***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: STUDY OBJECTIVE Local nasal hyperthermia or inhalation of heated water vapor is often recommended as a home remedy for various rhinitis disorders such as the common cold and allergic rhinitis .  Inhaled heated vapor treatments and simple saline solution nasal irrigation were investigated for their effect on inflammatory mediator production in nasal secretions . DESIGN Three treatments were given for nasal irrigation : heated water particles ( large particle water vapor ) at 43 degrees C , heated molecular water vapor ( molecular water vapor ) at 41 degrees C , and simple saline solution nasal irrigation . Nasal washes were done before each treatment ( baseline ) , immediately after treatments , and at 30 min , 2 , 4 , and 6 h. Histamine , prostagl and in D2 , and leukotriene C4 ( LTC4 ) concentrations were measured in nasal secretions and compared with baseline values . PATIENTS AND PARTICIPANTS Thirty symptomatic patients with active perennial allergic rhinitis underwent three treatments at weekly intervals . MEASUREMENTS AND RESULTS Nasal histamine concentrations fell substantially with the nasal irrigation ( p < 0.01 immediately posttreatment and at 30 min ; p < 0.05 at 2 , 4 , and 6 h ) . Large particle vapor also reduced histamine concentrations for up to 4 h posttreatment compared with baseline values ( p < 0.05 ) . Alternatively , molecular water vapor did not alter nasal histamine concentrations . Surprisingly , the three treatments did not alter prostagl and in D2 concentrations over the 6 h. Leukotriene C4 concentrations fell briefly after the large particle treatment but did not with the molecular water vapor . With saline solution irrigation , LTC4 concentrations in nasal secretions were lower than baseline at 30 min to 4 h after a treatment ( p < 0.05 ) . CONCLUSIONS This study demonstrated the usefulness of large particle vapor treatment and saline solution irrigation in reducing inflammatory mediators in nasal secretions and indirectly supports the clinical efficacy of these treatments for chronic rhinitis The upper airway respiratory diseases ( i.e. common cold , allergic rhinitis , nonallergic/vasomotor rhinitis , acute and chronic rhinosinusitis and nasal polyposis ) in which nasal congestion is a common symptom are often undertreated due to the frequent inadequate efficacy and safety concern with current therapies . In scientific literature , few studies seem to support the hypothesis that nasal inhalatory treatment with thermal water promotes the improvement of nasal symptoms , even if the mechanisms by which the improvement from SPA therapy can be expected remain debated . A prospect i ve comparative study with a pre – post design has been performed consecutively enrolling 33 ( males 70 % ) patients of both genders older than 12 years of age , affected by chronic sinonasal inflammation . All patients underwent a 14-days course of radioactive water warm vapour inhalations followed by nasal aerosol of the same thermal water 10 min each once/day at Merano Therme . At the beginning and end of the study , in all the subjects , nasal function evaluation by active anterior rhinomanometry , mucociliary transport time ( MCTt ) determination and nasal cytology were performed . After the inhalatory treatment , the mucociliary function was improved and the pathologic mucociliary transport times recorded at the beginning of the study being significantly reduced to physiologic ones . Besides , before treatment , the cytologic picture showed an inflammatory cell infiltration ( eosinophils , neutrophils with/without bacteria , mast cells ) in 37 % of patients ; after therapy in 66 % of these patients , the rhinocytogram was normal . Our results suggest , according to the literature data , that SPA therapy with radioactive water could represent an alternative choice in chronic inflammatory diseases of the upper airways , nonresponsive to pharmacological therapy OBJECTIVES Aim of the research was to demonstrate the efficacy of a treatment with thermal water as nasal spray ( Salsomaggiore Italy ) vs saline on chronic rhinosinusitis with/out nasal polyps . MATERIAL S AND METHODS 55 patients affected by chronic rhinosinusitis with/out I degree nasal polyposis r and omised into two groups were enrolled . 30 patients of the study group were treated with thermal water nasal spray 4 times/day for 4 weeks . 