human
***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: Recent sonographic monitoring of patients treated for amoebic liver abscess has shown the healing or resolution time varying between 10 and 300 days . The effect of percutaneous needle aspiration under or resolution time was studied in 36 patients . Nineteen patients had drugs and needle aspiration under ultrasound guide whilst the 17 patients had drugs -- metronidazole , diloxanide , and chloroquine -- alone . Both groups were monitored clinical ly and sonographically . Results showed that the abscess cavities of 18 out of 19 patients ( 94.7 % ) of the aspirated group and 10 of 17 patients ( 58.8 % ) of the non-aspirated group had resolved at the end of three weeks . The difference in response to treatment was significant ( P less than 0.02 ) more so for lesion size more than 6 cm ( P less than 0.01 ) . There was also a more rapid clinical response in the aspirated group than in the non-aspirated group , particularly for patients whose lesion size was more than 6 cm ( P less than 0.01 ) . In conclusion , percutaneous needle aspiration is safe , enhances clinical recovery , and accelerates resolution particularly in patients with large abscess cavities This prospect i ve study was carried out on 200 patients with clinical ly , ultrasonographically and serologically confirmed amoebic liver abscess . The role of ultrasound-guided needle aspiration in addition to medications was evaluated compared to drug treatment alone . Both the groups were monitored clinical ly and sonographically for up to 6 months after diagnosis . The initial response ( after 15 days ) was better in the aspirated group ( P < 0.05 ) but resolution of abscess after 6 months were similar . There was a more rapid clinical response in the aspirated group , particularly in those with larger ( > 6 cm ) abscesses and there were no complications . Percutaneous ultrasound-guided needle aspiration is a safe diagnostic and therapeutic approach which enhances clinical recovery , accelerates resolution , especially in large abscesses , and prevents complications This prospect i ve study was carried out on 33 patients with clinical ly , serologically and ultrasonographically confirmed amoebic liver abscess . All patients were r and omly treated with metronidazole and chlorochin or a combination of medicamentous therapy and percutaneous drainage .  Ultrasonographic characteristics of amoebic liver abscesses were rotound or oval shape , usually hypoechogenic content with specific dorsal sonic enhancement , and in the majority of cases , location near liver capsule . Shorter duration of amoebic liver abscess resolution time in the group of patients treated with the combined therapy was observed particularly in the first four weeks of the treatment . The authors concluded that percutaneous drainage in combination with medicamentous therapy represents a successful therapeutic approach in the treatment of amoebic liver abscesses OBJECTIVE --To determine the value of needle aspiration in uncomplicated amoebic liver abscess . DESIGN --R and omised case-control study with a minimum follow up of one year , comparing patients treated with drugs alone with those treated with additional needle aspiration . SETTING --Referral based gastroenterology clinic . PATIENTS --39 Consecutive patients with amoebic liver abscess in the right lobe , of whom 37 completed the study . INTERVENTION -- Metronidazole 2.4 g/day was given to all patients for 10 days . Needle aspiration of the abscess was performed in 19 patients on the day of admission to hospital . MAIN OUTCOME MEASURES --Abdominal pain , fever , anorexia , and hepatomegaly were measured . Erythrocyte sedimentation rate , serum aspartate , and alanine aminotransferase activities , and alkaline phosphatase activity were also measured . RESULTS -- Clinical improvement was similar in both groups of patients . Improvement in haematological and biochemical variables and rates of healing of cavities were also similar . CONCLUSIONS --Chemotherapy with potent tissue amoebicidal drugs such as metronidazole is optimally effective in treating amoebic liver abscess , and in uncomplicated cases routine aspiration is not required OBJECTIVE The purpose of this study was to determine the effectiveness of percutaneous catheter drainage ( PCD ) and to compare PCD with percutaneous needle aspiration in the management of liver abscess . SUBJECTS AND METHODS Sixty patients with pyogenic liver abscess were r and omly assigned to two groups in a prospect i ve study . Antibiotics were administered for 10 days , starting the