***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 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 More than 25 million patients have peripheral intravenous ( IV ) catheters placed each year in US hospitals .  Infusion therapy is believed to account for one third of all nosocomial bacteremias . METHODS We performed a r and omized , prospect i ve , controlled study in a university-affiliated hospital to determine whether the use of an IV therapy team decreases peripheral venous catheter-related complications in adult medical patients . Patients were r and omized to undergo peripheral catheter insertion and /or maintenance either by the IV team or by medical house staff . A dedicated observer review ed catheter sites daily ; findings were applied to a scoring system to define the severity of complications . Bacteremic complications were review ed by a physician . RESULTS Patients with catheters  started by the house staff and maintained by ward nursing staff more often had signs or symptoms of inflammation ( 21.7 % ) than did patients with catheters maintained by the IV team ( 7.9 % ) ( P<.001 ) . Patients monitored by the IV team had a greater mean number of catheters placed per patient than did patients monitored by house staff ( 2.1 and 1.6 , respectively ) ( P<.01 ) . Three episodes of catheter-related sepsis occurred in house staff patients and none in IV team patients ( P=.004 ) . CONCLUSIONS An IV therapy team significantly reduced both local and bacteremic complications of peripheral IV catheters . Timely replacement of the catheter appeared to be the most important factor in reducing the occurrence of complications In a prospect i ve , double-blind , r and omized trial the efficacy of a heparinoid in ointment form was assessed in treating superficial thrombophlebitis developing after continuous intravenous infusion . One hundred surgical patients were studied , and clinical examination and the iodine-125-labelled fibrinogen test used to assess the results . The mean time required for the relief of local symptoms and signs and the rate of local decline in radioactivity differed significantly between patients receiving the heparinoid cream and those recieving the placebo We have carried out a prospect i ve double-blind r and omized study in 40 patients with infusion-related thrombophlebitis . Twenty-two patients were included in the  glyceryltrinitrate ( GTN ) ointment group and 18 patients in the control heparinoid group .  Pain was assessed by an analogue scale . At 48 hours the analgesic index was 84.6 + /- 18 units with GTN and 49 + /- 45 units with heparinoid ointment ( P < 0.01 ) . Faster relief of oedema was also observed in the GTN-treated group . All signs of thrombophlebitis were relieved in less than 4 days in the GTN group compared with 9 days in the controls ( P < 0.005 ) . We conclude that transdermal GTN is useful therapy for infusion-related thrombophlebitis showing evidence of anti-inflammatory and analgesic effect Abstract Objective : To assess the clinical efficacy of a topical gel containing 1000 IU · g−1 of heparin , applied three times daily for a maximal period of 7 days to patients with acute superficial phlebitis secondary to indwelling intravenous catheter . Methods : A Double-blind , r and omized , placebo-controlled study was conducted in one of the internal medicine wards of a tertiary General Hospital in Barcelona , Spain . In patients of both genders over 18 years of age that developed superficial phlebitis and gave informed consent were included in the study . The sample size estimation was 132 patients . Sixty-six patients were allocated to each group . There were five protocol deviations and 24 withdrawals in the intervention group , and one protocol deviation and 25 withdrawals in the control group . Consequently , 37 patients in the intervention group and 40 in the control group completed the trial . The main outcome measure was the disappearance of the symptoms and signs of superficial phlebitis . Clinical course , investigator 's global impression and adverse events were also recorded . Results : According to the intention-to-treat analysis , after treatment for 7 days superficial phlebitis healed in 27 of the 61 patients ( 44.3 % ) who received topical heparin , and in 17 of the 65 patients ( 26.1 % ) receiving placebo , giving a relative risk [ 95 % confidence interval ( CI ) ] of 1.69 ( 1.03–2.78 ) . This indicates that six patients ( 95 % CI , 3–72 ) have to be treated in order to induce one additional healing . The clinical course and the overall clinical impression were similar in both groups . One patient treated with topical heparin developed mild urticaria . Conclusion : Topical heparin  is safe and effective for the treatment of superficial phlebitis secondary to indwelling intravenous catheter Four dressing regimens for peripheral venous catheters were studied in a prospect i ve r and omized clinical trial with 2088 Teflon catheters : ( 1 ) sterile gauze , replaced every other day , and three dressings left on for the lifetime of the catheter ; ( 2 ) gauze ; ( 3 ) a transparent polyurethane dressing ; and ( 4 ) an iodophor-transparent dressing . The four dressings provided comparable coverage , except moisture accumulated more frequently under the transparent dressings ( 26 % to 28 % vs 20 % to 21 % ) . Cutaneous colonization under the dressing was low level and comparable with all four dressings ( range , 10(0.58 ) to 10(0.70 ) colony-forming units ) . The rate of local catheter-related infection ( greater than or equal to 15 colony-forming units ) was also low and did not differ significantly ( range , 4.6 % to 5.9 % ) ; no catheter caused bacteremia . Stepwise logistic multivariate analysis showed cutaneous colonization