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: BACKGROUND & AIMS The Rome III criteria for functional dyspepsia have been changed to include 2 distinct syndromes : postpr and ial distress syndrome and epigastric pain syndrome . We investigated risk factors for functional dyspepsia among the functional dyspepsia subgroups defined by the Rome III criteria . METHODS We performed a cross-sectional population -based study in a primary care setting ( the Kalix and a study ) . A r and om sample ( n = 2860 ) of the adult population from 2 northern Swedish municipalities ( n = 21,610 ) was surveyed using a vali date d postal question naire to assess gastrointestinal symptoms ( response rate , 74.2 % ; n = 2122 ) . A r and omly selected subgroup ( n = 1001 ) of responders was invited to undergo an esophagogastroduodenoscopy ( participation rate , 73.3 % ) including biopsy specimen collection , Helicobacter pylori culture and serology , and symptom assessment s. RESULTS Of the 1001 subjects examined by endoscopy , 202 ( 20.2 % ; 95 % confidence interval [ CI ] , 17.7 - 22.7 ) were classified as having uninvestigated dyspepsia and 157 ( 15.7 % ; 95 % CI , 13.4 - 18.0 ) as having functional dyspepsia . Major anxiety ( Hospital Anxiety and Depression Scale score > or = 11 ) was associated with uninvestigated dyspepsia ( odds ratio [ OR ] , 3.01 ; 95 % CI , 1.39 - 6.54 ) , as was obesity ( body mass index > or = 30 kg/m(2 ) ) ( OR , 1.86 ; 95 % CI , 1.15 - 3.01 ) . Major anxiety was associated with functional dyspepsia and postpr and ial distress syndrome ( OR of 2.56 [ 95 % CI , 1.06 - 6.19 ] and 4.35 [ 95 % CI , 1.81 - 10.46 ] , respectively ) , as was use of nonsteroidal anti-inflammatory drugs ( OR , 2.49 [ 95 % CI , 1.29 - 4.78 ] and 2.75 [ 95 % CI , 1.38 - 5.50 ] , respectively ) . Depression was not associated with any dyspepsia group . CONCLUSIONS Anxiety but not depression is linked to uninvestigated dyspepsia , functional dyspepsia , and postpr and ial distress syndrome but not to epigastric pain syndrome BACKGROUND Visceral hypersensitivity is one of the proposed underlying mechanisms in functional dyspepsia ( FD ) . It is not clear whether visceral hypersensitivity in FD is a manifestation of a central sensitization also encompassing somatic sensitization . Transient receptor potential vanilloid-1 ( TRPV(1 ) ) pathways are involved in gastric mechanosensory physiology and the TRPV(1 ) receptor agonist , capsaicin , has been used as a chemical stimulant . METHODS In this double-blind , r and omized study we evaluated both visceral and somatic sensory function in 34 FD patients and 42 healthy controls using quantitative sensory testing . Visceral pain sensitivity was assessed using a vali date d gastric pain model with oral capsaicin capsule titration and somatic pain sensitivity was determined by foot heat and h and electric stimulation . KEY RESULTS The median capsaicin dose required to attain moderate pain was 0.5 mg in FD and 1 mg in controls ( P = 0.03 ) . At these doses , mean pain intensities on a 0 - 100 visual analog scale were greater for FD than controls [ 56.9 ( 95 % confidence intervals , 52.2 - 61.5 ) vs 45.1 ( 41.6 - 48.6 ) , resp . ] ( P = 0.005 ) . Overall , mean somatic sensory and pain thresholds were similar in FD and control groups , but in a subgroup of FD pain hypersensitivity was seen on the h and and on the foot at different stimulation thresholds . CONCLUSIONS & INFERENCES A majority of patients with FD have visceral chemo-hypersensitivity involving TRPV(1 ) pathways . A substantial subgroup also has somatic hypersensitivity as evidence of central sensitization BACKGROUND & AIMS Functional abnormalities of the duodenum have been observed in non-ulcer dyspepsia . We aim ed to identify whether eosinophils in the upper gastrointestinal tract are a biomarker for non-ulcer dyspepsia . METHODS A r and om sample of an adult Swedish population ( n = 1001 ; mean age , 54 y ; 51 % female ) underwent upper endoscopy . Non-ulcer dyspepsia cases ( n = 51 , Rome II ) and r and omly selected controls ( n = 48 ) were identified . Two blinded independent observers assessed the gastroduodenal eosinophil counts . Eosinophils were quantified by counting the number per 5 high-power fields at each of 5 sites ( cardia , body , antrum , D1 duodenal bulb , and D2 second portion of duodenum ) , and total counts were summed over the 5 fields at each site . RESULTS The odds ratio for