Background. Neurosurgical pathology of the brain is an urgent problem of modern medicine. Existing models of cognitive rehabilitation are based on neuropsychological correction. The literature does not contain enough information about the effect of medical and physiotherapeutic techniques on higher nervous activity.

Objective. To assess the effect of neurorehabilitation in cognitive impairment in patients with neurosurgical brain pathology.

Design and methods. The dynamics of cognitive impairment was studied in 165 neurosurgical patients (72 men, 93 women, average age 52.82 ± 14.79 years) at the second stage of rehabilitation. The severity of the deficit of higher cortical functions was assessed upon admission and after 30 days in the rehabilitation department. Roschina test, MMSE, FAB, HDRS were used to detect depression.

Results. When analyzing the dynamics of indicators for scoring higher cortical functions, it was found that in all groups of patients, cognitive rehabilitation led to positive results.

Conclusion. The combined use of neuropsychological, medical and physiotherapeutic techniques can significantly improve the results of rehabilitation treatment.

Stroke is one of the leading causes of death and disability worldwide, despite successful strategies to manage the main risk factors for ischemic stroke (hypertension, atrial fibrillation, diabetes mellitus and others). Sleep-disordered breathing (SDB) is poorly studied, but potentially significant and modifiable risk factor for stroke, so it draws attention of investigators. In this review we have focused on some aspects and analyzed the relationship of different variants of SBD with the lesions localization and the type of acute ischemic stroke according to TOAST criteria. During the analysis, it was shown that in the early period after cerebrovascular accident, the frequency and severity of respiratory disturbances in sleep were higher, mainly due to the presence of central apnea, which develops when the vertebro-basilar pool is involved in the blood supply zone. However, impaired cerebral circulation of supratentorial localization can also be a factor contributing to the appearance or exacerbation of respiratory failure in a dream. With regard to the relationship of respiratory disorders in a dream with a type of cerebrovascular accident according to the TOAST classification, we can talk about the likely relationship of obstructive sleep apnea with a cerebrovascular accident of cardioembolic and atherothrombotic origin.

It becomes apparent that the neurological complications of COVID-19 are significantly common, but in some cases, establishing a causal relationship is difficult. For example, a stroke can occur for reasons unrelated to coronavirus infection, while Guillain–Barré syndrome and meningoencephalitis are likely to be a parainfection. Only long-term epidemiological studies in large groups of patients can clarify some of these issues. This will help to better understand the mechanisms of development of complications and develop schemes for their treatment and subsequent rehabilitation. The article presents the mechanisms of penetration of the coronavirus into the nervous system and systematizes the neurological manifestations and complications of COVID-19, which were described in the first 3 months of the pandemic. Particular attention is paid to the consideration of the complications of COVID-19 from the central and peripheral nervous system, the most interesting clinical examples are considered. Summing up the analysis of the literature, we can say that the clinical picture of neurological diseases and syndromes caused by coronavirus infection corresponds to the usual notions. Also considered is the assumption that SARS-CoV-2 can persist for a long time in the central nervous system in the form of inactive fragments, which means that it can recur in predisposed individuals when appropriate conditions arise. This suggestion is alarming regarding distant neurological complications in infected and cured patients.

In the context of the new coronavirus infection spreading it is particularly relevance to obtain information on the clinical course, diagnostic possibilities and features of the COVID-19 treatment. By May 2020 in the world more than 4 million people were infected by the SARS-CoV-2 virus and more than 300 thousand died. In this review data about the clinical course, diagnostic possibilities and treatment of patients with COVID-19 are present. The authors analyzed publications presented in local and international databases from December 2019 to May 2020 on the new coronavirus infection. According to the analysis the most frequent symptoms described in literature wee fever, weakness, cough, dyspnea, gastroenterological manifestation and smell dysfunction. The main methods of diagnostic are the results of clinical evaluation, computer tomography and molecular genetic methods of examination. The treatment of his infection is limited by the absence of etiological treatment and the need for symptomatic therapy. All data presented in COVID-19 treatment trials have efficacy not more than 65 %, among which lopinavir/ritonavir shows the lowest result (20 %), hydroxychloroquine and tocilizumab show better results (45 and 65 % respectively). Great hope rests on the effectiveness of immunosuppressive therapy. Moreover, all treating methods don’t reduce mortality, which is 13–22 % regardless of the treatment type.

