Jaundice Syndrome Research Articles

EXPERIENCE IN PERFORMING PUNCTURE AND DRAINAGE MINI-INVASIVE INTERVENTIONS UNDER ULTRASOUND CONTROL IN THE DIAGNOSIS AND TREATMENT OF ABDOMINAL DISEASES AND POSTOPERATIVE COMPLICATIONS. Review

The article presents a description of the main puncture and drainage interventions, indicating the method of their implementation, techniques, materials used for their implementation. The own experience of application of the specified minimally invasive interventions in the treatment of a syndrome of mechanical jaundice of benign and malignant genesis, acute cholecystitis, acute pancreatitis and its complications, hepatic abscesses, limited liquid accumulations of an abdominal cavity and retroperitoneal space is described. The advantages and disadvantages are noted, a comparative assessment is made and recommendations are given for the use of different puncture and drainage interventions depending on the type of pathology in which they are used.

Jaundice syndrome in patient with alcoholic liver disease in therapeutic practice

With liver diseases, jaundice syndrome is one of the most common. It is extremely important for the doctor to suspect and identify this syndrome in the early stages of the disease, as well as decide which hospital to hospitalize the patient: infectious, surgical or therapeutic. The detection of jaundice syndrome during the initial examination, as a rule, does not require therapeutic additional research methods, but a common pathology accompanied by jaundice syndrome is an alcoholic liver disease.

Obstetric outcomes of pregnancy complicated by urolithiasis: a retrospective cohort study.

Evaluate the association between urolithiasis during pregnancy and obstetric outcomes outside the context of urological intervention. We conducted a retrospective cohort study of singleton, non-anomalous gestations delivered at 23-42weeks in California from 2007 to 2011. Maternal outcomes (preterm delivery [early (<32weeks) and late (<37weeks)], preeclampsia, gestational diabetes, cesarean deliveries, urinary tract infection [UTI] at delivery, chorioamnionitis, endomyometritis, and maternal sepsis) and newborn outcomes (seizure, respiratory distress syndrome, hypoglycemia, jaundice, and neonatal abstinence syndrome [NAS]) were compared using χ2-tests and multivariable logistic regression. A total of 2,013,767 pregnancies met inclusion criteria, of which 5,734 (0.28%) were complicated by urolithiasis. Stone disease during pregnancy was associated with 30% greater odds of each early (aOR 1.30; 95% CI 1.19-1.43) and late (aOR 1.29; 95% CI 1.18-1.41) preterm delivery. Cesarean delivery, UTI at delivery, gestational hypertension, gestational diabetes, preeclampsia, and sepsis were all significantly positively associated with urolithiasis. Odds of NAS (aOR 2.11; 95% CI 1.27-3.51) and jaundice were significantly greater in the neonates of stone-forming patients (aOR 1.08; 95% CI 1.01-1.16). Urolithiasis during pregnancy was associated with 30% greater odds of preterm delivery and increased risk of myriad metabolic, hypertensive, and infectious disorders of gestation. Neonates born to stone-forming patients were more than twice as likely to develop neonatal abstinence syndrome but did not have significantly greater odds of complications of prematurity.

Stauffer syndrome, clinical implications and knowledge gaps, does size matter? Case report

BackgroundStauffer Syndrome (SS) is a paraneoplastic disorder associated with renal cell carcinoma (RCC). First described by Herbert Maurice Stauffer in 1961, it is characterized by hepatic dysfunction in the absence of metastasis, and elevated alkaline phosphatase, aminotransferases and prolonged prothrombin time. Initial reports did not include jaundice as an inclusion criterion. We aim to report the rare SS jaundice variant in a patient with a small renal mass and review the literature to determine if the size of the renal mass could influence the development of the SS.Case presentationThe aim of this article is to present the case of a 53-year-old male with Stauffer syndrome jaundice variant secondary to a 2.5 cm renal mass, treated with laparoscopic radical nephrectomy with complete resolution of the syndrome.ConclusionsThis syndrome is yet to be fully understood, and as far as the evidence shows, size does not matter. This entity should always be in mind when encountered with a patient with liver dysfunction and jaundice with a suspicion or confirmed diagnosis of a renal mass. To date, and to our knowledge, there have been eleven reported cases of paraneoplastic cholestatic jaundice syndrome including the current case. Six cases presented in patients with small renal mases (< 4 cm), curiously there were not a laterality tendency.

