***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: Allergic rhinitis ( AR ) is highly prevalent in children .  Olopatadine , 0.6 % nasal spray ( olopatadine ) is approved for the relief of seasonal allergic rhinitis ( SAR ) symptoms in children 6 years of age and older . The objective of this study is to provide a comprehensive report of all clinical studies conducted with olopatadine in children with SAR . A pooled analysis was conducted of 2 r and omized , double-blind , 2-week , IRB-approved studies that compared olopatadine with placebo ( 1 spray/nostril twice-daily ) in patients 6 - 11 years of age with SAR . Assessment s included the reflective total nasal symptom score ( rTNSS ) and total ocular symptom score ( rTOSS ) , the Pediatric Rhinoconjunctivitis Quality -of-Life Question naire ( PRQLQ ) , and the Caregiver Treatment Satisfaction Question naire for Allergic Rhinitis ( CGTSQ-AR ) . Safety results were reported for these studies in combination with a pediatric pharmacokinetic study . Olopatadine was superior to placebo for mean decrease in rTNSS ( p = 0.0012 ) and rTOSS ( p = 0.0094 ) , mean decrease in overall PRQLQ score ( p = 0.0003 ) , and mean summary CGTSQ AR score ( p = 0.0013 ) ; ( n = 944 ) . The most frequently reported treatment-related events in the olopatadine group were epistaxis and dysgeusia ( bad taste ) ( n = 1,046 ) . For SAR treatment in patients 6 - 11 years of age , olopatadine was superior to placebo in reducing the symptoms of SAR , improving quality of life , and satisfying caregivers .  Olopatadine is a safe and effective treatment for SAR patients as young as 6 years of age and it has been demonstrated to reduce disease impact on the lives of these children and their families Fluticasone propionate ( FP ) is a topical corticosteroid with minimal systemic activity . We examined safety and compared the efficacy of FP aqueous nasal spray , 200 micrograms every day with loratadine tablets , 10 mg by mouth every day in 240 adolescents with ragweed pollen-induced seasonal allergic rhinitis for 4 weeks in a r and omized , double-blind , parallel-group study . Nasal and eye symptoms were recorded daily on a 4-point ( 0 to 3 ) scale . A higher percentage of symptom-free days was observed for nasal blockage on waking during treatment with FP ( p < 0.0001 ) . Significant results were also obtained for all other nasal symptoms when analyzed for both symptom-free days and symptom scores . No differences were found for eye irritation symptoms ( p = 0.14 ) . Morning and evening nasal peak inspiratory flow ( PIF ) was recorded daily by 57 subjects . FP treatment was associated wit significantly higher PIF values than loratadine both morning ( p = 0.0051 ) and evening ( p = 0.0036 ) . A greater improvement over 4 weeks was observed for PIF morning values in the FP group ( p = 0.008 ) but not for evening values ( p = 0.358 ) . Statistically significant correlations were found for nasal blockage and PIF in the morning ( r = -0.54 , p = 0.0001 ) and in the evening ( r = -0.46 , p = 0.008 ) Olopatadine ( OLO ) nasal spray 0.6 % is indicated for treatment of seasonal allergic rhinitis ( SAR ) in subjects > or = 12 years of age . This study was design ed to present the results of two studies that evaluated the efficacy , safety , and pharmacokinetics ( PK ) of OLO in children with allergic rhinitis ( AR ) . These were multicenter , double-blind , r and omized , parallel-group studies in subjects 6 to < 12 years of age ( study 1 ) and 2 to < 6 years of age ( study 2 ) with SAR ( study 1 ) or AR ( study 2 ) . In study 1 , nasal and ocular symptoms were scored for efficacy , and study 2 included PK analyses . In both studies , subjects were evaluated based on physical/nasal examinations and adverse events ( AEs ) . Overall , 1188 subjects ( study 1 ) and 132 subjects ( study 2 ) were r and omized , respectively . OLO ( 1 or 2 sprays/nostril , b.i.d . ) was superior to vehicle in the percent decrease in reflective total nasal symptom scores ( p < or = 0.0120 ) . OLO 1 spray/nostril b.i.d . was also superior to vehicle in the percent decreases in reflective total ocular symptom scores ( p < or = 0.0084 ) , change from baseline in Pediatric Rhinoconjunctivitis Quality -of-Life Question naire scores ( p < or = 0.0377 ) , Caregiver Treatment Satisfaction Question naire scores ( p < or = 0.0450 ) , and proportions of subjects reporting improvements in Subject Global Assessment s ( p = 0.0035 ) . The most frequently reported treatment-related events in the OLO group were bad/bitter taste and epistaxis . In subjects 6 to < 12 years of age , OLO was superior to vehicle in the treatment of SAR . In subjects 2 to < 12 years of age , OLO had an overall low rate of AEs and low systemic exposure tion of both CP and cisplatin . Hypersensitivity to mannitol was reported as a cause of apparent hypersensitivity to cisplatin . 