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: Premenstrual syndrome ( PMS ) symptoms can reduce quality of life and impair daily functioning . This study examined the effects of Korean h and acupuncture therapy ( HAT ) and h and moxibustion therapy ( HMT ) on symptom severity in Korean women with PMS . This quasi-experimental pilot study based on the khi , yin , yang , and the five elements theory used a nonequivalent control group pretest — posttest design . Experimental groups received 10 sessions of either HAT or HMT treatment . Outcome measures included menstrual symptom severity as measured with the Menstrual Symptom Severity List and skin temperature change measured with Digital Infrared Thermographic Imaging . Both experimental groups had significantly reduced overall PMS symptom severity scores following therapy as compared to women in the control group .  The HMT but not the HAT group showed improved flow of khi and balanced skin temperature in symmetric body areas . HAT and HMT may be effective strategies for women to reduce PMS symptoms Background : To evaluate the safety of acupuncture in a large number of patients receiving conventional health care and , based on these results , to develop a new medical consent form for acupuncture . Methods : The prospect i ve observational study included patients who received acupuncture treatment for chronic osteoarthritis pain of the knee or hip , low back pain , neck pain or headache , allergic rhinitis , asthma , or dysmenorrhoea . After treatment , all patients documented adverse events associated with acupuncture ( defined as adverse effects ) . Patients who reported a need for treatment due to an adverse effect completed an additional st and ardised question naire on the most important adverse effect . Based on this data and considering ethical and legal aspects a new consent form was developed . Results : A total of 229,230 patients received on average 10.2 ± 3.0 acupuncture treatments . Altogether , 19,726 patients ( 8.6 % ) reported experiencing at least one adverse effect and 4,963 ( 2.2 % ) reported one which required treatment . Common adverse effects were bleedings or haematoma ( 6.1 % of patients , 58 % of all adverse effects ) , pain ( 1.7 % ) and vegetative symptoms ( 0.7 % ) . Two patients experienced a pneumothorax ( one needed hospital treatment , the other observation only ) . The longest duration of a side effect was 180 days ( nerve lesion of the lower limb ) . The result ing medical consent form consists of five modules : Introduction to acupuncture and moxibustion , Risks of acupuncture treatment , Conditions which can increase the risk , Doctor ’s statement , and Consent . Conclusion : Acupuncture provided by physicians is a relatively safe treatment and the proposed consent form could support both patients and professionals in the process of obtaining informed consent STUDY QUESTION Are markers of chronic inflammation associated with menstrual symptom severity and premenstrual syndrome ( PMS ) ? SUMMARY ANSWER Serum levels of inflammatory markers , including interleukin (IL)-2 , IL-4 , IL-10 , IL-12 and interferon (IFN)-γ were positively associated with menstrual symptom severity and /or PMS in young women . WHAT IS KNOWN ALREADY Chronic inflammation has been implicated in the etiology of depression and other disorders that share common features with PMS , but whether inflammation contributes to menstrual symptom severity and PMS is unknown . STUDY DESIGN , SIZE , DURATION Cross-sectional study of 277 women aged 18 - 30 years , conducted in 2006 - 2011 . PARTICIPANTS / MATERIAL S , SETTING , METHODS Participants provided information on menstrual symptoms , lifestyle , diet , anthropometry and other factors by question naire and /or direct measurement , and a mid-luteal phase fasting blood sample was taken between 7 a.m. and 12 p.m. Total , physical and affective menstrual symptom scores were calculated for all participants , of whom 13 % ( n = 37 ) met criteria for moderate-to-severe PMS and 24 % ( n = 67 ) met PMS control criteria . Inflammatory factors assayed in serum included IL-1β , IL-2 , IL-4 , IL-5 , IL-6 , IL-7 , IL-8 , IL-10 , IL-12p70 , IL-13 , tumor necrosis factor-α , granulocyte macrophage colony stimulating factor , IFN-γ and C-reactive protein . MAIN RESULTS AND THE ROLE OF CHANCE