***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 
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    ***EXAMPLES*** 
    Input: The paper reports the results obtained in 20 patients affected by varicophlebitis of the lower limbs following the oral administration of an anti-inflammatory substance .  Results were compared with findings in single-blind study performed in a group of 20 patients treated with placebo .  The evaluation of residual signs and symptoms and the control of recanalization of venous collectors using Doppler tests revealed a difference between the two groups in favour of the patients treated with the anti-inflammatory agent , although this was not statistically significant . The use of the drug was considered useful as a support to conservative varicophlebitis therapy with the aim of accelerating the resolution of the inflamed condition and thus reducing the functional disability of the limb In contrast with extensive information on the management of deep vein thrombosis of the lower extremities , little is known on the most appropriate treatment of the superficial vein thrombosis ( SVT ) . In a multicenter , prospect i ve , controlled , double-blind , double-dummy clinical trial , 164 consecutive patients with acute SVT of the great saphenous vein were r and omized to receive the s.c . administration of either fixed prophylactic doses ( 2850 a-Xa IU ) or body-weight adjusted therapeutic doses of nadroparin once daily for 1 month . The main study outcome was to compare the rate of asymptomatic and symptomatic extension of SVT and /or venous thromboembolic ( VTE ) complications during a 3-month follow-up period . Of the 81 patients r and omized to the prophylactic doses , seven [ 8.6 % ; 95 % confidence interval ( CI ) , 3.5 - 17.0 ] developed SVT progression or VTE complications as compared with six of the 83 ( 7.2 % ; 95 % CI , 2.8 - 15.1 ) allocated to the treatment group ( absolute difference , 1.4 ; 96 % CI , -6.9 to 9.7 ; P = 0.74 ) . No patient in either group developed major bleeding . Our findings suggest that therapeutic doses of low-molecular-weight heparin , administered for 1 month in patients with SVT of the greater saphenous vein do not improve results obtained by prophylactic doses , administered for the same period , over a 3-month follow-up period Fifty-six patients with superficial thrombovaricophlebitis of the lower limbs were enrolled in an open and multicenter ( 4 centers ) trial for a period of thirty days . Patients were r and omly allocated to three treatment groups to receive a new low-molecular-weight dermatan sulfate ( Desmin ) at the dose , respectively , of 100 mg once daily by subcuta neous ( SC ) route , 100 mg twice a day SC , and 200 mg once daily by intramuscular ( IM ) route . The general and local tolerability and the clinical efficacy of the drug were evaluated by means of clinical , instrumental , and laboratory parameters . Desmin proved capable of effectively improving the symptoms of patients affected by thrombovari cophlebitis  , inducing rapid regression by the tenth day of treatment . The daily dose of 200 mg ( either SC or IM ) was more effective than the 100 mg dose . The systemic toler ability of the drug , administered for the first time for one month , was extremely good , without significant variations in the relevant laboratory tests . Local tolerance ( at the site of injection ) of the drug was also good BACKGROUND The efficacy and safety of anticoagulant treatment for patients with acute , symptomatic superficial-vein thrombosis in the legs , but without concomitant deep-vein thrombosis or symptomatic pulmonary embolism at presentation , have not been established . METHODS In a r and omized , double-blind trial , we assigned 3002 patients to receive either fondaparinux , administered subcutaneously at a dose of 2.5 mg once daily , or placebo for 45 days . The primary efficacy outcome was a composite of death from any cause or symptomatic pulmonary embolism , symptomatic deep-vein thrombosis , or symptomatic extension to the saphenofemoral junction or symptomatic recurrence of superficial-vein thrombosis at day 47 . The