Federal Medical-Biological Agency

Pulmonary arteriovenous malformation (PAVM) is an embryonic disorder of pulmonary vessels characterized by a communication between arterial and venous vessels. It occurs in 2–3 cases per 100 thousand population. In 60–70% of cases, PAVM can be single, in 30–40% of cases they are multiple, in 75% of cases – unilateral. It is known that the effect of oncogenes, teratogens, and ionizing radiation in the 7–12th weeks of embryogenesis is a prerequisite for the formation of vascular anomalies. However, the main role belongs to genetic factors involved in angiogenesis, inflammatory cytokine genes and genes encoding factors involved in vascular wall remodeling. The article presents a clinical case of PAVM in S4, S5 of the left lung diagnosed by contrast-enhanced multislice computed tomography. The pathology was detected in a 43-year-old male patient who complained of non-productive cough, inspiratory dyspnea with minor physical exertion, headaches, severe general weakness, which appeared after left-sided pneumonia suffered a month before admission to the hospital. Left-sided video-assisted thoracic surgery was performed with segmentectomy of S4, S5 left lung segments. Histological examination revealed arteriovenous anastomoses.

Aim. To demonstrate a multidisciplinary approach in management of a patient with generalized sarcoidosis, heart disease and a life-threatening complication in the form of cerebral infarction which required selection of treatment tactics. Material and methods. Patient A., 41, presented with sarcoidosis and Löfgren’s syndrome onset at the age of 23 and developed clinically manifested cardiac disease over the next three years. Cardiac sarcoidosis was characterized by complex life-threatening arrhythmias, progression of chronic heart failure, and infarction-like changes in electrocardiograms and echocardiograms necessitating differential diagnosis. Results. Uncontrolled intermittent use of prednisolone, lack of regular standard therapy for sarcoidosis, and lack of antiarrhythmic therapy largely predetermined the unfavorable course of events, including development of an ischemic stroke at a young age. The development of the cerebral infarction was due to a combination of factors: arrhythmia, newly diagnosed congenital heart defect (patent foramen ovale), hyperhomocysteinemia, and the presence of polymorphisms in the folate cycle genes (MTHFR, MTR). Conclusion. The diversity of clinical manifestations often leads to diagnostic difficulties and errors. In the absence of adequate therapy, the disease progresses and has an unfavorable prognosis. This article presents a clinical observation of a young patient with generalized sarcoidosis with progressive heart disease, hereditary thrombophilia, patent foramen ovale complicated by the development of a stroke.

We present a clinical observation of the failure of treatment of a patient with urethritis caused by M. genitalium (MG). Therapy with doxycycline was prescribed to the patient. However, complaints persisted at the follow-up visit. Control examination by real-time PCR showed the presence of MG in the urethra. After the course of treatment with azithromycin, complaints remained, MG was again detected in the urethra. A sample of the patient’s biological material was transferred to the laboratory of molecular diagnostics of the Research Institute of Antimicrobial Chemotherapy of the Smolensk State Medical University, where a nucleotide substitution at the A2059G position of the 23S rRNA gene in MG, indicating resistance of the microorganism to macrolides, was found. Therapy was adjusted by prescribing Moxifloxacin. Clinical and microbiological cure occurred after the end of therapy. The feature of this clinical case is that in the practice of dermatovenereologists, there may be cases of ineffectiveness of treatment of MG infection with tetracyclines (doxycycline) and macrolides (azithromycin), which requires a change in therapy tactics. The optimal approach includes pre-test of patients’ biological samples for MG antimicrobial resistance mutations and personalization of therapy according to the antibiotic resistance profile.

