The Pallof press

The use of core training is very common in the field of strength and conditioning. The Pallof press is one such exercise which is considered a transverse plane or trunk rotation exercise. The use of this trunk-based exercise is implemented in strength and conditioning programs to aid in core stability. Exercise technique and the benefits of this exercise has been described in this article. The key coaching points for each position along with a progression and regression continuum for the Pallof press, has also been outlined. This continuum along with the suggested programming can be utilized by practitioners to aid in lumbopelvic stability

Strength and conditioning considerations for hurling: an amateur Gaelic Games sport

Hurling is a high intensity, intermittent, amateur gaelic games sport. A rise in the number of studies have been conducted on the biomechanical, physiological, and injury epidimology characteristics of hurling athletes, and this review provides the strength and conditioning professional with guidelines on key parameters relating to the needs analysis of hurling. A proposed fitness testing battery and program design for the reduction of injuries and enhanced physical performance is provided

Effects of concurrent activation potentiation on countermovement jump performance

The purpose of this study was to assess the effects of concurrent activation potentiation (CAP) on countermovement jump (CMJ) performance. Twenty-four resistance trained males (mean ± SD, age 25 ± 4 years; body mass: 78.7 ± 10.3 kg) performed a CMJ on a force plate under four different conditions: a) a control condition where the CMJ was performed with hands on hips and lips pursed, thus preventing jaw or fist contraction from occurring, b) a jaw condition where the CMJ was performed with maximal contraction of the jaw, c) a fist condition where the CMJ was performed with maximal contraction of the fists, and d) a combined condition where the CMJ was performed with maximal contraction of both jaw and fists. Jump height (JH), peak force (PF), rate of force development (RFD) and time to peak force (TTPF) were calculated from the vertical force trace. There was no significant difference in PF (P = 0.88), TTPF (P = 0.96), JH (P = 0.45), or RFD (P = 0.06) between the four conditions. Effect size (ES) comparisons suggests a potential for the BOTH condition to augment both PF (2.4%; ES: 0.62) and RFD (9.9%; ES: 0.94) over NORM. It is concluded that CAP via singular and combined contractions has no significant impact on CMJ performance, however, substantial inter-individual variation in the response to CAP was observed and such techniques may therefore warrant consideration on an individual basis

American Society for Transplantation and Cellular Therapy series: #5-Management of Clostridioides difficile infection in hematopoietic cell transplant recipients

The Practice Guidelines Committee of the American Society for Transplantation and Cellular Therapy partnered with its Transplant Infectious Disease Special Interest Group to update its 2009 compendium-style infectious disease guidelines for hematopoietic cell transplantation (HCT). A completely new approach was taken with the goal of better serving clinical providers by publishing each standalone topic in the infectious disease series as a concise format of frequently asked questions (FAQ), tables, and figures. Adult and pediatric infectious disease and HCT content experts developed and then answered FAQs and finalized topics with harmonized recommendations that were made by assigning an A through E strength of recommendation paired with a level of supporting evidence graded I through III. This fifth guideline in the series focuses on Clostridioides difficile infection with FAQs that address the prevalence, incidence, clinical features, colonization versus infection, clinical complications, diagnostic considerations, pharmacological therapies for episodic or recurrent infection, and the roles of prophylactic antibiotics, probiotics, and fecal microbiota transplantation

Multiple Myeloma Baseline Immunoglobulin G Level and Pneumococcal Vaccination Antibody Response

