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Relationship of CDC group EO-2 and psychrobacter immobilis.

Thirty strains of microorganisms previously classified in the CDC group EO-2 were studied to determine the relationship of this group and the recently proposed Psychrobacter immobilis. Results of transformation studies indicated that 9 of the 30 studied strains should be reclassified as P. immobilis. While transformation studies should be used to identify the Psychrobacter genus definitively, some presumptive characteristics useful in differentiating the CDC group EO-2 and P. immobilis were observed. The Psychrobacter genus, compared with the CDC group EO-2, grew well at 25 degrees C, lightly or not at all at 35 degrees C, and not at all at 42 degrees C, grew in nutrient broth without NaCl and with only one exception grew in 6% NaCl, usually did not produce acid from adonitol, dextrin, fructose, or D-mannitol, did not demonstrate the O-shaped cellular morphology, and usually possessed an odor resembling that noted from a phenylethyl alcohol blood agar plate.

DNA, Bacterial↗

Use of chemotaxonomy as an aid to differentiate among Capnocytophaga species, CDC group DF-3, and aerotolerant strains of Leptotrichia buccalis.

Four strains of fastidious gram-negative rods, thought to be Capnocytophaga species (formerly CDC group DF-1 or Bacteroides ochraceus) or CDC group DF-3 on the basis of conventional phenotypic criteria, were also analyzed for cellular fatty acid (CFA) composition. It was found that the CFA compositions of these strains were qualitatively incorrect for those taxa. Subsequently, it was determined that all four bacteria were in fact aerotolerant strains of Leptotrichia buccalis, based on biochemical reactions, CFA composition, and lactic acid as the major end product of glucose fermentation. It is recommended that, in addition to conventional cultural and biochemical criteria, all strains of Capnocytophaga or CDC group DF-3 should also be tested for metabolic end products of fermentation and CFA composition as essential adjuncts for identification.

Bacteroidaceae↗

Chemical and cultural characterization of CDC group WO-1, a weakly oxidative gram-negative group of organisms isolated from clinical sources.

Ninety-six strains of weakly oxidative gram-negative rods isolated primarily from clinical specimens form a distinct group that has been designated Centers for Disease Control (CDC) group WO-1 (WO stands for weak oxidizer). The phenotypic characteristics of CDC group WO-1 were most similar to those of Comamonas acidovorans, Pseudomonas mallei, and CDC pink coccoid group III. The WO-1 group can be differentiated from C. acidovorans by the oxidation of glucose (often weak and sometimes delayed), motility by means of one or two polar flagella, and, when positive, the complete reduction of nitrate and nitrite. Motility and usually the failure to produce arginine dihydrolase distinguish this group from P. mallei. The WO-1 strains differ from the pink coccoid group III by the absence of pink growth pigment, the lack of predominantly coccoid cellular morphology, and usually the inability to produce acid from xylose. The cellular fatty acid compositions of 29 group WO-1 strains were characterized by large amounts of C16:0 and C16:1w7c; smaller amounts of C18:1w7c, C14:0, C12:0, and 3-OH-C10:0; and trace to small amounts of C15:1w6 and C17:0 acids. The fatty acid profile of WO-1, compared with the profiles of other bacteria we have tested previously, was most similar to the profiles of two phenotypically different organisms, Comamonas terrigena (a nonoxidative, multipolar gram-negative rod) and Chromobacterium violaceum (a fermentative gram-negative rod). Ubiquinone-8 was the major quinone in the five WO-1 strains examined. Eighty-five percent of the WO-1 strains were isolated from human specimens. Thirty-three percent were from blood, and 10% were from cerebrospinal fluid.

Cell Movement↗

Recognition of Dermabacter hominis, formerly CDC fermentative coryneform group 3 and group 5, as a potential human pathogen.

Thirty strains of fermentative coryneform-like bacteria designated CDC fermentative coryneform group 3 and coryneform group 5 were compared biochemically by cellular fatty acid analysis and by DNA relatedness with the type strain of Dermabacter hominis, ATCC 49369. DNA from 22 strains of both CDC groups showed 69 to 96% relatedness (hydroxyapatite method) to labeled DNA from ATCC 49369 and to DNA from CDC group 3 strain G4964, and the strains are considered to belong to D. hominis. The remaining eight strains were genetically but not phenotypically differentiable from D. hominis. They were genetically heterogeneous, but hybridization results indicated that they probably belong to the genus Dermabacter. Thirteen of the 22 D. hominis strains and all 8 of the other Dermabacter strains had been isolated from blood, which indicates the pathogenic potential of this species and genus.

