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 Lung resections determine a variable functional reduction depending on the extent of the resection and the time elapsed from the operation . The objectives of this study were to prospect ively investigate the postoperative changes in FEV(1 ) , carbon monoxide lung diffusion capacity ( Dlco ) , and exercise tolerance after major lung resection at repeated evaluation times . METHODS  FEV(1 ) , Dlco , and peak oxygen consumption ( Vo(2)peak ) calculated using the stair climbing test were measured in 200 patients preoperatively , at discharge , and 1 month and 3 months after lobectomy or pneumonectomy .  Preoperative and repeated postoperative measures were compared , and a time-series , cross-sectional regression analysis was performed to identify factors associated with postoperative Vo(2)peak . RESULTS One month after lobectomy , FEV(1 ) , Dlco , and Vo(2)peak values were 79.5 % , 81.5 % , and 96 % of preoperative values and recovered up to 84 % , 88.5 % , and 97 % after 3 months , respectively . One month after pneumonectomy , FEV(1 ) percentage of predicted , Dlco percentage of predicted , and Vo(2)peak values were 65 % , 75 % , and 87 % of preoperative values , and were 66 % , 80 % , and 89 % after 3 months , respectively . Three months after lobectomy , 27 % of patients with COPD had improved FEV(1 ) , 34 % had improved Dlco , and 43 % had improved Vo(2)peak compared to preoperative values . The time-series , cross-sectional regression analysis showed that postoperative Vo(2)peak values were directly associated with preoperative values of Vo(2)peak , and postoperative values of FEV(1 ) and Dlco , and were inversely associated with age and body mass index . CONCLUSIONS Our findings may be used during preoperative counseling and for deciding eligibility for operation along with other more traditional measures of outcome OBJECTIVE To identify predictors of postoperative exercise oxygen desaturation ( EOD ) in patients su bmi tted to lobectomy or pneumonectomy for lung carcinoma . PATIENTS AND METHODS A consecutive series of 227 patients with non-small cell lung cancer su bmi tted to lobectomy or pneumonectomy from January 2000 through October 2002 were prospect ively analyzed . Maximal stair-climbing tests were performed preoperatively ( the day before the operation ) and postoperatively ( on average , 9.2 days after operation ) in room air for all patients . A fall in oxygen saturation during the exercise below 90 % was termed ' desaturation ' . Univariate and multivariate analyses were performed to identify predictors of postoperative EOD . RESULTS Thirty-five patients ( 15.4 % ) developed postoperative EOD . After multivariate analysis , the only independent predictor of postoperative EOD result ed a reduction in oxygen saturation during the preoperative exercise ( P=0.0004 ) . CONCLUSIONS Patients with a reduction in oxygen saturation during the preoperative exercise test are at increased risk to develop a postoperative EOD below 90 % . A postoperative exercise test should be performed in all these patients . Should EOD be confirmed , an intermittent home oxygen therapy is recommended in order to facilitate recovery from operation and improve the quality of life Background : The lower limb muscle strength is an important determinant of physical function in older people . However , measurement in clinical and epidemiological setting s has been limited because of the requirement for large-scale equipment . A protocol using a novel , versatile h and -held dynamometer ( HHD ) has been developed to measure the quadriceps strength in a supine position . Objective : The objective of this study was to assess the validity of this new methodology for measuring the lower limb muscle strength compared to the gold st and ard Biodex dynamometer . Methods : The supine quadriceps strength was measured twice with each of the Biodex and the HHD  in 20 men and women , aged 61–81 years , on their non-dominant leg . The agreement between the peak torques obtained by Biodex and HHD was analyzed . Results : The mean peak Biodex and HHD results were 83.4 ± ( SD ) 28.0 Nm and 68.9 ± 19.6 Nm , respectively . The HHD undermeasured the quadriceps strength by an average of 14.5 Nm ( 95 % CI 8.5 , 20.6 ) compared to the Biodex , and this effect was most marked in the strongest participants . Nevertheless , there was a good correlation between the measures ( r = 0.91 , p < 0.0001 ) . Classification of individuals into tertiles of muscle strength showed good agreement between the two methods ( Kappa = 0.69 , p < 0.0001 ) . Conclusions : Our findings suggest that the HHD using a supine positioning offers a feasible , inexpensive , and portable test of quadriceps muscle strength for use in healthy older people . It underestimates the absolute quadriceps strength compared to the Biodex particularly in stronger people , but is a useful tool for ranking muscle strength of older people in epidemiological studies . It may also be of value for quick and objective assessment of physical function in the clinical setting BACKGROUND The objective of this study was to assess the role of a modified stair climbing test in predicting postoperative cardiopulmonary complications . METHODS A consecutive series of 150 patients who had undergone pulmonary resection for lung carcinoma formed the prospect i ve data base of this study . All patients performed a preoperative modified stair climbing test .  Univariate and multivariate analyses were performed to identify predictors of postoperative cardiopulmonary complications . RESULTS With univariate analysis , the patients with complications had a lower pre-exercise and postexercise percentage of oxygen saturation . PaO ( 2 ) levels were found to be lower and a greater change in oxygen desaturation during exercise was noted . Logistic regression analysis showed that the percent of oxygen saturation pre-exercise and the change in percent of oxygen desaturation during exercise were independent and reliable predictors of cardiopulmonary morbidity . CONCLUSIONS A modified stair climbing test is a safe , economical and simple test capable of predicting cardiopulmonary complications Abstract Background . Patients with lung cancer are often burdened by dyspnoea , fatigue , decreased physical ability and loss of weight . Earlier studies of physical exercise of patients with COPD have shown promising results . The aim of this study was to investigate , if a well-documented COPD rehabilitation protocol can improve physical fitness and quality of life ( QoL ) in patients with lung cancer . Material and methods . Forty-five patients , with a minimum walking distance of 50 meters , absence of cognitive deficits or severe heart disease and motivated for physical training were invited to an exercise intervention .  The intervention consisted of seven weeks of twice weekly training , focusing on walking training , circuit training , h and ling of dyspnoea and instructions in daily diary-based training at home . Prior to , and after the intervention , Incremental- and Endurance Shuttle Walk Test ( ISWT and ESWT ) were performed , and pulmonary function as well as self-reported QoL ( EORTC-QLQ-C30 and LC13 ) were measured . Results . Fourteen subjects dropped out before commencement of the intervention . Seven were excluded after physiotherapeutic evaluation . Of the remaining 24 , three were excluded because of insufficient attendance ( < 65 % of scheduled exercise sessions ) thus 21 patients completed the intervention . For 17 patients with complete pre- and post intervention data , ISWT increased 9 % ( −77 to 39 % ) ( median and range ) ( p = 0.021 ) , while ESWT increased 109 % ( −70 to 432 % ) ( p = 0.002 ) . Twelve of 17 improved in ISWT , while 15 improved in ESWT . No changes in pulmonary function and improvements in QoL were observed . Conclusion . Patients with pulmonary cancer can achieve significant improvements in physical fitness measured with ISWT and ESWT after completion of the intervention program . No changes in pulmonary function and QoL were observed . In addition , we found that a large number of patients dropped out before intervention and that the patients , who succeeded , often discontinued training at home OBJECTIVES Maximum oxygen consumption per min ( VO(₂max ) ) is currently considered the most accurate test for the preoperative risk assessment in patients scheduled for pulmonary resection . Due to its high-technology requirements and cost , VO(₂max ) is performed less frequently than is desired . The objective of this investigation is to determine if the measurement of the basal daily ambulatory activity of the patients , with a pedometer , can be used to predict VO(₂max ) values . METHODS This is a prospect i ve study on 38 patients referred for scheduled lobectomy or pneumonectomy .  