A Possible Correlation Between Auricular Angiomas and Breast Cancer Through Auricular Acupuncture Diagnosis: An Observational Case-Control Study.

Introduction Auricular acupuncture (AA) can be used for both diagnosis and therapy. Diagnosis done with AA has become more prominent, with inspection by evaluating skin alterations considered the most important step. Literature on AA diagnosis in cancer patients is scarce. Globally, breast cancer (BC) is the most commonly diagnosed cancer in women. Materials and methods Subjects accessing the outpatient Breast Unit Clinic of Padua for BC were evaluated for auricle angiomas, with collected data including a number of angiomas, Romoli's Sectogram sector of identified angiomas, laterality of the auricle with the angioma, age, and laterality of BC. Results Of the 438 subjects evaluated, 129 had BC, and 64 had an identifiable auricle angioma. The odds of an auricular angioma were higher in subjects with BC diagnosis, mainly localized in tumor area II and predominantly ipsilateral to the side affected by BC. Conclusions AA auricle inspection is a simple, quick, and easy diagnostic tool. Screening for the presence and location of auricular angiomas may help health practitioners refer women for BC screening for early diagnosis.

Bibliometric analysis of auriculotherapy research trends over the past 20 years.

OBJECTIVES: Auriculotherapy has long been used to treat various diseases. We analyzed and visualized auriculotherapy's geographical distribution, key contributors, and thematic trends over the past 20 years to provide current trends in auriculotherapy field and to offer recommendations for future research directions. DESIGN/SETTING: We searched for relevant studies in the Web of Science between January 10, 2003, and December 31, 2022. A bibliometric analysis was performed using VOSviewer for annual publications, journals, countries, institutions, authors, and keywords. RESULTS: A total of 800 studies were included in the analysis, and the number of studies steadily increased over the 20 examined years. In 2018, there was a noteworthy rise in publications, nearly twice as many as the preceding year. Integrative & complementary medicine was the most researched area, with most articles published in Evidence-Based Complementary and Alternative Medicine. China was the country with the most published research, and the most active organization was Guangzhou University of Chinese Medicine in China, followed by Kyung Hee University in South Korea. The most prolific author was Yeh Mei-ling, who reported the effects of auriculotherapy on dysmenorrhea and smoking cessation. Keyword analysis revealed four clusters: pain, mental health, obesity, and smoking cessation. CONCLUSION: Auriculotherapy research primarily focused on clinical studies related to pain, obesity, smoking cessation, and depression. Future research should place greater emphasis on verifying the mechanisms of auriculotherapy for specific ailments and may require efforts to enhance the robustness of clinical trials. Through visual analysis, our study may serve as a foundational resource, offering valuable insights into the trajectory of auriculotherapy research.

Effects of Frequency-Controlled Ear Acupuncture on COVID-19- related Refractory Olfactory Dysfunction: a Randomized Clinical Trial.

Background: Olfactory dysfunction is a common COVID-19 symptom, posing treatment challenges. Objectives: We aimed to investigate the efficacy of frequency-controlled ear acupuncture in treating COVID-19-related olfactory dysfunction. Methods: A randomized, participant-blind clinical trial occurred at the Rasoul Akram Hospital (IRCT20210311050671N1). Forty patients were recruited, and 20 patients were randomly assigned to either the experimental or control group. The primary outcome was the improvement in patients' quality of smell. The olfactory dysfunction was confirmed using the Smell Identification Test. The intervention group received two sessions of acupuncture treatment according to auricular frequency treatment, with a one-week interval, while the control group received an equal number of switched-off laser sessions. Both groups were instructed to use nasal betamethasone drops. The patients were asked to rank their ability to smell before and after each intervention on a 10-point visual analog scale. Secondary outcomes were related side effects. Results: Covariance analysis revealed a significant difference in adjusted scores between the groups (F [37, 1] = 37.463; p = 0.000, Eta2 = 0.503). The smell quality improved from 2.80 ± 1.76 to 5.22 ± 3.40 after treatment in the intervention group (p = 0.007), while the control group showed no significant change (p = 0.184). Three patients reported short and transient side effects, such as nausea, headache, and dizziness, in the first hours after the intervention. Conclusion: Frequency-controlled ear acupuncture is an effective option for treating COVID-19-related olfactory dysfunction. The study highlights the potential of alternative therapies in the treatment of this condition, and further research is warranted to investigate its long-term effects.

Networks of Nerve Fibers, and Blood and Lymphatic Vessels in the Mouse Auricle: The Structural Basis of Ear Acupuncture.

