Disseminated Cryptococcal Disease in Non-HIV, Nontransplant Patient

Disseminated cryptococcal infection carries a high risk of morbidity and mortality. Typical patients include HIV individuals with advanced immunosuppression or solid organ or hematopoietic transplant recipients. We report a case of disseminated cryptococcal disease in a 72-year-old male who was immunocompromised with chronic lymphocytic leukemia and ongoing chemotherapy. The patient presented with a subacute history of constitutional symptoms and headache after he received five cycles of FCR chemotherapy (fludarabine/cyclophosphamide/rituximab). Diagnosis of disseminated cryptococcal disease was made based on fungemia in peripheral blood cultures with subsequent involvement of the brain, lungs, and eyes. Treatment was started with liposomal amphotericin, flucytosine, and fluconazole as induction. He was discharged after 4 weeks of hospitalization on high dose fluconazole for consolidation for 2 months, followed by maintenance therapy

Exceptional Points of Degeneracy in Periodic Coupled Waveguides and the Interplay of Gain and Radiation Loss: Theoretical and Experimental Demonstration

We present a novel paradigm for dispersion engineering in coupled transmission lines (CTLs) based on exceptional points of degeneracy (EPDs). We also develop a theory for fourth-order EPDs consisting of four Floquet-Bloch eigenmodes coalescing into one degenerate eigenmode; present unique wave propagation properties associated with the EPD; develop a figure of merit (FOM) to assess the practical occurrence of the fourth-order EPDs in CTLs with tolerances and losses; and experimentally verify for the first time the existence of a fourth EPD (the degenerate band edge), through dispersion and transmission measurements in microstrip-based CTLs at microwave frequencies. In addition, we report that based on experimental observation and the developed FOM, the EPD features are still observable in structures that radiate (leak energy away), even in the presence of fabrication tolerances and dissipative losses. We investigate the 'gain and loss balance' regime in CTLs as a means of recovering an EPD in the presence of radiation and/or dissipative losses, without necessarily resorting to parity-time (PT)-symmetry regimes. The versatile EPD concept is promising in applications such as high-intensity and power-efficiency oscillators, spatial power combiners, or low-threshold oscillators and opens new frontiers for boosting the performance of large coherent sources

Review of recent advances in the leaky-wave analysis of 2-D leaky-wave antennas

Recent developments are reviewed in the area of leaky-wave analysis of two-dimensional (2-D) leaky-wave antennas. Recent results are reviewed in three areas: (1) new beamwidth formulas for 2-D leaky-wave antennas, (2) leakywave analysis of wideband Fabry-Pérot cavity antennas, and (3) leaky-wave analysis of 2-D periodic leaky-wave antennas (those that radiate from higher-order space harmonics)

Practicing breast self-examination among women attending primary health care in Kuwait

Background: Despite the benefits associated with breast self-examination (BSE), few women perform it and many do not even know how to perform it. Objectives: The purpose of this study was to identify the proportion of women practicing BSE, factors that could affect its performance and explore women’s awareness about its practice steps. Methods: The study design can be differentiated into two components. The first was a cross-sectional survey to determine the prevalence of BSE. Recruitment efforts resulted in 510 women. BSE was practiced by 109. The second component of the study was a case-control study to identify factors associated with BSE, whereas practicing subjects (control) were compared with a randomly selected similar number of non-practicing females (cases). Results: The prevalence of BSE was 21%. Most of the socio-demographic variables have no significant effect on the practice of BSE. Practicing women had sufficient level of knowledge about BSE, clinical breast examination, and mammography. They believed significantly that bloody discharge from the nipple, presence of masses in the breasts, abnormal arm swelling, nipple retraction and discoloration of the breast were signs and symptoms of breast cancer. About 35% of practicing women in the current study performed correctly ⩽6 steps out of 12 steps. Conclusion: Only 21% of women attending PHC had ever practiced BSE. Even a high proportion of them were not aware of the correct steps of the procedure. Health education programs are essential to encourage and improve women’s practice of BSE. KEYWORDS: Breast self, Examination, Warning signs, Step