Bodybuilding With Steroids Damages Kidneys

Athletes who use anabolic steroids may gain muscle mass and strength, but they can also destroy their kidney function, according to a paper being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA. The findings indicate that the habitual use of steroids has serious harmful effects on the kidneys that were not previously recognized.Reports of professional athletes who abuse anabolic steroids are increasingly common. Most people know that using steroids is not good for your health, but until now, their effects on the kidneys have not been known. Leal Herlitz, MD (Columbia University Medical Center) and her colleagues recently conducted the first study describing injury to the kidneys following long-term abuse of anabolic steroids. The investigators studied a group of 10 bodybuilders who used steroids for many years and developed protein leakage into the urine and severe reductions in kidney function. Kidney tests revealed that nine of the ten bodybuilders developed a condition called focal segmental glomerulosclerosis, a type of scarring within the kidneys. This disease typically occurs when the kidneys are overworked. The kidney damage in the bodybuilders has similarities to that seen in morbidly obese patients, but appears to be even more severe.

When the bodybuilders discontinued steroid use their kidney abnormalities improved, with the exception of one individual with advanced kidney disease who developed end-stage kidney failure and required dialysis. Also, one of the bodybuilders started taking steroids again and suffered a relapse of severe kidney dysfunction.

The researchers propose that extreme increases in muscle mass require the kidneys to increase their filtration rate, placing harmful levels of stress on these organs. It's also likely that steroids have direct toxic effects on the kidneys. "Athletes who use anabolic steroids and the doctors caring for them need to be aware of the potentially serious risks to the kidney," said Dr. Herlitz.

This study was conducted in the laboratory of Dr. Vivette D'Agati, MD at Columbia Univeristy Medical Center. Study co-authors include Glen Markowitz, MD, Joshua Schwimmer, MD, Michael Stokes, MD, Cheryl Kunis, MD, Vivette D'Agati, MD, (Columbia University Medical Center); Alton Farris, MD, and Robert Colvin, MD (Massachusetts General Hospital).

The study abstract, "Development of FSGS Following Anabolic Steroid Use in Bodybuilders," (TH-PO163) will be presented as part of a Poster Session during the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition on Oct. 29 in the Scientific Exposition Hall of the San Diego Convention Center in San Diego, CA.

Just One Cigarette Has Harmful Effect On Arteries Of Young Healthy Adults

Even one cigarette has serious adverse effects on young adults, according to research presented by Dr. Stella Daskalopoulou at the Canadian Cardiovascular Congress 2009, co-hosted by the Heart and Stroke Foundation and the Canadian Cardiovascular Society.Her study found that smoking one cigarette increases the stiffness of the arteries in 18 to 30 year olds by a whopping 25 per cent.

Arteries that are stiff or rigid increase resistance in the blood vessels, making the heart work harder. The stiffer the artery, the greater the risk for heart disease or stroke.

"Young adults aged 20-24 years have the highest smoking rate of all age groups in Canada," says Dr. Daskalopoulou, an internal medicine and vascular medicine specialist at McGill University Health Centre. "Our results are significant because they suggest that smoking just a few cigarettes a day impacts the health of the arteries. This was revealed very clearly when these young people were placed under physical stress, such as exercise."

The study compared the arterial stiffness of young smokers (five to six cigarettes a day) to non-smokers. The median age was 21 years. Arterial measurements were taken in the radial artery (in the wrist), the carotid artery (in the neck), and in the femoral artery (in the groin), at rest and after exercise.

Arterial stiffness in both smokers and non-smokers was measured using a new but well established method called applanation tonometry. Dr. Daskalopoulou introduced the 'arterial stress test' which measures the arteries' response to the stress of exercise. The test is comparable to a cardiac stress test, which measures the heart's response to the stress of exercise.

"In effect we were measuring the elasticity of arteries under challenge from tobacco," explains Dr. Daskalopoulou.

An initial arterial stress test was carried out to establish a baseline measurement for both the non-smokers and the smokers, who were asked not to smoke for 12 hours prior to the test. After the first meeting, smokers returned and smoked one cigarette each and then repeated the stress test. During the final meeting, smokers were asked to chew a piece of nicotine gum prior to the stress test.

Dr. Daskalopoulou found that after exercise the arterial stiffness levels in non-smokers dropped by 3.6 per cent. Smokers, however, showed the reverse: after exercise their arterial stiffness increased by 2.2 per cent. After nicotine gum, it increased by 12.6 per cent. After one cigarette, it increased by 24.5 per cent.

Interestingly, there was no difference in the arterial stiffness measurements between smokers and non-smokers at rest.

