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 بشرى سارة لمرضى " الأزمة " .. ! a pretty profound impact
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آخر ما تم التوصل إليه من علاج لمرضى "الأزمة" و "نوبة الربو"..
شمار علمي حاآآآر من دولة كندا, نحتاج إلي مترجم !
Heat treatment for asthma gets positive review
Last Updated: Wednesday, March 28, 2007 | 5:14 PM ET
CBC News
A minor surgical approach to treating asthma significantly reduces symptoms, a Canadian-led international study has found.
The procedure, called bronchial thermoplasty, uses a flexible scope inserted through the nose or mouth into the lungs to apply radio waves and heat to the walls of airways.آ
Asthma inhaler change
Inhalers using a new propellant with the same medications are equally as effective but will cost up to three times more, a second study appearing in Wednesday's online issue of the New England Journal of Medicine has found.
In 2008, all asthma inhalers in the U.S. that use chlorofluorocarbon (CFC), which deplete the ozone layer in Earth's atmosphere, will be taken off the market.
While the medicine itself remains the same, the CFC propellant will be replaced with hydrofluoroalkane or HFA.
Leslie Hendeles, a professor of pharmacy and pediatrics at University of Florida, led the review of inhalers with albuterol as the key medicinal ingredient.
Until generic versions of inhalers containing the new HFA propellants reach pharmacies after 2012, the widely prescribed medicine could cost more, the team said.
The HFA inhalers release slower, warmer medication than their CFC counterparts, so patients may think they're getting a lower dose.
Since HFA inhalers also tended to clog more easily, users should remove the metal once a week, and clean the plastic part with warm water, Hendeles advised.
Two brands of HFA inhalers contain ethanol, which may not appropriate depending on religious beliefs, and can temporarily cause false readings on breath alcohol tests given by police.
The therapy reduces some of the underlying smooth muscle tissue and limits the ability of airways to constrict or tighten inآ asthma attacks.
"It really is an electrocution, a heat treatment that injures the airway temporarily. And as it heals, all the normal pieces of the airway return with the exception of the smooth muscle," said one of the lead researchers, Dr. John Miller, head of thoracic surgery at St. Joseph's Healthcare in Hamilton.
In Wednesday's online issue of the New England Journal of Medicine, Miller and his colleagues reported they had found that one year after bronchial thermoplasty, 56 people showed:
Fewer asthma attacks.
Twice as many symptom-free days.
Half as many medications needed.
Compared with the other 112 people in the control group, those who had bronchial therapy "gained well over 100 days with absolutely no asthma symptoms," said Miller, who called it a "pretty profound impact."
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About 200 branches of the airway are probed in three separate procedures. The out-patient surgeries are done at three-week intervals under light anesthetic. Only part of the lung is done each time because the device can exacerbate asthma for about a week, or bring on bronchitis.
"My hope was that I could at least reduce my medication, which has been accomplished," said Brenda Donahue, 44, of Hamilton, who tried the procedure five years ago. Donahue now reaches for her puffer perhaps once a day, compared with five times daily before.
The findings are promising, but more research is needed, said Dr. Dennis Bowie, a respirologist in Halifax.
"It's not likely to be a cure, but I think it provides us with insights into a different method of treatment," Bowie said.
It's not yet clear what other effects thermoplasty might have, such as onآ nerves or mucus glands, according to an editorial accompanying the study. Another research projectآ that is just getting underway could help answer those questions.
Bronchial thermoplasty is not yet widely available, with only a few Canadian centres using it in clinical trials. The investigators said the procedure is easy to do, and they hopeآ after some refinements, it will be approved for wider use by the end of 2008.آ
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ناذر محمد الخليفة
jini
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