Pancreatic tumors in children and young adults with tuberous sclerosis complex.

BACKGROUND: Pancreatic neuroendocrine tumors are not included in the diagnostic criteria for tuberous sclerosis complex, although an association has been described. OBJECTIVE: To investigate the association of pancreatic neuroendocrine tumor in children and young adults with tuberous sclerosis complex and define MRI characteristics of the tumor. MATERIALS AND METHODS: We retrospectively evaluated the abdominal MRI scans of 55 children and young adults with tuberous sclerosis complex for the presence of a pancreatic mass. The scans were performed over a period of 7 years to monitor renal pathology. We obtained each patient's clinical history and treatment protocol from the hospital's electronic medical records. RESULTS: A solid pancreatic mass was identified in 5/55 (9%, 95% confidence interval [CI] 3-20%) patients (4 male) with a mean age of 12.6 years. Four of the lesions were located in the pancreatic tail and one in the pancreatic body. All of the lesions were solid, ovoid and well demarcated, with a mean diameter of 3.1 cm. The masses uniformly demonstrated T1 and T2 prolongation, but their diffusion behavior and post-contrast enhancement varied. The two surgically resected lesions were synaptophysin (+) non-functional pancreatic neuroendocrine tumors on pathology. Two of the patients who did not have surgery were treated with everolimus; one of the lesions has shown interval decrease in size and the other has remained stable. CONCLUSION: Pancreatic tumor is relatively common in children and young adults with tuberous sclerosis complex.

Are Future Doctors Prepared to Address Patients' Nutritional Needs? Cooking and Nutritional Knowledge and Habits in Medical Students.

Background. Many diseases are linked to lifestyle in the United States, yet physicians receive little training in nutrition. Medical students' prior knowledge of nutrition and cooking is unknown. Objective. To determine incoming medical students' prior nutrition knowledge, culinary skills, and nutrition habits. Methods. A dual-methods study of first-year medical students. Cross-sectional survey assessing prior knowledge, self-efficacy, and previous education of cooking and nutrition. Interviews of second-year medical students explored cooking and nutrition in greater depth. Results. A total of 142 first-year medical students participated; 16% had taken a nutrition course, with majority (66%) learning outside classroom settings. Students had a mean score of 87% on the Nutritional Knowledge Questionnaire versus comparison group (64.9%). Mean cooking and food skills score were lower than comparison scores. Overall, students did not meet guidelines for fiber, fruit, vegetables, and whole grains. Interviews with second-year students revealed most learned to cook from their families; all believed it important for physicians to have this knowledge. Conclusions. Medical students were knowledgeable about nutrition, but typically self-taught. They were not as confident or skilled in cooking, and mostly learned from their family. They expressed interest in learning more about nutrition and cooking.

Knowledge and Habits of Exercise in Medical Students.

Objective. To examine the exercise habits, knowledge, and self-efficacy of incoming medical students. Methods. Mixed-methods study consisting of (1) cross-sectional surveys and (2) qualitative key-informant interviews. (1) International Physical Activity Questionnaire (IPAQ), American Adult's Knowledge of Exercise Recommendations Survey (AAKERS), and Self-Efficacy for Exercise Scale (SEES) to assess student's physical activity level, knowledge of exercise recommendations, and self-efficacy for exercise. (2) Scripted questions explored exercise habits, sources of exercise knowledge, attitude toward exercise. Results. (1) Results of IPAQ classified students as 50% having high, 40% moderate, and 10% low levels of physical activity (n = 132). AAKERS demonstrated a mean total score of 16.2/20 (n = 130) (81% correct), similar to the national average (mean = 16/20) (n = 2002). SEES mean score of 48.5/90 (n = 128) is similar to previous studies (mean = 48.6/90, 52.75/90). (2) Interviews revealed that most students have a consistent exercise routine. Few students received formal education in exercise (10%), while the rest cited either peers, sports, or internet as primary sources of exercise knowledge. Less than half stated they would be comfortable designing an exercise routine for patients. Conclusions. Incoming medical students live an active lifestyle but have limited knowledge and formal training in exercise. Student's knowledge is predominantly self-taught from independent resources.