bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bmas Policy Statements in Some Controversial Areas of Acupuncture Practice
Authors: Cummings Mike , Reid Frankie 
Published: April 2009

The safe and competent practice of acupuncture requires the practitioner to conform to a number of basic principles. These include minimising the risk of transmission of infection, maintaining sufficient knowledge of anatomy to guide safe needling, and seeking an orthodox medical diagnosis before embarking on treatment. Beyond these basic principles, there are certain circumstances in practice that generate regular debate amongst practitioners. This article details advice on a limited selection of such circumstances. This advice has been drawn from a set of policy statements originally drafted to facilitate clarity and consistency within the teaching of Western medical acupuncture provided by the BMAS. It is not comprehensive, but covers the areas where there were the greatest differences in approach among the teaching staff. The original policy statements were also incorporated into the BMAS Code of Practice. By using the guidance in this article, in addition to applying sound clinical judgement and a knowledge of relevant anatomy, we hope that practitioners will minimise both the theoretical risks and the reported serious adverse events related to acupuncture, yet be able to practise unencumbered by illogical restrictions.
The Importance of Postural Habits in Perpetuating Myofascial Trigger Point Pain
Authors: Edwards Janet 
Published: April 2009

Various structural abnormalities that contribute to the perpetuation of myofascial trigger point activity and the pain arising from it, have previously been well documented. In addition, however, there are a number of postural habits that are important to recognise as they may also contribute, as shown in the five cases discussed. These postural habits, which are likely to be carried out both frequently and unconsciously, are adopted during the course of sitting, standing or sleeping. They are entirely independent of any structural abnormalities that may be present. Correcting them is a necessary contribution to treatment, as failure to do so is liable to lead to persistence of the pain.
The Effects of Auricular Acupuncture on Smoking Cessation May Not Depend on the Point Chosen – An Exploratory Meta-Analysis
Authors: White Adrian , Moody Russell 
Published: April 2009

Introduction Auricular acupuncture is given as a treatment for drug dependence. Points are usually chosen on the assumption that the body is represented somatotopically in the ear, although there is no anatomical basis for this. In clinical trials, sham treatment is often given at points that are supposedly ‘incorrect’ for the condition, in the belief that they are inactive. The aim of this study was to explore whether there is any difference in the effectiveness of auricular acupuncture at ‘correct’ and ‘incorrect’ points. Methods Controlled trials of semi-permanent auricular acupuncture or acupressure for smoking cessation were systematically located, and the results combined in exploratory meta-analyses which took into account the study quality. Results Thirteen studies were included. Combining ten studies showed auricular acupuncture at ‘correct’ points to be more effective than control interventions, odds ratio 2.24 (95% CI 1.61, 3.10), a result which is confirmed in the four high validity studies. Other analyses showed inconsistent results between all studies and higher quality studies. Comparisons of three higher quality studies suggest that ‘correct’ and ‘incorrect’ point acupuncture is no different (odds ratio 1.22, CI 0.72, 2.07); and two studies showed that ‘incorrect’ point acupuncture may be more effective than other interventions (odds ratio 1.96, CI 1.00, 3.86). Conclusion Auricular acupuncture appears to be effective for smoking cessation, but the effect may not depend on point location. This calls into question the somatotopic model underlying auricular acupuncture and suggests a need to re-evaluate sham controlled studies which have used ‘incorrect’ points. Further experiments are necessary to confirm or refute these observational conclusions.
Guidelines for Providing Acupuncture Treatment for Cancer Patients – a Peer-Reviewed Sample Policy Document
Authors: Filshie Jacqueline , Hester Joan 
Published: April 2009

