Search

To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM). In this cross-sectional, observational study, “real world” data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses. The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (− 0.22), pain-related interference with everyday life (− 0.19), general activity (0.13), general health perception (0.11), punishing response from others (− 0.11), work status (− 0.10), vitality (− 0.11) and cognitive difficulties (− 0.12). Pain intensity or frequency was not an independent correlate. More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

Background: Patient education is key in the management of chronic musculoskeletal diseases like osteoarthritis (OA) of the hip and/or knee. Comparatively few studies provide information on the content of educational programs and their specific impact on patient-related parameters such as self-efficacy. The objective of this study was to evaluate the effect of two single-session educational trainings containing different motivational psychology elements. Methods: Two different types of educational training conveying the same information were designed as a one-time intervention. Training A was designed according to the Health Action Process Approach (HAPA). Training B included motivational elements based on positive images. Patients with OA of the hip or knee were randomly assigned to participate in either Training A or Training B. The patients completed questionnaires at baseline, directly after the training and 16 weeks after the training. The main evaluated parameters were disease-specific knowledge, assessed by two different questionnaires, pain-related self-efficacy and OA symptoms (WOMAC score).Results: Fifty-two patients participated. Of these, 27 were assigned to group A and 25 to group B. Disease-specific knowledge improved significantly in both groups immediately after the training and at 16 weeks follow-up. Self-efficacy was initially enhanced in both groups after the trainings but a significant improvement at 16 weeks follow-up was only found for group A. The increase in self-efficacy scores after 16 weeks was significantly higher in group A than in group B. There was a trend towards improved WOMAC scores after 16 weeks for group A but not for group B. Conclusion: The results indicate that disease-specific knowledge of OA patients can be enhanced by one-time educational trainings including motivational psychology elements. A HAPA-based training could possibly also lead to lasting improvements regarding patients’ self-efficacy and OA-related symptoms. Thus HAPA-based educational programs seem to be a promising, feasible tool to improve OA patients’ self-care. Trial registration: The study was registered with the German Clinical Trials Register (DRKS00021827).

Objectives This study aims to evaluate the effectiveness of two multidisciplinary fibromyalgia programs with different intensities. Materials and methods In this retrospective real-world comparison of patient data, pre- and post-program datasets of Short Form 36 (SF36) and Fibromyalgia Impact Questionnaire (FIQ) were obtained from a total of 210 female patients in two fibromyalgia multidisciplinary day hospital programs including one intensive program with daily treatments summing up to 20 treatment days during four weeks (P20, n=70) versus a less intensive program with 12 treatment days during four weeks (P12, n=140). Results Multiple subscales of SF36 and FIQ were improved in the pre-post comparison in both groups. In the comparison between the two groups, a statistically significantly higher improvement was found in the P20 group compared to the P12 group for the FIQ subscales of stiffness (p=0.001) and the number of days during which the patient felt "good" (p=0.007). Conclusion An intensive program of daily treatments and activity seems to be more effective in reducing fibromyalgia-associated stiffness and improving the number of days during which patients feel good than a less intensive program.

To identify correlates of quality of life (QoL) measured with the Quality of Life Scale (QOLS) in participants of a multidisciplinary day hospital treatment program for fibromyalgia (FM).In this cross-sectional, observational study, "real world" data from 480 FM patients including socio-demographics, pain variables and questionnaires such as the SF-36, Beck Depression Inventory (BDI), Multiphasic Pain Inventory (MPI), SCL-90-R and others were categorized according to the components (body structure and function, activities and participation, personal factors, environmental factors) of the International Classification of Functioning (ICF). For every ICF component, a linear regression analysis with QOLS as the dependent variable was computed. A final comprehensive model was calculated on the basis of the results of the five independent analyses.The following variables could be identified as main correlates for QoL in FM, explaining 56% of the variance of the QOLS (subscale/questionnaire and standardized beta in parenthesis): depression (- 0.22), pain-related interference with everyday life (- 0.19), general activity (0.13), general health perception (0.11), punishing response from others (- 0.11), work status (- 0.10), vitality (- 0.11) and cognitive difficulties (- 0.12). Pain intensity or frequency was not an independent correlate.More than 50% of QoL variance could be explained by distinct self-reported variables with neither pain intensity nor pain frequency playing a major role. Therefore, FM treatment should not primarily concentrate on pain but should address multiple factors within multidisciplinary therapy.

