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: To compare the disposition of  5-aminosalicylic acid ( 5-ASA ) and its acetylated metabolite during treatment with olsalazine and mesalazine , 14 patients with inactive ulcerative colitis were r and omly assigned to olsalazine ( 1 g twice daily ) and the mesalazines , Asacol ( 800 + 400 + 800 mg daily ) , Pentasa ( 750 + 500 + 750 mg daily ) , and Salofalk ( 750 + 500 + 750 mg daily ) in a crossover design trial so that all received each drug for seven days . Intraluminal colonic concentrations of 5-ASA were estimated after five days by the method of equilibrium in vivo dialysis of faeces . A predose serum sample and a 24 hour urine collection were obtained on day seven . The 5-ASA and acetyl-5-aminosalicylic acid ( Ac-5-ASA ) values were determined by high performance liquid chromatography . Olsalazine almost doubled the colonic concentrations ( mean 23.7 ( SEM ) ( 1.9 ) mmol/l ) of its therapeutically active ingredient ( 5-ASA ) compared with equimolar doses of Pentasa ( 12.6 ( 2.2 ) mmol/l ; p less than 0.0003 ) and Salofalk ( 15.0 ( 2.0 ) mmol/l ; p less than 0.003 ) . At the same time , olsalazine treatment was associated with lower serum concentrations and urinary excretions ( p less than 0.05 ) of 5-ASA and Ac-5-ASA compared with the mesalazine preparations . The low systemic load of 5-ASA provided by olsalazine reduces the potential risk of nephrotoxicity during long term treatment We assessed the tolerance and safety of two new preparations design ed to release 5-aminosalicylic acid in the colon in patients with ulcerative colitis who were intolerant of sulphasalazine .  Twenty-eight of 37 patients ( 76 % ) given mesalazine and 18 of 21 patients ( 86 % ) given olsalazine  tolerated the new preparations with no adverse effects . No haematologic or biochemical abnormalities were detected . Adverse reactions to the new preparations were usually but not always similar to those they had previously encountered with sulphasalazine , but a few patients experienced rash and diarrhoea . In some patients intolerant of one of the new preparations , their tolerance of the other was assessed . Three patients intolerant of mesalazine  tolerated olsalazine .  Similarly , three other patients intolerant of olsalazine  tolerated mesalazine .  We conclude that not all adverse effects of sulphasalazine are due to the sulphapyridine part of the molecule . Some are due to the released 5-aminosalicylic acid and some to the parent compound . Both drugs are likely to prove useful in the management of patients intolerant of sulphasalazine Some semen characteristics of eight male patients with clinical ly inactive ulcerative colitis were investigated . Semen analysis was carried out twice during salicylazosulfapyridine ( SASP ) treatment and repeated twice after at least 3 months ' treatment with mesalazine . The motility variables all showed significant improvement during mesalazine treatment : the grade d motility ( p less than 0.05 ) , motility in percentage ( p less than 0.01 ) , and the penetration in egg white ( p less than 0.05 ) . The semen plasma was analyzed for mesalazine and the metabolite Ac-mesalazine during both regimens . There was no difference in the semen plasma concentration of mesalazine during the two regimens , whereas Ac-mesalazine was significantly higher during mesalazine treatment than during SASP treatment , indicating that other SASP metabolites , most likely sulfapyridine , are the agent causing the abnormal sperm characteristics . We suggest that pure mesalazine preparations are a safer alternative in young men with chronic inflammatory bowel disease PURPOSE We conducted a prospect i ve study to determine the effects of nonadherence with mesalamine among patients with quiescent ulcerative colitis . METHODS We followed a cohort of 99 consecutive patients who had ulcerative colitis in remission for more than 6 months and who were taking maintenance mesalamine .  