"In effect, this means that even light smoking in otherwise young healthy people can damage the arteries, compromising the ability of their bodies to cope with physical stress, such as climbing a set of stairs or running to catch a bus," says Dr. Daskalopoulou. "It seems that this compromise to respond to physical stress occurs first, before the damage of the arteries becomes evident at rest."

"More than 47,000 Canadians will die prematurely each year due to tobacco use, which often starts in the teen years," warns Heart and Stroke Foundation spokesperson Dr. Beth Abramson. "We know that over 90 per cent of teenagers who smoke as few as three to four cigarettes a day may be trapped into a lifelong habit of regular smoking, which typically lasts 35 to 40 years."

Smoking contributes to the build up of plaque in the arteries, increases the risk of blood clots, reduces the oxygen in the blood, increases blood pressure, and makes the heart work harder. Smoking also nearly doubles the risk of ischemic stroke.

Dr. Abramson says this study reinforces the importance of education, prevention programs, and legislation such as the recently passed Bill C-32, Cracking Down on Tobacco Marketing Aimed at Youth Act.

Smoking Bans Reduce Risk Of Heart Attacks Associated With Secondhand Smoke

Smoking bans are effective at reducing the risk of heart attacks and heart disease associated with exposure to secondhand smoke, says a new report from the Institute of Medicine. The report also confirms there is sufficient evidence that breathing secondhand smoke boosts nonsmokers' risk for heart problems, adding that indirect evidence indicating that even relatively brief exposures could lead to a heart attack is compelling."It's clear that smoking bans work," said Lynn Goldman, professor of environmental health sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, and chair of the committee of experts that wrote the report. "Bans reduce the risks of heart attack in nonsmokers as well as smokers. Further research could explain in greater detail how great the effect is for each of these groups and how secondhand smoke produces its toxic effects. However, there is no question that smoking bans have a positive health effect."

About 43 percent of nonsmoking children and 37 percent of nonsmoking adults are exposed to secondhand smoke in the United States, according to public health data. Despite significant reductions in the percentages of Americans breathing environmental tobacco smoke over the past several years, roughly 126 million nonsmokers were still being exposed in 2000.

A 2006 report from the U.S. Surgeon General's office, The Health Consequences of Involuntary Exposure to Tobacco Smoke, concluded that exposure to secondhand smoke causes heart disease and indicated that smoke-free policies are the most economical and effective way to reduce exposure. However, the effectiveness of smoking bans in reducing heart problems has continued to be a source of debate.

The IOM committee conducted a comprehensive review of published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems. Eleven key studies that evaluated the effects of smoking bans on heart attack rates informed the committee's conclusions about the positive effects of smoke-free policies. The studies calculated that reductions in the incidence of heart attacks range from 6 percent to 47 percent. Given the variations in how the studies were conducted and what they measured, the committee could not determine more precisely how great the effect is. Only two of the studies distinguished between reductions in heart attacks suffered by smokers versus nonsmokers. However, the repeated finding of decreased heart attack rates overall after bans were implemented conclusively demonstrates that smoke-free policies help protect people from the cardiovascular effects of tobacco smoke, the committee said.

The report also provides a detailed discussion of the evidence from animal research and epidemiological studies showing a cause-and-effect relationship between secondhand smoke exposure and heart problems. The committee was not able to determine the exact magnitude of the increased risk presented by breathing environmental tobacco smoke, but noted that studies consistently indicate it increases the risks by 25 percent to 30 percent. Although there is no direct evidence that a relatively brief exposure to secondhand smoke could precipitate a heart attack, the committee found the indirect evidence compelling. Data on particulate matter in smoke from other pollution sources suggest that a relatively brief exposure to such substances can initiate a heart attack, and particulate matter is a major component of secondhand smoke.

The report was sponsored by the U.S. Centers for Disease Control and Prevention. Established in 1970 under the charter of the National Academy of Sciences, the Institute of Medicine provides independent, objective, evidence-based advice to policymakers, health professionals, the private sector, and the public. The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.

Exercise Improves Body Image For Fit And Unfit Alike

Attention weekend warriors: the simple act of exercise and not fitness itself can convince you that you look better, a new University of Florida study finds.People who don't achieve workout milestones such as losing fat, gaining strength or boosting cardiovascular fitness feel just as good about their bodies as their more athletic counterparts, said Heather Hausenblas, a UF exercise psychologist. Her study is published in the September issue of the Journal of Health Psychology.

"You would think that if you become more fit that you would experience greater improvements in terms of body image, but that's not what we found," she said. "It may be that the requirements to receive the psychological benefits of exercise, including those relating to body image, differ substantially from the physical benefits."

