***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 DATA The use of low-level laser therapy ( LLLT ) and polarized polychromatic non-coherent light as supplements to an exercise program has been recommended for the management of lateral elbow tendinopathy ( LET ) . OBJECTIVE To investigate whether an exercise program supplemented with LLLT is more successful than an exercise program supplemented with polarized polychromatic non-coherent light in treating LET . MATERIAL S AND METHODS Patients with unilateral LET for at least 4 wk were sequentially allocated to receive either an exercise program with LLLT or an exercise program with polarized polychromatic non-coherent light . The exercise program consisted of eccentric and static stretching exercises of wrist extensors . In the LLLT group a 904-nm Ga-As laser was used in continuous mode , and the power density was 130 mW/cm(2 ) , and the dose was 0.585 J/point . In the group receiving polarized polychromatic non-coherent light the Bioptron 2 was used to administer the dose perpendicularly to the lateral epicondyle at three points at an operating distance of 5 - 10 cm for 6 min at each position . The outcome measures were pain and function and were evaluated at baseline , at the end of the treatment ( week 4 ) , and 3 mo after the end of treatment ( week 16 ) . RESULTS Fifty patients met the inclusion criteria . At the end of treatment there was a decline in pain and a rise in function in both groups compared with baseline ( p < 0.0005 on the paired t-test ) . There were no significant differences in the reduction of pain and the improvement of function between the groups at the end of treatment and at the 3-mo follow-up ( p > 0.0005 on the independent t-test ) . CONCLUSIONS The results suggest that the combination of an exercise program with LLLT or polarized polychromatic non-coherent light is an adequate treatment for patients with LET . Further research to establish the relative and absolute effectiveness of such a treatment approach is needed Background : Low level laser therapy ( LLLT ) has gained increasing popularity in the management of tendinopathy and arthritis . Results from in vitro and in vivo studies have suggested that inflammatory modulation is one of several possible biological mechanisms of LLLT action . Objective : To investigate in situ if LLLT has an anti-inflammatory effect on activated tendinitis of the human Achilles tendon . Subjects : Seven patients with bilateral Achilles tendinitis ( 14 tendons ) who had aggravated symptoms produced by pain inducing activity immediately before the study . Method : Infrared ( 904 nm wavelength ) LLLT ( 5.4 J per point , power density 20 mW/cm2 ) and placebo LLLT ( 0 J ) were administered to both Achilles tendons in r and om blinded order . Results : Ultrasonography Doppler measurements at baseline showed minor inflammation through increased intratendinous blood flow in all 14 tendons and measurable resistive index in eight tendons of 0.91 ( 95 % confidence interval 0.87 to 0.95 ) . Prostagl and in E2 concentrations were significantly reduced 75 , 90 , and 105 minutes after active LLLT compared with concentrations before treatment ( p = 0.026 ) and after placebo LLLT ( p = 0.009 ) . Pressure pain threshold had increased significantly ( p = 0.012 ) after active LLLT compared with placebo LLLT : the mean difference in the change between the groups was 0.40 kg/cm2 ( 95 % confidence interval 0.10 to 0.70 ) . Conclusion : LLLT at a dose of 5.4 J per point can reduce inflammation and pain in activated Achilles tendinitis . LLLT may therefore have potential in the management of diseases with an inflammatory component Background Eccentric exercises ( EEs ) are recommended for the treatment of Achilles tendinopathy , but the clinical effect from EE has a slow onset . Hypothesis The addition of low-level laser therapy ( LLLT ) to EE may cause more rapid clinical improvement . Study Design R and omized controlled trial ; Level of evidence , 1 . Methods A total of 52 recreational athletes with chronic Achilles tendinopathy symptoms were r and omized to groups receiving either EE + LLLT or EE + placebo LLLT over 8 weeks in a blinded manner . Low-level laser therapy ( Λ = 820 nm ) was administered in 12 sessions by irradiating 6 points along the Achilles tendon with a power density of 60 mW/cm2 and a total dose of 5.4 J per session . Results The results of the intention-to-treat analysis for the primary outcome , pain intensity during physical activity on the 100-mm visual analog scale , were significantly lower in the LLLT group than in the placebo LLLT group , with 53.6 mm versus 71.5 mm ( P = .0003 ) at 4 weeks , 37.3 mm versus 62.8 mm ( P = .0002 ) at 8 weeks , and 33.0 mm versus 53.0 mm ( P = .007 ) at 12 weeks after r and omization . Secondary outcomes of morning stiffness , active dorsiflexion , palpation tenderness , and crepitation showed the same pattern in favor of the LLLT group . Conclusion Low-level laser therapy , with the parameters used in this study , accelerates clinical recovery from chronic Achilles tendinopathy when added to an EE regimen . For the LLLT group , the results at 4 