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 Colic causes crying in 10–30 % of infants and is one of the primary reasons parents seek health care . Treatments are generally not totally effective and some cause side effects . In this study we aim ed to test the effect of light needling ( minimal acupuncture ) on crying . Methods Forty children ( median six weeks of age ) with excessive crying unresponsive to conventional therapies , were recruited from 21 Child Welfare Clinics within an area of western Sweden , and quasi-r and omised to control or light needling treatment . Parents were unaware of which group their child was assigned to . Children were given light needling acupuncture on one point ( LI4 ) on both h and s for approximately 20 seconds on four occasions , or received the same care except needling .  Parental assessment question naires were used pre- and post-treatment to assess crying intensity , frequency , duration of crying and pain related behaviour throughout the day in six hour periods . Results Light needling result ed in a significant reduction in the rated crying intensity ( assessed by a numeric rating scale , 0 to 10 ) . For example , during the morning time period 0600–1200 hours , the median ( range ) rated crying intensity changed from 6 ( 1 to 9 ) pre-treatment to 2 ( 0 to 5 ) post-treatment ( P=0.002 ) , in the light needling group . The corresponding ratings for the children in the control group was 6 ( 0 to 10 ) and 5 ( 0 to 10 ) respectively . The difference between the groups was significant ( P=0.016 ) . There were also significant differences between the groups for the afternoon ( 1200–1800 hours ) , and evening ( 1800–midnight ) time periods . Pain related behaviour like facial expression , was also significantly less pronounced in the light needling group as compared to the control group post-treatment , ( P=0.027 ) . The parents rated the light needling as more effective in improving symptoms than the control group ( P<0.001 ) . Conclusion Four treatments with light needling on one point in the h and may alleviate crying and pain related behaviour without any noted side effects INTRODUCTION Despite its increasing use as a complementary therapy to treat pain , acupuncture is rarely considered by pediatricians , in part due to perceptions that it will not be acceptable to pediatric patients . We wished to describe pediatric pain patients ' experience with acupuncture treatment for chronic pain . DESIGN Retrospective case series . METHODS Subjects were pediatric pain patients referred by the Pain Treatment Service at Children 's Hospital in Boston , who went to a pediatric acupuncturist .  A research assistant not involved in the patient 's care conducted the survey by telephone . Data were analyzed qualitatively and descriptively . RESULTS Of 50 eligible patients , 47 families were reached by telephone ; all agreed to be interviewed . Patients had a median age of 16 years at the time of referral , 79 % were female , and 96 % were white . The most common three diagnoses were migraine headache ( n = 7 ) , endometriosis ( n = 6 ) , and reflex sympathetic dystrophy ( n = 5 ) . Patients had a median of 8 treatments ( range : 0 - 60 ) within 3 months ( range : 0 - 48 months ) ; 85 % of families paid out-of-pocket . Acupuncture therapies included needle insertion ( 98 % ) , heat/moxa ( 85 % ) , magnets ( 26 % ) , and cupping ( 26 % ) . Most patients and parents rated the therapy as pleasant ( 67 % children/60 % parents ) , and most ( 70 % children/59 % parents ) felt the treatment had helped their symptoms ; only 1 said that treatment made symptoms worse . CONCLUSION Pediatric patients with chronic , severe pain found  acupuncture treatment pleasant and helpful . Additional , prospect i ve studies are needed to quantify the costs and effectiveness of acupuncture treatment for pediatric pain Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Acupuncture has been used therapeutically in China for thous and s of years and is growing in prominence in Europe and the United States . In a recent review of complementary and alternative medicine use in the US population , an estimated 2.1 million people or 1.1 % of the population sought acupuncture care during the past 12 months . Four percent of the US population used acupuncture at any time in their lives . We review ed 31 different published journal articles , including 23 r and omized controlled clinical trials and 8 meta- analysis / systematic review s. We found evidence of some efficacy and low risk associated with acupuncture in pediatrics . From all the conditions we review ed , the most extensive research has looked into acupuncture 's role in managing postoperative and chemotherapy-induced nausea/vomiting . Postoperatively , there is far more evidence of acupuncture 's efficacy for pediatrics than for children treated with chemotherapy . Acupuncture seems to be most effective in preventing postoperative induced nausea in children . For adults , research shows that acupuncture can inhibit chemotherapy-related acute vomiting , but conclusions about its effects in pediatrics can not be made on the basis of the available published clinical trials data to date . Besides nausea and vomiting , research conducted in pain has yielded the most convincing results on acupuncture efficacy . Musculoskeletal and cancer-related pain commonly affects children and adults , but unfortunately , mostly adult studies have been conducted thus far . Because the manifestations of pain can be different in children than in adults , data can not be extrapolated from adult research . Systematic review s have shown that existing data often