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: The aim of this study was to determine the effect of colloidal bismuth subcitrate ( De Nol ) on symptoms and gastric histology in patients with non-ulcer dyspepsia . In a single centre trial , patients with food related upper abdominal pain not caused by ulcer disease were r and omised to receive one tablet of colloidal bismuth subcitrate or matching placebo four times daily for eight weeks . Seventy three patients were entered and 51 completed the trial : 28 patients in the colloidal bismuth subcitrate group and 23 in the placebo group . Overall there was no difference between the two groups in terms of symptom relief . Among patients with histological gastritis ( n = 23 ) , however , those who took colloidal bismuth subcitrate used fewer antacid tablets ( for three of four fortnightly periods ) and were more likely to become asymptomatic ( eight of 11 v three of 12 , p less than 0.05 ) ; their gastritis was more likely to resolve ( five of 10 v 0 of 12 , p less than 0.025 ) and their gastric biopsies more likely to become negative for Helicobacter like organisms ( eight of nine v 0 of 12 , p less than 0.001 ) when compared with patients taking placebo . In contrast , patients who did not have gastritis in their index biopsies ( n = 28 ) fared similarly whether they received colloidal bismuth subcitrate or placebo . Our results indicate that the administration of colloidal bismuth subcitrate benefited non-ulcer dyspepsia patients with gastritis but had no effect on those without Background —Helicobacter pylori is a human pathogen that colonises the gastric mucosa and causes permanent gastric inflammation . Aims —To assess the symptoms of H pylori infection in an adult unselected population . Subjects — A r and om sample of 3589 adult Danes who were examined in 1982 and 1987 ( n=2987 ) . Methods —Abdominal symptoms within the preceding year were recorded at both attendances . Circulating IgG antibodies against H pylori in serum sample s drawn in 1982 were measured by using in-house indirect enzyme linked immunosorbent assays ( ELISA ) . Results —People with increased levels of IgG antibodies to H pylori were more likely than uninfected individuals to report heartburn ( odds ratio ( OR ) = 1.26 , 95 % confidence interval ( CI ) 1.03–1.54 ) and abdominal pain characterised by daily length ( OR = 1.33 , 95 % CI 0.92–1.91 ) , nocturnal occurrence ( OR = 1.62 , 95 % CI 1.19–2.19 ) , spring aggravation ( OR = 1.68 , 95 % CI 0.70–4.05 ) , and no relation to meals ( OR = 0.62 , 95 % CI 0.43–0.91 ) or stress ( OR = 0.69 , 95 % CI 0.50–0.95 ) . The inclusion of people with increased levels of IgG antibodies to H pylori , but without upper dyspepsia , at study entry significantly increased the likelihood of reporting upper dyspepsia at follow up ( OR = 1.71 , 95 % CI 1.24–2.36 ) . People with epigastric pain and increased levels of IgM antibodies to H pylori only indicative of acute H pylori infection were more likely to report nocturnal pain , heartburn , nausea , and vomiting . Conclusions —H pylori infection may precede the development of dyspepsia and is associated with a variety of gastrointestinal symptoms in people with no history of peptic ulcer disease This r and omised double blind placebo controlled study evaluated the effectiveness of colloidal bismuth subcitrate ( CBS ) , ampicillin and their combination in the treatment of Helicobacter Pylori in non-ulcer dyspepsia ( NUD ) and assessed if elimination of this organism is associated with improvement of gastritis and the symptoms .  Forty-eight NUD patients with H. pylori and histologic gastritis were r and omly allocated to one of the three regimens for 28 days . Symptoms were assessed before and after treatment . Forty-three patients completed the trial . Repeat endoscopy within 48 hours of completing treatment showed suppression of H. pylori in 6 of 7 patients ( 85.7 % ) on combined therapy and one of 8 patients ( 12.5 % ) on CBS therapy ( p = 0.0205 ) . There was no suppression of the bacteria in patients treated with ampicillin . Repeat endoscopy performed 2 weeks after completing treatment showed suppression of H. pylori in 3 of 7 patients ( 42.9 % ) on combined therapy and none in the other two groups . Patients on combined therapy who had suppression of H. pylori , 48 hours or 2 weeks after completing treatment were noted to have historical improvement of their gastritis ( p = 0.0001 and p = 0.05 respectively ) . This was also associated with improvement of symptoms in these patients The aim of this study was to assess the effect of colloidal bismuth subcitrate ( CBS ) and metronidazole on Helicobacter pylori eradication and on the course of symptoms due to functional dyspepsia . Forty-one patients with functional dyspepsia were entered into the study and r and omized to treatment with CBS ( 120 mg four times a day ) for four weeks combined with metronidazole ( 250 mg four times a day ) for one week ( group A , N=21 ) or matching placebo ( group B , N=20 ) . The severity of gastritis and of bacterial colonization and the symptom score was assessed by endoscopy and clinical evaluation at baseline and after four , eight , and 24 weeks from the start of the treatment . With intent-to-treat analysis eradication was achieved in 16/25 ( 64 % ) patients in group A and in 6/24 ( 25 % ) in group B. At eight and 24 weeks the gastritis score was significantly lower only in those patients with eradication . No change was seen in patients in whom the bacteria was not eradicated . The symptom score at eight weeks was considerably lower both in patients with eradication and in those with infection . However , at 24 weeks a gradual decrease in the symptom score in patients with eradication and a worsening of symptoms in controls was observed . No differences were observed between patients with ulcerlike and those with dysmotility-like dyspepsia .  The study confirms the need for a long observation period after antibacterial treatment in patients with functional dyspepsia and suggests thatHelicobacter pylori-eradicating treatment improves the course of this functional syndrome Gastritis caused byHelicobacter pylori ( HP ) is common in patients with nonulcer dyspepsia ( NUD ) , but an etiologic relationship between the histologic lesion and clinical symptoms is unproven . HP is inhibited by bismuth subsalicylate ( BSS ) , a traditional remedy for dyspeptic complaints . The aim of this study was to assess the short- and long-term effects of BSS on HP , gastritis , and symptoms in patients with NUD . One hundred twenty-six patients with NUD who were shown to be infected withH. pylori ( HP+ ) were enrolled . There was a two-week placebo run-in period to eliminate placebo responders . Fifty patients remained symptomatic and were r and omly assigned to therapy with either BSS liquid or a matching placebo .  EGD , biopsy , and clinical evaluations were performed at entry , at week 5 ( end of therapy ) , at week 9 ( four weeks after therapy ) , or at time of symptomatic relapse . Twenty-seven patients received placebo and 23 patients received BSS . BSS  suppressedH. pylori in 15/23 patients ( 65 % ) and eradicated it in one patient , whereas the placebo had no effect onH. pylori . Gastritis improved during therapy with BSS but relapsed by week 9 . There was no significant change in level of dyspeptic symptoms during or after treatment , although one month after the end of treatment , the patients in the BSS group consistently had lower symptom scores and fewer symptomatic days for all symptoms measured . The study confirms that BSS given for three weeks suppresses but does not usually eradicateH. pylori . Such short-term suppression ofH. pylori heals gastritis but does not result in clinical improvement Infection with Helicobacter pylori probably increases the risk for developing duodenal and gastric ulcer disease . Previous studies have shown that 75 % to 100 % of patients with duodenal ulcer and 35 % to 86 % of patients with gastric ulcer have evidence of an H. pylori infection [ 1 ] . The finding that eradication of H. pylori in patients with duodenal ulcer is associated with a statistically significant decrease in the recurrence rate of the disease further supports the association [ 2 - 5 ] . However , these observations may just reflect the frequent coexistence of duodenal ulcer with antral gastritis [ 6 ] , which has been shown to be caused by H. pylori [ 7 , 8 ] . Wormsley [ 9 ] has noted that the Henle-Koch postulates have not been