Category Archives: Odds and ends

Odds and ends

More than a Spoonful

Posted on by
Reply

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 Twitter, Facebook 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 www.nature.com/naturemedicine where the news will keep rolling out.

We’re seeking an assistant news editor

Posted on by
Reply

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 r.khamsi@us.nature.com and https://home.eease.adp.com/recruit/?id=10018071 by 30 July 2014.

 

 

Discrepancies in serious adverse event reporting may distort the medical evidence base

Posted on by
Reply

CT blog

The worst thing that can happen to a person participating in a clinical trial is what’s known as a ‘serious adverse event’, which can describe anything from permanent kidney damage or liver failure to hospitalization or even death. Federal law in the US mandates that researchers conducting trials of drugs or other products regulated by the country’s Food and Drug Administration (FDA) report adverse events on ClinicalTrials.gov, a data repository open to the public. But a new study shows that many of these serious adverse events don’t appear in medical journals, making some interventions seem more favorable than they may actually be.

Reporting online today in the Archives of Internal Medicine, a group of researchers led by Daniel Hartung, a drug safety and policy analyst at Oregon Health & Science University in Portland, looked at how the data reported on ClincialTrials.gov stack up against the results published in the medical literature. The team limited their focus to phase 3 or 4 trials with results reported on ClinicalTrials.gov and completed prior to 2009, to allow sufficient time for the trials’ results to be published in medical journals. Hartung’s group then randomly selected 10% of those trials that had matching publications, yielding a total of 110 trials.

Hartung’s team found that 33 of the trials reported a greater number of serious adverse events on ClinicalTrials.gov than in the medical literature. For example, a 13,608-person study comparing the blood-thinning drugs Effient (prasugrel) and Plavix (clopidogrel) reported in the online database a total of 3,406 serious adverse events among all participants in the trial, and 3,082 in a related publication. (The patients in the trial were at high risk of heart attack, and were undergoing angioplasty, so it’s important to note that these adverse events were not necessarily linked to the drugs.)

Of the 84 trials that reported the occurrence of serious adverse events in the public database, 16 of the matching publications either failed to mention them or incorrectly reported that they did not occur. (Notably, 5 trials actually reported more serious adverse events in related medical papers than they did in the public database.)

Continue reading →

Intern at Nature Medicine

Posted on by
Reply

Have a passion for reporting on biomedical news? We’re currently accepting applications for our science writing internship. The intern will be closely involved in the editorial process and write news articles and briefs. This is not a paper-pushing internship! The person selected for the position will be reporting stories and working on editorial content, including the blog (https://blogs.nature.com/spoonful/).

Applicants should have completed one year in a graduate program in journalism or have equivalent work experience in journalism. Additionally, a strong understanding of biology and current issues in medicine is required.

This four-month, paid internship and will start in May or early June and be based in our New York offices.

The deadline for applications is March 31st. To apply please send 1) a cover letter, 2) your resume and 3) three published writing clips to r.khamsi@us.nature.com.

‘Google Earth’ of the brain slated for planetarium show

Posted on by
Reply

If you’re anything like me, you love a good planetarium show. I don’t mean the trippy laser light shows set to Pink Floyd tunes (although these certainly have their place), but rather the kind of immersive experience that gives you a glimpse into the untold depths of the universe and a few wondrous moments of what it feels like to soar through outer space. Now, a team of neuroscientists, astronomers, software engineers and film specialists are working on a new planetarium show to give us a fly-through experience in a different kind of vast and awe-inspiring space: the human brain.

The project is called the Neurodome. It’s the brainchild of Jonathan Fisher, a neuroscientist at New York Medical College who also has a background in astrophysics. Although the planetarium version of the Neurodome is not yet complete, you can get a taste of what to expect tomorrow evening at Columbia University in New York, where Fisher and Columbia astronomer Matt Turk will guide viewers through pictures of outer space and images of human brains, explaining how light travels across the universe from distant stars and into the eye, triggering electrical impulses in the brain’s neural pathways. “Just like you can walk through Google Earth, we’ll walk through the brain,” says Fisher.