This prospective cohort study aimed to characterize the sensory profile during acute herpes zoster (AHZ) and to explore sensory signs as well as physical and psychosocial health as predictors for postherpetic neuralgia (PHN). Results of quantitative sensory testing of 74 patients with AHZ at the affected site and at the distant contralateral control site were compared to a healthy control group. Pain characteristics (Neuropathic Pain and Symptom Inventory and SES), physical functioning, and psychosocial health aspects (Pain Disability Index, SF-36, and STAI) were assessed by questionnaires. Patients with PHN (n = 13) at 6-month follow-up were compared to those without PHN (n = 45). Sensory signs at the affected site were thermal and vibratory hypesthesia, dynamic mechanical allodynia (DMA), pressure hyperalgesia, and high wind-up (18%-29%), as well as paradoxical heat sensations and pinprick hypalgesia (13.5%). The unaffected control site exhibited thermal and vibratory hypesthesia, DMA, and pressure hyperalgesia. Dynamic mechanical allodynia and pinprick hypalgesia were mutually exclusive. Postherpetic neuralgia was associated with DMA (38.5% vs 6.7%; P = 0.010) and vibratory hypesthesia (38.5% vs 11.1%; P = 0.036) at the control site, with mechanical gain and/or loss combined with normal thermal detection (affected site: 69.2% vs 31.1%; P = 0.023; control site: 53.8% vs 15.5%; P = 0.009). Pain Disability Index (P = 0.036) and SES affective pain perception scores (P = 0.031) were over 50% higher, and 6 of 8 SF-36 subscores were over 50% lower (P < 0.045) in PHN. Sensory profiles in AHZ indicate deafferentation and central but not peripheral sensitization. Sensory signs at distant body sites, strong affective pain perception, as well as reduced quality of life and physical functioning in the acute phase may reflect risk factors for the transition to PHN.

Background Pre-emptive analgesia in perioperative care has potential benefits for patients. The pre-emptive and postoperative analgesic effects of the cyclooxygenase-2 inhibitor etoricoxib have been investigated using a 2 × 2 factorial trial design. Methods According to the 2 × 2 factorial study design, 103 patients scheduled for visceral surgery, were randomly allocated to two groups prior to surgery. Patients could receive either etoricoxib or placebo (to investigate pre-emptive analgesia). Subsequent to surgery, patients randomly received either etoricoxib or placebo, again. It follows, that four treatment modalities (continuous or replaced intervention) result, to investigate postoperative analgesia. Main Outcome Measure was the cumulative morphine use 48 h post-surgery. Other outcomes included pain intensities, pain thresholds and sensory detection. Results Eighty-six patients (female n = 42; mean age 53.82 ± 13.61 years) were evaluated on the basis of an intention to treat analysis. Pre-emptive administration of 120 mg etoricoxib did not significantly reduce the cumulative morphine dose within the first 48 h after surgery, when compared to the administration of placebo. The analysis of the post-operative treatment groups showed a non-significant 8% reduction in morphine dose during the continuous administration of etoricoxib. There were no changes in sensory perception as detected with QST before and after surgery or between groups. Conclusions The effect of administering etoricoxib was not superior to placebo in reducing the morphine dose required for postoperative analgesia. The lack of changes in peripheral nociception suggests that central algetic mechanisms are of higher impact in the development of postoperative pain following abdominal or thoracic surgery.

Zusammenfassung Seit der Metaanalyse von Tough et al. 2009 wurden viele Arbeiten veroffentlicht. Nach wie vor existiert eine starke Inhomogenitat in Bezug auf Fallzahlen, Qualitat und Art der Behandlung, sodass in diesem Rahmen nicht abgeschatzt werden kann, wie die Einstufung der wissenschaftlichen Evidenz ausfallen wurde. Allerdings spricht die Tatsache, dass in allen Arbeiten eine Besserung der Beschwerden durch Akupunktur im Vorher-Nachher-Vergleich gesehen wurde, fur sich. Bei sieben von zehn randomisiert-kontrollierten Studien (RCTs) war die Verum-Akupunktur signifikant der Sham-Akupunktur uberlegen. In 14 RCTs war die Akupunktur der Kontrolltherapie uberlegen. In neun Studien war sie in Bezug auf die Wirksamkeit vergleichbar mit einer anderen (nicht Sham-)Therapie.

