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: BACKGROUND AND OBJECTIVE : Impoverished urban children suffer disproportionately from asthma and underuse preventive asthma medications . The objective of this study was to examine cost-effectiveness ( CE ) of the School-Based Asthma Therapy ( SBAT ) program compared with usual care ( UC ) . METHODS : The analysis was based on the SBAT trial , including 525 children aged 3 to 10 years attending urban preschool or elementary school who were r and omized to either UC or administration of 1 dose of preventive asthma medication at school by the school nurse each school day . The primary outcome was the mean number of symptom-free days ( SFDs ) . The impact of the intervention on medical costs was estimated by using parent-reported child health services utilization data and average national reimbursement rates . We estimated the cost of running the program using wages for program staff . Productivity costs were estimated by using value of parent lost time due to child illness . CE of the SBAT program compared with UC was evaluated based on the incremental CE ratio . RESULTS : The health benefit of the intervention was equal to ∼158 SFD gained per each 30-day period ( P < .05 ) per 100 children . The programmatic expenses summed to an extra $ 4822 per 100 children per month . The net saving due to the intervention ( reduction in medical costs and parental productivity , and improvement in school attendance ) was $ 3240 , result ing in the incremental cost-savings difference of $ 1583 and CE of $ 10 per 1 extra SFD gained . CONCLUSIONS : The SBAT was effective and cost-effective in reducing symptoms in urban children with asthma compared with other existing programs A r and omised , double-blind trial was undertaken to investigate the efficacy and tolerability of formoterol Turbuhaler in children with mild to moderate asthma . After a two-week run-in , 248 children aged 6 - 17 years were r and omised to receive formoterol 4.5 and 9 pmicro b.i.d . or placebo for 12 weeks . Morning PEF ( primary variable ) , was significantly improved versus placebo only in the formoterol 9 pmicro b.i.d . group ( 13 l/min , 95 % CCI 1.9 , 24.2 % ; p = 0 .02 ) . Both formoterol 4.5 and 9 pmicro significantly increased the pre-bronchodilator FEV1 by 5.2 - 6.7 % ( p < 0 .05 ) and reduced use of daytime relief medication versus placebo ( p < 0 .05 ) . Formoterol 9 pmicro significantly reduced night-time reliever use and awakenings due to asthma versus placebo ( p < 0.05 ) . Both doses of formoterol were as well tolerated as placebo . In conclusion , formoterol 4.5 and 9 micro b.i.d . is effective and well tolerated as maintenance therapy in children with mild to moderate asthma BACKGROUND For children older than 5 years with asthma who remain symptomatic despite inhaled corticosteroid ( ICS ) therapy , the preferred treatment is to add an inhaled long-acting beta2-agonist vs increasing the ICS dose . OBJECTIVE To compare the safety of twice-daily treatment with inhaled fluticasone propionate plus the inhaled long-acting beta2-agonist salmeterol with that of fluticasone propionate used alone in children aged 4 to 11 years with persistent asthma . METHODS A r and omized , multicenter , double-blind , active-controlled , parallel-group study in 203 children with persistent asthma who were symptomatic during ICS therapy . Patients received fluticasone propionate-salmeterol ( 100/50 microg ) or fluticasone propionate ( 100 microg ) alone twice daily for 12 weeks . RESULTS The safety profile of fluticasone propionate-salmeterol was similar to that of fluticasone propionate alone . The overall incidence of adverse events was 59 % for fluticasone propionate-salmeterol and 57 % for fluticasone propionate . Both treatments were well tolerated . Two patients receiving fluticasone propionate-salmeterol and 5 receiving fluticasone propionate withdrew from the study because of worsening asthma . Changes in heart rate , blood pressure , and laboratory variables were infrequent and were similar between treatments . No patients had clinical ly significant abnormal electrocardiographic findings during treatment . Geometric mean 24-hour urinary cortisol excretion at baseline and after 12 weeks of treatment was comparable within and between groups ; no patient in either group had abnormally low 