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Latest News: Singer Kesha denied drug, sex claims against producer three years ago

By Eric Kelsey

LOS ANGELES (Reuters) - Pop singer Kesha said in a deposition three years ago, unsealed on Tuesday, that music producer Dr. Luke never had sex with her nor gave her drugs in the latest salvo in the legal battle between the longtime music partners.

An attorney for Dr. Luke, whose legal name is Lukasz Gottwald, successfully asked a New York state judge to unseal portions of the depositions which stem from a 2010 lawsuit brought by Kesha's former manager against the singer and producer.

The statements contradict the "Die Young" singer's lawsuit filed last week accusing the pop hit-maker of forcing Kesha, whose legal name is Kesha Sebert, to "take drugs and alcohol in order to take advantage of her sexually." The lawsuit alleges the producer drugged and raped the singer.

Kesha's attorney, Mark Geragos, said the 27-year-old singer was ambiguous in the deposition and had been threatened by Dr. Luke if she ever mentioned the alleged sexual assault to anyone.

"She goes into rehab and she goes into therapy and she's able to stand strong now," Geragos said, adding that the questions about drugs and sex with the producer prove that she had spoken to her former manager about them.

In the 2011 deposition, Kesha said she didn't know if Dr. Luke, who has produced hits for the likes of Katy Perry and Miley Cyrus, had given her "drugs which could not be purchased at a pharmacy" and said the two never had an intimate relationship.

Kesha and Dr. Luke, 41, unleashed duelling lawsuits a week ago, trading accusations of abuse and extortion as Kesha sued Dr. Luke to get out of her record contract with the producer. She has been under contract to him since 2005.

Dr. Luke countersued in New York, accusing Kesha and her mother, Pebe Sebert, of defamation, breach of contract and contractual interference.

Kesha's lawsuit filed in Los Angeles alleges Dr. Luke's insults to her appearance caused her to develop bulimia nervosa. The singer, who has scored No. 1 U.S. hits "Tik Tok" and "We R Who We R" that Dr. Luke helped write and produce, finished a more than two-month treatment for the condition in March.

(Reporting by Eric Kelsey; Editing by Mary Milliken, Bernard Orr)

Latest News: U.S. to funnel travellers from Ebola-hit region through five airports

By Jeffrey Dastin

NEW YORK (Reuters) - The United States ratcheted up its safeguards against Ebola on Tuesday, requiring travellers from three countries at the centre of an epidemic in West Africa to fly into one of five major airports conducting enhanced screening for the virus.

Restrictions on passengers whose trips originated in Liberia, Sierra Leone or Guinea were announced by the U.S. Department of Homeland Security and due to go into effect on Wednesday. The precautions stop well short of the travel ban sought by some U.S. lawmakers to prevent more Ebola cases in the United States.

Affected travellers will have their temperatures checked for signs of a fever that may indicate Ebola infection, among other protocols, at New York's John F. Kennedy, New Jersey's Newark, Washington Dulles, Atlanta, and Chicago's O'Hare international airports, officials said.

"We are working closely with the airlines to implement these restrictions with minimal travel disruption," Homeland Security Secretary Jeh Johnson said in a statement. "If not already handled by the airlines, the few impacted travellers should contact the airlines for rebooking, as needed."

Johnson said those airports account for about 94 percent of travellers flying to the United States from the three countries, noting that there are no direct, nonstop commercial flights from Liberia, Sierra Leone or Guinea to the United States.

"We currently have in place measures to identify and screen anyone at all land, sea and air ports of entry into the United States who we have reason to believe has been present in Liberia, Sierra Leone or Guinea in the preceding 21 days," Johnson said.

Washington-based trade group Airlines for America, or A4A, noted that under 150 people per day travel to the United States from those three countries and about 6 percent of them, some nine people daily, have been arriving at airports other than the five airports with enhanced Ebola screening.

The group's member airlines are "cooperating fully" with the U.S. Customs and Border Protection agency to reroute that 6 percent of travellers to the five designated airports, A4A spokeswoman Jean Medina said.

