Author Archives: Nature Medicine Editor

This is your city on drugs

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What’s the drug of choice in your city? Cocaine? Methamphetamine? Or a simple cup of java?

Turns out it’s a lot easier to find out than lurking in alleyways or crashing hipster parties. Scientists from Oregon State University have figured out a way to test an entire city for its drug use — legal and illegal.

The scientists sampled about a teaspoon of water from the sewers — because that’s eventually where what people consume ends up — of 10 American cities and tested them for 15 different drugs.

The results, which they presented the Amercan Chemical Society meeting in Boston on Tuesday, are not all that surprising in the end. Here are a few gems:

Most Americans are not too wild and crazy, and their drug of choice is caffeine. People in the midwest are a little more conservative and don’t seem to indulge too much in meth use. One city with a heavy gambling industry — Las vegas, anyone? — shows meth levels five times higher than other cities.

I have no doubt New York has its share of drug use, what with all our models, actors and and hyperactive investment bankers. How do you think your city would fare?

You may experience nausea

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You know that really, really fast rattling off of side effects at the end of every drug ad on TV? That’s there because companies are requried to present a “balanced” picture of the risks and benefits.

But seriously, who can understand a word beyond the rapid-fire “You may experience nausea, headache, blah blah, blah” or read fast enough to decipher the side effects that rapidly scroll down?

Well, apparently the FDA is planning a study with 2,000 people to see whether people are too distracted by the cheery ads to notice the risks. To which I say, Duh. This is such a sadly obvious stalling tactic: “Look, we’re doing this study, and we can’t take any action till our analysts have told us what it all means.”

It’s also damage control. Last week, a report in the New England Journal of Medicine said that in 2006, the FDA sent 21 warnings to companies about their ads, down from 142 in 1997. The amount companies have spent on ads went up a whopping 330% during that same time.

Here’s another sad little fact that the Associated Press mentioned in its coverage of this issue: The U.S. is one of two industrialized countries that permit TV drug ads — the other is New Zealand.

When cleanliness is not a good thing

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A rather and confusing and counter-intuitive report came out earlier this week, when scientists announced that uncircumcised men who wash their penis after sex are increasing their risk of AIDS.

This is of course contrary to all common sense. Washing after sex, and hygeine generally, is always presented as the way to avoid sexually transmitted infections. So it’s not clear why the longer the men waited to wash after sex, the lower their risk of HIV infections became.

Unfortunately, the scientists didn’t ask the men how exactly they washed, according to the New York Times, which reported the story on Tuesday. This could be important because the soaps used in Africa are more irritating than the ones in the US, for example, and could be contributing to the bizarre observation. The researchers say it’s also possible that vaginal secretions, which are acidic, may be harming the virus. The latter seems unlikely to me — surely if vaginal secretions offered some protection, women would not now be the brunt of the epidemic?

In any case, resolving this seemingly contradictory study is important so public health workers can spread the right message about cleanliness — and not unwittingly put men even more at risk.

Let’s hear it for Texas

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While I was traveling in Australia — where most hotels do not seem to have heard of the internet — I missed this rather heartwarming press release from the University of Texas M. D. Anderson Cancer Center.

The center is launching an effort to “recruit, retain, and develop women faculty”, led by Elizabeth Travis, the center’s first associate vice president for women faculty programs.

About half of medical school students and graduate students are women but a 2006 study by the American Association of Medical Colleges easily shows the “leaky pipeline”: women account for 15% of assistant professors, 6% of associate professors and only 4% of full professors. Women also make up just 10% of deans, department and division chairs.

The press release also cites research by Wayne State University linguists in 2003, which showed that the same resume gets a lower evaluation score when attached to a woman’s name than when attached to a man’s name.

The new program at Anderson aims to recognize those who support women faculty; help women build leadership skills and continue to collect data.

I must say it all sounds promising. I particularly like Travis’ comments that all past efforts focused on helping women navigate the system. Rather than “fixing the women,” she says, “we need to focus on fixing the academic environment instead.”

Hear, hear!

Science down under

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I’ve just returned from a two-week trip to Australia to scout out stories on the state of research in the country. We’re planning to run a special issue about Australia science early next year so you can read about it in detail then, but one thing I can tell you is I have never met a bunch of people who take more pride in their country.

Almost every scientist I spoke to had trained abroad and they all said they couldn’t imagine living anywhere else. They could go on — and do — for hours about the marvelous lifestyle. Despite the lack of jobs for young scientists, postdocs come back to Australia for the 9-to-5 days, the slower pace, the lack of intense competition all around them.

There’s no doubt that despite this lack of intensity, Australia does produce some world-class science. But here’s my question for you: Is it possible for scientists to lead this kind of laidback lifestyle and still stay competitive? Or would Australia be a much bigger contender in science if its researchers burned the midnight oil like their American and European counterparts do?

Brazen new world

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Talk about chipping away at human rights: lawmakers in Papua, an Indonesian province, want to implant microchips in HIV-positive people.

Yep, you read right. Apparently, the government is fed up with its inability to control the country’s AIDS epidemic so the parliament’s health committee came up with this scheme to track those who are infected and stop them from transmitting the virus to others. Oh, and they’re also calling for mandatory testing of the general population — about 2.4% of whom are believed to be HIV-positive.

