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According to the latest research, the AIDS virus invaded the United States from Haiti, sometime around 1969, it then flourished and spread worldwide.

Scientists say it was probably brought into the country by a single infected immigrant, setting the stage for it to become the tragic epidemic which has since swept across the world.

Michael Worobey, who is based at the University of Arizona (UA) says the 1969 U.S. entry date is earlier than some experts had suggested and is the first human immunodeficiency virus discovered.

The HIV-1 group M subtype B, is the dominant strain of the AIDS virus in most countries outside sub-Saharan Africa and almost all the viruses are descendants of the one that emerged from Haiti.

A study by the assistant professor of ecology & evolutionary biology suggests that HIV infections were occurring in the United States for about 12 years before AIDS was first recognized by scientists as a disease in 1981 and by then many had died.

Worobey and his colleagues carried out a genetic analysis of stored blood samples from early AIDS patients in order to determine when the human immunodeficiency virus first entered the United States.

They discovered that HIV was brought to Haiti by an infected person from central Africa in about 1966, which ties in with earlier estimates; it then came to the United States in about 1969.

The researchers suspect the culprit was an unknown single infected Haitian immigrant who arrived in a large city such as Miami or New York; the virus circulated for years, initially in the U.S. population and then to other nations.

Experts say it can be several years after infection before a person develops AIDS.

Worobey says that single infection would have become two and then doubled again until over a number of years as a hundred or more were infected.

Worobey says from then on it multiplied until hundreds of thousands were infected before AIDS was recognized in the early 1980s.

The route the virus traversed as it spread from nation to nation has always been a topic for debate and Dr. Arthur Pitchenik, a co-author of the study says that as early as 1979 Haitian immigrants in Miami, who died from a mystery illness, had AIDS.

Worobey and his colleagues analyzed samples of archived blood samples from five of these Haitian immigrants dating from 1982 and 1983 and also looked at genetic data from 117 earlier AIDS patients from around the world in order to construct genetic family trees for HIV.

In this way the scientists were able to calibrate the molecular clock of the strain of HIV that has spread most widely, and calculate when it arrived first in Haiti from Africa and then the United States.

The researchers believe there is a 99.8 percent probability that Haiti was the steppingstone for the virus to enter America.

Other studies have suggested the virus first entered the human population in about 1930 in central Africa, possibly as a result of people slaughtering infected chimpanzees for meat.

The research is the first to definitively pinpoint when and from where HIV-1 entered the United States and shows that most HIV/AIDS viruses in the U.S. descended from a single common ancestor.

To date AIDS has killed more than 25 million people and about 40 million others are infected with HIV.

Worobey says the next step is to follow the trail of HIV even further back in time using older archival samples.

The research, 'The emergence of HIV/AIDS in the Americas and beyond,' is published in the Proceedings of the National Academy of Sciences.

The Food and Drug Administration (FDA) in the U.S. has given approval for a new drug to treat chronic myeloid leukemia (CML).

The drug Tasigna (nilotinib), made by Novartis, will be used with patients who are resistant or intolerant to other therapies.

CML is one of the most common forms of leukemia and almost 5,000 people each year are diagnosed with the disease in the U.S. alone.

Some of these sufferers have become resistant to or cannot tolerate the standard therapy for CML, which is Glivec (imatinib).

Novartis says Tasigna, which is taken twice daily, targets a protein that is produced only by cells that have an abnormal chromosome in people with Philadelphia chromosome-positive CML.

The protein is a key cause of the over-production of the white blood cells that characterizes this form of CML.

Novartis says side effects of Tasigna which include rash, nausea, fatigue, headache, constipation, diarrhea, and vomiting, have been reported with the drug and users are advised to avoid food two hours before and one hour after taking it.

The European Union is also expected to approve Tasigna by the end of the year; the drug is already approved in Switzerland and applied for approval in Japan in June.

Tasigna will compete against Bristol-Myers Squibb 'Sprycel' and could replace Glivec in some situations.

