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: Intermittent treatment with an acid lactate gel ( Lactal , ACO , Sweden ) reduced symptoms of  bacterial vaginosis ( BV )  and promoted the reestablishment of the normal vaginal flora of lactobacilli . Forty-two women seriously affected by recurrent BV were initially given acid gel ( lactate gel , pH 3.8 , 5 ml ) to be inserted into the vagina daily for 7 consecutive days . Thereafter they entered into a double blind clinical trial and were treated prophylactically 3 days monthly for 6 months with either lactate gel or a placebo gel . Women treated with the lactate gel were clinical ly improved , i.e. no signs of BV in 88 % compared to 10 % in the placebo group ( p less than 0.001 ) . The vaginal lactobacilli flora was reestablished in 83 % of the lactate group and in 16 % of the placebo group . Local intermittent application of lactate gel was found to be free of side effects and is a preferable alternative to repeated treatments with antibiotics in patients with recurrent BV Forty-one adult women with acute lower urinary tract infections ( UTI ) were r and omly treated for three days with norfloxacin or trimethoprim/sulfamethoxazole ( TMP/SMX ) . Infection was eradicated in 100 % of norfloxacin-treated patients and in 95 % of TMP/SMX-treated patients . UTI recurred in 29 % of patients treated with norfloxacin and in 41 % of those treated with TMP/SMX . Post-therapy vaginal administration of lactobacillus suppositories result ed in a recurrence rate of UTI of only 21 % , while in patients given  sterilized skim-milk suppositories the recurrence rate was 47 % . This study indicates that lactobacillus vaginal suppositories are safe and may be effective in reducing the recurrence of UTI following antimicrobial therapy Objective : The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis ( BV ) led to markedly different conclusions about treatment efficacy in a r and omized trial comparing metronidazole gel versus metronidazole/nystatin ovules . Study : We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14 , 42 , and 104 days after initiating treatment . Results : Compared with gel , ovules more effectively eliminated amines , clue cells , and Gardnerella , Prevotella , or Mobiluncus morphotypes from vaginal fluid , thus achieving cure based on “ usual ” criteria ( absence of BV by Amsel or Nugent criteria ) , but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH , thus not meeting Federal Drug Administration ( FDA ) criteria for cure . Conclusion : Because early vaginal recolonization by lactobacilli was poor after both gel and ovules , FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella , clue cells , and amines . Cure defined more “ usually ” may give more useful information 60 women with bacterial vaginosis were entered into a double blind , placebo-controlled treatment trial with lyophilized Lactobacillus acidophilus . The lactobacilli used were producing H2O2 . Immediately after completion of treatment , 16 out of 28 women who were treated with lactobacilli had normal vaginal wet smear results , in comparison to none of the 29 women treated with placebo . All women harboured Bacteroides at inclusion . Bacteroides was eliminated from the vagina of 12 out of 16 healthy women after treatment . Only three of the women who received the Lactobacillus suppository were free of bacterial vaginosis after the subsequent menstruation This study enrolled 125 premenopausal women diagnosed with bacterial vaginosis ( BV ) by presence of vaginal irritation , discharge and ' fishy ' odor , and Nugent criteria and detection of sialidase enzyme . The subjects were treated with oral metronidazole ( 500 mg ) twice daily from days 1 to 7 , and r and omized to receive oral Lactobacillus rhamnosus GR-1 ( 1 x 10(9 ) ) and Lactobacillus reuteri RC-14 ( 1 x 10(9 ) ) or placebo twice daily from days 1 to 30 . Primary outcome was cure of BV as determined by normal Nugent score , negative sialidase test and no symptoms or signs of BV at day 30 . A total of 106 subjects returned for 30-day follow-up , of which 88 % were cured in the antibiotic/probiotic group compared to 40 % in the antibiotic/placebo group ( p<0.001 ) . Of the remaining subjects , 30 % subjects in the placebo group and none in the probiotic group had BV , while 30 % in the placebo and 12 % in the probiotic group fell into the intermediate category based upon Nugent score , sialidase result and clinical findings . High counts of Lactobacillus sp. ( > 10(5 ) CFU/ml ) were recovered from the vagina of 96 % probiotic-treated subjects compared to 53 % controls at day 30 . In summary , this study showed efficacious use of lactobacilli and antibiotic in the eradication of BV in black African women OBJECTIVE To assess whether daily ingestion of yogurt containing Lactobacillus acidophilus prevents  vulvovaginal c and idal infections .  