Objectives One theory about acupuncture suggests that pathological processes can cause measurable changes in electrical skin resistance (ESR) at acupuncture points (APs). Although the theory has yet to be proven, ESR measurements (ESRMs) form a frequently used part of contemporary acupuncture. The aim of this study was to test the so-called ‘electrical responsiveness’ of APs in the setting of a defined operative trauma. Methods ESRMs (n=424) were performed at the APs and surrounding skin of GB34 and ST38 in 163 participants using an impedance meter array developed for the purpose of ESRMs. For each group the percentage of measurements with a significantly different ESR between the APs and the surrounding skin was calculated and compared with each other. Measurements of four groups were compared: healthy control subjects (n=30) and patients after ophthalmic (n=29), hip (n=42) and shoulder (n=30) surgery. The influence of postoperative pain intensity was also assessed. Results Group comparison showed no significant differences for ST38. The ESRMs at GB34 had a significantly higher percentage of measurements with an increased ESR after ophthalmic (23.2%) and hip (22.2%) surgery, but not after shoulder surgery (7.5%). Subgroup analysis showed that an increase in pain intensity tended to lead to a decrease in the number of APs with ESR changes. Conclusion These results suggest that reactive changes in ESR at APs might exist. Pain and alertness seem to have an impact on ESR at APs. However, the current data do not allow for conclusions to be drawn concerning the clinical use of ESRMs.

Background: Studies assessing the point-specific effect of acupuncture or the characteristics of acupuncture points (APs) tend to yield inconclusive results. In order to identify a possible confounding factor, we aimed to examine the variability in AP localization by means of a survey. Material and Methods: Attendees of the 14th ICMART (International Council of Medical Acupuncture and Related Techniques) congress as well as DAGfA (German Medical Society of Acupuncture) lecturers and students were asked to locate and mark the APs LI 10 and TH 5 on a research assistant’s arm. Identified points were transferred into a coordinate system, and the respective bivariate distribution function was calculated. Additionally, participants filled out a questionnaire about their acupuncture education and experience, the acupuncture style and point localization techniques used most frequently, and their estimation of the size of an AP. Results: The areas of the ellipses, theoretically containing 95% of AP localizations, varied between 44.49 and 5.18 cm2. The largest distance between 2 identified points was 8.45 cm for LI 10 and 5.3 cm for TH 5. Apart from being trained at the same school, no other factor could be identified that determined the variability in AP localization. Conclusion: Our results indicate that congruity of AP localization among experienced acupuncturists might be low. Although there are some limitations to our results, this possible bias should be taken into account when conducting acupuncture trials and interpreting results of previous acupuncture studies.

Objectives: The aim of this study was to evaluate the phenomenon of electrical skin resistance (ESR) changes at different acupuncture points (APs). Setting: This single-blinded study was performed at the hospital of the University of Munich. Design: Six common APs were measured (TE5, PC6, LU6, ST36, SP6, GB39) in 53 subjects. Subgroups were formed with varying time intervals for follow-ups (1 minute, 1 hour, 1 week) and a varying grade of reduction of the stratum corneum. Methods: Electrical skin resistance measurements (ESRMs) were taken from a skin area of 6 x 6 cm using an array consisting of 64 (8 x 8) electrodes. The electrodes corresponding to the AP were located and the ESRM results were compared to those of the surrounding electrodes. The methodological setting made it possible to minimize major influence factors on electrical skin impedance measurements. Results: A total of 631 ESRMs was evaluated: In 62.8% of the measured APs, no significant ESR difference was found. In 234 (37.2%) of the ESRMs, the ESR at the AP was significantly different from the surrounding skin area, with 163 (25.9%) points showing a lower and 71 (11.3%) points showing a higher ESR. Reproducibility was extremely high after 1 minute but was low after 1 hour and 1 week. Conclusions: This study shows that electrical skin resistance at APs can either be lower or higher compared to the surrounding area. The phenomenon is characterized by high short-term and low long-term reproducibility. Therefore, we conclude that APs might possess specific transient electrical properties. However, as the majority of the measured APs did not show a changed ESR, it cannot be concluded from our data that electrical skin resistance measurements can be used for acupuncture point localization or diagnostic/therapeutic purposes.

