Medline hits on Acupuncture

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Tang P, Walsh S, Murray C, Alterman C, Varia M, Broukhanski G, Chedore

P, Dekoven J, Assaad D, Gold WL, Ghazarian D, Finkelstein M, Pritchard

M, Yaffe B, Jamieson F, Henry B, Phillips E. Outbreak of Acupuncture-

Associated Cutaneous Mycobacterium abscessus Infections. J Cutan Med

Surg. 2006 July/August;10(4):166-169. BACKGROUND: Cutaneous atypical

mycobacterial infections have been increasingly described in association

with cosmetic and alternative procedures. OBJECTIVE: We report an

outbreak of acupuncture-associated mycobacteriosis. Between April and

December 2002, 32 patients developed cutaneous mycobacteriosis after

visiting an acupuncture practice in Toronto, Canada. RESULTS: Of 23

patients whose lesions were biopsied, 6 (26.1%) had culture-confirmed

infection with Mycobacterium abscessus. These isolates were genetically

indistinguishable by amplified fragment length polymorphism. The median

incubation period was 1 month. Of 24 patients for whom clinical information

was available, 23 (95.8%) had resolution of their infection. All patients

developed residual scarring or hyperpigmentation. CONCLUSION:

Nontuberculous mycobacteria should be recognized as an emerging, but

preventable, cause of acupuncture-associated infections. PMID: 17234114

[PubMed - as supplied by publisher]

 

Maeda Y, Lisi TL, Vance CG, Sluka KA. Release of GABA and activation of

GABA(A) in the spinal cord mediates the effects of TENS in rats. Brain Res.

2007 Jan 15; [Epub ahead of print] Physical Therapy and Rehabilitation

Science Graduate Program, Neuroscience Graduate Program, Pain

Research Program, 1-242 MEB, University of Iowa, Iowa City, IA 52242,

USA. Transcutaneous electrical nerve stimulation (TENS) is a commonly

utilized non-pharmacological, non-invasive treatment for pain. GABA is a

neurotransmitter in the dorsal horn of the spinal cord that mediates

analgesia locally, and also through activation of supraspinal sites. TENS

reduces hyperalgesia through activation of receptor-mediated pathways at

the level of the spinal cord, and supraspinally. The current study tested the

hypothesis that either high or low frequency TENS applied to the inflamed

knee joint increases GABA in the spinal cord dorsal horn and activates

GABA receptors spinally. We utilized microdialysis to sample the

extracellular fluid before, during and after TENS and analyzed GABA in

dialysates with high performance liquid chromatography. We analyzed the

extracellular GABA concentrations in animals with and without knee joint

inflammation induced by intra-articular injection of kaolin and carrageenan.

We further tested if spinal blockade of GABA receptors prevents the

antihyperalgesia produced by TENS in rats with joint inflammation. We

show that high frequency TENS increases extracellular GABA

concentrations in the spinal cord in animals with and without joint

inflammation. The increases in GABA do not occur in response to low

frequency TENS, and there are no increases in glycine in response to low or

high frequency TENS. However, the reduction in primary hyperalgesia by

both high and low frequency TENS is prevented by spinal blockade of

GABA(A) receptors with bicuculline. Thus, high frequency TENS increases

release of GABA in the deep dorsal horn of the spinal cord, and both high

and low frequency TENS reduce primary hyperalgesia by activation of

GABA(A) receptors spinally. PMID: 17234163 [PubMed - as supplied by

publisher]

 

Mehl-Madrona L, Kligler B, Silverman S, Lynton H, Merrell W. The impact of

acupuncture and craniosacral therapy interventions on clinical outcomes in

adults with asthma. Explore (NY). 2007 Jan-Feb;3(1):28-36. Department of

Family Medicine, University of Saskatchewan College of Medicine,

Saskatoon, SK, Canada. OBJECTIVE: Synergy has been proposed

between modalities operating at different levels of action. Acupuncture and

craniosacral therapy are two very different modalities for which synergy has

been proposed. This study sought to test for such synergy and to determine

if complementary therapies would improve pulmonary function and quality of

life for people suffering from asthma, as well as reducing anxiety,

depression, and medication usage. DESIGN: Subjects were randomly

assignment to one of five groups: acupuncture, craniosacral therapy,

acupuncture and craniosacral, attention control, and waiting list control.

