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: OBJECTIVE To assess the efficacy of individualized classical homeopathy in the treatment of fibromyalgia . METHODS This study was a double-blind , r and omized , parallel-group , placebo-controlled trial of homeopathy .  Community-recruited persons ( N = 62 ) with physician-confirmed fibromyalgia ( mean age 49 yr , s.d . 10 yr , 94 % women ) were treated in a homeopathic private practice setting . Participants were r and omized to receive oral daily liquid LM ( 1/50,000 ) potencies with an individually chosen homeopathic remedy or an indistinguishable placebo . Homeopathic visits involved joint interviews and concurrence on remedy selection by two experienced homeopaths , at baseline , 2 months and 4 months ( prior to a subsequent optional crossover phase of the study which is reported elsewhere ) . Tender point count and tender point pain on examination by a medical assessor uninvolved in providing care , self-rating scales on fibromyalgia-related quality of life , pain , mood and global health at baseline and 3 months , were the primary clinical outcome measures for this report . RESULTS Fifty-three people completed the treatment protocol . Participants on active treatment showed significantly greater improvements in tender point count and tender point pain , quality of life , global health and a trend toward less depression compared with those on placebo . CONCLUSIONS This study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy . Using a broad selection of remedies and the flexible LM dose ( 1/50,000 dilution factor ) series , the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia OBJECTIVES To assess the feasibility of a R and omised Controlled Trial ( RCT ) design of usual care compared with usual care plus adjunctive care by a homeopath for patients with Fibromyalgia syndrome ( FMS ) . METHODS In a pragmatic parallel group RCT design , adults with a diagnosis of FMS ( ACR criteria ) were r and omly allocated to usual care or usual care plus adjunctive care by a homeopath . Adjunctive care consisted of five in depth interviews and individualised homeopathic medicines . The primary outcome measure was the difference in Fibromyalgia Impact Question naire ( FIQ ) total score at 22 weeks . RESULTS 47 patients were recruited .  Drop out rate in the usual care group was higher than the homeopath care group ( 8/24 vs 3/23 ) . Adjusted for baseline , there was a significantly greater mean reduction in the FIQ total score ( function ) in the homeopath care group than the usual care group ( -7.62 vs 3.63 ) . There were significantly greater reductions in the homeopath care group in the McGill pain score , FIQ fatigue and tiredness upon waking scores . We found a small effect on pain score ( 0.21 , 95 % CI -1.42 to 1.84 ) ; but a large effect on function ( 0.81 , 95 % CI -8.17 to 9.79 ) . There were no reported adverse events . CONCLUSIONS Given the acceptability of the treatment and the clinical ly relevant effect on function , there is a need for a definitive study to assess the clinical and cost effectiveness of adjunctive healthcare by a homeopath for patients with FMS In this article , we test the hypothesis that r and omized clinical trials of acupuncture for pain with certain design features ( A + B versus B ) are likely to generate false positive results . Based on electronic search es in six data bases , 13 studies were found that met our inclusion criteria . They all suggested that  acupuncture is effected ( one only showing a positive trend , all others had significant results ) . We conclude that the ' A + B versus B ' design is prone to false positive results and discuss the design features that might prevent or exacerbate this problem OBJECTIVES To characterize initial central nervous system responses to olfactory administration of homeopathic remedies as biomarkers for subsequently exceptional , simillimum-like clinical outcomes at a systemic level ( i.e. , both locally and globally ) . DESIGN Double-blinded , r and omized , placebo-controlled clinical trial . SETTING A private homeopathic clinic in Phoenix , AZ , and a university laboratory in Tucson , AZ . PATIENTS Sixty-two ( 62 ) persons with physician-confirmed fibromyalgia ( FM ) ( mean age , 49 years ; 94 % women ) enrolled ; 53 completed the 3-month assessment visit . Exceptional responders ( n = 6 , 23 % of active treatment group ; none on placebo ) were those with improvements in the top one-third for both tender point pain and global health ratings after 3 months . INTERVENTION Patients took daily oral doses of treatment solution in LM ( 1/50,000 dilution ) potency ( active group received individualized remedy ; placebo group received plain solvent ) . Dependent measures : Baseline and 3-month difference scores for initial prefrontal electroencephalographic alpha frequency cordance ( EEG-C , a correlate of functional brain activity ) during 16 