***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: OBJECTIVE --To assess the relation between breast feeding and subsequent experience of lower respiratory tract illness . DESIGN -- Prospect i ve ( from well child visits ) and retrospective ( from maternal recall ) study of breast feeding and prospect i ve assessment by paediatricians of lower respiratory tract illness in infants during first year of life . SETTING --Health maintenance organisation . PARTICIPANTS --Over 1000 infants who were healthy at birth and whose parents used the paediatricians of a local health maintenance organisation . MAIN OUTCOME MEASURES -- Duration of breast feeding and type of lower respiratory tract illness ( wheezing and non-wheezing ) at different age intervals during the first year of life . RESULTS --Breast feeding was associated with a decreased incidence of wheezing illnesses only in the first four months of life . Interactions existed between breast feeding and sharing a room , being Mexican American , and being a boy . Multivariate techniques showed that after controlling for a variety of factors children who received minimal breast milk had a greater risk of early wheezing illnesses ; the risk was further increased by simultaneous exposure to sharing a room . CONCLUSION --Breast feeding seems to protect against wheezing respiratory tract illnesses in the first four months of life , particularly when other risk factors are present Infectious asthma differs from extrinsic infection-triggered asthma in children . Only 25 % of children who have asthma attacks associated with infection have true infectious asthma . In a doubleblind study with placebos , infectious asthma was treated by hyposensitization with large doses of mixed respiratory bacterial vaccine . There was significant statistical benefit in the vaccine-treated patients , and similar results were obtained in a larger longitudinal prospect i ve study group with the method of paired data for controls . Indiscriminate use of such vaccines in asthma associated with infection is not justified and has less than one chance in four of being effective OBJECTIVE The aim of this study was to determine whether Echinacea purpurea given to children for the treatment of acute upper respiratory tract infection ( URI ) was effective in reducing the risk of subsequent URI . DESIGN This was a secondary analysis of data from a r and omized , double-blind , placebo-controlled trial of Echinacea for the treatment of URI in children . SETTING The study was conducted as a joint project between the Puget Sound Pediatric Research Network ( Seattle , WA ) and Bastyr University ( Kenmore , WA ) . PARTICIPANTS A total of 524 children ages 2 to 11 years were enrolled in the study . INTERVENTION Children were monitored for URIs over a 4-month observation period during the fall/winters of 2000 - 2001 and 2001 - 2002 . At entry the children were r and omized to receive Echinacea or placebo to treat acute URIs during the observation period . MAIN OUTCOME MEASURES The occurrence of a second URI and the number of days between the end of the first URI and the start of the second URI was ascertained . Survival and Cox regression analyses were used to determine whether children who took Echinacea for their URIs were less likely to develop subsequent URIs . RESULTS Among the 401 children with at least one URI treated with study medication , 69.2 % of those receiving placebo developed a second URI versus 55.8 % of those who received Echinacea . Use of Echinacea was associated with a 28 % decreased risk of subsequent URI ( p = 0.01 , 95 % confidence interval 8%-44 % decreased risk ) . CONCLUSIONS Echinacea purpurea may be effective in reducing the occurrence of subsequent URIs in children . However this finding needs to be replicated in a URI prevention trial The efficacy of Broncho-Vaxom/Imocur ( OM-85 BV ) , an orally administered lyophilized bacterial extract , for recurrent respiratory and ear , nose and throat ( ENT ) infections was evaluated in 116 children aged 6 months to 19 years by comparing its activity in 61 children with that of a placebo in 55 children . The study was r and omized , double-blind , and comprised a 90-day treatment period followed by a 90-day follow-up period without test drugs . Over the 180 days , 39.5 % of patients taking OM-85 BV  remained free from infection compared with 16.5 % on placebo ( p less than 0.01 ) . 