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: The aim of this study was to determine if 2 doses of oral dexamethasone are as effective as a 5-day course of oral prednisone in preventing relapse for pediatric asthma exacerbations . Patients presenting to the emergency department with an asthma exacerbation were r and omized to receive 0.6 mg/kg of dexamethasone or 2 mg/kg of prednisone in a prospect i ve , double-blind study . The primary outcome was relapse within 10 days , and the secondary outcome was vomiting in the emergency department .  Eighty-nine patients completed the study : 38 in the prednisone group and 51 in the dexamethasone group . In all , 3 patients in the prednisone group ( 8 % ) and 8 patients in the dexamethasone group ( 16 % ) required an unscheduled follow-up visit ( P = .27 ) . In all , 7 patients in the prednisone group ( 18 % ) and 5 patients in the dexamethasone group ( 10 % ) had vomiting ( P = .24 ) . No difference was found in the relapse rate or incidence of vomiting between patients given prednisone and dexamethasone for pediatric asthma exacerbations STUDY OBJECTIVE Dexamethasone has a longer half-life than prednisone and is well tolerated orally . We compare the time needed to return to normal activity and the frequency of relapse after acute exacerbation in adults receiving either 5 days of prednisone or 2 days of dexamethasone . METHODS We r and omized adult emergency department patients ( aged 18 to 45 years ) with acute exacerbations of asthma ( peak expiratory flow rate less than 80 % of ideal ) to receive either 50 mg of daily oral prednisone for 5 days or 16 mg of daily oral dexamethasone for 2 days . Outcomes were assessed by telephone follow-up . RESULTS Ninety-six prednisone and 104 dexamethasone subjects completed the study regimen and follow-up . More patients in the dexamethasone group reported a return to normal activities within 3 days compared with the prednisone group ( 90 % versus 80 % ; difference 10 % ; 95 % confidence interval 0 % to 20 % ; P=.049 ) . Relapse was similar between groups ( 13 % versus 11 % ; difference 2 % ; 95 % confidence interval -7 % to 11 % , P=.67 ) . CONCLUSION In acute exacerbations of asthma in adults , 2 days of oral dexamethasone is at least as effective as 5 days of oral prednisone in returning patients to their normal level of activity and preventing relapse Background Asthma is a major cause of pediatric morbidity and mortality . In acute exacerbations of asthma , corticosteroids reduce relapses , subsequent hospital admission and the need for ß2-agonist therapy . Prednisolone is relatively short-acting with a half-life of 12 to 36 hours , thereby requiring daily dosing . Prolonged treatment course , vomiting and a bitter taste may reduce patient compliance with prednisolone . Dexamethasone is a long-acting corticosteroid with a half-life of 36 to 72 hours . It is used frequently in children with croup and bacterial meningitis , and is well absorbed orally . The purpose of this trial is to examine whether a single dose of oral dexamethasone ( 0.3 mg/kg ) is clinical ly non-inferior to prednisolone ( 1 mg/kg/day for three days ) in the treatment of exacerbations of asthma in children who attend the Emergency Department . Methods / design This is a r and omized , non-inferiority , open-label clinical trial . After informed consent with or without assent , patients will be r and omized to either oral dexamethasone 0.3 mg/kg stat or prednisolone 1 mg/kg/day for three days . The primary outcome measure is the comparison between the Pediatric Respiratory Assessment Measure ( PRAM ) across both groups on Day 4 . The PRAM score , a vali date d , responsive and reliable tool to determine asthma severity in children aged 2 to 16 years , will be performed by a clinician blinded to treatment allocation . Secondary outcomes include relapse , hospital admission and requirement for further steroid therapy . Data will be analyzed on an intention-to-treat and a per protocol basis . With a sample size of 232 subjects ( 105 in each group with an estimated 10 % loss to follow-up ) , we will be able to reject the null hypothesis - that the population means of the experimental and control groups are equal with a probability ( power ) of 0.9 . The Type I error probability associated with this test ( of the null hypothesis ) is 0.05 . Discussion This clinical trial may provide evidence that a shorter steroid course using dexamethasone can be used in the treatment of acute pediatric asthma , thus eliminating the issue of compliance to treatment . Registration IS RCT N26944158 and EudraCT Number 2010 - 022001 - In a r and omised trial , treatment with prednisolone in two formulations ( oral solution or crushed tablets ) was compared in 78 young children with acute asthma .  