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I enjoyed reading the excellent article on adverse effects of acupuncture by Melchart et al.¹ To make their list more complete, I would like to mention 3 more serious complications of acupuncture: infective endocarditis,^2-4 cardiac tamponade,⁵ and AIDS.⁶ The last is of special importance. A large number of patients with AIDS have now turned to alternative therapies, including acupuncture.⁶ Accordingly, this means of transmission may become increasingly important not only to thousands of patients receiving acupuncture treatments for various other ailments, but also to the acupuncturists themselves through needlestick accidents.

Acupuncture is safe but complications do occur, though rarely. According to Ernst and White,⁷ hundreds of thousands of acupunturists worldwide perform millions of acupuncture procedures per year. Ernst and White⁷ also stated that many cases of adverse events might not be reported, for various reasons, and those reported might not all be published. Therefore, such prospective studies as the one . . . [Full Text of this Article]

Tsung O. Cheng, MD

Correspondence: Dr Cheng, Division of Cardiology, George Washington University, 2150 Pennsylvania Ave, Washington, DC 20037.

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Prospective Investigation of Adverse Effects of Acupuncture in 97 733 Patients
Dieter Melchart, Wolfgang Weidenhammer, Andrea Streng, Susanne Reitmayr, Andrea Hoppe, Edzard Ernst, and Klaus Linde
Arch Intern Med. 2004;164(1):104-105.
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