***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 Pulmonary arterial hypertension ( PH ) is a progressive disease with a poor prognosis that ultimately leads to right ventricular failure and death . The pathogenesis of severe PH seems to be related to inflammatory responses and coagulation disturbances . Many diseases can develop PH in their course , thus aggravating their outcome . The objective was to investigate the values of vascular endothelial growth factor ( VEGF ) , sP-selectin , lipoprotein-associated phospholipase A2 ( PLA2-LDL ) , antiphospholipid antibodies ( APLA ) and their relation with PH , in systemic lupus erythematosus ( SLE ) and chronic obstructive pulmonary disease ( COPD ) , two conditions in which the occurrence of PH is frequent . DESIGN Prospect i ve clinical study . SETTING A University Department of Internal Medicine , a National Institute of Research . PATIENTS 30 SLE patients ( 15 patients without PH ( group I ) and 15 patients with PH group II ) ) , 30 patients with COPD ( 15 patients without PH ( group III ) and 15 patients with PH ( group IV ) ) and 10 healthy controls , selected by clinical , immunological , echocardiographical criteria and pulmonary functional tests . MAIN OUTCOME MEASURES VEGF , sP-selectin and PLA2-LDL level in plasma and presence of antiphospholipids antibodies ( lupus anticoagulant , anticardiolipin and anti beta2 GPI ) in plasma . - RESULTS In patients with PH , the values of VEGF were significantly increased [ group II ( 1023.1 ) and IV ( 904.3 ) ] compared with group I ( 744.2 ) , III ( 356.4 ) , and controls ( 330.3 ) . The values of sP-selectin in group II ( 9.7 ) , and IV ( 10.4 ) were also increased compared with controls ( 6 ) . APLA were present in all patients in group II ( 100 % ) , and in 8 patients in group IV ( 53 % ) , while in the other groups the frequency was low ( 33 % group I and 13 % group III ) . PLA2-LDL activity was higher in group II ( 429.1 ) and group IV ( 394.5 ) than in group I ( 317.8 ) , group III ( 343.2 ) and controls ( 256.3 ) . CONCLUSION PH is a severe complication in COPD and SLE . The increased values of VEGF , PLA2-LDL and P-selectin in patients with long st and ing PH are related to severe endothelial dysfunction and may have prognostic values . APLA may have pathogenic value in SLE patients with PH . APLA are possibly implicated in the pathogenesis of PH in these diseases . VEGF , APLA and sP-selectin may constitute new therapeutic targets for PH BACKGROUND There is a need for a reliable marker of endometriosis , especially in early stages of peritoneal disease during which imaging is not effective . The use of serum interleukin (IL)-6 as a marker is controversial . To readdress the matter , patients undergoing laparoscopy  were prospect ively evaluated for serum IL-6 levels . MATERIAL S AND METHODS A total of 119 women 31 years old who underwent laparoscopy  were divided into groups : control patients ( n = 38 ) with no pathologic findings ; endometriosis sufferers ( n = 47 ) with minimal-mild ( MM , n = 11 ) or moderate-severe ( MS , n = 36 ) endometriosis ; uterine myomas ( n = 13 ) and benign ovarian pathologies ( n = 21 ) . Blood was drawn on cycles days 5 - 12 and stored for subsequent analysis of IL-6 and carbohydrate antigen (CA)-125 levels . RESULTS Serum IL-6 levels were significantly ( P = 0.002 ) higher in women with MM endometriosis ( 29.4 9.0 pg/ml ) than in controls ( 15.7 9.3 pg/ml ) . When all the non-endometriosis patients were grouped together ( n = 72 ) and serum IL-6 ( 17.8 12.1 pg/ml ) compared with MS ( n = 36 ; 17.6 10.3 pg/ml ) and MM ( n = 11 ; 29.4 9.0 pg/ml ) endometriosis significantly ( P < 0.01 ) higher levels in MM endometriosis were observed as compared to the other two groups . Serum Ca-125 levels were significantly ( P < 0.01 ) elevated in MS endometriosis . A serum IL-6 threshold of 25.75 pg/ml afforded a sensitivity of 75 % and specificity of 83 % in the diagnosis of MM endometriosis . Sensitivity and specificity for CA-125 in the diagnosis of MS endometriosis , using 35 IU/ml as the cut-off value , were 47 % and 97 % , respectively . CONCLUSIONS IL-6 is a reliable non-invasive marker of MM endometriosis , whereas Ca-125 is of use as a marker of severe cases