non-ulcer dyspepsia ( vs asymptomatic controls ) in subjects with high duodenal bulb eosinophil counts ( median , > /=22 , relative to < 22 ) was 11.7 ( 95 % confidence interval , 3.9 - 34.9 ) , adjusting for age , sex , and H pylori ; similar results were observed in D2 ( odds ratio = 7.3 ; 95 % confidence interval , 2.9 - 18.1 ) . A significant association with the number of eosinophil clusters was detected in the duodenum , with higher values in non-ulcer dyspepsia ( P < .01 ) . By immunostaining with major basic protein antibody in a subset of duodenal biopsy specimens , eosinophil degranulation was observed in non-ulcer dyspepsia ( 7 of 15 vs 0 of 5 controls ; P = .11 ) . Gastric eosinophil counts were overall not significantly increased in non-ulcer dyspepsia vs controls . Early satiety was associated with eosinophilia in D1 ( P = .01 ) and D2 ( P = .02 ) , adjusting for age , sex , and H pylori . CONCLUSIONS Duodenal eosinophilia may characterize a subset of adults with non-ulcer dyspepsia AIM To evaluate sertraline , a selective serotonin reuptake inhibitor in the treatment of patients with functional dyspepsia . METHODS Consecutive tertiary hospital patients with a clinical diagnosis of functional dyspepsia ( FD ) according to the Rome II criteria with a Hong Kong dyspepsia index ( HKDI ) of greater than 16 were recruited . Patients commenced enrolment prior to the inception of the Rome III criteria for functional dyspepsia . All patients were ethnic Chinese , had a normal upper endoscopy and were Helicobacter pylori negative prior to enrolment . Study patients were r and omized to receive sertraline 50 mg or placebo daily for 8 wk . HKDI symptom scores , quality of life , hospital anxiety and depression ( HAD ) scale and global symptom relief were evaluated before , during and after treatment . Adverse effects were monitored during and after treatment . RESULTS A total of 193 patients were r and omized in the intention to treat ( ITT ) , and 150 patients were included in the per protocol ( PP ) analysis . In both the ITT and PP , there was no difference in the primary outcome of global dyspepsia symptoms between the sertraline and placebo groups at week 8 . In the ITT analysis , 98 and 95 patients were r and omized to the sertraline and placebo groups respectively . A total of 43 patients withdrew from the study ( 22.3 % ) by week 8 , with 23 of the 24 drop-outs in the sertraline group occurring prior to week 4 ( 95.8 % ) . In contrast , in the placebo arm , 11 of 19 patients dropped out by week 4 ( 57.9 % ) . Utilizing the last response carried forward to account for the drop-outs , there were no differences between the sertraline and placebo groups at baseline in terms of the HKDI , HKDI 26.08 ± 6.19 vs 26.70 ± 5.89 , P = 0.433 ; and at week 8 , HKDI 22.41 ± 6.36 vs 23.25 ± 7.30 , P = 0.352 respectively . In the PP analysis , 74 and 76 patients were r and omized to the sertraline and placebo groups respectively . At baseline , there were no statistically significant differences between the sertraline and placebo groups , HKDI 25.83 ± 6.313 vs 27.19 ± 5.929 respectively , P = 0.233 ; however by week 8 , patients in the sertraline group demonstrated a statistically significant difference in their Hong Kong Dyspepsia Index compared to placebo , HKDI 20.53 ± 6.917 vs 23.34 ± 7.199 , P = 0.02 , respectively ) . There was also no statistically significant difference in overall quality of life measures or the HAD scale related to treatment in either the ITT or PP analysis at week 8 . CONCLUSION This pilot study , the first to examine sertraline , a selective serotonin reuptake inhibitor , for the management of FD , did not find that it was superior to placebo BACKGROUND : Low-dose tricyclic antidepressants have been used to treat chronic somatic and gastrointestinal pain disorders , including refractory functional dyspepsia . However , there are only limited data on the effects of these drugs on upper gastrointestinal function . AIM : To compare the effects of two doses of amitriptyline ( AMT ) and placebo on gastric accommodation , emptying , satiation , and postpr and ial symptoms in healthy volunteers . METHODS : Using a parallel-group , double-blind , placebo-controlled design , 41 healthy volunteers were r and omized to AMT 25 mg , AMT 50 mg , or placebo for 2 wk . During the final 3 days of therapy , the following end points were assessed : fasting and postpr and ial gastric