***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: Thirteen house dust mite-allergic young asthmatics were entered into a double-blind , crossover clinical trial to compare " in use " with " non-use " of a laminar flow air cleaner bed attachment . The study design encouraged maintenance of symptom control by adjustment of the dose of medications used . There was a significant reduction in the amount of medications required by the patients during the trial period that the air cleaner was in use . Histamine airway responsiveness was significantly decreased for a group of eight of the subjects tested at the end of a 3-month open trial BACKGROUND Children with asthma who live in the inner city are exposed to multiple indoor allergens and environmental tobacco smoke in their homes . Reductions in these triggers of asthma have been difficult to achieve and have seldom been associated with decreased morbidity from asthma . The objective of this study was to determine whether an environmental intervention tailored to each child 's allergic sensitization and environmental risk factors could improve asthma-related outcomes . METHODS We enrolled 937 children with atopic asthma ( age , 5 to 11 years ) in seven major U.S. cities in a r and omized , controlled trial of an environmental intervention that lasted one year ( intervention year ) and included education and remediation for exposure to both allergens and environmental tobacco smoke . Home environmental exposures were assessed every six months , and asthma-related complications were assessed every two months during the intervention and for one year after the intervention . RESULTS For every 2-week period , the intervention group had fewer days with symptoms than did the control group both during the intervention year ( 3.39 vs. 4.20 days , P<0.001 ) and the year afterward ( 2.62 vs. 3.21 days , P<0.001 ) , as well as greater declines in the levels of allergens at home , such as Dermatophagoides farinae ( Der f1 ) allergen in the bed ( P<0.001 ) and on the bedroom floor ( P=0.004 ) , D. pteronyssinus in the bed ( P=0.007 ) , and cockroach allergen on the bedroom floor ( P<0.001 ) . Reductions in the levels of cockroach allergen and dust-mite allergen ( Der f1 ) on the bedroom floor were significantly correlated with reduced complications of asthma ( P<0.001 ) . CONCLUSIONS Among inner-city children with atopic asthma , an individualized , home-based , comprehensive environmental intervention decreases exposure to indoor allergens , including cockroach and dust-mite allergens , result ing in reduced asthma-associated morbidity Baseline levels of the house-dust mite allergen , Der p 1 , were measured on the carpets and mattresses of 60 pure-mite-sensitive asthmatic children in the Cape Peninsula , by means of an enzyme-linked immunosorbent assay ( ELISA ) . High levels of mite allergens were recorded ( range 2 - 50 micrograms Der p 1/g dust ) . In order to investigate the efficacy of the application of acaricides to carpets and bedding , 3 groups of 20 children were studied . Carpets and mattresses in group A were treated with a detergent , Metsan ( Snowchem ) , and in group B with Metsan combined with the acaricide , Acarosan ( Noristan ) . Group C was a control group in which no treatment was applied . The level of airway hyperreactivity ( PC20 ) to histamine was measured at the beginning of the study and again 3 months after acaricide treatment . Significant reductions in carpet Der p 1 levels were achieved in group A ( 22.83 v. 13.26 micrograms Der p 1/g dust ; P = 0.04 ) and group B ( 21.76 v. 13.26 micrograms Der p 1/g dust ; P = 0.01 ) , but mite levels were not reduced in any of the mattresses treated . There was also no improvement in airway hyperreactivity in any of the groups . This study clearly demonstrates that at present it is not possible to reduce Der p 1 antigen levels in mattresses in the Cape Peninsula with the available acaricides , even when one of these is combined with a detergent solution . Until strategies are developed which will significantly reduce Der p 1 levels in the bedding of sensitive individuals , a reduction in ongoing airway inflammation and airway hyperreactivity can not be expected BACKGROUND The efficacy of bed covers that are impermeable to house dust mites has been disputed . AIM The aim of the present study was to investigate whether the combination of ' house dust mite impermeable ' covers and a self-management plan , based on peak flow values and symptoms , leads to reduced use of  inhaled corticosteroids  ( ICS ) than self-management alone . DESIGN OF STUDY Prospect i ve , r and omised , double blind , placebo-controlled trial . SETTING Primary care in a south-eastern