Clinical guidelines are statements that have been systematically developed and which aim to assist clinicians in making decisions about treatment for specific conditions, and promote best practice. They are linked to evidence and are meant to facilitate good medical practice. We are not aware of any guidelines for the safe practice of acupuncture in a conventional healthcare setting, yet they are necessary as acupuncture may be performed in a variety of settings and by a variety of healthcare professionals: doctors, nurses, physiotherapists, midwives, and non medically trained practitioners. These guidelines were developed for use in cancer patients, mainly for pain but also for some non-pain indications such as hot flushes. They are presented here as a template for other acupuncturists who are requested to provide policies for acupuncture treatment for cancer patients. This article includes a general review of the evidence on mechanisms, effectiveness and safety of acupuncture that is intended to be used in conjunction with the guidelines; and the guidelines themselves. An appendix includes instructions for self acupuncture. The guidelines contain sections on roles and responsibilities, criteria for acupuncture practice, indications for acupuncture, contraindications and cautions, acupuncture treatment, and review and audit. These guidelines set basic, minimum standards of care, and need reassessment and ongoing validation as further data and evidence accumulate.
The Safety of Acupuncture – Evidence from the Uk
Authors: White Adrian 
Published: April 2009

Background Patients are attracted to acupuncture partly by its reputation for having low risks. The safety of acupuncture should be established by positive evidence. Methods Two prospective surveys were conducted among different groups of professionals in the UK, including doctors, physiotherapists and practitioners primarily trained in acupuncture. Participants monitored adverse events over a defined period of time, and reported minor and significant events on purpose designed forms. Results A total of 652 acupuncturists reported 6733 adverse reactions including tiredness in 66 229 patients, an adverse event rate of 10.2%. The most common events were tiredness (3%) bleeding or bruising (3%), aggravation of symptoms (2%) and pain at the needling site (1%). There were no serious adverse events. A total of 86 (0.1%) of the treatments was associated with an event that the practitioner judged to be significant though without persistent consequences for the patient's health. Conclusion The risks associated with acupuncture can be classified as negligible, and acupuncture is a very safe treatment in the hands of competent practitioners.
Acupuncture Needling versus Lidocaine Injection of Trigger Points in Myofascial Pain Syndrome in Elderly Patients – a Randomised Trial
Authors: Ga Hyuk , Choi Ji-Ho , Park Chang-Hae , Yoon Hyun-Jung 
Published: April 2009

Aim To compare the efficacy of acupuncture needling and 0.5% lidocaine injection of trigger points in myofascial pain syndrome of elderly patients. Methods Thirty nine participants with myofascial pain syndrome of one or both upper trapezius muscles were randomised to treatment with either acupuncture needling (n=18) or 0.5% lidocaine injection (n=21) at all the trigger points on days 0, 7 and 14, in a single-blinded study. Pain scores, range of neck movement, pressure pain intensity and depression were measured up to four weeks from the first treatment. Results Local twitch responses were elicited at least once in 94.9% of all subjects. Both groups improved, but there was no significant difference in reduction of pain in the two groups at any time point up to one month. Overall, the range of cervical movement improved in both groups, apart from extension in the acupuncture needling group. Changes in depression showed only trends. Conclusion There was no significant difference between acupuncture needling and 0.5% lidocaine injection of trigger points for treating myofascial pain syndrome in elderly patients.
Manual Acupuncture as An Adjunctive Treatment of Nausea in Patients with Cancer in Palliative Care – a Prospective, Observational Pilot Study
Authors: Nystrom Elisabeth , Ridderstrom Gunilla , Leffler Ann-Sofie 
Published: April 2009

Background Good clinical evidence has been reported for the effect of PC6 acupuncture in preventing or attenuating postoperative and pregnancy related nausea. Our primary aim was to examine whether PC6 acupuncture during a period of chemotherapy could complement pharmacological treatment of nausea in cancer patients in the palliative stage of their disease. Method We conducted a prospective observational pilot study to measure changes in nausea, and also explored the relationship between nausea, pain and constipation. Twelve patients suffering from nausea and four nausea free patients participated in the study. The nausea free patients were included because they had been troubled by nausea in a previous course of chemotherapy, despite medication with antiemetic drugs, and were about to start a new course of treatment. The patients rated their intensity of nausea, pain and constipation on a numerical rating scale before each of 10 treatment sessions with PC6 acupuncture over the course of three weeks, and at two follow ups during the following week. Results Fifteen patients completed the study. Compared to before treatment, the patients scored a significantly reduced intensity of nausea before the last treatment session (P<0.01) and at the first follow up (P<0.05). Three out of four nausea free patients were still nausea free before the last treatment session with acupuncture. No relationship could be found between nausea, pain and constipation before, during or after the treatment period had finished. Conclusion The study demonstrated that acupuncture treatment in cancer patients can be associated with a significantly reduced intensity of nausea during a period of chemotherapy in their final phase of life.
Effects of Manual Acupuncture with Sparrow Pecking on Muscle Blood Flow of Normal and Denervated Hindlimb in Rats
Authors: Shinbara Hisashi , Okubo Masamichi , Sumiya Eiji , Fukuda Fumihiko , Yano Tadashi , Kitade Toshikatsu 
Published: April 2009

