Failed IVF attempt tied to depression, anxiety

Reuters – 1 hr 40 mins ago NEW YORK (Reuters Health) - Women who are stressed and anxious before in vitro fertilization (IVF) are no less likely to have a baby, new research suggests. But if the treatment fails, it may take a toll on their mental health.

In two separate studies in the journal Fertility and Sterility, researchers found women with anxiety or depression symptoms were just as likely as others to become pregnant.

One study focused on women undergoing IVF and the other followed women trying to conceive naturally.

"Our findings are consistent with the most recent research," said Lauri A. Pasch, a clinical psychologist at the University of California, San Francisco Center for Reproductive Health, and the lead researcher on the IVF study.

Based on that body of research, she told Reuters Health, "I think we can safely say to women,

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From a Failed Vaccine, New Insights Into Fighting HIV

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- A new study offers insight into why an HIV vaccine failed to protect most people who received it, but it also points to promising new targets for future vaccine efforts.

Scientists believe an HIV vaccine, designed to prevent infection with the virus that causes AIDS, is still several years away. Tests of experimental vaccines have largely been failures so far.

Nevertheless, the prospect of a vaccine remains tantalizing because it could make a major dent in the spread of HIV and AIDS around the world.

The new research "gives us a handle on how the immune system deals with the virus and is affected by a vaccine," said study lead author Dr. Barton Haynes, director at the Duke Human Vaccine Institute at Duke University in Durham, N.C. "It gives us clues and a firm direction to look into."

The study is based on work by more than 100 scientists from 25 institutions, and appears in the April 5 issue of the New England Journal of Medicine.

Haynes and his colleagues examined the results of a 2009 study of an HIV vaccine in Thailand. In a trial involving more than 16,000 people, the vaccine appeared to cut the risk of infection by only 31 percent. That was still considered a major advance over previous vaccines that didn't work at all, Haynes noted.

The vaccine, called RV144, wasn't ready for prime time because it didn't protect enough people, Haynes said. "You want to get it above 50 percent," he said, and some scientists believe the rate should be even higher than that.

Despite the vaccine's failure, the authors of the new study were able to use the data to learn more about how the immune system deals with HIV and how the vaccine changes the "big picture" of the body's response to the virus.

The new research is an "exhaustive molecular analysis," said Dr. Lindsey Baden, an associate professor of medicine in the infectious disease division at Brigham and Women's Hospital in Boston who co-wrote a commentary accompanying the study.

Haynes said one surprising finding is about an antibody -- a soldier of the immune system -- that helps protect against influenza infection. Ironically, the antibody appears to boost the likelihood of HIV infection, he said.

Another finding was that higher levels of antibodies that home in on a particular region of HIV's outer shell, called V1V2, were associated with lower rates of infection with the virus.

This and other information in the study may help researchers come up with theories about where to go next with vaccine development, Baden said. Among other things, it can reveal parts of the immune system that can be most useful in battling the transmission of HIV.

Vaccines are available to fight other kinds of viruses, such as measles and influenza. HIV is unique, however, because it inserts its genetic material into the body's cells.

"When a person gets infected with HIV, that genetic material goes underground," Haynes said. "It's invisible to the body's immune system."

Another challenge is that the virus mutates, becoming a moving target.

"It changes so rapidly in the person who gets infected that even when the immune system does try to control it, in most people the immune system is always playing catch up," Haynes said.

More information

There's more on HIV/AIDS at the U.S. National Library of Medicine.

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From a Failed Vaccine, New Insights Into Fighting HIV

HealthDay – 2 hrs 26 mins ago WEDNESDAY, April 4 (HealthDay News) -- A new study offers insight into why an HIV vaccine failed to protect most people who received it, but it also points to promising new targets for future vaccine efforts.

Scientists believe an HIV vaccine, designed to prevent infection with the virus that causes AIDS, is still several years away. Tests of experimental vaccines have largely been failures so far.

Nevertheless, the prospect of a vaccine remains tantalizing because it could make a major dent in the spread of HIV and AIDS around the world.

The new research "gives us a handle on how the immune system deals with the virus and is affected by a vaccine," said study lead author Dr. Barton Haynes, director at the Duke Human Vaccine Institute at Duke University in Durham, N.C. "It gives us clues and a firm direction to look into."

The study is based on work by more than 100 scientists from 25 institutions, and appears in the April 5 issue of the New England Journal of Medicine.

Haynes and his colleagues examined the results of a 2009 study of an HIV vaccine in Thailand. In a trial involving more than 16,000 people, the vaccine appeared to cut the risk of infection by only 31 percent. That was still considered a major advance over previous vaccines that didn't work at all, Haynes noted.

The vaccine, called RV144, wasn't ready for prime time because it didn't protect enough people, Haynes said. "You want to get it above 50 percent," he said, and some scientists believe the rate should be even higher than that.