of the insertion site ( relative risk [ RR ] of infection , 3.86 ) , contamination of the catheter hub ( RR , 3.78 ) , moisture under the dressing ( RR , 2.48 ) , and prolonged catheterization ( RR , 1.75 ) to be significant risk factors for catheter-related infection . These data indicate that it is not cost-effective to redress peripheral venous catheters at periodic intervals ; for most patients , either sterile gauze or a transparent dressing can be used and left on until the catheter is removed A prospect i ve study of the incidence and severity of infusion thrombophlebitis in peripheral intravenous infusions used for anaesthetic and postoperative purpose s in 645 patients was conducted over a four-month period . Conditions of insertion were carefully controlled while ward management was according to st and ard practice . A total of 330 polyurethane Vialon ® and 315 FEP-A Teflon ® cannulae were used . The results show that the nature of the cannula was the single most important factor in the incidence and severity of infusion thrombophlebitis , Vialon ® cannulae being associated with a 46 % lower incidence than the Teflon ® type . Less important but significant factors included intravenous antibiotics , duration of infusion , cannula tip damage and caesarean section . Factors not associated with infusion thrombophlebitis included potassium therapy , blood transfusion or site of insertion in the upper limb . Heparinisation increased duration of infusion without affecting the incidence of infusion thrombophlebitis The efficacy of an organo-heparinoid ointment ( Hirudoid 40,000 ) compared with a placebo ointment was tested in a double blind trial on 40 patients with post-operative infusion thrombophlebitis . It was possible to provide objective data by means of the 125I-fibrinogen test for accelerated regression of thrombi following treatment with organo-heparinoid . The differences found between the 2 treatment groups were statistically significant . The clinical results conformed largely to the measured data . Especially pain and swelling were favourably affected by treatment with the active compound . 1 case of local allergic reaction to organo-heparinoid was observed . No further side-effects were seen The incidence and causes of iatrogenic illness in a department of internal medicine were studied prospect ively in 1,176 patients admitted from 1 January 1986 to 31 December 1986 . A total of 295 patients ( 25.1 % ) developed 367 episodes of iatrogenic illness . Phlebitis occurred most frequently ( 75.2 % of all iatrogenic events ) , followed by drug reactions ( 10.7 % ) , contusion ( 4.6 % ) , and urinary tract infections ( 1.4 % ) . Nineteen patients developed life-threatening events ( in 2 it was the cause of death ) . Etiologic agents included intravenous catheter ( 79 % of all adverse reactions ) , drugs ( 9.5 % ) , falls from bed ( 5.4 % ) , diagnostic procedures ( 3.3 % ) , and urinary catheterization ( 1.6 % ) . Risk factors associated with iatrogenic illness were hospital stay longer than 12 days , female sex , poor general medical status on admission , intravenous catheterization , and intravenously administered antibiotics and anticoagulants . We conclude that in our hospital ( a ) 25 % of the inpatient admissions to the general medicine service result ed in iatrogenic illness , ( b ) most iatrogenic illnesses were not severe ( phlebitis ) , but 2 of 19 patients with life-threatening events died , and ( c ) the probability of developing iatrogenic illness generally depended on long hospital stay , poor general status at admission , and the use of both intravenous catheters and medication . In our patients , a reduction of hospital stay and a rational limitation of these procedures may diminish the rate of complications The aim of this r and omized , placebo-controlled study was to evaluate the effect of local treatment with Essaven gel ( EG ) , in comparison with placebo and with a group of controls in 23 patients with superficial vein thrombophlebitis ( SVTPH ) of the arms . SVTPH was consequent to infusional treatment with an intravenous catheter . The 4-week study evaluated the average skin temperature and an analogue symptomatic score . In patients treated with active EG , the decrease in score and in composite skin temperature was significantly larger than in the placebo and control groups . No intolerance was observed . The decrease in score and temperature in the placebo group was mainly due to skin manipulation and massage and to spontaneous resolution . In conclusion treatment with EG in arm SVTPH improves signs /symptoms and decreases skin temperature faster . This study confirms earlier observations on the effective , local use of EG in SVTPH OBJECTIVE To identify risk factors for  infusion-related phlebitis with peripheral intravenous catheters . DESIGN A r and omized trial of two catheter material s , with consideration of 21 potential risk factors . SETTING A university hospital . PATIENTS Hospitalized adults without granulocytopenia who received a peripheral intravenous catheter .  INTERVENTIONS House officers or ward nurses inserted the catheters , and each insertion was r and omized to a catheter made of tetrafluoroethylene-hexafluoropropylene ( FEP-Teflon ) or a novel polyetherurethane without leachable addit 
    Output:
    
Compared to placebo , oral non-steroidal anti-inflammatory drugs reduced signs and symptoms intensity .
Safety issues were reported sparsely and were not available for some interventions , such as notoginseny creams , parenteral low-molecular-weight heparin or defibrotide .
Data appear too preliminary to assess the effectiveness and safety of topical treatments , systemic anticoagulation or oral non-steroidal anti-inflammatory drugs