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Biomedical subjects

Y Shapiro

Publications and source records attributed to Y Shapiro.

At least 37 records · Page 2Linked to original sources

Predicting heart rate response to various metabolic rates, environments, and clothing.

A mathematical model that describes heart rate (HR) responses to different combinations of metabolic levels, climatic conditions, and clothing ensembles was developed. The database that served to construct the model consisted of 48 variations representing a wide range of environmental conditions, clothing ensembles, and metabolic rates. The model, which correlates highly with the observed values (r = 0.88, P < 0.0001), is based on physiological and environmental parameters: HR = 57.1 + 0.6HRi + [0.07M - 19.06 - 0.011(Emax - Ereq)] log t, where HRi is initial HR in beats per minute (at rest before the exposure), t is the time of exposure in minutes, M is the metabolic rate in watts, Ereq is the required sweat evaporation for thermal equilibrium in watts, and Emax is the maximal evaporative capacity of the environment in watts. The model's validity was tested by using two independent databases representing wide ranges of conditions; the correlation between measured and predicted values was found to be highly significant (r = 0.83, P < 0.001 and r = 0.77, P < 0.001, respectively). In summary, the present study suggests a valid predictive model for HR that overcomes some of the difficulties observed in other models.

Adult↗

Calculation of mean arterial pressure during exercise as a function of heart rate.

Mean arterial blood pressure (MAP) is a common characteristic of the cardiac cycle. Usually it is evaluated by assuming that the left ventricular ejection time (systole) constitutes a constant proportion of the cardiac cycle (i.e. 1/3), regardless of the heart rate (HR). However, elevation of HR during exercise results in a reduction of the duration of the ejection period and even a greater reduction of the ventricular filling period. Therefore, a constant diastole/systole proportion at various heart rates may be misleading. The purpose of this study was therefore to evaluate the accurate proportion of the systolic period from the cardiac cycle at different metabolic rates and calculate MAP accordingly. Twenty healthy subjects (age: 20-50 yr.) exercised at different work intensities on a cycle ergometer to elicit HR in the range of 55-180 bpm. During the ride the mitral and aortic flow velocity wave form were recorded by Doppler echocardiography; the mitral flow from the apical view and the aortic flow from the apical long axis view. Blood pressure was measured using a sphygmomanometer. The fraction of systole (St) from the heart cycle was related to HR and was described in mathematical terms as: St = 0.01exp(4.14-40.74/HR) MAP was then calculated from the diastolic blood pressure (dBP) and the pulse pressure (PP) adjusted for St as follows: MAP = dBP+St.PP; (mmHg) The use of the suggested model reduces errors in the evaluation of various cardiac parameters which are related to arterial pressure, such as peripheral resistance, especially under exercise-heat stress.

Adult↗

Glucose utilization in morbidly obese subjects before and after weight loss by gastric bypass operation.

OBJECTIVE: To investigate the effect of weight reduction induced by gastric bypass operation (GBO), on the peripheral resistance to insulin in extremely obese subjects. DESIGN: A three-stage euglycemic clamp was applied to assess the metabolic clearance rate of glucose (g-MCR) in lean controls and in obese subjects, prior to and 6-12 months post operation. SUBJECTS: Six obese subjects (four obese normoglycemics-ON and two obese non-insulin dependent diabetics-OD) before and after GBO and six healthy, lean controls (LC) were compared. MAIN OUTCOME MEASURES: Body mass index after GBO, metabolic clearance rate of glucose under increasing insulin concentrations. RESULTS: GBO resulted in a significant change in body mass index from a pre-operation value (mean +/- s.d.) of 45.0 +/- 8.5 to 30.4 +/- 5.9 kg m-2 and remained significantly greater than controls (23.3 +/- 2.3 kg m-2). Glucose MCR increased from a mean baseline value of 3.0 +/- 1.6 to 6.7 +/- 3.9 ml kg-1 min-1 at post GBO (P) (P < 0.02). Similar effects were obtained under the two higher insulin concentration. CONCLUSIONS: GBO resulted in a massive reduction in BMI, that still remained above normal controls. This could explain the effect of weight reduction to decrease, but not completely reverse, peripheral resistance to insulin associated with obesity.

