human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The antiemctic efficacy of ondansetron and dexamethasone ( Ondex ) was r and omly compared to that of high-dose metoclopramide , dexamethasone , and orphcnadrine ( Control ) in the prevention of emesis induced by cyclophosphamide-doxoruhicin chemotherapy in 64 chemotherapy-naive breast cancer patients . For the control of acute emesis ( day 1 ) , patients were r and omized to receive either ondasetron 8 mg p.o . 1 hour prior to chemotherapy ( CT ) and repeated after 6 and 12 hours plus dexamethasone 20 mg i.v . 40 minutes prior to CT ( Ondex ) or dexamethasone 20 mg i.v . 40 minutes prior to CT , orphenadrine 40 mg i.m . 35 minutes prior to CT and metoclopramide 3 mg/kg i.v . 30 minutes prior to CT and repeated after 90 minutes followed by 40 mg p.o . every 3 hours for 4 times ( Control ) . To control delayed emesis , patients on Ondex received ondansetron 8 mg PO t.i.d . days 2 and 3 and patients in the Control arm received metoclopramide 0.5 mg/kg p.o . q.i.d . and dexamethasone 8 mg i.m . b.i.d . days 2 and 3 . Complete and major control of acute emesis was observed in 74%/94 % and 44%/67 % of patients treated with Ondex and Control , respectively ( p < .01/p < .005 ) . Acute nausea was absent in 38 % and 34 % of patients treated with Ondex and Control , respectively ( p = NS ) . Complete and major control of delayed emesis ( days 2–5 ) was observed in 65%/91 % versus 44%/66 % of patients in the Ondex and Control arms , respectively ( p = NS/p < .01 ) . In patients receiving 6 courses of FEC/FAC , control of acute emesis was significantly superior with Ondex at all treatment courses PURPOSE The purpose is to investigate an additional antiemetic effect to ondansetron with needle acupuncture at P6 compared with nonskin-penetrating placebo acupuncture in patients undergoing high-dose chemotherapy and autologous peripheral blood stem cell transplantation . EXPERIMENTAL DESIGN Eighty patients who were admitted to hospital for high-dose chemotherapy and autologous peripheral blood stem cell transplantation were included into a r and omized placebo-controlled single-blind trial . The patients were r and omized to receive acupuncture ( n = 41 ) or noninvasive placebo acupuncture ( n = 39 ) at the acupuncture point P6 30 min before first application of high-dose chemotherapy and the day after . All patients received 8 mg ondansetron/day i.v . as basic antiemetic prophylaxis . The main outcome measure was the rate of patients who either had at least one episode of vomiting or required any additional antiemetic drugs on the first 2 days of chemotherapy . RESULTS The main outcome measure showed no significant difference ( P = 0.82 ) : 61 % failure in the acupuncture group and 64 % in the placebo acupuncture group ( 95 % confidence interval of 3 % difference : -18.1 and 24.3 % ) . Comparing nausea , episodes of vomiting or retching and number of additionally required antiemetic drugs did not provide any discrepancy with the main result . CONCLUSIONS This study suggests that in combination with ondansetron i.v . , invasive needle acupuncture at P6 compared with nonskin-penetrating placebo acupuncture has no additional effect for the prevention of acute nausea and vomiting in high-dose chemotherapy This study assessed the effects of acupressure wrist b and s on the nausea and vomiting  ofterminally ill patients . Using a single subject experimental design , six hospice patients were exposed to three conditions : • An acupressure wrist b and ; • A placebo wrist b and ; • A no wrist b and condition . Patients and their caregivers rated nausea and vomiting during the treatment . Despitesome difficultyobtaining complete data , the results of this preliminary test indicate that acupressure wrist b and swere not effective in reducing nausea and vomiting in this small sample of hospice patients BACKGROUND To evaluate the efficacy of a miniaturized portable transcutaneous electrical nerve stimulation ( TENS ) unit ( ReliefB and ) as an adjunct to st and ard antiemetic therapy for controlling nausea and vomiting induced by cisplatin-based chemotherapy in gynecologic oncology patients . METHODS Forty-two patients were enrolled in a r and omized , double-blind , placebo-controlled parallel-subjects trial with