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 Although the anti-inflammatory effects of immunomodulating diets ( IMDs ) have recently attracted attention , the efficacy of enteral feeding of such diets after radical surgery remains controversial . Thus , we conducted a new prospect i ve , r and omized controlled study to eluci date any beneficial effect of an IMD containing eicosapentaenoic acid ( EPA ) and γ-linolenic acid ( GLA ) in patients undergoing radical esophagectomy for thoracic esophageal cancer . Methods From November 2009 to July 2011 , 87 consecutive patients were r and omized to receive either an IMD enriched with EPA , GLA , and antioxidants ( n = 42 ) or a st and ard isocaloric , isonitrogenous diet ( control group , n = 45 ) after esophagectomy with radical lymphadenectomy . The primary outcome measure was changes in the oxygenation status ( PaO2/FIO2 ratio ) , and the secondary outcome measures were body composition , inflammation-related factors , coagulation markers , cholesterol concentrations , and major clinical outcomes . Results Oxygenation was significantly better on postoperative days ( PODs ) 4 , 6 , and 8 in the IMD than control group ( 366.5 ± 63.3 vs. 317.3 ± 58.8 , P = 0.001 ; 361.5 ± 52.6 vs. 314.0 ± 53.2 , P < 0.001 ; 365.4 ± 71.2 vs. 315.2 ± 56.9 , P = 0.001 , respectively ) . Changes in the ratio of body weight on PODs 14 and 21 and lean body weight on POD 21 were significantly greater in the IMD than control group . No significant differences were observed in other measures . Conclusions An enteral IMD enriched with EPA and GLA improved oxygenation and maintained the body composition of patients undergoing radical esophagectomy , indicating the potential efficacy of such a diet after esophagectomy Background Postoperative weight loss and malnutrition are major issues in gastric cancer patients . The concept of oral nutritional supplements ( ONS ) is gaining widespread acceptance . We investigated the effects of ONS administration on postoperative body weight loss in patients with gastric cancer who had undergone total gastrectomy or distal gastrectomy . Methods Patients were r and omized to either the treatment or the control group . In both groups , st and ard surgery for gastric cancer was performed . In the treatment group , intervention with ONS was performed until 12 weeks after discharge . In the control group , patients were fed the usual postoperative diet .  Weight , body composition , quality of life , hematological parameters , and blood chemistry were evaluated . Results We analyzed 113 cases ( 73 distal gastrectomy , 40 total gastrectomy ) .  Weight loss in the ONS group after total gastrectomy was significantly less than that in the control group . Weight loss and skeletal muscle mass loss after distal gastrectomy did not differ significantly between the ONS and control groups . Conclusion This study showed ONS after total gastrectomy to significantly diminish postoperative weight loss Aim : N-3 fatty acids , especially eicosapentaenoic acid ( EPA ) , may possess anticachectic properties . This trial compared a protein and energy dense supplement enriched with n-3 fatty acids and antioxidants ( experimental : E ) with an isocaloric isonitrogenous control supplement ( C ) for their effects on weight , lean body mass ( LBM ) , dietary intake , and quality of life in cachectic patients with advanced pancreatic cancer . Methods : A total of 200 patients ( 95 E ; 105 C ) were r and omised to consume two cans/day of the E or C supplement ( 480 ml , 620 kcal , 32 g protein ± 2.2 g EPA ) for eight weeks in a multicentre , r and omised , double blind trial . Results : At enrolment , patients ’ mean rate of weight loss was 3.3 kg/month . Intake of the supplements ( E or C ) was below the recommended dose ( 2 cans/day ) and averaged 1.4 cans/day . Over eight weeks , patients in both groups stopped losing weight ( Δ weight E : −0.25 kg/month versus C : −0.37 kg/month ; p = 0.74 ) and LBM ( Δ LBM E : + 0.27 kg/month versus C : + 0.12 kg/month ; p = 0.88 ) to an equal degree ( change from baseline E and C , p<0.001 ) . In view of evident non-compliance in both E and C groups , correlation analyses were undertaken to examine for potential dose-response relationships . E patients demonstrated significant correlations between their supplement intake and weight gain ( r = 0.50 , p<0.001 ) and increase in LBM ( r = 0.33 , p = 0.036 ) . Such correlations were not statistically significant in C patients . The relationship of supplement intake with change in LBM was significantly different between E and C patients ( p = 0.043 ) . Increased plasma EPA levels in the E group were associated with weight and LBM gain ( r = 0.50 , p<0.001 ; r = 0.51 , p = 0.001 ) . Weight gain was associated with improved quality of life ( p<0.01 ) only in the E group . Conclusion : Intention to treat group comparisons indicated that at the mean dose taken , enrichment with n-3 fatty acids did not provide a therapeutic advantage and that both supplements were equally effective in arresting weight loss . Post hoc dose-response analysis suggests that if taken in sufficient quantity , only the n-3 fatty acid enriched energy and protein dense supplement results in net gain of weight , lean tissue , and improved quality of life . Further trials are required to examine the potential role of n-3 enriched supplements in the treatment of cancer cachexia BACKGROUND Patients who undergo surgery are at risk of malnutrition due to periods of starvation , the stress of surgery , and subsequent increase in metabolic rate . There are limited data on nutritional outcome of surgical patients . AIMS To investigate changes in nutritional status and the influence of oral supplements on nutritional status , morbidity , and quality of life in postoperative surgical patients . METHODS Entry was determined by the presence of malnutrition , as defined by a body mass index ( BMI ) ⩽20 kg/m2 , anthropometric measurements ⩽15th percentile on admission , or initiation of oral diet postoperatively and /or a weight loss of 5 % or more during the operative period . We studied 101 patients : 52 were r and omised to the treatment group ( TG ) and prescribed a 1.5 kcal/ml nutritional supplement ; 49 patients were r and omised to the control group ( CG ) and continued with routine nutritional management .  Nutritional status was assessed by weight , anthropometry , and grip strength , with measurements taken at two weekly intervals for 10 weeks . Complications , namely wound infection , chest infection , and antibiotic use were documented . Quality of life ( QOL ) was assessed using the UK SF-36 question naire . RESULTS Patients in the control group lost a maximum mean ( SD ) of 5.96 ( 4.21 ) kg in weight over a period of eight weeks while patients in group TG lost less weight overall ( maximum mean ( SD ) 3.40 ( 0.89 ) kg ( p<0.001 ) occurring at four weeks and progressively regained weight from week 4 ) . Anthropometry , grip strength , and QOL were similarly significantly different between groups ( p<0.001 ) . Fewer patients in the treatment group ( 7/52 ) required antibiotic prescriptions compared with the control group ( 15/49 ) . CONCLUSIONS Nutritional status declined for two months after discharge . Postoperative nutritional supplementation improved nutritional status , QOL , and morbidity in these patients OBJECTIVES This r and omized clinical trial tested whether fish oil supplements can improve human coronary atherosclerosis .  