eLetters

311 e-Letters

  • Buteyko
    Alexandra Hough

    Dear Editor

    Thank you for a well-reasoned explanation on the effect of yoga on asthma.

    The study quoted [1] which justifies the Buteyko technique was flawed by:
    * unequal groups in that the Buteyko group initially required 1½ times the steroids of the control group
    * the Buteyko group receiving seven times the follow-up phone calls as the control group, plus extra breathin...

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  • Re: Self-management of asthma in general practice, asthma control and quality of life
    Pablo J Martin Olmedo

    Dear Editor

    I would like to ask the authors a question:

    In the results we can observe that the control of illness is better in the SM group but you say also that there were a saving in inhaled corticosteroids.... so how can you explain the best control? May be the environmental control or there are others explanations?

  • Self management of asthma in primary care
    Chris Griffiths

    Dear Editor

    Evidence that self management programmes for asthma are effective in primary care is elusive.[1] Thoonen and colleagues have carried out a complex and impressive cluster randomised trial from which they conclude that a self management programme implemented in Dutch general practices lowers the burden of illness.[2] Parts of their analysis require comment.

    It is not clear whether clustering has bee...

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  • Re: Medication compliance and difficult-to-treat asthma
    Andrew Bush

    Dear Editor

    We thank Dr Agarwal for responding to our article. We agree that the commonest cause of steroid resistant asthma is failure to take the prescribed steroids. However, there are perhaps more diagnostic aids than is acknoweldged. Compliance can be taken out of the equation by doing a therapeutic trial of a single intramuscular injection of depot triamcinolone.[1-4] If asthma persists, then it can truly be...

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  • Medication compliance and difficult-to-treat asthma
    SK Agarwal

    Dear Editor

    Medication compliance in asthma is disappointingly low and leads to poor asthma control in children. It is very common that parents do not supervise treatment and often report poor asthma control. Many difficult-to-manage asthmatics have ongoing exposure to allergens or other asthma triggers. In such instances, required medication may be very high and the results may be disappointing. Only 30% of pediatric a...

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  • Response to David Fishwick
    P Sherwood Burge

    Dear Editor

    Experts were given no clinical details except for times of waking and sleeping, and times of starting and leaving work. They were asked to make judgements based on the peak expiratory flow record alone, similar to the judgements made by the Oasys program. Oasys-2 has been shown to have a sensitivity of around 70%, when tested against independent objective diagnoses (mostly specific bronchial provocation t...

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  • Man versus machine
    David Fishwick

    Dear Editor

    We read with interest the article by Baldwin et al.[1] relating to the level of agreement between expert clinicians and OASYS software when making a diagnosis of occupational asthma. Our clinical unit uses OASYS plotting regularly, and find this of great use as one element of the diagnostic toolkit available for the confirmation of a diagnosis of occupational asthma.

    We were interested...

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  • Re: Chronic respiratory failure
    Gerben P Bootsma

    Dear Editor

    The recent case report from Smyth and Riley[1] describes nicely an extremely uncommon chronic respiratory failure due to hypoventilation secondary to brainstem stroke, and documents a new treatment option with medroxyprogesterone acetate.

    We recently saw two patients also with central hypoventilation resulting in chronic type II respiratory failure and treated both with, among other things, me...

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  • See top of letter
    John H. Lange

    Dear Editor

    Endotoxin: it’s activity in atopy and asthma is not the only controversial issue – does it play a role in prevention of lung cancer in some occupational populations

    The paper Does environmental endotoxin exposure prevent asthma? by Douwes et al. provides an interesting overview of how endotoxin may interact in atopy and asthma. This paper discusses issues as to whether endotoxin pl...

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  • Marginal benefits of adding formoterol
    Brian J Lipworth

    Dear Editor

    Price and colleages conclude that adding formoterol confers a therapeutic advantage to inhaled steroid in patients with mild to moderate asthma. For the 6 month follow up in part 2 of the study, for the secondary outcome of mild asthma exacerbations,the frequency differed by 2.5 per patient per 6 months ,while for poorly controlled asthma days the difference was 4.2 days per patient per 6 months.

    T...

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