a follow-up crossover trial . All patients received a st and ardized antiemetic protocol , then wore the ReliefB and continuously for 7 days . RESULTS Thirty-two patients were evaluable for the parallel-subjects component , 16 in each group . The percentage of patients with absent or minimal nausea was 59 % overall , which was similar to that for both the active ( 56 % ) and placebo ( 62 % ) groups . The incidence and severity of nausea and vomiting was similar for each group . Eighteen patients completed two consecutive cycles and were evaluable for the crossover component . The average age of the crossover patients and their dose intensity were comparable with those of the overall study population ( 56.3 versus 58.6 years and 22.7 versus 22.7 mg/m2/week , respectively ) . The percentage of cycles with absent or minimal nausea was 47 % overall , which was similar to that of the active ( 50 % ) and placebo ( 44 % ) cycles . However , the severity of nausea was significantly lower in the active cycles during days 2 to 4 . Patients averaged less than one episode of vomiting daily in each cycle . CONCLUSIONS The ReliefB and is an effective adjunct to st and ard antiemetic agents for controlling nausea induced by cisplatin-based chemotherapy in gynecologic oncology patients CONTEXT High-dose chemotherapy poses considerable challenges to emesis management . Although prior studies suggest that acupuncture may reduce nausea and emesis , it is unclear whether such benefit comes from the nonspecific effects of attention and clinician-patient interaction . OBJECTIVE To compare the effectiveness of electroacupuncture vs minimal needling and mock electrical stimulation or antiemetic medications alone in controlling emesis among patients undergoing a highly emetogenic chemotherapy regimen . DESIGN Three-arm , parallel-group , r and omized controlled trial conducted from March 1996 to December 1997 , with a 5-day study period and a 9-day follow-up . SETTING Oncology center at a university medical center . PATIENTS One hundred four women ( mean age , 46 years ) with high-risk breast cancer . INTERVENTIONS Patients were r and omly assigned to receive low-frequency electroacupuncture at classic antiemetic acupuncture points once daily for 5 days ( n = 37 ) ; minimal needling at control points with mock electrostimulation on the same schedule ( n = 33 ) ; or no adjunct needling ( n = 34 ) . All patients received concurrent triple antiemetic pharmacotherapy and high-dose chemotherapy ( cyclophosphamide , cisplatin , and carmustine ) . MAIN OUTCOME MEASURES Total number of emesis episodes occurring during the 5-day study period and the proportion of emesis-free days , compared among the 3 groups . RESULTS The number of emesis episodes occurring during the 5 days was lower for patients receiving electroacupuncture compared with those receiving minimal needling or pharmacotherapy alone ( median number of episodes , 5 , 10 , and 15 , respectively ; P<.001 ) . The electroacupuncture group had fewer episodes of emesis than the minimal needling group ( P<.001 ) , whereas the minimal needling group had fewer episodes of emesis than the antiemetic pharmacotherapy alone group ( P = .01 ) . The differences among groups were not significant during the 9-day follow-up period ( P = .18 ) . CONCLUSIONS In this study of patients with breast cancer receiving high-dose chemotherapy , adjunct electroacupuncture was more effective in controlling emesis than minimal needling or antiemetic pharmacotherapy alone , although the observed effect had limited duration . JAMA . 2000;284:2755 - 2761 Objective : To evaluate the effectiveness of acupressure in reducing nausea and vomiting of pregnancy .  