day of the beginning of percutaneous treatment . One group was treated with sonographically guided PCD and the other group with repeated percutaneous needle aspiration . Percutaneous needle aspiration was attempted a maximum of three times . Lack of response to the third aspiration was considered failure of treatment ; these patients were treated with PCD but were not included in the PCD group for analysis . Patient demographics , duration of hospital stay , treatment outcome , and complications were analyzed . RESULTS Percutaneous needle aspiration was successful in 20 ( 67 % ) of the 30 patients after one ( n = 12 ) , two ( n = 7 ) , or three ( n = 1 ) aspirations . PCD was curative in all 30 patients after one ( n = 24 ) or two ( n = 6 ) procedures . All abscesses 50 mm or less in longest diameter were successfully managed , 10 by percutaneous needle aspiration and 12 by PCD . None of patients in the percutaneous needle aspiration group with multiloculated abscesses ( n = 5 ) was successfully treated . Hospital stay did not differ significantly between the groups . There were no complications related to the procedure . CONCLUSION PCD is more effective than percutaneous needle aspiration in the management of liver abscess . Percutaneous needle aspiration can be used as a valid alternative for simple abscesses 50 mm in diameter or smaller Objective To compare the effectiveness of percutaneous catheter drainage ( PCD ) and percutaneous needle aspiration ( PNA ) in the management of large ( > 10 cm diameter ) liver abscesses . Methods Seventy-two patients with liver abscess ( amebic 48 , pyogenic 24 ) were r and omly allocated to PCD or PNA ( 36 each ) , which were done within 24 hours of admission . Both groups received parenteral antibiotics for at least 10 days . PNA was repeated every third day if the cavity size had not declined to 50 % of the original for up to three times . Persistence of cavity or of clinical symptoms was considered failure of treatment . Duration to attain clinical relief , duration of hospital stay , complications , treatment failure , and deaths were recorded . Results PNA was successful in 31 of 36 ( 86 % ) patients ( one aspiration in 10 , two in 18 , and three in 3 patients ) , whereas PCD was successful in 35 ( 97 % ) patients ( p = ns ) . Duration to attain clinical relief ( 10.2 [ 2.0 ] vs. 8.1 [ 2.7 ] days ; p=0.02 ) and parenteral antibiotics needed ( 15.5 [ 1.1 ] vs. 10.9 [ 2.7 ] days ; p=0.04 ) were significantly lower in PCD group . Duration of hospital stay was similar in the two groups . One patient with PNA had a subcapsular hematoma and one with PCD had continuous bile leakage which stopped spontaneously . One patient in PCD group died . Conclusion PCD is a better treatment option than PNA for the management of large liver abscesses of size > 10 cm , in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed The performance of therapeutic aspiration in the treatment of amebic liver abscess , advocated and practice d in many centers , is controversial . Previously , this practice has been evaluated in retrospective analyses . To test the potential benefit of therapeutic aspiration , the authors undertook a prospect i ve r and omized trial in 57 patients admitted for suspected amebic liver abscess during a 15-month period . Sixteen patients were excluded from the trial . The remaining 41 patients were r and omly included in one of two study groups to receive amebicidal therapy alone or amebicidal therapy coupled with image-guided percutaneous therapeutic aspiration . All patients in the trial recovered . No statistically significant benefit was demonstrated in the aspiration group for the two objective parameters evaluated : length of hospitalization and duration of time to becoming afebrile . Subjective improvement in symptoms after aspiration was greater in the aspiration group at a marginally statistically significant level . These data do not support the adjunctive performance of percutaneous therapeutic aspiration in the treatment of uncomplicated amebic liver abscess . Amebicidals alone were equally efficacious in treating the group studied Background The aim of the study was to evaluate the clinical presentation , and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses . Methods This is a prospect i ve r and omized comparative study of 60 patients , presented in outpatient and emergency department at the hospital , r and omized equally into two groups , percutaneous needle aspiration and pigtail catheter drainage .  