In this multicenter, randomized, blinded trial comparing dopamine and norepinephrine as the initial vasopressor therapy in the treatment of shock, there was no significant difference in the rate of death at 28 days between patients who received dopamine and those who received norepinephrine. Dopamine was associated with more arrhythmic events than was norepinephrine, and arrhythmic events that were severe enough to require withdrawal from the study were more frequent in the dopamine group. In addition, dopamine was associated with a significant increase in the rate of death in the predefined subgroup of patients with cardiogenic shock.
Overall, 309 patients (18.4%) had an arrhythmia; the most common type of arrhythmia was atrial fibrillation, which occurred in 266 patients (86.1%). More patients had an arrhythmia, especially atrial fibrillation, in the dopamine group than in the norepinephrine group (Table 3). The study drug was discontinued in 65 patients owing to severe arrhythmias — 52 patients (6.1%) in the dopamine group and 13 patients (1.6%) in the norepinephrine group (P<0.001). These patients were included in the intention-to-treat analysis. There were no significant differences between the groups in the incidences of other adverse events.
Three weeks after I received that counsel, on a rare afternoon when I felt fully rested, I dunked a volleyball on a 9' 11" rim. Again, I knew I could never swing my arms while palming a basketball the way I’d swung them while palming that volleyball, but I’d be lying if I said it didn’t feel badass. Thirteen failed attempts later, I did it again. Then two more times, each one an unexpected thunderclap. All of the explosive Olympic lifting I’d been doing was paying off, but my problem wasn’t going anywhere: How could I get my hand and a basketball over the cylinder? A lob to myself off the backboard? A big bounce off the blacktop?
At the competitive level (i.e., the NFL and NBA combines), vertical leap is measured using a “jump tester”—a tripod with a series of thin plastic sticks one inch apart. If you have access to this equipment, it’s your best bet for getting an accurate measurement. A cheaper, more feasible option is to do your jump next to a wall and mark the highest point you touch with a piece of chalk.
Another aspect to look at for any potential dunkers is flexibility. I'm about 6'4 and 21. In high school, I, like many of you on here, worked on jumping and lifting to gain power. I had some decent strength, but the flexibility of a toothpick. Once I got out of high school and got more interested in fitness, I saw how much that affected me. If you can't touch your toes or only squat 8 inches down, this is a great place to start working on your flexibility.
Which is why, on April 1, 2014, I dedicated myself to dunking a basketball for the first time. So that I could live it, breathe it, perhaps take a crack at it with my pen. I had tossed this idea around for years, realizing with each passing birthday that my chances of success were dimming. However, on that April Fool’s Day (a coincidence) I spent three hours on the court and at the gym, with a promise to myself to return several times each week until I threw one down like Gerald Green. Or at least like Litterial Green, who played in 148 NBA games between 1992 and ’99, and who, like me, was born in the early ’70s, stands 6'1", 185 pounds and is at no risk of having dunker carved into his epitaph.
Thus, dopamine and norepinephrine may have different effects on the kidney, the splanchnic region, and the pituitary axis, but the clinical implications of these differences are still uncertain. Consensus guidelines and expert recommendations suggest that either agent may be used as a first-choice vasopressor in patients with shock.6-8 However, observational studies have shown that the administration of dopamine may be associated with rates of death that are higher than those associated with the administration of norepinephrine.3,9,10 The Sepsis Occurrence in Acutely Ill Patients (SOAP) study,3 which involved 1058 patients who were in shock, showed that administration of dopamine was an independent risk factor for death in the intensive care unit (ICU). In a meta-analysis,11 only three randomized studies, with a total of just 62 patients, were identified that compared the effects of dopamine and norepinephrine in patients with septic shock. The lack of data from clinical trials in the face of growing observational evidence that norepinephrine may be associated with better outcomes called for a randomized, controlled trial. Our study was designed to evaluate whether the choice of norepinephrine over dopamine as the first-line vasopressor agent could reduce the rate of death among patients in shock.
A second, more efficient and correct method is to use an infrared laser placed at ground level. When an athlete jumps and breaks the plane of the laser with his/her hand, the height at which this occurs is measured. Devices based on United States Patent 5031903, "A vertical jump testing device comprising a plurality of vertically arranged measuring elements each pivotally mounted..." are also common. These devices are used at the highest levels of collegiate and professional performance testing. They are composed of several (roughly 70) 14-inch prongs placed 0.5 inches apart vertically. An athlete will then leap vertically (no running start or step) and make contact with the retractable prongs to mark their leaping ability. This device is used each year at the NFL scouting combine.