The group's members include Delta Air Lines, United Airlines and American Airlines, none of which fly to the affected countries. However, they may carry passengers from these countries on a connecting flight.

The worst Ebola outbreak on record has killed more than 4,500 people, mostly in Liberia, Sierra Leone and Guinea. Only three Ebola cases have been diagnosed in the United States: Liberian Thomas Eric Duncan, who died on October 8 at Texas Health Presbyterian Hospital in Dallas, and two nurses who treated him.

On Tuesday, the U.S. National Institutes of Health outside Washington, D.C., upgraded the medical condition of one of the nurses, Nina Pham, to good from fair. She entered a special NIH facility in Bethesda, Maryland, for treatment last Thursday.

The other nurse, Amber Vinson, is being treated at Emory University Hospital in Atlanta. Vinson's mother, Debra Berry, told ABC's "Good Morning America" program her daughter is weak but recovering.

NBC freelance cameraman Ashoka Mukpo, who contracted Ebola while working in West Africa, is free of the virus and will leave the Nebraska Medical Center on Wednesday, the hospital said. Mukpo arrived in the United States on Oct. 6 for treatment.

He is the second patient to be successfully treated for Ebola at the Nebraska Medical Center, the hospital said on Tuesday, and the fifth treated in the United States to fully recover.

“Recovering from Ebola is a truly humbling feeling,” Mukpo said in a statement. “Too many are not as fortunate and lucky as I've been. I'm very happy to be alive.”

“I was around a lot of sick people the week before I got sick,” said Mukpo, the first U.S. journalist known to have contracted Ebola. “I thought I was keeping a good distance and wish I knew exactly what went wrong.”

He said his illness had not changed his feelings about Liberia. “I don't regret going to Liberia to cover the crisis. That country was a second home to me and I had to help raise the alarm.”

SUPPORT FOR TRAVEL BAN

A Reuters/Ipsos online poll released on Tuesday showed that nearly three-fourths of 1,602 Americans surveyed favoured a U.S. ban on civilian air travel in and out of Liberia, Sierra Leone and Guinea.

In Washington, some lawmakers welcomed the government's new steps while others said more needed to be done.

Democratic U.S. Senator Charles Schumer of New York called the Department of Homeland Security move "a good and effective step towards tightening the net and further protecting our citizens."

Republican Representative Bob Goodlatte of Virginia, who heads the House of Representatives Judiciary Committee, said Obama needs to impose a travel ban.

President Obama has a real solution at his disposal under current law and can use it at any time to temporarily ban foreign nationals from entering the United States from Ebola-ravaged countries," Goodlatte said.

White House spokesman Josh Earnest told reporters Obama is "not philosophically opposed to a travel ban" and remains "open to it" if the scientists and public health experts advising him say it would help protect Americans. Earnest said those advising the president currently oppose such a ban.

Airlines for America official Vaughn Jennings said the group opposes a travel ban. "We agree with the White House that discussions of flight bans are not necessary and actually impede efforts to stop the disease in its tracks in West Africa," Jennings said.

On Tuesday, the Dominican Republic became the latest country to impose a travel ban on foreigners who have visited Ebola-affected countries in the previous 30 days.

Concerns that Americans might fall victim to scams because of fear about Ebola prompted a warning from New York state Attorney General Eric Schneiderman about bogus Ebola preparedness kits and preventative medications.

There are no U.S. government-approved vaccines, medications or dietary supplements to prevent or treat Ebola.

In Texas, 60 people have been removed from watch lists after showing no Ebola symptoms in 21 days of monitoring, with 112 more people still being monitored for possible exposure, federal health officials said.

(Additional reporting by Gabriel Debenedetti and Susan Heavey in Washington, Sharon Begley and Michele Gershberg in New York, Jon Herskovitz in Dallas, Manuel Jimenez in Santo Domingo, Domican Republic; Writing by Will Dunham, Steve Gorman; Editing by Jonathan Oatis, Toni Reinhold)

Latest News: Tekmira begins limited manufacturing of drug targeting Ebola

(Reuters) - Canadian drugmaker Tekmira Pharmaceuticals Corp has begun limited manufacturing of a drug targeting the Ebola-Guinea virus that has killed more than 4,500 people, mostly in West Africa.

