ДЕЯКІ АКТУАЛЬНІ ПРОБЛЕМИ ДІАГНОСТИКИ, КЛАСИФІКАЦІЇ, ПСИХОПАТОЛОГІЇ ШИЗОФРЕНІЇ
Ключові слова:
шизофренія, аналіз літератури.Анотація
роботі на основі аналізу світової літератури наведено дані щодо розуміння найбільш важливих питань класифікації, етіології та патогенезу, діагностики і клінічних проявів шизофренії. Показано, що жодне із вказаних питань не має сьогодні однозначного трактування.
Посилання
1. Психиатрия: справочник практического врача / Под ред. Гофмана А.Г. – М.: Медпрессинформ, 2006. – 591 с.
2. Джонс П. Шизофрени / П. Джонс, П. Бакли. – М.: Медпрессинформ, 2008. – 192 с.
3. Руководство по психиатрии. Т.1 / Под ред. Снежневского А.В. – М.: Медицина, 1983. – С. 299.
4. Руководство по психиатрии.Т.1 / Под ред. Тиганова А.С. – М.: Медицина, 1989.
5. Уотсон Д. ДНК и мозг (впоисках генов психических заболеваний) / Д. Уотсон // Лекция 3 июля 2008 г. в Москве, http://elementy.ru/lib/430639.
6. The spectrum of psychoyic disorders: neurobiology, etiology, and psthogenesis / Ahmed, Iqbal, Fujii, Daryl. – Cambridge, UK: Cambridge University Press, 2007.
7. Andreasen N.C. Negative symptoms in schizophrenia / N.C. Andreasen // Arch. Gen. Psychiatry. – 1982. – Vol.39. – P. 784-788.
8. Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives / B. Arts, N. Jabben, L. Krabbendam et al. // Psychol. Med. – 2008. – Vol.38. – P. 771-785.
9. Awad A.G. The burden of schizophrenia on caregivers: a review / A.G. Awad, Voruganti L.N. // Pharmacoeconomics. – 2008. – Vol.26(2). – P. 149-162.
10. Benes F.M. Quantiativecytoarchitectural studies of the cerebral cortex of schizophrenics / F.M. Benes, J. Davidson, E.D. Bird // Arch. Gen. Psychiatry. – 1986. – Vol.43(1). – P. 31-35.
11. Cognitive impairment in schizophrenia and affective psychoses: implications for DSM-V criteria and beyond / Bora et al. // Schizophren. Bull. – 2010. – Vol.36. – P. 36-42.
12. Buchanan R.W. Schizophrenia. Introduction and overview / R.W. Buchanan, W.T. Carpenter, In: Kaplan B., Sadock V. // Comprehensive textbook of psychiatry. 7th edition, vol.I. – Philadelphia, Lippincotte, Williams and Wilkins. 2000. – P. 1096-1110.
13. genetic variation in MAOA modulates ventromedial prefrontal circuity mediating individual differences in human personality / J.W. Buckholtz, J.H. Callicott, B. Kolachana et al.// Mol. Psychiatry. – 2008. – Vol.13(3). – P. 313-324.
14. Variation in DISC1 affects hippocampal structure and function and increases risk for schizophrenia / J.H. Callicott, R.E. Straub, L. Pezawas et al. // Proc. Natl. Acad. Sci USA. – 2005. – Vol.102(24). – P. 8627-8632.
15. Campaign for The Abolition of The Schizophrenia Label (http://www/caslcampaign.com/).
16. Association of DISC1/TRAX halotypes with schizophrenia, reduced prefrontal gray matter, and impaired short- and long-term memory / T.D. Cannon, W. Hennah, T.G. van Erp et al. // Arch. Gen. Psychiatry. – 2005. – Vol.62(11). – P. 1205-1213.
17. Collier D.A. Schizophrenia: the polygene princess and the pea / D.A. Colli¬er // Psychol. Med. – 2008. – P. 1-5.
18. Crespi Psychosis and autism as diametrical disorders of the social brain (http://www.bbsonline.org/Preprints/Crespi-02162007).
