human
***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: Ninety-five children with difficult to treat asthma were given cromolyn in double-blind , crossover studies . Of these , 70 were studied for the next five to six years by open trial cromolyn prophylaxis to determine decreasing dependency on bronchodilators or corticosteroids . Evaluated at two-month intervals , 28 children required prednisone and bronchodilators , 37 required round-the-clock bronchodilators only and five required neither .  Peak expiratory flow rates were below 80 % of predicted normal in eight patients , the remaining 62 showed reversibility of airways obstruction . Exercise-induced asthma was reported by 44 during the first two years but persistent improvement in exercise tolerance occurred in 24 patients . IgE specific RAST indicated a continuing extrinsic element in the etiology of 38 of 45 patients tested . Cromolyn was an effective prophylaxis for children with chronic asthma ; however , it was difficult to evaluate in 17 steroid-dependent subjects . Attempts to reduce the need for and especially to discontinue steroids were not as successful as other reports indicate OBJECTIVE To compare the effects of 2 nebulizable controller asthma medications on caregiver and pediatric quality of life .  METHODS In this 52-week , r and omized trial , children aged 2 to 6 years with mild to moderate persistent asthma received budesonide inhalation suspension 0.5 mg ( total daily dose ) once or twice daily ( n = 168 ) or cromolyn sodium nebulizer solution 20 mg 4 times daily ( n = 167 ) for 8 weeks , with dosage adjustment thereafter at the investigators ' discretion . The Pediatric Asthma Caregiver 's Quality of Life Question naire ( PACQLQ ) , Compliance/Caregiver Satisfaction Question naire ( CCSQ ) , Modified Child Health Question naire-Parent Form 50 ( CHQ-PF50 ) , and Functional Status-II(R ) ( FS-II[R ] ) Question naire were administered at baseline and weeks 8 , 28 , and 52 . Global assessment s of ease of asthma management and child health status were obtained from caregivers and physicians at the end of the study . RESULTS Improvements from baseline in domain-specific ( activities and emotional function ) and total PACQLQ scores were greater at each time point ( weeks 8 , 28 , and 52 ) for caregivers of patients treated with budesonide compared with caregivers of patients receiving cromolyn sodium . Only the budesonide group met the criterion for a clinical ly important improvement ( > or=0.5 unit change ) in all PACQLQ domains by week 8 , which was maintained at weeks 28 and 52 . Moreover , improvements surpassed the criterion for moderate clinical importance ( 1.0 unit change ) in all PACQLQ domains for the budesonide group , but this level of improvement was only achieved in the activities domain ( at week 28 ) for the cromolyn sodium group . Based on the CCSQ , budesonide result ed in greater caregiver satisfaction , treatment convenience , ease of use , and compliance compared with cromolyn sodium . Thus , 90.7 % of caregivers in the budesonide group were " completely or very satisfied " compared with 53.4 % in the cromolyn sodium group . Over half ( 54.6 % ) of caregivers in the budesonide group rated  budesonide " highly or very convenient " compared with 23 % for cromolyn sodium ; 77 % rated budesonide  " extremely or very easy " to use compared with 47 % for cromolyn .  Adherence with daily medication regimens was reported for 76 % of children in the budesonide group compared with 57 % in the cromolyn sodium group . Child health status , as indicated by mean FS-II(R ) scores , showed improvements from baseline in both groups at weeks 8 , 28 , and 52 . There was a trend for these improvements to be superior in the budesonide group . Additionally , budesonide was superior to cromolyn sodium in caregiver and physician global assessment s. At the end of the study , 76 % of caregivers of children receiving budesonide  reported asthma management to be " a great deal easier " compared with the start of the study , and 74 % rated the overall health status of their child as " much better now than 1 year ago . " In contrast , only 29 % and 37 % of caregivers whose children received cromolyn sodium provided these respective ratings . CONCLUSIONS Budesonide inhalation suspension improved the quality of life for caregivers of children with asthma . Caregivers of children treated with budesonide  had significantly fewer limitations in daily activities and emotional functioning compared with caregivers of children treated with cromolyn sodium nebulizer solution . The improvements in caregiver quality of life occurred earlier with budesonide compared with cromolyn sodium . Only caregivers in the budesonide group had a clinical ly important mean change from baseline in all PACQLQ domains by week 8 . These benefits were maintained at week 52 . Children treated with budesonide inhalation suspension and cromolyn sodium experienced improvements in health status , assessed using the FS-II(R ) . The greatest differences between treatments were seen in the disease-specific portion of the FS-II(R ) , which relates impairments in functional status to the child 's illness . Caregiver and physician