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The first thing to do is to declutter your Mac. Older Macs are going to be full of documents, apps, images, videos you don't need. Just like a house, when all of that clutter gets in the way, you can’t find what you do need. Your Mac struggles the same way, causing it to overheat. In Windows, you should not play your music tracks stored on a USB key for DJing purposes. You should 1) copy the audio tracks from the USB key to your computer hard drive first, 2) then remove th. If you've been around the Mac long enough to have an @mac.com address, you've seen Apple trying to migrate you to @icloud.com. Now it's removed yet another trace of the old, favorite email address. I completed the course and I am glad I opted to take them in the end. People mainly leave reviews if they have a bad experience and hardly ever if they have had a good one. Do yourself a favour, stop reading these reviews as they will just scare you, your Dr obviously thinks you need this medication and the benefits outweigh the risks. If you’ve been missing MagSafe, good news—rumor has it that Apple’s magnetic power adaptor is set to make a return to two upgraded MacBook Pros later this year. The news comes via Bloomberg.

Pulmonary Mycobacterium avium complex (MAC) infection is a type of non-tuberculous mycobacterial (NTM) infection. It is relatively common and continues to pose significant therapeutic challenges. In addition, the role of MAC in pulmonary pathology remains controversial in many instances.

Epidemiology

MAC infections often occur in patients with a pre-existing pulmonary disease or those with depressed immunity. However, it is also seen frequently in otherwise healthy patients, with a predilection for older women who deliberately suppress the cough reflex (Lady Windermere syndrome) ^1-3.

Associations

A number of patient groups have been associated with increased risk of pulmonary MAC. They include ^2,3:

• elderly, white, thin women: nodular bronchiectatic form (see below)
• middle-aged or elderly males who are smokers (often with COPD) or alcoholics: upper lobe cavitary form (see below)
• immunocompromised patients, e.g. AIDS
• patients with cystic fibrosis: MAC isolated in up to 13% of patients
• patients with alpha-1-antitrypsin deficiency
• other causes of bronchiectasis
• chronic obstructive pulmonary disease (COPD)

Isolation of MAC from a patient's lung is not pathognomonic of infection, as colonization is common, and thus microbiology needs to be correlated with clinical and radiographic appearances ^2,3.

Clinical presentation

Pulmonary MAC infection is typically insidious, with a chronic cough usually productive of purulent sputum being most common. Hemoptysis and constitutional symptoms are not typical ².

Pathology

Mycobacterium avium and Mycobacterium intracellulare are now considered together, and referred to as Mycobacterium avium complex (MAC) or Mycobacterium avium-intracellulare complex (MAIC). They cannot be distinguished on the grounds of human pathologic manifestation or imaging features, and are treated similarly, although M. avium has a predilection for chickens whereas M. intracellulare prefers rabbits ^2,3.

They are ubiquitous organisms, found in both fresh and salt water, but do not tend to cause human disease. Patients with MAC infection, unlike those with pulmonary tuberculosis, are not contagious ².

Variants

• hot tub lung: granulomatous pneumonitis from exposure to aerosolized Mycobacterium avium complex (MAC) organisms in contaminated water (may not necessarily imply infection) ⁴

Radiographic features

Three main forms of pulmonary MAC infections are recognized ^3,5,6:

1. upper lobe fibrocavitary pattern/cavitary form (classic infection)
2. nodular bronchiectatic form/bronchiectatic form (non-classic infection)
3. mixed form

In upper lobe cavitary form, thin-walled cavities with overall volume loss and fibrosis are the dominant feature, often also with features of endobronchial spread with tree-in-bud opacities seen elsewhere.

In the nodular or non-classic manifestation, the dominant feature is bronchiectasis with associated centrilobular nodules. Unlike pulmonary tuberculosis, there is no predilection for the upper lobes. In elderly white females, the right middle lobe and lingula are particularly affected.

Plain radiograph

Bronchiectasis, seen as tram-track opacities and ring shadows, may be evident. Patchy airspace opacities are also common. Pleural effusions are uncommon ². Upper zone cavities may also be seen with associated volume loss and scarring ³.

CT

The most common findings of MAC infections include ^1,2:

• bronchiectasis and bronchial wall thickening: most common findings
• small centrilobular nodules and tree-in-bud appearance
• patchy consolidation
• a predilection for the right middle lobe and lingula is seen particularly in elderly white women
• pleural thickening may be seen, usually adjacent to parenchymal change
• upper lobe cavitation may also be seen, although it is more characteristic of pulmonary tuberculosis

Treatment and prognosis

Many treatment regimes have been published, with no clear gold-standard evident, although as is the case with pulmonary TB, multi-drug therapy is ideal to avoid resistance ².

In patients who are unable to tolerate medical management, and who have an adequate respiratory reserve, resection of affected portions of the lung may be undertaken. Complications of surgery include bronchopleural fistulas, hemoptysis and empyema².

In patients in whom isolates of MAC are not clearly pathogenic, follow-up is required, keeping in mind that evidence of radiographic progression may take a number of years to be convincing ³.

