***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 Docosahexaenoic acid ( DHA ) might help prevent or attenuate posttraumatic stress disorder ( PTSD ) symptoms . We examined the efficacy and safety of DHA for preventing PTSD ( DSM-IV ) after severe accidental injury . METHOD From December 2008 to August 2013 , we conducted a r and omized , double-blind , placebo-controlled trial of 110 accident-injured patients consecutively admitted to an intensive care unit of the National Disaster Medical Center in Tokyo , Japan . All patients were taught about their psychological reactions to accidental injury for 20 minutes and were r and omly assigned to receive 1,470 mg/d of DHA plus 147 mg/d of eicosapentaenoic acid ( EPA ; n = 53 ) or placebo ( n = 57 ) for 12 weeks . The primary outcome was total score on the Clinician-Administered PTSD Scale ( CAPS ) at 3-month follow-up . Secondary outcomes included PTSD diagnosis ( full-blown or partial PTSD ) . Adherence to the interventions was assessed by erythrocyte fatty acid composition . RESULTS At 3 months , the CAPS total score revealed no differences between the 2 groups ( 10.78 in the DHA group vs 9.22 in the placebo group ; n = 100 ; P = .572 ) . We found that 11.1 % of the DHA group and 5.5 % of the placebo group developed PTSD . The erythrocyte level of DHA and EPA in the DHA group was significantly elevated compared to the placebo group ( P < .01 ) . CONCLUSIONS Docosahexaenoic acid supplementation was not superior to placebo for the secondary prevention of PTSD symptoms at 3 months after severe accidental injury . The efficacy of a different ratio of DHA and EPA and higher doses of omega-3 fatty acids as secondary prevention of PTSD remains to be determined . TRIAL REGISTRATION Clinical Trials.gov Identifier : NCT00671099 This pilot aims to better underst and the market for childcare in Saudi Arabia – both the supply and dem and sides – and to design a r and omized controlled experiment to test whether access to affordable day care ( in the form of subsidies , for example ) would incentivize Saudi mothers to search actively for employment and to remain employed once they are hired . In addition , the study seeks to underst and the degree to which employment early on in one ’s life impacts employment in later stages . The pilot will provide information on the groups of women the experiment should target , appropriate levels for the childcare subsidy , and the quality and current geographic locations of daycare sites . Expected Impact Determine the effects of facilitating childcare access on Saudi women ’s employment . PRINCIPAL INVESTIGATORS  Boston University Patricia Cortes  Harvard University Claudia Goldin  Swarthmore College Jennifer OBJECTIVE This study examined whether acute propranolol treatment prevented posttraumatic stress disorder ( PTSD ) , anxiety , and depression in children hospitalized in the pediatric intensive care unit for large burns . We hypothesized that the prevalence of PTSD , anxiety , and depression would be significantly less in the  propranolol  than nonpropranolol groups . METHODS Children who had previously participated in a r and omized controlled clinical trial of acute propranolol and nonpropranolol controls were invited to participate in long-term follow-up interviews . Eligible participants from 1997 to 2008 were identified from the electronic medical records , and data were collected in 2010 - 2011 . Measures included the Missouri Assessment of Genetics Interview for Children to assess lifetime PTSD , Revised Children 's Manifest Anxiety Scale to assess anxiety , and two depression inventories Children 's Depression Inventory and Beck Depression Inventory-II . RESULTS Of 202 participants , 89 were in the propranolol group and 113 were nonpropranolol controls . Children were an average of 7 years postburn . The average total body surface area burned was 56.4 + 15.1 % ( range = 24%-99 % ) . The mean dose of propranolol was 3.64 ± 3.19 mg/kg per day ( range = 0.36 - 12.12 ) . The duration of propranolol inpatient treatment days varied , mean days 26.5 ± 19.8 . The prevalence of lifetime PTSD in the propranolol group was 3.5 % and controls 7.2 % , but this difference was not statistically significant . We controlled for administration of pain medications , anxiolytics , and antidepressants overall and no significant differences were detected in the rates of PTSD , anxiety , or depression . CONCLUSIONS The prevalence of PTSD , anxiety , and depression was similar in children who received propranolol acutely and those who did not . This may