19. Crow T.J. The two syndrome concept, origins and current status / T.J. Crow // Schiz. Bull. – 1985. – Vol.11. – P. 471-477.
20. Crow T.J. How and why genetic linkage has not solved the problem of psychosis: rewiew and hypothesis / T.J. Crow // Am J. Psychiatry. – 2007. – V.164. – P. 13-21.
21. Crow T.J. The emperors of the schizophrenia polygene have no clothes / T.J. Crow // Psychol. Med. – 2008. – P. 1-5.
22. Cuesta M.J. Empirical validation of competing definitions of schi¬zophrenia: a poly-diagnostic study of cognitive impairment in non-affective psychosis / M.J. Cuesta, V. Peralta, A. Zarzuela // Schizophr. Res. – 2007. – Vol.95. – P. 39-47.
23. Dysfunctional Perception Syndrome (http://astridvanwoerkom.wordpress.com/2009/10/09/schizophrenia-now¬called-dysfunctional-perception-syndrom/)
24. Neuropsychologic functioning among the nonspecific relatives of schi¬zophrenic patients: a four-year follow up study / S.V. Faraone, I.J. Seidman, W.S. Kremen et al. // J. Abnorm. Psychol. – 1999. – Vol.108. – P. 176-181.
25. Jackson J.H. Selected writings / J.H. Jackson. – Holder and Stoughton, London, 1931. – Vol.1. – 411 p.
26. The G72/G30 gene complex and cognitive abnormalities in schizophrenia / T.E. Goldberg, R.E. Straub, J.H. Callicott et al. // Neuropsychopharmacol¬ogy. – 2006. – Vol.31(9). – P. 2022-2032.
27. Green M.F. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS / M.F. Green, R.S. Kern, R.K. Heaton // Schizophr. Res. – 2004. – Vol.72(1). – P. 41-51.
28. Griesinger W. Die Pathologic und Therapie der psychischen Krankheiten / W. Griesinger. – Braunsduweig: Verlag von Friedrich Wreden, 1871. – Р. 53-85.
29. A neuregulin 1 variant associated with abnormal cortical function and psychotic symptoms / J. Hall, H.C. Whalley, E. d. Job et al. // Nat. Neurosci. – 2006. – Vol.9(12). – P. 1477-1478.
30. Heinrichs R.W. The primacy of cognition in schizophrenia / R.W. Heinrichs // Am. Psychol. – 2005. – Vol.60(3). – P. 229-242.
31. Neuropsychological dysfunction in antipsychotic-naХve first-episode uni¬polar psychotic depression / S.K. Hill, M.S. Keshavan, M.E. Thase et al. // Am. J. Psychiatry. – 2004. – Vol.161(6). – P. 996-1003.
32. Hoche A. Die Medizin der Gegenwart in Sellbstdarstellungen, 1925.
33. Kay S.R. Cognitive abnormality in schizophrenia: A dual process model / S.R. Kay, M.M. Singh // Biol. Psychiat. – 1979. – Vol.14. – P. 155-176.
34. Keefe R.S. Defining a cognitive function decrement in schizophrenia / R.S. Keefe, C.E. Eesley, M.P. Poe // Biol. Psychiatry. – 2005. – Vol.57, №6. – P. 688-692.
35. A Separate Disease within the Syndrome of Schizophrenia / B. Kirkpatrick, R.W. Buchanan, D.E. Ross, W.T. Carpenter // Arch. Gen. Psychiatry. – 2001. – Vol.58. – P. 165-171.
36. McClellan J.M. Schizophrenia: a common disease caused by multiple rare alleles / J.M. McClellan, E. Susser, M.C. King // British Journal Psychiatry. – 2007. – №3. Vol.190. – P. 194-199.