The American Academy of Pediatrics says children should be screened for the disorder twice before the age of two, as early intervention can lessen the severity of the symptoms.

Autism is a complex developmental disorder and the causes remain a puzzle and a controversial issue.

Autism causes problems with social interaction and communication and symptoms range from mild awkwardness to severe disability and mental retardation; delays in the development of communication skills are often are an early warning sign.

According to the U.S. Centers for Disease Control and Prevention (CDC) as many as one in every 150 U.S. children has autism or an autism spectrum disorder, such as Asperger's syndrome.

In two separate reports published this week experts advise parents to watch for symptoms such as babies four month old who do not smile at the sound of a parents' voice, do not babble or point or make other gestures by 12 months, use no single words by 16 months, no two-word phrases by 24 months and show a regression or loss of language or social skills at any age.

Dr. Scott Myers, a pediatrician and specialist in neurodevelopment was involved in the two clinical reports designed to help pediatricians identify and manage autism and he says children who start treatment earlier do better in the long term.

The pediatricians recommend early treatment of at least 25 hours of intensive behavior-based therapy each week throughout the year which includes education-based and fun activities in order to improve a child's chances for effective treatment.

They also suggest pediatricians familiarize themselves with and consider alternative and complementary approaches to treatment.

Dr. Cynthia Johnson, director of the Autism Center at the Children's Hospital Pittsburgh says pediatricians need to be aware of the alternatives in order to help parents make treatment decisions based on scientific evidence.

Dr. Johnson says if families feel dismissed by their doctor, they may not disclose all the treatments they are trying.

The pediatricians also say that not all children with potential symptoms will be suffering from autism and parents should not overreact.

Both reports emphasise the need for pediatricians and parents to understand which issues they need to be concerned about.

The experts say if autism is suspected parents should not wait for a specialist to confirm the diagnosis before seeking treatment for the specific symptoms.

These are the second renewed guidelines issued by the academy as a result of increased awareness from their earlier efforts in 2001.

In 2006 they called for autism screening during regular doctor visits for all children at the age of 18 months and 24 months.

The guidelines are published in the journal Pediatrics and on the group's Web site at http://www.aap.org.

Thresholds limiting bariatric surgeries to high-volume centers disproportionately restrict access for poor and underinsured patients, populations which are among the most in need of them, an analysis led by UT Southwestern Medical Center researchers shows.

Government-imposed restrictions currently mandate a 125-case annual threshold for facilities permitted to perform bariatric surgeries under Medicare and Medicaid because some studies have identified better outcomes for centers performing large volumes of bariatric surgeries. But most bariatric surgeries for the poor - about 60 percent - are performed in low-volume centers.

"Restricting surgeries to high-volume centers has the effect of limiting bariatric surgery as an option for many poor and underinsured who rely on Medicare and Medicaid," said Dr. Edward Livingston, senior author of the study appearing in the October edition of Archives of Surgery. "This is a population that stands to gain the most from bariatric surgery."

Dr. Livingston is chairman of gastrointestinal and endocrine surgery at UT Southwestern and chairman of the Veteran's Administration Central Office Bariatric Surgery Work Group.

Nearly three quarters of hospitals offering bariatric surgery are considered low-volume facilities under the 125-case threshold, thereby leaving few centers available for impoverished populations.

Yet low-income patients, particularly those in rural areas, may not be able to travel to the limited number of high-volume centers due to costs such as gas, access to public transportation or personal vehicles, or health matters that limit their travel, Dr. Livingston said.

Such restrictions further limit medical expertise for morbidly obese patients by reducing the number of hospitals well-equipped and properly staffed to handle the special needs of these cases.  "Regionalization results in the global reduction of experience in managing obese patients at a time when obesity is rapidly increasing in the population," the study notes.

Researchers led by Dr. Livingston reviewed 51,000 records involving weight-loss surgeries carried out in nearly 750 U.S. hospitals over a three-year span (2001-2003).

