Highlights
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## Acupuncture

![Figure1](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/185/6/455/F1.medium.gif)

[Figure1](http://www.cmaj.ca/content/185/6/455/F1)

Image courtesy of © 2013 Thinkstock

The placebo effect may be hard to disentangle from the effect of acupuncture itself; outcome measures may be subjective; and participants may be able to tell whether they are in the treatment or control group. Fletcher shows how Xu and colleagues addressed these concerns in their randomized controlled trial of acupuncture for Bell palsy and concludes that perhaps it is time for acupuncture to become more mainstream. **See Editorial, page [459](http://www.cmaj.ca/lookup/volpage/185/459)**

Manipulation of acupuncture needles resulted in better functional recovery from facial palsy than when the needles were left immobile. In this randomized controlled trial, 338 patients with uncomplicated Bell palsy were allocated to 1 of 2 methods of acupuncture. Recovery of facial expression was judged from photographs after 6 months by 3 neurologists who were kept unaware of the treatments given. The effects of acupuncture using strong stimulation should be taken into consideration in future practice and research, say the authors. **See Research, page [473](http://www.cmaj.ca/lookup/volpage/185/473)**

## Finding a doctor is harder for the poor

![Figure2](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/185/6/455/F2.medium.gif)

[Figure2](http://www.cmaj.ca/content/185/6/455/F2)

Image courtesy of © 2013 Thinkstock

People of lower socioeconomic status were less likely to be offered an appointment with a family doctor than those of a higher status. Using 1 of 4 randomly allocated standardized scripts, researchers called 375 practices and asked for an appointment with a family doctor. Although patients with chronic health conditions did receive higher priority, greater efforts are needed to ensure that physicians and their office staff do not discriminate against people of lower socioeconomic status, say the authors. **See Research, page [E263](http://www.cmaj.ca/lookup/volpage/185/E263)**

## Stillbirth in Aboriginal populations

Stillbirth rates in Aboriginal populations of Quebec are high throughout pregnancy, especially among the Inuit. In their study of stillbirths and live births among Quebec residents from 1981 to 2009, Auger and colleagues found that the causes most strongly associated with stillbirth were diabetic and hypertensive complications among First Nations mothers and poor fetal growth and placental disorders among Inuit mothers. The authors suggest that prevention may require improvements in pregnancy and obstetric care, and possibly modification of behavioural risk factors. **See Research, page [E256](http://www.cmaj.ca/lookup/volpage/185/E256)**

## Therapies for spinal cord injury

![Figure3](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/185/6/455/F3.medium.gif)

[Figure3](http://www.cmaj.ca/content/185/6/455/F3)

Image courtesy of © 2013 Thinkstock

As the population ages, the incidence and prevalence of traumatic spinal cord injury are expected to increase, primarily as a result of falls among older adults. This review by Wilson and colleagues provides general clinicians with the relevant pathophysiology and recent evidence pertaining to the medical, surgical and cellular-based treatment of these injuries. **See Review, page [485](http://www.cmaj.ca/lookup/volpage/185/485)**

## Neurosyphilis

Neurosyphilis, “the great imitator,” can be mistaken for other conditions such as bipolar disorder, seizure disorder and dementia. Costiniuk and MacPherson describe 3 men with neurosyphilis in whom diagnosis and treatment were delayed for up to a year because their initial presentations were in keeping with primary neurological or psychiatric problems. **See Practice, page [499](http://www.cmaj.ca/lookup/volpage/185/499)**

## Frey syndrome

Parents of a toddler noticed that he had episodic warmth and flushing over his right cheek when chewing solid food from the age of 6 months. They said that he had been born at term by an induced vaginal delivery with the assistance of forceps. Caulley and Hong explain how these 2 events are connected. **See Practice, page [504](http://www.cmaj.ca/lookup/volpage/185/504)**

## Nonsuicidal self-injury

![Figure4](http://www.cmaj.ca/https://www.cmaj.ca/content/cmaj/185/6/455/F4.medium.gif)

[Figure4](http://www.cmaj.ca/content/185/6/455/F4)

“Cutting” or other forms of nonsuicidal self-injury are common among youth and young adults. This behaviour is predominantly used to manage negative feelings, say Lewis and Heath, rather than to seek attention or be manipulative. Most who engage in nonsuicidal self-injury do not have a history of sexual or physical abuse, or borderline personality disorder. However, the behaviour is associated with an increased risk of suicide. **See Practice, page [505](http://www.cmaj.ca/lookup/volpage/185/505)**