Aids não se associa com guerras civis na África.

Mesmo cientistas e pesquisadores não gostam de ser contrariados nas suas crenças adquiridas e disseminadas por eles mesmo sem qualquer base empírica. Abaixo, um exemplo que é contra-intuivo: Paulo B Spiegel e colegas avaliaram todos os artigos sobre incidência de aids e prevalência de soropositivos para o HIV em populações que passaram por guerras civis na África e, não encontraram associação direta. O texto citado publicado no The Lancet é de acesso gratuito para quem se cadastrar no site. Abaixo, o resumo

Prevalence of HIV infection in conflict-affected and displaced people in seven sub-Saharan African countries: a systematic review. Dr Paul B Spiegel e colaboradores. Background Violence and rape are believed to fuel the HIV epidemic in countries affected by conflict. We compared HIV prevalence in populations directly affected by conflict with that in those not directly affected and in refugees versus the nearest surrounding host communities in sub-Saharan African countries. Methods Seven countries affected by conflict (Democratic Republic of Congo, southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia, and Burundi) were chosen since HIV prevalence surveys within the past 5 years had been done and data, including original antenatal-care sentinel surveillance data, were available. We did a systematic and comprehensive literature search using Medline and Embase. Only articles and reports that contained original data for prevalence of HIV infection were included. All survey reports were independently evaluated by two epidemiologists to assess internationally accepted guidelines for HIV sentinel surveillance and population-based surveys. Whenever possible, data from the nearest antenatal care and host country sentinel site of the neighbouring countries were presented. 95% CIs were provided when available. Findings Of the 295 articles that met our search criteria, 88 had original prevalence data and 65 had data from the seven selected countries. Data from these countries did not show an increase in prevalence of HIV infection during periods of conflict, irrespective of prevalence when conflict began. Prevalence in urban areas affected by conflict decreased in Burundi, Rwanda, and Uganda at similar rates to urban areas unaffected by conflict in their respective countries. Prevalence in conflict-affected rural areas remained low and fairly stable in these countries. Of the 12 sets of refugee camps, nine had a lower prevalence of HIV infection, two a similar prevalence, and one a higher prevalence than their respective host communities. Despite wide-scale rape in many countries, there are no data to show that rape increased prevalence of HIV infection at the population level. Interpretation We have shown that there is a need for mechanisms to provide time-sensitive information on the effect of conflict on incidence of HIV infection, since we found insufficient data to support the assertions that conflict, forced displacement, and wide-scale rape increase prevalence or that refugees spread HIV infection in host communities

Brasileiras obesas nos Estados Unidos.

O jornal eletrônico Pesquisa Fapesp traz artigo do professor Antônio Bianco sobre o impacto da obesidade sobre as brasileiras que vivem nos Estados Unidos, na região de Boston, Estados Unidos. Não há novidade: brasileiras estão mais gordas e as mulheres de Boston muito mais obesas do que a média das brasileiras. O que há de novo é também muito antigo no Brasil, mas relativamente desconhecido nos Estados Unidos e, introduzido lá por nossos compatriotas: o uso de hormônio tireoideano e outros medicamentos para reduzir o peso corpóreo. A globalização traz novos desafios, um deles, a assistência médica e farmacêutica, ainda regulada dentro dos limites dos Estados-nação. Abaixo, trecho do artigo de Bianco.

Tireóide, Brasil e obesidade. Qualquer uma dessas palavras chama a minha atenção, mas as três juntas, na mesma sentença, me fizeram parar o que estava fazendo e prestar atenção. No meu laboratório, por um motivo ou outro, um rádio está sempre ligado, invariavelmente na National Public Radio (NPR), uma estação sem fins lucrativos que fornece notícias e talk shows sem comerciais para cerca de 26 milhões de pessoas, por semana. Ao escutar a seqüência de palavras-chave, interrompi a conversa com o colega John Harney e sintonizei mentalmente na matéria que estava sendo noticiada por Alan Coukell, um repórter de ciência e saúde da NPR. Coukell estava contando que muitos residentes de Massachusetts estão usando pílulas brasileiras para emagrecer, para perder os quilinhos a mais que ganharam durante o inverno. Essas pílulas, manipuladas no Brasil, são desconhecidas das autoridades locais, portanto ilegais, e potencialmente fatais

A volta de Hong Kong à China e, mais uma vez a droga....