Medication adherence rates were calculated based on pharmacy records and a vali date d formula . Nonadherence was defined as refilling less than 80 % of prescribed medication . Patients were followed prospect ively and evaluated either in clinic or via telephone at 6 , 12 , and 24 months . The primary outcome was clinical recurrence of ulcerative colitis . Proportional hazards models were used to adjust for confounders . RESULTS At 6 months , 12 patients ( 12 % ) had clinical recurrence of disease symptoms , all of whom were nonadherent with medication . At 12 months , 19 of 86 patients had recurrent disease , 13 ( 68 % ) of whom were nonadherent . Patients who were not adherent with medication had more than a fivefold greater risk of recurrence than adherent patients ( hazard ratio = 5.5 ; 95 % confidence interval : 2.3 to 13 ; P < 0.001 ) . CONCLUSION Nonadherence with medication increases the risk of clinical relapse among patients with quiescent ulcerative colitis . Future research should be directed at behavioral interventions to improve adherence Sulfasalazine appears to exert its beneficial effect in colitis by releasing 5-aminosalicylic acid in the colon , but its use can be limited by side effects . Ipsalazide and balsalazide are novel sulfasalazine analogs design ed to release 5-aminosalicylic acid and a nontoxic carrier molecule in the gastrointestinal tract . They have a low oral toxicity following single or repeat administration to mouse , rat , and ferret , and balsalazide is not mutagenic in the Ames test . Ipsalazide and balsalazide are split in rat and man , and the urinary and fecal excretion pattern of the 5-aminosalicylic acid released is similar to that of sulfasalazine ; the carrier molecules are absorbed to a lesser extent than the sulfapyridine derived from sulfasalazine . These two analogs deserve therapeutic trial To determine the influence of inflammation and topical treatment with 5-aminosalicylic acid or prednisolone on arachidonic acid metabolism in vivo , we carried out a double-blind controlled study on the release of prostagl and in E2 and leukotriene B4 to the rectal lumen in 24 consecutive patients with proven distally located ulcerative colitis . Before and at days 15 and 29 a dialysis bag was placed in the emptied rectum for 4 h prior to assessing clinical , endoscopic , and histologic disease activity . A single enema was given daily at bedtime ( 1 g 5-aminosalicylic acid or 25 mg prednisolone ) until complete remission or for a maximum of 4 wk . Clinical and endoscopic remission was obtained in 16 ( 7 on 5-aminosalicylic acid ) and 11 ( 3 on 5-aminosalicylic acid ) patients , respectively . Luminal concentrations of prostagl and in E2 and leukotriene B4 were positively correlated to disease activity and significantly decreased among the prednisolone-treated patients . In both treatment groups a decrease toward normal levels occurred in patients responding to therapy . In retrospect , the pretreatment prostagl and in E2 and leukotriene B4 levels were significantly higher in patients not responding to therapy than in those improving during treatment . In conclusion , luminal prostagl and in E2 and leukotriene B4 levels may prove more useful predictors of the outcome of treatment in relapsing ulcerative colitis than clinical indices of disease activity Sulphasalazine ( S.A.S.P. ) is of proven value in the treatment of ulcerative colitis , but its mode of action is unknown . When it is taken by mouth , nearly all the dose reaches the colon intact , where it is split by bacteria into sulphapyridine ( S.P. ) and 5-aminosalicylic acid ( 5-A.S.A. ) . An experiment was devised to determine whether the therapeutic property of S.A.S.P. is a function of the parent molecule or of these two principal metabolites . Retention enemas of S.A.S.P. , S.P. , and 5-A.S.A. were administered to volunteer patients with sigmoidoscopic evidence of active ulcerative colitis . The experiment was conducted as a blind controlled therapeutic trial , each patient having one of the test enemas daily for two weeks . Pronounced histological improvement was observed in approximately 30 % of the patients receiving S.A.S.P. or 5-A.S.A. , and in only 5 % of those receiving S.P. It is concluded that the active therapeutic moiety of S.A.S.P. IS 5-A.S.A. and that the S.P. functions as a carrier ensuring that the 5-A.S.A. is liberated within the colon Aminosalicylates are used as st and ard treatment for maintaining remission in ulcerative colitis . As yet , there is no other existing alternative with proven efficacy . In light of the hypothesis that the intestinal environment may contribute to the pathophysiology of ulcerative colitis , a trial was conducted to test the effects of probiotic treatment with an oral preparation of non‐pathogenic E. coli 
