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 — Arterial hypertension is a prime cause of morbidity and mortality in the general population . Pharmacological treatment has limitations result ing from drug side effects , costs , and patient compliance . Thus , we investigated whether traditional Chinese medicine acupuncture is able to lower blood pressure . Methods and Results — We r and omized 160 out patients ( age , 58±8 years ; 78 men ) with uncomplicated arterial hypertension in a single-blind fashion to a 6-week course of active acupuncture or sham acupuncture ( 22 sessions of 30 minutes ' duration ) . Seventy-eight percent were receiving antihypertensive medication , which remained unchanged . Primary outcome parameters were mean 24-hour ambulatory blood pressure levels after the treatment course and 3 and 6 months later . One hundred forty patients finished the treatment course ( 72 with active treatment , 68 with sham treatment ) . There was a significant ( P<0.001 ) difference in posttreatment blood pressures adjusted for baseline values between the active and sham acupuncture groups at the end of treatment . For the primary outcome , the difference between treatment groups amounted to 6.4 mm Hg ( 95 % CI , 3.5 to 9.2 ) and 3.7 mm Hg ( 95 % CI , 1.6 to 5.8 ) for 24-hour systolic and diastolic blood pressures , respectively . In the active acupuncture  group , mean 24-hour ambulatory systolic and diastolic blood pressures decreased significantly after treatment by 5.4 mm Hg ( 95 % CI , 3.2 to 7.6 ) and 3.0 mm Hg ( 95 % CI , 1.5 to 4.6 ) , respectively . At 3 and 6 months , mean systolic and diastolic blood pressures returned to pretreatment levels in the active treatment group . Conclusions — Acupuncture according to traditional Chinese medicine , but not sham acupuncture , after 6 weeks of treatment significantly lowered mean 24-hour ambulatory blood pressures ; the effect disappeared after cessation of acupuncture treatment Background We investigated whether there had been an improvement in quality of reporting for r and omised controlled trials of acupuncture since the publication of the STRICTA and CONSORT statements . We conducted a before- and -after study , comparing ratings for quality of reporting following the publication of both STRICTA and CONSORT recommendations . Methodology and Principal Findings Ninety peer review ed journal articles reporting the results of acupuncture trials were selected at r and om from a wider sample frame of 266 papers . Papers published in three distinct time periods ( 1994–1995 , 1999–2000 and 2004–2005 ) were compared . Assessment criteria were developed directly from CONSORT and STRICTA checklists . Papers were independently assessed for quality of reporting by two assessors , one of whom was blind to information which could have introduced systematic bias ( e.g. date of publication ) . We detected a statistically significant increase in the reporting of CONSORT items for papers published in each time period measured . We did not , however , find a difference between the number of STRICTA items reported in journal articles published before and 3 to 4 years following the introduction of STRICTA recommendations . Conclusions and Significance The results of this study suggest that general st and ards of reporting for acupuncture trials have significantly improved since the introduction of the CONSORT statement in 1996 , but that quality in reporting details specific to acupuncture interventions has yet to change following the more recent introduction of STRICTA recommendations . Wider targeting and revision of the guidelines is recommended AIM Irritable bowel syndrome ( IBS ) is a common disorder and many patients fail to find adequate relief from conventional therapies for their symptoms . This study tests the cl aim that acupuncture is effective for a majority of these patients . METHODS A prospect i ve , blinded , sham acupuncture-controlled trial of traditional Chinese acupuncture was performed at a single postgraduate teaching hospital in Europe . Sixty patients with well-established IBS were recruited . The blinded comparator was sham acupuncture administered by the second of two acupuncturists who alone was aware of the r and omization , and who otherwise followed the prescription of the first . The primary end-point was a defined fall in the symptom score at 13 wk ( by intention to treat ) . The prior expectation was a 30 % placebo response , and a response rate of 70 % from acupuncture , for which the study was adequately powered . RESULTS Patients in treated and sham groups improved significantly during the study -mean improvement in scores being equal ( minus 1.9 ) and significant for both ( P<0.05 ; one-tailed t test ) . There was a small numeric but non-significant difference between the response rate in patients receiving acupuncture ( 40.7 % ) and sham treatment ( 31.2 % ) . Several secondary end-points marginally favored active treatment , but an improved symptom score of any degree of magnitude occurred more often with sham therapy ( 65.6 % vs 59.2 % ) . For no criterion was statistical significance approached . CONCLUSION Traditional Chinese acupuncture is relatively ineffective in IBS in the European hospital setting , and the magnitude of any effect appears insufficient to warrant investment in acupuncture services Objective : Hot flashes are a significant problem in women going through the menopausal transition that can substantially affect quality of life . The world of estrogen therapy has been thrown into turmoil with the recent results of the Women 's Health Initiative trial report . Pursuant to a growing interest in the use of alternative therapies to alleviate menopausal symptoms and a few pilot trials that suggested that acupuncture could modestly alleviate hot flashes , a prospect i ve , r and omized , single-blind , sham-controlled clinical trial was conducted in women experiencing hot flashes . Design : Participants , after being r and omized to medical versus sham acupuncture  , received biweekly treatments for 5 weeks after a baseline assessment week . They were then followed for an additional 7 weeks . Participants completed daily hot flash question naires , which formed the basis for analysis . Results : A total of 103 participants were r and omized to medical or sham acupuncture . At week 6 the percentage of residual hot flashes was 60 % in the medical acupuncture group and 62 % in the sham acupuncture group . At week 12 , the percentage of residual hot flashes was 73 % in the medical acupuncture group and 55 % in the sham acupuncture group . Participants reported no adverse effects related to the treatments . Conclusions : The results of this study suggest that the used medical acupuncture was not any more effective for reducing hot flashes than was the chosen sham acupuncture BACKGROUND Nausea and vomiting in early pregnancy are troublesome symptoms for some women . We undertook a single blind r and omized controlled trial to determine whether acupuncture reduced nausea , dry retching , and vomiting , and improved the health status of women in pregnancy . METHODS The trial was undertaken at a maternity teaching hospital in Adelaide , Australia , where 593 women less than 14 weeks ' pregnant with symptoms of nausea or vomiting were r and omized into 4 groups : traditional acupuncture , pericardium 6 ( p6 ) acupuncture , sham acupuncture , or no acupuncture ( control ) . Treatment was administered weekly for 4 weeks . The primary outcomes were nausea , dry retching , vomiting , and health status . Comparisons were made between groups over 4 consecutive weeks . RESULTS Women receiving traditional acupuncture reported less nausea ( p < 0.01 ) throughout the trial and less dry retching ( p < 0.01 ) from the second week compared with women in the no acupuncture control group . Women who received p6 acupuncture ( p < 0.05 ) reported less nausea from the second week of the trial , and less dry retching ( p < 0.001 ) from the third week compared with women in the no acupuncture control group . Women in the sham acupuncture group ( p < 0.01 ) reported less nausea and dry retching ( p < 0.001 ) from the third week compared with women in the no acupuncture group . No differences in vomiting were found among the groups at any time . CONCLUSION Acupuncture is an effective treatment for women who experience nausea and dry retching in early pregnancy . A time-related placebo effect was found for some women Management of acute and chronic low back and leg pain often includes the use of acupuncture . The effectiveness of this form of therapy is dependent upon compliance , which in turn is dependent on availability , response , treatment of proper acupoints , and the placebo effect . We hypothesized that classical acupuncture would be more effective than placebo acupuncture .  One hundred and thirty-two patients with acute and chronic low back and leg pain were examined before and after surgery for lumbar disc protrusion . Diagnosis was based on CT and MRT findings . Patients received acupuncture drug-free throughout the study period . The visual analogue scale was used to assess pain intensity before and after ( i.e. 30 min . 60 min . 