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: OBJECTIVE To determine the change in prevalence of  asthma , eczema and allergic rhinitis in Australian schoolchildren between 1993 and 2002 . DESIGN Question naire based survey , using the protocol of the International Study of Asthma and Allergy in Childhood . SETTING Metropolitan Melbourne primary schools within a 20 km radius of the GPO in 1993 and 2002 . SUBJECTS All children in school years 1 and 2 ( ages 6 and 7 ) attending a r and om sample of 84 schools in 1993 and 63 schools in 2002 . MAIN OUTCOME MEASURES Parent-reported symptoms of atopic disease ; treatment for asthma ; country of birth . RESULTS There was a 26 % reduction in the 12-month period prevalence of reported wheeze , from 27.2 % in 1993 to 20.0 % in 2002 . The magnitude of reduction was similar for boys ( 27 % ) and girls ( 25 % ) . The 12-month period prevalence of reported eczema increased from 11.1 % in 1993 to 17.2 % in 2002 , and rhinitis increased from 9.7 % to 12.7 % . There were reductions in the proportion of children attending an emergency department for asthma in the previous year ( 3.6 % to 2.3 % ) , the proportion admitted to hospital ( 1.7 % to 1.1 % ) and the proportion taking asthma medication ( 18.5 % to 13.4 % ) . Of those who reported frequent wheeze , there was an increase in the proportion taking regular inhaled steroids ( 34.5 % to 40.9 % ) . CONCLUSION There has been a significant reduction in the prevalence of reported asthma in Melbourne schoolchildren , whereas the prevalence of eczema and allergic rhinitis has continued to increase The treatment of an acute asthma attack usually includes bronchodilators and often steroids . We studied 70 children who were r and omly assigned to receive either single dose steroids ( oral prednisone : 20–40 mg ) or placebo on a double blind basis . The time course of the observation was 72 h. We demonstrate that a single dose of steroids , given orally in paediatric community clinics during an acute mild to moderate asthma attack , significantly improves the patient 's course ; deterioration was prevented , symptoms were relieved faster , and hospitalization was not required . We encourage paediatricians in the ambulatory clinics to follow this treatment modality and to give , in addition to other conventional therapy , a single oral dose of steroids early in the asthma attack , in order to relieve and shorten the child 's distress STUDY OBJECTIVE To compare nebulized dexamethasone with oral prednisone in the treatment of children with asthma . DESIGN A r and omized , double-blind , double-placebo study . SETTING An urban pediatric emergency department . PARTICIPANTS Patients aged 1 to 17 years with acute asthma . INTERVENTIONS Patients with moderate asthma exacerbation received frequent aerosolized albuterol and either 1.5 mg/kg of nebulized dexamethasone or 2 mg/kg of oral prednisone . RESULTS A total of 111 children was evaluated ; 21 % of those treated with dexamethasone required hospitalization , compared with 31 % of those treated with prednisone ( P = .26 ) . A significantly greater proportion of dexamethasone-treated children were discharged home within 2 hours ( 23 % versus 7 % , P = .02 ) . In the dexamethasone group , 8 % who received the drug by mouthpiece were hospitalized compared with 33 % who received it by face mask ( P = .06 ) . Fewer children treated with dexamethasone  vomited ( 0 % versus 15 % , P = .001 ) and fewer relapsed within 48 hours of ED discharge ( 0 % versus 16 % , P = .008 ) . CONCLUSION Nebulized dexamethasone was as effective as oral prednisone in the ED treatment of moderately ill children with acute asthma and was associated with more rapid clinical improvement , more reliable drug delivery , and fewer relapses In a double blind , partial crossover trial we compared treatment with prednisolone with treatment with placebo ( 56 treatments ) in 38 children aged less than 18 months ( mean age 9.8 months , range 3 - 17 months ) , 30 of whom had required previous admission to hospital .  Placebo or oral prednisolone 2 mg/kg/day in two divided doses for five days was given during acute exacerbations of symptoms on an outpatient basis . Daily symptom scores of cough , wheeze , and breathlessness did not show any significant difference in rate of improvement or overall outcome , either between the two whole groups or within subgroups aged less than 6 months , 6 - 12 months , and 12 - 18 months . Parental preference failed to indicate superiority of treatment with prednisolone over treatment with placebo in the 18 crossover patients , and parents were equally as likely to feel that treatment with either placebo or prednisolone had had positive effect in non-crossover patients . Two children required admission to hospital during treatment , one aged 5 1/2 months being treated with prednisolone , and one aged 14 months being treated with placebo BACKGROUND Many young children wheeze during viral respiratory infections , but the pathogenesis of these episodes