Methods : Symptomatic pregnant women were r and omized to one of two acupressure groups : one treatment group using an acupressure point ( PC-6 ) and one sham control group using a placebo point . Subjects were blind to the group assignment . Each evening for 10 consecutive days , the subjects completed an assessment scale describing the severity and frequency of symptoms that occurred . Data from the first 3 days were used as pre-treatment scores . Beginning on the morning of the fourth day , each subject used acupressure at her assigned point for 10 minutes four times a day . Data from day 4 were discarded to allow 24 hours for the treatment to take effect . Data from days 5 - 7 were used to measure treatment effect . Results : Sixty women completed the study . There were no differences between groups in attrition  ,  parity , fetal number , maternal age , gestational age at entry , or pre-treatment nausea and emesis scores . Analysis of variance indicated that both groups improved significantly over time , but that nausea improved significantly more in the treatment group than in the sham control group ( F1,58=10.4 , P = .0021 ) . There were no differences in the severity or frequency of emesis between the groups . There was a significant positive correlation ( r=0.261 , P = .044 ) between maternal age and severity of nausea . Conclusion : Our results indicate that acupressure at the PC-6 anatomical site is effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women This experiment examined the efficacy of an acustimulation wrist b and for the relief of chemotherapy-induced nausea using a r and omized three-arm clinical trial ( active acustimulation , sham acustimulation , and no acustimulation ) in 96 women with breast cancer who experienced nausea at their first chemotherapy treatment .  Five outcomes related to  wrist b and efficacy ( acute nausea , delayed nausea , vomiting , QOL , and total amount of antiemetic medication used ) were examined . The five outcomes were examined separately using analysis of covariance controlling for age and severity of past nausea . There were no significant differences in any of these study measures among the three treatment conditions ( P>0.1 for all ) . Study results do not support the hypothesis that acustimulation b and s are efficacious as an adjunct to pharmacological antiemetics for control of chemotherapy-related nausea in female breast cancer patients Goals Our goal was to evaluate the efficacy and tolerability of the Reliefb and as an adjunct to st and ard antiemetics in patients receiving moderately-high to highly emetogenic chemotherapy . Patients and methods Forty-nine adult cancer patients receiving moderately-high or highly emetogenic chemotherapy were r and omized to receive either the active Reliefb and ( n=26 ) or an inactive device ( n=23 ) . Patients continued to receive all scheduled and as needed antiemetic agents as prescribed . The device was worn the day of chemotherapy administration for 5 days ( days 1–5 ) . Patients maintained a daily dairy of nausea severity , vomiting and retching episodes , and antiemetic medications taken . Each patient completed a Functional Living Index Emesis ( FLIE ) and a tolerability survey at the conclusion of the study . A Wilcoxon rank sum test was used to compare the number of vomiting episodes , severity of nausea and FLIE scores between the two groups . Main results Patients wearing the active Relifb and experienced less vomiting ( Reliefb and 1.9 versus inactive device 4.6 mean episodes ; p=0.05 ) , retching ( 1.4 versus 3.6 mean episodes ; p=0.05 ) , and nausea severity ( 0.91 versus 1.65 mean cm/day ; p=0.01 ) over the 5-day period compared to patients wearing the inactive device . Vomiting was statistically significantly reduced during the delayed period ( 0.42 versus 1 ; p=0.032 ) , whereas nausea was significantly reduced during the acute ( 0.71 versus 2.3 ; p=0.028 ) and delayed ( 1.8 versus 3.3 ; p=0.020 ) periods . FLIE scores did not differ between the two treatment groups ( 91 versus 80 ; p=0.088 ) . Conclusions This study suggests that patients receiving moderately-high to highly emetogenic chemotherapy who experience nausea and vomiting despite scheduled antiemetics may benefit from the use of the Reliefb and as an adjunct to antiemetics . Limitations of this study include differences in risk factors for emesis , chemotherapy , and antiemetic regimens . A larger , better , controlled r and omized study is needed to better define optimal use of this device CONTEXT Substantial evidence suggests that acupuncture-point stimulation may be effective in controlling side effects of chemotherapy . OBJECTIVE To examine the efficacy of an acustimulation wristb and for the relief of chemotherapy-induced nausea . DESIGN R and omized clinical trial using a 3-level crossover design . SETTING Three outpatient on 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The antiemctic efficacy of ondansetron and dexamethasone ( Ondex ) was r and omly compared to that of high-dose metoclopramide , dexamethasone , and orphcnadrine ( Control ) in the prevention of emesis induced by cyclophosphamide-doxoruhicin chemotherapy in 64 chemotherapy-naive breast cancer patients . For the control of acute emesis ( day 1 ) , patients were r and omized to receive either ondasetron 8 mg p.o . 