***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 Short-term targeted treatment can potentially prevent fall asthma exacerbations while limiting therapy exposure . OBJECTIVE We sought to compare ( 1 ) omalizumab with placebo and ( 2 ) omalizumab with an inhaled corticosteroid ( ICS ) boost with regard to fall exacerbation rates when initiated 4 to 6 weeks before return to school . METHODS A 3-arm , r and omized , double-blind , double placebo-controlled , multicenter clinical trial was conducted among inner-city asthmatic children aged 6 to 17 years with 1 or more recent exacerbations ( clincaltrials.gov # NCT01430403 ) . Guidelines -based therapy was continued over a 4- to 9-month run-in phase and a 4-month intervention phase . In a subset the effects of omalizumab on IFN-α responses to rhinovirus in P BMC s were examined . RESULTS Before the falls of 2012 and 2013 , 727 children were enrolled , 513 were r and omized , and 478 were analyzed .  The fall exacerbation rate was significantly lower in the omalizumab versus placebo arms ( 11.3 % vs 21.0 % ; odds ratio [ OR ] , 0.48 ; 95 % CI , 0.25 - 0.92 ) , but there was no significant difference between omalizumab and ICS boost ( 8.4 % vs 11.1 % ; OR , 0.73 ; 95 % CI , 0.33 - 1.64 ) . In a prespecified subgroup analysis , among participants with an exacerbation during the run-in phase , omalizumab was significantly more efficacious than both placebo ( 6.4 % vs 36.3 % ; OR , 0.12 ; 95 % CI , 0.02 - 0.64 ) and ICS boost ( 2.0 % vs 27.8 % ; OR , 0.05 ; 95 % CI , 0.002 - 0.98 ) . Omalizumab  improved IFN-α responses to rhinovirus , and within the omalizumab group , greater IFN-α increases were associated with fewer exacerbations ( OR , 0.14 ; 95 % CI , 0.01 - 0.88 ) . Adverse events were rare and similar among arms . CONCLUSIONS Adding omalizumab before return to school to ongoing guidelines -based care among inner-city youth  reduces fall asthma exacerbations , particularly among those with a recent exacerbation BACKGROUND Exacerbations of bronchial asthma usually occur in the autumn . To our knowledge , however , the effectiveness of drugs for preventing exacerbations of asthma in the autumn has not been studied previously , except for leukotriene receptor antagonists and Omalizmab . METHODS This study compared the prophylactic effectiveness of suplatast tosilate with that of mequitazine in children with asthma symptoms , which is usually exacerbated in the autumn . The study group comprised 27 children aged 2 to 15 years who required treatment for asthmatic attacks during the past year and tested positive at least for mite allergen in the preceding autumn . The subjects were r and omly assigned to receive either suplatast or mequitazine . The primary endpoint of this study was the number of days without symptoms during the 8 weeks of treatment . In addition , the Japanese Pediatric Asthma Control Program ( JPAC ) scores were also recorded every 2 weeks in each group . RESULTS Overall , 14 patients received suplatast , and 13 received mequitazine for 8 weeks from September through early October . During follow-up , the number of days without symptoms and the total JPAC scores did not differ significantly between the groups . However , as compared with weeks 1 to 2 of treatment , the mean number of days without symptoms during weeks 7 to 8 increased significantly in only the suplatast group ( 8.6 vs. 11.5 days ; p = 0.004 ) . CONCLUSIONS Our results suggest that short-term additional treatment with suplatast is useful for preventing asthma symptoms in children with asthma , which is usually exacerbated in the autumn Pediatric asthma rates are reaching epidemic proportions , adversely affecting children 's quality of life , educational potential , and health care costs , especially those in the inner city . This study evaluated the effectiveness of a school-based asthma case management ( CM ) approach with medically underserved inner-city children attending Memphis City schools . Fourteen elementary schools with high rates of asthma-related hospital utilization were grouped according to school size , percentage of children with asthma enrolled , and percentage of children eligible for free or reduced-price lunch . Schools were r and omized to either a nurse CM intervention or a usual care ( UC ) condition . The CM group included 115 students ; 128 students were in the UC group . A longitudinal design was used to follow students ' progress . Students were primarily African-American children diagnosed with asthma . In CM schools , nurse case managers conducted weekly group sessions incorporating the