AIDS Stopped in Haiti Before U.S.

(HealthDay News) -- New research into the genetic history of HIV suggests that the virus that causes AIDS stopped in Haiti during the middle of the last century, prior to reaching the United States.

The findings are unlikely to help scientists discover better treatments for AIDS, but they could provide insight into how HIV evolves and moves from place to place, said Michael Worobey, a professor in the University of Arizona's Department of Ecology and Evolutionary Biology and co-author of a study released Monday.

"It matters when these events occurred and how often colonizations of new locales occur," he said. "That helps us predict the future complexity of the HIV pandemic."

The study findings about the spread of HIV are "definitive," added Dr. Beatrice Hahn, a professor in the University of Alabama at Birmingham's departments of medicine and microbiology. Hahn, who studies how the virus developed, said the next step in research is to go "further back in time" and use old blood samples from central Africa to understand more about the early days of AIDS.

Scientists are certain that the AIDS virus developed somewhere in Africa after a virus jumped from monkeys to humans. But there are still questions about the history of HIV and how it incubated in Africa before moving on to the rest of the world.

In the new study, Worobey and colleagues studied a strain of the AIDS virus known as subtype B, which commonly affects people in many countries, including the United States. The researchers tried to figure out how the virus traveled by studying blood samples of Haitian immigrants to the United States who were among the first in the country to be diagnosed as suffering from AIDS.

"For the last few years, we've been thinking it would be good to try to collect and analyze as many archival human samples as possible," Worobey said. "We can travel back in time and look directly at the viruses that were circulating at early time points."

The findings were published this week in an online edition of the Proceedings of the National Academy of Sciences.

After using genetic techniques to study the evolution of the virus, the researchers came to believe that the AIDS strain moved from Africa to Haiti at some time during the mid-1960s. They think it circulated in Haiti for perhaps a few years before moving on to the United States in about 1969.

Doctors didn't begin picking up on the existence of the virus in the United States until 1981, when they noticed that some gay men were developing unusual diseases. "That leaves a 12-year period between when we think it came in, and people realized there was something new," he said.

What could explain that? It's possible that the virus was around and making people sick for a decade or more, but the number of people infected may have been tiny, Worobey said. After all, it can often take 10 to 12 years for someone to become ill with AIDS after being infected by the virus, he said.

Going back even earlier, some scientists suspect that AIDS stalked Africa since the 1930s. "It's not that surprising that it circulated for 30 years before we have any hard evidence of it," Worobey said. "In Africa, most people die of tuberculosis when they have AIDS, and that adds a whole layer of fog" to detecting HIV disease, he said.

What now? Scientists could use the findings about Haiti as they try to develop vaccines, Worobey said. The AIDS strain in question "has a deeper history in Haiti than in all these other countries (that it traveled to). Its genetic diversity is more extensive, and that should be considered when either testing or designing subtype B vaccines in the future."

More information
There's more on the history of HIV and AIDS at the U.S. Food and Drug Administration.

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Survey Finds Many Women Misinformed About Cancer

(HealthDay News) -- Sixty-three percent of American women think that if there's no family history of cancer, you're not likely to develop the disease, a new survey found.

In fact, most people who develop cancer have no family history of cancer, according to the American College of Obstetricians and Gynecologists (ACOG), which sponsored the survey. The survey underscores the need for better education and understanding of the steps women can take to prevent cancer and to detect it early.

"Too many women are dying from cancer," Dr. Douglas W. Laube, ACOG's immediate past president and chairman of the department of obstetrics and gynecology at the University of Wisconsin School of Medicine and Public Health, said during a Friday teleconference. "An estimated 200,070 women will die in the U.S this year, and over 600,078 women will be diagnosed with cancer. The results of this survey found a worrisome gap in women's knowledge about cancer."

Based on the findings, ACOG is increasing its efforts to educate women about cancer and the need for regular screening tests, such as Pap tests, mammograms and colonoscopies.

Although the survey found many misconceptions about cancer, 76 percent of women surveyed did say they feel knowledgeable about how they can reduce their risk of the disease.

However, only 52 percent said they're doing enough to reduce that risk. And 10 percent said they hadn't done anything in the past year to lower their risk. Seventeen percent said they wouldn't change their lifestyles, even if changes would lower their cancer risk.

