Tradução para o português e avaliação da confiabilidade de uma escala para diagnóstico da polineuropatia distal diabética

Abstract

The aim of this study was to translate into Portuguese and to assess the reliability of an instrument for the diagnosis of diabetic distal polyneuropathy (DPN). The process for translation and adaptation into Portuguese of the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS) was performed following internationally standardized procedures. The instruments were applied by 2 raters in 57 consecutive subjects. Spearman correlation was used to evaluate the reliability and Cronbachs' alpha to evaluate the internal consistency of the items. Both, ECN and ESN, showed a good reliability (r= 0.77, p< 0.0001 and r= 0.76, p< 0.0001, respectively). ESN showed a good internal consistency (alpha= 0.74). The diagnosis of DPN, defined as the combination of the two scores (ECN+ESN) also showed a good reliability (r= 0.63, p< 0.0001). The Portuguese versions of the ESN and the ECN seem to be adequate for the diagnosis of DPN in this population.

Vasculopathy associated with peripheral neuropathy in gait parameters of diabetic people

“…Inclusion in the NVG: medical confirmation of type 2 DM, DPN, and PVD. DPN confirmed by insensitivity to the 10 g Semmes-Weinstein monofilament at least one of the 11 points tested in the plantar and dorsal regions of the foot 13 and the Scale for Diagnosis of Diabetic Distal Polyneuropathy 15 . Change in the circulation and peripheral blood perfusion, detected respectively by an ankle/arm index of <0.90 (obtained by analysis and Doppler sphygmomanometer in the upper and lower members) and by values that differ by two or more points between the upper and lower limbs in the oximetry test 14 .…”

“…To confirm the DPN, the Scale for Diagnosis of Diabetic Distal Polyneuropathy was applied, composed of the Neuropathy Symptom Score (NSS) and the Neuropathy Disability Score (NDS) 15 . For the NSS, a score of 3-4 implies mild symptoms, 5-6 moderate symptoms, and 7-9 severe symptoms and for NDS, scores of 3-5 are considered mild neuropathic signs, 6-8 as moderate, and a score of 9-10 as severe neuropathic signs.…”

“…Inclusion in the NG: medical confirmation of type 2 DM, DPN confirmed by insensitivity to the 10 g Semmes-Weinstein monofilament in nine points in the plantar region and two in the dorsal region 13 and the Scale for Diagnosis of Diabetic Distal Polyneuropathy 15 , without a medical diagnosis of peripheral vascular disease, ankle/upper arm index greater than 0.9 (obtained by analysis and Doppler sphygmomanometer in the upper and lower members), and blood perfusion with a difference of up to two points between the upper and lower limbs measured by the oximetry test on the fingers and toes and grade 1 diabetic foot impairment 11 . Inclusion in the NVG: medical confirmation of type 2 DM, DPN, and PVD.…”

Neuropatia Periférica E Sinais Clínicos De Síndrome Coronariana Aguda Em Pacientes Com Diabetes Mellitus

“…Durante todo o acompanhamento, 5% dos indivíduos com NP apresentaram eventos cardiovasculares em comparação com 2,8% de indivíduos sem NP (13) . Pacientes com doença aterosclerótica portadores de DM têm sido sujeitos de diversas pesquisas com o intuito de avaliar a melhor forma de estratificação de risco, com o objetivo de reduzir as complicações na fase aguda (8)(9)(10)(11)(12)(14)(15)(16)(17)(18) . Diante da dificuldade na triagem nos serviços de emergências em pacientes DM, em decorrência da presença de sinais atípicos secundários à neuropatia periférica, são altamente indicados instrumentos que possam facilitar a identificação destas condições ou mesmo estratificar o risco de mortalidade/ complicações destes pacientes.…”

“…Para a avaliação do nível de neuropatia periférica, foi utilizada a Escala de Sintomas Neuropáticos (ESN), traduzida e validada para a população brasileira (18) . Esta escala possui seis questões com pontuação mínima de três pontos e a pontuação máxima de nove pontos sendo classificado em sintomas neuropáticos leve quando o escore foi de três a quatro pontos, moderado quando obtido o escore de cinco a seis pontos e grave quando o escore for maior que sete (18) .…”