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: Painful and /or damaged nipples associated with breastfeeding are common and represent a challenge for both the persons experiencing nipple pain and /or trauma and for those providing treatment . However , evidence -based data has been insufficient to demonstrably minimize these common reasons for failure to initiate or continue successful breastfeeding . The aim of this study was to evaluate the efficacy of specific- grade highly purified anhydrous ( HPA ) lanolin versus expressed breastmilk ( EBM ) for the treatment of painful and damaged nipples associated with breastfeeding in a prospect i ve controlled clinical trial evaluating 84 lactating mothers .  Nipple trauma and healing rates were rated by the Nipple Trauma Score . Nipple pain intensity was assessed on a visual analog scale . Outcome parameters were in favor of the HPA lanolin group , reaching statistical significance for healing rates , nipple trauma and nipple pain . In our study , we found HPA lanolin more effective than EBM , inducing faster healing of nipple trauma ( absolute risk reduction of 0.43 ) and reducing nipple pain ( absolute risk reduction of 0.61 on day 3 ) . We concluded that HPA lanolin , combined with breastfeeding education , was more effective than EBM , combined with breastfeeding education , in reducing nipple pain and promoting healing of nipple trauma BACKGROUND Sore nipples in breast-feeding mothers are a common cause of premature weaning , and are difficult to treat owing to recurrent trauma and exposure to the infant 's oral flora . OBJECTIVE To compare the safety and efficacy of a hydrogel moist wound dressing ( Elasto-gel , Southwest Technologies Inc , Baltimore , Md ) with the use of breast shells and lanolin cream in the treatment of maternal sore nipples associated with breast-feeding . DESIGN R and omized controlled trial comparing the above treatments for sore nipples . Patients were seen for a maximum of 3 follow-up visits within 10 days , or until the resolution of symptoms . SETTING The Maternal-Infant Lactation Center at the Mercy Hospital of Pittsburgh , Pittsburgh , Pa , a tertiary care teaching hospital in inner-city Pittsburgh . PATIENTS A referred sample of 42 breast-feeding women who presented to the Maternal-Infant Lactation Center for the treatment of sore nipples . All patients with breast infection or chronic unrelated pain conditions were excluded from the study . INTERVENTION After informed consent , patients were r and omized to receive either a hydrogel wound dressing or breast shells and lanolin .  All patients underwent a history , physical examination of the infant and the mother 's breasts , assessment of breast-feeding technique , and breast-feeding instruction . MAIN OUTCOME MEASURES The degree of pain on self-report question naires and the change in scores for physical examination , breast-feeding technique , and pain behaviors during breast-feeding . RESULTS Although both treatments , in association with instruction in breast-feeding technique , were effective , greater improvement was seen in the group using breast shells and lanolin . This reached statistical significance for physician-rated healing ( P<.01 ) and self-reported pain ( P<.05 ) . There were significantly more infections in the dressing group ( P<.05 ) , which result ed in early discontinuation of the study . CONCLUSIONS Prevention of sore nipples by teaching proper technique on the initiation of breast-feeding should be instituted . For those cases in which sore nipples do develop , breast shells and lanolin in association with instruction in breast-feeding technique are more effective than moist wound dressings . Lanolin and shells should remain first-line therapy This study was design ed to evaluate whether maintenance of a moist environment on the nipple skin during the first week of breast-feeding would improve damaged nipple skin condition , as indicated by the presence of eschar , erythema , and fissures , and reduce pain . Fifty White women applied a polyethylene film dressing with a perimeter adhesive system to a r and omly determined nipple . The dressing was present at all times except during feeding . Subjects were assessed every 48 hours ( four times ) over 7 days . Serial photographic slides were obtained and assessed for skin characteristics . Nipple pain was self-rated with a verbal descriptor scale . Use of an occlusive film dressing on nipple skin during the first week of breast-feeding appeared to have limited influence on improvement in damaged skin condition . Summary scores indicated significant reduction in the amount of eschar on the surface of the nipple . There were no differences in erythema intensity or fissure severity . Use of a dressing significantly reduced nipple pain during the study period 
