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: A prospect i ve r and omised single-blind study of the effects of real and sham acupuncture on  exercise-induced asthma  was conducted in nineteen children .  Forced expiratory flow in 1st second ( FEV1 ) , forced vital capacity ( FVC ) , and peak expiratory flow rate ( PEFR ) were measured throughout acupuncture and after treadmill exercise . Neither real nor sham acupuncture affected the basal bronchomotor tone but both , when applied 20 min before exercise , attenuated exercise induced asthma : mean maximum percentage falls in FEV1 , FVC , and PEFR were 44.4 % , 33.3 % , and 49.5 % without acupuncture ; 23.8 % , 15.8 % , and 25.9 % after real acupuncture ; and 32.6 % , 26.1 % , and 34.3 % after sham acupuncture . Real acupuncture provided better protection against exercise-induced asthma than did sham acupuncture ( p less than 0.05 ) The acute effect of electric transcutaneous nerve stimulation ( TNS ) on bronchomotor tone was studied in 20 asthmatics . The stimulation was applied to four classical acupuncture points on the chest and back , and bronchomotor response was determined by measuring peak expiratory flow ( PEF ) . The experiments consisted of an adaptation period , placebo " stimulation " , TNS , and an isoprenaline inhalation test , in that order . In 11 patients PEF increased significantly ( greater than 15 % ) after placebo " stimulation " ; the mean change in all 20 patients after that period was + 12 % ( P less than 0.01 ) . TNS , however , did not change PEF significantly in any patient in spite of the fact that marked residual bronchoconstriction was shown in all patients demonstrated by an increase in PEF after inhalation of two isoprenaline puffs at the end of the experiment . The results suggest that the acute bronchodilatation obtainable with TNS is probably psychogenic ; no cutaneous-bronchial reflex could be demonstrated . The same kind of psychogenic reaction may also be involved in the bronchodilator response to needle acupuncture in asthma In 25 patients with moderate to severe asthma , we compared the therapeutic effectiveness of classic Chinese acupuncture with that of " placebo " acupuncture administered in a r and omly ordered , subject- and evaluator-blind , crossover fashion twice weekly for 4 weeks . Real and placebo acupuncture periods were each preceded and followed by 3- to 4-week periods during which no acupuncture was administered . Outcome variables consisted of the following : daily symptoms and medication use self-scored on patient diaries , spirometry and whole body plethysmography performed once weekly during the entire course of the study and repeated serially during 3 hours after real and placebo acupuncture treatment , patients ' self- assessment of acute efficacy of acupuncture therapy , and physician 's physical findings before and after  acupuncture treatment . Two-way analysis of variance failed to reveal a significant effect of either form of acupuncture  on symptoms , medication use , or lung function measurements . Similarly , no significant acute effect of  acupuncture on lung function , self-ratings of efficacy , or physician 's physical findings was found by covariance analysis or the Wilcoxon signed-rank test . When data during the entire course of the study were examined on an individual basis by analysis of variance with repeated measures , only two subjects demonstrated significantly favorable responses to real versus placebo acupuncture , but one subject demonstrated the reverse , suggesting that these responses were not specifically related to acupuncture therapy . Thus , our findings failed to demonstrate any short- or long-term benefit of acupuncture therapy in the management of moderate to severe asthma The cost to society and the individual of treating asthma has been increasing in developed countries . This has given rise to studies of the efficacy of complementary treatments . The aim of this study was to evaluate the efficacy of traditional Chinese Acupuncture in patients with mild asthma . The method used for evaluation of efficacy was total airway resistance at 5Hz ( R5 ) as measured by impulse oscillometry ( IOS ) – a forced oscillation technique , at baseline and after a bronchial challenge with voluntary isocapnic hyperventilation of cold air ( IHCA ) . The study was a parallel group r and omised placebo controlled trial with evaluator blinding . Twenty-seven asthmatics were recruited and 24 completed the study , 10 of them received acupuncture and 14 received a placebo treatment ( mock-TENS ) . Treatment continued for 15 weeks , and efficacy was tested two weeks following the last treatment . R and omisation result ed in female over representation in the acupuncture group , but lung-function and bronchial responsiveness to IHCA were comparable in the two population s before the start of treatment ( p>0.05 vs. p>0.05 ) . There were no statistically significant effects of the treatment before ( p>0.05 ) or after IHCA ( p>0.05 ) in either of the groups . The statistical power of the study to show a clinical ly relevant difference in bronchial responsiveness to IHCA after treatment was near 80 % . We conclude that there were no significant effects of traditional Chinese Acupuncture on airway status in our patients with asthma 1 . Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma . 2 . In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated , and in five patients wheezing was abolished . 3 . Stimulation at the correct site produced a significant increase in the mean FEV1 - 0 ( 58 % ) and FVC ( 29 % ) but not in maximal mid-expiratory flow rate ( MMFR ; 76 % ) , when compared with the findings before acupuncture , along with a significant fall in the Pa , CO2 and an insignificant fall in Pa , O2 . A mild tachycardia was also observed . 4 . After acupuncture a greater improvement in FEV1 - 0 , FVC and MMFR was produced by inhalation of isoprenaline . 5 . No significant changes in FEV1 - 0 , FVC , MMFR , pulse rate or arterial blood gas tensions occurred after acupuncture at control sites . 6 . In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge , but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction . 7 . It is concluded that acupunture probably reduced the reflex component of the bronchoconstriction , but failed to influence direct smooth muscle constriction caused by histamine A double-blind crossover study of the effects of real and placebo acupuncture on bronchial reactivity to histamine was carried out on 16 patients with moderately severe asthma . Treatment with real or placebo acupuncture  failed to modulate the bronchial hyperreactivity to histamine . These results suggest that a single treatment with acupuncture is unlikely to provide improvement in the management of acute bronchial asthma Background : Laser acupuncture , a painless technique , is a widely used alternative treatment method for childhood asthma , although its efficacy has not been proved in controlled clinical studies . Methods : A double blind , placebo controlled , crossover study was performed to investigate the possible protective effect of a single laser acupuncture treatment on cold dry air hyperventilation induced bronchoconstriction in 44 children and adolescents of mean age 11.9 years ( range 7.5–16.7 ) with exercise induced asthma .  Laser acupuncture was performed on real and placebo points in r and om order on two consecutive days . Lung function was measured before laser acupuncture , immediately after laser acupuncture ( just before cold dry air challenge ( CACh ) ) , and 3 and 15 minutes after CACh . CACh consisted of a 4 minute isocapnic hyperventilation of –10 ° C absolute dry air . Results : Comparison of real acupuncture with placebo acupuncture showed no significant differences in the mean maximum CACh induced decrease in forced expiratory volume in 1 second ( 27.2 (18.2)% v 23.8 (16.2)% ) and maximal expiratory flow at 25 % remaining vital capacity ( 51.6 (20.8)% v 44.4 (22.3)% ) . Conclusions : A single laser acupuncture treatment offers no protection against exercise induced bronchoconstriction in paediatric and adolescent patients Acupuncture treatment and control group interventions in parallel-group r and omised trials of acupuncture are not always precisely reported . In an attempt to improve st and ards , an international group of experienced acupuncturists and research ers devised a set of recommendations , design ating them STRICTA : ST and ards for Reporting Interventions in Controlled Trials of Acupuncture . In a further consensus-building round , the editors of several journals helped redraft the recommendations . These follow the Consoli date d St and ards for Reporting Trials ( CONSORT ) format , acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies . Participating journals are publishing the STRICTA recommendations and requesting prospect i ve authors to adhere to them when preparing reports for publication . Other journals are invited to adopt these recommendations . The intended outcome is that interventions in controlled trials of acupuncture  will be more adequately reported , thereby facilitating an improvement in critical appraisal , analysis and replication of trials In a double-blind ( patient and evaluator ) , crossover study effects of real acupuncture , simulated acupuncture , nebulized isoproterenol , nebulized saline and no treatment in reversing methacholine-induced bronchospasm were compared in 12 asthmatics ( ages 16 to 64 ) . Saline and simulated acupuncture did not result in any significant improvement in specific airway conductance ( SGaw ) , thoracic gas volume ( Vtg ) or forced expiratory flow rates compared with no treatment following methacholine-induced bronchospasm . Isoproterenol and real acupuncture were both followed by increases in SGaw and flow rates and decreases in Vtg which were significantly different from the changes observed following no treatment , saline or simulated acupuncture , although isoproterenol produced greater improvement than real acupuncture , although isoproterenol produced greater improvement than real acupuncture . These findings suggest that stimulation of specific acupuncture loci reduces methacholine-induced bronchospasm and hyperinflation to an extent greater than can be attributed to placebo phenomena STUDY OBJECTIVES Acupuncture traditionally has been used to treat asthma . Nevertheless , only a few controlled studies have