Presence of Bisphenol A and Parabens in a Neonatal Intensive Care Unit: An Exploratory Study of Potential Sources of Exposure.

BACKGROUND: Newborns in neonatal intensive care units (NICUs) are in contact with a variety of medical products whose production might include synthetic chemicals with hormonal activity. OBJECTIVES: Our aim was to assess the content of bisphenol A (BPA) and parabens (PBs) and the hormone-like activities of a subset of medical products commonly used in NICUs in prolonged intimate contact with NICU newborns. METHODS: Fifty-two NICU items were analyzed, determining the concentrations of BPA and PBs [methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butylparaben (BuP)] and using the E-Screen and PALM-luciferase assays to measure the in vitro (anti-)estrogenic and (anti-)androgenic activity, respectively, of the extracts. Items found to have elevated BPA/PB content or hormone-like activities were further extracted using leaching methodologies. RESULTS: BPA was found in three-fifths and PBs in four-fifths of tested NICU items, and ∼25% and ∼10% of extracts evidenced estrogenic and anti-androgenic activity, respectively. The highest BPA content was found in the three-way stopcock (>7.000 ng/g), followed by patterned transparent film dressing, gastro-duodenal feeding tubes, sterile gloves, single-lumen umbilical catheters, and intravenous (IV) infusion extension sets (concentrations ranged from 100 to 700 ng/g BPA). A total PB concentration (∑PBs) >100 ng/g was observed in several items, including light therapy protection glasses, patterned transparent film dressing, winged IV catheters, IV infusion extension sets, and textile tape. The highest estrogenic activity [>450 pM estradiol equivalent (E2eq)] was found in small dummy nipples, three-way stopcocks, and patterned transparent film dressing and the highest anti-androgenic activity [>5 mM procymidone equivalent units per gram (Proceq/g)] in small dummy nipples and three-way stopcocks. DISCUSSION: According to these findings, neonates might be exposed to multiple sources of BPA and PBs in NICUs via inhalation, dermal, oral, and IV/parenteral routes. There is a need to address the future health implications for these extremely vulnerable patients and to adopt precautionary preventive measures as a matter of urgency. https://doi.org/10.1289/EHP5564.

Assessment of hormone-like activities in Ginkgo biloba, Elettaria cardamomum and Plantago ovata extracts using in vitro receptor-specific bioassays.

Medicinal plants are widely used for the treatment of diseases and for the development of new drugs. This study was designed to determine the presence of hormone-like activities dependent on the activation of human estrogen receptor alpha (hERa) and/or androgen receptor (hAR) in methanol extracts prepared from three medicinal plants historically and currently used for therapeutic purposes: Ginkgo biloba leaves (GBL), Elettaria cardamomum seeds (ECS) and Plantago ovata seeds (POS). After a solid-liquid extraction (SLE) step, their effects on hERa function were assessed in MCF-7 breast cancer cells using the E-Screen bioassay, and their ability to induce hAR-mediated reporter gene expression was evaluated using the androgen-sensitive stable prostatic PALM cell line. Unlike POS extracts, GBL and ECS extracts showed estrogenic (0.07 and 0.20 nM E2Eq mg(-1), respectively) and anti-estrogenic (0.01 and 0.02 µM ICI182780Eq mg(-1), respectively) activities. ECS extracts evidenced androgenic activity (0.30 nM R1881Eq mg(-1)) and POS extracts anti-androgenic activity (22.30 µM ProcEq mg(-1)). According to these findings, these plant extracts may interfere with the endocrine system via one or more hormonal receptors, and further investigation is warranted into their role as endocrine disrupters in humans.

Evaluation of estrogenic, antiestrogenic and genotoxic activity of nemorosone, the major compound found in brown Cuban propolis.

BACKGROUND: Brown propolis is the major type of propolis found in Cuba; its principal component is nemorosone, the major constituent of Clusia rosea floral resins. Nemorosone has received increasing attention due to its strong in vitro anti-cancer action. The citotoxicity of nemorosone in several human cancer cell lines has been reported and correlated to the direct action it has on the estrogen receptor (ER). Breast cancer can be treated with agents that target estrogen-mediated signaling, such as antiestrogens. Phytoestrogen can mimic or modulate the actions of endogenous estrogens and the treatment of breast cancer with phytoestrogens may be a valid strategy, since they have shown anti-cancer activity. METHODS: The aim of the present investigation was to assess the capacity of nemorosone to interact with ERs, by Recombinant Yeast Assay (RYA) and E-screen assays, and to determine by comet assay, if the compound causes DNA-damaging in tumoral and non-tumoral breast cells. RESULTS: Nemorosone did not present estrogenic activity, however, it inhibited the 17-ß-estradiol (E2) action when either of both methods was used, showing their antiestrogenicity. The DNA damage induced by the benzophenone in cancer and normal breast cells presented negative results. CONCLUSION: These findings suggest that nemorosone may have therapeutic application in the treatment of breast cancer.