The pharmaceutical company said on Tuesday that the new drug, part of its TKM-Ebola programme, would be available by early December.

Tekmira's investigational new drug application to U.S. regulators for TKM-Ebola remains on partial clinical hold.

U.S.-listed shares of the company rose as much as 6 percent in trading after the company gave an update on its Ebola programme.

Tekmira has completed the design of a modified RNAi (Ribonucleic acid interference) drug which particularly targets the Ebola-Guinea variant, the virus responsible for the worst Ebola outbreak on record that has hit hardest Liberia, Sierra Leone and Guinea.

Three Ebola cases have been diagnosed in the United States: Liberian Thomas Eric Duncan, who died on Oct. 8 at Texas Health Presbyterian Hospital in Dallas, and two nurses who treated him.

TKM-Ebola, an RNAi therapeutic, works by preventing the virus from replicating.

In September, U.S. and Canadian regulators authorized the use of TKM-Ebola in patients who have confirmed or suspected infections from the deadly virus.

(Reporting by Tanvi Mehta in Bangalore; Editing by Lisa Shumaker)

Latest News: Mentally ill put in police cells
Depressed manBeing locked in a cell is especially frightening for those in mental health crisis, says Mind

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Too many people in the middle of a mental health crisis end up locked in police cells after being turned away from hospitals, says a report.

People are being turned away because of full wards, staff shortages or because they are too young or too drunk, said the Care Quality Commission (CQC).

Police cells are inappropriate and make people feel "punished for being unwell", said the charity Mind.

Home Secretary Theresa May said the situation was unacceptable.

Violent and intoxicated

The CQC said in some areas, patients were well provided for, but that the standard was not universal.

Between 2012 and 2013, in total 21,814 people were detained by the police under Section 136 of the Mental Health Act.

Start Quote

We must never accept a situation when a person in crisis is denied care just because the person is intoxicated”

End Quote Theresa May Home Secretary

The law says those people should be interviewed by a registered doctor, or mental health professional, to make arrangements for care.

But the CQC said 7,761 cases ended up in a police cell, rather than safe rooms in A&E, mental health trusts or children's hospitals.

Patients were being turned away from hospitals because they were violent, intoxicated, disturbed or under 18. Or because the hospitals either did not have an appropriate place to put them or staff with the right skills to deal with them.

Mrs May said the situation "wastes police time" and leaves people with mental health problems without the care and support they need.

Start Quote

Being detained in a cell is frightening, especially for someone in crisis”

End Quote Sophie Corlett Mind
'Not good enough'

"We must never accept a situation when a person in crisis is denied care because a health-based place of safety is full or unstaffed, or just because the person is intoxicated," she added.

She said the "exclusion" was not in line with a plan launched by the government on looking after people in crisis and called upon local health leaders, commissioners and providers to improve care.

The CQC's survey also found many hospitals did not have the data to quantify if there was a problem and record how many patients were sent away.

Dr Paul Lelliott, of the CQC, said the survey findings were "not good enough".

"Imagine if people who had had a heart attack or stroke, were regularly turned away from an A&E department due to a lack of staff or beds," he said.

Sophie Corlett at Mind said: "Being detained in a cell is frightening, especially for someone in crisis, who is often confused, and might even be harming themselves, experiencing suicidal feelings or psychosis."

"An emergency is an emergency, and those who are intoxicated and in need of help should still receive the same level of mental health care and treatment as anyone else," she added.

She said local agencies should work together to give support.

Latest News: Schools 'should check kids' teeth'
Child at dentist having tooth drilled to treat tooth decay

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Schools and nurseries need to step in to tackle the worrying trend of tooth decay in children, the advisory body NICE has said.

More than one in 10 three-year-olds in England have rotten teeth.

In some parts of the country, as many as half of five-year-olds have decayed, missing or filled teeth.

NICE's new guidelines for England say nurseries and schools should consider introducing supervised tooth-brushing and fluoride varnishing programmes.

Prof Mike Kelly, director of the Centre for Public Health at NICE, said: "Children, as young as three, are being condemned to a life with rotten teeth, gum disease and poor health going into adulthood.

