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The otologic manifestations of AIDS are protean The pinna and external auditory canal may be affected by Kaposi s sarcoma as well as persistent and potentially invasive fungal infections, particularly due to Aspergillus fumigatus The most common middle ear manifestation of AIDS is serous otitis media due to auditory tube dysfunction arising from adenoidal hypertrophy (HIV lymphadenopathy), recurrent mucosal viral infections, or an obstructing nasopharyngeal tumor (eg, lymphoma) For middle ear effusions, ventilating tubes are seldom helpful and may trigger profuse watery otorrhea Acute otitis media is usually caused by the typical bacterial organisms that occur in nonimmunocompromised patients, although Pneumocystis jiroveci (formerly Pneumocystis carinii) otitis has been reported Sensorineural hearing loss is common and in some cases appears to result from viral central nervous system infection In cases of progressive hearing loss, it is important to evaluate for cryptococcal meningitis and syphilis Acute facial paralysis due to herpes zoster infection (Ramsay Hunt s syndrome) is quite common and follows a clinical course similar to that in nonimmunocompromised patients Treatment is primarily with

{ return false; } return this == (Fraction) o; }

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commonly affected sinus Unilateral facial fullness, pressure and tenderness over the cheek are the usual symptoms Pain may refer to the upper incisor and canine teeth via branches of the trigeminal nerve, which traverse the floor of the sinus Maxillary sinusitis may result from dental infection, and teeth that are tender should be carefully examined for signs of abscess Purulent nasal drainage is an important symptom and helps differentiate sinusitis from acute rhinitis Finally, recurrent illness following recent presumed viral rhinitis, the double-sickening history, is also an important predictor of acute bacterial sinusitis Nonspecific symptoms include fever, malaise, halitosis, headache, nasal congestion, hyposmia, and cough Acute ethmoiditis in adults is usually accompanied by maxillary sinusitis In such cases, the symptoms of maxillary sinusitis generally predominate Localized ethmoid sinusitis may present with pain and pressure over the high lateral wall of the nose between the eyes that may radiate to the orbit Sphenoid sinusitis is usually seen in the setting of pansinusitis, or infection of all the paranasal sinuses on at least one side The patient may complain of a headache in the middle of the head and often points to the vertex Acute frontal sinusitis usually causes pain and tenderness of the forehead This is most easily elicited by palpation of the orbital roof just below the medial end of the eyebrow Nosocomial sinusitis is a form of acute bacterial sinusitis that may present without any symptoms in the head and neck It is a common source of fever in critically ill patients and is often associated with prolonged presence of a nasogastric tube Pansinusitis on the side of the tube is common on imaging studies

Patick AK Rhinovirus chemotherapy Antiviral Res 2006 Sep;71(2 3):391 6 [PMID: 16675037]

A Sheet is a Mac OS X implementation of a modal dialog box. When an application displays a Sheet, it appears attached to the application s document or window (see figure 1.4). Because it attaches to its creator, you can always tell what program element the Sheet belongs to. See the Aqua Human Interface guidelines for more information about Sheets (http://developer.apple.com/techpubs/macosx/Essentials/ AquaHIGuidelines/AHIGDialogs/index.html).

Pain is usually unilateral over the maxillary sinus or is toothache-like Symptoms usually last for more than 1 week but less than 4 weeks Change of secretions from mucoid to purulent green or yellow Occasional visible swelling or erythema over a sinus Postnasal drainage, headache, and cough may also be present Diseases that swell the nasal mucous membrane, such as viral or allergic rhinitis, are usually the initiating cause

The is operator is used to check the runtime type of an object (in this case, Fraction). Therefore, o is Fraction evaluates true if o is, in fact, a Fraction or a type derived from Fraction. Once you know that you are comparing two Fractions, you can delegate the decision as to their equality to the overloaded operator (operator==) that you ve already written, just as you did with the != operator. This allows you to avoid duplicate code. Notice, though, that before you can compare this to o, you need to cast o to a Fraction. We discussed casting with intrinsic types back in 3. In this way, the Equals( ) method determines only that you do in fact have two fractions. If so, it delegates deciding whether the two fractions are truly equal to the already implemented operator ==. The complete modification of the Fraction class is shown in Example 12-2, followed by the analysis.

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