Objective: Ear acupuncture, as a system for treating and preventing diseases through stimulation of points on the auricle, has been systematically introduced during the last 60 years. Although the auricular cartography was described somatotopically as an inverted fetus by Paul Nogier, MD, the underlying mechanism of auricular stimulation remains unclear. The aim of this research was to gain an understanding of the structural basis of auricular stimulation, as well as showing the distribution of the nerve fibers, and the blood and lymphatic vessels. Materials and Methods: The distribution of nerve fibers, and blood and lymphatic vessels was examined in whole-mount auricular skins of mice by combining the biomarkers protein gene product 9.5, cluster of differentiation 31, and lymphatic-vessel endothelial hyaluronan receptor-1 following tissue-clearing treatment with multiple immunofluorescent staining. Results: The labeled nerve fibers, and the blood and lymphatic vessels were distributed extensively in the inner and outer parts of the auricular skin. Auricular nerves aligning with blood vessels ran from the basal region to the peripheral region and crossed over lymphatic vessels, thus forming the neural, vascular, and lymphatic networks. Conclusions: As these are important tissue components of auricular skin, this result implies that the auricular nerve fibers, and blood and lymphatic vessels may coordinate with each other to respond directly to auricular stimulation.

NADA Acupuncture in Specialized Palliative Care: Patients' and Family Caregivers' Experiences.

CONTEXT: Over the last 30 years, non-pharmacological treatment with ear acupuncture, including National Acupuncture Detoxification Association (NADA) acupuncture, has become popular in Western society to relieve cancer-related symptoms. OBJECTIVES: This study aim is to explore whether NADA acupuncture plays a role in relieving suffering experienced by patients hospitalized in a specialized palliative care ward and their family caregivers and whether it contributes to their coping skills. METHODS: A qualitative study with a hermeneutic approach utilizing inductive thematic content analysis. Purposeful sampling took place in a specialized palliative care ward in Denmark and all data were collected through semi-structured interviews with patients and family caregivers as either individual or family interviews. RESULTS: A total of 10 patients and 15 family caregivers participated in interviews. Four themes emerged: (1) communication about treatment with NADA acupuncture, (2) relief of suffering generates extra energy and inner strength, (3) sharing the experience with the family is beneficial, and (4) physical and psychological effects after receiving NADA acupuncture. CONCLUSION: Patients in palliative care and their family caregivers experienced relief of suffering after receiving NADA acupuncture, as well as improved well-being, and extra energy and inner strength to cope with their life situation. The ability to share NADA acupuncture gave family caregivers the feeling of being cared for and contributed to feelings of fellowship and togetherness within the family, strengthening their ability to communicate and cope.

The combined application of ear acupuncture in the treatment of allergic rhinitis: A meta-analysis.

Objective: Meta-analysis was used to evaluate the clinical efficacy of auricular acupressure in the treatment of allergic rhinitis. Methods: Randomised controlled trials (RCTS) on the treatment of allergic rhinitis with ear acupuncture were searched by computer in PubMed, Cochrane Library, Embase、Web of Science、China National Knowledge Infrastructure (CNKI), Wanfang Database (Wanfang), VIP database, and China Biomedical Literature Service System (CBM). The search time was from the establishment of the database to September 18, 2022. Meta-analysis was performed using RevMan 5.4 software. Results: A total of 15 papers with 1002 patients were included in the final study. ①Clinical efficiency: The clinical efficiency of ear acupuncture combined with control group was higher than that of control group, and the difference was statistically significant (P < 0.00001); ② Nasal symptom score: the effect of ear acupuncture combined with control group on allergic rhinitis on nasal symptoms was more obvious than that of control group, and the difference was statistically significant (P = 0.004); ③ Nasal itching symptom score: the efficacy of ear acupuncture combined with control group on allergic rhinitis on nasal itching symptom was significantly higher than that of control group, and the difference was statistically significant (P = 0.01). ④Sneeze symptom score: the effect of ear acupuncture combined with control group on allergic rhinitis on nasal itching symptom was more effective than that of control group, and the difference was statistically significant (P < 0.00001); ⑤Score of runny nose symptom: the effect of ear acupuncture combined with control group on allergic rhinitis on runny nose symptom was more obvious than that of control group, the difference was statistically significant (P = 0.004); ⑥Nasal congestion symptom scores: The effect of ear acupuncture combined with control group on allergic rhinitis on nasal congestion symptom was more obvious than that of control group, and the difference was statistically significant (P = 0.003). Conclusion: Ear acupuncture as an adjunctive therapy of allergic rhinitis can achieve better clinical efficacy.

Auricular acupuncture for sleep quality in participants with mental and behavioral disorders due to prior multiple drug use: a retrospective consecutive case series.

BACKGRUOUND: Poor sleep quality is associated with psychoactive substance abuse/addiction/withdrawal. Auricular acupuncture (AA) is a nonpharmacological method used for the treatment of sleep disturbances. This study aimed to examine the quality of sleep before and after AA in participants with mental and behavioral disorders due to prior multiple drug use in the therapeutic community. METHODS: This was a consecutive case series of 27 participants (25 male [92.6%]). The median age was 35.0 years (interquartile range [IQR], 29.0-37.2 years), methadone/buprenorphine were not used, and the participants were treated with AA (median number of treatments, 15.0 [IQR, 12.0-18.0]) during a median period of 51.0 days (IQR, 49.0-51.0 days) according to the National Acupuncture Detoxification Association (NADA)-Acudetox protocol. Sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI), a self-rated questionnaire that assesses sleep quality and disturbances over a 1-month interval. RESULTS: The global PSQI score dropped (indicating better sleep quality) by a median of 3.0 points (IQR, 0.0-8.0 points) after treatment. In the multivariate logistic regression analysis, with an increase in global PSQI score during AA by 1 point, there was a 0.73-fold reduction in the risk of poor sleep quality post-AA (adjusted odds ratio, 0.73; 95% confidence interval, 0.52-1.01; p<0.055; Nagelkerke's R2=0.66). CONCLUSION: The results revealed a positive effect of AA (by the NADA-Acudetox protocol) on sleep quality (as measured by PSQI) among participants in a treatment center with mental and behavioral disorders due to multiple drug use.