Actinomycetales↗

Prediction of peak oxygen uptake in patients fulfilling the 1994 CDC criteria for chronic fatigue syndrome.

PURPOSE: To establish an inexpensive, simple method of predicting peak oxygen uptake (VO2peak) in patients fulfilling the 1994 Centers for Disease Control and Prevention (CDC) criteria for chronic fatigue syndrome (CFS). DESIGN: A retrospective observational study. SETTING: An outpatient tertiary care chronic fatigue clinic. SUBJECTS: Two hundred and forty consecutive patients fulfilling the 1994 CDC criteria for CFS. INTERVENTIONS: Heart rate, metabolic and ventilatory parameters were measured continuously during a maximal exercise stress test on a bicycle ergometer. Using the equation peak oxygen uptake = 13.1 x peak workload +284 (used by Mullis et al., Br J Sports Med 1999; 33: 352-56), VO2peak was predicted from the peak workload of a maximal exercise capacity test. Pearson correlation coefficient and linear regression analysis were used to establish the most accurate way to predict VO2peak. RESULTS: Percentage error encountered when comparing actual measured VO2peak with predicted value was 17.3% (+/-10.0). A strong correlation between VO2peak and peak workload was observed (r= 0.89, p < 0.001). A regression analysis established the relation as VO2peak = 10.47 x peak workload +284.1, where VO2peak is given in ml/min and peak workload in W (error in prediction = 11.0+/-9.5%). CONCLUSIONS: Monitoring of the peak workload during a maximal, graded bicycle ergometric test suffices to predict the VO2peak. When predicting VO2peak the used operational definition for the diagnosis of CFS could be taken into account. Compared with the equation used by Mullis et al., peak workload is multiplied by 10.47 in order to predict peak oxygen uptake in CDC-defined CFS patients.

Adult↗

The new CDC and AAP lead poisoning prevention recommendations: consensus versus controversy.

A considerable body of evidence has surfaced over the past several decades indicating that low-level lead exposure has detrimental effects for young children. As neurocognitive deficits have increasingly been found to be associated with lead levels as low as 10 micrograms/dL, the CDC has progressively lowered the threshold lead level designated as elevated to the present level of 10 micrograms/dL. The CDC also has recommended universal screening of all children for lead. These recommendations have engendered much controversy. After independently reviewing the relevant literature, the AAP and the National Academy of Science concurred with the CDC's conclusions and recommendations. As additional prevalence information becomes available, a more targeted approach to screening based on local prevalence data eventually may replace universal screening. However, as long as lead is found everywhere in the environment, children will continue to develop lead poisoning and suffer from its adverse effects. The problem of lead poisoning can be summarized best by a quote from a report of the Agency for Toxic Substances and Disease Registry to Congress, "Lead is toxic wherever it is found, and it is found everywhere."

Centers for Disease Control and Prevention, U.S.↗

Disease prevention and the CDC. Interview by C. Burns Roehrig.

As director of the Centers for Disease Control (CDC) in Atlanta, William L. Roper, MD, leads the agency of the U.S. Public Health Service responsible for promoting health and preventing disease, injury and premature death. Before coming to CDC in March of 1990, Dr. Roper, a pediatrician, served as a health care adviser for two presidents throughout the 1980s and as head of the Health Care Financing Administration (HCFA) from 1986 to 1989. Reflecting recently on the various roles he has played, Dr. Roper spoke with C. Burns Roehrig, MD, editor of The Internist: Health Policy in Practice about the CDC and its efforts to prevent the spread of AIDS, hepatitis and other diseases.

Acquired Immunodeficiency Syndrome↗

Revised diphtheria, tetanus, and pertussis (DTP/DTaP/DT) vaccine information materials--CDC. Notice.