The effectiveness of either treatment was measured in terms of duration of hospital stay , days to achieve clinical improvement , 50 % reduction in abscess cavity size and total/near total resolution of abscess cavity . Independent t-test was used to analyze these parameters . Results The success rate was significantly better in catheter drainage group ( P=0.006 ) . The patients in pigtail catheter drainage group showed earlier clinical improvement ( P=0.039 ) and 50 % decrease in abscess cavity volume ( P=0.000 ) as compared to those who underwent percutaneous needle aspiration . Conclusion Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus Thirty-nine patients with amoebic liver abscess ( ALA ) , admitted to the Central Hospital of Hué ( Vietnam ) , were evaluated in a comparative , prospect i ve and r and omized study for the treatment of ALA . Adult patients with an abscess located in the right liver lobe and an abscess diameter of 6 to 10 cm were included . Bacterial abscesses were excluded by microbiological examination of abscess fluid in all patients . Nineteen patients were treated with metronidazole for 10 days alone and 20 patients were punctured under ultrasound guidance with aspiration of abscess fluid in addition to drug administration . The clinical symptoms fever , pain in right upper abdomen and liver tenderness , and the laboratory parameters erythrocyte sedimentation rate , white blood cells , haemoglobin and C-reactive protein and the abscess size were determined on the day of admission and followed during an observation period of 38 days . Improvement of liver tenderness was significantly faster in the aspiration group during the first 3 days ( P < 0.001 ) , whereas all the other parameters showed no differences between the two groups . This minor benefit is obviously not sufficient to justify routine needle aspiration and advocates drug treatment alone for uncomplicated amoebic liver abscesses with a diameter up to 10 cm located in the right liver lobe Summary Amoebic liver abscess develops in less than 1 % of patients with amoebaisis and metronidazole is the drug of choice for the treatment of amebic liver abscess . Abscesses of less than 5 cm can be treated with metronidazole alone . However , abscesses of more than 10 cm must undergo ultrasound guided percutaneous needle aspiration along with metronidazole . The role of percutaneous needle aspiration in abscesses of 5 to 10 cm is not clear . Fifty-seven patients with a solitary , right lobe , uncomplicated amoebic liverabscess of 5–10 cm were r and omized to receive either metronidazole alone ( control group ; n = 29 ) or ultrasound guided percutaneous needle aspiration along with metronidazole ( intervention group ; n = 28 ) . Although the resolution of pain and fever occurred earlier in the intervention group ( 27 h and 17 h , respectively ) than the control group ( 48 h and 30 h , respectively ) , the difference was not statistically significant ( P = 0.16 and 0.48 , respectively ) . There were no deaths during the study period and treatment failure , complications ( rupture of abscess ) , days to normalization of leukocytosis and duration of hospitalization were similar in both groups . Ultrasound guided percutaneous needle aspiration along with metronidazole was no better than metronidazole alone in the management of uncomplicated , solitary , right lobe amoebic liver abscess of 5 to 10 cm BACKGROUND Amebic liver abscess ( ALA ) is a common and serious problem in our country . There are only a few controlled trials on the efficacy and advantages of combination therapy with percutaneous needle aspiration and pharmacotherapy , over pharmacotherapy alone for amebic liver abscess . MATERIAL AND METHODS This study was conducted to compare the efficacy of two different treatment modalities i.e. drug treatment alone vs. drug treatment and aspiration of abscess cavity in patients with small ( up to 5 cm ) and large ( 5 cm to 10 cm ) size ALA . This is one of the largest single center , prospect i ve , r and omized studies comparing the efficacy of aspiration in ALA . RESULTS ( i ) Mean body temperature , liver tenderness , total leukocyte count ( TLC ) , serum alanine aminotransferase ( ALT ) and liver span were significantly decreased in the aspiration group on days 8 and 15 
    Output:
    
agent
There was no significant difference in relation to the resolution of fever , abscess size , and hospital stay .
The beneficial effects of PA were seen with medium-to-large ( > 5 cm ) ALA and not with small ( < 5 cm ) ALA .
Percutaneous aspiration as compared with metronidazole alone results in the early resolution of pain and tenderness in patients with medium-to-large ALA .