been performed to determine the efficacy of this treatment . Our study aim ed to determine the efficacy of acupuncture in patients with moderate persistent asthma . METHODS Twenty-three patients with moderate persistent asthma who had been treated only with inhaled beta(2)-agonists were r and omly assigned to receive four sessions of real acupuncture ( RA ) or sham acupuncture ( SA ) in a blinded manner . After a washout period of 3 weeks , the patients were crossed over . Monitoring included FEV(1 ) , methacholine challenge , daily peak flow ( PF ) variability , and the keeping of an asthma diary . RESULTS Twenty of 23 patients completed the study . There was no significant change in FEV(1 ) following treatment . The mean ( + /- SE ) FEV(1 ) values before and after the RA were 73 + /- 4 % and 73 + /- 3 % , respectively ( not significant [ NS ] ) . FEV(1 ) values before and after SA were 70 + /- 3 % and 70 + /- 3 % , respectively ( NS ) . There was also no change in provocative methacholine concentration causing a 20 % fall in FEV(1 ) ( PC(20 ) ) before and after treatment . The mean PC(20 ) values before and after RA were 0.92 + /- 0.42 mg/mL and 1.16 + /- 0.51 mg/mL , respectively ( p = 0.71 ) , while the PC(20 ) values before and after SA were 1.47 + /- 0.83 mg/mL and 1.11 + /- 0.79 mg/mL , respectively ( p = 0.59 ) . There was no change in the mean PF variability before and after the RA ( 1.6 + /- 3.1 % and 1.8 + /- 2.3 % , respectively [ NS ] ) . The PF variability before and after SA were 3.6 + /- 2.8 % and 2.8 + /- 3.4 % , respectively ( NS ) . No significant difference was demonstrated for symptom scores or for the use of beta(2)-agonist inhalers ( RA , 6.7 + /- 3.4 ; SA , 8.1 + /- 3.6 ; p = 0.58 ) . CONCLUSION In patients with moderate persistent asthma , a short course of acupuncture treatment result ed in no change in lung functions , bronchial hyperreactivity , or patient symptoms Twenty patients r and omly assigned to an experimental and a control group participated in a double blind study to assess the effectiveness of  acupuncture  in bronchial asthma , using the peak expiratory flow rate ( PEFR ) as an index of bronchial patency . All patients in the control group showed a significant improvement in their PEFR while only 3 patients in the treated group showed an improvement . A subjective improvement and a reduction in drug dosages were observed in both groups . It is concluded that acupuncture has a placebo effect in bronchial asthma The effectiveness of acupuncture therapy for asthmatic patients was studied by continuous monitoring of the 
    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: A prospect i ve r and omised single-blind study of the effects of real and sham acupuncture on  exercise-induced asthma  was conducted in nineteen children .  Forced expiratory flow in 1st second ( FEV1 ) , forced vital capacity ( FVC ) , and peak expiratory flow rate ( PEFR ) were measured throughout acupuncture and after treadmill exercise . Neither real nor sham acupuncture affected the basal bronchomotor tone but both , when applied 20 min before exercise , attenuated exercise induced asthma : mean maximum percentage falls in FEV1 , FVC , and PEFR were 44.4 % , 33.3 % , and 49.5 % without acupuncture ; 23.8 % , 15.8 % , and 25.9 % after real acupuncture ; and 32.6 % , 26.1 % , and 34.3 % after sham acupuncture . Real acupuncture provided better protection against exercise-induced asthma than did sham acupuncture ( p less than 0.05 ) The acute effect of electric transcutaneous nerve stimulation ( TNS ) on bronchomotor tone was studied in 20 asthmatics . The stimulation was applied to four classical acupuncture points on the chest and back , and bronchomotor response was determined by measuring peak expiratory flow ( PEF ) . The experiments consisted of an adaptation period , placebo " stimulation " , TNS , and an isoprenaline inhalation test , in that order . In 11 patients PEF increased significantly ( greater than 15 % ) after placebo " stimulation " ; the mean change in all 20 patients after that period was + 12 % ( P less than 0.01 ) . TNS , however , did not change PEF significantly in any patient in spite of the fact that marked residual bronchoconstriction was shown in all patients demonstrated by an increase in PEF after inhalation of two isoprenaline puffs at the end of the experiment . The results suggest that the acute bronchodilatation obtainable with TNS is probably psychogenic ; no cutaneous-bronchial reflex could be demonstrated . The same kind of psychogenic reaction may also be involved in the bronchodilator response to needle acupuncture in asthma In 25 patients with moderate to severe asthma , we compared the therapeutic effectiveness of classic Chinese acupuncture with that of " placebo " acupuncture administered in a r and omly ordered , subject- and evaluator-blind , crossover fashion twice weekly for 4 weeks . Real and placebo acupuncture periods were each preceded and followed by 3- to 4-week periods during which no acupuncture was administered . Outcome variables consisted of the following : daily symptoms and medication use self-scored on patient diaries , spirometry and whole body plethysmography performed once weekly during the