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: Asthma is a chronic inflammatory disease of the airways mediated , at least in part , by leukotrienes and other lipid mediators . Experimental studies have shown that lipid extract of New Zeal and green-lipped mussel , Perna canaliculus , is effective in inhibiting 5′-lipoxygenase and cyclo-oxygenase pathways responsible for production of eicosanoids , including leukotrienes and prostagl and ins . The aim of this study was to assess its effect on symptoms , peak expiratory flow ( PEF ) and hydrogen peroxide ( H2O2 ) in expired breath condensate as a marker of airway inflammation in patients with steroid-naïve atopic asthma in a double-blind r and omised , placebo-controlled clinical trial . Forty six patients with atopic asthma received two capsules of lipid extract ( Lyprinol ® ) or placebo b.i.d . for 8 weeks . Each capsule of lipid extract contained 50 mg ω-3 polyunsaturated fatty acids and 100 mg olive oil , whereas placebo capsules contained only 150 mg olive oil . There was a significant decrease in daytime wheeze , the concentration of exhaled H2O2 and an increase in morning PEF in the lipid extract group compared to the placebo group . There were no significant side-effects . The authors conclude that lipid extract of New Zeal and green-lipped mussel may have some beneficial effect in patients with atopic asthma BACKGROUND Previous research has demonstrated that fish oil supplementation has a protective effect on exercise-induced bronchoconstriction ( EIB ) in elite athletes , which may be attributed to its antiinflammatory properties . Since EIB in asthma involves proinflammatory mediator release , it is feasible that fish oil supplementation may reduce the severity of EIB in asthmatic subjects . STUDY OBJECTIVES To determine the efficacy of fish oil supplementation on severity of EIB in subjects with asthma . DESIGN R and omized , double-blind , crossover study . SETTING Lung function and exercise testing in a university research laboratory . PATIENTS AND MEASUREMENTS Sixteen asthmatic patients with documented EIB entered the study on their normal diet  and then received either fish oil capsules containing 3.2 g of eicosapentaenoic acid and 2.0 g of docohexaenoic acid ( fish oil diet , n = 8) or placebo capsules ( placebo diet , n = 8) daily for 3 weeks . At the beginning of the study ( normal diet ) and at the end of each treatment phase , the following pre-exercise and postexercise measures were assessed : ( 1 ) pulmonary function ; ( 2 ) induced sputum differential cell count percentage and proinflammatory eicosanoid metabolite ( leukotriene C4 [LTC4]-leukotriene E4 [ LTE4 ] and prostagl and in D2 [ PGD2 ] ) and cytokine ( interleukin [IL]-1beta and tumor necrosis factor [TNF]-alpha ) concentrations ; and ( 3 ) eicosanoid metabolites leukotriene B4 ( LTB4 ) and leukotriene B5 ( LTB(5 ) ) generation from activated polymorphonuclear leukocytes ( PMNLs ) . RESULTS On the normal and placebo diet , subjects exhibited EIB . However , the fish oil diet improved pulmonary function to below the diagnostic EIB threshold , with a concurrent reduction in bronchodilator use . Induced sputum differential cell count percentage and concentrations of LTC4-LTE4 , PGD2 , IL-1beta , and TNF-alpha were significantly reduced before and following exercise on the fish oil diet compared to the normal and placebo diets . There was a significant reduction in LTB4 and a significant increase in LTB5 generation from activated PMNLs on the fish oil diet compared to the normal and placebo diets . CONCLUSION Our data suggest that fish oil supplementation may represent a potentially beneficial nonpharmacologic intervention for asthmatic subjects with EIB We assessed the clinical and biochemical effects in asthmatic children of fish oil supplementation and a diet that increases omega-3 and reduces omega-6 fatty acids . Thirty nine asthmatic children aged 8 - 12 yrs participated in a double-blind , r and omized , controlled trial for 6 months during which they received fish oil capsules plus canola oil and margarine ( omega-3 group ) or safflower oil capsules plus sunflower oil and margarine ( omega-6 group ) . Plasma fatty acids , stimulated tumour necrosis factor alpha ( TNFalpha ) production , circulating eosinophil numbers and lung function were measured at baseline and after 3 and 6 months