In medicine, the current method of treatment of various pathologies — ozone therapy is gaining popularity. On the basis of modern literary data, the advantage of the use of ozone therapy in the complex treatment of certain diseases has been shown, as well as the main contraindications have been identified. The main task of ozone therapy is to improve tissue circulation, as well as to promote better supply of oxygen to cells, which has a positive effect and accelerates tissue regeneration. It has been found that ozone therapy is widespread in more than ten sanatoriums of the Republic of Crimea. Data on the use of ozone therapy in some sanatoriums of Crimea, such as “Sanatorium Kirov”, “Poltava Crimea”, “Tavria”, in sanatorium named after N. I. Pyrogov, “Slavutich”, “Mishor”, “Ai-Petri” and hotel complex “Yalta-Inturist” are presented. The review describes possible methods of ozone therapy, as well as some peculiarities of ozone use in sanatorium treatment.

Background. “Scimitar” syndrome is a rare congenital malformation with a frequency of 2 per 100,000 newborns. The syndrome is manifested by complete abnormal drainage of the pulmonary veins of the right lung into the inferior vena cava. According to the literature, a typical symptom of scimitar syndrome can be detected on radiographs in no more than 1/3 of patients. Only complex radiation diagnostics with the inclusion of multispiral computed tomographic angiography allows to diagnose “scimitar” syndrome, determine all its components, clarify the anatomical features and determine the volume and tactics of further cardiac surgery.

Objective of the present clinical case is to assess the role of radiation research methods in the primary diagnosis and control of surgical treatment of scimitar syndrome.

Materials and methods. A 39-year-old patient with a history of open arterial duct ligation and complaints of fatigue, shortness of breath arising from household loads was examined. According to the results of the chest x-ray and MSCT angiography of the chest organs, “scimitar” syndrome was diagnosed, the patient underwent a two-stage cardiosurgical treatment with the assessment of the results by MSCT angiography. Results. According to the results of radiation studies, the patient revealed a rare congenital malformation — “scimitar” syndrome.

Conclusion. MSCT angiography of the chest is a highly informative, minimally invasive diagnostic method for the scimitar syndrome. MSCT angiography of the chest allows you to visually and accurately visualize the type of abnormal drainage, the course and place of the confluence of the collector, the presence of anastomoses with the left heart, which directly affects the definition of tactics for surgical correction of the disease. MSCT angiography of the chest allows you to evaluate the results of surgical treatment.

Granulomatosis with polyangiitis is characterized by necrotizing granulomatous inflammation, vasculitis with vascular lesions of small and medium caliber and focal necrotizing glomerulonephritis. A frequent and one of the most formidable complications is kidney damage, which in a large number of cases leads to a complete loss of organ function and a switch to renal replacement therapy. Given the rare occurrence of this disease in the clinical work of practitioners, and their low awareness of this pathology, problems often arise with the diagnosis and treatment of patients with HPA. Due to the diversity and non-specific nature of the manifestations of the disease, a delay in diagnosis may occur. The presented case illustrates the manifestations of granulomatosis with polyangiitis in the form of severe damage to the upper respiratory tract and kidneys, the diagnosis of which was difficult due to the rarity of the disease and the multiple organ pathology. This article presents a clinical case of severe progression of rapidly progressive glomerulonephritis in a patient with ANCA-associated vasculitis, a brief review of the literature is given. Despite adequate therapy, the disease progressed mainly due to deterioration of renal function, which subsequently led to a complete loss of kidney function and the transition to treatment with chronic hemodialysis.