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: BACKGROUND We did a r and omised controlled trial to assess the benefit of maintenance infliximab therapy in patients with active Crohn 's disease who respond to a single infusion of infliximab .  METHODS 573 patients with a score of at least 220 on the Crohn 's disease activity index ( CDAI ) received a 5 mg/kg intravenous infusion of infliximab at week 0 . After assessment of response at week 2 , patients were r and omly assigned repeat infusions of placebo at weeks 2 and 6 and then every 8 weeks thereafter until week 46 ( group I ) , repeat infusions of 5 mg/kg infliximab at the same timepoints ( group II ) , or 5 mg/kg infliximab at weeks 2 and 6 followed by 10 mg/kg ( group III ) . The prespecified co- primary endpoints were the proportion of patients who responded at week 2 and were in remission ( CDAI < 150 ) at week 30 and the time to loss of response up to week 54 in patients who responded . Analyses of the co- primary endpoints were by intention to treat . FINDINGS 335 ( 58 % ) patients responded to a single infusion of infliximab within 2 weeks . At week 30 , 23 of 110 ( 21 % ) group I patients were in remission , compared with 44 of 113 ( 39 % ) group II ( p=0.003 ) and 50 of 112 ( 45 % ) group III ( p=0.0002 ) patients . Thus , patients in groups II and III combined were more likely to sustain clinical remission than patients in group I ( odds ratio 2.7 , 95 % CI 1.6 - 4.6 ) . Throughout the 54-week trial , the median time to loss of response was 38 weeks ( IQR 15 to > 54 ) and more than 54 weeks ( 21 to > 54 ) for groups II and III , respectively , compared with 19 weeks ( 10 - 45 ) for group I ( p=0.002 and p=0.0002 , respectively ) .  Infliximab safety was consistent with that seen in other trials of infliximab in Crohn 's disease and rheumatoid arthritis . In particular , the incidence of serious infections was similar across treatment groups . INTERPRETATION Patients with Crohn 's disease who respond to an initial dose of infliximab are more likely to be in remission at weeks 30 and 54 , to discontinue corticosteroids , and to maintain their response for a longer period of time , if infliximab treatment is maintained every 8 weeks BACKGROUND Infliximab , a chimeric monoclonal antibody directed against tumor necrosis factor alpha , is an established treatment for Crohn 's disease but not ulcerative colitis . METHODS Two r and omized , double-blind , placebo-controlled studies --the Active Ulcerative Colitis Trials 1 and 2 ( ACT 1 and ACT 2 , respectively)--evaluated the efficacy of infliximab for induction and maintenance therapy in adults with ulcerative colitis . In each study , 364 patients with moderate-to-severe active ulcerative colitis despite treatment with concurrent medications received placebo or infliximab  ( 5 mg or 10 mg per kilogram of body weight ) intravenously at weeks 0 , 2 , and 6 and then every eight weeks through week 46 ( in ACT 1 ) or week 22 ( in ACT 2 ) . Patients were followed for 54 weeks in ACT 1 and 30 weeks in ACT 2 . RESULTS In ACT 1 , 69 percent of patients who received 5 mg of infliximab and 61 percent of those who received 10 mg had a clinical response at week 8 , as compared with 37 percent of those who received placebo ( P<0.001 for both comparisons with placebo ) . A response was defined as a decrease in the Mayo score of at least 3 points and at least 30 percent , with an accompanying decrease in the subscore for rectal bleeding of at least 1 point or an absolute rectal-bleeding subscore of 0 or 1 . In ACT 2 , 64 percent of patients who received 5 mg of infliximab and 69 percent of those who received 10 mg had a clinical response at week 8 , as compared with 29 percent of those who received placebo ( P<0.001 for both comparisons with placebo ) . In both studies , patients who received infliximab were more likely to have a clinical response at week 30 ( P < or = 0.002 for all comparisons ) . In ACT 1 , more patients who received 5 mg or 10 mg of infliximab had a clinical response at week 54 ( 45 percent and 44 percent , respectively ) than did those who received placebo ( 20 percent , P<0.001 for both comparisons ) . CONCLUSIONS Patients with moderate-to-severe active ulcerative colitis treated with infliximab at weeks 0 , 2 , and 6 and every eight weeks thereafter were more likely to have a clinical response at weeks 8 , 30 , and 54 than were those receiving placebo . ( Clinical Trials.gov numbers , NCT00036439 and NCT00096655 . BACKGROUND : Preoperative infliximab treatment may influence postoperative infectious complications in patients with Crohn ’s disease . OBJECTIVE : The aim of this study was to identify predictors of surgical site