lack adequate control groups and sample sizes . Vas et al , Alimi et al , and Mehling et al demonstrated some relief for adults treated with acupuncture but we could not find any well-conducted r and omized controlled studies that looked at pediatrics and acupuncture exclusively . Pain is often unresolved from drug therapy , thus there is a need for more studies in this setting . For seasonal allergic rhinitis , we review ed studies conducted by Ng et al and Xue et al in children and adults , respectively . Both population s showed some relief of symptoms through acupuncture , but questions remain about treatment logistics . Additionally , there are limited indications that acupuncture may help cure children afflicted with nocturnal enuresis . Systematic review s show that current published trials have suffered from low trial quality , including small sample sizes . Other areas of pediatric afflictions we review ed that suffer from lack of research include asthma , other neurologic conditions , gastrointestinal disorders , and addiction . Acupuncture has become a dominant complementary and alternative modality in clinical practice today , but its associated risk has been question ed . The National Institutes of Health Consensus Statement states “ one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same conditions . ” A review of serious adverse events by White et al found the risk of a major complication occurring to have an incidence between 1:10,000 and 1:100,000 , which is considered “ very low . ” Another study found that the risk of a serious adverse event occurring from acupuncture therapy is the same as taking penicillin . The safety of acupuncture is a serious concern , particularly in pediatrics . Because acupuncture 's mechanism is not known , the use of needles in children becomes question able . For example , acupoints on the vertex of infants should not be needled when the fontanel is not closed . It is also advisable to apply few needles or delay treatment to the children who have overeaten , are overfatigued , or are very weak . Through our review of pediatric adverse events , we found a 1.55 risk of adverse events occurring in 100 treatments of acupuncture that coincides with the low risk detailed in the studies mentioned previously . The actual risk to an individual patient is hard to determine because certain patients , such as an immunosuppressed patient , can be predisposed to an increased risk , acupuncturist 's qualifications differ , and practice s vary in certain parts of the world . Nevertheless , it seems acupuncture is a safe complementary/alternative medicine modality for pediatric patients on the basis of the data we review ed Background The aim was to describe the feeding- and stooling patterns of infants with colic and evaluate the influence of minimal acupuncture . Methods A prospect i ve , r and omized , controlled , blind clinical study was conducted at a private acupuncture clinic in Sweden . 90 otherwise healthy 2 - 8 weeks old infants , born after gestational week 36 , fulfilling the criteria for infantile colic and not medicated with dicyclomine , were included . 81 infants went through a structured program consisting of six visits to the clinic , twice weekly . Infants r and omized to receive acupuncture  were given minimal , st and ardized acupuncture for two seconds in LI4 . Frequency and size of stooling , as well as duration of , and intervals between , feeding sessions were reported by parents in a diary . Parental assessment of sleep and comments on stooling and side effects were collected in a question naire . Results At baseline when the mean age was five weeks , infants in both groups were fed a median of eight times/day , 148 min/day , with considerable variations . No differences were found between groups in the frequency and duration of feeding during the intervention weeks . Furthermore there were no significant differences between the groups regarding the frequency of stooling , neither at baseline , at which point the infants of both groups had bowel movements 4.2 times/day , nor during the intervention weeks . There was an expected decrease in frequency of stooling in both groups , reaching 2.1 ( p = 0,001 ) in the acupuncture group and 3.1 ( p < 0,001 ) in the control group . The groups differed regarding large bowel movements which decreased linearly in the control group ( p = 0,011 ) but not in the acupuncture group ( p = 0,787 ) . More parents in the acupuncture group than in the control group ( 28 % and 15 % respectively , p = 0.006 ) experienced the infant 's sleep to be " better " or " much better . " No other significant differences were found . However , parents described a normalized stooling and experienced an improvement in colic in their infants more frequently in the acupuncture group than in the control group . Conclusions Infants with colic in the present study had a higher frequency of stooling than reported internationally in healthy infants .  Minimal acupuncture had no major effect on feeding , stooling and sleep , although a minor effect of minimal acupuncture on stooling and sleep can not be ruled out . Trial registration Clinical Trials.govID Objective To conduct a pilot study to assess the feasibility of a proposed design of an acupuncture trial to relieve symptoms of  infantile colic .  Method An open r and omised single-blinded controlled trial , using st and ardised bilateral treatment of the acupuncture point ST36 . Infants fulfilling Wessel 's definition of infantile colic were included . Patients were r and omised to active treatment or to no-treatment control .  