44 % on OM-85 BV did not need antibiotics  compared with 23.5 % on placebo ( p less than 0.05 ) . These differences were even greater in the subgroup of children aged 6 years and less ( 34 vs. 3.5 % for the absence of infections , p less than 0.01 and 37 vs. 10 % for the need of antibiotics , p less than 0.05 ) . Tolerance to OM-85 BV was excellent , and laboratory investigations showed no abnormalities attributable to this product . This work confirms that the immunomodulator OM-85 BV is an effective immunotherapy for recurrent respiratory and ENT infections in children Background : Upper respiratory tract infections are a major source of morbidity throughout the world . Extracts of the root of North American ginseng ( Panax quinquefolium ) have been found to have the potential to modulate both natural and acquired immune responses . We sought to examine the efficacy of an extract of North American ginseng root in preventing colds . Methods : We conducted a r and omized , double-blind , placebo-controlled study at the onset of the influenza season . A total of 323 subjects 18–65 years of age with a history of at least 2 colds in the previous year were recruited from the general population in Edmonton , Alberta . The participants were instructed to take 2 capsules per day of either the North American ginseng extract or a placebo for a period of 4 months . The primary outcome measure was the number of Jackson-verified colds . Secondary variables measured included symptom severity , total number of days of symptoms and duration of all colds . Cold symptoms were scored by subjects using a 4-point scale . Results : Subjects who did not start treatment were excluded from the analysis ( 23 in the ginseng group and 21 in the placebo group ) , leaving 130 in the ginseng group and 149 in the placebo group . The mean number of colds per person was lower in the ginseng group than in the placebo group ( 0.68 [ st and ard deviation ( SD ) 0.82 ] v. 0.93 [ SD 0.91 ] , difference 0.25 % , 95 % confidence interval [ CI ] 0.04–0.45 ) . The proportion of subjects with 2 or more Jackson-verified colds during the 4-month period ( 10.0 % v. 22.8 % , 12.8 % difference , 95 % CI 4.3–21.3 ) was significantly lower in the ginseng group than in the placebo group , as were the total symptom score ( 77.5 [ SD 84.6 ] v. 112.3 [ SD 102.5 ] , difference 1.5 % , 95 % CI 1.2–2.0 ) and the total number of days cold symptoms were reported ( 10.8 [ SD 9.7 ] v. 16.5 [ SD 13.8 ] days , difference 1.6 % , 95 % CI 1.3–2.0 ) for all colds . Interpretation : Ingestion of a poly-furanosyl-pyranosyl-saccharide – rich extract of the roots of North American ginseng in a moderate dose over 4 months reduced the mean number of colds per person , the proportion of subjects who experienced 2 or more colds , the severity of symptoms and the number of days cold symptoms were reported The objective of this pilot study was to evaluate efficacy , tolerance and compliance of paediatric patients vis-à-vis a cycle of PMBL treatment ( a sublingual tablet taken for ten consecutive days over three consecutive months ) . The study enrolled 89 children ( 65 r and omised to the treated group and 24 to the control group ) . The study protocol included an enrolment check-up ( TO ) and follow-ups at two months ( T1 ) , three months ( T2 ) and nine months ( T3 ) following the end of treatment , during which episodes of RRI were recorded ; the main blood chemistry , immunology and phlogosis parameters were measured , together with hepatic , renal and bone marrow toxicity indexes . The administration of PMBL led to a significant decrease in RRI in the treated group , not only among the same children in relation to the previous winter , but also in comparison with untreated children during the same winter ( mean number of infective episodes per patient 7.84 vs. 4.78 , p<0.05 , in the first case ; 6.78 vs. 4.78 , p<0.05 , in the second case ) . White blood cell count showed a drop in the treated group as opposed to an increase in the untreated group , but there were no statistically significant differences in the intergroup analysis or in the intragroup one . Phlogosis indexes ( PCR and plasma mucoprotein ) in the treated group fell following treatment with PMBL , and this is statistically significant not only in the intragroup analysis but also the intergroup one . Mean