Pain and sensory neuropathy are common in patients with peripheral arterial disease. So far it is unknown to what extent pain and sensory parameters can be ameliorated by endovascular intervention used to resolve the arterial obstruction. Seventeen nondiabetic patients with intermittent claudication were investigated in the present study. The patients had to undergo percutaneous transluminal angioplasty (PTA) to improve blood flow in the affected leg. To acquire detailed information of their sensory state quantitative sensory testing (QST) was performed before and 24 hours and 3 months after PTA. QST is a standardized clinical testing procedure for the detection of sensory changes that consists of multiple tests for thermal and mechanical detection and pain thresholds as well as vibratory thresholds and stimulus response functions. An age-matched control group was investigated with an interval of 3 months. Pain during exercise decreased by 60% (examined by numerical rating scale) after endovascular intervention, whereas the ankle/brachial-index—representing the peripheral hemodynamic situation—increased by 29%. Sensory function determined by QST did not change significantly following PTA over a 3-month period. Successfully performed PTA is highly effective in reducing exercise induced pain in patients with intermittent claudication. Perspective The study demonstrates that successfully performed PTA is a highly effective tool in reducing exercise induced pain in patients with intermittent claudication. However, the pain reduction observed cannot be verified by evaluating sensory functions using standardized quantitative sensory testing.

Background Neck pain is one of the three most frequently reported complaints of the musculoskeletal system. Treatments for neck pain are varied, as are perceptions of benefit. Acupuncture has been used as an alternative to more conventional treatment for musculoskeletal pain. This review summarises the most current scientific evidence on the effectiveness of acupuncture for acute, subacute and chronic neck pain. This update replaces our 2006 Cochrane review update on this topic. Objectives To determine the effects of acupuncture for adults with neck pain, with focus on pain relief, disability or functional measures, patient satisfaction and global perceived effect. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Manual, Alternative and Natural Therapy Index System (MANTIS), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Index to Chiropractic Literature (ICL) from their beginning to August 2015. We searched reference lists, two trial registers and the acupuncture database Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS) in China to 2005. Selection criteria We included published trials that used random assignment to intervention groups, in full text or abstract form. We excluded quasirandomised controlled trials (RCTs). Data collection and analysis Two review authors made independent decisions for each step of the review: article inclusion, data abstraction and assessment of quality of trial methods. We assessed study quality by using the Cochrane Back Review Group ’Risk of bias’ tool. We used consensus to resolve disagreements, and when clinical heterogeneity was absent, we combined studies by using random-effects meta-analysis models. Main results Of the 27 included studies, three represented individuals with whiplash-associated disorders (WADs) ranging from acute to chronic (205 participants), five explored chronic myofascial neck pain (186 participants), five chronic pain due to arthritic changes (542 participants), six chronic non-specific neck pain (4,011 participants), two neck pain with radicular signs (43 participants) and six subacute or chronic mechanical neck pain (5,111 participants). For mechanical neck pain, we found that acupuncture is beneficial at immediate-term follow-up compared with sham acupuncture for pain intensity; at short-term follow-up compared with sham or inactive treatment for pain intensity; at short-term follow-up compared with sham treatment for disability; and at short-term follow-up compared with wait-list control for pain intensity and neck disability improvement. Statistical pooling was appropriate for acupuncture compared with sham for short-term outcomes due to statistical homogeneity (P value = 0.83; I 2 = 20 %). Results of the meta-analysis favoured acupuncture (standardised mean difference (SMD) – 0.23, 95 % confidence interval (CI) –0.20 to –0.07; P value = 0.0006). This effect does not seem sustainable over the long term. Whether subsequent repeated sessions would be successful was not examined by investigators in our primary studies. Acupuncture appears to be a safe treatment modality, as adverse effects are minor. Reported adverse effects include increased pain, bruising, fainting, worsening of symptoms, local swelling and dizziness. These studies reported no life-threatening adverse effects and found that acupuncture treatments were cost-effective. Since the time of our previous review, the quality of RCTs has improved, and we have assessed many of them as having low risk of bias. However, few large trials have provided high-quality evidence. Authors’ conclusions Moderate-quality evidence suggests that acupuncture relieves pain better than sham acupuncture, as measured at completion of treatment and at short-term follow-up, and that those who received acupuncture report less pain and disability at short-term follow-up than those on a wait-list. Moderate-quality evidence also indicates that acupuncture is more effective than inactive treatment for relieving pain at short-term follow-up.