main safety outcome was major bleeding . The patients were followed until day 77 . RESULTS The primary efficacy outcome occurred in 13 of 1502 patients ( 0.9 % ) in the fondaparinux group and 88 of 1500 patients ( 5.9 % ) in the placebo group ( relative risk reduction with fondaparinux , 85 % ; 95 % confidence interval [ CI ] , 74 to 92 ; P<0.001 ) . The incidence of each component of the primary efficacy outcome was significantly reduced in the fondaparinux group as compared with the placebo group , except for the outcome of death ( 0.1 % in both groups ) . The rate of pulmonary embolism or deep-vein thrombosis was 85 % lower in the fondaparinux group than in the placebo group ( 0.2 % vs. 1.3 % ; 95 % CI , 50 to 95 ; P<0.001 ) . Similar risk reductions were observed at day 77 . A total of 88 patients would need to be treated to prevent one instance of pulmonary embolism or deep-vein thrombosis . Major bleeding occurred in one patient in each group . The incidence of serious adverse events was 0.7 % with fondaparinux and 1.1 % with placebo . CONCLUSIONS Fondaparinux at a dose of 2.5 mg once a day for 45 days was effective in the treatment of patients with acute , symptomatic superficial-vein thrombosis of the legs and did not have serious side effects . ( Funded by GlaxoSmithKline ; Clinical Trials.gov number , NCT00443053 . Background The heterogeneity statistic I2 , interpreted as the percentage of variability due to heterogeneity between studies rather than sampling error , depends on precision , that is , the size of the studies included . Methods Based on a real meta- analysis , we simulate artificially ' inflating ' the sample size under the r and om effects model . For a given inflation factor M = 1 , 2 , 3 , ... and for each trial i , we create a M-inflated trial by drawing a treatment effect estimate from the r and om effects model , using si2MathType@MTEF@5@5@+=feaagaart1ev2aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBaebbnrfifHhDYfgasaacPC6xNi = xH8viVGI8Gi = hEeeu0xXdbba9frFj0xb9qqpG0dXdb9aspeI8k8fiI+fsY = rqGqVepae9pg0db9vqaiVgFr0xfr = xfr = xc9adbaqaaeGaciGaaiaabeqaaeqabiWaaaGcbaGaem4Cam3aa0baaSqaaiabdMgaPbqaaiabikdaYaaaaaa@2FBE@/M as within-trial sampling variance . Results As precision increases , while estimates of the heterogeneity variance τ2 remain unchanged on average , estimates of I2 increase rapidly to nearly 100 % . A similar phenomenon is apparent in a sample of 157 meta-analyses . Conclusion When deciding whether or not to pool treatment estimates in a meta- analysis , the yard-stick should be the clinical relevance of any heterogeneity present . τ2 , rather than I2 , is the appropriate measure for this purpose BACKGROUND Optimal doses and duration of low-molecular-weight heparin ( LMWH ) for the treatment of superficial vein thrombosis ( SVT ) are still uncertain . OBJECTIVES To compare the efficacy and safety of different doses and duration s of LMWH parnaparin for symptomatic lower limb SVT . PATIENTS AND METHODS Out patients with at least a 4-cm-long SVT of long or short saphenous veins or their collaterals were r and omized to receive parnaparin either 8500 UI once daily ( o.d . ) for 10 days followed by placebo for 20 days ( group A ) or 8500 UI o.d . for 10 days followed by 6400 UI once daily ( o.d . ) for 20 days ( group B ) or 4250 UI o.d . for 30 days ( group C ) in a double-blind fashion in 16 clinics . Primary outcome was the composite of symptomatic and asymptomatic deep vein thrombosis ( DVT ) , symptomatic pulmonary embolism ( PE ) and relapse and /or symptomatic or asymptomatic SVT recurrence in the first 33 days with 60 days follow-up . RESULTS Among 664 patients , primary outcome occurred in 33/212 ( 15.6 % ) , 4/219 ( 1.8 % ) and 16/217 ( 7.3 % ) subjects in groups A , B and C , respectively ( B vs. A : absolute risk reduction [ ARR ] : 13.7 % , 95 % confidence intervals [ CI ] : 8 - 18.9 P<0.001 ; B vs. C : ARR : 5.5 % ; 95 % CI : 1.6 - 9.4 P= 0.011 ; C vs. A : ARR : 8.2 % , 95 % CI : 2 - 14 P=0.012 ) . During days 0 - 93 , the event rate was higher in group A ( 22.6 % ) than either in group B ( 8.7 % ; P=0.001 ) or C ( 14.3 % , P=0.034 ) . No major