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Thailand wins praise for AIDS vaccine trial


Thailand wins praise for AIDS vaccine trial

An experimental AIDS vaccine that appears to be the first to protect people was mired for years in controversy, and credit for its success must go to Thailand where the trial was conducted, experts said.

The trial was criticised five years ago by 22 prominent U.S. scientists who doubted it would have any effect. Washington was accused of wasting more than a $100 million by funding it.

But Thai health authorities and their U.S. partners at the National Institutes of Health and the Walter Reed Army Institute of Research pressed on with the trial involving 16,000 volunteers in a country at the forefront of the battle against HIV.

“It was a tough decision. I am glad we made it,” said Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, who defied the criticism and continued the trial.

The trial vaccine was made using two failed products — Sanofi-Pasteur’s ALVAC canary pox/HIV vaccine and AIDSVAX, made by a San Francisco company called VaxGen and now owned by the non-profit Global Solutions for Infectious Disease.

Donald Burke, dean of the University of Pittsburgh’s Graduate School of Public Health, said the trial was controversial from the start and had been dismissed by prominent U.S. scientists because of the failure of previous vaccine tests.

“But given the importance of the AIDS epidemic, the decision was made to go forward regardless of these criticisms. It was a difficult choice, but a courageous choice,” said Burke, who was head of AIDS research at Walter Reed before retiring in 1997.

Burke isolated the AIDS virus taken from a young HIV-infected Thai soldier in 1989 after Thai army doctors discovered an HIV outbreak among young recruits in Chiang Mai in northern Thailand. That virus sample went on to become one of the seed viruses in the experimental vaccine, Burke said.

To their credit the Thais did a remarkable job on this,” Dr. Eric Schoomaker, the Surgeon General of the U.S. Army, told reporters. “They did remarkable job of recruiting volunteers and conducting this trial almost flawlessly.”

The $105 million trial was sponsored and paid for by the U.S. government and results showed it cut the risk of infection by 31.2 percent among 16,402 volunteers over three years.


Those results mark a triumph for Thailand, a country of 67 million people where a booming sex industry had stoked fears of a major epidemic. Local authorities battled hard against a disease that threatened to spiral out of control some 20 years ago.

Experts had predicted that 4 million people would be infected by 2000 if nothing was done to slow the spread of HIV. But a massive government-led Aids education and prevention campaign in the early 1990s had an enormous effect.

HIV prevalence among injecting drug users in Thailand was as high as 30-50 percent in 1991, and 33.2 percent among female sex workers in 1994, according to UNAIDS. The number of infections has since been reduced to 20,000 annually from 140,000 in 1991.

Billboards and airwaves were bombarded with safe sex messages while health workers promoted condom use in the country’s notorious sex trade. Leading the campaign was “Mr Condom,” family planner-turned Public Health Minister, Meechai Viravaidya.

Health check-ups were made available to sex workers for free. Men were discouraged from visiting prostitutes and condom usage in Bangkok’s brothels rose from 15 percent in the early 1990s to 98 percent by 2000.

Infection rates fell and the exercise remains widely cited as a model in disease prevention among health experts — although numbers have shown signs of creeping up in the last few years among some high risk groups, such as gay and bisexual men.

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Exercising for Weight Loss (Sex Health Guru)

Running at the fitness club

Exercising for Weight Loss (Sex Health Guru)

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Physical exercise is any bodily activity that enhances or maintains physical fitness and overall health. It is performed for many different reasons. These include strengthening muscles and the cardiovascular system, honing athletic skills, weight loss or maintenance and for enjoyment. Frequent and regular physical exercise boosts the immune system, and helps prevent the “diseases of affluence” such as heart disease, cardiovascular disease, Type 2 diabetes and obesity. It also improves mental health and helps prevent depression. Childhood obesity is a growing global concern and physical exercise may help decrease the effects of childhood obesity in developed countries.

Types of exercise

Exercises are generally grouped into three types depending on the overall effect they have on the human body:

Flexibility exercises, such as stretching, improve the range of motion of muscles and joints.

Aerobic exercises, such as cycling, swimming, walking, rowing, running, hiking or playing tennis, focus on increasing cardiovascular endurance.

Anaerobic exercises, such as weight training, functional training or sprinting, increase short-term muscle strength.

Categories of physical exercise

Aerobic exercise

Anaerobic exercise

Strength training

Agility training

Sometimes the terms ‘dynamic’ and ‘static’ are used. ‘Dynamic’ exercises such as steady running, tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly (during the exercise).

Exercise benefits

thumb|right|200px|A common [[elliptical trainer|elliptical training machine.]] Physical exercise is important for maintaining physical fitness and can contribute positively to maintaining a healthy weight, building and maintaining healthy bone density, muscle strength, and joint mobility, promoting physiological well-being, reducing surgical risks, and strengthening the immune system.

Exercise also reduces levels of cortisol, thereby benefiting health. Cortisol is a stress hormone that builds fat in the abdominal region, making weight loss difficult. Cortisol causes many health problems, both physical and mental.

Frequent and regular aerobic exercise has been shown to help prevent or treat serious and life-threatening chronic conditions such as high blood pressure, obesity, heart disease, Type 2 diabetes, insomnia, and depression. Strength training appears to have continuous energy-burning effects that persist for about 24 hours after the training, though they do not offer the same cardiovascular benefits as aerobic exercises do.

Effect on the immune system

Although there have been hundreds of studies on exercise and the immune system, there is little direct evidence on its connection to illness. Epidemiological evidence suggests that moderate exercise appears to have a beneficial effect on the human immune system while extreme exercise appears to impair it, an effect which is modeled in a J curve. Moderate exercise has been associated with a 29% decreased incidence of upper respiratory tract infections (URTI), but studies of marathon runners found that their prolonged high-intensity exercise was associated with an increased risk of an infection, although another study did not find the effect. Immune cell functions are impaired following acute sessions of prolonged, high-intensity exercise, and some studies have found that athletes are at a higher risk for infections. The immune systems of athletes anf nonathletes are generally similar. Athletes may have slightly elevated NK cell count and cytolytic action, but these are unlikely to be clinically significant.

Supplementation with the antioxidants vitamin C and E has been found to decrease the release of interleukin-6 (IL-6), which would be expected to decrease the depression of the immune system. Further, vitamin C supplementation has been associated with lower URTIs in marathon runners. However, the decreased release of IL-6 limits the anti-inflammatory effect of exercse and could limit the positive adaptation effects of exercise.

Biomarkers of inflammation such as C-reactive protein, which are associated with chronic diseases, are reduced in active individuals relative to sedentary individuals, and the positive effects of exercise may be due to its anti-inflammatory effects. The depression in the immune system following acute bouts of exercise may be one of the mechanisms for this anti-inflammatory effect.


Active exhalation during physical exercise helps the body to increase its maximum lung capacity. This results in greater efficiency, since the heart has to do less work to oxygenate the muscles, and there is also increased muscular efficiency through greater blood flow. Consciously breathing deeply during aerobic exercise helps this development of the heart and lungs.

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