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PubMedDate not supplied

Serum IL-10 levels in HIV-positive subjects: correlation with CDC stages.

HIV-1 infection and the HIV gp120 have been shown to induce an IL-10 increase in cultured peripheral blood mononuclear cells. Furthermore, the expression of this cytokine has been reported to increase in lymphnodes of infected patients along the disease course, and a shift from the TH-1 towards the TH-0/TH-2 phenotypes (with subsequent IL-10 release) has been hypothesized to underly AIDS progression. In this study the serum IL-10 levels found in 30 HIV-negative controls and in 65 HIV-positive patients, untreated with AZT and negative for HBsAg and HCV-Ab have been compared, using a commercial, competitive ELISA method based on a polyclonal anti-IL-10 serum. With this test, HIV-positive sea showed IL-10 levels significantly higher than those found in the controls. In addition the IL-10 levels progressively increased in the subsequent CDC stages, without further changes from the stage III to the stage IV. Accordingly, patients evaluated two times in CDC stage II, with a time interval of at least one year, showed significant IL-10 increases, even more pronounced when the same patients passed from CDC stage II to stage III. Furthermore, a significant, negative correlation was observed between the circulating IL-10 levels and the patients' CD4/CD8 ratios. These data may be important from a clinical point of view since IL-10 monitoring could be considered as a surrogate marker for evaluating the disease progression. In addition, several immunological abnormalities present in HIV positive patients, such as the monocyte/macrophage impairment and the hypergammaglobulinemia could be related to the enhanced IL-10 expression.

Adult↗
PubMed1994

Differential survival of patients with AIDS according to the 1987 and 1993 CDC case definitions.

OBJECTIVE: To evaluate the impact of the 1993 Centers for Disease Control and Prevention (CDC) revised classification system for human immunodeficiency virus and expanded surveillance case definition for acquired immunodeficiency syndrome (AIDS) on the number of cases and on survival of patients with AIDS. DESIGN: Retrospective analysis of data from a prospective cohort study of patients treated with zidovudine. PATIENTS: A total of 3515 patients enrolled in the Italian National Registry of Zidovudine-Treated Patients between July 1987 and December 1991 were analyzed. MAIN OUTCOME MEASURES: Numbers and survival probability estimates (using the Kaplan-Meier method) for patients satisfying the 1993 CDC case definition compared with patients fulfilling the 1987 CDC classification. Multiple regression analysis was also used to analyze the combined effect of independent variables on survival. RESULTS: According to the new classification system, the number of AIDS cases in the study population would increase by 188%. While the median survival of patients meeting the 1987 definition was 24 months, at the end of 57 months 53% of patients meeting the 1993 definition were still alive. Among the patients meeting the laboratory criteria for AIDS diagnosis using the new definition (CD4+ lymphocyte count < 0.20 x 10(9)/L [200/microL]), the presence of an AIDS-defining illness was a strong independent predictor of death. CONCLUSIONS: The application of the new definition results in a considerable increase in the number of cases. Survival for patients classified according to the 1993 definition is much longer than for those classified with the 1987 definition. Clinical status plays a major role in predicting survival outcome among patients whose CD4+ lymphocyte counts meet the new case definition.

Acquired Immunodeficiency Syndrome↗
PubMed1996

The new CDC surgical water recommendations: why they should be implemented and what they require.

On May 28, 1993, the Centers for Disease Control and Prevention (CDC) issued its new Recommended Infection-Control Practices for Dentistry, 1993. The American Dental Association adopted these recommendations in August of 1995. Although most of these recommendations are commonly practiced in most dental offices, one aspect has changed dramatically. In the current recommendations, the CDC formally states that sterile saline or sterile water should be used during dental surgical procedures. This article will discuss why these new water recommendations should be implemented and how they complement previously issued CDC recommendations.

Biofilms↗
PubMed1997

Brain atrophy in HIV infection is more strongly associated with CDC clinical stage than with cognitive impairment.

