***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 usefulness of micronutrient antioxidant therapy for recurrent ( non‐gallstone ) pancreatitis has recently been endorsed by a 20‐week double‐blind double‐dummy cross‐over trial in 20 patients . Treatment was delivered as two types of tablets , providing daily doses of 600 μ g organic selenium , 9000 i.u . β ‐carotene , 0.54 g vitamin C , 270 i.u . vitamin E and 2 g methionine . We report antioxidant profiles in blood sample s collected before entry , at the cross‐over stage and upon completion of trial . Baseline serum concentrations of selenium , β ‐carotene and vitamin E  in the patients were significantly lower than in healthy controls , were unaltered by placebo and normalized by active treatment , but reverted to basal values in the subgroup that received placebo subsequently . The baseline serum concentration of a free radical marker — the 9‐cis , II‐trans isomer of linoleic acid — was significantly higher in the patients than in controls , fell inexplicably in the placebo phase and fell further upon active treatment . Discriminant analysis eliminated the overlap in free radical marker and selenium concentrations between control sera on the one h and and baseline or post‐placebo sample s from the patients on the other : antioxidant treatment normalized the relationship between these biochemical parameters . Subnormal baseline serum levels of S‐adenosylmethionine drifted downwards upon active treatment whereas a sharp rise was noted when a relapse of pancreatitis occurred during the placebo phase . The results confirm that adequate exposure to antioxidants in the active treatment phase was associated with amelioration of oxidative stress , and that there was no residual effect 10 weeks after switching over to placebo treatment . Furthermore , the paradoxical behaviour of S‐adenosylmethionine may imply that the beneficial effect of micronutrient antioxidants in recurrent pancreatitis is linked with preservation of the methionine trans‐sulfuration pathway in pancreatic acinar cells Oxidant stress has been proposed as the initiating pathogenetic mechanism in pancreatitis , hence micronutrient antioxidant therapy has been assessed in patients with recurrent attacks and /or constant pancreatic pain . In a 20‐week double‐blind double‐dummy crossover trial active treatment was given as two types of tablets providing daily doses of 600 μg organic selenium , 9000 IU β carotene , 0.54 g vitamin C , 270 IU vitamin E and 2 g methionine . Of 28 patients enrolled , 20 adhered to the full protocol ( idiopathic chronic 8 , alcoholic chronic 7 , idiopathic acute 5 ) . Six patients had an attack whilst on placebo but none whilst on active treatment ( P= 0.032 ) . Analysis of visual analogue scoresheets to compare background pain in the 10‐week period before entry and during each phase of the trial , using a 10‐cm scale for each of 11 best descriptors , endorsed the beneficial effect of active treatment ( placebo v baseline , P= 0.073 ; active v baseline , P < 0.001 ; active v placebo , P= 0.049 ) . The same trend emerged from analysis of pain‐score diaries by conventional and time series methods . Micronutrient antioxidant therapy thus offers a new approach to the treatment of recurrent ( non‐gallstone ) pancreatitis and /or pancreatic pain BACKGROUND & AIMS Endoscopic retro grade cholangiopancreatography ( ERCP ) is associated with a risk of pancreatitis ( PEP ) . Animal studies suggest that ( single-dose ) allopurinol ( xanthine oxidase inhibitor with high oral bioavailability and long-lasting active metabolites ) may reduce this risk ; human study results are conflicting . The aim of this study was to determine if allopurinol decreases the rate of PEP . METHODS Patients referred for ERCP to 9 endoscopists at 2 tertiary centers were r and omized to receive either allopurinol 300 mg or identical placebo orally 60 minutes before ERCP , stratified according to high-risk