    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: To compare the disposition of  5-aminosalicylic acid ( 5-ASA ) and its acetylated metabolite during treatment with olsalazine and mesalazine , 14 patients with inactive ulcerative colitis were r and omly assigned to olsalazine ( 1 g twice daily ) and the mesalazines , Asacol ( 800 + 400 + 800 mg daily ) , Pentasa ( 750 + 500 + 750 mg daily ) , and Salofalk ( 750 + 500 + 750 mg daily ) in a crossover design trial so that all received each drug for seven days . Intraluminal colonic concentrations of 5-ASA were estimated after five days by the method of equilibrium in vivo dialysis of faeces . A predose serum sample and a 24 hour urine collection were obtained on day seven . The 5-ASA and acetyl-5-aminosalicylic acid ( Ac-5-ASA ) values were determined by high performance liquid chromatography . Olsalazine almost doubled the colonic concentrations ( mean 23.7 ( SEM ) ( 1.9 ) mmol/l ) of its therapeutically active ingredient ( 5-ASA ) compared with equimolar doses of Pentasa ( 12.6 ( 2.2 ) mmol/l ; p less than 0.0003 ) and Salofalk ( 15.0 ( 2.0 ) mmol/l ; p less than 0.003 ) . At the same time , olsalazine treatment was associated with lower serum concentrations and urinary excretions ( p less than 0.05 ) of 5-ASA and Ac-5-ASA compared with the mesalazine preparations . The low systemic load of 5-ASA provided by olsalazine reduces the potential risk of nephrotoxicity during long term treatment We assessed the tolerance and safety of two new preparations design ed to release 5-aminosalicylic acid in the colon in patients with ulcerative colitis who were intolerant of sulphasalazine .  Twenty-eight of 37 patients ( 76 % ) given mesalazine and 18 of 21 patients ( 86 % ) given olsalazine  tolerated the new preparations with no adverse effects . No haematologic or biochemical abnormalities were detected . Adverse reactions to the new preparations were usually but not always similar to those they had previously encountered with sulphasalazine , but a few patients experienced rash and diarrhoea . In some patients intolerant of one of the new preparations , their tolerance of the other was assessed . Three patients intolerant of mesalazine  tolerated olsalazine .  Similarly , three other patients intolerant of olsalazine  tolerated mesalazine .  We conclude that not all adverse effects of sulphasalazine are due to the sulphapyridine part of the molecule . Some are due to the released 5-aminosalicylic acid and some to the parent compound . Both drugs are likely to prove useful in the management of patients intolerant of sulphasalazine Some semen characteristics of eight male patients with clinical ly inactive ulcerative colitis were investigated . Semen analysis was carried out twice during salicylazosulfapyridine ( SASP ) treatment and repeated twice after at least 3 months ' treatment with mesalazine . The motility variables all showed significant improvement during mesalazine treatment : the grade d motility ( p less than 0.05 ) , motility in percentage ( p less than 0.01 ) , and the penetration in egg white ( p less than 0.05 ) . The semen plasma was analyzed for mesalazine and the metabolite Ac-mesalazine during both regimens . There was no difference in the semen plasma concentration of mesalazine during the two regimens , whereas Ac-mesalazine was significantly higher during mesalazine treatment than during SASP treatment , indicating that other SASP metabolites , most likely sulfapyridine , are the agent causing the abnormal sperm characteristics . We suggest that pure mesalazine preparations are a safer alternative in young men with chronic inflammatory bowel disease PURPOSE We conducted a prospect i ve study to determine the effects of nonadherence with mesalamine among patients with quiescent ulcerative colitis . METHODS We followed a cohort of 99 consecutive patients who had ulcerative colitis in remission for more than 6 months and who were taking maintenance mesalamine .  