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Biomedical subjects

Y Epstein

Publications and source records attributed to Y Epstein.

At least 55 records · Page 3Linked to original sources
PubMed1995

Exertional heatstroke: a preventable condition.

Exertional heatstroke is a syndrome occurring in the young and active population when homeostatic thermoregulatory mechanisms are unable to meet the demands of heat stress. In most cases its occurrence is sporadic and it is regarded as an extreme medical emergency that might result in death if not immediately diagnosed and properly treated. Following some simple regulations and providing proper instructions have proven efficient in preventing this serious disease.

Adolescent↗
PubMed1994

Fatal classic and exertional heat stroke--report of four cases.

Heat stroke is the outcome of impaired heat dissipation which is aggravated by hot and humid environmental conditions. The very young and debilitated on the one hand and healthy individuals under considerable physical stress on the other are vulnerable to heat stroke. Post-mortem findings will depend on the time lapse between the stroke event and death. We report on the deaths resulting from heat stroke in a 12-month-old baby and three 19-year-old soldiers. Reconstruction of the environmental conditions enables elucidation of the circumstances that precipitated exogenous hyperpyrexia. The Discomfort Index presents reliable criteria for the assessment of heat load: values above 28 units are considered as severe heat load and are life threatening. Awareness of the hazards related to severe heat load on the body is helpful in preventing avoidable calamities.

Adult↗
PubMed1994

Glucose polymer ingestion--effect on fluid balance and glycemic state during a 4-d march.

The effect of glucose-polymer solution on physical performance has been extensively studied under controlled laboratory conditions. The present study was conducted to investigate the influence of such beverages on fluid balance and on glycemic state during a moderate, prolonged field exercise. Forty-eight endurance trained, male subjects participated in the study. The maneuver consisted of a 4-d march; 29, 39, 36, 30 km.d-1, at a speed of 5-6 km.h-1. The subjects covered a total distance of 134 km at an estimated exercise intensity of approximately 40% VO2max, under hot climate conditions (ambient temperature, 32-41 degrees C; relative humidity, 60-14%). Subjects were randomly assigned to one of two groups: glucose polymer-electrolyte beverage (GP; N = 24) and tap water (TW; N = 24). Each group was then divided into two subgroups consuming fluid ad libitum (TWa, GPa) or instructed to consume 900 ml.h-1 (TWb, GPb). The mean daily fluid consumption of all subgroups was similar (5252 +/- 229 and 4640 +/- 67 ml in TWa and TWb; 5257 +/- 317 and 5253 +/- 216 ml in GPa and GPb, respectively). Weight loss, reflecting the degree of dehydration, was 1.2 +/- 0.1% and 1.9 +/- 0.3% of initial body weight in TW and GP, respectively. On day 1, plasma volume changed by +0.4% and -1.8% in the TW and GP groups, respectively. On the days 2-4 changes in both groups were similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The relationship between short-term antibiotic treatments and fatigue in healthy individuals.

Antibiotic treatment tends sometimes to result in sensations of fatigue and decreased physical performance. The effects of antibiotics were therefore studied in 50 healthy, male trainees, aged 18-25 years, assigned in a random, double-blind fashion to one of the following treatments: tetracycline, ampicillin, trimethoprim/sulphamethoxazole, placebo I and placebo II. Duration of treatment was five times the half-life of each agent and the placebo was matched accordingly. Muscle enzyme activity (serum glutamine oxaloacetate transaminase, lactate dehydrogenase, creatine phosphokinase), maximal aerobic capacity (VO2max), muscle strength (MS), and rating of subjective sensation of fatigue were assessed prior to and upon conclusion of treatment. Compared to pretreatment values, plasma enzymes activity was elevated in all five groups (P < 0.005). No differences in VO2max or in MS were found among the subjects treated with either one of the antibiotics or those given a placebo. A significant difference in VO2max was found between the groups treated for 1 day (antibiotic and placebo) and the groups treated for 3 days (antibiotic and placebo) (P < 0.0001). The rating of subjective sensation was not affected by any of the agents. We concluded that in healthy individuals, a short-term antibiotic treatment had no deleterious effect on aerobic capacity or on muscle strength and was not associated with subjective side effects. The time interval between the two maximal tests could, however, have affected the aerobic capacity. Physiological disturbances associated with a sensation of fatigue following a longer period of antibiotics cannot be excluded.

Adolescent↗
PubMed1993

Long-term psychological and physiological effects of heat stroke.