region of the Netherl and s. METHOD Asthma patients aged between 16 and 60 years with a house dust mite allergy requiring ICS were r and omised to intervention and placebo groups . They were trained to use a self-management plan based on peak flow and symptoms . After a 3-month training period , the intervention commenced using house dust mite impermeable and placebo bed covers . The follow-up period was 2 years . Primary outcome was the use of ICS ; secondary outcomes were peak expiratory flow parameters , asthma control , and symptoms . RESULTS One hundred and twenty-six patients started the intervention with house dust mite impermeable or placebo bed covers . After 1 and 2 years , significant differences in allergen exposure were found between the intervention and control groups ( P<0.001 ) . No significant difference between the intervention and control groups was found in the dose of ICS ( P = 0.08 ) , morning peak flow ( P = 0.52 ) , peak flow variability ( P = 0.36 ) , dyspnoea ( P = 0.46 ) , wheezing ( P = 0.77 ) , or coughing ( P = 0.41 ) . There was no difference in asthma control between the intervention and control groups . CONCLUSION House dust mite impermeable bed covers combined with self-management do not lead to reduced use of ICS compared with self-management alone Background : The use of anti-allergic mattress covers in patients with asthma can result in a large reduction in the level of house dust mite allergen in dust sample s. Apart from a reduction in histamine induced bronchial hyperresponsiveness , there are few data on the effect of mattress covers on clinical efficacy and quality of life in patients with moderate to severe asthma . Methods : Thirty patients with asthma and house dust mite allergy were studied in a r and omised , double blind , placebo controlled study . Before and after using anti-allergic covers for 1 year , dust was collected from the mattresses to determine concentrations of Dermatophagoides pteronyssinus ( Der p 1 ) , and bronchial hyperresponsiveness and quality of life were measured . The patients scored their symptoms ( lungs and nose ) , morning and evening peak flow values , and rescue medication for 14 days before and after the intervention period . Results : There was a significant reduction in the concentration of Der p 1 in the dust collected from the mattresses in the actively treated group after 1 year compared with before treatment ; no change was found in the placebo group . In both the actively treated and placebo groups there was no significant improvement in PC20 histamine . Quality of life improved similarly in both groups . The symptom score of the lower airways did not significantly change in either group . A significant decrease in nasal symptom score was seen in the actively treated group compared with before treatment , but there was no significant difference between the groups . No changes in morning and evening peak flow values , peak flow variability , nor in the use of rescue medication were found in either group . Conclusion : The use of anti-allergic mattress covers results in significant reductions in Der p 1 concentrations in carpet-free bedrooms . However , in patients with moderate to severe asthma , airways hyperresponsiveness and clinical parameters are not affected by this effective allergen avoidance Abstract Objective To compare the distribution of P values in abstract s of r and omised controlled trials with that in observational studies , and to check P values between 0.04 and 0.06 . Design Cross sectional study of all 260 abstract s in PubMed of articles published in 2003 that contained “ relative risk ” or “ odds ratio ” and reported results from a r and omised trial , and r and om sample s of 130 abstract s from cohort studies and 130 from case-control studies . P values were noted or calculated if unreported . Main outcome measures Prevalence of significant P values in abstract s and distribution of P values between 0.04 and 0.06 . Results The first result in the abstract was statistically significant in 70 % of the trials , 84 % of cohort studies , and 84 % of case-control studies . Although many of these results were derived from subgroup or secondary analyses , or biased selection of results , they were presented without reservations in 98 % of the trials . P values were more extreme in observational studies ( P < 0.001 ) and in cohort studies than in case-control studies ( P = 0.04 ) . The distribution of P values around P = 0.05 was extremely skewed . Only five trials had 0.05 ≤ P < 0.06 , whereas 29 trials had 0.04 ≤ P < 0.05 . I could check the calculations for 27 of these trials . One of four non-significant results was significant . Four of the 23 significant