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Biomedical subjects

C R White

Publications and source records attributed to C R White.

At least 91 records · Page 5Linked to original sources
PubMed1990

Premarital screening for antibodies to human immunodeficiency virus type 1 in the United States. The Premarital Screening Study Group.

To evaluate premarital human immunodeficiency virus (HIV) screening as an approach to AIDS prevention in the United States, we determined the HIV antibody seroprevalence in marriage license applicants in eight areas by blinded testing of blood specimens routinely collected for syphilis serology. The seroprevalences were 0.0-0.4 percent in women and 0.0-1.1 percent in men. We also examined the impact of mandatory premarital HIV screening on marriage rates in Louisiana and Illinois. In 1988, after screening began, 9 percent and 16 percent fewer marriage licenses than in the previous two years were issued in Louisiana and Illinois, respectively. We estimated that mandatory premarital screening, if adopted nationally, would cost $167,230,000. We conclude that compared with other HIV prevention programs mandatory premarital screening would be expensive and would probably have a minor impact on the HIV epidemic.

AIDS Serodiagnosis↗
PubMed1990

Histopathology of exogenous and systemic contact eczema.

The histopathology of systemic allergic contact dermatitis is usually characterized by spongiosis. A number of other much less common to rare histological findings have also been reported, including erythema multiforme-like eruption, vasculitis, urticaria, and miscellaneous groups.

Dermatitis, Contact↗
PubMed1990

Lack of transmission of human immunodeficiency virus from infected children to their household contacts.

The possibility of transmission of the human immunodeficiency virus (HIV) from infected children to their contacts has been confronted in households, schools, day-care centers, and other child care settings. Cases reported to the Centers for Disease Control and several studies of close contacts of HIV-infected patients suggested that the risk of transmission in these settings is extremely low. However, most of these studies involved infected adults or older children. Younger children, who drool, bite, mouth toys, and are incontinent, may be more likely to transmit HIV in these settings. To assess this possibility, the authors tested 89 members of households in which 25 children with HIV infection, most of whom were preschool-aged, resided. Household members had close personal contact with the infected children. They shared many items likely to be soiled with blood and body fluids, such as toys, toothbrushes, eating utensils, toilets, and bathtubs. Hugging, kissing, sharing a bed, and bathing together were common. Household members were tested no sooner than 4 months after initial contact with the infected child, to allow adequate time for sero-conversion. All 89 participating household members were anti-HIV seronegative, and 78 who were tested were serum p24 antigen negative. It was concluded from this study and other evidence that the risk of transmission from children to their contacts is extremely low and has not been clearly documented in the household setting.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Investigations of AIDS patients with no previously identified risk factors.

Through Sept 30, 1987, two thousand fifty-nine patients with acquired immunodeficiency syndrome (AIDS) and no recognized risk factors were reported to the Centers for Disease Control. Risk history was incomplete or unobtainable for 921 (45%) of them. Risk factors were ultimately identified for 825 (72%) of the remaining 1138. Another 32 persons (3%) did not meet the case definition for AIDS. Risk factors could not be identified for the remaining 281 patients (25%), despite additional information. Of these, 178 (63%) were interviewed with standard questionnaires; 38% reported sexually transmitted diseases and 34% of the men reported sexual contact with prostitutes. There was no evidence for new transmission modes. Although the proportion of AIDS patients with undetermined risk factors has increased significantly during the past year, the adjusted proportion shows no significant change over time. Thus, follow-up of AIDS patients with no apparent risk factors suggests that modes of transmission for human immunodeficiency virus have remained stable.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Granulomatous variants of cutaneous T-cell lymphoma. The histopathology of granulomatous mycosis fungoides and granulomatous slack skin.

