jueves, 2 de agosto de 2012

Bibliotecas. Alerta

El Cabildo de Tenerife presenta 'El barco de los sueños', octavo ...
Europa Press
El Cabildo de Tenerife, a través de la Sociedad Insular para la Promoción de las Personas con Discapacidad (Sinpromi), ha presentado este martes 'El barco de los sueños', octavo volumen de la colección Biblioteca Sonora de Canarias (BSC), una iniciativa ...
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Europa Press
Engalana Coro infantil-Juvenil “Gabilondo Soler” el Teatro Degollado
Milenio.com
Guadalajara • En el marco del programa “Mis Vacaciones en la Biblioteca 2012”, se presentó en el Teatro Degollado el Coro Infantil- Juvenil “Gabilondo Soler” y la puesta en escena “Ofelia y el teatro de sombras”. En la tercera edición del evento cultural, ...
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Sin Internet, 27 de 30 bibliotecas públicas en Ciudad Juárez
Noticias.terra.com
Chihuahua.- Únicamente tres de las 30 bibliotecas públicas municipales de la ciudad cuentan con Internet, mientras que sólo una tiene línea telefónica, en el resto, están suspendidos ambos servicios. Las bibliotecas Salvárcar, Manuel Talamás Camandari y ...
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La Biblioteca pone a prueba la imaginación de los jóvenes ...
segoviaudaz.es
La Biblioteca Pública de Segovia ha organizado para el mes de agosto en el I Concurso de Microrrelatos, convocado, a través de su blog juvenil 'Travesías de tinta', para que los jóvenes de entre 12 y 24 años puedan presentar relatos que tengan como ...
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segoviaudaz.es
La Biblioteca Gloria Fuertes de Parla aumenta su horario en verano
Madrid Actual
120731 biblioteca gloria fuertes La Biblioteca Gloria Fuertes de Parla, ubicada en la intersección de las calles Isabel II y Alfonso XIII, ampliará su horario de apertura los fines de semana desde el próximo día 4 de agosto y hasta el 23 de septiembre, con el ...
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Madrid Actual
Contarán Bibliotecas de Zitácuaro con Internet Inalámbrico Gratuito
Primer Plano
En breve, estudiantes y ciudadanos en general podrán hacer uso, de manera gratuita, del internet inalámbrico que está en proceso de instalación en las 3 bibliotecas públicas del municipio de Zitácuaro. Así lo informó Gregorio García Torres, director de la ...
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La Biblioteca universitaria municipal abrirá en agosto en horario de ...
Crónicas de Lanzarote
La Biblioteca universitaria municipal vinculada a la Universidad Nacional de Educación a Distancia (UNED) abrirá sus puertas durante el mes de agosto, en horario de cinco a diez de la noche. Según confirma el Ayuntamiento en nota de prensa, así lo ha ...
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“Mis Vacaciones en la Biblioteca 2012” en el Teatro Degollado
El Sur (México)
GUADALAJARA, JALISCO (BI).- Se realizó la tercera edición del evento cultural “Mis Vacaciones en laBiblioteca 2012”, organizado por la Secretaría de Cultura de Jalisco, la Dirección General de Vinculación Cultural y la Red Estatal de Bibliotecas Públicas ...
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Alistan 'Mis vacaciones en la biblioteca'
La Tarde
El próximo dia seis de agosto dará inicio el programa “Mis vacaciones en la biblioteca” el cual se llevará a cabo en las tres bibliotecas con que cuenta el municipio en Reynosa. Será únicamente para niños de siete a 13 años de edad. El slogan del programa ...
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Cierre de las bibliotecas 2-19 de agosto de 2012 « El astronauta ...
Las bibliotecas de la Universidad de Salamanca permanecerán cerradas entre el 2 y el 19 de agosto de 2012. El cierre se debe a la política general de la USAL ...
diarium.usal.es/bibliotecas/.../cierre-de-las-bibliotecas-2-19/