results were wrong , five were doubtful , and four could be discussed . Nine cohort studies and eight case-control studies reported P values between 0.04 and 0.06 , but in all 17 cases P < 0.05 . Because the analyses had been adjusted for confounders , these results could not be checked . Conclusions Significant results in abstract s are common but should generally be disbelieved Fifty adult asthmatic patients with strongly positive skinprick tests to the house dust mite were admitted into a prospect i ve r and omised controlled trial of house dust mite avoidance in the community . Twenty-two of the experimental group completed one year of dust avoidance and 19 of these tolerated the use of plastic mattress and pillow covers .  Twenty of the control group ( who did not alter their housecleaning habits ) also completed one year of study . A fall in mite and dust levels was noted in the homes of the experimental but not the control group . Fifteen of the experimental group who completed the study were strongly RAST positive ( score 3 or more ) to the house dust mite . These patients had a significant improvement in FEV1/FVC , PEFR , PC20 , use of treatment , and symptom score at one year , whilst the seven experimental patients who were not strongly RAST positive ( score 2 or less ) did not , suggesting that the change noted in the former patients was not merely due to a placebo effect . Fifteen of the control group who completed the study were also strongly RAST positive for the house dust mite and these patients showed no change in any of the parameters . This study demonstrates that adult asthmatic patients can successfully carry out house dust eradication procedures in the community over a long period of time , and that those patients who are allergic to the house dust mite appear to have both subjective and objective improvement in their asthma BACKGROUND Exposure to cat and dog allergens is very common in the Western World and is a serious cause of asthma in sensitized subjects . OBJECTIVE We sought to study the clinical effects of air cleaners in living rooms and bedrooms of asthmatic children sensitized to cat or dog allergens . METHODS Twenty asthmatic children sensitized to pet allergens ( cat/dog ) and with an animal at home participated in a double-blind , placebo-controlled , cross-over study in which the effects of air cleaners placed in the living room and bedroom for 3 months were compared with the effects of sham air cleaners . Before and after each study period , lung function , airway hyperresponsiveness ( adenosine monophosphate ) , and peak flow variation were recorded . Cat and dog allergen levels were assessed in the filters of the air cleaners . RESULTS After a 3-month intervention with active air cleaners , airway hyperresponsiveness decreased significantly , showing a 1.2 doubling dose increase of PC(20 ) adenosine ( P = .003 ) . Peak flow amplitude also decreased ( P = . 045 ) . Substantial amounts of airborne cat and dog allergen were captured by the air cleaners in living rooms and bedrooms as well . Allergen levels in floor dust were not changed . CONCLUSION In young asthmatic patients sensitized and exposed to pets in the home , application of air cleaners in living rooms and bedrooms was accompanied by a significant improvement in airway hyperresponsiveness and a decrease in peak flow amplitude BACKGROUND Manufacturers of ionisers cl aim many benefits from the use of their devices , including the relief of asthma . Particles removed from the air are likely to include airborne allergens , so ionisers may achieve an effect by reducing the allergen load . METHODS The effect of ionisers on airborne concentrations of house dust mite allergen Der p I was investigated in a double blind , crossover , placebo controlled trial in the homes of 20 children with allergic asthma . Subjects recorded their peak expiratory flow rate ( PEFR ) twice daily and completed a daily symptom score and treatment schedule on a diary card for two six week periods , one with an active ioniser and the other with a placed ioniser ( r and omly allocated ) used in the living room and the bedroom . RESULTS Airborne Der p I concentrations fell significantly during the active period compared with the placebo period , but there was no significant change in PEFR , symptom scores , or treatment usage . There was an increase in night time cough which almost reached significance during the active period . CONCLUSIONS This study indicates that the use of ionisers can not be recommended in the 
    Output:
    
Despite the fact that many trials were of poor quality and would be expected to exaggerate the reported effect , we did not find an effect of the interventions .