METHODS: Subjects received 12 sessions of equal length with

pretreatment and posttreatment assessment of pulmonary function, asthma

quality of life, depression, and anxiety. Medication use was also assessed.

RESULTS: Synergy was not demonstrated. When treatment was compared

with the control group, statistically treatment was significantly better than

the

control group in improving asthma quality of life, whereas reducing

medication use with pulmonary function test results remained the same.

However, the combination of acupuncture and craniosacral treatment was

not superior to each therapy alone. In fact, although all active patients

received 12 treatment sessions, those who received all treatments from one

practitioner had statistically significant reductions in anxiety when compared

with those receiving the same number of treatments from multiple

practitioners. No effects on depression were found. CONCLUSIONS:

Acupuncture and/or craniosacral therapy are potentially useful adjuncts to

the conventional care of adults with asthma, but the combination of the two

does not provide additional benefit over each therapy alone. PMID:

17234566 [PubMed - in process]

 

Miloro M, Miller JJ, Stoner JA. Low-level laser effect on mandibular

distraction osteogenesis. J Oral Maxillofac Surg. 2007 Feb;65(2):168-76.

Leon F. Davis Professor and Section Chief, Residency Program Director,

Section of Oral and Maxillofacial Surgery, University of Nebraska Medical

Center, Omaha, NE. PURPOSE: The purpose of this study was to

determine whether low-level laser (LLL) application during distraction

osteogenesis could accelerate bone regeneration and decrease the length

of the consolidation phase and thereby reduce potential patient morbidity.

MATERIALS AND METHODS: Nine adult female New Zealand white

rabbits underwent bilateral mandibular corticotomies and placement of

unidirectional distraction devices (KLS-Martin LP, Jacksonville, FL). Each

rabbit served as its own internal control. After a latency of 1 day, distraction

progressed bilaterally at 1 mm per day for 10 days. Immediately after each

device activation, the experimental side, chosen randomly, was treated with

real LLL (Laser Medical Systems, Hedehusene, Denmark) of 6.0 J x 6

transmucosal sites in the area of the distraction gap. Radiographs were

taken presurgically, immediately postsurgically, and weekly until sacrifice,

and the bone was analyzed using a semiquantitative 4-point scale (Bone

Healing Score [bHS]). Three animals each were sacrificed at 2, 4, and 6

weeks postdistraction, and each hemimandible was prepared for histologic

examination in a blinded fashion. RESULTS: Ten millimeters of distraction

was achieved in each rabbit bilaterally. Radiographically, the BHS was

higher for the LLL-treated group at all time periods. Histologically, the area

of new bone trabeculation and ossification was more advanced for the LLL-

treated group, with less intervening fibrovascular intermediate zone in the

bony regenerate, at all time periods. The formation of a complete inferior

border occurred sooner in the treatment group than in the controls.

CONCLUSIONS: LLL accelerates the process of bone regeneration during

the consolidation phase after distraction osteogenesis. The adjunctive use

of LLL may allow a shortened period of consolidation and therefore permit

earlier device removal, with the avoidance of morbidity associated with

prolonged device retention. PMID: 17236917 [PubMed - in process]

 