The study by Hausenblas and graduate student Anna Campbell is the first to systematically analyze the wide-ranging effects of exercise on body image by examining all intervention studies on the subject until June 2008. From the 57 publications, the researchers found conclusively that exercise buffed up the way people see their bodies regardless of the actual benefits, but the results varied.

Negative body image has grown to almost epidemic proportions in the past 20 years, with as many as 60 percent of adults in national studies saying they don't like the way their bodies look, Hausenblas said.

Americans spend billions of dollars a year for products designed to change their body size and shape, including diet pills and various cosmetic procedures, she said.

"Body dissatisfaction is a huge problem in our society and is related to all sorts of negative behavior including yo-yo dieting, smoking, taking steroids and undergoing cosmetic surgery," she said. "It affects men and women and all ages, starting with kids who are as young as five years old saying they don't like how their bodies look."

The psychological advantages of exercise have been less explored, including the reduction of depression or confidence in body image, compared with the well-researched and understood physical benefits, she said.

The study found no difference in body image improvement between people who met the American College of Sports Medicine guidelines by exercising at least 30 minutes a day five days a week and those who did not, Hausenblas said. The guidelines are considered the minimum amount of exercise needed to receive the health related benefits of physical activity, she said.

"We would have thought that people exercising this amount would have felt better about their bodies than those who did not work out as much," she said.

In other results, the study showed slightly larger benefits from exercise in terms of improving body image for women than men, Hausenblas said.

"We believed the gap would be much bigger, but what could be coming into play is the rise of body image issues among men," she said. "We're seeing more media portrayals of the ideal physique for men rather than the overriding emphasis on women we did in the past."

Age presented another difference, with older people most likely to report enhanced body images from exercise, Hausenblas said. The gap may be explained by the older generation having more concerns about their body image than young people, who tend to exercise more, she said.

While the frequency of exercise mattered for boosting body perceptions, there were no differences for the duration, intensity, length or type of exercise, the study found.

"People who say they have high body dissatisfaction tend to exercise the least, so we wanted to take it a step further and see whether exercise causes people's body image to improve," she said.

Kathleen Martin Ginis, a kinesiology professor at McMaster University in Ontario, Canada, and exercise expert, praised the research. "This is an important study because it shows that doing virtually any type of exercise, on a regular basis, can help people feel better about their bodies," she said. "With such a large segment of the population dissatisfied with their physiques, it's encouraging to know that even short, frequent bouts of lower intensity exercise can improve body image."

Women's Soccer: Get Fit While Having Fun

New research shows that women benefit more from playing recreational soccer than from running when it comes to overall fitness. And that's not all: women playing soccer experience a higher degree of motivation when it comes to sticking to their sport, and they increase their ability to bridge and create new acquaintances. Video and photos available from the project website.The study

Over a period of two years, 30 scientist lead by Associate Professor Peter Krustrup, University of Copenhagen, have investigated physiological, sociological and psychological aspects of women's soccer in comparison to running. 100 untrained adult premenopausal women have participated in the study.

The women (65 participated in the physiological study) were randomly divided into three groups: One soccer group, one running group and one control group. The soccer players and runners trained twice a week for one hour. After four and sixteen weeks, all the subjects went through extensive physiological tests. The same 65 subjects + another 35 women playing in soccer clubs were continually observed and interviewed to study the sociological and psychological effects of their training.

Soccer players stick to their game

Many women find it difficult to fit in sport and exercise in their busy daily lives, and many state family and especially small children as the main reason for not finding the time.

The study reveals that contrary to common assumption, the flexibility of running as exercise form actually makes running harder to stick to for most women than soccer, which requires a fixed time and place.

"What is really interesting is that the soccer players differed from the runners in their motivation. The runners were motivated by the idea of getting in shape and improving health. But the soccer players focused on the game itself and were motivated by the social interaction and by having fun with others. As it turns out, the soccer players got in better shape than the runners, and that combined with the social benefits makes soccer a great alternative to running", says Associate Professor Laila Ottesen and continues:

"The women who played soccer have continued their soccer training as a group whereas few of the women in the running group continued running after the study. Actually, some of the women from the running group joined teams with the soccer group after the project finished."

Why soccer players are more fit

When choosing a sport, women tend to favour cardiovascular training to strength training although the build-up of muscles and bone strength are vital to preserve health into old age.

"While playing soccer, the women have high heart rates and perform many sprints, turns, kicks and tackles, making soccer an effective integration of both cardio and strength training", says project leader Peter Krustrup.

