***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 : To assess the efficacy of an orally administered antioxidant dietary supplement for managing marginal dry eye . Design : A prospect i ve , r and omised , placebo controlled trial with cross-over . Setting : Eye Clinic , Department of Vision Sciences , Glasgow Caledonian University . Subjects : Forty marginal dry eye sufferers composed of 30 females and 10 males ( median age 53 y ; range 38–69 y ) . Interventions : Baseline assessment s were made of tear volume sufficiency ( thread test ) , tear quality ( stability ) , ocular surface status ( conjunctival impression cytology ) and dry eye symptoms ( question naire ) . Each subject was administered courses of active treatment , placebo and no treatment , in r and om order for 1 month each and results compared to baseline . Results : Tear stability and ocular surface status were significantly improved following active treatment ( P<0.05 ) . No changes from baseline were detected following administration of placebo and no treatment ( P>0.05 ) . Absolute increase in tear stability correlated with absolute change in goblet cell population density . Tear volume was not improved following any treatment period and dry eye symptom responses were subject to placebo effect . Conclusions : Oral antioxidants improved both tear stability and conjunctival health , although it is not yet understood whether increased ocular surface health mediates increased tear stability or vice versa . Sponsors : This study was supported by a PhD scholarship funded by the Department of Vision Sciences , Glasgow Caledonian University , Scotl and . Antioxidant supplements and placebos were kindly donated by Vitabiotics . European Journal of Clinical Nutrition ( 2001 ) 55 , & NA ; In the present study , we examined the effects of preoperative electroacupuncture ( EA ) at classical bilateral acupuncture points ( Zusanli , also known as ST‐36 ) on postoperative pain and opioid‐related side effects . One hundred healthy consenting women undergoing lower abdominal surgery were r and omly assigned to four treatment regimens : Group I ( n=25 ) , control ; Group II ( n=25 ) , sham‐EA ( needle insertion without electrical stimulation ) ; Group III ( n=25 ) , low‐EA ( 2 Hz of electrical stimulation ) ; and Group IV ( n=25 ) , high‐EA ( 100 Hz of electrical stimulation ) . EA groups received needle insertion with or without electrical stimulation 20 min prior to anesthesia . All patients received patient‐controlled analgesia ( PCA ) of morphine postoperation . Postoperative pain was evaluated by recording ( 1 ) the time of the first required analgesic , ( 2 ) the number of PCA dem and s , ( 3 ) the total amount of morphine required by PCA , and ( 4 ) patients ' VAS pain score . We found that the time of first analgesic requested was 10 , 18 , 28 , and 28 min in the control , sham‐ , low‐ , and high‐EA groups , respectively . During the first 24 h , the total amount of morphine required was decreased by 21 , 43 and 61 % in the sham‐ , low‐ and high‐EA groups , respectively . The incidence of nausea and dizziness during the first 24 h after surgery was significantly reduced in both the low‐EA and high‐EA groups compared with the control and sham‐EA groups . We also found that sham‐EA exerts a beneficial effect with respect to its pain relieving quality but not the side effect profiles . Our findings demonstrates that preoperative treatment with low‐EA and high‐EA can reduce postoperative analgesic requirements and associated side effects in patients undergoing lower abdominal surgery SUMMARY The decline in blood pressure ( BP ) in essential hypertensives following hospitalization may result from : 1 ) regression toward the mean ; 2 ) reduction of anxiety as patients habituate to a new enrironment ; 3 ) the placebo effect of medication ; and 4 ) an independent effect of hospitalization itself . A r and omized crossover study of 12 essential hypertensives demonstrated a fall in supine blood pressure from 165.0/97.9 ± 2.3/1.1 mm Hg to 154.3/89.6 ± 2.7/1.1 mm Hg ( p < 0.005 ) due to hospitalization . A similar reduction in BP from 164.9/99.5 ± 8.4/4.1 mm Hg to 151.9/93.4 ± 4.5/1.9 mm Hg ( p < 0.005 ) result ed from regression toward the mean and habituatlon during the study period . Urinary catecholamines fell from 68.7 ± 5.0 to 55.1 ± 4.3 Mg/g creatinine/24 hours ( p < 0.05 ) due to hospitalization and from 56.1 ± 5.4 to 49.7 ± 43 fig/g creatinine/24 hours ( p < 0.05 ) with