HIV infection often results in MRI-detectable brain atrophy and white matter signal hyperintensities (WMSHs). Magnetic resonance images were obtained from 31 HIV+ male patients and 10 high-risk controls. Variation within the HIV+ group on neuropsychological (NP) impairment and stage of systemic disease were relatively independent, allowing examination of the relative association of MRI measures with NP impairment versus with systemic stage of disease. HIV+ patients compared to high-risk controls evidenced global atrophy, reduced caudate nuclei volume, and a trend to gray matter volume loss but no difference in white matter volume or in WMSHs. These effects were progressive with CDC clinical stage such that patients at CDC stage A had values very close to those of controls, while patients at CDC stage C had the most abnormal values. In contrast, the relationship between these MRI variables and severity of NP impairment was much less dramatic, with the mildly to moderately impaired HIV+ subjects showing MRI volume effects greater than or equal to those of the severely impaired HIV+ subjects. These results suggest that MRI-detectable brain atrophy secondary to HIV infection is not the primary substrate underlying the progressive NP impairment in HIV disease.

AIDS Dementia Complex↗
PubMed2000

National HIV Testing Day at CDC-funded HIV counseling, testing, and referral sites--United States, 1994-1998.

CDC-funded human immunodeficiency virus (HIV) counseling, testing, and referral sites are an integral part of national HIV prevention efforts (1). Voluntary counseling, testing, and referral opportunities are offered to persons at risk for HIV infection at approximately 11,000 sites, including dedicated HIV counseling and testing sites, sexually transmitted disease (STD) clinics, drug-treatment centers, hospitals, and prisons. Services also are offered to women in family planning and prenatal/obstetric clinics to increase HIV prevention efforts among women and decrease the risk for perinatal HIV transmission. To increase use of HIV counseling, testing, and referral services by those at risk for HIV infection, in 1995, the National Association of People with AIDS designated June 27 each year as National HIV Testing Day. This report compares use of CDC-funded counseling, testing, and referral services the week before and the week of June 27 from 1994 through 1998 and documents the importance of a national public health campaign designed to increase knowledge of HIV serostatus.

AIDS Serodiagnosis↗
PubMed2006

CDC's 60th anniversary: director's perspective--James O. Mason, M.D., Dr.P.H., 1983-1989.

The growing momentum toward expanding CDC's responsibilities beyond infectious diseases gained strength during the 1980s. Tremendous advances in controlling infectious diseases had dramatically reduced illness and death from many long-standing health threats. In addition, the detrimental effects of chronic and other noncommunicable diseases on the nation's health were rapidly increasing. Programs to address cancer, heart disease, diabetes, and other leading killers became central to CDC's focus. Yet, for much of this decade, a newly emerging infectious disease would demand the skills and talents of persons across the agency. These new responsibilities led to additional funding, programs, staff, and partnerships for the growing agency, while introducing a host of new challenges.

Centers for Disease Control and Prevention, U.S.↗
PubMed2002

CDC-25.1 regulates germline proliferation in Caenorhabditis elegans.

The cell cycles in C. elegans are tightly controlled but appear to use the same regulators found in other organisms. Four homologues of the dual-specificity phosphatase Cdc25 are present in the C. elegans genome. In our study, we have characterized a deletion mutant for one of these orthologues. We show that embryonic defects are absent in cdc-25.1 homozygous mutants, presumably because of maternally contributed CDC-25.1 product. These embryos hatch and develop into sterile adults. The adults do not appear to have any somatic defects. The sterility results from inadequate germline proliferation. Germline precursors divide slowly and produce abnormally sized daughter cells. Only three to four rounds of germ-cell division occur before they die during the L3 and L4 larval stages.

Animals↗
PubMed1994

AIDS-free survival and overall survival in HIV infection: the new CDC classification system (1993) for HIV disease and AIDS.

The clinical history of 1538 HIV positive patients was analyzed on the basis of the new CDC classification system of HIV disease and AIDS. This classification system combines three CD4 cell categories (1, 2, and 3) with three clinical categories (A, B, and C) into nine subgroups A1-C3. We examined the overall survival for all subgroups and the AIDS-free survival for subgroups A1-B3. AIDS-free survival for patients in subgroups A1, A2, and B1 was considerably longer than survival in patients from subgroups A3, B2, and B3 (P < 0.0001). According to these findings, the new CDC classification system could be simplified into three stages, stage I and II comprising the above mentioned six subgroups, and stage III comprising clinical AIDS defining categories C1, C2, and C3. These three stages correspond to different periods in the management of HIV positive patients, i.e., period of observation, period of prophylaxis, and period of treatment.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Comparing the ESA HPLC total homocysteine assay with electrochemical detection to the CDC in-house HPLC assay with fluorescence detection.