Dez anos após a volta de Hong Kong à China, uma notícia da Reuters reproduzida abaixo mostra o consumo de drogas no sul da China aumenta e, pelo preço mais baixo do que o cobrado na ex-colônia inglesa. A droga - no caso o ópio - faz parte da história da China e Inglaterra (clique aqui) e, parece que permanecerá ainda por um bom tempo.

Hong Kong drug addicts head to China to pop pills Fri Jun 29, 2007 9:35am ET By Tan Ee Lyn HONG KONG (Reuters) - The ease of travel to the China mainland since Hong Kong's handover in 1997 has drawn the city's young people to a cheap and convenient playground just across the border in Shenzhen city. Every weekend, young people pour into Shenzhen in China's southern Guangdong province to devour cheap food, entertainment -- and illicit party drugs. Street drugs of all types -- cocaine, ecstasy, heroin, ketamine and methamphetamine -- are more easily available and cheaper in discotheques in southern China than in Hong Kong. "At first I didn't like Shenzhen because it seemed foreign and dangerous, but after a while it was very nice, a new place with new faces and we didn't get raided there," said Siu Bak, a former addict of nine years who kicked the habit in 2005. "It's far easier to get drugs in China. Any staff can get it for you. The security guards will just turn a blind eye or they will tell you to take them in the toilet," said Siu Bak, 24. Ketamine is one of the most popular party drugs now in Hong Kong and it is proving to be a disastrous health hazard. In a report published last week, a group of Hong Kong doctors detailed cases of bladder and kidney dysfunction in 10 ketamine addicts. Their mean age was 25, with the youngest only 18.

Google se organiza na área da saúde.

O texto abaixo foi liberado pela empresa Google informando que estabeleceu um conselho consultivo para assuntos referentes a saúde, devido a procura de informações sobre o tema cada vez mais frequente.

6/27/2007 09:50:00 AM Posted by Missy Krasner, Product Marketing ManagerEvery day, people use Google to learn more about an illness, drug, or treatment, or simply to research a condition or diagnosis. We want to help users make more empowered and informed healthcare decisions, and have been steadily developing our ability to make our search results more medically relevant and more helpful to users. Although we have some talented people here with extensive backgrounds in health policy and technology, this is an especially complex area. We often seek expertise from outside the company, and health is no exception. We have formed an advisory council, made up of healthcare experts from provider organizations, consumer and disease-based groups, physician organizations, research institutions, policy foundations, and other fields. The mission of the Google Health Advisory Council is broadly to help us better understand the problems consumers and providers face every day and offer feedback on product ideas and development. It's a great privilege for us to work with this esteemed group

Psiquiatras premiados pelo excesso de diagnóstico e prescrição.

Uma revelação assustadora publicada no The New York Times (27/06/07): psiquiatras americanos são os especialistas que mais ganham presentes da indústria farmacêutica, em parte pela prescrição de medicamentos para crianças. Esses dados são do Estado de Vermont, um dos que exigem a declaração de ganhos por parte dos médicos. Quando morava nos Estados Unidos no final dos anos 90 fiquei estarrecido com o excesso de diagnóstico de hiperatividade em crianças. Não via qualquer motivo para esse diagnóstico, mas tome-lhe Ritalin (metilfenidato).

