Severity and disability related to epilepsy from the perspective of patients and physicians: A cross-cultural adaptation of the GASE and GAD scales.

PURPOSE: To perform a cross-cultural adaptation of the Global Assessment of Severity of Epilepsy (GASE) and Global Assessment of Disability (GAD) scales to Brazilian Portuguese and compare patients' self-rated scores with their attending physicians' ratings. METHODS: We conducted an observational, multicentre, cross-sectional study. Patients followed up in five epilepsy centres in Brazil responded to GASE and GAD questionnaires and to the Hospital Anxiety and Depression Scale and the Adverse Events Profile, both previously validated in Brazil. GASE and GAD scales were also completed by 20 attending physicians providing care to these patients. RESULTS: A total of 138 patients were interviewed, with a mean age of 39.9 ± 13.81 years and a median of 11 (interquartile range, IQR = 7.5-12) years of education. Eighty-five (61.6%) patients were female. Most patients were diagnosed with focal epilepsy (82.6%). Only 5.8% and 3.6% of respondents reported having difficulty understanding the GASE and GAD, respectively. The patients scored a median of 3 (IQR = 2-5) on the self-perceived GASE and 4 (IQR = 2-6) on the GAD. Physician ratings were moderately to highly correlated with patients' self-perceived scores on the GASE and GAD. Linear regression analysis demonstrated that physicians' GASE and GAD scores predicted 37% and 20% of the patients' self-reported GASE and GAD variation, respectively. CONCLUSION: Brazilian Portuguese cross-cultural adaptation of the GASE and GAD was successful. These scales were found to be easy to use by patients and health professionals, and revealed the burden of epilepsy on patients' lives.

Oral dietary intake level in thrombolysed and non-thrombolysed patients after ischemic stroke.

BACKGROUND: Dysphagia can be a stroke sequelae and may impact patient prognosis. Thrombolytic therapy has been used as a treatment of choice which aims to reduce sequelae. OBJECTIVE: Assess the ability of dietary intake orally in subjects undergoing thrombolytic therapy and compare it with non-thrombolytic subjects post-ischemic stroke. METHODS: Documentary cross-sectional study with 87 post-ischemic stroke patients. Subjects were divided as to the type of neurological intervention: group 1 consisted of subjects undergoing brain reperfusion therapy or thrombolysis and group 2 for those undergoing no such therapy or non-thrombolysed. Data was obtained from the subjects relative to age, sex, level of oral dietary intake at the beginning of hospitalization and at discharge, length of hospital stay, comorbidities and site of neurological lesion. RESULTS: Group 1 was composed of 39 patients while 48 patients were in group 2. Both groups consisted of subjects with similar mean age and balanced gender distribution. Both groups presented hypertension as the most frequent comorbidity. The individuals in group 1 demonstrated improvement of oral dietary intake (p = 0.002) and shorter hospital stay (p = 0.007) when compared with group 2. CONCLUSION: There was greater improvement of oral dietary intake and shorter hospital stay for patients undergoing thrombolytic therapy.