OBJECTIVES: This revised clinical practice guideline, intended for use by primary care clinicians, provides recommendations for the diagnosis and management of the obstructive sleep apnea syndrome (OSAS) in children and adolescents. This practice guideline focuses on uncomplicated childhood OSAS, that is, OSAS associated with adenotonsillar hypertrophy and/or obesity in an otherwise healthy child who is being treated in the primary care setting. METHODS:Of 3166 articles from 1999-2010, 350 provided relevant data. Most articles were level II-IV. The resulting evidence report was used to formulate recommendations. RESULTS AND CONCLUSIONS:The following recommendations are made. (1) All children/adolescents should be screened for snoring.(2) Polysomnography should be performed in children/adolescents with snoring and symptoms/signs of OSAS; if polysomnography is not available, then alternative diagnostic tests or referral to a specialist for more extensive evaluation may be considered.

CrossFit is becoming increasingly popular as a method to increase fitness and as a competitive sport in both the Unites States and Europe. However, little research on this mode of exercise has been performed to date. The purpose of the present investigation involving experienced CrossFit athletes and naïve healthy young men was to investigate the relationship of aerobic capacity and anaerobic power to performance in two representative CrossFit workouts: the first workout was 12 minutes in duration, and the second was based on the total time to complete the prescribed exercise. The participants were 32 healthy adult males, who were either naïve to CrossFit exercise or had competed in CrossFit competitions. Linear regression was undertaken to predict performance on the first workout (time) with age, group (naïve or CrossFit athlete), VO2max and anaerobic power, which were all significant predictors (p < 0.05) in the model. The second workout (repetitions), when examined similarly using regression, only resulted in CrossFit experience as a significant predictor (p < 0.05). The results of the study suggest that a history of participation in CrossFit competition is a key component of performance in CrossFit workouts which are representative of those performed in CrossFit, and that, in at least one these workouts, aerobic capacity and anaerobic power are associated with success.

The purpose of the present investigation was to examine the association of a novel test of upper body isometric strength against a 1RM bench press measurement. Forty college age adults (n = 20 female, n = 20 male; age 22.8 ± 2.8 years; body height 171.6 ± 10.8 cm; body mass 73.5 ± 16.3 kg; body fat 23.1 ± 5.4%) volunteered for the present investigation. The participants reported to the lab on three occasions. The first visit included anthropometric measurements and familiarization with both the upper body isometric test and bench press exercise. The final visits were conducted in a randomized order, with one being a 1RM assessment on the bench press and the other consisting of three trials of the upper body isometric assessment. For the isometric test, participants were positioned in a “push-up” style position while tethered (stainless steel chain) to a load cell (high frequency) anchored to the ground. The peak isometric force was consistent across all three trials (ICC = 0.98) suggesting good reliability. Multiple regression analysis was completed with the predictors: peak isometric force, gender, against the outcome variable 1RM bench press. The analysis resulted in a significant model (r2 = 0.861, p≤0.001) with all predictor variables attaining significance in the model (p<0.05). Isometric peak strength had the greatest effect on the model (Beta = 5.19, p≤0.001). Results from this study suggest that the described isometric upper body strength assessment is likely a valid and reliable tool to determine strength. Further research is warranted to gather a larger pool of data in regard to this assessment.

The purpose of this study was to examine tympanic temperature, melatonin, and cognitive function during a 36-hour endurance event. Nine male and three female participants took part in a 36-hour sustained endurance event without sleep (N = 12, mean age = 31.8 ± 5.0 yrs). Participants were stopped for data collection at checkpoints throughout the 36-hour event. Tympanic temperature was assessed, a psychomotor vigilance test (PVT) was administered, and saliva samples were collected. Salivary melatonin was determined via immunoassay. During the 36 hours of competition, melatonin levels were negatively correlated with the day of the race (rs = −0.277, P = 0.039) and positively associated with nighttime (rs = 0.316, P = 0.021). Significant main effects of tympanic temperature (P < 0.001), day of the competition (P = 0.018), and a tympanic temperature ∗ day of competition interaction (P < 0.001) were used to predict minor lapses in attention. No associations between melatonin levels and cognitive function were observed (P > 0.05). During the event tympanic temperature declined and was associated with an increase in lapses in attention. With sustained endurance events becoming more popular future research is warranted to evaluate the physiological impact of participation.

BackgroundRecent studies have suggested that alpha glycerylphosphorylcholine (A-GPC) may be an effective ergogenic aid. The present study was designed to assess the efficacy of two doses of A-GPC in comparison to placebo and caffeine for increasing countermovement jump performance, isometric strength, and psychomotor function.MethodsForty-eight healthy, college aged males volunteered for the present study and underwent baseline assessment of countermovement jump (CMJ), isometric mid thigh pull (IMTP), upper body isometric strength test (UBIST), and psychomotor vigilance (PVT). Following this assessment participants were randomly assigned to groups consisting of 500 mg A-GPC, 250 mg A-GPC, 200 mg Caffeine or Placebo taken daily. Blood samples were collected 1 h and 2 h post initial dose to quantify serum free choline and thyroid stimulating hormone then subjects returned after 7 days of supplementation to repeat CMJ, IMTP, UBIST and PVT.ResultsNo differences were noted between groups for IMTP, UBIST or PVT performance. Serum free choline was found to be elevated in the two A-GPC groups as compared to placebo (132% and 59% respectively). Serum TSH was found to be significantly depressed in the 500 mg A-GPC group compared to other treatments (p < 0.04). Group differences were noted for maximum velocity and maximum mechanical power on the CMJ (p < 0.05) with the 250 mg A-GPC group demonstrating the greatest improvements in result.ConclusionsBased upon this evidence, and previous evidence regarding A-GPC, it should be considered as an emerging ergogenic supplement.