Introduction Undergraduate and graduate medical education both have been reported to have high rates of depression, anxiety, and burnout as a result of the rigors of their educational curricula. Wellness, including physical fitness, is important to the profession because it may help mitigate these increased rates of depression and anxiety. While several studies examine physical fitness and academic performance in primary and secondary education, few studies have examined the association between fitness and performance in health professions education. Given the demands of medical school, this investigation aimed to investigate the possibility of an association between physical fitness and body mass index (BMI) with academic performance. Another goal was to examine the change in physical fitness and BMI throughout medical school. Materials and Methods Standardized measures of physical fitness were examined in 192 Army students from the Uniformed Services University of Health Sciences over 4 years from the classes of 2017–2019. Measurements include (1) body composition (BMI); (2) muscular endurance (timed push-ups); (3) aerobic endurance (timed run), and (4) total fitness defined as total points from sit-ups, run, and push-ups (everything but BMI). Pearson correlation analysis was conducted between physical fitness and academic performance measures such as United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2 Clinical Knowledge (CK), and average core clerkship National Board of Medical Examiners (NBME) exam scores. A repeated measures analysis of variance was conducted to examine the differences of students’ fitness total points and BMI over 4 fitness measurements spanning approximately 1.7 years. Results There were weak positive correlations, 0.20 and 0.22, between USMLE Step 2 CK exam scores and push-up points and total fitness points, respectively. There also were weak positive correlations, 0.21 and 0.24, between core clerkship average NBME exam scores and push-up points and total fitness points, respectively. No statistically significant change of individual students’ fitness total point change was observed (F(2.52, 334.93 = 1.37, P = 0.26)). There was also no individual BMI change (F(2.36, 274.21 = 2.78, P = .06)) over the first four assessment measurements (about 1.7 years lapse). However, the class means over the four measurements showed a decrease of fitness total points and an increase of BMI. Conclusions Our investigation suggests that there may be correlations between physical fitness and clinical exam performance such as USMLE Step 2 CK and average core clerkship NBME exams. Although there is no statistically significant change in individual fitness total points or BMI, the study suggests that physical fitness and BMI may decline during medical school. This may be as a result of increasing academic demands while balancing clinical duties from clerkship rotations.

The industrial solvents benzene and trichloroethylene (TCE) are known carcinogens, and these solvents contaminated the drinking water at Marine Corps Base Camp Lejeune from the 1950s to 1980s. Benzene and TCE are linked to the hematopoietic cancers acute myelocytic and lymphocytic leukemia and chronic lymphocytic leukemia. We report the case of a veteran stationed at Marine Corps Base Camp Lejeune during this period who developed hairy cell leukemia (HCL), a rare form of lymphocytic leukemia. We review his presentation, medical history, solvent exposure, and literature on the carcinogenicity of benzene and TCE. This patient represents a possible link of TCE or benzene to HCL. The case also informs clinicians of the updated epidemiology with regards to clinical findings for HCL.

This qualitative study identifies military-specific themes from the tobacco user perspective that help to guide research and policy in reducing tobacco use among military servicemembers. Possible interventions suggested by our findings may include replacing tobacco breaks with fitness breaks to relieve workplace stress and support the culture of fitness, expanding the use of pharmacologic stimulants to replace tobacco when used to maintain alertness, and gathering social support for tobacco cessation from non-healthcare unit members. Further study is needed to elucidate the effectiveness of proposed interventions suggested by our findings, with the ultimate aim of policy changes within the military to optimize health and military readiness, while decreasing long-term health effects and costs of tobacco use.

A 57-year-old man with a history of diabetes and coronary artery disease was referred to haematology for the evaluation of anaemia in the setting of non-cardiac chest pain, fatigue, dyspnoea and dizziness. Previous investigations into these recurrent symptoms focused on a re-evaluation of his known ischaemic heart disease, which required multiple percutaneous interventions with stenting several years ago. In the year leading up to his referral, the patient required two transfusions during separate hospitalisations. Previously, his chronic anaemia was attributed to chronic inflammation because of unrevealing micronutrient and endoscopic evaluations. The patient underwent a bone marrow biopsy, which demonstrated normal karyotype myelodysplastic syndrome with ringed sideroblasts. This patient was found to have favourable cytogenetics and low-risk disease. His anaemia and associated symptoms improved with the administration of an erythroid-stimulating agent. Now 75 years old, he has remained on single-agent therapy for 10 years without need of transfusion.