The aims of this systematic review were to study the analgesic effect of real acupuncture and to explore whether sham acupuncture (SA) type is related to the estimated effect of real acupuncture for musculoskeletal pain. Five databases were searched. The outcome was pain or disability immediately (≤1 week) following an intervention. Standardized mean differences (SMDs) with 95 % confidence intervals were calculated. Meta-regression was used to explore possible sources of heterogeneity. Sixty-three studies (6382 individuals) were included. Eight condition types were included. The pooled effect size was moderate for pain relief (59 trials, 4,980 individuals, SMD −0.61, 95 % CI −0.76 to −0.47; P P

Many studies show an effectiveness of hypnotic analgesia. It has been discussed whether the analgesic effect is mainly caused by the relaxation that is concomitant to hypnosis. This study was designed to evaluate the effects of hypnotic relaxation suggestion on different somatosensory detection and pain thresholds. Quantitative sensory testing (QST) measurements were performed before and during hypnosis in twenty-three healthy subjects on the dorsum of the right hand. Paired t-test was used to compare threshold changes. The influence of hypnotic susceptibility was evaluated by calculating correlation coefficients for threshold changes and hypnotic susceptibility (Harvard group scale). During hypnosis significantly changed somatosensory thresholds (reduced function) were observed for the following sensory detection thresholds: Cold Detection Threshold (CDT), Warm Detection Threshold (WDT), Thermal Sensory Limen (TSL) and Mechanical Detection Threshold (MDT). The only unchanged sensory detection threshold was Vibration Detection Threshold (VDT). No significant changes were observed for the determined pain detection thresholds (Cold Pain Thresholds, Heat Pain Thresholds, Mechanical Pain Sensitivity, Dynamic Mechanical Allodynia, Wind-up Ratio and Pressure Pain Threshold). No correlation of hypnotic susceptibility and threshold changes were detected. Hypnotic relaxation without a specific analgesic suggestion results in thermal and mechanical detection, but not pain threshold changes. We thus conclude that a relaxation suggestion has no genuine effect on sensory pain thresholds. ClinicalTrials.gov, Identifier: NCT02261155 (9th October 2014).

Objective Electrodermal screening is widely used in the acupuncture community for point location, diagnosis and therapy. However the underlying theory that electrical skin resistance (ESR) of an area corresponding to an acupuncture point (AP) is lower than ESR of the surrounding areas is yet to be proven. The objective of this study was to evaluate and quantify the phenomenon of ESR changes at the Gallbladder 34 (GB34) Acupuncture Point (AP). Materials and Methods In this single-blinded study GB34 was measured bilaterally in 43 healthy volunteers. Electrical skin resistance measurements (ESRMs) were performed with a specially designed array consisting of 64 (8 × 8) electrodes on an area of 6 × 6 cm. Then the electrodes corresponding to the AP were identified and compared with those of the surrounding electrodes with Wilcoxon rank sum test. Values for p of less than 0.05 were considered statistically significant. Results Eighty-one ESRMs were evaluated. ESR was significantly different from the surrounding skin area in 27 (33.3%) cases with 15 (18.5%) points showing a lower and 12 (14.1%) points showing a higher ESR. Conclusion This shows that ESR changes at APs exist in one third of the measured points, a very low rate for a postulation that forms the basis of various diagnosis and therapy systems.

