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Epstein Y.,Heller Institute of Medical Research | Epstein Y.,Tel Aviv University | Yanovich R.,Heller Institute of Medical Research | Yanovich R.,Israel Defense Forces | And 3 more authors.
European Journal of Applied Physiology | Year: 2013

Anthropometric and physiological factors place the average female soldier at a disadvantage relative to male soldiers in most aspects of physical performance. Aerobic and anaerobic fitness levels are lower in women than in men. Thus, women have a lower overall work capacity and must therefore exert themselves more than men to achieve the same output. The lower weight and fat-free mass and the higher body fat of women are associated with lower muscle strength and endurance, placing them at disadvantage compared with men in carrying out military tasks such as lifting and carrying weights or marching with a load. Working at a higher percentage of their maximal capacity to achieve the same performance levels as men, women tire earlier and are at increased risk of overuse injuries. Their smaller size, different bone geometry and lower bone strength also predispose women to a higher incidence of stress fractures. Although training in gender-integrated groups narrows the gaps in fitness, significant differences between the genders after basic training still remain. Nevertheless, integration of women into military combat professions is feasible in many cases. Some 'close combat roles' will still be an exception, mainly because of the extreme physical demands that are required in those units that are beyond the physiological adaptability capacities of an average female. There is no direct evidence that women have a negative impact on combat effectiveness. Once the gender differences are acknowledged and operational doctrines adjusted accordingly, female soldiers in mixed-gender units can meet the physical standards for the assigned missions. © 2012 Springer-Verlag Berlin Heidelberg.

Epstein Y.,Heller Institute of Medical Research | Epstein Y.,Tel Aviv University | Druyan A.,Heller Institute of Medical Research | Druyan A.,Israel Defense Forces | And 2 more authors.
Journal of Strength and Conditioning Research | Year: 2012

Epstein, Y, Druyan, A, and Heled, Y. Heat injury prevention - A military perspective. J Strength Cond Res 26(7): S82-S86, 2012 - Heat-related injuries, and specifically exertional heat stroke, are a significant occupational risk in the armed forces, especially for those soldiers who are rapidly deployed from a temperate climate region to hot climate regions. Traditionally, adaptation to heat was considered as a matter of physiological adaptation. It is clear today that these injuries are mostly avoidable when applying proper education and behavioral adaptations. Education on behavioral adaptation for the prevention of heat injuries should be targeted at the individual and the organization level. This article summarizes the issue of proper preventive measures that should be taken to avoid, or at least minimize, the risk of exertional heat related injuries during military operations and training. © 2012 National Strength and Conditioning Association.

Kaplan B.,Heller Institute of Medical Research | Aizenbud B.M.,Elta Systems IAI | Golderman S.,Heller Institute of Medical Research | Yaskariev R.,Institute of Chemical Pathology | And 2 more authors.
Journal of Neuroimmunology | Year: 2010

A new procedure of free light chain (FLC) analysis was developed to assist the diagnosis of multiple sclerosis (MS). In this procedure, Western blotting technique was used to analyze monomeric and dimeric FLCs in the cerebrospinal fluid (CSF) and serum of patients with MS and other neurological diseases. The intensity of immunoreactive FLC bands was quantified by a specially developed software. Analysis of the obtained monomer/dimer patterns of κ and Λ type FLCs allowed the determination of the diagnostically useful FLC parameters. The combined use of three FLC indices accounting for monomeric FLC-κ level and κ/Λ ratio values in the CSF and serum was found to be of promising diagnostic importance for differentiation of MS from other non-MS neurological diseases. © 2010 Elsevier B.V.

La Regina M.,Catholic University | Ben-Chetrit E.,Hebrew University of Jerusalem | Gasparyan A.Y.,Yerevan State Medical University | Livneh A.,Heller Institute of Medical Research | And 2 more authors.
Clinical and Experimental Rheumatology | Year: 2013

Objectives. Since the publication of the first reports on the efficiency of colchicine in familial Mediterranean fever (FMF), very few randomised studies have investigated issues related to its long-term use. Thus, different approaches taken by physicians involved in FMF care, are exclusively empiric, emulative, and based on case-reports or case-series. Problems such as colchicine intolerance and colchicine resistance have not been solved yet. This paper aims to evaluate trends in colchicine therapy among physicians taking care of FMF patients around the world. Methods. We conducted a survey by sending questionnaires to FMF research and treatment centres in Europe and Asia. Many issues (such as dosages, schedules, side effects, interactions, efficacy and toxicity monitoring, definition of colchicine intolerance, colchicine resistance and responsiveness, etc) have been investigated. When more than 70% of physicians responded giving similar answers to an item, the response was considered as a "trend". A comparison between answers of physicians from FMF-prevalent and non-prevalent countries was also made. Results. Thirty-five physicians from 11 countries filled the questionnaires, taking care of a total of more than 15000 FMF patients (pts). Different approaches were evident among the various physicians. Statistically significant different approaches between physicians from FMF-prevalent countries with respect to those from non-prevalent countries were found in items like colchicine during pregnancy, severity score and blood tests for disease monitoring. No consensus was found regarding the definition of colchicine resistance. Conclusion. The current study demonstrated significant variations in the strategy of colchicine therapy for FMF around the world and re-emphasised the need for standardised definitions of colchicine resistance and colchicine intolerance. © Clinical and Experimental Rheumatology 2013.

Hadid A.,Tel Aviv University | Epstein Y.,Heller Institute of Medical Research | Epstein Y.,Tel Aviv University | Shabshin N.,Sheba Medical Center | Gefen A.,Tel Aviv University
Journal of Applied Physiology | Year: 2012

Shoulder strain is a major limiting factor associated with load carriage. Despite advances in backpack designs, there are still reports of shoulder discomfort, loss of sensorimotor functions, and brachial plexus syndrome. The current study is aimed at characterizing mechanical loading conditions (strains and stresses) that develop within the shoulder's soft tissues when carrying a backpack. Open MRI scans were used for reconstructing a three-dimensional geometrical model of an unloaded shoulder and for measuring the soft tissue deformations caused by a 25-kg backpack; subsequently, a subject-specific finite element (FE) model for nonlinear, large-deformation stressstrain analyses was developed. Skin pressure distributions under the backpack strap were used as reference data and for verifying the numerical solutions. The parameters of the model were adjusted to fit the calculated tissue deformations to those obtained by MRI. The MRI scans revealed significant compression of the soft tissues of the shoulder, with substantial deformations in the area of the subclavian muscle and the brachial plexus. The maximal pressure values exerted by a 25-kg load were substantial and reached ∼90 kPa. In the muscle surrounding the brachial plexus, the model predicted maximal compressive strain of 0.14 and maximal tensile strain of 0.13, which might be injurious for the underlying neural tissue. In conclusion, the FE model provided some insights regarding the potential mechanisms underlying brachial plexus injuries related to load carriage. The large tissue deformations and pressure hotspots that were observed are likely to result in tissue damage, which may hamper neural function if sustained for long time exposures. Copyright © 2012 the American Physiological Society.

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