***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: INTRODUCTION Macrolide treatment has been reported to reduce the risk of recurrent ischaemic heart disease . The influence of a macrolide on the expansion rate of small abdominal aortic aneurysms ( AAA ) is unknown at present . The aim of this study was to investigate the effect of roxithromycin on the expansion rate of small AAA . MATERIAL S AND METHODS A total of 92 patients with a small AAA were recruited from two population s. One population consisted of 6.339 men aged 65 - 73 years who were offered participation in a mass screening programme for AAA at the local hospital . From this population 66 subjects were recruited . The remaining 26 were recruited from among 49 subjects diagnosed at interval screening for an initial aortic diameter between 25 mm and 29 mm . The patients were r and omized to receive either oral roxithromycin 300 mg once daily for 28 days or matching placebo , and followed for a mean of 1.5 years . RESULTS During the first year the mean annual expansion rate of AAA was reduced by 44 % in the macrolid group ( 1.56 mm/year ) compared to 2.80 mm/year after placebo ( p = 0.02 ) . During the second year the difference was only 5 % . Multiple linear regression analysis showed that roxithromycin treatment and initial AAA size were significantly related to AAA expansion when adjusted for smoking , diastolic blood pressure , and IgA level > or = 20 . The logistic regression analysis confirmed a significant difference in expansion rates above 2 mm annually between the intervention and placebo groups , OR = 0.09 ( 95 % CI : 0.01 - 0.83 ) . DISCUSSION In comparison to placebo , roxithromycin 300 mg daily for four weeks reduced the expansion rate of AAA BACKGROUND To study the propranolol treatment of small abdominal aortic aneurysms ( AAA ) concerning intention to treat , side effects , and inhibition of expansion . METHODS DESIGN Two-year lasting prospect i ve r and omised double-blinded intervention trial . SETTING Hospital-based mass screening for AAA with annual ambulatory control of small AAA . PARTICIPANTS Of 122 screening-diagnosed small AAA , 51 ( 42 % ) were excluded because of contraindications or present beta-blockage , and 17 refused participation . Thus , 54 ( 44.3 % ) were included . INTERVENTION Participants were r and omised to 40 mg propranolol twice a day or placebo . MEASURES The same observed was used to follow-up AAA-expansion , side effects , quality of life ( QL ) , branchial and ankle blood pressure ( ABI ) , and pulmonary function ( FEV1 and FVC ) . RESULTS Sixty percent in the propranolol group , and 25 % in the placebo group dropped out , mainly caused by dyspnoea in the propranolol group ( RR=1.74 , 95 % C.I. : 1.06 - 2.86 ) . Five ( 16.7 % ) died in the propranolol group , while 1 ( 4.2 % ) died in the placebo group ( RR=1.6 ( 1.02 - 2.51 ) ) . Furthermore , decreased pulmonary function , ABI , and QL was noticed in the propranolol group . Consequently , the trial was stopped after two years . Ninety-five percent of the measurements of the AAA were measured within 2 mm variation . If expansion was defined as above 2 mm annually , the relative risk of expansion in the placebo group was 1.17 ( 0.74 - 1.85 ) , and 2.44 ( 0.88 - 6.77 ) among the non-drop-outs . CONCLUSIONS Only 22 % of small screenings-diagnosed AAA were treatable with propranolol for two years . Consequently , only large scale studies are capable of showing potential minor inhibition of expansion by propranolol . However , whether such treatment ever becomes ethically acceptable is debatable Objectives — To assess the importance of the private costs incurred by patients when making a judgment on the economics of  screening for abdominal aortic aneurysm ( AAA ) , and to explore the variation in such costs depending on screening location . Setting — A district general hospital and general practitioner surgeries . Methods — Four hundred and ninety nine consecutive subjects attending for AAA screening  completed a question naire asking about travel arrangements for the journey to and from the clinic , the distance travelled , the time