Prednisolone oral solution was better tolerated than crushed tablets ( less vomiting , superior taste ) ; clinical resolution was similar STUDY OBJECTIVE In acute exacerbations of asthma in children , corticosteroids reduce relapses , subsequent hospital admission , and the need for ß2-agonist bronchodilators . Prednisolone is the most commonly used corticosteroid , but prolonged treatment course , vomiting , and a bitter taste may reduce patient compliance . Dexamethasone has a longer half-life and has been used safely in other acute pediatric conditions . We examine whether a single dose of oral dexamethasone is noninferior to prednisolone in the emergency department ( ED ) treatment of asthma exacerbations in children , as measured by the Pediatric Respiratory Assessment Measure ( PRAM ) at day 4 . METHODS We conducted a r and omized , open-label , noninferiority trial comparing oral dexamethasone ( single dose of 0.3 mg/kg ) with prednisolone ( 1 mg/kg per day for 3 days ) in patients aged 2 to 16 years and with a known diagnosis of asthma or at least 1 previous episode of ß2-agonist-responsive wheeze who presented to a tertiary pediatric ED . The primary outcome measure was the mean PRAM score ( range of 0 to 12 points ) performed on day 4 . Secondary outcome measures included requirement for further steroids , vomiting of study medication , hospital admission , and unscheduled return visits to a health care practitioner within 14 days . RESULTS There were 245 enrollments involving 226 patients . There was no difference in mean PRAM scores at day 4 between the dexamethasone and prednisolone groups ( 0.91 versus 0.91 ; absolute difference 0.005 ; 95 % CI -0.35 to 0.34 ) . Fourteen patients vomited at least 1 dose of prednisolone compared with no patients in the dexamethasone group . Sixteen children ( 13.1 % ) in the dexamethasone group received further systemic steroids within 14 days after trial enrollment compared with 5 ( 4.2 % ) in the prednisolone group ( absolute difference 8.9 % ; 95 % CI 1.9 % to 16.0 % ) . There was no significant difference between the groups in hospital admission rates or the number of unscheduled return visits to a health care practitioner . CONCLUSION In children with acute exacerbations of asthma , a single dose of oral dexamethasone ( 0.3 mg/kg ) is noninferior to a 3-day course of oral prednisolone ( 1 mg/kg per day ) as measured by the mean PRAM score on day 4 Objective : To compare the efficacy of a single dose of oral dexamethasone ( Dex ) versus 5 days of twice-daily prednisolone ( Pred ) in the management of mild to moderate asthma exacerbations in children . Study Design : A prospect i ve , r and omized , double-blinded trial of children 2 to 16 years of age who presented to the emergency department ( ED ) with acute mild to moderate asthma exacerbations . Subjects received single-dose oral Dex ( 0.6 mg/kg to a maximum of 18 mg ) or oral Pred ( 1 mg/kg per dose to a maximum of 30 mg ) twice daily for 5 days . After discharge , subjects were contacted by telephone at 48 h to assess symptoms and reevaluated in the ED in 5 days . The primary outcome was the number of days needed for Patient Self Assessment Score to return to baseline ( score of 0 - 0.5 ) . Main Results : Baseline characteristics of the 2 groups were similar . The mean number of days needed for Patient Self Assessment Score to return to baseline ( 0 - 0.5 ) in the Dex and Pred groups were 5.21 versus 5.22 days , respectively ( mean difference , −0.01 ; confidence interval , −0.70 , 0.68 ) . Pulmonary index scores were similar in both groups at initial presentation , initial ED discharge and at the day 5 follow-up visit . At the first visit , mean time to discharge was 3.5 h (±1.93)for Dex and 4.3 h ( ±3.67 ) for Pred ( mean difference , −0.8 ; confidence interval , −1.8 , 0.2 ) . Initial admission rate was 9 % ( Dex ) versus 13.4 % ( Pred ) . There was no significant difference in the number of salbutamol therapies needed in the ED nor at home after discharge . For subjects discharged home , the admission rate after initial discharge was 4.9 % ( Dex ) versus 1.8 % ( Pred ) , result ing in overall hospital admission rates of 13.4 % ( Dex ) and 14.9 % ( Pred ) . Conclusion : A single dose of oral Dex ( 0.6 mg/kg ) is no worse than 5 days of twice-daily prednisolone ( 1 mg/kg per dose ) in the management of children with mild to moderate asthma OBJECTIVE To determine whether a 5-day course of oral prednisolone is superior to a 3-day course in reducing the 2-week morbidity of children with asthma exacerbations who are not hospitalised . DESIGN , SETTING AND PARTICIPANTS Double-blind r and omised