***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: OBJECTIVES To analyze sources search ed in Cochrane review s , to determine the proportion of trials included in review s that are indexed in major data bases , and to compare the quality of these trials with those from other sources . METHODS All new systematic review s in the Cochrane Library , Issue1 2001 , that were restricted to r and omized controlled trials ( RCTs ) or quasi- RCTs were selected . The sources search ed in the review s were recorded , and the trials included were checked to see whether they were indexed in four major data bases . Trials not indexed were checked to determine how they could be identified . The quality of trials found in major data bases was compared with those found from other sources . RESULTS The range in the number of data bases search ed per review ranged between one and twenty-seven . The proportion of the trials in the four data bases were Cochrane Controlled Trials Register = 78.5 % , MEDLINE = 68.8 % , Embase = 65.0 % , and Science/Social Sciences Citation Index = 60.7 % . Search ing another twenty-six data bases after Cochrane Controlled Trials Register ( CCTR ) , MEDLINE , and Embase only found 2.4 % additional trials . There was no significant difference between trials found in the CCTR , MEDLINE , and Embase compared with other trials , with respect to adequate allocation concealment or sample size . CONCLUSIONS There was a large variation between review s in the exhaustiveness of the literature search es . CCTR was the single best source of RCTs . Additional data base search ing retrieved only a small percentage of extra trials . Contacting authors and manufacturers to find unpublished trials appeared to be a more effective method of obtaining the additional better quality trials BACKGROUND / AIMS Cefotaxime or ceftriaxone were considered the first-choice antibiotic for empirical treatment in cirrhotic patients developing spontaneous bacterial peritonitis . It has been suggested that ciprofloxacin could be an alternative to cefotaxime or ceftriaxone in cirrhotic patients developing spontaneous bacterial peritonitis . The aim of the present study was to compare oral ciprofloxacin with cefotaxime and ceftriaxone in the treatment of spontaneous bacterial peritonitis in cirrhotic patients . METHODOLOGY Fifty-three hospitalized cirrhotic patients with spontaneous bacterial peritonitis were prospect ively included and r and omized into three groups : group A ( n = 16 ) ; received orally 500 mg ciprofloxacin every 12 h , group B ( n = 18 ) ; received intravenous cefotaxime 2 g every 8 h and group C ( n = 19 ) received intravenous ceftriaxone 2 g every 24 h. RESULTS 15 patients from the ciprofloxacin group , 17 from the cefotaxime group and 17 patients from the ceftriaxone group were finally analyzed . Spontaneous bacterial peritonitis resolution in three groups was found to be 80 % , 76 % , and 83 % , respectively ( p = NS ) . Incidence of complications and hospital mortality was similar in the three groups . No adverse events were observed in any of the three groups . The cost of the treatment was statistically lower in the ciprofloxacin group than in the cefotaxime group and ceftriaxone group ( p < 0.001 ) . CONCLUSIONS These results suggest that orally ciprofloxacin is as effective as cefotaxime and ceftriaxone in the empirical treatment of spontaneous bacterial peritonitis in cirrhotic patients , and is also less expensive and can be administered orally We compared the effectiveness and incidence of nephrotoxicity of ampicillin-tobramycin and cefotaxime in 73 cirrhotics who had severe bacterial infection . Most of these patients had spontaneous peritonitis and /or bacteremia . Patients were r and omly allocated into two groups . Group I included 36 patients treated with ampicillin-tobramycin and Group II comprised 37 patients treated with cefotaxime . Patients from both groups were similar with respect to clinical data , st and ard liver and renal function tests , types of infection and isolated organisms . Ninety-two per cent of bacteria isolated in Group I and 98 % of those isolated in Group II were susceptible in vitro to ampicillin-tobramycin and to cefotaxime , respectively . Ampicillin-tobramycin  