***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 Influenza and its complications are common at all ages , especially in children .  Vaccines and anti-influenza drugs aim to prevent it . Preventative approaches with favorable risk profiles should be considered for flu , particularly since the evidence of the efficacy of anti-viral drugs is debated . METHODS This pragmatic clinical trial was conducted in the Brazilian Public Health System in Petrópolis ( BPHSP ) with children aged from 1 to 5 years old . The medications used were mainly selected based on in vitro experiments ( InfluBio ) , and in successful qualitative clinical experiences ( Homeopathic Complex ) . Following informed parental consent , subjects were r and omly distributed , in a blind manner , to three experimental groups : Homeopathic Complex , Placebo , and InfluBio . BPHSP health agents collected flu and acute respiratory infection symptomatic episodes monthly following the established protocol . The number of these episodes was registered in one year ( 2009 - 2010 ) . RESULTS Out of the 600 children recruited , 445 ( 74.17 % ) completed the study ( 149 : Homeopathic complex ; 151 :  Placebo ; 145 : InfluBio ) . The number of flu and acute respiratory infection symptomatic episodes detected in this clinical trial was low ; however , it was different between homeopathic groups and placebo ( p < 0.001 ) . In the first year post-intervention , 46/151 ( 30.5 % ) of children in the placebo group developed 3 or more flu and acute respiratory infection episodes , while there was no episode in the group of 149 children who used Homeopathic Complex , and only 1 episode in the group of 145 ( 1 % ) children who received InfluBio . CONCLUSION These results suggested that the use of homeopathic medicines minimized the number of flu and acute respiratory infection symptomatic episodes in children , signalizing that the homeopathic prophylactic potential should be investigated in further studies OBJECTIVE To assess the effectiveness of a homeopathic ear drop for treatment of  otalgia in children with acute otitis media ( AOM ) . METHODS Children with AOM were enrolled in the study at the time of diagnosis and r and omized to receive either st and ard therapy alone or st and ard therapy plus a homeopathic ear drop solution that was to be used on as needed basis for up to 5 days . Parents of children in both treatment groups rated the severity of 5 AOM symptoms twice daily for 5 days in a symptom diary . A symptom score was computed for each assessment with lower scores denoting less severe symptoms . Parents of children r and omized to receive ear drops also recorded information regarding symptoms being treated and response to treatment . RESULTS A total of 119 eligible children were enrolled in the study ; symptom diaries were received from 94 ( 79 % ) . Symptom scores tended to be lower in the group of children receiving ear drops than in those receiving st and ard therapy alone ; these differences were significant at the second and third assessment s ( P = 0.04 and P = 0.003 , respectively ) . In addition , the rate of symptom improvement was faster in children in the ear drop group compared with children in st and ard therapy alone group ( P = 0.002 ) . The most common reason for administration of ear drops was ear pain , recorded for 93 doses ; improvement was noted after 78.4 % of doses for this indication . There were no significant side effects related to use of the ear drops . CONCLUSIONS This study suggests that homeopathic ear drops were moderately effective in treating otalgia in children with AOM and may be most effective in the early period after a diagnosis of AOM . Pediatricians and other primary health care providers should consider homeopathic ear drops a useful adjunct to st and ard therapy OBJECTIVE To pilot a model for determining whether homoeopathic treatment of children suffering from glue ear is more effective than st and ard GP care at producing a return to normal hearing ( a hearing loss of less than 20 dB ) within 12 months . DESIGN Non-blind , r and omized controlled trial . SETTING General practice in two locations in southern Engl and . SUBJECTS Thirty-three children aged 18 months to 8 years with otitis media with effusion , hearing loss > 20 dB and an abnormal tympanogram . OUTCOME MEASURES Hearing loss , tympanogram , referrals to specialists and number of courses of antibiotics at 12 month follow-up . RESULTS A higher proportion of children receiving homoeopathic care