weeks were similar to the placebo LLLT group results after 12 weeks OBJECTIVE To test the feasibility of a r and omized controlled trial to assess the clinical effectiveness of low-level laser therapy ( LLLT ) when used in addition to eccentric exercise in the management of Achilles tendinopathy . BACKGROUND DATA LLLT has emerged as a possible treatment modality for tendon injuries . Over the past 20 years only three human studies have investigated LLLT for Achilles tendinopathy . MATERIAL S AND METHODS Twenty patients were r and omized into an active  laser  or  placebo group ; all patients , therapists , and investigators were blinded to allocation . All patients were given a 12-week eccentric exercise program and irradiated three times per week for 4 wk with either an active or placebo laser at st and ardized points over the affected tendons . Irradiation parameters in the active treatment group were : 810 nm , 100 mW , applied to six points on the tendon for 30 s , for a total dose of 3 J per point and 18 J per session . Outcome measures were the VISA-A question naire , pain , and isokinetic strength . Patients were measured before treatment and at 4 and 12 wk . Analysis of covariance was used to analyze data , using the effects of baseline measurements as a covariate . RESULTS Within groups , there were significant improvements ( p < 0.05 ) at 4 and 12 wk for all outcome measures , except eccentric strength for the placebo group at 4 wk ( p = 0.11 ) . Based on the results of the current study , recruitment of 20 subjects per group would be required to perform an adequately powered study based on minimally important clinical differences in VISA-A scale . CONCLUSION This study has demonstrated the feasibility of undertaking a r and omized controlled trial of LLLT for Achilles tendinopathy . Conclusions regarding effectiveness can not be made due to the low statistical power of this pilot study AIM To assess the role of echo-Doppler ultrasonography in postpr and ial hyperemia  in cirrhotic patients by comparing the results with the hepatic vein catheterization technique . METHODS Patients with cirrhosis , admitted to the portal hemodynamic laboratory were included into the study . After an overnight fast , echo-Doppler ultrasonography ( basal and 30 min after a st and ard meal ) and hemodynamic studies by hepatic vein catheterization ( basal , 15 min and 30 min after a st and ard meal ) were performed . Ensure Plus ( Abbot Laboratories , North Chicago , IL ) was used as the st and ard liquid meal . Correlation analysis of the echo-Doppler and hepatic vein catheterization measurements were done for the basal and postpr and ial periods . RESULTS Eleven patients with cirrhosis ( 5 Child A , 4 Child B , 2 Child C ) were enrolled into the study . After the st and ard meal , 8 of the 11 patients showed postpr and ial hyperemia with increase in portal blood flow , portal blood velocity and hepatic venous pressure gradient . Hepatic venous pressure gradient in the postpr and ial period correlated positively with postpr and ial portal blood velocity ( r = 0.8 , P < 0.05 ) and correlated inversely with postpr and ial superior mesenteric artery pulsatility index ( r = -1 , P < 0.01 ) . CONCLUSION Postpr and ial hyperemia can be efficiently measured by echo-Doppler ultrasonography and the results are comparable to those obtained with the hemodynamic studies AIM to investigate the value of duplex Doppler ultrasonography ( US ) in the assessment of the hemodynamics of the portal and hepatic veins in a cohort of children with chronic liver disease ( CLD ) and to detect any relationship between the US changes , etiology and severity ( or stage ) of CLD . METHODS we prospect ively enrolled 25 children with biopsy-proven CLD . Thirteen had cirrhosis ( aged 8.9 ± 2.0 years ) and 12 had chronic hepatitis ( aged 9.3 ± 2.3 years ) .  Gray scale and color-coded duplex Doppler US were performed for all , as well as 30 healthy age and sex-matched controls . Findings were correlated with clinical , laboratory and histopathological characteristics . RESULTS prominent cau date lobe was detected in 100 % of cirrhotics , but none of the chronic hepatitis or controls . Thickened lesser omentum and loss of the triphasic waveform of the hepatic vein were present in 69.2 % and 53.8 % of cirrhotics vs 33.3 % and 8.3 % of chronic hepatitis respectively . Portal vein flow velocity was significantly lower ( P < 0.0001 ) and the congestion index was significantly higher ( P < 0.005 ) in both patient groups compared to controls . Child-Pugh 's staging showed a positive correlation with both abnormal hepatic vein waveform and direction of portal blood flow ; and a negative correlation with both hepatic and portal vein flow velocities . No correlation with the etiology of CLD could be detected . CONCLUSION duplex Doppler added to grayscale US can detect significant morphologic and portal hemodynamic changes that correlate with the severity ( stage ) of CLD , but not with etiology 
    Output:
    
Despite the need for more studies about this theme , the low-level laser therapy demonstrates consistent results in the treatment of tendinopathy