Under the National Childhood Vaccine Injury Act (42 U.S.C section 300aa-26), the CDC must develop vaccine information materials that health care providers, either public or private, are required to distribute to patients/parents prior to administration of each dose of specific vaccines. On September 13, 1996, CDC published a notice in the Federal Register (61 FR 48597) seeking public comment on proposed revision of the diphtheria, tetanus, and pertussis vaccine information materials to reflect Food and Drug Administration (FDA) licensure of acellular pertussis vaccine combined with diphtheria and tetanus toxoids (DTaP) for administration to infants as young as two months of age. The 60-day comment period ended on November 12, 1996. Following review of the comments submitted and consultation as required under the law, CDC has finalized the revised diphtheria, tetanus, and pertussis vaccine information materials. Those final materials are contained in this notice.

Centers for Disease Control and Prevention, U.S.↗

Privacy Act of 1974; annual publication of systems of records--CDC.

The Centers for Disease Control (CDC) is publishing this document to meet the requirement of the Privacy Act, as amended by the Congressional Reports Elimination Act (Pub. L. 97-375), to republish the notices of systems of records which have been revised. This publication provides a table of contents which contains the numerical designations and titles of all systems of records maintained by CDC and its organizational components, including the National Institute for Occupational Safety and Health (NIOSH). In addition, the notices of systems of records which have been revised following a comprehensive review are indicated by an asterisk in the Table of Contents and are published below in their entirety. CDC's system notices were last published in the Federal Register, Vol. 47, No. 198, pp. 45469-45513, October 13, 1982. One additional new system of records: 09-20-0161, "Records of Health Professional in Disease Prevention and Control Training Programs," HHS/CD/CPS, has been published in the Federal Register Vol. 48, No. 127, pp. 30187-30188, June 30, 1983. Twenty-five of the forty-two notices which were published in the 1982 annual compilation have been modified to clarify the descriptions and to ensure that they are complete, accurate, and timely. None of these changes requires a report of altered system to be sent to the Congress and the Office of Management and Budget. The notices are complete and accurate as of August 15, 1983.

Centers for Disease Control and Prevention, U.S.↗

New vaccine information materials for hepatitis B, Haemophilus influenzae type b (Hib), and varicella (chickenpox) vaccines, and revised vaccine information materials for measles, mumps, rubella (MMR) vaccines. Centers for Disease Control and Prevention (CDC), Department of Health and Human Services. Notice.

Under the National Childhood Vaccine Injury Act (42 U.S.C. 300aa-26), the CDC must develop vaccine information materials that all health care providers, whether public or private, are required to distribute to patients/parents prior to administration of each dose of specific vaccines. On September 3, 1998, CDC published a notice in the Federal Register (63 FR 47026) seeking public comment on proposed vaccine information materials for the newly covered vaccines hepatitis B, Haemophilus influenzae type b, and varicella vaccines, and also seeking comment on proposed revised vaccine information materials for measles, mumps, rubella (MMR) vaccines. The 60 day comment period ended on November 2, 1998. Following review of the comments submitted and consultation as required under the law, CDC has finalized these vaccine information materials. The final materials are contained in this notice.

Centers for Disease Control and Prevention, U.S.↗

Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC.

Group B streptococcus (GBS) remains a leading cause of serious neonatal infection despite great progress in perinatal GBS disease prevention in the 1990s. In 1996, CDC, in collaboration with other agencies, published guidelines for the prevention of perinatal group B streptococcal disease (CDC. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR 1996;45[RR-7]:1-24). Data collected after the issuance of the 1996 guidelines prompted reevaluation of prevention strategies at a meeting of clinical and public health representatives in November 2001. This report replaces CDC's 1996 guidelines. The recommendations are based on available evidence and expert opinion where sufficient evidence was lacking. Although many of the recommendations in the 2002 guidelines are the same as those in 1996, they include some key changes: * Recommendation of universal prenatal screening for vaginal and rectal GBS colonization of all pregnant women at 35-37 weeks' gestation, based on recent documentation in a large retrospective cohort study of a strong protective effect of this culture-based screening strategy relative to the risk-based strategy * Updated prophylaxis regimens for women with penicillin allergy * Detailed instruction on prenatal specimen collection and expanded methods of GBS culture processing, including instructions on antimicrobial susceptibility testing * Recommendation against routine intrapartum antibiotic prophylaxis for GBS-colonized women undergoing planned cesarean deliveries who have not begun labor or had rupture of membranes * A suggested algorithm for management of patients with threatened preterm delivery * An updated algorithm for management of newborns exposed to intrapartum antibiotic prophylaxis Although universal screening for GBS colonization is anticipated to result in further reductions in the burden of GBS disease, the need to monitor for potential adverse consequences of intrapartum antibiotic use, such as emergence of bacterial antimicrobial resistance or increased incidence or severity of non-GBS neonatal pathogens, continues, and intrapartum antibiotics are still viewed as an interim strategy until GBS vaccines achieve licensure.

