***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: Prevention of relapse following depression is a pressing research problem . The authors tested the efficacy of the tricyclic antidepressant amitriptyline and psychotherapy , alone and in combination , in preventing the relapse of 150 neurotic depressed female patients . They found that patients receiving amitriptyline and little psychotherapy had a 12-percent relapse rate , compared to a 16-percent rate for those receiving more psychotherapy and no medication . There was no significant difference between drug therapy alone or drug therapy in combination with psychotherapy . However ,  psychotherapy was beneficial to patients with problems of social adjustment and interpersonal relations .  The need for further research and implication s for treatment are discussed A group of 200 patients who presented in general practice with symptoms but no abnormal physical signs and in whom no definite diagnosis was made were r and omly selected for one of four consultations : a consultation conducted in a " positive manner , " with and without treatment , and a consultation conducted in a " non-positive manner , " called a negative consultation , with and without treatment . Two weeks after consultation there was a significant difference in patient satisfaction between the positive and negative groups but not between the treated and untreated groups . Similarly , 64 % of those receiving a positive consultation  got better , compared with 39 % of those who received a negative consultation ( p = 0.001 ) and 53 % of those treated got better compared with 50 % of those not treated ( p = 0.5 ) Meditation training appears to be a promising psychological approach to the control of hypertension . However , most studies to date have had serious deficiencies . This study attempted to correct many of these deficiencies . Forty-one unmedicated hypertensives referred by general practitioners were r and omly allocated to three groups . The treatment group ( SRELAX ) underwent training procedures based on Transcendental Meditation ; a placebo control group ( NSRELAX ) underwent identical training but without a mantra . Both procedures were compared with a no-treatment control group . The results showed modest reductions in blood pressure in both SRELAX and NSRELAX groups , compared with the no-treatment controls , with diastolic percentage reductions reaching significance ( p<0.05 ) . There was considerable subject variation in response , with overall a mean decline in diastolic blood pressure of 8–10 % on 3-month follow-up . Possible indicators to predict the response of subjects are considered and reasons for the similarity in the effectiveness of the SRELAX and NSRELAX conditions are discussed Twenty‐seven long‐term psychiatric in patients maintained on neuroleptics with concomitant antiparkinsonian medication were entered into a study in which anticholinergic medication was gradually withdrawn in a r and omized double‐blind within‐subjects design . The extrapyramidal symptoms of each patient were compared when taking their usual anticholinergic medication , when taking placebo and when taking no antiparkinsonian drug . The relapse rate on no medication was 14 % , and if patients relapsed on no medication they also relapsed on placebo . The relapse rate was not significantly different on active medication . Nor were there significant differences in ratings of parkinsonism or dyskinesia . The lack of difference between double‐blind and overt withdrawal does not mean that studies that find a much higher relapse rate are necessarily unaffected by nonspecific factors , as significant unblinding may occur in clinical trials Four series of duodenal ulcer patients presenting with pain have been treated with two types of placebos ( intramuscular injections or tablets ) by 4 different physicians while a fifth group of patients did  not receive any treatment . Patients noted the number of days with pain since the beginning of the test by themselves . All patients treated with placebo presented with a significantly shorter duration of pain than untreated patients . There was a significant difference between the actions of the different physicians on the duration of pain . This suggests that some , until now unprecised , character(s ) of the physician plays an important part in the relief of duodenal ulcer pain A prospect i ve , r and omized , controlled study was carried out to investigate the dilating and softening effect on the cervix of prostagl and in F2-alpha gel administered intracervically and of prostagl and in E2 tablets administered orally . A total of 581 patients were included in the study : 149 received 2.5 mg prostagl and in F2-alpha in gel form intracervically , 150 received 1 