[escepticos] Fwd: RV: Efectos adversos. soBRE HOMEOPATIA. Colaboración del Dr. Manuel Nevado.

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> From: "Manuel Nevado Santos" 
> To: 
> Subject: RV: Efectos adversos 
> Date: Tue, 9 Feb 1999 20:09:25 +0100 
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>  
> -----Mensaje original-----
> De: Servicio de Anatomía Patológica
> <<mailto:anatomia en valme.sas.cica.es>anatomia en valme.sas.cica.es>
> Para: <mailto:mnevado en lix.intercom.es>mnevado en lix.intercom.es
> <<mailto:mnevado en lix.intercom.es>mnevado en lix.intercom.es>
> Fecha: jueves 28 de enero de 1999 14:14
> Asunto: Efectos adversos
>
>  
>


 Life-threatening adverse reactions after acupuncture? A systematic 
 review. 

 Life-threatening adverse reactions after acupuncture? A systematic 
                             review. 

 Ernst E, White A. . 1997. Life-threatening adverse reactions after 
 acupuncture? A systematic review.. Pain 71(2): pp.123-126. 

 Author's objective 

 To summarise the published evidence on potentially 
 life-threatening adverse complications after acupuncture. 

 Type of intervention 

 Treatment. 

 Specific interventions included in the review 

 Acupuncture. 

 Participants included in the review 

 Patients who experienced life-threatening events allegedly caused 
 by acupuncture. 

 Outcomes assessed in the review 

 The outcome assessed was that of a life-threatening event 
 classified miscellaneous. 

 Study designs of evaluations included in the review 

 Studies included case-reports, case series, clinical trials or 
 reviews relating to life-threatening adverse effects in human 
 subjects. 

 What sources were searched to identify primary studies? 

 A search using the terms "acupuncture" and "adverse" was performed 
 on MEDLINE from 1969-1996 and specialised databases (eg CISCOM). 
 Reports were retrieved from the author's collection of relevant 
 papers. Other experts working in the area were consulted. All 
 articles found were screened for further relevant publications in 
 their biographies. 

 Criteria on which the validity (or quality) of studies was 
 assessed 

 Not stated. 

 How were the inclusion criteria applied? 

 Not stated. 

 How were judgements of validity (or quality) made? 

 Not stated. 

 How were the data extracted from primary studies? 

 Not stated. 

 Number of studies included 

 56 studies which fitted the inclusion criteria were identified. 

 How were the studies combined? 

 Narrative review. 

 How were differences between studies investigated? 

 Not stated. 

 Results of the review 

 5 fatalities were documented including two septicaemia, two 
 cardiac tamponade, one acute asthmatic attack. Adverse reactions 
 reported were: infections including hepatitis B, HIV, and 
 sub-acute bacterial endocarditis; trauma including pneumothorax 
 and cardiac tamponade; miscellaneous including dermatitis, spinal 
 cord injury and suppression of a demand pacemaker by 
 electromagnetic interference. 

 Was any cost information reported? 

 No. 

 Author's conclusions 

 Serious adverse events have been associated with acupuncture 
 though the incidence is unknown. Acupuncturists should demonstrate 
 how successfully they minimise the risks and put in place 
 regulatory and surveillance systems that enable the extent of the 
 problems to be defined. 

 CRD commentary 

 This review mentions some of the adverse reactions allegedly 
 caused by acupuncture. Details of the "specialised databases" 
 searched are lacking as is information on the sources of the 
 authors' collection of papers on the subject. The search strategy 
 outlined together with contact with other experts may have 
 revealed most of the relevant studies but without more details of 
 the sources used it is not possible to be certain of this. There 
 was no critical assessment of the primary studies. 

 As the author correctly points out there are problems with proof 
 of causality, the incidence of adverse reactions is unknown, and 
 the possibility that many cases may for various reasons not be 
 reported and those reported may not be published may result in an 
 incomplete catalogue of adverse events. 

 Record status 

 This record is a structured abstract written by CRD reviewers. The 
 original has met a set of quality criteria. Since September 1996 
 abstracts have been sent to authors for comment. Additional 
 factual information is incorporated into the record. Noted as 
 [A:....]. 

 Index 
 Index terms 

 Subject indexing assigned by NLM 

 Acupuncture-Analgesia/ae [adverse-effects] 

 Contact address 

 Professor E Ernst, Department of Complementary Medicine, 
 Postgraduate Medical School, University of Exeter, 25 Victoria 
 Park Road, Exeter EX2 4NT, United Kingdom. 

 Copyright 

 Copyright: University of York, 1997. 

 Database no.: DARE-970810 

 CRG code: HM-SYMPT 


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