Baseline hemoglobin-A1c impacts clinical outcomes in patients with pancreatic cancer.

An association between diabetes mellitus and pancreatic ductal adenocarcinoma (PDA) has long been recognized. This article assesses the effect of the baseline hemoglobin-A1c (HbA1c) value on the clinical outcomes of patients with PDA. HbA1c values were prospectively collected on 656 consecutive patients presenting to a pancreas multidisciplinary cancer clinic from 2009 to 2012. Patients were diagnosed with benign pancreatic disease (BPD) or biopsy-confirmed resectable (R), borderline/locally advanced (BL), or metastatic (M) PDA. Excluded were those with prior treatment for PDA or a history of chronic diabetes mellitus (>1-year or unknown duration), resulting in a final cohort of 284 patients. Of 284 patients, 44 had benign disease, 62 had R-PDA, 115 had BL-PDA, and 63 had M-PDA. Patients with malignant disease (R-, BL-, and M-PDA) collectively had a higher average HbA1c value than patients with BPD (6.1% vs 5.6%; P<.001). Among patients with PDA (n=240), HbA1c values of 6.5% or greater were significantly associated with inferior overall survival (OS) compared with patients with HbA1c values less than 6.5% (hazard ratio [HR], 1.74; OS, 10.2 vs 13.0 months; P=.007), along with other known prognostic factors, such as age of 65 years or older, ECOG performance status of 1 or greater, carbohydrate antigen 19-9 level greater than 90, tumor size larger than 3 cm, and disease stage. HbA1c values of 6.5% or greater remained in the final predictive model using backward elimination (HR, 1.46; P=.097), indicating that HbA1c values of 6.5% or greater influence OS of patients with PDA even when accounting for other known prognostic factors. HbA1c level at presentation is significantly higher in patients with PDA than patients with BPD and seems to affect survival.

Descriptive characteristics of NCAA Division I women lacrosse players.

The purpose of this investigation was to describe anthropometric and physical performance characteristics of Division I college female lacrosse players. An additional aim of the study was to examine positional differences in this sample of athletes. Eighty-four university lacrosse players (age=19.8+/-1.1 years; height=168.3+/-5.9 cm; body mass=64.7+/-6.9 kg) volunteered to participate and were evaluated at the end of their off-season. Test items included standing height, body mass, linear sprint speed (9.14-36.58 m), agility (pro-agility and Illinois), countermovement jump height and the 20 Meter Shuttle Run Test (MSRT). Standing height was different between positions, pairwise comparisons indicating that attackers were taller than defenders (p=0.029). No other dependent variable differed between positions. Homogeneity between positions for women's lacrosse players indicates that the tests used do not have a high discriminatory value or could reflect the lack of development of positional specificity due to relatively minimal playing experience by participants. Although positional distinctions were not observed in this study, quartiles and ranges provide evidence that performance in female lacrosse players varies markedly.

Assessment of linear sprinting performance: a theoretical paradigm.

The purpose of this manuscript is to describe a theoretical paradigm from which to more accurately assess linear sprinting performance. More importantly, the model describes how to interpret test results in order to pinpoint weaknesses in linear sprinting performance and design subsequent training programs. A retrospective, quasi-experimental cross sectional analysis was performed using 86 Division I female soccer and lacrosse players. Linear sprinting performance was assessed using infrared sensors at 9.14, 18.28, 27.42, and 36.58 meter distances. Cumulative (9.14, 18.28, 27.42, and 36.58 meter) and individual (1(st), 2(nd), 3(rd), and 4(th) 9.14 meter) split times were used to illustrate the theoretical paradigm. Sub-groups were identified from the sample and labelled as above average (faster), average, and below average (slower). Statistical analysis showed each sub-group was significantly different from each other (fast < average < slow). From each sub-group select individuals were identified by having a 36.58 meter time within 0.05 seconds of each other (n = 11, 13, and 7, respectively). Three phases of the sprint test were suggested to exist and called initial acceleration (0-9.14 m), middle acceleration (9.14-27.42 m), and metabolic-stiffness transition (27.42-36.58 m). A new model for assessing and interpreting linear sprinting performance was developed. Implementation of this paradigm should assist sport performance professionals identify weaknesses, minimize training errors, and maximize training adaptations. Key PointsAssessment of linear sprinting should include splits for a greater understanding of performance.Individual split times can be used to identify specific areas of weakness.Appropriate training strategies can be developed and used to improve the identified weaknesses.