mg prostagl and in E2 in tablet form orally , 138 were given placebo gel and 144 no medication at all . In the group given prostagl and in F2-alpha gel intracervically , success was achieved in 85.8 % of patients and partial success in 8.8 % . In the group given prostagl and in E2 tablets orally , the results were successful in 29.4 % and partially successful in 40.6 % . The incidence of side effects in the group given prostagl and in F2-alpha gel was rather high - 53 % . The results show that prostagl and in can bring about a certain softening of the cervix , but side effects can not be ruled out . Nevertheless , priming of the cervix is to be recommended in young primigravidas A prospect i ve , double-blind study was carried out to assess the efficacy of interferon alfa-2b , with or without pre-treatment prednisone withdrawal , in patients with chronic hepatitis B. A total of 57 Belgian and Dutch patients were included in the study . Patients were divided into four treatment groups : Group A , prednisone withdrawal followed by interferon 5 million units per day ; Groups B and C , placebo followed by interferon 5 or 1 million units , respectively ; and Group D , untreated controls followed for 1 year . All treated patients received interferon for 16 weeks . Two of the 14 control patients lost hepatitis B e antigen during the year of study , and only one of 15 patients in the interferon 1 million units group . Among the 28 patients receiving 5 million units of interferon ( with or without prednisone withdrawal ) , ten ( 36 % ) cleared hepatitis B e antigen during the study or within 6 months of the end of therapy . This was associated with a marked improvement in serum transaminase levels . When comparing Groups A and B , it was found that prednisone withdrawal therapy enhanced the response to interferon  in patients with pre-treatment serum alanine aminotransferase levels below 100 IU/l , bringing the seroconversion rate up to 50 % , compared to 17 % on interferon alone . This effect was not seen in patients with high pre-treatment transaminase levels . All treatment responders showed a marked improvement in Knodell index score , whereas in the 15 non-responders from groups A and B , overall inflammatory activity remained the same in six , improved in five and worsened in four . ( ABSTRACT TRUNCATED AT 250 WORDS Studies in smoking cessation have generally failed to adequately control for active treatment effects and have assumed that measures of smoking behaviour ( i.e. , estimated smoking rate , self-monitoring and chemical analysis ) are equally reliable measures . Sixty smokers were r and omly assigned to one of four different smoking cessation treatment groups : hypnosis , focussed smoking , attention placebo and a waiting list control . Subjects were asked to estimate and monitor their own smoking  behaviour . Blood sample s were also taken for thiocyanate analysis before treatment . Smoking rates were similarly measured directly , at 3 months and 6 months after treatment . The results indicate that the three measures of smoking behaviour were all highly correlated . No significant differences were found between treatments , directly after treatment or at the 3- and 6-month follow-ups . These results suggest that active treatment effects may not be responsible for behavioural change in a smoking cessation program . The implication s of these findings are discussed Study Design A r and omized , placebo-controlled trial in which patients received either usual care by a general practitioner ( information and analgesics ) , or placebo physiotherapy given by a physiotherapist , or exercise therapy given by a physiotherapist . Objective To assess the efficacy of exercise therapy on sickness absence from work in patients with acute low back pain . Summary of Background Data Exercise therapy during the nonchronic phase of back pain is considered to reduce sickness absence , but this opinion is controversiel . Methods Patients with acute nonspecific low back pain and a paid job were included for analysis .  Sickness absence ( number of days ) was checked monthly during the 1-year follow-up period and compliance was also assessed . Results From 40 general practice s 363 patients who were gainfully employed were included . In the exercise therapy group the percentage of patients with sickness absence was higher and the duration of absence was longer than in the placebo and usual care groups , but these differences were not significant . Indications of more absence in the exercise therapy group appeared to be based largely on a greater number of patients with absences during the first 3 months . Patients in the exercise group who had not reported sick at entry had more sickness absences during the follow-up year than patients in the usual care and placebo group . Good compliance did not affect the results . Conclusions Exercise therapy for patients with acute low back pain does not reduce sickness absence & NA ; Post‐herpetic neuralgia ( PHN ) is a common and often intractable neuropathic pain syndrome predominantly affecting the elderly .  