***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: 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 Seventy-four children from three weeks to two years of age with various upper respiratory symptoms were r and omly assigned to three groups : two intervention groups ( saline nose drops ; medicated nose drops ) and a control group ( no nose drops ) . Forty-six children returned for check-up two days later . Subjects in all three groups improved between first and second contact . There was no significant difference between the three groups . It is concluded that medicated nose drops are not essential in the treatment of upper respiratory infection and rhinitis OBJECTIVE To evaluate the efficacy of the atomized nasal douche in the restoration of physiological nasal functions in patients affected by acute viral rhinosinusitis , when compared with nasal lavages with isotonic sodium chloride solution . DESIGN R and omized clinical trial . SETTING The ENT Department at the University of Siena Medical School . PATIENTS Two hundred patients affected by acute viral rhinosinusitis were included in the study . INTERVENTIONS Patients were r and omly divided into 2 groups : group 1 patients received an atomized nasal douche , and group 2 patients received nasal lavages with isotonic sodium chloride solution . Patients underwent treatments 4 times per day for 15 days in our institution under our direct control . RESULTS Atomized nasal douches significantly improved inspiratory and expiratory rhinomanometric resistance ( P<.01 ) and nasal volumes measured by acoustic rhinometry ( P<.001 ) . Nasal lavages were unable to modify these variables significantly ( P<.3 ) . Only atomized nasal douches were able to normalize mucociliary transport time to a physiological level ( P<.001 ) . CONCLUSIONS The atomized nasal douche demonstrated a better efficacy than traditional nasal lavages with isotonic sodium chloride solution in restoring all the physiological nasal functions . For this reason , and considering ease of use , painlessness , cheapness , and manageability of the instrument , we suggest the use of the compressor-micronizer chamber system ( Rinoflow Nasal Wash & Sinus System ) as a routine adjuvant to every treatment of acute rhinopathies Recent evidence suggests that nasal irrigation with hypertonic saline may be useful as an adjunctive treatment modality in the management of many sinonasal diseases . However , no previous studies have investigated the efficacy of this regimen in the prevention of seasonal allergic rhinitis-related symptoms in the pediatric patient . Twenty children with seasonal allergic rhinitis to Parietaria were enrolled in the study . Ten children were r and omized to receive three-times daily nasal irrigation with hypertonic saline for the entire pollen season , which had lasted 6 weeks . Ten patients were allocated to receive no nasal irrigation and were used as controls . A mean daily rhinitis score based on the presence of nasal itching , rhinorrea , nasal obstruction and sneezing was calculated for each week of the pollen season . Moreover , patients were allowed to use oral antihistamines when required and the mean number of drug assumption per week was also calculated . In patients allocated to nasal irrigation , the mean daily rhinitis score was reduced during 5 weeks of the study period . This reduction was statistically significantly different in the 3th , 4th and 5th week of therapy . Moreover , a decreased consumption of oral antihistamines was observed in these patients . This effect became evident after the second week of treatment and result ed in statistically significant differences during the 3th , 4th and 6th week . This study supports the use of nasal irrigation with hypertonic saline in the pediatric patient with seasonal allergic rhinitis during the pollen season . This treatment was tolerable , inexpensive and effective OBJECTIVE To evaluate the potential of nasal isotonic saline application to prevent reappearance of cold and flu in children during the winter . DESIGN Prospect i ve , multicenter , parallel-group , open , and r and omized comparison . SETTING Eight pediatric outpatient clinics . PATIENTS A total of 401 children ( aged 6 - 10 years ) with uncomplicated cold or flu . INTERVENTIONS We r and omly assigned patients to 2 treatment groups , one with just st and ard medication , the other with nasal wash with a modified seawater solution ( Physiomer ) plus st and ard medication , and observed them for 12 weeks . MAIN OUTCOME MEASURES The primary efficacy end points were nasal symptoms resolution during acute illness ( visits 1 and 2 ) . We also looked for reappearance of cold or flu , consumption of medication , complications , days off school , and reported days of illness during the following weeks when preventive potential was evaluated ( visits 3 and 4 ) . RESULTS At visit 2 , patients in the saline group achieved primary end points ( measured on a 4-point numeric scale on which 1 indicated no symptoms and 4 , severe symptoms ) in the parameters nasal secretion and obstruction ( mean scores vs nonsaline group , 1.79 vs 2.10 and 1.25 vs 1.58 , respectively ) ( P < .05 for both ) . During the prevention phase ( at visit 3 , 8 weeks after study entry ) patients in the saline group showed significantly lower scores in sore throat , cough , nasal obstruction , and secretion ( P < .05 for all ) . By visit 3 , significantly fewer children in the saline group were using antipyretics ( 9 % vs 33 % ) , nasal decongestants ( 5 % vs 47 % ) , mucolytics ( 10 % vs 37 % ) , and systemic antiinfectives ( 6 % vs 21 % ) ( P < .05 for all ) . During the same period children in the saline group also reported significantly fewer illness days ( 31 % vs 75 % ) , school absences ( 17 % vs 35 % ) , and complications ( 8 % vs 32 % ) ( P < .05 for all ) . Similar results were found at the final visit . CONCLUSION Children in the saline group showed faster resolution of some nasal symptoms during acute illness and less frequent reappearance of rhinitis subsequently OBJECTIVES /HYPOTHESIS Nasal disease , including chronic rhinosinusitis and allergic rhinitis , is a significant source of morbidity . Nasal irrigation has been used as an adjunctive treatment of sinonasal disease . However , despite an abundance of anecdotal reports , there has been little statistical evidence to support its efficacy . The objective of this study was to determine the efficacy of the use of pulsatile hypertonic saline nasal irrigation in the treatment of sinonasal disease . STUDY DESIGN A prospect i ve controlled clinical study . METHODS Two hundred eleven patients from the University of California , San Diego ( San Diego , CA ) Nasal Dysfunction Clinic with sinonasal disease ( including allergic rhinitis , aging rhinitis , atrophic rhinitis , and postnasal drip ) and 20 disease-free control subjects were enrolled . Patients irrigated their nasal cavities using hypertonic saline delivered by a Water Pik device using a commercially available nasal adapter twice daily for 3 to 6 weeks . Patients rated nasal disease-specific symptoms and completed a self-administered quality of well-being question naire before intervention and at follow-up . RESULTS Patients who used nasal irrigation for the treatment of sinonasal disease experienced statistically significant improvements in 23 of the 30 nasal symptoms queried . Improvement was also measured in the global assessment of health status using the Quality of Well-Being scale . CONCLUSIONS Nasal irrigation is effective in improving symptoms and the health status of patients with sinonasal disease OBJECTIVE To determine whether hypertonic saline nasal spray relieves nasal symptoms and shortens illness duration in patients with the common cold or acute rhinosinusitis . DESIGN R and omized trial with 2 control groups . SETTING Two family practice clinics . PARTICIPANTS One hundred forty-three adult patients with a cold or sinus infection . Patients with allergic rhinitis , symptoms for more than 3 weeks , or other respiratory diagnoses were excluded , as were those who had used topical decongestants . INTERVENTION Hypertonic saline or normal saline spray 3 times a day or observation . Subjects completed a  
    Output:
    
Most results showed no difference between nasal saline treatment and control .
The trial also showed a significant reduction in the use of decongestant medication by the saline group .
Nasal saline irrigation possibly has benefits for relieving the symptoms of acute URTIs .