satisfied for causation of duodenal ulcer by H. pylori because the organism has not been shown to produce the disease . The evidence is weaker that H. pylori causes gastric ulcer because only a single study with 26 patients has shown that antimicrobial therapy directed against H. pylori decreased the gastric ulcer recurrence rate [ 5 ] . None of the previous studies evaluated patients with duodenal or gastric ulcers before they were diagnosed or hospitalized with their disease . The usual temporal sequence is that patients with peptic ulcer disease are examined to detect H. pylori infection at the time the diagnosis is made or after they have had treatment to eradicate the organism . Consequently , peptic ulceration could possibly predispose persons to colonization by H. pylori [ 9 ] . We did a prospect i ve study in a large population -based cohort using serum specimens that were obtained from study participants before they were diagnosed with peptic ulcer . We tried to determine whether H. pylori infection , as shown by the presence of specific IgG antibodies , is a risk factor for the subsequent development of either duodenal or gastric ulceration . Methods Study Population Japanese-American men born from 1900 to 1919 , who were identified by the Honolulu Heart Program in 1965 by using the comprehensive 1942 Selective Service draft registration files [ 10 ] , composed the study population . Of 11 148 eligible men , 8006 ( 72 % ) were interviewed and examined from 1965 to 1968 , 180 ( 2 % ) died before they could be examined , and 2962 ( 26 % ) did not participate in the program . Study participants ranged in age from 45 to 68 years . The data collected included birthplace , marital status , history of alcohol use , blood pressure , and body mass index ( the weight in kilograms divided by the square of the height in meters ) . Serum cholesterol values were determined by the Auto Analyzer N-24A method , and serum glucose values were determined by the Auto Analyzer N-2B method 1 hour after a 50-g glucose load had been given [ 11 ] . A total of 7498 ( 94 % ) men returned for a second examination between 1967 and 1970 , and a serum specimen was obtained at this time . Serum specimens for a 20 % r and om sample of the men were sent to the U.S. Public Health Service Hospital in San Francisco , whereas specimens for the remaining 5924 men were stored at 20C at the study site . Four hundred eighty-one patients with previous gastrectomy or a previous diagnosis of peptic ulcer disease were excluded from the study . The average age of the remaining 5443 patients at the time of their second examination was 56.6 years . Surveillance Methods Surveillance of the cohort to identify incident patients with peptic ulcer was done by a continuous review of discharge records of all general hospitals on Oahu . Based on a 19-year follow-up survey of the study patients from the time of their examination in 1965 to 1968 , only 1.3 % of the men could not be located on Oahu . Thus , surveillance was nearly complete . Two hundred fifty-eight patients were hospitalized with peptic ulcer disease from 1968 to 1989 . One hundred sixty ( 62 % ) patients had their diagnosis confirmed by examination of tissue obtained by either surgery or biopsy , 36 ( 14 % ) were diagnosed by radiologic examination , and 62 ( 24 % ) were clinical ly diagnosed based on the endoscopic or surgical report of the presence of an ulcer . One hundred sixty-nine incident patients had gastric ulcer , 73 had duodenal ulcer , and 16 had gastric and duodenal ulcers . Seventeen of the 169 patients with gastric ulcer , 6 of the 73 patients with duodenal ulcer , and 2 of the 16 patients with gastric and duodenal ulcers were removed from study because they had an insufficient amount of serum in the freezer repository . Selection of Controls Each of the remaining patients was matched with one control from the study cohort based on age at examination ( 47 to 70 years ) and date of serum collection . If a potential control had a diagnosis of gastric cancer before or 
    Output:
    
agent
Reports of strong associations in small observational studies without appropriate adjustment for potential confounding factors were not generally confirmed by larger and better- design ed studies .