Introduction In clinical practice, it has been thought that acupuncture might serve to wash out pain-generating metabolic end-products by improving blood circulation in muscles. We investigated the effects of manual acupuncture (MA) on muscle blood flow (MBF) of normal and denervated hindlimbs in rats. Method Sprague-Dawley rats (n=100) anaesthetised with urethane (1.2g/kg ip) were used. Manual acupuncture with sparrow pecking (SP) at different doses (1, 10 or 30 pecks) was given to the right ventral hindlimb muscles (tibial anterior and extensor digitorum longus muscles) or the right dorsal hindlimb muscles (gastrocnemius, plantaris and soleus muscles). MBF with or without MA was measured using the radiolabelled microsphere technique. The blood pressure was recorded through the right common carotid artery until MBF measurement started. Denervation of hindlimb was conducted by cutting the sciatic and femoral nerves. Results In normal rats, significantly increased MBF after MA were observed only in muscles which were penetrated by an acupuncture needle. The size of the increase depended on the number of times of pecking and seemed to be sustained at least until 60 minutes after MA. However, the increase was observed after both acute and chronic denervation. On the other hand, the mean arterial blood pressure (MAP) did not change significantly before, during or after MA. Conclusion These results suggest that MA could increase muscle blood flow locally in a dose-dependent manner and that this increase may be caused by local vasodilators, as well as the axon reflex. A further study is needed to elucidate the mechanism.
Acupuncture for Preconditioning of Expectancy And/Or Pavlovian Extinction
Authors: Lundeberg Thomas , Lund Iréne 
Published: April 2009

Both specific and non-specific factors, as well as the therapist, may play a role in acupuncture therapy. Recent results suggest that verum acupuncture has specific physiological effects and that patients’ expectations and belief regarding a potentially beneficial treatment modulate activity in the reward and ‘self-appraisal’ systems in the brain. We suggest that acupuncture treatment may partly be regarded and used as an intervention that preconditions expectancy, which results in both ‘conditional reflexes’ and conditioning of expected ‘reward’ and ‘self-appraisal’. If so, acupuncture should preferably be applied before the start of the ‘specific’ treatment (drug or behavioural intervention which is given with the intention of achieving a specific outcome) to enhance the specific and non-specific effects. This hypothesis is further supported by the suggestions that acupuncture may be viewed as a ‘neural’ stimulus that triggers Pavlovian ‘extinction’. If this is the case, acupuncture should preferably be applied repeatedly (ie in a learning process) before the start of the ‘specific’ treatment to initiate the extinction of previous unpleasant associations like pain or anxiety. Our clinical data suggest that acupuncture may precondition expectancy and conditional reflexes as well as induce Pavlovian ‘extinction’. Based on the above we suggest that acupuncture should be tried (as an adjunct) before any ‘specific’ therapy.
Moxibustion: Respiratory Complications
Authors: Urneh Beatrice 
Published: April 2009