DESIGN Crossover trial for at least 1 year during which patients were examined for c and idal infections and colonizations while receiving either a yogurt-free or a yogurt-containing diet . Patients served as their own controls . SETTING Ambulatory infectious disease center in a teaching hospital providing tertiary care . PATIENTS Thirty-three women with recurrent c and idal vaginitis were eligible after recruitment from community practice s and clinics and through advertising . Twelve patients were eliminated for protocol violations . Of the remaining 21 patients , 8 who were assigned to the yogurt arm initially refused to enter the control phase 6 months later . Thus , 13 patients completed the protocol . INTERVENTIONS Women ate yogurt for 6 months of the study period . MEASUREMENTS Colonization of lactobacilli and c and ida in the vagina and rectum ; c and idal infections of the vagina . MAIN RESULTS Thirty-three eligible patients were studied . A threefold decrease in infections was seen when patients consumed yogurt containing Lactobacillus acidophilus . The mean ( + /- SD ) number of infections per 6 months was 2.54 + /- 1.66 in the control arm and 0.38 + /- 0.51 per 6 months in the yogurt arm ( P = 0.001 ) . C and idal colonization decreased from a mean of 3.23 + /- 2.17 per 6 months in the control arm to 0.84 + /- 0.90 per 6 months in the yogurt arm ( P = 0.001 ) . CONCLUSION Daily ingestion of 8 ounces of yogurt containing Lactobacillus acidophilus decreased both c and idal colonization and infection Probiotics , beneficial living microorganisms , have been proven to be effective in preventing gastrointestinal infections , but their effect in preventing urinary tract infection ( UTI ) is inconclusive . A prospect i ve r and omized controlled study was done to compare the preventive effect of probiotics with conventional antibiotics in children with persistent primary vesicoureteral reflux ( VUR ) . One hundred twenty children who had had persistent primary VUR after antibiotic prophylaxis for 1 year were r and omly allocated into a probiotics ( Lactobacillus acidophilus 108 CFU/g 1 g b.i.d . , n = 60 ) or an antibiotics ( trimethoprim/sulfamethoxazole 2/10 mg/kg h.s . , n = 60 ) prophylaxis group during the second year of follow-up . The incidence of recurrent UTI was 18.3 % ( 11/60 ) in the probiotics group , which was not different from 21.6%(13/60 ) in the antibiotic group ( P = 0.926 ) . The causative organisms of recurrent UTI were not significantly different between the two groups ( P = 0.938 ) . Even after stratification by VUR grade , age , gender , phimosis , voiding dysfunction and renal scar , the incidence of recurrent UTI did not differ significantly between the two groups ( P > 0.05 ) . The development of new renal scar was not significantly different between the two groups ( P > 0.05 ) . In conclusion , probiotics prophylaxis was as effective as antibiotic prophylaxis in children with persistent primary VUR We compared the efficacy and safety of estriol-containing vaginal pessary use with those of oral nitrofurantoin macrocrystal ( NM ) therapy for preventing urinary tract infection ( UTI ) in postmenopausal women with recurrent UTI . Over a period of 9 months , 86 women received an  estriol-containing vaginal pessary ( 0.5 mg estriol ) twice weekly , and 85 women received NM ( 100 mg ) once daily . We recorded 124 episodes of UTI in women who received estriol-releasing pessaries and 48 episodes of UTI in women treated with NM ( P=.0003 ) . Twenty-eight women ( 32.6 % ) who received estriol had no episodes of UTI versus 41 women ( 48.2 % ) in the NM group . There was a significant increase in the number of superficial cells in women who received estriol , whereas in the NM group , no such changes occurred . However , there was no change in the extent of Lactobacillus colonization and in the vaginal pH in women who received estriol . Use of an estriol-containing pessary is less effective than oral NM therapy in the prevention of bacteriuria in postmenopausal women because of its failure to restore the population of lactobacilli and to reduce the vaginal pH in these women Abstract Objective To test whether oral or vaginal lactobacillus can prevent  vulvovaginitis after antibiotic treatment . Design R and omised , placebo controlled , double blind , factorial 2 × 2 trial . Setting Fifty general practice s and 16 pharmacies in Melbourne , Australia . Participants Non-pregnant women aged 18 - 50 years who required a short course of oral antibiotics for a non-gynaecological infection : 278 were enrolled in the study , and results were available for 235 . Interventions Lactobacillus preparations taken orally or vaginally , or both , from enrolment until four days