Daily basal preoperative activity  of the patients was measured 3 weeks before surgery by means of an OMROM HJ-72OIT-E2 pedometer . Before surgery , VO(₂max ) ( dependent variable ) was calculated using a Master Screen CPX module of Jaeger-Vyasis-Healthcare . The following independent variables were studied : age , sex , preoperative forced expiratory volume in 1s percentage ( FEV1 % ) and carbon monoxide diffusing capacity percentage ( DLCO% ) , mean number of steps per day ( aerobic and non-aerobic ) , mean daily time of aerobic activity ( in min ) and mean daily walked distance ( in km ) . Two linear regression models with bootstrap robust estimation of the st and ard error of the coefficients were adjusted and the estimated values of VO(₂max ) were kept as a new variable for comparison . To avoid collinearity problems , only one of the pedometer records entered the regression model . RESULTS Data of the series ( mean ± SD ) : age 62.8 ± 10.14 years ; FEV1 % 90.1 ± 21.8 ; DLCO% 82.8 ± 20.1 . After collinearity analysis , mean daily walked distance was chosen as the most representative variable . In the first regression model , ' Distance ' ( p = 0.000 ) was highly correlated to the dependent variable ( adjusted R² : 0.812 ) . The second model improved the predictive value of the first one adding DLCO% to the model . In this model , DLCO% ( p = 0.000 ) and ' Distance ' ( p = 0.002 ) were correlated to the dependent variable . The adjusted R² of the second lineal model was 0.935 . CONCLUSION These preliminary data show that a combination of the measured daily ambulatory activity using a pedometer , especially the mean daily walked distance in km , and the DLCO% of the patient could predict the VO(₂max ) value . Larger data series are needed for conclusive results CONTEXT AND OBJECTIVE There is increasing involvement of health professionals in organizing protocol s to determine the impact of lung surgery on functional state and activities of daily living , with the aim of improving quality of life ( QoL ) . The objective of this study was to investigate predictors of QoL improvement among patients undergoing parenchyma resection due to lung cancer . DESIGN AND SETTING Prospect i ve study , at teaching hospital of Universidade Estadual de Campinas ( Unicamp ) . METHODS 36 patients with lung cancer diagnosis were assessed before surgery and on the 30th , 90th and 180th days after surgery . The  Short-Form Health Survey ( SF-36 )  was used as the dependent variable . The independent variables were the  Hospital Anxiety and Depression ( HAD ) scale , a six-minute walking test ( 6-MWT ) , a visual analogue scale for pain , forced vital capacity ( FVC ) , type of surgery and use of radiotherapy and chemotherapy .  Generalized estimation equations ( GEE ) were utilized . RESULTS The median age for these 20 men and 16 women was 55.5 + /- 13.4 years . Both FVC and 6-MWT were predictors of improvement in the physical dimensions of QoL ( p = 0.011 and 0.0003 , respectively ) , as was smaller extent of surgical resection ( p = 0.04 ) . The social component of QoL had improved by the third postoperative month ( p = 0.0005 ) . CONCLUSION The predictors that affected QoL positively were better FVC and 6-MWT results and less extensive lung resection . Three months after the surgery , an improvement in social life was already seen Objectives For the measurement of  patient-reported outcomes , such as ( health-related ) quality of life , often many measurement instruments exist that intend to measure the same construct . To facilitate instrument selection , our aim was to develop a highly sensitive search filter for finding studies on measurement properties of measurement instruments in PubMed and a more precise search filter that needs less abstract s to be screened , but at a higher risk of missing relevant studies . Methods A r and om sample of 10,000 PubMed records ( 01 - 01 - 1990 to 31 - 12 - 2006 ) was used as a gold st and ard . Studies on measurement properties were identified using an exclusion filter and h and search ing . Search terms were selected from the relevant records in the gold st and ard as well as from 100 systematic review s of measurement properties and combined based on sensitivity and precision . The performance of the filters was tested in the gold st and ard as well as in two validation sets , by calculating sensitivity , precision , specificity , and number needed to read . Results We identified 116 studies on measurement properties in the gold st and ard . The sensitive search filter was able to retrieve 113 of these 116 studies ( sensitivity 97.4 % , precision 4.4 % ) . The precise search filter had a sensitivity of 93.1 % and a precision of  
    Output:
    
agent
Criterion validity for three of these measures was established in NSCLC but not the reliability or responsiveness .