The statistics of neurotoxicant poisonings in the world and, in particular, in Russia are alarming. Despite the fact that there is information that recently severe forms of intoxication with neurotoxicants are registered less frequently, and the initial and moderate forms that develop during long-term work with increased concentrations of neurotropic poisons predominate, neurotoxicant poisonings continue to occupy a special place among production factors. Poisonings received at industrial enterprises or in laboratories, during accidents or gross violations of safety precautions deserve special attention. Typical representatives of the group of neurotropic toxicants are representatives of the groups of heavy metals (lead, mercury, etc.), combustion products (carbon monoxide, etc.), organic solvents, for example, methanol. Thus, according to WHO data, the world production of heavy metals is growing annually by 10%, which increases the risk of poisoning. The problem of methanol poisoning is no less acute, which accounts for more than 13% of poisonings. Neurotoxicants primarily affect the central nervous system, but their detrimental effects on other human organs and systems are also noted. Intoxication with most representatives of this group of poisons leads to permanent disability, and in some cases, to death. This study analyzes original articles devoted to the issues of poisoning with neurotoxicants, presented in bibliographic and abstract databases such as PubMed, Scopus, Web of Science, NEB (eLIBRARY.RU) and CyberLeninka. The causes and consequences of poisoning are described, the mechanism of action of toxicants and the symptoms of the victim’s health are briefly shown. It is concluded that even with relative safety of production, emissions of neurotropic toxicants into the environment can have serious and long-term consequences for human health.Contribution: Potapov P.K. – material processing, editing; Shustov E.B. – concept and design of research, editing; Noskov N.S. – collection and analysis of literary sources, writing the text; Markin I.V. – formulation of conclusions, writing the text and editing the article; Melnikova M.V. – writing the text, editing. All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.Conflict of interest. The authors declare no conflict of interest.Funding. The scientific research was conducted within the framework of the State assignment of the Federal Medical and Biological Agency of Russia N. 388-00071-24-00 (topic code 64.004.24.800).Received: April 6, 2025 / Revised: April 14, 2025 / Accepted: October 15, 2025 / Published: March 13, 2026

The oncolytic adenovirus Ad5-delta-24-RGD (Ad5Δ24RGD) exhibits suboptimal therapeutic efficacy in high-grade glioma. Here, we show that combining two specific potency-enhancing mutations in E3-19K and i-leader (designated 19KSS-iLQ125Ter) markedly increases the cytolytic efficiency and the size of vital dye-stained plaques. Unexpectedly, these mutations do not enhance actual spread efficiency, measured as the size of fluorescent plaques, in most tested cell lines. In contrast, the type of fiber modification (F5RGD4C, F5/3, or F5/35) strongly influences actual spread efficiency, with F5RGD4C generally conferring the greatest enhancement. In some cell lines, the fiber modification F5RGD10(2C) or verapamil treatment further improves actual spread efficiency. Nelfinavir inhibits spread and plaque formation of oncolytic adenoviruses with the 19KSS-iLQ125Ter modifications, irrespective of adenovirus death protein (ADP) expression. Expression of the reporter transgenes EGFP and Fluc or the human hyaluronidase PH20/SPAM1 from the E1B-55K region or downstream of the L3-23K or L5-Fiber region differentially affects the oncolytic potency of Ad5-delta-24-RGD-19KSS-iLQ125Ter. We identified an insertion site downstream of the L3-23K region that supports relatively high hPH20 activity while preserving the enhanced oncolytic potency of the virus. Combining 19KSS-iLQ125Ter with hPH20 expression may potentially improve therapeutic benefit in glioma.

Thyroid spindle cell tumors are rare and heterogeneous group of neoplasms originating from both follicular and parafollicular (C cells) cells of the thyroid gland. They further include primary mesenchymal tumors of the thyroid and metastatic lesions from other sites. Spindle cell papillary thyroid cancer, an extremely rare and understudied subtype of papillary cancer, poses diagnostic challenges both during preoperative cytology and postoperative histology due to its morphological overlap with other thyroid tumors.