global assessment indicated significantly better overall child health after 1 year of treatment with budesonide , supporting an improvement in health status . Clinical trials in children 4 to 16 years of age with asthma have demonstrated greater effectiveness of inhaled corticosteroids versus cromolyn sodium on several clinical measures of efficacy . Measures of asthma control in this study , reported in detail elsewhere [ Leflein et al. Pediatrics 2002;109:866 - 872 ] , also have shown greater improvements with budesonide therapy . Treatment with budesonide inhalation suspension result ed in a significantly lower mean rate of asthma exacerbations , significantly longer times to first asthma exacerbation , significantly longer times to first additional use of chronic asthma therapy , and significant improvements in asthma symptom scores and breakthrough medication use compared with cromolyn sodium therapy . Additionally , children receiving budesonide inhalation suspension experienced more symptom-free days and episode-free days compared with children receiving cromolyn sodium .  Safety profiles were similar between the 2 treatment groups . Budesonide inhalation suspension was associated with significantly greater caregiver satisfaction , convenience , ease of use , and compliance compared with cromolyn sodium nebulizer solution . This greater caregiver satisfaction and quality of life may be related to the greater asthma control achieved in children treated with budesonide therapy compared with cromolyn sodium . In addition , the convenience of once- or twice-daily dosing with budesonide inhalation suspension , compared with 3- or 4-times-daily dosing of cromolyn sodium , may decrease caregiver burden and enhance the willingness of caregivers to adhere to treatment regimens prescribed for their young children with asthma . This effect on caregiver adherence could further improve treatment effectiveness . This is the first clinical trial comparing the effects of a nebulized corticosteroid with that of an alternative nebulized therapy on quality of life in young children with asthma and their families . Compared with nebulized cromolyn sodium , budesonide inhalation suspension not only provides better overall child health status and asthma management , but greater caregiver quality of life and greater caregiver satisfaction , convenience , ease of use , and compliance The effect of single-dose inhaled terbutaline , sodium cromo-glycate and budesonide were compared with control in 11 exercise-induced asthma ( EIA ) patients , aged 9 - 14 years . Patients exercise for 6 minutes , 15 minutes after inhaling drugs . The FVC , FEV1 , PEFR and MMEF were recorded before exercise and after exercise at 5 minutes interval up to 25 minutes . After exercise , the mean ( SEM ) maximal percentage fall in FEV1 after placebo , 200 micrograms of terbutaline , 10 mg of sodium cromoglycate , and 100 micrograms of budesonide were 22.81 ( 3.45 ) , 4.05 ( 2.11 ) , 11.29 ( 1.18 ) , and 20.36 ( 2.33 ) respectively . It was concluded that single-dose inhaled terbutaline and sodium cromoglycate result ed in a significant protective effect on exerxide-induced asthma whereas budesonide did not The objective of this study was to analyze data on parents ' adherence to their child 's prescribed nebulizer treatment regimen and compliance with the dem and s of the nebulizer and the face mask . Data on adherence and compliance were recorded in a 24-week double-blind , r and omized , parallel-group study with budesonide inhalation suspension in 125 young children with mild to moderate asthma .  Budesonide was administered with an Adaptive Aerosol Delivery ( AAD ) system , which recorded adherence to treatment and compliance with the AAD system . A total of 35,481 treatments were recorded and analyzed . A study question naire regarding the parents ' and children 's acceptance of the AAD system has also been analyzed . The adherence to the treatment regimen was 91.3 % , and the compliance with the AAD system was 90.4 % . True adherence , the product of adherence and compliance , was 82.5 % . Approximately 90 % of the parents found the face mask easy to seal and the AAD equipment easy to use , and over 90 % of the children accepted it within 1 week . In conclusion , the results indicate that the AAD system could be of real clinical advantage for treatment of asthma in young children Cromolyn sodium , a specific inhibitor of mediator release induced by antigen-antibody interaction , was studied for corticosteroid sparing effect and clinical usefulness in a double-blind double-crossover , and in a subsequent open trial in 30 corticosteroid-dependent adults with severe perennial asthma . Of 29 patients completing the trials , 19 had corticosteroid dose reduction while receiving cromolyn in the double-blind trial , and 22 had corticosteroid dose reduction in the open trial . Cromolyn was judged to be clinical ly useful for corticosteroid sparing effect or symptomatic improvement , however , in only ten patients . Corticosteroid sparing effect and clinical usefulness were noted in all types of asthmatics studied . One patient noted increased asthma following inhalation of either cromolyn or placebo and did not