"Many children have poor diets and poor mouth hygiene because there is misunderstanding about the importance of looking after children's early milk teeth and gums," he added.

School tooth-brushing

Nurseries and primary schools should supervise tooth-brushing in areas with a high level of child tooth decay, the advisory body said.

Tooth decay in children and adults is disproportionately higher in disadvantaged areas, as well for vulnerable people, and in some ethnic minorities, NICE said.

After local authorities identify areas that would benefit, free toothbrushes and fluoride toothpaste should be handed out to parents and carers for use at school and at home, it advises.

If a supervised tooth-brushing scheme is not feasible, children's teeth should be painted with fluoride varnish at least twice a year to strengthen teeth, NICE added.

A recent Public Health England survey found that 12% of three-year-olds had suffered from rotten teeth.

In one area - Leicester - 34% of children had tooth decay.

Milk teeth 'don't matter'

Part of the issue is that many parents don't recognise that they should take steps against tooth decay, according to health consultant Mandy Murdoch, who was part of the team that developed the guidelines.

"Many people believe that the health of a child's first teeth does not matter as 'they will fall out anyway'," she said.

"However, severe tooth decay at a young age can have negative consequences in later life."

Rotten teeth, aside from being painful for the child, can lead to higher incidences of oral health problems later in life.

Thousands of children have to undergo general anaesthetic to have teeth out, said Prof Elizabeth Kay, foundation dean for the Peninsula Dental School, Plymouth.

"Around 25,000 young children every year are admitted to hospital to have teeth taken out," she said.

"Given that we know how to prevent dental disease this really should not be happening," Prof Kay added.

Poor oral hygiene in adults has been linked to increased gum disease, tooth loss, and oral cancers.

The British Dental Association said that there were "still unacceptable inequalities which need to be tackled" in people's dental health.

Dr Christopher Allen, chairman of the BDA's dental public health committee, welcomed the NICE guidelines.

However, he added: "It's important that local authorities have access to specialist dental health advice to ensure that the interventions chosen are the most appropriate for the needs of the population."

Dr Allen added that water fluoridation programmes would be a more efficient means of strengthening people's teeth.

Only around six million people in the UK have access to fluoridated water, the BDA said.

Latest News: NICE conflicts of interests claim
statin pill

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A group of leading doctors and researchers has called on MPs to investigate potential conflicts of interest at the watchdog NICE.

In a letter to the Health Select Committee, they have expressed concern about financial ties to drug companies among experts working for NICE.

The concerns follow controversy over the recent NICE guideline on statin drugs.

NICE has defended its procedures on conflicts of interests.

The letter reflects continuing disquiet among some doctors and researchers over the recent decision by NICE to extend the availability of cholesterol-lowering drugs to millions of people at low risk of developing heart disease.

A majority on the NICE panel that recommended this had ties to pharmaceutical companies.

Their interests were declared but the letter argues that is not enough to ensure impartiality.

'Licensed' to advise?

"Transparency is important but accuracy and objectivity should be the gold standard expected of an independent panel," it says.

The letter argues disclosure of a conflict of interest may even make matters worse because experts may feel "licensed" to emphasise their advice still further.

NICE rules stipulate that members of advisory committees should not have had a personal financial interest in a related company in the last 12 months.

One of the letter signatories, the former Conservative shadow health minister Lord Ian McColl, said this was dubious.

"They could have had millions paid before the 12 months. It really needs to be tightened up."

Another signatory, a London cardiologist Dr Aseem Malhotra, urged NICE to act.

"I have always had tremendous respect for NICE but their conflicts-of-interest policy clearly needs to be strengthened so that the medical profession and patients can feel fully confident that decisions are made completely independent of personal or industry interests."

Not "fit for purpose"

The letter is clear that there is no suggestion of any impropriety, but it says the governance arrangements for conflicts of interest at NICE are "not fit for purpose".

It proposes the establishment of "more independent panels" to minimise the possibility of conflicts of interest, and calls on the Health Select Committee to consider looking into the issue "as a matter of urgency". They will discuss the matter later today.