Agreement between telerehabilitation and face-to-face clinical outcome assessments for low back pain in primary care.

STUDY DESIGN: A descriptive study of repeated measures using a crossover design. OBJECTIVE: To determine the level of agreement between assessments obtained via telerehabilitation and those obtained by traditional face-to-face method in a population of individuals with chronic low back pain (LBP) in a primary care setting. SUMMARY OF BACKGROUND DATA: Musculoskeletal assessment using telerehabilitation has shown adequate inter- and intrarater agreement and concordance with face-to-face clinical assessment in different diseases. There have been no published studies on the reliability of a telerehabilitation system to assess LBP. METHODS: Fifteen individuals (6 males; mean age, 37 yr) with chronic LBP attended a session for a clinical interview, followed by face-to-face and real-time online telerehabilitation evaluations. There was a 30-minute interval between the 2 assessments, the order of which was randomly selected for each patient. The telerehabilitation system used an Internet application conducted via Internet connection (17 kB/s) between 2 personal computers. Real-time video connection facilitated communication between the therapist and the subject. Outcome measures included lumbar spine mobility, Sorensen test, anterior straight leg raise test, Oswestry Disability Index, visual analogue scale for pain, 12-Item Short Form Health Survey questionnaire, and Tampa Kinesiophobia Scale. RESULTS: The α reliability between face-to-face and telerehabilitation evaluations was more than 0.80 for 7 of the 9 outcome measures. Lowest reliability was for lateral flexion range of motion (α= 0.75). Very good inter- and intrarater intraclass correlation coefficients (ρ) were obtained (0.92-0.96). CONCLUSION: The findings of our pilot study suggest that this telerehabilitation system may be useful to assess individuals with chronic LBP, providing initial support for its implementation in primary care. LEVEL OF EVIDENCE: 2.

Influence of gender in the psychoneuroimmunological response to therapeutic interval exercise.

Interval exercise has been used as an alternative modality to continuous exercise in patients with various conditions. Although interval exercise can improve health status, it may also exert deleterious effects. Few data are available on differences in psychoneuroimmunological response to high-intensity interval exercise, and it is not known whether males and females differ in their responses to a similar physical stress task. The aim of this study was to evaluate the differences between the psychoneuroimmunological responses of healthy active males and females to a high-intensity interval exercise protocol. Fifty healthy active subjects (25 females) underwent 2 exercise protocol sessions at least 2 weeks apart and at the same time of the day. The first session familiarized participants with the protocol. In the second, after a baseline measurement, subjects performed an exercise protocol with a standardized warm-up followed by three 30-s Wingate tests and an active recovery period. Baseline and postintervention data were gathered on the following: Holter electrocardiogram recordings (standard deviation of normal-to-normal interval [SDNN], square root of mean squared differences of successive NN intervals [RMSSD]); heart rate variability (HRV) index; salivary total protein and immunoglobulin A levels; pressure pain thresholds in masseter and upper trapezius muscles; and profile of mood states. After the exercise protocol, mood disturbance was significantly greater in the males than in the females, while the salivary immunoglobulin A level relative to total proteins was significantly lower in the males. These results suggest that high-intensity interval exercise induces a worse psychoneuroimmunological state in males than in females.

Massage after exercise--responses of immunologic and endocrine markers: a randomized single-blind placebo-controlled study.

