ABSTRACT
The Internet is modifying the lives of people around the world. Although many talk about the democratization of knowledge and information, differences remain among users as older netcitizens are under-represented and less involved. We use national and representative U.S. data, the Current Population Survey, to show age-based differences. We complement our analysis with web-based data, the Georgia Tech World Wide Web User Surveys, to show Internet characteristics and trends by age for netcitizens. Results show that older users compose a lower share of Internet users than that of the total U.S. population; however, once they join the ranks of avid Internet users, older netcitizens are similar to their younger counterparts.
ABSTRACT
Web-based distance learning programs offer seniors unprecedented access to courses ranging from photography to business accounting. As courses and programs continue to multiply, new and exciting learning opportunities that are both flexible and high quality will be available to millions online. Web based learning will continue to transform education and provide access to important educational resources.
Subject(s)
AIDS-Related Opportunistic Infections/complications , Lung Diseases, Parasitic/complications , Respiratory Distress Syndrome, Newborn/complications , Toxoplasmosis/complications , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/prevention & control , Adult , Humans , Infant, Newborn , Lung Diseases, Parasitic/diagnosis , Male , Toxoplasmosis/diagnosis , Toxoplasmosis/prevention & control , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacologyABSTRACT
Among 504 cases of AIDS diagnosed between 1983 and 1990, there were 86 patients (17%) with toxoplasma encephalitis (TE). All were symptomatic at the time of diagnosis. General signs such as fever, neck stiffness, or headache were present in 87.2%, and 75.6% had focal signs. The primary means of diagnosis was computerized tomographic scanning, revealing 169 lesions of which 80% were immediately contrast-enhancing. All patients had IgG antibodies against Toxoplasma gondii either before (74 of 75 evaluable patients) or at the time of diagnosis of TE (73 of 75). Elevated antibody titers were present in 44% of evaluable patients, compared to 11% of patients with AIDS and other opportunistic infections. Initial treatment was pyrimethamine plus sulfonamides in 65 patients, and pyrimethamine plus clindamycin in 12 patients, with other combinations or no treatment accounting for the remainder. Life-table analysis of the time to discontinuation of treatment because of suspected side effects suggested that sulfadiazine was significantly more toxic, with 48% of patients experiencing an interruption in treatment after 30 days, than pyrimethamine (12%) or clindamycin (24%). The 30-day mortality rate was 12%, and median survival was 310 days after diagnosis, 530 in patients treated with zidovudine and 190 days in those not so treated. Of 82 evaluable patients, 16 relapsed once and 4 of these more than once. The risk of relapse was 27% 1 year after diagnosis of a first episode of TE.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Toxoplasmosis, Cerebral/epidemiology , Acquired Immunodeficiency Syndrome/blood , Acquired Immunodeficiency Syndrome/drug therapy , Adult , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/adverse effects , Anti-Bacterial Agents/therapeutic use , Antibodies, Protozoan/blood , Biopsy , CD4-Positive T-Lymphocytes , Cerebrospinal Fluid/chemistry , Female , Hospitals, University , Humans , Immunoglobulin G/immunology , Leukocyte Count , Magnetic Resonance Imaging , Male , Middle Aged , Retrospective Studies , Risk Factors , Survival Rate , Switzerland/epidemiology , Tomography, X-Ray Computed , Toxoplasmosis, Cerebral/diagnosis , Toxoplasmosis, Cerebral/drug therapy , Zidovudine/therapeutic useABSTRACT
OBJECTIVE: To determine whether long-term maintenance treatment for toxoplasmosis protects against Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome (AIDS). DESIGN: Cohort study. SETTING: Switzerland. PATIENTS: A total of 453 patients with human immunodeficiency virus (HIV) entered the Swiss HIV Cohort Study. Ninety-nine patients with cerebral toxoplasmosis but no previous or simultaneous P. carinii pneumonia were compared with 240 patients with AIDS and other severe opportunistic infections (Centers for Disease Control [CDC] stage IVC1 infection other than toxoplasmosis and P. carinii pneumonia) as well as with 114 patients receiving inhaled pentamidine in a study of primary pneumocystis prophylaxis in patients infected with HIV. MEASUREMENTS: Life-table analysis for P. carinii-free survival. MAIN RESULTS: Six of 99 (6%) patients with toxoplasmosis, 50 of 240 (21%) patients with other severe opportunistic infections, and 8 of 114 (6%) patients receiving inhaled pentamidine developed P. carinii pneumonia. Life-table analysis showed that the incidence of pneumonia was substantially lower in patients with toxoplasmosis compared with that in patients with other severe opportunistic infections and was similar to the incidence in patients receiving pentamidine as prophylaxis. Analysis of the medication records from patients with toxoplasmosis showed that pyrimethamine and sulfonamides were administered 50% of the time; pyrimethamine and clindamycin, 25% of the time; and pyrimethamine alone, 9.9% of the time but that only one of the six patients with toxoplasmosis who developed P. carinii pneumonia received pyrimethamine and sulfonamides in the month before diagnosis. CONCLUSION: Patients with cerebral toxoplasmosis have a low risk for subsequently developing P. carinii pneumonia. This decreased risk is probably the result of chronic suppressive treatment with pyrimethamine and sulfonamides.