entire course of the study and repeated serially during 3 hours after real and placebo acupuncture treatment , patients ' self- assessment of acute efficacy of acupuncture therapy , and physician 's physical findings before and after  acupuncture treatment . Two-way analysis of variance failed to reveal a significant effect of either form of acupuncture  on symptoms , medication use , or lung function measurements . Similarly , no significant acute effect of  acupuncture on lung function , self-ratings of efficacy , or physician 's physical findings was found by covariance analysis or the Wilcoxon signed-rank test . When data during the entire course of the study were examined on an individual basis by analysis of variance with repeated measures , only two subjects demonstrated significantly favorable responses to real versus placebo acupuncture , but one subject demonstrated the reverse , suggesting that these responses were not specifically related to acupuncture therapy . Thus , our findings failed to demonstrate any short- or long-term benefit of acupuncture therapy in the management of moderate to severe asthma The cost to society and the individual of treating asthma has been increasing in developed countries . This has given rise to studies of the efficacy of complementary treatments . The aim of this study was to evaluate the efficacy of traditional Chinese Acupuncture in patients with mild asthma . The method used for evaluation of efficacy was total airway resistance at 5Hz ( R5 ) as measured by impulse oscillometry ( IOS ) – a forced oscillation technique , at baseline and after a bronchial challenge with voluntary isocapnic hyperventilation of cold air ( IHCA ) . The study was a parallel group r and omised placebo controlled trial with evaluator blinding . Twenty-seven asthmatics were recruited and 24 completed the study , 10 of them received acupuncture and 14 received a placebo treatment ( mock-TENS ) . Treatment continued for 15 weeks , and efficacy was tested two weeks following the last treatment . R and omisation result ed in female over representation in the acupuncture group , but lung-function and bronchial responsiveness to IHCA were comparable in the two population s before the start of treatment ( p>0.05 vs. p>0.05 ) . There were no statistically significant effects of the treatment before ( p>0.05 ) or after IHCA ( p>0.05 ) in either of the groups . The statistical power of the study to show a clinical ly relevant difference in bronchial responsiveness to IHCA after treatment was near 80 % . We conclude that there were no significant effects of traditional Chinese Acupuncture on airway status in our patients with asthma 1 . Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma . 2 . In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated , and in five patients wheezing was abolished . 3 . Stimulation at the correct site produced a significant increase in the mean FEV1 - 0 ( 58 % ) and FVC ( 29 % ) but not in maximal mid-expiratory flow rate ( MMFR ; 76 % ) , when compared with the findings before acupuncture , along with a significant fall in the Pa , CO2 and an insignificant fall in Pa , O2 . A mild tachycardia was also observed . 4 . After acupuncture a greater improvement in FEV1 - 0 , FVC and MMFR was produced by inhalation of isoprenaline . 5 . No significant changes in FEV1 - 0 , FVC , MMFR , pulse rate or arterial blood gas tensions occurred after acupuncture at control sites . 6 . In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge , but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction . 7 . It is concluded that acupunture probably reduced the reflex component of the bronchoconstriction , but failed to influence direct smooth muscle constriction caused by histamine A double-blind crossover study of the effects of real and placebo acupuncture on bronchial reactivity to histamine was carried out on 16 patients with moderately severe asthma . Treatment with real or placebo acupuncture  failed to modulate the bronchial hyperreactivity to histamine . These results suggest that a single treatment with acupuncture is unlikely to provide improvement in the management of acute bronchial asthma Background : Laser acupuncture , a painless technique , is a widely used alternative treatment method for childhood asthma , although its efficacy has not been proved in controlled clinical studies . Methods : A double blind , placebo controlled , crossover study was performed to investigate the possible protective effect of a single laser acupuncture treatment on cold dry air hyperventilation induced bronchoconstriction in 44 children and adolescents of mean age 11.9 years ( range 7.5–16.7 ) with exercise induced asthma .  