The antinociceptive effect of manual acupuncture in the auricular branch of the vagus nerve in visceral and somatic acute pain models and its laterality dependence.

AIMS: The vagus nerve provides an important route to the central nervous system, and its brain projections are involved in nociceptive control and pain perception. We investigated the effect of ABVN stimulation on the inhibition of nociceptive signaling and the role of the cholinergic system in its neurobiological effects in models of visceral-somatic pain in rats, as well as the potential difference in stimulus laterality. MATERIALS AND METHODS: Male and female Wistar rats were pretreated with auricular acupuncture in the ABVN and submitted to the visceral-somatic nociception model by acetic acid or somatic nociception by formalin. Vagotomy and pharmacological tools were used to verify the participation of the cholinergic system in the experiments. KEY FINDINGS: Acupuncture on the left, but not the right, in the ABVN inhibited nociceptive signaling in the visceral-somatic nociception model in male and female rats. Acupuncture on the left ABVN reduced the response time in the formalin test. The cervical vagotomy of the left branch, but not the right, also inhibited nociceptive signaling in the visceral-somatic nociception model and reduced the effect of ABVN stimulation. Furthermore, cholinergic antagonists reduced the left ABVN stimulation effects in the same model. SIGNIFICANCE: Our data show that only the stimulation in the left ABVN is capable of producing antinociceptive effect in acute pain models in rats, and that it is dependent on the activation of the vagus nerve caudal to the nodose ganglion, as well as the muscarinic and nicotinic cholinergic receptors.

Effects of ear acupuncture combined with cupping therapy on severity and threshold of chronic back pain and physical disability: A randomized clinical trial.

Background and aim: Chronic back pain causes physical, functional, and emotional disabilities. Traditional Chinese Medicine therapies have been shown as interventions to treat chronic back pain. The present study aimed to clinically evaluate the effects of ear acupuncture combined with cupping therapy on people with chronic back pain. Experimental procedure: We conducted an open-label, randomized, parallel-group controlled clinical trial. Following the CONSORT statement recommendations, 198 participants were randomized into 'ear acupuncture' and 'ear acupuncture and cupping therapy' groups. Data were collected in three different points; before the first session (initial) with the patient, after the last session (final), and seven days after the end of the treatment (follow-up). The Brief Pain Inventory, a digital algometer, and the Rolland Morris Disability Questionnaire were used for data collection. Generalized Estimation Equation model was used to examine the association between the interventions and the primary outcome pain severity. Results: Pain severity, pressure pain threshold, and physical disability improved over time in both groups. However, for the patients being treated with both ear acupuncture and cupping therapy, significant changes were seen in pain severity, pain relief, and physical disabilities between the initial and final sessions. For the 'ear acupuncture and cupping therapy' group, significant changes were also seen for pain relief and physical disability in the follow-up session. Conclusion: Ear acupuncture combined with cupping therapy was shown to be more effective in the treatment of chronic back pain when compared to treatment using only ear acupuncture.

Combination of Battlefield Acupuncture and Local Point Acupuncture for Post Laparotomy Scar Pain.

Background: Scar pain is a residual symptom of a wound that can cause physiologic and psychologic disorders in patients. In addition to mechanical stimulation in nociceptive fibers, pain can be caused by a neuroma-an adhesion between the layers of skin and fascia that disrupts blood flow around the scar-as well as an increase in peptidergic nerve-fiber density due to dysregulation between synthesis and degradation of collagen tissue that cause abnormal scar formation. Research has shown that ear acupuncture is effective for management of acute pain, including scar pain. Acupuncture in the local area of the scar is also effective for reducing pain significantly. The combination of these 2 therapies is expected to be effective for management of scar pain in cases that have not improved for 4 years. Case: A 69-year-old woman, with a history of a laparotomy 4 years ago, came to the RSCM acupuncture outpatient unit with severe pain in her stomach. The pain was located in a 30-cm long laparotomy wound that ran between the xiphoideus process and the umbilicus, and felt like a rope binding and pressing upward in the area. Manual acupuncture was given at a Battlefield Acupuncture (BFA) point, combined with acupuncture to local point on the scar. Results: She had with a positive vascular autonomic sign response for 30 minutes at each session. At the end of her 12th therapy session, she reported that she was pain-free and did not experience any severe side-effects. Conclusion: A combination of BFA with local-point acupuncture was effective in reducing the severe pain of caused by a post-laparotomy scar.

