It's been a while since I last posted--holiday parties, you know, and the stupor that usually follows. But some news that's being widely reported today jolted me right out of that. Newspapers everywhere are saying that doing housework can reduce a woman's chance of breast cancer more than playing sports or jogging or whatever. Housework! If you could see me now, you'd know I was spluttering.

What really gets me is that none of the articles I read looked beyond the basics to ask whether the study might be flawed in some way. Only one pointed out that the number of women who were doing job-related activities might have been too low to show a decrease in breast cancer risk. I know being retro is in right now, but surely this kind of study should raise at least some eyebrows--and some hard-hitting questions about the methodology?

Call me paranoid, but this sounds to me like an awfully convenient study for men: "I would mop the floor, honey, but you know how you need it for your health." Please!

The researchers are speculating that the moderate level of activity doing housework could be more useful than the bursts women experience with more vigorous exercise. Apparently, the women who showed this benefit did at least 16-17 hours a week of housework.

Well, that probably explains it then: the poor things were probably so busy cooking and cleaning that they never got a chance to go out and drink alcohol, eat unhealthy or skip going to the gym because that new Daniel Craig movie opened and they just had to see it. Seems to me that being a hardworking housewife may go along with some other good habits that just might explain the extra benefit.

Posted by Apoorva Mandavilli at 10:44 AM | Permalink | Comments (3)

The big news last week was that breast cancer rates are down. Apparently, after years of a steady climb, diagnoses of breast cancer went down by 7% in 2003. That's great news, undoubtedly.

The papers have been making much of the fact that the dip is probably a result of women turning away from hormone replacement after a 2002 study linked the therapy to breast cancer. But there's a lot more to this story. Yes, hormone replacement can be harmful--but only in women who take the hormones more than a decade after hitting menopause. In fact, as I reported last year, scientists say estrogen is good for women between the ages of 50 and 59 or those who've recently gone through menopause, and only increases breast cancer risk in older women.

That's complicated--but isn't that what these articles should do? Parse out the complicated news for their readers? Sadly, the results of the original study were so grossly misreported that it triggered panic among women, many of whom stopped taking hormones even when they needn't have. The fact is that, apart from these hormones, there are no effective remedies for menopause symptoms. Case in point, a year-long study released today showed that the popular herbal supplement black cohosh did not relieve hot flashes and night sweats.

You know what did? Hormones.

Posted by Apoorva Mandavilli at 04:25 PM | Permalink | Comments (0)

Against all our best hopes, the Libyan court has delivered the worst verdict possible: it sentenced six foreign medical workers accused of deliberately infecting children with HIV to be shot.

The defense says it will appeal to the Libyan supreme court.

The Libyan courts have refused to consider scientific evidence that the more than 400 children infected at a Libyan hospital were the victims of unsafe medical practices—and that the outbreak had begun before the medics arrived. Whether the diplomatic community has been forceful enough in pushing this evidence forward is unclear. An article in today’s New York Times, for instance, says that some diplomats have suggested that the US response has been muted.

Despite the efforts of the scientific community in the last few months, continuing activism—and stepped up diplomatic pressure—will be necessary if the medics are to have any hope. In Declan’s article on news@nature, Emmanuel Altit, head of the international defense team backs up this view. He says that the international community can help by insisting that the scientific evidence of the medic’s innocence be included.

Posted by Charlotte Schubert at 04:03 PM | Permalink | Comments (0)

Tomorrow a Libyan court will release its verdict on whether to sentence six foreign medical workers to death.

Five Bulgarian nurses and a Palestinian doctor are accused of deliberately infecting more than 400 children with HIV in a Libyan hospital in 1998. Scientists and medical groups have rallied behind the medics, with forceful letters highlighting the scientific evidence of their innocence.

The diplomatic community seems to be less energized. Both the European Union and the United States have called for a fair trial. But when the United States resumed diplomatic relations with Libya this spring, the plight of the medics was not part of the deal. And in a recent press conference, a spokesperson for the US State Department was dismissive of evidence published last week in Nature that would exonerate the accused.