be influenced by the st and ard of care that all children received timely pharmacotherapy for pain and anxiety management and psychotherapy beginning in their acute phase of treatment BACKGROUND There are currently few preventive interventions available for posttraumatic stress disorder ( PTSD ) . Intranasal oxytocin administration early after trauma may prevent PTSD , because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors , including neural fear responsiveness , peripheral stress reactivity , and socioemotional functioning . Therefore , we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms . We then assessed whether baseline characteristics moderated the intervention 's effects . METHODS We performed a multicenter , r and omized , double-blind , placebo-controlled clinical trial . Adult emergency department patients with moderate to severe acute distress ( n = 120 ; 85 % accident victims ) were r and omized to intranasal oxytocin ( 8 days/40 IU twice daily ) or placebo ( 8 days/10 puffs twice daily ) , initiated within 12 days posttrauma . The Clinician-Administered PTSD Scale ( CAPS ) was administered at baseline ( within 10 days posttrauma ) and at 1.5 , 3 , and 6 months posttrauma . The intention-to-treat sample included 107 participants ( oxytocin :  n = 53 ; placebo : n = 54 ) . RESULTS We did not observe a significant group difference in CAPS total score at 1.5 months posttrauma ( primary outcome ) or across follow-up ( secondary outcome ) . Secondary analyses showed that participants with high baseline CAPS scores receiving oxytocin had significantly lower CAPS scores across follow-up than participants with high baseline CAPS scores receiving placebo . CONCLUSIONS Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress . However , participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin . Although replication is warranted , these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms OBJECTIVE Prospect i ve studies have not identified a viable pharmacologic strategy for secondary prevention of  posttraumatic stress disorder ( PTSD ) . The authors examined whether preventive intervention via early and short-term administration of a selective serotonin reuptake inhibitor ( SSRI ) , within 1 month of exposure to a traumatic event ( before diagnosis of PTSD could be made ) , may reduce the severity of PTSD symptoms according to DSM-IV at 13 months ' follow-up . METHODS Over 25,000 screening calls to patients referred to an emergency department for a traumatic event performed between June 2006 and December 2008 yielded 353 participants who were recruited within the month following a traumatic event . Participants were r and omly assigned in a double-blind design to escitalopram ( n = 176 ) or placebo ( n = 177 ) . The per- protocol analysis comprised 198 participants ( escitalopram , n = 102 ; placebo , n = 96 ) who received treatment for 12 to 24 weeks and were available for follow-up at week 56 . RESULTS The primary outcome measure , the Clinician Administered PTSD Scale ( CAPS ) , revealed no prevention effect . However , a secondary outcome , the Pittsburgh Sleep Quality Inventory ( PSQI ) , showed better results for the SSRI group than for the placebo group . For a subset of participants who experienced intentional trauma ( missile attacks , rape , or physical assault ; n = 50 ) , the prevention effect was found on both primary and secondary measures ( CAPS , PSQI and measures of depression and global illness severity ) . CONCLUSIONS Early and short-term administration of escitalopram was not shown to prevent PTSD , although it did improve sleep quality . In a subgroup of participants who experienced intentional trauma , however , this early-treatment approach may be effective as secondary prevention . This large study is the first to investigate the preventive effect of early administration of escitalopram on PTSD . It highlights the relevance of the type of trauma ( intentional vs unintentional ) to the outcome . TRIAL REGISTRATION Clinical Trials.gov identifier : BACKGROUND Exposure to intense physical and psychological stress during septic shock can result in posttraumatic stress disorder in survivors . Patients with chronic posttraumatic stress disorder often show sustained reductions in serum cortisol concentration . This investigation examines whether increasing serum cortisol levels with hydrocortisone treatment during septic shock reduces the incidence of posttraumatic stress disorder in survivors . METHODS Patients ( n = 20 ) were recruited from a prospect i ve , r and omized double-blind