infection after surgery for Crohn ’s disease and evaluate the effects of preoperative infliximab administration . DESIGN : We performed a prospect i ve surveillance and review of surgical site infections . SETTING S : This study was conducted in the Surgical Department of Hyogo College of Medicine . PATIENTS : A total of 405 consecutive patients with Crohn ’s disease who underwent abdominal surgery between January 2008 and December 2011 were included . MAIN OUTCOME MEASURES : Infection was diagnosed by the infection control team . The possible risk factors were analyzed by using logistic regression analyses to determine their predictive significance . RESULTS : Within the patient population , 20 % of patients received infliximab , and 60 % had penetrating disease . The median duration from the last infliximab infusion to surgery was 43 days ( range , 4–80 ) . The overall incidence of surgical site infection was 27 % . The incidence of incisional surgical site infection was 18 % , and the organ/space surgical site infection rate was 8 % . In the multivariate analysis , proctectomy was the highest risk factor for all surgical site infection ( OR , 3.4–11.8 ; p < 0.01 ) . The administration of preoperative infliximab was not a risk factor for surgical site infection . By contrast , there was a significantly reduced risk of incisional surgical site infection in patients with penetrating disease who received infliximab ( OR , 0.1 ; p < 0.01 ) . LIMITATIONS : This study was a cohort study and not a r and omized trial . The data analyses were performed for surgical site infections but not for other infectious complications . CONCLUSIONS : Proctectomy was a high-risk factor for surgical site infection in patients with Crohn ’s disease . The administration of preoperative infliximab was not a risk factor for surgical site infection Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Anti‐TNFα therapy with infliximab is effective for Crohn ’s disease .  Infliximab neutralizes the biological activities of TNFα , a cytokine involved in host‐defence against certain infections Purpose The high incidence of infectious complications in ulcerative colitis ( UC ) is generally recognized to be due to several factors related to a compromised host . In our previous study , a high dose of corticosteroid was shown to be a risk factor for surgical site infection ( SSI ) . Recently , infliximab ( IFX ) has been used for refractory UC . In this study , the effect of IFX on the occurrence of infectious postoperative complications for UC was evaluated , because it remains controversial . Method A total of 196 UC patients who underwent laparotomy between January 2010 and September 2012 were included . Possible factors related to complications were analyzed to identify significant predictors . Results Twenty-two patients had IFX before surgery . The overall incidence of SSI was 47/196 ( 24.0 % ) . The incidence of infections , including SSI and other infections , was 69/196 ( 35.2 % ) . On multivariate analysis , national nosocomial infection surveillance ( NNIS ) risk index ≥2 ( p<0.01 ) and preoperative prednisolone dose ≥0.2 mg/kg/day ( p = 0.01 ) were identified as independent risk factors for overall SSI ; NNIS risk index ≥2 ( p < 0.01 ) and duration from onset of UC ≥6.3 years ( p = 0.045 ) were identified as independent risk factors for incisional SSI ; contaminated wound class ( p < 0.01 ) , preoperative hospital stay ≥6 days ( p = 0.048 ) , severe/fulminant disease activity ( p = 0.04 ) , and pancolitis ( p = 0.02 ) were identified as independent risk factors for organ/space SSI ; and contaminated wound ( p < 0.01 ) , severe/fulminant disease activity ( p = 0.02 ) , and age at surgery ≥43 years ( p = 0.047 ) were identified as independent risk factors for total infectious complications . Conclusion IFX administration was not associated with infectious complications for UC surgery Objective : To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease ( CD ) . Summary Background Data : The risk factors of morbidity after surgery for CD , particularly the role of anti-TNF therapy , remain controversial and have not been evaluated in a large prospect i ve cohort study . Methods : From 2013 to 2015 , data on 592 consecutive patients who underwent surgery for CD in 19 French specialty centers were collected prospect ively . Possible relationships between anti-TNF and postoperative overall morbidity were tested by univariate and multivariate analyses . Because treatment by anti-TNF is possibly dependent on the characteristics of the patients and disease , a propensity score was calculated and introduced in the analyses using adjustment of the inverse probability of treatment-weighted