Background. There is a notable lack of education on nutrition and physical activity guidelines in medical schools and postgraduate training. The purpose of this study is to assess the nutrition and exercise knowledge and personal health behaviors of physicians in the Department of Medicine at a large academic center. Methods. We conducted a survey study in the Department of Medicine at the University of Florida in 2018. The survey instrument included questions on demographics, medical comorbidities, baseline perception of health and fitness, and knowledge of nutrition concepts. The Duke Activity Status Index assessed activity/functional capacity and the validated 14-point Mediterranean Diet Survey evaluated dietary preferences. Data were analyzed using descriptive statistics and the χ2 test was used to perform comparisons between groups. Statistical significance was determined at P < .05. Results. Out of 331 eligible physicians, 303 (92%) participated in the study. While all respondents agreed that eating well is important for health, less than a fourth followed facets of a plant-based Mediterranean diet. Only 25% correctly identified the American Heart Association recommended number of fruit and vegetable servings per day and fewer still (20%) were aware of the recommended daily added sugar limit for adults. Forty-six percent knew the American Heart Association physical activity recommendations and 52% reported more than 3 hours of personal weekly exercise. Reported fruit and vegetable consumption correlated with perceived level of importance of nutrition as well as nutrition knowledge. Forty percent of physicians (102/253) who considered nutrition at least somewhat important reported a minimum of 2 vegetable and 3 fruit servings per day, compared with 7% (3/44) of those who considered nutrition less important (“neutral,” “not important,” or “important, but I don’t have the time to focus on it right now”; P < .0001). Conclusions. This study highlights the need for significant improvement in education of physicians about nutrition and physical activity and need for physicians to focus on good personal health behaviors, which may potentially improve with better education.
Purpose To compare pulsatile ocular blood flow (POBF) in Europeans and Indians and provide reference values for a group of healthy Indians.Patients and Methods Measurement with the POBF Tonograph was performed on healthy Indian subjects in India (n ¼ 252). A further 80 subjects (40 of Indian descent and 40 Europeans) underwent measurements in Cambridge, England. The instrument used for measurement was the same for both the studies.Results The mean POBF in the Indians in India was found to be 1176 ll/min. The mean POBF value in the Europeans was found to be 1033 ll/min and that for Indians in England was 1061 ll/min. The difference between the POBF within groups was significant (one-way ANOVA Po0.05) with the POBF of Indians in India being higher than Europeans and Indians in the UK. The difference between the Europeans and Indians in the UK did not reach statistical significance.Conclusions POBF values in Indians living in India were found to be considerably higher than the previously published normal value of 650 ll/min in European studies and other studies for other racial groups. The reason for this apparent difference may be instrumentrelated rather than genetic because such a large difference was not observed when a comparison was performed in the UK. In addition, the results for both groups in our comparative study were still considerably higher than reported in previous studies. The POBF of Indians in India is slightly higher than the POBF of people of Indian ethnic origin in England.
A 48-year-old woman with recurrent syncope presented with acute left vision loss after another syncopal fall. She reported no prodromal symptoms and no prior syncope workup. Vital signs were normal. Ophthalmologic exam revealed left corneal ulcerations. Cardiopulmonary and neurologic examinations were unremarkable. Brain MRI, carotid ultrasound, serial troponins, telemetry, and EKG were normal. Transthoracic echocardiography uncovered a diagnosis of cor triatriatum, an obstructing patent membrane in a dilated, bisected left atrium ( Fig. 1) with constricted blood flow and increased flow velocity across the restrictive orifice (Fig. 2).Cor triatriatum represents only 0.1-0.4% of congenital cardiac malformations and has several anatomic variants. 1,2 Ventricular inflow obstruction results from abnormal septation within the left or right atrium, creating two atrial chambers subdivided by a thin membrane. Many remain asymptomatic until their thirties. Most cases in adulthood are discovered incidentally. [3][4][5] Clinicians should suspect cor triatriatum in young healthy patients with clinical features mimicking mitral stenosis but no cardiovascular co-morbidities. Early and severe manifestations occur in smaller communicating orifices and higher obstruction between bisected atrial chambers. 1 Late symptoms results from progressive increase in pulmonary artery pressure. 2 Syncope, heart failure, and sudden cardiac arrest are well cited. 5,6 Early diagnosis by echocardiography is important to expedite surgical cure. 2,7,8
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