BACKGROUND: Environmental science has developed a simple high performance liquid chromatography (HPLC) assay with electrochemical detection for total homocysteine (tHcy) measurement that does not require derivatization of free thiols. We evaluated this method and compared it with the CDC HPLC assay with fluorescence detection (FD). METHODS: tHcy is measured after reduction of disulfides/protein-bound thiols and protein precipitation using four channels of an ESA CoulArray detector. L-homocystine is used as calibrator, penicillamine as internal standard. RESULTS: Aqueous calibration of the ESA assay resulted in overestimation of tHcy by approximately 30% compared to the HPLC-FD method. Calibration in plasma alleviated the matrix effect. The within- (n=3) and between-run (n=20) imprecision was <6%, the linearity up to 100 micromol/l was excellent, and the recovery of tHcy added to plasma was nearly complete (98.7%+/-2.3%). Good correlation was observed between both methods for 266 plasma samples. The ESA assay showed a minimal negative bias of 0.28 micromol/l (3.3%). CONCLUSION: The ESA tHcy assay performed well in terms of accuracy and precision, and showed good agreement with the CDC HPLC-FD assay when calibrated in plasma. The major advantage of this assay is that it does not require sample derivatization. Disadvantages include instability of the prepared samples for prolonged storage and matrix effects.

Calibration↗
PubMed2005

Public health research at the CDC: implications for communication sciences and disorders.

UNLABELLED: The following paper provides an overview of public health research at the Centers for Disease Control and Prevention (CDC), with emphasis on research involving speech, language and hearing disorders. Public health research involves a sequence of activities from disease tracking to disease prevention. Public health focuses on populations and works to identify changes in programs and policies that can positively impact population health. This paper uses three recent studies conducted by CDC investigators to illustrate different types of research along the public health prevention continuum, with emphasis on activities involving speech, language, and hearing endpoints. The three examples are: a study of cochlear implants and the subsequent risk of meningitis (illustrative of a public health response); a study examining the prevalence of autism in several U.S. populations (an example of a surveillance or monitoring activity); and a study examining the role of in utero cigarette exposure in the etiology of oral facial clefts (illustrative of a epidemiologic risk factor study). The public health continuum provides an important vehicle for advancing our knowledge of the causes and effective prevention of communication disorders. LEARNING OUTCOMES: The reader will become familiar with the public health sequence and the manners in which public health research relates to speech, language, and hearing disorders. The reader will be able to identify and discriminate among the components of public health research using the examples provided.

Autistic Disorder↗
PubMed2006

Successful treatment of a localised CDC Group EF-4a infection in a cat.

Organisms classified within the Center for Disease Control (CDC) Group eugonic fermenter (EF)-4a are facultative anaerobic, Gram-negative coccobacilli, thought to be of the family Neisseriaceae. CDC Group EF-4a is considered a component of normal oral flora in cats and dogs and is most commonly isolated from bite injuries of human patients. Most previously reported cases in cats have involved fatal necrotising pneumonia. We report a localised infection of the retropharyngeal/mandibular tissues in a cat, which responded to surgical drainage and a 5-week course of amoxycillin clavulanate. There are no prior reports of successfully treated EF-4a infections in cats in the literature.

Animals↗
PubMed1987

Diffusion and adoption of CDC guidelines for the prevention and control of nosocomial infections in US hospitals.

Since 1981, the Centers for Disease Control (CDC) has been publishing Guidelines for the Prevention and Control of Nosocomial Infections as a useful reference tool in infection control. The extent to which practices recommended by CDC to reduce hospital-acquired infections have been successfully diffused and adopted were evaluated in a stratified random sample of 445 US hospitals that were sent a questionnaire in 1985. The data suggest that over 84% of infection control practitioner respondents (78% response rate) are aware of each guideline, although small hospitals (less than 50 beds) are least likely to be aware of the guidelines or to have reviewed them thoroughly. Adoption of the recommendations remains far from universal, ranging from 23% to 75% for 16 specific recommendations investigated. Smaller hospitals were significantly less likely than large hospitals to have adopted each suggested policy. Recommendations that carried Category I rankings were more likely to be adopted, as were those procedures that had cost-savings implications.