General practitioners ( GPs ) educated in Western medical acupuncture did the interventions . Parents and GPs ’ assistants were blinded . Active treatment was the bilateral insertion of 0.20 × 15 mm Seirin needles to 12 mm depth at ST36 . The intervention consisted of daily treatments of 30 s duration for three consecutive workdays . Blinding was done with a red point mark on the skin and circular adhesive dressing covering . The parents were asked two blinding validation questions in the course of the study period . The primary end point was the effect of the intervention assessed as change in crying time per 24 h measured with a crying registration form . Results The authors improved the st and ardisation and changed the blinding procedure as a result of the pilot study . Blinding validation questions were considered necessary . The changes made in the main study protocol are discussed . Conclusion The pilot study led to important changes that were implemented into the final trial protocol . Blinding validation is essential in no-treatment controlled trials of acupuncture on infants , where the parents are blinded assessors of symptom reduction . The authors suggest that blinding validation questions , and the answers to these questions , should be reported . Clinical Trial Registry Identifier : NCT00907621 54 cases of peripheral nerve injury were treated by electric acupuncture and compared with 54 control cases treated with supportive medication . The changes after treatment were observed chiefly by electromyography while sensory and motor improvement were also recorded as auxiliary indicators . The therapeutic results in the acupuncture group were 5 cases cured , 26 markedly effective , 19 improved , and 4 cases failed , a total effective rate of 92.6 % in contrast to the 55.6 % for the controls . Analysis of the therapeutic results showed that 1 ) those in the acupuncture group were significantly better than in the control group ; 2 ) nerve injuries should be treated as early as possible ; 3 ) the radial nerve and the common peroneal nerve recovered faster than others ; 4 ) cases not surgically explored recovered faster than those that were , and 5 ) patients with prompt propagation of the needling sensation recovered significantly faster than those with slow propagation OBJECTIVES The use of complementary and alternative medicine ( CAM ) has increased over recent years . Little is known about the use of CAM by children and adolescents . The study objectives were to characterize reasons for referrals and types of therapy for children and adolescents who turned to a CAM clinic . DESIGN An observational study with prospect i ve collection of data through interviews with the parents conducted by the clinic triage physician using question naires . SUBJECTS Parents of children and adolescents 
    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 Colic causes crying in 10–30 % of infants and is one of the primary reasons parents seek health care . Treatments are generally not totally effective and some cause side effects . In this study we aim ed to test the effect of light needling ( minimal acupuncture ) on crying . Methods Forty children ( median six weeks of age ) with excessive crying unresponsive to conventional therapies , were recruited from 21 Child Welfare Clinics within an area of western Sweden , and quasi-r and omised to control or light needling treatment . Parents were unaware of which group their child was assigned to . Children were given light needling acupuncture on one point ( LI4 ) on both h and s for approximately 20 seconds on four occasions , or received the same care except needling .  Parental assessment question naires were used pre- and post-treatment to assess crying intensity , frequency , duration of crying and pain related behaviour throughout the day in six hour periods . Results Light needling result ed in a significant reduction in the rated crying intensity ( assessed by a numeric rating scale , 0 to 10 ) . For example , during the morning time period 0600–1200 hours , the median ( range ) rated crying intensity changed from 6 ( 1 to 9 ) pre-treatment to 2 ( 0 to 5 ) post-treatment ( P=0.002 ) , in the light needling group . The corresponding ratings for the children in the control group was 6 ( 0 to 10 ) and 5 ( 0 to 10 ) respectively . The difference between the groups was significant ( P=0.016 ) . There were also significant differences between the groups for the afternoon ( 1200–1800 hours ) , and evening ( 1800–midnight ) time periods . Pain related behaviour like facial expression , was also significantly less pronounced in the light needling group as compared to the control group post-treatment , ( P=0.027 ) . The parents rated the light needling as more effective in improving symptoms than the control group ( P<0.001 ) . Conclusion Four treatments with light needling on one point in the h and may alleviate crying and pain related behaviour without any noted side effects INTRODUCTION Despite its increasing use as a complementary therapy to treat pain , acupuncture is rarely considered by pediatricians , in part due to perceptions that it will not be acceptable to pediatric patients . We wished to describe pediatric pain patients ' experience with acupuncture treatment for chronic pain . DESIGN Retrospective case series . METHODS Subjects were pediatric pain patients referred by the Pain Treatment Service at Children 's Hospital in Boston , who went to a pediatric acupuncturist .  