Significant Loss of Areal Bone Mineral Density Following Prolonged Bed Rest During Treatment With Teriparatide.

We present of a case of severe osteoporosis with thoracic myelopathy secondary to nontraumatic T8 compression fracture managed nonsurgically with 3.5 months of bed rest. Despite treatment with teriparatide starting at initial presentation, 1-year follow-up dual energy x-ray absorptiometry scan revealed a significantly greater than expected 19% reduction in lumbar spine bone mineral density (BMD) and a 6% reduction in total hip density.

Effect of exercise on disorders of carbohydrate and lipid metabolism in adults with traumatic spinal cord injury: systematic review of the evidence.

Background/objective: Carbohydrate and lipid metabolism disorders may affect adults with spinal cord injuries (SCIs) differently than able-bodied individuals because of reduced physical activity in the SCI population. The objective of this study was to conduct a systematic review to determine the effectiveness of exercise to improve carbohydrate and lipid metabolism disorders in adults with chronic SCI.

Methods: Studies were identified in MEDLINE (1996-2008), Cochrane Library, bibliographies of identified articles, and expert recommendations.

Carbohydrate and lipid disorders and relevant considerations in persons with spinal cord injury.

Objectives: To assess the prevalence of carbohydrate and lipid disorders in adults with chronic spinal cord injury and evaluate their risk contribution to cardiovascular diseases and the potential impact of exercise and pharmacologic and dietary therapies to alter these disorders and reduce cardiovascular disease risk.

Data Sources: MEDLINE (PubMed), Cochrane Database and Web sites of the American Spinal Injury Association, American Paraplegia Society, Paralyzed Veterans of America, Consortium of Spinal Cord Medicine, and WorldCat through August 2007.

Review Methods: English language observational studies addressing prevalence of carbohydrate and lipid disorders were included if they evaluated at least 100 adults with chronic spinal cord injury or a total of 100 subjects if using a control group.

The Minnesota Virtual Clinic: using a simulated EMR to teach medical students basic science and clinical concepts.

The Minnesota Virtual Clinic is a web-based educational tool using a simulated EMR to expose students to critical basic science and clinical concepts in the context of patient care. The clinic enrolls a group of simulated patients representing a variety of conditions and cultural backgrounds and follows them over time. Students "attend" the clinic weekly to review the latest developments for its patients.