Many familiar with the trial are pessimistic about the outcome. Whether the EU and the US are exerting enough pressure on Libya for a fair verdict should become clear tomorrow. If the medics are sentenced to death, it would not only be a miscarriage of justice; it may also reflect a failure of diplomatic will.

To learn more about the trial, go to Declan Butler’s blog. Declan is a reporter at Nature, who is following the case. Mickey Grant, an independent film-maker, has also covered the trial in his movie, “Injection," which I reviewed for news@nature. Grant explores the probable cause of the childrens' infection—poor medical practices, which he claims are rife and underreported in Africa.

Posted by Charlotte Schubert at 06:36 PM | Permalink | Comments (0)

Hello! This is Charlotte, the News and Views editor here at Nature Medicine, and it’s about time I posted. I’ve been scurrying around getting out my section, which involves mainly commentaries written by scientists. Part of my job as editor is trying to get scientists to write in a lively way—and to push them to have opinions. So I hope I manage to achieve that myself here in this blog! If not, you can excoriate me in the comments section.

While much of the rest of our team is based in New York City, I’m in Washington DC—land of the wonk. So that means I get to attend all sorts of panels, science policy events and schmooze fests of dubious value. Some of them are worthwhile.

In fact, this last Thursday I attended the “White House Summit on Malaria” —along with just about every luminary in the public health world, Condoleeza Rice, singing children and a superstar pastor.

The summit, hosted by President and Mrs. Bush, was designed to raise awareness of the disease; the administration’s campaign against malaria has been garnering some praises lately for shaking down red tape and increasing transparency.

For a while I was wondering if anything was really going to happen at this event. But among numerous platitudes—“We have a chance to make history” —several new endeavors were announced and achievements highlighted. For instance, as part of a push for greater business involvement, the National Basketball Association and other groups have raised $1.7 million dollars since May for mosquito bed nets, spurred by a column in Sports Illustrated.

And while we were all waiting for the president to speak, silenced by the delay and the intimidating stare of the secret service guys lining the corridors, Yvonne Chaka Chaka, a UNICEF Goodwill Ambassador for Malaria, spontaneously broke into song onstage, "The power of Africa". (Chaka Chaka, being a pop star, could probably sense the need for the security guys and the rest of us to be amused). The crowd started to bounce in their seats. One silver-haired lady, wearing a red suit in the way that only the well-off can do, got up and danced—and so did Eyitayo Lambo, Nigeria’s minister of health (on stage). He has reason—last week his country got a loan of more than $180 million from the World Bank to fight malaria.

Perhaps most thought-provoking was the call for greater involvement of religious groups.

Rick Warren, a star on the sermon circuit, and author of the Christian bestseller, “A purpose-driven life” explained his approach. He said religious groups, of whatever faith, have access to the community, credibility and an unprecedented volunteer pool. His network of churches is partnering with the government of Rwanda and other groups to train villagers to counteract malaria. Already more than 1000 church leaders in the country have signed up, he said.

Warren’s approach has the blessing of Richard Feachem, head of the Global Fund to Fight AIDS, Tuberculosis and Malaria. “There is a church in every village,” he said.

Religious groups have played a big role in the public health effort against AIDS—not without controversy, because of issues about condoms and sexuality. But with malaria, hopefully, there will be more consensus. This seems like a good idea to me—what do you think?

Posted by Charlotte Schubert at 04:15 PM | Permalink | Comments (1)

Did you hear this, men? Losing a little bit of your skin could cut your risk -- and perhaps ours -- of getting AIDS. The NIH reported yesterday that circumcision halves the risk of HIV infection. This is such good news that the agency decided to stop two trials early so they could offer circumcision even to men in the control arm.

The result isn't entirely a surprise. A previous study had pegged the protection at 60% and ever since then, some experts -- especially in Africa -- have been clamoring for circumcision to be implemented.