After adjustment for age , smoking status and BMI , total menstrual symptom score was positively associated with levels of IL-2 ( percentage difference in women at the 75th percentile of total symptom score versus at the 25th percentile = 24.7 % ; P = 0.04 ) , IL-4 ( 21.5 % ; P = 0.04 ) , IL-10 ( 28.0 % ; P < 0.01 ) and IL-12 ( 42.0 % ; P = 0.02 ) in analyses including all participants . Affective menstrual symptom score was linearly related to levels of IL-2 ( percentage difference at 75th percentile versus 25th percentile = 31.0 % ; P = 0.02 ) , while physical/behavioral symptom score was linearly related to levels of IL-4 ( 19.1 % ; P = 0.03 ) and IL-12 ( 33.2 % ; P = 0.03 ) . Additionally , mean levels of several factors were significantly higher in women meeting PMS criteria compared with women meeting control criteria , including IL-4 ( 92 % higher in cases versus controls ; P = 0.01 ) ; IL-10 ( 87 % ; P = 0.03 ) ; IL-12 ( 170 % ; P = 0.04 ) and IFN-γ ( 158 % ; P = 0.01 ) . LIMITATIONS , REASONS FOR CAUTION Our study has several limitations . While a single blood sample may not perfectly capture long-term levels of inflammation , ample data suggest that levels of cytokines are stable over time . Although we did not base our assessment of PMS on prospect i ve symptom diaries , we used vali date d criteria to define PMS cases and controls , and excluded women with evidence of comorbid mood disorders . Furthermore , because of the cross-sectional design of the study , the temporal relation of inflammatory factors and menstrual symptoms is unclear . WIDER IMPLICATION S OF THE FINDINGS To our knowledge , this is among the first studies to suggest that inflammatory factors may be elevated in women experiencing menstrual symptoms and PMS . Additional studies are needed to determine whether inflammation plays an etiologic role in PMS . STUDY FUNDING /COMPETING INTERESTS This study was funded by the Departments of Public Health and Nutrition and by a Faculty Research Grant , University of Massachusetts Amherst . No conflicts declared . TRIAL REGISTRATION NUMBER Abstract More than 60 % of the women in both groups suffered from premenstrual syndrome ( PMS ) symptoms , such as anxiety , mastalgia , insomnia , nausea and gastrointestinal disorders , whereas a smaller number of women suffered from phobic disorders , premenstrual headaches and migraines . There were three women from the first group and seven women from the second group who continued the medication treatment with progestins , whereas one woman from the first group and nine women from the second group continued to take fluoxetine . In the first group , nine women stopped having PMS symptoms after two AP treatments , eight women stopped having them after three treatments and one woman stopped having them after four treatments . In four women from the first group and 16 women from the second group , PMS symptoms appeared during the following period ( cycle ) or continued even after four treatments , so the medication was continued . In the first group , one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6 . There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group ( P<0.001 ) , whereas their reduction was irrelevant in the placebo AP group ( P>0.05 ) . The success rate of AP in treating PMS symptoms was 77.8 % , whereas it was 5.9 % . in the placebo group . The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions . The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment Background : Premenstrual syndrome ( PMS ) is a series of physical and psychological symptoms before menstruation which its prevalence around the world has been reported to be 80 % . Consumption of vitamin B6 is a common treatment for this syndrome , and this study was conducted to compare the effect of auriculotherapy and vitamin B6 on the symptoms of premenstrual syndrome . Material s and Methods : This study was a clinical trial . Eighty-four female students who lived at the university dorm were r and omly selected and allocated into two groups of 42 . The first group received auriculotherapy ( 10 sessions ) for two menstrual cycles and the second group consumed 40 mg of vitamin B6 daily from a week before their menstruation for two menstrual cycles . The severity of symptoms was recorded for both groups during two cycles before the