ERCP ( manometry or pancreatic therapy ) . The primary outcome ( PEP ) was adjudicated blindly ; pancreatitis was defined according to the Cotton consensus , and evaluated at 48 hours and 30 days . Secondary outcomes included severe PEP , length of stay , and mortality ( nil ) . The trial was terminated after the blinded ( midpoint ) interim analysis , as recommended by the independent data and safety monitoring committee . RESULTS We r and omized 586 subjects , 293 to each arm . The crude PEP rates were 5.5 % ( allopurinol ) and 4.1 % ( placebo ) , ( P = .44 ; difference = 1.4 % ; 95 % confidence interval , -2.1 % to 4.8 % ) . The Mantel-Haenszel combined risk ratio for PEP with allopurinol , considering stratification , was 1.37 ( 95 % confidence interval , 0.65 - 2.86 ) . Subgroup analyses suggested nonsignificant trends toward possible benefit in the high-risk group , and possible harm for the remaining subjects . Logistic regression found pancreatic therapy , pancreatic injection , and prior PEP to be the only independent predictors of PEP . CONCLUSIONS Allopurinol does not appear to reduce the overall risk of PEP ; however , its potential benefit in the high-risk group ( but potential harm for non-high-risk patients ) means further study is required BACKGROUND & AIMS Oxidative stress has been implicated in the pathophysiology of chronic pancreatitis ( CP ) . We evaluated the effects of antioxidant supplementation on pain relief , oxidative stress , and antioxidant status in patients with CP . METHODS In a placebo-controlled double blind trial , consecutive patients with CP were r and omized to groups that were given placebo or antioxidants for 6 months . The primary outcome measure was pain relief , and secondary outcome measures were analgesic requirements , hospitalization , and markers of oxidative stress ( thiobarbituric acid-reactive substances [ TBARS ] ) and antioxidant status ( ferric-reducing ability of plasma [ FRAP ] ) . RESULTS Patients ( age 30.5+/-10.5 years , 86 male , 35 alcoholic , and 92 with idiopathic CP ) were assigned to the placebo ( n=56 ) or antioxidant groups ( n=71 ) . After 6 months , the reduction in the number of painful days per month was significantly higher in the antioxidant group compared with the placebo group ( 7.4+/-6.8 vs 3.2+/-4 , respectively ; P < .001 ; 95 % CI , 2.07 , 6.23 ) . The reduction in the number of analgesic tablets per month was also higher in the antioxidant group ( 10.5+/-11.8 vs 4.4+/-5.8 respectively ; P= .001 ; 95 % CI , 2.65 , 9.65 ) . Furthermore , 32 % and 13 % of patients became pain free in the antioxidant and placebo groups , respectively ( P= .009 ) . The reduction in the level of TBARS and increase in FRAP were significantly higher in the antioxidant group compared with the placebo group ( TBARS : placebo 1.2+/-2.7 vs antioxidant 3.5+/-3.4 nmol/mL ; P= .001 ; 95 % CI 0.96 , 3.55 ; FRAP : placebo -5.6+/-154.9 vs antioxidant 97.8+/-134.9 microMFe(+2 ) liberated , P= .001 , 95 % CI 44.98 , 161.7 ) . CONCLUSIONS Antioxidant supplementation was effective in relieving pain and reducing levels of oxidative stress in patients with CP AIM To undertake a baseline study comparing quality of life ( QoL ) in patients with chronic pancreatitis ( CP ) on Antox to those with CP , matched for disease duration , who were not on this medication . METHODS CP was defined according to the Zurich classification . Sixty eight consecutive patients with CP who were taking Antox ( antioxidants ) were compared with 69 consecutive control CP patients not on Antox .  