***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 Probiotics purportedly reduce symptoms of gastrointestinal and upper respiratory-tract illness by modulating commensal microflora . Preventing and reducing symptoms of respiratory and gastrointestinal illness are the primary reason that dietary supplementation with probiotics are becoming increasingly popular with healthy active individuals . There is a paucity of data regarding the effectiveness of probiotics in this cohort . The aim of this study was to evaluate the effectiveness of a probiotic on faecal microbiology , self-reported illness symptoms and immunity in healthy well trained individuals . Methods Competitive cyclists ( 64 males and 35 females ; age 35 ± 9 and 36 ± 9 y , VO2max 56 ± 6 and 52 ± 6 ml.kg-1.min-1 , mean ± SD ) were r and omised to either probiotic ( minimum 1 × 109Lactobacillus fermentum ( PCC ® ) per day ) or placebo treatment for 11 weeks in a double-blind , r and omised , controlled trial . The outcome measures were faecal L. fermentum counts , self-reported symptoms of illness and serum cytokines . Results Lactobacillus numbers increased 7.7-fold ( 90 % confidence limits 2.1- to 28-fold ) more in males on the probiotic , while there was an unclear 2.2-fold ( 0.2- to 18-fold ) increase in females taking the probiotic . The number and duration of mild gastrointestinal symptoms were ~2-fold greater in the probiotic group . However , there was a substantial 0.7 ( 0.2 to 1.2 ) of a scale step reduction in the severity of gastrointestinal illness at the mean training load in males , which became more pronounced as training load increased . The load ( duration ×severity ) of lower respiratory illness symptoms was less by a factor of 0.31 ( 99%CI ; 0.07 to 0.96 ) in males taking the probiotic compared with placebo but increased by a factor of 2.2 ( 0.41 to 27 ) in females . Differences in use of cold and flu medication mirrored these symptoms . The observed effects on URTI had too much uncertainty for a decisive outcome . There were clear reductions in the magnitude of acute exercise-induced changes in some cytokines . Conclusion L. fermentum may be a useful nutritional adjunct for healthy exercising males . However , uncertainty in the effects of supplementation on URTI and on symptoms in females needs to be resolved . Trial registration The trial was registered in the Australia and New Zeal and Clinical Trials Registry ( ACTRN12611000006943 ) BACKGROUND AND OBJECTIVES Acute respiratory infection ( ARI ) is among the most common , debilitating and expensive human illnesses . The purpose of this study was to assess ARI-related costs and determine if mindfulness meditation or exercise can add value . METHODS One hundred and fifty-four adults ≥50 years from Madison , WI for the 2009 - 10 cold/flu season were r and omized to ( i ) wait-list control ( ii ) meditation or ( iii ) moderate intensity exercise .  ARI-related costs were assessed through self-reported medication use , number of missed work days and medical visits . Costs per subject were based on cost of generic medications , missed work days ( $ 126.20 ) and clinic visits ( $ 78.70 ) . Monte Carlo bootstrap methods evaluated reduced costs of ARI episodes . RESULTS The total cost per subject for the control group was $ 214 ( 95 % CI : $ 105-$358 ) , exercise $ 136 ( 95 % CI : $ 64-$232 ) and meditation $ 65 ( 95 % CI : $ 34-$104 ) . The majority of cost savings was through a reduction in missed days of work . Exercise had the highest medication costs at $ 16.60 compared with $ 5.90 for meditation ( P = 0.004 ) and $ 7.20 for control ( P = 0.046 ) . Combining these cost benefits with the improved outcomes in incidence , duration and severity seen with the Meditation or Exercise for Preventing Acute Respiratory Infection study , meditation and exercise add value for ARI . Compared with control , meditation had the greatest cost benefit . This savings is offset by the cost of the intervention ( $ 450/subject ) that would negate the short-term but perhaps not long-term savings . CONCLUSIONS Meditation and exercise add value to ARI-associated health-related costs with improved outcomes . Further research is needed to confirm results and inform policies on adding value to medical spending This study determined whether daily supplementation with 600 mg vitamin C would reduce the incidence of symptoms of  upper-respiratory-tract ( URT ) infections after participation in a competitive ultramarathon race ( > 42 km ) . Ultramarathon