Hintergrund Studien zur punktspezifischen Wirkung der Akupunktur oder Charakterisierung von Akupunkturpunkten (AP) fuhren oft zu uneindeutigen Ergebnissen. Um eine hierzu mogliche Einflussgrose zu identifizieren, war Ziel unserer Studie, die Variabilitat bei der AP-Lokalisation mittels einer Therapeutenbefragung zu untersuchen. Material und Methoden 30 Teilnehmer des 14. ICMART (International Council of Medical Acupuncture and Related Techniques)-Kongresses sowie Dozenten und Studenten der DAGfA (Deutsche Arztegesellschaft fur Akupunktur) wurden gebeten, die Akupunkturpunkte LI 10 (Dickdarm 10) und TH 5 (3E 5) auf dem Arm einer Studienassistentin zu lokalisieren und zu markieren. Die identifizierten Punkte wurden in ein Koordinatensystem ubertragen, und die entsprechende bivariate Verteilungsfunktion wurde berechnet. Zusatzlich wurden mittels eines Fragebogens die Akupunkturausbildung und -erfahrung der Teilnehmer, die von ihnen am haufigsten verwendeten Akupunkturstile und Punktlokalisationstechniken sowie ihre Einschatzung der Grose von AP abgefragt. Ergebnisse Die Flachen der Ellipsen, die entsprechend der errechneten Verteilungsfunktionen 95 % der AP-Lokalisationen beinhalten, lagen zwischen 44,49 und 5,18 cm2. Die groste Distanz zwischen 2 Lokalisationen war 8,45 cm fur LI 10 und 3,4 cm fur TH 5. Neben einer Ausbildung am gleichen Institut wurde kein anderer Einflussfaktor identifiziert, von dem die Variabilitat der AP-Lokalisation abhangt. Schlussfolgerung Unsere Ergebnisse deuten darauf hin, dass eine geringe Ubereinstimmung bei der AP-Lokalisation unter erfahrenen Akupunkteuren besteht. Trotz kleiner methodischer Mangel dieser Studie sollte dieses Ergebnis bei der Planung und Interpretation vorangegangener Akupunkturstudien Berucksichtigung finden.

Background: Deqi is defined in relation to acupuncture needling as a sensory perception of varying character. In a recently published sham laser validation study, we found that subjects in the verum and the sham laser group experienced deqi sensations. Therefore, we aim to further analyze whether the perceptions reported in the two study arms were distinguishable and whether expectancy effects exhibited considerable impact on our results. Methods: A detailed re-analysis focusing on deqi sensations was performed from data collected in a previously published placebo-controlled, double-blind, clinical cross-over trial for a sham laser evaluation. Thirty-four healthy volunteers (28 ± 10.7 years; 16 women, 18 men) received two laser acupuncture treatments at three acupuncture points LI4 (hegu), LU7 (lieque), and LR3 (taichong); once by verum laser and once using a sham device containing an inactive laser in randomized order. Outcome measures were frequency, intensity (evaluated by visual analogue scale; VAS), and quality of the subjects’ sensations perceived during treatments (assessed with the “acupuncture sensation scale”). Results: Both, verum and the sham laser acupuncture result in similar deqi sensations with regard to frequency (p-value = 0.67), intensity (p-value = 0.71) and quality (p-values between 0.15 - 0.98). In both groups the most frequently used adjectives to describe these perceptions were “spreading”, “radiating”, “tingling”, “tugging”, “pulsing”, “warm”, “dull”, and “electric”. Sensations reported were consistent with the perception of deqi as previously defined in literature. Subjects’ conviction regarding the effectiveness of laser acupuncture or the history of having received acupuncture treatments before did not correlate with the frequency or intensity of sensations reported. Conclusions: Since deqi sensations, described as sensory perceptions, were elicited without any cutaneous sensory input, we assume that they are a product of non-specific effects from the overall treatment procedure. Expectancyeffects due to previous acupuncture experience and belief in laser acupuncture do not seem to play a major role in elicitation of deqi sensations. Our results give hints that deqi might be a central phenomenon of awareness and consciousness, and that its relevance should be taken into account, even in clinical trials. However, further research is required to understand mechanisms underlying deqi.

