***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 AND METHODS The frequency of infection with multidrug-resistant Mycobacterium tuberculosis is increasing . We review ed the clinical courses of 171 patients with pulmonary disease due to M. tuberculosis resistant to rifampin and isoniazid who were referred to our hospital between 1973 and 1983 . The patients ' records were analyzed retrospectively . Their regimens were selected individually and preferably included three medications that they had not been given previously and to which the strain was fully susceptible . RESULTS The 171 patients ( median age , 46 years ) had previously received a median of six drugs and shed bacilli that were resistant to a median of six drugs . Thus , their regimens were frequently not optimal . Of 134 patients with sufficient follow-up data , 87 ( 65 percent ) responded to chemotherapy ( as indicated by negative sputum cultures for at least three consecutive months ) ; 47 patients ( 35 percent ) had no response , as shown by continually positive cultures . The median stay in the hospital was more than seven months . In a multivariate analysis , an unfavorable response was significantly associated with a greater number of drugs received before the current course of therapy ( odds ratio , 4.0 ; 95 percent confidence interval , 1.6 to 9.9 ; P < 0.001 ) and with male sex ( odds ratio , 2.5 ; 95 percent confidence interval , 1.1 to 6.2 ; P < 0.03 ) . Twelve of the patients with responses subsequently had relapses . The overall response rate was 56 percent over a mean period of 51 months . Of the 171 patients , 63 ( 37 percent ) died , and 37 of these deaths were attributed to tuberculosis . CONCLUSIONS For patients with pulmonary tuberculosis that is resistant to rifampin and isoniazid , even the best available treatment is often unsuccessful . Only about half of such patients eventually have negative sputum cultures despite carefully selected regimens administered for extended periods . Failure to control this resistant infection is associated with high mortality and ominous implication s for the public health A r and omized controlled study was undertaken to compare 2 policies of  default management in out- patients with smear-negative pulmonary tuberculosis attending a large chest clinic in Madras city . All the patients were due to collect monthly supplies of drugs for a year , for daily self-administration at home . In the routine ( R ) policy , if a patient failed to collect the drug supply on a due date , a reminder letter was posted on the fourth day and , if necessary , a health visitor visited the home a week later . In the intensive ( I ) policy , a health visitor visited the home on the 4th day and , if necessary , a week later and at 1 and at 2 months . The main analyses concern 150 patients ( 75 R , 75 I ) , of whom 16 R and 15 I patients had a positive culture . A total of 29 patients ( 11 R , 18 I ) did not default at any time . For the remaining 64 R and 57 I patients , the mean numbers of defaults were 3.0 and 2.3 , and the mean numbers of defaulter retrieval actions were 4.3 and 3.8 , respectively . The home visit as the first action ( I series ) was successful in retrieving defaulters on 65 % of 132 occasions , while the reminder letter ( R series ) was successful in 56 % of 193 occasions ( P = 0.1 ) . Following the second action , which was a home visit in both the series , these proportions became 80 % and 84 % , respectively . in the I series , 22 third and 18 fourth actions were taken , but the patient was retrieved in only 4 and 0 instances respectively . The mean number of drug collection s during the year was significantly higher in the I series ( 9.8 ) than in the R series ( 8.6 ) . Finally , the proportions of patients who made 12 collection s in a 15-month period , a satisfactory target under Indian Programme conditions , were 69 % and 52 % , respectively ( P = 0.07 ) INTRODUCTION This study assessed the impact of automated telephone reminders on tuberculin skin test returns . METHODS A total of 701 English-speaking and Spanish-speaking patients of a public health immunization program were r and omly assigned to an intervention or a control group . Those