study on the hemodynamic effects of hydrocortisone during septic shock . Eleven patients had received placebo and nine  stress doses of hydrocortisone . Posttraumatic stress disorder was diagnosed 31 months ( median ) after intensive care unit discharge using SCID-IV ( DSM-IV- criteria ) . Furthermore , the number of categories of traumatic memory from ICU treatment was determined in both groups at that time . RESULTS Only one of nine patients from the hydrocortisone group developed posttraumatic stress disorder , compared with seven of 11 patients in the placebo group ( p = .02 ) . There was no significant difference with regard to the number of categories of traumatic memory between the hydrocortisone and placebo groups . CONCLUSIONS The administration of hydrocortisone during septic shock in a dosage similar to the endogenous maximal production rate was associated with a lower incidence of posttraumatic stress disorder in long-term survivors , which seems to be independent of the number of categories of traumatic memory Background The neurotrophic drug Cerebrolysin accelerated recovery and prevented acute neuronal damage in pre clinical models of ischaemia . Previous clinical trials support therapeutic effects in stroke patients . The study investigated whether the combination with alteplase and Cerebrolysin is safe and can further reduce disability after acute ischaemic stroke . Methods This placebo-controlled , double-blind trial involved 119 patients with acute ischaemic hemispheric stroke , r and omly assigned to a combined treatment with alteplase plus Cerebrolysin or placebo ( administered 1 h after thrombolytic treatment ) starting within three-hours after onset of symptoms . A daily i.v . infusion of 30 ml Cerebrolysin or placebo was given for 10 consecutive days . Primary outcome was the modified Rankin Scale at day 90 . A sequential design with interim analyses was applied . Results The third interim analysis did not show a benefit in the modified Rankin Scale for Cerebrolysin on day 90 compared to placebo and the study was stopped . The National Institutes of Health Stroke Scale responder analysis ( secondary outcome measure ) showed significantly more patients with an improvement of 6 or more points ( or a total score of 0 or 1 ) after two- , five- , 10 , and 30 days in the Cerebrolysin group . Similar trends were observed for the modified Rankin Scale responder analysis without achieving statistical significance . There was no difference between treatment groups regarding adverse events . Conclusions The combination of Cerebrolysin with recombinant tissue-Plasminogen Activator is safe for treatment of acute ischaemic stroke but did not improve outcome at day 90 . During the treatment period with Cerebrolysin ( 10 days ) , significantly more patients had a favourable response in neurological outcome measures ( National Institutes of Health Stroke Scale ) as compared to the placebo group OBJECTIVE Acute stress disorder ( ASD ) can interfere with satisfactory recovery of children with severe burn injuries . Recent studies have found propranolol to be effective in reducing posttraumatic symptoms , but the benefits of this medication with ASD are unknown . Therefore , we hypothesized that individuals who were administered propranolol acutely would be less likely to develop ASD than those who were not . METHOD A review of electronic medical records was conducted on the children included in a previous blinded r and omized-control trial , in which the participants received propranolol or no propranolol during the acute phase of recovery ( first 30 days ) . These data were merged with electronic information regarding medication treatment for ASD . The psychologists and clinicians who had previously assessed for ASD for purpose s of treating the children 's distress were blinded to who received propranolol and who did not . RESULTS There were 363 participants ( 232 boys , 1 
    Output:
    
Hydrocortisone shows the most promise , of pharmacotherapies subjected to RCTs , as an emerging intervention in the prevention of PTSD within three months after trauma and should be a target for further investigation .
The limited evidence for hydrocortisone and its adverse effects mean it can not be recommended for routine use , but , it could be considered as a preventative intervention for people with severe physical illness or injury , shortly after a traumatic event , as long as there are no contraindications .
There is currently a lack of evidence to suggest that other pharmacological agents are likely to be effective