volumes , 2- and 4-h gastric emptying , time and volume to maximum satiation using a nutrient drink test , and postpr and ial symptoms 30 min later using 10-cm visual analog scales . AMT and metabolite levels were measured . RESULTS : AMT slowed gastric emptying at 2 h ( median 75 % for placebo , 57 % for AMT 25 mg , 67 % for AMT 50 mg ; P= 0.037 ) and 4 h ( median 98 % for placebo , 96 % for AMT 25 mg , 92 % for AMT 50 mg ; P= 0.003 ) . AMT did not affect gastric volumes or satiation volume , but it did reduce nausea scores at 30 min in a dose-dependent manner ( median 2.1 for placebo , 0.9 for AMT 25 mg , and 0.0 for AMT 50 mg ; P= 0.009 ) . CONCLUSION : In healthy volunteers , AMT slows gastric emptying of solids , but it does not significantly affect gastric volumes or satiation .  AMT reduces nausea after challenge with a high calorie liquid load Acute studies suggested a therapeutic benefit for fundus-relaxing drugs in functional dyspepsia ( FD ) with visceral hypersensitivity ( VH ) to gastric distention or impaired accommodation ( IA ) , but long-term studies are lacking . R-137696 is a serotonin-1A ( 5-HT(1A ) ) receptor agonist which relaxes the proximal stomach in man . Our aim was to investigate the influence of R-137696 on symptoms in FD with VH or IA . R and omized , double-blind , placebo-controlled , parallel group study of 4 weeks R-137696 2 mg t.i.d . in FD with VH or IA . Symptoms were assessed using the  patient assessment of upper gastrointestinal symptom severity index ( PAGI-SYM ) total score and individual symptom subscales . Barostat studies were performed before and after 4 weeks of treatment . Fifty-three patients ( 33 VH and 20 IA ) , 18 men , mean age 40 + /- 13 years were recruited . Twenty-four received placebo and 29 received R-137696 . In VH patients , both placebo and R-137696 improved total symptom scores , with a tendency for superiority of placebo ( -1.12 vs-0.51 , P = 0.07 ) . Placebo was superior for the subscales of early satiety , bloating , fullness and discomfort ( all P <  
    Output:
    
agent
However , benefit was limited to antipsychotics and tricyclic antidepressants .
Conclusions Psychotropic drugs may be an effective treatment for FD , but the effect appears to be limited to antipsychotics and tricyclic antidepressants with fewer trials for other agents , meaning that firm conclusions for efficacy can not be made .
***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 & AIMS The Rome III criteria for functional dyspepsia have been changed to include 2 distinct syndromes : postpr and ial distress syndrome and epigastric pain syndrome . We investigated risk factors for functional dyspepsia among the functional dyspepsia subgroups defined by the Rome III criteria . METHODS We performed a cross-sectional population -based study in a primary care setting ( the Kalix and a study ) . A r and om sample ( n = 2860 ) of the adult population from 2 northern Swedish municipalities ( n = 21,610 ) was surveyed using a vali date d postal question naire to assess gastrointestinal symptoms ( response rate , 74.2 % ; n = 2122 ) . A r and omly selected subgroup ( n = 1001 ) of responders was invited to undergo an esophagogastroduodenoscopy ( participation rate , 73.3 % ) including biopsy specimen collection , Helicobacter pylori culture and serology , and symptom assessment s. RESULTS Of the 1001 subjects examined by endoscopy , 202 ( 20.2 % ; 95 % confidence interval [ CI ] , 17.7 - 22.7 ) were classified as having uninvestigated dyspepsia and 157 ( 15.7 % ; 95 % CI , 13.4 - 18.0 ) as having functional dyspepsia . Major anxiety ( Hospital Anxiety and Depression Scale score > or = 11 ) was associated with uninvestigated dyspepsia ( odds ratio [ OR ] , 3.01 ; 95 % CI , 1.39 - 6.54 ) , as was obesity ( body mass index > or = 30 kg/m(2 ) ) ( OR , 1.86 ; 95 % CI , 1.15 - 3.01 ) . Major anxiety was associated with functional dyspepsia and postpr and ial distress syndrome ( OR of 2.56 [ 95 % CI , 1.06 - 6.19 ] and 4.35 [ 95 % CI , 1.81 - 10.46 ] , respectively ) , as was use of nonsteroidal anti-inflammatory drugs ( OR , 2.49 [ 95 % CI , 1.29 - 4.78 ] and 2.75 [ 95 % CI , 1.38 - 5.50 ] , respectively ) . Depression was not associated with any dyspepsia group . CONCLUSIONS Anxiety but not depression is linked to uninvestigated dyspepsia , functional dyspepsia , and postpr and ial distress syndrome but not to epigastric pain syndrome BACKGROUND Visceral