In June, a letter supported by many of the same signatories argued that plans to extend the use of statins should be scrapped. It said NICE had used data which "grossly underestimated" the side-effects.

NICE says its response to that letter dealt with concerns raised over conflicts of interests, and it has nothing to add. That statement from NICE defended its procedures.

"Where conflicting interest exists, the individual concerned is either not appointed in the first place or asked to withdraw temporarily, or to leave the group altogether, depending on the nature of the conflict."

Latest News: Brave healer of DR Congo's most horrific wounds

Congolese doctor Denis Mukwege, who won the Sakharov human rights prize Tuesday, has been dubbed "Doctor Miracle" for helping tens of thousands of gang rape victims in the Democratic Republic of Congo.

Mass rape has been used as a weapon of war during the decades of violence that has devastated the mineral-rich east of the country.

The 59-year-old gynaecologist founded the General Referral Hospital of Panzi near Bukavu in South Kivu province, scene of some of the worst violence, to treat the often appalling injuries suffered by rape victims.

Their internal injuries are sometimes so severe he has to carry out major reconstructive surgery.

Mukwege survived an assassination attempt two years ago after speaking out about the continued use of rape in the conflict, and accused the world of failing to act.

"My first patient in 1999 had been raped, then they stuck a gun into her genitals and fired. Her whole pelvis was destroyed. I thought it was the work of a madman, but the same year I treated 45 similar cases," Mukwege said last year.

"For 15 years I have witnessed mass atrocities committed against women's bodies and I cannot remain with my arms crossed because our common humanity calls on us to care for each other," he added.

- Systematic rape -

Aid agencies have accused all sides in the conflicts raging in the eastern DRC regions of North Kivu and South Kivu of using "systematic rape" against women as a weapon of war.

Last year Mukwege defied threats and returned to the DRC after narrowly escaping an attempt on his life on October 25, 2012 in which his guard was killed.

The US pressed for a "thorough" investigation of the killing, hailing Mukwege's dogged efforts "not only for the health of women in the eastern DRC, but also for peace in a troubled region."

He sought refuge in Sweden and Belgium before being welcomed home by thousands of people and urging them to declare "no to sexual violence, no to war, and no to the Balkanisation of the DRC".

The 50,000-euro ($64,000) Sakharov Prize, named after the late Soviet dissident Andrei Sakharov, is given by the European Parliament to outstanding human rights advocates.

The 350-bed hospital Mukwege founded treats more than 3,500 women a year, providing free consultations and doing reconstructive surgery on women who have suffered serious internal injuries.

The doctor relates the horror suffered by rape victims with a steady and soft voice, praising the women's bravery and resilience.

Born on March 1, 1955 in Bukavu, the third of nine children, Mukwege's father was a pastor and the son was inspired to study medicine by father's visits to sick members of the parish.

After going to school in neighbouring Burundi, he returned to work in his hometown hospital in Lemera, where women often suffered serious genital injuries giving birth.

He then pursued specialist training in gynaecology in Angers, France with help from a Swedish Pentecostal mission, before returning to the DRC in 1989.

But Lemera hospital was destroyed during fighting in 1996 and Mukwege shared the tenuous existence of the hundreds of thousands of refugees displaced around him.

- Set up male feminist group -

Married with five children, including four daughters, Mukwege said "he can not imagine healing without God's help".

He has been honoured by the United Nations and has received many international awards, including the Olof Palme Prize in January 2009.

His work "provides an outstanding example of what courage, persistency and enduring hope may accomplish for human rights and dignity in times when these values seen the most distant," the Palme Memorial Fund said.

In September 2012, Mukwege took the global community to task in a speech at the UN for failing to act against rape in the DRC.

He now travels worldwide to call attention to the situation there, while continuing to administer the Panzi hospital.

Since the beginning of this year, he has launched a male feminist group called V-Men Congo, and has called for a "general mobilisation" against the new scourge of rapes of children and babies.

Last year, Pakistani teenager Malala Yousafzai won the Sakharov prize for her campaign to ensure the right of all girls to an education. She was joint winner of the Nobel Peace Prize this month.