Prognosis depends on the form of the disease. In the upper lobe cavitary form, lung destruction is usually progressive and can lead to respiratory failure and death if successful treatment is not instituted.

In patients with the nodular bronchiectatic form (Lady Windermere syndrome) the disease is much more indolent, however, eventually, this form may also lead to enough parenchymal damage to result in respiratory failure and death ³.

Differential diagnosis

• Mycobacterium tuberculosis pulmonary infection:
  • bronchiectasis is less commonly the dominant feature ¹
  • changes usually in the upper lobes ¹
• see other causes of bronchiectasis

The underlying pulmonary abnormality (e.g. COPD, pneumoconiosis) may dominate the radiographic appearance.

• 1. Primack SL, Logan PM, Hartman TE et-al. Pulmonary tuberculosis and Mycobacterium avium-intracellulare: a comparison of CT findings. Radiology. 1995;194 (2): 413-7. Radiology (abstract) - Pubmed citation
• 2. Field SK, Fisher D, Cowie RL. Mycobacterium avium complex pulmonary disease in patients without HIV infection. Chest. 2004;126 (2): 566-81. doi:10.1378/chest.126.2.566 - Pubmed citation
• 3. Müller NL, Franquet T, Lee KS et-al. Imaging of pulmonary infections. Lippincott Williams & Wilkins. (2007) ISBN:078177232X. Read it at Google Books - Find it at Amazon
• 4. Hartman TE, Jensen E, Tazelaar HD et-al. CT findings of granulomatous pneumonitis secondary to Mycobacterium avium-intracellulare inhalation: 'hot tub lung'. AJR Am J Roentgenol. 2007;188 (4): 1050-3. doi:10.2214/AJR.06.0546 - Pubmed citation
• 5. Kim TS, Koh WJ, Han J et-al. Hypothesis on the evolution of cavitary lesions in nontuberculous mycobacterial pulmonary infection: thin-section CT and histopathologic correlation. AJR Am J Roentgenol. 2005;184 (4): 1247-52. doi:10.2214/ajr.184.4.01841247 - Pubmed citation
• 6. Martinez S, McAdams HP, Batchu CS. The many faces of pulmonary nontuberculous mycobacterial infection. AJR Am J Roentgenol. 2007;189 (1): 177-86. doi:10.2214/AJR.07.2074 - Pubmed citation

Hello and welcome to my User Tip

People are buying Mac's used where the previous owner didn't know or clear the machine properly before selling it, so what occurs is the next owner can't update OS X or programs because their AppleID doesn't match the previous owner.

Some are just ignoring the requests for updates because they know to change ownership to them will require a complete erase of all the installed programs by the previous owner, which is a fact unfortunately.

Not being able to update OS X or programs means the machine is eventually going to run insecure ones which sets the stage for another large scale botnet of compromised Mac's like what occurred with Flashback, or at the very least banking and credit card information of the secondhand user could be compromised.

Changing ownership of a Mac

1: Copy what users files you do want to save off the machine to a regular external storage drive using drag and drop methods on your internal Home folders of Music, Pictures, Movies, Documents etc. If a TimeMachine window request appears, deny it as it will copy the entire drive, accounts and everything which is not what you need in your case at this time.

If any of those files are over 4GB in size (like large movies/projects or audio files) then the external drive needs to be formatted in Disk Utility first using the Erase option, the default formatting is GUID and OS X Extended Journaled which will work fine only for a Mac. If your going to share this drive also with a Windows PC, then take it to the oldest Windows version and right click on the drive and format exFAT. If it's a Windows XP machine first download the free exFAT download from Microsoft first and reboot. Note: Formatting a drive will erase all data on the drive, so make sure you have what you want off it first.

You cannot save most applications, especially Apple/or AppStore ones as they are now copy protected. Any applications that are non-copy protected and self-contained completely in the app icon in the Applications folder are better off reinstalled fresh from original sources anyway.

Don't forget to export bookmarks from your browsers, any information contained in AddressBook, email addresses in Mail, application license keys in programs you've installed or any other sort of vital information as the entire MacintoshHD partition containing OS X, files and programs will have to be erased to properly turn ownership of the machine to you.

If you have Windows installed in BootCamp, it's a good idea to backup the data there as well.

2: Do a Apple Menu > About this Mac and get information of what OS X version is currently installed on the machine (so you can upgrade back to that version later) and it's model identification and serial number, this information is needed depending upon if disks/USB keys are needed or if the machine can't upgrade to the latest OS X version on AppStore and you have to call Apple to order the in between versions like 10.7 for instance.

3: On the Mac, be near a fast and reliable Internet connection, if you have a Ethernet cable connection to the router, that would be preferred as it's faster and more reliable than Wifi. If you know your Internet speed and it's not around 10 Mb/s or better and all to yourself, then you need something faster. There are various Internet speed tests online, search and use a few to get a accurate evaluation of your capability to reinstall OS X or take it to someone who has a faster connection.