Depresión. Alerta

¿Cómo afecta la depresión a la sexualidad de la pareja?
Radio Programas del Perú
La depresión es un estado psíquico que altera los sentimientos y pensamientos de las personas y suele afectar diversos aspectos de la vida del individuo con signos notorios de tristeza, decaimiento anímico, pérdida de interés en todo y la sensación de ser ...
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Radio Programas del Perú

Videojuegos, una manera de combatir depresión en Nueva Zelanda
Milenio.com
AUCKLAND • Los juegos de video, considerados a menudo como causas de aislamiento de los jóvenes, pueden ayudar a adolescentes deprimidos y en Nueva Zelanda un juego creado por psiquiatras muestra un mundo imaginario donde un joven asume ...
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Milenio.com
Juego de video ayuda a adolescentes con depresión
ElHeraldo.hn
El juego SPARX busca enseñar a los adolescentes a enfrentar la depresión, basándose en una terapia cognitivo-conductual (CBT). En el mundo imaginario de SPARX, el jugador se mete en la piel de un avatar que destruye los pensamientos negativos con ...
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El videojuego que ayuda a los jóvenes a derrotar su propia depresión
ElTiempo.com
Psiquiatras de Nueva Zelanda lo crearon. El objetivo es salvar al mundo de la desesperación. Los juegos de video, considerados a menudo como causas de aislamiento de los jóvenes, pueden ayudar a adolescentes deprimidos. Un grupo de psiquiatras de ...
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El ejercicio moderado puede aliviar la depresión en personas con ...
Una investigación de la Escuela de Medicina de la Universidad de Washington ( Estados Unidos), asegura que los individuos que sufren insuficiencia cardiaca ...
cardiologia.diariomedico.com/.../ejercicio-moderado-puede-ali...

"Evidencias en Pediatría" y Semana Mundial de la Lactancia Materna


Hola a tod@s

Desde el blog "Pediatría Basada en Pruebas", con motivo de la Semana Mundial de la Lactancia Materna (LM), hemos recogido una selección de los principales artículos sobre LM.

Podeis acceder a todos desde la entrada de hoy del blog:  http://tinyurl.com/d6js8x7


Saludos pre-vacaciones.

Cristóbal Buñuel

Coeditor del blog Pediatría Basada en Pruebas
http://www.pediatriabasadaenpruebas.com/
Codirector de "Evidencias en Pediatría"
http://www.evidenciasenpediatria.es/

3 nuevos artículos en "Evidencias en Pediatría"


Hola a tod@s

Ayer se publicaron en "Evidencias en Pediatría" 3 nuevos artículos correspondientes al número de septiembre.

Estos son sus títulos y enlaces:
Como siempre, deseamos que encontreis estos artículos interesante y útiles.

Un saludo.

Cristóbal Buñuel, en nombre del equipo editorial de "Evidencias en Pediatría"
http://www.evidenciasenpediatria.es/ 

Telemedicina. Alerta

Grupo Neat apuesta por las soluciones de telemedicina multiusuario
Asturi.as
Grupo Neat ha apostado de forma decidida por la telemedicina y especialmente por la telemonitorización de pacientes crónicos mediante la adquisición en 2011 de la compañía australiana TeleMedCare, que culminó con el proyecto de convergencia ...
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Especialista advierte sobre incidencia de cáncer de próstata
Hoy Digital (República Dominicana)
La información la dio el doctor Octavio Cruz Pineda, cirujano trasplantólogo del Centro de Diagnóstico, Medicina Avanzada y Telemedicina (Cedimat), que aseguró que un gran porcentaje de los hombres mayores de 45 años podría padecer cáncer de ...
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A Surprising Risk for Toddlers on Playground Slides


A Surprising Risk for Toddlers on Playground Slides

Stuart Bradford
  • F
Last spring, Katie Dickman of Dunkirk, Md., was at the playground with her 18-month-old toddler, Hannah, when the little girl asked to ride down a twisting slide. Ms. Dickman accompanied her daughter, carefully keeping the child on her lap as they coasted to the bottom.
But without warning, Hannah’s sneaker caught on the side of the slide. Although Ms. Dickman grabbed the leg and unstuck her daughter’s foot, by the time they reached the ground, the girl was whimpering and could not walk. A doctor’s visit later revealed a fractured tibia.
“My wife was just trying to keep Hannah extra safe and make sure she didn’t fall,” said Hannah’s father, Jed Dickman. “She felt very guilty about it.”