Latest News: VIDEO: Can pioneering paralysis therapy help others?

A paralysed man has been able to walk again after a pioneering therapy that involved transplanting cells from his nasal cavity into his spinal cord.

It is the first operation of its kind and no one knows if it will work on other victims of spinal injury in the same way - but it could be a pivotal moment.

David Shukman reports.

Latest News: US tightens restrictions on air travel from Ebola zone

The United States on Tuesday tightened restrictions on travelers arriving from the West African countries gripped by an Ebola outbreak, funneling them into five airports with extra health checks.

The Department of Homeland Security ordered passengers whose journeys begin in Guinea, Liberia or Sierra Leone to fly to New York's JFK or Newark airports, Washington Dulles, Atlanta or Chicago.

The new measures go into effect Wednesday.

There are no direct scheduled flights to the United States from the three countries at the heart of the Ebola epidemic, but travelers from the region can transfer through African and European hubs.

One Liberian with Ebola arrived in Dallas, Texas and infected at least two US health workers before dying earlier this month, piling pressure on President Barack Obama's government to impose a flight ban.

Health authorities have set up additional screening at five ports of entry, airports which they say normally handle 94 percent of the travelers arriving from the three worst-hit countries.

But Tuesday's order would prevent travelers from Guinea, Liberia or Sierra Leone from transferring to flights to other US airports where they would not necessarily have to pass additional screening.

"If not already handled by the airlines, the few impacted travelers should contact the airlines for rebooking, as needed," Homeland Security Secretary Jeh Johnson said.

"We currently have in place measures to identify and screen anyone at all land, sea and air ports of entry into the United States who we have reason to believe has been present in Liberia, Sierra Leone or Guinea in the preceding 21 days."

The virus has killed more than 4,500 people in West Africa this year, and stoked fears that it could spread beyond the three worst-hit countries and become a global threat.

But small outbreaks in Senegal and Nigeria have been halted and, with no new confirmed infections in the United States for six days, authorities are hopeful they have contained the danger here.

- Lawmakers urge stricter measures -

Congressman Michael McCaul, a Texas Republican who chairs the House Homeland Security Committee, hailed the DHS move as "a common sense proposal."

However, he joined many US lawmakers, including some Democrats, in urging even stricter measures to keep out travelers from West Africa.

"I continue to call on the administration to suspend all visas from Liberia, Sierra Leone and Guinea," he said in a statement.

Sixteen lawmakers who have worked as doctors or nurses wrote Obama on Tuesday calling for tighter restrictions, including a 21-day quarantine before entering the US for Americans exposed to Ebola.

"Containment is the key to stopping the spread of this highly contagious and deadly disease, and we strongly urge your administration to consider implementing a temporary travel ban for individuals who are citizens of, or travelled to, affected countries in West Africa," the lawmakers wrote.

Republican Senator Marco Rubio said he will introduce legislation next month, when Congress resumes in Washington after the current recess, that would ban the issuance of new visas from afflicted countries until the outbreak is contained.

Latest News: US expands Ebola checks; Rwanda to check Americans

ATLANTA (AP) — The government announced Tuesday that everyone traveling to the United States from Ebola-afflicted African nations will have to be screened at one of five airports, as officials took to the road with new guidelines to promote head-to-toe protection for health workers who might be at risk of contracting the disease.

Customs and Border Protection officers at New York's Kennedy, Newark Liberty, Washington's Dulles, Chicago's O'Hare and Hartsfield-Jackson Atlanta airports had already started screening people arriving from West Africa, using no-touch thermometers to determine if travelers have a temperature, a symptom of a possible Ebola infection.

Homeland Security Secretary Jeh Johnson said Tuesday that now everyone traveling from Liberia, Sierra Leone or Guinea will have to land in the U.S. at one of the five airports and then fly on to their destination.

About 94 percent of the roughly 150 people traveling daily from West Africa to the U.S. arrive at the one of the five airports.

The move falls short of meeting demands by some elected officials that the Obama administration halt all travel from West Africa. Sen. Chuck Schumer, D-N.Y., described the action as an "added layer of protection against Ebola entering our country."