hemorrhages occurred . CONCLUSIONS An intermediate dose of parnaparin for 30 days is superior to either a 30-day prophylactic dose or a 10-day intermediate dose for lower limb SVT treatment The objective of this study was to assess the efficacy and safety of liposomal heparin spray — a new formula of topical heparin delivery . This was a r and omized , multicenter , controlled open clinical trial with 2 parallel groups . Forty-six out patients with clinical signs of superficial venous thrombosis ( SVT ) were treated with either topical liposomal heparin spraygel ( LHSG ) ( Lipohep Forte Spraygel , 4 puffs of 458 IU tid ( n=22 ) or with low-molecular-weight heparin ( LMWH ) ( Clexane 40 mg once a day ( n=24 ) , administered subcutaneously ( sc ) . Main outcome measures were efficacy parameters ( improvement of local symptoms — pain control and planimetric evaluation of erythema size , duplex Doppler assessment of thrombus regression ) and safety parameters ( documentation of adverse events , with particular reference to deep vein thrombosis [ DVT ] by duplex sonography , and patients ’ and investigators ’ assessment of drug tolerance ) . Patients ’ and investigators ’ subjective assessment of efficacy of treatment and change in basic biochemical parameters were defined as secondary outcome measures . Statistical analysis was performed with use of Wilcoxon test , Mann-Whitney U-test and Chi-square test . Regression of SVT-related symptoms , including pain , erythema , and thrombus presence , was shown as comparable in LHSG and LMWH groups . These results were corroborated by efficacy assessment by investigators and patients . Three cases of deep venous thrombosis in heparin spraygel and 1 in heparin sc group were reported . No significant adverse reactions were observed in the spraygel group , but 1 serious allergic reaction was observed in the LMWH group . Tolerance of new formula heparin was assessed as good . Heparin spraygel — a new topical mode of heparin application , seems a promising method of heparin delivery . This initial study has demonstrated comparable efficacy and safety of LHSG and LMWH in local treatment of SVT . These findings should be confirmed by further extensive study that will reach appropriate statistical power to support such conclusion , for despite heparin treatment , significant risk of DVT was demonstrated in both groups BACKGROUND The efficacy and safety of antithrombotic treatment in patients with superficial vein thrombosis remain to be established in adequately design ed trials . METHODS In a double-blind trial , 427 patients older than 18 years , with documented acute symptomatic superficial vein thrombosis of the legs , were r and omly assigned to receive subcutaneous enoxaparin sodium , 40 mg ; subcutaneous enoxaparin , 1.5 mg/kg ; oral tenoxicam ; or placebo , once daily for 8 to 12 days . The primary efficacy outcome was deep venous thromboembolism between days 1 and 12 , defined as deep vein thrombosis detected by ultrasonography between days 8 and 12 or earlier if clinical ly indicated , or documented symptomatic pulmonary embolism . For the secondary efficacy outcomes , superficial vein thrombosis recurrence or extension was also considered . RESULTS The incidence of deep venous thromboembolism by day 12 was 3.6 % ( 4 of 111 patients ) in the placebo group , 0.9 % ( 1 of 109 patients ) in the 40-mg enoxaparin group ( P = .37 vs placebo ) , 1.0 % ( 1 of 102 patients ) in the 1.5-mg/kg enoxaparin group ( P = .37 vs placebo ) , and 2.1 % ( 2 of 94 patients ) in the ten 
    Output:
    
Overall , topical treatments improved local symptoms compared with placebo , but no data were provided on the effects on VTE and ST extension .
Surgical treatment combined with elastic stockings was associated with a lower VTE rate and ST progression compared with elastic stockings alone .
AUTHORS ' CONCLUSIONS Prophylactic dose fondaparinux given for 45 days appears to be a valid therapeutic option for ST of the legs for most people .
The evidence on topical treatment or surgery is too limited and does not inform clinical practice about the effects of these treatments in terms of VTE .