6 In case 2 the result of a skin test with mannitol was negative , whereas the result of a skin test with the commercial formulation containing CP and mannitol was positive , suggesting that CP was solely responsible for the hypersensitivity reaction . In addition to the clinical tolerance induced by the desensitization protocol , skin responses to intradermal CP  diminished . As shown in Table I , the ratio between wheal sizes of CP and histamine decreased more than 3.5 times after the desensitization . The observation of wheal- and -flare responses becoming negative has already been described in penicillin desensitization . 7 This phenomenon supports an antigen-specific desensitization . The rate at which the drug concentration increases in the extracellular fluid seems to be the most important factor in a successful outcome of desensitization . As suggested by our two patients , this rate can differ in each individual case . We conclude that the 4-hour desensitization protocol may not be suitable for all patients allergic to CP  , whereas a modified prolonged protocol seems to be more tolerable . Until further data have been accumulated , the short protocol may be at tempted initially but should be replaced by the prolonged protocol if adverse effects appear . The prolonged protocol seems to be both safe and efficacious with regard to anti tumor activity BACKGROUND We wondered whether short-term coseasonal sublingual immunotherapy ( SLIT ) can reduce the development of  asthma in children with hay fever in an open r and omized study . OBJECTIVE We sought to determine whether SLIT is as effective as subcutaneous immunotherapy in reducing hay fever symptoms and the development of asthma in children with hay fever . METHODS One hundred thirteen children aged 5 to 14 years ( mean age , 7.7 years ) with hay fever limited to grass pollen and no other clinical ly important allergies were r and omized in an open study involving 6 Italian pediatric allergy centers to receive specific SLIT for 3 years or st and ard symptomatic therapy . All of the subjects had hay fever symptoms , but at the time of study entry , none reported seasonal asthma with more than 3 episodes per season . Symptomatic treatment was limited to cetirizine , loratadine , nasal budesonide , and salbutamol on dem and . The hay fever and asthma symptoms were quantified clinical ly . RESULTS The actively treated children used less medication in the second and third years of therapy , and their symptom scores tended to be lower . From the second year of immunotherapy , subjective evaluation of overall allergy symptoms was favorable in the actively treated children . Development of asthma after 3 years was 3.8 times more frequent ( 95 % confidence limits , 1.5 - 10.0 ) in the control subjects . CONCLUSIONS Three years of coseasonal SLIT improves seasonal allergic rhinitis symptoms and reduces the development of seasonal asthma  in children with hay fever BACKGROUND Concern has been directed at the relative sedating properties of lipophilic and lipophobic antihistamines , but few studies have sought to determine the comparative benefit of seasonal allergic rhinitis ( SAR ) treatments in controlling symptoms and consequently improving alertness . OBJECTIVE To compare the relative contributions of fluticasone propionate aqueous nasal spray and loratadine in enhancing daytime performance in 8- to 17-year-old children . METHODS All participants had a documented history of SAR , positive response to a skin prick ( wheal 3-mm greater than negative control or equal to the positive control ) for seasonal aeroallergens , and clinical ly identifiable symptoms at the time of r and omization . Following confirmation during baseline of current SAR symptoms , participants were r and omized to 1 of the 2 treatments and returned 2 weeks later for evaluation of symptom control , quality of life , attention , reaction time , and memory . RESULTS Children in the fluticasone propionate aqueous nasal spray group but not the loratadine group demonstrated improvement in nasal symptoms , nasal quality of life score , and composite verbal memory . No differences were identified on any scores from the Conners Continuous Performance Test . CONCLUSIONS Treatments that most effectively control SAR symptoms are also likely to provide the greatest benefit to children whose daytime functioning , including their capacity to learn at school , is compromised by their illness BACKGROUND Nasal obstruction is recognized as an important cause of sleep disordered breathing . Congestion of the nasal mucosa and obstruction are common symptoms of allergic rhinitis .  