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 concentration of magnesium in serum has been shown to fall to potentially dangerously low levels after several courses of treatment with cis-diamminedichloroplatinum II ( cis-platin ) . The aims of this study were to examine the effects of magnesium supplementation on predicted outcome of treatment , rate of response to treatment and toxicity of treatment .  Sixteen patients with testicular cancer were studied in detail over a 14 month period . One patient with an ovarian dysgerminoma was also included in the study . Eight patients were r and omised to receive magnesium supplements both intravenous and oral ; nine did not . The non-supplemented group showed significantly greater renal tubular damage as assessed by urine N-acetyl-B-D-glucosaminidase ( NAG ) . There was a trend towards a reduction in treatment delays due to neutropenic episodes in the supplemented group , and serum magnesium concentrations remained significantly higher . Neither group showed differences in tumour growth rates or outcome . These results show that magnesium supplements are of considerable benefit and show no harmful effects in patients receiving cis-platin treatment . It is is suggested that magnesium supplements should be a routine part of the treatment regime , and that these should comprise both i.v . supplements during treatment and oral supplements between courses Goals of workTo describe the Quality of Life ( QoL ) characteristics of users of dietary supplements vs nonusers . Patients and methods A survey of 225 cancer patients presenting for treatment at Cancer Treatment Centers of America was completed between November 2001 and October 2003 . A vali date d instrument assessed the use of 56 dietary supplements in the past month . Two vali date d question naires assessed QoL. Mean QoL scores were compared between the users and nonusers using univariate and multivariate linear regression . Results Of 225 patients , 91 ( 40 % ) were males and 134 ( 60 % ) females . Sixty seven ( 30 % ) had breast cancer , 40 ( 18 % ) colorectal cancer , and 32 ( 14 % ) lung cancer . One hundred sixty four ( 73 % ) had used dietary supplements in the past month , while 61 ( 27 % ) had not . Mean European Organization for Research Treatment of Cancer QoL scores were significantly better among the users for physical and emotional function scales and fatigue , nausea , appetite loss , and constipation symptom scales adjusting for tumor site . In the stratified analysis , lung cancer patients did not show any statistically significant differences in QoL scores between the users and nonusers . Colorectal cancer patients demonstrated statistically significant differences in constipation symptom , with dietary supplement users having better QoL. Breast cancer patients demonstrated statistically significant differences in several QoL scale scores between users and nonusers . Conclusions Contrary to some of the previously published research , this study , conducted at a community hospital comprehensive cancer center that combines alternative treatment approaches with conventional cancer care , found better self-reported QoL among the users of dietary supplements , as compared to nonusers . The next step in this research is to prospect ively evaluate the patterns of changing QoL in relation to dietary supplement use across the entire duration of cancer diagnosis and treatment A prospect i ve r and omized crossover trial was conducted to determine the effect of a branched chain amino acid (BCAA)‐enriched solution on whole body leucine kinetics and fractional rates of albumin synthesis in patients with intra‐abdominal metastatic adenocarcinoma . Ten malnourished cancer patients were provided isonitrogenous amounts of both a conventional total parenteral nutrition ( TPN ) formula containing 19 % BCAA and a BCAA‐enriched TPN formula containing 50 % of the amino acids as BCAA in a r and om order . Whole body protein turnover was determined by a 10 hour continuous infusion of leucine14C . Increased whole body leucine flux ( 68 ± 5 ųumols/kg BW/hr versus 145 ± 11 ; mean ± SEM ; P 0.001 ) and oxidation ( 13 ± 2 ųmols/kg BW/hr to 46 ± 5 ; P 0.001 ) were determined on the BCAA‐enriched TPN . Increased whole body protein synthesis ( 2.2 ± 0.2 g protein/kg BW/day versus 3.9 ± 