of dietary modification . Day and night symptoms , peak flow rates and medication use were recorded for 1 week prior to laboratory visits . Plasma phospholipid omega-3 fatty acids were significantly greater in the omega-3 group at 3 and 6 months compared to the omega-6 group ( p<0.001 ) . In the omega-3 group TNFalpha production fell significantly compared with baseline ( p=0.026 ) , but the magnitude of change between groups did not reach significance ( p=0.075 ) . There were no significant changes in clinical outcome measures . Dietary enrichment of omega-3 fatty acids over 6 months increased plasma levels of these fatty acids , reduced stimulated tumour necrosis factor alpha production , but had no effect on the clinical severity of asthma in these children Omega-3 polyunsaturated fatty acids have anti-inflammatory effects in vitro , and high dietary levels are associated with a lower incidence of inflammatory diseases . However , only limited effects have been demonstrated in asthma . The effects of dietary supplementation with fish oil for 10 months in 29 children with bronchial asthma was investigated in a r and omized controlled fashion . In order to minimize the effects of environmental inhaled allergens and diet , this study was performed in a long-term treatment hospital . Subjects received fish oil capsules containing 84 mg eicosapentaenoic acid ( EPA ) and 36 mg docosahexaenoic acid ( DHA ) or control capsules containing 300 mg olive oil . The daily dosages of EPA and DHA were 17.0 - 26.8 and 7.3 - 11.5 mg x kg body weight(-1 ) , respectively . Asthma symptom scores decreased and responsiveness to acetylcholine decreased in the fish oil group but not in the control group . In addition , plasma EPA levels increased significantly only in the fish oil group ( p<0.0088 ) . No significant side-effects were observed . The present results suggest that dietary supplementation with fish oil rich in the omega-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid is beneficial for children with bronchial asthma in a strictly controlled environment in terms of inhalant allergens and diet Airway inflammation is a major component of asthma . Food intake of N-3 fatty acids ( FA ) is associated with a low incidence of inflammatory diseases , such as asthma . We treated 12 asthmatic patients with  FA  and report the positive results of this 1-year double-blind study . A positive effect on forced expiratory volume in 1 s was observed after the 9 month of treatment . Our results are in favor of the use of FA , but have to be confirmed by other studies Recruitment of inflammatory leucocytes to the airways may play a part in the pathogenesis of asthma . As dietary enrichment with fish oil lipids can suppress leucocyte function , the effect of these lipids on asthma control and neutrophil function was studied in 20 subjects with mild asthma . Twelve subjects received capsules containing 3.2 g of eicosapentaenoic acid and 2.2 g of docosahexaenoic acid daily and eight subjects received placebo capsules containing olive oil for 10 weeks in a double blind fashion . Baseline specific airways conductance , airways responsiveness to histamine and exercise , diurnal peak expiratory flow , symptom scores , and bronchodilator use were measured . Neutrophil fatty acid composition was evaluated by gas chromatography , calcium ionophore induced neutrophil leukotriene (LT)B4 and LTB5 generation were measured by reverse phase high performance liquid chromatography and radioimmunoassay , and neutrophil chemotactic responses to formyl-methionyl-leucyl-phenylalanine ( FMLP ) and LTB4 were assessed by a microchemotaxis technique . Although the fish oil supplemented diet produced a greater than 10 fold increase in the eicosapentaenoic acid content of neutrophil phospholipids , there was no significant change in airways responsiveness to histamine or any change in any of the clinical measurements . After dietary supplementation with fish oil there was a 50 % inhibition of total LTB ( LTB4 + LTB5 ) generation by ionophore stimulated neutrophils and neutrophil chemotaxis was substantially suppressed . Neutrophil function remained unchanged in the placebo group . It is concluded that in subjects with mild asthma a fish oil enriched diet attenuates neutrophil function without changing the severity of asthma OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity The effects of taking 18 capsules a day of Max-EPA ( 3.2 g/day eicosapentaenoic acid ) on clinical symptoms and bronchial hyperresponsiveness were studied in pollen-sensitive subjects over a pollen season in a parallel , double-blind , placebo-controlled ( olive oil ) fashion . The study was conducted over the 1990 and 1991 pollen seasons in London , Engl and . A total of 37 nonsmoking pollen-sensitive asthmatic subjects were entered into the trial , and 25 completed the 6-month study period over the 2 yr . The preseasonal geometric mean PD35 SGaw of histamine for the fish oil ( n = 12 ) and placebo ( n = 9 ) groups were 0.62 and 0.42 mumol , respectively . During the middle of the pollen season , histamine PD35 SGaw fell significantly for both the fish oil ( 0.11 mumol , p < 0.0001 ) and placebo groups ( 0.10 mumol , p < 0.007 ) , indicating increased bronchial reactivity compared with preseasonal values , but there was no significant difference between the groups . Similarly , morning and evening peak expiratory flow ( PEF ) , diurnal variability in PEF , nocturnal cough and wheeze , daytime wheeze , and activity , as well as nasal symptoms and increased usage of medication , were not significantly different between the groups . Compliance was confirmed by neutrophil and plasma phospholipid analysis , which showed significant rises in eicosapentaenoic acid content in the fish oil group but not in the placebo group . We conclude that dietary fish oil supplementation does not prevent seasonal hay fever and asthma in pollen-sensitive subjects during the pollen season OBJECTIVE The effects of perilla seed oil ( n-3 fatty acids ) on bronchial asthma were compared with the effects of corn oil ( n-6 fatty acids ) in relation to the pulmonary function and the generation of leukotriene B4 ( LTB4 ) and C4 ( LTC4 ) by leucocytes . METHODS AND SUBJECTS 14 asthmatic subjects were divided r and omly into two groups : one group ( 7 subjects ) consumed perilla seed oil-rich supplementation and the other group ( 7 subjects ) consumed corn oil-rich supplementation for 4 weeks .  Generation of LTs by leucocytes and respiratory function were compared 
    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: Asthma is a chronic inflammatory disease of the airways mediated , at least in part , by leukotrienes and other lipid mediators . Experimental studies have shown that lipid extract of New Zeal and green-lipped mussel , Perna canaliculus , is effective in inhibiting 5′-lipoxygenase and cyclo-oxygenase pathways responsible for production of eicosanoids , including leukotrienes and prostagl and ins . The aim of this study was to assess its effect on symptoms , peak expiratory flow ( PEF ) and hydrogen peroxide ( H2O2 ) in expired breath condensate as a marker of airway inflammation in patients with steroid-naïve atopic asthma in a double-blind r and omised , placebo-controlled clinical trial . Forty six patients with atopic asthma received two capsules of lipid extract ( Lyprinol ® ) or placebo b.i.d . for 8 weeks . Each capsule of lipid extract contained 50 mg ω-3 polyunsaturated fatty acids and 100 mg olive oil , whereas placebo capsules contained only 150 mg olive oil . There was a significant decrease in daytime wheeze , the concentration of exhaled H2O2 and an increase in morning PEF in the lipid extract group compared to the placebo group . There were no significant side-effects . The authors conclude that lipid extract of New Zeal and green-lipped mussel may have some beneficial effect in patients with atopic asthma BACKGROUND Previous research has demonstrated that fish oil supplementation has a protective effect on exercise-induced bronchoconstriction ( EIB ) in elite athletes , which may be attributed to its antiinflammatory properties . Since EIB in asthma involves proinflammatory mediator release , it is feasible that fish oil supplementation may reduce the severity of EIB in asthmatic subjects . STUDY OBJECTIVES To determine the efficacy of fish oil supplementation on severity of EIB in subjects with asthma . DESIGN R and omized , double-blind , crossover study . SETTING Lung function and exercise testing in a university research laboratory . PATIENTS AND MEASUREMENTS Sixteen asthmatic patients with documented EIB entered the study on their normal diet  and then received either fish oil capsules containing 3.2 g of