Acupuncture is a complementary and alternative medical modality. A considerable body of acupuncture research has accumulated since 1998. Acupuncture has been integrated into palliative care settings in the United Kingdom but is yet to be widely offered in the United States. The literature was searched to identify clinical trials involving acupuncture, palliative care, hospice, chronic obstructive pulmonary disease, bone marrow, and cancer. Twenty-seven randomized controlled clinical trials of acupuncture were found that reported on conditions common to the hospice and palliative care setting, including dyspnea, nausea and vomiting, pain, and xerostomia, and 23 reported statistically significant results favoring acupuncture use for the conditions investigated. Acupuncture is safe and clinically cost-effective for management of common symptoms in palliative care and hospice patients. Acupuncture has potential as adjunctive care in palliative and end-of-life care, and the evidence warrants its inclusion in reimbursed palliative and end-of-life care in the United States.

According to conventional wisdom within the acupuncture community, acupuncture points and meridians are special conduits for electrical signals. This view gained popularity after anecdotal reports and clinical studies asserted that these anatomical structures are characterized by lower electrical impedance compared to adjacent controls. To ascertain whether evidence exists to support or refute this claim, we conducted a systematic review of studies directly evaluating the electrical characteristics of acupuncture structures and appropriate controls. We searched seven electronic databases until August 2007, hand-searched references, and consulted technical experts. We limited the review to primary data human studies published in English. A quality scoring system was created and employed for this review. A total of 16 articles representing 18 studies met inclusion criteria: 9 examining acupuncture points and 9 examining meridians. Five out of 9 point studies showed positive association between acupuncture points and lower electrical resistance and impedance, while 7 out of 9 meridian studies showed positive association between acupuncture meridians and lower electrical impedance and higher capacitance. The studies were generally poor in quality and limited by small sample size and multiple confounders. Based on this review, the evidence does not conclusively support the claim that acupuncture points or meridians are electrically distinguishable. However, the preliminary findings are suggestive and offer future directions for research based on in-depth interpretation of the data. Bioelectromagnetics, 2008. 2008 Wiley-Liss, Inc.

Background Allergic rhinitis affects approximately 30% of adults and up to 40% of children in industrialized societies. Medicines available for relief of allergic rhinitis symptoms include antihistamines, decongestants, leukotriene inhibitors, topical hormones, and corticosteroids. However, the negative side-effects of antiallergic medicines cause many patients with allergic rhinitis to choose traditional Chinese medical treatments, such as taking Chinese herbs or treatment with acupuncture. Objectives This study assessed the effect of acupuncture for treatment of allergic rhinitis. Methods Eighteen (18) patients with allergic rhinitis were treated with acupuncture 8 times over a 4-week period, and peripheral blood of these patients was collected at each visit for analysis of gene expression via cDNA microarray. To estimate the therapeutic effect of acupuncture objectively, patients completed the rhinoconjunctivitis quality of life questionnaire (RQLQ) before and after acupuncture therapy. Results Based upon patients' response to the RQLQ, acupuncture therapy significantly reduced allergic rhinitis symptoms, including nasal symptoms, non-hay fever symptoms, and sleep and practical problems (associated with daily activities). In addition, expression of interleukin-1 receptor-α (IL1R1) in peripheral blood was significantly decreased at 2 hours, 24 hours, and 4 weeks after acupuncture treatment in these patients. Conclusions To our knowledge, this is the first report of cDNA microarray analysis of differential gene expression the peripheral blood of patients with allergic rhinitis before and after acupuncture treatment. Out data suggest that the balance between T-helper 1 and T-helper 2 cell-derived proinflammatory versus anti-inflammatory cytokines might be improved by acupuncture treatment.

Objectives Chemotherapy-induced peripheral neuropathy (CIPN) can produce severe neurological deficits and neuropathic pain and is a potential reason for terminating or suspending chemotherapy treatments. Specific and effective curative treatments are lacking. Methods A pilot study was conducted to evaluate the therapeutic effect of acupuncture on CIPN as measured by changes in nerve conduction studies(NCS) in six patients treated with acupuncture for 10 weeks in addition to best medical care and five control patients who received the best medical care but no specific treatment for CIPN. Results In five of the six patients treated with acupuncture, NCS improved after treatment. In the control group, three of five patients did not show any difference in NCS, one patient improved and one showed impaired NCS. Conclusion The data suggest that acupuncture has a positive effect on CIPN. The encouraging results of this pilot study justify a randomised controlled trial of acupuncture in CIPN on the basis of NCS. Beschreibung Bei dieser Publikation handelt es sich um eine Subgruppenanalyse einer Studie mit 192 Patienten zur Wirksamkeit der Akupunktur bei peripherer Neuropathie [ 1 ]. Im Jahr 2007 wurden die Daten der Subgruppe mit peripherer Neuropathie unklarer Genese untersucht. Der jetzt vorliegende Artikel behandelt die Subgruppenanalyse zum Behandlungserfolg bei der Chemotherapie induzierten Neuropathie. Elf Patienten mit dieser Diagnose war Akupunktur angeboten worden, funf davon lehnten ab und wurden als Vergleichsgruppe beobachtet. Neben der Patientenbefragung (Symptomatik unverandert, verbessert, verschlechtert) wird als objektiver Zielparameter die Neurographie verwendet.