24-hour urinary cortisol excretion after 12 weeks of treatment . The incidence of withdrawals due to asthma exacerbations was 2 % in the fluticasone propionate-salmeterol group and 5 % in the fluticasone propionate group . CONCLUSIONS In pediatric patients with persistent asthma , fluticasone propionate-salmeterol twice daily was well tolerated , with a safety profile similar to that of fluticasone propionate used alone OBJECTIVE Intranasal beclomethasone dipropionate ( BDP ) has generally been considered to have no systemic activity at recommended doses , but the potential for long-term effects on growth has not previously been evaluated . This study was undertaken to assess the effects of 1 year of treatment with intranasal BDP on growth in children . STUDY DESIGN In this double-blind , r and omized , parallel-group study , 100 prepubertal children 6 to 9 years old with perennial allergic rhinitis were treated with aqueous BDP 168 microg twice daily ( n = 51 ) or placebo ( n = 49 ) for 1 year . Subjects ' baseline heights were required to be between the 5th and 95th percentile , and skeletal age as determined by left wrist radiograph was required to be within 2 years of chronological age . Washout periods for medications known to affect growth , including other forms of corticosteroids , were established , and these medications were prohibited during the study . However , short courses of oral prednisolone lasting no more than 7 days , and short courses of dermatologic corticosteroids lasting no more than 10 days , were allowed . Height was measured with a stadiometer after 1 , 2 , 4 , 6 , 8 , 10 , and 12 months of treatment . The hypothalamic-pituitary-adrenocortical axis was assessed by measurements of 8 AM basal cortisol concentrations and response to . 25 mg cosyntropin stimulation . The primary safety parameter was the rate of change in st and ing height . Statistical analyses were based on all r and omized subjects who received at least 1 dose of medication ( intent-to-treat principle ) . The rate of change in st and ing height was analyzed for all subjects who entered the study and for those completing the full 12 months of treatment ( n = 80 ) . The rate of change in st and ing height over the 1-year study was calculated as the slope of a linear regression line fitted to each subject 's height measurements over time . Because there was a statistically significant between-group difference in st and ing height at baseline , an analysis of covariance was performed for all analyses of st and ing height data . RESULTS Of the 100 subjects enrolled , 90 completed the study . The 2 treatment groups were generally comparable at baseline ; however , at baseline , mean age and mean height were significantly greater in the BDP treatment group that the in placebo treatment group . In both analyses , overall growth rate was significantly slower in BDP-treated subjects than placebo-treated subjects . The mean change in st and ing height after 1 year was 5.0 cm in the BDP-treated subjects compared with 5.9 cm in the placebo-treated subjects . The difference in growth rates was evident as early as the 1-month treatment visit , suggesting that the effect on growth occurred initially . The growth-suppressive effect of BDP remained consistent across all age and gender subgroups , and among subjects with and without a previous history of corticosteroid use . Use of additional exogenous corticosteroids during the study was similar in both groups and did not affect the results . Because there was a baseline imbalance in height , a supplemental analysis of the differences in pre study growth rates was performed . This analysis found no baseline imbalance in pre study growth rates . To determine whether the difference in growth rates during the study could be attributed to preexisting growth rates , a z score analysis was performed . The heights of both groups were normalized at baseline and at the end of the study using the US National Center for Health Statistics data for mean and st and ard deviations of height . This analysis confirmed that the difference in growth rates between the 2 groups was primarily attributable to the treatment rather than to any preexisting difference in growth . Additional analyses confirmed that the results were not influenced by outlier values . No significant between-group difference were