***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 Lung resections determine a variable functional reduction depending on the extent of the resection and the time elapsed from the operation . The objectives of this study were to prospect ively investigate the postoperative changes in FEV(1 ) , carbon monoxide lung diffusion capacity ( Dlco ) , and exercise tolerance after major lung resection at repeated evaluation times . METHODS  FEV(1 ) , Dlco , and peak oxygen consumption ( Vo(2)peak ) calculated using the stair climbing test were measured in 200 patients preoperatively , at discharge , and 1 month and 3 months after lobectomy or pneumonectomy .  Preoperative and repeated postoperative measures were compared , and a time-series , cross-sectional regression analysis was performed to identify factors associated with postoperative Vo(2)peak . RESULTS One month after lobectomy , FEV(1 ) , Dlco , and Vo(2)peak values were 79.5 % , 81.5 % , and 96 % of preoperative values and recovered up to 84 % , 88.5 % , and 97 % after 3 months , respectively . One month after pneumonectomy , FEV(1 ) percentage of predicted , Dlco percentage of predicted , and Vo(2)peak values were 65 % , 75 % , and 87 % of preoperative values , and were 66 % , 80 % , and 89 % after 3 months , respectively . Three months after lobectomy , 27 % of patients with COPD had improved FEV(1 ) , 34 % had improved Dlco , and 43 % had improved Vo(2)peak compared to preoperative values . The time-series , cross-sectional regression analysis showed that postoperative Vo(2)peak values were directly associated with preoperative values of Vo(2)peak , and postoperative values of FEV(1 ) and Dlco , and were inversely associated with age and body mass index . CONCLUSIONS Our findings may be used during preoperative counseling and for deciding eligibility for operation along with other more traditional measures of outcome OBJECTIVE To identify predictors of postoperative exercise oxygen desaturation ( EOD ) in patients su bmi tted to lobectomy or pneumonectomy for lung carcinoma . PATIENTS AND METHODS A consecutive series of 227 patients with non-small cell lung cancer su bmi tted to lobectomy or pneumonectomy from January 2000 through October 2002 were prospect ively analyzed . Maximal stair-climbing tests were performed preoperatively ( the day before the operation ) and postoperatively ( on average , 9.2 days after operation ) in room air for all patients . A fall in oxygen saturation during the exercise below 90 % was termed ' desaturation ' . Univariate and multivariate analyses were performed to identify predictors of postoperative EOD . RESULTS Thirty-five patients ( 15.4 % ) developed postoperative EOD . After multivariate analysis , the only independent predictor of postoperative EOD result ed a reduction in oxygen saturation during the preoperative exercise ( P=0.0004 ) . CONCLUSIONS Patients with a reduction in oxygen saturation during the preoperative exercise test are at increased risk to develop a postoperative EOD below 90 % . A postoperative exercise test should be performed in all these patients . Should EOD be confirmed , an intermittent home oxygen therapy is recommended in order to facilitate recovery from operation and improve the quality of life Background : The lower limb muscle strength is an important determinant of physical function in older people . However , measurement in clinical and epidemiological setting s has been limited because of the requirement for large-scale equipment . A protocol using a novel , versatile h and -held dynamometer ( HHD ) has been developed to measure the quadriceps strength in a supine position . Objective : The objective of this study was to assess the validity of this new methodology for measuring the lower limb muscle strength compared to the gold st and ard Biodex dynamometer . Methods : The supine quadriceps strength was measured twice with each of the Biodex and the HHD  in 20 men and women , aged 61–81 years , on their non-dominant leg . The agreement between the peak torques obtained by Biodex and HHD was analyzed . Results : The mean peak Biodex and HHD results were 83.4 ± ( SD ) 28.0 Nm and 68.9 ± 19.6 Nm , respectively . The HHD undermeasured the quadriceps strength by an average of 14.5 Nm ( 95 % CI 8.5 , 20.6 ) compared to the Biodex , and this effect was most marked in the strongest participants . Nevertheless , there was a good correlation between the measures ( r = 0.91 , p < 0.0001 ) . Classification of individuals into tertiles of muscle strength