Background Acute herpes zoster is a prevalent condition. One of its major symptoms is pain, which can highly influence patient's quality of life. Pain therapy is limited. Acupuncture is supposed to soften neuropathic pain conditions and might therefore act as a therapeutic alternative. Objective of the present study is to investigate whether a 4 week semi-standardised acupuncture is non-inferior to sham laser acupuncture and the anticonvulsive drug gabapentine in the treatment of pain associated with herpes zoster. Methods/Design Three-armed, randomised, placebo-controlled trial with a total follow-up time of 6 months. Up to estimated 336 patients (interim analyses) with acute herpes zoster pain (VAS > 30 mm) will be randomised to one of three groups (a) semi-standardised acupuncture (168 patients); (b) gabapentine with individualised dosage between 900–3600 mg/d (84 patients); (c) sham laser acupuncture. Intervention takes place over 4 weeks, all patients will receive analgesic therapy (non-opioid analgesics: metamizol or paracetamol and opioids: tramadol or morphine). Therapy phase includes 4 weeks in which group (a) and (c) consist of 12 sessions per patient, (b) visits depend on patients needs. Main outcome measure is to assess the alteration of pain intensity before and 1 week after treatment sessions (visual analogue scale VAS 0–100 mm). Secondary outcome measure are: alteration of pain intensity and frequency of pain attacks; alteration of different aspects of pain evaluated by standardised pain questionnaires (NPI, PDI, SES); effects on quality of life (SF 36); analgesic demand; alteration of sensoric perception by systematic quantitative sensory testing (QST); incidence of postherpetic neuralgia; side effects and cost effectiveness. Credibility of treatments will be assessed. Discussion This study is the first large-scale randomised placebo controlled trial to evaluate the efficacy of acupuncture compared to gabapentine and sham treatment and will provide valuable new information about the clinical and physiological effects of acupuncture and gabapentine in the treatment of acute herpes zoster pain. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if acupuncture can be shown to be an effective treatment strategy in acute herpes zoster pain. Trial registration NCT00885586

Acupuncture is a complementary and alternative medical modality. A considerable body of acupuncture research has accumulated since 1998. Acupuncture has been integrated into palliative care settings in the United Kingdom but is yet to be widely offered in the United States. The literature was searched to identify clinical trials involving acupuncture, palliative care, hospice, chronic obstructive pulmonary disease, bone marrow, and cancer. Twenty-seven randomized controlled clinical trials of acupuncture were found that reported on conditions common to the hospice and palliative care setting, including dyspnea, nausea and vomiting, pain, and xerostomia, and 23 reported statistically significant results favoring acupuncture use for the conditions investigated. Acupuncture is safe and clinically cost-effective for management of common symptoms in palliative care and hospice patients. Acupuncture has potential as adjunctive care in palliative and end-of-life care, and the evidence warrants its inclusion in reimbursed palliative and end-of-life care in the United States.

Kaum ein Wort hat ahnlich hohe Konjunktur wie das der “Information”. Erst seit ein paar Jahrzehnten in Gebrauch, ist die “Information” schon „im Begriffe“, wissenschaftliche Denkmodelle wie auch unsere Alltagssprache zu durchdringen und zu einer Schlusselkategorie moderner Wissenschafts-, Technik- und Gesellschaftsanalyse zu avancieren.

This paper makes four arguments. First, classical information theory is not really about information. Second, electronic calculators do not in truth process information. Third, “information” is not so much a scientific concept as it is a mythical one. Finally, there is an attempt to outline the preconditions for a fully scientific theory of information.