***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 effect of periconceptional multivitamin supplementation on postnatal development was studied in a r and omised controlled trial comparing the use of a multivitamin tablet ( Elevit Pronatal ) with a tablet containing trace elements as part of the Hungarian Optimal Family Planning Programme . Of 4122 liveborn infants , 3356 were examined after the eighth month of life and medical records were obtained for a further 357 ; thus the total number of infants evaluated was 3713 ( 90.1 % ) . The mortality was not significantly different between the groups receiving the multivitamins ( 9.6/1000 ) and trace elements ( 7.1/1000 ) . There was no significant difference in the rates of serious or chronic disorders between the study groups except for atopic dermatitis , which was reported more often in the group receiving multivitamins ( 15 v four cases ) . Somatic development ( body weight , body length , and head circumference ) did not show a significant difference between the two groups . Mental and behavioural development was also similar in the two groups Abstract Background : Atopic dermatitis is a chronically relapsing , highly pruritic and inflammatory skin disease . This study was done to assess the effects of vitamins D and E supplementation on the clinical manifestation of atopic dermatitis . Methods : Forty-five atopic dermatitis patients were included in a r and omized , double-blind , placebo-controlled trial . They were r and omly divided into four groups and treated for 60 days : group P ( n = 11 ) , vitamins D and E placebos ; group D ( n = 12 ) , 1600 IU vitamin D3 plus vitamin E placebo ; group E ( n = 11 ) , 600 IU synthetic all-rac-α-tocopherol plus vitamin D placebo ; and group DE ( n = 11 ) , 1600 IU vitamin D3 plus 600 IU synthetic all-rac-α-tocopherol .  Serum 25(OH ) vitamin D and plasma α-tocopherol were determined before and after the trial . The clinical improvement was evaluated with SCORing Atopic Dermatitis ( SCORAD ) . Data were analyzed by analysis of variance ( ANOVA ) and Kruskal-Wallis tests . Results : SCORAD was reduced after 60 days in groups D , E and DE by 34.8 % , 35.7 % and 64.3 % , respectively ( p = 0.004 ) . Objective SCORAD also showed significant improvement . There was a positive correlation between SCORAD and intensity , objective , subjective and extent ( p < 0.001 ) . We found a significant negative association between plasma α-tocopherol and SCORAD , intensity , objective and extent ( p = 0.02 ) . Conclusion : This study supports the contributing and beneficial effects of vitamins D and E in the treatment of atopic dermatitis OBJECTIVE To evaluate the impact of childhood atopic eczema on families and assess the personal financial cost of its management . DESIGN Cross sectional survey . SETTING Paediatric dermatology and paediatric diabetology outpatient clinics . PATIENTS Parents of 48 r and omly selected children with atopic eczema and 46 with insulin dependent diabetes mellitus . MAIN OUTCOME MEASURES The impact on family score , the reported cost of relevant medical treatments , medical consultations , relevant hospitalisation , and income loss . RESULTS Families of children with moderate or severe atopic eczema had a significantly higher impact on family score than families of diabetic children . A conservative estimate of the annual personal financial cost of managing mild , moderate , and severe eczema was Aus$330 , 818 , and 1255 , respectively . The financial cost to the community for the management of atopic eczema in the study groups was greater . The personal financial cost of managing eczema was greater than for asthma . CONCLUSION Childhood atopic eczema has a profound impact on the social , personal , emotional , and financial perspectives of families It is uncertain whether B group vitamins are risk or preventive factors for allergic disorders . We prospect ively investigated the association between maternal intake of folate and vitamins B(12 ) , B(6 ) , and B(2 ) during pregnancy and the risk of wheeze and eczema in the infants aged 16 - 24 months . Subjects were 763 Japanese mother-child pairs . Data on maternal intake during pregnancy were assessed with a  diet history question naire ( DHQ ) . Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood . Among 763 infants , 169 ( 22.1 % ) and 142 ( 18.6 % ) had symptoms of wheeze and eczema  , respectively . There were no evident relationships between maternal consumption  of folate , vitamin B(12 ) , vitamin B(6 ) , and vitamin B(2 ) during pregnancy and the risk of wheeze or eczema in the offspring after adjustment for maternal age , gestation at baseline , residential municipality at baseline , family income , maternal and paternal education , maternal and paternal history of asthma , atopic eczema , and allergic rhinitis , changes in maternal diet in the previous 1 month , season when data at baseline were collected , maternal smoking during pregnancy , baby 's older siblings , baby 's sex , baby 's birth weight , household smoking in the same room as the infant , breastfeeding duration , age at which solid foods were introduced , age of infant at the third survey , and maternal intake of docosahexaenoic acid , n-6 polyunsaturated fatty acids , vitamin D , calcium , vitamin E , and β-carotene during pregnancy . Further investigation is warranted to draw conclusions as to the question of whether maternal B vitamin intake during pregnancy is related to the risk of childhood allergic disorders The present prospect i ve study examined the association between maternal consumption of dairy products , calcium , and vitamin D during pregnancy and the  risk of wheeze and eczema in the infants aged 16–24 months . Subjects were 763 Japanese mother – child pairs . Data on maternal intake during pregnancy were assessed with a diet history question naire . Symptoms of wheeze and eczema were based on criteria of the International Study of Asthma and Allergies in Childhood . Higher maternal intake of total dairy products , milk , cheese and calcium during pregnancy was significantly related to a decreased risk of infantile wheeze , but not eczema ( adjusted ORs ( 95 % CI ) between extreme quartiles were 0.45 ( 0.25−0.79 ) , 0.50 ( 0.28−0.87 ) , 0.51 ( 0.31−0.85 ) , and 0.57 ( 0.32−0.99 ) , respectively ) . When  maternal vitamin D consumption during pregnancy was categorised into two groups using a cut-off point at the 25th percentile , children whose mothers had consumed ≥4.309 μg·day−1 had a significantly reduced risk of wheeze and eczema ( adjusted ORs ( 95 % CI ) were 0.64 ( 0.43−0.97 ) and 0.63 ( 0.41−0.98 ) , respectively ) . Higher consumption of calcium and dairy foods other than yoghurt during pregnancy may reduce the risk of infantile wheeze .  Higher vitamin D intake during pregnancy may be protective against childhood wheeze and eczema Background : Hempseed oil is a rich and balanced source of omega‐6 and omega‐3 polyunsaturated fatty acids ( PUFAs ) . Anecdotal evidence indicated that dietary hempseed oil might be useful in treating symptoms of atopic dermatitis . Patients and methods : Dietary hempseed oil and olive oil were compared in a 20‐week r and omized , single‐blind crossover study with atopic patients . Fatty acid profiles were measured in plasma triglyceride , cholesteryl and phospholipid fractions . A patient question naire provided additional information on skin dryness , itchiness and usage of dermal medications . Skin transepidermal water loss ( TEWL ) was also measured . Results : Levels of both essential fatty acids ( EFAs ) , linoleic acid ( 18:2n6 ) and alpha‐linolenic acid ( 18:3n3 ) , and gamma‐linolenic acid ( GLA ; 18:3n6 ) increased in all lipid fractions after hempseed oil , with no significant increases of arachidonic acid ( 20:4n6 ) in any lipid fractions after either oil . Intra‐group TEWL values decreased ( p = 0.074 ) , qualities of both skin dryness and itchiness improved ( p = 0.027 ) and dermal medication usage decreased ( p = 0.024 ) after hempseed oil intervention . Conclusions : Dietary hempseed oil caused significant changes in plasma fatty acid profiles and improved clinical symptoms of atopic dermatitis . It is suggested that these improvements result ed from the balanced and abundant supply of PUFAs in this hempseed oil While atopic dermatitis ( AD ) usually presents early in life , few prospect i ve studies focus on young children with AD . The objective of this study was to characterize , phenotypically and prospect ively , young children with AD . From a community birth cohort of 2,256 children , consecutive children with AD ( n = 221 ) were followed to 2 years of age , when they were re-examined and screened for atopic sensitization ( skin-prick test to foods ; Phadiatop ) .  