    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: Painful and /or damaged nipples associated with breastfeeding are common and represent a challenge for both the persons experiencing nipple pain and /or trauma and for those providing treatment . However , evidence -based data has been insufficient to demonstrably minimize these common reasons for failure to initiate or continue successful breastfeeding . The aim of this study was to evaluate the efficacy of specific- grade highly purified anhydrous ( HPA ) lanolin versus expressed breastmilk ( EBM ) for the treatment of painful and damaged nipples associated with breastfeeding in a prospect i ve controlled clinical trial evaluating 84 lactating mothers .  Nipple trauma and healing rates were rated by the Nipple Trauma Score . Nipple pain intensity was assessed on a visual analog scale . Outcome parameters were in favor of the HPA lanolin group , reaching statistical significance for healing rates , nipple trauma and nipple pain . In our study , we found HPA lanolin more effective than EBM , inducing faster healing of nipple trauma ( absolute risk reduction of 0.43 ) and reducing nipple pain ( absolute risk reduction of 0.61 on day 3 ) . We concluded that HPA lanolin , combined with breastfeeding education , was more effective than EBM , combined with breastfeeding education , in reducing nipple pain and promoting healing of nipple trauma BACKGROUND Sore nipples in breast-feeding mothers are a common cause of premature weaning , and are difficult to treat owing to recurrent trauma and exposure to the infant 's oral flora . OBJECTIVE To compare the safety and efficacy of a hydrogel moist wound dressing ( Elasto-gel , Southwest Technologies Inc , Baltimore , Md ) with the use of breast shells and lanolin cream in the treatment of maternal sore nipples associated with breast-feeding . DESIGN R and omized controlled trial comparing the above treatments for sore nipples . Patients were seen for a maximum of 3 follow-up visits within 10 days , or until the resolution of symptoms . SETTING The Maternal-Infant Lactation Center at the Mercy Hospital of Pittsburgh , Pittsburgh , Pa , a tertiary care teaching hospital in inner-city Pittsburgh . PATIENTS A referred sample of 42 breast-feeding women who presented to the Maternal-Infant Lactation Center for the treatment of sore nipples . All patients with breast infection or chronic unrelated pain conditions were excluded from the study . INTERVENTION After informed consent , patients were r and omized to receive either a hydrogel wound dressing or breast shells and lanolin .  All patients underwent a history , physical examination of the infant and the mother 's breasts , assessment of breast-feeding technique , and breast-feeding instruction . MAIN OUTCOME MEASURES The degree of pain on self-report question naires and the change in scores for physical examination , breast-feeding technique , and pain behaviors during breast-feeding . RESULTS Although both treatments , in association with instruction in breast-feeding technique , were effective , greater improvement was seen in the group using breast shells and lanolin . This reached statistical significance for physician-rated healing ( P<.01 ) and self-reported pain ( P<.05 ) . There were significantly more infections in the dressing group ( P<.05 ) , which result ed in early discontinuation of the study . CONCLUSIONS Prevention of sore nipples by teaching proper technique on the initiation of breast-feeding should be instituted . For those cases in which sore nipples do develop , breast shells and lanolin in association with instruction in breast-feeding technique are more effective than moist wound dressings . Lanolin and shells should remain first-line therapy This study was design ed to evaluate whether maintenance of a moist environment on the nipple skin during the first week of breast-feeding would improve damaged nipple skin condition , as indicated by the presence of eschar , erythema , and fissures , and reduce pain . Fifty White women applied a polyethylene film dressing with a perimeter adhesive system to a r and omly determined nipple . The dressing was present at all times except during feeding . Subjects were assessed every 48 hours ( four times ) over 7 days . Serial photographic slides were obtained and assessed for skin characteristics . Nipple pain was self-rated with a verbal descriptor scale . Use of an occlusive film dressing on nipple skin during the first week of breast-feeding appeared to have limited influence on improvement in damaged skin condition . Summary scores indicated significant reduction in the amount of eschar on the surface of the nipple . There were no differences in erythema intensity or fissure severity . Use of a dressing significantly reduced nipple pain during the study period 
    Output:
    