BACKGROUND Epidemiologic studies of population s whose intake of oily fish is high , as well as laboratory studies of the effects of the polyunsaturated fatty acids in fish oil , support the hypothesis that fish oil is antiatherogenic . METHODS Patients with angiographically documented coronary heart disease and normal plasma lipid levels were r and omized to receive either fish oil capsules ( n = 31 ) , containing 6 g of n-3 fatty acids , or olive oil capsules ( n = 28 ) for an average duration of 28 months . Coronary atherosclerosis on angiography was quantified by computer-assisted image analysis . RESULTS Mean ( + /- SD ) baseline characteristics were age 62 + /- 7 years , plasma total cholesterol concentration 187 + /- 31 mg/dl ( 4.83 + /- 0.80 mmol/liter ) and triglyceride levels 132 + /- 70 mg/dl ( 1.51 + /- 0.80 mmol/liter ) . Fish oil lowered triglyceride levels by 30 % ( p = 0.007 ) but had no significant effects on other plasma lipoprotein levels . At the end of the trial , eicosapentaenoic acid in adipose tissue sample s was 0.91 % in the fish oil group compared with 0.20 % in the control group ( p < 0.0001 ) . At baseline , the minimal lumen diameter of coronary artery lesions ( n = 305 ) was 1.64 + /- 0.76 mm , and percent narrowing was 48 + /- 14 % . Mean minimal diameter of atherosclerotic coronary arteries decreased by 0.104 and 0.138 mm in the fish oil and control groups , respectively ( p = 0.6 between groups ) , and percent stenosis increased by 2.4 % and 2.6 % , respectively ( p = 0.8 ) . Confidence intervals exclude improvement by fish oil treatment of > 0.17 mm , or > 2.6 % . CONCLUSIONS Fish oil treatment for 2 years does not promote major favorable changes in the diameter of atherosclerotic coronary arteries BACKGROUND High levels of circulating proinflammatory cytokines are characteristic of inflammaging , a term coined to describe age-related chronic systemic inflammation involved in the etiology of many age-related disorders including nonhealing wounds . Some studies have shown that supplementing diets with n-3 polyunsaturated fatty acids ( eicosapentaenoic acid [ EPA ] and docosahexaenoic acid [ DHA ] ) lowers systemic levels of key proinflammatory cytokines associated with inflammaging . However , findings from the few studies that have focused exclusively on older adults are inconclusive . As such , the objective of this r and omized controlled study was to test the effects of EPA+DHA therapy on circulating levels of proinflammatory cytokines in adults in middle to late adulthood . METHODS Plasma levels of fatty acids and interleukin (IL)-6 , IL-1β and tumor necrosis factor-α ( TNF-α ) were measured in 35 participants with chronic venous leg ulcers ( mean age : 60.6 years ) r and omnly assigned to 8 weeks of EPA+DHA therapy ( 2.5 g/d ) or placebo therapy . RESULTS EPA+DHA therapy had a significant lowering effect on levels of IL-6 , IL-1β and TNF-α after 4 weeks of therapy and an even greater lowering effect after 8 weeks of therapy . Further , after adjusting for baseline difference , the treatment group had significantly lower levels of IL-6 ( p = 0.008 ) , IL-1β ( p < 0.001 ) , and TNF-α ( p < 0.001 ) at Week 4 and at Week 8 [ IL-6 ( p = 0.007 ) , IL-1β ( p < 0.001 ) , and TNF-α ( p < 0.001 ) ] compared to the control group . CONCLUSION Adults in middle to late adulthood  receiving EPA+DHA therapy demonstrated significantly greater reductions in circulating levels of proinflammatory cytokines compared with those receiving placebo therapy . EPA+DHA therapy may be an effective low-risk dietary intervention for assuaging the harmful effects of inflammaging Goals The aim of the study was to assess the impact of an eicosapentanoic acid-containing protein and energy dense oral nutritional supplement ( EPA-ONS ) on nutritional and inflammatory status , quality of life ( QOL ) , plasma phospholipids ( PPL ) and cytokine profile , tolerance of irinotecan-containing chemotherapy and EPA-ONS in patients with advanced colorectal cancer ( CRC ) receiving chemotherapy . Material s and methods Patients with advanced CRC having one prior chemotherapy regimen received 480 ml of EPA-ONS daily for 3 weeks before commencing chemotherapy with folinic acid , 5-fluorouracil , irinotecan ( FOLFIRI ) , and continued for 3 cycles of treatment ( 9 weeks ) . All assessment s including weight , body composition , C-reactive protein ( CRP ) , QOL , dietary intake , PPL and cytokine analyses were performed at baseline , 3 and 9 weeks . Results Twenty-three patients were enrolled ,  