1 hour prior to chemotherapy ( CT ) and repeated after 6 and 12 hours plus dexamethasone 20 mg i.v . 40 minutes prior to CT ( Ondex ) or dexamethasone 20 mg i.v . 40 minutes prior to CT , orphenadrine 40 mg i.m . 35 minutes prior to CT and metoclopramide 3 mg/kg i.v . 30 minutes prior to CT and repeated after 90 minutes followed by 40 mg p.o . every 3 hours for 4 times ( Control ) . To control delayed emesis , patients on Ondex received ondansetron 8 mg PO t.i.d . days 2 and 3 and patients in the Control arm received metoclopramide 0.5 mg/kg p.o . q.i.d . and dexamethasone 8 mg i.m . b.i.d . days 2 and 3 . Complete and major control of acute emesis was observed in 74%/94 % and 44%/67 % of patients treated with Ondex and Control , respectively ( p < .01/p < .005 ) . Acute nausea was absent in 38 % and 34 % of patients treated with Ondex and Control , respectively ( p = NS ) . Complete and major control of delayed emesis ( days 2–5 ) was observed in 65%/91 % versus 44%/66 % of patients in the Ondex and Control arms , respectively ( p = NS/p < .01 ) . In patients receiving 6 courses of FEC/FAC , control of acute emesis was significantly superior with Ondex at all treatment courses PURPOSE The purpose is to investigate an additional antiemetic effect to ondansetron with needle acupuncture at P6 compared with nonskin-penetrating placebo acupuncture in patients undergoing high-dose chemotherapy and autologous peripheral blood stem cell transplantation . EXPERIMENTAL DESIGN Eighty patients who were admitted to hospital for high-dose chemotherapy and autologous peripheral blood stem cell transplantation were included into a r and omized placebo-controlled single-blind trial . The patients were r and omized to receive acupuncture ( n = 41 ) or noninvasive placebo acupuncture ( n = 39 ) at the acupuncture point P6 30 min before first application of high-dose chemotherapy and the day after . All patients received 8 mg ondansetron/day i.v . as basic antiemetic prophylaxis . The main outcome measure was the rate of patients who either had at least one episode of vomiting or required any additional antiemetic drugs on the first 2 days of chemotherapy . RESULTS The main outcome measure showed no significant difference ( P = 0.82 ) : 61 % failure in the acupuncture group and 64 % in the placebo acupuncture group ( 95 % confidence interval of 3 % difference : -18.1 and 24.3 % ) . Comparing nausea , episodes of vomiting or retching and number of additionally required antiemetic drugs did not provide any discrepancy with the main result . CONCLUSIONS This study suggests that in combination with ondansetron i.v . , invasive needle acupuncture at P6 compared with nonskin-penetrating placebo acupuncture has no additional effect for the prevention of acute nausea and vomiting in high-dose chemotherapy This study assessed the effects of acupressure wrist b and s on the nausea and vomiting  ofterminally ill patients . Using a single subject experimental design , six hospice patients were exposed to three conditions : • An acupressure wrist b and ; • A placebo wrist b and ; • A no wrist b and condition . Patients and their caregivers rated nausea and vomiting during the treatment . Despitesome difficultyobtaining complete data , the results of this preliminary test indicate that acupressure wrist b and swere not effective in reducing nausea and vomiting in this small sample of hospice patients BACKGROUND To evaluate the efficacy of a miniaturized portable transcutaneous electrical nerve stimulation ( TENS ) unit ( ReliefB and ) as an adjunct to st and ard antiemetic therapy for controlling nausea and vomiting induced by cisplatin-based chemotherapy in gynecologic oncology patients . METHODS Forty-two patients were enrolled in a r and omized , double-blind , placebo-controlled parallel-subjects trial with a follow-up crossover