pairs of r and omized , double-blinded bottle sniffs ( treatment minus control solutions ) . RESULTS Exceptional responders versus other patients exhibited significantly more negative initial EEG-C difference scores at prefrontal sites . Right prefrontal cordance findings correlated with subsequently reduced pain ( r = 0.85 , p = 0.03 ) , better global health ( r = -0.73 , p = 0.10 ) , and trait absorption ( genetically determined ability to focus attention selectively and fully ) ( r = 0.91 , p = 0.012 ) . CONCLUSIONS These observations suggest prefrontal EEG-C as an early biomarker of individualized homeopathic medicine effects in patients with FM who later exhibit exceptional outcomes . Prefrontal cortex controls executive function , including ability to redirect attention . Interactions between executive function , absorption , and the simillimum remedy could facilitate exceptional responses Previous studies have shown that changes in brain function precede clinical response to antidepressant medications . Here we examined quantitative EEG ( QEEG ) absolute and relative power and a new measure , cordance , for detecting regional changes associated with treatment response . Fifty-one adults with unipolar depression completed treatment trials using either fluoxetine or venlafaxine vs. placebo . Data were recorded at baseline and after 48 h and 1 week on drug or placebo . Baseline and change from baseline values were examined for specific brain regions in four subject groups ( medication and placebo responders and nonresponders ) . No regional baseline QEEG differences were found among the groups ; there also were no significant changes in theta power over time . In contrast , medication responders uniquely showed significant decreases in prefrontal cordance at 48 h and 1 week . Clinical differences did not emerge until after four weeks . Subjects with greater changes in cordance had the most complete 8-week responses . These findings implicate the prefrontal region in mediating response to antidepressant medications . Cordance may have clinical applicability as a leading indicator of individual response mens . Several treatments were required for each tumour , and injecting alcohol was often associated with considerable pain , whereas our patients did not report pain . These reports did not mention changes seen on ultrasound scans during or immediately after injection , which we found useful in laser treatment . The most important advantage of the laser is its precision . It is unlikely that it will ever be possible to predict the extent of necrosis around a site at which absolute alcohol has been injected with an accuracy comparable to that already possible with the laser technique . In conclusion , interstitial laser hyperthermia is feasible and seems to be safe . A multiple fibre system makes it feasible to treat tumours of clinical ly relevant size in the centre of solid organs . The real challenge for the future will be to develop diagnostic techniques that disclose exactly how far individual tumours extend in a wider range of organs ( unlike the well defined tumours treated in this pilot study ) and to establish the conditions of laser treatment that give complete tumour ablation with safe healing . This combination of technologies may be valuable for treating otherwise untreatable tumours in a range of solid organs and for the primary treatment of small neoplasms such as tumours of the prostate and adrenal gl and OBJECTIVE To assess individual difference characteristics of subgroups of patients with fibromyalgia ( FM ) patients with respect to the decision to stay in or switch from r and omly-assigned verum or placebo treatment during an optional crossover phase of a double-blinded homeopathy study . DESIGN Double-blinded , r and omized , placebo-controlled , optional crossover clinical trial . PARTICIPANTS Fifty-three ( 53 ) community-recruited patients with FM entered the optional crossover phase . INTERVENTION Two homeopaths jointly selected an individualized homeopathic remedy for all patients . The pharmacy dispensed either verum LM remedy or indistinguishable placebo in accord with r and omized assignment for 4 months and the patient 's optional crossover decision for an additional 2 months . OUTCOME MEASURES Patients completed a battery of baseline state/trait question naires , including mood , childhood neglect and abuse , and trait absorption . They rated global health ( whole person-centered ) and tender point pain on physical examination ( disease-specific ) at baseline , 3 months , and 6 months . RESULTS Rates of optional crossover from verum to placebo or placebo to verum were comparable ( p = 0.6 ; 31 % , and 41 % , respectively ) . The switch subgroups had greater baseline psychologic issues ( emotional neglect in placebo-switch ; depression and anger in verum-switch ) . The verum-stay subgroup scored highest on treatment helpfulness and included all