Effects of Auriculotherapy on treatment of women with premenstrual syndrome symptoms: A randomized, placebo-controlled clinical trial.

OBJECTIVE: This study aimed to investigate the effect of auriculotherapy on the intensity of physical and mood Premenstrual syndrome (PMS) symptoms. DESIGN: Single-blind randomized, placebo-controlled clinical trial. SETTING: Federal University of Parana, Curitiba, Brazil. INTERVENTION: Ninety-one women were randomly assigned to Auriculotherapy (AG), Placebo (PG), and Control (CG) groups. The intervention was 8 weeks long, done once per week. At each session in AG the microneedles were placed in seven points related to PMS symptoms (Anxiety; Endocrine; Muscle relaxation; Analgesia; Kidney; Shen Men; and Sympathetic). At PG the microneedles also were placed in seven points but unrelated to PMS symptoms (Tonsils; Vocal cords; Teeth; Eyes; Allergy; Mouth; and External nose). MAIN OUTCOME MEASURES: Assessments of PMS symptoms (Premenstrual Syndrome Screening Tool), musculoskeletal pain (Nordic Musculoskeletal Questionnaire), anxiety (Beck Anxiety Inventory), and quality of life (WHOQOL-Bref) were done at baseline, before the 5th session, after program completion, and a month follow-up. RESULTS: The AG and PG showed significantly lower scores of PMS symptoms, musculoskeletal pain, and anxiety. On the quality of life and follow-up analysis, the significance was observed only in PG. CONCLUSION: Auriculotherapy can be used as adjunctive therapy to reduce the physical and mood PMS symptoms.

Ear acupuncture as an adjunct in a treatment protocol for anorexia nervosa: utilization rate and nurses' experience.

BACKGROUND: Anorexia nervosa (AN) is a life-threatening illness. Sometimes long inpatient treatment is necessary, increasing the anxiety that comes with hospitalization and the necessary weight gain. Safe, non-pharmacological adjunctive therapies that improve subjective health are called for. OBJECTIVE: The aim of this non-randomized, mixed-methods observational study was to describe the utilization rate and nurses' experiences of ear acupuncture in a highly specialized clinic for eating disorders in Sweden, in which acupuncture had been implemented as part of routine clinical care. Twenty-five patients with AN-treated voluntarily or by law were included. The semi-standardized National Acupuncture Detoxification Association (NADA) ear acupuncture protocol, sometimes combined with needling at 2 traditional acupuncture point locations on the body, had been implemented as a voluntary adjunct to usual care, twice weekly. To evaluate the acceptance of acupuncture, the study examined how often patients chose acupuncture when offered on schedule, and how often they asked for extra acupuncture sessions. Patients rated their subjective health using the hospital anxiety and depression scale (HADS) and visual analogue scale (VAS), treatment satisfaction with usual care and acupuncture, and health-related quality of life with the RAND36 instrument. A credibility/expectancy questionnaire (CEQ) was used to measure confidence in treatment. Body mass index (BMI) was calculated to follow the patients' recovery. Nurses' experiences of giving acupuncture as a part of routine care were captured in interviews, and analysed with content analysis. Ethical approval was obtained. RESULTS: Despite an initially moderate level of trust in acupuncture, the utilization rate of the scheduled acupuncture was 89% and patients asked for extra acupuncture sessions on 28 occasions. No serious side effects were reported. Nurses' experiences of providing acupuncture were positive. They were generally enthusiastic, although they reported finding it difficult to organize group treatments and to find time for acupuncture sessions if they were not scheduled. CONCLUSION: Further research into the effectiveness and costs of acupuncture in psychiatric care is needed. This study provides relevant information for clinicians as well as researchers planning future randomized controlled trials.

Laser acupuncture and intravascular laser irradiation of blood for management of pediatric dental anxiety.

The aim of this study was to assess the effectiveness of laser acupuncture and intravascular laser irradiation of blood (ILIB) for managing anxiety in pediatric dentistry. Eighty-four children recruited at a university dental clinic were randomly assigned to three groups: the Sham group (n = 27) underwent sham laser irradiation of three acupuncture points, the ILIB group (n = 25) underwent 10 min of ILIB, and the laser acupuncture group (LAC, n = 32) underwent 40 s of laser acupuncture over points VG20 (Baihui), PC6 (Neiguan), and the Oppression Point. The results suggest that ILIB and laser acupuncture are feasible alternatives for managing dental anxiety in children.

Ear Acupuncture Points in Neonates From Drug-Dependent Mothers: A Prospective Study.