The available evidence indicates that there is no strong association between H pylori and dyspepsia , but there is insufficient evidence to confirm or refute the existence of a modest association
***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: The aim of this study was to determine the effect of colloidal bismuth subcitrate ( De Nol ) on symptoms and gastric histology in patients with non-ulcer dyspepsia . In a single centre trial , patients with food related upper abdominal pain not caused by ulcer disease were r and omised to receive one tablet of colloidal bismuth subcitrate or matching placebo four times daily for eight weeks . Seventy three patients were entered and 51 completed the trial : 28 patients in the colloidal bismuth subcitrate group and 23 in the placebo group . Overall there was no difference between the two groups in terms of symptom relief . Among patients with histological gastritis ( n = 23 ) , however , those who took colloidal bismuth subcitrate used fewer antacid tablets ( for three of four fortnightly periods ) and were more likely to become asymptomatic ( eight of 11 v three of 12 , p less than 0.05 ) ; their gastritis was more likely to resolve ( five of 10 v 0 of 12 , p less than 0.025 ) and their gastric biopsies more likely to become negative for Helicobacter like organisms ( eight of nine v 0 of 12 , p less than 0.001 ) when compared with patients taking placebo . In contrast , patients who did not have gastritis in their index biopsies ( n = 28 ) fared similarly whether they received colloidal bismuth subcitrate or placebo . Our results indicate that the administration of colloidal bismuth subcitrate benefited non-ulcer dyspepsia patients with gastritis but had no effect on those without Background —Helicobacter pylori is a human pathogen that colonises the gastric mucosa and causes permanent gastric inflammation . Aims —To assess the symptoms of H pylori infection in an adult unselected population . Subjects — A r and om sample of 3589 adult Danes who were examined in 1982 and 1987 ( n=2987 ) . Methods —Abdominal symptoms within the preceding year were recorded at both attendances . Circulating IgG antibodies against H pylori in serum sample s drawn in 1982 were measured by using in-house indirect enzyme linked immunosorbent assays ( ELISA ) . Results —People with increased levels of IgG antibodies to H pylori were more likely than uninfected individuals to report heartburn ( odds ratio ( OR ) = 1.26 , 95 % confidence interval ( CI ) 1.03–1.54 ) and abdominal pain characterised by daily length ( OR = 1.33 , 95 % CI 0.92–1.91 ) , nocturnal occurrence ( OR = 1.62 , 95 % CI 1.19–2.19 ) , spring aggravation ( OR = 1.68 , 95 % CI 0.70–4.05 ) , and no relation to meals ( OR = 0.62 , 95 % CI 0.43–0.91 ) or stress ( OR = 0.69 , 95 % CI 0.50–0.95 ) . The inclusion of people with increased levels of IgG antibodies to H pylori , but without upper dyspepsia , at study entry significantly increased the likelihood of reporting upper dyspepsia at follow up ( OR = 1.71 , 95 % CI 1.24–2.36 ) . People with epigastric pain and increased levels of IgM antibodies to H pylori only indicative of acute H pylori infection were more likely to report nocturnal pain , heartburn , nausea , and vomiting . Conclusions —H pylori infection may precede the development of dyspepsia and is associated with a variety of gastrointestinal symptoms in people with no history of peptic ulcer disease This r and omised double blind placebo controlled study evaluated the effectiveness of colloidal bismuth subcitrate ( CBS ) , ampicillin and their combination in the treatment of Helicobacter Pylori in non-ulcer dyspepsia ( NUD ) and assessed if elimination of this organism is associated with improvement of gastritis and the symptoms .  