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 Despite it is accepted that acne is mostly caused by an hyper-responsiveness of the pilo-sebaceous unit to normal circulating and rogen hormones , in a few patients , especially women , acneic lesions can be associated with increased serum and rogen levels ( hyper and rogenism ) , of which polycystic ovary syndrome ( PCOS ) is the most common cause . In women with acne and proven PCOS therapy with estroprogestins ( EPs )  can be an excellent option . OBJECTIVE The aim of the study was to assess the effects of two estroprogestins ( EPs ) , ethinyl-estradiol ( EE ) 30 mcg/drospirenone ( DRSP ) 3 mg , and ethinyl-estradiol ( EE ) 30 mcg/chlormadinone acetate ( CMA ) 2 mg , both on increased serum and rogen levels and on several skin parameters in women affected by mild to severe acne and polycystic ovary syndrome ( PCOS ) . METHODS Fifty-nine women were r and omized to receive EE/DRSP ( n = 32 ) or EE/CMA ( n = 27 ) for six months . Evaluation of serum and rogen levels , grading of acne and hirsutism ( respectively with Pillsbury and Ferriman-Gallwey score ) and non-invasive assessment of skin hydration , transepidermal water loss ( TEWL ) and skin homogeneity were performed at baseline , at 3 and 6 months ( end of treatment ) . RESULTS Both treatments were well tolerated and showed a significant improvement of skin and hormonal parameters , although EE/DRSP showed a more potent effect on acne and seborrhea . CONCLUSIONS Estroprogestins represent an effective and safe treatment in women with acne and polycystic ovary syndrome ( PCOS ) . Nevertheless , the combination EE 30 mcg/DRSP 3 mg appears to be a more potent therapeutic option Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Background Despite the heavy burden and impact of the polycystic ovary syndrome ( PCOS ) in reproduction and public health , estimates regarding its prevalence at community levels are limited . We aim ed to ascertain prevalence of PCOS in a community based sample using the National Institute of Health ( NIH ) , the Rotterdam consensus ( Rott . ) and the And rogen Excess Society ( AES ) criteria . Methods Using the stratified , multistage probability cluster sampling method , 1126 women were r and omly selected from among reproductive aged women of different geographic regions of Iran . PCOS were diagnosed using universal assessment of ultrasonographic parameters , hormonal profiles and clinical histories . Results The mean + /- SD of age of study population was 34.4 + /- 7.6 years . Estimated prevalence of idiopathic hirsutism was 10.9 % ( 95 % CI : 8.9 - 12.9 % ) ; 8.3 % of women had only oligo/anovulation and 8.0 % had only polycystic ovaries . The prevalence of PCOS was 7.1 % ( 95 % CI : 5.4 - 8.8 % ) using the NIH definition , 11.7 % ( 95 % CI : 9.5 - 13.7 % ) by AES criteria and 14.6 % ( 95 % CI : 12.3 - 16.9 % ) using the Rott definition . Conclusions At community level , widespread screening of Rotterdam criteria will increase the estimated prevalence of PCOS over twofold . Establishing an explicit and contemporaneous method for definition and screening of each PCOS criteria has important investigational implication s and increase the comparability of published research Objective Women with polycystic ovary syndrome ( PCOS ) have multiple risk factors for cardiovascular disease . The cardiovascular risk marker homocysteine ( Hcy ) is elevated in women with PCOS . This prospect i ve study investigated the effect of oral contraceptives containing ethinyl estradiol – cyproterone acetate ( EE – CA ) on serum Hcy levels in women with PCOS . Study design A total of 30 women with PCOS were enrolled in this prospect i ve study . The diagnosis of PCOS was made according to the criteria of the Rotterdam PCOS consensus workshop group . All women  took oral contraceptives containing EE/CA ( 35 μg/2 mg ) for 3 months . Serum sample s for Hcy , lipid profile and hormones were obtained during the early follicular phase ( days 3–5 ) of the spontaneous or progestin-induced bleeding at baseline , and after the third treatment cycle . Results Three months of EE – CA therapy significantly decreased the Hcy levels from 55.97 ± 16.04 to 54.03 ± 16.15 ( P = 0.01 ) . A significant correlation was observed between the Hcy and total and free testosterone levels ( r = 0.44 , P = 0.015 and r = 0.46 , P = 0.001 respectively ) . Conclusions Although the decrease in Hcy levels with EE – CA therapy was statistically significant , further studies are necessary to determine the clinical benefit of this treatment BACKGROUND A prospect i ve r and omized trial was conducted to compare efficacy of a drospirenone-containing combined oral contraceptives ( COC ) with desogestrel-containing COC in women with polycystic ovary-syndrome ( PCOS ) not desirous of child-bearing . STUDY DESIGN Sixty women were r and omized into study group [ ethinylestradiol ( EE ) 30 mcg+drospirenone 3 mg ] and control group ( EE 30 mcg+desogestrel 150 mcg ) , treated