Many women said they were afraid to undergo screening out of fear of finding cancer. Twenty percent said they didn't want to know if they had cancer.

Other survey findings included:

• Only 56 percent of women had seen a doctor in the past year, but 77 percent said regular physician visits help reduce the risk of cancer.
• 29 percent of women haven't seen a doctor on a regular basis or had a Pap test or a mammogram in the past year.
• 18 percent said Pap tests and mammograms weren't necessary, 7 percent said they didn't know how to get screened, and 7 percent thought screening was a waste of time.
• 37 percent of the women said they couldn't afford to see a doctor.

Michael Stefanek, director of behavioral research at the American Cancer Society, said the survey results mirrored other study findings.

"The data is not inconsistent with what we know about women's knowledge and screening practices," he said. "We need to do a better job alerting women that they are at risk for cancer even if they have no family history."

Stefanek noted that U.S. cancer deaths dropped an average 2.1 percent each year from 2002 through 2004 -- double the average 1.1 percent decline seen from 1993 through 2002. This improvement is largely due to better cancer screening and early detection, he said.

Stenfanek also thinks more women need to be screened, and there needs to be greater access to health care so women can get the care they require.

In response to these findings, ACOG will launch on Oct. 29 a new Web site -- Protect & Detect: What Women Should Know about Cancer. The guide is designed to help women, working with their ob-gyns, to take charge of their health and improve their understanding of their risk of cancer -- and the lifestyle steps they can take to cut that risk.

ACOG has also developed new guidelines for colorectal cancer screening. The guidelines recommend that women, starting at 50, receive a colonoscopy every 10 years. Colonoscopy is the "gold standard" for preventing colorectal cancer because of its ability to detect precancerous lesions and remove them during the procedure.

While ACOG is recommending colonoscopy for women at high risk for colon cancer, it's also recommending the procedure for women at average risk.

Not all experts agree with that approach.

"There are other methods that are acceptable if you choose not to get colonoscopy," said Robert Smith, director of cancer screening at the American Cancer Society. "Not all women are going to have access to colonoscopy or affordable colonoscopy."

Virtual CT colonoscopy may be as effective as a colonoscopy for detecting serious lesions, Smith said. Other screening tests include fecal occult blood tests and sigmoidoscopy, he said.

For women who have a low risk of colon cancer, other screening methods are effective, Smith said. "However, for women who have a family history or personal history of colorectal cancer, colonoscopy is the preferred test," he said.

More information
For more on woman and cancer, visit the American College of Obstetricians and Gynecologists.

Many at Risk for HIV Not Being Tested

(HealthDay News) -- Rates of HIV testing in the United States have remained constant since 2000, with some one-third of all Americans ever having been screened for the virus that causes AIDS.

But less than 25 percent of those at high risk of infection -- such as people who have unprotected sex or are intravenous drug users -- have been tested within the past year, making it tougher to contain the epidemic, Duke University researchers report.

That gap involving high-risk individuals can be bridged through outreach programs and making HIV testing part of routine health exams, the researchers suggested.

"We found that groups that would be considered at higher risk for HIV expressed the greatest desire to get tested, and yet those groups also had the greatest gap between their desire to get tested and their actual intention to get tested," said lead researcher Brian Wells Pence, an infectious diseases epidemiologist at Duke University's Center for Health Policy.

An estimated 1.1 million Americans are infected with HIV, and about 25 percent of them don't know they carry the virus, according to the U.S. Centers for Disease Control and Prevention.
"Our best estimate is that those 25 percent who don't know that they are infected are responsible for more than half of new infections, because they don't know to take preventative measures," Pence said.

"There are barriers that may affect high-risk groups," he continued, citing such potential obstacles as access to health care, the stigma that still surrounds HIV, and questions about the benefits of treatment.

"Expanding testing to help individuals know their status is a really critical element of addressing the HIV epidemic in this country," Pence said.

The findings were published in the Oct. 22 online edition of Archives of Internal Medicine.
For the study, Pence's team analyzed health surveys of 146,868 Americans and found that people at high risk for HIV tended to say they wanted to be tested but didn't follow through.

Twenty-seven percent of those at highest risk said they wanted to be tested within the next year, but only 11 percent had actually had a recent test.