"Our study shows that the 16 weeks of recreational women's soccer causes marked improvement in maximal oxygen uptake, muscle mass and physical performance, including the endurance, intermittent exercise and sprinting ability, explains Peter Krustrup, and continues

"This makes soccer a very favourable choice of exercise training for women.

In the recent decade, we have seen a significant rise in women and girls playing soccer. It seems as though women are really beginning to take in soccer and make it a popular sport for women on their own terms. This is a very positive step forward, not only because of the improved physical fitness and health profile but also for the enjoyment of sports", Krustrup concludes.

Publication plans

The present results will be submitted online in the international journal Scandinavian Journal of Medicine and Science in Sports next week (Bangsbo, Nielsen, Mohr, Randers, Krustrup, Brito, Nybo and Krustrup. Performance enhancements and muscular adaptations of a 16-week recreational football intervention for untrained women. Scand J Med Sci Sports, 2009).

In January 2010, the same journal will publish a supplementum describing multiple health effects of recreational football for various subject groups, including men, women, young and elderly. The supplementum includes one review and 13 original scientific papers.

The data will also be presented at the Scandinavian Congress of Medicine and Science in Sports 2010, Copenhagen, Denmark, 4-6 February 2010, and at the 3rd International Football Medicine Conference in Sun City, South Africa, 19-21 February 2010.

The project group currently includes collaborators from Switzerland, Norway and Italy, and major applications are currently being processed to include collaborators from England, Portugal, Belgium, Australia and Kenya.

Funding

The work has been financially supported by F-MARC, The Danish Ministry of Culture, The Danish Football Association and The Danish Sport Federation, The Danish Gymnastics and Sports Associations and by 3F (United Federation of Danish Workers).

List Of Hazardous Chemicals In Smokeless Tobacco Is Expanded In New Study

Attention all smokeless tobacco users: It's time to banish the comforting notion that snuff and chewing tobacco are safe because they don't burn and produce inhalable smoke like cigarettes. A study that looked beyond the well-researched tobacco hazards, nitrosamines and nicotine, has discovered a single pinch –– the amount in a portion –– of smokeless tobacco exposes the user to the same amount of another group of dangerous chemicals as the smoke of five cigarettes.The research on polycyclic aromatic hydrocarbons (PAH) in smokeless tobacco was reported at the 238th National Meeting of the American Chemical Society (ACS). It adds to existing evidence that smokeless contains two dozen other carcinogens that cause oral and pancreatic cancers, the scientists say.

"This study once again clearly shows us that smokeless tobacco is not safe," said Irina Stepanov, Ph.D., who led the research team. "Our finding places snuff on the same list of major sources of exposure to polycyclic aromatic hydrocarbons as smoking cigarettes." PAHs are widespread environmental contaminants formed as a result of incomplete burning of wood, coal, fat in meat, and organic matter. PAHs form, for instance, during the grilling of burgers, steaks and other meat.

The findings come in the midst of a rise in both marketing and consumption of smokeless tobacco, which many consumers regard as less dangerous than other forms of tobacco. Estimates suggest that sales of moist snuff in the United States have doubled since the 1980s.

"The feeling of safety among some smokeless users is wrong," said Stepanov, a chemist with Masonic Cancer Center, University of Minnesota, Minneapolis. "A total of 28 carcinogens were identified in smokeless tobacco even before our study. Continued exposure to these over a period of time can lead to cancer. Now we have found even more carcinogens in snuff." In addition to the heightened cancer risk, she noted that chronic use of snuff leads to nicotine addiction, just as it does with cigarette smoking.

Stepanov said that until recently, scientists believed that only trace amounts of PAH existed in snuff because the tobacco was not burned when used. This assumption proved to be wrong. "Even though smokeless tobacco use does not involve burning, moist snuff is getting contaminated with PAH during its manufacturing," according to Stepanov. The most likely source of this contamination with PAH is the curing process that is used to turn tobacco leaves into snuff. This process is called 'fire-curing', and it puts tobacco into direct contact with the smoke generated by smoldering hardwoods –– a rich source of various PAHs.

Looking to the next project, she said the team is working on a study that will examine a wide range of smokeless tobacco brands to compare PAH levels among them.

Funding for Stepanov's research came from the National Cancer Institute and the National Institute on Drug Abuse to the Transdisciplinary Tobacco Use Research Center at the University of Minnesota. The research team working on this project includes Dr. Dorothy Hatsukami and Dr. Stephen Hecht, renowned experts in tobacco carcinogenesis and tobacco harm reduction.

