A modest increase in unprotected sex is enough to erode the benefits of other interventions, researchers said

A fall in the proportion of gay and bisexual men using condoms is behind the rise in HIV infections in those groups in the UK, say researchers.

Wider use of anti-retroviral drugs has helped to stop a sharper rise, a study by the Health Protection Agency (HPA) and a number of universities found.

They found a 26% rise, from 1990-2010, in the proportion of men who have sex with men who did not use condoms.

The report said the figures showed it was vital to promote safe sex.

Rates of HIV have been rising in recent years with latest figures showing cases among men who have sex with men (MSM) in the UK reaching an all-time high.

A recent report from the HPA found that nearly half of the 6,280 people diagnosed in the UK in 2011 were MSM.

Overall, one in 20 MSM are infected with HIV.

For this study, researchers analysed data from 1990 to 2010. They concluded that, without the introduction of anti-retroviral drugs to treat those with HIV, infections would be 68% higher in MSM.

Therapy with anti-retrovirals lowers the risk of people with HIV infecting others.

The report suggested the incidence of HIV could be 32% lower if all anti-retroviral treatment were prescribed from the moment of diagnosis rather than when health declined.
Informed choices

Further analysis showed that, if all MSM had stopped using condoms from 2000, rates of HIV in this group would now be 400% higher, the journal PLoS One reported.

The data also showed that the incidence of HIV could have dropped by a quarter if more HIV testing had been done.

But the researchers said the results showed that even a modest increase in unprotected sex was enough to erode the benefits of other interventions.

Study leader Professor Andrew Phillips, from University College London, said: "By better understanding the driving forces behind the trends we've seen in the past, it will allow us to make informed choices to reduce new HIV infections in the future."

Co-author Dr Valerie Delpech, who is head of HIV surveillance at the HPA, said: "Everyone should use a condom when having sex with new or casual partners, until all partners have had a sexual health screen.

"We also encourage men who have sex with men to get an HIV and STI screen at least annually, and every three months if having condomless sex with new or casual partners - and clinicians to take every opportunity to recommend HIV testing to this group."

Sir Nick Partridge, chief executive of the Terrence Higgins Trust, said condom use by gay men had played a key part in containing the spread of HIV in the UK.

"Without it, there would have been 80,000 more gay men with HIV between 2000 and 2010."

He added that the study showed the impact of the combined HIV strategy of promoting condoms, increasing regular HIV testing and encouraging the earlier use of anti-HIV drug therapy.

He added: "At a time when funding for local HIV prevention programmes is under threat, this only reinforces the important role which local authorities can and must play in funding local HIV prevention."

When people lose hope that they will ever get another good night`s sleep, they become at high risk for suicide, according to researchers.

Insomnia and nightmares, which are often confused and may go hand-in-hand, are known risk factors for suicide but just how they contribute was unknown, said Dr. W. Vaughn McCall, Chair of the Medical College of Georgia Department of Psychiatry and Health Behavior at Georgia Regents University.

The new study reaffirms that link and adds the element of hopelessness about sleep that is independent of other types of hopelessness, such as those regarding personal relationships and careers, said McCall, corresponding author of the study.

"It turns out insomnia can lead to a very specific type of hopelessness and hopelessness by itself is a powerful predictor of suicide," he said.

If the findings hold true in larger studies, they wave a red flag about suicide risk and point toward prevention that targets the negative thoughts with pharmaceuticals and psychological intervention.

The finding also is a reminder to physicians that depressed patients who report increased sleep problems should be asked if they are having suicidal thoughts, McCall said.

The scientists used psychometric testing to objectively assess the mental state of 50 depressed patients age 20-80 being treated as an inpatient, outpatient or in the Emergency Department. More than half had attempted suicide and most were taking an anti-depressant. Testing enabled the researchers to filter out other suicide risks such as depression itself and hone in on the relationship between insomnia and suicide risk, asking specific questions about dysfunctional beliefs about sleep such as: Do you think you will ever sleep again?
"It was this dysfunctional thinking, all these negative thoughts about sleep that was the mediating factor that explained why insomnia was linked to suicide," said McCall, who specializes in depression and sleep disorders.

The likelihood of being suicidal at least doubles with insomnia as a symptom, McCall noted.

The finding appeared in Journal of Clinical Sleep Medicine , the journal of the American Academy of Sleep Medicine.

Birth order may raise the risk of first-born children developing diabetes or high blood pressure, a study has claimed.

It found that first-born children have greater difficulty absorbing sugars into the body and have higher daytime blood pressure than children who have older siblings.

The study conducted at the University of Auckland's Liggins Institute in New Zealand, measured fasting lipid and hormonal profiles, height, weight and body composition in 85 healthy kids between the ages of 4 and 11.
The 32 first-born children, who participated in the study had a 21 percent reduction in insulin sensitivity and a 4 mmHg increase in blood pressure.