Fortunately, saner heads prevailed and the bill was turned down, but no doubt the parliamentarians will come up with more boneheaded schemes.

At one point, they also apparently dicussed tattooing those infected. What would the tattoos say, I wonder? Something along the lines of: “I live in a fascist state”?

A step back for South Africa

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South African president Thabo Mbeki, famous for questioning the link between HIV and AIDS, has dismissed Nozizwe Madlala-Routledge, the health minister who seemed to be making a real difference to the country’s fight against AIDS.

Madlala-Routledge had replaced previous health minister Manto Tshabalala-Msimang — often called simply “Manto” — who likes to offer beetroot, lemon juice and garlic as remedies for AIDS. After that particular brand of denialism, Madlala-Routledge’s tenure was particularly welcome, as I wrote last November.

After her arrival, South Africa announced a comprehensive prevention program and openly acknowledged the gravity of its epidemic. Only a few days ago, the government announced that for the first time in years, its HIV prevalence had fallen — albeit not by much.

It’s a shame that the president has so quickly undone the small progress the country had made. No more beetroot and garlic, please!

Free at last!

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A lesson for us all: when reason and logic don’t work, try bribery. After eight years in prison, the medics being held in Libya for allegedly infecting more than 400 children with HIV are free.

But their freedom has been bought rather than won, with the US and Europe helping to pay off the affected families and promising Libya millions, if not billions, of dollars in aid and debt forgiveness.

Many expected the five Bulgarian nurses and Palestinian doctor to be freed five years ago, when expert virologists Luc Montagnier and Vittorio Colizzi submitted a report showing that the children had become infected before the medics ever set foot in Libya, and that the infections were almost certainly the result of poor hospital hygiene rather than sinister acts.

But the court threw out the report and refused to accept further international evidence, relying instead on a flimsy Libyan document that researchers say contained “a shocking lack of evidence” to slap the accused with a death sentence.

Just as children who misbehave shouldn’t be given treats, Libya shouldn’t be rewarded for acting up. With lives hanging in the balance, the international community couldn’t afford the diplomatic version of tough love. But now that the medics are on friendly soil, I think we should stop dangling cupcakes.

Uploaded on behalf of Cassandra Willyard, Nature Medicine’s news intern

In China, dinosaurs, dragons — and death

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Why is it that the most bizarre — and disturbing — science stories always come from Asia, usually China or India? (I can say that, I’m from India).

I live about three blocks from the American Museum of Natural History in New York, which has some of the most stunning displays anywhere of dinosaur fossils. People come from all over the world to gawk at these wonders.

In China’s Henan province, it seems, I could have bought dinosaur bones for a mere 50 cents per kilogram.

For at least the last 20 years, villagers in China have apparently been grinding up precious dinosaur bones and boiling them in soup to treat dizziness, leg cramps and such or making a paste and applying them to fractures. One local had collected up to 8,000 kilos of bones, according to the BBC.

The villagers did this because they believed that the bones were from dragons that could fly in the sky and had special powers, according to Dong Zhiming of the Chinese Academy of Sciences.

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On a far more serious and horrible note, China has executed its former Food and Administration chief, who had been made the scapegoat for all its recent problems with the regulation of food and drugs. The Associated Press led its story on this saying it was “the strongest signal yet from Beijing that it is serious about tackling its product safety crisis.”

I’m sorry, what??

How is rushing to execute one man, who became a convenient symbol for everything that ails China’s regulatory system, an indication that the country is serious about fixing its problems?

Although many versions of this story included the offensive phrase, (The Guradian, the NYT) some papers at least (The Independent) edited it out. China may blunder in its rush to fix its image, but we should be demanding an actual clean up of the system, not this tyrannical turn of events, as proof of its intentions.

The lead made me do it

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Yesterday’s Washington Post ran an article that I found really provocative, linking the drop in crime in recent decades to… um, lead poisoning.

The general idea is that children who are exposed to lead are more prone to committing violent crime as adolescents presenting, according to the article, “a unifying new neurochemical theory for fluctuations in the crime rate.”

Sounds really good. Too good, in fact. I’m wary of “unifying theories” with such sweeping implications.

There is apparently a lot of literature linking lead exposure to aggressive behavior. But it’s a big step from that to linking crime rates across the world to lead levels.

The article is based on the work of economist Rick Nevin, who looked at nine countries with different abortion rates, police strategies, demographics and economic conditions and found that up to 90% of the variation in violent crime in these countries could be explained by lead.

In the U.S., for example, children were exposed to lead — in household paint at the turn of the 20th century and in gasoline fumes after World War II — and in each case, violent crime peaked roughly 20 years later. Much of the lead in gasoline was eliminated by the mid-1980s explaining, according to Nevin, the drop in crime in the 1990s (what do you have to say that, Rudy Giuliani?), and because this had the biggest impact on inner-city neighborhoods, Nevin says, violent crime in those neighborhoods has declined faster than the overall crime rate.

I know the writer, Shankar Vedantam, and deeply respect his journalistic abilities, so I’m sure he checked out the credibility of this research. But I would have felt better if pretty much the only other expert quoted in the article hadn’t been the editor of the journal, Environmental Research, in which Nevin has published most of his work. The article says Nevin’s work, and the other research that supports this hypothesis, hasn’t received much attention. If it’s good science, why ever not??