found in the hypothalamic-pituitary-adrenocortical axis assessment s. No unusual adverse events were observed . ( Objective : This study was design ed to demonstrate that four weeks of fluticasone propionate ( FP ) 100 micrograms ( mcg ) combined with salmeterol 50 mcg twice daily ( BID ) via DISKUS ® result ed in protection against bronchospasm induced by activity , as measured by st and ardized exercise challenge testing in pediatric and adolescent subjects who required regular use of inhaled corticosteroids for the treatment of persistent asthma . Methods : Prior to study entry , all patients reported regular use of inhaled corticosteroids ( ICS ) . During screening all patients demonstrated ≥20 % fall in FEV1 following exercise . Results : A total of 231 subjects aged 4 to 17 were r and omized to the two study treatments : 113 to the FP/salmeterol combination group ( FSC ) and 118 to receive FP 100 mcg BID . Of the subjects r and omized , 106 ( 94 % ) subjects in the FSC 100/50 group and 108 ( 92 % ) subjects in the FP 100 group completed the study . At the end of treatment ( Week 4 ) , both FSC and FP  protected against a fall in FEV1 following exercise in patients who at baseline experienced ≥20 % fall in FEV1 following exercise . A mean decrease in FEV1 of 9.9 % was observed in the FSC 100/50 group as compared with a mean decrease of 11.1 % in the FP 100 group ; there was no statistical difference between treatments . Conclusion : Both FSC 100/50 and FP 100 provided protection against an exercised-induced fall in FEV1 ; but statistically significant differences we not noted . Both treatments were well-tolerated over four weeks and FSC 100/50 had an adverse event profile comparable to that observed with FP 100 This 12-month dose-titration study assessed the effectiveness of budesonide/formoterol for maintenance plus relief with a control group using salmeterol/fluticasone for maintenance plus salbutamol for relief . Adolescents and adults ( n = 2,143 ; mean forced expiratory volume in one second ( FEV1 ) 73 % predicted ; mean inhaled corticosteroid ( ICS ) 884 µg·day−1 ) were r and omised  to budesonide/formoterol 160/4.5 µg two inhalations b.i.d . plus additional inhalations as needed , or salmeterol/fluticasone 50/250 µg b.i.d . plus salbutamol as needed . Treatment was prescribed open label ; after 4 weeks , physicians could titrate maintenance doses in accordance with normal clinical practice . Maintenance plus as-needed budesonide/formoterol prolonged the time to first severe exacerbation versus salmeterol/fluticasone ( 25 % risk reduction ) . The total number of severe exacerbations was significantly reduced in the budesonide/formoterol group ( 255 versus 329 ) . Both regimens provided sustained improvements in symptoms , as-needed use , quality of life and FEV1 , with differences in favour of the budesonide/formoterol group for as-needed use ( 0.58 versus 0.93 inhalations·day−1 ) and FEV1 ( post-β2-agonist values ) . Mean ICS dose during treatment was similar in both groups ( 653 µg budesonide·day−1 ( maintenance plus as-needed ) versus 583 µg fluticasone·day−1 ) . The simplified strategy using budesonide/formoterol for maintenance and reliever therapy is feasible , safe and at least as effective as salmeterol/fluticasone plus salbutamol Background Asthma is a major health problem and has significant mortality around the world . Although the symptoms can be controlled by drug treatment in most patients , effective low-risk , non-drug strategies could constitute a significant advance in asthma management . An increasing number of patients with asthma are attracted by acupuncture and moxibustion . Therefore , it is of importance that scientific evidence about the efficacy of this type of therapy is regarded . Our past research es suggested heat-sensitive moxibustion might be effective in treatment of asthma . Our objective is to investigate the effectiveness of  heat-sensitive moxibustion  compared with conventional drug treatment . Methods / Design This study is comprised of a multi-centre ( 12 centers in China ) , r and omized , controlled trial with two parallel arms ( A : heat-sensitive moxibustion ; B : conventional drug ) . Group A selects heat- sensitive acupoints from the rectangle region which consist of two outer lateral lines of dorsal Bladder Meridian of Foot-Taiyang 