and their relation to the development of asthma later in life are not well understood . METHODS In a prospect i ve study , we investigated the factors affecting wheezing before the age of three years and their relation to wheezing at six years of age . Of 1246 newborns in the Tucson , Arizona , area enrolled between May 1980 and October 1984 , follow-up data at both three and six years of age was available for 826 . For these children , assessment s in infancy included measurement of cord-serum IgE levels  ( measured in 750 children ) , pulmonary-function testing before any lower respiratory illness had occurred ( 125 ) , measurement of serum IgE levels at nine months of age ( 672 ) , and question naires completed by the children 's parents when the children were one year old ( 800 ) . Assessment s at six years of age included measurement of serum IgE levels  ( in 460 ) ,  pulmonary-function testing  ( 526 ) , and  skin allergy testing  ( 629 ) . RESULTS At the age of six years , 425 children ( 51.5 percent ) had never wheezed , 164 ( 19.9 percent ) had had at least one lower respiratory illness with wheezing during the first three years of life but had no  wheezing at six years of age , 124 ( 15.0 percent ) had no  wheezing  before the age of three years but had wheezing at the age of six years , and 113 ( 13.7 percent ) had wheezing both before three years of age and at six years of age . The children who had wheezing before three years of age but not at the age of six had diminished airway function ( length-adjusted maximal expiratory flow at functional residual capacity [ Vmax FRC ] ) both before the age of one year and at the age of six years , were more likely than the other children to have mothers who smoked but not mothers with asthma , and did not have elevated serum IgE levels or skin-test reactivity . Children who started wheezing in early life and continued to wheeze at the age of six were more likely than the children who never wheezed to have mothers with a history of asthma ( P < 0.001 ) , to have elevated serum IgE levels ( P < 0.01 ) , to have normal lung function in the first year of life , and to have elevated serum IgE levels ( P < 0.001 ) and diminished values for VmaxFRC ( P < 0.01 ) at six years of age . CONCLUSIONS The majority of infants with wheezing have transient conditions associated with diminished airway function at birth and do not have increased risks of asthma or allergies later in life . In a substantial minority of infants , however , wheezing episodes are probably related to a predisposition to asthma OBJECTIVE To determine the effectiveness of a single dose of prednisone administered by a parent to a child early in an asthma attack . DESIGN A r and omized , double-blind , placebo-controlled , crossover study with children enrolled for 12 months ( 6 months prednisone , 6 months placebo ) . SETTING A primary -care clinic and emergency department of an inner-city teaching hospital from March 1992 through May 1993 . CHILDREN Children 2 to 14 years of age enrolled in this clinic who had made two or more outpatient ( emergency department or primary -care clinic ) visits for acute asthma in the preceding year . SELECTION There were 204 eligible children , of whom 86 were contacted and enrolled ; of these , 78 ( 91 % ) completed the study . INTERVENTION Capsules containing prednisone ( 2 mg/kg up to 60 mg ) or placebo . Parents were instructed to give their child one capsule for an asthma attack that had not improved after a dose of the child 's regular acute asthma medicine . MEASUREMENTS Parents were interviewed every 3 months . Computerized patient records and chart review s were used to verify parent reports . Outcome measures were the numbers of outpatient visits and hospitalizations for treatment of acute asthma . RESULTS Neither the total number of attacks nor the number for which medicine was used differed significantly by arm of study . There was a larger number of attacks result ing in outpatient visits when children were in the group that received prednisone ( 1.1 + /- 0.59 versus 0.59 + /- 0.86 ) . This trend was less pronounced but persisted when limited to attacks for which the medicine was given ( 0.58 + /- 0.99 versus 0.35 + /- 0.55 ) . Neither the number of attacks result ing in admission nor the number of hospital days differed significantly by arm of study . CONCLUSIONS A single dose of prednisone available for use at home early in an asthma attack was associated with an increase in outpatient visits made for acute asthma . When prednisone was given for an attack , there was no reduction in outpatient visits . This intervention can not be recommended for children with asthma . These results should be confirmed in other pediatric population Fifty four patients aged from 1 to 6 years who had had recurrent attacks of wheezy bronchitis were prospect ively followed up for three months to find out if there was an association between different viral respiratory infections and episodes of wheezing . Of the 115 episodes of