method . Results : Postoperative mortality , overall and intra-abdominal septic morbidity rates in the entire cohort were 0 % , 29.7 % , and 8.4 % , respectively ; 143 ( 24.1 % ) patients had received anti-TNF <3 months prior to surgery . In the multivariate analysis , anti-TNF <3 months prior to surgery was identified as an independent risk factor of the overall postoperative morbidity ( odds-ratio [ OR ] = 1.99 ; confidence interval [ CI ] 95 % = 1.17–3.39 , P = 0.011 ) , with preoperative hemoglobin < 10 g/dL ( OR = 4.77 ; CI 95 % = 1.32–17.35 , P = 0.017 ) , operative time > 180 min ( OR = 2.71 ; CI 95 % = 1.54–4.78 , P < 0.001 ) and recurrent CD ( OR = 1.99 ; CI 95 % = 1.13–3.36 , P = 0.017 ) . After calculating the propensity score and adjustment according to the inverse probability of treatment-weighted method , anti-TNF <3 months prior to surgery remained associated with a higher risk of overall ( OR = 2.98 ; CI 95 % = 2.04–4.35 , P < 0.0001 ) and intra-abdominal septic postoperative morbidities ( OR = 2.22 ; CI 95 % = 1.22–4.04 , P = 0.009 ) . Conclusions : Preoperative anti-TNF therapy is associated with a higher risk of morbidity after surgery for ileocolonic CD . This information should be considered in the surgical management of these patients , particularly with regard to the preoperative preparation and indication of temporary defunctioning stoma Background Few studies have evaluated preoperative infliximab use and postoperative outcomes in Crohn ’s patients . Our aim was to evaluate 30-day postoperative outcomes for Crohn ’s patients treated with infliximab within 3 months prior to ileocolonic resection . Methods The study is a retrospective evaluation of data for patients undergoing ileocolonic resection after 1998 from a prospect i ve Crohn ’s disease data base .  Patient characteristics and 30-day complications were compared for patients treated with infliximab within 3 months before surgery and an infliximab naïve group . The infliximab group was also compared with  non-infliximab patients undergoing ileocolonic surgery  before 1998 . Results Sixty of 389 Crohn ’s patients undergoing ileocolonic resection received infliximab . The infliximab and non-infliximab groups had similar characteristics , preoperative risk factors , and surgical procedure . However , steroid 
    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: BACKGROUND We did a r and omised controlled trial to assess the benefit of maintenance infliximab therapy in patients with active Crohn 's disease who respond to a single infusion of infliximab .  METHODS 573 patients with a score of at least 220 on the Crohn 's disease activity index ( CDAI ) received a 5 mg/kg intravenous infusion of infliximab at week 0 . After assessment of response at week 2 , patients were r and omly assigned repeat infusions of placebo at weeks 2 and 6 and then every 8 weeks thereafter until week 46 ( group I ) , repeat infusions of 5 mg/kg infliximab at the same timepoints ( group II ) , or 5 mg/kg infliximab at weeks 2 and 6 followed by 10 mg/kg ( group III ) . The prespecified co- primary endpoints were the proportion of patients who responded at week 2 and were in remission ( CDAI < 150 ) at week 30 and the time to loss of response up to week 54 in patients who responded . Analyses of the co- primary endpoints were by intention to treat . FINDINGS 335 ( 58 % ) patients responded to a single infusion of infliximab within 2 weeks . At week 30 , 23 of 110 ( 21 % ) group I patients were in remission , compared with 44 of 113 ( 39 % ) group II ( p=0.003 ) and 50 of 112 ( 45 % ) group III ( p=0.0002 ) patients . Thus , patients in groups II and III combined were more likely to sustain clinical remission than patients in group I ( odds ratio 2.7 , 95 % CI 1.6 - 4.6 ) . Throughout the 54-week trial , the median time to loss of response was 38 weeks ( IQR 15 to > 54 ) and more than 54 weeks ( 21 to > 54 ) for groups II and III , respectively , compared with 19 weeks ( 10 - 45 ) for group I ( p=0.002 and p=0.0002 , respectively ) .  