OBJECTIVES: To review the traumatic injuries that have been associated with acupuncture and to discuss how these adverse effects may be reduced by increased awareness of normal anatomy and anatomical variations. METHODS: Literature search accompanied by postmortem anatomical studies. RESULTS: Traumatic lesions after acupuncture have been described in thoracic and abdominal viscera, in the peripheral and central nervous systems, and in blood vessels. Deaths have been recorded from pneumothorax and cardiac tamponade. The anatomical structure of the body at several acupuncture points is such that needles can reach vulnerable structures. CONCLUSION: While the frequency of adverse effects of acupuncture is unknown and they may be rare, knowledge of normal anatomy and anatomical variations is essential for safe practice and should be reviewed by regulatory bodies and those responsible for training courses.

Acupuncture Therapy↗

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Complementary medicine. What physicians think of it: a meta-analysis.

BACKGROUND: Complementary (or alternative) medicine has become a prevalent phenomenon in most industrialized countries. At present the evidence from randomized controlled trials investigating its effectiveness is fragmentary and therefore inconclusive. OBJECTIVE: To assess whether physicians perceive complementary medicine as useful and/or effective. METHOD: A literature search was performed to retrieve all relevant articles. Twelve surveys addressing this question were found and analyzed by evaluating perceived usefulness and/or effectiveness. RESULTS: The results show a remarkable variability between surveys. On average physicians perceive complementary medicine as moderately effective--the rating was 46 +/- 18 on a scale of 0 to 100 points. Young physicians seem to judge complementary medicine more optimistically than their more seasoned colleagues. There is no trend to suggest that complementary medicine is increasingly perceived as useful and/or effective. The data do not answer the question whether physicians view complementary medicine as a nonspecific powerful placebo or as specifically effective. CONCLUSION: Complementary medicine may be useful; however, the notion urgently needs to be tested in randomized controlled trials.

Attitude of Health Personnel↗

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Articles on complementary medicine in the mainstream medical literature: an investigation of MEDLINE, 1966 through 1996.

OBJECTIVE: To investigate the growth of interest, if any, in complementary or alternative medicine by the professional scientific community from the number of MEDLINE-listed and clinical trial-type articles for January 1, 1966, through December 31, 1996. METHODS: Systematic literature searches of the MEDLINE database, using the expanded terms "alternative medicine," "traditional medicine," "acupuncture," "homeopathy," and "chiropractic," were conducted in January 1998 to evaluate the number of all articles. The number of clinical trial-type articles on the above was obtained by conducting searches for those indexed as 1 or more of the following publication types: clinical trial; clinical trial phase 1, 2, 3, or 4; controlled clinical trial; metaanalysis; randomized controlled trial; and limited to "human" trials only. RESULTS: Articles indexed as alternative medicine formed a small proportion (0.4%) of the total number of MEDLINE-listed articles throughout the period studied. From 1966 through 1996, the total number of articles listed in MEDLINE rose significantly to a peak of 400000 additions per annum in 1996 (r = 0.97; P<.001). By contrast, the number of articles indexed under alternative medicine rose progressively only from 1972 through 1986 and since then has been relatively stable at around 1500 additions per annum. For this period, the proportion of clinical trial-type alternative medicine articles was low (mean, 2.1% per annum) but increased significantly from 1987 through 1996, reaching around 10% of the total in 1996 (r = 0.79; P<.001). Patterns of growth in the number of publications for individual therapies have varied during the period studied, and clinical trial-type articles form only a small part of any increase. CONCLUSIONS: Interest in and awareness of complementary medicine among orthodox health care professionals has increased in the past 30 years. The increase in the number and proportion of reports of clinical trials indicates an increasing level of original research activity in complementary medicine and suggests a trend toward an evidence-based approach in this discipline. The cumulative number of clinical trial-type articles is small, however, and more high-quality original research in complementary medicine is required.

Complementary Therapies↗

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Autometallographic detection of silver in hypothalamic neurons of rats exposed to silver nitrate.

The silver amplification technique, autometallography, has been used to reveal silver accumulation in neurons in the hypothalamus of male Wistar-Kyoto rats. Silver penetrated the blood-brain barrier after exposure to silver nitrate, and differences in staining intensity were found between the hypothalamic nuclei. When using light microscopy, the silver staining of the hypothalamic neurons was highly heterogeneous. Silver was detected exclusively in lysosomes of the loaded neurons. Aspects of this heterogeneous localization are discussed in relation to the distribution of autometallographically developed gold and mercury.

Animals↗

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Spotlight on herbal medicine.

Explore the source record for details and available documents.

Drug Utilization↗

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A monoclonal ELISA for bovine viral diarrhoea pestivirus antigen detection in persistently infected cattle.

Detection of cattle persistently infected with bovine viral diarrhoea virus (BVDV) is crucial to controlling mucosal disease. A sandwich enzyme-linked immunosorbent assay (ELISA) using monoclonal antibodies raised against the 48-kDa glycoprotein and the 120/80-kDa protein was developed for detecting antigens in leucocytes of 3 persistently BVDV-infected calves. The test is simple, sensitive and rapid. Moreover the same ELISA was able to recognise Belgian field isolates of BVDV. These results show that the test can be applied in the field.

Animals↗

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Autometallographic detection of mercury in testicular tissue of an infertile man exposed to mercury vapor.

A 25-year-old male patient presented with unexplained infertility. Semen analysis showed azoospermia or severe oligoasthenoteratospermia with elevated serum FSH. The history revealed that he had been employed in a chemical factory for 5 years working with chloralkali-electrophoresis. Mercury concentrations in hair, blood, and urine samples were considerably above levels of unexposed controls. Bilateral testicular biopsies revealed marked interstitial lymphatic infiltration. About 33% of the tubules analyzed showed a Sertoli-cell-only (SCO) syndrome and tubular atrophy. Fewer than 4% of tubules showed qualitatively intact spermatogenesis. Autometallographic (AMG) analysis of the biopsy material yielded silver-enhanced mercury grains, primarily in the interstitial Leydig cells. Sections from a control patient not exposed to mercury were devoid of mercury grains.

Adult↗