As the Dickmans soon learned, such injuries are surprisingly common. Although nobody keeps national statistics, orthopedic specialists say they treat a number of toddlers and young children each year with broken legs as a result of riding down the slide on a parent’s lap. A study at Winthrop University Hospital in Mineola, N.Y., found that nearly 14 percent of pediatric leg fractures over an 11-month period involved toddlers riding down the slide with a parent.
Dr. Edward Holt, the orthopedic surgeon at Anne Arundel Medical Center in Annapolis who treated Hannah’s injury last April, said that just two weeks ago he treated a 4-year-old boy who had been injured going down the slide with his father.
“This fracture is entirely preventable,” said Dr. Holt, who has created a warning poster for local pediatrician offices and a You Tube video alerting parents to the hazard.
This may be one of those counterintuitive cases when a child is safer by himself. If a foot gets caught while the child is sliding alone, he can just stop moving or twist around until it comes free. But when a child is sitting in an adult lap, the force of the adult’s weight behind him ends up breaking his leg.
The injury is typically treated with a cast from the foot to above the knee; the good news is that no surgery or resetting is needed. The child wears the cast for four to six weeks and heals without any lasting complications.
But the damage is not merely physical. “The parents are always crushed that they broke their kid’s leg and are baffled as to why nobody ever told them this could happen,” Dr. Holt said. “Sometimes one parent is angry at the other parent because that parent caused the child’s fracture. It has some real consequences to families, and I hate to see it happen.”
The Mineola study was done by Dr. John Gaffney, a pediatric orthopedic specialist at Winthrop, after he had treated a rash of playground slide fractures. The hospital’s data indicated that every sliding fracture involved a child younger than 3 riding in an adult’s lap. The fracture might not be immediately obvious, but typically the child appeared to be in pain and could not put weight on the leg.
Dr. Gaffney said he has treated three playground fractures in the last month for children sliding with a grandparent, a parent and a baby sitter.
“As soon as the weather gets warm, this starts to happen,” he said. “It’s so common, but parents say: ‘How did I not know about this? I thought it was doing something good for my child by having them sit on my lap.’ ”
Andy Dworkin, a former journalist who is now a medical student in Portland, Ore., said his son Felix, then 18 months, was playing with a toddler friend at an elementary school where they were drawn to a blue slide. Felix rode down first, on the lap of his mother, but his rubber-soled shoe caught on the slide and he started to scream when he got off the slide.
Another mother, at the top of the slide with her own 17-month-old, quickly slid down with her son to try to help. But soon that little boy was crying as well. At the emergency room, both boys were found to have fractures, and they were fitted with orange and blue casts.
“I was surprised at how easy it was for a young child to break their leg on a playground,” said Mr. Dworkin, who wrote about the experience for his hometown paper, The Oregonian. “I was even more surprised how nonchalant the hospital staff was about what was happening. They said they see this all the time.”
Both boys had full recoveries. Felix, now 3 ½, doesn’t remember the accident, but will now go down small slides only and remains cautious around large twisting slides, said Mr. Dworkin.
Dr. Holt said he did not want to discourage parents from taking their children to the playground or even playing on slides, but did want to spread the word about the risks of sliding with a child on your lap.
To prevent the injury, the best solution is to allow a child to slide by himself, with supervision and instructions on how to play safely. Young children can be placed on the slide at the halfway point with a parent standing next to the slide. At the very least, parents should remove a child’s shoes before riding down the slide with the child on their laps, and make sure the child’s legs don’t touch the sides or sliding surface.
“I’m not saying we need to make the entire world out of rubber and insulate kids,” he said. “But this is something that is so totally predictable and preventable. That’s why I want to get the word out this one could go away.”