Aim: The aim of the study was to determine the presence or absence of ear acupuncture points (EAP) in newborn children with or without neonatal abstinence syndrome (NAS) and to confirm the hypothesis that neonates with NAS have more EAP than healthy neonates. Methods: We conducted a prospective case control study with ethical consent at the University Children's Hospital, Division of Neonatology Bern and the Department of Gynecology and Obstetrics Inselspital Bern in Switzerland. We determined the EAP in n = 26 newborn children born to drug-dependent mothers compared with n = 50 healthy newborns. For the detection of EAP, we used an ear point detection pen. EAP are present only if weakness exists in the corresponding area. Results: Twenty-six neonates who were born to drug-dependent mothers and developed NAS were screened on the 5th day after delivery (range 1-22). The median Finnegan Score was 12 points (range 6-18) on the day of examination. Twenty-four active EAP were detected on the left earlobe and 25 were detected on the right earlobe. There was no significant difference between the right and left lobes (p = 0.9285, two tailed test) and the number of acupuncture points. The correlation between the Finnegan Score and the number of EAP was highly significant (p = 0.0001). The most common active points were the psycho-vegetative rim of the reflex zone of sympathicus and parasympathicus. Organic points were also commonly detected. The urinary bladder, kidney and hip points were detected with a frequency of 12-15%. The shen men pain point was found in three neonates, and the point of desire as a psychological point, was also detected. The correlation between sex and active EAP was highly significant (p = 0.0093, Mann-Whitney test for the left earlobe and p = 0.0025 for the right earlobe). Boys had a significantly higher number of EAP than girls. All NADA points were detected in the neonates born to drug-dependent mothers, and the most frequent point was the vegetative point. Healthy neonates showed only the vegetative point in the vegetative rim 1/3 among the NADA points. A comparison of newborns born to drug-dependent mothers and 50 healthy neonates showed that the former group had statistically significantly more active points. For the left earlobe, the difference between neonates born to drug-dependent mothers and controls was statistically significant (p = 0.0008, Mann-Whitney test). Highly similar results were found for the right earlobe (p = 0.0001, Mann-Whitney test). Discussion: Our current work confirms that neonates born to drug-dependent mothers with high Finnegan scores and NAS have more EAP than healthy neonates. The vegetative rim is the most common point as shown in our previous studies. Our observations showed that twins had similar but not identical points; each individual had unique points depending on health status. Newborn boys with NAS had a higher number of EAP than newborn girls in the neonatal intensive care unit. This findings may be attributed to the reserve of newborns with NAS. Newborn girls are considered more robust than boys in the neonatal care setting. EAP in neonates might potentially be used for diagnosis and therapeutic opinions in neonates in the future.

History of Auriculotherapy: Additional Information and New Developments.

Auriculotherapy, the treatment of patients using ear-point stimulation, is a French technique, deeply rooted in a European medical tradition. Although the French physician, Paul Nogier, MD (1908-1996 ad) invented and promoted auriculotherapy, it is nevertheless worth mentioning, in the course of European history, the occasional use of the ear to relieve head, face, or sciatic nerve pain. It took several centuries to find a physician who attempted to understand why some healers obtained interesting therapeutic results with ear-point stimulation. The exact history of auriculotherapy remained a mystery for a long time. Only recently have researchers begun to understand it better. Many articles, admittedly not based on robust data, wrongly ascribed the discovery of auricular somatotopy to ancient civilizations. It was the recent reading of a book on the treatment of sciatica written in 1869 by Lagrelette that enabled the current author of this article to characterize and confirm the Western roots of auriculotherapy through the history of cauterizations.

Efetividade da acupuntura auricular associada ao treinamento muscular pélvico para controle da incontinência urinária pós-prostatectomia radical: ensaio clínico randomizado / Effectiveness of auricular acupuncture associated with pelvic muscle training to control urinary incontinence after radical prostatectomy: randomized clinical trial