showed good agreement between the two methods ( Kappa = 0.69 , p < 0.0001 ) . Conclusions : Our findings suggest that the HHD using a supine positioning offers a feasible , inexpensive , and portable test of quadriceps muscle strength for use in healthy older people . It underestimates the absolute quadriceps strength compared to the Biodex particularly in stronger people , but is a useful tool for ranking muscle strength of older people in epidemiological studies . It may also be of value for quick and objective assessment of physical function in the clinical setting BACKGROUND The objective of this study was to assess the role of a modified stair climbing test in predicting postoperative cardiopulmonary complications . METHODS A consecutive series of 150 patients who had undergone pulmonary resection for lung carcinoma formed the prospect i ve data base of this study . All patients performed a preoperative modified stair climbing test .  Univariate and multivariate analyses were performed to identify predictors of postoperative cardiopulmonary complications . RESULTS With univariate analysis , the patients with complications had a lower pre-exercise and postexercise percentage of oxygen saturation . PaO ( 2 ) levels were found to be lower and a greater change in oxygen desaturation during exercise was noted . Logistic regression analysis showed that the percent of oxygen saturation pre-exercise and the change in percent of oxygen desaturation during exercise were independent and reliable predictors of cardiopulmonary morbidity . CONCLUSIONS A modified stair climbing test is a safe , economical and simple test capable of predicting cardiopulmonary complications Abstract Background . Patients with lung cancer are often burdened by dyspnoea , fatigue , decreased physical ability and loss of weight . Earlier studies of physical exercise of patients with COPD have shown promising results . The aim of this study was to investigate , if a well-documented COPD rehabilitation protocol can improve physical fitness and quality of life ( QoL ) in patients with lung cancer . Material and methods . Forty-five patients , with a minimum walking distance of 50 meters , absence of cognitive deficits or severe heart disease and motivated for physical training were invited to an exercise intervention .  The intervention consisted of seven weeks of twice weekly training , focusing on walking training , circuit training , h and ling of dyspnoea and instructions in daily diary-based training at home . Prior to , and after the intervention , Incremental- and Endurance Shuttle Walk Test ( ISWT and ESWT ) were performed , and pulmonary function as well as self-reported QoL ( EORTC-QLQ-C30 and LC13 ) were measured . Results . Fourteen subjects dropped out before commencement of the intervention . Seven were excluded after physiotherapeutic evaluation . Of the remaining 24 , three were excluded because of insufficient attendance ( < 65 % of scheduled exercise sessions ) thus 21 patients completed the intervention . For 17 patients with complete pre- and post intervention data , ISWT increased 9 % ( −77 to 39 % ) ( median and range ) ( p = 0.021 ) , while ESWT increased 109 % ( −70 to 432 % ) ( p = 0.002 ) . Twelve of 17 improved in ISWT , while 15 improved in ESWT . No changes in pulmonary function and improvements in QoL were observed . Conclusion . Patients with pulmonary cancer can achieve significant improvements in physical fitness measured with ISWT and ESWT after completion of the intervention program . No changes in pulmonary function and QoL were observed . In addition , we found that a large number of patients dropped out before intervention and that the patients , who succeeded , often discontinued training at home OBJECTIVES Maximum oxygen consumption per min ( VO(₂max ) ) is currently considered the most accurate test for the preoperative risk assessment in patients scheduled for pulmonary resection . Due to its high-technology requirements and cost , VO(₂max ) is performed less frequently than is desired . The objective of this investigation is to determine if the measurement of the basal daily ambulatory activity of the patients , with a pedometer , can be used to predict VO(₂max ) values . METHODS This is a prospect i ve study on 38 patients referred for scheduled lobectomy or pneumonectomy .  