This review presents the mechanisms for the development of fatigue associated with psychophysical overload. The aim of the work was the analysis of available literature sources touching upon the problem of psychophysical fatiguability. This study was conducted using information retrieval systems (PubMed), as well as databases (eLibrary). Physical exertion experienced by highly skilled athletes, as well as persons in hazardous occupations (divers, astronauts, alpinists), leads to the activation of free radical reactions, CNS disorders, metabolic disorders, oxidative stress, and mitochondrial dysfunctions, which lead to the development of many different diseases and reduced labor activity. It has been established that the pathogenesis of psychophysical fatigue combines psychomental and musculoskeletal symptoms, by acting upon which, it is possible to reduce the manifestations of fatigue. The analysis of various publications made it possible to establish the key elements of the pathogenesis of this dysfunction with possible ways of its pharmacological correction.

The work is devoted to the issues of abilitation of extremely premature infants, as well as problems and prospects of development of this direction. The importance of abilitation and methods of developmental care for further physical and psychomotor development of premature infants are reflected. It is emphasized that the methodology of nursing extremely preterm newborns is inseparable from the humanization of diagnostic and therapeutic procedures, which involves the active participation of the mother at all stages of child care. Special attention is paid to the issues of catamnestic observation, its main tasks and their solution in modern conditions. The importance of an integrated, multidisciplinary approach to the care of low birth-weight babies, continuity between specialists of related specialties is shown; the role of family in the maximum use of individual “compensation potential” of the child is reflected. The authors argue that the combination of medical, psychological, social and pedagogical models in the system concept of abilitation is a special methodological setting that makes it possible to obtain the most positive effect for the progressive development of very premature infants.

The review provides information on some aspects of comorbid pathology, as well as features of the rehabilitation process in cerebral palsy. There is currently no uniform system of views in understanding of etiological criteria, pathogenesis, diagnostic aspects of the disease, the assessment of the severity, as well as factors that influence the course of illness. Processes of endothelial dysfunction and oxidative stress contributing to dystrophic changes of neurons, disorders of the cardiovascular system are closely interrelated. There are certain difficulties in the formation of a rehabilitation program in children with cerebral palsy. Part of the problem lies in the low adaptability of the child’s body to increasing physical exertion, caused both by the manifestation of the underlying disease and by the presence of comorbid pathology, which exacerbates the severity of the child’s condition.

The article presents the analysis of the results of the study of hepatic membrane antibodies in blood serum using the method of indirect immunofluorescence assay. 51 patients with acute and chronic hepatitis “B”, 16 - with autoimmune hepatitis, 103 - with various hemoblastoses and 33 healthy donors were examined. The aim of the investigation was to assess the diagnostic value of hepatic membrane antibodies in patients with hemoblastoses as markers of autoimmune liver pathology and to establish the frequency of its development in hemoblastosis. The results obtained indicate a high diagnostic significance of the immunofluorescence technique to anti-membrane liver antibodies for the detection of autoimmune liver disease, including in patients with hemoblastoses. Timely detection of liver pathology and assessment of the severity of its autosensitization in hemoblastoses is of great value in complex therapy of the underlying disease and its hepatic complications.

Technological studies have been carried out on the development of a complex medicinal collection, the extraction from which affects the processes arising as a result of lesions of the joints of inflammatory etiology. The result of the studies conducted on paramecia was the creation of an optimal complex including 13 objects of medicinal plant materials. Biological screening carried out on paramecia confirmed the membrane-stabilizing and antioxidant effect of the developed complex, which may suggest an anti-inflammatory action. The technological aspect of obtaining the complex extraction consisted of a remaceration method, where the ratio of “raw materials: extractant” is 1: 8. The studies have shown that the resulting alcohol-water extraction from the complex of medicinal plant raw materials meets the requirements of the State Pharmacopoeia of the XIII edition and makes it possible to refer it to Category 4 B microbiological purity. Compliance of the obtained data with the specified requirements will allow it to be used both as an independent medicinal product and as an intermediate product in the development of more complex dosage forms.

Stress as an actual medical and biological factor necessitates the study of its various consequences for the macroorganism. The article deals with chronic restraint stress effects on the experimental animals’ colon microbiota. To assess the qualitative and quantitative composition of the microbiocenosis of this biotope, biopsy specimens of the mucous membrane of the large intestine of Wistar rats were used. It was established that stress led to a significant decrease in the number of obligate representatives of the microbiota, while the content of the facultative microflora increased. Evaluation of the frequency of occurrence and the relative average of the identified genera of microorganisms showed that chronic immobilization significantly changed the values of the studied parameters in relation to opportunistic pathogenic representatives of the microbiocenosis, and also affected their correlation with obligate bacteria. The obtained data clearly demonstrate the role of stress in the dysbiosis creation.

The effect of the “Semax” drug was studied in a randomly selected group that included 17 young men (38,3 ± 4,9 years old) with higher education having repeated closed head injuries in the anamnesis. The “Semax” medicine in a concentration of 0,1 % was used intranasally (2 drops into each nasal passage 3 times a day) for 4 weeks. The assessment of cognitive functions included doing a correction task, a test of Luria with memorization of 10 words, as well as a test of exclusion of concepts with recording the time of its execution. All participants had MRI of the brain, which did not reveal gross focal changes. The positive effect of the “Semax” medicine on the neurodynamic cognitive functions of the examined individuals is shown. Subjective improvement of well-being was noted in 15 surveyed, all patients having no side effects. The “Semax” medicine is suitable for the treatment of cognitive impairment in young people with repeated craniocerebral injuries and possible concomitant somatic comorbid pathology.