Detection of Piscine orthoreoviruses (PRV-1b AND PRV-3a) in farmed Coho salmon with jaundice syndrome from Chile

Piscine orthoreoviruses (PRVs) represent a group of marine viruses belonging to Reoviridae family, which are associated to emerging diseases in farmed Atlantic salmon, Rainbow trout and Coho salmon around the world. In Chile, the prevalence and deleterious effects of PRV infection in farmed salmonids had been studied recently, showing the occurrence of PRV-1 (formerly PRV-Ss) in Atlantic salmon with Heart and Skeletal Muscle Inflammation (HSMI), PRV-3 (formerly PRV-Om) in Rainbow trout with HSMI-like disease, and both viruses (PRV-1 and PRV-3) in Coho salmon with HSMI-like disease. In 1997, Jaundice Syndrome in Coho salmon was first described in Chile associated to outbreaks with high mortality, which occur during autumn season. Then, it was reported in 2006 that the jaundice condition in Coho salmon is consistent with an infectious form of hemolytic anemia and probably a virus was the causative agent, however the identification of the putative virus was not possible. Currently, the etiology of this syndrome is unknown, but several of the clinical signs exhibited by diseased Coho salmon are comparable to the signs showed by salmonids affected with some disease which are caused by PRVs. Therefore, it was of interest to determine if some PRVs could be related to Jaundice Syndrome in Coho salmon. In this manner, heart and head kidney tissue samples obtained from Coho salmon mortalities were analyzed in search of viral pathogens, where the presence of both PRV-1 and PRV-3 was confirmed by RT-qPCR and Sanger sequencing. Moreover, full-length genomic segment S1 sequences were obtained to determine the phylogenetic relationship with others PRV isolates previously described in Europe, America and Japan. One group of sequences found in Coho salmon with Jaundice Syndrome clustered into Sub-genotype Ib together with PRV-1 isolate described in Coho salmon with HSMI-like condition from Chile, and other group of sequences clustered into Genotype II with the first PRV-3 detected in Rainbow trout from Norway into previously described PRV-3a clade. Our results also suggest that PRVs has developed an infection cycle, which involves to Atlantic salmon, Rainbow trout and Coho salmon.

Functional state of the liver after external drainage of bile ducts in patients with a high level of obstructive jaundice.

The results of the examina­tion and treatment of 67 patients with a high level of obstructive jaundice were analyzed. Diagnosis of obstructive jaundice syndrome was based on the data of anamnesis, complaints, physical, laboratory and instrumental research methods. Among the latter we performed ultrasound investigation (USI)of abdominal organs and bile ducts as a screening method, fibrogastroduodenoscopy (FGDS),computed tomography(CT),magnetic resonance cholan­gio­pancreatography (MRCPG)was carried out if necessary. The cause of a high level of obstructive jaundice: pancreatic head cancer - 27 (40.3%); choledocholithiasis - 21 (31.3%); Klatskin tumour - 5 (7.5%); cancer of the large duodenal papilla – 4 (6.0%); chronic pseudotumor pancreatitis – 4 (6.0%); choledoch cancer – 3 (4.5%); choledochal stricture – 3 (4.5%). The first stage of treatment started from the implementation of percutaneous and hepatic external drainage of the bile ducts under ultrasound control. The functional state of the liver was evaluated according to the level of total bilirubin and its fractions, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). The researches were performed at the admission of patients to the clinic and on day 1, 3 and 7 after external drainage of the bile ducts. Patients were divided into 2 groups, depending on the bile flow rate on the first day after decompression of the biliary tract. It was concluded that the degree of hepatitis in the early period after the performed procedure is directly associated with the bile flow rate during the first day after external drainage of the bile ducts.