for 6 months and followed up at 1 month , 3 months , 6 months , during treatment and 3 and 6 months post-treatment . Acne and hirsutism scoring , bodyweight , body mass index ( BMI ) , blood pressure ( BP ) , ultrasound parameters , lipid profile , glycemic profile and hormonal profile were compared . RESULTS Cycles were regular in both groups during treatment . Effect of regular cycles persisted in 44.83 % ( 13/30 ) vs. 17.24 % ( 5/30 ) in study vs. control group at 6 months post-treatment with 33.3 % decreased hirsutism score in the study group ( versus no change in control group ) even at 6 months after stopping treatment . With treatment , BMI fell by 0.52 kg/m(2 ) in the study group ; systolic and diastolic BP fell in the study group while it rose in the control group . Low-density lipoprotein significantly decreased and high-density lipoprotein was elevated in the study group ( p<.05 ) . The study group showed a significant fall in fasting/postpr and ial blood sugar and insulin and total testosterone against a rise in the control group . CONCLUSION In women with PCOS , a drospirenone containing COC has better outcome in terms of persistent regular cycles , anti and rogenic effect , fall in BMI and BP , better lipid profile , favorable glycemic and hormonal profile than desogestrel-containing COC 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 Non-r and omised studies of the effects of interventions are critical to many areas of healthcare evaluation , but their results may be biased . It is therefore important to underst and and appraise their strengths and weaknesses . We developed ROBINS-I ( “ Risk Of Bias In Non-r and omised Studies - of Interventions ” ) , a new tool for evaluating risk of bias in estimates of the comparative effectiveness ( harm or benefit ) of interventions from studies that did not use r and omisation  to allocate units ( individuals or clusters of individuals ) to comparison groups . The tool will be particularly useful to those undertaking systematic review s that include non-r and omised studies Purpose To compare the effects of combined oral contraceptives ( OCs ) containing cyproterone acetate and drospirenone in the treatment of polycystic ovary syndrome ( PCOS ) . Methods Fifty-two patients with PCOS were r and omized in two groups : group A ( n = 26 ) received 0.035 mg ethinyl estradiol + 2 mg cyproterone acetate and group B ( n = 26 ) received 0.03 mg ethinyl estradiol + 3 mg drospirenone-containing OCs for 12 months . Baseline clinical features including body mass index , waist to hip ratio ( WHR ) , and modified Ferriman-Gallwey ( mFG ) score were noted . Baseline biochemical parameters included and rogen profile , carbohydrate metabolism , lipid profile , and oxidative stress . The percentages of changes for all parameters were compared . Results The groups were comparable regarding the baseline characteristics . WHR decreased significantly from baseline ( −4 % [ −31 to 35 ] ) in group B when compared to group A ( 0 % [ −11 to 14 ] ) ( P = 0.033 ) . The total mFG score decreased significantly from baseline ( −35 % [ −71 to 10 ] ) in group A when compared to group B ( −18 % [ −72 to 30 ] ) ( P = 0.035 ) . Changes in and rogen hormone profile were comparable except DHEA-SO4 ( −32 % [ −53 to 15 ] in group B vs. −10 % [ −49 to 63 ] in group A ; P = 0.046 ) . The effects of the drugs were similar regarding carbohydrate metabolism , lipid profile , and oxidative stress parameters . Conclusions Cyproterone acetate containing OCs seem to be more effective to treat clinical hirsutism in patients with PCOS after 12 months of treatment OBJECTIVE This study represents long term clinical and biochemical results and the response of different body parts to medical therapy with oral ethinyl estradiol/drospirenone combination in hirsute patients with or without polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve , open , controlled clinical study . SETTING Out patients at Erciyes University Medical School . PATIENT(S ) Fifty women with moderate to severe hirsutism were recruited . Two women were lost to follow-up . INTERVENTION(S ) Women were treated with 3 mg of drospirenone and 30 microg of ethinyl estradiol for 12 cycles . MAIN OUTCOME MEASURE(S ) Hirsutism was assessed at 6-month intervals using the Ferriman-Gallwey ( F-G ) scoring system . Serum FSH , LH , total and free testosterone ( T ) , and rostenedione ( A ) , dehydroepi and rosterone sulfate ( DHEAS ) , estradiol ( E2 ) , and sex-hormone binding globulin ( SHBG ) levels at 6 and 12 months of therapy were compared with baseline values . RESULT ( S ) Total mean FG score declined by 67 % and 78 % after 6 and 12 months , respectively . Improvement was most prominent on the chest and abdomen , followed by the upper lip and chin . The lowest effect was observed on the back and arms . Serum levels of total and free T and A decreased , whereas SHBG levels increased significantly after 6 and 12 months when compared with baseline levels 
