**4.7 Limitations**

Language was the first limitation, several articles have been found in France [124, 125], Portugal [126], Russia [127], Germany [128], Italy [129], Denmark [130], and Iceland [131] that have not been included in the revision due to its

original language. 3 reviews in Chinese [132], German [128] and Danish [133] respectively were excluded for the same reason. The first two expose a synthesis or classification of adverse effects and the third, is a review on acupuncture in children in Denmark. Letters and comments were also excluded; however, we highlight the case of acupuncture in the disease of behgets [134]; a letter to editor where they expose a case of pneumothorax during a demonstration of dry needling in the thoracic iliocostal [135] and a needle broken as a complication of acupuncture [136]. Neither has been taken into account articles on practical applications, effectiveness of such techniques or superiority of some over others.