Researchers found that statistical sampling methods used in the handful of studies favoring high-volume centers skewed results by amplifying a small number of excess deaths in very low-volume facilities. Databases used in the studies typically had sparse information on individual patients' backgrounds. Accounting for the specific health risks of patients, however, often eliminates the advantages seen for high-volume centers, the analysis showed.

Low-volume centers tend to accept higher-risk patients, while high-volume centers gravitate toward more lower-risk patients, the researchers found. In either case, the overall risk was small, as the survival rate at low-income centers was 99.66 percent.

"Restricting cases to high-volume centers isn't going to have a profound effect in limiting the number of deaths, but would have a profound effect in limiting accessibility to bariatric surgery," Dr. Livingston said. "More likely, the surgeon's cumulative experience and access to multidisciplinary teams of doctors available before, during and after surgery result in better outcomes."

Rather than limiting procedures to high-volume centers, bariatric programs should be judged by risk-adjusted outcomes, such as the National Surgical Quality Improvement Program, he said.

That's important because studies indicate that non-surgical therapies for morbidly obese patients are uniformly unsuccessful for sustained weight loss. In addition, despite increasing numbers of bariatric surgeries performed, they are still dwarfed by the eligible population. The Centers for Disease Control and Prevention estimates that nearly one-third of adult Americans - more than 60 million people - are obese, with nearly 5 percent of adults classified as extremely obese.

Bariatric surgeries, which are usually reserved for those more than 100 pounds overweight, can help not only with weight, but related health problems. Obese adults are at increased risk of diabetes, hypertension, stroke and even some cancers.

Weight-loss surgeries have become more common as obesity has increased, with more than 140,000 gastric bypass procedures now performed in the U.S. annually.

UT Southwestern's Center for Minimally Invasive Surgery is one of only seven facilities in North America, and the only one in Texas, to be accredited by the American College of Surgeons. It has been named a Bariatric Surgery Center of Excellence by the American Society for Bariatric Surgery.

Surgeons at UT Southwestern performed the first laparoscopic gastric bypass surgery in Texas in 1999 and were the first in the Dallas area approved to perform the Lap Band procedure in 2001. UT Southwestern's bariatric specialists have performed approximately 4,000 procedures and have trained more than 100 surgeons from across the U.S.

Other UT Southwestern researchers involved in the study were Dr. Linda Hynan, associate professor of clinical sciences, and Alan Elliott faculty associate in clinical sciences. Scientists from the University of California, Los Angeles' department of biomathematics also contributed.

http://www.utsouthwestern.edu

Results soon to be published in the International Journal of Obesity reveal that overweight and underweight perception rather than weight status or weight misperception are significant risk factors associated with medium and high psychological distress in Australian men and women.

Investigators, Dr Evan Atlantis from The University of Sydney's Faculty of Health Science along with a senior research scientist from Deakin University, analysed data obtained from the Australian National Health Survey 2004-5 to determine whether weight status and weight perceptions are independently associated with psychological distress.

They found that individuals with overweight or underweight perceptions have an increased chance of experiencing medium (40 per cent and 50 per cent, respectively) and high levels of psychological distress (50 per cent and 120 per cent, respectively), whereas weight status and weight misperception (i.e., incorrect with weight status) are not associated with psychological distress when accounting for weight perceptions.

Dr Atlantis concludes that "weight perceptions that deviate from societal 'ideals' are more closely and consistently associated with psychological distress than actual weight status, regardless of weight misperception".

"If unhealthy weight perceptions are subsequently found to cause psychological distress or worse, depression, then we'll need to determine whether social stigma, discrimination, and slim body image marketing trigger feelings of depression amongst those whom recognize that their weight status does not conform to a societal ideal", he said.

"Clearly both obesity and underweight are hazardous to health, increasing the risk of premature death, for example, but our findings suggest that public health initiatives targeting psychological distress at the population level may need to promote healthy attitudes towards body weight and self-acceptance, regardless of weight status", he said.

http://www.usyd.edu.au/