controlled trial of asthma outcomes following a 5-day course of oral prednisolone ( 1 mg/kg ) compared with a 3-day course of prednisolone plus placebo for 2 days . Participants were children aged 2 - 15 years who presented to the emergency departments of three Queensl and hospitals between March 2004 and February 2007 with an acute exacerbation of asthma , but were not hospitalised . Sample size was defined a priori for a study power of 90 % . MAIN OUTCOME MEASURES Difference in proportion of children who were symptom-free at Day 7 , as measured by intention-to-treat ( ITT ) and per- protocol analysis ; quality of life ( QOL ) on Days 7 and 14 . RESULTS 201 children were enrolled , and there was an 82 % completion rate . There was no difference between groups in the proportion of children who were symptom-free ( observed difference , 0.04 [ 95 % CI , - 0.09 to 0.18 ] by ITT analysis ; 0.04 [ 95 % CI , - 0.17 to 0.09 ] by per- protocol analysis ) . There was also no difference between groups in QOL ( P = 0.42 ) . The difference between groups for the primary outcome was within the equivalence range calculated post priori . CONCLUSION A 5-day course of oral prednisolone confers no advantage over a 3-day course for children with asthma exacerbations who are not hospitalised . TRIAL REGISTRATION Australian Clinical Trials Registry ACTRN012605000305628 Background : Systemic corticosteroids and inhaled β2 agonists are accepted first line treatments for acute severe asthma , but there is no consensus on their optimum dosage and frequency of administration . American regimens include higher initial dosages of β2 agonists and corticosteroids than UK regimens . Methods : In a prospect i ve , pragmatic , r and omised , parallel group study , 170 patients of mean ( SD ) age 37 ( 12 ) years with acute asthma ( peak expiratory flow ( PEF ) 212 ( 80 ) l/min ) presenting to hospital received treatment with either high dose prednisolone and continuous nebulised salbutamol as recommended in the US or lower dose prednisolone and bolus nebulised salbutamol as recommended in the UK by the BTS . Results : Outcome measures were : ΔPEF at 1 hour ( BTS 89 l/min , US 106 l/min , p=0.2 , CI –8 to 41 ) and at 2 hours ( BTS 49 l/min , US 101 l/min , p<0.0001 , CI 28 to 77 ) ; time to discharge if admitted ( BTS 4 days , US 4 days ) ; rates of achieving 
    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: The aim of this study was to determine if 2 doses of oral dexamethasone are as effective as a 5-day course of oral prednisone in preventing relapse for pediatric asthma exacerbations . Patients presenting to the emergency department with an asthma exacerbation were r and omized to receive 0.6 mg/kg of dexamethasone or 2 mg/kg of prednisone in a prospect i ve , double-blind study . The primary outcome was relapse within 10 days , and the secondary outcome was vomiting in the emergency department .  Eighty-nine patients completed the study : 38 in the prednisone group and 51 in the dexamethasone group . In all , 3 patients in the prednisone group ( 8 % ) and 8 patients in the dexamethasone group ( 16 % ) required an unscheduled follow-up visit ( P = .27 ) . In all , 7 patients in the prednisone group ( 18 % ) and 5 patients in the dexamethasone group ( 10 % ) had vomiting ( P = .24 ) . No difference was found in the relapse rate or incidence of vomiting between patients given prednisone and dexamethasone for pediatric asthma exacerbations STUDY OBJECTIVE Dexamethasone has a longer half-life than prednisone and is well tolerated orally . We compare the time needed to return to normal activity and the frequency of relapse after acute exacerbation in adults receiving either 5 days of prednisone or 2 days of dexamethasone . METHODS We r and omized adult emergency department patients ( aged 18 to 45 years ) with acute exacerbations of asthma ( peak expiratory flow rate less than 80 % of ideal ) to receive either 50 mg of daily oral prednisone for 5 days or 16 mg of daily oral dexamethasone for 2 days . Outcomes were assessed by telephone follow-up . RESULTS Ninety-six prednisone and 104 dexamethasone subjects completed the study regimen and follow-up . More patients in the dexamethasone group reported a return to normal activities within 3 days compared with the prednisone group ( 90 % versus 80 % ; difference 10 % ; 95 % confidence interval 0 % to 20 % ; P=.049 ) . Relapse was similar between groups ( 13 % versus 11 % ; difference 2 % ; 95 % confidence interval -7 % to 11 % , P=.67 ) . CONCLUSION In acute exacerbations of asthma in adults , 2 days of oral dexamethasone is at least as effective as 5 days of oral prednisone in returning patients to their normal level of activity and preventing