    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 Despite it is accepted that acne is mostly caused by an hyper-responsiveness of the pilo-sebaceous unit to normal circulating and rogen hormones , in a few patients , especially women , acneic lesions can be associated with increased serum and rogen levels ( hyper and rogenism ) , of which polycystic ovary syndrome ( PCOS ) is the most common cause . In women with acne and proven PCOS therapy with estroprogestins ( EPs )  can be an excellent option . OBJECTIVE The aim of the study was to assess the effects of two estroprogestins ( EPs ) , ethinyl-estradiol ( EE ) 30 mcg/drospirenone ( DRSP ) 3 mg , and ethinyl-estradiol ( EE ) 30 mcg/chlormadinone acetate ( CMA ) 2 mg , both on increased serum and rogen levels and on several skin parameters in women affected by mild to severe acne and polycystic ovary syndrome ( PCOS ) . METHODS Fifty-nine women were r and omized to receive EE/DRSP ( n = 32 ) or EE/CMA ( n = 27 ) for six months . Evaluation of serum and rogen levels , grading of acne and hirsutism ( respectively with Pillsbury and Ferriman-Gallwey score ) and non-invasive assessment of skin hydration , transepidermal water loss ( TEWL ) and skin homogeneity were performed at baseline , at 3 and 6 months ( end of treatment ) . RESULTS Both treatments were well tolerated and showed a significant improvement of skin and hormonal parameters , although EE/DRSP showed a more potent effect on acne and seborrhea . CONCLUSIONS Estroprogestins represent an effective and safe treatment in women with acne and polycystic ovary syndrome ( PCOS ) . Nevertheless , the combination EE 30 mcg/DRSP 3 mg appears to be a more potent therapeutic option Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Background Despite the heavy burden and impact of the polycystic ovary syndrome ( PCOS ) in reproduction and public health , estimates regarding its prevalence at community levels are limited . We aim ed to ascertain prevalence of PCOS in a community based sample using the National Institute of Health ( NIH ) , the Rotterdam consensus ( Rott . ) and the And rogen Excess Society ( AES ) criteria . Methods Using the stratified , multistage probability cluster sampling method , 1126 women were r and omly selected from among reproductive aged women of different geographic regions of Iran . PCOS were diagnosed using universal assessment of ultrasonographic parameters , hormonal profiles and clinical histories . Results The mean + /- SD of age of study population was 34.4 + /- 7.6 years . Estimated prevalence of idiopathic hirsutism was 10.9 % ( 95 % CI : 8.9 - 12.9 % ) ; 8.3 % of women had only oligo/anovulation and 8.0 % had only polycystic ovaries . The prevalence of PCOS was 7.1 % ( 95 % CI : 5.4 - 8.8 % ) using the NIH definition , 11.7 % ( 95 % CI : 9.5 - 13.7 % ) by AES criteria and 14.6 % ( 95 % CI : 12.3 - 16.9 % ) using the Rott definition . Conclusions At community level , widespread screening of Rotterdam criteria will increase the estimated prevalence of PCOS over twofold . Establishing an explicit and contemporaneous method for definition and screening of each PCOS criteria has important investigational implication s and increase the comparability of published research Objective Women with polycystic ovary syndrome ( PCOS ) have multiple risk factors for cardiovascular disease . The cardiovascular risk marker homocysteine ( Hcy ) is elevated in women with PCOS . This prospect i ve study investigated the effect of oral contraceptives containing ethinyl estradiol – cyproterone acetate ( EE – CA ) on serum Hcy levels in women with PCOS . Study design A total of 30 women with PCOS were enrolled in this prospect i ve study . The diagnosis of PCOS was made according to the criteria of the Rotterdam PCOS consensus workshop group . All women  took oral contraceptives containing EE/CA ( 35 μg/2 mg ) for 3 months . Serum sample s for Hcy , lipid profile and hormones were obtained during the early follicular phase ( days 3–5 ) of the spontaneous or progestin-induced bleeding at baseline , and after the third treatment cycle . Results Three months of EE – CA therapy significantly decreased the Hcy levels from 55.97 ± 16.04 to 54.03 ± 16.15 ( P = 0.01 ) . A significant correlation was observed between the Hcy and total and free testosterone levels ( r = 0.44 , P = 0.015 and r = 0.46 , P = 0.001 respectively ) . Conclusions Although the decrease in Hcy levels with EE – CA therapy was statistically significant , further studies are necessary to determine the clinical benefit of this treatment BACKGROUND A prospect i ve r and omized trial was conducted to compare efficacy of a drospirenone-containing combined oral contraceptives ( COC ) with desogestrel-containing COC in women with polycystic ovary-syndrome ( PCOS ) not desirous of child-bearing . STUDY DESIGN Sixty women were r and omized into study group [ ethinylestradiol ( EE ) 30 mcg+drospirenone 3 mg ] and control group ( EE 30 mcg+desogestrel 150 mcg ) , treated for 