0.3 ; P 0.005 ) and leucine balance ( 2.5 ± 0.4 g leucine/d versus 6.5 ± 0.6 ; P 0.001 ) were also observed in patients receiving the BCAA‐enriched TPN  solution . Leucine release from protein breakdown was not statistically elevated ( 1.65 ± 0.18 g protein/kg BW/d versus 2.48 ± 0.40 ; P > 0.05 ) but , incorporation of leucine 14C into plasma albumin was significantly elevated ( 2.37 ± 0.23 ųumols/g/hr to 4.21 ± 0.33 ; P 0.001 ) when the patients received BCAA‐enriched TPN . Despite the better leucine balance , the improvement in the 24‐hour urinary nitrogen balance was not statistically significant ( 6.6 ± 3.9 g protein/d versus 11.4 ± 2.9 ; control versus BCAA‐enriched ; P=0.15 ) . BCAA‐enriched formulas  improve whole body leucine kinetics , fractional rates of albumin synthesis , and leucine balance , and thus may favorably influence protein metabolism in cancer cachexia . Cancer 58:147–157 , 1986 BACKGROUND Malnourished head and neck cancer patients are at increased risk of postoperative complications . OBJECTIVE We studied the effect of perioperative , arginine-supplemented nutritional support on nutritional status , immune status , postoperative outcome , and survival in severely malnourished ( weight loss > 10 % of body weight ) head and neck cancer patients undergoing major surgery . DESIGN Forty-nine patients were r and omly assigned to receive 1 ) no preoperative and st and ard postoperative tube feeding , 2 ) st and ard preoperative and postoperative tube feeding , or 3 ) arginine-supplemented preoperative and postoperative tube feeding . RESULTS Patients in both prefed groups received approximately 9 d of preoperative tube feeding , result ing in energy intakes of 110 % and 113 % of calculated needs ( compared with 79 % in the control group ; P = 0.007 ) . Compared with no preoperative feeding , preoperative enteral nutrition did not significantly improve nutritional status or any of the studied biochemical or immunologic indexes . Major postoperative complications occurred in 53 % , 47 % , and 59 % of patients in study groups 1 , 2 , and 3 ( NS ) . A trend was seen toward better survival in the arginine-supplemented group ( P = 0.15 ) . Secondary analysis showed that survivors had better human leukocyte antigen-DR expression on monocytes ( P = 0.05 ) and higher endotoxin-induced cytokine production ( P = 0.010 for tumor necrosis factor alpha and P = 0.042 for interleukin 6 ) at the start of the study than did patients who died . CONCLUSIONS Nine days of preoperative tube feeding , with or without arginine , did not significantly improve nutritional status , reduce the surgery-induced immune suppression , or affect clinical outcome in severely malnourished head and neck cancer patients . Patients supplemented with arginine-enriched nutrition tended to live longer . Some markers of immune function may distinguish patients with good or bad prognoses OBJECTIVES /HYPOTHESIS Malnutrition is a significant risk factor for postoperative infections in patients undergoing oncologic surgery . This study was undertaken to determine if perioperative nutritional supplementation with an immune-enhancing formula is superior to st and ard formula in the prevention of postoperative infectious complications . STUDY DESIGN This was a prospect i ve , r and omized , double-blind trial comparing perioperative nutritional supplementation with Impact and st and ard nutritional formulas . METHODS Following stratification , 136 patients undergoing oncologic head and neck surgery were r and omly assigned to one of four treatment groups : preoperative/postoperative Impact , postoperative Impact , preoperative/postoperative st and ard formula , and postoperative st and ard formula . Outcome measures included laboratory evaluations of nutritional status , infectious and wound healing complications , and duration of hospitalization . Statistical analysis was performed using chi2 or two-tailed Fisher Exact Tests , when appropriate . RESULTS Intent-to-treat ( P = .02 ) and actual therapy ( P = .04 ) analyses revealed a significant decrease in the incidence of postoperative infectious complications ( all sites ) in patients who received Impact . There was no significant difference in wound healing problems or duration of hospitalization . Postoperative measures of nutrition status demonstrated a