Topical local anesthetics have shown promise in both uncontrolled and controlled studies . Thirty‐five subjects with established PHN affecting the torso or extremities completed a four‐session , r and om order , double‐blind , vehicle‐controlled study of the analgesic effects of topically applied 5 % lidocaine in the form of a non‐woven polyethylene adhesive patch .  All subjects had allodynia on examination . Up to 3 patches , covering a maximum of 420 cm2 , were applied to cover the area of greatest pain as fully as possible . Lidocaine containing patches were applied in two of the four 12‐h‐long sessions , in one session vehicle patches were applied , and one session was a no‐treatment observation session . Lidocaine containing patches significantly reduced pain intensity at all time points 30 min to 12 h compared to no‐treatment observation , and at all time points 4–12 h compared to vehicle patches . Lidocaine patches were superior to both no‐treatment observation and vehicle patches in averaged category pain relief scores . The highest blood Lidocaine level measured was 0.1 & mgr;g/ ml , indicating minimal systemic absorption of Lidocaine . Patch application was without systemic side effects and well tolerated when applied on allodynic skin for 12 h. This study demonstrates that topical 5 % Lidocaine in patch form is easy to use and relieves post‐herpetic neuralgia In a diabetes detection survey carried out between 1962 and 1965 , 2477 ( 1.1 % ) of 228,883 subjects had Clinistix-positive glucosuria after a carbohydrate-rich luncheon meal . Of these 2477 , 578 displayed impaired tolerance to oral glucose without having manifest diabetes . From this group , 267 men were divided into five groups and subjected to the following treatments and controls : ( a ) diet regulation and 0.5 g tolbutamide t.i.d . ( N = 49 ) , annual oral glucose tolerance test ( OGTT ) ; ( b ) diet regulation and one placebo tablet t.i.d . ( N = 48 ) , annual OGTT ; ( c ) diet regulation only ( N = 50 ) , annual OGTT ; ( d ) no treatment ( N = 61 ) , annual OGTT ; and ( e ) no treatment , OGTT at follow-up ( N = 59 at follow-up ) . In addition , a control group was included comprised of men with normal OGTT ( N = 52 ) . At follow-up , 29 % of those without diet regulation and medication ( group e ; N = 59 ) had developed diabetes . Of those on diet regulation , but without active medication ( group b plus group c , N = 98 ) , 13 % had diabetes . No individual maintaining tolbutamide  and diet regulation ( N = 23 ) had progressed to diabetes . In this group , 80 % of those later examined ( N = 11 ) had serum tolbutamide concentrations in the therapeutic range . No individual with initially normal OGTT developed diabetes or impaired OGTT . The findings suggest that normal oral glucose tolerance signifies little risk of progress to impaired glucose tolerance and manifest diabetes , whereas impaired glucose tolerance is associated with a high risk of progression to diabetes . In addition , it seems possible that treatment with diet regulation , in combination with tolbutamide , may prevent or postpone progression from impaired glucose tolerance to manifest diabetes The present study evaluated the efficacy of olfactory aversion conditioning in the management of  overeating problems . 42 overweight female subjects were assigned to one of three treatment conditions : olfactory aversion therapy , attention placebo control , and no-contact control . One experimenter administered the 8-wk . treatment phase . The aversion therapy procedure entailed the pairing of selected target foods ( CSs ) with noxious odors ( UCSs ) . There were 25 pairings of the CS and UCSs during each weekly session . Four noxious odors were employed , one each week , to prevent habituation to the UCS . The attention-placebo control procedure was identical except that “ air ” was substituted for the putative UCS of the aversion therapy condition . At the end of the treatment period the aversion therapy group had lost 4.7 lb . ; the attention placebo controls had lost 3.6 lb . and the no-contact controls 0.5 lb . The difference between the aversion therapy group and the no-contact controls was significant and that between the attention placebo group and the no-contact controls approached significance . At a follow-up 
    Output:
    
REVIEW ER 'S CONCLUSIONS There was no evidence that placebo interventions in general have clinical ly important effects .