Heat stroke leads only rarely to permanent neurological deficits and the convalescence is almost complete. There are, however, some sporadic descriptions of disturbances that lasted for up to 4 months. Little has been mentioned in the literature on residual changes in personality and late neurological side effects. The present study was conducted to follow systematically late personality and behavioral abnormalities in a population of heat stroke victims. This study analyzed 21 young subjects (age: 21 +/- 2 years), who were inflicted by heat stroke. They were invited for a physiological and psychological follow-up examination at least 6 months post-hospitalization. The psychological assessment was comprised of the self-report symptom checklist-90R (SCL-90R), which inquires about symptoms during the 2 weeks preceding the interview. The results indicated that the subjects are psychologically healthy because their scores fell within the normal range. Comparison with a carefully matched control group strengthened this finding. The conclusion was that prominent neurological or behavioral sequelae in heat stroke victims are rare. The psychological assessments clearly indicate that heat stroke did not leave long-term adverse residues. However, one should be aware of the possible complications and follow the patient for several months after the event.

Adult↗
PubMed1992

[Glucose polymer solutions and prolonged exertion in the heat].

The effect of glucose polymer solutions on physical performance has been extensively investigated, mainly under controlled laboratory conditions. The influence of such beverages on fluid balance and on glycemic state in the field, during prolonged exercise of moderate intensity (a 134 km march) in the heat (32-41 degrees C, 60-14% relative humidity) was therefore studied. 48 endurance-trained men were randomly assigned to drink either a 7.2% glucose polymer (GP) electrolyte beverage or tap water (TW); there were 24 in each group. Each group was then divided into subgroups that either consumed fluid ad libitum, or were instructed to consume 1000 ml/hr. Mean fluid consumption of all subgroups was similar. There was a greater change in plasma volume for the TW than for the GP group (+7.9% vs. +4.8%, respectively; p less than 0.05). However, in neither the GP nor the TP group did dehydration exceed 2% of body weight. Blood glucose concentration increased significantly in subjects ingesting GP (p less than 0.01) while it decreased on each day of march in those drinking TW. It is concluded that the fluid intake recommended at present by the IDF is adequate to maintain hydration within the normal range during physical effort in the heat. The differences between the GP and the TW groups in this study do not justify the substitution of glucose-polymer solutions for water during prolonged, moderate exercise.

Adult↗
PubMed1992

Glucose uptake by adipocytes of obese rats: effect of one bout of acute exercise.

The effect of one bout of acute exercise on impaired glucose metabolism was studied in obese (480 +/- 20 g), untrained rats, at rest (n = 10) and after 60 min of swimming (n = 5). Using the euglycemic, hyperinsulinemic (10 mU.kg-1 x min-1) clamp, glucose clearance rate increased from 7.6 +/- 0.9 at rest to 9.7 +/- 0.5 mL.kg-1 x min-1 after exercise (p < 0.05). Glucose (3-O-[14C]methylglucose) transport (GT) into epididymal adipocytes were incubated with or without insulin. In the absence of insulin, GT was 0.13 +/- 0.02 and 0.26 +/- 0.07 fmol.cell-1 x min-1 at rest and after exercise, respectively. In the presence of insulin (25-1000 microU.mL-1) GT increased at rest from 0.97 +/- 0.08 to 1.13 +/- 0.07 fmol.cell-1 x min-1, and after exercise from 1.35 +/- 0.05 to 1.87 +/- 0.11 fmol.cell-1 x min-1. GT was significantly higher after exercise compared with rest (p < 0.004). At rest, maximal insulin effect was achieved at 100 microU.mL-1, whereas with exercise, GT increased gradually with the insulin dosage. The following may be concluded: (i) the biological effect of insulin is amplified in obese rats by one bout of exercise and (ii) exercise affects GT into enlarged adipocytes by enhancing tissue responsiveness to insulin and by a cellular mechanism unrelated to the insulin action.

3-O-Methylglucose↗
PubMed1992

The effects of powered air supply to the respiratory protective device on respiration parameters during rest and exercise.