Links Between Video-game Playing And Health Risks In Adults Found

While video gaming is generally perceived as a pastime for children and young adults, research shows that the average age of players in the United States is 35. Investigators from the Centers for Disease Control and Prevention (CDC), Emory University and Andrews University analyzed survey data from over 500 adults ranging in age from 19 to 90 in the Seattle-Tacoma area on health risks; media use behaviors and perceptions, including those related to video-game playing; and demographic factors. In an article published in the October 2009 issue of the American Journal of Preventive Medicine, they found measurable correlations between video-game playing and health risks.Participants reported whether they were players or nonplayers, and weekly usage was collected. Internet usage was assessed, as was the relative importance of the Internet as a social support. The personal determinants examined in this study included self-assessments of depression, personality, health status, physical and mental health, body mass index (BMI), and poor quality of life. Immersion in media environments was evaluated using the participants' estimates of the time they spent during a typical week surfing the Internet and watching TV, including videos and DVDs. The Seattle–Tacoma area was selected because of its size (13th largest US media market) and its Internet usage level is the highest in the nation.

A total of 45.1% of respondents reported playing video games. Female video-game players reported greater depression and lower health status than female nonplayers. Male video-game players reported higher BMI and more Internet use time than male nonplayers. The only determinant common to both female and male video-game players was greater reliance on the Internet for social support.

Writing in the article, Dr. James B Weaver III, PhD, MPH, National Center for Health Marketing, CDC, Atlanta, states, "As hypothesized, health-risk factors – specifically, a higher BMI and a greater number of poor mental-health days – differentiated adult video-game players from nonplayers. Video-game players also reported lower extraversion, consistent with research on adolescents that linked video-game playing to a sedentary lifestyle and overweight status, and to mental-health concerns. Internet community support and time spent online distinguished adult video-game players from nonplayers, a finding consistent with prior research pointing to the willingness of adult video-game enthusiasts to sacrifice real-world social activities to play video games. The data illustrate the need for further research among adults to clarify how to use digital opportunities more effectively to promote health and prevent disease."

In a commentary in the same issue, Brian A. Primack, MD, EdM, MS, from the University of Pittsburgh School of Medicine, applauds Weaver et al. for focusing on the current popularity of video games not only among youth, but also among adults. He suggests that many video games are different enough from original forms of play that they may be better defined as "playlike activities." He writes, "There are noteworthy differences between the oldest forms of play (e.g., chase games) and today's 'playlike activities.' These playlike activities may stimulate the right centers of the brain to be engaging ... However, the differences between today's 'playlike activities' and original forms of play may illuminate some of the observed health-related correlates discovered by Weaver, et al."

Dr. Primack observes that our greatest challenge will be maintaining the balance: "How do we simultaneously help the public steer away from imitation playlike activities, harness the potentially positive aspects of video games, and keep in perspective the overall place of video games in our society? There are massive, powerful industries promoting many playlike activities. And industry giants that can afford to will successfully tout the potential benefits of health-related products they develop. But who will be left to remind us that – for children and adults alike – Hide-And-Seek and Freeze Tag are still probably what we need most?"

The article is "Health-Risk Correlates of Video-Game Playing Among Adults" by James B Weaver III, PhD MPH; Darren Mays, MPH; Stephanie S Weaver, PhD, MPH; Wendi Kannenberg, MPH; Gary L Hopkins, MD DrPH; Dogan Eroglu, PhD; and Jay M Bernhardt, PhD MPH. The commentary is "Video Games: Play or 'Playlike Activity'?" by Brian A Primack, MD, EdM, MS. Both appear in the American Journal of Preventive Medicine, Volume 37, Issue 4 (October 2009) published by Elsevier.

Autonomous Robot Detects Shrapnel In Flesh

Bioengineers at Duke University have developed a laboratory robot that can successfully locate tiny pieces of metal within flesh and guide a needle to its exact location -– all without the need for human assistance.The successful proof-of-feasibility experiments lead the researchers to believe that in the future, such a robot could not only help treat shrapnel injuries on the battlefield, but might also be used for such medical procedures as placing and removing radioactive "seeds" used in the treatment of prostate and other cancers.

In their latest experiments, the engineers started with a rudimentary tabletop robot whose "eyes" are a novel 3-D ultrasound technology developed at Duke. An artificial intelligence program served as the robot's "brain" by taking the real-time 3-D information, processing it and giving the robot specific commands to perform. In their simulations, the researchers used tiny (2 millimeter) pieces of needle because, like shrapnel, they are subject to magnetism.

"We attached an electromagnet to our 3-D probe, which caused the shrapnel to vibrate just enough that its motion could be detected," said A.J. Rogers, who just completed an undergraduate degree in bioengineering at Duke. "Once the shrapnel's coordinates were established by the computer, it successfully guided a needle to the site of the shrapnel."