runners with age-matched controls were r and omly divided into placebo and experimental ( vitamin C-supplemented ) groups . Symptoms of URT infections were monitored for 14 d after the race . Sixty-eight percent of the runners in the placebo group reported the development of symptoms of URT infection after the race ; this was significantly more ( P < 0.01 ) than that reported by the vitamin C-supplemented group ( 33 % ) . The duration and severity of symptoms of URT infections reported in the vitamin C-supplemented nonrunning control group was also significantly less than in the nonrunning control group receiving the placebo ( P < 0.05 ) . This study provides evidence that vitamin C supplementation may enhance resistance to the postrace URT infections that occur commonly in competitive ultramarathon runners and may reduce the severity of such infections in those who are sedentary PURPOSE This study was design ed to evaluate potential preventive effects of meditation or exercise on incidence , duration , and severity of acute respiratory infection ( ARI ) illness . METHODS Community-recruited adults aged 50 years and older were r and omized to 1 of 3 study groups : 8-week training in mindfulness meditation , matched 8-week training in moderate-intensity sustained exercise , or observational control . The primary outcome was area-under-the-curve global illness severity during a single cold and influenza season , using the Wisconsin Upper Respiratory Symptom Survey ( WURSS-24 ) to assess severity . Health care visits and days of missed work were counted . Nasal wash collected during ARI illness was assayed for neutrophils , interleukin-8 , and viral nucleic acid . RESULTS Of 154 adults r and omized into the study , 149 completed the trial ( 82 % female , 94 % white , mean age 59.3 ± 6.6 years ) . There were 27 ARI episodes and 257 days of ARI illness in the meditation group ( n = 51 ) , 26 episodes and 241 illness days in the exercise group ( n = 47 ) , and 40 episodes and 453 days in the control group ( n = 51 ) . Mean global severity was 144 for meditation , 248 for exercise , and 358 for control . Compared with control , global severity was significantly lower for meditation ( P = .004 ) . Both global severity and total days of illness ( duration ) trended toward being lower for the exercise group ( P=.16 and P=.032 , respectively ) , as did illness duration for the meditation group ( P=.034 ) . Adjusting for covariates using zero-inflated multivariate regression models gave similar results . There were 67 ARI-related days of-work missed in the control group , 32 in the exercise group ( P = .041 ) , and 16 in the meditation group ( P < .001 ) . Health care visits did not differ significantly . Viruses were identified in 54 % of sample s from meditation , 42 % from exercise , and 54 % from control groups . Neutrophil count and interleukin-8 levels were similar among intervention groups . CONCLUSIONS Training in meditation or exercise may be effective in reducing ARI illness burden Objective In this study , the effects of Difflam Forte Anti-inflammatory Throat Spray on the incidence of  upper respiratory symptoms  ( URS ) and inflammatory responses after a half-marathon race were investigated . Design and setting Double-blind placebo-controlled r and omised trial conducted in association with a half-marathon event . Participants 45 well-trained half-marathon runners . Interventions Difflam ( n = 25 ) or placebo ( n = 20 ) throat sprays were self-administered three times daily for 1 week before and 2 weeks after the race . Main outcome measures Self-reported respiratory symptoms ; plasma prostagl and in E2 , myeloperoxidase , interleukin ( IL ) 6 , IL8 , IL10 and IL1 receptor antagonist ( IL1ra ) concentrations ; and salivary myeloperoxidase and IL6 concentrations . Results All subjects completed the intervention without reporting any adverse events . The proportion of athletes reporting URS was not substantially different between Difflam ( 52 % ) and placebo ( 56 % ) groups ( p = 0.82 ) . However , symptom severity scores were ∼29 % lower during Difflam treatment ( 4.7 ( 7.4 ) vs 6.6 ( 9.6 ) ) AU ) . Post-exercise responses in plasma inflammatory markers did not differ substantially between Difflam and placebo groups . Post-race increases in salivary myeloperoxidase ( ∼63 % ; trivial to moderate difference ; p = 0.13 ) and salivary IL6 ( ∼50 % ; trivial to moderate difference ; p = 0.25 ) were greater in the Difflam group . Conclusions Prophylactic use