    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: BACKGROUND AND OBJECTIVE : Impoverished urban children suffer disproportionately from asthma and underuse preventive asthma medications . The objective of this study was to examine cost-effectiveness ( CE ) of the School-Based Asthma Therapy ( SBAT ) program compared with usual care ( UC ) . METHODS : The analysis was based on the SBAT trial , including 525 children aged 3 to 10 years attending urban preschool or elementary school who were r and omized to either UC or administration of 1 dose of preventive asthma medication at school by the school nurse each school day . The primary outcome was the mean number of symptom-free days ( SFDs ) . The impact of the intervention on medical costs was estimated by using parent-reported child health services utilization data and average national reimbursement rates . We estimated the cost of running the program using wages for program staff . Productivity costs were estimated by using value of parent lost time due to child illness . CE of the SBAT program compared with UC was evaluated based on the incremental CE ratio . RESULTS : The health benefit of the intervention was equal to ∼158 SFD gained per each 30-day period ( P < .05 ) per 100 children . The programmatic expenses summed to an extra $ 4822 per 100 children per month . The net saving due to the intervention ( reduction in medical costs and parental productivity , and improvement in school attendance ) was $ 3240 , result ing in the incremental cost-savings difference of $ 1583 and CE of $ 10 per 1 extra SFD gained . CONCLUSIONS : The SBAT was effective and cost-effective in reducing symptoms in urban children with asthma compared with other existing programs A r and omised , double-blind trial was undertaken to investigate the efficacy and tolerability of formoterol Turbuhaler in children with mild to moderate asthma . After a two-week run-in , 248 children aged 6 - 17 years were r and omised to receive formoterol 4.5 and 9 pmicro b.i.d . or placebo for 12 weeks . Morning PEF ( primary variable ) , was significantly improved versus placebo only in the formoterol 9 pmicro b.i.d . group ( 13 l/min , 95 % CCI 1.9 , 24.2 % ; p = 0 .02 ) . Both formoterol 4.5 and 9 pmicro significantly increased the pre-bronchodilator FEV1 by 5.2 - 6.7 % ( p < 0 .05 ) and reduced use of daytime relief medication versus placebo ( p < 0 .05 ) . Formoterol 9 pmicro significantly reduced night-time reliever use and awakenings due to asthma versus placebo ( p < 0.05 ) . Both doses of formoterol were as well tolerated as placebo . In conclusion , formoterol 4.5 and 9 micro b.i.d . is effective and well tolerated as maintenance therapy in children with mild to moderate asthma BACKGROUND For children older than 5 years with asthma who remain symptomatic despite inhaled corticosteroid ( ICS ) therapy , the preferred treatment is to add an inhaled long-acting beta2-agonist vs increasing the ICS dose . OBJECTIVE To compare the safety of twice-daily treatment with inhaled fluticasone propionate plus the inhaled long-acting beta2-agonist salmeterol with that of fluticasone propionate used alone in children aged 4 to 11 years with persistent asthma . METHODS A r and omized , multicenter , double-blind , active-controlled , parallel-group study in 203 children with persistent asthma who were symptomatic during ICS therapy . Patients received fluticasone propionate-salmeterol ( 100/50 microg ) or fluticasone propionate ( 100 microg ) alone twice daily for 12 weeks . RESULTS The safety profile of fluticasone propionate-salmeterol was similar to that of fluticasone propionate alone . The overall incidence of adverse events was 59 % for fluticasone propionate-salmeterol and 57 % for fluticasone propionate . Both treatments were well tolerated . Two patients receiving fluticasone propionate-salmeterol and 5 receiving fluticasone propionate withdrew from the study because of worsening asthma . Changes in heart rate , blood pressure , and laboratory variables were infrequent and were similar between treatments . No patients had clinical ly significant abnormal electrocardiographic findings during treatment . Geometric mean 24-hour urinary cortisol excretion at baseline and after 12 weeks of treatment was comparable within and between groups ; no patient in either group had abnormally low 24-hour