A prostatectomia radical pode causar efeitos urinários indesejáveis como incontinência urinária, noctúria, urgência miccional, frequência e esvaziamento incompleto da bexiga. Disfunções miccionais acarretam sentimentos e vivência de exclusão social e, consequente diminuição na qualidade de vida. Para casos de incontinência urinária pós-prostatectomia radical é indicada a realização do treinamento muscular do soalho pélvico como primeira escolha para auxiliar no mecanismo de fechamento uretral. Dentre as práticas integrativas e complementares que têm contribuições na área da saúde, pode-se citar a acupuntura auricular. Esta baseia-se na estimulação de acupontos no pavilhão auricular para aliviar sinais e sintomas de diversas condições, dentre elas, os sintomas do trato urinário inferior. O objetivo deste estudo foi avaliar a efetividade da acupuntura auricular associada ao treinamento muscular do soalho pélvico na incontinência urinária pós-prostatectomia radical. Trata-se de um ensaio clínico randomizado baseado nas recomendações do Consolidated Standards of Reporting Trials e Standards for Reporting Interventions in Clinical Trials of Acupuncture. Os dados foram coletados entre abril de 2019 e abril de 2020. A amostra foi constituída por 60 homens com incontinência urinária após retirada do cateter vesical de demora, alocados em dois grupos: controle (n=30) que recebeu orientações sobre treinamento muscular do soalho pélvico; e intervenção (n=30) que recebeu acupuntura auricular associada às orientações sobre treinamento muscular do soalho pélvico. As orientações sobre treinamento muscular ocorreram durante oito sessões presenciais semanais associadas à entrega de um livreto que auxiliava a continuidade dos exercícios em domicílio. Para o grupo intervenção, a acupuntura auricular também foi ofertada em oito sessões semanais. A avaliação ocorreu em dois momentos: antes de qualquer tratamento (pré-teste) e após oito semanas de acompanhamento (9ª sessão ­ pós-teste). Foram utilizados os instrumentos questionário sociodemográfico e clínico, daily pad used, pad test de uma hora, escala de incontinência urinária pós-prostatectomia radical, International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) e King's Health Questionnaire (KHQ). O modelo longitudinal, com o uso das equações de estimações generalizadas e teste de diferença de proporções, foi empregado na análise estatística. O nível de significância adotado foi de 0,05. Resultados: a gravidade da incontinência urinária diminuiu entre o pré-teste e pós-teste no grupo intervenção e, também, no grupo controle sem diferenças estatísticas na evolução entre os dois grupos. Em relação ao impacto da incontinência na qualidade de vida, identificou-se diferença estatisticamente significativa entre os grupos no pós-teste ao nível do domínio "medidas de gravidade" (p=0,013), o que indicou menor impacto da IU para este domínio apenas no grupo intervenção. Na análise da frequência dos itens deste domínio, detectou-se diferença estatisticamente significativa entre os grupos no pós-teste para o item "troca suas roupas íntimas quando elas estão molhadas" (p=0,018). Evidenciou-se também que o grupo intervenção teve, respectivamente, 20,8% (p=0,007) e 25,3% (p=0,002) menos chance de apresentar noctúria e urgência miccional. Verificou-se também redução estatisticamente significativa no impacto da incontinência na qualidade de vida nos domínios "emoções" (p<0,001) e "sono e disposição" (p=0,008) no grupo intervenção. Conclusão: a AA não mostrou-se efetiva para potencializar a ação do treinamento muscular na redução da gravidade da incontinência urinária. Por outro lado, quanto ao impacto da incontinência urinária na qualidade vida, a associação da acupuntura auricular ao treinamento mostrou-se mais efetiva, principalmente pela diferença estatisticamente significativa entre os grupos no pós-teste para o domínio "medidas de gravidade", bem como pela redução da chance dos sintomas de noctúria e urgência miccional. Frente a esses achados, recomenda-se a associação das terapias como um cuidado efetivo aos homens com incontinência urinária pós-prostatectomia radical. Registro Brasileiro de Ensaios Clínicos: RBR-3jm5y2.

Radical prostatectomy can cause undesirable urinary effects such as urinary incontinence, nocturia, urinary urgency, frequency and incomplete emptying of the bladder. Voiding dysfunctions cause feelings and experience of social exclusion and, consequently, decrease in quality of life. For cases of urinary incontinence after radical prostatectomy, muscle training of the pelvic floor is indicated as the first choice to assist in the urethral closure mechanism. Among the integrative and complementary practices that have contributions in the health area, we can mention auricular acupuncture. This is based on the stimulation of acupoints in the ear to relieve signs and symptoms of several conditions, including lower urinary tract symptoms. The aim of this study was to evaluate the effectiveness of auricular acupuncture associated with pelvic floor muscle training in urinary incontinence after radical prostatectomy. This is a randomized clinical trial based on the recommendations of the Consolidated Standards of Reporting Trials and Standards for Reporting Interventions in Clinical Trials of Acupuncture. Data were collected between April 2019 and April 2020. The sample consisted of 60 men with urinary incontinence after removal of the indwelling bladder catheter, allocated into two groups: control (n = 30) who received guidance on floor muscle training pelvic; and intervention (n = 30) that received auricular acupuncture associated with guidelines on muscle training of the pelvic floor. The guidelines on muscle training took place during eight weekly face-to-face sessions associated with the delivery of a booklet that helped to continue the exercises at home. For the intervention group, auricular acupuncture was also offered in eight weekly sessions. The evaluation took place in two moments: before any treatment (pre-test) and after eight weeks of follow-up (9th session - post-test). The socio-demographic and clinical questionnaire, daily pad used, one-hour pad test, urinary incontinence scale after radical prostatectomy, International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF) and King's Health Questionnaire (KHQ) were used. The longitudinal model, using generalized estimation equations and proportional difference test, was used in the statistical analysis. The level of significance adopted was 0.05. Results: the severity of urinary incontinence decreased between the pre-test and post-test in the intervention group and also in the control group without statistical differences in the evolution between the two groups. Regarding the impact of incontinence on quality of life, a statistically significant difference was identified between the groups in the post-test at the level of the "severity measures" domain (p = 0.013), which indicated a lower impact of UI for this domain only in the intervention group. In the analysis of the frequency of the items in this domain, a statistically significant difference was detected between the groups in the post-test for the item "change your underwear when they are wet" (p = 0.018). It was also evident that the intervention group had, respectively, 20.8% (p = 0.007) and 25.3% (p = 0.002) less chance of presenting nocturia and urinary urgency. There was also a statistically significant reduction in the impact of incontinence on quality of life in the domains "emotions" (p <0.001) and "sleep and mood" (p = 0.008) in the intervention group. Conclusion: AA was not effective in potentiating the action of muscle training in reducing the severity of urinary incontinence. On the other hand, regarding the impact of urinary incontinence on quality of life, the association of ear acupuncture with training proved to be more effective, mainly due to the statistically significant difference between the groups in the post-test for the "severity measures" domain, as well as by reducing the chance of nocturia symptoms and urinary urgency. In view of these findings, the association of therapies as an effective care for men with urinary incontinence after radical prostatectomy is recommended. Brazilian Registry of Clinical Trials: RBR-3jm5y2.