Granulomatous mycosis fungoides is an unusual histologic variant of mycosis fungoides, a condition that is ordinarily indolent. Granulomatous slack skin, like granulomatous mycosis fungoides, shows epidermotropism, granulomatous inflammation, a clonal T-helper cell population, and progression to systemic lymphoma in some cases. Unlike granulomatous mycosis fungoides, it is characterized clinically by bulky, pendulous skin folds. The similarities between the two conditions prompted us to compare the histologic features. We reviewed 24 biopsies from 10 patients with granulomatous mycosis fungoides. These showed several distinct histologic patterns, including three cases that mimicked granuloma annulare. We also reviewed biopsy specimens from four patients with granulomatous slack skin. These specimens had a more stereotypic appearance, with permeation of the entire dermis and subcutis by lymphocytes, marked epidermotropism, and a more even distribution of granulomas and giant cells within the infiltrate. Biopsies of fully developed lesions of granulomatous slack skin showed elastolysis involving the full thickness of the dermis--a feature not seen in any of our granulomatous mycosis fungoides cases. Biopsy specimens from granulomatous mycosis fungoides and granulomatous slack skin may be mistaken for nonneoplastic granulomatous dermatitides, but they can usually be distinguished from these by the presence of epidermotropism or atypical lymphocytes. Because several of our patients with granulomatous mycosis fungoides died after courses of unremarkable length, it seems unlikely that the presence of granulomas is invariably correlated with a more benign course than nongranulomatous mycosis fungoides.

Adolescent↗
PubMed1988

Primary carcinoid tumor of the testis.

We have presented a case of primary testicular carcinoid in an otherwise asymptomatic 50-year-old white man treated by right orchiectomy; a postoperative abdominal CT scan was normal. Histologically and cytologically the tumor resembled carcinoids of midgut origin. Most primary testicular carcinoid tumors are not clinically functional, and thus the diagnosis is not suspected preoperatively.

Carcinoid Tumor↗
PubMed1986

Improved survival rates of patients with acral lentiginous melanoma treated with hyperthermic isolation perfusion, wide excision, and regional lymphadenectomy.

Twenty-three patients with extremity malignant melanoma who fit the clinical and pathologic criteria for acral lentiginous melanoma were treated in a prospective, nonrandomized trial of wide local excision, regional lymphadenectomy, and hyperthermic isolation perfusion. There were 17 patients (73.9 percent) pathologically judged to be in stage I and 6 (26.1 percent) in stage II. Three patients entered the study with regional recurrence. Delay in diagnosis of the lesions averaged almost 3 1/2 years. Increasing awareness about the occurrence of acral lentiginous melanoma may result in earlier diagnosis, increased survival rates, and cure. Life table survival analysis revealed 5 and 10 year survival rates of 75 percent and 58 percent, respectively. This supports the findings of Krementz et al and suggests not only that a marked improvement in survival can be achieved through the use of hyperthermic isolation perfusion, but that the survival of patients with acral lentiginous melanoma is comparable with that of patients with other extremity malignant melanomas treated with aggressive multimodality therapy.

Actuarial Analysis↗
PubMed1986

The histology of malignant melanoma.

A brief review of the histology of malignant melanoma is presented, including various prognostic indicators of the biologic behavior of this neoplasm. Reproducible criteria are outlined in an attempt to provide for a more accurate diagnosis and subsequent treatment of this life-threatening disease.

Diagnosis, Differential↗
PubMed1986

Treatment of multiple keratoacanthomas with oral isotretinoin.

A patient with multiple keratoacanthomas was successfully treated with oral isotretinoin. The treatment resulted in clearing of existing keratoacanthomas and prevented the development of new lesions. An induction dose of 1.5 mg/kg/day was necessary to initiate the response. This is the third report of successful treatment of multiple keratoacanthomas with isotretinoin.

Administration, Oral↗
PubMed1984

Porokeratosis plantaris palmaris et disseminata.

Porokeratosis plantaris palmaris et disseminata (PPPD) is a rare variant of porokeratosis. We report a second kinship with PPPD that typically appears first on the palms and soles and then gradually progresses to the extremities and trunk. We discuss clinical, histologic, pathogenetic, and therapeutic aspects of PPPD and review the literature concerning the histogenesis of cornoid lamella formation.

Adult↗
PubMed1983

Pruritic dermatitis in asthmatic basenji-greyhound dogs: a model for human atopic dermatitis.