higher serum albumin ( P = .05 ) in patients who received Impact compared with st and ard formula . CONCLUSIONS Compared with st and ard formula , perioperative nutritional supplementation with Impact significantly reduced the incidence of infectious complications . The length of hospitalization was significantly prolonged in patients with postoperative infections , suggesting potential cost savings with the use of immune-enhancing formulas such as Impact Over the years there has been a great deal of controversy on the effect of vitamin C on cancer . To investigate the effects of vitamin C on cancer patients '  health-related quality of life , we prospect ively studied 39 terminal cancer patients . All patients were given an intravenous administration of 10 g vitamin C twice with a 3-day interval and an oral intake of 4 g vitamin C daily for a week . And then we investigated demographic data and assessed changes in patients ' quality of life after administration of vitamin C.  Quality of life was assessed with EORTC QLQ-C30 . In the global health/ quality of life scale , health score improved from 36±18 to 55±16 after administration of vitamin C ( p=0.001 ) . In functional scale , the patients reported significantly higher scores for physical , role , emotional , and cognitive function after administration of vitamin C ( p<0.05 ) . In symptom scale , the patients reported significantly lower scores for fatigue , nausea/vomiting , pain , and appetite loss after administration of vitamin C ( p<0.005 ) . The other function and symptom scales were not significantly changed after administration of vitamin C. In terminal cancer patients  , the quality of life is as important as cure . Although there is still controversy regarding anticancer effects of vitamin C , the use of vitamin C is considered a safe and effective therapy to improve the quality of life of terminal cancer patients The aim of the current prospect i ve , r and omized control study was to investigate the effect of dietary omega‐3 polyunsaturated fatty acids plus vitamin E on the immune status and survival of well‐nourished and malnourished patients with generalized malignancy Background Cachexia , a > 10 % loss of body-weight , is one factor determining the poor prognosis of pancreatic cancer . Deficiency of L-Carnitine has been proposed to cause cancer cachexia . Findings We screened 152 and enrolled 72 patients suffering from advanced pancreatic cancer in a prospect i ve , multi-centre , placebo-controlled , r and omized and double-blinded trial to receive oral L-Carnitine ( 4 g ) or placebo for 12 weeks . At entry patients reported a mean weight loss of 12 ± 2,5 ( SEM ) kg . During treatment body-mass-index increased by 3,4 ± 1,4 % under L-Carnitine and decreased ( −1,5 ± 1,4 % ) in controls ( p < 0,05 ) . Moreover , nutritional status ( body cell mass , body fat ) and quality -of-life parameters improved under L-Carnitine . There was a trend towards an increased overall survival in the L-Carnitine group ( median 519 ± 50 d versus 399 ± 43 d , not significant ) and towards a reduced hospital-stay ( 36 ± 4d versus 41 ± 9d , n.s . ) . Conclusion While these data are preliminary and need confirmation they indicate that patients with pancreatic cancer may have a clinical ly relevant benefit from the inexpensive and well tolerated oral supplementation of L-Carnitine BACKGROUND Cancer-related cachexia is caused by a diverse combination of accelerated protein breakdown and slowed protein synthesis . The hypothesis proposed in this study is that supplementation of specific nutrients known to positively support protein synthesis and reduce protein breakdown will reverse the cachexia process in advanced cancer patients . METHODS Patients with solid tumors who had demonstrated a weight loss of at least 5 % were considered for the study . Patients were r and omly assigned in a double-blind fashion to either an isonitrogenous control mixture of nonessential amino acids or an experimental treatment containing beta-hydroxy-beta-methylbutyrate ( 3 g/d ) , L-arginine ( 14 g/d ) , and L-glutamine ( 14 g/d [ HMB/Arg/Gln ] ) . The primary outcomes measured were the change in body mass and fat-free mass ( FFM ) , which were assessed at 0 , 4 , 8 , 12 , 16 , 20 , and 24 weeks . RESULTS Thirty 
    Output:
    
agent