European Organization for Research and Treatment of Cancer Quality of Life Question naire Core questions 30 and Pancreatic Modification ( 28 questions ) were used to assess QoL. Out of a total of 137 patients 28 in each group were matched for disease duration ( within 12 mo ) . Median disease duration was 8 ( 1 - 22 ) years in the Antox group and 7 ( 1 - 23 ) years in the Non-Antox cohort ( P = NS , Mann-Whitney U-test ) . Other parameters ( age , gender , etiology , endocrine and exocrine insufficiency ) were similar between groups . RESULTS Median visual analogue pain score in the Antox group was 3 ( 0 - 8 ) compared with 6 ( 0 - 8 ) in the Non-Antox group ( P < 0.01 ) . Perceptions of cognitive , emotional , social , physical and role function were impaired in the Non-Antox group compared to Antox patients ( P < 0.0001 , P = 0.0007 , P = 0.0032 and P < 0.005 and P < 0.001 , respectively ) . Analgesics and opiate usage was significantly lower in the Antox group ( P < 0.01 ) . Overall physical health and global QoL was better in the Antox group ( P < 0.0001 , 95 % CI : 1.5 - 3 ) . CONCLUSION Contemporary quality of life assessment s show that after correction for disease duration and cigarette smoking , patients with CP taking antox had better scores than non-antox controls UNLABELLED Incidence and prevalence of chronic pancreatitis ( CP ) are poorly known and prospect i ve nationwide epidemiologic estimation has never been performed . AIMS To estimate prospect ively national incidence and prevalence of patients attending gastroenterologists for CP in France . PATIENTS AND METHODS Study was proposed to all of the French gastroenterologists ( N=3215 ) of whom 753 accepted to participate ( 24 % private , 40 % hospital and 36 % both ) . Were included all patients suffering from proved or suspected CP , from 04 - 2003 to 07 - 2003 . Certain diagnostic criteria were pancreatic calcifications , ductal or histological abnormalities . For all of non-responder gastroenterologists , a tracking system was used ( mail or by phone ) . RESULTS A total of 456 gastroenterologists returned at least 1 case on 1748 patients . Median patient age was 51 years ; sex-ratio was 5.07 . Median duration between the first CP sign and the inclusion was 41 months . CP cause was alcoholism ( 84 % ) , hereditary ( 1 % ) , cystic fibrosis ( 1 % ) , idiopathic ( 9 % ) , other ( 6 % ) . CP diagnosis was certain in 77 % : calcifications ( 85 % ) , ductal abnormalities ( 57 % ) , and histology ( 8 % ) . CP symptoms were : chronic abdominal pain ( 53 % ) , acute pancreatitis episodes ( 67 % ) , pseudocysts ( 40 % ) , bi-liary tract compression ( 21 % ) , diabetes mellitus ( 32 % ) , pancreatic exocrine insufficiency ( 36 % ) . Maximal annual incidence was 4,646 ( crude annual incidence : 7.7 per 100,000 ; 12.9 in male ; 2.6 in female ) and prevalence was 15,832 cases ( crude prevalence : 26.4 per 100,000 ; 43.8 in male ; 9.0 in female ) . CONCLUSION New CP patients attending gastroenterologists are about 5,000 a year . CP prevalence is about 16,000 patients ( in France : 60,400,000 inhabitants ) . Frequency of main complications is close to hospital series , confirming that results issued from these centers are not or a few biased This r and omized double-blind trial examined the influence of the radical scavengers allopurinol ( 50 mg per rectum , four times per day ) and dimethyl sulfoxide ( 500 mg per rectum , four times per day ) on pancreatic pain treated with intramuscular pethidine hydrochloride ( 100 mg followed by 50 mg every 4 hours until complete pain relief ) in patients given nothing orally and intravenously hydrated . Addition of allopurinol or dimethyl sulfoxide to the analgesic regimen significantly enhanced its efficacy , enabling at least 57 % ( 13 patients receiving allopurinol  and 12 patients receiving dimethyl sulfoxide ) of 43 patients to be free of pain within 12 hours after admission compared with only four ( 17 % ) of 23 controls achieving the same effect . This advantage extended to all patients within 24 hours after admission , leaving 11 controls ( 48 % ) still in pain . Consequently , all patients given allopurinol or dimethyl sulfoxide were discharged 3 days after admission , a result realized in 
    Output:
    
Current evidence shows that antioxidants can reduce pain slightly in patients with chronic pancreatitis .