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Biomedical subjects

R H Rapkin

Publications and source records attributed to R H Rapkin.

At least 19 recordsLinked to original sources
PubMed1986

Pathology of opportunistic infections in children with acquired immune deficiency syndrome.

Opportunistic infections (OI) were diagnosed by histology and culture of biopsy and autopsy material in 15 children with the acquired immune deficiency syndrome (AIDS). The opportunistic pathogens included Pneumocystic carinii, Toxoplasma gondii, Candida species, Aspergillus species, Mycobacterium avium-intracellulare, cytomegalovirus, and herpes simplex virus. Seven of 15 patients also had multiple systemic infections with common pathogenic bacteria. Accurate diagnosis of OI in AIDS is of importance in the decision regarding the choice of appropriate antimicrobial therapy. Careful histologic assessment of the biopsy specimens; awareness of unusual features such as paucity of organisms and inflammatory reaction, "histoid" variety of reaction, lack of granuloma formation, and resemblance to Whipple's disease in certain OI; and demonstration of causative organisms by appropriate special stains and/or culture are essential in the evaluation of these patients.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Pathologic pulmonary findings in children with the acquired immunodeficiency syndrome: a study of ten cases.

Lung tissue and tissue from the lymphoreticular system obtained at open biopsy and/or autopsy were studied in ten children with the acquired immunodeficiency syndrome (AIDS). One or both parents of nine of the children had AIDS or risk factors for AIDS. The remaining child had hemophilia. The following pulmonary lesions were seen: 1) diffuse alveolar damage (DAD), 2) Pneumocystis carinii and/or cytomegalovirus pneumonitis, 3) lymphoid interstitial pneumonitis (LIP), and 4) desquamative interstitial pneumonitis (DIP). Combinations of such factors as mechanical ventilation, oxygen therapy, and opportunistic infection played a role in the pathogenesis of DAD. Opportunistic infections were related to the defective cell-mediated immunity in these children. The clinical, epidemiologic, immunologic, and pathologic features of the thymuses of these patients indicate that the immune deficiency was unlikely to have been of congenital origin. The immunologic abnormalities may also have been related to the pathogenesis of LIP and DIP. Neither LIP nor DIP has been described in adults with AIDS. Open lung biopsy is of practical importance in the diagnosis and treatment of pulmonary disease in children with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Pathology of suspected acquired immune deficiency syndrome in children: a study of eight cases.

Biopsy and/or autopsy material from lymphoreticular and other organs was studied in 8 children with suspected acquired immune deficiency syndrome (AIDS). One or both parents of each of these children had one or more of the recognized risk factors for AIDS, such as intravenous drug abuse, prostitution, Haitian origin. The following histologic patterns were noted in the lymph nodes: (1) follicular hyperplasia with normocellular paracortex, (2) follicular hyperplasia with depletion of paracortex, and (3) atrophy of follicles with depletion of paracortex. Lymphoid interstitial pneumonitis (LIP), a previously unreported lesion in AIDS, was present in 4 cases. It is suggested that the pulmonary lymphoid lesion may be part of a more generalized lymphoid hyperplasia involving B cells. The gross and microscopic features of the thymus, available in 2 of the 8 cases, indicated that the immunologic defect in these children was not of congenital type. Pathologic findings can be helpful in the diagnosis of the syndrome when correlated with clinical and immunologic features of suspected cases and of the pulmonary lesion. The latter is of importance in deciding the type of therapy to be given for the pulmonary disease process.

Acquired Immunodeficiency Syndrome↗
PubMed1976

The subspecialist and the child.

Specialty services for children may be defective because the subspecialist has not had adequate training in general pediatrics. Pediatric and pediatric surgery postgraduate programs should encourage this type of training for all subspecialists who care for children. Unless or until this occurs, the pediatrician must remain involved in the care of his patients whether their problems are primarily medical or surgical.

Child↗
PubMed1976

Pseudomonas cepacia in an intensive care nursery.

A small epidemic of Pseudomonas cepacia infection in an intensive care nursery was associated with contaminated, distilled water. This appeared to have occurred because of a leak in the distiller, contaminating its effluent. The distilled water was not subsequently sterilized, nor were the bottles used to distribute it. The epidemic was promptly terminated by substitution of sterile, distilled water distributed in sterile containers. Both professional and nonprofessional hospital personnel failed to oversee the appropriateness of handling of patient care materials.

Aged↗