37. Lower prefrontal gray matter volume in schizophrenia in chronic but not in first episode schizophrenia patients / V. Molina, J. Sanz, F. Sarramea et al. // Psychiatry Res. – 2004. – Vol.131(1). – P. 45-56.
38. Murray R. Assessing Symptom Dimensions in Psychosis: Towards the Diagnostic and Statistical Manual of Mental Disorders – V (DSM-V) and the International Classification of Diseases and Health-Related Problems – (11th Revision) (ICD-11) / R. Murray // Presentation at Satellite Sympo¬sium «Treatment of Schizophrenia: Towards a Comprehensive Approach» on the occasion of the 20th ECNP Congress, 16 October 2007. – P. 1-12.
39. Neocortical gray matter volume in first-episode schizophrenia and first-episode affective psychosis: a cross-sectional and longitudinal MRI study / M. Nakamura, D.F. Salisbury, Y. Hirayasu et al.// Biol. Psychiatry. – 2007. – Vol.62(7). – P. 773-783.
40. Roceedings and Data From The schizophrenia Summit: a clinical appraisal to improve the management of schizophrenia / H.A. Nasrallah, M.S. Keshavan, F.M. Benes et al. // J. Clin. Psychiatry. – 2009. – Vol.70. – Suppl 1. – P. 4-46.
41. National Collaborating Centre for Mental Health: Schizophrenia. Full national clinical guidelines on core interventions in primary and secondary care. – London, Gaskell and British Psychological Society, 2003. – 252 p.
42. O’Donovan M.C. Schizophrenia: complex genetics, not fairy tales / M.C. O’Donovan, N. Cradock, M.J. Owen // Psychol. Med. – 2008. – P. 1-3.
43. Peralta V. Diagnostic significance of Schneider’s first-rank symptoms in schizophrenia. Comparative study between schizophrenic and non-schizophrenic psychotic disorders / V. Peralta, M.J. Cuesta // Br. J. psychiatry. – 1999. – Vol.174. – P. 243-248.
44. Size of burden of schizophrenia and psychotic disorders / W. Rossler,H.J. Salize, J. Van Os et al. // Eur. Neuropsychopharmacol. – 2005. – Vol.15(4). – P. 399-409.
45. Rund B.R. A review of longitudinal studies of cognitive functions in schizophrenia patients / B.R. Rund // Schizophr. Bull. – 1998. – Vol.24. – P. 425-435.
46. Sato M. Renaming schizophrenia: a Japanese perspective / M. Sato // World Psychiatry. – 2006. – Vol.1. – P. 53-55.
47. Neuropsychological function decrement in schizophrenia: selective impairment in memory and learning / A.J. Saykin, R.C. Gur, R.E. Gur et al. // Arch. Gen psychiatry. – 1991. – Vol.48(7). – P. 618-624.
48. Selemon L.D. Abnormally high neuronal density in the schizophrenic cortex: a morphometric analysis of prefrontal area 9 and occipital area 17 / L.D. Selemon, G. Rajkowska, P.S. Goldman-Rakic // Arch. Gen. Psychiatry. – 1995. – Vol.52(10). – P. 805-818; discussion 819-820.
49. Allelic variation in GAD1 (GAD67) is associated with schizophrenia and influences cortical function and expression / R.E. Straub, B.K. Lipska, M.F. Egan et al. // Mol. Psychiatry. – 2007. – Vol.12(9). – P. 854-869.
50. Strauss J.S. The diagnosis and understanding of schizophrenia: III. Speculations on the process that underlie schizophrenic symptoms and signs / J.S. Strauss, W.T. Carpenter, J.J. Bartko // Shcizophs. Ball. – 1974. – Vol.11. – P. 61-76.
51. Sullivan P.F. The dice are rolling for schizophrenia genetics / P.F. Sulli¬van // Psychol. Med. – 2008. – P. 1-4.
52. Tunbrige E.M. Catechol-o-menthyltransferase, cognition, and psychosis: Val158Met and beyond / E.M. Tunbrige, P.J. Harrison, D.R. Weinberger // Biol. Psychiatry. – 2006. – Vol.60(2). – P. 141-151.