urinary cortisol excretion after 12 weeks of treatment . The incidence of withdrawals due to asthma exacerbations was 2 % in the fluticasone propionate-salmeterol group and 5 % in the fluticasone propionate group . CONCLUSIONS In pediatric patients with persistent asthma , fluticasone propionate-salmeterol twice daily was well tolerated , with a safety profile similar to that of fluticasone propionate used alone OBJECTIVE Intranasal beclomethasone dipropionate ( BDP ) has generally been considered to have no systemic activity at recommended doses , but the potential for long-term effects on growth has not previously been evaluated . This study was undertaken to assess the effects of 1 year of treatment with intranasal BDP on growth in children . STUDY DESIGN In this double-blind , r and omized , parallel-group study , 100 prepubertal children 6 to 9 years old with perennial allergic rhinitis were treated with aqueous BDP 168 microg twice daily ( n = 51 ) or placebo ( n = 49 ) for 1 year . Subjects ' baseline heights were required to be between the 5th and 95th percentile , and skeletal age as determined by left wrist radiograph was required to be within 2 years of chronological age . Washout periods for medications known to affect growth , including other forms of corticosteroids , were established , and these medications were prohibited during the study . However , short courses of oral prednisolone lasting no more than 7 days , and short courses of dermatologic corticosteroids lasting no more than 10 days , were allowed . Height was measured with a stadiometer after 1 , 2 , 4 , 6 , 8 , 10 , and 12 months of treatment . The hypothalamic-pituitary-adrenocortical axis was assessed by measurements of 8 AM basal cortisol concentrations and response to . 25 mg cosyntropin stimulation . The primary safety parameter was the rate of change in st and ing height . Statistical analyses were based on all r and omized subjects who received at least 1 dose of medication ( intent-to-treat principle ) . The rate of change in st and ing height was analyzed for all subjects who entered the study and for those completing the full 12 months of treatment ( n = 80 ) . The rate of change in st and ing height over the 1-year study was calculated as the slope of a linear regression line fitted to each subject 's height measurements over time . Because there was a statistically significant between-group difference in st and ing height at baseline , an analysis of covariance was performed for all analyses of st and ing height data . RESULTS Of the 100 subjects enrolled , 90 completed the study . The 2 treatment groups were generally comparable at baseline ; however , at baseline , mean age and mean height were significantly greater in the BDP treatment group that the in placebo treatment group . In both analyses , overall growth rate was significantly slower in BDP-treated subjects than placebo-treated subjects . The mean change in st and ing height after 1 year was 5.0 cm in the BDP-treated subjects compared with 5.9 cm in the placebo-treated subjects . The difference in growth rates was evident as early as the 1-month treatment visit , suggesting that the effect on growth occurred initially . The growth-suppressive effect of BDP remained consistent across all age and gender subgroups , and among subjects with and without a previous history of corticosteroid use . Use of additional exogenous corticosteroids during the study was similar in both groups and did not affect the results . Because there was a baseline imbalance in height , a supplemental analysis of the differences in pre study growth rates was performed . This analysis found no baseline imbalance in pre study growth rates . To determine whether the difference in growth rates during the study could be attributed to preexisting growth rates , a z score analysis was performed . The heights of both groups were normalized at baseline and at the end of the study using the US National Center for Health Statistics data for mean and st and ard deviations of height . This analysis confirmed that the difference in growth rates between the 2 groups was primarily attributable to the treatment rather than to any preexisting difference in growth . Additional analyses confirmed that the results were not influenced by outlier values . No significant between-group difference were found