2 h and 6 h ) acupuncture . Classical acupuncture result ed in a significant reduction in pain that become increasingly stronger during the 6h study period . Placebo acupuncture lead to same early pain relief that did not reach statistic significant and then declined thereafter Context A substantial number of patients use acupuncture to treat the symptoms of fibromyalgia , but previous r and omized trials of this intervention are inconclusive , in part because of control groups that did not permit adequate blinding of the patients . Contribution This study r and omly assigned 100 patients with fibromyalgia to 12 weeks of either true acupuncture treatment or one of 3 types of sham acupuncture . No differences in pain were identified between acupuncture and sham acupuncture . Caution s The study had too few patients to detect small differences between the groups . Patients could use other fibromyalgia therapies , so this study evaluates acupuncture as adjunctive treatment . The Editors Fibromyalgia is a condition of unknown cause that is characterized by chronic , diffuse pain and tenderness to palpation at specific musculoskeletal sites ( 1 ) . It is the second most common rheumatologic condition after osteoarthritis , afflicting 2 % to 4 % of the U.S. population ( 2 ) . Most r and omized , controlled trials of allopathic interventions have not demonstrated sustained benefit , and use of complementary and alternative medicine for fibromyalgia is common ( 3 ) . For example , 60 % to 90 % of patients with fibromyalgia report using 1 or more complementary or alternative treatments ( 4 , 5 ) , and 22 % of these patients have tried acupuncture ( 6 ) . Despite skepticism in western cultures , the literature suggests that acupuncture may alleviate chronic pain ( 7 ) . R and omized , controlled trials of acupuncture face many method ologic challenges , including the identification of appropriate treatment and control groups , blinding of study participants , and the inability to blind practitioners ( 8) . Needle placement and the extent to which needle insertion and stimulation is necessary are also controversial ( 7 - 9 ) . In the only rigorous r and omized , controlled trial of acupuncture for fibromyalgia , 7 of 8 outcome measures significantly improved after 3 weeks of treatment with electroacupuncture ( 10 ) . However , because blinding was not assessed and electroacupuncture involves perceptible current , these promising results could reflect a lack of blinding to treatment condition . Moreover , the study followed patients only during treatment . Because fibromyalgia is a chronic condition , longer-term outcomes should be examined . To address these method ologic problems , we performed a r and omized , controlled trial of acupuncture to treat fibromyalgia that included 3 sham acupuncture treatments to account for the effects of needle insertion and placement . The adequacy of participant blinding was carefully evaluated . We sought to determine whether directed acupuncture that is design ed to treat fibromyalgia relieves pain better than does sham acupuncture in adults with fibromyalgia . On the basis of the scant literature and our clinical experience , we hypothesized a priori that directed acupuncture would result in the greatest clinical improvement . Methods Participants Participants were recruited from the greater Seattle , Washington , metropolitan area between January 2001 and September 2002 . Recruitment strategies included dissemination of information on the study through newspapers , television , advertisements , signs posted at university-affiliated hospitals , and letters to local fibromyalgia support groups and health care providers with large caseloads of patients with fibromyalgia . Potential participants were told that they had an equal chance of being assigned to 1 of 4 acupuncture interventions , none of which have been proven but 1 of which was believed to have the most potential to improve the symptoms of fibromyalgia . The institutional review boards at the participating institutions approved the study , and participants provided written informed consent . Eligible participants were English-speaking adults 18 years of age or older in whom fibromyalgia was diagnosed by a physician and who had a prer and omization global pain score of 4 or greater on a visual analogue scale ( 0 = no pain , 10 = worst pain ever ) . Participants agreed to undergo r and omization and kept use of any fibromyalgia-related pharmacologic and nonpharmacologic therapies constant throughout the study . At the baseline evaluation before r and omization , a research coordinator trained in tender-point examination confirmed the diagnosis of fibromyalgia by using the 1990 criteria of the American College of Rheumatology ( 1 ) . Participants were excluded if they reported other pain-related medical conditions or potential contraindications to acupuncture 