    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 Although the anti-inflammatory effects of immunomodulating diets ( IMDs ) have recently attracted attention , the efficacy of enteral feeding of such diets after radical surgery remains controversial . Thus , we conducted a new prospect i ve , r and omized controlled study to eluci date any beneficial effect of an IMD containing eicosapentaenoic acid ( EPA ) and γ-linolenic acid ( GLA ) in patients undergoing radical esophagectomy for thoracic esophageal cancer . Methods From November 2009 to July 2011 , 87 consecutive patients were r and omized to receive either an IMD enriched with EPA , GLA , and antioxidants ( n = 42 ) or a st and ard isocaloric , isonitrogenous diet ( control group , n = 45 ) after esophagectomy with radical lymphadenectomy . The primary outcome measure was changes in the oxygenation status ( PaO2/FIO2 ratio ) , and the secondary outcome measures were body composition , inflammation-related factors , coagulation markers , cholesterol concentrations , and major clinical outcomes . Results Oxygenation was significantly better on postoperative days ( PODs ) 4 , 6 , and 8 in the IMD than control group ( 366.5 ± 63.3 vs. 317.3 ± 58.8 , P = 0.001 ; 361.5 ± 52.6 vs. 314.0 ± 53.2 , P < 0.001 ; 365.4 ± 71.2 vs. 315.2 ± 56.9 , P = 0.001 , respectively ) . Changes in the ratio of body weight on PODs 14 and 21 and lean body weight on POD 21 were significantly greater in the IMD than control group . No significant differences were observed in other measures . Conclusions An enteral IMD enriched with EPA and GLA improved oxygenation and maintained the body composition of patients undergoing radical esophagectomy , indicating the potential efficacy of such a diet after esophagectomy Background Postoperative weight loss and malnutrition are major issues in gastric cancer patients . The concept of oral nutritional supplements ( ONS ) is gaining widespread acceptance . We investigated the effects of ONS administration on postoperative body weight loss in patients with gastric cancer who had undergone total gastrectomy or distal gastrectomy . Methods Patients were r and omized to either the treatment or the control group . In both groups , st and ard surgery for gastric cancer was performed . In the treatment group , intervention with ONS was performed until 12 weeks after discharge . In the control group , patients were fed the usual postoperative diet .  Weight , body composition , quality of life , hematological parameters , and blood chemistry were evaluated . Results We analyzed 113 cases ( 73 distal gastrectomy , 40 total gastrectomy ) .  Weight loss in the ONS group after total gastrectomy was significantly less than that in the control group . Weight loss and skeletal muscle mass loss after distal gastrectomy did not differ significantly between the ONS and control groups . Conclusion This study showed ONS after total gastrectomy to significantly diminish postoperative weight loss Aim : N-3 fatty acids , especially eicosapentaenoic acid ( EPA ) , may possess anticachectic properties . This trial compared a protein and energy dense supplement enriched with n-3 fatty acids and antioxidants ( experimental : E ) with an isocaloric isonitrogenous control supplement ( C ) for their effects on weight , lean body mass ( LBM ) , dietary intake , and quality of life in cachectic patients with advanced pancreatic cancer . Methods : A total of 200 patients ( 95 E ; 105 C ) were r and omised to consume two cans/day of the E or C supplement ( 480 ml , 620 kcal , 32 g protein ± 2.2 g EPA ) for eight weeks in a multicentre , r and omised , double blind trial . Results : At enrolment , patients ’ mean rate of weight loss was 3.3 kg/month . Intake of the supplements ( E or C ) was below the recommended dose ( 2 cans/day ) and averaged 1.4 cans/day . Over eight weeks , patients in both groups stopped losing weight ( Δ weight E : −0.25 kg/month versus C : −0.37 kg/month ; p = 0.74 ) and LBM ( Δ LBM E : + 0.27 kg/month versus C : + 0.12 