Aneurisma de Aorta Abdominal

Aneurisma de Aorta Abdominal 
Gerardo Rodríguez-Planes, Diego Medlam, Ricardo Leyro-Díaz, Cristian Vita, Santiago Muzzio
The Flying Publisher Guide to
2011 Edition
Se trata de un texto escrito en español por expertos cirujanos vasculares con más de 25 años
de experiencia.
http://www.operationflyingpublisher.com/pdf/FPG_006_AneurismadeAortaAbdominal2011.pdf


 Atentamente
Anestesiología y Medicina del Dolor

martes, 31 de julio de 2012

Surgeon vs. Knee Maker: Who’s Rejecting Whom?

Fuente: NYT    http://www.nytimes.com/2010/06/20/business/20knee.html?pagewanted=all

Surgeon vs. Knee Maker: Who’s Rejecting Whom?

Sally Ryan for The New York Times
Dr. Richard Berger, center, made millions working with Zimmer, an artificial-knee maker. The checks stopped after he spoke up about what he saw as flaws.
CHICAGO
 Weekend Business: Barry Meier on problems with knee replacements.
Multimedia
IT was a long, fruitful medical marriage that is fast becoming an angry public divorce, one that offers a rare look at a clash between a top-shelf consultant and his corporate patron over patient safety.
For years, Dr. Richard A. Berger designed surgical tools and artificial joints for Zimmer Holdings, trained hundreds of doctors to use its products and talked it up wherever he went. In return, Zimmer, an orthopedic implant maker, helped enrich Dr. Berger, portraying him as a master surgeon and paying him more than $8 million over a decade.
Those days are gone. Dr. Berger started complaining to Zimmer a while back that one of its artificial-knee models was failing prematurely, and he went public recently with a study that he says proves it. Zimmer told him that the problem was not the artificial knee, but his technique, and pointed to data overseas indicating that the knee was safe.
Last year, Zimmer did not give Dr. Berger a new contract. The company says it routinely rotates consultants.
“I trained hundreds of doctors for them and made them tens of millions,” Dr. Berger said in interview here, in which he also lambasted Zimmer executives as dissembling, out-of-touch bureaucrats. “So was this just a coincidence? Maybe it was. Maybe it wasn’t.”
Zimmer executives declined to be interviewed. The company said in a statement that it had thoroughly investigated Dr. Berger’s complaints in 2006 and that he had disagreed with its findings.
Amid the booming use of artificial joints in the United States, the breakup between Dr. Berger and Zimmer highlights what experts say is a troubling situation for patients and doctors: when disputes arise about orthopedic implant safety, there are no independent referees or sources of information because no one tracks the performance of the devices.
“There is no way of knowing who is right because we don’t have the data,” said Dr. Kevin J. Bozic, a professor of orthopedic surgery at the University of California, San Francisco.
While producers of implanted heart devices have a voluntary system in which outside panels investigate problems, American makers of orthopedic devices do not. Many of the artificial joints that surgeons like Dr. Berger use, including the Zimmer knee at issue, are cleared under law by the Food and Drug Administration for sale without testing in patients. In addition, no one in the country tracks the long-term performance of artificial hips and knees, a $6.7 billion annual business that surged as baby boomers reached middle age.
THOSE with the most to lose are the hundreds of thousands of people who receive an orthopedic device each year.
One patient, Lisé Markham, said she underwent surgery recently to replace a flawed hip just two years after getting it. She said the experience awakened her to how little patients can find out about an implant’s track record.
“My doctor knew everything about me, every personal detail, but what did I know on the other side?” said Ms. Markham, who lives in San Diego.
Two years ago, another top Zimmer consultant, Dr. Lawrence Dorr of Los Angeles, alerted surgeons that a company hip model was failing after a few years. Zimmer shot back, saying the problem was Dr. Dorr’s technique, not the device. Along with briefly halting sales, it also provided the F.D.A. with data from 12 surgical centers showing that the hip was working well. Based on that, the agency decided to close its investigation, said an F.D.A. spokeswoman, Mary Long.
But in interviews, two doctors who provided Zimmer with supportive data in 2008 said the hip started failing soon afterward in their patients, too. One, Dr. Richard Illgen of theUniversity of Wisconsin, said he now realizes that Dr. Dorr’s technique was not the issue, but that Dr. Dorr had just started using the Zimmer hip before other surgeons. Zimmer still defends the product, which is known as the Durom hip.
These days, companies like Zimmer have fewer consultants, part of the fallout fromsettlements in 2007 by several companies, including Zimmer, of Justice Department charges that consultant payments were used to disguise kickbacks to surgeons. However, relationships with Dr. Berger and Dr. Dorr were not called into question.
ABOUT a decade ago, when the relationship between Dr. Berger and Zimmer began, it was filled with promise. The surgeon, a tall, balding man with a boyish manner, was finishing his fellowship at the Rush University Medical Center in Chicago at the time, one of the country’s top centers for joint replacement. The center has had long ties to Zimmer, whose headquarters is about two hours away, in Warsaw, Ind., and the young surgeon quickly came to the company’s attention.