Forty-eight NUD patients with H. pylori and histologic gastritis were r and omly allocated to one of the three regimens for 28 days . Symptoms were assessed before and after treatment . Forty-three patients completed the trial . Repeat endoscopy within 48 hours of completing treatment showed suppression of H. pylori in 6 of 7 patients ( 85.7 % ) on combined therapy and one of 8 patients ( 12.5 % ) on CBS therapy ( p = 0.0205 ) . There was no suppression of the bacteria in patients treated with ampicillin . Repeat endoscopy performed 2 weeks after completing treatment showed suppression of H. pylori in 3 of 7 patients ( 42.9 % ) on combined therapy and none in the other two groups . Patients on combined therapy who had suppression of H. pylori , 48 hours or 2 weeks after completing treatment were noted to have historical improvement of their gastritis ( p = 0.0001 and p = 0.05 respectively ) . This was also associated with improvement of symptoms in these patients The aim of this study was to assess the effect of colloidal bismuth subcitrate ( CBS ) and metronidazole on Helicobacter pylori eradication and on the course of symptoms due to functional dyspepsia . Forty-one patients with functional dyspepsia were entered into the study and r and omized to treatment with CBS ( 120 mg four times a day ) for four weeks combined with metronidazole ( 250 mg four times a day ) for one week ( group A , N=21 ) or matching placebo ( group B , N=20 ) . The severity of gastritis and of bacterial colonization and the symptom score was assessed by endoscopy and clinical evaluation at baseline and after four , eight , and 24 weeks from the start of the treatment . With intent-to-treat analysis eradication was achieved in 16/25 ( 64 % ) patients in group A and in 6/24 ( 25 % ) in group B. At eight and 24 weeks the gastritis score was significantly lower only in those patients with eradication . No change was seen in patients in whom the bacteria was not eradicated . The symptom score at eight weeks was considerably lower both in patients with eradication and in those with infection . However , at 24 weeks a gradual decrease in the symptom score in patients with eradication and a worsening of symptoms in controls was observed . No differences were observed between patients with ulcerlike and those with dysmotility-like dyspepsia .  The study confirms the need for a long observation period after antibacterial treatment in patients with functional dyspepsia and suggests thatHelicobacter pylori-eradicating treatment improves the course of this functional syndrome Gastritis caused byHelicobacter pylori ( HP ) is common in patients with nonulcer dyspepsia ( NUD ) , but an etiologic relationship between the histologic lesion and clinical symptoms is unproven . HP is inhibited by bismuth subsalicylate ( BSS ) , a traditional remedy for dyspeptic complaints . The aim of this study was to assess the short- and long-term effects of BSS on HP , gastritis , and symptoms in patients with NUD . One hundred twenty-six patients with NUD who were shown to be infected withH. pylori ( HP+ ) were enrolled . There was a two-week placebo run-in period to eliminate placebo responders . Fifty patients remained symptomatic and were r and omly assigned to therapy with either BSS liquid or a matching placebo .  EGD , biopsy , and clinical evaluations were performed at entry , at week 5 ( end of therapy ) , at week 9 ( four weeks after therapy ) , or at time of symptomatic relapse . Twenty-seven patients received placebo and 23 patients received BSS . BSS  suppressedH. pylori in 15/23 patients ( 65 % ) and eradicated it in one patient , whereas the placebo had no effect onH. pylori . Gastritis improved during therapy with BSS but relapsed by week 9 . There was no significant change in level of dyspeptic symptoms during or after treatment , although one month after the end of treatment , the patients in the BSS group consistently had lower symptom scores and fewer symptomatic days for all symptoms measured . The study confirms that BSS given for three weeks suppresses but does not usually eradicateH. pylori . Such short-term suppression ofH. pylori heals gastritis but does not result in clinical improvement Infection with Helicobacter pylori probably increases the risk for developing duodenal and gastric ulcer disease . Previous studies have shown that 75 % to 100 % of patients with duodenal ulcer and 35 % to 86 % of patients with gastric ulcer have evidence of an H. pylori infection [ 1 ] . The finding that eradication of H. pylori in patients with duodenal ulcer is associated with a statistically significant decrease in the recurrence rate of the disease further supports the association [ 2 - 5 ] . However , these observations may just reflect