Currently, there is an acute problem of social protection of children left without parental care. Placement of a child in a foster family is associated with many different risks of a socio-psychological and medical nature, which can have a negative impact on the effectiveness of parenting and the mental health of children. In this regard, the implementation of psychological and pedagogical support for foster families becomes priority to create conditions for effective family education of foster children and careful selection of candidates for foster parents.

Abstract. In connection with the growth of resistance of pathogens of pyoinflammatory infections (PII) to antibiotics, physicians began to use bacteriophages, which are widespread where there are homologous bacteria. They are also found in the human body, possibly protecting against PII. It was found that mortality in patients with bacteriophages was lower than in patients without homologous endogenous bacteriophages. The most common were mild bacteriophages, which “protected” patients from infection, although it is believed that only virulent bacteriophages may do this.Aim of study. To study the effect of virulent and moderate endogenous bacteriophages on the course of pyoinflammatory infections in intensive care units (ICU) patients.Material and methods. The study included 33 patients with positive blood culture who were treated in the ICU. Of these, 12 (36.4%) had endogenous bacteriophages (10 men, 2 women).We isolated 16 strains of various bacteria. Bacteriological blood tests were performed using an automatic blood culture analyzer Bactec-9050. Identification of isolated microorganisms was carried out using an automatic microbiological analyzer WalkAway 40. Traditional virological methods on the basis of LLC SPC MicroMir were used for work with bacteriophages.Results and discussion. From 16 positive blood cultures, the following were isolated: Klebsiella pneumoniaе — in 7 samples, Acinetobacter spр. — in 4 samples, Staphylococcus spp. — in 2 samples, and one strain in each sample: Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis. Endogenous phages were isolated in 36.4% of patients, which were detected in all blood cultures. The exception was K. pneumoniae strains, for which in 42.9% of cases (3 cases out of 7) bacteriophages were absent.Out of 12 patients with isolated bacteriophages, 6 had positive treatment outcomes.Of 14 blood samples, 11 moderate bacteriophages were isolated, which amounted to 78.6%, virulent — 21.4%. Despite this, the protective effect of bacteriophages was noted.Conclusion. 1. All blood cultures contained homologous bacteriophages, except K. pneumoniaе strains, which had no endogenous bacteriophages in 42.9% of cases. 2. Most of the isolated endogenous bacteriophages (78.6%) were moderate. 3. In the absence of homologous bacteriophages in the blood of ICU patients, the likelihood of death increases (66.7%) compared to patients with bacteriophages (33.3%).

The article is devoted to the study of the effect of own endogenous bacteriophages on the course and outcomes of severe concominant injury. The microflora isolated from the blood of resuscitation patients was analyzed. The mortality rate and the presence or absence of endogenous bacteriophages were compared. Less lethal outcomes were found in patients with endogenous bacteriophages, regardless of whether they are virulent or moderate. In the absence of endogenous bacteriophages, K. pneumonia and staphylococci were isolated from the blood of patients with further lethal outcome more often than other species.

Резюме. Розглянуто основні підходи до фізичної реабілітації хворих нейрохірургічного профілю. Наведено основні принципи побудови програм, обґрунтовано необхідність мультидисциплінарного підходу, визначено способи вирішення завдань, поставлених в різні періоди фізичної реабілітації відповідно до факторів, що визначають спрямованість процесу фізичної реабілітації. Обґрунтовано необхідність включення до програм фізичної реабілітації базового та варіативного компонентів. Основою програм фізичної реабілітації повинні бути індивідуально підібрані і диференційовані заходи, спрямовані на скорочення терміну відновлення функцій та поліпшення якості життя тематичних пацієнтів. Ключові слова: фізична реабілітація, нейрохірургія, фактори, принципи, мультидисциплінарність. Summary. The main approaches to physical rehabilitation of neurosurgical profile patients have been considered.The basic principles of the program construction have been presented, the necessity of a multidisciplinary approach has been substantiated, ways of solving tasks set in different periods of physical rehabilitation according to the factors, determining the orientation of the physical rehabilitation process have been determined. The necessity of inclusion of basic and variable components in the physical rehabilitation program has been substantiated. Individually selected and differentiated measures aimed at reducing the term of functional recovery and improvement of quality of life of patients should be the basis of physical rehabilitation programs.