It comes as the Centers for Disease Control worked to spread the word about its new protective guidelines. The, advice, released Monday night, had been avidly sought by health workers after two Dallas nurses became infected while caring for the first person diagnosed with the virus in the United States.

It's not clear exactly how they became infected, but clearly there was some kind of problem, CDC Director Dr. Tom Frieden said.

"The bottom line is the guidelines didn't work for that hospital," he said.

CDC officials demonstrated the recommended techniques Tuesday at a massive training at New York City's Javits Center.

"We're here today because one health care worker getting Ebola while caring for a patient is too many," Dr. Arjun Srinivasan told the gathering.

Earlier CDC guidelines had been modeled on how Ebola patients in Africa were treated, though that tends to be less intensive care done in rougher settings — like tents. They also allowed hospitals some flexibility to use available covering when dealing with suspected Ebola patients.

The new guidelines set a firmer standard, calling for full-body garb and hoods that protect worker's necks; setting rigorous rules for removal of equipment and disinfection of hands; and calling for a "site manager" to supervise the putting on and taking off of equipment.

They also call for health workers who may be involved in an Ebola patient's care to repeatedly practice and demonstrate proficiency in donning and doffing gear — before ever being allowed near a patient.

And they ask hospitals to establish designated areas for putting on and taking off equipment, whether it's a room adjacent to an Ebola patient's room or a hallway area cordoned off with a plastic sheet.

The CDC cannot require hospitals to follow the guidance; it's merely official advice. But these are the rules hospitals are following as they face the possibility of encountering patients with a deadly infectious disease that a few months ago had never been seen in this country.

The president of a group representing 3 million registered nurses said she's glad to finally see better federal advice. Health care workers said the CDC's old guidance was confusing and inadequate, and left them fearfully unprepared for how to deal with an Ebola patient.

"Today's guidance moves us forward," said Pamela Cipriano, president of the American Nurses Association, in a statement.

___

Schmall reported from Dallas. Alicia A. Caldwell reported from Washington.

Latest News: VIDEO: More UK medics travel to Ebola area

About 100 soldiers from the Royal Army Medical Corps have travelled to Sierra Leone as part of the UK's efforts to tackle the Ebola outbreak.

International Development Secretary Justine Greening has joined the medics to see how Britain's £125m aid package is helping to combat the deadly virus.

She said the international community had reacted too slowly to the outbreak but the UK was working to help contain the outbreak.

Latest News: Paralysed man walks again after pioneering surgery

Tuesday October 21 2014

It is said this is the first time the spinal cord has been directly repaired

The spinal cord carries nerve signals

"World first as man whose spinal cord was severed WALKS," the Mail Online reports. In pioneering research, transplanted cells have been used to stimulate the repair of a man's spinal cord.

The headlines are based on a scientific report describing a 38-year-old man whose spinal cord was almost completely severed in a knife attack. The man had completely lost feeling and movement below the injury and was paralysed from the chest down.

Researchers injected the man's damaged spinal cord with cells taken from parts of the brain involved in interpreting smell signals from the nose to the brain. This treatment was combined with a graft from one of the nerves in his lower leg to reconnect the stumps of spinal cord severed by the injury. 

After surgery, the man had improved trunk stability, partial recovery of the voluntary movements of the lower extremities, and an increase of muscle in one thigh, as well as improvements in sensation. According to an accompanying press release, the man is now able to walk using a frame.

While previous techniques have managed to "re-route" nerve signals around a damaged section of the spinal cord, this is the first time that damage to the cord has been directly repaired.

These results are very encouraging, but, as the researchers note, the findings will need to be confirmed in other patients with similar types of spinal cord injury.

 

Where did the story come from?

The study was carried out by researchers from Wroclaw Medical University, the Polish Academy of Sciences, Karol Marcinkowski Medical University, the Neurorehabilitation Center for Treatment of Spinal Cord Injuries AKSON in Poland, the Medical University of Warsaw, the University Clinical Hospital and the UCL Institute of Neurology in the UK.

It was funded by the Wroclaw Medical University, the Nicholls Spinal Injury Foundation and the UK Stem Cell Foundation.