    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 — Arterial hypertension is a prime cause of morbidity and mortality in the general population . Pharmacological treatment has limitations result ing from drug side effects , costs , and patient compliance . Thus , we investigated whether traditional Chinese medicine acupuncture is able to lower blood pressure . Methods and Results — We r and omized 160 out patients ( age , 58±8 years ; 78 men ) with uncomplicated arterial hypertension in a single-blind fashion to a 6-week course of active acupuncture or sham acupuncture ( 22 sessions of 30 minutes ' duration ) . Seventy-eight percent were receiving antihypertensive medication , which remained unchanged . Primary outcome parameters were mean 24-hour ambulatory blood pressure levels after the treatment course and 3 and 6 months later . One hundred forty patients finished the treatment course ( 72 with active treatment , 68 with sham treatment ) . There was a significant ( P<0.001 ) difference in posttreatment blood pressures adjusted for baseline values between the active and sham acupuncture groups at the end of treatment . For the primary outcome , the difference between treatment groups amounted to 6.4 mm Hg ( 95 % CI , 3.5 to 9.2 ) and 3.7 mm Hg ( 95 % CI , 1.6 to 5.8 ) for 24-hour systolic and diastolic blood pressures , respectively . In the active acupuncture  group , mean 24-hour ambulatory systolic and diastolic blood pressures decreased significantly after treatment by 5.4 mm Hg ( 95 % CI , 3.2 to 7.6 ) and 3.0 mm Hg ( 95 % CI , 1.5 to 4.6 ) , respectively . At 3 and 6 months , mean systolic and diastolic blood pressures returned to pretreatment levels in the active treatment group . Conclusions — Acupuncture according to traditional Chinese medicine , but not sham acupuncture , after 6 weeks of treatment significantly lowered mean 24-hour ambulatory blood pressures ; the effect disappeared after cessation of acupuncture treatment Background We investigated whether there had been an improvement in quality of reporting for r and omised controlled trials of acupuncture since the publication of the STRICTA and CONSORT statements . We conducted a before- and -after study , comparing ratings for quality of reporting following the publication of both STRICTA and CONSORT recommendations . Methodology and Principal Findings Ninety peer review ed journal articles reporting the results of acupuncture trials were selected at r and om from a wider sample frame of 266 papers . Papers published in three distinct time periods ( 1994–1995 , 1999–2000 and 2004–2005 ) were compared . Assessment criteria were developed directly from CONSORT and STRICTA checklists . Papers were independently assessed for quality of reporting by two assessors , one of whom was blind to information which could have introduced systematic bias ( e.g. date of publication ) . We detected a statistically significant increase in the reporting of CONSORT items for papers published in each time period measured . We did not , however , find a difference between the number of STRICTA items reported in journal articles published before and 3 to 4 years following the introduction of STRICTA recommendations . Conclusions and Significance The results of this study suggest that general st and ards of reporting for acupuncture trials have significantly improved since the introduction of the CONSORT statement in 1996 , but that quality in reporting details specific to acupuncture interventions has yet to change following the more recent introduction of STRICTA recommendations . Wider targeting and revision of the guidelines is recommended AIM Irritable bowel syndrome ( IBS ) is a common disorder and many patients fail to find adequate relief from conventional therapies for their symptoms . This study tests the cl aim that acupuncture is effective for a majority of these patients . METHODS A prospect i ve , blinded , sham acupuncture-controlled trial of traditional Chinese acupuncture was performed at a single postgraduate teaching hospital in Europe . Sixty patients with well-established IBS were recruited . The blinded comparator was sham acupuncture administered by the second of two acupuncturists who alone was aware of the r and omization , and who otherwise followed the prescription of the first . The primary end-point was a defined fall in the symptom score at 13 wk ( by intention to treat ) . The prior expectation was a 30 % placebo response , and a response rate of 70 % from acupuncture , for which the study was adequately powered . RESULTS Patients in treated and sham groups improved significantly during the study -mean improvement in scores being equal ( minus 1.9 ) and significant for both ( P<0.05 ; one-tailed t test ) . There was a small numeric but non-significant difference between the response rate in patients receiving acupuncture ( 40.7 % ) and sham treatment ( 31.2 % ) . Several secondary end-points marginally favored active treatment , but an improved symptom score of any degree of magnitude occurred more often with sham therapy ( 65.6 % vs 59.2 % ) . For no criterion was statistical significance approached . CONCLUSION Traditional Chinese acupuncture is relatively ineffective in IBS in the European hospital setting , and the magnitude of any effect appears insufficient to warrant investment in acupuncture services Objective : Hot flashes are a significant problem in women going through the menopausal transition that can substantially affect quality of life . The world of estrogen therapy has been thrown into turmoil with the recent results of the Women 's Health Initiative trial report . Pursuant to a growing interest in the use of alternative therapies to alleviate menopausal symptoms and a few pilot trials that suggested that acupuncture could modestly alleviate hot flashes , a prospect i ve , r and omized , single-blind , sham-controlled clinical trial was conducted in women experiencing hot flashes . Design : Participants , after being r and omized to medical versus sham acupuncture  , received biweekly treatments for 5 weeks after a baseline assessment week . They were then followed for an additional 7 weeks . Participants completed daily hot flash question naires , which formed the basis for analysis . Results : A total of 103 participants were r and omized to medical or sham acupuncture . At week 6 the percentage of residual hot flashes was 60 % in the medical acupuncture group and 62 % in the sham acupuncture group . At week 12 , the percentage of residual hot flashes was 73 % in the medical acupuncture group and 55 % in the sham acupuncture group . Participants reported no adverse effects related to the treatments . Conclusions : The results of this study suggest that the used medical acupuncture was not any more effective for reducing hot flashes than was the chosen sham acupuncture BACKGROUND Nausea and vomiting in early pregnancy are troublesome symptoms for some women . We undertook a single blind r and omized controlled trial to determine whether acupuncture reduced nausea , dry retching , and vomiting , and improved the health status of women in pregnancy . METHODS The trial was undertaken at a maternity teaching hospital in Adelaide , Australia , where 593 women less than 14 weeks ' pregnant with symptoms of nausea or vomiting were r and omized into 4 groups : traditional acupuncture , pericardium 6 ( p6 ) acupuncture , sham acupuncture , or no acupuncture ( control ) . Treatment was administered weekly for 4 weeks . The primary outcomes were nausea , dry retching , vomiting , and health status . Comparisons were made between groups over 4 consecutive weeks . RESULTS Women receiving traditional acupuncture reported less nausea ( p < 0.01 ) throughout the trial and less dry retching ( p < 0.01 ) from the second week compared with women in the no acupuncture control group . Women who received p6 acupuncture ( p < 0.05 ) reported less nausea from the second week of the trial , and less dry retching ( p < 0.001 ) from the third week compared with women in the no acupuncture control group . Women in the sham acupuncture group ( p < 0.01 ) reported less nausea and dry retching ( p < 0.001 ) from the third week compared with women in the no acupuncture group . No differences in vomiting were found among the groups at any time . CONCLUSION Acupuncture is an effective treatment for women who experience nausea and dry retching in early pregnancy . A time-related placebo effect was found for some women Management of acute and chronic low back and leg pain often includes the use of acupuncture . The effectiveness of this form of therapy is dependent upon compliance , which in turn is dependent on availability , response , treatment of proper acupoints , and the placebo effect . We hypothesized that classical acupuncture would be more effective than placebo acupuncture .  One hundred and thirty-two patients with acute and chronic low back and leg pain were examined before and after surgery for lumbar disc protrusion . Diagnosis was based on CT and MRT findings . Patients received acupuncture drug-free throughout the study period . The visual analogue scale was used to assess pain intensity before and after ( i.e. 30 min . 60 min . 