CDC Announces New Guidelines For Health Care Workers Treating Ebola Patients

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The Centers for Disease Control and Prevention issued new guidelines on Monday for health care workers caring for patients with Ebola.

The new guidelines "provide an increased margin of safety," CDC Director Tom Frieden said in a conference call with reporters.

Frieden added that they represented a "consensus" by the health care workers who have treated people with Ebola in the United States, including those workers at hospitals in Atlanta and Nebraska that have treated Ebola without further transmission.

The CDC is, of course, reacting to what happened at Presbyterian Hospital Dallas, where two nurses caring for Thomas Eric Duncan, the first person diagnosed with Ebola in the United States, contracted the virus.

"The [old] guidelines didn't work for that hospital," Frieden said.

Because of the lessons learned, the CDC said it was implementing three new recommendations:

First, they will make sure that health care workers dealing with Ebola patients are "repeatedly trained," especially when it comes to learning how to put on and take off their personal protective equipment.

Second, the equipment used should leave no skin exposed.

Third, these regulations should be monitored by a "trained observer" or site manager, who watches each employee take on and off their personal protective equipment.

"All patients treated at Emory University Hospital, Nebraska Medical Center and the NIH Clinical Center have followed the three principles," the CDC said in a press release. "None of the workers at these facilities have contracted the illness."

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CDC Announces New Guidelines For Health Care Workers Treating Ebola Patients

Speakers Emphasize Need to Integrate Primary, Mental Health Care

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For years, the prevailing notion in medicine held that the body is treated in a physician's office and the mind in a separate mental health facility.

That view is slowly changing, however, as a growing number of medical professionals and others contend that such separation leads to ineffective treatment that does not answer patients' needs.

"When you take mental health out of primary care, you get poor outcomes and you pay more for it," said Benjamin Miller, Psy.D., director of the Eugene S. Farley Jr. Health Policy Center, an initiative of the Department of Family Medicine at the University of Colorado Denver School of Medicine. The majority of patients who are diagnosed with mental illness are initially seen and treated in a primary care setting, he noted.

Miller spoke during a recent forum hosted by the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, "From Fragmentation to Integration: A Triple Aim Imperative." During the event, panelists addressed how the notion that a patient's mental health can be separated from his or her physical health is an outdated one.

Unfortunately, said Miller, the majority of patients who receive a referral from their primary care physician to a mental health specialist do not make the visit. He suggested that one reason for the lack of follow-up is the unwillingness of patients to describe their mental health to another professional with whom they are not familiar after having already detailed their concerns to a physician they trust.

"People are saying, 'When I go for primary care, I want my mental health needs to be addressed there," said Miller.

Parinda Khatri, Ph.D., chief clinical officer at Cherokee Health Systems, a comprehensive community health care organization with 56 clinical sites in 13 counties in Tennessee, recalled a woman who recently visited a clinic after her son died in an accident. The day after the accident, the woman went to see her primary care physician to discuss her situation. If she had instead tried to make an appointment with a therapist, she might have faced a six-week waiting period.

"We need to be on the path that patients have decided to walk," said Khatri.

According to Miller, policymakers and private insurers have sufficient reason to combine mental and physical health care because there is a market incentive to reduce overall costs and a public health mandate to improve patient outcomes.

Still, those in the general population don't place a premium on taking care of their own health, Khatri observed, perhaps because they don't receive strong enough encouragement to do so.

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Speakers Emphasize Need to Integrate Primary, Mental Health Care

CDC issues new protocols for health care workers treating Ebola patients

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Dallas TheUnited Statesissued stringent new protocols on Monday for health workers treatingEbolavictims, directing medical teams to wear protective gear that leaves no skin or hair exposed to prevent medical workers from becoming infected.

The new guidelines from the U.S. Centers for Disease Control and Prevention inAtlantacome as 43 people who were exposed to the first patient diagnosed in theUnited Stateswere declared risk free, easing a national sense of crisis that took hold after twoTexasnurses who treated him contracted the disease.

Under new protocols,Ebolahealthcare workers also must undergo special training and demonstrate competency in using protective equipment. Use of the gear, now including coveralls, and single-use, disposable hoods, must be overseen by a supervisor to ensure proper procedures are followed when caring for patients withEbola, which is transmitted through direct contact with bodily fluids but is not airborne. (CDC protocols: http://1.usa.gov/1vYIwWA)

The hemorrhagic fever has killed more than 4,500 people, mainly in the West African nations ofLiberia,Sierra LeoneandGuinea.

"Even a single healthcare worker infection is unacceptable," CDC DirectorTom Friedensaid in a teleconference with reporters outlining the new regulations.

The old guidelines for health workers, based on World Health Organization protocols, said they should wear masks or goggles but allowed some skin exposure.

More than 40 people exposed to the firstEbolapatient diagnosed in theUnited States,Thomas Eric Duncan, emerged from isolation with a clean bill of health on Monday.

Among those released from monitoring on Monday were the only four individuals quarantined by official order - Duncan's fiance and three other people who shared an apartment with him inDallasbefore he was hospitalized. Duncan died on Oct. 8.

Texasofficials said 120 other potentially exposed people in the state, more than half of them medical workers who had contact with Duncan after he was hospitalized, were still being monitored forEbolasymptoms for the remainder of a 21-day incubation period.

That group includes the two nurses who became infected while treating him atTexas Health Presbyterian Hospital in Dallas, presumably because they were wearing flimsy protective gear that left some of their skin exposed.