in the intervention group received an automated telephone reminder to return for the reading of their skin test . RESULTS Automated telephone reminders significantly reduced return failures 53 % ( from 14 % to 7 % ) when the scheduled interval between test administration and reading was three days , but had no impact for a two-day interval . Effectiveness of reminders did not differ significantly by patient age , gender , or language ( English versus Spanish ) . CONCLUSIONS Results suggest the value of automated reminder calls for intra-appointment intervals as short as three days OBJECTIVES We sought to determine the efficacy of coaching Latino adolescents with latent tuberculosis infection to adhere to isoniazid treatment . METHODS Participants ( n = 286 ) were r and omly assigned to adherence coaching , attention control , or usual care groups . Adherence was measured via interviews and vali date d with urine assays . RESULTS Coaching result ed in significant increases in adherence compared with attention and usual care groups . Bicultural adolescents were more likely to be adherent than those most or least acculturated . Age and risk behavior were negatively related to adherence . CONCLUSIONS Coaching can increase Latino adolescents ' adherence to treatment for latent tuberculosis infection and should contribute to tuberculosis control for adolescents at high risk of contracting the disease The design , logic , and results of a two-year health education study directed at i m proving rates of patient adherence to antituberculosis medical regimens are presented . An incentive scheme to reward positive health behaviors plus targeted educational coun seling sessions was implemented in a r and omized clinical controlled trial . The 205 subjects who participated in the study are categorized according to patients with active tuberculosis ( n = 88 ) or preventive patients with no evidence of active disease ( n = 117 ) . Patients in each of these groups were r and omly assigned to a special intervention ( SI ) group or a usual care ( UC ) control group and were followed monthly throughout their treatment program . While SI patients with active tuberculosis demonstrated higher levels of ap pointment-keeping behavior and mean percent of medication taken compared to UC patients , no statistically significant differences between the two groups were found . Pre ventive therapy patients assigned to the SI group , however , were significantly more likely than UC patients to remain in care during their 12-month regimen ( 64 % vs 47 % ; p = .003 ) . Furthermore , SI patients had significantly higher levels of adherence to their medical regimen compared to UC patients ( 68 % vs 38 % ; p < .001 ) . These results demonstrate the positive effects of a structured health education program on the i m provement of continuity of care and adherence behavior among patients with tuberculosis . This study was funded by the Centers for Disease Control through contract # 200 - 85 - 0835 . The assistance of the Project Clerk , Sook Hee Treadwell , the Project Health Educators , Magda Fischer , Jennifer Adams , Nancy Murray , Fred Dominguez , and the clinic staff and patients who participated in this project are gratefully acknowledged . 1 . US Department of Health and Human Services , Public Health Service : The 1990 Health Objectives for the Nation : A Midcourse Review . Office of Disease Prevention and Health Promotion , 1986 . 2 . Centers for Disease Control . Tuberculosis — Provisional data —United States , 1986 . MMWR 36 : 254 - 255 , 1987 . 3 . Centers for Disease Control . Tuberculosis . Final Data —United States , 1986 . MMWR 36 : 817 - 820 , 1988 . 4 . County of Los Angeles , Department of Health Services , Public Health Programs : Communicable Disease Morbidity Report , County of Los Angeles , 1986 . 5 . Kopanoff DE , Snider DE , Johnson M : Recurrent tuberculosis : Why do patients develop disease again ? A United States Public Health Service Cooperative Survey . Am J Public Health 78 : 30 - 33 , 1988 . 6 . American Thoracic Society : Treatment of tuberculosis and tuberculosis infection in adults and children . Am Rev Respir Dis 134 : 355 - 363 , 1986 . 