Introduction. As a kind of sport, winter swimming differs from pool- or open-water swimming due to the extreme cold stress it places on the body. Swims in cold water with facial immersion trigger a diving reflex, which may be accompanied by the development of cardiac arrhythmias under low-temperature conditions. We believe that specific criteria should be developed for permitting individuals to engage in cold-water swimming. Objective. Study of the characteristics of changes in the state of the cardiovascular and nervous systems, autonomic regulation, and metabolic parameters in winter swimmers at water temperatures from +0.5 °C to +2.0 °C both over various standard distances and during a 10-min swim of 450–550 m. Materials and methods. Under competitive conditions and during training camps (at water temperatures from +0.5 °C to +1.5 °C and air temperatures from –15 °C to –18 °C), 24 winter swimmers were examined. These were 9 women aged 23–55 (mean age 39.1 ± 2.7 years); 3 men aged 71 ± 3 years; and 12 men aged 35–60 (mean age 43 ± 1.8 years), all of whom had received medical clearance for participation. The participants’ condition was analyzed before and after swims at distances of 25 m backstroke, 25 m and 200 m front crawl (freestyle), as well as after a 10-min swim of 400–450 m. The functional state of the body was assessed using 12-lead electrocardiography, blood pressure measurement, determination of capillary blood glucose concentration, and assessment of simple sensorimotor reaction to a light stimulus. Statistical analysis to identify differences between parameters was performed using the GraphPad Prism 8 software package for Windows 10. Results. A statistically significant increase in the mean capillary blood glucose levels was observed after swims of 25 m ( p < 0.05), 200 m ( p < 0.01), and 400 m compared to the baseline. An increase in the simple sensorimotor reaction time after 10-min swims was noted; thus, the baseline of 263 ± 10 ms vs. 328 ± 21 ms after the swim ( p < 0.01). According to ECG data, at baseline, 67% of the examined individuals showed a widened P wave > 0.11 ms. After short-distance swims of 25 m, P wave duration exceeded the upper limit of normal in 85% of the examined. Compared to backstroke swims, swims with facial immersion in water were accompanied by a significantly more pronounced widening of the P wave ( p < 0.05), slowing of atrial conduction PQ ( p < 0.01), and a more pronounced increase in the QTc interval ( p < 0.05). The QTc value progressively increased in accordance with the duration of the swims. During a 10-min swim, 50% of the examined individuals showed a QTc > 500 ms. Conclusions. Low water temperature is a factor that, even in cold-adapted athletes, provokes stress accompanied by an increase in blood glucose. During swims in cold water with facial immersion, the activated diving reflex triggers cardiac arrhythmias. During long-distance swims, conduction in the nervous system slows down, manifested in an increased simple sensorimotor reaction time and slowed myocardial conduction, reaching pathological values. In this regard, we believe that an additional criterion for medical clearance — assessment of the response of the cardiovascular system to cold-water immersion — should be developed and implemented for beginners wishing to engage in cold-water swimming, in order to avoid the risk of a pathological cardiovascular reaction.

The incidence of dirofilariasis in humans is increasing worldwide. Dirofilariasis is the only mosquito-borne transmissible helminthiasis recorded in the Russian Federation. The definitive hosts of this helminth are dogs, cats, and wild predators; humans are rarely infected. The most common infections in humans and animals are caused by Dirofilaria repens and Dirofilaria immitis . The main sites of dirofilaria infestation in humans are the subcutaneous tissue, periorbital area, and lungs. Pulmonary dirofilariasis is usually asymptomatic, detected as a focal or pathological lesion on chest X-ray. Currently, noninvasive laboratory diagnostic methods for dirofilariasis are lacking; diagnosis is established by histological examination of lung tissue. Treatment of the disease is usually surgical. The aim of the work was to demonstrate and discuss in detail the epidemiology, clinical picture, approaches to diagnosis and treatment of two clinical observations of the classic low-symptom course of pulmonary dirofilariasis. Surgical intervention was necessary to exclude a malignant lung tumor. The epidemiological features, clinical, radiological, and pathological presentation of the disease, complications, and patient management are discussed. Conclusion. Pulmonary dirofilariasis should be considered in the differential diagnosis of focal and pathological lung lesions. Improvement of noninvasive laboratory methods for detecting this helminthiasis in humans is necessary.

The article presents a comprehensive overview of the toxicological characteristics of persulfate salts (ammonium, sodium and potassium), widely used in various industries. The study aims to systematize modern scientific data on the toxic effect of persulfates on the animal body at various routes of entry and levels of exposure.The research methodology included an information and analytical approach using PubMed, Google Scholar, and eLibrary databases.RU and specialized toxicological registers.The authors conducted an analysis of experimental studies of acute, subchronic toxicity, local irritant effect and sensitizing properties of persulfate salts.The results of the study have showed that sulfate ion is the main toxicologically significant component of persulfate compounds. The main mechanisms of toxic action have been established: neurological disorders, systemic organ damage, respiratory disorders, local irritant effects on the skin and mucous membranes. Scientists have identified differences in the toxicity of salts depending on the cation: potassium persulfate is the safest, ammonium persulfate is the most toxic.The scientific novelty of the work lies in the comprehensive assessment of the toxicological properties of persulfate salts and the identification of the need for further study, especially of sodium persulfate.The practical significance of the study is to substantiate the need to develop a full-fledged regulatory framework for persulfate salts in order to ensure sanitary and epidemiological safety.Contributions:Fedotova L.A. — development of research design, writing the text of the manuscript, review of publications on the topic of the article, analysis of the data obtained, editing of the material, systematization of data, conceptualization, approval of the final version of the article;Manaeva E.S. — development of the research design, writing the text of the manuscript, review of publications on the topic of the article, analysis of the data obtained, approval of the final version of the article;Tonshin A.A. — editing of the material, systematization of data, conceptualization, approval of the final version of the article.Funding. The study had no funding.Conflict of interest. The authors declare no conflict of interest.Received: 30.10.2025 / Accepted: 14.12.2025 / Published: 15.02.2026