six exceptional responders who fell , prior to crossover , into the top terciles for improvement in both global health and pain . Patients staying in their r and omly assigned groups , active or placebo ( n = 34 ) , scored significantly higher in trait absorption than did those who switched groups ( n = 19 ) . CONCLUSION Individual difference factors may predict better and poorer responders with FM to specific and nonspecific effects of homeopathic and placebo treatment Fibromyalgia ( FM ) patients show evidence of sensitizability in pain pathways and electroencephalographic ( EEG ) alterations . One proposed mechanism for the cl aim ed effects of homeopathy , a form of complementary medicine used for FM , is time-dependent sensitization ( TDS , progressive amplification ) of host responses . This study examined possible sensitization-related changes in EEG relative alpha magnitude during a clinical trial of homeopathy in FM . A 4-month r and omized , placebo-controlled double-blind trial of daily orally administered individualized homeopathy in physician-confirmed FM , with an additional 2-month optional crossover phase , included three laboratory sessions , at baseline , 3 and 6 months ( N = 48 , age 49.2 ± 9.8 years , 94 % women ) . Nineteen leads of EEG relative alpha magnitude at rest and during olfactory administration of treatment and control solutions were evaluated in each session . After 3 months , the active treatment group significantly increased , while the placebo group decreased , in global alpha-1 and alpha-2 during bottle sniffs over sessions . At 6 months , the subset of active patients who stayed on active continued to increase , while the active-switch subgroup reversed direction in alpha magnitude . Groups did not differ in resting alpha . Consistent with the TDS hypothesis , sniff alpha-1 and alpha-2 increases at 6 months versus baseline correlated with total amount of time on active remedy over all subjects ( r = 0.45 , p = .003 ) , not with dose changes or clinical outcomes in the active group . The findings suggest initiation of TDS in relative EEG alpha magnitude by daily oral administration of active homeopathic medicines versus placebo , with laboratory elicitation by temporolimbic olfactory stimulation or sniffing 
    Output:
    
agent
Invariably , their results suggested that homoeopathy was better than the control interventions in alleviating the symptoms of FM .
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To assess the efficacy of individualized classical homeopathy in the treatment of fibromyalgia . METHODS This study was a double-blind , r and omized , parallel-group , placebo-controlled trial of homeopathy .  Community-recruited persons ( N = 62 ) with physician-confirmed fibromyalgia ( mean age 49 yr , s.d . 10 yr , 94 % women ) were treated in a homeopathic private practice setting . Participants were r and omized to receive oral daily liquid LM ( 1/50,000 ) potencies with an individually chosen homeopathic remedy or an indistinguishable placebo . Homeopathic visits involved joint interviews and concurrence on remedy selection by two experienced homeopaths , at baseline , 2 months and 4 months ( prior to a subsequent optional crossover phase of the study which is reported elsewhere ) . Tender point count and tender point pain on examination by a medical assessor uninvolved in providing care , self-rating scales on fibromyalgia-related quality of life , pain , mood and global health at baseline and 3 months , were the primary clinical outcome measures for this report . RESULTS Fifty-three people completed the treatment protocol . Participants on active treatment showed significantly greater improvements in tender point count and tender point pain , quality of life , global health and a trend toward less depression compared with those on placebo . CONCLUSIONS This study replicates and extends a previous 1-month placebo-controlled crossover study in fibromyalgia that pre-screened for only one homeopathic remedy . Using a broad selection of remedies and the flexible LM dose ( 1/50,000 dilution factor ) series , the present study demonstrated that individualized homeopathy is significantly better than placebo in lessening tender point pain and improving the quality of life and global health of persons with fibromyalgia OBJECTIVES To assess the feasibility of a R and omised Controlled Trial ( RCT ) design of usual care compared with usual care plus adjunctive care by a homeopath for patients with Fibromyalgia syndrome ( FMS ) . METHODS In a pragmatic parallel group RCT design , adults with a diagnosis of FMS ( ACR criteria ) were r and omly allocated to usual care or usual care plus adjunctive care by a homeopath . Adjunctive care consisted of five in depth interviews and individualised homeopathic medicines . The primary outcome measure was the difference in Fibromyalgia Impact Question naire ( FIQ ) total score at 22 weeks . RESULTS 47 patients were recruited .  