Centers for Disease Control and Prevention, U.S.↗
PubMed1998

Local reinvention of the CDC HIV prevention community planning initiative.

The Centers for Disease Control and Prevention (CDC), in coordination with 65 states, cities, and territories, implemented HIV prevention community planning beginning in 1994. This large scale innovation in public health planning has involved tens of thousands of professionals and community residents. Though a single case study, Michigan provides a strong test of the implementation of this national prevention planning model because of the state's decentralized approach to HIV prevention community planning involving several hundred residents. A decentralized approach to community planning promises to maximize participation and the sharing of leadership as well as obstacles to community planning. Here, the CDC Guidance for community planning is contrasted with empirical observation of implementation in Michigan. We conclude that the high expectations for a decentralized approach to HIV prevention community planning can be best achieved when a distinction is drawn between information-seeking tasks and decision-making tasks. We recommend that information-seeking tasks be centrally coordinated, and that decision-making tasks be decentralized, to most fully achieve the potential of HIV prevention community planning.

Centers for Disease Control and Prevention, U.S.↗
PubMed2006

Sequential functioning of the ECT-2 RhoGEF, RHO-1 and CDC-42 establishes cell polarity in Caenorhabditis elegans embryos.

During development, the establishment of cell polarity is important for cells to undergo asymmetric cell divisions that give rise to diverse cell types. In C. elegans embryos, cues from the centrosome trigger the cortical flow of an actomyosin network, leading to the formation of anterior-posterior polarity. However, its precise mechanism is poorly understood. Here, we show that small GTPases have sequential and crucial functions in this process. ECT-2, a potential guanine nucleotide-exchange factor (GEF) for RHO-1, was uniformly distributed at the cortex before polarization, but was excluded from the posterior cortex by the polarity cue from the centrosomes. This local exclusion of ECT-2 led to an asymmetric RHO-1 distribution, which generated a cortical flow of the actomyosin that translocated PAR proteins and CDC-42 (Refs 4, 5) to the anterior cortex. Polarized CDC-42 was, in turn, involved in maintaining the established anterior-cortical domains. Our results suggest that a local change in the function of ECT-2 and RHO-1 links the centrosomal polarity cue with the polarization of the cell cortex.

Actomyosin↗
PubMed2006

Is the 2000 CDC growth reference appropriate for developing countries?

In 2000, the Centers for Disease Control and Prevention (CDC) produced a revised growth reference. This has already been used in different settings outside the USA. Using data obtained during a nutritional survey in Madagascar, we compare results produced by using both the 2000 CDC and the 1978 National Center for Health Statistics (NCHS)/World Health Organization (WHO) growth references. We show that changing the reference has an important impact on nutritional diagnosis. In particular, the prevalence of wasting is greatly increased. This could generate substantial operational and clinical difficulties. We recommend continued use of the 1978 NCHS/WHO reference until release of the new WHO multi-country growth charts.

Age Factors↗
PubMed1998

Evaluating the control of tuberculosis among healthcare workers: adherence to CDC guidelines of three urban hospitals in California.