Infliximab safety was consistent with that seen in other trials of infliximab in Crohn 's disease and rheumatoid arthritis . In particular , the incidence of serious infections was similar across treatment groups . INTERPRETATION Patients with Crohn 's disease who respond to an initial dose of infliximab are more likely to be in remission at weeks 30 and 54 , to discontinue corticosteroids , and to maintain their response for a longer period of time , if infliximab treatment is maintained every 8 weeks BACKGROUND Infliximab , a chimeric monoclonal antibody directed against tumor necrosis factor alpha , is an established treatment for Crohn 's disease but not ulcerative colitis . METHODS Two r and omized , double-blind , placebo-controlled studies --the Active Ulcerative Colitis Trials 1 and 2 ( ACT 1 and ACT 2 , respectively)--evaluated the efficacy of infliximab for induction and maintenance therapy in adults with ulcerative colitis . In each study , 364 patients with moderate-to-severe active ulcerative colitis despite treatment with concurrent medications received placebo or infliximab  ( 5 mg or 10 mg per kilogram of body weight ) intravenously at weeks 0 , 2 , and 6 and then every eight weeks through week 46 ( in ACT 1 ) or week 22 ( in ACT 2 ) . Patients were followed for 54 weeks in ACT 1 and 30 weeks in ACT 2 . RESULTS In ACT 1 , 69 percent of patients who received 5 mg of infliximab and 61 percent of those who received 10 mg had a clinical response at week 8 , as compared with 37 percent of those who received placebo ( P<0.001 for both comparisons with placebo ) . A response was defined as a decrease in the Mayo score of at least 3 points and at least 30 percent , with an accompanying decrease in the subscore for rectal bleeding of at least 1 point or an absolute rectal-bleeding subscore of 0 or 1 . In ACT 2 , 64 percent of patients who received 5 mg of infliximab and 69 percent of those who received 10 mg had a clinical response at week 8 , as compared with 29 percent of those who received placebo ( P<0.001 for both comparisons with placebo ) . In both studies , patients who received infliximab were more likely to have a clinical response at week 30 ( P < or = 0.002 for all comparisons ) . In ACT 1 , more patients who received 5 mg or 10 mg of infliximab had a clinical response at week 54 ( 45 percent and 44 percent , respectively ) than did those who received placebo ( 20 percent , P<0.001 for both comparisons ) . CONCLUSIONS Patients with moderate-to-severe active ulcerative colitis treated with infliximab at weeks 0 , 2 , and 6 and every eight weeks thereafter were more likely to have a clinical response at weeks 8 , 30 , and 54 than were those receiving placebo . ( Clinical Trials.gov numbers , NCT00036439 and NCT00096655 . BACKGROUND : Preoperative infliximab treatment may influence postoperative infectious complications in patients with Crohn ’s disease . OBJECTIVE : The aim of this study was to identify predictors of surgical site infection after surgery for Crohn ’s disease and evaluate the effects of preoperative infliximab administration . DESIGN : We performed a prospect i ve surveillance and review of surgical site infections . SETTING S : This study was conducted in the Surgical Department of Hyogo College of Medicine . PATIENTS : A total of 405 consecutive patients with Crohn ’s disease who underwent abdominal surgery between January 2008 and December 2011 were included . MAIN OUTCOME MEASURES : Infection was diagnosed by the infection control team . The possible risk factors were analyzed by using logistic regression analyses to determine their predictive significance . RESULTS : Within the patient population , 20 % of patients received infliximab , and 60 % had penetrating disease . The median duration from the last infliximab infusion to surgery was 43 days ( range , 4–80 ) . The overall incidence of surgical site infection was 27 % . The incidence of incisional surgical site infection was 18 % , and the organ/space surgical site infection rate was 8 % . In the multivariate analysis , proctectomy was the highest risk factor for all surgical site infection ( OR , 3.4–11.8 ; p < 0.01 ) . The administration of preoperative infliximab was not a risk factor for surgical site infection . By contrast , there was a significantly reduced risk of incisional surgical site infection in patients with penetrating disease who received infliximab ( OR , 0.1 ; p < 0.01 ) . LIMITATIONS : This study was a cohort study and not a r and omized trial . The data analyses were performed for surgical site infections but not for other infectious complications . CONCLUSIONS : Proctectomy was a high-risk factor for surgical site infection in patients with Crohn ’s disease . The administration of preoperative infliximab was not a risk factor for surgical site infection Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Anti‐TNFα therapy with infliximab is effective for Crohn ’s disease .  