53. Focal gray matter changes in schizophrenia across the course of the ilness: a 5-year follow-up study / N.E. Van Haren, H.E. Pol Hulshoff, H.G. Schnack et al. // Neuropsychopharmacology. – 2007. – Vol.32(10). – P. 2057-2066.
54. Van Os J. Salience syndrome replaces schizophrenia in DSM-V and ICD¬11: psychiatry’s evidence-based entry into the 21st century? / J. Os Van // ActaPsychiatr Scand. – 2009. – №120(5). – Р. 363-72.
55. Van Os J. A salience dysregulation syndrome / J. Os Van // Br. J. Psychiatry. – 2009. – № 194(2). – Р. 101-103.
56. Van Os J. Schizophrenia / J. Os Van, S. Kapur // Lancet. – 2009. – №374(9690). – Р. 635-45.
2. Джонс П. Шизофрени / П. Джонс, П. Бакли. – М.: Медпрессинформ, 2008. – 192 с.
3. Руководство по психиатрии. Т.1 / Под ред. Снежневского А.В. – М.: Медицина, 1983. – С. 299.
4. Руководство по психиатрии.Т.1 / Под ред. Тиганова А.С. – М.: Медицина, 1989.
5. Уотсон Д. ДНК и мозг (впоисках генов психических заболеваний) / Д. Уотсон // Лекция 3 июля 2008 г. в Москве, http://elementy.ru/lib/430639.
6. The spectrum of psychoyic disorders: neurobiology, etiology, and psthogenesis / Ahmed, Iqbal, Fujii, Daryl. – Cambridge, UK: Cambridge University Press, 2007.
7. Andreasen N.C. Negative symptoms in schizophrenia / N.C. Andreasen // Arch. Gen. Psychiatry. – 1982. – Vol.39. – P. 784-788.
8. Meta-analyses of cognitive functioning in euthymic bipolar patients and their first-degree relatives / B. Arts, N. Jabben, L. Krabbendam et al. // Psychol. Med. – 2008. – Vol.38. – P. 771-785.
9. Awad A.G. The burden of schizophrenia on caregivers: a review / A.G. Awad, Voruganti L.N. // Pharmacoeconomics. – 2008. – Vol.26(2). – P. 149-162.
10. Benes F.M. Quantiativecytoarchitectural studies of the cerebral cortex of schizophrenics / F.M. Benes, J. Davidson, E.D. Bird // Arch. Gen. Psychiatry. – 1986. – Vol.43(1). – P. 31-35.
11. Cognitive impairment in schizophrenia and affective psychoses: implications for DSM-V criteria and beyond / Bora et al. // Schizophren. Bull. – 2010. – Vol.36. – P. 36-42.
12. Buchanan R.W. Schizophrenia. Introduction and overview / R.W. Buchanan, W.T. Carpenter, In: Kaplan B., Sadock V. // Comprehensive textbook of psychiatry. 7th edition, vol.I. – Philadelphia, Lippincotte, Williams and Wilkins. 2000. – P. 1096-1110.
13. genetic variation in MAOA modulates ventromedial prefrontal circuity mediating individual differences in human personality / J.W. Buckholtz, J.H. Callicott, B. Kolachana et al.// Mol. Psychiatry. – 2008. – Vol.13(3). – P. 313-324.
14. Variation in DISC1 affects hippocampal structure and function and increases risk for schizophrenia / J.H. Callicott, R.E. Straub, L. Pezawas et al. // Proc. Natl. Acad. Sci USA. – 2005. – Vol.102(24). – P. 8627-8632.
15. Campaign for The Abolition of The Schizophrenia Label (http://www/caslcampaign.com/).
16. Association of DISC1/TRAX halotypes with schizophrenia, reduced prefrontal gray matter, and impaired short- and long-term memory / T.D. Cannon, W. Hennah, T.G. van Erp et al. // Arch. Gen. Psychiatry. – 2005. – Vol.62(11). – P. 1205-1213.