Laser acupuncture was performed on real and placebo points in r and om order on two consecutive days . Lung function was measured before laser acupuncture , immediately after laser acupuncture ( just before cold dry air challenge ( CACh ) ) , and 3 and 15 minutes after CACh . CACh consisted of a 4 minute isocapnic hyperventilation of –10 ° C absolute dry air . Results : Comparison of real acupuncture with placebo acupuncture showed no significant differences in the mean maximum CACh induced decrease in forced expiratory volume in 1 second ( 27.2 (18.2)% v 23.8 (16.2)% ) and maximal expiratory flow at 25 % remaining vital capacity ( 51.6 (20.8)% v 44.4 (22.3)% ) . Conclusions : A single laser acupuncture treatment offers no protection against exercise induced bronchoconstriction in paediatric and adolescent patients Acupuncture treatment and control group interventions in parallel-group r and omised trials of acupuncture are not always precisely reported . In an attempt to improve st and ards , an international group of experienced acupuncturists and research ers devised a set of recommendations , design ating them STRICTA : ST and ards for Reporting Interventions in Controlled Trials of Acupuncture . In a further consensus-building round , the editors of several journals helped redraft the recommendations . These follow the Consoli date d St and ards for Reporting Trials ( CONSORT ) format , acting as an extension of the CONSORT guidelines for the specific requirements of acupuncture studies . Participating journals are publishing the STRICTA recommendations and requesting prospect i ve authors to adhere to them when preparing reports for publication . Other journals are invited to adopt these recommendations . The intended outcome is that interventions in controlled trials of acupuncture  will be more adequately reported , thereby facilitating an improvement in critical appraisal , analysis and replication of trials In a double-blind ( patient and evaluator ) , crossover study effects of real acupuncture , simulated acupuncture , nebulized isoproterenol , nebulized saline and no treatment in reversing methacholine-induced bronchospasm were compared in 12 asthmatics ( ages 16 to 64 ) . Saline and simulated acupuncture did not result in any significant improvement in specific airway conductance ( SGaw ) , thoracic gas volume ( Vtg ) or forced expiratory flow rates compared with no treatment following methacholine-induced bronchospasm . Isoproterenol and real acupuncture were both followed by increases in SGaw and flow rates and decreases in Vtg which were significantly different from the changes observed following no treatment , saline or simulated acupuncture , although isoproterenol produced greater improvement than real acupuncture , although isoproterenol produced greater improvement than real acupuncture . These findings suggest that stimulation of specific acupuncture loci reduces methacholine-induced bronchospasm and hyperinflation to an extent greater than can be attributed to placebo phenomena STUDY OBJECTIVES Acupuncture traditionally has been used to treat asthma . Nevertheless , only a few controlled studies have been performed to determine the efficacy of this treatment . Our study aim ed to determine the efficacy of acupuncture in patients with moderate persistent asthma . METHODS Twenty-three patients with moderate persistent asthma who had been treated only with inhaled beta(2)-agonists were r and omly assigned to receive four sessions of real acupuncture ( RA ) or sham acupuncture ( SA ) in a blinded manner . After a washout period of 3 weeks , the patients were crossed over . Monitoring included FEV(1 ) , methacholine challenge , daily peak flow ( PF ) variability , and the keeping of an asthma diary . RESULTS Twenty of 23 patients completed the study . There was no significant change in FEV(1 ) following treatment . The mean ( + /- SE ) FEV(1 ) values before and after the RA were 73 + /- 4 % and 73 + /- 3 % , respectively ( not significant [ NS ] ) . FEV(1 ) values before and after SA were 70 + /- 3 % and 70 + /- 3 % , respectively ( NS ) . There was also no change in provocative methacholine concentration causing a 20 % fall in FEV(1 ) ( PC(20 ) ) before and after treatment . The mean PC(20 ) values before and after RA were 0.92 + /- 0.42 mg/mL and 1.16 + /- 0.51 mg/mL , respectively ( p = 0.71 ) , while the PC(20 ) values before and after SA were 1.47 + /- 0.83 mg/mL and 1.11 + /- 0.79 mg/mL , respectively ( p = 0.59 ) . There was no change in the mean PF variability before and after the RA ( 1.6 + /- 3.1 % and 1.8 + /- 2.3 % , respectively [ NS ] ) . The PF variability before and after SA were 3.6 + /- 2.8 % and 2.8 + /- 3.4 % , respectively ( NS ) . No significant difference was demonstrated for symptom scores or for the use of beta(2)-agonist inhalers ( RA , 6.7 + /- 3.4 ; SA , 8.1 + /- 3.6 ; p = 0.58 ) . CONCLUSION In patients with moderate persistent asthma , a short course of acupuncture treatment result ed in no change in lung functions , bronchial hyperreactivity , or patient symptoms Twenty patients r and omly assigned to an experimental and a control group participated in a double blind study to assess the effectiveness of  acupuncture  in bronchial asthma , using the peak expiratory flow rate ( PEFR ) as an index of bronchial patency . All patients in the control group showed a significant improvement in their PEFR while only 3 patients in the treated group showed an improvement . A subjective improvement and a reduction in drug dosages were observed in both groups . It is concluded that acupuncture has a placebo effect in bronchial asthma The effectiveness of acupuncture therapy for asthmatic patients was studied by continuous monitoring of the 
    Output:
    