Non-Hodgkin's lymphoma (NHL) is a frequent complication of human immunodeficiency virus (HIV) infection, but involvement of the sinonasal region has only rarely been reported. We report three cases of AIDS-associated sinonasal NHL that occurred at our institution and review eight cases that were reported in the literature. The epidemiological and clinicopathologic features of these cases are described and compared with those of three other groups of patients: non-HIV-infected patients with sinonasal NHL, HIV-infected patients with NHL of any anatomic site, and HIV-infected patients with infectious sinusitis. Patients with AIDS-associated sinonasal NHL more frequently developed bony erosion and presented with signs and symptoms referable to adjacent structures, such as the orbit, than did HIV-infected patients with sinusitis, and patients with AIDS and NHL less frequently had typical sinus symptoms and diffuse sinus involvement than did patients with sinusitis. However, the clinical manifestations of these conditions overlap; thus a high index of suspicion for NHL is imperative for prompt diagnosis. These lymphomas typically are high-grade and disseminate early, and the prognosis is generally poor.

Most adults with community-acquired pneumonia are treated as outpatients. Despite this, the majority of studies regarding community-acquired pneumonia have been in hospitalized patients only and may not be applicable to an ambulatory population. This review critically examines the literature regarding the diagnosis, cause, appropriate patient selection, and treatment of nonhospitalized adults with community-acquired pneumonia, including human immunodeficiency virus-infected individuals. English-language articles on oral antibiotic trials for community-acquired pneumonia, obtained from a MEDLINE search from 1966 to the present, are reviewed. Etiologic diagnosis is helpful in determining appropriate outpatient treatment for community-acquired pneumonia, and usually requires only sputum Gram's stain analysis. Viral, mycoplasmal, and chlamydial agents are among the most common pathogens encountered in individuals treated as outpatients, although much variability exists. Many oral antibiotic trials for community-acquired pneumonia have been published, but shortcomings in study design limit their clinical applicability. A treatment algorithm is offered, using the best available data.

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In brief: The need for expert supervision in cardiac rehabilitation exercise programs is generally accepted, but the use of ECG monitoring as a safety measure in such programs is controversial. No randomized controlled studies of monitoring vs supervision alone have been performed. Consequently, there is no uniform approach to the role of ECG monitoring in cardiac exercise programs. In addition, considerable expense for labor and equipment would be required to monitor all participants continuously for the duration of a program, which typically lasts 12 weeks. The data indicate that administrators of such a program would spend approximately $1 million on ECG monitoring over eight years in the hope of preventing one serious cardiac event.