Continue reading →

Head injury documentary points to global concussion crisis

Posted on by
Reply

headgames_global_ landscapeAlthough it wasn’t a contender for last night’s Academy Awards, there’s a powerful new film out this week that you may want to see. It’s the sports documentary, Head Games: The Global Concussion Crisis, and it provides a human face to the seemingly endless stream of high-profile reports linking repetitive head trauma to degenerative brain disease.

Early in the film, we meet Christopher Nowinski, who confesses that he once “loved the violence” of football. “It’s the closest thing to being a warrior without actually having to go to war,” says Nowinski, a former Harvard football defensive lineman turned pro-wrestler. But not long after that, we see him lying on a cold concrete floor, clutching his head after what would turn out to be a career-ending concussion he sustained during a wrestling match in 2003.

As Nowinski continued to experience headaches, memory problems and sleepwalking for the next year, he decided to see Boston University School of Medicine concussion expert Robert Cantu, who asked Nowinski how often he saw stars or felt woozy after being hit in the wrestling ring or on the football field. “All the time,” Nowinski recalls sheepishly, dumbfounded that he had likely been experiencing regular concussions but had never before given much thought to the potential long-term consequences of such injuries.

That experience led Nowinski on a crusade to better understand his condition, and in 2006 he published the book, “Head Games: Football’s Concussion Crisis,” which inspired the documentary from director Steve James (who also gave us the 1994 Oscar-nominated documentary, Hoop Dreams). But whereas Nowinski’s book largely focused on the brain hazards associated with professional and amateur football, the new film makes painfully clear that all athletes who engage in contact sports—be it hockey, rugby, soccer or any of a variety of games—are potentially at risk.

Continue reading →

Peanut allergy therapy produces epigenetic changes in immune cells

Posted on by
Reply

Earlier this week, news that six months of exposure therapy to peanuts enabled almost 100 children with an allergy to this food to eat the equivalent of ten peanuts stirred a lot of optimism. It was just one of many studies showing that some patients with severe peanut allergies can actually gain the ability to consume small amounts of the food by eating a little bit of this nut each day, gradually increasing the dose over several months.

Scientists may now have a better handle on how this ability to shrug off peanut allergy forms, and why some individuals respond to the treatment while others do not. A study published today in the Journal of Allergy and Clinical Immunology reports that the immune cells of some patients with peanut allergies who became tolerant to peanuts after exposure therapy showed DNA modifications thought to perhaps have a role in defending against allergies. “By understanding what changes occur,” says lead author Kari Nadeau, an immunologist at the Stanford School of Medicine in California, “we can identify targets for new therapy and biomarkers by which we can decide whether or not to keep treating a patient.”

Continue reading →

Whole-exome sequencing rises to top in largest clinical application for undiagnosed disease

Posted on by
Reply

Numerous studies have demonstrated the promise of whole-exome sequencing, which focuses on the protein-coding regions of DNA, but the clinical use of this technology has remained limited. Now, the largest report of results from this technology in a population of patients with undiagnosed disease of suspected hereditary origin highlights that the value of this testing is considerable, and that it can even uncover recessive mutations not previously linked to a given disease.

There are an increasing number of genetic tests for various illnesses, and doctors faced with a difficult-to-diagnose patient will order tests that look for mutations in a predetermined set of genes or larger chromosomal abnormalities, such as that detected by karyotype analysis. But the diagnostic success rate of such assays disappoints: karyotype analysis is only about 5% to 15%, and other methods generally fall below 20%.

A pilot study published today in the New England Journal of Medicine offers hope. It suggests that whole-exome sequencing might have as high as a 25% success rate in solving these hereditary disease mysteries. “For years we’ve known that whole-exome sequencing can identify new disease-causing mutations,” says Yaping Yang, a clinical geneticist at the Baylor College of Medicine in Houston and a study coauthor. “But this puts it on the map as a tool for clinical medicine.”

