clinicaltrials.gov Identifier: NCT00091637.

This study aimed to assess the effects of post-activation potentiation in the strength related variables of a kick start. Thirteen competitive swimmers performed three kick starts after a standardized warm up (denoted USUAL) and another after inducing post-activation through five isotonic repetitions on an eccentric flywheel (denoted PAP). A T-test was used to quantify differences between USUAL and PAP warm up. The best trial of each subject achieved by natural conditions (denoted PEAK) was compared with data obtained after PAP. An instrumented starting block with independent triaxial force plates, collected the strength variables related with the impulse at take off. Improvements in the vertical components of force were observed after PAP compared with USUAL, meanwhile no differences were detected on the horizontal components of it. The velocity at take off was higher after PAP compared with USUAL (4.32 ± 0.88 vs 3.93 ± 0.60 m*s-1; p = 0.02). No differences in force or velocity were detected comparing PAP with PEAK (4.13 ± 0.62 m*s-1, p = 0.11). The PAP warm-up increased vertical force and it was transferred to a higher resultant velocity at take-off. This improvement would equal the best result possible obtained in natural conditions after some trials.

This study sought to evaluate the potential impact of domino liver transplantation (DLT) on initial graft function and early postoperative outcome in patients with cirrhosis in a Portuguese liver transplantation center. A retrospective comparative analysis was performed between 77 domino recipients (from familial amyloidotic polyneuropathy donors) and 91 deceased donor recipients, all submitted to primary elective whole liver transplantation, using the piggyback technique, in a 42-month period. Outcome parameters included graft dysfunction (defined as either primary nonfunction or initial poor function, according to the Ploeg-Maring criteria) and Clavien II-IV complications in the first postoperative week. Domino and deceased donor recipients had similar preoperative severity indices (Child-Pugh classification and Model for End-Stage Liver Disease score) and immediate postoperative severity scores (APACHE II [Acute Physiology and Chronic Health Evaluation II] and SAPS II [Simplified Acute Physiology Score II]). In DLT, donors were younger, cold ischemia time was shorter, and intraoperative transfusion requirements of packed red blood cells and fresh-frozen plasma were significantly lower. Graft dysfunction incidence was 3.4-fold lower in DLT: 5.2% (only 4 cases of initial poor function) versus 18.0% (1 primary nonfunction and 15 cases of initial poor function), P ¼ 0.010. Postoperative bleeding was the most frequent early Clavien II-IV complication (n ¼ 29, 17.3%), with an incidence 2.2-fold lower in domino recipients. A statistically significant difference was not found in the other analyzed Clavien II-IV complications, intensive care unit stay, mechanical ventilation time, intensive care unit mortality, and 1-year survival rate. In conclusion, in this study the younger donors and shorter ischemic time associated with DLT may provide a protective role in regards to graft dysfunction and perioperative bleeding, which are 2 important determinants of early morbidity after liver transplantation. Liver Transpl 17:270-278, 2011. V C 2011 AASLD.Received May 11, 2010; accepted October 2, 2010.The sequential or domino liver transplantation (DLT), using the morphologically normal liver from a familial amyloidotic polyneuropathy (FAP) patient, was first performed in 1995. 1,2 The DLT created a new category of donors and expanded the donor pool, but also raised new technical and ethical issues. 3,4 A technical difficulty arose because domino donors and recipients must share a relatively short segment of the suprahepatic vena cava. Regarding this technical issue, the conventional technique (retrohepatic vena cava excision and venovenous bypass) has been traditionally used in the FAP patient, nonetheless with potential complications. 3,5 A modified piggyback technique, 6 with reconstruction of the suprahepatic venous outflow of the domino graft, allowed FAP hepatectomy to be performed with inferior vena cava preservation and became the standard domino technique in our center. The DLT has also created an ethical dilemma conce...

The external forces applied in swimming starts have been often studied, but using direct analysis and simple interpretation data processes. This study aimed to develop a tool for vertical and horizontal force assessment based on the swimmers’ propulsive and structural forces (passive forces due to dead weight) applied during the block phase. Four methodological pathways were followed: the experimented fall of a rigid body, the swimmers’ inertia effect, the development of a mathematical model to describe the outcome of the rigid body fall and its generalization to include the effects of the inertia, and the experimental swimmers’ starting protocol analysed with the inclusion of the developed mathematical tool. The first three methodological steps resulted in the description and computation of the passive force components. At the fourth step, six well-trained swimmers performed three 15 m maximal grab start trials and three-dimensional (3D) kinetic data were obtained using a six degrees of freedom force plate. The passive force contribution to the start performance obtained from the model was subtracted from the experimental force due to the swimmers resulting in the swimmers’ active forces. As expected, the swimmers’ vertical and horizontal active forces accounted for the maximum variability contribution of the experimental forces. It was found that the active force profile for the vertical and horizontal components resembled one another. These findings should be considered in clarifying the active swimmers’ force variability and the respective geometrical profile as indicators to redefine steering strategies.