***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 --Tuberculous pleurisy can result in pleural fibrosis , calcification and thickening . To prevent these complications , corticosteroids are frequently used in addition to antituberculous drugs ; however , new therapeutic regimens can control the disease and minimise the sequelae , and there is no convincing evidence of the benefit of the use of corticosteroids as adjuvant therapy . METHODS -- Patients received isoniazid 5 mg/kg and rifampicin 10 mg/kg daily for six months . Additionally , they were r and omly assigned to a double blind treatment with either prednisone ( 1 mg/kg/day for 15 days and then tapering off ) or placebo during the first month of treatment . Different clinical , radiological , and functional parameters were evaluated to assess the effect of corticosteroids . RESULTS --Fifty seven patients received prednisone and 60 placebo .  At the end of the treatment the clinical outcome , the rate of reabsorption of the pleural fluid , the pleural sequelae , as well as lung capacity were similar in both groups . CONCLUSIONS --Corticosteroids do not influence the clinical outcome or the development of long term pleural sequelae in tuberculous pleurisy To determine the effect of adjunct therapy , we carried out a prospect i ve cohort study on 190 patients with tuberculous pleural effusion during May 2003-April 2004 . Patients were divided into 3 groups . All groups were treated with anti-tuberculosis ( TB ) drugs for 6 months ; in group 2 ( n = 46 ) prednisolone , 30 mg/day for 10 days , was added ; group 3 ( n = 78 ) were given paracentesis to remove fluid .  Fever and constitutional symptoms disappeared faster in group 2 ( P > 0.05 ) . After 10 days , there was a significantly greater reduction in the size of pleural effusion in group 2 , but after 6 months the difference was not statistically significant . We found corticosteroids and therapeutic paracentesis are not necessary in the management of TB pleural effusion BACKGROUND Active tuberculosis may accelerate progression of human immunodeficiency virus ( HIV ) infection by promoting viral replication in activated lymphocytes . Glucocorticoids are used in pleural tuberculosis to reduce inflammation-induced pathology , and their use also might reduce progression of HIV by suppressing immune activation . We examined the effect that prednisolone has on survival in HIV-1-associated pleural tuberculosis . METHODS We conducted a r and omized , double-blind , placebo-controlled trial of prednisolone as an adjunct to tuberculosis treatment , in adults with HIV-1-associated pleural tuberculosis . The primary outcome was death . Analysis was by intention to treat . RESULTS Of 197 participants , 99 were assigned to the prednisolone group and 98 to the placebo group . The mortality rate was 21 deaths/100 person-years ( pyr ) in the prednisolone group and 25 deaths/100 pyr in the placebo group ( age- , sex- , and initial CD4 + T cell count-adjusted mortality rate ratio , 0.99 [ 95 % confidence interval , 0.62 - 1.56 ] [ P = .95 ] ) . Resolution of tuberculosis was faster in the prednisolone group , but recurrence rates were slightly ( though not significantly ) higher , and use of prednisolone was associated with a significantly higher incidence of Kaposi sarcoma ( 4.2 cases/100 pyr , compared with 0 cases/100 pyr [ P = .02 ] ) . CONCLUSIONS In view of the lack of survival benefit and the increased risk of Kaposi sarcoma , the use of prednisolone in HIV-associated tuberculous pleurisy is not recommended Although several studies on tuberculous ( TB ) pleurisy suggest that the addition of corticosteroids to anti-TB therapy may have beneficial effects , these agents are not used routinely . To assess the effects of short-term oral prednisone therapy in TB pleurisy , 74 patients were r and omly assigned in a double-blind fashion to treatment with either placebo or prednisone at a dose of 0.75 mg/kg/d for up to 4 weeks with gradual reduction over an additional 2 weeks . All subjects received a st and ard 3-drug anti-TB chemotherapy regimen for 6 months . TB pleurisy was diagnosed by histologic study and /or culture of pleural biopsy specimens obtained at thoracoscopy . Complete drainage of the effusion was performed simultaneously . Outcome measures were assessed periodically for 24 weeks , including indexes of morbidity and pleural thickening . After r and omization , four patients were excluded from the final analysis . Of the 70 patients analyzed , 34 received prednisone and 36 received placebo . Demographic and clinical characteristics of the treatment groups were comparable at the time of hospital admission . Although a statistically significant improvement in symptoms occurred earlier in the prednisone group ( 8 weeks ) than in the placebo group ( 12 weeks ) , between-group comparison showed no significant differences at any of the follow-up evaluations . The proportion of subjects in the prednisone group ( 53.1 % ) with residual pleural thickening at 6 months did not differ significantly from that of the placebo group ( 60 % ) . Pleural effusions did not recur in any of the patients . Initial complete drainage of the effusion was associated with greater symptomatic improvement than any subsequent therapy . We conclude that st and ard anti-TB therapy and early complete drainage is adequate for the treatment of TB pleurisy . The addition of short-term oral prednisone therapy neither results in clinical ly relevant earlier symptom relief nor confers a beneficial effect on residual pleural thickening 
    Output:
    
Compared to the controls ( placebos or non-steroids ) , adjunctive corticosteroid use reduced the risk of residual pleural fluid after 4 weeks and the number of days to symptom improvement ; however , there was no convincing evidence to support the positive effects of corticosteroids over the long term ( 8 weeks ) on residual pleural fluid , pleural thickening , or pleural adhesions , and there was no statistical difference between the corticosteroid group and control group with respect to 7-days relief of the clinical symptoms or death from any cause .
In addition , more adverse events were observed in patients who received corticosteroids than in those in the control group .
Our results suggest that adjunctive corticosteroid use did not improve long-term efficacy and might induce more adverse events , although the risk of residual pleural fluid at 4 weeks and the number of days to symptom improvement were reduced