Open Airways curriculum , followed up on students ' school absences , and coordinated students ' asthma care with families , school personnel , and medical providers . In UC schools , students received routine school nursing services . CM students had fewer school absences than their counterparts in UC schools ( mean 4.38 vs 8.18 days , respectively ) and experienced significantly fewer emergency department visits ( p < .0001 ) and fewer hospital days ( p < .05 ) than UC students . No such differences existed before program initiation . Replication and follow-up in year 2 showed continued significant improvements . School-based nurse CM can achieve significant improvements in school attendance and medical utilization OBJECTIVE To measure the effect of an asthma intervention on the functional status and morbidity of children with undiagnosed asthma . STUDY DESIGN Data from a r and omized trial were used to compare outcomes at baseline and follow-up for children with undiagnosed and diagnosed asthma . We studied 510 symptomatic children with diagnosed asthma ( diagnosed ) and 299 children with symptoms but no diagnosis ( undiagnosed ) . Baseline functioning and morbidity were similar for undiagnosed and diagnosed patients classified as moderate-severe . RESULTS There were fewer undiagnosed reported allergies , seasonal symptoms , and other respiratory diagnoses ( all P < 0.01 ) . Among the moderate-severe , functional status , for example , symptom-days ( P = .02 ) , symptom-nights ( P < .01 ) , and days of restricted activity ( P < .01 ) , was significantly reduced at follow-up for the undiagnosed in the intervention group but not for undiagnosed control subjects . Findings were similar for children with diagnosed asthma . CONCLUSIONS Children with undiagnosed asthma were generally nonatopic , although some had symptoms at a level comparable to children with a diagnosis . The intervention successfully improved functional status for children with undiagnosed asthma as well as for children with diagnosed asthma . These results can be applied to ongoing discussion s related to case detection The authors investigated the relation between ambient concentrations of five of the Environmental Protection Agency 's criteria pollutants and asthma exacerbations ( daily symptoms and use of rescue inhalers ) among 990 children in eight North American cities during the 22-month prer and omization phase ( November 1993-September 1995 ) of the Childhood Asthma Management Program . Short-term effects of carbon monoxide , nitrogen dioxide , particulate matter less than 10 mum in aerodynamic diameter ( PM10 ) , sulfur dioxide , and warm-season ozone were examined in both one-pollutant and two-pollutant models , using lags of up to 2 days . Lags in carbon monoxide and nitrogen dioxide were positively associated with both measures of asthma exacerbation , and the 3-day moving sum of sulfur dioxide levels was marginally related to asthma symptoms . PM10 and ozone were unrelated to exacerbations . The strongest effects tended to be seen with 2-day lags , where a 1-parts-per-million change in carbon monoxide and a 20-parts-per-billion change in nitrogen dioxide were associated with symptom odds ratios of 1.08 ( 95 % confidence interval ( CI ) : 1.02 , 1.15 ) and 1.09 ( 95 % CI : 1.03 , 1.15 ) , respectively , and with rate ratios for rescue inhaler use of 1.06 ( 95 % CI : 1.01 , 1.10 ) and 1.05 ( 95 % CI : 1.01 , 1.09 ) , respectively . The authors believe that the observed carbon monoxide and nitrogen dioxide associations can probably be attributed to mobile- source emissions , though more research is required This study aim ed to detect the effect of influenza vaccination on quality of life , symptomatology and spirometry in asthmatic children . A r and omised double-blind placebo-controlled trial in 696 ( 296 in 1999–2000 and 400 in 2000–2001 ) asthmatic children aged 6–18 yrs , which were vaccinated with either vaccine or placebo  , was performed . Children participated for only one influenza season . They recorded symptoms in a diary and reported when symptom scores reached a predefined severity level . If this occurred research nurses visited them twice , first to take a pharyngeal swab and spirometry , and a week later to assess quality of life over the past illness week . Compared with placebo , vaccination  improved health-related quality of life in the weeks of illness related to influenza-positive swabs . However , no effect was found for respiratory symptoms recorded in the diaries during those weeks . Similarly , no differences were found for quality of life in all weeks of illness or for respiratory symptoms throughout the seasons . Influenza vaccination was found to have a moderately beneficial effect on quality of life in influenza-positive weeks of illness in children with asthma OBJECTIVE This study explored the safety and efficacy of cetirizine for treatment of  allergic rhinitis and asthma .  