Postoperative analgesic efficacy of ear acupuncture in patients undergoing abdominal hysterectomy: a randomized controlled trial.

BACKGROUND: Numerous studies have revealed that acupuncture can increase the somatic pain threshold. Electro-acupuncture (EA) can help pain-relieving with minimal physiologic disturbance. Various painful disorders, as well as pain following various surgeries, like cesarean section, gastrostomy, and enterectomy were managed properly with acupuncture. Therefore we studied the postoperative analgesic effect of EA in patients undergoing abdominal hysterectomy. METHODS: A randomized, prospective clinical trial study was carried out on 56 women undergoing hysterectomy under spinal anesthesia. Patients were allocated randomly to receive either spinal anesthesia and electric ear acupuncture (EEA group) or spinal anesthesia alone (control group). EEA was done by fine needles to anatomically defined 4 points of the ear: Shen Men Point, thalamus Point 26, Analgesia Point 3, and Uterus Point 58, and connected to EA therapeutic apparatus. After finishing surgery, the fine needles were substituted by permanent press needles to be removed after 24 hours. The primary outcome was the postoperative 24 h morphine consumption by patient-controlled analgesia, while secondary outcomes included Post-operative pain scores and postoperative 1st request of analgesia. RESULTS: Total morphine consumption in the first 24 postoperative hours was obviously reduced in the EEA group versus the control group (mean ± SD:6.214± 2.1319 mg vs 15.714 ± 3.3428 mg, d = - 3.3886, 95% Confidence interval = - 4.2061,-2.5712, p-value =0.000). The postoperative pain scores were significantly reduced in the EEA group in comparison to the control group, with delayed 1st request of postoperative analgesia. CONCLUSIONS: Electric ear acupuncture provides postoperative analgesia, reducing morphine requirement and consequently its side effects. TRIAL REGISTRATION: The trial was registered before enrolment of the first patient at the Pan African Clinical Trial Registry ( www.pactr.org ) database ( PACTR201903770607799 , Date of registration: 5th March 2019).

Lessons Learned in Teaching Battlefield (Ear) Acupuncture to Emergency Medicine Clinicians.

Background: Acupuncture, in general, is being proclaimed as an alternative analgesic amid the opioid crisis, and along with this, within emergency departments (EDs) there is a specific interest in a form of ear acupuncture called Battlefield Acupuncture (BFA). It is expected that BFA will be used more widely in emergency medicine as it is easy to learn and can be applied both promptly and easily. Teaching programs will be required to sustain this increased demand and upskill emergency clinicians in this skill. Objectives: This article provides experiences and recommendations, based on faculty experiences from teaching BFA in Australia to ED clinicians combined with formal participant feedback. Main Points: BFA courses were adjusted to suit ED doctors and nurses, along with their unique case mix and associated challenging environment. The content of the BFA courses included evidence, pain indications, contraindications, application, safety, mechanism of action, and how to negotiate barriers of credentialing. Workshops used the latest and most effective teaching methods that encompassed problem-based learning, infotainment, simulation, "four stage skills teaching," and "teaching on the run." Conclusion: It is hoped that the experiences gained, and lessons learned in educating this new frontier of BFA to emergency clinicians will assist others in teaching BFA and its related techniques as a viable analgesic alternative in emergency medicine.

Auriculotherapy for sleep bruxism in children: a series of cases

Sleep bruxism is defined as a behavior that causes masticatory muscle activities during sleep. Sleep bruxism in childhood leads to consequences, which may vary from teeth wear in deciduous dentition to temporomandibular disfunction symptoms. There's no data that demonstrates improvement of children with sleep bruxism during and after auricular acupuncture treatment. Objective: Therefore, this case report series aimed to evaluate the effect of auriculotherapy on children presenting sleep bruxism. Methods: Twelve patients were included in this study, in the mean age of 6,9. The diagnosis was evaluated by the question: "Does your kid grind their teeth while sleeping?". Treatment was performed by an acupuncture specialist in a standardized way. The therapy was given for three weeks and the effect was evaluated through a sleep diary, in which the parents noted whether or not their child grinded teeth while sleeping before (baseline) and during therapy (T1 to T3). Sleep bruxism was categorized as presence or absence of nocturnal teeth grinding and the frequency varied from 0 to 7 (baseline), 0 to 5 (T1), 0 to 7 (T2) and 0 to 4 (T3) between patients. The intensity of the reported sleep bruxism was compared according to the periods by pared T-test ( =0.05). Results: It was observed that the frequency of reports decreased significantly from baseline to T3. Conclusion: These results suggest that ear acupuncture may be an alternative therapy for sleep bruxism in childhood, once it demonstrated to reduce its frequency in this study, although patients may present different effects to therapy due to biological variability.