The researchers offered whole-exome sequencing, which cost about $7,000, as part of the medical care given to 250 people with undiagnosed diseases—many of whom were pediatric patients—who were referred by physicians after other methods, microarray analysis or tests looking at a single gene, failed to pinpoint the source of their illness. Whole-exome sequencing resulted in a genetic diagnosis for 62 of the patients, 20 of whom had autosomal recessive diseases—a less common finding because both parents must pass along a faulty copy of the given gene for clinical symptoms to arise. In some cases, patients had recessive mutations that hadn’t previously been reported as associated with their disease. For example, the researchers found one patient with two mutated copies of the spastic ataxia of Charlevoix-Saguenay gene, or ‘SACS’ gene, which included a new DNA deletion not previously known to cause this progressive movement disorder.

Continue reading →

Surprising epigenetic switch for ‘natural killer’ cells eyed for cancer therapy

Posted on by
Reply

NKcellsNatural killer cells are the instant assassins of the immune system with the ability to destroy foreign invaders and cancer cells at first sight. Although scientists have been studying how to harness the lethal abilities of these cells for more than three decades, little has been known about how these ‘NK’ cells develop from unspecialized immune cells. Now, researchers have discovered an enzyme that uses an epigenetic pathway—a process that modifies the way a cell’s DNA is read without actually changing the genetic blueprint itself—to boost the growth and function of NK cells.

NK cells could be a boon to cancer immunotherapy. These immune system soldiers are on constant surveillance duty, so it’s thought that they could eliminate the stray tumor cells that often elude chemotherapy. More than two dozen clinical trials to enhance NK activity against cancer are currently underway.

However, none of these drugs in development takes an epigenetic approach. That might be a mistake, in light of a study published today in the Proceedings of the National Academy of Sciences. A team of scientists led by Si-Yi Chen, an immunologist from the University of Southern California’s Norris Comprehensive Cancer Center in Los Angeles, shows that the enzyme MYSM1 (which stands for Myb-like, SWIRM and MPN domain-containing protein 1) controls the final steps of NK cell maturation through epigenetic changes. They suggest that increasing levels of this enzyme could help fight cancer by boosting the numbers of mature NK cells on patrol.

“It’s a very important contribution to our understanding of NK cell development,” says Porunelloor Mathew, a cancer immunologist at the University of North Texas Health Science Center in Fort Worth, who was not involved in the study.

Continue reading →

Experimental leishmaniasis vaccine could overcome challenge of multiple species

Posted on by
Reply

L. DonovaniMost of the 12 million people currently infected with leishmaniasis worldwide are also afflicted with poverty. The ‘black fever’ is caused by a single-cell parasite that gets passed from one person to another by the bite of a tiny sand fly and produces disfiguring skin lesions, severe mouth and throat ulcers, or swollen internal organs. In 2005, the ministers of India, Bangladesh, and Nepal committed to a ten-year plan to eliminate infections of Leishmania in their region. Two years later, the World Health Organization (WHO) adopted a resolution to take control of the disease.

The problem of defeating the pathogen is complicated, though, in part because there are more than 20 species of Leishmania, linked to three distinct clinical manifestations of the disease. In visceral leishmaniasis, the most fatal form, species such as Leishmania donovani infiltrate the liver, spleen, and bone marrow, crowding the host’s cells and overwhelming the immune system. A new study published today in Science Translational Medicine offers hope: immunologist Amitabha Mukhopadhyay of the India National Institute of Immunology in New Delhi and his colleagues describe a new vaccine that completely blocks the parasite from causing visceral leishmaniasis in mice and hamsters by targeting a receptor that they say is common to many forms of the parasite.

Progress in preventing visceral leishmaniasis would be welcome. Even though the disease can often be cured with antibiotics such as amphotericin B, or paromomycin, which is given with the anti-cancer drug miltefosine, these treatments can have severe side effects. Miltefosine has been linked with higher incidences of resistant forms of the disease. Also, for reasons the researchers don’t yet understand, drugs that work well against Leishmania infections in India are only about 80% effective against the same parasites in other regions, such as East Africa. “Visceral leishmaniasis has a pattern of causing outbreaks every eight to twelve years,” says Jorge Alvar, head of the leishmaniasis clinical program at the Drugs for Neglected Diseases initiative (DNDi), headquartered in Geneva. “So even if we had a good treatment, an effective vaccine would make a lot more sense.”

Continue reading →