The researchers also found that about 44 percent of the tests taken came during regular patient visits, such as prenatal care visits or other routine medical appointments. This finding supports the belief that incorporating HIV testing into routine medical care helps make testing more available, the researchers said.

David Paltiel, an associate professor of public health at the Yale School of Public Health, agrees that HIV testing should be a part of general medical care. "It's true that we aren't testing enough people," he said. "The high risk groups have really bad follow-up, really bad linkage to care, really bad access to health care.

"Even these at-risk groups come into contact with a primary health care setting, and making it a routine part of care is the answer," he said.

Paltiel admits there are legal, political and financial problems to be overcome before HIV testing becomes routine.

Philip Alcabes, an associate professor in the School of Health Sciences at Hunter College in New York City, thinks any policy for HIV testing needs to balance privacy issues with the desire to find infected people in order to treat them.

"Making testing available in some routine way makes some sense if your goal is to find more cases and get treatment to people," Alcabes said. "But there are people who are very concerned about people knowing they have HIV. That's a reasonable concern that needs to be respected. There are people who don't want their names on lists."

More information
Visit National HIV Testing Resources to find an HIV testing site near you.

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Fluid Displacement From Leg to Neck Can Cause Apnea

(HealthDay News) -- Fluid displacement from the legs to the neck that occurs when a person lies down can narrow soft tissue around the throat, increasing airflow resistance by more than 100 percent and boosting the risk of obstructive sleep apnea, a new study says.

Obstructive sleep apnea, which affects about 18 million Americans, occurs when a blockage in the throat or upper airway causes a sleeping person to repeatedly stop breathing long enough to decrease the amount of oxygen in the blood and increase the amount of carbon dioxide.

"Our data show that the displacement of a small amount of fluid such as 340 ml, about 12 ounces, from the legs is sufficient to cause a 102 percent increase in airflow resistance of the pharynx in healthy, non-obese subjects," study author Dr. T. Douglas Bradley, of Toronto General Hospital in Canada, said in a prepared statement.

The researchers studied leg fluid volume, neck circumference and airflow resistance in the throats of seven men and four women, average age 36, while they lay on their backs.

A lower body positive pressure device (anti-shock suit) was then used for five minutes on each participant to displace fluid from their legs to their necks.

"Obesity and neck circumference are important risk factors in obstructive sleep apnea, but together only account for approximately one-third of the variability in the apnea-hyponea index," Bradley said.

"A factor not ordinarily considered is fluid accumulation at the nape of the neck and around pharyngeal soft tissue. Obstructive sleep apnea is very common in fluid-retaining states such as heart failure, renal failure and peripheral edema of unknown cause," he noted.

The study was published in the December issue of the American Journal of Respirator and Critical Care Medicine.

More information
The U.S. National Heart, Lung, and Blood Institute has more about sleep apnea.

Insomniac Fish May Help Sleepless People

(HealthDay News) -- They may not toss and turn, but even fish can get insomnia, according to new research that could help sleepless humans.

A team at Stanford University School of Medicine in California found that zebrafish -- a common aquarium pet -- can carry a genetic mutation linked to sleep problems. The finding may help scientists in their efforts to learn more about the genetics of sleep disorders.

Fish with the mutation have brain cells that lack receptors for a neuropeptide called hypocretin. These fish got 30 percent less overall sleep than normal zebrafish. When the mutant fish did fall asleep, they slept only half as long as their normal counterparts.

This study was published in the Oct. 16 issue of the journal Public Library of Science - Biology.

The researchers' next step is to look for mutations in zebrafish that cause oversleep or complete lack of sleep, with the ultimate goal of discovering new sleep-related regulatory molecules and brain networks passed on through evolution to humans.

"Many people ask the questions, 'Why are we sleeping?' and, 'What is the function of sleep?' I think it is more important to figure out first how the brain produces and regulates sleep," study author Dr. Emmanuel Mignot said in a prepared statement. "This will give us important clues on how and maybe why sleep has been selected by natural evolution and is so universal."

More information
The American Academy of Family Physicians has more about insomnia.

Antidepressants Boost GI Bleeding Risk

(HealthDay News) -- Antidepressant drugs called selective serotonin reuptake inhibitors (SSRIs), which include Celexa, Paxil, Prozac and Zoloft, can double the risk of gastrointestinal bleeding, and the threat is more than six times higher if patients take aspirin and similar pain medications at the same time as SSRIs, a new study finds.