relapse Background Asthma is a major cause of pediatric morbidity and mortality . In acute exacerbations of asthma , corticosteroids reduce relapses , subsequent hospital admission and the need for ß2-agonist therapy . Prednisolone is relatively short-acting with a half-life of 12 to 36 hours , thereby requiring daily dosing . Prolonged treatment course , vomiting and a bitter taste may reduce patient compliance with prednisolone . Dexamethasone is a long-acting corticosteroid with a half-life of 36 to 72 hours . It is used frequently in children with croup and bacterial meningitis , and is well absorbed orally . The purpose of this trial is to examine whether a single dose of oral dexamethasone ( 0.3 mg/kg ) is clinical ly non-inferior to prednisolone ( 1 mg/kg/day for three days ) in the treatment of exacerbations of asthma in children who attend the Emergency Department . Methods / design This is a r and omized , non-inferiority , open-label clinical trial . After informed consent with or without assent , patients will be r and omized to either oral dexamethasone 0.3 mg/kg stat or prednisolone 1 mg/kg/day for three days . The primary outcome measure is the comparison between the Pediatric Respiratory Assessment Measure ( PRAM ) across both groups on Day 4 . The PRAM score , a vali date d , responsive and reliable tool to determine asthma severity in children aged 2 to 16 years , will be performed by a clinician blinded to treatment allocation . Secondary outcomes include relapse , hospital admission and requirement for further steroid therapy . Data will be analyzed on an intention-to-treat and a per protocol basis . With a sample size of 232 subjects ( 105 in each group with an estimated 10 % loss to follow-up ) , we will be able to reject the null hypothesis - that the population means of the experimental and control groups are equal with a probability ( power ) of 0.9 . The Type I error probability associated with this test ( of the null hypothesis ) is 0.05 . Discussion This clinical trial may provide evidence that a shorter steroid course using dexamethasone can be used in the treatment of acute pediatric asthma , thus eliminating the issue of compliance to treatment . Registration IS RCT N26944158 and EudraCT Number 2010 - 022001 - In a r and omised trial , treatment with prednisolone in two formulations ( oral solution or crushed tablets ) was compared in 78 young children with acute asthma .  Prednisolone oral solution was better tolerated than crushed tablets ( less vomiting , superior taste ) ; clinical resolution was similar STUDY OBJECTIVE In acute exacerbations of asthma in children , corticosteroids reduce relapses , subsequent hospital admission , and the need for ß2-agonist bronchodilators . Prednisolone is the most commonly used corticosteroid , but prolonged treatment course , vomiting , and a bitter taste may reduce patient compliance . Dexamethasone has a longer half-life and has been used safely in other acute pediatric conditions . We examine whether a single dose of oral dexamethasone is noninferior to prednisolone in the emergency department ( ED ) treatment of asthma exacerbations in children , as measured by the Pediatric Respiratory Assessment Measure ( PRAM ) at day 4 . METHODS We conducted a r and omized , open-label , noninferiority trial comparing oral dexamethasone ( single dose of 0.3 mg/kg ) with prednisolone ( 1 mg/kg per day for 3 days ) in patients aged 2 to 16 years and with a known diagnosis of asthma or at least 1 previous episode of ß2-agonist-responsive wheeze who presented to a tertiary pediatric ED . The primary outcome measure was the mean PRAM score ( range of 0 to 12 points ) performed on day 4 . Secondary outcome measures included requirement for further steroids , vomiting of study medication , hospital admission , and unscheduled return visits to a health care practitioner within 14 days . RESULTS There were 245 enrollments involving 226 patients . There was no difference in mean PRAM scores at day 4 between the dexamethasone and prednisolone groups ( 0.91 versus 0.91 ; absolute difference 0.005 ; 95 % CI -0.35 to 0.34 ) . Fourteen patients vomited at least 1 dose of prednisolone compared with no patients in the dexamethasone group . Sixteen children ( 13.1 % ) in the dexamethasone group received further systemic steroids within 14 days after trial enrollment compared with 5 ( 4.2 % ) in the prednisolone group ( absolute difference 8.9 % ; 95 % CI 1.9 % to 16.0 % ) . There was no significant difference between the groups in hospital admission rates or the number of unscheduled return visits to a health care practitioner . CONCLUSION In children with acute exacerbations of asthma , a single dose of oral dexamethasone ( 