Sunday, March 27, 2011

More on asthma and Buteyko breathing

An abstract from 1998 below. Conclusion: It works but nobody knows how

Buteyko breathing techniques in asthma: a blinded randomised controlled trial

By Simon D Bowler et al.


Objective: To evaluate the effect of Buteyko breathing techniques (BBT) in the management of asthma.

Design: Prospective, blinded, randomised study comparing the effect of BBT with control classes in 39 subjects with asthma. The study was conducted from January 1995 to April 1995.

Participants and setting: Subjects recruited from the community, aged 12 to 70 years, with asthma and substantial medication use.
Main outcome measures: Medication use; morning peak expiratory flow (PEF); forced expiratory volume in one second (FEV1); end-tidal (ET) CO2; resting minute volume (MV); and quality of life (QOL) score, measured at three months.

Results: No change in daily PEF or FEV1 was noted in either group. At three months, the BBT group had a median reduction in daily beta2-agonist dose of 904 µg (range, 29 µg to 3129 µg), whereas the control group had a median reduction of 57 µg (range, - 2343 µg to 1143 µg) (P = 0.002). Daily inhaled steroid dose fell 49% (range, - 100% to 150%) for the BBT group and 0 (range, - 82% to +100%) for the control group (P = 0.06). A trend towards greater improvement in QOL score was noted for BBT subjects (P = 0.09). Initial MV was high and similar in both groups; by three months, MV was lower in the BBT group than in the control group (P = 0.004). ET CO2 was low in both groups and did not change with treatment.

Conclusion: Those practising BBT reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre.


New injectable drug hailed as milestone in fight against skin cancer

A breakthrough cancer drug hailed as the first to prolong the lives of patients with melanoma as been approved by the Food and Drug Administration.

The injectable drug Yervoy, known chemically as ipilimumab, has been given the go-ahead to treat late-stage melanoma.

The drug only worked in a small proportion of patients studied, and on average they lived just four months longer than patients given older medications. But experts say it's milestone in treating the deadliest form of skin cancer.

Melanoma is the fastest growing form of cancer in terms of new diagnoses. Its growth is attributed to longer life expectancies and increased use of indoor tanning by young people. About 68,000 people in the U.S. were diagnosed last year and 8,700 patients died, according to the American Cancer Society.

'Clearly this is not a home run, but it's a solid base hit,' said Tim Turnham, director of the Melanoma Research Foundation. 'And because we see other things in the pipeline, we think this is the first in a series of important new therapies for melanoma.'

The FDA has only approved two other drugs for advanced melanoma, the last of which was more than 13 years ago. Neither drug has been shown to significantly extend patients' lives.

Ipilimumab is part of a group of targeted cancer medicines that harness the body's immune system, instead of attacking the disease with outside chemicals like chemotherapy.

The drug works by blocking a molecule linked to melanoma called CTLA-4, which interferes with the protective activity of white blood cells. When the molecule is blocked, the cells behave normally and help fight off cancer.

Yervoy's side effects may include diarrhea, swelling of the colon, rash and fatigue, the Associated Press reports. The FDA said severe to fatal immune reactions, such as inflammations of the colon and small intestine, liver, and skin,occurred in 12.9 percent of patients during clinical trials.

The agency has asked its makers Bristol-Myers Squibb to create a risk evaluation strategy designed to identify and reduce the risks associated with the drug.

FDA approved the drug based on a Bristol-Myers study of 676 people with advanced, inoperable melanoma who had already failed two other treatments, giving them a very short life expectancy.

They were given one of three treatments: ipilimumab by itself, ipilimumab combined with another immune-stimulating treatment, or the immune-stimulating treatment alone. The average survival was 10 months with ipilimumab and just over six months with the others.

Mike Brockey of Frederick, Md., was diagnosed with late-stage melanoma in 2008 and tried both conventional and alternative medicines before starting therapy with ipilimumab last September. He took the drug four times every three weeks and says his latest scans show that his tumors are inactive. Mr Brockley said: 'This is the first time in two years I had a sense that anything was going in the right direction.'

Bristol said it would disclose pricing details of the drug in the coming months.


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