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CDC issues new protocols for health care workers treating Ebola patients

Genetic variant helps protect Latinas from breast cancer

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Women of Latin American descent, particularly those with indigenous ancestry, may carry a genetic variant that protects them from breast cancer.

Previous epidemiological studies have shown that Latinas seem to be less susceptible to developing breast cancer than women of other ethnicities. Now an international group of scientists, led by UCSF researchers, have identified the spot on the DNA sequence responsible for that protective effect.

The research is still a long way from making testing for the variant available. Scientists still have a lot more work to do to figure out what the variant means and exactly how it interacts with the body to reduce breast cancer risk.

Its good news in a very general sense. But ... I dont think anyone should stop mammograms because of the variant, said Laura Nejerman, lead author of the study published earlier this week and assistant professor of medicine at UCSF. Now what we are trying to do is think of how best to incorporate this genetic information with other risk-factor information to better provide a picture of breast cancer risk.

But the discovery highlights the existence of genetic risk factor differences between racial groups and ethnicities, and the advent of genome decoding allows researchers to explore those differences. Understanding these variations could shed light on who is most at risk for breast cancer and why some people are less likely to develop the disease and knowing those could lead to a better understanding of cancer overall.

White women of European descent have about a 13 percent lifetime risk of breast cancer, according to National Cancer Institute data from 2007 to 2009. For African American women the risk is about 11 percent; for Asians and Pacific Islanders the risk is about 10 percent.

For Latinas, the risk is 9.8 percent, but its even lower in the 7 percent range among those with indigenous American ancestry, including those from Alaska.

The researchers initially focused on trying to figure out whether there was a genetic variant in European populations that put them at higher risk. Research has identified various mutations, particularly the BRCA genes most closely associated with those of European Jewish descent, that put certain people at higher risk of breast cancer. But their work eventually led them to discover the protective variant in Native American and Latina populations.

Significant impact

Theres no question this is the real thing, said Dr. Elad Ziv, professor of medicine at UCSF and senior author of the study, which was published this week in the journal Nature Communications.

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Genetic variant helps protect Latinas from breast cancer

With Collaboration, Scientists Test Gene Therapy for 'Bubble Boy Disease'

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A new variation of gene therapy raises hopes for a safe and effective long-term treatment for X-linked severe combined immunodeficiency syndrome (SCID-X1), a life-threatening heritable disorder.

The research was produced by a collaborative research team from Dana-Farber/Boston Children's Cancer and Blood Disorders Center, along with other institutions participating in an international clinical trial that involved boys from the United States and France.

SCID-X1, dubbed bubble boy disease after a patient who lived for 12 years in a sterile bubble, is a rare genetic disorder that hinders the ability of individuals to combat infections. Because the disease is carried in an X-chromosome recessive pattern, the disorder occurs almost only in males. The resulting mutations inactivate a gene called IL-2 receptor gamma (IL2RG), severely weakening immune system functions. Left untreated, individuals who inherit the disorder usually die within a year.

Previous gene therapy trials conducted in Europe over a decade ago promised dramatic progress, until a quarter of patients developed leukemia about two to five years following treatment. Scientists found that the previously used vectorthe device for transporting the correct gene in therapyinadvertently activated oncogenes, which can cause cancer.

In this new study, the vector in use is a self-inactivating gammaretrovirus, which has a specific sequence deleted that basic research had implicated in the process of inappropriate activation of oncogenes, David A. Williams, chief of the hematology/oncology department at Boston Children's Hospital, wrote in an email.

Of the nine patients who underwent the treatment, eight had survived between 12 and 38 months after treatment. One boy died from a severe infection he was fighting at the time he enrolled in the study.

A single round of therapy restored normal disease-fighting T cell count300 cells or more per microliter of bloodin six of the eight patients. One patient underwent a second round of treatment and remains healthy despite a low cell count. The eighth patient received a hematopoietic stem cell transplant after the therapy led to less than optimal uptake of the virus and failed to stimulate T-cell production, according to Williams.

We feel the surrogate assays for safety look excellent and are very encouraged, Williams said. However, because leukemia can take years to develop (and although some of our patients are now approaching 4 years of [follow-up]) we must be cautious and continue to follow these children closely.

Williams noted that the research was the result of positive collaboration between institutions.

Work by Sung-Yun Pai and Gigi Notarangelo, funding from [Boston Childrens Hospital] (and other childrens hospitals) and [the National Institute of Health] were essential for success, he said. This is the first international collaborative trial in stem cell gene therapy, which was critical for success due [to the] rarity of [this] disease.

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With Collaboration, Scientists Test Gene Therapy for 'Bubble Boy Disease'

Waza Ena Kumneger 18 Oct 2014 on Mahibere Kidusan and press freedom – Video

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Waza Ena Kumneger 18 Oct 2014 on Mahibere Kidusan and press freedom
ESAT http://ethsat.com is the first independent Ethiopian satellite service tasked to produce accurate and balanced news and information, as well as other entertainment, sports and cultural...

By: ESATtv Ethiopia

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Waza Ena Kumneger 18 Oct 2014 on Mahibere Kidusan and press freedom - Video

Far Cry 4 – Lead Writer Interview – Far Cry 4 is "embracing the freedom even more" – Video

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Far Cry 4 - Lead Writer Interview - Far Cry 4 is "embracing the freedom even more"
At a recent preview event in Paris, we caught up with Lucien Soulban, the lead writer on Far Cry 4, and discussed the story and setting of the next game in the series. "What we ended up doing...

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Far Cry 4 - Lead Writer Interview - Far Cry 4 is "embracing the freedom even more" - Video