after completion of their antibiotic course . Main outcome measures Participants ' reports of symptoms of post-antibiotic vulvovaginitis , with microbiological evidence of c and idiasis provided by a self obtained vaginal swab . Results Overall , 55/235 ( 23 % ( 95 % confidence interval 18 % to 29 % ) ) women developed post-antibiotic vulvovaginitis . Compared with placebo , the odds ratio for developing post-antibiotic vulvovaginitis with oral lactobacillus was 1.06 ( 95 % confidence interval 0.58 to 1.94 ) and with vaginal lactobacillus 1.38 ( 0.75 to 2.54 ) . Compliance with antibiotics and interventions was high . The trial was terminated after the second interim analysis because of lack of effect of the interventions . Given the data at this time , the chances of detecting a significant reduction in vulvovaginitis with oral or vaginal lactobacillus treatment were less than 0.032 and 0.0006 respectively if the trial proceeded to full enrolment . Conclusions The use of oral or vaginal forms of lactobacillus to prevent post-antibiotic vulvovaginitis is not supported by these results . Further research on this subject is unlikely to be fruitful , unless new underst and ings about the pathogenesis of post-antibiotic vulvovaginitis indicate a possible role for lactobacillus Forty-two healthy women were r and omized to receive one of three encapsulated Lactobacillus rhamnosus GR-1 plus Lactobacillus fermentum RC-14 probiotic dosage regimens or L. rhamnosus GG by mouth each day for 28 days . However , the vaginal flora , assessed by Nugent scoring , was only normal in 40 % of the cases , and 14 patients had asymptomatic bacterial vaginosis . Treatment with L. rhamnosus GR-1/L. fermentum RC-14 once and twice daily correlated with a healthy vaginal flora in up to 90 % of patients , and 7/11 patients with bacterial vaginosis converted to normal or intermediate scores within 1 month . Ingestion of L. rhamnosus GG failed to have an effect . This study confirms the potential efficacy of orally administered lactobacilli as a non-chemotherapeutic means to restore and maintain a normal urogenital flora , and shows that over 10(8 ) viable organisms per day is the required dose Vag 
    Output:
    
agent
Overall , lactobacilli were beneficial for the treatment of patients with bacterial vaginosis .
No clear benefit was seen for c and idiasis or urinary tract infection .
In conclusion , the use of certain lactobacillus strains such as L. rhamnosus GR-1 and L. reuteri for prevention and treatment of recurrent urogenital infection is promising , especially for recurrent bacterial vaginosis .
***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: Intermittent treatment with an acid lactate gel ( Lactal , ACO , Sweden ) reduced symptoms of  bacterial vaginosis ( BV )  and promoted the reestablishment of the normal vaginal flora of lactobacilli . Forty-two women seriously affected by recurrent BV were initially given acid gel ( lactate gel , pH 3.8 , 5 ml ) to be inserted into the vagina daily for 7 consecutive days . Thereafter they entered into a double blind clinical trial and were treated prophylactically 3 days monthly for 6 months with either lactate gel or a placebo gel . Women treated with the lactate gel were clinical ly improved , i.e. no signs of BV in 88 % compared to 10 % in the placebo group ( p less than 0.001 ) . The vaginal lactobacilli flora was reestablished in 83 % of the lactate group and in 16 % of the placebo group . Local intermittent application of lactate gel was found to be free of side effects and is a preferable alternative to repeated treatments with antibiotics in patients with recurrent BV Forty-one adult women with acute lower urinary tract infections ( UTI ) were r and omly treated for three days with norfloxacin or trimethoprim/sulfamethoxazole ( TMP/SMX ) . Infection was eradicated in 100 % of norfloxacin-treated patients and in 95 % of TMP/SMX-treated patients . UTI recurred in 29 % of patients treated with norfloxacin and in 41 % of those treated with TMP/SMX . Post-therapy vaginal administration of lactobacillus suppositories result ed in a recurrence rate of UTI of only 21 % , while in patients given  sterilized skim-milk suppositories the recurrence rate was 47 % . This study indicates that lactobacillus vaginal suppositories are safe and may be effective in reducing the recurrence of UTI following antimicrobial therapy Objective : The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis ( BV ) led to markedly different conclusions about treatment efficacy in a r and omized trial comparing metronidazole gel versus metronidazole/nystatin ovules . Study : We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14 , 42 , and 104 days after initiating treatment . Results : Compared with gel , ovules more effectively eliminated amines , clue cells , and Gardnerella , Prevotella , or Mobiluncus morphotypes from vaginal fluid , thus achieving cure based on “ usual ” criteria ( absence of BV by Amsel or Nugent criteria ) , but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH , thus not meeting Federal Drug Administration ( FDA ) criteria for cure . Conclusion : Because early vaginal recolonization by lactobacilli was poor after both gel and ovules , FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella , clue cells , and amines . Cure defined more “ usually ” may give more useful information 60 women with bacterial vaginosis were entered into a double blind , placebo-controlled treatment trial with lyophilized Lactobacillus acidophilus . The lactobacilli used were producing H2O2 . Immediately after completion of treatment , 16 out of 28 women who were treated with lactobacilli had normal vaginal wet smear results , in comparison to none of the 29 women treated with placebo . All women harboured Bacteroides at inclusion . Bacteroides was eliminated from the vagina of 12 out of 16 healthy women after treatment . Only three of the women who received the Lactobacillus suppository were free of bacterial vaginosis after the subsequent menstruation This study enrolled 125 premenopausal women diagnosed with bacterial vaginosis ( BV ) by presence of vaginal irritation , discharge and ' fishy ' odor , and Nugent criteria and detection of sialidase enzyme . The subjects were treated with oral metronidazole ( 500 mg ) twice daily from days 1 to 7 , and r and omized to receive oral Lactobacillus rhamnosus GR-1 ( 1 x 10(9 ) ) and Lactobacillus reuteri RC-14 ( 1 x 10(9 ) ) or placebo twice daily from days 1 to 30 . Primary outcome was cure of BV as determined by normal Nugent score , negative sialidase test and no symptoms or signs of BV at day 30 . A total of 106 subjects returned for 30-day follow-up , of which 88 % were cured in the antibiotic/probiotic group compared to 40 % in the antibiotic/placebo group ( p<0.001 ) . Of the remaining subjects , 30 % subjects in the placebo group and none in the probiotic group had BV , while 30 % in the placebo and 12 % in the probiotic group fell into the intermediate category based upon Nugent score , sialidase result and clinical findings . High counts of Lactobacillus sp. ( > 10(5 ) CFU/ml ) were recovered from the vagina of 96 % probiotic-treated subjects compared to 53 % controls at day 30 . In summary , this study showed efficacious use of lactobacilli and antibiotic in the eradication of BV in black African women OBJECTIVE To assess whether daily ingestion of yogurt containing Lactobacillus acidophilus prevents  vulvovaginal c and idal infections .  DESIGN Crossover trial for at least 1 year during which patients were examined for c and idal infections and colonizations while receiving either a yogurt-free or a yogurt-containing diet . Patients served as their own controls . SETTING Ambulatory infectious disease center in a teaching hospital providing tertiary care . PATIENTS Thirty-three women with recurrent c and idal vaginitis were eligible after recruitment from community practice s and clinics and through advertising . Twelve patients were eliminated for protocol violations . Of the remaining 21 patients , 8 who were assigned to the yogurt arm initially refused to enter the control phase 6 months later . Thus , 13 patients completed the protocol . INTERVENTIONS Women ate yogurt for 6 months of the study period . MEASUREMENTS Colonization of lactobacilli and c and ida in the vagina and rectum ; c and idal infections of the vagina . MAIN RESULTS Thirty-three eligible patients were studied . A threefold decrease in infections was seen when patients consumed yogurt containing Lactobacillus acidophilus . The mean ( + /- SD ) number of infections per 6 months was 2.54 + /- 1.66 in the control arm and 0.38 + /- 0.51 per 6 months in the yogurt arm ( P = 0.001 ) . C and idal colonization decreased from a mean of 3.23 + /- 2.17 per 6 months in the control arm to 0.84 + /- 0.90 per 6 months in the yogurt arm ( P = 0.001 ) . CONCLUSION Daily ingestion of 8 ounces of yogurt containing Lactobacillus acidophilus decreased both c and idal colonization and infection Probiotics , beneficial living microorganisms , have been proven to be effective in preventing gastrointestinal infections , but their effect in preventing urinary tract infection ( UTI ) is inconclusive . A prospect i ve r and omized controlled study was done to compare the preventive effect of probiotics with conventional antibiotics in children with persistent primary vesicoureteral reflux ( VUR ) . One hundred twenty children who had had persistent primary VUR after antibiotic prophylaxis for 1 year were r and omly allocated into a probiotics ( Lactobacillus acidophilus 108 CFU/g 1 g b.i.d . , n = 