N ATION/WORLD
The Michigan Daily - Thursday, February 1, 1996 - 5A
I
Inexperienced doctors may
cut short AIDS patients' lives
WASHINGTON (AP)-- Picking an
experienced doctor may be an AIDS
patient's most important decision. A
study shows those whose physicians
rarely treat the disease die a year sooner.
AIDS is a new disease and, com-
pared with many others, quite rare, es-
pecially outside big cities. Many doc-
tors have had little or no experience
with it.
The new research shows that being a
physician's first AIDS patient is risky
business. These patients are more likely
to miss important treatment to forestall
life-threatening problems.
"Our results support the hypothesis
that practice makes perfect," said Dr.
Mari Kitahata of the University of
Washington, who conducted the study.
She based her results on 403 men
with AIDS who were treated at the
Group Health Cooperative of Puget
Sound, a health maintenance organiza-
tion in Washington state, between 1984
and 1994.
She found that the risk of dying on
any particular day is one-third less for
AIDS patients whose physicians have
lots of AIDS experience than for those
whose doctors are seeing AIDS for the
first time.
"There is no question that if you
know what you're doing, you'll do bet-
ter. And if patients know what they're
doing, they'll go to a doctor who does a.
lot of this," said Dr. Robert Schooley of
the University of Colorado.
People will fare better if their doctors
are experienced, no matter what dis-
ease they have. Infections with HIV,
the AIDS virus,
are somewhat dif-
ferent from many
other common
conditions.
Unlike diabetes
or high blood
pressure, AIDS is
such a new dis-
ease that many
doctors have no
formal training in
it, so they must
pick up what they
know on the job.
AIDS is also an
"Ourre
support th
hypothesi
practice n
perfect".
--Dr.I
University o
especially complex
primary care physicians must continually
find new information as they acquire HIV-
infected patients in their practices."
Kitahata presented her findings yes-
terday at the Conference on Retroviruses
and Opportunistic Infections.
In the HMO she studied, 125 family
physicians scat-
tered across the
suits state provided
AIDS care.
ie Thirty-nine per-
that cent of the doctors
S Asawjustone AIDS
patient during the
make I10-year period.
The study
found that the
Mari Kitahata men who were
of Washington their doctors' first
AIDS patients
survived an aver-
age of 14 months after finding they
had the disease, compared with 26
months for those whose doctors had
seen five or more AIDS patients.
Kitahata also looked at what hap-
pened as doctors acquired more AIDS
patients. "We found a decreasing rela-
tive risk of mortality for each succes-
sive patient," she said.
disease to treat. Patients must be tested
regularly. And besides treating the pri-
mary viral infection, doctors must know
how to handle a variety of unusual
infections that occur because of their
patients' weakened immune systems.
Kitahata noted that "there have been
rapid changes in the standard of care, so
A moment in Bosnia
A Bosnian Muslim pauses on his bike in front of an American IFOR checkpoint yesterday in Memici, some 13 miles
east of Tuzla.
.Lasers, robot warplanes seen in 21st century
WASHINGTON (AP)--Unmanned
bombers attack with laser beams in-
stead of bombs. Hypersonic fighters
soar into battle at 12 times the speed of
sound. Micro-bombs kill tanks with
mere grams of explosive. Information
"munitions" seek out and confuse en-
emy computers.
e These are scenes Air Force planners
imagine as they peer into the 21st cen-
tury.
The Air Force already is the most
powerful in the world. What it wants
now is to find ways to stay ahead, even
as itgets smallerandmoney gets scarcer.
Some of the answers are sketched out
in a 15-volume report, "New World
Vistas," Air Force Secretary Sheila
Widnall said yesterday. An advisory
group of outside experts- mostly sci-
entists and engineers - compiled the
report at Widnall's request.
"The changes will be as profound as
those experienced by the Army in mov-
ing from horse to tank orby the Navy in
converting from sail to steam," the study
says.
Widnall said the Air Force is setting
asidemoney to pursuethese ideas, which
apply to a broad range of Air Force
The changes will be as profound as
those experienced by the Army in
moving from horse to tank or by the
Navy in converting from sail to
steam-t"
-"New World Vistas" report
activities from using smaller, more ad-
vanced satellites in space to developing
better trained officers.
Prominent among the "Vistas" ideas:
Use unmanned aircraft to do more than
the spy-missions they perform now; let
them take the place of some combat
planes. Guided from control centers
inside the United States, robot planes
could roam the world with laser weap-
ons to destroy ground and air targets.
Although it goes against the grain of
traditional Air Force people, the idea of
pilotless combat aircraft has inherent
advantages over manned warplanes.
Unmanned craft could be more sur-
vivable, for starters. Shape and func-
tion need not be constrained by a cock-
pit, a human body or an ejection seat.
Gene McCall, who directed the "Vis-
tas" project, told a Pentagon news con-
ference an unmanned strike plane could
be designed to accelerate at 20 times the
force of gravity, or double what a pilot
can withstand. With such speed of ma-
neuver the unmanned plane could sim-
ply outfly a hostile missile, McCall said.
An unmanned bomber or fighter also
could be stealthier, McCall said. The
plane could be perfectly flat on the
bottom, reducing vulnerability to radar
detection. The landing gear could be on
top rather than on the bottom, and a
simple rollover maneuver - impos-
sible with a human in the cockpit -
would put it in landing position.
Small versions of the unmanned com-
bat plane could be carried aboard and
launched from large conventional air-
craft -- giving them truly global reach.
For all its promise, remotely piloted
combat planes aren't likely to enter the
Air Force for another 20 years or so,
McCall said.
Even then, McCall said, pilots will
notbecomeextinct."l don'tthinkwe're
ever going to replace completely the
manned aircraft," he said.
Among the other innovations foreseen
for the early part of the 21st century are
hypersonic missiles. With on-board
links to navigation satellites, they not
only will be faster but also more accu-
rate. McCall said a one-second elec-
tronic emission from a hostile surface-
to-air, or SAM, missile radar would be
enough to enable an Air Force plane
200 miles away to strike it within one
minute.
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