“Rich has a very clever set of hands, and because of that he is enabled with the ability to innovate surgical techniques,” said Roy Crowninshield, who was Zimmer’s chief scientific officer.
Dr. Berger’s skills matched Zimmer’s marketing strategy. To distinguish itself from competitors, the device maker had started promoting minimally invasive surgery, a technique that uses smaller incisions than traditional surgery. Zimmer trained doctors in the procedure, using its device.
Soon, Dr. Berger, who was then pioneering a type of small-incision surgery that allowed patients to leave the hospital on the day of surgery, became a linchpin of Zimmer’s efforts. In 2002, he was prominently featured in a press release about Zimmer’s plans to build a training facility for minimally invasive surgery.
“We are clearly excited about Dr. Berger’s data,” J. Raymond Elliott, the company’s chairman and chief executive at the time, stated in the release.
Over the next few years, the physician estimates, he helped train hundreds of surgeons on Zimmer’s behalf. His star also rose: he and his technique were featured on “World News Tonight” on ABC, and he was soon performing about 1,000 hip and knee replacements annually, nearly all with Zimmer devices.
But Dr. Berger, who is 47, with energy and self-confidence to spare, also became a lightning rod. Other doctors questioned whether his technique of using such a small incision could be broadly adopted, and interest in his approach fell. The concern was that such a tiny opening left doctors with little room for error.
Dr. Berger brushes off complaints, saying that many surgeons do not have the skill or the patience to learn his technique. “There are lots of reasons that people don’t want to do something new,” he said.
As he tells it, his relationship with Zimmer frayed over a version of a widely used Zimmer knee, known as the NexGen. The model at issue, called the NexGen CR-Flex, is designed to provide a greater range of motion than the standard NexGen.
Most surgeons implant an artificial knee using a cement-like adhesive to bond the thigh bone to the portion of the device that bends. But some specialists, like Dr. Berger, try to avoid adhesives because the cement can break down and cause device failure. So Zimmer also sells an uncemented version of the CR-Flex that relies instead on the bone naturally fusing with the implant.
Dr. Berger says that he gave the device, which is supposed to last about 15 years, to about 125 patients in 2005, the first full year he used it. But by early 2006, some X-rays showed lines where the implant met the thigh bone, an indication that the device was loose and had not fused completely. Patients could walk, but they were reporting pain, apparently a result of the loose joint.
He says he soon brought the problem to the attention of Zimmer officials, including the company’s new top scientist, Cheryl R. Blanchard. Zimmer executives pointed to the success of the NexGen, but the company did not have separate test data on the uncemented flexible model because the F.D.A. had not required the company to study it in patients before selling it.
Later, as more patients complained about the device and Dr. Berger had to replace some of them, he spoke to Ms. Blanchard again, he said. This time, he said, she and other Zimmer officials suggested that his technique was the problem because no other surgeon had complained.
“Suddenly, I went from someone who was their master teacher to someone who didn’t know what he was doing,” he said.
BY 2007, Dr. Berger, although still a Zimmer consultant, had stopped using the device and had learned, he said, that several other surgeons had also experienced problems with it. But unlike Dr. Dorr, the physician who sent out the alert about Zimmer, Dr. Berger said he initially had hoped to avoid a public showdown with the company. So he followed a more traditional route by performing a study with another Rush surgeon, Dr. Craig J. Della Valle, who was also having to replace the Zimmer knee.
Dr. Berger and Dr. Della Valle first presented their study at a medical meeting last fall and again this year at a national meeting of the American Association of Orthopedic Surgeons. They found that the uncemented Zimmer knee failed early in about 9 percent of some 100 patients studied. Also, the knee exhibited signs of looseness in about half of all patients and has since been replaced in some of them, Dr. Berger said.
But Zimmer was unswayed. In a filing with the Securities and Exchange Commission, Zimmer made note of the study but also pointed to the knee’s very positive results in a large database of orthopedic patients in Australia. Officials there confirmed the low failure rate. The company also said that the cement-free CR Flex accounted for only a small fraction — about 2 percent — of its overall knee sales.
Zimmer said that collaboration with surgeons like Dr. Berger was critical to the success of its products. “To date, Dr. Berger remains a valued customer of Zimmer,” the company stated.
That may also change soon. Dr. Berger said he was talking with another device maker about consulting and is trying out other products.
As for Zimmer, he said, “I have lost confidence.”