"Clinicians who prescribe these medications should be aware of the potential risk and may need to consider alternatives," senior researcher Dr. Sonal Singh, assistant professor of internal medicine at Wake Forest University School of Medicine, in Winston-Salem, N.C., said in a prepared statement.

His team published the findings in the journal Alimentary Pharmacology & Therapeutics.
In addition to depression, SSRIs are also used to treat panic disorder and obsessive-compulsive disorder. There's growing evidence that SSRIs may be associated with upper gastrointestinal (GI) bleeding.

Singh and colleagues analyzed data from four studies involving 153,000 patients. They found that those taking SSRIs were nearly twice as likely to develop upper GI bleeding as people who weren't taking the drugs.

When patients taking SSRIs also took nonsteroidal anti-inflammatory drugs (NSAIDs) -- such as aspirin, Aleve and Celebrex -- they were six times more likely to develop upper GI bleeding than people who weren't taking either type of drug.

The combined use of SSRIs and NSAIDs may have a "synergistic effect" that greatly increases the risk of upper GI bleeding beyond the risk posed by each kind of drug alone, the study authors suggested.

"While the risk to an individual may increase by only a small amount, the impact to the general population is likely to be substantial because of the large numbers of people who use these drugs," Singh said.

He and his colleagues estimated that one of every 411 patients over age 50 taking an SSRI, and one out of 82 taking both an SSRI and a NSAID, is likely to develop upper GI bleeding requiring hospitalization.

More information
The American College of Gastroenterology has more about GI bleeding.

Tea Helps Toughen Older Women's Hips

(HealthDay News) -- New Australian research suggests that having a cuppa (tea, that is) may help strengthen older women's hips.

"This study suggests that drinking tea in moderation can actually benefit your bones," said lead researcher Amanda Devine, a senior lecturer in the nutrition program at the School of Exercise, Biomedical and Health Science, Edith Cowan University, and adjunct senior lecturer at the University of Western Australia's School of Medicine and Pharmacology, in Perth.

"Those who drank tea in the study had a higher bone density over the four years that they were studied," she said. "These women lost less bone than those who did not drink tea. More than three-quarters of the women drank tea daily, and they consumed on average about three cups per day."

Outside experts called the findings intriguing but still preliminary.

"Some tea may be potentially helpful," said Paul Brandt, an associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine. "One or two cups of tea a day probably couldn't hurt, but I wouldn't say that it absolutely will help. It's possible that it could prevent some loss."

Prior research has suggested that drinking tea may improve bone mineral density in people at risk for osteoporosis, but the findings are not conclusive. One study found that drinking green tea might help ease the inflammation and pain of rheumatoid arthritis.

Fractures, especially hip fractures associated with osteoporosis, are a major source of disability in postmenopausal women. Osteoporosis causes the bones to become fragile and more likely to break. Although it primarily affects older women, osteoporosis can affect others as well.

The new study, published in the American Journal of Clinical Nutrition, involved 1,500 elderly (70 to 85 years old) Australian women who participated in a five-year trial of the effect of calcium supplementation on osteoporotic hip fracture.

Information on tea consumption was collected at the beginning of the study for 275 participants, and all participants filled out a beverage consumption questionnaire at the end of the trial.
Bone mineral density at the hip was measured at years 1 and 5.

By the end of the study, bone mineral density at the hip was 2.8 percent greater in tea drinkers than in non-tea drinkers, the researchers found.

Over four years, tea drinkers lost an average of only 1.6 percent of their total hip bone mineral density, while non-tea drinkers lost 4 percent -- consistent with previous studies.

There was, however, no relationship between the amount of tea consumed and bone gains, which raises some questions about the mechanisms which might be responsible for the effect.

"We didn't see a dose-response to tea drinking -- that is, if you drank more tea, then your bones were even better," Devine said. "The lack of relationship may be due to the small numbers of tea drinkers in each group, once we started examining these data. When we just look at the whole group, we have more power to see a difference."

The authors speculated that certain components of tea, such as antioxidant flavonoids, might account for the benefit seen.

