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BMJ 2011; 343 doi: (Published 10 August 2011) Cite this as: BMJ 2011;343:d5016

Patients with dysfunctional breathing—breathing problems not attributed to a medical diagnosis—improved dramatically after breathing retraining. This entailed teaching diaphragmatic breathing and explaining normal breathing patterns. At five year follow-up, patients reported fewer breathing difficulties during daily functioning and exercise. In addition, quality of life measures improved and they attended emergency rooms less often. The only downside: the authors admit they can’t be sure all these improvements could be put down to their original intervention (Respiratory Medicine 2011;105:1153-9, doi:10.1016/j.rmed.2011.03.006).

People who have tinnitus may or may not have hearing loss. An Indian team hypothesises that tinnitus without hearing loss may be caused by central and subcortical abnormalities, and altered outer hair cell function. The changes they observed in auditory brainstem and middle latency responses in patients with tinnitus and no hearing loss indicate central auditory alterations. As tinnitus involves both peripheral and central activity, the team says that complete audiological and neurophysiological investigation is necessary, and that management should be based on both (Journal of …

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