OBJECTIVE This study was undertaken to evaluate serum leptin concentrations in women with endometriosis during treatment with danazol and with leuprolide depot . STUDY DESIGN Twenty patients aged 18 to 42 years with regular menses and documented pelvic endometriosis were recruited from a university hospital setting . Treatment was 200 mg danazol 3 times daily for 6 months or 3.75 mg leuprolide depot every 28 days for 6 months . Serum leptin concentrations were measured before , during , and after treatment . A single blood sample was taken from each of 10 control women without endometriosis for comparison . Serum leptin level was measured with a radioimmunoassay kit with human leptin , and analysis of variance and paired t tests were used for statistical analysis . RESULTS Serum leptin levels were almost the same among women with endometriosis as in the control group . Leptin levels were higher among women with endometriosis during treatment with danazol and leuprolide(P < .001 ) . Three months after treatment , leptin values remained moderately higher than before treatment . CONCLUSION Danazol and leuprolide increased serum leptin levels . The mechanism of leptin increase is unclear . Further studies are needed to determine whether an adipogonadal axis exists OBJECTIVE The role of natural killer ( NK ) cells in the decreased cellular immunity of women with endometriosis was investigated . DESIGN , SETTING , PATIENTS Thirty-four women were investigated prospect ively before a CO2-laser laparoscopy for infertility and /or pain at the University Hospital Gasthuisberg . Endometriosis was scored blindly . MAIN OUTCOME MEASURE The cytotoxicity , directed against the endometrium , was mediated by NK cells because this cytotoxicity could be removed by treating the effector cells with the NK-specific anti-Leu-11b monoclonal antibody . Consequently , we evaluated prospect ively in those women the lymphocyte-mediated cytotoxicity toward NK sensitive ( K562-assay ) and autologous endometrial target cells . RESULTS The NK activity ( K562-assay ) and the cytotoxicity against autologous endometrial cells were similarly decreased in women with endometriosis and correlated with the severity of the disease . Using heterologous effector cells , the decreased chromium release in women with endometriosis was less pronounced but still present . CONCLUSION The decreased cytotoxicity to endometrial cells in women with endometriosis is mainly because of a defect in NK activity but is also partially because of a resistance of the endometrium to NK cytotoxicity Abstract Objective To examine the extent and nature of outcome reporting bias in a broad cohort of published r and omised trials . Design Retrospective review of publications and follow up survey of authors . Cohort All journal articles of r and omised trials indexed in PubMed whose primary publication appeared in December 2000 . Main outcome measures Prevalence of incompletely reported outcomes per trial ; reasons for not reporting outcomes ; association between completeness of reporting and statistical significance . Results 519 trials with 553 publications and 10 557 outcomes were identified . Survey responders ( response rate 69 % ) provided information on unreported outcomes but were often unreliable — for 32 % of those who denied the existence of such outcomes there was evidence to the contrary in their publications . On average , over 20 % of the outcomes measured in a parallel group trial were incompletely reported . Within a trial , such outcomes had a higher odds of being statistically non-significant compared with fully reported outcomes ( odds ratio 2.0 ( 95 % confidence interval 1.6 to 2.7 ) for efficacy outcomes ; 1.9 ( 1.1 to 3.5 ) for harm outcomes ) . The most commonly reported reasons for omitting efficacy outcomes included space constraints , lack of clinical importance , and lack of statistical significance . Conclusions Incomplete reporting of outcomes within published articles of r and omised trials is common and is associated with statistical non- significance . The medical literature therefore represents a selective and biased subset of study outcomes , and trial protocol s should be made publicly available The purpose of this study was to investigate the frequency of antibodies in the serum of patients with endometriosis reacting with endometrial , ovarian , thyroid and skeletal muscle antigens . A total of 55 fertile patients with pelvic pain who had endometriosis diagnosed by laparoscopy and confirmed by histology formed the study group , while 43 fertile patients without pelvic pain and undergoing tubal sterilization formed the control group .  