trial . All patients received a st and ardized antiemetic protocol , then wore the ReliefB and continuously for 7 days . RESULTS Thirty-two patients were evaluable for the parallel-subjects component , 16 in each group . The percentage of patients with absent or minimal nausea was 59 % overall , which was similar to that for both the active ( 56 % ) and placebo ( 62 % ) groups . The incidence and severity of nausea and vomiting was similar for each group . Eighteen patients completed two consecutive cycles and were evaluable for the crossover component . The average age of the crossover patients and their dose intensity were comparable with those of the overall study population ( 56.3 versus 58.6 years and 22.7 versus 22.7 mg/m2/week , respectively ) . The percentage of cycles with absent or minimal nausea was 47 % overall , which was similar to that of the active ( 50 % ) and placebo ( 44 % ) cycles . However , the severity of nausea was significantly lower in the active cycles during days 2 to 4 . Patients averaged less than one episode of vomiting daily in each cycle . CONCLUSIONS The ReliefB and is an effective adjunct to st and ard antiemetic agents for controlling nausea induced by cisplatin-based chemotherapy in gynecologic oncology patients CONTEXT High-dose chemotherapy poses considerable challenges to emesis management . Although prior studies suggest that acupuncture may reduce nausea and emesis , it is unclear whether such benefit comes from the nonspecific effects of attention and clinician-patient interaction . OBJECTIVE To compare the effectiveness of electroacupuncture vs minimal needling and mock electrical stimulation or antiemetic medications alone in controlling emesis among patients undergoing a highly emetogenic chemotherapy regimen . DESIGN Three-arm , parallel-group , r and omized controlled trial conducted from March 1996 to December 1997 , with a 5-day study period and a 9-day follow-up . SETTING Oncology center at a university medical center . PATIENTS One hundred four women ( mean age , 46 years ) with high-risk breast cancer . INTERVENTIONS Patients were r and omly assigned to receive low-frequency electroacupuncture at classic antiemetic acupuncture points once daily for 5 days ( n = 37 ) ; minimal needling at control points with mock electrostimulation on the same schedule ( n = 33 ) ; or no adjunct needling ( n = 34 ) . All patients received concurrent triple antiemetic pharmacotherapy and high-dose chemotherapy ( cyclophosphamide , cisplatin , and carmustine ) . MAIN OUTCOME MEASURES Total number of emesis episodes occurring during the 5-day study period and the proportion of emesis-free days , compared among the 3 groups . RESULTS The number of emesis episodes occurring during the 5 days was lower for patients receiving electroacupuncture compared with those receiving minimal needling or pharmacotherapy alone ( median number of episodes , 5 , 10 , and 15 , respectively ; P<.001 ) . The electroacupuncture group had fewer episodes of emesis than the minimal needling group ( P<.001 ) , whereas the minimal needling group had fewer episodes of emesis than the antiemetic pharmacotherapy alone group ( P = .01 ) . The differences among groups were not significant during the 9-day follow-up period ( P = .18 ) . CONCLUSIONS In this study of patients with breast cancer receiving high-dose chemotherapy , adjunct electroacupuncture was more effective in controlling emesis than minimal needling or antiemetic pharmacotherapy alone , although the observed effect had limited duration . JAMA . 2000;284:2755 - 2761 Objective : To evaluate the effectiveness of acupressure in reducing nausea and vomiting of pregnancy .  