hypersensitivity is one of the proposed underlying mechanisms in functional dyspepsia ( FD ) . It is not clear whether visceral hypersensitivity in FD is a manifestation of a central sensitization also encompassing somatic sensitization . Transient receptor potential vanilloid-1 ( TRPV(1 ) ) pathways are involved in gastric mechanosensory physiology and the TRPV(1 ) receptor agonist , capsaicin , has been used as a chemical stimulant . METHODS In this double-blind , r and omized study we evaluated both visceral and somatic sensory function in 34 FD patients and 42 healthy controls using quantitative sensory testing . Visceral pain sensitivity was assessed using a vali date d gastric pain model with oral capsaicin capsule titration and somatic pain sensitivity was determined by foot heat and h and electric stimulation . KEY RESULTS The median capsaicin dose required to attain moderate pain was 0.5 mg in FD and 1 mg in controls ( P = 0.03 ) . At these doses , mean pain intensities on a 0 - 100 visual analog scale were greater for FD than controls [ 56.9 ( 95 % confidence intervals , 52.2 - 61.5 ) vs 45.1 ( 41.6 - 48.6 ) , resp . ] ( P = 0.005 ) . Overall , mean somatic sensory and pain thresholds were similar in FD and control groups , but in a subgroup of FD pain hypersensitivity was seen on the h and and on the foot at different stimulation thresholds . CONCLUSIONS & INFERENCES A majority of patients with FD have visceral chemo-hypersensitivity involving TRPV(1 ) pathways . A substantial subgroup also has somatic hypersensitivity as evidence of central sensitization BACKGROUND & AIMS Functional abnormalities of the duodenum have been observed in non-ulcer dyspepsia . We aim ed to identify whether eosinophils in the upper gastrointestinal tract are a biomarker for non-ulcer dyspepsia . METHODS A r and om sample of an adult Swedish population ( n = 1001 ; mean age , 54 y ; 51 % female ) underwent upper endoscopy . Non-ulcer dyspepsia cases ( n = 51 , Rome II ) and r and omly selected controls ( n = 48 ) were identified . Two blinded independent observers assessed the gastroduodenal eosinophil counts . Eosinophils were quantified by counting the number per 5 high-power fields at each of 5 sites ( cardia , body , antrum , D1 duodenal bulb , and D2 second portion of duodenum ) , and total counts were summed over the 5 fields at each site . RESULTS The odds ratio for non-ulcer dyspepsia ( vs asymptomatic controls ) in subjects with high duodenal bulb eosinophil counts ( median , > /=22 , relative to < 22 ) was 11.7 ( 95 % confidence interval , 3.9 - 34.9 ) , adjusting for age , sex , and H pylori ; similar results were observed in D2 ( odds ratio = 7.3 ; 95 % confidence interval , 2.9 - 18.1 ) . A significant association with the number of eosinophil clusters was detected in the duodenum , with higher values in non-ulcer dyspepsia ( P < .01 ) . By immunostaining with major basic protein antibody in a subset of duodenal biopsy specimens , eosinophil degranulation was observed in non-ulcer dyspepsia ( 7 of 15 vs 0 of 5 controls ; P = .11 ) . Gastric eosinophil counts were overall not significantly increased in non-ulcer dyspepsia vs controls . Early satiety was associated with eosinophilia in D1 ( P = .01 ) and D2 ( P = .02 ) , adjusting for age , sex , and H pylori . CONCLUSIONS Duodenal eosinophilia may characterize a subset of adults with non-ulcer dyspepsia AIM To evaluate sertraline , a selective serotonin reuptake inhibitor in the treatment of patients with functional dyspepsia . METHODS Consecutive tertiary hospital patients with a clinical diagnosis of functional dyspepsia ( FD ) according to the Rome II criteria with a Hong Kong dyspepsia index ( HKDI ) of greater than 16 were recruited . Patients commenced enrolment prior to the inception of the Rome III criteria for functional dyspepsia . All patients were ethnic Chinese , had a normal upper endoscopy and were Helicobacter pylori negative prior to enrolment . Study patients were r and omized to receive sertraline 50 mg or placebo daily for 8 wk . HKDI symptom scores , quality of life , hospital anxiety and depression ( HAD ) scale and global symptom relief were evaluated before , during and after treatment . Adverse effects were monitored during and after treatment . RESULTS A total of 193 patients were r and omized in the intention to treat ( ITT ) , and 150 patients were included in the per protocol ( PP ) analysis . In both the ITT and