Eutopic endometrial membrane antigen was prepared from biopsies taken from patients or controls by an ultracentrifugation technique and used in an enzyme-linked immunosorbent assay ( ELISA ) for immunoglobulin ( Ig ) G , IgA and IgM endometrial antibodies . Ovarian , thyroid and skeletal muscle antigens were prepared similarly and used in an ELISA . There was a significant difference in the prevalence of IgG antibodies to eutopic endometrial antigens derived from either control or endometriosis patients ( P < 0.05 ) . IgA or IgM antibodies against endometrial antigens were not detected . Endometrial antibodies were detectable in both the luteal and the follicular phases of the menstrual cycle . Immunoblot analysis demonstrated the presence of endometrial antigens with molecular weights of 60 and 66 kDa in the eutopic endometrium of patients with endometriosis . Antibodies to thyroid , ovary or skeletal muscle were not detected in these patients . These findings indicate that endometrial antibodies of the IgG class can be detected in approximately 50 % of patients with endometriosis but it remains unclear whether these represent a pathologically distinct subgroup of such patients OBJECTIVE To examine the expression of gremlin-1 ( GREM1 ) on the levels of messenger RNA ( mRNA ) and protein in eutopic endometrium and its serum level in patients with endometriosis . DESIGN Prospect i ve , experimental study using reverse-transcription polymerase chain reaction , Western blot , immunofluorescence , and ELISA . SETTING Gynecological oncology laboratory in a department of obstetrics and gynecology in a medical college in China . PATIENT(S ) Thirty-five patients with endometriosis and 23 healthy control women . INTERVENTION(S ) During surgery , the eutopic endometria and peripheral serum were obtained from the patients with endometriosis and the control women . MAIN OUTCOME MEASURE(S ) The cellular compartment location of GREM1 expression was examined by using immunofluorescent double staining . The expression levels of mRNA and protein for GREM1 were determined by reverse-transcription polymerase chain reaction and Western blot , respectively . The serum level of GREM1 was measured by indirect ELISA . RESULT ( S ) The expression of GREM1 was defined within endometrial blood vessel endothelium exclusively , with the concomitant expressions of GREM1 and CD146 . The expression of GREM1 on the levels of mRNA and protein was significantly higher in eutopic endometria of patients with endometriosis than in those from healthy control women . According to the ELISA established in our laboratory , the concentration of GREM1 in peripheral serum that was collected during the follicular menstrual phase of patients with endometriosis was significantly higher than that in serum from healthy control women . CONCLUSION ( S ) Gremlin-1 plays a role to some extent in the aberrant angiogenesis of eutopic endometrium in patients with endometriosis . It is possible that the peripheral serum level of GREM1 is a prospect i ve serum biomarker of endometriosis Macrophage migration inhibitory factor ( MIF ) is an important pro-inflammatory cytokine expressed at sites of inflammation . We have assessed this factor ( MIF ) in urinary tract infections with the aim of determining a non-invasive and sensitive method to differentiate upper and lower renal involvement . Thirty-three pediatric patients with urinary track infection ( 25 with acute pyelonephritis , eight with acute cystitis ) and 40 healthy subjects were recruited for this prospect i ve case – control study . Pyelonephritis was differentiated from cystitis by dimercaptosuccinic acid ( DMSA ) scan .  Urinary MIF concentration was determined using an enzyme-linked immunos 
    Output:
    
Panels of markers may allow increased sensitivity and specificity of any diagnostic test