***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: OBJECTIVE We studied the ability of carbazochrome sodium sulfonate ( AC-17 ) to prevent capillary permeability in dengue hemorrhagic fever/dengue shock syndrome . METHOD A r and omized , placebo-controlled trial in 95 children stratified by age and sex was conducted in two hospitals during 1992 .  AC-17 ( n = 45 cases ) or B vitamins as placebo ( n = 50 ) were given as a bolus infusion and then as a continuous drip for 24 hours ; a total of 300 mg of AC-17 was administered on the first 2 days and 150 mg on the third day . RESULTS The two groups were comparable in age , sex , duration of illness , and clinical manifestations . No significant difference in shock or pleural effusion was noted between the two groups . Shock developed in 8.9 % ( 4/45 ) of patients in the AC-17 group and 6 % ( 3/50 ) in the placebo group ( p = 0.44 ) . Pleural effusion was found at 0 , 24 , 48 , and 72 hours after admission in 4.4 % , 20 % , 31.1 % , and 20 % in the AC-17 group and 2 % , 14 % , 28 % , and 14 % in the placebo group , respectively . CONCLUSION Administration of AC-17 does not prevent plasma leakage or shock in dengue hemorrhagic fever/dengue shock syndrome Despite the absence of a clear-cut rationale for their use , corticosteroids are widely employed in the treatment of dengue shock syndrome . Previous comparative therapeutic trials have yielded contradictory results . Resolution of this therapeutic controversy has been attempted with a double-blind evaluation of the clinical effect of steroid administration in dengue shock syndrome . Placebo or a single dose of hydrocortisone hemisuccinate , 50 mg/kg of body weight , was administered r and omly to 97 physiologically treated patients with dengue shock syndrome . The severity of disease on admission to the hospital and the effectiveness of treatment were quantified by a World Health Organization scoring system . The response to therapy as measured by mortality , duration of shock , and amount of replacement fluids required was virtually identical in 47 children who were and 50 children who were not treated with steroids . The comparison groups were composed of children similar in age , sex , and severity of illness . It is concluded that hydrocortisone is of no value in the treatment of dengue shock syndrome . Reliance should be placed on appropriate supportive and physiologic therapy Dengue hemorrhagic fever and dengue shock syndrome ( DSS ) are major causes of childhood morbidity and mortality in many tropical countries . Increased intravascular permeability leading to shock is the cardinal feature of DSS . Fluid resuscitation to counteract massive plasma leakage is the mainstay of treatment . A double-blind , r and omized trial comparing four intravenous-fluid regimens for acute resuscitation of 50 children with DSS was conducted . Colloids ( dextran 70 or the protein digest gelafundin 35,000 ) restored cardiac index and blood pressure and normalized hematocrit more rapidly than crystalloids ( Ringer 's lactate or 0.9%-weight/volume saline ) . Dextran 70 provided the most rapid normalization of the hematocrit and restoration of the cardiac index , without adverse effects , and may be the preferred solution for acute resuscitation in DSS . Further large-scale double-blind trials are required to provide an evidence -based approach to the management of DSS Dengue hemorrhagic fever is an important cause of morbidity among Asian children , and the more severe dengue shock syndrome ( DSS ) causes a significant number of childhood deaths . DSS is characterized by a massive increase in systemic capillary permeability with consequent hypovolemia . Fluid resuscitation is critical , but as yet there have been no large trials to determine the optimal fluid regimen . We undertook a r and omized blinded comparison of 4 fluids ( dextran , gelatin , lactated Ringer 's , and " normal " saline ) for initial resuscitation of 230 Vietnamese children with DSS . All the children survived , and there was no clear advantage to using any of the 4 fluids , but the longest recovery times occurred in the lactated Ringer 's group . The most significant factor determining clinical response was the pulse pressure at presentation . A comparison of the colloid and crystalloid groups suggested benefits in children presenting with lower pulse pressures who received one of the colloids . Further large-scale studies , stratified for admission pulse pressure , are indicated A total of 98 patients with dengue shock syndrome admitted into Children 's Hospital from February 1973 to February 1974 were r and omly selected into 2 groups . A double blind controlled trial of the efficacy of pharmacologic doses of hydrocortisone hemisuccinate was carried out . The 2 groups were confirmed to be completely matched by age , sex and severity of the disease . Nine deaths occurred out of 48 cases in the steroid group ( Case Fatality Rate 18.75 % ) and 22 deaths out of 50 cases in the non-steroid group ( Case Fatality Rate 44 % ) , the difference being statistically significant . No significant difference was detected in fluid requirements and other morbidity pattern Patients diagnosed clinical ly as having grade II dengue haemorrhagic fever , and confirmed serologically to have been recently infected by dengue virus were r and omly assigned to two groups , to assess suppression of plasma leakage by intravenous administration of carbazochrome sodium sulfonate(AC-17 ) . The double-blind prospect i ve study over three successive epidemic periods included 39 patients in the placebo group , and 38 in the AC-17 group . The effects of the administration were evaluated with respect to pleural effusion of the chest X-ray films . A clear difference between the two groups was found in the numbers of patients with pleural effusion and severity of the pleural effusion thus the administration of AC-17 may be useful in eliminating the risk factors of severe bleeding and shock in dengue haemorrhagic fever 
    Output:
    
There is insufficient evidence to justify the use of corticosteroids in managing dengue shock syndrome .