Psychiatrists Top List in Drug Maker Gifts By GARDINER HARRIS Published: June 27, 2007 WASHINGTON, June 26 — As states begin to require that drug companies disclose their payments to doctors for lectures and other services, a pattern has emerged: psychiatrists earn more money from drug makers than doctors in any other specialty. How this money may be influencing psychiatrists and other doctors has become one of the most contentious issues in health care. For instance, the more psychiatrists have earned from drug makers, the more they have prescribed a new class of powerful medicines known as atypical antipsychotics to children, for whom the drugs are especially risky and mostly unapproved. Vermont officials disclosed Tuesday that drug company payments to psychiatrists in the state more than doubled last year, to an average of $45,692 each from $20,835 in 2005. Antipsychotic medicines are among the largest expenses for the state’s Medicaid program. Over all last year, drug makers spent $2.25 million on marketing payments, fees and travel expenses to Vermont doctors, hospitals and universities, a 2.3 percent increase over the prior year, the state said. The number most likely represents a small fraction of drug makers’ total marketing expenditures to doctors since it does not include the costs of free drug samples or the salaries of sales representatives and their staff members. According to their income statements, drug makers generally spend twice as much to market drugs as they do to research them. “For the fourth year in a row, our analysis shows that there is a great deal of money being spent in our small state on marketing pharmaceutical products,” said William H. Sorrell, the Vermont attorney general. Endocrinologists received the second largest amount, according to the Vermont analysis, earning an average of $33,730. Since the state identified the specialties of only the top 100 earners, these averages represent the money earned by only some of the state’s specialists. There were 11 psychiatrists and 5 endocrinologists in that top group of 100. Still, a similar pattern was evident in a Minnesota database that was the subject of a series of articles in The New York Times this year. As in Vermont, psychiatrists earned on aggregate the most in Minnesota, with payments ranging from $51 to $689,000. The Times found that psychiatrists who took the most money from makers of antipsychotic drugs tended to prescribe the drugs to children the most often. These and other stories have helped to fuel a growing interest among state and federal officials to document and restrict payments to doctors from drug makers. At a gathering last month at Columbia Law School in New York, state attorneys general from across the country discussed ways to get similar data for their states. And today, the Senate Special Committee on Aging, which is led by Senator Herb Kohl, Democrat of Wisconsin, will hold the first of a series of hearings on the issue, which could lead to legislative proposals to restrict and require disclosure of payments and gifts to doctors from drug companies nationwide. Several lawmakers on Capitol Hill have expressed interest in such legislation, including Senator Charles E. Grassley, Republican of Iowa. “A federal law requiring public disclosure of payments to doctors could be very effective if it was carefully monitored and consistently applied,” Mr. Grassley said. Efforts to require disclosure of payments to doctors began almost by happenstance in 1993, when The Minnesota Legislature passed a law that restricts drug companies from giving doctors gifts valued at more than $100 in any given year. The legislation also required companies to report and make public any consulting fees paid to doctors. Lee Greenfield, a former state representative in Minnesota and one of the law’s authors, said it passed with little fanfare or debate after legislators heard stories about doctors accepting gifts of great value from drug makers. “Why do we want them bribing doctors to use what may not be the best or most cost-effective drug for the patient purely to get some hand-held TV, we all asked,” Mr. Greenfield said.

A indústria alimentícia se adapta, mas....

A Gazeta Mercantil (27/06/07) destaca que empresas como Nestlé, McDonald´s, Kellogg e Hellman´s (Unilever) estão se adequando à "busca do consumidor por uma vida mais saudável". Trata-se de iniciativa que pode ter impacto em indicadores de saúde pública, como obesidade, diabetes e doença cardiovascular. A sintonia das empresas alimentícias com o conhecimento epidemiológico é bem vinda. No entanto, o problema está no que é estado da arte na epidemiologia nutricional porque há aspectos importantes: (1) o conhecimento ainda insuficiente para permitir ações coletivas; (2) extrapolação indevida de resultados obtidos em populações muito específicas; (3) equívocos conceituais, como o de considerar somente a qualidade dietética e, desconsiderar a importância do consumo calórico total.

Harvard na varguarda....

Segue abaixo reportagem do The Boston Globe, do dia 19 de junho de 2007, mas somente "postado" aqui, por ser o momento certo. Notem que os eventos ocorreram em Harvard em 2001 antes do 11 de setembro foram depois repetidos em Vermont, Purdue e California. . Interessante, não?

Protesters' hunger strikes stir worry on campuses By Marcella Bombardieri, Globe Staff June 19, 2007 At Harvard, they consumed only Gatorade and water for nine days. At the University of Vermont, they subsisted for five days on orange juice, herbal tea, and sea salt. At the University of California, some lived off a potion of lemon juice, maple syrup, and cayenne pepper. This is not the latest dieting craze, but a controversial trend in student activism: hunger strikes. Students on at least five campuses went on hunger strikes this year, most of them protesting what they saw as their university's involvement in unfair treatment of workers. At Purdue University in Indiana, a strike last winter lasted 26 days. In most of the protests, the hunger strikers claimed to have won concessions. But they have also alarmed university leaders and, on some campuses, triggered a backlash from fellow students. Hunger strikes demonstrate the depth of passion many students feel about the fight against economic inequality. They also represent a certain desperation, according to some students and labor historians, as universities become less tolerant of public disruptions, such as a high-profile sit-in at Harvard in 2001. While most protests are nonviolent, activists believe that a cultural shift since the Sept. 11, 2001 terrorist attacks has encouraged administrators to crack down on civil disobedience on campus.