Introdução: Bruxismo do sono é definido como um comportamento que causa atividades musculares durante o sono. Na infância, leva a consequências que podem variar de desgaste dentário na dentição decídua a sintomas de disfunção temporomandibular. Não há estudos que demonstrem melhora de casos de crianças com bruxismo do sono durante e após tratamento com auriculoterapia. Objetivo: portanto, esta série de casos visou avaliar o efeito da auriculoterapia em crianças apresentando este quadro. Métodos: Doze pacientes foram inclusos neste estudo, com a media de idade de 6,9. O diagnóstico foi avaliado pela pergunta "Seu filho range os dentes quando dorme?". O tratamento foi executado por um especialista em acupuntura de forma padronizada. A terapia foi feita por três semanas e o efeito foi avaliado através de um diário do sono, no qual os pais anotavam se a criança rangeu os dentes enquanto dormia antes (baseline) e durante a terapia (T1 a T3). Bruxismo do sono foi categorizado como presença ou ausência de ranger de dentes e a frequência variou de 0 a 7 (baseline), 0 a 5 (T1), 0 a 7 (T2) e 0 a 4 (T3) entre os pacientes. A intensidade foi comparada de acordo com os períodos pelo teste-T pareado (=0,05). Resultados: Foi observado que a frequência de relatos diminuiu significativamente de baseline a T3. Conclusão: Estes resultados sugerem que auriculoterapia pode ser uma terapia alternativa para o bruxismo do sono na infância, uma vez que demonstrou reduzir sua frequência neste estudo, embora os pacientes possam apresentar efeitos diferentes devido à variabilidade biológica.

Auriculoterapia com agulhas para melhora da qualidade de vida em pacientes com câncer: revisão integrativa / Auriculotherapy with needles to improve the quality of life of cancer patients: an integrative literature review / La acupuntura auricular y la calidad de vida de pacientes con cáncer: revisión integradora

Objective: The study's goal has been to identify in the literature the use of auriculotherapy with needles as an intervention to improve cancer patients' life quality. Methods: It is an Integrative Literature Review of articles published in Portuguese, English, Spanish and/or German, available in full at the databases VHL, CAPES, CINHAL, PubMed, Web of Science and Scopus. The study was carried out in January 2017. The descriptors employed were cancer, neoplasms, auriculotherapy, ear acupuncture, and auricular acupuncture, and six studies were then selected. Results: The use of auricular therapy with needles as interventions in the clinical symptoms due to cancer and its treatment, as well as in the improvement of the domains affected in people's life quality have indicated satisfactory evidence. Conclusion: The evidences have identified an improvement in the quality of life of oncology patients that underwent auriculotherapy with needles, therefore, this intervention is a safe, effective and economical complementary therapy, which is very well accepted by the patients

Objetivo: Identificar na literatura o uso da auriculoterapia com agulhas como intervenção para melhoria da qualidade de vida de pacientes com câncer. Método: Revisão integrativa de artigos publicados em português, inglês, espanhol e/ou alemão, disponíveis na íntegra nas bases de dados BVS, CAPES, CINHAL, PUBMED, WEB of SCIENCE e SCOPUS. A pesquisa ocorreu no período de janeiro de 2017. Foram utilizados os descritores câncer, neoplasia, auriculoterapia, acupuntura orelha e acupuntura auricular, sendo selecionados seis estudos. Resultados: O uso da auriculoterapia com agulhas como intervenções nos sintomas clínicos decorrentes do câncer e de seu tratamento bem como na melhoria dos domínios afetados na qualidade de vida apontou evidências satisfatórias. Conclusão: As evidências identificaram melhora na qualidade de vida de pacientes oncológicos que foram submetidos a auriculoterapia com agulhas e que esta intervenção é uma terapia complementar segura, eficaz e econômica, muito bem aceita pelos pacientes

Objetivo: Identificar la producción disponible relacionada al uso de la acupuntura auricular como intervención para la mejora de la calidad de vida de pacientes con cáncer. Método: Revisión integrativa de literatura con búsqueda en bases electrónicas y bibliotecas virtuales BVS, CAPES, CINHAL, PUBMED, WEB of SCIENCE y SCOPUS En el período de enero de 2017 con los descriptores cáncer, neoplasia, auriculoterapia, acupuntura o acupuntura auricular y acupuntura auricular, la acupuntura auricular y la acupuntura auricular. La revisión integrativa propuesta tuvo lugar en seis etapas distintas y complementarias. Resultados: Se identificaron seis artículos con evidencias satisfactorias de las intervenciones en los síntomas clínicos inherentes al cáncer y su tratamiento que demostraron impactos positivos de la auriculoterapia como intervención. Conclusión: Los estudios relacionados con el tema son escasos, apuntan una realidad científica poco explorada. Un número mayor de estudios clínicos debe ocurrir para fortalecer las evidencias de las intervenciones terapéuticas efectivas, subsidiar la práctica y asegurar asistencia cualificada