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IntroductionSelf-care activities, including exercise, may be neglected by medical students in response to increasing academic demands. Low levels of exercise among medical students may have ripple effects on patient care and counseling. This study investigates the reciprocal role of recreation use and academic performance among first-year medical students.MethodsWe combined retrospective administrative data from four cohorts of first-year medical students at the University of Illinois at Urbana-Champaign from 2006 to 2010 (n=408). We estimated regression models to clarify the role of changes in recreation use before examinations on changes in academic performance, and vice versa.ResultsThe use of recreation facilities by first-year medical students was highly skewed. We found that changes in recreation use before an exam were positively associated with changes in exam performance, and vice versa. Students who make large decreases in their recreation use are likely to decrease their exam scores, rather than increase them.DiscussionStudents who make decreases in their recreation, on average, are likely to decrease their exam scores. These findings suggest that medical students may be able to boost their achievement through wellness interventions, even if they are struggling with exams. We find no evidence that decreasing wellness activities will help improve exam performance.

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Background and purpose: Radiotherapy has been associated with late dose-dependent cardiovascular toxicity. In this cross-sectional pilot study, radiation dose distributions were correlated with areas of localized and diffuse myocardial fibrosis as measured by novel cardiac MRI (CMR) sequences including late gadolinium enhancement (LGE) and T1 mapping with the goal to identify early markers of myocardial damage. Materials and methods: Twenty-eight patients with chest tumors including lung, breast, esophagus, and lymphoma underwent CMR per study protocol on average 46.4 months (range 1.7-344.5) after radiotherapy. Patients without pretreatment cardiac history were included if the volume of heart receiving 5 Gy or more was at least 10% (V5Gy ≥ 10%). The association of LGE with cardiac dosimetric factors, clinical factors (e.g., tumor type, smoking history, BMI), and T1 values was analyzed. Results: Cardiac maximum (Dmax) and mean dose (Dmean) equivalent to doses delivered in 2 Gy fractions (EQD2) were on average 50.9 Gy (range 6.2-108.0) and 8.2 Gy (range 1.0-35.7), respectively, compared to 60.8 Gy (40.8-108.0) and 6.8 Gy (1.8-21.8) among the 9 patients with LGE. Doses were not different between patients with and without LGE (p = 0.16 and 0.56, respectively). The average T1 value of the left ventricle myocardium was 1009 ms (range 933-1117). No significant correlation was seen for heart Dmax and Dmean and T1 values (p = 0.14 and 0.58, respectively). In addition, no significant association between clinical factors and the development of LGE was identified. Conclusions: No relation between cardiac doses, the presence of LGE or T1 values was observed. Further study is needed to determine the benefit of CMR for detecting radiotherapy-related myocardial fibrosis.

Dietary modification has been shown to substantially reduce blood pressure among people with hypertension. This article uses data from the 2007-2008 and 2009-2010 cross-sections of the National Health and Nutrition Examination Survey (NHANES) to examine the extent to which a hypertension diagnosis can influence individuals' dietary choices. Several models were estimated to clarify the association of a hypertension diagnosis with dietary factors related to hypertension management. A comparison group of individuals at risk for developing hypertension was used. Results suggest that individuals who received a recent diagnosis of hypertension are more likely to have lower intakes of some dietary factors important in blood pressure management, including sodium. The results also highlight a discrepancy between added salt use and dietary sodium intake. While more recent hypertensive patients tended to consume lower levels of dietary sodium, patients diagnosed longer ago tended to use less added salt. Given that those diagnosed were more likely to have lower blood pressure profiles and improved diets, especially close to the time of diagnosis, the results of this study underscore the need for a prompt and accurate diagnosis of hypertension.

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