cured the infection in 56 % of Group I patients , and cefotaxime in 85 % of Group II patients ( p less than 0.02 ) . Five patients treated with ampicillin-tobramycin , and none treated with cefotaxime developed superinfections ( p = 0.024 ) . Nephrotoxicity ( impairment of renal function associated with an increase of urinary beta 2-microglobulin to over 2,000 micrograms per liter ) occurred in two patients in Group I and none in Group II . These results suggest that broad-spectrum cephalosporins should be considered as first choice antibiotics in cirrhotic patients with severe infections BACKGROUND AND AIM Spontaneous bacterial peritonitis and bacterascites prevalence in asymptomatic cirrhotic patients on large-volume paracentesis  is unknown . The aim of this study was to investigate spontaneous bacterial peritonitis and bacterascites prevalence in a prospect i ve cohort of cirrhotic out patients following large-volume paracentesis with low risk of infection . METHODS We prospect ively studied all large-volume paracenteses performed in cirrhotic out patients for 1 year . Patients with fever , abdominal pain , peritonism or hepatic encephalopathy were excluded from the study . The ascitic fluid was analyzed by means of a reagent strip with a colorimetric scale from 0 to 4 . A strip test of 0 or 1 was considered negative . In those cases with a reagent strip > or = 2 , conventional polymorphonuclear count was performed . Ascitic fluid culture was done into blood culture bottles in all cases . RESULTS We performed 204 paracenteses in 40 patients . Nine cases were excluded .  Culture-negative neutrocytic ascites was diagnosed in one case ( 0.5 % ) , while bacterascites was diagnosed in six out of 195 cases ( 3 % ) , mainly by gram-positive cocci . CONCLUSION The spontaneous bacterial peritonitis prevalence in outpatient cirrhotics with low risk of infection undergoing large-volume paracentesis  is very low . Moreover , the prevalence of bacterascites is low and without clinical consequences . The routine analysis of ascitic fluid may be unnecessary in this clinical setting . Nevertheless , the use of reagent strips is a reasonable alternative due to its accessibility and low cost We compared cefonicid ( 2 g every 12 h ) and ceftriaxone ( 2 g every 24 h ) for their efficacy and safety in treating spontaneous bacterial peritonitis in cirrhotic patients in an open r and omized clinical trial ( 30 patients in each group ) . Clinical , laboratory , and bacteriologic characteristics were similar in both groups . Ceftriaxone-susceptible strains were isolated on 44 occasions ( 94 % ) , and cefonicid-susceptible strains were isolated on 43 occasions ( 91.5 % ) . The antibiotic concentration in ascitic fluid/MIC ratio for ceftriaxone was > 100 throughout the dose interval ( 24 h ) , while it was lower for cefonicid ( between 1 and 18 ) . A total of 100 % of patients treated with ceftriaxone , and 94 % of those treated with cefonicid were cured of their infections ( P was not significant ) . Hospitalization mortality was 37 % in the cefonicid group and 30 % in the ceftriaxone group ( P was not significant ) . The time that elapsed between the initiation of treatment and the patient 's death was shorter in the  cefonicid group patients ( 5.3 + /- 3.90 days ) than in the ceftriaxone  group patients ( 11.8 + /- 9.15 days ) ( P < 0.05 ) . None of the patients presented with superinfections , and only two patients treated with cefonicid and three patients treated with ceftriaxone developed colonizations with Enterococcus faecalis or C and ida albicans .  Ceftriaxone and cefonicid are safe and useful agents for treating cirrhotic spontaneous bacterial peritonitis  , although the pharmacokinetic characteristics of ceftriaxone seem to be more advantageous than those of cefonicid UNLABELLED Recent studies have shown that the diagnosis of  spontaneous bacterial peritonitis  ( SBP ) can be rapidly obtained using leukocyte esterase reagent strips . However , published studies were restricted to one or two centers , and the number of patients with SBP was thus limited . The aims of the current prospect i ve multicenter study were : ( 1 ) to assess the diagnostic accuracy of the Multistix 8SG urine test for the diagnosis of SBP ; and ( 2 ) to assess the prevalence of SBP . From January to May 2004 , 2 reactive strips were tested independently in in patients with cirrhosis and in out patients undergoing paracentesis .  