Antibiotic Prophylaxis↗

Center for Disease Control (CDC) flow cytometry panel for human immunodeficiency virus infection allows recognition of infectious mononucleosis caused by Epstein-Barr virus or cytomegalovirus.

AIM: To analyze the distribution of lymphocyte subsets in the peripheral blood of patients with infectious mononucleosis caused by Epstein-Barr virus (EBV) and cytomegalovirus (CMV) and to investigate the possible diagnostic usefulness of flow cytometry panel recommended by the Center for Disease Control and Prevention (CDC) for HIV-1 infection. METHODS: The study included 130 immunocompetent adults with infectious mononucleosis caused by EBV (n=103) and CMV (n=27) and 50 controls. EBV-infected patients were divided into two groups based on typical (n=92) or atypical (n=11) clinical presentation of the disease. Lymphocyte subpopulations were determined by flow cytometry and a panel of monoclonal antibodies recommended by the CDC for the immunophenotyping of patients infected with human immunodeficiency virus (HIV). RESULTS: Patients with typical and atypical presentation of EBV-induced infectious mononucleosis showed increased percentages of total T-cells, cytotoxic-suppressor CD8(+) T cells and activated HLA-DR(+) T cells compared to healthy controls. Percentages of CD4(+) T cells, as well as CD4/CD8 ratio, were significantly decreased. Absolute counts of CD4(+) T cells and percentages of B cells did not differ from healthy controls. Pattern of changes in CMV-infected patients was completely identical to that in healthy controls, although less pronounced. CONCLUSION: Lymphocyte subpopulations represented in the CDC panel for HIV are sufficient for the recognition of patients with infectious mononucleosis caused by EBV and CMV. Flow cytometry can be useful support for reaching diagnosis in patients with atypical clinical presentation of EBV-induced infectious mononucleosis.

Adult↗

CDC's Model Performance Evaluation Program: assessment of the quality of laboratory performance for HIV-1 antibody testing.

In 1986, the Centers for Disease Control (CDC) implemented the Model Performance Evaluation Program (MPEP) to evaluate the performance of laboratories that test for antibody directed against human immunodeficiency virus type 1 (HIV-1). The impetus for developing this program came from the recognition of a need to assess the quality of existing and changing laboratory technology and to ensure that the quality of testing was sufficient to meet medical and public health needs. To develop the program, CDC chose HIV-1 antibody testing as the first specific application for assessing the quality of laboratory performance because (a) of the importance of accurate and reproducible test results for acquired immunodeficiency syndrome (AIDS) surveillance, prevention, and treatment programs; (b) HIV-1 testing technology is new to many laboratories; and (c) HIV-1 testing practices and applications continue to evolve. Unlike proficiency testing programs, the MPEP is not limited to assessing quality in the analytical step, alone. It will also assess quality in the preanalytical and postanalytical steps of the testing process, that is, from the time a test is requested until the clinician who ordered the test takes an action based on the test result. The participating laboratories furnish the information needed for the performance evaluation program by (a) completing questionnaires designed to describe HIV-1 testing laboratories and their testing practices, (b) analyzing specially prepared sample panels for HIV-1 antibody reactivity, and (c) reporting results to CDC.

AIDS Serodiagnosis↗

Training and service in public health practice, 1951-90--CDC's Epidemic Intelligence Service.

The Epidemic Intelligence Service (EIS) was created at the Centers for Disease Control (CDC) in 1951 as a combined training and service program in the practice of applied epidemiology. Since 1951, more than 1,700 professional have served in this 2-year program of the Public Health Service. In the decade of the 1980s, EIS underwent dramatic changes in response to the increased breadth of the CDC mission and the rapid expansion of epidemiologic methods. Modifications in the experience of an EIS Officer have resulted from the increased need for more sophisticated analytic methods and the use of microcomputers, as well as CDC's expanded mission into chronic diseases, environmental health, occupational health, and injury control. Officers who have entered the EIS in the past decade tend to be older than their predecessors, tend to enter the program with more experience and training in epidemiology, and are more likely to stay in public health either at the Federal level or in State and local health departments. The EIS Program continues to be a critical source for men and women to respond to the need and demand for epidemiologic services both domestically and internationally.