kg/month ; p = 0.88 ) to an equal degree ( change from baseline E and C , p<0.001 ) . In view of evident non-compliance in both E and C groups , correlation analyses were undertaken to examine for potential dose-response relationships . E patients demonstrated significant correlations between their supplement intake and weight gain ( r = 0.50 , p<0.001 ) and increase in LBM ( r = 0.33 , p = 0.036 ) . Such correlations were not statistically significant in C patients . The relationship of supplement intake with change in LBM was significantly different between E and C patients ( p = 0.043 ) . Increased plasma EPA levels in the E group were associated with weight and LBM gain ( r = 0.50 , p<0.001 ; r = 0.51 , p = 0.001 ) . Weight gain was associated with improved quality of life ( p<0.01 ) only in the E group . Conclusion : Intention to treat group comparisons indicated that at the mean dose taken , enrichment with n-3 fatty acids did not provide a therapeutic advantage and that both supplements were equally effective in arresting weight loss . Post hoc dose-response analysis suggests that if taken in sufficient quantity , only the n-3 fatty acid enriched energy and protein dense supplement results in net gain of weight , lean tissue , and improved quality of life . Further trials are required to examine the potential role of n-3 enriched supplements in the treatment of cancer cachexia BACKGROUND Patients who undergo surgery are at risk of malnutrition due to periods of starvation , the stress of surgery , and subsequent increase in metabolic rate . There are limited data on nutritional outcome of surgical patients . AIMS To investigate changes in nutritional status and the influence of oral supplements on nutritional status , morbidity , and quality of life in postoperative surgical patients . METHODS Entry was determined by the presence of malnutrition , as defined by a body mass index ( BMI ) ⩽20 kg/m2 , anthropometric measurements ⩽15th percentile on admission , or initiation of oral diet postoperatively and /or a weight loss of 5 % or more during the operative period . We studied 101 patients : 52 were r and omised to the treatment group ( TG ) and prescribed a 1.5 kcal/ml nutritional supplement ; 49 patients were r and omised to the control group ( CG ) and continued with routine nutritional management .  Nutritional status was assessed by weight , anthropometry , and grip strength , with measurements taken at two weekly intervals for 10 weeks . Complications , namely wound infection , chest infection , and antibiotic use were documented . Quality of life ( QOL ) was assessed using the UK SF-36 question naire . RESULTS Patients in the control group lost a maximum mean ( SD ) of 5.96 ( 4.21 ) kg in weight over a period of eight weeks while patients in group TG lost less weight overall ( maximum mean ( SD ) 3.40 ( 0.89 ) kg ( p<0.001 ) occurring at four weeks and progressively regained weight from week 4 ) . Anthropometry , grip strength , and QOL were similarly significantly different between groups ( p<0.001 ) . Fewer patients in the treatment group ( 7/52 ) required antibiotic prescriptions compared with the control group ( 15/49 ) . CONCLUSIONS Nutritional status declined for two months after discharge . Postoperative nutritional supplementation improved nutritional status , QOL , and morbidity in these patients OBJECTIVES This r and omized clinical trial tested whether fish oil supplements can improve human coronary atherosclerosis .  