intervention and two cycles after the intervention . Data gathering tool was a 28- question , question naire to assess the severity of symptoms of premenstrual syndrome based on DSM-IV . Results : The mean score of symptoms in the  auriculotherapy group in the first and second cycles was 26.70 ( 19.49 ) and 24.76 ( 17.07 ) , respectively , and in the vitamin B6 group , was 22.60 ( 10.87 ) and 24.17 ( 14.15 ) , respectively , which showed a significant difference compared to before the intervention ( P = 0.001 ) . However , comparing the total score of symptoms in the first and second cycles after the intervention between both groups showed no significant difference . Conclusions : Auriculotherapy , similar to vitamin B6 , decreases the severity of PMS symptoms Objective The objective of this investigation was to evaluate the effects of acupuncture and sham acupuncture on the symptoms of anxiety and depression  brought on by premenstrual dysphoric disorder ( PMDD ) . Methods In a single-blind r and omised clinical trial , 30 volunteers with PMDD were assigned alternately to group 1 ( acupuncture ) or group 2 ( sham acupuncture ) , and completed an evaluation of symptoms of anxiety and depression using the Hamilton Anxiety ( HAM-A ) and Hamilton Depression ( HAM-D ) Rating Scales . The procedure was performed twice a week for two menstrual cycles , for a total of 16 attendances for each participant . Results Before the intervention the mean HAM-A and HAM-D scores did not differ between groups . Following the intervention symptoms of anxiety and depression were reduced in both groups ; however , the improvement was significant in group 1 compared to group 2 , as shown by a mean reduction in HAM-A scores of 58.9 % in group 1 and 21.2 % in group 2 ( p<0.001 ) . The reduction in the mean HAM-D scores was 52.0 % in group 1 and 19.6 % in group 2 , result ing in a significant difference ( p=0.012 ) . Conclusions The results suggest that acupuncture could be another treatment option for PMDD patients Summary ¶A variety of instruments have been used in an attempt to operationalize DSM-IV criteria for premenstrual dysphoric disorder ( PMDD ) and to underst and clinical ly significant premenstrual syndrome ( PMS ) . The objectives of this research were to devise a simple user friendly screening tool to identify women who suffer from severe PMS/PMDD and who are likely to benefit from treatment . Five hundred and nineteen women , between the ages of 18 and 55 yrs , who were seen at a primary care facility completed “ The  Premenstrual Symptoms Screening tool ” ( PSST )  . The PSST reflects and ‘ translates ’ categorical DSM-IV criteria into a rating scale with degrees of severity . The results are in line with reported prevalence rates from several recent large prospect i ve studies . We believe that the PSST applies a necessary degree of measure of severity and impact of premenstrual symptoms , establishes quickly if women qualify for PMDD , and is less time consuming and more practical than two cycles of prospect i ve charting . This fast simple tool is an effective screening tool and an important starting point for further assessment OBJECTIVE To evaluate the effect of simple acupressure protocol in LIV3 , LI4 and placebo points on the quality of life ( QOL ) in women with premenstrual syndrome ( PMS ) . METHOD This paper reports a r and omized , single blinded clinical trial . 97 participants ( students in of Hormozgan University of Medical Sciences , Iran ) with PMS were allocated to three groups to receive 20min acupressure on different acupoints for 14days before menstruation for three consecutive menstrual cycles ( training and then two cycles self applied acupressure ) . The acupoints were LIV3 and LI4 ; one group received acupressure at a placebo point . Each participant completed the PSST scale ( to determine PMS severity ) , HADS scale ( for depression and anxiety ) , and quality of life SF12 . RESULTS The number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group ( p<0.04 ) . Moreover , depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the place 