OBJECTIVE: To evaluate adherence to components of the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities. DESIGN: Multihospital study using direct observation and a standardized questionnaire. SETTING: Three urban hospitals (two county hospitals and one private community hospital) in counties in California with a high number and incidence rate of tuberculosis (TB) cases. MEASUREMENTS: The ventilation performance of treatment and TB-patient isolation rooms was assessed. Questionnaire data regarding TB control policy and procedures were obtained through interviews with the person(s) responsible for each program component; review of written TB control plans, training, and educational materials; and attendance at hospital TB control meetings and trainings. RESULTS: Twenty-eight percent of isolation rooms tested (7/25) were under positive pressure; 83% of rooms tested (20/24) had six or more nominal air changes per hour (ACH), but supply air did not mix rapidly with room air. Therefore, the nominal ACH likely overestimated the effective ACH and the subsequent protection provided. In virtually all rooms tested (26/27), air potentially containing M tuberculosis aerosol moved toward, rather than away from, likely worker locations. None of the hospitals regularly checked the performance of engineering controls. Only one hospital adhered to the CDC minimum requirements for respiratory protection. Training of healthcare workers generally was underutilized as a TB prevention measure. Hospitals did not provide comprehensive counseling regarding the need for healthcare workers to know their immune status and the risks associated with M tuberculosis infection in an immunocompromised individual. Employee representatives did not have a voice in TB-related decision making. CONCLUSIONS: Important aspects of day-to-day TB control practice did not conform to the written TB control policy. Subsequent to the identification of TB patients, healthcare workers at all three hospitals were potentially exposed to M tuberculosis aerosol due to breaches in negative-pressure isolation, the limitations of dilution ventilation, and the failure to maintain engineering controls and to implement respiratory protection controls fully. These findings lend support to the Occupational Safety and Health Administration's policy presumption that, absent clear evidence to the contrary, newly acquired healthcare-worker M tuberculosis infections are work-related.

California↗
PubMedDate not supplied

Serious infections involving the CDC group Ve bacteria Chryseomonas luteola and Flavimonas oryzihabitans.

Chryseomonas luteola and Flavimonas oryzihabitans are phenotypically similar gram-negative bacilli and are also referred to as CDC groups Ve-1 and Ve-2, respectively. These bacteria are rarely reported as pathogens in humans. Infections described in the literature include primarily bacteremia in critically ill patients and peritonitis in patients undergoing continuous ambulatory peritoneal dialysis. We describe three cases of polymicrobial infection secondary to infection with group Ve organisms, including the first reported case (to our knowledge) of CNS infection due to F. oryzihabitans. These three cases and a review of literature suggest an association between the presence of indwelling catheters and polymicrobial infections with CDC group Ve organisms. F. oryzihabitans and C. luteola should be added to the expanding list of nosocomial pathogens with a propensity to infect critically ill patients who have undergone surgical procedures and/or had indwelling catheters placed. The isolation of either of these organisms from clinical specimens should prompt a search for a device-related source.

Adolescent↗
PubMed2005

CDC international HIV prevention research activities among injection drug users in Thailand and Russia.

The Centers for Disease Control and Prevention (CDC) has participated in collaborative HIV prevention research activities in injection drug users (IDUs) with the Bangkok Metropolitan Administration (BMA) in Bangkok, Thailand, from 1995 to the present and with the Orel AIDS Center in Orel Oblast, Russia, from 2001 to 2003. Studies in Bangkok have included an HIV prevention trial preparatory cohort from 1995 to 1998, a seroconverter cohort from 1998 to the present, a phase III trial of the AIDSVAX B/E gp120 HIV vaccine from 1999 to 2003, and a phase II/III HIV prophylaxis trial with tenofovir scheduled to begin in 2005. Activities in Orel included a review of HIV surveillance data in 2001, focus group discussions and a case-control study with HIV-infected and -uninfected IDUs in 2001, a cross-sectional study with the female sex partners of male IDUs in 2002, and a community outreach intervention in 2002-2003. In Bangkok, 1,209 IDUs were enrolled in the preparatory cohort which revealed an HIV incidence of 5.8% per 100 person-years; 133 HIV-infected IDUs have been followed in the seroconverter cohort with >85% follow-up and HIV and tuberculosis care provided; 2,546 IDUs were enrolled in the HIV vaccine efficacy trial which was successfully completed with a follow-up rate of >95%, although the vaccine was not shown to be effective at reducing HIV incidence; and 1,600 IDUs will be enrolled in the daily tenofovir HIV prophylaxis trial in 2005. In Orel, initial focus group discussions and epidemiologic studies revealed low HIV knowledge and high rates of unsafe injecting and sexual practices among IDUs and their female sex partners; and educational campaigns and the community outreach intervention were developed and implemented. A steady decline in new HIV infections in IDUs was then observed in Orel in 2002-2003. CDC has participated in the conduct of successful collaborative HIV prevention research activities in Thailand and Russia over the past decade. The establishment of long-term relationships with in-country public health and community partners has been instrumental in the success of these efforts.

AIDS Vaccines↗