time . Although placebo therapy tended to reduce BP , it failed to do so significantly . When expressed as a percentage of the individual 's overall mean , urinary catecholamine excretion fell from 110.5 % ± 3.7 % to 89.5 % ± 3.7 % ( p < 0.001 ) during hospitalization and from 105.8 % ± 3.9 % to 94.2 % ± 3.9 % ( p < 0.05 ) during the outpatient period . Blood pressure and sympathetic activity rapidly returned to prehospitalization values on discharge . These factors may confound the analysis of drug effects on BP and sympathetic activity in essential hypertensives following admission to hospital Sixty-six tension headache patients were r and omly assigned to one of four conditions for 8 weeks : ( a ) progressive muscle relaxation ( PMR ) alone ; ( b ) PMR plus cognitive therapy ( PMR + Cog ) ; ( c ) pseudomeditation , a credible attention-placebo control ; or ( d ) continued headache monitoring . A comparison of overall headache activity ( headache index ) , derived from a daily headache diary , for 4 weeks before treatment to 4 weeks after treatment , revealed that active treatment ( PMR and PMR + Cog ) was superior to either control condition . Moreover , level of headache medication consumption decreased significantly for the active treatment groups . Although headache-index comparisons of the two active treatments showed no advantage for adding cognitive therapy to PMR , a measure of clinical ly significant change showed a trend for PMR + Cog to be superior to PMR alone The roots of essential hypertension extend back into the first two decades of life , suggesting that effective intervention during those years may lead to a reduction in the incidence of adult hypertension . Decreasing the dietary sodium/potassium ratio offers a potentially effective approach to blood pressure reduction . This study tested the feasibility of 3-year sodium reduction or potassium supplementation in adolescents and the effect of these interventions on the rate of rise of blood pressure during adolescence . After 19,452 5th to 8th grade students were screened , 210 from the upper 15 percentiles of blood pressure distribution ( 105 boys , 105 girls ) were r and omly assigned to one of three groups : low sodium diet ( 70 mmol sodium intake per day ) , potassium chloride supplementation ( normal diet plus 1 mmol/kg potassium chloride per day ) , or placebo ( normal diet plus placebo capsule ) . Capsules for the potassium chloride and placebo groups were administered in a double blind protocol . Blood pressure was measured every 3 months for 3 years . The effect of the intervention was determined by comparing the rate of rise ( slope ) of blood pressure among the groups using a r and om-coefficient growth curve model . The boys groups and the girls placebo group had similar positive blood pressure slopes that were significantly different from zero . The girls low sodium group had a slightly negative slope ( significantly lower than the slope of the girls placebo group ) , and the girls potassium group had a slightly positive slope . Both of these slopes were not significantly different from zero and were significantly lower than the slopes of the respective boys groups . ( ABSTRACT TRUNCATED AT 250 WORDS Background : The objectives were to determine whether a eutectic mixture of local anesthetic ( EMLA ) or placebo cream reduces pain during extracorporeal piezoelectric shock wave lithotripsy ( EPSWL ) , and to determine which of the components of the application ( i.e. , the occlusive dressing , the cream , or the local anesthetic ) contributes to analgesia . Methods : A r and omized , double blind , crossover study ( part 1 ) was performed in 12 patients who were scheduled for EPSWL procedures on an ambulatory basis who received the first treatment without any intervention and who had verbal pain scores of 70 or more ( on a 0-to-100 scale ) . For the next two treatments at 2-week intervals , patients were r and omly assigned to receive either 10 g EMLA or 10 g placebo cream and then crossed over to receive the other . The cream and occlusive dressing were left in place and immersed in water throughout the procedure . Verbal numeric pain score was assessed at 5 min after receiving the maximal tolerable intensity of shock wave and at the end of the procedure . The study continued ( part 2 ) in 202 ambulatory patients ; 125 men and 77 women , American Society of Anesthesiologists physical status I and II , subjected to EPSWL were r and omly allocated into