    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: Premenstrual syndrome ( PMS ) symptoms can reduce quality of life and impair daily functioning . This study examined the effects of Korean h and acupuncture therapy ( HAT ) and h and moxibustion therapy ( HMT ) on symptom severity in Korean women with PMS . This quasi-experimental pilot study based on the khi , yin , yang , and the five elements theory used a nonequivalent control group pretest — posttest design . Experimental groups received 10 sessions of either HAT or HMT treatment . Outcome measures included menstrual symptom severity as measured with the Menstrual Symptom Severity List and skin temperature change measured with Digital Infrared Thermographic Imaging . Both experimental groups had significantly reduced overall PMS symptom severity scores following therapy as compared to women in the control group .  The HMT but not the HAT group showed improved flow of khi and balanced skin temperature in symmetric body areas . HAT and HMT may be effective strategies for women to reduce PMS symptoms Background : To evaluate the safety of acupuncture in a large number of patients receiving conventional health care and , based on these results , to develop a new medical consent form for acupuncture . Methods : The prospect i ve observational study included patients who received acupuncture treatment for chronic osteoarthritis pain of the knee or hip , low back pain , neck pain or headache , allergic rhinitis , asthma , or dysmenorrhoea . After treatment , all patients documented adverse events associated with acupuncture ( defined as adverse effects ) . Patients who reported a need for treatment due to an adverse effect completed an additional st and ardised question naire on the most important adverse effect . Based on this data and considering ethical and legal aspects a new consent form was developed . Results : A total of 229,230 patients received on average 10.2 ± 3.0 acupuncture treatments . Altogether , 19,726 patients ( 8.6 % ) reported experiencing at least one adverse effect and 4,963 ( 2.2 % ) reported one which required treatment . Common adverse effects were bleedings or haematoma ( 6.1 % of patients , 58 % of all adverse effects ) , pain ( 1.7 % ) and vegetative symptoms ( 0.7 % ) . Two patients experienced a pneumothorax ( one needed hospital treatment , the other observation only ) . The longest duration of a side effect was 180 days ( nerve lesion of the lower limb ) . The result ing medical consent form consists of five modules : Introduction to acupuncture and moxibustion , Risks of acupuncture treatment , Conditions which can increase the risk , Doctor ’s statement , and Consent . Conclusion : Acupuncture provided by physicians is a relatively safe treatment and the proposed consent form could support both patients and professionals in the process of obtaining informed consent STUDY QUESTION Are markers of chronic inflammation associated with menstrual symptom severity and premenstrual syndrome ( PMS ) ? SUMMARY ANSWER Serum levels of inflammatory markers , including interleukin (IL)-2 , IL-4 , IL-10 , IL-12 and interferon (IFN)-γ were positively associated with menstrual symptom severity and /or PMS in young women . WHAT IS KNOWN ALREADY Chronic inflammation has been implicated in the etiology of depression and other disorders that share common features with PMS , but whether inflammation contributes to menstrual symptom severity and PMS is unknown . STUDY DESIGN , SIZE , DURATION Cross-sectional study of 277 women aged 18 - 30 years , conducted in 2006 - 2011 . PARTICIPANTS / MATERIAL S , SETTING , METHODS Participants provided information on menstrual symptoms , lifestyle , diet , anthropometry and other factors by question naire and /or direct measurement , and a mid-luteal phase fasting blood sample was taken between 7 a.m. and 12 p.m. Total , physical and affective menstrual symptom scores were calculated for all participants , of whom 13 % ( n = 37 ) met criteria for moderate-to-severe PMS and 24 % ( n = 67 ) met PMS control criteria . Inflammatory factors assayed in serum included IL-1β , IL-2 , IL-4 , IL-5 , IL-6 , IL-7 , IL-8 , IL-10 , IL-12p70 , IL-13 , tumor necrosis factor-α , granulocyte macrophage colony stimulating factor , IFN-γ and C-reactive protein . MAIN RESULTS AND THE ROLE OF CHANCE After adjustment for age , smoking status and BMI , total menstrual symptom score was positively associated with levels of IL-2 ( percentage difference in women at the 75th percentile of total symptom score versus at the 