***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 concentration of magnesium in serum has been shown to fall to potentially dangerously low levels after several courses of treatment with cis-diamminedichloroplatinum II ( cis-platin ) . The aims of this study were to examine the effects of magnesium supplementation on predicted outcome of treatment , rate of response to treatment and toxicity of treatment .  Sixteen patients with testicular cancer were studied in detail over a 14 month period . One patient with an ovarian dysgerminoma was also included in the study . Eight patients were r and omised to receive magnesium supplements both intravenous and oral ; nine did not . The non-supplemented group showed significantly greater renal tubular damage as assessed by urine N-acetyl-B-D-glucosaminidase ( NAG ) . There was a trend towards a reduction in treatment delays due to neutropenic episodes in the supplemented group , and serum magnesium concentrations remained significantly higher . Neither group showed differences in tumour growth rates or outcome . These results show that magnesium supplements are of considerable benefit and show no harmful effects in patients receiving cis-platin treatment . It is is suggested that magnesium supplements should be a routine part of the treatment regime , and that these should comprise both i.v . supplements during treatment and oral supplements between courses Goals of workTo describe the Quality of Life ( QoL ) characteristics of users of dietary supplements vs nonusers . Patients and methods A survey of 225 cancer patients presenting for treatment at Cancer Treatment Centers of America was completed between November 2001 and October 2003 . A vali date d instrument assessed the use of 56 dietary supplements in the past month . Two vali date d question naires assessed QoL. Mean QoL scores were compared between the users and nonusers using univariate and multivariate linear regression . Results Of 225 patients , 91 ( 40 % ) were males and 134 ( 60 % ) females . Sixty seven ( 30 % ) had breast cancer , 40 ( 18 % ) colorectal cancer , and 32 ( 14 % ) lung cancer . One hundred sixty four ( 73 % ) had used dietary supplements in the past month , while 61 ( 27 % ) had not . Mean European Organization for Research Treatment of Cancer QoL scores were significantly better among the users for physical and emotional function scales and fatigue , nausea , appetite loss , and constipation symptom scales adjusting for tumor site . In the stratified analysis , lung cancer patients did not show any statistically significant differences in QoL scores between the users and nonusers . Colorectal cancer patients demonstrated statistically significant differences in constipation symptom , with dietary supplement users having better QoL. Breast cancer patients demonstrated statistically significant differences in several QoL scale scores between users and nonusers . Conclusions Contrary to some of the previously published research , this study , conducted at a community hospital comprehensive cancer center that combines alternative treatment approaches with conventional cancer care , found better self-reported QoL among the users of dietary supplements , as compared to nonusers . The next step in this research is to prospect ively evaluate the patterns of changing QoL in relation to dietary supplement use across the entire duration of cancer diagnosis and treatment A prospect i ve r and omized crossover trial was conducted to determine the effect of a branched chain amino acid (BCAA)‐enriched solution on whole body leucine kinetics and fractional rates of albumin synthesis in patients with intra‐abdominal metastatic adenocarcinoma . Ten malnourished cancer patients were provided isonitrogenous amounts of both a conventional total parenteral nutrition ( TPN ) formula containing 19 % BCAA and a BCAA‐enriched TPN formula containing 50 % of the amino acids as BCAA in a r and om order . Whole body protein turnover was determined by a 10 hour continuous infusion of leucine14C . Increased whole body leucine flux ( 68 ± 5 ųumols/kg BW/hr versus 145 ± 11 ; mean ± SEM ; P 0.001 ) and oxidation ( 13 ± 2 ųmols/kg BW/hr to 46 ± 5 ; P 0.001 ) were determined on the BCAA‐enriched TPN . Increased whole body protein synthesis ( 2.2 ± 0.2 g protein/kg BW/day versus 3.9 ± 0.3 ; P 0.005 ) and leucine balance ( 2.5 ± 0.4 g leucine/d versus 6.5 ± 0.6 ; P 0.001 ) were also observed in patients receiving the BCAA‐enriched TPN  solution . Leucine release from protein breakdown was not statistically elevated ( 1.65 ± 0.18 g protein/kg BW/d versus 2.48 ± 0.40 ; P > 0.05 ) but , incorporation of leucine 14C into plasma albumin was significantly elevated ( 2.37 ± 0.23 ųumols/g/hr to 4.21 ± 0.33 ; P 0.001 ) when the patients received BCAA‐enriched TPN . Despite the better leucine balance , the improvement in the 24‐hour urinary nitrogen balance was not statistically significant ( 6.6 ± 3.9 g protein/d versus 11.4 ± 2.9 ; control versus BCAA‐enriched ; P=0.15 ) . BCAA‐enriched formulas  improve whole body leucine kinetics , fractional rates of albumin synthesis , and leucine balance , and thus may favorably influence protein metabolism in cancer cachexia . Cancer 58:147–157 , 1986 BACKGROUND Malnourished head and neck cancer patients are at increased risk of postoperative complications . OBJECTIVE We studied the effect of perioperative , arginine-supplemented nutritional support on nutritional status , immune status , postoperative outcome , and survival in severely malnourished ( weight loss > 10 % of body weight ) head and neck cancer patients undergoing major surgery . DESIGN Forty-nine patients were r and omly assigned to receive 1 ) no preoperative and st and ard postoperative tube feeding , 2 ) st and ard preoperative and postoperative tube feeding , or 3 ) arginine-supplemented preoperative and postoperative tube feeding . RESULTS Patients in both prefed groups received approximately 9 d of preoperative tube feeding , result ing in energy intakes of 110 % and 113 % of calculated needs ( compared with 79 % in the control group ; P = 0.007 ) . Compared with no preoperative feeding , preoperative enteral nutrition did not significantly improve nutritional status or any of the studied biochemical or immunologic indexes . Major postoperative complications occurred in 53 % , 47 % , and 59 % of patients in study groups 1 , 2 , and 3 ( NS ) . A trend was seen toward better survival in the arginine-supplemented group ( P = 0.15 ) . Secondary analysis showed that survivors had better human leukocyte antigen-DR expression on monocytes ( P = 0.05 ) and higher endotoxin-induced cytokine production ( P = 0.010 for tumor necrosis factor alpha and P = 0.042 for interleukin 6 ) at the start of the study than did patients who died . CONCLUSIONS Nine days of preoperative tube feeding , with or without arginine , did not significantly improve nutritional status , reduce the surgery-induced immune suppression , or affect clinical outcome in severely malnourished head and neck cancer patients . Patients supplemented with arginine-enriched nutrition tended to live longer . Some markers of immune function may distinguish patients with good or bad prognoses OBJECTIVES /HYPOTHESIS Malnutrition is a significant risk factor for postoperative infections in patients undergoing oncologic surgery . This study was undertaken to determine if perioperative nutritional supplementation with an immune-enhancing formula is superior to st and ard formula in the prevention of postoperative infectious complications . STUDY DESIGN This was a prospect i ve , r and omized , double-blind trial comparing perioperative nutritional supplementation with Impact and st and ard nutritional formulas . METHODS Following stratification , 136 patients undergoing oncologic head and neck surgery were r and omly assigned to one of four treatment groups : preoperative/postoperative Impact , postoperative Impact , preoperative/postoperative st and ard formula , and postoperative st and ard formula . Outcome measures included laboratory evaluations of nutritional status , infectious and wound healing complications , and duration of hospitalization . Statistical analysis was performed using chi2 or two-tailed Fisher Exact Tests , when appropriate . RESULTS Intent-to-treat ( P = .02 ) and actual therapy ( P = .04 ) analyses revealed a significant decrease in the incidence of postoperative infectious complications ( all sites ) in patients who received Impact . There was no significant difference in wound healing problems or duration of hospitalization . Postoperative measures of nutrition status demonstrated a higher serum