By proving that the robot could guide a needle to an exact location, it would simply be a matter of replacing the needle probe with a tiny tool, such as a grabber, the researchers said.

Rogers worked in the laboratory of Stephen Smith, director of the Duke University Ultrasound Transducer Group and senior member of the research team. The results of the experiments were published early online in the July issue of the journal IEEE Transactions on Ultrasonics, Ferroelectrics and Frequency Control.

Since the researchers achieved positive results using a rudimentary robot and a basic artificial intelligence program, they are encouraged that simple and reasonably safe procedures will become routine in the near future as robot and artificial intelligence technology improves.

"We showed that in principle, the system works," Smith said. "It can be very difficult using conventional means to detect small pieces of shrapnel, especially in the field. The military has an extensive program of exploring the use of surgical robots in the field, and this advance could play a role."

In addition to its applications recovering the radioactive seeds used in treating prostate cancer, Smith said the system could also prove useful in removing foreign, metallic objects from the eye.

Advances in ultrasound technology have made these latest experiments possible, the researchers said, by generating detailed, 3-D moving images in real-time. The Duke team has a long track record of modifying traditional 2-D ultrasound – like that used to image babies in utero – into the more advanced 3-D scans. Since inventing the technique in 1991, the team has shown its utility by developing specialized catheters and endoscopes for real-time imaging of blood vessels in the heart and brain.

In the latest experiments, the robot successfully performed its main task: locating a tiny piece of metal in a water bath, then directing a needle on the end of the robotic arm to it. The researchers had previously used this approach to detect micro-calcifications in simulated breast tissue. In the latest experiments, Rogers added an electromagnet to the end of the transducer, or wand, the device that sends out and receives the ultrasonic waves.

"The movement caused by the electromagnet on the shrapnel was not visible to the human eye," Rogers said. "However, on the 3-D color Doppler system, the moving shrapnel stood out plainly as bright red."

The robot used in these experiments is a tabletop version capable of moving in three axes. For the next series of tests, the Duke researchers plan to use a robotic arm with six-axis capability.

The research in Smith's lab is supported by the National Institutes of Health. Duke's Ned Light was also part of the research team.

BPA Found In Many Plastics May Cause Heart Disease In Women

New research by a team of scientists at the University of Cincinnati (UC) shows that bisphenol A (BPA) may be harmful for the heart, particularly in women.Results of several studies are being presented in Washington, D.C., at ENDO 09, the Endocrine Society's annual meeting, June 10-13.

A research team lead by Scott Belcher, PhD, Hong Sheng Wang, PhD, and Jo El Schultz, PhD, in the department of pharmacology and cell biophysics, found that exposure to BPA and/or estrogen causes abnormal activity in hearts of female rats and mice.

In addition, these researchers found that estrogen receptors are responsible for this affect in heart muscle cells.

"There is broad exposure to bisphenol A, despite recognition that BPA can have harmful effects," Belcher says. "We had reason to believe that harmful cardiovascular affects can be added to the list."

BPA, an environmental pollutant with estrogen activity, is used to make hard, clear plastic and is common in many food product containers. It has been linked to neurological defects, diabetes and breast and prostate cancer.

Using live cultures of cells isolated from rat or mouse hearts, researchers briefly exposed the cardiac cells to BPA and/or estrogen. Both compounds caused striking changes in the activity of cardiac muscle cells from females but not males. Additional studies revealed that these cellular changes in activity caused improperly controlled beating in the female heart.

"Low doses of BPA markedly increased the frequency of arrhythmic events," Belcher says. "The effect of BPA on these cardiac arrhythmias was amplified when exposed to estradiol, the major estrogen hormone in humans."

The mechanism underlying this harmful effect was investigated using cellular imaging techniques.

"BPA and/or estrogen rapidly stimulated contraction by altering control of the concentrations of free calcium inside the heart cell but only in heart muscle cells from females, showing that these effects were sex-specific," Belcher says. "BPA's presence increased the frequency of calcium 'sparks' from the sarcoplasmic reticulum—the part of the cardiac muscle that stores and releases calcium ions—indicating spontaneous release or 'leak' that's likely causing the heart arrhythmias and may have other harmful actions, especially following heart attack."

Belcher and colleagues also investigated the nature of the mechanisms that mediated the responses of the cardiac muscle cells to estrogen and BPA.

"Pharmacological studies using selective estrogen receptor drugs and animal models lacking estrogen receptors were used to investigate the role of each estrogen receptor in mediating the rapid sex-specific function effects of E2 and BPA in cells," he says. "Our findings suggest that estrogen has opposing actions in cardiac cells.