PP , there was no difference in the primary outcome of global dyspepsia symptoms between the sertraline and placebo groups at week 8 . In the ITT analysis , 98 and 95 patients were r and omized to the sertraline and placebo groups respectively . A total of 43 patients withdrew from the study ( 22.3 % ) by week 8 , with 23 of the 24 drop-outs in the sertraline group occurring prior to week 4 ( 95.8 % ) . In contrast , in the placebo arm , 11 of 19 patients dropped out by week 4 ( 57.9 % ) . Utilizing the last response carried forward to account for the drop-outs , there were no differences between the sertraline and placebo groups at baseline in terms of the HKDI , HKDI 26.08 ± 6.19 vs 26.70 ± 5.89 , P = 0.433 ; and at week 8 , HKDI 22.41 ± 6.36 vs 23.25 ± 7.30 , P = 0.352 respectively . In the PP analysis , 74 and 76 patients were r and omized to the sertraline and placebo groups respectively . At baseline , there were no statistically significant differences between the sertraline and placebo groups , HKDI 25.83 ± 6.313 vs 27.19 ± 5.929 respectively , P = 0.233 ; however by week 8 , patients in the sertraline group demonstrated a statistically significant difference in their Hong Kong Dyspepsia Index compared to placebo , HKDI 20.53 ± 6.917 vs 23.34 ± 7.199 , P = 0.02 , respectively ) . There was also no statistically significant difference in overall quality of life measures or the HAD scale related to treatment in either the ITT or PP analysis at week 8 . CONCLUSION This pilot study , the first to examine sertraline , a selective serotonin reuptake inhibitor , for the management of FD , did not find that it was superior to placebo BACKGROUND : Low-dose tricyclic antidepressants have been used to treat chronic somatic and gastrointestinal pain disorders , including refractory functional dyspepsia . However , there are only limited data on the effects of these drugs on upper gastrointestinal function . AIM : To compare the effects of two doses of amitriptyline ( AMT ) and placebo on gastric accommodation , emptying , satiation , and postpr and ial symptoms in healthy volunteers . METHODS : Using a parallel-group , double-blind , placebo-controlled design , 41 healthy volunteers were r and omized to AMT 25 mg , AMT 50 mg , or placebo for 2 wk . During the final 3 days of therapy , the following end points were assessed : fasting and postpr and ial gastric volumes , 2- and 4-h gastric emptying , time and volume to maximum satiation using a nutrient drink test , and postpr and ial symptoms 30 min later using 10-cm visual analog scales . AMT and metabolite levels were measured . RESULTS : AMT slowed gastric emptying at 2 h ( median 75 % for placebo , 57 % for AMT 25 mg , 67 % for AMT 50 mg ; P= 0.037 ) and 4 h ( median 98 % for placebo , 96 % for AMT 25 mg , 92 % for AMT 50 mg ; P= 0.003 ) . AMT did not affect gastric volumes or satiation volume , but it did reduce nausea scores at 30 min in a dose-dependent manner ( median 2.1 for placebo , 0.9 for AMT 25 mg , and 0.0 for AMT 50 mg ; P= 0.009 ) . CONCLUSION : In healthy volunteers , AMT slows gastric emptying of solids , but it does not significantly affect gastric volumes or satiation .  AMT reduces nausea after challenge with a high calorie liquid load Acute studies suggested a therapeutic benefit for fundus-relaxing drugs in functional dyspepsia ( FD ) with visceral hypersensitivity ( VH ) to gastric distention or impaired accommodation ( IA ) , but long-term studies are lacking . R-137696 is a serotonin-1A ( 5-HT(1A ) ) receptor agonist which relaxes the proximal stomach in man . Our aim was to investigate the influence of R-137696 on symptoms in FD with VH or IA . R and omized , double-blind , placebo-controlled , parallel group study of 4 weeks R-137696 2 mg t.i.d . in FD with VH or IA . Symptoms were assessed using the  patient assessment of upper gastrointestinal symptom severity index ( PAGI-SYM ) total score and individual symptom subscales . Barostat studies were performed before and after 4 weeks of treatment . Fifty-three patients ( 33 VH and 20 IA ) , 18 men , mean age 40 + /- 13 years were recruited . Twenty-four received placebo and 29 received R-137696 . In VH patients , both placebo and R-137696 improved total symptom scores , with a tendency for superiority of placebo ( -1.12 vs-0.51 , P = 0.07 ) . Placebo was superior for the subscales of early satiety , bloating , fullness and discomfort ( all P <  
    Output:
    