The effectiveness of massage for postexercise recovery remains unclear, despite numerous studies on this issue. The aim of this study was to determine the effect of massage on endocrine and immune functions of healthy active volunteers after intense exercise. After repeated Wingate tests, the effects of whole-body massage and placebo on salivary cortisol, immunoglobulin A (IgA), and total protein levels were compared using a between-group design. Sixty healthy active subjects (23 women, 37 men) underwent 2 exercise protocol sessions at least 2 weeks apart and at the same time of day. The first session familiarized participants with the protocol. In the second session, after a baseline measurement, subjects performed a standardized warm-up followed by three 30-second Wingate tests. After active recovery, subjects were randomly allocated to massage (40-minute myofascial induction) or placebo (40-minute sham electrotherapy) group. Saliva samples were taken before and after the exercise protocols and after recovery. In both groups, the exercise protocol induced a significant increase in cortisol (p < 0.001), decrease in salivary IgA (sIgA) (p < 0.001), and increase in total proteins (p = 0.01) in saliva. Generalized estimating equations showed a significant effect of massage on sIgA rate (p = 0.05), a tendency toward significant effect on salivary total protein levels (p = 0.10), and no effect on salivary flow rate (p = 0.55) or salivary cortisol (p = 0.39). The sIgA secretion rate was higher after the recovery intervention than at baseline among women in the massage group (p = 0.03) but similar to baseline levels among women in the placebo group (p = 0.29). Massage may favor recovery from the transient immunosuppression state induced by exercise in healthy active women, of particular value between high-intensity training sessions or competitions on the same day.

Valores de trihalometanos en agua de consumo de la provincia de Granada, España / Trihalomethane levels in drinking water in the province of Granada [Spain]

Objetivos: La cloración del agua da lugar a la formación desubproductos potencialmente dañinos para la salud, entre elloslos trihalometanos, que se han hallado elevados en algunaszonas de España. En este estudio se investigan los valoresde trihalometanos en el agua de consumo suministrada porvarios sistemas de abastecimiento de la provincia de Granada,en el área de actuación de la cohorte madres-hijos de laRed INMA (Infancia y Medio Ambiente).Métodos: Se analizaron 82 muestras de agua de consumoen dos campañas de muestreo en invierno y verano de 2006.Se determinó la concentración de cloroformo, bromodiclorometano,dibromoclorometano y bromoformo, siguiendo un procedimientooptimizado basado en cromatografía de gases yespectrometría de masas.Resultados: El rango de concentración de trihalometanos totalesse situó entre 0,14 y 18,75 g/l en la campaña de inviernoy entre 0,01 y 31,87 g/l en la de verano. El compuestomayoritario fue cloroformo. La concentración media de trihalometanosen agua de origen superficial y subterráneo fue de10,13 y 1,41 g/l, respectivamente.Conclusiones: Los valores de trihalometanos encontradosson muy inferiores a la concentración máxima admisible (100g/l) establecida por la Unión Europea para estos compuestos.Estos valores varían significativamente según el origendel agua, con mayores concentraciones en áreas urbana ysemiurbana, donde el agua es mayoritariamente de origen superficial.La presencia de trihalometanos en la zona es menora la descrita en otras regiones españolas(AU)

Objectives: Drinking water chlorination generates potentiallyharmful by-products, such as trihalomethanes. Trihalomethanelevels are high in some parts of Spain. The aim of the presentstudy was to investigate trihalomethane concentrationsin drinking water from distinct water supplies in the provinceof Granada, within the framework of the Childhood and Environment(INMA) study.Methods: Eighty-two tap water samples were collected in twocampaigns during the winter and summer of 2006. An optimizedprocedure based on gas chromatography and massspectrometry was used to determine concentrations of chloroform,bromodichloromethane, dibromochloromethane, andbromoform in the samples.Results: Total trihalomethane concentrations ranged from 0.14to 18.75 g/l in winter samples and from 0.01 to 31.87 g/lin summer samples. The most abundant compound waschloroform. Mean trihalomethane concentrations were 10.13in surface waters and 1.41 g/l in ground waters.Conclusions: The trihalomethane levels found were considerablybelow the maximum permitted level of 100 g/l in the European Union. The values obtained varied widely accordingto the type of water source: the highest concentrations werefound in urban and sub-urban areas, where the water is largelyof surface origin. The presence of trihalomethanes waslower than that reported in other Spanish regions(AU)

Effects of myofascial release after high-intensity exercise: a randomized clinical trial.