Despite the vaccine's failure, the authors of the new study were able to use the data to learn more about how the immune system deals with HIV and how the vaccine changes the "big picture" of the body's response to the virus.

The new research is an "exhaustive molecular analysis," said Dr. Lindsey Baden, an associate professor of medicine in the infectious disease division at Brigham and Women's Hospital in Boston who co-wrote a commentary accompanying the study.

Haynes said one surprising finding is about an antibody -- a soldier of the immune system -- that helps protect against influenza infection. Ironically, the antibody appears to boost the likelihood of HIV infection, he said.

Another finding was that higher levels of antibodies that home in on a particular region of HIV's outer shell, called V1V2, were associated with lower rates of infection with the virus.

This and other information in the study may help researchers come up with theories about where to go next with vaccine development, Baden said. Among other things, it can reveal parts of the immune system that can be most useful in battling the transmission of HIV.

Vaccines are available to fight other kinds of viruses, such as measles and influenza. HIV is unique, however, because it inserts its genetic material into the body's cells.

"When a person gets infected with HIV, that genetic material goes underground," Haynes said. "It's invisible to the body's immune system."

Another challenge is that the virus mutates, becoming a moving target.

"It changes so rapidly in the person who gets infected that even when the immune system does try to control it, in most people the immune system is always playing catch up," Haynes said.

More information

There's more on HIV/AIDS at the U.S. National Library of Medicine.

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Stem-Cell Trial Failed to Treat Heart Failure

HealthDay – 15 hrs ago SATURDAY, March 24 (HealthDay News) -- An innovative approach using patients' own bone marrow cells to treat chronic heart failure came up short in terms of effectiveness, researchers report.

Use of stem cell therapy to repair the slow, steady damage done to heart muscle and improve heart function is safe, but has not been shown to improve most measures of heart function, the study authors said.

"For the measures we paid most attention to, we saw no effect, there is no question about that," said researcher Dr. Lemuel Moye, a professor of biostatistics at the University of Texas School of Public Health in Houston.

"Ultimately, this is going to pay off handsomely for individuals and for public health in general, but it's going to take years of work," Moye said. "We are the vanguard looking for new promising lines of research."

While the hoped-for results didn't materialize, there appeared to be a small improvement in some patients, he said. "When we looked at another commonly used measure of heart function called ejection fraction, or the strength of the heart's pumping, that's where all the action was," Moye noted.

It's hard to know which measures of heart function to look at, Moye explained. "We have had some difficulty with that," he said.

Future research will look at other measures of heart function, pay more attention to the characteristics of the cells that are injected and determine which cells are best, he added.

Cardiac cells and other types of specially prepared cells are available now that were not accessible when this study started in 2009, Moye pointed out.

The results of the trial, which was sponsored by the U.S. National Heart, Lung, and Blood Institute, were to be presented Saturday at the American College of Cardiology's annual meeting in Chicago. The report was also published online March 24 in the Journal of the American Medical Association.

For the study, Moye and colleagues worked with 92 patients, average age 63 and mostly male, who had heart failure with and without chest pain. They were randomly assigned to receive either an injection of 100 million bone marrow cells from their own bone marrow, or an inactive placebo. Patients in both groups also received aggressive medical therapy.

During the trial, the researchers looked for improvements in blood volume in the heart, oxygen use by the heart and blood flow through the heart.

After six months, the researchers said they saw no difference between the groups in these measures. Nor was any difference seen in the extent of heart damage, heart movement during contractions or overall condition.

Moye's team did find a slight improvement in the heart's ability to pump blood among patients 62 and younger. The improvement was small, only 3.1 percent, but patients in the placebo group declined 1.6 percent in this measure, they said.

It's possible that cells of younger people are more potent, and that's borne out by improvement in heart function seen in younger patients who did not get bone marrow cells, Moye said.

"We have demonstrated that the characteristics of the cells are correlated with heart function, so that the better the cells, the better the response -- so even in patients who did not get stem cells, those younger patients did better," he said.

Commenting on the study, Dr. Gregg Fonarow, director of the Ahmanson-University of California, Los Angeles, Cardiomyopathy Center, said there has been "tremendous interest in cell-based therapies" to treat acute and chronic heart disease and chronic heart failure.

Most studies trying delivery of different types of cells have been small and not adequately powered to demonstrate improvement in cardiac function or clinical outcomes, and results have been mixed, Fonarow said.

"While this study failed to meet any of its primary or secondary endpoints, the insights provided will be helpful in designing future trials," Fonarow added. "However, whether cell-based therapies will be of therapeutic value to patients with heart disease and heart failure remains to be seen."

More information

For more information on heart disease, visit the American Heart Association.

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