In our study, the volume fraction of interstitial collagen was analyzed in 345 patients with chronic heart failure, who were divided into groups depending on the left ventricular ejection fraction (preserved, mid-range and reduced) and the disease stage (I, IIA and IIB+III). The control group consisted of somatically healthy individuals. A statistically significant increase in the volume fraction of interstitial collagen was observed in all examined groups of patients compared to the control group. In patients with preserved left ventricular ejection fraction, the volume fraction of interstitial collagen was higher than in patients with mid-range and reduced left ventricular ejection fraction. It was found that the volume fraction of interstitial collagen increased in the groups of patients with a more severe stage of the disease in the group of patients with preserved, mid-range and reduced left ventricular ejection fraction. The findings suggest that the hyperproduction of interstitial collagen is an important pathogenetic factor in the development and progression of chronic heart failure.

Clinical variants of the hepatobiliary system disorders in newborns were studied depending on the etiology of the disease. We observed 41 newborns with intrauterine infections and bacterial sepsis. Against the background of these diseases, clinical diagnostic criteria for liver damage were revealed. A longitudinal (prospective) study of patients with hepatobiliary problems was performed with case follow-up during the entire period of the disease. The etiological characteristic of intrauterine infections and sepsis is given. Basing on clinical, laboratory and instrumental symptoms, it was established that in cases of liver damage as a result of intrauterine infections, hepatobiliary injuries are more often reversible due to the prevalence of degenerative processes without significant hepatocyte necrosis. Therefore, the majority of patients with intrauterine infection on the background of adequate etiological and pathogenetic therapy had a favorable outcome. In bacterial sepsis, newborns most often developed hepatic failure with a fatal outcome in 58 % of cases. Patients were diagnosed with impaired partial functions of the hepatobiliary system as a result of hepatocyte necrosis. A close statistical relationship was established between the hemorrhagic syndrome, with an increase in the activated partial thromboplastin time, prothrombin time, thrombin time rates with respect to bacterial sepsis. Laboratory and instrumental indicators - an increase in the level of alanine aminotransferase and aspartate aminotransferase, decrease in prothrombin index, hypoproteinemia, visualization of the vascular system of the liver, increased density of the parenchyma according to the ultrasound data were in moderate correlation with bacterial sepsis.

The analysis of the combined drug therapy of children undergoing inpatient treatment in a psychiatric hospital has been carried out based on the identification of off-label drug use and risk assessment of potential drug-drug interactions. Case histories of inpatients and lists of prescriptions have been retrospectively studied. Clinically unconfirmed and contraindicated off-label drug use has not been identified. We have found 14 drug combinations that can lead to moderate drug-drug interactions and require monitoring of the patient's clinical condition, as well as one combination that can lead to minor drug-drug interaction. Contraindicated and dangerous combinations of drugs have not been found. The safety of the combined pharmacotherapy from the perspective of clinical pharmacology has been assessed.

The article presents the prognostic factors that contribute to the development of complications of myocardial infarction and the risk of death in elderly and senile patients. It has been proven that the gender of the patient, the level of troponin, the localization of myocardial infarction and the combination of comorbid pathology are the predictors of unfavorable prognosis. According to the data obtained, myocardial infarction in 7,7 % of cases (33 patients) is complicated by ischemic stroke, often of a cardioembolic subtype, in the first week of the disease, the combination of two vascular accidents resulting in high lethality (69,7 %, p < 0,05). In the case of a combination of myocardial infarction and cerebral stroke, there was the prevalence of cerebral focal symptoms, which considerably complicates the diagnosis of myocardial infarction. The development of algorithms for individual preclinical prediction allows reducing the number of adverse outcomes and repeated hospitalizations of elderly and senile patients.

Internal carotid and vertebral arteries dissection is the leading cause of ischemic stroke in young patients. It is a tearing of the intima of the artery with the formation of intramural hematoma, leading to stenosis or occlusion of its lumen. Isolated cervical / headache, not combined with cerebral ischemia, is one of the manifestations of extracranial arteries dissection. The problems of diagnosis and management of patients with this pathology are discussed on the example of the present clinical case.

Variations of the axillary artery and its branches are quite common. Some variations are clinically significant and knowledge of them can be useful for prevention of diagnostic errors during surgical interventions in the axillary fossa. The article deals with a branching pattern of the right subscapular artery (that has not been described in the literature before) from which anterior and posterior circumflex humeral arteries, circumflex scapular, thoracodorsal and profunda brachii artery arise. The latter followed downwards to the canal for radial nerve and didn’t give any branches, except for the superior ulnar collateral artery. The external diameter of the profunda brachii artery was 4 mm. No variations in the first and second parts of the right and all parts of the left axillary arteries were discovered. The branching pattern description of the subscapular artery can be important and essential for surgeons and radiologists. The additional fibrous band was also found during dissection of right arm.