Students know they can be arrested or expelled for taking over the president's office -- a time-tested way to get noticed on campus -- but they cannot really be punished for forsaking their meal plans. In society at large, "people are more afraid of dissent than they should be," said Kelly Lee , who just graduated from Harvard and took part in a hunger strike there last month. "The tactics have to fit the time and the audience." Hunger strikes have a long tradition, from Mahatma Gandhi to Bobby Sands , the IRA member who starved himself to death in prison in 1981. But they have not been a dominant form of campus protest in the past. Some of the recent student hunger strikes have clearly been inspired by those on other campuses. Janitors in a few places have also gone on hunger strikes, but labor leaders say there were no coordinated efforts to enlist students. Hunger strikes -- on campus and off -- are a relatively new phenomenon in the labor movement, said Eve Weinbaum , a professor of labor studies at the University of Massachusetts at Amherst. Workers today have less ability to influence their employers, she said, because they are so often part-time employees who are not in unions and, in many cases, are in the country without proper immigration documents. In the spring of 2001, Harvard students occupied the main administration building for three weeks, demanding the university pay workers a "living wage." The school eventually agreed; some of the 30 protesters were briefly put on probation, a punishment seen as mild.

This year, activists declared that Harvard security guards, who are employed by an outside contractor, were not being offered a decent contract. Marches and rallies had produced no result, and time was running short before summer vacation. But another sit-in like in 2001 seemed out of the question. Lee and three other students had been arrested in April for heckling the director of the FBI, which students and officials believe are the first arrests of protesters on campus in decades. Lee, of Springfield, Ore., said campus police told the detained students that Harvard had a new policy to discourage disruptive protests. So they were worried about taking action that could get them suspended, expelled, or dragged out by police. A hunger strike seemed like the answer. Before they started fasting, the protesters met with a university health services doctor to learn how to stay as healthy as possible. After five days on their Gatorade diet, they visited the health center for blood tests. Late that night, Javier Castro received a call from the health center: His sodium levels were dangerously low. Castro learned he had taken in too much water, putting him at risk of seizure or coma even though he felt fine. What topics are worth protesting, and what protesting method is most effective? He was admitted to Mount Auburn Hospital at 2 a.m. but insisted on fasting for nearly another two days. "It was not the best thing a pre-med like myself could do," Castro, 19, of Irvine, Calif., said last week. Still, "I definitely think it was worth it." However, most of the hunger strike participants have made it clear that they would not be willing to fast to death. At some schools, the protesters weighed themselves daily or had student EMTs take their blood pressure. "I want to be effective, not dead," Lee wrote on a blog kept by the Harvard activists. Fasting was not that uncomfortable, said students who have taken part in hunger strikes. Several described the first few days as most difficult, due to headaches, stomach cramps, and nausea. But they kept enough energy to go to classes and study for finals. Several described feeling a high or a sense of clarity and well-being on the third or fourth day. "Basically, your body adjusts," said Zack Pesavento , who went on a juice-and-salt-only hunger strike at Georgetown two years ago. "On day three or four I felt a sense of peace. I remember on the seventh day thinking, 'How is it possible that I'm walking around and talking to people?' " Although the hunger strikers managed to avoid punishment, in some cases they also acknowledged that the results were not all they desired. The Harvard protesters broke their fast when negotiators appeared to be making progress. The guards and the company reached a deal a few weeks later, but only after labor leaders had threatened to disrupt commencement. Most university officials are loath to comment on the tactics of student protesters. A Harvard spokesman would only refer to official statements expressing concern for the students' well-being and commitment to the university's wage guidelines. Enrique Corredera , a spokesman for the University of Vermont, readily credited the "strong and very passionate" student activism that started long before the hunger strike in April for the university's decision to reexamine salaries and benefits for its low-wage workers. But he refused to credit the hunger strike , saying it had only added stress and anxiety to students and administrators, without changing the results. Some students who believe universities should treat workers better see hunger strikes as a distraction. Jessica Coggins , a senior at Harvard, said she agreed with the protesters' goals but said hunger strikes are "a very alienating tactic" that put lives at risk and discourage more moderate students from attending rallies. The hunger strikers counter that they needed an extreme form of protest to break though the indifference to their concerns. Marcella Bombardieri can be reached at bombardieri@globe.com.

Ah, esse monstro de olhos verdes..

Heartwire, o boletim do InfoHeart apresenta os problemas do foco na pessoa de Steven Nissen e, não no FDA e na Glaxo-Smith Kline no caso Avandia. O título acima é uma tradução tosca de Otello de Shakespeare, que os americanos popularizam como The Irish eyes of envy. Sim, a inveja é a aquilo que os caminhoneiros escrevem nos para-choques.