6 months and followed up at 1 month , 3 months , 6 months , during treatment and 3 and 6 months post-treatment . Acne and hirsutism scoring , bodyweight , body mass index ( BMI ) , blood pressure ( BP ) , ultrasound parameters , lipid profile , glycemic profile and hormonal profile were compared . RESULTS Cycles were regular in both groups during treatment . Effect of regular cycles persisted in 44.83 % ( 13/30 ) vs. 17.24 % ( 5/30 ) in study vs. control group at 6 months post-treatment with 33.3 % decreased hirsutism score in the study group ( versus no change in control group ) even at 6 months after stopping treatment . With treatment , BMI fell by 0.52 kg/m(2 ) in the study group ; systolic and diastolic BP fell in the study group while it rose in the control group . Low-density lipoprotein significantly decreased and high-density lipoprotein was elevated in the study group ( p<.05 ) . The study group showed a significant fall in fasting/postpr and ial blood sugar and insulin and total testosterone against a rise in the control group . CONCLUSION In women with PCOS , a drospirenone containing COC has better outcome in terms of persistent regular cycles , anti and rogenic effect , fall in BMI and BP , better lipid profile , favorable glycemic and hormonal profile than desogestrel-containing COC 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 Non-r and omised studies of the effects of interventions are critical to many areas of healthcare evaluation , but their results may be biased . It is therefore important to underst and and appraise their strengths and weaknesses . We developed ROBINS-I ( “ Risk Of Bias In Non-r and omised Studies - of Interventions ” ) , a new tool for evaluating risk of bias in estimates of the comparative effectiveness ( harm or benefit ) of interventions from studies that did not use r and omisation  to allocate units ( individuals or clusters of individuals ) to comparison groups . The tool will be particularly useful to those undertaking systematic review s that include non-r and omised studies Purpose To compare the effects of combined oral contraceptives ( OCs ) containing cyproterone acetate and drospirenone in the treatment of polycystic ovary syndrome ( PCOS ) . Methods Fifty-two patients with PCOS were r and omized in two groups : group A ( n = 26 ) received 0.035 mg ethinyl estradiol + 2 mg cyproterone acetate and group B ( n = 26 ) received 0.03 mg ethinyl estradiol + 3 mg drospirenone-containing OCs for 12 months . Baseline clinical features including body mass index , waist to hip ratio ( WHR ) , and modified Ferriman-Gallwey ( mFG ) score were noted . Baseline biochemical parameters included and rogen profile , carbohydrate metabolism , lipid profile , and oxidative stress . The percentages of changes for all parameters were compared . Results The groups were comparable regarding the baseline characteristics . WHR decreased significantly from baseline ( −4 % [ −31 to 35 ] ) in group B when compared to group A ( 0 % [ −11 to 14 ] ) ( P = 0.033 ) . The total mFG score decreased significantly from baseline ( −35 % [ −71 to 10 ] ) in group A when compared to group B ( −18 % [ −72 to 30 ] ) ( P = 0.035 ) . Changes in and rogen hormone profile were comparable except DHEA-SO4 ( −32 % [ −53 to 15 ] in group B vs. −10 % [ −49 to 63 ] in group A ; P = 0.046 ) . The effects of the drugs were similar regarding carbohydrate metabolism , lipid profile , and oxidative stress parameters . Conclusions Cyproterone acetate containing OCs seem to be more effective to treat clinical hirsutism in patients with PCOS after 12 months of treatment OBJECTIVE This study represents long term clinical and biochemical results and the response of different body parts to medical therapy with oral ethinyl estradiol/drospirenone combination in hirsute patients with or without polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve , open , controlled clinical study . SETTING Out patients at Erciyes University Medical School . PATIENT(S ) Fifty women with moderate to severe hirsutism were recruited . Two women were lost to follow-up . INTERVENTION(S ) Women were treated with 3 mg of drospirenone and 30 microg of ethinyl estradiol for 12 cycles . MAIN OUTCOME MEASURE(S ) Hirsutism was assessed at 6-month intervals using the Ferriman-Gallwey ( F-G ) scoring system . Serum FSH , LH , total and free testosterone ( T ) , and rostenedione ( A ) , dehydroepi and rosterone sulfate ( DHEAS ) , estradiol ( E2 ) , and sex-hormone binding globulin ( SHBG ) levels at 6 and 12 months of therapy were compared with baseline values . RESULT ( S ) Total mean FG score declined by 67 % and 78 % after 6 and 12 months , respectively . Improvement was most prominent on the chest and abdomen , followed by the upper lip and chin . The lowest effect was observed on the back and arms . Serum levels of total and free T and A decreased , whereas SHBG levels increased significantly after 6 and 12 months when compared with baseline levels 
    Output:
    