Infections are a major cause of morbidity and mortality in multiple myeloma (MM), a cancer of the immune system. Vaccination clinical efficacy endpoints have not been demonstrated, and there are limited data on surrogate markers of efficacy. This pilot study evaluated sequential immunologic markers after standard pneumococcal vaccination (PV) in patients with MM and non-MM controls. Vaccination was standard for PV (PCV13 or PPV23), with laboratory testing at baseline and at 2, 4, 12 and 24 weeks after vaccination. Immunoglobulin G (IgG) antibodies to pneumococcal antigens were detected by ELISA. Prevaccination total IgG levels and IgG subclass levels were also measured by ELISA. Four of 6 controls responded with at least a 2-fold increase in antibody concentration; only 2 controls had a sustained increase in concentration. Six of 8 patients with MM had at least a 2-fold antibody increase; however, only 2 of these patients showed a sustained increase of antipneumococcal antibody. Response rate differences were not statistically significant in this small pilot, and there was no relationship between responsiveness to PV and initial serum total IgG levels or IgG subclasses at study entry. Future prospective studies are needed to ascertain the immunological and clinical efficacy and effectiveness of various vaccines and vaccination strategies in MM

Radiologic imaging in cystic fibrosis: cumulative effective dose and changing trends over 2 decades

Objective: With the increasing life expectancy for patients with cystic fibrosis (CF), and a known predisposition to certain cancers, cumulative radiation exposure from radiologic imaging is of increasing significance. This study explores the estimated cumulative effective radiation dose over a 17-year period from radiologic procedures and changing trends of imaging modalities over this period. Methods: Estimated cumulative effective dose (CED) from all thoracic and extrathoracic imaging modalities and interventional radiology procedures for both adult and pediatric patients with CF, exclusively attending a nationally designated CF center between 1992-2009 for > 1 year, was determined. The study period was divided into three equal tertiles, and estimated CED attributable to all radiologic procedures was estimated for each tertile. Results: Two hundred thirty patients met inclusion criteria (2,240 person-years of follow-up; 5,596 radiologic procedures). CED was > 75 mSv for one patient (0.43%), 36 patients (15.6%) had a CED between 20 and 75 mSv, 56 patients (24.3%) had a CED between 5 and 20 mSv, and in 138 patients (60%) the CED was estimated to be between 0 and 5 mSv over the study period. The mean annual CED per patient increased consecutively from 0.39 mSv/y to 0.47 mSv/y to 1.67 mSv/y over the tertiles one to three of the study period, respectively (P < .001). Thoracic imaging accounted for 46.9% of the total CED and abdominopelvic imaging accounted for 42.9% of the CED, respectively. There was an associated 5.9-fold increase in the use of all CT scanning per patient (P < .001). Conclusions: This study highlights the increasing exposure to ionizing radiation to patients with CF as a result of diagnostic imaging, primarily attributable to CT scanning. Increased awareness of CED and strategies to reduce this exposure are needed

Reexamining treatment of high-grade T1 bladder cancer according to depth of lamina propria invasion: a prospective trial of 200 patients

BACKGROUND: Management of high-grade T1 (HGT1) bladder cancer represents a major challenge. We studied a treatment strategy according to substaging by depth of lamina propria invasion. METHODS: In this prospective observational cohort study, patients received initial transurethral resection (TUR), mitomycin-C, and BCG. Subjects with shallower lamina propria invasion (HGT1a) were followed without further surgery, whereas subjects with HGT1b received a second TUR. Association of clinical and histological features with outcomes (primary: progression; secondary: recurrence and cancer-specific survival) was assessed using Cox regression. RESULTS: Median age was 71 years; 89.5% were males, with 89 (44.5%) cases T1a and 111 (55.5%) T1b. At median follow-up of 71 months, disease progression was observed in 31 (15.5%) and in univariate analysis, substaging, carcinoma in situ, tumour size, and tumour pattern predicted progression. On multivariate analysis only substaging, associated carcinoma in situ, and tumour size remained significant for progression. CONCLUSIONS: In HGT1 bladder cancer, the strategy of performing a second TUR only in T1b cases results in a global low progression rate of 15.5%. Tumours deeply invading the lamina propria (HGT1b) showed a three-fold increase in risk of progression. Substaging should be routinely evaluated, with HGT1b cases being thoroughly evaluated for cystectomy. Inclusion in the TNM system should also be carefully considered

Clostridium: Transmission difficile?

Stephan Harbarth and Matthew Samore discuss the implications, and the limitations, of new research that might indicate that most Clostridium difficile cases are imported into hospitals