25 patients of the control group were treated , with the same protocol , with saline . At the beginning and at the end of the study , in all the subjects the clinical history , objective examination and the instrumental analysis of nasal functions by active anterior rhinomanometry , mucociliary transport ( MCT ) time determination and nasal cytology were performed . RESULTS At the end of the treatment patients in the study group showed an improvement statistically significant , with respect to the control group , of headache , rhinorrea and hiposmia . Significant differences were also observed between the study and control group concerning objective examination ( nasal mucosa appearance and crusts ) and instrumental analysis ( rhinomanometric values and mucociliary transport times ) . Nasal cytology ( epithelial and goblet cells , neutrophils , eosinophils , bacteria ) improved in both groups without any statistical difference . CONCLUSIONS Thermal water ( Salsomaggiore Italy ) nasal spray showed a greater efficacy with respect to saline in the treatment of patients affected by chronic rhinosinusitis The saccharin test was carried out in a r and omly selected sample of schoolchildren ( 142 boys and 153 girls , age range 11 - 14 years ) to determine the variability and reproducibility of the test and to assess whether it could be used as a screening test for nasal mucociliary clearance . Nasal mucociliary clearance times were analysed according to clinical history ( asthma , rhinitis , asthma with rhinitis , and acute upper respiratory tract infections ) , laboratory findings ( positive skin test responses and bronchial hyper-reactivity assessed by methacholine challenge ) , and parental smoking . Nasal mucociliary clearance times showed a narrow coefficient of repeatability ( six minutes ) in 50 subjects and there was substantial agreement between the two tests . Nasal mucociliary clearance times were less than 40 minutes in all the children . Normal children had nasal mucociliary clearance times of less than 24 minutes while significantly impaired nasal mucociliary clearance was detected in those with positive skin reactions and a positive response to methacholine challenge . We were unable to show that passive smoking had any consistent effect on nasal mucociliary clearance . We suggest that a time response between 30 - 60 minutes should be checked again at least two weeks later , and that children in whom repeated saccharin tests show a nasal mucociliary clearance of greater than 30 minutes should have ciliary beat frequency estimated Conclusions : In order to confirm these preliminary results , a prospect i ve double-blind study has been instituted in Padova University ENT Section to compare the efficacy of sulphurous-arsenical-ferruginous thermal water nasal irrigations vs isotonic sodium chloride solution nasal irrigations after functional endoscopic sinus surgery for chronic sinusitis . Objectives : Despite their widespread use , much uncertainty exists about the indications and therapeutic mechanisms of nasal thermal water inhalations in the treatment of sinonasal chronic disease . The aim of the present study was to evaluate the effects of sulphurous-arsenical-ferruginous thermal water inhalations on nasal respiratory flow , mucociliary transport , nasal cytology , and chemo-physics of nasal mucus in a group of consecutive patients with chronic sinonasal disease . Patients and methods : Thirty-seven patients with chronic sinonasal disease underwent a 12-day course of sulphurous-arsenical-ferruginous thermal water warm vapour inhalations ( 38 ° C ) followed by nasal aerosol of the same thermal water ( 7 microns micelle ) . Results : This preliminary study showed that a course of sulphurous-arsenical-ferruginous thermal water inhalations determined a significant improvement in nasal flow and reduction of nasal resistance ; a statistically significant reduction of mean mucociliary transport time , from pathologic to physiologic values , has also been shown . Statistical analysis of our data confirmed that the presence of nasal bacteria was significantly reduced by thermal water inhalations OBJECTIVES Aim of the research was the demonstration of the efficacy of thermal water vs saline in the recurrent and chronic nasosinusal pathologies treatment . MATERIAL S AND METHODS 120 patients r and omized into 2 groups of 60 subjects each , all affected by recurrent or chronic rhinosinusitis with/without I degree nasal polyposis . At the beginning and at the end of the study , in all the subjects the clinical history , objective examination and the instrumental analysis of nasal functions by active anterior rhinometry , acustic rhinometry , nasal mucociliary transport time determination and nasal mucosa scraping were performed . Patients of the study