upper or lower respiratory tract symptoms , virus or Mycoplasma pneumoniae infection were diagnosed in 52 ( 45 % ) . Thirty four of rhinoviruses . The patients had an average of 2.1 episodes of respiratory tract symptoms the total mean ( SD ) duration of which was 30 ( 2 ) days of the 92 days that followed . Wheezing occurred during 76 ( 66 % ) of the 115 episodes and during a third of these the patient was admitted to hospital because of severe dyspnoea . Wheezing started a mean ( SD ) of 43 ( 7 ) hours after the first symptoms of respiratory infection and persisted for 3.8 ( 4.2 ) days in patients in whom virus infection was diagnosed . The incidence of wheezing was not associated with IgE mediated atopy , with positive virological tests , or with fever during virus infection , but was associated with parental smoking and more than one sibling Aims : To investigate the relation between parentally  reported wheeze ( unconfirmed ) , physician confirmed wheeze , and subsequent lung function . Methods : Children at risk of allergic disease ( one parent atopic ) were recruited antenatally and followed prospect ively from birth . During the first three years of life parents were asked to contact the study team if their child was wheezy . The presence of wheeze was confirmed or not by the primary care or study physician .  Respiratory question naire and specific airway resistance measurement ( sRaw , body plethysmograph )  were completed at age 3 years . Results : A total of 454 children were followed from birth to 3 years of age . One hundred and eighty six ( 40.9 % ) of the parents reported their child wheezing in the first three years of life , and in 130 ( 28.6 % ) the wheeze was confirmed . A total of 428 children attended the three year clinic review , of whom 274 ( 64 % ) successfully carried out lung function tests . There was no significant difference in sRaw ( kPa·s ; geometric mean , 95 % CI ) between children who had never wheezed ( n = 152 ; 1.03 , 1.00 to 1.06 ) and those with a parentally reported but unconfirmed wheeze ( n = 36 ; 1.02 , 0.96 to 1.07 , p = 1.00 ) . sRaw was significantly higher in children with a physician confirmed wheeze ( n = 86 ; 1.17 , 1.11 to 1.22 , p < 0.001 ) compared to those with no history of wheeze or with unconfirmed wheeze . Conclusions : Children with physician confirmed wheeze  have significantly poorer lung function compared to those with parentally reported but unconfirmed and those who have never wheezed . A proportion of parents 
    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: OBJECTIVE To determine the change in prevalence of  asthma , eczema and allergic rhinitis in Australian schoolchildren between 1993 and 2002 . DESIGN Question naire based survey , using the protocol of the International Study of Asthma and Allergy in Childhood . SETTING Metropolitan Melbourne primary schools within a 20 km radius of the GPO in 1993 and 2002 . SUBJECTS All children in school years 1 and 2 ( ages 6 and 7 ) attending a r and om sample of 84 schools in 1993 and 63 schools in 2002 . MAIN OUTCOME MEASURES Parent-reported symptoms of atopic disease ; treatment for asthma ; country of birth . RESULTS There was a 26 % reduction in the 12-month period prevalence of reported wheeze , from 27.2 % in 1993 to 20.0 % in 2002 . The magnitude of reduction was similar for boys ( 27 % ) and girls ( 25 % ) . The 12-month period prevalence of reported eczema increased from 11.1 % in 1993 to 17.2 % in 2002 , and rhinitis increased from 9.7 % to 12.7 % . There were reductions in the proportion of children attending an emergency department for asthma in the previous year ( 3.6 % to 2.3 % ) , the proportion admitted to hospital ( 1.7 % to 1.1 % ) and the proportion taking asthma medication ( 18.5 % to 13.4 % ) . Of those who reported frequent wheeze , there was an increase in the proportion taking regular inhaled steroids ( 34.5 % to 40.9 % ) . CONCLUSION There has been a significant reduction in the prevalence of reported asthma in Melbourne schoolchildren , whereas the prevalence of eczema and allergic rhinitis has continued to increase The treatment of an acute asthma attack usually includes bronchodilators and often steroids . We studied 70 children who were r and omly assigned to receive either single dose steroids ( oral prednisone : 20–40 mg ) or placebo on a double blind basis . The time course of the observation was 72 h. We demonstrate that a single dose of steroids , given orally in paediatric community clinics during an acute mild to moderate asthma attack , significantly improves the patient 's course ; deterioration was prevented , symptoms were relieved faster , and hospitalization was not required . We encourage paediatricians in the ambulatory clinics to follow this treatment modality and to give , in addition to other conventional therapy , a single oral dose of steroids early in the asthma attack , in order to relieve and shorten the child 's distress STUDY OBJECTIVE To compare nebulized dexamethasone with oral prednisone in