Fluconazole versus itraconazole for candida esophagitis in acquired immunodeficiency syndrome. Candida Esophagitis

BACKGROUNDS & AIMS: Contrasting opinions exist about the pharmacological treatment of esophageal candidiasis in patients with acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the long-term efficacy of fluconazole and itraconazole treatment. METHODS: This study evaluated 2213 human immunodeficiency virus-positive patients at first episode of esophageal candidiasis diagnosed by endoscopy; 1105 received fluconazole and 1108 received itraconazole. The endoscopic and clinical response to treatment was assessed periodically until the end of the follow-up period (1 year). RESULTS: At week 2, endoscopic cure occurred in 81.2% of patients treated with fluconazole and in 65.6% of patients treated with itraconazole (P < 0.001). Clinical cure was observed in 81.5% of patients treated with fluconazole and in 75.2% of patients treated with itraconazole (P < 0.001). At the end of the follow-up period, endoscopic and clinical cure were observed in 96% of patients treated with fluconazole and in 95.6% of patients treated with itraconazole (P = 0.788), with similar differences by intention-to-treat analysis (93.6% vs. 93.3%; P = 0.853). Treatment failure was observed in 22.3% of fluconazole-treated patients and in 26.6% of itraconazole-treated patients (P = 0.022). CONCLUSIONS: Fluconazole and itraconazole are provided with good long-term therapeutic efficacy in the treatment of Candida esophagitis in patients with AIDS. Fluconazole is associated with a higher rate of cure than itraconazole in short-term treatment.     

Using Multimedia to Support Cooperative Editing

By Cooperative Editing we mean the coordinated manipulation of information by a group of authors. During the editing process the (co-)authors need to communicate their ideas, drafts and constraints (remotely or face-to-face) until a final version of the information is achieved. For the different phases of this process - discussion of ideas, editing, cross-checking - different media or media integration are adequate. Furthermore, analysing the transition from individual work to group work, within different human activities, two pitfalls are often detected if computer support is considered: a) technological communication difficulties, especially if the group is remotely located on heterogeneous hardware, associated with a fall in productivity and frequent social inadequacies of the group's computer support; b) the lack of integrated media processing tools available for group editing. In order to solve these problems, we suggest that Multimedia can be applied in two ways: to effectively support the necessary group communication links; and to enhance the expressiveness of the information edited. To test this statement we have been conceptualising and implementing a prototype system. Most of the techniques involved can be used in other tools that need multimedia capabilities or that support other specific types of group activities. The innovative aspects of the work are the use of multimedia techniques to support demanding applications, possibly on cross-platforms, and the integration of several concepts to support cooperation.     

Performance of the PAC optical packet network

For multiuser packet communications with unpredictable user demands (e.g., in a local or metropolitan area network), coordination and control of access to the frequency-division multiplexing (FDM) channels are difficult. B. Glance (J. Lightwave Technol., vol.10, pp.1323-1328, Sep 1992) proposed using a simple protection-against-collision (PAC) circuit to solve this media access problem and achieve full optical connectivity. The PAC system has the potential to interconnect hundreds of ports, each transmitting at several gigabits per second. Performance aspects of the PAC optical packet network are discussed here. The delay-throughout performance of this network is analyzed for uniform traffic patterns. The results show that in geographically distributed applications the maximum achievable throughput (normalized to the transmission rate) is typically between 0.4 and 0.5 per channel. In a centralized switch the (normalized) maximum achievable throughput can approach 0.8 per channel     

New lamps for old: the story of electric lighting

Of all the products of electrical technology, none has made a more profound difference to our way of life than the humble light bulb. The author describes the history of the light bulb from the time it was introduced and started to replace gas lamps to the present day. In particular the author discusses the early developments in arc lighting and incandescent filament lamps. The author also discusses the introduction of mercury vapour lamps, fluorescent lamps, and evacuation of the lamps     

An adaptive plasma glucose controller based on a nonlinearinsulin/glucose model

The design of plasma glucose controllers traditionally relies on linear approaches. The implementation of an appropriate nonlinear model of the insulin/glucose regulatory system into an adaptive controller should predict the insulin-dependent glucose removal more reliably and hence provide better control over a wide spectrum of insulin signals. A discretized form of the model leads to a two-step procedure. First, the measured plasma glucose levels associated with the erogeneous glucose infusion rates are used in the estimation of the past removal rates which, in turn, can be expressed as a weighted sum of past insulin inputs and previous values of the removal rate. Parameters of the sum are adjusted on-line by a recursive method of estimation which features a prefiltering of data to account for a corrupting coloured process noise. The same equation is in turn used to predict the time course of the insulin-dependent fractional rate of glucose removal. The performance of the controller. Tested in vivo in three pigs, is presented for various intravenous or subcutaneous rapid injections and staircase infusions of insulin. Plasma glucose is maintained at an average level of 99.9±8.7% of the target value (% set point±coefficient of variation). The controller reacts promptly to large and rapid variations in insulin action. Although control improves with the number of glucose measurements, the prediction of glucose removal allows for some flexibility in the monitoring of the plasma glucose. Sampling frequency varied from a 2 min interval during transient periods to 7 min as steady states were reached