BACKGROUND Epidemiologic studies of population s whose intake of oily fish is high , as well as laboratory studies of the effects of the polyunsaturated fatty acids in fish oil , support the hypothesis that fish oil is antiatherogenic . METHODS Patients with angiographically documented coronary heart disease and normal plasma lipid levels were r and omized to receive either fish oil capsules ( n = 31 ) , containing 6 g of n-3 fatty acids , or olive oil capsules ( n = 28 ) for an average duration of 28 months . Coronary atherosclerosis on angiography was quantified by computer-assisted image analysis . RESULTS Mean ( + /- SD ) baseline characteristics were age 62 + /- 7 years , plasma total cholesterol concentration 187 + /- 31 mg/dl ( 4.83 + /- 0.80 mmol/liter ) and triglyceride levels 132 + /- 70 mg/dl ( 1.51 + /- 0.80 mmol/liter ) . Fish oil lowered triglyceride levels by 30 % ( p = 0.007 ) but had no significant effects on other plasma lipoprotein levels . At the end of the trial , eicosapentaenoic acid in adipose tissue sample s was 0.91 % in the fish oil group compared with 0.20 % in the control group ( p < 0.0001 ) . At baseline , the minimal lumen diameter of coronary artery lesions ( n = 305 ) was 1.64 + /- 0.76 mm , and percent narrowing was 48 + /- 14 % . Mean minimal diameter of atherosclerotic coronary arteries decreased by 0.104 and 0.138 mm in the fish oil and control groups , respectively ( p = 0.6 between groups ) , and percent stenosis increased by 2.4 % and 2.6 % , respectively ( p = 0.8 ) . Confidence intervals exclude improvement by fish oil treatment of > 0.17 mm , or > 2.6 % . CONCLUSIONS Fish oil treatment for 2 years does not promote major favorable changes in the diameter of atherosclerotic coronary arteries BACKGROUND High levels of circulating proinflammatory cytokines are characteristic of inflammaging , a term coined to describe age-related chronic systemic inflammation involved in the etiology of many age-related disorders including nonhealing wounds . Some studies have shown that supplementing diets with n-3 polyunsaturated fatty acids ( eicosapentaenoic acid [ EPA ] and docosahexaenoic acid [ DHA ] ) lowers systemic levels of key proinflammatory cytokines associated with inflammaging . However , findings from the few studies that have focused exclusively on older adults are inconclusive . As such , the objective of this r and omized controlled study was to test the effects of EPA+DHA therapy on circulating levels of proinflammatory cytokines in adults in middle to late adulthood . METHODS Plasma levels of fatty acids and interleukin (IL)-6 , IL-1β and tumor necrosis factor-α ( TNF-α ) were measured in 35 participants with chronic venous leg ulcers ( mean age : 60.6 years ) r and omnly assigned to 8 weeks of EPA+DHA therapy ( 2.5 g/d ) or placebo therapy . RESULTS EPA+DHA therapy had a significant lowering effect on levels of IL-6 , IL-1β and TNF-α after 4 weeks of therapy and an even greater lowering effect after 8 weeks of therapy . Further , after adjusting for baseline difference , the treatment group had significantly lower levels of IL-6 ( p = 0.008 ) , IL-1β ( p < 0.001 ) , and TNF-α ( p < 0.001 ) at Week 4 and at Week 8 [ IL-6 ( p = 0.007 ) , IL-1β ( p < 0.001 ) , and TNF-α ( p < 0.001 ) ] compared to the control group . CONCLUSION Adults in middle to late adulthood  receiving EPA+DHA therapy demonstrated significantly greater reductions in circulating levels of proinflammatory cytokines compared with those receiving placebo therapy . EPA+DHA therapy may be an effective low-risk dietary intervention for assuaging the harmful effects of inflammaging Goals The aim of the study was to assess the impact of an eicosapentanoic acid-containing protein and energy dense oral nutritional supplement ( EPA-ONS ) on nutritional and inflammatory status , quality of life ( QOL ) , plasma phospholipids ( PPL ) and cytokine profile , tolerance of irinotecan-containing chemotherapy and EPA-ONS in patients with advanced colorectal cancer ( CRC ) receiving chemotherapy . Material s and methods Patients with advanced CRC having one prior chemotherapy regimen received 480 ml of EPA-ONS daily for 3 weeks before commencing chemotherapy with folinic acid , 5-fluorouracil , irinotecan ( FOLFIRI ) , and continued for 3 cycles of treatment ( 9 weeks ) . All assessment s including weight , body composition , C-reactive protein ( CRP ) , QOL , dietary intake , PPL and cytokine analyses were performed at baseline , 3 and 9 weeks . Results Twenty-three patients were enrolled ,  
    Output:
    