the treatment of children with asthma . DESIGN A r and omized , double-blind , double-placebo study . SETTING An urban pediatric emergency department . PARTICIPANTS Patients aged 1 to 17 years with acute asthma . INTERVENTIONS Patients with moderate asthma exacerbation received frequent aerosolized albuterol and either 1.5 mg/kg of nebulized dexamethasone or 2 mg/kg of oral prednisone . RESULTS A total of 111 children was evaluated ; 21 % of those treated with dexamethasone required hospitalization , compared with 31 % of those treated with prednisone ( P = .26 ) . A significantly greater proportion of dexamethasone-treated children were discharged home within 2 hours ( 23 % versus 7 % , P = .02 ) . In the dexamethasone group , 8 % who received the drug by mouthpiece were hospitalized compared with 33 % who received it by face mask ( P = .06 ) . Fewer children treated with dexamethasone  vomited ( 0 % versus 15 % , P = .001 ) and fewer relapsed within 48 hours of ED discharge ( 0 % versus 16 % , P = .008 ) . CONCLUSION Nebulized dexamethasone was as effective as oral prednisone in the ED treatment of moderately ill children with acute asthma and was associated with more rapid clinical improvement , more reliable drug delivery , and fewer relapses In a double blind , partial crossover trial we compared treatment with prednisolone with treatment with placebo ( 56 treatments ) in 38 children aged less than 18 months ( mean age 9.8 months , range 3 - 17 months ) , 30 of whom had required previous admission to hospital .  Placebo or oral prednisolone 2 mg/kg/day in two divided doses for five days was given during acute exacerbations of symptoms on an outpatient basis . Daily symptom scores of cough , wheeze , and breathlessness did not show any significant difference in rate of improvement or overall outcome , either between the two whole groups or within subgroups aged less than 6 months , 6 - 12 months , and 12 - 18 months . Parental preference failed to indicate superiority of treatment with prednisolone over treatment with placebo in the 18 crossover patients , and parents were equally as likely to feel that treatment with either placebo or prednisolone had had positive effect in non-crossover patients . Two children required admission to hospital during treatment , one aged 5 1/2 months being treated with prednisolone , and one aged 14 months being treated with placebo BACKGROUND Many young children wheeze during viral respiratory infections , but the pathogenesis of these episodes and their relation to the development of asthma later in life are not well understood . METHODS In a prospect i ve study , we investigated the factors affecting wheezing before the age of three years and their relation to wheezing at six years of age . Of 1246 newborns in the Tucson , Arizona , area enrolled between May 1980 and October 1984 , follow-up data at both three and six years of age was available for 826 . For these children , assessment s in infancy included measurement of cord-serum IgE levels  ( measured in 750 children ) , pulmonary-function testing before any lower respiratory illness had occurred ( 125 ) , measurement of serum IgE levels at nine months of age ( 672 ) , and question naires completed by the children 's parents when the children were one year old ( 800 ) . Assessment s at six years of age included measurement of serum IgE levels  ( in 460 ) ,  pulmonary-function testing  ( 526 ) , and  skin allergy testing  ( 629 ) . RESULTS At the age of six years , 425 children ( 51.5 percent ) had never wheezed , 164 ( 19.9 percent ) had had at least one lower respiratory illness with wheezing during the first three years of life but had no  wheezing at six years of age , 124 ( 15.0 percent ) had no  wheezing  before the age of three years but had wheezing at the age of six years , and 113 ( 13.7 percent ) had wheezing both before three years of age and at six years of age . The children who had wheezing before three years of age but not at the age of six had diminished airway function ( length-adjusted maximal expiratory flow at functional residual capacity [ Vmax FRC ] ) both before the age of one year and at the age of six years , were more likely than the other children to have mothers who smoked but not mothers with asthma , and did not have elevated serum IgE levels or skin-test reactivity . Children who started wheezing in early life and continued to wheeze at the age of six were more likely than the children who never wheezed to have mothers with a history of asthma ( P < 0.001 ) , to have elevated serum IgE levels ( P < 0.01 ) , to have normal lung function in the first year of life , and to have elevated serum IgE levels ( P < 0.001 ) and diminished values for VmaxFRC ( P < 0.01 ) at six years of age . CONCLUSIONS The majority of infants with wheezing have transient conditions associated with diminished airway function at birth and do not have increased risks of asthma or allergies later in life . In a substantial minority of infants , however , wheezing episodes