Ninety-nine controls were also examined . AD debuted during the first year in 88 % of cases . At the 2-year examination , when the children had already undergone topical treatment , 157/221 ( 71 % ) had ongoing eczema ranging among mild ( 45 % ) , moderate ( 53 % ) and severe ( 2 % ) . Airway problems indicating asthma had occurred in 9 % of cases and 6 % of controls ( not significant ) , and allergic rhinoconjunctivitis in 5 % and 0 % , respectively ( p<0.05 ) . The skin-prick test to common food allergens was positive in 27 % of cases and Phadiatop was positive in 15 % . In 67 % both tests were negative . Eczema severity did not differ between sensitized and non-sensitized children . Positive Phadiatop was more common in boys than in girls with ongoing AD ( 22 % vs 3 % , p<0.01 ) , and more boys than girls had ongoing AD ( 82 % vs 59 % , p<0.001 ) ; otherwise , no differences attributable to gender were found BACKGROUND Little is known about the prevalence of atopic eczema outside Northern Europe . OBJECTIVES We sought to describe the magnitude and variation in the prevalence of atopic eczema symptoms throughout the world . METHODS A cross-sectional question naire survey was conducted on r and om sample s of schoolchildren aged 6 to 7 years and 13 to 14 years from centers in 56 countries throughout the world . Those children with a positive response to being question ed about the presence of an itchy relapsing skin rash in the last 12 months that had affected their skin creases were considered to have atopic eczema . Children whose atopic eczema symptoms result ed in sleep disturbance for 1 or more nights per week were considered to have severe atopic eczema . RESULTS Complete data was available for 256,410 children aged 6 to 7 years in 90 centers and 458,623 children aged 13 to 14 years in 153 centers . The prevalence range for symptoms of atopic eczema was from less than 2 % in Iran to over 16 % in Japan and Sweden in the 6 to 7 year age range and less than 1 % in Albania to over 17 % in Nigeria for the 13 to 14 year age range . Higher prevalences of atopic eczema symptoms were reported in Australasia and Northern Europe , and lower prevalences were reported in Eastern and Central Europe and Asia . Similar patterns were seen for symptoms of severe atopic eczema . CONCLUSIONS Atopic eczema is a common health problem for children and adolescents throughout the world . Symptoms of atopic eczema exhibit wide variations in prevalence both within and between countries inhabited by similar ethnic groups , suggesting that environmental factors may be critical in determining disease expression . Studies that include objective skin examinations are required to confirm these findings Objective : To investigate whether dietary supplementation with polyunsaturated fatty acids ( PUFA ) of the omega 3 series ( n‐3 PUFA : 18:3 , n‐3 ; 20:5 , n‐3 ; and 22:6 , n‐3 ) , the omega 6 series ( n‐6 PUFA : 18:3 , n‐6 ) , vitamins and minerals have a clinical effect on atopic dermatitis . Methods : A total of 19 patients aged 17–43 years with moderate to severe atopic dermatitis participated in an open trial of high oral doses of n‐3 and n‐6 PUFA in dry form ( powder ) or omega 3,6,9 fatty acid capsules , vitamin E tablets ( d‐alpha‐tocopherol ) , zinc solution or tablets , and multivitamin capsules daily for 16 weeks . Results : The mean SCORAD improved in 14 of 17 patients by more than 50 % 
    Output:
    
There is no convincing evidence of the benefit of dietary supplements in eczema , and they can not be recommended for the public or for clinical practice at present .
Whilst some may argue that at least supplements do not do any harm , high doses of vitamin D may give rise to serious medical problems , and the cost of long-term supplements may also mount up