group underwent crenotherapy treatment ( vapour inhalation , aerosol and nasal douching ) with thermal water for 14 days at Salsomaggiore Thermal baths . Other patients underwent nasal douching and aerosol with saline twice a day for 14 days at the Rhinologic Centre of the ENT Clinic of Siena University . RESULTS At the end of the study , only the patients undergone to crenothrapic treatment with salt-bromine-iodic water showed a significant improvement of nasal obstruction , rinorrea and number of nocturnal arousals . The improvement , even if present , was not significant in the control group . Same positive variations were observed concerning nasal mucosa congestion , nasal secretion and mucociliary transport time reaching the significance in the study group . CONCLUSIONS Crenotherapy with salt-bromine-iodic water should be considered as efficacious therapeutic tool in the management of chronic and recurrent rhinosinusitis Recurrent respiratory infections ( RRI ) represent a social problem for both the pharmaco-economic impact and the burden on the family . Thermal water is popularly well accepted . However , there is no scientific evidence of its preventive activity on recurrent respiratory tract infections ( RRI ) . Therefore , the purpose of this study was to evaluate the effects of Agnano thermal water nasal irrigation on RRI prevention in children . A total of 107 children ( 70 males , mean age 4.5±1.2 years ) with RRI were enrolled in the study . At baseline , children were r and omly assigned to the treatment with : A ) inhaled crenotherapy with salso-sulphide water or B ) isotonic saline ( NaCl 0.9 % ) . Inhaled therapy was performed using nasal washing by Rino-jet ( ASEMA srl , Milan , Italy ) b.i.d . for 12 days . Nasal washing lasted 2 minutes per nostril . Immediately before washing , children inhaled 1 l of water by stream inhalation per 2 minutes . Crenotherapy was capable of significantly reducing : the number of respiratory infections , nasal symptoms , neutrophil and bacteria count , turbinate and adenoidal hypertrophy , presence of biofilm , and blockage of ostiomeatal complex ( OCM ) . In conclusion , this study provides the first evidence that Agnano crenotherapy may be capable of preventing RRI  in children as it exerts some positive effects , such as reduction of nasal obstruction , OCM blockage , biofilm , and inflammatory events OBJECTIVE This prospect i ve , r and omized , and controlled study examined the effects of normal saline and selenium-enriched hot spring water on experimentally induced rhinosinusitis in rats . METHODS The study comprised two control groups ( untreated and saline-treated ) and three experimental groups of Sprague Dawley rats . The experimental groups received an instillation of lipopolysaccharide ( LPS ) only , LPS+normal saline ( LPS/saline ) , or LPS+selenium-enriched hot spring water ( LPS/selenium ) .  Histopathological changes were identified using hematoxylin-eosin staining . Leakage of exu date was identified using fluorescence microscopy . Microvascular permeability was measured using the Evans blue dye technique . Expression of the Muc5ac gene was measured using reverse transcription-polymerase chain reaction . RESULTS Mucosal edema and expression of the Muc5ac gene were significantly lower in the LPS/saline group than in the LPS group . Microvascular permeability , mucosal edema , and expression of the Muc5ac gene were significantly lower in the LPS/selenium group than in the LPS group . Mucosal edema was similar in the LPS/selenium group and LPS/saline group , but capillary permeability and Muc5ac expression were lower in the LPS/selenium group . CONCLUSIONS This study shows that normal saline and selenium-enriched hot spring water reduce inflammatory activity and mucus hypersecretion in LPS-induced rhinosinusitis in rats 42 patients ( 27 women and 15 men aged 14 - 65 years ) suffering from atopic and non atopic rhinitis were su bmi tted for 24 days to the subterraneo-therapy in salt chambers of Kinga Spa in Wieliczka during the exacerbation of their illness . 20 patients suffered from pollen or dust mites allergy and the next 22 patients from non atopic rhinitis with recurrent nasal polyposis . In the first week and at the end of the therapy rhinoscopy , peak nasal inspiratory flow and smell were evaluated as well as daily symptoms score was noted in each treated patient . The results of performed observations indicate that un 
    Output:
    
Conclusion .
Thermal water applications with radon or sulphur can be recommended as additional nonpharmacological treatment in upper airway diseases .