Percutaneous catheter drainage is better for larger ALA .
***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: Recent sonographic monitoring of patients treated for amoebic liver abscess has shown the healing or resolution time varying between 10 and 300 days . The effect of percutaneous needle aspiration under or resolution time was studied in 36 patients . Nineteen patients had drugs and needle aspiration under ultrasound guide whilst the 17 patients had drugs -- metronidazole , diloxanide , and chloroquine -- alone . Both groups were monitored clinical ly and sonographically . Results showed that the abscess cavities of 18 out of 19 patients ( 94.7 % ) of the aspirated group and 10 of 17 patients ( 58.8 % ) of the non-aspirated group had resolved at the end of three weeks . The difference in response to treatment was significant ( P less than 0.02 ) more so for lesion size more than 6 cm ( P less than 0.01 ) . There was also a more rapid clinical response in the aspirated group than in the non-aspirated group , particularly for patients whose lesion size was more than 6 cm ( P less than 0.01 ) . In conclusion , percutaneous needle aspiration is safe , enhances clinical recovery , and accelerates resolution particularly in patients with large abscess cavities This prospect i ve study was carried out on 200 patients with clinical ly , ultrasonographically and serologically confirmed amoebic liver abscess . The role of ultrasound-guided needle aspiration in addition to medications was evaluated compared to drug treatment alone . Both the groups were monitored clinical ly and sonographically for up to 6 months after diagnosis . The initial response ( after 15 days ) was better in the aspirated group ( P < 0.05 ) but resolution of abscess after 6 months were similar . There was a more rapid clinical response in the aspirated group , particularly in those with larger ( > 6 cm ) abscesses and there were no complications . Percutaneous ultrasound-guided needle aspiration is a safe diagnostic and therapeutic approach which enhances clinical recovery , accelerates resolution , especially in large abscesses , and prevents complications This prospect i ve study was carried out on 33 patients with clinical ly , serologically and ultrasonographically confirmed amoebic liver abscess . All patients were r and omly treated with metronidazole and chlorochin or a combination of medicamentous therapy and percutaneous drainage .  Ultrasonographic characteristics of amoebic liver abscesses were rotound or oval shape , usually hypoechogenic content with specific dorsal sonic enhancement , and in the majority of cases , location near liver capsule . Shorter duration of amoebic liver abscess resolution time in the group of patients treated with the combined therapy was observed particularly in the first four weeks of the treatment . The authors concluded that percutaneous drainage in combination with medicamentous therapy represents a successful therapeutic approach in the treatment of amoebic liver abscesses OBJECTIVE --To determine the value of needle aspiration in uncomplicated amoebic liver abscess . DESIGN --R and omised case-control study with a minimum follow up of one year , comparing patients treated with drugs alone with those treated with additional needle aspiration . SETTING --Referral based gastroenterology clinic . PATIENTS --39 Consecutive patients with amoebic liver abscess in the right lobe , of whom 37 completed the study . INTERVENTION -- Metronidazole 2.4 g/day was given to all patients for 10 days . Needle aspiration of the abscess was performed in 19 patients on the day of admission to hospital . MAIN OUTCOME MEASURES --Abdominal pain , fever , anorexia , and hepatomegaly were measured . Erythrocyte sedimentation rate , serum aspartate , and alanine aminotransferase activities , and alkaline phosphatase activity were also measured . RESULTS -- Clinical improvement was similar in both groups of patients . Improvement in haematological and biochemical variables and rates of healing of cavities were also similar . CONCLUSIONS --Chemotherapy with potent tissue amoebicidal drugs such as metronidazole is optimally effective in treating amoebic liver abscess , and in uncomplicated cases routine aspiration is not required OBJECTIVE The purpose of this study was to determine the effectiveness of percutaneous catheter drainage ( PCD ) and to compare PCD with percutaneous needle aspiration in the management of liver abscess . SUBJECTS AND METHODS Sixty patients with pyogenic liver abscess were r and omly assigned to two groups in a