are probably related to a predisposition to asthma OBJECTIVE To determine the effectiveness of a single dose of prednisone administered by a parent to a child early in an asthma attack . DESIGN A r and omized , double-blind , placebo-controlled , crossover study with children enrolled for 12 months ( 6 months prednisone , 6 months placebo ) . SETTING A primary -care clinic and emergency department of an inner-city teaching hospital from March 1992 through May 1993 . CHILDREN Children 2 to 14 years of age enrolled in this clinic who had made two or more outpatient ( emergency department or primary -care clinic ) visits for acute asthma in the preceding year . SELECTION There were 204 eligible children , of whom 86 were contacted and enrolled ; of these , 78 ( 91 % ) completed the study . INTERVENTION Capsules containing prednisone ( 2 mg/kg up to 60 mg ) or placebo . Parents were instructed to give their child one capsule for an asthma attack that had not improved after a dose of the child 's regular acute asthma medicine . MEASUREMENTS Parents were interviewed every 3 months . Computerized patient records and chart review s were used to verify parent reports . Outcome measures were the numbers of outpatient visits and hospitalizations for treatment of acute asthma . RESULTS Neither the total number of attacks nor the number for which medicine was used differed significantly by arm of study . There was a larger number of attacks result ing in outpatient visits when children were in the group that received prednisone ( 1.1 + /- 0.59 versus 0.59 + /- 0.86 ) . This trend was less pronounced but persisted when limited to attacks for which the medicine was given ( 0.58 + /- 0.99 versus 0.35 + /- 0.55 ) . Neither the number of attacks result ing in admission nor the number of hospital days differed significantly by arm of study . CONCLUSIONS A single dose of prednisone available for use at home early in an asthma attack was associated with an increase in outpatient visits made for acute asthma . When prednisone was given for an attack , there was no reduction in outpatient visits . This intervention can not be recommended for children with asthma . These results should be confirmed in other pediatric population Fifty four patients aged from 1 to 6 years who had had recurrent attacks of wheezy bronchitis were prospect ively followed up for three months to find out if there was an association between different viral respiratory infections and episodes of wheezing . Of the 115 episodes of upper or lower respiratory tract symptoms , virus or Mycoplasma pneumoniae infection were diagnosed in 52 ( 45 % ) . Thirty four of rhinoviruses . The patients had an average of 2.1 episodes of respiratory tract symptoms the total mean ( SD ) duration of which was 30 ( 2 ) days of the 92 days that followed . Wheezing occurred during 76 ( 66 % ) of the 115 episodes and during a third of these the patient was admitted to hospital because of severe dyspnoea . Wheezing started a mean ( SD ) of 43 ( 7 ) hours after the first symptoms of respiratory infection and persisted for 3.8 ( 4.2 ) days in patients in whom virus infection was diagnosed . The incidence of wheezing was not associated with IgE mediated atopy , with positive virological tests , or with fever during virus infection , but was associated with parental smoking and more than one sibling Aims : To investigate the relation between parentally  reported wheeze ( unconfirmed ) , physician confirmed wheeze , and subsequent lung function . Methods : Children at risk of allergic disease ( one parent atopic ) were recruited antenatally and followed prospect ively from birth . During the first three years of life parents were asked to contact the study team if their child was wheezy . The presence of wheeze was confirmed or not by the primary care or study physician .  Respiratory question naire and specific airway resistance measurement ( sRaw , body plethysmograph )  were completed at age 3 years . Results : A total of 454 children were followed from birth to 3 years of age . One hundred and eighty six ( 40.9 % ) of the parents reported their child wheezing in the first three years of life , and in 130 ( 28.6 % ) the wheeze was confirmed . A total of 428 children attended the three year clinic review , of whom 274 ( 64 % ) successfully carried out lung function tests . There was no significant difference in sRaw ( kPa·s ; geometric mean , 95 % CI ) between children who had never wheezed ( n = 152 ; 1.03 , 1.00 to 1.06 ) and those with a parentally reported but unconfirmed wheeze ( n = 36 ; 1.02 , 0.96 to 1.07 , p = 1.00 ) . sRaw was significantly higher in children with a physician confirmed wheeze ( n = 86 ; 1.17 , 1.11 to 1.22 , p < 0.001 ) compared to those with no history of wheeze or with unconfirmed wheeze . Conclusions : Children with physician confirmed wheeze  have significantly poorer lung function compared to those with parentally reported but unconfirmed and those who have never wheezed . A proportion of parents 
    Output:
    