More than a Spoonful

Back in December 2006, readers got their first dose of the Spoonful of Medicine blog. Over the last eight years, there’s been a lot of news to dispense—from our look at the ongoing problem of drug shortages and the movement to pressure companies to make cheaper therapies available to our reporting in April about experimental Ebola drugs (when much of the world was ignoring the rising outbreak in West Africa). We’ve highlighted many of the biggest breakthroughs in biomedical research, and also detailed a few of the ones that went under the radar. Take, for example, our reporting on insights into the tapeworm genome last year, or a study indicating that a diabetes drug could potentially work to treat emphysema. In every instance we went beyond simply reporting the results and tried to give our readers a better understanding of the biological mechanisms underpinning new findings, as well as a level-headed take on what the real implications were for any future medical applications. We put all claims—big and small—under the microscope.

Every drug needs an antidote, and so the Spoonful of Medicine blog has also given readers some light-hearted posts about the research enterprise. We’ve taken on the amusing and bizarre acronyms for clinical trials, such as the ‘AWESOME’ trial, in a story that became a reader favorite. Another popular post detailed the findings of an ancient shipwreck that contained tablets with ingredients similar to what might find in today’s over-the-counter medicine Cold-EEZE.

We are now committing more time than ever before to bring you investigative news features (our piece on missing follow-up clinical trial data is one example) and although that means this blog will be put on pause for the foreseeable future, we will continue to publish news on the Nature Medicine homepage, which underwent a redesign earlier this year. Our first ‘advance online publication’ news story, about how universities are banning medical staff from helping with the Ebola outbreak in West Africa, went live online just recently. There will be more of those to come, and we hope you will subscribe—via TwitterFacebook or the journal’s table of contents RSS feed—to keep up to date about all the news that we offer. Our news reporting goes far beyond the Spoonful site, and we hope you’ll seek us out at where the news will keep rolling out.

We’re seeking an assistant news editor

Nature Medicine (that’s us!) seeks an assistant news editor to report and edit must-read stories about the fast-changing field of drug development. We are looking for a person with a passion for understanding and communicating biomedical research, who is eager to break new ground with insightful investigative journalism in this area. The responsibilities of the position include writing and editing news content, as well as helping to manage the journal’s robust online presence.

The job requires an individual who can work with minimal guidance, finding and developing exclusive stories. The ideal candidate will have a degree in biology or a related science and at least two years of experience as a working journalist. S/he should be able to commission and guide freelancers and work with production staff to conceptualize artwork for print layout. The assistant news editor will be based in our Cambridge, Massachusetts, offices and work closely with our team in New York.

The job offers opportunity for travel and attendance at leading scientific meetings, as well as excellent benefits. Nature Publishing Group is an Equal Opportunity Employer.

Please submit a resume, cover letter and any relevant published writing samples to and by 30 July 2014.



Real-time tissue analysis could guide brain tumor surgery

The intraoperative mass spectrometry platform for image-guided surgery in the Advanced Mutimodality Image Guided Operating (AMIGO) suite at Brigham and Women's Hospital, Harvard Medical School as part of the National Center for Image Guided Therapy. Part of the team from left to right: Dr. David Calligaris, Postdoctoral Fellow, Dr. Sandro Santagata, Neuropathologist, Dr. Alexandra Golby, Neurosurgeon, and Isaiah Norton, Senior Programmer Analyst.

Santagata (second from left) and part of his team with the mass spectrometry platform for image-guided surgery in the Advanced Mutimodality Image Guided Operating (AMIGO) suite at Brigham and Women’s Hospital, Harvard Medical School.

It doesn’t get much more complicated than brain surgery. Surgeons tasked with removing brain tumors have limited information available to help them make decisions about what tissue appears cancerous and how much to excise without damaging brain regions important to key functions such as movement and speech.

But decisions about how much to cut might become easier in the near future: A study published today offers a possible way to discern which brain tissue is cancerous and guide surgeons in real time. The research, which appears in the Proceedings of the National Academy of Sciences, uses a technique formerly confined to analytical chemistry labs, called mass spectrometry, to make this determination right in the operating room.

“It’s hard to distinguish normal tissue from tumor,” explains Sandro Santagata, a pathologist at Brigham and Women’s Hospital in Boston and co-author of the study.** Thanks to the new approach, he says, “we’re many steps closer to getting a complete picture at the time of surgery.”

Techniques currently used in the operating room to guide tumor excision, such as tissue pathology and magnetic resonance imaging (MRI), can be costly and time consuming. A surgeon may have to wait 30 minutes for the biopsy results or an hour to perform MRI, adding to surgery time and increasing patient risk.

In an effort to speed up the process, Santagata and his colleagues joined with analytical chemist Graham Cooks at Purdue University in West Lafayette, Indiana, to exploit a hallmark feature of brain tumors as a way of defining the boundaries of these malignancies. As it turns out, brain tumors known as gliomas tend to express high amounts of a lipid metabolite called 2-hydroxyglutarate (2-HG).

According to Dan Cahill, a neurosurgeon at Massachusetts General Hospital in Boston who was not associated with the new study, doctors already use other methods, like polymerase chain reaction, to check tissue for 2-HG levels after surgery to ensure that they have thoroughly excised the tumor. The absence of it in the area immediately surrounding the tumor site means that all of the cancerous cells have been removed. “If you have it [2-HG], you know your margin isn’t clean,” he says. Unfortunately, current methods to detect 2-HG take far too long—about two daysto influence decisions made mid-surgery.

Santagata and his colleagues installed a mass spectrometer in an operating suite at Brigham and Women’s Hospital and analyzed 35 biopsied glioma specimens for the 2-HG metabolite. Although they performed the analysis immediately, the results were not used to inform the surgeons since the research is still in early stages. The mass spectrometry technique used, called desorption electrospray ionization, analyzes the tissue without destroying it, allowing detailed pathology, which is still the gold standard for tumor assessment, to be performed on the same sample. Pathology done for the study confirmed that 2-HG was detected at the highest levels in areas with the most tumor cells.

“I’m hoping we can start incorporating this into therapy for this subset of tumors,” says Nathalie Agar, a neuroscientist at Brigham and Women’s Hospital and co-author of the study. She and Santagata are currently advising the biotech company, BayesianDx, which is trying to develop the technology and bring it into clinical use. It may be years before this technology becomes widespread, but Agar says she is encouraged by this proof-of-concept study.

**Correction (2 July): In an earlier version of this story, Sandro Santagata was referred to as the lead author of the study. He was the first author. Nature Medicine regrets the error.

Drug target suggested for MERS as case count rises

Cluster of vesicles made by virus from usurped and reshaped membranes.

Cluster of vesicles made by virus from usurped and reshaped membranes.

Volker Thiel, Edward Trybala and colleagues

Since its appearance in Saudi Arabia in 2012, Middle Eastern Respiratory Syndrome (MERS) has spread to fifteen countries, including the US, where two cases were confirmed in the past month. Worryingly, about 30% of confirmed cases have been fatal, and the lack of specific antiviral drugs for the MERS-coronavirus (MERS-CoV), which causes the illness, poses a threat to public health.

A new insight could help pave the way to treatments in the future for this type of virus. In a paper published today in Plos Pathogens, clinical virologist Edward Trybala and his colleagues at the University of Gothenburg in Sweden describe a compound called K22 that inhibits coronavirus growth in human cells.

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