Longhurst JC. Electroacupuncture Treatment of Arrhythmias in Myocardial

Ischemia. Am J Physiol Heart Circ Physiol. 2007 Jan 19; [Epub ahead of

print] Medicine, University of California, Irvine, Irvine, California, United

States. Acupuncture is beginning to become recognized as a legitimate

therapy for a number of diseases. However, only recently are we beginning

to understand its mechanisms of action. A neural influence involving

afferent nerve stimulation, central hypothalamic, midbrain and medullary

network processing and ultimately regulation of sympathetic outflow

appears to underlie acupuncture's cardiovascular actions. The ability to

lower blood pressure, decrease myocardial ischemia and, as shown in this

issue of the journal, reduced ischemically related ventricular arrhythmias

constitute some of the cardiovascular conditions where acupuncture may

have a beneficial effect. While the acupuncture-related improvement in

myocardial oxygen demand may underlie its inhibition of ischemia and

arrhythmias, more studies are required to fully understand its actions. Key

words: Acupuncture, ventricular tachycardia, ventricular fibrillation, central

nervous system, sympathetic nerves. PMID: 17237254 [PubMed - as

supplied by publisher]

 

Weidenhammer W, Linde K, Streng A, Hoppe A, Melchart D. Acupuncture

for Chronic Low Back Pain in Routine Care: A Multicenter Observational

Study. Clin J Pain. 2007 Feb;23(2):128-135. *Department of Internal

Medicine II, Center for Complementary Medicine Research, Technische

Universitat Munchen, Germany daggerDivision of Complementary Medicine,

Department of Internal Medicine, University Hospital Zurich, Switzerland.

OBJECTIVE: To investigate patient characteristics and outcomes after

undergoing acupuncture treatment for chronic low back pain (cLBP) in

Germany and to analyze chronification, pain grading, and depression as

predictors for treatment outcomes. PATIENTS AND METHODS: Patients

with cLBP (ICD-10 diagnoses M54.4 or M54.5) who underwent acupuncture

therapy (mean number of sessions 8.7+/-2.9) within the framework of a

reimbursement and research program sponsored by German statutory

sickness funds were included in an observational study. Patients were

asked to complete detailed questionnaires that included questions on

intensity and frequency of pain and instruments measuring functional ability,

depression, and quality of life (SF-36) before and after treatment and 6

months after beginning acupuncture. Participating physicians assessed pain

chronification in patients. RESULTS: A total of 2564 patients (mean age

57.7+/-14.0 y, 78.7% female), who were treated by 1607 physicians, were

included in the main analysis. After 6 months (6-mo follow-up), 45.5% of

patients demonstrated clinically significant improvements in their functional

ability scores. The mean number of days with pain was decreased by half

(from 21 to 10 d/mo). Employed patients (employed patient subgroup

analysis) reported a 30% decrease from baseline in days of work lost. In all,

8.1% of patients reported adverse events, the majority of which were minor.

Subgroup analyses focusing on pain severity, stage of chronification, and

depression revealed statistically significant relationships both to baseline

measures and to reduction of pain after acupuncture. CONCLUSIONS:

Acupuncture treatment is associated with clinically relevant improvements in

patients suffering from cLBP of varying degrees of chronification and/or

severity. PMID: 17237661 [PubMed - as supplied by publisher]

 