Inhalation of fumes from smouldering moxa stick during moxibustion has been found to provoke tightness in the chest, dyspnoea and increased production of phlegm in persons prone to asthmatic, and bronchitic attacks. Ingestion of the antihistamine, Tavegyl Sandoz (clemastine), prior to exposure to moxa slick fumes attenuates the severity of these chest complications. Free airflow, away from patients and attendants should be ensured during moxibustion. Wherever possible, an alternative heat source such as a lighter, should be used for acubustion. The use of a suitable antihistamine for prophylaxis is recommended whenever moxibustion must be applied to individuals or by acupuncturists with allergic tendencies.
Defective Repair of Oxidative DNA Damage in Triple-Negative Breast Cancer Confers Sensitivity to Inhibition of Poly(ADP-Ribose) Polymerase
Authors: Alli Elizabeth , Sharma Vandana B. , Sunderesakumar Preethi , Ford James M. 
Published: April 2009

Abstract
Subtypes of breast cancer that represent the two major types of epithelial cells in the breast (luminal and basal) carry distinct histopathologic profiles. Breast cancers of the basal-like subtype, which include the majority of hereditary breast cancers due to mutations in the breast cancer susceptibility gene 1 (BRCA1), frequently assume triple-negative status, i.e., they lack expression of estrogen receptor-α and progesterone receptor, and lack overexpression or amplification of the HER2/NEU oncogene. Defects in DNA damage response pathways result in genome instability and lead to carcinogenesis, but may also be exploited for therapeutic purposes. We analyzed repair of oxidative DNA damage by the base-excision repair (BER) pathway, which when aberrant leads to genomic instability and breast carcinogenesis, in cell lines that represent the different subtypes of breast cancer and in the presence of BRCA1 deficiency. We found that basal-like and BRCA1-mutated breast cancer cells were defective in BER of oxidative DNA damage, and that this defect conferred sensitivity to inhibition of poly(ADP-ribose) polymerase, a DNA repair enzyme. The defect may be attributed, at least in part, to a novel role for BRCA1 in the BER pathway. Overall, these data offer preventive, prognostic, and therapeutic usefulness. [Cancer Res 2009;69(8):3589–96]
Detection of Precancerous Cervical Lesions Is Differential by Human Papillomavirus Type
Authors: Safaeian Mahboobeh , Schiffman Mark , Gage Julia , Solomon Diane , Wheeler Cosette M. , Castle Philip E. 
Published: April 2009

Abstract
Epidemiologic studies have reported the underrepresentation of cervical precancerous lesions caused by human papillomavirus (HPV) types 18 and 45 (HPV18/45) compared with the proportion of cervical cancers attributed to these HPV types. We investigated the timing of diagnosis of histologic cervical intraepithelial neoplasia grade 3 or worse (CIN3+) using data from the atypical squamous cells of undetermined significance–low-grade squamous intraepithelial lesion triage study (ALTS). Of the 2,725 women who underwent enrollment colposcopy, 412 of 472 (87.3%) diagnosed with histologic CIN3+ over the 2-year duration of ALTS could be assigned to a HPV type or group of types and were included in this analysis. Eighty-four percent of HPV16-positive CIN3+ were diagnosed at enrollment, compared with 57% of HPV18/45-positive CIN3+, and 58% of CIN3 positive for other carcinogenic HPV types at enrollment. In contrast, only 8% of HPV16-positive CIN3+ were diagnosed at exit, whereas 31% were HPV18/45 positive and 22% were positive for other carcinogenic types at study exit (P &lt; 0.001). These results indicate the underrepresentation of HPV18/45 in precancers, whereas HPV16-associated CIN3+ is diagnosed much earlier. Whether the underrepresentation of 18/45 may be due to occult pathology needs further investigation. [Cancer Res 2009;69(8):3262–6]
Thrombin Induces Tumor Cell Cycle Activation and Spontaneous Growth by Down-regulation of p27Kip1, in Association with the Up-regulation of Skp2 and MiR-222
Authors: Hu Liang , Ibrahim Sherif , Liu Cynthia , Skaar Jeffrey , Pagano Michele , Karpatkin Simon 
Published: April 2009