Methods : Symptomatic pregnant women were r and omized to one of two acupressure groups : one treatment group using an acupressure point ( PC-6 ) and one sham control group using a placebo point . Subjects were blind to the group assignment . Each evening for 10 consecutive days , the subjects completed an assessment scale describing the severity and frequency of symptoms that occurred . Data from the first 3 days were used as pre-treatment scores . Beginning on the morning of the fourth day , each subject used acupressure at her assigned point for 10 minutes four times a day . Data from day 4 were discarded to allow 24 hours for the treatment to take effect . Data from days 5 - 7 were used to measure treatment effect . Results : Sixty women completed the study . There were no differences between groups in attrition  ,  parity , fetal number , maternal age , gestational age at entry , or pre-treatment nausea and emesis scores . Analysis of variance indicated that both groups improved significantly over time , but that nausea improved significantly more in the treatment group than in the sham control group ( F1,58=10.4 , P = .0021 ) . There were no differences in the severity or frequency of emesis between the groups . There was a significant positive correlation ( r=0.261 , P = .044 ) between maternal age and severity of nausea . Conclusion : Our results indicate that acupressure at the PC-6 anatomical site is effective in reducing symptoms of nausea but not frequency of vomiting in pregnant women This experiment examined the efficacy of an acustimulation wrist b and for the relief of chemotherapy-induced nausea using a r and omized three-arm clinical trial ( active acustimulation , sham acustimulation , and no acustimulation ) in 96 women with breast cancer who experienced nausea at their first chemotherapy treatment .  Five outcomes related to  wrist b and efficacy ( acute nausea , delayed nausea , vomiting , QOL , and total amount of antiemetic medication used ) were examined . The five outcomes were examined separately using analysis of covariance controlling for age and severity of past nausea . There were no significant differences in any of these study measures among the three treatment conditions ( P>0.1 for all ) . Study results do not support the hypothesis that acustimulation b and s are efficacious as an adjunct to pharmacological antiemetics for control of chemotherapy-related nausea in female breast cancer patients Goals Our goal was to evaluate the efficacy and tolerability of the Reliefb and as an adjunct to st and ard antiemetics in patients receiving moderately-high to highly emetogenic chemotherapy . Patients and methods Forty-nine adult cancer patients receiving moderately-high or highly emetogenic chemotherapy were r and omized to receive either the active Reliefb and ( n=26 ) or an inactive device ( n=23 ) . Patients continued to receive all scheduled and as needed antiemetic agents as prescribed . The device was worn the day of chemotherapy administration for 5 days ( days 1–5 ) . Patients maintained a daily dairy of nausea severity , vomiting and retching episodes , and antiemetic medications taken . Each patient completed a Functional Living Index Emesis ( FLIE ) and a tolerability survey at the conclusion of the study . A Wilcoxon rank sum test was used to compare the number of vomiting episodes , severity of nausea and FLIE scores between the two groups . Main results Patients wearing the active Relifb and experienced less vomiting ( Reliefb and 1.9 versus inactive device 4.6 mean episodes ; p=0.05 ) , retching ( 1.4 versus 3.6 mean episodes ; p=0.05 ) , and nausea severity ( 0.91 versus 1.65 mean cm/day ; p=0.01 ) over the 5-day period compared to patients wearing the inactive device . Vomiting was statistically significantly reduced during the delayed period ( 0.42 versus 1 ; p=0.032 ) , whereas nausea was significantly reduced during the acute ( 0.71 versus 2.3 ; p=0.028 ) and delayed ( 1.8 versus 3.3 ; p=0.020 ) periods . FLIE scores did not differ between the two treatment groups ( 91 versus 80 ; p=0.088 ) . Conclusions This study suggests that patients receiving moderately-high to highly emetogenic chemotherapy who experience nausea and vomiting despite scheduled antiemetics may benefit from the use of the Reliefb and as an adjunct to antiemetics . Limitations of this study include differences in risk factors for emesis , chemotherapy , and antiemetic regimens . A larger , better , controlled r and omized study is needed to better define optimal use of this device CONTEXT Substantial evidence suggests that acupuncture-point stimulation may be effective in controlling side effects of chemotherapy . OBJECTIVE To examine the efficacy of an acustimulation wristb and for the relief of chemotherapy-induced nausea . DESIGN R and omized clinical trial using a 3-level crossover design . SETTING Three outpatient on 
    Output:
    