taken , the mode of transport , and any out-of-pocket expenses incurred . In addition , at the clinic each subject was asked what activities they had forgone in attending the clinic . Time was valued differently depending on whether work or leisure activities were forgone . The total private cost for each attender was calculated and comparison was made between attenders at hospital and at general practice . Results — A significantly greater proportion of subjects were accompanied when attending hospital than when attending general practitioner ( GP ) surgeries . Most attenders travelled by car , but the journey time was significantly longer for those visiting hospital . The expected total private cost associated with attendance for AAA screening was £ 5.47 . Attendance at GP surgeries had a lower private cost ( £ 4.21 ) than attendance at hospital ( £ 6.87 ) . Only 7·3 % of all men surveyed , and 6·5 % of all companions , would have been taking part in some form of paid occupation if they had not attended for screening . Conclusion — Despite the fact that most attenders for AAA screening will be retired , the associated private costs are appreciable and should be considered in assessing the economics of such screening programmes . The level of private costs varied depending on the location of screening : clinics held at GP practice s had lower private costs than those held at hospital Screening for abdominal aortic aneurysm ( AAA ) is commonly restricted to men . Recent studies have indicated a possible increase in deaths due to ruptured AAA in women , and a higher rate of rupture in women than in men . The present report details results from a r and omized controlled trial that assessed the effects of screening women for AAA BACKGROUND Opposing views have been published on the importance of ultrasound screening for abdominal aortic aneurysms . The Multicentre Aneurysm Screening Study was design ed to assess whether or not such screening is beneficial . METHODS A population -based sample of men ( n=67800 ) aged 65 - 74 years was enrolled , and each individual r and omly allocated to either receive an invitation for an abdominal ultrasound scan ( invited group , n=33839 ) or not ( control group , n=33961 ) . Men in whom abdominal aortic aneurysms ( > or =3 cm in diameter ) were detected were followed-up with repeat ultrasound scans for a mean of 4.1 years . Surgery was considered on specific criteria ( diameter > or = 5.5 cm , expansion > or = 1 cm per year , symptoms ) . Mortality data were obtained from the Office of National Statistics , and an intention-to-treat analysis was based on cause of death . Quality of life was assessed with four st and ardised scales . The primary outcome measure was mortality related to abdominal aortic aneurysm . FINDINGS 27147 of 33839 ( 80 % ) men in the invited group accepted the invitation to screening , and 1333 aneurysms were detected . There were 65 aneurysm-related deaths ( absolute risk 0.19 % ) in the invited group , and 113 ( 0.33 % ) in the control group ( risk reduction 42 % , 95 % CI 22 - 58 ; p=0.0002 ) , with a 53 % reduction ( 95 % CI 30 - 64 ) in those who attended screening . 30-day mortality was 6 % ( 24 of 414 ) after elective surgery for an aneurysm , and 37 % ( 30 of 81 ) after emergency surgery . INTERPRETATION Our results provide reliable evidence of benefit from screening for abdominal aortic aneurysms The study was an up date at 10 years of a r and omized trial of the efficacy of  screening for abdominal aortic aneurysm ( AAA ) . The extent of benefit , feasibility and compliance were examined , and reasons why this intervention may fail a proportion of those screened were identified Macrolide treatment has been reported to lower the risk of recurrent ischaemic heart disease . The influence of macrolides on the expansion rate of abdominal aortic aneurysms ( AAAs ) remains unknown . The aim was to investigate the effect of roxithromycin on the expansion rate of small AAAs OBJECTIVE To investigate risk factors associated with aneurysm rupture using patients r and omized into the U.K. Small Aneurysm Trial ( n = 1090 ) or monitored for