RESUMO
BACKGROUND: Enoxaparin was shown to have a neuroprotective effect in animal models as well as a human study following traumatic brain injury. This study was conducted to assess the effect of enoxaparin on the clinical outcome of severe traumatic brain injury (TBI) and its safety. METHODS: This study is a randomized double-blinded placebo-controlled trial. The inclusion criteria were age 16-70, a closed head injury, a postresuscitation Glasgow Coma Scale (GCS) between 5 and 8, and a latency time between the injury and entering the study of less than 5 h. The patients were randomized into enoxaparin and placebo groups. In the enoxaparin group, 0.5 mg/kg enoxaparin was injected subcutaneously every 6 h in six total doses. The two groups were compared for the occurrence of intracranial hematoma (ICH) and for clinical neurological outcome, assessed by the Glasgow Outcome Scale. RESULTS: Twenty-seven patients were assigned to the placebo group and 26 to the enoxaparin group. The two groups were similar regarding baseline characteristics, including age, sex, postresuscitation GCS, and best motor response. The occurrence of new ICH or an ICH size increase was insignificantly more frequent in the enoxaparin group than the placebo group (26.9% vs. 7.4%, P = 0.076). The favorable outcome rate in the enoxaparin group was significantly higher than in the placebo group (57.7% vs. 25.9%, P = 0.019). CONCLUSIONS: This study showed that the early administration of enoxaparin could lead to favorable outcomes in severe TBI patients without significantly increasing cerebral hemorrhagic complications.
RESUMO
BACKGROUND: Low back pain (LBP) is one of the most common complaints of patients referred to the clinics. Studies indicated that psychosocial factors have great impact on the patients' complaints and disability. The aim of this study was to evaluate a broad range of psychiatric disorders in patients with chronic LBP (CLBP) and compare them with those of the control group. PATIENTS AND METHODS: We applied Symptom Checklist 90-R to compare 50 CLBP patients in the case group with 100 participants without it in the control group. The questionnaire measured somatization, obsessive-compulsive disorder, depression, anxiety, phobic anxiety, hostility, interpersonal sensitivity, paranoid ideation, and psychoticism. RESULTS: Average "global severity index" was 1.10 in the case and 0.5 in the control group. Average "positive symptom total" was 45.26 in the case and 27.41 in the control group. Average "positive symptom distress index" was 2.50 in the case and 1.50 in the control group. Average scores for all test dimensions were significantly different between the two groups (P = 0.00). CONCLUSIONS: All dimensions were significantly more common in CLBP patients. Therefore, early diagnosis and treatment of these disorders may improve the outcome of CLBP.