Napadow V, Kettner N, Liu J, Li M, Kwong KK, Vangel M, Makris N, Audette

J, Hui KK. Hypothalamus and amygdala response to acupuncture stimuli in

carpal tunnel syndrome. Pain. 2007 Jan 18; [Epub ahead of print] Martinos

Center for Biomedical Imaging, Department of Radiology, Massachusetts

General Hospital, Charlestown, MA, USA; Department of Radiology, Logan

College of Chiropractic, Chesterfield, MO, USA. Brain processing of

acupuncture stimuli in chronic neuropathic pain patients may underlie its

beneficial effects. We used fMRI to evaluate verum and sham acupuncture

stimulation at acupoint LI-4 in Carpal Tunnel Syndrome (CTS) patients and

healthy controls (HC). CTS patients were retested after 5 weeks of

acupuncture therapy. Thus, we investigated both the short-term brain

response to acupuncture stimulation, as well as the influence of longer-term

acupuncture therapy effects on this short-term response. CTS patients

responded to verum acupuncture with greater activation in the

hypothalamus and deactivation in the amygdala as compared to HC,

controlling for the non-specific effects of sham acupuncture. A similar

difference was found between CTS patients at baseline and after

acupuncture therapy. For baseline CTS patients responding to verum

acupuncture, functional connectivity was found between the hypothalamus

and amygdala - the less deactivation in the amygdala, the greater the

activation in the hypothalamus, and vice versa. Furthermore, hypothalamic

response correlated positively with the degree of maladaptive cortical

plasticity in CTS patients (inter-digit separation distance). This is the first

evidence suggesting that chronic pain patients respond to acupuncture

differently than HC, through a coordinated limbic network including the

hypothalamus and amygdala. PMID: 17240066 [PubMed - as supplied by

publisher]

 

Karst M, Winterhalter M, Munte S, Francki B, Hondronikos A, Eckardt A,

Hoy L, Buhck H, Bernateck M, Fink M. Auricular acupuncture for dental

anxiety: a randomized controlled trial. Anesth Analg. 2007 Feb;104(2):295-

300. Department of Anesthesiology, Pain Clinic, Hannover Medical School,

Hannover, Germany. karst.matthias Auricular

acupuncture can be an effective treatment for acute anxiety, but there is a

lack of direct comparisons of acupuncture to proven standard drug

treatments. In this study we compared the efficacy of auricular acupuncture

with intranasal midazolam, placebo acupuncture, and no treatment for

reducing dental anxiety. Patients having dental extractions (n = 67) were

randomized to (i) auricular acupuncture, (ii) placebo acupuncture, and (iii)

intranasal midazolam and compared with a no treatment group. Anxiety was

assessed before the interventions, at 30 min, and after the dental

extraction. Physiological variables were assessed continuously. With the no

treatment group as control, the auricular acupuncture group, and the

midazolam group were significantly less anxious at 30 min as compared

with patients in the placebo acupuncture group (Spielberger Stait-Trait

Anxiety Inventory X1, P = 0.012 and <0.001, respectively). In addition,

patient compliance assessed by the dentist was significantly improved if

auricular acupuncture or application of intranasal midazolam had been

performed (P = 0.032 and 0.049, respectively). In conclusion, both, auricular

acupuncture and intranasal midazolam were similarly effective for the

treatment of dental anxiety. PMID: 17242083 [PubMed - in process]

 

Tsuchiya M, Sato EF, Inoue M, Asada A. Acupuncture enhances generation

of nitric oxide and increases local circulation. Anesth Analg. 2007

Feb;104(2):301-7. Departments of Biochemistry, Osaka City University

Medical School, Abeno-Ku, Japan. Although it is widely used, the

mechanisms and effects of acupuncture on pain are not completely

understood. Recently, increased nitric oxide (NO) synthase activity has

been found in meridians and acupoints. Because NO is a key regulator of

local circulation, and because change in circulation can affect the

development and persistence of pain, we propose that acupuncture might

regulate NO levels. We studied the effects of acupuncture on local NO

levels and circulation in a randomized, double-blind, crossover study with 20

volunteers, each of whom underwent one session each of real and

noninvasive sham acupuncture in a single hand and forearm with a 1-wk

interval between treatments. NO concentration in the plasma from the

acupunctured arm was significantly increased by 2.8 +/- 1.5 micromol/L at 5

min and 2.5 +/- 1.4 micromol/L at 60 min after acupuncture. Blood flow in

palmar subcutaneous tissue of the acupunctured arm also increased, and

this correlated with the NO increase. These changes were not observed in

noninvasive sham-acupunctured hands and forearms. In conclusion,

acupuncture increases the NO level in treated regions and thereby

increases local circulation. These regulatory effects might contribute to pain

relief provided by acupuncture. PMID: 17242084 [PubMed - in process]

 

Schlunzen L, Vafaee MS, Cold GE. Acupuncture of LI-4 in Anesthetized

healthy humans decreases cerebral blood flow in the putamen measured

with positron emission tomography. Anesth Analg. 2007 Feb;104(2):308-11.