albumin ( P = .05 ) in patients who received Impact compared with st and ard formula . CONCLUSIONS Compared with st and ard formula , perioperative nutritional supplementation with Impact significantly reduced the incidence of infectious complications . The length of hospitalization was significantly prolonged in patients with postoperative infections , suggesting potential cost savings with the use of immune-enhancing formulas such as Impact Over the years there has been a great deal of controversy on the effect of vitamin C on cancer . To investigate the effects of vitamin C on cancer patients '  health-related quality of life , we prospect ively studied 39 terminal cancer patients . All patients were given an intravenous administration of 10 g vitamin C twice with a 3-day interval and an oral intake of 4 g vitamin C daily for a week . And then we investigated demographic data and assessed changes in patients ' quality of life after administration of vitamin C.  Quality of life was assessed with EORTC QLQ-C30 . In the global health/ quality of life scale , health score improved from 36±18 to 55±16 after administration of vitamin C ( p=0.001 ) . In functional scale , the patients reported significantly higher scores for physical , role , emotional , and cognitive function after administration of vitamin C ( p<0.05 ) . In symptom scale , the patients reported significantly lower scores for fatigue , nausea/vomiting , pain , and appetite loss after administration of vitamin C ( p<0.005 ) . The other function and symptom scales were not significantly changed after administration of vitamin C. In terminal cancer patients  , the quality of life is as important as cure . Although there is still controversy regarding anticancer effects of vitamin C , the use of vitamin C is considered a safe and effective therapy to improve the quality of life of terminal cancer patients The aim of the current prospect i ve , r and omized control study was to investigate the effect of dietary omega‐3 polyunsaturated fatty acids plus vitamin E on the immune status and survival of well‐nourished and malnourished patients with generalized malignancy Background Cachexia , a > 10 % loss of body-weight , is one factor determining the poor prognosis of pancreatic cancer . Deficiency of L-Carnitine has been proposed to cause cancer cachexia . Findings We screened 152 and enrolled 72 patients suffering from advanced pancreatic cancer in a prospect i ve , multi-centre , placebo-controlled , r and omized and double-blinded trial to receive oral L-Carnitine ( 4 g ) or placebo for 12 weeks . At entry patients reported a mean weight loss of 12 ± 2,5 ( SEM ) kg . During treatment body-mass-index increased by 3,4 ± 1,4 % under L-Carnitine and decreased ( −1,5 ± 1,4 % ) in controls ( p < 0,05 ) . Moreover , nutritional status ( body cell mass , body fat ) and quality -of-life parameters improved under L-Carnitine . There was a trend towards an increased overall survival in the L-Carnitine group ( median 519 ± 50 d versus 399 ± 43 d , not significant ) and towards a reduced hospital-stay ( 36 ± 4d versus 41 ± 9d , n.s . ) . Conclusion While these data are preliminary and need confirmation they indicate that patients with pancreatic cancer may have a clinical ly relevant benefit from the inexpensive and well tolerated oral supplementation of L-Carnitine BACKGROUND Cancer-related cachexia is caused by a diverse combination of accelerated protein breakdown and slowed protein synthesis . The hypothesis proposed in this study is that supplementation of specific nutrients known to positively support protein synthesis and reduce protein breakdown will reverse the cachexia process in advanced cancer patients . METHODS Patients with solid tumors who had demonstrated a weight loss of at least 5 % were considered for the study . Patients were r and omly assigned in a double-blind fashion to either an isonitrogenous control mixture of nonessential amino acids or an experimental treatment containing beta-hydroxy-beta-methylbutyrate ( 3 g/d ) , L-arginine ( 14 g/d ) , and L-glutamine ( 14 g/d [ HMB/Arg/Gln ] ) . The primary outcomes measured were the change in body mass and fat-free mass ( FFM ) , which were assessed at 0 , 4 , 8 , 12 , 16 , 20 , and 24 weeks . RESULTS Thirty 
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