients with knee OA-related pain. Participants were distributed in two groups: Group LC and Group P (placebo), who received tablets to be used three times a day for 30 days. Evaluations were performed initially, 15 days after and at study completion, as to pain intensity at rest, at initial movement, ambulation and joint compression; and the need for additional analgesia, morning stiffness; pain-related functional incapacity, adherence, tolerability and global treatment evaluation. RESULTS: LC has significantly decreased pain at initial movement and ambulation already in the first 15 days, with 30% decrease in protokinetic pain and 31.6% in ambulation, but best results were seen after 30 days, when reductions were 42.3% and 45.5%, respectively. Additional analgesia was significantly lower with LC: 2.6% and 9.5% for groups LC and P, respectively. There were no differences between groups in morning stiffness and functional incapacity. There has been major adherence and tolerability. Global evaluation was favorable to LC, being excellent or good for 50% of patients. CONCLUSION: Lysine clonixinate was effective to treat knee OA-related pain in elderly people.