eicosapentaenoic acid and 2.0 g of docohexaenoic acid ( fish oil diet , n = 8) or placebo capsules ( placebo diet , n = 8) daily for 3 weeks . At the beginning of the study ( normal diet ) and at the end of each treatment phase , the following pre-exercise and postexercise measures were assessed : ( 1 ) pulmonary function ; ( 2 ) induced sputum differential cell count percentage and proinflammatory eicosanoid metabolite ( leukotriene C4 [LTC4]-leukotriene E4 [ LTE4 ] and prostagl and in D2 [ PGD2 ] ) and cytokine ( interleukin [IL]-1beta and tumor necrosis factor [TNF]-alpha ) concentrations ; and ( 3 ) eicosanoid metabolites leukotriene B4 ( LTB4 ) and leukotriene B5 ( LTB(5 ) ) generation from activated polymorphonuclear leukocytes ( PMNLs ) . RESULTS On the normal and placebo diet , subjects exhibited EIB . However , the fish oil diet improved pulmonary function to below the diagnostic EIB threshold , with a concurrent reduction in bronchodilator use . Induced sputum differential cell count percentage and concentrations of LTC4-LTE4 , PGD2 , IL-1beta , and TNF-alpha were significantly reduced before and following exercise on the fish oil diet compared to the normal and placebo diets . There was a significant reduction in LTB4 and a significant increase in LTB5 generation from activated PMNLs on the fish oil diet compared to the normal and placebo diets . CONCLUSION Our data suggest that fish oil supplementation may represent a potentially beneficial nonpharmacologic intervention for asthmatic subjects with EIB We assessed the clinical and biochemical effects in asthmatic children of fish oil supplementation and a diet that increases omega-3 and reduces omega-6 fatty acids . Thirty nine asthmatic children aged 8 - 12 yrs participated in a double-blind , r and omized , controlled trial for 6 months during which they received fish oil capsules plus canola oil and margarine ( omega-3 group ) or safflower oil capsules plus sunflower oil and margarine ( omega-6 group ) . Plasma fatty acids , stimulated tumour necrosis factor alpha ( TNFalpha ) production , circulating eosinophil numbers and lung function were measured at baseline and after 3 and 6 months of dietary modification . Day and night symptoms , peak flow rates and medication use were recorded for 1 week prior to laboratory visits . Plasma phospholipid omega-3 fatty acids were significantly greater in the omega-3 group at 3 and 6 months compared to the omega-6 group ( p<0.001 ) . In the omega-3 group TNFalpha production fell significantly compared with baseline ( p=0.026 ) , but the magnitude of change between groups did not reach significance ( p=0.075 ) . There were no significant changes in clinical outcome measures . Dietary enrichment of omega-3 fatty acids over 6 months increased plasma levels of these fatty acids , reduced stimulated tumour necrosis factor alpha production , but had no effect on the clinical severity of asthma in these children Omega-3 polyunsaturated fatty acids have anti-inflammatory effects in vitro , and high dietary levels are associated with a lower incidence of inflammatory diseases . However , only limited effects have been demonstrated in asthma . The effects of dietary supplementation with fish oil for 10 months in 29 children with bronchial asthma was investigated in a r and omized controlled fashion . In order to minimize the effects of environmental inhaled allergens and diet , this study was performed in a long-term treatment hospital . Subjects received fish oil capsules containing 84 mg eicosapentaenoic acid ( EPA ) and 36 mg docosahexaenoic acid ( DHA ) or control capsules containing 300 mg olive oil . The daily dosages of EPA and DHA were 17.0 - 26.8 and 7.3 - 11.5 mg x kg body weight(-1 ) , respectively . Asthma symptom scores decreased and responsiveness to acetylcholine decreased in the fish oil group but not in the control group . In addition , plasma EPA levels increased significantly only in the fish oil group ( p<0.0088 ) . No significant side-effects were observed . The present results suggest that dietary supplementation with fish oil rich in the omega-3 polyunsaturated fatty acids eicosapentaenoic acid and docosahexaenoic acid is beneficial for children with bronchial asthma in a strictly controlled environment in terms of inhalant allergens and diet Airway inflammation is a major component of asthma . Food intake of