values of B-lymphocytes in the treated group seemed to increase significantly following treatment , which was not the case in the untreated group . The variations in all the blood chemistry indexes for toxicity were far from significant and they remained within the norm , without significant clinical manifestations of side-effects of drug intolerance . As to evaluation of patient compliance , use of the device we describe enabled acceptable compliance with treatment even in the youngest children , similar to the compliance observed among appropriately motivated older children Abstract Isoprinosine , an in vitro immuno-enhancing agent principally acting by stimulating T-lymphocytes , is one of a number of agents sometimes used in an attempt to prevent recurrent respiratory infections in children , although there are no formal trials for this particular drug . We performed a placebo-controlled double-blind trial to assess the efficacy of isoprinosine ( 50 mg/kg per day ) for 6 weeks followed by 50 mg/kg per day twice weekly for 6 weeks in the prevention of frequent acute respiratory tract infections in 102 children aged 4–8 years . A total of 43 children treated with isoprinosine and 41 with placebo finished the study . Despite a transient increase in the total number of CD3 + , CD4 + and CD8 + T-lymphocytes after 6 weeks of daily isoprinosine treatment , there was no difference in the number and length of duration of acute respiratory infections , number of antibiotic courses and number of days with cough , pharyngitis , rhinitis and increased body temperature ( ≥37.0 ° C and ≥38.0 ° C ) . There were no changes in markers of T- or B-lymphocyte activation ( CD25 , HLA-DR , CD45RA/RO , CD23 ) . Conclusion Attempts at immunomodulation using isoprinosine in the dose and for the duration used may increase the total numbers of both CD4 and CD8 T-lymphocytes but is ineffective in prevention of respiratory tract infections in childhood BACKGROUND Recurrent acute respiratory tract infections ( RARTIs ) in children are related to IgG subclass deficiencies . The aim of the trial was to evaluate the effect of OM-85 BV in the number of RARTIs as well as in the IgG subclass levels . METHODS This was a r and omized , double-blind , placebo-controlled clinical trial . Patients of ages three to six years , having three or more documented ARTIs during the last six months with subnormal IgG subclass levels were included . Patients took either one capsule of OM-85 BV ( 3.5 mg ) or placebo orally every day for ten consecutive days per month during three consecutive months . Patients were followed three further months without drug intake . IgG subclass levels were determined before and after treatment . RESULTS IgG4 levels diminished after the OM-85 BV treatment ( -3 [ -8.0 , -1.0 ] median difference [ 95 % CI ] p < 0.05 by Wilcoxon test ) . No other significant changes in IgG subclasses were observed . After six months the patients in the OM-85 BV group ( n = 20 ) experienced 2.8 1.4 ( mean SD ) ARTIs , while the patients in the placebo group ( n = 20 ) suffered 5.2 1.5 ARTIs ( -2.4 [ 3.3 , -1.5 ] mean difference [ 95 % CI ] p < 0.001 by Student 's t test ) . Three patients with OM-85 BV had gastrointestinal events related to drug administration , as well as three placebo patients . CONCLUSION This study demonstrated the clinical benefit of OM-85 BV in patients suffering from RARTIs and subnormal levels of IgG subclasses . This trial opens new perspectives in the research of the mechanism of action of OM-85 BV BACKGROUND Acute respiratory tract infections ( ARTIs ) are among the main causes of morbidity and mortality in children . The bacterial extract OM-85 BV has shown some protective effect for ARTIs in preschool children and a reduction in exacerbations of chronic bronchitis in adults . OBJECTIVES This trial reports results of a double-masked , placebo-controlled , parallel-group clinical study that assessed the efficacy and tolerability of OM-85 BV in the prevention of ARTIs in school girls living in an orphanage . METHODS Two hundred girls ( age range , 6 to 13 years ) living in an orphan 
    Output:
    
No difference in adverse events was evident between the placebo and IS groups AUTHORS ' CONCLUSIONS This review showed that IS reduces the incidence of ARTIs in children , by 40 % on average .
The safety profile of IS appears to be good .