The study found that the oldest and only children tended to be taller and slimmer than their later-born counterparts, even after the height and body mass index of their parents was taken into account.

The metabolic differences in younger siblings could be caused by physical changes in the mother's uterus during her first pregnancy. As a result of the changes, nutrient flow to the foetus tends to increase during subsequent pregnancies.

For this study, researchers focused on kids as puberty and adult lifestyle could affect insulin sensitivity.

The study will be published in The Endocrine Society's Journal of Clinical Endocrinology and Metabolism (JCEM).

Consistent physical activity and healthier lifestyle changes beginning in a woman`s first trimester can prevent excessive weight gain in obese pregnant women, helping to avoid preterm delivery, hypertension and gestational diabetes, suggests a new study.

This randomized study may help physicians understand why it is important to offer more specific advice to obese women who are pregnant regarding the amount of weight they should gain during their pregnancy.

"Weight gain should be monitored related closely to the starting weight. If you start with normal BMI [defined by weight before pregnancy divided by height measured in squared meters] could increase 11-16 kilograms. But if you are obese, the expectation is that you should only gain 5-9 kilos-more or less just the weight of the pregnancy" said Dr. Fabio Facchinetti, referencing the Institute of Medicine (IOM) in the United States.

Researchers from the University of Modena and Reggio Emilia`s mother-infant department teamed up with their colleagues in the clinical diagnostic medicine and public health department to create a Therapeutic Lifestyle Changes (TLC) Program.

The 33 women in the treatment group followed a regimen of 1500 kcal/day diet coupled with mild physical activity (30 minutes/day, 3 times/week). Twenty-eight women in the control group just received general advice from their OB/GYN. They only worked with single pregnancies and treatment began at 12 weeks.

Their research shows that of the obese subgroup of women [those in TLC group with BMI less than 30] who stuck with a proper diet and exercise, 77.8 percent were able to stay within the allotted weight gain limit, as opposed to only 30 percent from the control group. Additionally, the rate of, hypertension, preterm delivery and gestational diabetes was significantly lower in the TLC group.

"The diagnosis of gestational diabetes is done [by having the women drink] 75 grams of glucose and looking at the levels after one and two hours," said Facchinetti.

"In our study, we found [after monitoring the glucose levels] that 57 percent of obese women in the non-treatment group had diabetes whereas in the treatment group, it was only 21 percent. This is important because [the glucose test] was done at 16-18 weeks and, even if negative, repeated at 24 weeks. In other words, if the first evaluation occurred just 12 weeks after the treatment began, the small amount of time was enough to correct the body`s level of glucose," he added.

The study will be presented on February 15 at the Society for Maternal-Fetal Medicine`s annual meeting, The Pregnancy Meeting, in San Francisco.

It may be possible to use a patient's own skin to repair the damage caused by multiple sclerosis (MS), which is currently incurable, say researchers.

Nerves struggle to communicate in MS as their insulating covering is attacked by the immune system - causing fatigue and damaging movement.

Animal tests, described in the journal Cell Stem Cell, have now used modified skin cells to repair the insulation.

Experts said there was an "urgent need" for such therapies.

Just like electrical wires, nerves have insulation - but instead of plastic, the body uses a protein called myelin.

However, diseases that result in damage to the myelin, including MS, leave the nerves exposed and electrical signals struggle to travel round the body.
Stem cells

A team of scientists at the University of Rochester Medical Center, in the US, used advances in stem-cell research to attempt to repair the myelin.

They took a sample of human skin cells and converted it into stem cells, which are capable of becoming any other type of cell in the body.

The next step was to transform the stem cells into immature versions of cells in the brain that produce myelin.

When these cells had been injected into mice born without any myelin it had had a significant effect, said researchers.

Dr Steven Goldman told the BBC that "myelin was produced throughout the nervous system" and some mice had achieved "normal life spans".

He said: "In MS the underlying nerves fibres are still there, the objective is to re-myelinate them."

However, MS patients would still have the problem of their immune system attacking their myelin.

Any treatment would need to be used alongside other therapies to tame the immune system - or would need to be repeatedly performed.

Dr Goldman said he could see "no reason to be pessimistic" although further safety tests would be needed and the technique still needed to be refined before being used in people. He expects to begin trials within a couple of years.

Dr Emma Gray, from the MS Society, said: "Myelin repair therapies are urgently needed in MS and we're pleased to see researchers have been able to generate myelin making cells from human stem cells.

"This is still very early stage research, but with more development could one day be used to repair damage to myelin in people with MS. We look forward to seeing more research in this promising area."