***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: 60 patients , aged 15 - 51 years , with chronic allergic or bacterial maxillary sinusitis , were entered in a controlled , double-blind study comparing the efficacy of endonasal irrigations of tixocortol pivalate (Pivalone)-neomycin and neomycin . The treatment lasted 11 days and was administered once daily . A ventilometric measurement of sinus pressure was performed every two endonasal irrigations to assess treatment efficacy . The percentage of nasal deobstruction was significantly higher with tixocortol pivalate-neomycin than with neomycin alone by the fifth examination ( 9th day ) regardless of the etiology of the sinusitis ( allergic or bacterial ) . After 11 days of treatment , significantly better results were obtained in cases of bacterial sinusitis ( 94 % deobstruction with tixocortol pivalate-neomycin versus 74 % with neomycin ) than in cases of allergic sinusitis ( 69 % deobstruction with tixocortol pivalate-neomycin versus 36 % with neomycin ) BACKGROUND Chronic sinusitis ( CS ) is a common disease in children , especially those with allergies , that is caused by impaired drainage from the sinuses . Hypertonic NaCl solution has been shown to increase mucociliary clearance and ciliary beat frequency . OBJECTIVE We performed a r and omized double blind study to compare the effect of nasal wash with hypertonic saline ( HS ) ( 3.5 % ) versus normal saline ( NS ) ( 0.9 % ) on CS . METHODS Thirty patients with CS aged 3 to 16 years were studied . They were r and omly divided into two treatment groups matched by age and severity of the disease . Each individual was treated with either HS or NS for 4 weeks . All patients were evaluated by two clinical scores ( cough and nasal secretions/postnasal drip [ PND ] ) and by a radiology score at the beginning of the study and after 4 weeks . RESULTS The HS group improved significantly in all scores ( average + /- SD ) : cough score , from 3.6 + /- 0.51 to 1.6 + /- 0.74 ; nasal secretion/PND score , from 2.86 + /- 0.35 to 1.6 + /- 0.74 ; and radiology score , from 8.06 + /- 1.28 to 2.66 + /- 1.04 . The NS treatment group showed significant improvement only in the PND score ( from 2.66 + /- 0.49 to 1.53 + /- 0.83 ) but no significant change in both the cough score ( from 3.53 + /- 0.52 to 3.33 + /- 0.49 ) and the radiology score ( from 8.13 + /- 1.25 to 7.86 + /- 0.91 ) . Clinical observation 1 month after the end of the study showed no change compared with the end of the study in both groups . CONCLUSION HS nasal wash is an efficient treatment of CS OBJECTIVES To test whether daily hypertonic saline nasal irrigation improves sinus symptoms and quality of life and decreases medication use in adult subjects with a history of sinusitis . STUDY DESIGN R and omized controlled trial . Experimental subjects used nasal irrigation daily for 6 months . POPULATION Seventy-six subjects from primary care ( n=70 ) and otolaryngology ( n=6 ) clinics with histories of frequent sinusitis were r and omized to experimental ( n=52 ) and control ( n=24 ) groups . OUTCOMES MEASURED Primary outcome measures included the Medical Outcomes Survey Short Form ( SF-12 ) , the Rhinosinusitis Disability Index ( RSDI ) , and a Single-Item Sinus-Symptom Severity Assessment ( SIA ) ; all 3 were completed at baseline , 1.5 , 3 , and 6 months . Secondary outcomes included daily assessment of compliance and biweekly assessment of symptoms and medication use . At 6 months , subjects reported on side effects , satisfaction with nasal irrigation , and the percentage of change in their sinus-related quality of life . RESULTS No significant baseline differences existed between the 2 groups . Sixty-nine subjects ( 90.8 % ) completed the study .  