complete the trial ; no adverse effects of cromolyn per se were noted We investigated whether sodium cromoglycate 10 mg three times daily , delivered as an aerosol via Nebuhaler ( in addition to terbutaline 0.5 mg three times daily ) , could replace inhaled steroid in children with mild‐to‐moderate asthma . Children ( mean age 10.3 years ) were r and omly allocated to 12‐week treatment with sodium cromoglycate 10 mg plus terbutaline 0.5 mg ( group A ; n= 30 ) or placebo plus terbutaline 0.5 mg ( group B ; n= 32 ) , both taken three times a day . The daily steroid dose was reduced by 50 μg/week for 4 weeks from a starting dose of 200 μg . Fewer patients withdrew owing to worsening asthma from group A ( n= 1 ) than group B ( n = 11 ) . Symptom scores , morning and evening peak flows , and additional β2‐agonist usage , recorded on diary cards , were better in group A than group B. Lung function measured at clinic visits was unchanged in either group . Overall opinions of efficacy favoured Group A. Adverse events were similar in the groups  . Sodium cromoglycate plus terbutaline substituted effectively for inhaled steroid therapy In a controlled prospect i ve study we have measured growth and pulmonary function in children with asthma during long-term treatment with inhaled budesonide  and compared these findings with those obtained from children not treated with corticosteroids . Two hundred and sixteen children were followed at 6 monthly intervals for 1 - 2 years without inhaled budesonide and then for 3 - 6 years on inhaled budesonide .  Sixty-two children treated with theophylline , beta 2-agonists and sodium-cromoglycate but not with inhaled steroids were also followed for 3 - 7 years ( controls ) . During the period of budesonide therapy the mean daily dose decreased from 710 to 430 micrograms ( P < 0.01 ) and no signs of tachyphylaxis to the treatment were seen . Budesonide treatment was associated with a significant reduction in the number of annual hospital admissions due to acute severe asthma ( from 0.03 to 0.004 per child , P < 0.001 ) . In patients not treated with budesonide an annual decrease in % predicted FEV1 of 1 - 3 % was seen . In contrast FEV1 improved significantly with time during budesonide treatment , both compared with the run-in period and with the control group ( P < 0.01 ) . Furthermore , there was a significant ( P = 0.01 ) relationship between the duration of asthma at the start of budesonide and the annual increase in FEV1 during budesonide therapy . After 3 years of treatment with budesonide , children who started this therapy later than 
    Output:
    
agent
***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: Ninety-five children with difficult to treat asthma were given cromolyn in double-blind , crossover studies . Of these , 70 were studied for the next five to six years by open trial cromolyn prophylaxis to determine decreasing dependency on bronchodilators or corticosteroids . Evaluated at two-month intervals , 28 children required prednisone and bronchodilators , 37 required round-the-clock bronchodilators only and five required neither .  Peak expiratory flow rates were below 80 % of predicted normal in eight patients , the remaining 62 showed reversibility of airways obstruction . Exercise-induced asthma was reported by 44 during the first two years but persistent improvement in exercise tolerance occurred in 24 patients . IgE specific RAST indicated a continuing extrinsic element in the etiology of 38 of 45 patients tested . Cromolyn was an effective prophylaxis for children with chronic asthma ; however , it was difficult to evaluate in 17 steroid-dependent subjects . Attempts to reduce the need for and especially to discontinue steroids were not as successful as other reports indicate OBJECTIVE To compare the effects of 2 nebulizable controller asthma medications on caregiver and pediatric quality of life .  METHODS In this 52-week , r and omized trial , children aged 2 to 6 years with mild to moderate persistent asthma received budesonide inhalation suspension 0.5 mg ( total daily dose ) once or twice daily ( n = 168 ) or cromolyn sodium nebulizer solution 20 mg 4 times daily ( n = 167 ) for 8 weeks , with dosage adjustment thereafter at the investigators ' discretion . The Pediatric Asthma Caregiver 's Quality of Life Question naire ( PACQLQ ) , Compliance/Caregiver Satisfaction Question naire ( CCSQ ) , Modified Child Health Question naire-Parent Form 50 ( CHQ-PF50 ) , and Functional Status-II(R ) ( FS-II[R ] ) Question naire were administered at baseline and weeks 8 , 28 , and 52 . Global assessment s of ease of asthma management and child health status were obtained from caregivers and physicians at the end of the study . RESULTS Improvements from baseline in domain-specific ( activities and emotional function ) and total PACQLQ scores were greater at each time point ( weeks 8 , 28 , and 52 ) for caregivers of patients treated with budesonide compared with caregivers of patients receiving cromolyn sodium . Only the budesonide group met the criterion for a clinical ly important improvement ( > or=0.5 unit change ) in all PACQLQ domains by week 8 , which was maintained at weeks 28 and 52 . Moreover , improvements