25th percentile = 24.7 % ; P = 0.04 ) , IL-4 ( 21.5 % ; P = 0.04 ) , IL-10 ( 28.0 % ; P < 0.01 ) and IL-12 ( 42.0 % ; P = 0.02 ) in analyses including all participants . Affective menstrual symptom score was linearly related to levels of IL-2 ( percentage difference at 75th percentile versus 25th percentile = 31.0 % ; P = 0.02 ) , while physical/behavioral symptom score was linearly related to levels of IL-4 ( 19.1 % ; P = 0.03 ) and IL-12 ( 33.2 % ; P = 0.03 ) . Additionally , mean levels of several factors were significantly higher in women meeting PMS criteria compared with women meeting control criteria , including IL-4 ( 92 % higher in cases versus controls ; P = 0.01 ) ; IL-10 ( 87 % ; P = 0.03 ) ; IL-12 ( 170 % ; P = 0.04 ) and IFN-γ ( 158 % ; P = 0.01 ) . LIMITATIONS , REASONS FOR CAUTION Our study has several limitations . While a single blood sample may not perfectly capture long-term levels of inflammation , ample data suggest that levels of cytokines are stable over time . Although we did not base our assessment of PMS on prospect i ve symptom diaries , we used vali date d criteria to define PMS cases and controls , and excluded women with evidence of comorbid mood disorders . Furthermore , because of the cross-sectional design of the study , the temporal relation of inflammatory factors and menstrual symptoms is unclear . WIDER IMPLICATION S OF THE FINDINGS To our knowledge , this is among the first studies to suggest that inflammatory factors may be elevated in women experiencing menstrual symptoms and PMS . Additional studies are needed to determine whether inflammation plays an etiologic role in PMS . STUDY FUNDING /COMPETING INTERESTS This study was funded by the Departments of Public Health and Nutrition and by a Faculty Research Grant , University of Massachusetts Amherst . No conflicts declared . TRIAL REGISTRATION NUMBER Abstract More than 60 % of the women in both groups suffered from premenstrual syndrome ( PMS ) symptoms , such as anxiety , mastalgia , insomnia , nausea and gastrointestinal disorders , whereas a smaller number of women suffered from phobic disorders , premenstrual headaches and migraines . There were three women from the first group and seven women from the second group who continued the medication treatment with progestins , whereas one woman from the first group and nine women from the second group continued to take fluoxetine . In the first group , nine women stopped having PMS symptoms after two AP treatments , eight women stopped having them after three treatments and one woman stopped having them after four treatments . In four women from the first group and 16 women from the second group , PMS symptoms appeared during the following period ( cycle ) or continued even after four treatments , so the medication was continued . In the first group , one woman had a smaller subcutaneous hematoma after the AP acupoint Ren 6 . There was a statistical and relevant reduction in PMS symptoms with the AP treatments in the first group ( P<0.001 ) , whereas their reduction was irrelevant in the placebo AP group ( P>0.05 ) . The success rate of AP in treating PMS symptoms was 77.8 % , whereas it was 5.9 % . in the placebo group . The positive influence of AP in treating PMS symptoms can be ascribed to its effects on the serotoninergic and opioidergic neurotransmission that modulates various psychosomatic functions . The initial positive results of PMS symptoms with a holistic approach are encouraging and AP should be suggested to the patients as a method of treatment Background : Premenstrual syndrome ( PMS ) is a series of physical and psychological symptoms before menstruation which its prevalence around the world has been reported to be 80 % . Consumption of vitamin B6 is a common treatment for this syndrome , and this study was conducted to compare the effect of auriculotherapy and vitamin B6 on the symptoms of premenstrual syndrome . Material s and Methods : This study was a clinical trial . Eighty-four female students who lived at the university dorm were r and omly selected and allocated into two groups of 42 . The first group received auriculotherapy ( 10 sessions ) for two menstrual cycles and the second group consumed 40 mg of vitamin B6 daily from a week before their menstruation for two menstrual cycles . The severity of symptoms was