in the hypothalamic-pituitary-adrenocortical axis assessment s. No unusual adverse events were observed . ( Objective : This study was design ed to demonstrate that four weeks of fluticasone propionate ( FP ) 100 micrograms ( mcg ) combined with salmeterol 50 mcg twice daily ( BID ) via DISKUS ® result ed in protection against bronchospasm induced by activity , as measured by st and ardized exercise challenge testing in pediatric and adolescent subjects who required regular use of inhaled corticosteroids for the treatment of persistent asthma . Methods : Prior to study entry , all patients reported regular use of inhaled corticosteroids ( ICS ) . During screening all patients demonstrated ≥20 % fall in FEV1 following exercise . Results : A total of 231 subjects aged 4 to 17 were r and omized to the two study treatments : 113 to the FP/salmeterol combination group ( FSC ) and 118 to receive FP 100 mcg BID . Of the subjects r and omized , 106 ( 94 % ) subjects in the FSC 100/50 group and 108 ( 92 % ) subjects in the FP 100 group completed the study . At the end of treatment ( Week 4 ) , both FSC and FP  protected against a fall in FEV1 following exercise in patients who at baseline experienced ≥20 % fall in FEV1 following exercise . A mean decrease in FEV1 of 9.9 % was observed in the FSC 100/50 group as compared with a mean decrease of 11.1 % in the FP 100 group ; there was no statistical difference between treatments . Conclusion : Both FSC 100/50 and FP 100 provided protection against an exercised-induced fall in FEV1 ; but statistically significant differences we not noted . Both treatments were well-tolerated over four weeks and FSC 100/50 had an adverse event profile comparable to that observed with FP 100 This 12-month dose-titration study assessed the effectiveness of budesonide/formoterol for maintenance plus relief with a control group using salmeterol/fluticasone for maintenance plus salbutamol for relief . Adolescents and adults ( n = 2,143 ; mean forced expiratory volume in one second ( FEV1 ) 73 % predicted ; mean inhaled corticosteroid ( ICS ) 884 µg·day−1 ) were r and omised  to budesonide/formoterol 160/4.5 µg two inhalations b.i.d . plus additional inhalations as needed , or salmeterol/fluticasone 50/250 µg b.i.d . plus salbutamol as needed . Treatment was prescribed open label ; after 4 weeks , physicians could titrate maintenance doses in accordance with normal clinical practice . Maintenance plus as-needed budesonide/formoterol prolonged the time to first severe exacerbation versus salmeterol/fluticasone ( 25 % risk reduction ) . The total number of severe exacerbations was significantly reduced in the budesonide/formoterol group ( 255 versus 329 ) . Both regimens provided sustained improvements in symptoms , as-needed use , quality of life and FEV1 , with differences in favour of the budesonide/formoterol group for as-needed use ( 0.58 versus 0.93 inhalations·day−1 ) and FEV1 ( post-β2-agonist values ) . Mean ICS dose during treatment was similar in both groups ( 653 µg budesonide·day−1 ( maintenance plus as-needed ) versus 583 µg fluticasone·day−1 ) . The simplified strategy using budesonide/formoterol for maintenance and reliever therapy is feasible , safe and at least as effective as salmeterol/fluticasone plus salbutamol Background Asthma is a major health problem and has significant mortality around the world . Although the symptoms can be controlled by drug treatment in most patients , effective low-risk , non-drug strategies could constitute a significant advance in asthma management . An increasing number of patients with asthma are attracted by acupuncture and moxibustion . Therefore , it is of importance that scientific evidence about the efficacy of this type of therapy is regarded . Our past research es suggested heat-sensitive moxibustion might be effective in treatment of asthma . Our objective is to investigate the effectiveness of  heat-sensitive moxibustion  compared with conventional drug treatment . Methods / Design This study is comprised of a multi-centre ( 12 centers in China ) , r and omized , controlled trial with two parallel arms ( A : heat-sensitive moxibustion ; B : conventional drug ) . Group A selects heat- sensitive acupoints from the rectangle region which consist of two outer lateral lines of dorsal Bladder Meridian of Foot-Taiyang 
    Output:
    