0.3 mg/kg ) is noninferior to a 3-day course of oral prednisolone ( 1 mg/kg per day ) as measured by the mean PRAM score on day 4 Objective : To compare the efficacy of a single dose of oral dexamethasone ( Dex ) versus 5 days of twice-daily prednisolone ( Pred ) in the management of mild to moderate asthma exacerbations in children . Study Design : A prospect i ve , r and omized , double-blinded trial of children 2 to 16 years of age who presented to the emergency department ( ED ) with acute mild to moderate asthma exacerbations . Subjects received single-dose oral Dex ( 0.6 mg/kg to a maximum of 18 mg ) or oral Pred ( 1 mg/kg per dose to a maximum of 30 mg ) twice daily for 5 days . After discharge , subjects were contacted by telephone at 48 h to assess symptoms and reevaluated in the ED in 5 days . The primary outcome was the number of days needed for Patient Self Assessment Score to return to baseline ( score of 0 - 0.5 ) . Main Results : Baseline characteristics of the 2 groups were similar . The mean number of days needed for Patient Self Assessment Score to return to baseline ( 0 - 0.5 ) in the Dex and Pred groups were 5.21 versus 5.22 days , respectively ( mean difference , −0.01 ; confidence interval , −0.70 , 0.68 ) . Pulmonary index scores were similar in both groups at initial presentation , initial ED discharge and at the day 5 follow-up visit . At the first visit , mean time to discharge was 3.5 h (±1.93)for Dex and 4.3 h ( ±3.67 ) for Pred ( mean difference , −0.8 ; confidence interval , −1.8 , 0.2 ) . Initial admission rate was 9 % ( Dex ) versus 13.4 % ( Pred ) . There was no significant difference in the number of salbutamol therapies needed in the ED nor at home after discharge . For subjects discharged home , the admission rate after initial discharge was 4.9 % ( Dex ) versus 1.8 % ( Pred ) , result ing in overall hospital admission rates of 13.4 % ( Dex ) and 14.9 % ( Pred ) . Conclusion : A single dose of oral Dex ( 0.6 mg/kg ) is no worse than 5 days of twice-daily prednisolone ( 1 mg/kg per dose ) in the management of children with mild to moderate asthma OBJECTIVE To determine whether a 5-day course of oral prednisolone is superior to a 3-day course in reducing the 2-week morbidity of children with asthma exacerbations who are not hospitalised . DESIGN , SETTING AND PARTICIPANTS Double-blind r and omised controlled trial of asthma outcomes following a 5-day course of oral prednisolone ( 1 mg/kg ) compared with a 3-day course of prednisolone plus placebo for 2 days . Participants were children aged 2 - 15 years who presented to the emergency departments of three Queensl and hospitals between March 2004 and February 2007 with an acute exacerbation of asthma , but were not hospitalised . Sample size was defined a priori for a study power of 90 % . MAIN OUTCOME MEASURES Difference in proportion of children who were symptom-free at Day 7 , as measured by intention-to-treat ( ITT ) and per- protocol analysis ; quality of life ( QOL ) on Days 7 and 14 . RESULTS 201 children were enrolled , and there was an 82 % completion rate . There was no difference between groups in the proportion of children who were symptom-free ( observed difference , 0.04 [ 95 % CI , - 0.09 to 0.18 ] by ITT analysis ; 0.04 [ 95 % CI , - 0.17 to 0.09 ] by per- protocol analysis ) . There was also no difference between groups in QOL ( P = 0.42 ) . The difference between groups for the primary outcome was within the equivalence range calculated post priori . CONCLUSION A 5-day course of oral prednisolone confers no advantage over a 3-day course for children with asthma exacerbations who are not hospitalised . TRIAL REGISTRATION Australian Clinical Trials Registry ACTRN012605000305628 Background : Systemic corticosteroids and inhaled β2 agonists are accepted first line treatments for acute severe asthma , but there is no consensus on their optimum dosage and frequency of administration . American regimens include higher initial dosages of β2 agonists and corticosteroids than UK regimens . Methods : In a prospect i ve , pragmatic , r and omised , parallel group study , 170 patients of mean ( SD ) age 37 ( 12 ) years with acute asthma ( peak expiratory flow ( PEF ) 212 ( 80 ) l/min ) presenting to hospital received treatment with either high dose prednisolone and continuous nebulised salbutamol as recommended in the US or lower dose prednisolone and bolus nebulised salbutamol as recommended in the UK by the BTS . Results : Outcome measures were : ΔPEF at 1 hour ( BTS 89 l/min , US 106 l/min , p=0.2 , CI –8 to 41 ) and at 2 hours ( BTS 49 l/min , US 101 l/min , p<0.0001 , CI 28 to 77 ) ; time to discharge if admitted ( BTS 4 days , US 4 days ) ; rates of achieving 
    Output:
    