The media, the man, and his message: Nissen seeks to refocus scrutiny on rosiglitazone June 21, 2007Shelley Wood New York, NY - The first act appears to be over in the rosiglitazone (Avandia, GlaxoSmithKline) drama, but the media have not yet loosened their grip on the man who first sounded the alarm about the diabetes drug: Dr Steven Nissen (Cleveland Clinic, OH). Nissen's meta-analysis, published in the New England Journal of Medicine (NEJM) and reported by heartwire, propelled rosiglitazone into the spotlight, culminating in a congressional hearing earlier this month and an FDA hearing on July 30. Despite Nissen's repeated insistence that the focus should be on patient safety, not his methods or motives, newspapers and their editorialists—as well as alternative media—continue to take disparate views on the man in the middle of the maelstrom. Dr Steven Nissen An editorial in the Cleveland Plain Dealer insists Nissen is being victimized for championing the public good . "Nissen, and clinicians like him around the country, aren't sifting drug performance data so they can add to their scrapbooks of news clippings. They're doing it so they can add to the store of knowledge in the medical community, which can then improve care for patients," the Dealer asserts. "As it now stands, public-spirited doctors like Nissen, who are trying to save patients grief, can be accused of poking their noses where they don't belong. That's ludicrous." Other media outlets have profiled Nissen, emphasizing his lifelong activism in different spheres. A glowing portrait of Nissen on MedPageToday.com points out that he was a part of the college antiwar movement during the 1960s at the University of Michigan. "His years as a campus activist left him with an entrenched commitment to righting wrongs and a willingness to challenge the status quo, attributes that he has integrated into his medical career," Peggy Peck writes for MedPageToday. "And he never forgot the power of the press." Altruism not universally accepted Indeed, the mainstream media loves a whistleblower, but not all of the coverage of Nissen's role has accepted the notion of him as altruist. Earlier this week, the Wall Street Journal (WSJ) ran an editorial questioning the "larger political context" in which the rosiglitazone concerns were raised, noting that "Dr Nissen has a reputation as an adversary of the pharmaceutical industry" and that he "admitted that he consulted with several congressional committees" prior to the publication of his rosiglitazone meta-analysis. "Ostensibly serious medical research isn't supposed to be peer-reviewed by the Democratic majority," the WSJ editorial gibes. Nissen, for his part, has repeatedly rejected claims that politics had anything to do with it. "That's just not what happened," he told heartwire. "The scientific process proceeded in the usual way: the journal had the article reviewed by peer scientists, it was a very careful review, it was revised based upon those reviews, and it has absolutely nothing to do with politics, it was about patients. . . . If the reviewers had not recommended publication, I'm sure that the NEJM would not have published it." Other news coverage has implied that Nissen had a different, more personal, political agenda. On June 5, Boston Globe staff reporter Diedtra Henderson quotes critics who claim Nissen's motives stem from a desire to run the FDA, a charge Nissen flatly rejects. "I'm not running for anything," Nissen is quoted in the Globe. "I've got a great job here [at the Cleveland Clinic], and I'm not going anywhere." Nissen reiterated this point to heartwire: "Speculation about the FDA is a very common topic. I am very happy as the chair of CV medicine at the Cleveland Clinic: I have no interest in going anywhere else; I have my hands full. I'm certainly not interested in running for an office like the FDA commissioner, I don't know where that comes from, it certainly doesn't come from me." Headline news A sticking point for the media mania around Nissen has been his apparent eagerness to make headlines. That was also the charge levied by California Republican Rep Darrell Issa during the congressional hearing, where he accused Nissen of caring more for making a "public splash" in the media than informing the FDA directly of his concerns about rosiglitazone. Even earlier, a Bloomberg news report posted online when his meta-analysis was first published notes that Nissen "put the Cleveland Clinic's in-house television studio to good use this week, appearing on a dozen broadcasts across the world." Nissen agrees that his paper "had more than the usual amount of media attention," but, he insists, "We published this because of the science. It was certainly not about politics, it's certainly not about media. . . . Ninety-nine percent of the coverage of the rosiglitazone story has been very good and very responsible. It's a very tiny group that's making an effort here to make this about the messenger, not the message." Nontraditional media have their say The bulk of that negative press has come from independent bloggers and other nontraditional media, many with major conflicts of their own. One of the more novel was a video podcast on the popular video-sharing website, YouTube, that opens with the question, "What do you think about a doctor … who compares a diabetes drug to 9/11?" a reference to a comment Nissen made