Caracterización de la población gestante adolescente atendida en el Hospital Militar Central de Bogotá D.C., Colombia. 2012-2015

Introducción. A pesar de que en Colombia hay una alta prevalencia de embarazos en adolescentes, aún no se han establecido los resultados obstétricos y perinatales adversos en esta población.Objetivo. Caracterizar los desenlaces obstétricos y perinatales de las gestantes adolescentes atendidas en el Hospital Militar Central de Bogotá D.C., Colombia.Materiales y métodos. Estudio observacional, retrospectivo y transversal realizado mediante la revisión de las historias clínicas de 147 gestantes adolescentes atendidas entre mayo de 2012 y diciembre de 2015 en el Hospital Militar Central de Bogotá D.C.Resultados. El promedio de edad fue 17±1.5 años; 59.8% eran estudiantes (secundaria y educación superior) y 64.6%, solteras. En cuanto a los controles prenatales, 127 (86.4%) los iniciaron tardíamente y 108 (73.5%) tuvieron menos de 4. La frecuencia general de complicaciones obstétricas fue 27.9%, entre las que se destacan los trastornos hipertensivos del embarazo (10.2%) y la amenaza de parto pretérmino (8.2%); no se presentaron muertes maternas. Por su parte, las patologías neonatales más comunes fueron ictericia neonatal (4.8%) y síndrome de dificultad respiratoria (3.4%).Conclusiones. Las complicaciones se presentaron con mayor frecuencia en las adolescentes que iniciaron los controles prenatales de forma tardía, por lo que se deben implementar estrategias para garantizar el inicio temprano de estos controles y la adherencia a los mismos. Además, es necesario evaluar el impacto de los programas de planificación familiar en esta población.

MODERN TECHNOLOGIES FOR THE DIAGNOSIS OF BILIARY TRACT DISEASES COMPLICATED BY OBSTRUCTIVE JAUNDICE

Summary. Introduction. Diseases of the biliary tract can have a malignant, incendiary and traumatic etiology and be accompanied by a syndrome of obstructive jaundice.&#x0D; Objective: to study the effectiveness and specificity of modern technologies for the diagnosis of biliary tract diseases complicated by obstructive jaundice.&#x0D; Materials and research methods. We analyzed the instrumental examination of 118 patients with biliary tract diseases complicated by obstructive jaundice.&#x0D; Results and its discussion. Ultrasound is the first screening test in the diagnosis of biliary tract diseases. Ultrasound was performed in 74 (62.7 %) patients. The sensitivity of ultrasound as an indicator of biliary tract was 74.3 %. In 74.3 % (55 patients), an ultrasound scan was sufficient to make the correct clinical diagnosis.&#x0D; Multispiral computed tomography (MSCT) is an indispensable diagnostic method and method for predicting the volume of surgical intervention for malignant neoplasms of the organs of hepatopancreatic zone. MSCT performed in 59 (50 %) patients.&#x0D; The diagnostic accuracy of MSCT for cholangiocarcinoma of various localization was 91.5 %.&#x0D; Endoscopic examinations were performed in 31 (26.3 %) patients. Endoscopic retrograde cholangio-pancreatography, based on the results of which, if there are indications for further performance, endoscopic papillosphincterotomy, can be considered the method of choice in the diagnosis and stage-by-stage treatment of obstructive jaundice of gallstone etiology.&#x0D; Conclusions. In diseases of the biliary tract, complicated by obstructive jaundice, it is first necessary to perform an ultrasound scan. The highest diagnostic accuracy of ultrasound showed in benign diseases, especially with choledocholithiasis — 94.5 %. In case of insufficient information, MSCT should be used. In the presence of X-ray non-contrast calculi, the use of MSCT is impractical, the sensitivity is 80 %. The highest diagnostic accuracy of MSCT was shown for malignant neoplasms of the urinary tract — 91.5 % and is the method of choice in the diagnosis of the prevalence of tumors and its invasion in adjacent anatomical structures and major vessels.