Ancient Moves for Orthopedic Problems





PERSONAL HEALTH

Ancient Moves for Orthopedic Problems




With the costs of medical care spiraling out of control and an ever-growing shortage of doctors to treat an aging population, it pays to know about methods of prevention and treatment for orthopedic problems that are low-cost and rely almost entirely on self-care. As certain methods of alternative medicine are shown to have real value, some mainstream doctors who “think outside the box” have begun to incorporate them into their practices.
Jason Lee
FASTER THAN AN OPERATION The triangular forearm support may relieve shoulder pain in those with injured rotator cuffs.
One of them is Loren Fishman, a physiatrist — a specialist in physical and rehabilitative medicine affiliated with NewYork-Presbyterian/Columbia hospital. Some in the medical profession would consider Dr. Fishman a renegade, but to many of his patients he’s a miracle worker who treats their various orthopedic disorders without the drugs, surgery or endless months of physical therapy most doctors recommend.
Many years ago, I wrote about Dr. Fishman’s nonsurgical treatment of piriformis syndrome, crippling pain in the lower back or leg caused by a muscle spasm in the buttocks that entraps the sciatic nerve. The condition is often misdiagnosed as a back problem, and patients frequently undergo surgery or lengthy physical therapy without relief.
Dr. Fishman developed a simple diagnostic technique for piriformis syndrome and showed that an injection into the muscle to break up the spasm, sometimes followed by yoga exercises or brief physical therapy, relieves the pain in an overwhelming majority of cases.
Nowadays yoga exercises form a centerpiece of his practice. Dr. Fishman, a lifelong devotee of yoga who studied it for three years in India before going to medical school, uses various yoga positions to help prevent, treat, and he says, halt and often reverse conditions like shoulder injuries, osteoporosisosteoarthritis and scoliosis. I rarely devote this column to one doctor’s approach to treatment, and I’m not presenting his approach as a cure-all. But I do think it has value. And he has written several well-illustrated books that can be helpful if used in combination with proper medical diagnosis and guidance.
For many years, yoga teachers and enthusiasts have touted the benefits to the body of this ancient practice, but it is the rare physician who both endorses it and documents its value in clinical tests. Dr. Fishman has done both.
Rotator Cuff Relief
This year, Dr. Fishman received a prize at the International Conference on Yoga for Health and Social Transformation for a paper he presented on a surprising yoga remedy for rotator cuff syndrome, a common shoulder injury that causes extreme pain when trying to raise one’s arm to shoulder height and higher. He described a modified form of a yoga headstand that does not require standing on the head and takes only 30 seconds to perform, and presented evidence that it could relieve shoulder pain in most patients, and that adding brief physical therapy could keep the problem from recurring.
Rotator cuff injuries are extremely common, especially among athletes, gym and sports enthusiasts, older people, accident victims and people whose jobs involve repeated overhead motions.
For patients facing surgery to repair a tear in the rotator cuff and many months of rehabilitation, the yoga maneuver can seem almost a miracle. It is especially useful for the elderly, who are often poor candidates for surgery.