7 . Haynes RB : Introduction , in RB Haynes , DW Taylor , DL Sackett . ( eds ) : Compliance in Health Care . Baltimore , Johns Hopkins University Press , 1979 , pp 1 - 7 . 8 . Sackett DL , Haynes RB , editor : Compliance with Therapeutic Regimens . Baltimore , Johns Hopkins University Press , 1976 . 9 . Haynes RB , Taylor DW , Sackett DL , ed : Compliance in Health Care . Baltimore , Johns Hopkins University Press , 1979 . 10 . Meichenbaum D , Turk DC : Facilitating Treatment Adherence : A Practitioner 's Guidebook . Plenum Press , New York , 1987 . 11 . Addington WW : Patient compliance : The most serious remaining problem in the control of tuberculosis in the United States . Chest 76 (supp):741 - 743 , 1979 . 12 . Report of the Committee : A Strategic Plan for the Elimination of Tuberculosis in the United States . US Department of Health and Human Services , Centers for Disease Control , May 1988 . 13 . Comstock GW : New data on preventive treatment with isoniazid . Annals of Internal Medicine 98:663 - 665 , 1983 . 14 . Cross FS , Long MW , Banner AS , Snider DE Jr :  Rifampin-isoniazid therapy  of alcoholics and nonalcoholic tuberculosis patients in a U.S. Public Health Service cooperative trial . Am Rev Respir Dis 122:349 - 353 , 1980 . 15 . Snider DE Jr , . Improving Patient Compliance in Tuberculosis Treatment Programs . Atlanta , U.S. Department of Health and Human Services , Public Health Service , Centers for Disease Control , 1985 . 16 . Green LW , Kreuter MW , Deeds SG , Partridge KB : Health Education Planning : A Diagnostic Approach . Palo Alto , CA , Mayfield Publishing Company , 1980 . 17 . Hochbaum GM , Public Participation in Medical Science Programs : A Sociopsy chological Study . Washington , DC , United States Government Printing Office , PHS Publication No. 572 , 1958 . 18 . Rosenstock IM : What research in motivation suggests for public health . Am J Public Health 50:295 - 302 , 1960 . 19 . Becker MH : The health belief model and personal health behavior . Health Educ Monographs 2:324 - 473 , 1974 . 20 . Becker MH : Sociobehavioral determinants of compliance , in DL Sackett , RB Haynes ( eds ) : Compliance with Therapeutic Regimens . Baltimore , Johns Hopkins University Press , 1976 , pp 40 - 50 . 21 . Janz NK , Becker MH : The health belief model : A decade later . Health Education Quarterly 11:1 - 47 , 1984 . 22 . Sackett DL : Priorities and methods for future research , in DL Sackett , RB Haynes ( eds ) : Compliance with Therapeutic Regimens . Baltimore , Johns Hopkins University Press , 1976 , pp 169 - 189 . 23 . Dunbar JM , Stunkard AJ : Adherence to diet and drug regimen  , in Levy RI , Rifkind B , Dennis B , Ernst N ( eds ) : Nutrition , Lipids , and Coronary Heart Disease . New York , Raven Press , 1979 , pp 391 - 423 . 24 . Svarstad BL :  Physician-patient communication  and patient conformity  with medical advice , in Mechanie D ( ed ) : The Growth of Bureaucratic Medicine . New York , John Wiley and Sons , 1976 , pp 220 - 238 . 25 . Colcher IS , Bass JW :  Penicillin  treatment of streptococcal pharyngitis : A comparison of schedules and the role of specific counselling . JAMA 222:657 - 659 , 1972 . 26 . Sharpe TR , Mikeal RL :  Patient compliance with antibiotic regimens . Am J Hospital Pharm 31:479 - 484 , 1974 . 27 . Swain MA , Steckel SB : Influencing adherence among hypertensives . Res Nursing and Health 4:213 - 222 , 1981 . 28 . Levine DM , Green LW , Russell RP , Morisky DE , Chwalow J , Benson P : Compliance in  hypertension management : What the physician can do . Practical Cardiology 5:151- 160 , 1979 . 29 . DiMatteo MR , DiNicola DD , Achieving Patient Compliance : The Psychology of the Medical Practitioner 's Role . New York , Pergamon Press , 198 
    Output:
    
Late patient tracers ( home visit and letter ) were shown to be beneficial in increasing adherence to tuberculosis treatment compared with no late patient tracer .
The results from almost all the reminder trials , except one , show benefits of different types of reminders compared to no reminder on adherence to tuberculosis clinic appointments .
The included trials show significantly better outcomes among those tuberculosis patients for which  late patient tracers and reminders are used .