had a hearing loss less then 20 dB at follow-up ( 64 vs 56 % ) , though this difference did not reach statistical significance ( 95 % confidence interval for the difference between means of -25 and 42 % ) . More homoeopathy patients than controls had a normal tympanogram ( 75 vs 31 % , P = 0.015 ) . Referrals to specialists and antibiotic consumption was lower in the homoeopathy group , though differences between groups did not reach statistical significance . CONCLUSION Further research comparing homoeopathy to st and ard care is warranted . Assuming recovery rates of 50 and 30 % in homoeopathy and st and ard care groups respectively , 270 patients would be needed for a definitive trial Background The present study was initiated to investigate the effectiveness , safety and tolerability of complex homeopathic CalSuli-4 - 02 tablets on prevention of recurrent acute upper respiratory tract infections ( URTIs ) in children , in comparison to another complex homeopathic product . Methods The study was design ed as a prospect i ve , multicenter , r and omized , open , clinical trial with two parallel treatment groups at four outpatient pediatric clinics in Russia . Children aged ≤ 6 years with susceptibility to acute URTIs ( ≥ three occasions during the last 6 months ) were r and omized to receive either CalSuli-4 - 02 or a comparator homeopathic product ( control group ) for 3 weeks . Primary outcome was the frequency of acute URTIs after 3 and 6 months post-treatment follow-up . Secondary endpoints were changes in complaints and symptoms ( total and individual scores ) , treatment satisfaction , antibiotic use , safety and tolerability . Results The intention-to-treat analysis involved 200 children ( CalSuli-4 - 02 : N = 99 , Control : N = 101 ) . In both treatment groups , the median number of acute URTIs was one for 3 months and two , respectively , for the full 6 months post-treatment ( Relative Risk : 0.86 ( 95 % -CI : 0.72–1.03 ) , p = 0.1099 ) . Seasons had no influence on the outcome . At the end of study , CalSuli-4 - 02 had overall higher odds of getting lower complaints severity total score ( Odds ratio : 1.99 ( 95 % -CI : 1.31–3.02 ) , p = 0.0012 ) and showing symptom improvement ( Odds ratio : 1.93 ( 95 % -CI : 1.25–3.00 ) , p = 0.0033 ) . Specifically , the complaint “ appetite disorder ” and the symptom “ child ’s activities ” significantly improved more in the CalSuli-4 - 02 group ( p = 0.0135 and p = 0.0063 , respectively ) . Antibiotic use was decreased in both treatment groups at the study end . Overall assessment for satisfaction with and tolerability of treatment was higher with CalSuli-4 - 02 . A low number of non-serious adverse drug reactions was reported ( CalSuli-4 - 02 : N = 4 , Control : N = 1 ) . Conclusions Both complex homeopathic products led to a comparable reduction of URTIs . In the CalSuli-4 - 02 group , significantly less URTI-related complaints and symptoms and higher treatment satisfaction and tolerability were detected . The observation that the use of antibiotics was reduced upon treatment with the complex homeopathic medications , without the occurrence of complications , is interesting and warrants further investigations on the potential of CalSuli-4 - 02 as an antibiotic sparing option . Clinical trial registration numberRoszdravnadzor : Study No BACKGROUND Acute viral tonsillitis is an upper respiratory tract infection prevalent in school-aged children . Because this condition is self-limiting , conventional treatment options are usually palliative . Homeopathic remedies are a useful alternative to conventional medications in acute uncomplicated upper respiratory tract infections in children , offering earlier symptom resolution , cost-effectiveness , and fewer adverse effects . This study aim ed to determine the efficacy of a homeopathic complex on the symptoms of acute viral tonsillitis in African children in South Africa . METHODS This was a r and omized , double-blind , placebo-controlled , 6-day pilot study . Thirty children , age 6 to 12 years , with acute viral tonsillitis were recruited from a primary school in Gauteng , South Africa . Participants took two tablets of the medication four times daily . The treatment group received lactose tablets medicated with the homeopathic complex ( Atropa belladonna D4 , Calcarea phosphoricum D4 , Hepar sulphuris D4 , Kalium bichromat D4 , Kalium muriaticum D4 , Mercurius protoiodid D10 , and Mercurius biniodid D10 ) . The placebo consisted of the unmedicated vehicle only . The