Compliance averaged 87 % . Experimental group RSDI scores improved from 58.4 -/+ 2.0 to 72.8 -/+ 2.2 ( P < or = .05 ) compared with those of the control group ( from 59.6 -/+ 3.0 to 60.4 -/+ 1.1 ) ; experimental group SIA scores improved from 3.9 -/+ 0.1 to 2.4 -/+ 0.1 ( P < or = .05 ) compared with those of the control group ( from 4.08 -/+ 0.15 to 4.07 -/+ 0.27 ) . The number needed to treat to achieve 10 % improvement on RSDI at 6 months was 2.0 . Experimental subjects reported fewer 2-week periods with sinus-related symptoms ( P < .05 ) , used less antibiotics ( P < .05 ) , and used less nasal spray ( P = .06 ) . On the exit question naire 93 % of experimental subjects reported overall improvement of sinus-related quality of life , and none reported worsening ( P < .001 ) ; on average , experimental subjects reported 57 -/+ 4.5 % improvement . Side effects were minor and infrequent . Satisfaction was high . We found no statistically significant improvement on the SF-12 . CONCLUSIONS Daily hypertonic saline nasal irrigation improves sinus-related quality of life , decreases symptoms , and decreases medication use in patients with frequent sinusitis . Primary care physicians can feel comfortable recommending this therapy BACKGROUND Nasal irrigation has been used as an adjunctive therapy of sinonasal disease including acute/chronic sinusitis and allergic rhinitis . Several published articles reported it also improves clinical sinus symptoms . OBJECTIVE To evaluate the effectiveness of normal saline nasal irrigation in the management of acute sinusitis in children . DESIGN This was a r and omized , prospect i ve placebo-controlled study . METHODS We included 69 participants with acute sinusitis . 30 of 69 participants underwent normal saline nasal irrigation . 39 of 69 participants were not receiving nasal irrigation . All participants performed nasal peak expiratory flow rate ( nPEFR ) test , nasal smear examination , radiography ( Water 's projection ) and requested to complete the Pediatric Rhinoconjunctivitis Quality of Life Question naires ( PRQLQ ) at the baseline visit . All participants were requested to record the symptom diary card every day and were followed-up every 1 week during this period . A physical examination , nasal smear and nPEFR were performed at each visit , and all daily diary cards collected . At the final visit , the symptoms diaries were review ed and participants were requested to complete the PRQLQ again . The nPEFR , radiography ( Water 's projection ) and nasal smear were also repeated . RESULTS Normal saline irrigation group significantly improved mean PRQLQ values and nPEFR values at medium ( T=2.816 , P<0.05 ) and final period ( T=2.767 , P<0.05 ) compared with the other group . Although there were no statically significant improving rate of radiography ( Water 's projection ) in among two groups ( T=0.545 , P>0.05 ) , but normal saline irrigation group was better than the other group . The improval rate of mean TSS in the irrigation group significantly improved all symptoms compared with the placebo group , in which rhinorrhea , nasal congestion , throat itching , cough and sleep quality improved . 27 of 66 ( 40.9 % ) participants with atopy , 16 of 27 ( 53.33 % ) participants underwent normal saline irrigation . Normal saline irrigation atopy group significantly improved rhinorrhea , nasal congestion , throat itching and sleep quality symptoms compared with non-irrigation atopy group . Normal saline irrigation atopy group significantly improved nPEFR values at final period ( Z=2.53 , P<0.05 ) . CONCLUSION This study evidence that normal saline nasal irrigation improves Pediatric Rhinoconjunctivitis Quality of Life and decreases acute sinusitis symptoms . Nasal irrigation is an effective adjunctive treatment for pediatric acute sinusitis .  Normal saline nasal irrigation in atopy children also improves allergic-related symptoms . We may need larger , longer and extended study to assess the conclusion Antibiotic abuse for treating rhinopharyngitis induces the occurrence of resistant bacteria . As topical drugs might reduce this phenomenon , the aims of our study are to evaluate inhaled thiamphenicol associated with acetylcysteine in children with acute bacterial rhinopharyngitis and to compare it with the use of saline solution . The trial was conducted as r and omized , parallel group , and single blind . Children , aged 3–6 years , with acute bacterial rhinopharyngitis were treated with aerosolized thiamphenicol associated with acetylcysteine ( 250 mg : ½ vial in the morning and ½ vial in the evening ) ( Group A ) or saline solution twice daily ( Group B ) , both of them for 5 days . Both treatments were administered using a new device : Rinowash . The following parameters were assessed : nasal obstruction , mucopurulent rhinorrhea , post-nasal drip , cough , sore throat , fever , and cultures . Of 104 patients screened , 90 children , median age 3.7 years ( 44 females and 46 males ) , completed the study : 60 in Group A and 30 in Group B. Actively-treated children achieved a significant improvement of all parameters , but fewer than the control group . In conclusion , inhaled thiamphenicol associated with acetylcysteine may represent a valid treatment for acute bacterial rhinopharyngitis in children , as it is effective , safe , economic , and simple to use BACKGROUND The role of topical corticosteroids in the treatment of acute sinusitis has not been established in children . OBJECTIVE An attempt was made to determine the impact of topical corticosteroids as an adjunct to antibiotic treatment in the management of childhood sinusitis . METHODS In a double-blind , placebo-controlled study , 151 children with sinusitis were recruited from a general pediatric outpatient clinic and 89 completed a 3-week trial . Treatment consisted of amoxicillin-clavulanate potassium , 40 mg/kg/d tid , combined with bid nasal spray of either budesonide , 50 micrograms , to each nostril ( n = 43 ) or placebo ) n = 46 _ for 3 weeks . Patients maintained daily symptom cards throughout the study and were examined by the same physician each week . RESULTS Clinical symptoms and signs decreased significantly in both treatment groups in comparison to baseline ( P < .01 ) . We detected a significant improvement in the scores of the cough and nasal discharge at the end of second week in the budesonide group when compared with placebo ( P < .05 ) . Friedman nonparametric repeated measures ANOVA test revealed a significant decrease in the total weekly scores of cough during the second week of budesonide treatment ( P < .001 ) in contrast to continuous decline during the second and third weeks in the placebo group ( P < .001 and P < .05 , respectively ) . While the nasal discharge score decreased significantly during the second week in the budesonide group ( P < .01 ) , no significant effect on the nasal discharge score was observed in the placebo group . CONCLUSION These data suggest that topical corticosteroids may be a useful ancillary treatment to antibiotics in childhood sinusitis and effective in reducing the cough and nasal discharge earlier in the course of acute sinusitis OBJECTIVE The objective of this r and omized , prospect i ve , double-blind study was to compare nasal irrigation using hypertonic Dead Sea salt ( DSS ) solution with hypertonic saline in the treatment of chronic rhinosinusitis and improvement of quality of life ( QOL ) . METHODS With Institutional Review Board approval , 42 adults seeking treatment for chronic rhinosinusitis in a tertiary university-affiliated medical center were studied . After history and endonasal examination , computed tomography imaging , and QOL survey ( St and ardized Rhinoconjunctivitis Quality of Life Question naire [ RQLQ(S ) ] ) , patients were r and omized to self-administered hypertonic saline spray and irrigation twice daily or hypertonic DSS spray and irrigation . Patients were reassessed weekly and at 1 month . RESULTS Both groups had similar symptoms and RQLQ(S ) scores before treatment and had significant improvement after treatment . However , the DSS patients had significantly better symptom relief and only the DSS group showed improved RQLQ(S ) scores . CONCLUSIONS We present a short-term study providing level I evidence on the superiority of DSS over saline nasal irrigation for treatment of chronic rhinosinusitis preparation , and phenylephrine plus nitrofurazone 0.02 per cent solution t as the test preparation . Each was dispensed in a plastic dropping container marked only with a code number ; neither patient nor physician knew to which group the patient had been assigned . All 100 patients ---541 in each group-were from a general practice in pediatrics and had purulent rhinitis . Each patient was provided Purulent  nasal discharge  
    Output:
    
There is no evidence to determine whether the use of antihistamines , decongestants or nasal irrigation is efficacious in children with acute sinusitis .