Drop out rate in the usual care group was higher than the homeopath care group ( 8/24 vs 3/23 ) . Adjusted for baseline , there was a significantly greater mean reduction in the FIQ total score ( function ) in the homeopath care group than the usual care group ( -7.62 vs 3.63 ) . There were significantly greater reductions in the homeopath care group in the McGill pain score , FIQ fatigue and tiredness upon waking scores . We found a small effect on pain score ( 0.21 , 95 % CI -1.42 to 1.84 ) ; but a large effect on function ( 0.81 , 95 % CI -8.17 to 9.79 ) . There were no reported adverse events . CONCLUSIONS Given the acceptability of the treatment and the clinical ly relevant effect on function , there is a need for a definitive study to assess the clinical and cost effectiveness of adjunctive healthcare by a homeopath for patients with FMS In this article , we test the hypothesis that r and omized clinical trials of acupuncture for pain with certain design features ( A + B versus B ) are likely to generate false positive results . Based on electronic search es in six data bases , 13 studies were found that met our inclusion criteria . They all suggested that  acupuncture is effected ( one only showing a positive trend , all others had significant results ) . We conclude that the ' A + B versus B ' design is prone to false positive results and discuss the design features that might prevent or exacerbate this problem OBJECTIVES To characterize initial central nervous system responses to olfactory administration of homeopathic remedies as biomarkers for subsequently exceptional , simillimum-like clinical outcomes at a systemic level ( i.e. , both locally and globally ) . DESIGN Double-blinded , r and omized , placebo-controlled clinical trial . SETTING A private homeopathic clinic in Phoenix , AZ , and a university laboratory in Tucson , AZ . PATIENTS Sixty-two ( 62 ) persons with physician-confirmed fibromyalgia ( FM ) ( mean age , 49 years ; 94 % women ) enrolled ; 53 completed the 3-month assessment visit . Exceptional responders ( n = 6 , 23 % of active treatment group ; none on placebo ) were those with improvements in the top one-third for both tender point pain and global health ratings after 3 months . INTERVENTION Patients took daily oral doses of treatment solution in LM ( 1/50,000 dilution ) potency ( active group received individualized remedy ; placebo group received plain solvent ) . Dependent measures : Baseline and 3-month difference scores for initial prefrontal electroencephalographic alpha frequency cordance ( EEG-C , a correlate of functional brain activity ) during 16 pairs of r and omized , double-blinded bottle sniffs ( treatment minus control solutions ) . RESULTS Exceptional responders versus other patients exhibited significantly more negative initial EEG-C difference scores at prefrontal sites . Right prefrontal cordance findings correlated with subsequently reduced pain ( r = 0.85 , p = 0.03 ) , better global health ( r = -0.73 , p = 0.10 ) , and trait absorption ( genetically determined ability to focus attention selectively and fully ) ( r = 0.91 , p = 0.012 ) . CONCLUSIONS These observations suggest prefrontal EEG-C as an early biomarker of individualized homeopathic medicine effects in patients with FM who later exhibit exceptional outcomes . Prefrontal cortex controls executive function , including ability to redirect attention . Interactions between executive function , absorption , and the simillimum remedy could facilitate exceptional responses Previous studies have shown that changes in brain function precede clinical response to antidepressant medications . Here we examined quantitative EEG ( QEEG ) absolute and relative power and a new measure , cordance , for detecting regional changes associated with treatment response . Fifty-one adults with unipolar depression completed treatment trials using either fluoxetine or venlafaxine vs. placebo . Data were recorded at baseline and after 48 h and 1 week on drug or placebo . Baseline and change from baseline values were examined for specific brain regions in four subject groups ( medication and placebo responders and nonresponders ) . No regional baseline QEEG differences were found among the groups ; there also were no significant changes in theta power over time . In contrast , medication responders uniquely showed significant decreases in prefrontal cordance at 48 h and 1 week . Clinical differences did not emerge until after four weeks . Subjects with greater changes in cordance had the most complete 8-week responses . These findings implicate the prefrontal region in mediating response to antidepressant medications . Cordance may have clinical applicability as a leading indicator of individual response mens . Several treatments were required for each tumour , and injecting alcohol was often associated with considerable pain , whereas our patients did not