Daily basal preoperative activity  of the patients was measured 3 weeks before surgery by means of an OMROM HJ-72OIT-E2 pedometer . Before surgery , VO(₂max ) ( dependent variable ) was calculated using a Master Screen CPX module of Jaeger-Vyasis-Healthcare . The following independent variables were studied : age , sex , preoperative forced expiratory volume in 1s percentage ( FEV1 % ) and carbon monoxide diffusing capacity percentage ( DLCO% ) , mean number of steps per day ( aerobic and non-aerobic ) , mean daily time of aerobic activity ( in min ) and mean daily walked distance ( in km ) . Two linear regression models with bootstrap robust estimation of the st and ard error of the coefficients were adjusted and the estimated values of VO(₂max ) were kept as a new variable for comparison . To avoid collinearity problems , only one of the pedometer records entered the regression model . RESULTS Data of the series ( mean ± SD ) : age 62.8 ± 10.14 years ; FEV1 % 90.1 ± 21.8 ; DLCO% 82.8 ± 20.1 . After collinearity analysis , mean daily walked distance was chosen as the most representative variable . In the first regression model , ' Distance ' ( p = 0.000 ) was highly correlated to the dependent variable ( adjusted R² : 0.812 ) . The second model improved the predictive value of the first one adding DLCO% to the model . In this model , DLCO% ( p = 0.000 ) and ' Distance ' ( p = 0.002 ) were correlated to the dependent variable . The adjusted R² of the second lineal model was 0.935 . CONCLUSION These preliminary data show that a combination of the measured daily ambulatory activity using a pedometer , especially the mean daily walked distance in km , and the DLCO% of the patient could predict the VO(₂max ) value . Larger data series are needed for conclusive results CONTEXT AND OBJECTIVE There is increasing involvement of health professionals in organizing protocol s to determine the impact of lung surgery on functional state and activities of daily living , with the aim of improving quality of life ( QoL ) . The objective of this study was to investigate predictors of QoL improvement among patients undergoing parenchyma resection due to lung cancer . DESIGN AND SETTING Prospect i ve study , at teaching hospital of Universidade Estadual de Campinas ( Unicamp ) . METHODS 36 patients with lung cancer diagnosis were assessed before surgery and on the 30th , 90th and 180th days after surgery . The  Short-Form Health Survey ( SF-36 )  was used as the dependent variable . The independent variables were the  Hospital Anxiety and Depression ( HAD ) scale , a six-minute walking test ( 6-MWT ) , a visual analogue scale for pain , forced vital capacity ( FVC ) , type of surgery and use of radiotherapy and chemotherapy .  Generalized estimation equations ( GEE ) were utilized . RESULTS The median age for these 20 men and 16 women was 55.5 + /- 13.4 years . Both FVC and 6-MWT were predictors of improvement in the physical dimensions of QoL ( p = 0.011 and 0.0003 , respectively ) , as was smaller extent of surgical resection ( p = 0.04 ) . The social component of QoL had improved by the third postoperative month ( p = 0.0005 ) . CONCLUSION The predictors that affected QoL positively were better FVC and 6-MWT results and less extensive lung resection . Three months after the surgery , an improvement in social life was already seen Objectives For the measurement of  patient-reported outcomes , such as ( health-related ) quality of life , often many measurement instruments exist that intend to measure the same construct . To facilitate instrument selection , our aim was to develop a highly sensitive search filter for finding studies on measurement properties of measurement instruments in PubMed and a more precise search filter that needs less abstract s to be screened , but at a higher risk of missing relevant studies . Methods A r and om sample of 10,000 PubMed records ( 01 - 01 - 1990 to 31 - 12 - 2006 ) was used as a gold st and ard . Studies on measurement properties were identified using an exclusion filter and h and search ing . Search terms were selected from the relevant records in the gold st and ard as well as from 100 systematic review s of measurement properties and combined based on sensitivity and precision . The performance of the filters was tested in the gold st and ard as well as in two validation sets , by calculating sensitivity , precision , specificity , and number needed to read . Results We identified 116 studies on measurement properties in the gold st and ard . The sensitive search filter was able to retrieve 113 of these 116 studies ( sensitivity 97.4 % , precision 4.4 % ) . The precise search filter had a sensitivity of 93.1 % and a precision of  
    Output:
    