Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitides (AAV) are a group of inflammatory disorders in which autoantibodies damage small arteries throughout the body, including in the upper and lower respiratory system, kidneys, as well as the skin. AAV may be precipitated by a variety of causes, including infections. In this report, we examine the case of a patient who developed AAV that was suspected primarily based on mucocutaneous hemorrhagic bullae, elevated ANCA levels, and subsequently confirmed by kidney biopsy, while recovering from coronavirus disease 2019 (COVID-19) infection. AAV and COVID-19 infections may present with similar symptoms, rendering an accurate diagnosis challenging. Additionally, only a few other cases describing a similar onset of AAV post-COVID-19 infection have been described in the literature. Initial presenting features of AAV in such cases have varied considerably, which makes the diagnosis even more challenging. We also engage in a review of such cases to assess key similarities, different treatment options, and outcomes. Lastly, the fact that several mechanisms have been proposed for AAV highlights the need for continued research to help clarify the pathophysiology while also identifying the optimal therapy.
Intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly resulting from the failure of the duodenum to recanalize during embryogenesis leaving a duodenal diaphragm or web within the lumen of the duodenum. In theory, the peristaltic force gradually stretches the tissue over time forming a diverticulum within the duodenal lumen. Identification of IDD by endoscopy or diagnostic imaging can be difficult, these lesions can be mistaken for other lesions or the collapsed diverticulum can be overlooked. The median age of presentation is the fourth decade. Although most cases are asymptomatic, some can present with vague abdominal complaints such as bloating, nausea, abdominal discomfort, or pain. Complications of IDD are intestinal bleeding, biliary pancreatic symptoms, intestinal obstruction, and perforation. Management of IDD complications could be challenging since data are limited. We present an unusual case of a 78-year-old female presenting with acute chest pain, palpitations, and incidental findings of IDD and pancreatic divisum. Her course was complicated by recurrent gastrointestinal bleeding and small bowel obstruction.
Optimal rates for achieving an information processing task are often characterized in terms of regularized information measures. In many cases of quantum tasks, we do not know how to compute such quantities. Here, we exploit the symmetries in the recently introduced D # in order to obtain a hierarchy of semidefinite programming bounds on various regularized quantities. As applications, we give a general procedure to give efficient bounds on the regularized Umegaki channel divergence as well as the classical capacity and two-way assisted quantum capacity of quantum channels. In particular, we obtain slight improvements for the capacity of the amplitude damping channel. We also prove that for fixed input and output dimensions, the regularized sandwiched Rényi divergence between any two quantum channels can be approximated up to an ǫ accuracy in time that is polynomial in 1/ǫ.
Figure 1. Bowel cleansing performance of 1L PEG1ASC: (A) Rates of segmental-level adequate-cleansing (BBPS score $2); (B) Mean BBPS score for the overall colon and per colon segment; (C) Effect of time to colonoscopy on mean BBPS score in patients receiving same-day or split dose regimens.
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