Prediction of Perinatal Outcome with Meconium-stained Liquor

Background &amp; objective: Passage of meconium in the amniotic fluid during labor has long been considered as fetal compromise resulting from fetal hypoxia or increased vagal activity from cord compression. It is also a sign of normal gastrointestinal tract maturation under neuronal control. However, presence of meconium in the amniotic fluid is traditionally viewed as unfavorable perinatal outcome. So, the present study was contemplated to find the association between grade of meconium during labor and perinatal outcome.&#x0D; Methods: The present prospective study was conducted in the North Bengal Medical College, Sirajganj between January 2016 – April 2017. Based on predefined criteria, 53 singleton pregnant women with meconium-stained liquor (MSL) on spontaneous or artificial rupture of membrane after 37 completed weeks of gestation were included in the study. Meconium-stained liquor was graded as “Thick” if the fluid was dark green in colour, viscous, tenacious, opalescent or opaque containing large amount of particulate materials and “Thin” if the fluid was translucent, light yellow green in colour without particulate material. The perinatal outcome was evaluated in terms of APGAR score of neonates at 1 and at 5 minutes of birth, NICU admission, resuscitation needed, jaundice and respiratory distress syndrome (RDS) due to meconium aspiration. Asphyxia neonatorum was diagnosed if APGAR at birth and/or at 5 minutes was &lt; 7. All the outcomes were then compared between mothers forming ‘Thick’ and ‘Thin’ meconium cohort.&#x0D; Result: Of the 53 meconium-stained liquor, nearly half (49%) was with ‘Thick’ meconium and the half (51%) was with ‘Thin’ meconium. Approximately 85% of the neonates were delivered by lower uterine caesarean section (LUCS) and 80% of the neonates were asphyxiated at birth which reduced to 15.1% at 5 minutes. More than three-quarters (75.5%) of the neonates required resuscitation and 28.3% had respiratory distress syndrome (RDS). The incidences of asphyxia neonatorum, resuscitation needed and RDS were significantly higher in ‘Thick’ meconium cohort than those in ‘Thin’ meconium cohort with risks of having these conditions in the former cohort being 6(95% CI = 1.1–31.2), 4.5(95% CI = 1.1–18.9) and 4.2(95% CI = 1.1–15.7) times higher respectively than those in the latter cohort (p = 0.021, p = 0.031 and p = 0.026 respectively).&#x0D; Conclusion: Majority of the neonates born of mothers with thick meconium cohort are asphyxiated, need resuscitation and/or develop RDS. Asphyxia neonatorum, need for resuscitation and RDS are significantly higher in ‘Thick’ meconium cohort than those in ‘Thin’ meconium cohort with risks of having these conditions in the former cohort being several times higher than those in the latter cohort.&#x0D; Ibrahim Card Med J 2019; 9 (1&amp;2): 67-73

Russian consensus on current issues in the diagnosis and treatment of obstructive jaundice syndrome

The Russian consensus document on topical issues of the diagnosis and treatment of obstructive jaundice syndrome was prepared by a group of experts in various fields of surgery, endoscopy, interventional radiology, radiological diagnosis and intensive care. The goal of this document is to clarify and consolidate the opinions of national experts on the following issues: timing of diagnosis of obstructive jaundice, features of diagnostic measures, the need and possibility of conservative measures for obstructive jaundice, and strategy of biliary decompression depending on the cause and level of biliary block.