surpassed the criterion for moderate clinical importance ( 1.0 unit change ) in all PACQLQ domains for the budesonide group , but this level of improvement was only achieved in the activities domain ( at week 28 ) for the cromolyn sodium group . Based on the CCSQ , budesonide result ed in greater caregiver satisfaction , treatment convenience , ease of use , and compliance compared with cromolyn sodium . Thus , 90.7 % of caregivers in the budesonide group were " completely or very satisfied " compared with 53.4 % in the cromolyn sodium group . Over half ( 54.6 % ) of caregivers in the budesonide group rated  budesonide " highly or very convenient " compared with 23 % for cromolyn sodium ; 77 % rated budesonide  " extremely or very easy " to use compared with 47 % for cromolyn .  Adherence with daily medication regimens was reported for 76 % of children in the budesonide group compared with 57 % in the cromolyn sodium group . Child health status , as indicated by mean FS-II(R ) scores , showed improvements from baseline in both groups at weeks 8 , 28 , and 52 . There was a trend for these improvements to be superior in the budesonide group . Additionally , budesonide was superior to cromolyn sodium in caregiver and physician global assessment s. At the end of the study , 76 % of caregivers of children receiving budesonide  reported asthma management to be " a great deal easier " compared with the start of the study , and 74 % rated the overall health status of their child as " much better now than 1 year ago . " In contrast , only 29 % and 37 % of caregivers whose children received cromolyn sodium provided these respective ratings . CONCLUSIONS Budesonide inhalation suspension improved the quality of life for caregivers of children with asthma . Caregivers of children treated with budesonide  had significantly fewer limitations in daily activities and emotional functioning compared with caregivers of children treated with cromolyn sodium nebulizer solution . The improvements in caregiver quality of life occurred earlier with budesonide compared with cromolyn sodium . Only caregivers in the budesonide group had a clinical ly important mean change from baseline in all PACQLQ domains by week 8 . These benefits were maintained at week 52 . Children treated with budesonide inhalation suspension and cromolyn sodium experienced improvements in health status , assessed using the FS-II(R ) . The greatest differences between treatments were seen in the disease-specific portion of the FS-II(R ) , which relates impairments in functional status to the child 's illness . Caregiver and physician global assessment indicated significantly better overall child health after 1 year of treatment with budesonide , supporting an improvement in health status . Clinical trials in children 4 to 16 years of age with asthma have demonstrated greater effectiveness of inhaled corticosteroids versus cromolyn sodium on several clinical measures of efficacy . Measures of asthma control in this study , reported in detail elsewhere [ Leflein et al. Pediatrics 2002;109:866 - 872 ] , also have shown greater improvements with budesonide therapy . Treatment with budesonide inhalation suspension result ed in a significantly lower mean rate of asthma exacerbations , significantly longer times to first asthma exacerbation , significantly longer times to first additional use of chronic asthma therapy , and significant improvements in asthma symptom scores and breakthrough medication use compared with cromolyn sodium therapy . Additionally , children receiving budesonide inhalation suspension experienced more symptom-free days and episode-free days compared with children receiving cromolyn sodium .  Safety profiles were similar between the 2 treatment groups . Budesonide inhalation suspension was associated with significantly greater caregiver satisfaction , convenience , ease of use , and compliance compared with cromolyn sodium nebulizer solution . This greater caregiver satisfaction and quality of life may be related to the greater asthma control achieved in children treated with budesonide therapy compared with cromolyn sodium . In addition , the convenience of once- or twice-daily dosing with budesonide inhalation suspension , compared with 3- or 4-times-daily dosing of cromolyn sodium , may decrease caregiver burden and enhance the willingness of caregivers to adhere to treatment regimens prescribed for their young children with asthma . This effect on caregiver adherence could further improve treatment effectiveness . This is the first clinical trial comparing the effects of a nebulized corticosteroid with that of an alternative nebulized therapy on quality of life in young children with asthma and their families . Compared with nebulized cromolyn sodium , budesonide inhalation suspension not only provides better overall child health status and asthma management , but greater caregiver quality of life and greater caregiver satisfaction , convenience , ease of use , and compliance The effect of single-dose inhaled terbutaline , sodium cromo-glycate and budesonide were compared with control in 11 exercise-induced asthma ( EIA ) patients , aged 9 - 14 years . Patients exercise for 6 minutes , 15 minutes