recorded for both groups during two cycles before the intervention and two cycles after the intervention . Data gathering tool was a 28- question , question naire to assess the severity of symptoms of premenstrual syndrome based on DSM-IV . Results : The mean score of symptoms in the  auriculotherapy group in the first and second cycles was 26.70 ( 19.49 ) and 24.76 ( 17.07 ) , respectively , and in the vitamin B6 group , was 22.60 ( 10.87 ) and 24.17 ( 14.15 ) , respectively , which showed a significant difference compared to before the intervention ( P = 0.001 ) . However , comparing the total score of symptoms in the first and second cycles after the intervention between both groups showed no significant difference . Conclusions : Auriculotherapy , similar to vitamin B6 , decreases the severity of PMS symptoms Objective The objective of this investigation was to evaluate the effects of acupuncture and sham acupuncture on the symptoms of anxiety and depression  brought on by premenstrual dysphoric disorder ( PMDD ) . Methods In a single-blind r and omised clinical trial , 30 volunteers with PMDD were assigned alternately to group 1 ( acupuncture ) or group 2 ( sham acupuncture ) , and completed an evaluation of symptoms of anxiety and depression using the Hamilton Anxiety ( HAM-A ) and Hamilton Depression ( HAM-D ) Rating Scales . The procedure was performed twice a week for two menstrual cycles , for a total of 16 attendances for each participant . Results Before the intervention the mean HAM-A and HAM-D scores did not differ between groups . Following the intervention symptoms of anxiety and depression were reduced in both groups ; however , the improvement was significant in group 1 compared to group 2 , as shown by a mean reduction in HAM-A scores of 58.9 % in group 1 and 21.2 % in group 2 ( p<0.001 ) . The reduction in the mean HAM-D scores was 52.0 % in group 1 and 19.6 % in group 2 , result ing in a significant difference ( p=0.012 ) . Conclusions The results suggest that acupuncture could be another treatment option for PMDD patients Summary ¶A variety of instruments have been used in an attempt to operationalize DSM-IV criteria for premenstrual dysphoric disorder ( PMDD ) and to underst and clinical ly significant premenstrual syndrome ( PMS ) . The objectives of this research were to devise a simple user friendly screening tool to identify women who suffer from severe PMS/PMDD and who are likely to benefit from treatment . Five hundred and nineteen women , between the ages of 18 and 55 yrs , who were seen at a primary care facility completed “ The  Premenstrual Symptoms Screening tool ” ( PSST )  . The PSST reflects and ‘ translates ’ categorical DSM-IV criteria into a rating scale with degrees of severity . The results are in line with reported prevalence rates from several recent large prospect i ve studies . We believe that the PSST applies a necessary degree of measure of severity and impact of premenstrual symptoms , establishes quickly if women qualify for PMDD , and is less time consuming and more practical than two cycles of prospect i ve charting . This fast simple tool is an effective screening tool and an important starting point for further assessment OBJECTIVE To evaluate the effect of simple acupressure protocol in LIV3 , LI4 and placebo points on the quality of life ( QOL ) in women with premenstrual syndrome ( PMS ) . METHOD This paper reports a r and omized , single blinded clinical trial . 97 participants ( students in of Hormozgan University of Medical Sciences , Iran ) with PMS were allocated to three groups to receive 20min acupressure on different acupoints for 14days before menstruation for three consecutive menstrual cycles ( training and then two cycles self applied acupressure ) . The acupoints were LIV3 and LI4 ; one group received acupressure at a placebo point . Each participant completed the PSST scale ( to determine PMS severity ) , HADS scale ( for depression and anxiety ) , and quality of life SF12 . RESULTS The number of people with moderate/severe PMS decreased in LIV3 and LI4 acupressure groups by the second and third cycles compared with the placebo group ( p<0.04 ) . Moreover , depression and anxiety scores significantly decreased in the LIV3 and LI4 groups by the second and third cycles compared with the place 
    Output:
    