Cultures of ascitic fluid were performed at the bedside using aerobic and anaerobic blood culture bottles . Two thous and one hundred twenty-three paracenteses were performed in 1,041 patients from 70 centers . One hundred seventeen sample s , obtained from 91 patients , had ascites polymorphonuclear cell ( PMN ) counts > or=250/microl ( range , 250 - 34,000 ) , among which 56 were associated with positive ascitic fluid cultures . The prevalence of SBP was 5.5 % in the whole population , 9 % in in patients , and 1.3 % in out patients ( P<0.0001 ) . The prevalence of SBP was 0.57 % in asymptomatic out patients versus 2.4 % in symptomatic out patients ( P=0.04 ) . Using a threshold of 2 + for positivity of the reagent strip , sensitivity was 45.3 % for the diagnosis of SBP , specificity was 99.2 % , positive predictive value was 77.9 % , and negative predictive value was 96.9 % . CONCLUSION This study confirms the low prevalence of  SBP in asymptomatic out patients according to a priori defined criteria , and indicates an absence of diagnostic efficacy for this specific strip test Royal Free Hospital , London , UK Introduction Background of the European Liver Transplant RegistrySince 1968 the European Liver Transplant Registry ( ELTR ) collects prospect ively the data of liver transplantation ( LT ) in 145 centersall over Europe . It represents more than 95 % of the overallEuropean data compared to the published ofﬁcial ﬁgures [ 1 ] . This collection ismade prospect ivelythroughast and ardized question -naire . The ﬁrst part of the question naire includes items regarding date and indicationfor LT , donor and recipient data , surgical tech-niqueofLT , and theimmediatepostoperativeimmunosuppressiontherapy . The second part concerns graft and patient outcome , and immunosuppressive regimen follow-up . Participation in the ELTRis voluntary and a st and ard computerized data base is provided tocontributing centers with detailed instructions for the collection of accurate and uniform information [2].Along with reports concerning LT for speciﬁc hepatic diseases[3–12],ELTRhasallowedthedevelopmentofriskmodelsforliver-transplantation mortality according to the characteristics of thedonor and recipient , and of the transplant procedure [ 13,14 ] . Quality ofthe data isassessedroutinely . Aregularauditingpro-cessisconductedeachyeartoensurethereliabilityofthescientiﬁc analysis of the data , a control of the good adequacy between ELTR question naire and patient charts is performed by r and omly con-ductedauditvisits . Results oftheseauditvisitshaveindicatedthatELTR data were reliable and the scientiﬁc results of ELTR can beconsidered credible and representative of LT in Europe [15–18].In addition , a control quality program has been developed inter-nally . The data are subjected to checks for completeness , consis-tency , and range . Comprehensive logical intra- and inter-up date sare performed . Moreover , the ELTR has established agreementswith the European Organ Sharing Organizations ( OSO ) : UnitedKingdom Transplant Service Support Authority (UKTransplant),Spanish Organizacion Nacional de Transplantes ( ONT ) , Sc and ina-vian Sc and itransplant ( SKT ) , Dutch Transplant Foundation (NTS),Eurotransplant ( ET ) , French Agence de la Biomedecine ( ABM ) toexchange data collectedfromEuropeanCenters and tocrosscheckcommon data between OSO and ELTR . Patients and methods We have ﬁrst considered all data since 1968 to show the evolu-tion of results of LT in Europe since its initial development . Therest of the analysis has been undertaken during two differentperiods : ( a ) from January 1988 to December 2009 ( 89,865 LT –80,347 patients ) , where the date from January 1988 was chosenJournal of Hepatology 2012 vol . AIM To evaluate effective alternative antibiotics in treatment of cefotaxime-resistant spontaneous bacterial peritonitis . METHODS One hundred cirrhotic patients 
    Output:
    
Due to the wide CrIs and the very low-certainty evidence for all the outcomes , significant benefits or harms of antibiotics are possible .