The common chemical warfare protective masks impose an excessive respiratory load on the wearer due to elevated breathing resistance and increased dead space. For patients with severe respiratory disease, the excessive respiratory effort may be intolerable. Besides, the substantial negative pressure created within the mask during inspiration may result in an inward leakage in individuals having difficulties with proper facial fitting of the mask. The purpose of the current investigation was to evaluate the effects of a blower, actively driving air, through the mask's filter, at a flow (mean +/- SD) of 42 +/- 2 L/min, on respiratory parameters during rest and moderate exercise. Ten healthy subjects of either sex participated in two experimental sessions, wearing the mask with and without the blower. Each session included 6 min of sitting at rest and 6 min of walking on a treadmill (3.2 mph, and 10 percent grade). In nine of the subjects, the active air supply produced a positive inspiratory pressure at rest (5 +/- 4 vs -24 +/- 9 mm H2O peak inspiratory pressure with and without the blower, respectively, p < 0.0001). Inspiratory carbon dioxide concentration (FICO2) at rest was diminished (0.4 +/- 0.4 vs 1.3 +/- 0.7 percent with and without the blower, respectively; p < 0.01) while FIO2 increased from 19.5 +/- 0.7 percent to 20.6 +/- 0.4 percent with the device (p < 0.01). These changes were associated with a significant decrease in respiratory rate (15 +/- 2 vs 18 +/- 3 per minute, p < 0.01). During exercise the blower barely decreased the negative inspiratory pressures, had no effect on other respiratory parameters measured, but significantly shortened the inspiratory/cycle-length time ratio (0.46 +/- 0.03 vs 0.53 +/- 0.03, p < 0.005). The effects of active air supply were not different between male and female subjects. We conclude that the blower is expected to be a useful accessory to respiratory protective devices for patients with pulmonary disease.

Adult↗
PubMed1992

Vasopressin in thermoregulation--competitive demands: experimental evidence and theoretical considerations.

Previous studies have substantiated the antipyretic role played by extrahypothalamic limbic system (EXHY-LS) AVP during fever. Repeated attempts to elucidate other thermoregulatory functions of this hormone have failed. Circumstantial evidence, however, suggest central role for this hormone in thermoregulation under hypohydration. Hypohydration, hyperosmolarity and hypovolaemia induced upward shifts in temperature thresholds for activation of heat dissipating mechanisms. When hypovolaemia is superimposed on hyperosmolarity these shifts are additive. Analogously, these two stressors when combined, decrease the osmotic threshold for AVP release. In rats, the elevated temperature thresholds for evaporative cooling and peripheral vasodilation occurring with hypohydration are positively correlated with lower Hypothalamic/EXHY-LS AVP ratio. Reciprocal relations between limbic system and blood AVP contents suggest competitive interaction between central and peripheral demands. Hypothesis for the possible mode of action of central AVP in thermoregulation under hypohydration is discussed.

Animals↗
PubMed1992

Effects of heat-exercise stress, NBC clothing, and pyridostigmine treatment on psychomotor and subjective measures of performance.

This study investigated the effects of pyridostigmine pretreatment, NBC protective gear, and heat-exercise exposure on psychomotor performance and subjective sensations in eight healthy male volunteers. Exercise in heat enhanced performance of vertical addition (+7.3%, p less than 0.001) but prolonged the reaction time (+4.4%, p less than 0.01). The effects of pyridostigmine, protective gear, and the interactions between the various stressors were not significant. Cognitive performance was not dependent on body core temperature. Multiple complaints of subjective discomfort arose from wearing the protective garment. The results suggest the existence of a significant subjective discomfort but an absence of major cognitive decrements in a multiple-stresses state of chemical warfare alertness.

Exercise↗
PubMed1991

Are psoriatic patients at risk of heat intolerance?

Sixteen young male subjects with psoriasis (mean of 4.9% of skin surface area involvement) and 10 healthy controls underwent a heat exercise test (40 degrees C, 40% r.h.) for 2 h. Rectal temperature (Tr), mean skin temperature (Tsk), heart rate (HR) and heat storage (dS) were measured and calculated. A sharper rise was found for all parameters in the psoriatic patients as compared with controls. Statistically significant differences were found in Tr after 60 min (37.9 +/- 0.1 degrees C and 37.5 +/- 0.1 degrees C in patients and controls, respectively) and at termination of the exercise (38.3 +/- 0.1 degrees C and 37.5 +/- 0.1 degrees C). Heat storage at the end of the first hour was 78 +/- 9 and 30 +/- 7 kcal in patients and controls, respectively. At the end of 120 min, heat storage in the study group increased to 87 +/- 14 kcal, while the control group stored only 30 +/- 7 kcal. Sweat rate was lower in the psoriatic patients (590 +/- 49 g/h) than in controls (691 +/- 42 g/h), even when corrected for healthy skin area (337 +/- 26 g/h/m2 compared with 370 +/- 24 g/h/m2). It is suggested that psoriatic patients have a reduced ability to dissipate extra heat during exposure to exercise in the heat. Psoriasis should therefore be considered as a risk factor for heat intolerance.