17. Collier D.A. Schizophrenia: the polygene princess and the pea / D.A. Colli¬er // Psychol. Med. – 2008. – P. 1-5.
18. Crespi Psychosis and autism as diametrical disorders of the social brain (http://www.bbsonline.org/Preprints/Crespi-02162007).
19. Crow T.J. The two syndrome concept, origins and current status / T.J. Crow // Schiz. Bull. – 1985. – Vol.11. – P. 471-477.
20. Crow T.J. How and why genetic linkage has not solved the problem of psychosis: rewiew and hypothesis / T.J. Crow // Am J. Psychiatry. – 2007. – V.164. – P. 13-21.
21. Crow T.J. The emperors of the schizophrenia polygene have no clothes / T.J. Crow // Psychol. Med. – 2008. – P. 1-5.
22. Cuesta M.J. Empirical validation of competing definitions of schi¬zophrenia: a poly-diagnostic study of cognitive impairment in non-affective psychosis / M.J. Cuesta, V. Peralta, A. Zarzuela // Schizophr. Res. – 2007. – Vol.95. – P. 39-47.
23. Dysfunctional Perception Syndrome (http://astridvanwoerkom.wordpress.com/2009/10/09/schizophrenia-now¬called-dysfunctional-perception-syndrom/)
24. Neuropsychologic functioning among the nonspecific relatives of schi¬zophrenic patients: a four-year follow up study / S.V. Faraone, I.J. Seidman, W.S. Kremen et al. // J. Abnorm. Psychol. – 1999. – Vol.108. – P. 176-181.
25. Jackson J.H. Selected writings / J.H. Jackson. – Holder and Stoughton, London, 1931. – Vol.1. – 411 p.
26. The G72/G30 gene complex and cognitive abnormalities in schizophrenia / T.E. Goldberg, R.E. Straub, J.H. Callicott et al. // Neuropsychopharmacol¬ogy. – 2006. – Vol.31(9). – P. 2022-2032.
27. Green M.F. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS / M.F. Green, R.S. Kern, R.K. Heaton // Schizophr. Res. – 2004. – Vol.72(1). – P. 41-51.
28. Griesinger W. Die Pathologic und Therapie der psychischen Krankheiten / W. Griesinger. – Braunsduweig: Verlag von Friedrich Wreden, 1871. – Р. 53-85.
29. A neuregulin 1 variant associated with abnormal cortical function and psychotic symptoms / J. Hall, H.C. Whalley, E. d. Job et al. // Nat. Neurosci. – 2006. – Vol.9(12). – P. 1477-1478.
30. Heinrichs R.W. The primacy of cognition in schizophrenia / R.W. Heinrichs // Am. Psychol. – 2005. – Vol.60(3). – P. 229-242.
31. Neuropsychological dysfunction in antipsychotic-naХve first-episode uni¬polar psychotic depression / S.K. Hill, M.S. Keshavan, M.E. Thase et al. // Am. J. Psychiatry. – 2004. – Vol.161(6). – P. 996-1003.
32. Hoche A. Die Medizin der Gegenwart in Sellbstdarstellungen, 1925.
33. Kay S.R. Cognitive abnormality in schizophrenia: A dual process model / S.R. Kay, M.M. Singh // Biol. Psychiat. – 1979. – Vol.14. – P. 155-176.
34. Keefe R.S. Defining a cognitive function decrement in schizophrenia / R.S. Keefe, C.E. Eesley, M.P. Poe // Biol. Psychiatry. – 2005. – Vol.57, №6. – P. 688-692.
35. A Separate Disease within the Syndrome of Schizophrenia / B. Kirkpatrick, R.W. Buchanan, D.E. Ross, W.T. Carpenter // Arch. Gen. Psychiatry. – 2001. – Vol.58. – P. 165-171.