OBJECTIVE: The usefulness of massage as a recovery method after high-intensity exercise has yet to be established. We aimed to investigate the effects of whole-body massage on heart rate variability (HRV) and blood pressure (BP) after repeated high-intensity cycling exercise under controlled and standardized pretest conditions. METHODS: The study included 62 healthy active individuals. After baseline measurements, the subjects performed standardized warm-up exercises followed by three 30-second Wingate tests. After completing the exercise protocol, the subjects were randomly assigned to a massage (myofascial release) or placebo (sham treatment with disconnected ultrasound and magnetotherapy equipment) group for a 40-minute recovery period. Holter recording and BP measurements were taken after exercise protocol and after the intervention. RESULTS: After the exercise protocol, both groups showed a significant decrease in normal-to-normal interval, HRV index, diastolic BP (P > .001), and low-frequency domain values (P = .006). After the recovery period, HRV index (P = .42) and high-frequency (HF) (P = .94) values were similar to baseline levels in the massage group, whereas the HRV index tended (P = .05) to be lower and the HF was significantly (P < .01) lower vs baseline values in the placebo group, which also showed a tendency (P = .06) for HF to be lower than after the exercise. Likewise, diastolic BP returned to baseline levels in the massage group (P = .45) but remained lower in the placebo group (P = .02). CONCLUSION: Myofascial release massage favors the recovery of HRV and diastolic BP after high-intensity exercise (3 Wingate tests) to preexercise levels.

Psychophysiological effects of massage-myofascial release after exercise: a randomized sham-control study.

OBJECTIVE: The aim of this study was to evaluate the effect of massage on neuromuscular recruitment, mood state, and mechanical nociceptive threshold (MNT) after high-intensity exercise. DESIGN: This was a prospective randomized clinical trial using between-groups design. SETTING: The study was conducted at a university-based sports medicine clinic. PARTICIPANTS: Sixty-two (62) healthy active students age 18-26 participated. INTERVENTIONS: Participants, randomized into two groups, performed three 30-second Wingate tests and immediately received whole-body massage-myofascial induction or placebo (sham ultrasound/magnetotherapy) treatment. The duration (40 minutes), position, and therapist were the same for both treatments. MAIN OUTCOME MEASURES: Dependent variables were surface electromyography (sEMG) of quadriceps, profile of mood states (POMS) and mechanical nociceptive threshold (MNT) of trapezius and masseter muscles. These data were assessed at baseline and after exercise and recovery periods. RESULTS: Generalized estimating equations models were performed on dependent variables to assess differences between groups. Significant differences were found in effects of treatment on sEMG of Vastus Medialis (VM) (p = 0.02) and vigor subscale (p = 0.04). After the recovery period, there was a significant decrease in electromyographic (EMG) activity of VM (p = 0.02) in the myofascial-release group versus a nonsignificant increase in the placebo group (p = 0.32), and a decrease in vigor (p < 0.01) in the massage group versus no change in the placebo group (p = 0.86). CONCLUSIONS: Massage reduces EMG amplitude and vigor when applied as a passive recovery technique after a high-intensity exercise protocol. Massage may induce a transient loss of muscle strength or a change in the muscle fiber tension-length relationship, influenced by alterations of muscle function and a psychological state of relaxation.

Dual effects of phytoestrogens result in u-shaped dose-response curves.

Endocrine disruptors can affect the endocrine system without directly interacting with receptors, for example, by interfering with the synthesis or metabolism of steroid hormones. The aromatase that converts testosterone to 17beta-estradiol is a possible target. In this paper we describe an assay that simultaneously detects aromatase inhibition and estrogenicity. The principle is similar to that of other MCF-7 estrogenicity assays, but with a fixed amount of testosterone added. The endogenous aromatase activity in MCF-7 cells converts some of the testosterone to 17beta-estradiol, which is assayed by quantifying differences in the expression level of the estrogen-induced pS2 mRNA. Potential aromatase inhibitors can be identified by a dose-dependent reduction in the pS2 mRNA expression level after exposure to testosterone and the test compound. Using this assay, we have investigated several compounds, including synthetic chemicals and phytoestrogens, for aromatase inhibition. The phytoestrogens, except genistein, were aromatase inhibitors at low concentrations (< 1 micro M) but estrogenic at higher concentrations (greater than or equal to 1 micro M), resulting in U-shaped dose-response curves. None of the tested synthetic chemicals were aromatase inhibitors. The low-dose aromatase inhibition distinguished phytoestrogens from other estrogenic compounds and may partly explain reports about antiestrogenic properties of phytoestrogens. Aromatase inhibition may play an important role in the protective effects of phytoestrogens against breast cancer.