Adolescent↗

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↗

High-dose peripheral inositol raises brain inositol levels and reverses behavioral effects of inositol depletion by lithium.

Lithium (Li) reduces brain inositol levels. Berridge has suggested that this effect is related to Li's mechanism of action. It had previously been shown that pilocarpine causes a limbic seizure syndrome in lithium treated rats, and that these lithium-pilocarpine seizures are reversible by intracerebroventricular inositol administration to rats. We now show that although inositol passes the blood-brain barrier poorly, large doses of intraperitoneal (IP) inositol can also reverse Li-pilocarpine seizures. Using gas chromatography, IP inositol can raise brain inositol levels. Demonstration that inositol enters brain after peripheral administration provides a basis for possible pharmacological intervention in psychiatric disorders at the level of second messengers linked to the phosphatidylinositol cycle.

Animals↗

Behavioral evidence for the existence of two pools of cellular inositol.

Lithium reduces brain inositol levels by inhibiting inositol monophosphatase. In a previous study it was found that administration of pilocarpine to Li-treated rats causes limbic seizure behavior which can be reversed by i.c.v. myo-inositol but not chiro-inositol, suggesting that this behavior is related to inositol depletion in the PI cycle. Hyponatremia can lower brain inositol and hypernatremia can raise brain inositol. We now report that induction of low brain inositol by hyponatremia followed by pilocarpine did not cause limbic seizures. Induction of high brain inositol using hypernatremia followed by Li-pilocarpine administration did not reverse limbic seizures. These data support the concept that inositol available for P1 synthesis and inositol for osmotic function are sequestered in different cellular pools.

Animals↗

Seasonal changes in red blood cell parameters.

Seasonal changes in blood count (haematocrit and haemoglobin values) have been described in studies of small samples. Since Israel is characterized by high summer temperatures, we attempted to determine whether there are circannual changes in blood count, and how they are influenced by mean monthly temperature. In a cross-sectional study, venous blood was drawn from 4317 male employees in industry aged 20-64 years. Blood count values were analysed by month. To estimate possible changes in serum osmolality, serum electrolytes were also examined. Values of haemoglobin and haematocrit in August were significantly lower than during the rest of the year. Circannual rhythms explained between 10% and 57% of the variances of all the variables as assessed by cosinor rhythmometry, although they had wide confidence intervals and most were not statistically significant. The lower mean haematocrit in August reflected reduction in mean corpuscular volume (MCV) rather than a decrease in red blood cell count (RBC). The change observed in haematocrit and haemoglobin in August is possibly related to heat acclimatization rather than to endogenous sinusoidal circannual rhythms. Both plasma and red cell volume expansion appear to occur. Possible seasonal changes should be taken into account in evaluation of blood counts.

Adult↗

The effects of the modified intermittent sequential pneumatic device (MISPD) on exercise performance following an exhaustive exercise bout.

The Lymphapress, a pneumatic sequential intermittent device is recognized as one of the most effective conservative treatments for lymphoedema, due to its effective 'milking mechanism'. This led us to hypothesize that accelerated removal of fatigue-causing metabolites by mechanical massage could improve an athlete's performance capacity. We conducted trials with 11 men who exercised at a constant workload, on a cycle ergometer, until exhaustion. During a 20-min recovery period a new modified pneumatic sequential intermittent device (the MISPD) was applied to the subjects' legs. The men then performed a second constant load exercise bout. Cardiorespiratory parameters were measured during exercise and blood was withdrawn during recovery for the determination of lactate, pyruvate, ammonia, bicarbonate and pH. No difference was found in the blood levels of the 'fatigue causing metabolites' during passive recovery (PR) and recovery with the MISPD (MR). However, the MISPD effected a 45% improvement in the subjects' ability to perform the subsequent exercise bout. The accumulation of fluid in the interstitial space after exercise and its disappearance after the use of the MISPD offers one possible explanation for these results, although psychological effects cannot be discounted.

Adult↗

[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↗

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↗

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↗

Effect of an iron supplement on body iron status and aerobic capacity of young training women.