Hold the command (cloverleaf looking), option/alt and r keys down and press the power button until something appears, connect to the Internet if on Wifi. What you will see on the screen is a globe icon as Internet Recovery is downloaded from Apple's (via Akamai's) Servers.

(If this doesn't work, then your older machine isn't capable of Internet Recovery and usually has a slot for a 10.6 OS X install disk or requires a 10.6 boot USB key from Apple. You'll have to erase the ENTIRE drive and install with that first, then upgrade OS X via AppStore (paid upgrade). How to erase and install Snow Leopard 10.6 )

4: You will see several options. You want to select Disk Utility and the disk0 selected on the left, then choose Erase.

If a slider option appears, move the slider one spot to the right for a Zero erase. If you move it further for more secure erase than a Zero, then it's just going to take a lot longer for no gain. The Zero option maps off bad sectors on hard drives and also deletes any fragments of the previous owners data less there be something illegal there that might false incriminate you. If your handling sensitive data, then certainly move the slider all the way to the right for the maximum. It takes some time for the Zero erase to complete, if it fails after a few hours like it's stuck, the hard drive is defective and needs to be replaced by Apple.

If no slider for secure erase appears, it means your machine has a SSD or a Fusion/flash hybrid and there is no secure erase option available for these. Simply erase the drive, it doesn't erase it in reality, just reformats it and allows the old data to be overwritten. Keep that in mind when using your machine, NSA approved method for data destruction on a solid state drive is to gind it into a fine powder.

5: Select the Partition tab and that the drive has 1 Partition, click the box, Option: GUID and the format is OS X Extended Journaled and the name is MacintoshHD, if not, make it so.

6: From the File menu select Quit Disk Utility and select the Install OS X option. Using your AppleID and password, install OS X and Quit the installer which should reboot the machine.

7: Next you will see a 'Welcome to Mac' video animation and select a language and setup your machine.

Be warned that if you enter your real personal information at this stage or at the registration screen, that Apple will take that information and personalize the machine placing your real name all over the machine, including broadcasting it wirelessly (short range) via Bonjour (can't disable it, risk in coffee shops etc), in emails, account name info, network connections, computer name etc., which will compromise your personal security and privacy.

At this stage you may wish to use a alias, if you later find out it hampers your use of Apple services such as iCloud/AppleID and so forth, you can create a additional user account and log into that with your real name or simply start all over from #3 above. You'll have to be your own judge on what your personal security needs are, because Apple doesn't provide any options to secure your personal information.

8: Once the accounts are set up, you log into AppStore and upgrade OS X to the version that was on the machine previously if you want your all your proprietary file format files to work as before as later OS X versions of software change their files. Internet Recovery installs the OS X version that came with the machine from the factory, any OS X upgrades that occurred later are tied to the previous owner, thus if you want to get back to the OS X version you had before erasing, you have to purchase the upgrade and install it.

Next you install all your additional software you think you need before you return your user files, especially if the computer has a boot hard drive as it will perform better if your users files are returned and written last on the drive.

9: Connect the external drive containing your files you backed up previously. Select the drive on the Desktop and from the Finder Menu (or right click) > Get Info and at the bottom unlock and 'Ignore Permissions on this volume'

When you transferred those files earlier, they were assigned to the previous user account. Well you changed the user account thus thus the ownership of those files belongs to the previous user account. By ignoring permissions your allowing the files to be copied, but they are still not entirely assigned to your new account.

Once you have placed your files or imported then into the appropriate programs and your all done you perform a #6 Repair Users Permissions step here.

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How Do You Feel About Mac Mac Is Bad Thing

10: Next what you do is create a bootable backup of this ideal and pristine system state using a powered external drive and a copy of Carbon Copy Cloner. (I do not advise Superduper as it doesn't copy a necessary hidden partition you need to reinstall OS X if you upgrade the version later)

This bootable clone is accessible by holding the option/alt key down while booting the machine, it's awesome for the fact that you can easily copy your latest files, then erase and reverse clone any major software issues away in about a hour or so.

The object with a bootable clone is to keep it disconnected and only update it when you know you have a pristine OS X boot volume or before you do something major in software to the machine, like a OS X update, program install or tinkering. You can boot from the clone and make more clones on more external drives, but they will only boot to that machine, but you can use Apple's Migration Assistant to a new machine or use MacDrive to a PC if you ever need too. The first clone takes the longest, the updates to the clone go faster.

If TimeMachine pops up and asks to make the external drive a TM drive, deny it at this time, you can make one after the clone is completed.

After the bootable clone is created you may need a more always on and backing up solution, especially if your prone to deleting files by accident. Newbies especially should be using TimeMachine exclusively, more experienced Mac users usually use bootable clones instead or a combination of the two methods for more reliability.

TimeMachine software is always running on a Mac, if you connect a blank (or to be reformatted) external drive it's going to pop up a window asking you if you want to make one. Make sure the drive is free of data you want to keep and let TimeMachine do it's thing.

11: If you require more common questions answered about your machine there is plenty of advice in the User Tips