Department of Neuroanesthesiology, Aarhus University Hospital, Aarhus C,

Denmark. lise.schlunzen To minimize the influence of

exogenous factors, 13 volunteers were anesthetized with sevoflurane 1

MAC while exposed to manual acupuncture stimulation of LI-4 (Group 1, n =

7) or a placebo point in the space between the third and fourth metacarpals

(Group II, n = 6). During anesthesia (baseline) and anesthesia +

acupuncture, one H2(15)O scan was performed, respectively. Group I

demonstrated a significant decrease in regional cerebral blood flow in the

right medial frontal gyrus (20%) and in the left putamen (17%). In Group II

regional cerebral blood flow was decreased in the right medial frontal gyrus

(22%); in the putamen no significant changes were observed. These data

suggest that needle penetration of the skin affects the medial frontal gyrus,

whereas acupuncture of LI-4 influences the putamen. PMID: 17242085

[PubMed - in process]

 

Fassoulaki A, Paraskeva A, Kostopanagiotou G, Tsakalozou E,

Markantonis S. Acupressure on the extra 1 acupoint: the effect on bispectral

index, serum melatonin, plasma beta-endorphin, and stress. Anesth Analg.

2007 Feb;104(2):312-7. Department of Anesthesiology, Aretaieio Hospital,

Medical School, Athens, Greece. afassou1 BACKGROUND:

Acupressure on the " extra 1 " point decreases bispectral index (BIS) values

and stress. METHODS: We investigated the BIS, melatonin, beta-

endorphin, and verbal stress score values before, after 10 min of

acupressure application on the extra 1 point, on a sham point, after no

acupressure, and 1 h after completion of each intervention in 12 volunteers.

RESULTS: The BIS and verbal stress score values were decreased after

acupressure on the extra 1 point (P = 0.0001 and P = 0.008, respectively),

but melatonin and beta-endorphin did not change. CONCLUSION:

Acupressure on the extra 1 point has no effect on melatonin and beta-

endorphin levels. PMID: 17242086 [PubMed - in process]

 

Li X, Hirokawa M, Inoue Y, Sugano N, Qian S, Iwai T. Effects of

acupressure on lower limb blood flow for the treatment of peripheral arterial

occlusive diseases. Surg Today. 2007;37(2):103-8. Epub 2007 Jan 25.

Division of Vascular Surgery, Department of Surgery, Tokyo Medical and

Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.

PURPOSE: To investigate the effects of acupressure on lower limb blood

flow for the treatment of peripheral arterial occlusive diseases (PAOD).

METHODS: From February 2004 to February 2005, 30 patients with stage II

PAOD underwent measurements of the lower limb blood flow. Six patients

(group A) were assigned as controls without any acupoint stimulation, while

24 (group B) underwent stimulation at acupoints by acupressure. The

acupoints Yanglingquan (GB34), Zusanli (ST36), Yinlingquan (SP9), and

Sanyinjiao (SP6) of the symptomatic lower limbs were stimulated for 3 min.

Transcutaneous oximetry (tcPO(2)) was used to determine the blood flow of

the chest wall, bilateral distal crura, and bilateral dorsa of the foot before

and during the stimulations at the acupoints. RESULTS: Group A showed

no significant change in the lower limb blood flow. In group B, the tcPO(2)

values of chest wall, bilateral distal crura, and the dorsum of foot of the

stimulated lower limb increased significantly during acupressure (P < 0.01),

whereas no significant change was shown in the dorsum of the foot of the

non-stimulated lower limb. Moreover, the blood flow of the lower limbs that

had undergone an ipsilateral sympathectomy increased significantly (P <

0.01). CONCLUSIONS: Acupressure was found to cause significant

increases in the lower limb blood flow of stage II PAOD patients. This

treatment modality may therefore be effective for improving the symptoms

of such patients. PMID: 17243026 [PubMed - in process]

 

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