A research assistant not involved in the patient 's care conducted the survey by telephone . Data were analyzed qualitatively and descriptively . RESULTS Of 50 eligible patients , 47 families were reached by telephone ; all agreed to be interviewed . Patients had a median age of 16 years at the time of referral , 79 % were female , and 96 % were white . The most common three diagnoses were migraine headache ( n = 7 ) , endometriosis ( n = 6 ) , and reflex sympathetic dystrophy ( n = 5 ) . Patients had a median of 8 treatments ( range : 0 - 60 ) within 3 months ( range : 0 - 48 months ) ; 85 % of families paid out-of-pocket . Acupuncture therapies included needle insertion ( 98 % ) , heat/moxa ( 85 % ) , magnets ( 26 % ) , and cupping ( 26 % ) . Most patients and parents rated the therapy as pleasant ( 67 % children/60 % parents ) , and most ( 70 % children/59 % parents ) felt the treatment had helped their symptoms ; only 1 said that treatment made symptoms worse . CONCLUSION Pediatric patients with chronic , severe pain found  acupuncture treatment pleasant and helpful . Additional , prospect i ve studies are needed to quantify the costs and effectiveness of acupuncture treatment for pediatric pain Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Acupuncture has been used therapeutically in China for thous and s of years and is growing in prominence in Europe and the United States . In a recent review of complementary and alternative medicine use in the US population , an estimated 2.1 million people or 1.1 % of the population sought acupuncture care during the past 12 months . Four percent of the US population used acupuncture at any time in their lives . We review ed 31 different published journal articles , including 23 r and omized controlled clinical trials and 8 meta- analysis / systematic review s. We found evidence of some efficacy and low risk associated with acupuncture in pediatrics . From all the conditions we review ed , the most extensive research has looked into acupuncture 's role in managing postoperative and chemotherapy-induced nausea/vomiting . Postoperatively , there is far more evidence of acupuncture 's efficacy for pediatrics than for children treated with chemotherapy . Acupuncture seems to be most effective in preventing postoperative induced nausea in children . For adults , research shows that acupuncture can inhibit chemotherapy-related acute vomiting , but conclusions about its effects in pediatrics can not be made on the basis of the available published clinical trials data to date . Besides nausea and vomiting , research conducted in pain has yielded the most convincing results on acupuncture efficacy . Musculoskeletal and cancer-related pain commonly affects children and adults , but unfortunately , mostly adult studies have been conducted thus far . Because the manifestations of pain can be different in children than in adults , data can not be extrapolated from adult research . Systematic review s have shown that existing data often lack adequate control groups and sample sizes . Vas et al , Alimi et al , and Mehling et al demonstrated some relief for adults treated with acupuncture but we could not find any well-conducted r and omized controlled studies that looked at pediatrics and acupuncture exclusively . Pain is often unresolved from drug therapy , thus there is a need for more studies in this setting . For seasonal allergic rhinitis , we review ed studies conducted by Ng et al and Xue et al in children and adults , respectively . Both population s showed some relief of symptoms through acupuncture , but questions remain about treatment logistics . Additionally , there are limited indications that acupuncture may help cure children afflicted with nocturnal enuresis . Systematic review s show that current published trials have suffered from low trial quality , including small sample sizes . Other areas of pediatric afflictions we review ed that suffer from lack of research include asthma , other neurologic conditions , gastrointestinal disorders , and addiction . Acupuncture has become a dominant complementary and alternative modality in clinical practice today , but its associated risk has been question ed . The National Institutes of Health Consensus Statement states “ one of the advantages of acupuncture is that the incidence of adverse effects is substantially lower than that of many drugs or other accepted procedures for the same conditions . ” A review of serious adverse events by White et al found the risk of a major complication occurring to have an incidence between 1:10,000 and 1:100,000 , which is considered “ very low . ” Another study found that the risk of a serious adverse event occurring from acupuncture therapy is the same as taking penicillin . The safety of acupuncture is a serious concern , particularly in pediatrics . Because acupuncture 's mechanism is not known , the use of needles in children becomes question able . For example , acupoints on the vertex of infants should not be needled when the fontanel is not closed . It is also advisable to apply few needles or delay treatment to the children who have overeaten , are overfatigued , or are very weak . Through our review of pediatric adverse events , we found a 1.55 risk of adverse events occurring in 100 treatments of acupuncture that coincides with the low risk detailed in the studies mentioned previously . The actual risk to an individual patient is hard to determine because certain patients , such as an immunosuppressed patient , can be predisposed to an increased risk , acupuncturist 's qualifications differ , and practice s vary in certain parts of the world . Nevertheless , it seems acupuncture is a safe complementary/alternative medicine modality for pediatric patients on the basis of the data we review ed Background The aim was to describe the feeding- and stooling patterns of infants with colic and evaluate the influence of minimal acupuncture . Methods A prospect i ve , r and omized , controlled , blind clinical study was conducted at a private acupuncture clinic in Sweden . 