The study was published in the peer-reviewed journal Cell Transplantation and has been made available on an open access basis, so it is free to read online.

The news was widely reported by both the UK and international media. Coverage was accurate, if uncritical. The lead author's claim that this research was "more impressive than man walking on the moon" seems to have been accepted without question by the media.

However, other experts are less impressed. For example, Dr Simone Di Giovanni, Chair in Restorative Neuroscience at Imperial College London, is reported by the Science Media Centre as saying, "One case of a patient improving neurological impairment after spinal cord knife injury following nerve and olfactory cell transplantation is simply anecdotal.

"Extreme caution should be used when communicating these findings to the public, in order not to elicit false expectations on people who already suffer because of their highly invalidating medical condition."

 

What kind of research was this?

This was a case report, which often report unusual medical findings in a single person. They often describe rare diseases, strange symptoms or untypical responses to treatment.

The results of this case report will need to be confirmed in a larger group of patients with similar types of spinal cord injury before such stem cell transplants can be said to be an effective treatment for spinal cord injuries.

Even if the treatment proves effective, it may not be safe in all cases. Because of its complexity, neurological surgery has a higher rate of complications than most other types of surgery.

 

What did the research involve?

The case report describes a 38-year-old man whose spinal cord was damaged in a knife attack, leading to his spinal cord being almost completely severed. The man had completely lost sensory (feeling) and motor (movement) function below the injury, resulting in paraplegic paralysis (where both legs and the lower body are paralysed).

The researchers removed one of his olfactory bulbs, the parts of the nervous system that normally transmit information on smell from the nose to the brain.

They then grew cells from the man's olfactory bulbs in the laboratory. They were interested in two cell types: olfactory ensheathing cells and olfactory nerve fibroblasts. Both of these cell types have been shown to mediate regeneration and the reconnection of severed axons (nerve cells).

The researchers transplanted the cultured cells by injection into the man's spine above and below the injury. 

To fully bridge the gap and reconnect the stumps of spinal cord severed by the injury, they also combined this treatment with a graft of small strips of nerve taken from one of the nerves in the man's lower leg (the sural nerve).

The man received intense neurorehabilitation through exercises and other interventions designed to help recovery from a nervous system injury or compensate for its effects.

 

What were the basic results?

The man seemed to have no adverse effects in the 19 months following the operation.

From five months after the operation, the man had improved neurological function. By 19 months after surgery, he had improved trunk stability (sometimes known as core stability), partial recovery of the voluntary movements of the lower extremities, and an increase in the muscle of one thigh, as well as improvements in sensation (feeling).

According to accompanying media reports, the man is now able to walk using a walking frame.

Interestingly, removal of one of the olfactory bulbs did not cause the man to permanently lose his sense of smell on one side, as might have been expected.

 

How did the researchers interpret the results?

The researchers conclude that to their knowledge, "This is the first clinical indication of beneficial effects of transplanted autologous bulbar cells."

 

Conclusion

Overall, these results demonstrate the first person with a severed spinal cord to have regained movement and sensation in his lower limbs following a cell transplant. Specifically, this involved a combination of cells taken from the olfactory bulb and a graft from nerve cells in the leg, which were used to reconnect the severed sections of spinal cord.

These results are very encouraging, but, as the researchers note, these will need to be confirmed in a larger group of patients with similar types of spinal cord injury.

Further research is also required into how best to access the olfactory bulb. In this study, it was accessed by craniotomy – a surgical operation where a bone flap is temporarily removed from the skull to access the brain. As the researchers also state, there remains a possibility that sources of other, more readily obtainable reparative cells may be discovered.

Though this treatment has given good recovery of movement and sensation, there has not yet been a full recovery in terms of bowel, bladder and sexual function. These functional effects of spinal cord injury can of course have an equally devastating effect on a person as loss of movement or sensation.

The results will undoubtedly give hope to many people affected by paralysis as a result of spinal cord injury. However, while very promising, there are still many steps to go until a new treatment is found that gives complete functional recovery from severe spinal cord injury.

Analysis by Bazian. Edited by NHS Choices
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