of the Difflam reduced the severity , but not the frequency , of URS among half-marathon runners . Post-race increases in systemic inflammatory markers were not altered by Difflam use , but markers of local inflammation ( salivary myeloperoxidase and IL6 ) were augmented in the Difflam compared with the placebo group BACKGROUND AND PURPOSE In sensory hyperreactivity ( SHR ) , patients have symptoms from the airways and the chest induced by environmental irritants like scenting products and cigarette smoke . They are characterized by increased cough reaction to inhaled capsaicin compared with healthy controls . Lung function tests are normal , and asthma medications have no or little effect . In a recent published article , patients with SHR were found to have impaired chest mobility and increased pain sensitivity . The purpose of this study was to evaluate if a physiotherapeutic intervention can increase chest mobility in SHR , influence these patients ' symptoms and reduce capsaicin cough sensitivity . METHODS Forty-one SHR patients were initially r and omized in to groups , one for training and one for symptom registration in this controlled training study . It consisted of a daily training programme containing simple movements to increase the flexibility of the chest , a breathing exercise and a relaxation session as well as symptom registration . Chest expansion was measured with a measuring tape and thoracic and abdominal movement with light sensors . Pain sensitivity was assessed using pressure algometry and a st and ardized capsaicin inhalation threshold provocation-evaluated cough sensitivity . RESULTS Twenty seven patients were left for analyses after 12 weeks and 26 patients after 24 weeks . Chest mobility and upper thoracic respiratory movements improved ( p < 0.01 ) , feeling of chest pressure and the capsaicin cough sensitivity decreased ( p < 0.01 ) . The patients also showed of significantly lowered pain pressure thresholds measured with algometry , compared with healthy controls ( p < 0.001 ) . CONCLUSION Improvement of chest mobility after physiotherapeutic intervention indicates that these patients may have acquired a dysfunctional breathing pattern . The regular use of a training programme and structural breathing instructions can be used to improve chest mobility , chest symptoms and capsaicin cough sensitivity in patients with SHR and signs of dysfunctional breathing . Copyright © 2016 John Wiley & Sons , BACKGROUND Acute respiratory infections ( ARIs ) are the most common symptomatic reason to seek ambulatory care , but many ARI visits may not be necessary . OBJECTIVE To measure the proportion of primary care ARI visits that may not require an office visit . METHODS We identified 58398 ARI visits to 14 primary care practice s between May 2011 and May 2012 and r and omly selected 500 visits , 439 of which were new ARI visits . We separated non-visit-required information [ e.g. history of present illness ( HPI ) , past medical history , etc . ] from information that required an office visit ( e.g. physical exam , testing , etc . ) . Review ing non-visit-required information , we identified the diagnosis ( HPI diagnosis ) and whether office visit appeared necessary . Independently , we review ed the visit-required information and determined if the visit changed antibiotic management . RESULTS Based on non-visit-required information , 72 % ( 316/439 ) of visits did not appear to require an office visit . The most common diagnoses were non-specific upper respiratory infection ( 39 % ) , sinusitis ( 24 % ) and acute bronchitis ( 22 % ) . The HPI diagnosis was an exact match for clinicians ' diagnosis in 67 % ( 213/316 ) 
    Output:
    
However , one primary outcome , the number of symptom days per episode of illness , was reduced in those participants who exercised ( MD -1.1 day , 95 % CI -1.7 to -0.5 , moderate- quality evidence ) .We found no significant differences for the secondary outcomes ( laboratory parameters ( blood lymphocytes , salivary secretory immunoglobulin and neutrophils ) ; quality of life outcomes ; cost-effectiveness and exercise-related injuries).There was good adherence to the intervention with no difference between the exercise and non-exercise groups .
We can not determine whether exercise is effective at altering the occurrence , severity or duration of acute respiratory infections .
One analysis of four trials suggests that the number of days of illness per episode of infection might be reduced by exercise .