N-3 fatty acids ( FA ) is associated with a low incidence of inflammatory diseases , such as asthma . We treated 12 asthmatic patients with  FA  and report the positive results of this 1-year double-blind study . A positive effect on forced expiratory volume in 1 s was observed after the 9 month of treatment . Our results are in favor of the use of FA , but have to be confirmed by other studies Recruitment of inflammatory leucocytes to the airways may play a part in the pathogenesis of asthma . As dietary enrichment with fish oil lipids can suppress leucocyte function , the effect of these lipids on asthma control and neutrophil function was studied in 20 subjects with mild asthma . Twelve subjects received capsules containing 3.2 g of eicosapentaenoic acid and 2.2 g of docosahexaenoic acid daily and eight subjects received placebo capsules containing olive oil for 10 weeks in a double blind fashion . Baseline specific airways conductance , airways responsiveness to histamine and exercise , diurnal peak expiratory flow , symptom scores , and bronchodilator use were measured . Neutrophil fatty acid composition was evaluated by gas chromatography , calcium ionophore induced neutrophil leukotriene (LT)B4 and LTB5 generation were measured by reverse phase high performance liquid chromatography and radioimmunoassay , and neutrophil chemotactic responses to formyl-methionyl-leucyl-phenylalanine ( FMLP ) and LTB4 were assessed by a microchemotaxis technique . Although the fish oil supplemented diet produced a greater than 10 fold increase in the eicosapentaenoic acid content of neutrophil phospholipids , there was no significant change in airways responsiveness to histamine or any change in any of the clinical measurements . After dietary supplementation with fish oil there was a 50 % inhibition of total LTB ( LTB4 + LTB5 ) generation by ionophore stimulated neutrophils and neutrophil chemotaxis was substantially suppressed . Neutrophil function remained unchanged in the placebo group . It is concluded that in subjects with mild asthma a fish oil enriched diet attenuates neutrophil function without changing the severity of asthma OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity The effects of taking 18 capsules a day of Max-EPA ( 3.2 g/day eicosapentaenoic acid ) on clinical symptoms and bronchial hyperresponsiveness were studied in pollen-sensitive subjects over a pollen season in a parallel , double-blind , placebo-controlled ( olive oil ) fashion . The study was conducted over the 1990 and 1991 pollen seasons in London , Engl and . A total of 37 nonsmoking pollen-sensitive asthmatic subjects were entered into the trial , and 25 completed the 6-month study period over the 2 yr . The preseasonal geometric mean PD35 SGaw of histamine for the fish oil ( n = 12 ) and placebo ( n = 9 ) groups were 0.62 and 0.42 mumol , respectively . During the middle of the pollen season , histamine PD35 SGaw fell significantly for both the fish oil ( 0.11 mumol , p < 0.0001 ) and placebo groups ( 0.10 mumol , p < 0.007 ) , indicating increased bronchial reactivity compared with preseasonal values , but there was no significant difference between the groups . Similarly , morning and evening peak expiratory flow ( PEF ) , diurnal variability in PEF , nocturnal cough and wheeze , daytime wheeze , and activity , as well as nasal symptoms and increased usage of medication , were not significantly different between the groups . Compliance was confirmed by neutrophil and plasma phospholipid analysis , which showed significant rises in eicosapentaenoic acid content in the fish oil group but not in the placebo group . We conclude that dietary fish oil supplementation does not prevent seasonal hay fever and asthma in pollen-sensitive subjects during the pollen season OBJECTIVE The effects of perilla seed oil ( n-3 fatty acids ) on bronchial asthma were compared with the effects of corn oil ( n-6 fatty acids ) in relation to the pulmonary function and the generation of leukotriene B4 ( LTB4 ) and C4 ( LTC4 ) by leucocytes . METHODS AND SUBJECTS 14 asthmatic subjects were divided r and omly into two groups : one group ( 7 subjects ) consumed perilla seed oil-rich supplementation and the other group ( 7 subjects ) consumed corn oil-rich supplementation for 4 weeks .  Generation of LTs by leucocytes and respiratory function were compared 
    Output:
    