Serum iron deficiency has a high incidence in female athletes. We investigated the effects of a daily oral iron supplement, (160 mg) administered during an intensive 7-week physical training programme, on body iron status, and the maximal aerobic capacity (VO2max) of 13 women (group A) compared to 15 who took a placebo (group B). The subjects were 19 years old. Blood samples were obtained before training began and on days 1, 7, 21 and 42 of training. They were analysed for packed cell volume (PVC) and for haemoglobin (Hb), 2,3-diphosphoglycerate (2,3-DPG), haptoglobin, iron and ferritin concentrations. The VO2max was measured on days 0, 21 and 42 of training. Following 21 days of training Hb, PCV and ferritin were significantly higher (P less than or equal to 0.01) in group A compared to group B. Over the training period Hb rose by 9.3% and 2.4% in groups A and B, respectively. At the end of training 66% of group B exhibited ferritin concentrations below 10 ng.ml-1, while none of group A had such low values. Mean VO2max of group A had increased by 7.5% following 21 days of training (P less than or equal to 0.01) and by 15.3% after 42 days. No appreciable increase in VO2max had occurred in group B by day 21 (significantly lower than VO2max of group A; P less than or equal to 0.05), however by day 42 it had increased by 14.3% (P less than or equal to 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

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↗

Long term effects of peak strenuous effort on serum magnesium, lipids, and blood sugar in apparently healthy young men.

Earlier findings showed a sustained lowering of serum magnesium concentration (S-Mg) which indicated the presence of Mg deficit, and a parallel, delayed rise of blood sugar and serum lipids as a sequel to strenuous effort. S-Mg was still significantly decreased 3 months after termination of peak effort. To gain further perspective, we followed the biochemical sequels of exertion over an extended period of observation, while maintaining the same experimental conditions used earlier, which mimicked those employed in the training of military recruits. We examined two groups of military recruits, n = 15 (group 1), n = 16 (group 2), mean age 18.6, SD 1.3 and 18.7, SD 0.6, years respectively, who underwent a graded training programme of 7 months' duration culminating in a 120 km forced march. Blood was sampled for estimation of S-Mg in 20 soldiers on recruitment, 6 and 10 months after the 120 km march in group 1, and 9, 11 and 15 months after the march in group 2. Blood sugar and serum lipids were screened on recruitment and up to 11 months after the 120 km march. A significant lowering of mean S-Mg was found as late as 10 months after completion of the march in group 1, and 11 months in group 2 (P less than 0.01). Mean serum cholesterol and triglycerides showed a delayed rise, especially in group 2 (P less than 0.05 and P less than 0.001, respectively), whereas blood sugar decreased in group 1, but increased in group 2 (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

The effects of glucose polymer beverage ingestion during prolonged outdoor exercise in the heat.

The aim of this study was to examine the effect of ingestion of a glucose polymer drink on fluid and metabolic balance during a 30 km outdoor march in the heat (ambient temperature, 26-31 degrees C; relative humidity, 53-34%). The subjects were randomly assigned to one of three groups: 7.2% glucose polymer-electrolyte beverage (GP) (N = 16), flavored sweetened placebo drink (SP) (N = 15), and tap water (TW) (N = 18). The subjects in the three groups consumed similar volumes of fluid, and no differences were found in sweat rate and percent dehydration. Changes in plasma volume were smaller, though not statistically significant, for GP than for SP and TW (-2.8%, -5.4%, -9.4%, respectively). Changes in sodium concentrations and serum osmolality were similar in the three groups. Subjects consuming GP maintained during exercise a significantly higher (P less than 0.001) blood glucose concentration (range: 6.5-7.4 mmol.l-1) than the SP and TW groups. They were also found to have increased levels of serum insulin (29.3 +/- 18.5 mU.l-1) and no change in serum free fatty acids (0.52 +/- 0.19 mmol.l-1). In contrast, subjects ingesting SP or TW had significantly elevated (P less than 0.001) concentrations of free fatty acids (range: 1.35-1.74 mmol.l-1) compared with subjects consuming GP (0.35-0.52 mmol.l-1), with no significant change in blood glucose and serum insulin levels over the exercise period. We conclude that highly trained endurance athletes may maintain a higher blood glucose level by consuming GP during prolonged exercise in the heat without impairing fluid replacement.

Adult↗