Wong-Baker FACES Pain Rating Scale measured pain intensity , and a Symptom Grading Scale assessed changes in tonsillitis signs and symptoms . RESULTS The treatment group had a statistically significant improvement in the following symptoms compared with the placebo group : pain associated with tonsillitis , pain on swallowing , erythema and inflammation of the pharynx , and tonsil size . CONCLUSION The homeopathic complex used in this study exhibited significant anti-inflammatory and pain-relieving qualities in children with acute viral tonsillitis . No patients reported any adverse effects . These preliminary findings are promising ; however , the sample size was small and therefore a definitive conclusion can not be reached . A larger , more inclusive research study should be undertaken to verify the findings of this study We investigated the clinical effectiveness of a homeopathic add-on therapy in a pediatric sub population with upper respiratory tract infections ( URTI ) in a r and omized , controlled , multinational clinical trial . Patients received either on-dem and symptomatic st and ard treatment ( ST-group ) or the same ST plus a homeopathic medication ( Influcid ; IFC-group ) for 7 days . Outcome assessment was based on symptom and fever resolution and the Wisconsin Upper Respiratory Symptom Survey–21 ( WURSS-21 ) . A total of 261 pediatric ( < 12 years ) patients ( 130 IFC-group ; 131 ST-group ) were recruited in Germany and the Ukraine . The IFC-group used less symptomatic medication , symptoms resolved significantly earlier ( P = .0001 ) , had higher proportions of fever-free children from day 3 onwards , and the WURSS-assessed global disease severity was significantly less ( P < .0001 ) during the entire URTI episode . One adverse event ( vomiting ) was possibly related to IFC . IFC as add-on treatment in pediatric URTI reduced global disease severity , shortened symptom resolution , and was safe in use Cough is a frequent symptom associated to upper respiratory tract infections ( URTIs ) and , although being self-limiting , it might deeply affect the quality of life . Homeopathic products are often employed by patients to treat cough , but the evidence on their efficacy is scarce . Thus , we tested the efficacy of a homeopathic syrup in treating cough arising from URTIs with a r and omized , double blind , placebo controlled clinical trial . Patients were treated with either the homeopathic syrup or a placebo for a week , and recorded cough severity in a diary by means of a verbal category-descriptive score for two weeks . Sputum viscosity was assessed with a viscosimeter before and after 4 days of treatment ; patients were also asked to provide a subjective evaluation of viscosity .  Eighty patients were r and omized to receive placebo ( n = 40 ) or the homeopathic syrup ( n = 40 ) . All patients completed the study . In each group cough scores decreased over time , however , after 4 and 7 days of treatment , cough severity was significantly lower in the homeopathic group than in the placebo one ( p < 0.001 and p = 0.023 , respectively ) . Sputum was collected from 53 patients : in both groups its viscosity significantly decreased after 4 days of treatment ( p < 0.001 ) ; however , viscosity was significantly lower in the homeopathic group ( p = 0.018 ) . Instead , the subjective evaluation did not significantly differ between the two groups ( p = 0.059 ) . No adverse events related to any treatment were reported . We concluded that the homeopathic syrup employed in the study was able to effectively reduce cough severity and sputum viscosity , thereby representing a valid remedy for the management of acute cough induced by URTIs BACKGROUND The use of antibiotics in the initial treatment of acute otitis media is currently being question ed . Homeopathy has been used historically to treat this illness , but there have been no method ologically rigorous trials to determine whether there is a positive treatment effect . METHODS A r and omized double blind placebo control pilot study was conducted in a private pediatric practice in Seattle , WA . Seventy-five children ages 18 months to 6 years with middle ear effusion and ear pain and /or fever for no more 
    Output:
    
Pooling of two prevention and two treatment studies did not show any benefit of homeopathic medicinal products compared to placebo on recurrence of ARTI or cure rates in children .
We found no evidence to support the efficacy of homeopathic medicinal products for ARTIs in children .