Adult↗
PubMed1991

Heat stress on helicopter pilots during ground standby.

We attempted to use measurements of ambient thermal conditions to characterize and then predict thermal conditions in the cockpit before takeoff and during an hour standby period in Bell 206 and Bell 212 helicopters with a crew of two and with the cockpit doors opened. Dry bulb, wet bulb, and globe temperatures were measured on 28 separate summer days. The wet bulb globe temperature index (WBGT) was used to estimate heat stress. Ambient WBGT at time 0 ranged from 13 degrees C to 31 degrees C. There was a 2.9 +/- 3.7 degree difference in WBGT between ambient and cockpit conditions at time 0 which increased to 7.2 +/- 3.5 degrees after 1 h. Because of the cooling effect of opening the helicopter cockpit doors, the cockpit WBGT actually decreased over the standby period when cockpit WBGT values were 30 degrees C or more at time 0. Thus, there was an inverse correlation between cockpit WBGT at time 0 and the change in cockpit WBGT over the 1-h period (r = -0.767, p less than 0.001). The mean WBGT in the cockpit over the 1-h standby period was positively correlated with the ambient WBGT at time 0 (r = 0.783, p less than 0.001). We conclude that the greenhouse effect results in a cockpit WBGT which is significantly higher than ambient conditions. Subsequent changes in cockpit WBGT depend on the balance between heat transfer from the pilot's bodies to the cockpit and the loss of heat after the doors of the helicopters are opened. Ambient thermal conditions can be used to predict heat stress during the ground standby period.

Aerospace Medicine↗
PubMed1991

Hyponatremia induced by exercise: a 24-hour endurance march study.

In our previous studies on the relationship between prolonged physical stress and muscle enzyme activities, a number of individuals suffered a hyponatremic state. The present study was conducted to evaluate the effect of prolonged physical stress on the development of hyponatremia. Seventeen physically fit male subjects were studied during a 24-hour endurance march. Serum sodium, that averaged 142 +/- 2 before the march, decreased during the march to 135 +/- 2 mEq/l (p less than 0.01 versus before the march). Blood and plasma volumes increased by 8 and 16% (p less than 0.05), respectively. Creatinine clearance before the march declined from 118 +/- 24 to 74 +/- 19 ml/min (p less than 0.005) during the march and correlated negatively with serum sodium (p less than 0.002; r = 0.59). Urinary sodium excretion before the march was 132 +/- 55 and during the march was 123 +/- 62 mEq/24 h. Free water clearance rose during the march and correlated negatively with serum sodium (p less than 0.001), suggesting an appropriate renal diluting response. However, the fall in serum sodium correlated positively with water intake (p less than 0.01; r = 0.59). These results show that hyponatremia develops during endurance marching in normal subjects on an unrestricted high water intake. The renal response to water intake is appropriate; however, the subjects fall to produce maximally diluted urine. Therefore, we suggest that water intake should follow physiological needs and not forced to cause hyponatremia during prolonged physical stress.

Adult↗
PubMed1991

The effect of prolonged intermittent exercise, combined with food deprivation, on plasma metabolite concentration.

To examine the effect of continuous fasting combined with prolonged, intermittent exercise on glucose homeostasis, 16 endurance-trained subjects, ranging in age from 18-21 years, were completely deprived of food during 81 h of field maneuvers. Water was supplied to avoid dehydration. Participants marched 10 h each night at an estimated intensity of 35-45% of mean VO2 max covering a total distance of 105 km, and had a relative rest during day time. Blood was sampled prior to the beginning of the march, at the end of 81 h, and after 24 h of recovery. Samples were analyzed for plasma glucose, insulin, alanine, free fatty acids (FFA), and 3-hydroxybutyrate (3-HB). Body weight decreased from a mean (+/- S.E.M.) of 73.0 +/- 0.6 kg at pre-march to 66.5 +/- 0.6 kg at 81 h of fasting (p less than 0.05), and remained unchanged at 24 h after march termination. Glucose, insulin, and alanine decreased, whereas FFA and 3-HB increased significantly at 81 h fast (p less than 0.05). Within 24 h of recovery all parameters changed significantly (p less than 0.05), approaching baseline values. The results indicate that in trained individuals under extreme survival conditions, as in the present study, blood glucose is maintained above hypoglycemic levels at the expense of fat and fat-derived substrates that become the main energy sources utilized.

Adult↗