Centers for Disease Control and Prevention, U.S.↗

Comparison of an experimental updraft ultraviolet light trap with the CDC miniature light trap and biting collections in sampling for Anopheles albimanus in Haiti.

Three methods of capturing Anopheles albimanus mosquitoes were compared during a field study in four villages in northern Haiti. Updraft ultraviolet (UV) light traps proved to be more effective than biting collections, regardless of season or whether the tests were done indoors or outdoors. Biting collections were in turn more effective than the Centers for Disease Control (CDC) miniature light traps. Updraft UV light traps and biting collections yielded more An. albimanus outdoors than indoors; the reverse was found for the CDC miniature light traps. The updraft UV light traps caught An. albimanus on 86% of the occasions used outside and 75% of the occasions inside. The biting collections were equally as successful as the traps in catching mosquitoes outside but caught An. albimanus only on 64% of the occasions when used inside houses. The CDC miniature light traps were successful in collecting An. albimanus on 33% of the occasions outside and 60% of the occasions inside.

Animals↗

The use of CDC light traps and other procedures for sampling malaria vectors in southern Iran.

An investigation was carried out over a year in the village of Chelow, Hormozgan Province, southern Iran, to study the efficacy of CDC light traps for sampling malaria vectors. The CDC light traps were useful in determining the seasonal and habitat distribution of Anopheles stephensi and An. fluviatilis, the primary and secondary vectors of malaria, in Chelow, as well as other mosquitoes in that area. Light traps compared favorably with other adult mosquito collection techniques for detecting the presence of vectors during periods of low density. In Iran, time and labor-saving features and flexibility for use in different situations make CDC light traps a useful sampling tool in the entomological assessment of malaria control programs.

Animals↗

DATA2000: CDC WONDER information system linking Healthy People 2000 objectives to data sets.

To monitor progress on the Healthy People (HP) 2000 objectives, planners and researchers will need information on relevant data sources. DATA2000 is a project designed to identify these data and link them with objectives and to develop a computerized information system providing access to this information. Sources of information on objectives and data included Healthy People 2000, catalogs and data bases of data sets, and the HP 2000 Steering Committee. We created an "assessment" of the utility of the data set for the particular objective. A Centers for Disease Control (CDC) WONDER-based information system was developed (using methods previously described). We identified 204 data sets and created 408 assessments. All but one of the objectives were paired with corresponding data. Over half the data come from CDC. The CDC WONDER-based information system crosslinks the objectives, data sets, and assessments and provides 5-10 pages of information about each. Understanding the contribution of prevention will be critical in planning reforms of the health care system. DATA2000 can be an important resource in this process.

Centers for Disease Control and Prevention, U.S.↗

Metabolic and structural changes in Pseudomonas aeruginosa, Achromobacter CDC and Agrobacterium radiobacter cells injured in parenteral fluids.

The long term metabolic changes of three oxidase positive microorganisms (Pseudomonas aeruginosa, Agrobacterium radiobacter and Achromobacter CDC) all isolated from aquatic environment, were defined after they were inoculated in three parenteral fluids: Lactated Ringer's solution, Sodium Chloride 0.9% and Dextrose 5%. The number of microorganisms introduced into the parenteral products was adjusted to 10(5) bacteria/ml and left at room temperature (20-22 degrees C) for 30 days. Their enzymatic and protein profile as compared with their initial characteristics after they were grown in broth, were measured using API 20NE batteries of tests and gel electrophoresis. In L-R and NaCl 0.9% fluids, P. aeruginosa and Ag. radiobacter lost the ability to hydrolyse urea while Ac CDC retained this ability. In Dextrose 5% fluid the microorganisms lost most of their metabolic characters. The protein patterns in SDS-PAGE of samples prepared from cells of the tested microorganisms showed marked differences (in P. aeruginosa) to minor differences (in Ag. radiobacter and Ac CDC) while new proteins with M(r) > 66KDa revealed Ag. radiobacter cells. The gelatinolytic zymogram shows also differences between bacterial cells grown in nutrient broth and those that remained in parenteral fluids. These changes reflect the stress of the tested bacteria in an unfavorable condition. The alterations of injured bacteria could render them unable to grow on routine, for sterilization testing, culture media.

Alcaligenes↗