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In this issue
doi:10.1136/aim.2009.002006 Adrian White
Our first two papers and their commen- back pain in which they found significant
taries address areas of acupuncture prac- effects of acupuncture in rather small
tice that are quite contentious in the samples. The latest careful report by
scientific community—stroke and myo- Inoue et al (see page 174) does not give
fascial trigger point pain. any clues as to what it is about their
Could acupuncture make a real differ- acupuncture needling that is so effective,
ence to patients, or would resources be but the results will contribute to the
better used on other treatments? overall search for evidence on acupuncture
Firstly, in acute stroke, Inoue et al (see and so are welcome.
page 155) report observations that electro- Acupuncture is thriving in Brazil. Saad et
acupuncture can sometimes lead to al (see page 178) describe how acupuncture
immediate improvement in the clinical is already being offered as part of the pain
status of patients, and then test for possible service for inpatients, and describe how this
mechanisms using MRI (figure 1). The peer differs from an outpatient service. Our
reviewers questioned these reports, and the Education and practice section continues
authors vigorously defended their state- with Straiton’s essay which combines
ment with references (in Chinese). We knowledge about acupuncture mechanisms
asked Zhang and colleagues, experts on and theories of cortical development in the
acupuncture for stroke in China, to com- child to speculate on the important area of
ment (see page 146): they say that sudden acupuncture responders and non-respon-
improvement in acute stroke with electro- ders: it may all be due to the mother’s
acupuncture has been reported, though Figure 1 Cerebral blood flow (CBF) and nurturing skills in the first 18 months of
rather rarely, and that resources would be volume (CBV) after spontaneous stroke in rats.
life. Cakmak (page 183) provides another
b