2 h and 6 h ) acupuncture . Classical acupuncture result ed in a significant reduction in pain that become increasingly stronger during the 6h study period . Placebo acupuncture lead to same early pain relief that did not reach statistic significant and then declined thereafter Context A substantial number of patients use acupuncture to treat the symptoms of fibromyalgia , but previous r and omized trials of this intervention are inconclusive , in part because of control groups that did not permit adequate blinding of the patients . Contribution This study r and omly assigned 100 patients with fibromyalgia to 12 weeks of either true acupuncture treatment or one of 3 types of sham acupuncture . No differences in pain were identified between acupuncture and sham acupuncture . Caution s The study had too few patients to detect small differences between the groups . Patients could use other fibromyalgia therapies , so this study evaluates acupuncture as adjunctive treatment . The Editors Fibromyalgia is a condition of unknown cause that is characterized by chronic , diffuse pain and tenderness to palpation at specific musculoskeletal sites ( 1 ) . It is the second most common rheumatologic condition after osteoarthritis , afflicting 2 % to 4 % of the U.S. population ( 2 ) . Most r and omized , controlled trials of allopathic interventions have not demonstrated sustained benefit , and use of complementary and alternative medicine for fibromyalgia is common ( 3 ) . For example , 60 % to 90 % of patients with fibromyalgia report using 1 or more complementary or alternative treatments ( 4 , 5 ) , and 22 % of these patients have tried acupuncture ( 6 ) . Despite skepticism in western cultures , the literature suggests that acupuncture may alleviate chronic pain ( 7 ) . R and omized , controlled trials of acupuncture face many method ologic challenges , including the identification of appropriate treatment and control groups , blinding of study participants , and the inability to blind practitioners ( 8) . Needle placement and the extent to which needle insertion and stimulation is necessary are also controversial ( 7 - 9 ) . In the only rigorous r and omized , controlled trial of acupuncture for fibromyalgia , 7 of 8 outcome measures significantly improved after 3 weeks of treatment with electroacupuncture ( 10 ) . However , because blinding was not assessed and electroacupuncture involves perceptible current , these promising results could reflect a lack of blinding to treatment condition . Moreover , the study followed patients only during treatment . Because fibromyalgia is a chronic condition , longer-term outcomes should be examined . To address these method ologic problems , we performed a r and omized , controlled trial of acupuncture to treat fibromyalgia that included 3 sham acupuncture treatments to account for the effects of needle insertion and placement . The adequacy of participant blinding was carefully evaluated . We sought to determine whether directed acupuncture that is design ed to treat fibromyalgia relieves pain better than does sham acupuncture in adults with fibromyalgia . On the basis of the scant literature and our clinical experience , we hypothesized a priori that directed acupuncture would result in the greatest clinical improvement . Methods Participants Participants were recruited from the greater Seattle , Washington , metropolitan area between January 2001 and September 2002 . Recruitment strategies included dissemination of information on the study through newspapers , television , advertisements , signs posted at university-affiliated hospitals , and letters to local fibromyalgia support groups and health care providers with large caseloads of patients with fibromyalgia . Potential participants were told that they had an equal chance of being assigned to 1 of 4 acupuncture interventions , none of which have been proven but 1 of which was believed to have the most potential to improve the symptoms of fibromyalgia . The institutional review boards at the participating institutions approved the study , and participants provided written informed consent . Eligible participants were English-speaking adults 18 years of age or older in whom fibromyalgia was diagnosed by a physician and who had a prer and omization global pain score of 4 or greater on a visual analogue scale ( 0 = no pain , 10 = worst pain ever ) . Participants agreed to undergo r and omization and kept use of any fibromyalgia-related pharmacologic and nonpharmacologic therapies constant throughout the study . At the baseline evaluation before r and omization , a research coordinator trained in tender-point examination confirmed the diagnosis of fibromyalgia by using the 1990 criteria of the American College of Rheumatology ( 1 ) . Participants were excluded if they reported other pain-related medical conditions or potential contraindications to acupuncture 
    Output:
    