Infliximab neutralizes the biological activities of TNFα , a cytokine involved in host‐defence against certain infections Purpose The high incidence of infectious complications in ulcerative colitis ( UC ) is generally recognized to be due to several factors related to a compromised host . In our previous study , a high dose of corticosteroid was shown to be a risk factor for surgical site infection ( SSI ) . Recently , infliximab ( IFX ) has been used for refractory UC . In this study , the effect of IFX on the occurrence of infectious postoperative complications for UC was evaluated , because it remains controversial . Method A total of 196 UC patients who underwent laparotomy between January 2010 and September 2012 were included . Possible factors related to complications were analyzed to identify significant predictors . Results Twenty-two patients had IFX before surgery . The overall incidence of SSI was 47/196 ( 24.0 % ) . The incidence of infections , including SSI and other infections , was 69/196 ( 35.2 % ) . On multivariate analysis , national nosocomial infection surveillance ( NNIS ) risk index ≥2 ( p<0.01 ) and preoperative prednisolone dose ≥0.2 mg/kg/day ( p = 0.01 ) were identified as independent risk factors for overall SSI ; NNIS risk index ≥2 ( p < 0.01 ) and duration from onset of UC ≥6.3 years ( p = 0.045 ) were identified as independent risk factors for incisional SSI ; contaminated wound class ( p < 0.01 ) , preoperative hospital stay ≥6 days ( p = 0.048 ) , severe/fulminant disease activity ( p = 0.04 ) , and pancolitis ( p = 0.02 ) were identified as independent risk factors for organ/space SSI ; and contaminated wound ( p < 0.01 ) , severe/fulminant disease activity ( p = 0.02 ) , and age at surgery ≥43 years ( p = 0.047 ) were identified as independent risk factors for total infectious complications . Conclusion IFX administration was not associated with infectious complications for UC surgery Objective : To determine the risk factors of morbidity after surgery for ileocolonic Crohn disease ( CD ) . Summary Background Data : The risk factors of morbidity after surgery for CD , particularly the role of anti-TNF therapy , remain controversial and have not been evaluated in a large prospect i ve cohort study . Methods : From 2013 to 2015 , data on 592 consecutive patients who underwent surgery for CD in 19 French specialty centers were collected prospect ively . Possible relationships between anti-TNF and postoperative overall morbidity were tested by univariate and multivariate analyses . Because treatment by anti-TNF is possibly dependent on the characteristics of the patients and disease , a propensity score was calculated and introduced in the analyses using adjustment of the inverse probability of treatment-weighted method . Results : Postoperative mortality , overall and intra-abdominal septic morbidity rates in the entire cohort were 0 % , 29.7 % , and 8.4 % , respectively ; 143 ( 24.1 % ) patients had received anti-TNF <3 months prior to surgery . In the multivariate analysis , anti-TNF <3 months prior to surgery was identified as an independent risk factor of the overall postoperative morbidity ( odds-ratio [ OR ] = 1.99 ; confidence interval [ CI ] 95 % = 1.17–3.39 , P = 0.011 ) , with preoperative hemoglobin < 10 g/dL ( OR = 4.77 ; CI 95 % = 1.32–17.35 , P = 0.017 ) , operative time > 180 min ( OR = 2.71 ; CI 95 % = 1.54–4.78 , P < 0.001 ) and recurrent CD ( OR = 1.99 ; CI 95 % = 1.13–3.36 , P = 0.017 ) . After calculating the propensity score and adjustment according to the inverse probability of treatment-weighted method , anti-TNF <3 months prior to surgery remained associated with a higher risk of overall ( OR = 2.98 ; CI 95 % = 2.04–4.35 , P < 0.0001 ) and intra-abdominal septic postoperative morbidities ( OR = 2.22 ; CI 95 % = 1.22–4.04 , P = 0.009 ) . Conclusions : Preoperative anti-TNF therapy is associated with a higher risk of morbidity after surgery for ileocolonic CD . This information should be considered in the surgical management of these patients , particularly with regard to the preoperative preparation and indication of temporary defunctioning stoma Background Few studies have evaluated preoperative infliximab use and postoperative outcomes in Crohn ’s patients . Our aim was to evaluate 30-day postoperative outcomes for Crohn ’s patients treated with infliximab within 3 months prior to ileocolonic resection . Methods The study is a retrospective evaluation of data for patients undergoing ileocolonic resection after 1998 from a prospect i ve Crohn ’s disease data base .  Patient characteristics and 30-day complications were compared for patients treated with infliximab within 3 months before surgery and an infliximab naïve group . The infliximab group was also compared with  non-infliximab patients undergoing ileocolonic surgery  before 1998 . Results Sixty of 389 Crohn ’s patients undergoing ileocolonic resection received infliximab . The infliximab and non-infliximab groups had similar characteristics , preoperative risk factors , and surgical procedure . However , steroid 
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