prospect i ve study . Antibiotics were administered for 10 days , starting the day of the beginning of percutaneous treatment . One group was treated with sonographically guided PCD and the other group with repeated percutaneous needle aspiration . Percutaneous needle aspiration was attempted a maximum of three times . Lack of response to the third aspiration was considered failure of treatment ; these patients were treated with PCD but were not included in the PCD group for analysis . Patient demographics , duration of hospital stay , treatment outcome , and complications were analyzed . RESULTS Percutaneous needle aspiration was successful in 20 ( 67 % ) of the 30 patients after one ( n = 12 ) , two ( n = 7 ) , or three ( n = 1 ) aspirations . PCD was curative in all 30 patients after one ( n = 24 ) or two ( n = 6 ) procedures . All abscesses 50 mm or less in longest diameter were successfully managed , 10 by percutaneous needle aspiration and 12 by PCD . None of patients in the percutaneous needle aspiration group with multiloculated abscesses ( n = 5 ) was successfully treated . Hospital stay did not differ significantly between the groups . There were no complications related to the procedure . CONCLUSION PCD is more effective than percutaneous needle aspiration in the management of liver abscess . Percutaneous needle aspiration can be used as a valid alternative for simple abscesses 50 mm in diameter or smaller Objective To compare the effectiveness of percutaneous catheter drainage ( PCD ) and percutaneous needle aspiration ( PNA ) in the management of large ( > 10 cm diameter ) liver abscesses . Methods Seventy-two patients with liver abscess ( amebic 48 , pyogenic 24 ) were r and omly allocated to PCD or PNA ( 36 each ) , which were done within 24 hours of admission . Both groups received parenteral antibiotics for at least 10 days . PNA was repeated every third day if the cavity size had not declined to 50 % of the original for up to three times . Persistence of cavity or of clinical symptoms was considered failure of treatment . Duration to attain clinical relief , duration of hospital stay , complications , treatment failure , and deaths were recorded . Results PNA was successful in 31 of 36 ( 86 % ) patients ( one aspiration in 10 , two in 18 , and three in 3 patients ) , whereas PCD was successful in 35 ( 97 % ) patients ( p = ns ) . Duration to attain clinical relief ( 10.2 [ 2.0 ] vs. 8.1 [ 2.7 ] days ; p=0.02 ) and parenteral antibiotics needed ( 15.5 [ 1.1 ] vs. 10.9 [ 2.7 ] days ; p=0.04 ) were significantly lower in PCD group . Duration of hospital stay was similar in the two groups . One patient with PNA had a subcapsular hematoma and one with PCD had continuous bile leakage which stopped spontaneously . One patient in PCD group died . Conclusion PCD is a better treatment option than PNA for the management of large liver abscesses of size > 10 cm , in terms of duration to attain clinical relief and duration for which parenteral antibiotics are needed The performance of therapeutic aspiration in the treatment of amebic liver abscess , advocated and practice d in many centers , is controversial . Previously , this practice has been evaluated in retrospective analyses . To test the potential benefit of therapeutic aspiration , the authors undertook a prospect i ve r and omized trial in 57 patients admitted for suspected amebic liver abscess during a 15-month period . Sixteen patients were excluded from the trial . The remaining 41 patients were r and omly included in one of two study groups to receive amebicidal therapy alone or amebicidal therapy coupled with image-guided percutaneous therapeutic aspiration . All patients in the trial recovered . No statistically significant benefit was demonstrated in the aspiration group for the two objective parameters evaluated : length of hospitalization and duration of time to becoming afebrile . Subjective improvement in symptoms after aspiration was greater in the aspiration group at a marginally statistically significant level . These data do not support the adjunctive performance of percutaneous therapeutic aspiration in the treatment of uncomplicated amebic liver abscess . Amebicidals alone were equally efficacious in treating the group studied Background The aim of the study was to evaluate the clinical presentation , and to investigate the effectiveness of continuous catheter drainage in comparison to needle aspiration in the treatment of liver abscesses . Methods This is a prospect i ve r and omized comparative study of 60 patients , presented in outpatient and emergency department at the hospital , r and omized equally into two groups , percutaneous needle aspiration and pigtail catheter drainage .  