Medication adherence rates were calculated based on pharmacy records and a vali date d formula . Nonadherence was defined as refilling less than 80 % of prescribed medication . Patients were followed prospect ively and evaluated either in clinic or via telephone at 6 , 12 , and 24 months . The primary outcome was clinical recurrence of ulcerative colitis . Proportional hazards models were used to adjust for confounders . RESULTS At 6 months , 12 patients ( 12 % ) had clinical recurrence of disease symptoms , all of whom were nonadherent with medication . At 12 months , 19 of 86 patients had recurrent disease , 13 ( 68 % ) of whom were nonadherent . Patients who were not adherent with medication had more than a fivefold greater risk of recurrence than adherent patients ( hazard ratio = 5.5 ; 95 % confidence interval : 2.3 to 13 ; P < 0.001 ) . CONCLUSION Nonadherence with medication increases the risk of clinical relapse among patients with quiescent ulcerative colitis . Future research should be directed at behavioral interventions to improve adherence Sulfasalazine appears to exert its beneficial effect in colitis by releasing 5-aminosalicylic acid in the colon , but its use can be limited by side effects . Ipsalazide and balsalazide are novel sulfasalazine analogs design ed to release 5-aminosalicylic acid and a nontoxic carrier molecule in the gastrointestinal tract . They have a low oral toxicity following single or repeat administration to mouse , rat , and ferret , and balsalazide is not mutagenic in the Ames test . Ipsalazide and balsalazide are split in rat and man , and the urinary and fecal excretion pattern of the 5-aminosalicylic acid released is similar to that of sulfasalazine ; the carrier molecules are absorbed to a lesser extent than the sulfapyridine derived from sulfasalazine . These two analogs deserve therapeutic trial To determine the influence of inflammation and topical treatment with 5-aminosalicylic acid or prednisolone on arachidonic acid metabolism in vivo , we carried out a double-blind controlled study on the release of prostagl and in E2 and leukotriene B4 to the rectal lumen in 24 consecutive patients with proven distally located ulcerative colitis . Before and at days 15 and 29 a dialysis bag was placed in the emptied rectum for 4 h prior to assessing clinical , endoscopic , and histologic disease activity . A single enema was given daily at bedtime ( 1 g 5-aminosalicylic acid or 25 mg prednisolone ) until complete remission or for a maximum of 4 wk . Clinical and endoscopic remission was obtained in 16 ( 7 on 5-aminosalicylic acid ) and 11 ( 3 on 5-aminosalicylic acid ) patients , respectively . Luminal concentrations of prostagl and in E2 and leukotriene B4 were positively correlated to disease activity and significantly decreased among the prednisolone-treated patients . In both treatment groups a decrease toward normal levels occurred in patients responding to therapy . In retrospect , the pretreatment prostagl and in E2 and leukotriene B4 levels were significantly higher in patients not responding to therapy than in those improving during treatment . In conclusion , luminal prostagl and in E2 and leukotriene B4 levels may prove more useful predictors of the outcome of treatment in relapsing ulcerative colitis than clinical indices of disease activity Sulphasalazine ( S.A.S.P. ) is of proven value in the treatment of ulcerative colitis , but its mode of action is unknown . When it is taken by mouth , nearly all the dose reaches the colon intact , where it is split by bacteria into sulphapyridine ( S.P. ) and 5-aminosalicylic acid ( 5-A.S.A. ) . An experiment was devised to determine whether the therapeutic property of S.A.S.P. is a function of the parent molecule or of these two principal metabolites . Retention enemas of S.A.S.P. , S.P. , and 5-A.S.A. were administered to volunteer patients with sigmoidoscopic evidence of active ulcerative colitis . The experiment was conducted as a blind controlled therapeutic trial , each patient having one of the test enemas daily for two weeks . Pronounced histological improvement was observed in approximately 30 % of the patients receiving S.A.S.P. or 5-A.S.A. , and in only 5 % of those receiving S.P. It is concluded that the active therapeutic moiety of S.A.S.P. IS 5-A.S.A. and that the S.P. functions as a carrier ensuring that the 5-A.S.A. is liberated within the colon Aminosalicylates are used as st and ard treatment for maintaining remission in ulcerative colitis . As yet , there is no other existing alternative with proven efficacy . In light of the hypothesis that the intestinal environment may contribute to the pathophysiology of ulcerative colitis , a trial was conducted to test the effects of probiotic treatment with an oral preparation of non‐pathogenic E. coli 
    Output:
    