five groups who received ( 1 ) nothing on the skin ( control ) , ( 2 ) plastic occlusive dressing , ( 3 ) placebo cream and plastic occlusive dressing , ( 4 ) EMLA cream and plastic occlusive dressing , ( 5 ) EMLA cream and plastic occlusive dressing for 60 min to achieve cutaneous anesthesia , which was removed before EPSWL . Pain score was evaluated 10 min into the procedure and at the end of the procedure . Result : Both parts of the study showed that patients who received either EMLA or placebo cream with dressing throughout the procedure experienced less pain and tolerated higher energy levels compared with the control . Patients who received only pre-EPSWL cutaneous anesthesia of EMLA and who received only the occlusive dressing did not have a reduction in pain score . Conclusions : EMLA and placebo creams under occlusive dressing reduced pain during EPSWL . The presence of the cream itself as a coupling medium contributed to analgesia . This may be a useful , simple , safe , and economical adjuvant technique to reduce pain during immersion EPSWL BACKGROUND In a single-blind placebo-controlled study design we investigated the efficacy of acupuncture additionally applied to drug treatment in major depression . METHODS We r and omly included 70 in patients with a major depressive episode in three different treatment groups : verum acupuncture , placebo acupuncture and a control group . All three groups were pharmacologically treated with the antidepressant mianserin . The verum group received acupuncture at specific points considered effective in the treatment of depression . The placebo group was treated with acupuncture at non-specific locations and the control group received pharmacological treatment plus clinical management . Acupuncture was applied three times a week over a period of 4 weeks . Psychopathology was rated by judges blind to verum/placebo conditions twice a week over 8 weeks . RESULTS Patients who experienced acupuncture  improved slightly more than patients treated with mianserin  alone . CONCLUSIONS Additionally applied acupuncture improved the course of depression more than pharmacological treatment with mianserin alone . However , we could not detect any differences between placebo and verum acupuncture CONTEXT High-dose chemotherapy poses considerable challenges to emesis management . Although prior studies suggest that acupuncture may reduce nausea and emesis , it is unclear whether such benefit comes from the nonspecific effects of attention and clinician-patient interaction . OBJECTIVE To compare the effectiveness of electroacupuncture vs minimal needling and mock electrical stimulation or antiemetic medications alone in controlling emesis among patients undergoing a highly emetogenic chemotherapy regimen . DESIGN Three-arm , parallel-group , r and omized controlled trial conducted from March 1996 to December 1997 , with a 5-day study period and a 9-day follow-up . SETTING Oncology center at a university medical center . PATIENTS One hundred four women ( mean age , 46 years ) with high-risk breast cancer . INTERVENTIONS Patients were r and omly assigned to receive low-frequency electroacupuncture at classic antiemetic acupuncture points once daily for 5 days ( n = 37 ) ; minimal needling at control points with mock electrostimulation on the same schedule ( n = 33 ) ; or no adjunct needling ( n = 34 ) . All patients received concurrent triple antiemetic pharmacotherapy and high-dose chemotherapy ( cyclophosphamide , cisplatin , and carmustine ) . MAIN OUTCOME MEASURES Total number of emesis episodes occurring during the 5-day study period and the proportion of emesis-free days , compared among the 3 groups . RESULTS The number of emesis episodes occurring during the 5 days was lower for patients receiving electroacupuncture compared with those receiving minimal needling or pharmacotherapy alone ( median number of episodes , 5 , 10 , and 15 , respectively ; P<.001 ) . The electroacupuncture group had fewer episodes of emesis than the minimal needling group ( P<.001 ) , whereas the minimal needling group had fewer episodes of emesis than the antiemetic pharmacotherapy alone group ( P = .01 ) . The differences among groups were not significant during the 9-day follow-up period ( P = .1 
    Output:
    
We found no evidence of a generally large effect of placebo interventions .
A possible small effect on patient-reported continuous outcomes , especially pain , could not be clearly distinguished from bias