the frequent coexistence of duodenal ulcer with antral gastritis [ 6 ] , which has been shown to be caused by H. pylori [ 7 , 8 ] . Wormsley [ 9 ] has noted that the Henle-Koch postulates have not been satisfied for causation of duodenal ulcer by H. pylori because the organism has not been shown to produce the disease . The evidence is weaker that H. pylori causes gastric ulcer because only a single study with 26 patients has shown that antimicrobial therapy directed against H. pylori decreased the gastric ulcer recurrence rate [ 5 ] . None of the previous studies evaluated patients with duodenal or gastric ulcers before they were diagnosed or hospitalized with their disease . The usual temporal sequence is that patients with peptic ulcer disease are examined to detect H. pylori infection at the time the diagnosis is made or after they have had treatment to eradicate the organism . Consequently , peptic ulceration could possibly predispose persons to colonization by H. pylori [ 9 ] . We did a prospect i ve study in a large population -based cohort using serum specimens that were obtained from study participants before they were diagnosed with peptic ulcer . We tried to determine whether H. pylori infection , as shown by the presence of specific IgG antibodies , is a risk factor for the subsequent development of either duodenal or gastric ulceration . Methods Study Population Japanese-American men born from 1900 to 1919 , who were identified by the Honolulu Heart Program in 1965 by using the comprehensive 1942 Selective Service draft registration files [ 10 ] , composed the study population . Of 11 148 eligible men , 8006 ( 72 % ) were interviewed and examined from 1965 to 1968 , 180 ( 2 % ) died before they could be examined , and 2962 ( 26 % ) did not participate in the program . Study participants ranged in age from 45 to 68 years . The data collected included birthplace , marital status , history of alcohol use , blood pressure , and body mass index ( the weight in kilograms divided by the square of the height in meters ) . Serum cholesterol values were determined by the Auto Analyzer N-24A method , and serum glucose values were determined by the Auto Analyzer N-2B method 1 hour after a 50-g glucose load had been given [ 11 ] . A total of 7498 ( 94 % ) men returned for a second examination between 1967 and 1970 , and a serum specimen was obtained at this time . Serum specimens for a 20 % r and om sample of the men were sent to the U.S. Public Health Service Hospital in San Francisco , whereas specimens for the remaining 5924 men were stored at 20C at the study site . Four hundred eighty-one patients with previous gastrectomy or a previous diagnosis of peptic ulcer disease were excluded from the study . The average age of the remaining 5443 patients at the time of their second examination was 56.6 years . Surveillance Methods Surveillance of the cohort to identify incident patients with peptic ulcer was done by a continuous review of discharge records of all general hospitals on Oahu . Based on a 19-year follow-up survey of the study patients from the time of their examination in 1965 to 1968 , only 1.3 % of the men could not be located on Oahu . Thus , surveillance was nearly complete . Two hundred fifty-eight patients were hospitalized with peptic ulcer disease from 1968 to 1989 . One hundred sixty ( 62 % ) patients had their diagnosis confirmed by examination of tissue obtained by either surgery or biopsy , 36 ( 14 % ) were diagnosed by radiologic examination , and 62 ( 24 % ) were clinical ly diagnosed based on the endoscopic or surgical report of the presence of an ulcer . One hundred sixty-nine incident patients had gastric ulcer , 73 had duodenal ulcer , and 16 had gastric and duodenal ulcers . Seventeen of the 169 patients with gastric ulcer , 6 of the 73 patients with duodenal ulcer , and 2 of the 16 patients with gastric and duodenal ulcers were removed from study because they had an insufficient amount of serum in the freezer repository . Selection of Controls Each of the remaining patients was matched with one control from the study cohort based on age at examination ( 47 to 70 years ) and date of serum collection . If a potential control had a diagnosis of gastric cancer before or 
    Output:
    