基于机器学习的中医治疗阴黄证用药规律研究

基于机器学习的中医治疗阴黄证用药规律研究

Endoscopic ultrasonography in the differential diagnosis of biliopancreatoduodenal tumors

Objective . Todeterminethe role ofendoscopicultrasonography in preoperative differentialdiagnosis of bilio pancreatoduodenal tumorsand choice of further treatment strategy. Material and methods . A retrospective analysis included medical records of 89 patients hospital-ized with suspected biliopancreatoduodenal tumor.Pancreatic head tumor was diagnosed in 41(46.1%) patients, tumorof major duodenal papilla – in 15 patients (16.9%), tumor of distal seg-ment of common bile duct – in 10 patients (11.2%), cicatricial and inflammatory strictures of distal segment of common bile duct – in 19 patients (21.3%), post-necroticpseudocysts of pancreatic head – in 4 patients (4.5%). Results . Sensitivity ofendoscopic ultrasonography for tumors of pancreatic head, major duodenal papilla, distal common bile duct, cicatricial and inflammatory strictures of distal segment of com-mon bile duct and postnecroticpseudocysts of pancreatic head was 90.2%, 100%, 80%, 94.7% and 100%, respectively. Specificity was 97.9%, 94.6%, 98.7%, 98.6% and 100%, respectively. Overall accuracy was 94.4%, 95.5%, 96.6%, 97.8% and 100%, respectively. False-negative results were obtained in 7 cases. Tumor was not excluded in these patients, but there was a conclusion about an-other primary source of growth. Conclusion . Endoscopic ultrasonography is associated with high accuracy of preoperative differen-tial diagnosis of malignant and benign biliopancreatoduodenaltumors and useful to clarify diagnosis in patients with mechanical jaundice syndrome. These data are usedas an objective criterion to de-termine further treatment strategy depending on the results of endoscopic ultrasonography.

Painless obstructive jaundice leading to diagnosis of extrahepatic cholangiocarcinoma: a case study and review

A 26-year-old woman presented with jaundice, which results from raised serum bilirubin (hyperbilirubinemia) as a consequence of a number of underlying pathologies. Timely diagnosis is challenging but essential for prognosis and any possible treatment. To compare the many differential diagnoses, the hepatobiliary nurse specialist undertook a systems review and arranged an abdominal ultrasound and blood tests. The patient's medical history excluded autoimmune and metabolic conditions, including haemolytic anaemia, primary biliary cholangitis, primary sclerosing cholangitis, Wilson's disease and Gilbert syndrome. In terms of infectious causes of jaundice, schistosomiasis, liver flukes and Weil syndrome, as well as cholelithiasis and cholecystitis were also excluded. However, some symptoms and biomarkers linked with hepatitis A, B and C warranted consideration. Neoplastic disorders were thought unlikely due to the patient's young age but signs of biliary obstruction meant hepatobiliary cancer could not be excluded. Computerised tomography and endoscopic retrograde cholangio-pancreatography showed an obstructive stricture resulting from a 4.4 cm-wide periportal mass, although biliary brush cytology was inconclusive as to its malignancy. Endoscopic ultrasound and fine needle aspiration confirmed extrahepatic cholangiocarcinoma. Magnetic resonance imaging staging confirmed metastases that precluded surgery, and the patient died 4 months later.

Modern imaging modalities for diseases associated with obstructive jaundice syndrome

Obstructive jaundice (OJ) is a syndrome characterized by bile staining of the skin, mucous membranes, and sclera as a complication of pathological processes that lead to disruption of the bile ducts at various levels of the biliary tract. Obstructive jaundice represents various diseases with different onset, course, and outcome, as well as etiology, which implies the difficulties of the diagnostic process. Identification of a cholestasis cause and treatment of patients with OJ remain urgent and difficult tasks due to the steady rise in diseases of the hepatopancreatoduodenal zone (HPDZ) and the high frequency of diagnostic errors. The latter can lead to the progression of liver failure, as well as to the development of severe complications, which, in turn, are fatal. A significant role in detecting HPDZ pathology belongs to the radiological methods of studies, such as transabdominal ultrasonography (TUS), endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), endoscopic ultrasound (EUS), intraductal ultrasonography (IDUS), magnetic resonance cholangiopancreatography (MRCP), helical computed tomography (hCT), and helical CT cholangiography (hCT-CG). However, it should be noted that, as of today, there is no well-established conventional radiological algorithm for determining the causes of biliary obstruction. This, in turn, leads to repeated or sequential inefficient administration of all possible methods of visualization, complicating the diagnostic algorithm. In this regard, it is advisable to perform an in-depth study of the Russian and foreign literature sources, highlighting the problem of an early and highly effective diagnostics of the causes of biliary obstruction in patients with OJ.