METHODS Daily treatment for 6 weeks with  cetirizine 10 mg ( 93 patients ) was compared with  placebo treatment ( 93 patients ) in a r and omized , double-blind parallel study of patients with allergic rhinitis and asthma . This multicenter study was started just before onset of the fall pollen season . Rhinitis and asthma symptoms were assessed twice daily ; spirometry was performed weekly . RESULTS Placebo-treated patients experienced a worsening of rhinitis symptoms from baseline throughout the study , whereas cetirizine-treated patients had a significant improvement in rhinitis symptoms at week 1 , which was maintained after onset of the pollen season . Asthma symptoms in the cetirizine group improved from baseline at week 1 ; symptoms were significantly better than in the placebo group for 5 of 6 weeks of the study . Pulmonary function did not worsen in patients taking cetirizine or placebo ; there were no differences between treatments as determined by spirometry . Albuterol use was less frequent in the cetirizine-treated patients for every week of the study , but differences did not reach significance . Pseudoephedrine use was similar in both groups . More cetirizine-treated patients ( 90 % ) completed the trial than did placebo-treated patients ( 74 % ) . Both treatments were well tolerated . CONCLUSION Cetirizine 10 mg daily is safe and effective in relieving both upper and lower respiratory tract symptoms in patients with seasonal allergic rhinitis and concomitant asthma BACKGROUND Viral upper respiratory tract infections have been implicated as a major cause of  asthma exacerbations among school-aged children .  Regular h and washing is the most effective method to prevent the spread of viral respiratory tract infections , but effective h and -washing practice s are difficult to establish in schools . OBJECTIVES This r and omized controlled trial evaluated whether a st and ardized regimen of h and washing plus alcohol-based h and sanitizer could reduce asthma exacerbations more than schools ' usual h and hygiene practice s. METHODS This was a 2-year , community-based , r and omized controlled crossover trial . Schools were r and omized to usual care and then intervention ( sequence 1 ) or intervention and then usual care ( sequence 2 ) . Intervention schools were provided with alcohol-based h and sanitizer , h and soap , and h and hygiene education . The primary outcome was the proportion of students experiencing an asthma exacerbation each month . Generalized estimating equations were used to model the difference in the marginal rate of exacerbations between sequences while controlling for individual demographic factors and the correlation within each student and between students within each school . RESULTS Five hundred twenty-seven students with asthma were enrolled among 31 schools . The h and hygiene intervention did not reduce the number of asthma exacerbations compared with the schools ' usual h and hygiene practice s ( P = .132 ) . There was a strong temporal trend because both sequences experienced fewer exacerbations during year 2 compared with year 1 ( P < .001 ) . CONCLUSIONS Although the intervention was not found to be effective , the results were confounded by the H1N1 influenza p and emic that result ed in substantially increased h and hygiene behaviors and re sources in usual-care schools . Therefore these results should be viewed cautiously We have examined the effect of reducing relative humidity ( RH ) , with inbuilt mechanical ventilation and heat‐exchange ( MV 
    Output:
    
There was no evidence that a seasonal medication reminder letter decreased unscheduled contacts for a respiratory diagnosis between September and December .
There was no evidence that the proportion of participants experiencing at least one adverse event differed between intervention and usual care groups .
Seasonal omalizumab treatment from four to six weeks before school return might reduce autumn asthma exacerbations .
We found no evidence that this strategy is associated with increased adverse effects other than injection site pain , but it is costly .
There were no data upon which to judge the effect of this or other seasonal interventions on asthma control , quality of life , or asthma-related death .