Abstract
The effect of thrombin on tumor cell cycle activation and spontaneous growth was examined in synchronized serum-starved tumor cell lines and a model of spontaneous prostate cancer development in TRAMP mice. BrdUrd incorporation and propidium iodide staining of prostate LNCaP cells arrested in G0 and treated with thrombin or serum revealed a 48- and 29-fold increase in S phase cells, respectively, at 8 hours. Similar results were obtained with TRAMP cells and a glioblastoma cell line, T98G. Cell cycle kinases and inhibitors in synchronized tumor cells revealed high levels of p27Kip1 and low levels of Skp2 and cyclins D1 and A. Addition of thrombin, TFLLRN, or serum down-regulated p27Kip1 with concomitant induction of Skp2, Cyclin D1, and Cyclin A with similar kinetics. LNCaP p27Kip1-transfected cells or Skp2 knockdown cells were refractory to thrombin-induced cell cycle activation. MicroRNA 222, an inhibitor of p27Kip1, was robustly up-regulated by thrombin. The in vitro observations were tested in vivo with transgenic TRAMP mice. Repetitive thrombin injection enhanced prostate tumor volume 6- to 8-fold (P &lt; 0.04). Repetitive hirudin, a specific potent antithrombin, decreased tumor volume 13- to 24-fold (P &lt; 0.04). Thus, thrombin stimulates tumor cell growth in vivo by down-regulation of p27Kip1. [Cancer Res 2009;69(8):3374–81]
New Tricks for Animal MicroRNAs: Targeting of Amino Acid Coding Regions at Conserved and Nonconserved Sites
Authors: Rigoutsos Isidore 
Published: April 2009

Abstract
MicroRNAs (miRNA) are short RNAs that affect the expression of a protein-coding gene either by directing the degradation of its “target” mRNA or by disrupting its translation into amino acids. Target selection depends on the underlying sequence as well as other, currently not understood, factors. In plants, miRNAs typically interact with the amino acid coding region of the target mRNA. However, in animals, research has been nearly exclusively confined to studying miRNA interactions with the 3′ untranslated region of their mRNA targets. This region-limited view of animal miRNA activity, together with the assumption that bona fide animal miRNA targets ought to be conserved across organisms, have been in effect for many years. Recent work has shown that miRNAs can target extensively the amino acid coding region of animal mRNAs and can do so at locations that are not necessarily conserved across organisms. [Cancer Res 2009;69(8):3245–8]
Childhood Soy Intake and Breast Cancer Risk in Asian American Women
Authors: Korde Larissa A. , Wu Anna H. , Fears Thomas , Nomura Abraham M.Y. , West Dee W. , Kolonel Laurence N. , Pike Malcolm C. , Hoover Robert N. , Ziegler Regina G. 
Published: April 2009

AbstractIntroduction: Historically, breast cancer incidence has been substantially higher in the United States than in Asia. When Asian women migrate to the United States, their breast cancer risk increases over several generations and approaches that for U.S. Whites. Thus, modifiable factors, such as diet, may be responsible.Methods: In this population-based case-control study of breast cancer among women of Chinese, Japanese, and Filipino descent, ages 20 to 55 years, and living in San Francisco-Oakland (California), Los Angeles (California) and Oahu (Hawaii), we interviewed 597 cases (70% of those eligible) and 966 controls (75%) about adolescent and adult diet and cultural practices. For subjects with mothers living in the United States (39% of participants), we interviewed mothers of 99 cases (43% of eligible) and 156 controls (40%) about the daughter's childhood exposures. Seventy-three percent of study participants were premenopausal at diagnosis.Results: Comparing highest with lowest tertiles, the multivariate relative risks (95% confidence interval) for childhood, adolescent, and adult soy intake were 0.40 (0.18-0.83; Ptrend = 0.03), 0.80 (0.59-1.08; Ptrend = 0.12), and 0.76 (0.56-1.02; Ptrend = 0.04), respectively. Inverse associations with childhood intake were noted in all three races, all three study sites, and women born in Asia and the United States. Adjustment for measures of westernization attenuated the associations with adolescent and adult soy intake but did not affect the inverse relationship with childhood soy intake.Discussion: Soy intake during childhood, adolescence, and adult life was associated with decreased breast cancer risk, with the strongest, most consistent effect for childhood intake. Soy may be a hormonally related, early-life exposure that influences breast cancer incidence. (Cancer Epidemiol Biomarkers Prev 2009;18(4):1050–9)