The effectiveness of either treatment was measured in terms of duration of hospital stay , days to achieve clinical improvement , 50 % reduction in abscess cavity size and total/near total resolution of abscess cavity . Independent t-test was used to analyze these parameters . Results The success rate was significantly better in catheter drainage group ( P=0.006 ) . The patients in pigtail catheter drainage group showed earlier clinical improvement ( P=0.039 ) and 50 % decrease in abscess cavity volume ( P=0.000 ) as compared to those who underwent percutaneous needle aspiration . Conclusion Percutaneous catheter drainage is a better modality as compared to percutaneous needle aspiration especially in larger abscesses which are partially liquefied or with thick pus Thirty-nine patients with amoebic liver abscess ( ALA ) , admitted to the Central Hospital of Hué ( Vietnam ) , were evaluated in a comparative , prospect i ve and r and omized study for the treatment of ALA . Adult patients with an abscess located in the right liver lobe and an abscess diameter of 6 to 10 cm were included . Bacterial abscesses were excluded by microbiological examination of abscess fluid in all patients . Nineteen patients were treated with metronidazole for 10 days alone and 20 patients were punctured under ultrasound guidance with aspiration of abscess fluid in addition to drug administration . The clinical symptoms fever , pain in right upper abdomen and liver tenderness , and the laboratory parameters erythrocyte sedimentation rate , white blood cells , haemoglobin and C-reactive protein and the abscess size were determined on the day of admission and followed during an observation period of 38 days . Improvement of liver tenderness was significantly faster in the aspiration group during the first 3 days ( P < 0.001 ) , whereas all the other parameters showed no differences between the two groups . This minor benefit is obviously not sufficient to justify routine needle aspiration and advocates drug treatment alone for uncomplicated amoebic liver abscesses with a diameter up to 10 cm located in the right liver lobe Summary Amoebic liver abscess develops in less than 1 % of patients with amoebaisis and metronidazole is the drug of choice for the treatment of amebic liver abscess . Abscesses of less than 5 cm can be treated with metronidazole alone . However , abscesses of more than 10 cm must undergo ultrasound guided percutaneous needle aspiration along with metronidazole . The role of percutaneous needle aspiration in abscesses of 5 to 10 cm is not clear . Fifty-seven patients with a solitary , right lobe , uncomplicated amoebic liverabscess of 5–10 cm were r and omized to receive either metronidazole alone ( control group ; n = 29 ) or ultrasound guided percutaneous needle aspiration along with metronidazole ( intervention group ; n = 28 ) . Although the resolution of pain and fever occurred earlier in the intervention group ( 27 h and 17 h , respectively ) than the control group ( 48 h and 30 h , respectively ) , the difference was not statistically significant ( P = 0.16 and 0.48 , respectively ) . There were no deaths during the study period and treatment failure , complications ( rupture of abscess ) , days to normalization of leukocytosis and duration of hospitalization were similar in both groups . Ultrasound guided percutaneous needle aspiration along with metronidazole was no better than metronidazole alone in the management of uncomplicated , solitary , right lobe amoebic liver abscess of 5 to 10 cm BACKGROUND Amebic liver abscess ( ALA ) is a common and serious problem in our country . There are only a few controlled trials on the efficacy and advantages of combination therapy with percutaneous needle aspiration and pharmacotherapy , over pharmacotherapy alone for amebic liver abscess . MATERIAL AND METHODS This study was conducted to compare the efficacy of two different treatment modalities i.e. drug treatment alone vs. drug treatment and aspiration of abscess cavity in patients with small ( up to 5 cm ) and large ( 5 cm to 10 cm ) size ALA . This is one of the largest single center , prospect i ve , r and omized studies comparing the efficacy of aspiration in ALA . RESULTS ( i ) Mean body temperature , liver tenderness , total leukocyte count ( TLC ) , serum alanine aminotransferase ( ALT ) and liver span were significantly decreased in the aspiration group on days 8 and 15 
    Output:
    