90 otherwise healthy 2 - 8 weeks old infants , born after gestational week 36 , fulfilling the criteria for infantile colic and not medicated with dicyclomine , were included . 81 infants went through a structured program consisting of six visits to the clinic , twice weekly . Infants r and omized to receive acupuncture  were given minimal , st and ardized acupuncture for two seconds in LI4 . Frequency and size of stooling , as well as duration of , and intervals between , feeding sessions were reported by parents in a diary . Parental assessment of sleep and comments on stooling and side effects were collected in a question naire . Results At baseline when the mean age was five weeks , infants in both groups were fed a median of eight times/day , 148 min/day , with considerable variations . No differences were found between groups in the frequency and duration of feeding during the intervention weeks . Furthermore there were no significant differences between the groups regarding the frequency of stooling , neither at baseline , at which point the infants of both groups had bowel movements 4.2 times/day , nor during the intervention weeks . There was an expected decrease in frequency of stooling in both groups , reaching 2.1 ( p = 0,001 ) in the acupuncture group and 3.1 ( p < 0,001 ) in the control group . The groups differed regarding large bowel movements which decreased linearly in the control group ( p = 0,011 ) but not in the acupuncture group ( p = 0,787 ) . More parents in the acupuncture group than in the control group ( 28 % and 15 % respectively , p = 0.006 ) experienced the infant 's sleep to be " better " or " much better . " No other significant differences were found . However , parents described a normalized stooling and experienced an improvement in colic in their infants more frequently in the acupuncture group than in the control group . Conclusions Infants with colic in the present study had a higher frequency of stooling than reported internationally in healthy infants .  Minimal acupuncture had no major effect on feeding , stooling and sleep , although a minor effect of minimal acupuncture on stooling and sleep can not be ruled out . Trial registration Clinical Trials.govID Objective To conduct a pilot study to assess the feasibility of a proposed design of an acupuncture trial to relieve symptoms of  infantile colic .  Method An open r and omised single-blinded controlled trial , using st and ardised bilateral treatment of the acupuncture point ST36 . Infants fulfilling Wessel 's definition of infantile colic were included . Patients were r and omised to active treatment or to no-treatment control .  General practitioners ( GPs ) educated in Western medical acupuncture did the interventions . Parents and GPs ’ assistants were blinded . Active treatment was the bilateral insertion of 0.20 × 15 mm Seirin needles to 12 mm depth at ST36 . The intervention consisted of daily treatments of 30 s duration for three consecutive workdays . Blinding was done with a red point mark on the skin and circular adhesive dressing covering . The parents were asked two blinding validation questions in the course of the study period . The primary end point was the effect of the intervention assessed as change in crying time per 24 h measured with a crying registration form . Results The authors improved the st and ardisation and changed the blinding procedure as a result of the pilot study . Blinding validation questions were considered necessary . The changes made in the main study protocol are discussed . Conclusion The pilot study led to important changes that were implemented into the final trial protocol . Blinding validation is essential in no-treatment controlled trials of acupuncture on infants , where the parents are blinded assessors of symptom reduction . The authors suggest that blinding validation questions , and the answers to these questions , should be reported . Clinical Trial Registry Identifier : NCT00907621 54 cases of peripheral nerve injury were treated by electric acupuncture and compared with 54 control cases treated with supportive medication . The changes after treatment were observed chiefly by electromyography while sensory and motor improvement were also recorded as auxiliary indicators . The therapeutic results in the acupuncture group were 5 cases cured , 26 markedly effective , 19 improved , and 4 cases failed , a total effective rate of 92.6 % in contrast to the 55.6 % for the controls . Analysis of the therapeutic results showed that 1 ) those in the acupuncture group were significantly better than in the control group ; 2 ) nerve injuries should be treated as early as possible ; 3 ) the radial nerve and the common peroneal nerve recovered faster than others ; 4 ) cases not surgically explored recovered faster than those that were , and 5 ) patients with prompt propagation of the needling sensation recovered significantly faster than those with slow propagation OBJECTIVES The use of complementary and alternative medicine ( CAM ) has increased over recent years . Little is known about the use of CAM by children and adolescents . The study objectives were to characterize reasons for referrals and types of therapy for children and adolescents who turned to a CAM clinic . DESIGN An observational study with prospect i ve collection of data through interviews with the parents conducted by the clinic triage physician using question naires . SUBJECTS Parents of children and adolescents 
    Output:
    