Please select the eligibility criteria that correspond to the clinical trial below.
Title: Can Montelukast Shorten Corticosteroid Therapy In Children With Mild To Moderate Acute Asthma?
Brief Summary: The primary objective of this study is to evaluate if children with acute asthma given a single dose of oral prednisolone with a subsequent daily five-day course of oral Montelukast will achieve a therapeutic failure rate at day 8 not significantly higher than those given six daily doses of oral prednisolone. Secondary objectives include comparison of the two groups with respect to the changes in symptoms, beta2 agonists, clinical asthma score and days without asthma by day 8.


Options:
A: Asthmatic children from birth to 18 years. Emphasis is placed on infants and young children through 5 years of age.
B: Inclusion Criteria:

* age 2-17 years
* Clinical diagnosis of mild to moderate asthma as a second wheezing episode associated with signs of respiratory distress suggesting lower airway obstruction such as tachypnea and/or use of accessory muscles of respiration.
* baseline Pulmonary Index Clinical Score (Appendix B) ≤ 11 out of 15 possible points as well as PRAM ≤ 8 out of 12 points.
* Presenting to the Sick Kids Emergency Department
* Children capable of FEV1 measurement will have FEV1 more than 60% of the predicted value
* male or female
* Willing and able to provide informed consent (or informed consent by parents)

Exclusion Criteria:

* No previous history of wheezing or bronchodilator therapy. This population may eventually have diagnoses other than asthma or viral induced wheezing
* Patients who received more than a single dose of oral corticosteroids within 72 hours prior to arrival
* Patients receiving more than 500 mcg per day of fluticasone for more than 1 month or more than 250 mcg of fluticasone for more than 7 days prior to arrival
* Patients who have had more than 2 previous visits to the asthma clinic at SickKids
* Patients who received Montelukast within one week of arrival
* Critically ill patients requiring airway stabilization
* Patients with severe asthma, defined as PI 12 to 15 or PRAM 9 to 12.
* Co-existent co-morbidities such as chronic pulmonary disease and cardiac disease requiring pharmacotherapy, neurologic disease and immune disorders.
* Previous admission to ICU for asthma.
* More than 3 hospitalizations for asthma during the past 12 months.
* Contact with varicella within the previous 21 days.
* Insufficient command of the English language
C: Inclusion: Asthma not well-controlled; doctor-diagnosed asthma; currently taking asthma medications; 12 % and 200ml increase in FEV1 after 2 puffs of an inhaled short-acting -agonist (SABA) bronchodilator ; 2 or more control problems identified using the ATAQ asthma control instrument; 18-70 years of age; willing to be randomized to one of the three treatment arms and to participate in follow-up for 2 years; Kaiser Permanente member for 1 year

Exclusion: Mild intermittent asthma, defined as either seasonal asthma or (daytime asthma symptoms \<2x/week and nocturnal symptoms \<2x/month and no use of controller medications); under the ongoing care of an allergist or pulmonologist; regular use of oral corticosteroids; currently receiving case-management for their asthma; unable to speak, read or understand English; planning to leave the catchment area within the next two years
D: Inclusion Criteria:

* Children aged 5-15 years of age, either sex seeking treatment with acute moderate to severe asthma in pediatric casualty/ chest clinic/ out patient services. Acute moderate to severe asthma is defined as modified pulmonary index score of more than 9.

Exclusion Criteria:

* Children with life threatening asthma (poor respiratory efforts, cyanosis, altered sensorium).
* Children who had received montelukast within one week of arrival.
* Children with other chronic respiratory conditions (including congenital lung abnormalities) like tuberculosis, cystic fibrosis or other acute illnesses that would complicate current treatment and response for asthma.
* Children with altered sensorium/unable to take oral medication.

Answer: B