This pioneering cross-sectional study in São Luís, Maranhão State, Brazil, aimed

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BACKGROUND AND OBJECTIVES: Dysfunctional attitudes and beliefs in patients with low back pain may interfere with pain, disability, and mood. The objective of this study was to evaluate the behavior of beliefs and attitudes in chronic low back pain and to correlate them with the intensity of pain, disability, anxiety, and depression. METHODS: We evaluated 82 patients with chronic low back pain according to the Numerical Scale of Pain, Survey of Pain Attitudes, Hospital Scale of Anxiety and Depression, and Oswestry Disability Index. RESULTS: More than half of the patients were female (51.22%) with a mean age above 40 years. The pain was mild to moderate at 53.65%. Severe disability was observed in 64.63%, anxiety in 63.41% and depression in 41.46%. The solicitude and disability beliefs showed significant associations in all groups. For physical damage, there was an association with disability and anxiety. Medical cure correlated between the anxiety variable. CONCLUSION: Patients presented dysfunctional beliefs associated with the intensity of pain, anxiety, depression and mainly disability, with a probable influence on the treatment. This relationship shows how important it is to carry out new studies that evaluate therapeutic approaches, such as targeted interventions and educational programs, aimed at the patient's beliefs with low back pain to determine their impact on pain control and treatment.

BACKGROUND AND OBJECTIVES:Breakthrough pain is frequent among cancer patients and is poorly studied in Brazil. This study aimed at evaluating the characteristics of breakthrough pain and at comparing its evolution during three days. METHODS: This is a longitudinal study where a specific questionnaire developed for the study was applied and was made up of sociodemographic data (age, gender, marital status, profession, income, origin), cancer-related data (types of primary tumor, presence of metastases, therapeutic approach with chemotherapy and/or radiotherapy, surgical treatment and drugs) and parameters related to breakthrough pain (number of daily episodes, duration of crisis, intensity, pain onset velocity and types of breakthrough pain: spontaneous, incidental, drug failure at the end of the dose). RESULTS: Most patients were females (71.7%), aged between 30 and 50 years (41.7%), under concomitant chemotherapy and radiotherapy (41.7%) and had cervical cancer (54.2%). Mean pain intensity was 7, with standard deviation of 2.3. With regard to breakthrough pain, there have been no statistically significant differences in the three evaluation moments. During the three evaluations, it was observed that there has been decrease in the percentage of patients with pain for more than 15 minutes in the third evaluation (p=0.004). There has been no difference in pharmacological profile among the three evaluations (p=0.34). CONCLUSION: Breakthrough pain was frequent among the studied population. The use of opioids was effective to decrease pain duration and spontaneous pain. Keywords: Cancer pain, Incidental pain, Irruptive pain, Opioid. Difficult situation in cancer pain RESUMO JUSTIfICATIVA E OBJETIVOS:A dor do tipo breakthrough ocorre com frequência em pacientes oncológicos e é pouco estudada no Brasil. Este estudo teve como objetivo estudar as características da dor do tipo breakthrough e comparar a evolução durante três dias. METODOS: Trata-se de um estudo longitudinal em que foi aplicado um questionário específico criado para a pesquisa e composto por dados sociodemográficos (idade, gênero, estado civil, profissão, renda, procedência), dados referentes ao cânc-er (tipos de tumor primário, existência de metástase, abordagem terapêutica como quimioterapia e/ou radioterapia, tratamento cirúrgico e fármacos) e parâmetros referentes à dor do tipo breakthrough (número de episódios por dia, duração da crise, intensidade, velocidade de inicio da dor e as variedades de dor do tipo breakthrough: espontânea, incidental e falha do fármaco no final da dose). RESULTADOS: A maioria era do gênero feminino (71,7%), com idade de 30 a 50 anos (41,7%), realizava quimioterapia e radioterapia concomitante (41,7%), e tinha câncer de colo uterino (54,2%). A média da intensidade dolorosa foi 7, com desvio padrão de 2,3. Em relação à presença de dor do tipo breakthrough, não houve diferença estatisticamente significativa nos três momentos de avaliação. Durante as três avaliações observou-se que houve redução no percentual de pacien...