aneurysm growth in the associated study ( n = 1167 ) . SUMMARY BACKGROUND DATA The U.K. Small Aneurysm Trial has shown that ultrasound surveillance is a safe management option for patients with small abdominal aortic aneurysms ( 4.0 to 5.5 cm in diameter ) , with an annual rupture rate of 1 % . METHODS In the cohort of 2257 patients ( 79 % male ) , aged 59 to 77 years , 103 instances of abdominal aortic aneurysm rupture were identified during the 7-year period of follow-up ( 1991 - 1998 ) . Almost all patients ( 98 % ) had initial aneurysm diameters in the range of 3 to 6 cm , and the majority of ruptures ( 76 % ) occurred in patients with aneurysms > or = 5 cm in diameter . Kaplan-Meier survival and Cox regression analysis were used to identify baseline risk factors associated with aneurysm rupture . RESULTS After 3 years , the annual rate of aneurysm rupture was 2.2 % ( 95 % confidence interval 1.7 to 2.8 ) . The risk of rupture was independently and significantly associated with female sex ( p < 0.001 ) , larger initial aneurysm diameter ( p < 0.001 ) , lower FEV1 ( p = 0.004 ) , current smoking ( p = 0.01 ) , and higher mean blood pressure ( p = 0.01 ) . Age , body mass index , serum cholesterol concentration , and ankle/brachial pressure index were not associated with an increased risk of aneurysm rupture . CONCLUSIONS Within this cohort of patients , women had a threefold higher risk of aneurysm rupture than men . Effective control of blood pressure and cessation of smoking are likely to diminish the risk of rupture OBJECTIVES to analyse the hospital costs and benefits of screening  older males for abdominal aortic aneurysm ( AAA ) . MATERIAL S AND METHODS in 1994 a hospital-based screening trial of 12 658 65 - 73-year-old males was started . AAA > 5 cm were referred for surgery . The remaining AAA were offered annual scans . Those with aortic ectasia were rescreened at 5 yearly intervals . AAA-operations and hospital AAA-related deaths were research ed . The costs of screening , surveillance , and treatment  were also registered . RESULTS the attendance rate was 76 % ; of whom 191 ( 4.0 % ) had AAA . Mean observation time was 5.13 years . Sixty in the screened and 41 in the control group were operated ( p=0.06 ) , of which 7 and 27 respectively were operated as an emergency ( p<0.001 ) , and 6 and 19 respectively died due to AAA ( p=0.009 ) . The costs per scan were 83.50 DKK , 81 400 DKK per emergency operation ( 71 485 DKK after screening ) , and 117 000 DKK per emergency operation . The cost per prevented hospital death was 67 855 DKK , equivalent to approximately life year saved approx . 7540 DKK ( GBP1=12 DKK ) . CONCLUSION screening appears to reduce hospital AAA mortality and to be cost-effective OBJECTIVE To describe the potential psychological consequences of screening for abdominal aortic aneurysms ( AAAs ) . METHODS The participants were prospect ively and r and omly sample d from a r and omised screening trial for AAA and asked to complete a vali date d generic and global anonymous quality of life ( QL ) question naire by self- assessment ( ScreenQL ) . Material case-control study : ScreenQL was completed once by 168 ( 48 % ) of 350 non-responders to screening  , 271 ( 81 % ) of 335 attenders before screening , 286 ( 85 % ) of 335 attenders after screening , 127 ( 85 % ) of 149 with a small AAA diagnosed at screening , and 231 ( 66 % ) of 350 who were r and omised not to be offered screening for AAA ( controls ) . Prospect i ve study ( paired data ): 127 men having a small AAA diagnosed . Twenty-nine ( 81 % ) of 36 men operated after initial conservative treatment . RESULTS Initially , the QL score was 5 % lower among men with a small AAA compared to the controls ( p<0.05 ) , mainly because of poorer health perception . The QL score declined significantly further to 7 % below control values during the period of conservative treatment . This impair 
    Output:
    
AUTHORS ' CONCLUSIONS There is evidence of a significant reduction in mortality from AAA in men aged 65 to 79 years who undergo ultrasound screening .
There is insufficient evidence to demonstrate benefit in women .