after inhaling drugs . The FVC , FEV1 , PEFR and MMEF were recorded before exercise and after exercise at 5 minutes interval up to 25 minutes . After exercise , the mean ( SEM ) maximal percentage fall in FEV1 after placebo , 200 micrograms of terbutaline , 10 mg of sodium cromoglycate , and 100 micrograms of budesonide were 22.81 ( 3.45 ) , 4.05 ( 2.11 ) , 11.29 ( 1.18 ) , and 20.36 ( 2.33 ) respectively . It was concluded that single-dose inhaled terbutaline and sodium cromoglycate result ed in a significant protective effect on exerxide-induced asthma whereas budesonide did not The objective of this study was to analyze data on parents ' adherence to their child 's prescribed nebulizer treatment regimen and compliance with the dem and s of the nebulizer and the face mask . Data on adherence and compliance were recorded in a 24-week double-blind , r and omized , parallel-group study with budesonide inhalation suspension in 125 young children with mild to moderate asthma .  Budesonide was administered with an Adaptive Aerosol Delivery ( AAD ) system , which recorded adherence to treatment and compliance with the AAD system . A total of 35,481 treatments were recorded and analyzed . A study question naire regarding the parents ' and children 's acceptance of the AAD system has also been analyzed . The adherence to the treatment regimen was 91.3 % , and the compliance with the AAD system was 90.4 % . True adherence , the product of adherence and compliance , was 82.5 % . Approximately 90 % of the parents found the face mask easy to seal and the AAD equipment easy to use , and over 90 % of the children accepted it within 1 week . In conclusion , the results indicate that the AAD system could be of real clinical advantage for treatment of asthma in young children Cromolyn sodium , a specific inhibitor of mediator release induced by antigen-antibody interaction , was studied for corticosteroid sparing effect and clinical usefulness in a double-blind double-crossover , and in a subsequent open trial in 30 corticosteroid-dependent adults with severe perennial asthma . Of 29 patients completing the trials , 19 had corticosteroid dose reduction while receiving cromolyn in the double-blind trial , and 22 had corticosteroid dose reduction in the open trial . Cromolyn was judged to be clinical ly useful for corticosteroid sparing effect or symptomatic improvement , however , in only ten patients . Corticosteroid sparing effect and clinical usefulness were noted in all types of asthmatics studied . One patient noted increased asthma following inhalation of either cromolyn or placebo and did not complete the trial ; no adverse effects of cromolyn per se were noted We investigated whether sodium cromoglycate 10 mg three times daily , delivered as an aerosol via Nebuhaler ( in addition to terbutaline 0.5 mg three times daily ) , could replace inhaled steroid in children with mild‐to‐moderate asthma . Children ( mean age 10.3 years ) were r and omly allocated to 12‐week treatment with sodium cromoglycate 10 mg plus terbutaline 0.5 mg ( group A ; n= 30 ) or placebo plus terbutaline 0.5 mg ( group B ; n= 32 ) , both taken three times a day . The daily steroid dose was reduced by 50 μg/week for 4 weeks from a starting dose of 200 μg . Fewer patients withdrew owing to worsening asthma from group A ( n= 1 ) than group B ( n = 11 ) . Symptom scores , morning and evening peak flows , and additional β2‐agonist usage , recorded on diary cards , were better in group A than group B. Lung function measured at clinic visits was unchanged in either group . Overall opinions of efficacy favoured Group A. Adverse events were similar in the groups  . Sodium cromoglycate plus terbutaline substituted effectively for inhaled steroid therapy In a controlled prospect i ve study we have measured growth and pulmonary function in children with asthma during long-term treatment with inhaled budesonide  and compared these findings with those obtained from children not treated with corticosteroids . Two hundred and sixteen children were followed at 6 monthly intervals for 1 - 2 years without inhaled budesonide and then for 3 - 6 years on inhaled budesonide .  Sixty-two children treated with theophylline , beta 2-agonists and sodium-cromoglycate but not with inhaled steroids were also followed for 3 - 7 years ( controls ) . During the period of budesonide therapy the mean daily dose decreased from 710 to 430 micrograms ( P < 0.01 ) and no signs of tachyphylaxis to the treatment were seen . Budesonide treatment was associated with a significant reduction in the number of annual hospital admissions due to acute severe asthma ( from 0.03 to 0.004 per child , P < 0.001 ) . In patients not treated with budesonide an annual decrease in % predicted FEV1 of 1 - 3 % was seen . In contrast FEV1 improved significantly with time during budesonide treatment , both compared with the run-in period and with the control group ( P < 0.01 ) . Furthermore , there was a significant ( P = 0.01 ) relationship between the duration of asthma at the start of budesonide and the annual increase in FEV1 during budesonide therapy . After 3 years of treatment with budesonide , children who started this therapy later than 
    Output:
    