Dr. Fishman said he successfully treated a former basketball player, who responded immediately, and a 40-year-old magazine photographer who had torn his rotator cuff while on assignment. The photographer, he said, had been unable to lift his arm high enough to shake someone’s hand.
Instead of an operation that can cost as much as $12,000, followed by four months of physical therapy, with no guarantee of success, Dr. Fishman’s treatment, is an adaptation of a yoga headstand called the triangular forearm support. His version can be done against a wall or using a chair as well as on one’s head. The maneuver, in effect, trains a muscle below the shoulder blade, the subscapularis, to take over the job of the injured muscle, the supraspinatus, that normally raises the arm from below chest height to above the shoulder.
The doctor discovered the benefit of this technique quite accidentally. He had suffered a bad tear in his left shoulder when he swerved to avoid a taxi that had pulled in front of his car. Frustrated by an inability to practice yoga during the month he waited to see a surgeon, one day he attempted a yoga headstand. After righting himself, he discovered he could raise his left arm over his head without pain, even though an M.R.I. showed that the supraspinatus muscle was still torn.
Dr. Fishman, who has since treated more than 700 patients with this technique, said it has helped about 90 percent of them. “It doesn’t work on everyone — not on string musicians, for example, whose shoulder muscles are overtrained,” he said in an interview.
In a report published this spring in Topics in Geriatric Rehabilitation (an issue of the journal devoted to therapeutic yoga), he described results in 50 patients with partial or complete tears of the supraspinatus muscle. The initial yoga maneuver was repeated in physical therapy for an average of five sessions and the patients were followed for an average of two and a half years.
The doctor and his co-authors reported that the benefits matched, and in some cases exceeded, those following physical therapy alone or surgery and rehabilitation. All the yoga-treated patients maintained their initial relief for as long as they were studied, up to eight years, and none experienced new tears.
Yoga for Bone Disease
Perhaps more important from a public health standpoint is the research Dr. Fishman is doing on yoga’s benefits to bones. Bone loss is epidemic in our society, and the methods to prevent and treat it are far from ideal. Weight-bearing exercise helps, but not everyone can jog, dance or walk briskly, and repeated pounding on knees and hips can eventually cause joint deterioration.
Strength training, in which muscles pull on bones, is perhaps even more beneficial, and Dr. Fishman has observed that osteoporosis and resulting fractures are rare among regular yoga practitioners.
In a pilot study that began with 187 people with osteoporosis and 30 with its precursor, osteopenia, he found that compliance with the yoga exercises was poor. But the 11 patients who did 10 minutes of yoga daily for two years increased bone density in their hips and spines while seven patients who served as controls continued to lose bone. He noted that yoga’s benefits also decrease the risk of falls, which can result in osteoporotic fractures.
Medical guidance here is important, especially for older people who may have orthopedic issues that require adaptations of the yoga moves.