60 ) or an antibiotics ( trimethoprim/sulfamethoxazole 2/10 mg/kg h.s . , n = 60 ) prophylaxis group during the second year of follow-up . The incidence of recurrent UTI was 18.3 % ( 11/60 ) in the probiotics group , which was not different from 21.6%(13/60 ) in the antibiotic group ( P = 0.926 ) . The causative organisms of recurrent UTI were not significantly different between the two groups ( P = 0.938 ) . Even after stratification by VUR grade , age , gender , phimosis , voiding dysfunction and renal scar , the incidence of recurrent UTI did not differ significantly between the two groups ( P > 0.05 ) . The development of new renal scar was not significantly different between the two groups ( P > 0.05 ) . In conclusion , probiotics prophylaxis was as effective as antibiotic prophylaxis in children with persistent primary VUR We compared the efficacy and safety of estriol-containing vaginal pessary use with those of oral nitrofurantoin macrocrystal ( NM ) therapy for preventing urinary tract infection ( UTI ) in postmenopausal women with recurrent UTI . Over a period of 9 months , 86 women received an  estriol-containing vaginal pessary ( 0.5 mg estriol ) twice weekly , and 85 women received NM ( 100 mg ) once daily . We recorded 124 episodes of UTI in women who received estriol-releasing pessaries and 48 episodes of UTI in women treated with NM ( P=.0003 ) . Twenty-eight women ( 32.6 % ) who received estriol had no episodes of UTI versus 41 women ( 48.2 % ) in the NM group . There was a significant increase in the number of superficial cells in women who received estriol , whereas in the NM group , no such changes occurred . However , there was no change in the extent of Lactobacillus colonization and in the vaginal pH in women who received estriol . Use of an estriol-containing pessary is less effective than oral NM therapy in the prevention of bacteriuria in postmenopausal women because of its failure to restore the population of lactobacilli and to reduce the vaginal pH in these women Abstract Objective To test whether oral or vaginal lactobacillus can prevent  vulvovaginitis after antibiotic treatment . Design R and omised , placebo controlled , double blind , factorial 2 × 2 trial . Setting Fifty general practice s and 16 pharmacies in Melbourne , Australia . Participants Non-pregnant women aged 18 - 50 years who required a short course of oral antibiotics for a non-gynaecological infection : 278 were enrolled in the study , and results were available for 235 . Interventions Lactobacillus preparations taken orally or vaginally , or both , from enrolment until four days after completion of their antibiotic course . Main outcome measures Participants ' reports of symptoms of post-antibiotic vulvovaginitis , with microbiological evidence of c and idiasis provided by a self obtained vaginal swab . Results Overall , 55/235 ( 23 % ( 95 % confidence interval 18 % to 29 % ) ) women developed post-antibiotic vulvovaginitis . Compared with placebo , the odds ratio for developing post-antibiotic vulvovaginitis with oral lactobacillus was 1.06 ( 95 % confidence interval 0.58 to 1.94 ) and with vaginal lactobacillus 1.38 ( 0.75 to 2.54 ) . Compliance with antibiotics and interventions was high . The trial was terminated after the second interim analysis because of lack of effect of the interventions . Given the data at this time , the chances of detecting a significant reduction in vulvovaginitis with oral or vaginal lactobacillus treatment were less than 0.032 and 0.0006 respectively if the trial proceeded to full enrolment . Conclusions The use of oral or vaginal forms of lactobacillus to prevent post-antibiotic vulvovaginitis is not supported by these results . Further research on this subject is unlikely to be fruitful , unless new underst and ings about the pathogenesis of post-antibiotic vulvovaginitis indicate a possible role for lactobacillus Forty-two healthy women were r and omized to receive one of three encapsulated Lactobacillus rhamnosus GR-1 plus Lactobacillus fermentum RC-14 probiotic dosage regimens or L. rhamnosus GG by mouth each day for 28 days . However , the vaginal flora , assessed by Nugent scoring , was only normal in 40 % of the cases , and 14 patients had asymptomatic bacterial vaginosis . Treatment with L. rhamnosus GR-1/L. fermentum RC-14 once and twice daily correlated with a healthy vaginal flora in up to 90 % of patients , and 7/11 patients with bacterial vaginosis converted to normal or intermediate scores within 1 month . Ingestion of L. rhamnosus GG failed to have an effect . This study confirms the potential efficacy of orally administered lactobacilli as a non-chemotherapeutic means to restore and maintain a normal urogenital flora , and shows that over 10(8 ) viable organisms per day is the required dose Vag 
    Output:
    