A recurrent, nonseasonal pruritic dermatitis manifested as lichenified plaques and as inflammatory nodules and papules in each of fourteen basenji-greyhound (B-G) crossbreed dogs, all of which demonstrated both nonspecific and Ascaris-specific airway hyperreactivity, with changes in pulmonary mechanics of the same order as those seen in symptomatic human asthma. Other features analogous to human atopic disease included blunted cyclic adenosine monophosphate (cAMP) responsiveness to beta adrenergic agents and in vivo release of histamine and slow-reacting substance of anaphylaxis in response to antigen aerosol challenge. The dermatitis appears to be a manifestation of the atopic state in these dogs and may provide an animal model for the study of human atopic dermatitis.

Animals↗
PubMed1983

Aleukemic leukemia cutis: juvenile chronic granulocytic leukemia presenting with figurate cutaneous lesions.

We report a 3 1/2-year-old girl who developed a figurate cutaneous eruption. Distinctive findings in her skin biopsies, as well as unusual red cell characteristics, in the presence of a normal peripheral smear and bone marrow biopsy, led us to suspect the diagnosis of preleukemic juvenile type chronic granulocytic leukemia. This is the first case we know of in which this diagnosis was suspected prior to abnormal findings in the peripheral smear or bone marrow.

Biopsy↗
PubMed1983

Phytophotodermatitis due to Ruta graveolens.

We report phytophotodermatitis in a 5-year-old boy, his 6-year-old sister and his mother, evoked by their handling common rue (Ruta graveolens), a plant which contains psoralens. Psoralens are photoactive chemicals which, when rubbed on the skin, react with sunlight to produce erythema, hyperpigmentation and blistering. Phytophotodermatitis is an uncommon cause of such ill-effects, in children.

Child↗
PubMed1982

Immunosuppression in a homosexual man with Kaposi's sarcoma.

The occurrence of Kaposi's sarcoma in young homosexual men is a recently reported condition. The same individuals are at risk for the development of Pneumocystis carinii pneumonia and other unusual infections. These associations suggest these persons are somehow immunocompromised. Evidence of current or prior cytomegalovirus (CMV) infection is seen in a high percentage of these and other homosexual men. CMV infections are known to induce alterations in the immunoregulatory suppressor and helper T lymphocyte populations. The CMV infection is suspect as the cause of immunosuppression in these individuals. We present a case of Kaposi's sarcoma in a homosexual men with CMV cultured from his urine and semen. He showed a marked increase in his suppressor/cytotoxic cell (OKT8-positive) population, as well as a marked decrease in his helper cell (OKT4-positive) population. Mitogen and antigen studies demonstrated absent or markedly diminished response both in vitro and in vivo. Pokeweed mitogen (PWM)-induced IgG synthesis appeared normal. This patient, as well as the majority of other reported patients with this disease, manifested the HLA-Dr5 phenotype. The immunosuppression in this patient and possibly other similar men appears to be mediated by abnormalities in the immunoregulatory T lymphocytes.

Adult↗
PubMed1982

Perforating folliculitis of hemodialysis.

Three patients developed perforating skin lesions on the legs shortly after beginning hemodialysis for chronic renal failure. All had long-standing insulin-dependent diabetes mellitus and all three were white. The skin disease was refractory to all attempts at management. In one patient, however, the eruption cleared completely when hemodialysis was stopped in favor of a renal allograft transplanted from a cadaver. Clinically and histologically, some of the lesions showed evidence of prurigo nodularis, a consequence of vigorous rubbing of a discrete focus.

Adult↗
PubMed1978

Levamisole therapy in atopic dermatitis: randomized double-blind evaluation.

A randomized double-blind study of levamisole hydrochloride therapy in atopic dermatitis is reported. No improvement was noted in any of several assessments, which included patients' subjective impressions; physicians' clinical impressions; comparison of clinical extent and severity scores; and incidence of cutaneous infections or lessening of serum IgE levels. A trend toward improvement was seen in a majority of cases, whether treatment was with a placebo or an active drug. This study emphasizes the need for double-blind techniques for therapeutic trial in the management of patients with atopic dermatitis.

Adolescent↗
PubMed1969

Reach to recovery.

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Breast Neoplasms↗