According to guidelines set forth by Giardiello et al., PJS can be diagnosed if the following criteria are met: the presence of histopathologically confirmed hamartomatous polyps, plus two or more additional criteria, including a positive family history, mucocutaneous hyperpigmenta-tion, or small-bowel polyps. Peutz-Jeghers can generally be differentiated from other similar syndromes by clinical criteria. Commonly confused conditions are juvenile polyposis (no pigmentation; hamartomas with different histology), mixed hereditary polyposis syndrome (no pigmentation; adenomatous and hyperplastic polyps), and Carney complex (pigmentation present; no GI polyps).[3,7]
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.