And rightly so. In many parts of the world where AIDS is a problem, circumcision could save millions of lives.

But is it really so simple as all that?

For instance, in India, where I'm from, whether a man is circumcised is not an idle preference -- it's a matter of cultural and religious identity. As war movies have brutally shown, in a conflict between Hindu and Muslim, Jew and non-Jew, that is sometimes the only way to distinguish friend and foe.

It's not going to be easy to convince these groups to give up their beliefs. Here's hoping they understand that in the war against AIDS too, that little piece of skin could mean the difference between life and death.

Posted by Apoorva Mandavilli at 05:56 PM | Permalink | Comments (9)

If you read our year-end issue, you know that we voted Andrew von Eschenbach "least likely to succeed" as the FDA's new chief.

But who asked us? After months of dilly-dallying, the Senate yesterday confirmed von Eschenbach as the new commish. Not that this is a plum job. The last chief, Lester Crawford, lasted exactly two months before he abruptly resigned--which all became more clear when a federal court charged him with lying about his shares in drug companies.

What the FDA needs is someone tough and smart, with enough integrity to stand up to drug companies and a clear plan for dealing with all the messy conflict-of-interest issues, not to mention the urgent scientific questions--like the one the new British panel will tackle.

It's a lot to handle, and I'm just not sure von Eschenbach is the man for the job. This is after all the same man who, as director of the National Cancer Institute, famously declared that we would cure cancer by 2015.

Overall, this has been a terrible year for the FDA. I hope it didn't just get worse.

Posted by Apoorva Mandavilli at 12:17 PM | Permalink | Comments (1)

Yes, yes, I know, it's not quite over yet. But for us here at Nature Medicine, it already feels like the new year because we're busy putting together our January issue.

December, and with it 2006, is history for us. But to bid the year a proper farewell, we've compiled the year's best, worst and most ridiculous moments. We've given out awards in the style of American high school yearbooks, charted a timeline of events, highlighted the absurdity of some things in numbers and asked scientists what they thought made the biggest difference in 2006--and what they think might happen in 2007.

The fun all begins here.

Posted by Apoorva Mandavilli at 04:42 PM | Permalink | Comments (1)

Speaking of doses, there is news today from across the pond that the UK will set up a special panel to look at high-risk studies of drugs.

You'll remember that in March, German company TeGenero tested its monoclonal antibody TGN1412 on six healthy volunteers. Within hours, all six ended up in intensive care. Hindsight being 20/20 and all that, critics said later that the company should have given the drug to just one guy and proceeded with caution.

Apparently, this new panel will make sure those kinds of blunders don't happen again. A bit late for the men, one of whom swelled up to look like an 'elephant man', but a good move nonetheless.

Here's the thing, though: some of these ill-considered studies make it through because the reviewers are overburdened and don't have time for the details, or because they have conflicts of interest, or simply because science is unpredictable.

In the case of this drug, the preclinical work, which included data from monkeys, gave no hint that the trial might end disastrously. After all, this was not a 'first in class' drug.

So how would this panel have known to be more cautious?

But maybe I'm being too cynical--I'd love to be proven wrong.

Posted by Apoorva Mandavilli at 04:31 PM | Permalink | Comments (3)

Hello everyone!

Welcome to 'Spoonful of medicine', where we hope to enlighten, entertain and occasionally exasperate you with our comments on biomedical research and public health.

We hope you'll be active participants as well, letting us know when we've made sense and, of course, when you think we're stark, raving mad. We hope the proportion is at least slightly more of the former.

Initially, at least, most entries will be posted either by me, Apoorva Mandavilli, or by my colleague, Charlotte Schubert. I am the news editor and am responsible for pretty much everything you read in our news section. You can read more about me here.

Charlotte edits the News & Views section, which involves much editing of copy written by scientists. She'll say hello soon... you can read more about her here.

Let the games begin...

Posted by Apoorva Mandavilli at 03:16 PM | Permalink | Comments (0)