report pain . These reports did not mention changes seen on ultrasound scans during or immediately after injection , which we found useful in laser treatment . The most important advantage of the laser is its precision . It is unlikely that it will ever be possible to predict the extent of necrosis around a site at which absolute alcohol has been injected with an accuracy comparable to that already possible with the laser technique . In conclusion , interstitial laser hyperthermia is feasible and seems to be safe . A multiple fibre system makes it feasible to treat tumours of clinical ly relevant size in the centre of solid organs . The real challenge for the future will be to develop diagnostic techniques that disclose exactly how far individual tumours extend in a wider range of organs ( unlike the well defined tumours treated in this pilot study ) and to establish the conditions of laser treatment that give complete tumour ablation with safe healing . This combination of technologies may be valuable for treating otherwise untreatable tumours in a range of solid organs and for the primary treatment of small neoplasms such as tumours of the prostate and adrenal gl and OBJECTIVE To assess individual difference characteristics of subgroups of patients with fibromyalgia ( FM ) patients with respect to the decision to stay in or switch from r and omly-assigned verum or placebo treatment during an optional crossover phase of a double-blinded homeopathy study . DESIGN Double-blinded , r and omized , placebo-controlled , optional crossover clinical trial . PARTICIPANTS Fifty-three ( 53 ) community-recruited patients with FM entered the optional crossover phase . INTERVENTION Two homeopaths jointly selected an individualized homeopathic remedy for all patients . The pharmacy dispensed either verum LM remedy or indistinguishable placebo in accord with r and omized assignment for 4 months and the patient 's optional crossover decision for an additional 2 months . OUTCOME MEASURES Patients completed a battery of baseline state/trait question naires , including mood , childhood neglect and abuse , and trait absorption . They rated global health ( whole person-centered ) and tender point pain on physical examination ( disease-specific ) at baseline , 3 months , and 6 months . RESULTS Rates of optional crossover from verum to placebo or placebo to verum were comparable ( p = 0.6 ; 31 % , and 41 % , respectively ) . The switch subgroups had greater baseline psychologic issues ( emotional neglect in placebo-switch ; depression and anger in verum-switch ) . The verum-stay subgroup scored highest on treatment helpfulness and included all six exceptional responders who fell , prior to crossover , into the top terciles for improvement in both global health and pain . Patients staying in their r and omly assigned groups , active or placebo ( n = 34 ) , scored significantly higher in trait absorption than did those who switched groups ( n = 19 ) . CONCLUSION Individual difference factors may predict better and poorer responders with FM to specific and nonspecific effects of homeopathic and placebo treatment Fibromyalgia ( FM ) patients show evidence of sensitizability in pain pathways and electroencephalographic ( EEG ) alterations . One proposed mechanism for the cl aim ed effects of homeopathy , a form of complementary medicine used for FM , is time-dependent sensitization ( TDS , progressive amplification ) of host responses . This study examined possible sensitization-related changes in EEG relative alpha magnitude during a clinical trial of homeopathy in FM . A 4-month r and omized , placebo-controlled double-blind trial of daily orally administered individualized homeopathy in physician-confirmed FM , with an additional 2-month optional crossover phase , included three laboratory sessions , at baseline , 3 and 6 months ( N = 48 , age 49.2 ± 9.8 years , 94 % women ) . Nineteen leads of EEG relative alpha magnitude at rest and during olfactory administration of treatment and control solutions were evaluated in each session . After 3 months , the active treatment group significantly increased , while the placebo group decreased , in global alpha-1 and alpha-2 during bottle sniffs over sessions . At 6 months , the subset of active patients who stayed on active continued to increase , while the active-switch subgroup reversed direction in alpha magnitude . Groups did not differ in resting alpha . Consistent with the TDS hypothesis , sniff alpha-1 and alpha-2 increases at 6 months versus baseline correlated with total amount of time on active remedy over all subjects ( r = 0.45 , p = .003 ) , not with dose changes or clinical outcomes in the active group . The findings suggest initiation of TDS in relative EEG alpha magnitude by daily oral administration of active homeopathic medicines versus placebo , with laboratory elicitation by temporolimbic olfactory stimulation or sniffing 
    Output:
    