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Tue Jan 2 12:15:17 GMT 2007

Short medline searche doen't support it entirely, but there seems te be some light at the end of this tunnel ?
I think the Medscape link, wich I couldn't open, is about the first article.

Later,
Marc

Ann Emerg Med. 2006 Sep 28;[Epub ahead of print]
ProTECT: A Randomized Clinical Trial of Progesterone for Acute Traumatic Brain Injury.Wright DW, Kellermann AL, Hertzberg VS, Clark PL, Frankel M, Goldstein FC, Salomone JP, Dent LL, Harris OA, Ander DS, Lowery DW, Patel MM, Denson DD, Gordon AB, Wald MM, Gupta S, Hoffman SW, Stein DG. 
Department of Emergency Medicine, School of Medicine of Emory University, Atlanta, GA.

STUDY OBJECTIVE: Laboratory evidence indicates that progesterone has potent neuroprotective effects. We conducted a pilot clinical trial to assess the safety and potential benefit of administering progesterone to patients with acute traumatic brain injury. METHODS: This phase II, randomized, double-blind, placebo-controlled trial was conducted at an urban Level I trauma center. One hundred adult trauma patients who arrived within 11 hours of injury with a postresuscitation Glasgow Coma Scale score of 4 to 12 were enrolled with proxy consent. Subjects were randomized on a 4:1 basis to receive either intravenous progesterone or placebo. Blinded observers assessed patients daily for the occurrence of adverse events and signs of recovery. Neurologic outcome was assessed 30 days postinjury. The primary safety measures were differences in adverse event rates and 30-day mortality. The primary measure of benefit was the dichotomized Glasgow Outcome Scale-Extended 30 days postinjury. RESULTS: Seventy-seven patients received progesterone; 23 received placebo. The groups had similar demographic and clinical characteristics. Laboratory and physiologic characteristics were similar at enrollment and throughout treatment. No serious adverse events were attributed to progesterone. Adverse and serious adverse event rates were similar in both groups, except that patients randomized to progesterone had a lower 30-day mortality rate than controls (rate ratio 0.43; 95% confidence interval 0.18 to 0.99). Thirty days postinjury, the majority of severe traumatic brain injury survivors in both groups had relatively poor Glasgow Outcome Scale-Extended and Disability Rating Scale scores. However, moderate traumatic brain injury survivors who received progesterone were more likely to have a moderate to good outcome than those randomized to placebo. CONCLUSION: In this small study, progesterone caused no discernible harm and showed possible signs of benefit.

Curr Opin Neurol. 2006 Dec;19(6):514-519.
Neuroprotection targets after traumatic brain injury.Wang KK, Larner SF, Robinson G, Hayes RL. 
aCenter for Neuroproteomics and Biomarkers Research, Department of Psychiatry, USA bCenter for Traumatic Brain Injury Studies, Department of Neuroscience, McKnight Brain Institute of the University of Florida, Gainesville, Florida, USA cBanyon Biomarkers Inc., Alachua, Florida, USA.

PURPOSE OF REVIEW: The scarcity of pharmacological neuroprotective treatments for traumatic brain injury is a concern being targeted on various fronts. This review examines the latest treatments under investigation. RECENT FINDINGS: In the last 12-18 months, no drug has completed phase III clinical trials as a clearly proven method to treat traumatic brain injury. While the drugs work in rodents, when they make it to clinical trial they have failed primarily due to negative side-effects. Those still in trial show promise, and even those rejected have undergone modifications and now show potential, e.g. second-generation N-methyl-D-aspartic acid and alpha-amino-3-hydroxy-methyl-4-isoxazolyl-propionic acid receptor antagonists, calpain inhibitors, and cyclosporine A analogues. Also, several drugs not previously given much attention, such as the antibiotic minocycline, estrogen and progesterone, and a drug already approved for other diseases, erythropoietin, are being examined. Finally, a treatment generating some controversy, but showing potential, is the application of hypothermia to the patients. SUMMARY: Clearly, finding treatments for traumatic brain injury is not going to be easy and is evidently going to require numerous trials. The good news is that we are closer to finding one or more methods for treating traumatic brain injury patients.

M.G.M. Scot  MD
Consultant Anesthesology
Department Anesthesiology & Pain
Medisch Centrum Alkmaar
Alkmaar
the Netherlands
+31 (0)72 548 3123  / 3124
 Snailmail
PO Box 501
1800 AM Alkmaar
the Netherlands
 Email
M.Scot at MCA.Nl

I hear and I forget. I see and I remember. I do and I understand.
Confucius (551 BC - 479 BC)

-----Oorspronkelijk bericht-----
Van: Tabi Alonso [mailto:tabi at cruzroja.org]
Verzonden: maandag 1 januari 2007 18:34
Aan: trauma-list at trauma.org
Onderwerp: Progesterone IV & brain injury

Does anyone of you guys know anything about this?
Sounds very interesting and easy to have around...

October 4, 2006 < Progesterone given soon after traumatic brain injury (TBI)
is safe, appears to cut the risk of death by 50%, and reduces subsequent
disability, a small pilot study suggests.
Here is the link...

 http://www.medscape.com/viewarticle/545573

¡Have a great year starting NOW!

Tabi Alonso EMT II
Cancun, Mexico

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