"In female cardiac muscle cells, the blocking or genetic removal of estrogen receptor beta completely blocked the contractile effects of BPA and estrogen, while in males, blockade of the effects of estrogen receptor alpha caused the male heart to become more 'female-like' and become responsive to estrogen and BPA.

"These studies have identified new and important potential cardiac risks associated with BPA exposure that may be especially important for women's heart health," he says.

This study was funded by grants from the National Institutes of Health and the UC Center for Environmental Genetics.

Soap-sniffing Technology Encourages Hand Washing To Reduce Hospital-acquired Infections, Save Money

Call it a Breathalyzer for the hands. Using sensors capable of detecting drugs in breath, new technology developed at University of Florida monitors health-care workers' hand hygiene by detecting sanitizer or soap fumes given off from their hands.By reminding workers to clean their hands to remove disease-causing organisms such as the bacteria MRSA, the system could help reduce hospital-acquired infections and save millions of dollars now spent to treat them.

The trademarked system, called HyGreen, logs, down to the second, the frequency of hand cleaning and contact with patients in a database that clinical supervisors can review immediately.

This is the first system that enables real-time monitoring of hand washing.

"This isn't big brother, this is just another tool," said Richard J. Melker, M.D., Ph.D., a UF College of Medicine anesthesiology professor who developed the technology along with professors Donn Dennis, M.D., and Nikolaus Gravenstein, M.D., of the anesthesiology department, and Christopher Batich, Ph.D., a materials science professor in the College of Engineering. "A hospital worker never wants to be responsible for someone getting sick or dying from an infection acquired in the hospital."

HyGreen is now being tested in the Neuro Intensive Care Unit at Shands at UF medical center, and will be presented at the annual meeting of the Association for Professionals in Infection Control and Epidemiology June 6 to June 9 in Fort Lauderdale, Fla.

Here's how it works: The health-care worker squirts sanitizer gel or soap into his or her hand before passing it under a wall-mounted sensor. A wireless signal from a badge worn by the worker activates a green light on the hand-washing sensor. When the worker enters a patient room, a monitor near the bed detects the status of the badge, and flashes green if the person has clean hands. If the person has not washed, or too much time has passed between washing and approaching the patient, the badge will give a gentle "reminder" vibration.

"I do wash my hands more often," said nurse Carrie McGirr, R.N., who volunteered to help test the HyGreen system. "It's a fairly simple process to learn."

Close to 2 million hospital-acquired infections occur each year and more than 250 related deaths occur each day in the United States, according to the Centers for Disease Control and Prevention.

"A substantial number of those are preventable, and also one of the key modes of transmission is via the hands of health-care personnel and patients," said Dr. Lennox Archibald, a professor of infectious diseases at the UF College of Medicine, and the Shands at UF epidemiologist leading the evaluation of HyGreen.

Six pathogens, including the ones known as MRSA and VRE, account for two-thirds of all hospital-acquired infections and are readily transmitted by hand.

Studies have shown that up to half of all hospital-acquired infections might be prevented if health-care workers washed their hands according to guidelines set forth by the CDC.

It costs at least $30 billion a year in additional spending to treat hospital-acquired infections. The Center for Medicare and Medicaid Services last year ruled that it would no longer reimburse hospitals for the expense of treating the infections.

Today, more than 160 years after Hungarian physician Ignaz Semmelweiss was ridiculed for suggesting that hand washing by doctors who moved directly from working with cadavers to delivering babies could reduce fatal cases of birth-related infection, the practice still meets with resistance.

"But it's not because people don't want to do it," Archibald said. "It's not inherent in people's behavior to wash their hands, for some reason."

Various studies show that health-care workers wash their hands less than half the time after direct contact with patients. The reasons people give include skin irritation caused by hand hygiene products, a preference for gloves or simply failure to remember.

Previous hand-washing compliance studies have been based on observation of a limited number of people at a time, who likely improve their behavior when they know they are being watched — a phenomenon known as the Hawthorne effect.

"This system is a noninvasive way of measuring — it allows for nonbiased measurement and is unobtrusive," said Loretta Fauerbach, Shands at UF director of infection control, who helped write the CDC hand-washing guidelines and leads the collaboration with HyGreen to evaluate the system in a hospital setting.

"Nobody has ever taken a systems approach to this problem before," said Melker, chief technology officer of Xhale Inc., which is marketing HyGreen.

Developers anticipate that hospitals will readily accept the system because not only can it help reduce infections, it also will pay for itself within a few months.