Daytime sleepiness is a common finding in symptomatic allergic rhinitis . Effective therapy of the nasal congestion of allergic rhinitis should alter sleep patterns in patients with symptomatic allergic rhinitis . OBJECTIVE To measure objective changes in polysomnograms ( sleep studies ) of children with allergic rhinitis before and after therapy with intranasal budesonide and to measure changes in the quality of life of these patients during treatment . METHODS Open clinical trial with objective measurements  ( polysomnography )  and subjective data  ( Rhinitis Quality of Life Question naire [ RQLQ ] )  . Evaluations were performed before , during , and at completion of therapeutic intervention . RESULTS The 14 studied children tolerated the procedures and treatment without problems . The mean number of sleep arousals per hour ( all apneas and hypopneas ) decreased from a baseline of 8.4 to 1.2 ( P = .005 ) after treatment . The change was mainly in hypopneic episodes ( 7.5 - 0.9 , P = .003 ) . Objective responses on the RQLQ showed improvements consistent with improved sleep and lessened rhinitis symptoms . CONCLUSIONS Decreasing the nasal congestion associated with allergic rhinitis can improve sleep measured by objective sleep studies and lead to improvement in daytime quality of life BACKGROUND Children with allergic rhinitis are likely to develop asthma . OBJECTIVE The purpose of this investigation was to determine whether specific immunotherapy can prevent the development of asthma and reduce bronchial hyperresponsiveness in children with seasonal allergic rhinoconjunctivitis . METHODS From 6 pediatric allergy centers , 205 children aged 6 to 14 years ( mean age , 10.7 years ) with grass and /or birch pollen allergy but without any other clinical ly important allergy were r and omized either to receive specific immunotherapy for 3 years or to an open control group . All subjects had moderate to severe hay fever symptoms , but at inclusion none reported asthma with need of daily treatment . Symptomatic treatment was limited to loratadine , levocabastine , sodium cromoglycate , and nasal budesonide .  Asthma was evaluated clinical ly and by peak flow . Methacholine bronchial provocation tests were carried out during the season(s ) and during the winter . RESULTS Before the start of immunotherapy , 20 % of the children had mild asthma symptoms during the pollen season(s ) . Among those without asthma , the actively treated children had significantly fewer asthma symptoms after 3 years as evaluated by clinical diagnosis ( odds ratio , 2.52 ; P < .05 ) . Methacholine bronchial provocation test results improved significant in the active group ( P < .05 ) . CONCLUSION Immunotherapy can reduce the development of asthma in children with seasonal rhinoconjunctivitis BACKGROUND There has been no study comparing the long-term effects of ketotifen , oxatomide , and cetirizine for the treatment of perennial allergic rhinitis among children . OBJECTIVE We conducted a study to compare the efficacy of the three agents for the treatment of perennial allergic rhinitis among children . METHODS The study consisted of a double-blind , placebo-controlled , r and omized design , comprising 69 perennial allergic rhinitis patients with mite allergy , aged 6 to 12 years , r and omly assigned to 1 of 4 test treatment groups for 3 months : 19 in the cetirizine group ( 10 mg daily ) , 18 in the ketotifen group ( 1 mg , twice daily ) , 
    Output:
    
All medication classes improved impairment related to AR , but between-treatment comparisons were limited because of different assessment s. Intranasal steroids improved risk outcomes associated with asthma and obstructive sleep apnea .
Small single studies suggested possible effects of oral antihistamines on asthma and sleep-disordered breathing .
Treatment of AR , particularly with intranasal steroids , improves disease control in children by reducing disease-associated impairment and risk .
All AR medications with proved efficacy probably improve impairment , paralleling symptom reduction .
Intranasal steroids may reduce the likelihood of comorbidities that increase health care use .