We present our experience of using the UROLASE+ surgical system, based on thulium laser technology, in the context of plastic surgery. Our work with the thulium fiber laser for soft tissue dissection in vitro, ex vivo, and in vivo is described, and the positive outcomes of using the thulium fiber laser, which has not previously been employed in aesthetic surgery of the face and body, are demonstrated in this study. Integration of the thulium fiber laser may enhance safety and facilitate tissue dissection through more precise interventions, reduced blood loss, and improved clinical outcomes. This is particularly relevant for patients who have undergone cosmetic procedures leading to fibrotic changes in soft tissues, which complicate inter-tissue dissection when using traditional methods.

Background. Described a rare case of leprosy, borderline form in the active stage. Aim. To present a clinical case of the development of leprosy with atypical manifestations in a patient outside a region endemic for leprosy. Case report. A 67-year-old patient from 2018 to 2020 received treatment for allergic dermatitis, pyoderma, no effect was observed; in 2020 he was examined for sarcoidosis, the diagnosis was not confirmed. In the Leprosy Research Institute, an examination was carried out, including a bacterioscopic examination of skin scarificates, a pathomorphological examination of skin biopsies, and molecular genetic methods. Results. Based on complaints, anamnesis, examination data and physical examination, the results of clinical and laboratory examination, the diagnosis was made: leprosy, borderline form (ICD-10 A30.3), active stage. Conclusion. The presented observation indicates that the variety of clinical manifestations of leprosy and the lack of alertness in relation to this disease, about the difficulty in establishing the correct clinical diagnosis in the patient, given the lack of history of data on contact with patients with leprosy.

A 60-year-old male with hypertrophic cardiomyopathy, conduction disorders, post-COVID-19 myopericarditis and heart failure was admitted to the hospital’s cardiology department. Blood tests revealed an increase in CPK activity, troponin T elevation and high titers of anticardiac antibodies. Whole exome sequencing showed the presence of the pathogenic variant NM_213599:c.2272C>T of the ANO5 gene. Results of the skeletal muscle biopsy excluded the diagnosis of systemic amyloidosis. Microscopy of the muscle fragment demonstrated sclerosis of the perimysium, moderate lymphoid infiltration, sclerosis of the microvessels, dystrophic changes and a lack of cross striations in the muscle fibers. Hypertrophy of the LV with a low contractile ability, atrial fibrillation, weakness of the distal skeletal muscles and increased plasma CPK activity and the results of the skeletal muscle biopsy suggested a diagnosis of a late form of distal myopathy (Miyoshi-like distal myopathy, MMD3). Post-COVID-19 myopericarditis, for which genetically modified myocardium could serve as a favorable background, caused heart failure decompensation.