Flavonoids "have been shown to have a stimulatory effect on new cells that build bone in cell line studies," Devine explained. "Also, the weak estrogenic [effect] of phytoestrogens found in tea may be beneficial especially to older women whose levels of endogenous estrogen is low. Also, the addition of milk to tea will add calcium to the diet, which is also needed for healthy bones."

More information
There's more on bone loss at the National Osteoporosis Foundation.

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New Kidney Disease Can Be Fatal

(HealthDay News) -- Kidney disease patients with a newly identified disease called nephrogenic systemic fibrosis (NSF) are at increased risk of death, U.S. researchers report.

The researchers also concluded that exposure to gadolinium, a contrast agent used in MRI scans, is a significant risk factor for developing NSF, a painful and debilitating condition characterized by a thickening and hardening of the skin. It usually affects the arms and legs but can also affect internal organs. The disease can progress so rapidly that some patients are immobilized and confined to a wheelchair within weeks.

The study, led by Jonathan Kay of Massachusetts General Hospital in Boston, conducted skin examination of 186 kidney dialysis patients.

They found that 25 had skin changes consistent with NSF.

Within two years, 25 of the 186 patients (24 percent) had died. The death rate for those with NSF was 48 percent, compared to 20 percent for patients without the illness.

The researchers also found that 30 percent of patients exposed to gadolinium developed NSF compared to one percent of those who had not been exposed to the contrast agent.

The findings are published in the October issue of the journal Arthritis & Rheumatism.

This is the first study to examine the prevalence of NSF in dialysis patients and the first to quantify the association between NSF and gadolinium exposure. Contrast agents containing gadolinium should only be used with extreme caution in patients with chronic kidney disease, the researchers concluded. If they are exposed to gadolinium, these patients should subsequently receive regular skin examinations.

In an accompanying editorial, experts at Yale University School of Medicine noted that a U.S. federal Public Health Advisory urges caution in the use of MRI scans for kidney disease patients and prompt dialysis for those who've had scans involving gadolinium.

More information
The FDA has more about gadolinium-containing contrast agents.

Lyme Disease Relapse Often a New Infection

(HealthDay News) -- Many people who believe they're suffering a relapse of Lyme disease may actually have been bitten by another tick and have a second, completely new infection, a new study suggests.

"It is striking how often re-infection appears to occur," lead author Dr. Robert B. Nadelman, professor of medicine at New York Medical College, said in a prepared statement. "Our findings support clinical evidence that a surprising number of patients experience more than one episode of Lyme disease and that recurrent infections are unrelated to the original infection."

Lyme disease, which affects about 20,000 Americans a year, is caused by Borrelia burgdorferi, a bacterium that's transmitted to humans by deer ticks. About 95 percent of patients recover completely and quickly with two to three weeks of antibiotic treatment. Left untreated, the infection usually goes away within a month. However, untreated patients can relapse and/or develop late complications that affect the joints, heart, or nervous system, according to background information in a new release about the study.

Many patients who are diagnosed and successfully treated for Lyme disease develop the infection again, likely because they live in areas where deer ticks are common, the researchers said.

They analyzed B. burgdorferi genotypes from skin biopsies of 272 people diagnosed with Lyme diseases between 1991 and 2005. The team found that some of the patients had suffered separate Lyme disease-causing tick bites.

The findings "underscore the importance of preventing exposure to ticks, by covering exposed skin, using tick repellants, and performing self-examination for ticks on a regular basis during the tick season," Nadelman said.

The findings were to be reported Thursday at the annual meeting of the Infectious Diseases Society of America, in San Diego.

More information
The American Medical Association has more about Lyme disease.

Health Tip: Caffeine Facts

(HealthDay News) - Caffeine, the natural substance found in many foods and beverages including coffee, tea and chocolate, can cause symptoms that can vary widely from person to person.

This is known as "caffeine sensitivity," which refers to how much caffeine a person can consume before experiencing side effects.

Here are some common side effects of caffeine, courtesy of the U.S. National Library of Medicine:

• Rapid or increased heart rate.


• Frequent urination.


• Nausea and vomiting.


• Restlessness and insomnia.


• Anxiety and depression.


• Shakiness or tremors.

If you have any of the symptoms occurring regularly, you should check with your physician. Your caffeine tolerance may be less than you think.