The system of epidemiological control of hepatitis E and complex of anti-epidemic, hygienic and veterinary sanitary activities in the Belgorod oblast

The Hepatitis E (HE) is a viral liver disease that is common on all continents at different rates and very frequently is not symptomatically distinguishable from other viral hepatitis, such as hepatitis A, B and C, as well as from other infectious diseases referred to as "acute jaundice syndrome". The GE-anthroponosis (in the case of infection caused by genotypes 1 or 2 of hepatitis E virus) or anthropozoonosis (in the case of infection caused by 3 or 4 viruses) is predominantly propagated through fecal-oral transmission. The article presents the general characteristics of VGE, human risk factors and means of prevention. The particular attention is paid to the development of complex of anti-epidemic, hygienic and veterinary sanitary measures in the Belgorod Oblast.

Antibiotic prophylaxis of purulent and septical complications during surgical treatment of complicated gallstone disease on background of liver cirrhosis

Purpose of the study. The goal of this investigation was to determine the main risk factors in development of purulent and septical complications during surgical treatment of complicated gallstone disease on background of liver cirrhosis.&#x0D; Materials and methods. We retrospectively reviewed medical records of 247 patients who undergone treatment in minimally invasive surgery centre of Zhytomyr regional clinical hospital during 2009–2018. All patients with complicated gallstone disease were divided in two groups: group 1 – patients with concomitant liver cirrhosis – 79(31,98%), and group 2 – patients without liver cirrhosis – 168 (68,02%). Theinclusion criteria were presents of complicated gallstone disease (acute calculous cholecystitis, choledocholithiasis with obstructive jaundice and Mirizzi syndrome), and verified liver cirrhosis. Patients with oncological history, immunodeficiency and morbid obesity were excluded. Liver cirrhosis was staged by Child-ТurcotteРugh system. In all cases patient’s condition was assessed by APACHE II scoring system and patients with cirrhotic lesion were additionally analyzed by MELD score. Acute calculous cholecystitis was diagnosed in 185 patients: group 1 – 68(Child A – 36, Child B – 31, Child C – 1), group 2 – 117 patients. The signs of cholodecholithiasis with obstructive jaundice were present in 49 cases: group 1 – 7 (Child A – 5, Child B – 1, Child C – 1), group 2 – 42. Mirizzi syndrome was verified in 9 cases: group 1 – 2 (Child A – 1, Child B – 1, group 2 – 7.&#x0D; Results and discussion. In all patients treatment was started in conservative way that included detoxic, antibacterial and hepatoprotective components. In group of control early operative tactic in cases with acute calculous cholecystitis was preferred. Antimicrobial prophylaxis was performed in cases of severe and moderate calculous cholecystitits with use of cephalosporines of 2 generation in moderate case, and protected cephalosporines of 3 generation in combination with metronidazol in severe. In main group providing of antimicrobial therapy was performed very carefully, because of higher risk of hepato-renal insufficiency. The early de-escalation therapy was mandatory performed. Purulent complications occurred in 13,2% of patient with liver cirrhosis in comparison with control group with 1,7% of complications.&#x0D; Conclusion. The treatment of complicated gallstone disease in patients with liver cirrhosis is very risky in case of postoperative purulent complications. In case of Child A stage of cirrhosis the treatment is safe, and the incidents of purulent complications is the same like in the absence of cirrhosis. Administration of antibiotics in cirrhotic should be very careful because of higher risk of hepato-renal insufficiency. The early de-escalation therapy should be mandatory performed. The «gold» standard of empirical antimicrobial therapy is the use of cephalosporines of 2 and 3 generation.