during an interview that aired on ABC's Nightline website. The one and a half minute video features Dr Michael Weber (SUNY, Brooklyn, NY) expressing his misgivings about how Nissen described rosiglitazone's risks in the media. But the YouTube video was funded by the Center for Medicine in the Public Interest (CMPI), a "research" organization funded by the pharmaceutical industry, and Weber's own ties to industry have been scrutinized in the past. Contacted by heartwire, Weber said he did not even know what YouTube was. He stated that he is a member of an external, unpaid advisory group of directors for the CMPI and that the CMPI approached him to do "a video," not the other way around. He also emphasized that his comments were not about the scientific validity of the study, but about how they were disseminated. "As far as I'm concerned, the full story about Avandia still isn't known, and the concerns that were raised by Dr Nissen may be something we need to find out about," Weber said. "I'm not criticizing or disputing the scientific data, and in fact the whole reason I agreed to be videoed was because I did get very upset when I saw that Steve had said that the Avandia situation was worse than what happened on 9/11. I found that to be the sort of hyperbole that is really unacceptable in discussing these sorts of issues, and as a New Yorker, the statement was particularly unacceptable." But Weber rejected any suggestions that he himself was conflicted in this particular circumstance. "I do consult for industry, and I have done research projects and been a part of research activities that have been funded by industry, and I've always fully disclosed or acknowledged those. In this case, there is really not an industry connection, because I have not in any way defended Avandia or defended the way the company that manufactures Avandia has managed the situation." Nissen says he hasn't seen the video and doesn't want to. "What can I say? We publish scientific work, we did this analysis not to address the YouTube audience but because we believe that providers and patients have a right to know that there are significant safety issues with rosiglitazone," he told heartwire. "If it in fact stimulates people to create YouTube videos, I can't do anything about that, but that's not the audience." Blogs and missed potential Other blogs, associated with online editions of newspapers and magazines, have also debated Nissen's role. Ivan Oransky, blogger for The Scientist online, pointed out that Nissen has twice in the past year been wrong about drugs that he thought "held promise": torcetrapib (Pfizer), and now rimonabant (Sanofi-Aventis), the latter unanimously panned by the FDA's advisory panel last week. Oransky's observations were subsequently picked up in the WSJ health blog by veteran reporter Scott Hensley, who observed that Nissen, "a frequent and outspoken critic of the drug industry," has an "imperfect crystal ball." Oransky, quoted by Hensley, writes: "I think it's worth noting the record of someone whose pronouncements on drugs are so often held up by drug industry critics and that make media headlines." This is not like handicapping horse races; it's about doing good scientific studies and reporting the results in a faithful and accurate fashion. Nissen calls this a "straw-man" argument. "I'm always enthusiastic about drugs that we're studying, but when results come in, we tell it the way it is," he told heartwire. "I don't predict the success of drugs, I study the effects of drugs. . . . I have no vested interest, personally, one way or another in whether a drug works or not. It's my job to report scientific results in a neutral fashion, and I never predicted that torcetrapib would be successful. I thought it had great potential, and that was a potential that didn't pan out." In the case of rimonabant, investigators, including Nissen, did not have data on psychiatric side effects of the drug. "I'm glad that those data were reviewed; I hope that it can be overcome, because I do think [rimonabant] has potential. But this is not like handicapping horse races; it's about doing good scientific studies and reporting the results in a faithful and accurate fashion." Biting the hand that leads For health reporters, Nissen is a rare gem in the parched, baked earth that is the medical/pharmaceutical beat. In a sphere where wooden interviews, cautious opinions, and technical jargon are the norm, Nissen speaks his mind and is deliciously quotable. At the major cardiology meetings when he's spoken at a press conference, Nissen will glide through the pressroom like he's hosting a garden party, offering opinions, warmly greeting reporters by name. Asked whether the proximity he's always enjoyed, even nurtured, with the press has come back to bite him, Nissen cordially steers the conversation back to where he insists it should remain. "The last thing in the world I want is for this to be about me. It has to be about the science. If there are criticisms of the manuscript, let them be directed at the science, not at the messenger." Yet even as the hue and cry dies down, many journalists following the rosiglitazone saga are left wondering if Nissen—always so frank with and accessible to the media—may, this time, have gotten more attention than he wanted. Which just goes to prove the adage: Be careful what you wish for, you just might get it.