"Something has to be done about hand washing," Archibald said. "Otherwise the bugs are going to win."

Stronger Material For Filling Dental Cavities Has Ingredients From Human Body

Scientists in Canada and China are reporting development of a new dental filling material that substitutes natural ingredients from the human body for controversial ingredients in existing "composite," or plastic, fillings. The new material appears stronger and longer lasting as well, with the potential for reducing painful filling cracks and emergency visits to the dentist, the scientists say. Julian X.X. Zhu and colleagues point out that dentists increasingly are using white fillings made from plastic, rather than "silver" dental fillings. Those traditional fillings contain mercury, which has raised health concerns among some consumers and environmental issues in its production. However, many plastic fillings contain controversial ingredients (such as BisGMA) linked to premature cracking of fillings and slowly release bisphenol A, a substance considered as potentially toxic to humans and to the environment.

The scientists developed a dental composite that does not contain these ingredients. Instead, it uses "bile acids," natural substances produced by the liver and stored in the gallbladder that help digest fats. The researchers showed in laboratory studies that the bile acid-derived resins form a hard, durable plastic that resists cracking better than existing composites.

Bad Breath? New Pocket-sized Breath Test Developed

A quick breath check in the palm of your hand can never give accurate results. Whether you're about to lean in for a smooch or start a job interview, you're better off asking a trusted friend if your breath is sweet. But what if a friend isn't around when you need one?

Tel Aviv University researchers have come up with the ultimate solution — a pocket-size breath test which lets you know if malodorous bacteria are brewing in your mouth. A blue result suggests you need a toothbrush. But if it's clear, you're "okay to kiss."

Until now, scientists believed that only one population of bacteria (the Gram-negative ones) break down the proteins in the mouth and produce foul odor. But Prof. Mel Rosenberg and Dr. Nir Sterer of TAU's Sackler Faculty of Medicine recently discovered that the other population of bacteria (the Gram-positive ones) are bad breath's bacterial partner. These bacteria appear to help the Gram-negative ones by producing enzymes that chop sugary bits off the proteins that make them more easily degraded. This enzymatic activity, present in saliva, serves as the basis for the new "OkayToKiss" test.

Prof. Rosenberg, international authority on the diagnosis and treatment of bad breath, who co-developed the kit with Dr. Sterer, published their findings this past March in the Journal of Breath Research, of which Prof. Rosenberg is editor-in-chief. An earlier invention of Prof. Rosenberg led to the development of two-phase mouthwashes that have become a hit in the UK, Israel and elsewhere.

From the Lab to Your Pocket

The patent-pending invention is the result of ongoing research in Prof. Rosenberg's laboratory.

"All a user has to do is dab a little bit of saliva onto a small window of the OkayToKiss kit," explains Prof. Rosenberg: "OkayToKiss will turn blue if a person has enzymes in the mouth produced by the Gram-positive bacteria. The presence of these enzymes means that the mouth is busily producing bacteria that foster nasty breath," he explains.

Apart from its social uses, the test can be used as an indicator of a person's oral hygiene, encouraging better health habits, such as flossing, brushing the teeth, or scheduling that long-delayed visit to the dentist.

OkayToKiss could be ready in about a year for commercial distribution, probably in the size of a pack of chewing gum, to fit in a pocket or purse. It is disposable and could be distributed alongside breath-controlling products.

Science Behind the Smells

"For about 7 years now, we've suspected that there's another kind of bacteria at work in the mouth which causes bad breath," says Prof. Rosenberg. "Now, we are able to grow these bacteria from saliva in an artificial biofilm, showing that there are two distinct populations at work."

In the biofilm — the basis of the new breath test — the color difference between the Gram-positive and Gram-negative bacteria is remarkable. In the top layer of the biofilm, the bacterium take the glycoproteins in the saliva and chop off sugar residues to produce volatile proteins. On the lower layer in the biofilm, which could roughly be compared to one's tongue or inner lining of the mouth, reside the known and established Gram-negative bacteria.

Biomarkers, like the ones used by Prof. Rosenberg's new invention, are the basis of popular diagnostic kits today, like home pregnancy tests or glucose monitors used by diabetics. Checking the sweetness of one's breath may seem frivolous, but millions worry about it on a continual basis. Prof. Rosenberg's continued research into biomarkers in saliva is very promising for diagnosing other more serious disorders, including indicators for lung cancer, asthma and ulcers.

Prof. Rosenberg has summarized his twenty years of his research and experience on bad breath problems in a new book, Save Your Breath, due out in two months. This new work is a collaborative effort with Dr. Nir Sterer and Dr. Miriam Shaharbany of the Sackler Medical Faculty.