***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND There are few data on the use of alternative therapies in adult asthma and their impact on health outcomes . OBJECTIVE The objective of this study was to study the prevalence and morbidity of asthma self-treatment with herbs , coffee or black tea , and over-the-counter ( OTC ) medications containing ephedrine or epinephrine . METHODS We carried out a cross-sectional analysis of interview data for 601 adults with asthma recruited from a r and om sample of pulmonary and allergy specialists . We estimated the 12-month prevalence of reported use of herbal products , coffee or black tea , or OTC products to self-treat asthma and their association with emergency department visits and hospitalization . RESULTS Herbal asthma self-treatment was reported by 46 ( 8 % ; 95 % confidence interval [ CI ] 6 % to 10 % ) ; coffee or black tea self-treatment by 36 ( 6 % ; 95 % CI 4 % to 8 % ) , epinephrine or ephedrine OTC use by 36 ( 6 % ; 95 % CI 4 % to 8 % ) , and any of the three practice s by 98 subjects ( 16 % ; 95 % CI 13 % to 19 % ) . Adjusting for demographic and illness covariates , herbal use ( odds ratio [ OR ] 2.5 ; 95 % CI 1.1 to 5.6 ) and coffee or black tea use ( OR 3.1 ; 95 % CI 1.2 to 7.8 ) were associated with asthma hospitalization ; OTC use was not ( OR 0.8 ; 95 % CI 0.3 to 2.5 ) . CONCLUSIONS Even among adults with access to specialty care for asthma , self-treatment with nonprescription products was common and was associated with increased risk of reported hospitalization . This association does not appear to be accounted for by illness severity or other disease covariates . It may reflect delay in utilization of more efficacious treatments Difficultes ethiques rencontrees pour l'organisation d'experimentations cliniques concernant l'asthme chez l'enfant ( un appareil pour inhalation de corticosteroides , une method e d'immunotherapie , une method e de desensibilisation Asthma is characterized as a chronic inflammatory process . Pycnogenol((R ) ) , a bioflavonoid mixture extracted from Pinus maritima , is known to scavenge free radicals while possessing antioxidant and antiinflammatory properties . The objective of this study was to evaluate the efficiency of this agent in a r and omized , double-blinded , placebo-controlled , crossover study in patients with varying asthma severity . Twenty-six patients who fulfilled the American Thoracic Society criteria for asthma were enrolled in the study . Medical history , physical examination , blood sample analyses , and spirometric values were obtained at baseline , 4 weeks , and 8 weeks . The patients were r and omly assigned to receive either 1 mg/lb/day ( maximum 200 mg/day ) Pycnogenol or placebo for the first period of 4 weeks and then crossed over to the alternate regimen for the next 4 weeks . No adverse effects were observed related to the study drug . Within the contingent of 22 patients who completed the study , almost all responded favorably to Pycnogenol in contrast to placebo . Pycnogenol treatment also significantly reduced serum leukotrienes compared with placebo . The results of this pilot study indicate that Pycnogenol may be a valuable nutraceutical in the management of chronic asthma . We recommend that further clinical trials be conducted in larger groups of asthmatics to establish its efficacy OBJECTIVE To explore the mechanism of acupoint electro-superconducting therapy with Chinese herbal drugs contained pad in treating children asthma . METHODS Sixty asthma children in the mild to moderate stage of asthma attack were r and omly divided into two groups , the treated group and the control group . Besides the basic treatment , acupoint electro-superconducting therapy with the pad containing Chinese herbal drugs was applied to the treated group , and to the control group the same therapy but with pad of placebo was applied , seven days as a course of treatment . The peak exhalation force ( PEF ) was measured daily , and the cytokines , interleukin-10 ( IL-10 ) and interferon-gamma ( IFN-gamma ) were determined before and after treatment . RESULTS No significant difference was found in the ratio of patients ' PEF to the normal predicted value between the two groups before treatment ( P > 0.05 ) . But on the fourth day of the treatment course , the increase of PEF in the treated group was more obvious than that in the control group ( P < 0.05 ) . The IL-10 levels of two groups were raised after ending the treatment course , but the increment in the treated group was more obvious ( P < 0.01 ) . However , the changes of IFN-gamma levels after treatment showed insignificant difference between the two groups ( P > 0.05 ) . CONCLUSION Acupoint electro-superconducting therapy with Chinese herbal drugs contained pad is helpful to improve the pulmonary function of children with asthma , it could also increase the serum IL-10 level in attack stage of the asthma children The efficacy and tolerability of a butterbur root extract ( Petadolex ) for the treatment of asthma was analyzed in a prospect i ve , non-r and omized , open trial . Subjects included 64 adults and 16 children/adolescents treated for two months with the extract , followed by two months during which the intake of the extract was optional . Concomitant asthma medication was permitted . The number , duration , and severity of asthma attacks decreased , while peak flow , forced expiratory volume ( FEV1 ) , and all measured symptoms improved during therapy . In addition , more than 40 percent of patients using asthma medications at baseline reduced intake of these medications by the end of the study . This study suggests the Petasites hybridus extract Petadolex is an effective and safe therapy for the treatment of asthma CONTEXT A prior national survey documented the high prevalence and costs of  alternative medicine use in the United States in 1990 . OBJECTIVE To document trends in alternative medicine use in the United States between 1990 and 1997 . DESIGN Nationally representative r and om household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997 , respectively . PARTICIPANTS A total of 1539 adults in 1991 and 2055 in 1997 . MAIN OUTCOMES MEASURES Prevalence , estimated costs , and disclosure of alternative therapies to physicians . RESULTS Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8 % in 1990 to 42.1 % in 1997 ( P < or = .001 ) . The therapies increasing the most included herbal medicine , massage , megavitamins , self-help groups , folk remedies , energy healing , and homeopathy . The probability of users visiting an alternative medicine practitioner increased from 36.3 % to 46.3 % ( P = .002 ) . In both surveys alternative therapies were used most frequently for chronic conditions , including back problems , anxiety , depression , and headaches . There was no significant change in disclosure rates between the 2 survey years ; 39.8 % of alternative therapies were disclosed to physicians in 1990 vs 38.5 % in 1997 . The percentage of users paying entirely out-of-pocket for services provided by alternative medicine practitioners did not change significantly between 1990 ( 64.0 % ) and 1997 ( 58.3 % ) ( P=.36 ) . Extrapolations to the US population suggest a 47.3 % increase in total visits to alternative medicine practitioners , from 427 million in 1990 to 629 million in 1997 , thereby exceeding total visits to all US primary care physicians . An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and /or high-dose vitamins ( 18.4 % of all prescription users ) . Estimated expenditures for alternative medicine professional services increased 45.2 % between 1990 and 1997 and were conservatively estimated at $ 21.2 billion in 1997 , with at least $ 12.2 billion paid out-of-pocket . This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations . Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $ 27.0 billion , which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services . CONCLUSIONS  Alternative medicine use and expenditures increased substantially between 1990 and 1997 , attributable primarily to an increase in the proportion of the population seeking alternative therapies , rather than increased visits per patient The aim of this study was to evaluate the efficacy and safety of a Chinese herbal formula modified Mai-Men-Dong-Tang ( mMMDT ) for treatment of persistent , mild-to-moderate asthma . A total of 100 asthmatic patients were enrolled and assigned to three treatment groups in this double-blind , r and omized , placebo-controlled clinical trial . Over a period of 4 months , patients in groups A and B received 80 and 40 mg/kg/day of mMMDT , while those in group C received a placebo . Efficacy variables included changes in forced expiratory volume in 1 s ( FEV1 ) , symptom score , serum total immunoglobulin E ( IgE ) , and dust mite-specific IgE. Safety assessment s included complete blood count , and liver and kidney function . Relative to baseline , significantly greater increases in FEV1 were demonstrated for both A and B groups in comparison with the placebo-treated analog ( both p < 0.05 ) . Further , similar improvements in symptom score were observed for both mMMDT treatment groups . The serum total IgE for group A showed a decreasing tendency after treatment but no statistical difference was noted . Furthermore , no drug-related adverse effects were reported . Blood test , and liver and kidney function were within normal range during the study , with no marked changes demonstrated over time . In conclusion , the Chinese herbal formula mMMDT provided improvements in lung function and relieved asthma symptoms in our sample of patients . Given its efficacy and safety , we consider mMMDT a credible treatment regimen for persistent , mild-to-moderate asthma Alternative medicine use has increased at a remarkable pace all over the world in recent years . Although herbal medicine for the treatment of asthma is becoming the focus of public attention , r and omized studies had not been performed , even in Eastern countries including Japan . This study was design ed to investigate whether one of the Japanese government approved herbal complexes Saiboku-to ( TJ-96 ) is effective for the treatment of atopic asthma , and to investigate whether this protective activity is associated with a reduction in eosinophilic inflammation . A double-blind , r and omized , crossover design was used . Subjects received 2.5 g of TJ-96 or placebo orally 3 times daily for 4 weeks and then , after a washout period of at least 4 weeks , crossed over to receive the alternative treatment . We assessed the effects of pretreatment with TJ-96 on bronchoconstriction precipitated by inhalation of methacholine . Furthermore , eosinophil counts and measurement of eosinophilic cationic protein ( ECP ) were performed . After 4 weeks of treatment with TJ-96 , values of PC20 -methacholine significantly improved in the treatment with TJ-96 . Also , patients ' symptoms , blood eosinophils , serum ECP , sputum eosinophils , and sputum ECP were significantly decreased . Our results suggest that TJ-96 has an antiinflammatory effect on bronchial eosinophilic infiltration . This study raises further interesting therapeutic possibilities and argues for further trials of new approaches to the treatment of asthma Essential fatty acids are cl aim ed to have positive effects in atopic diseases . In a double blind , placebo controlled , parallel group study 58 out of 60 children , with atopic dermatitis and the need for regular treatment with topical skin steroids , completed a 16 weeks ' treatment period with either Epogam evening primrose oil or placebo capsules .  Twenty two of these subjects also had asthma . The parents used diaries to record symptom scores and concomitant medication . Peak expiratory flow was measured and disease activity was monitored by the clinician every four weeks . The plasma concentrations of essential fatty acids increased significantly in the group treated with Epogam capsules . The study demonstrated significant improvements of the eczema symptoms but no significant difference was found between the placebo and the Epogam groups . No therapeutic effect was shown on asthma symptoms or fidget Dietary gammalinolenic acid ( GLA ) , a potent inhibitor of 5-lipoxygenase ( 5-LOX ) and suppressor of leukotriene B4 ( LTB4 ) , can attenuate the clinical course of rheumatoid arthritics , with negligible side effects . Since Zileuton , also an inhibitor of 5-LOX , attenuates asthma but with an undesirable side effect , we investigated whether dietary GLA would suppress bio synthesis of PMN-LTB4 isolated from asthma patients and attenuate asthma . Twenty-four mild-moderate asthma patients ( 16 - 75 years ) were r and omized to receive either 2.0 g daily GLA ( b 
    Output:
    
The data that are available from the studies provide only a small insight into the long-term efficacy and harm profiles of these treatments .