Retrograde minimally invasive technologies in the treatment of obstructive jaundice syndrome

Approaches and results of endoscopic transpapillary procedures in the treatment of patients with obstructive jaundice of various origins are analyzed. Modern trends in the development of endobiliary surgery and recommendations devoted to various endoscopic techniques and methods of biliary decompression depending on etiology and severity of obstructive jaundice, management of patients and dates of interventions are described. Leading specialized centers are characterized by quite high effectiveness of endoscopic transpapillary interventions in patients with cholelithiasis complicated by obstructive jaundice (95.2–97.5%), benign biliary strictures (63.7–92.8%) and biliopancreatoduodenal malignancies (70–96.8%). Analysis of modern tactical and technical approaches and international guidelines for transpapillary interventions allowed us to determine the current capabilities of retrograde minimally invasive curative technologies, systematize and optimize the basic algorithms for endoscopic care in patients with obstructive jaundice, and outline the prospects for the introduction and improvement of the effectiveness of new techniques.

Jaundice of mixed genesis treatment: a case report

As the number of patients in whom the leading disease syndrome is jaundice continues to increase, the issues of their differential diagnosis, the surgery extension choice (if necessary), rational conservative therapy in the postoperative period remain relevant. A case report of treating management in patient with jaundice of mixed genesis, who was hospitalized in the surgical department with yellowish skin and sclera, complaints of nausea and heartburn, is given. The chronic calculous cholecystitis, choledocholithiasis, acute obstructive jaundice was diagnosed in patient. A planned surgical intervention included upper-median laparotomy, cholecystectomy, intraoperative cholangiography, choledochotomy, Holsted choledochal drainage, and subhepatic space drainage was performed. In the postoperative period the jaundice despite adequate functioning of the choledochal drainage attracted attention. Serological tests revealed antibodies to yersiniosis and pseudotuberculosis. Against the background of therapy, taking into account the recommendations of related specialists, the general somatic condition has improved. Total bilirubin levels have progressively decreased. The patient was discharged with recommendations in a relatively satisfactory condition. In our opinion, this clinical example illustrates the complexity of jaundice syndrome and proves how difficult it is sometimes to differentiate the diagnosis of diseases, the leading syndrome of which is jaundice, and how important it is to identify the appropriate pathology in a timely manner and choose the right therapeutic approach.

Obstructive jaundice, gallbladder cancer vs Mirizzi syndrome?

Obstructive jaundice, gallbladder cancer vs Mirizzi syndrome?

Piscine orthoreovirus subtype 3 (PRV-3) causes heart inflammation in rainbow trout (Oncorhynchus mykiss)

Piscine orthoreovirus (PRV) mediated diseases have emerged throughout salmonid aquaculture. Three PRV subtypes are currently reported as causative agents of or in association with diseases in different salmonid species. PRV-1 causes heart and skeletal muscle inflammation (HSMI) in Atlantic salmon (Salmo salar) and is associated with jaundice syndrome in farmed chinook salmon (Oncorhynchus tshawytscha). PRV-2 causes erythrocytic inclusion body syndrome (EIBS) in coho salmon in Japan. PRV-3 has recently been associated with a disease in rainbow trout (Oncorhynchus mykiss) characterized by anaemia, heart and red muscle pathology; to jaundice syndrome in coho salmon (Oncorhynchus kisutch). In this study, we conducted a 10-week long experimental infection trial in rainbow trout with purified PRV-3 particles to assess the causal relationship between the virus and development of heart inflammation. The monitoring the PRV-3 load in heart and spleen by RT-qPCR shows a progressive increase of viral RNA to a peak, followed by clearance without a measurable change in haematocrit. The development of characteristic cardiac histopathological findings occurred in the late phase of the trial and was associated with increased expression of CD8+, indicating cytotoxic T cell proliferation. The findings indicate that, under these experimental conditions, PRV-3 infection in rainbow trout act similarly to PRV-1 infection in Atlantic salmon with regards to immunological responses and development of heart pathology, but not in the ability to establish a persistent infection.