List Archives

Wed Apr 23 13:08:45 BST 2008

I kinda figured he would reply in an eloquent and unambiguous fashion......

>>> <KMATTOX at aol.com> 4/23/2008 12:14 AM >>>
No, NO, NO, NO NO

In a message dated 4/22/2008 11:06:45 P.M. Central Daylight Time,  
ivanhronek at yahoo.com writes:

Be a  better friend, newshound, and know-it-all with Yahoo! Mobile. Try it 
now.  
I got an approval from Sandy Miller to post this here, anyone feels  strongly 
about it ?

At the PGA (Postgraduate Assembly of the  NYSSA)last December, the 
question came up in a discussion during a panel  (I missed the main 
talk because of another meeting).

This is for  those who deal with acute spinal cord injured patients. 
The question asked  was: given a patient who is both head and spinal 
cord injured,would you  use megadose steroids? To my surprise--and 
shock--the panelist answered  yes. I didn't get a chance to make a 
comment myself because time was  up.

Now, I had thought that it was generally understood by now that the  
evidence for any good effect of steroids in SCI is at best  
questionable, and that the evidence for harm from steroids in acute  
brain injury is unequivocable. Hence my shock. Certainly, if you have  
to be most concerned with any injury, one to the brain should be at  
the top of the list.

So, my question for the list: does anyone  still use megadose steroids 
for spinal cord injured pts? If so, why? If  not, why not? If you have 
a pt with SCI who also has a head injury, would  you use them then? If 
so, why?

Shameful self-promotion: I have an  article on this in the current 
issue of Jopurnal of Neurosurgical  Anesthesiology, and just finished 
our chapter on Trauma and Burns for the  next issue of Barash, so I 
have gone over the literature pretty  thoroughly. I'll post some 
references if you like; I'm running out of time  now.

Sanford M. Miller, MD

Ivan Hronek MD 
SFMC, Los  Angeles
cell: 310  487-3288
http://health.groups.yahoo.com/group/Anesthideas/ 
Your most  unhappy customers are your greatest source of learning. Bill Gates.
P  Please don't print this e-mail unless you really need  to.

Confidentiality Notice: This transmission and any attached  documents may be 
confidential and contain information protected by State and  Federal Medical 
Privacy statutes and is legally privileged. They are intended  for use only by 
the addressee. If you are not the intended recipient of this  transmission, or 
an agent of the intended recipient, you are prohibited from  reading, 
disclosing, printing, saving, copying, using, or otherwise  disseminating any 
information contained in this transmission. If you received  this transmission in 
error, please accept our apologies and notify me at   ivanhronek at yahoo.com and 
delete the entire message and its attachments. Thank  you. Disclaimer: this 
message contains the personal views of the author. The  author will not be 
responsible in any way for procedures or approaches  perfomed in the way suggested in 
this note. 

______________________________________________________________________________
______
Be  a better friend, newshound, and 
know-it-all with Yahoo! Mobile.  Try  it now.   
http://mobile.yahoo.com/;_ylt=Ahu06i62sR8HDtDypao8Wcj9tAcJ 
--
trauma-list  : TRAUMA.ORG
To change your settings or unsubscribe  visit:
http://www.trauma.org/index.php?/community/ 

**************Need a new ride? Check out the largest site for U.S. used car 
listings at AOL Autos.      
(http://autos.aol.com/used?NCID=aolcmp00300000002851)
--
trauma-list : TRAUMA.ORG
To change your settings or unsubscribe visit:
http://www.trauma.org/index.php?/community/

List Archives

For your convenience, find the Trauma List Archive Below

Steroids in spinal cord injury ?