36. McClellan J.M. Schizophrenia: a common disease caused by multiple rare alleles / J.M. McClellan, E. Susser, M.C. King // British Journal Psychiatry. – 2007. – №3. Vol.190. – P. 194-199.
37. Lower prefrontal gray matter volume in schizophrenia in chronic but not in first episode schizophrenia patients / V. Molina, J. Sanz, F. Sarramea et al. // Psychiatry Res. – 2004. – Vol.131(1). – P. 45-56.
38. Murray R. Assessing Symptom Dimensions in Psychosis: Towards the Diagnostic and Statistical Manual of Mental Disorders – V (DSM-V) and the International Classification of Diseases and Health-Related Problems – (11th Revision) (ICD-11) / R. Murray // Presentation at Satellite Sympo¬sium «Treatment of Schizophrenia: Towards a Comprehensive Approach» on the occasion of the 20th ECNP Congress, 16 October 2007. – P. 1-12.
39. Neocortical gray matter volume in first-episode schizophrenia and first-episode affective psychosis: a cross-sectional and longitudinal MRI study / M. Nakamura, D.F. Salisbury, Y. Hirayasu et al.// Biol. Psychiatry. – 2007. – Vol.62(7). – P. 773-783.
40. Roceedings and Data From The schizophrenia Summit: a clinical appraisal to improve the management of schizophrenia / H.A. Nasrallah, M.S. Keshavan, F.M. Benes et al. // J. Clin. Psychiatry. – 2009. – Vol.70. – Suppl 1. – P. 4-46.
41. National Collaborating Centre for Mental Health: Schizophrenia. Full national clinical guidelines on core interventions in primary and secondary care. – London, Gaskell and British Psychological Society, 2003. – 252 p.
42. O’Donovan M.C. Schizophrenia: complex genetics, not fairy tales / M.C. O’Donovan, N. Cradock, M.J. Owen // Psychol. Med. – 2008. – P. 1-3.
43. Peralta V. Diagnostic significance of Schneider’s first-rank symptoms in schizophrenia. Comparative study between schizophrenic and non-schizophrenic psychotic disorders / V. Peralta, M.J. Cuesta // Br. J. psychiatry. – 1999. – Vol.174. – P. 243-248.
44. Size of burden of schizophrenia and psychotic disorders / W. Rossler,H.J. Salize, J. Van Os et al. // Eur. Neuropsychopharmacol. – 2005. – Vol.15(4). – P. 399-409.
45. Rund B.R. A review of longitudinal studies of cognitive functions in schizophrenia patients / B.R. Rund // Schizophr. Bull. – 1998. – Vol.24. – P. 425-435.
46. Sato M. Renaming schizophrenia: a Japanese perspective / M. Sato // World Psychiatry. – 2006. – Vol.1. – P. 53-55.
47. Neuropsychological function decrement in schizophrenia: selective impairment in memory and learning / A.J. Saykin, R.C. Gur, R.E. Gur et al. // Arch. Gen psychiatry. – 1991. – Vol.48(7). – P. 618-624.
48. Selemon L.D. Abnormally high neuronal density in the schizophrenic cortex: a morphometric analysis of prefrontal area 9 and occipital area 17 / L.D. Selemon, G. Rajkowska, P.S. Goldman-Rakic // Arch. Gen. Psychiatry. – 1995. – Vol.52(10). – P. 805-818; discussion 819-820.
49. Allelic variation in GAD1 (GAD67) is associated with schizophrenia and influences cortical function and expression / R.E. Straub, B.K. Lipska, M.F. Egan et al. // Mol. Psychiatry. – 2007. – Vol.12(9). – P. 854-869.
50. Strauss J.S. The diagnosis and understanding of schizophrenia: III. Speculations on the process that underlie schizophrenic symptoms and signs / J.S. Strauss, W.T. Carpenter, J.J. Bartko // Shcizophs. Ball. – 1974. – Vol.11. – P. 61-76.
51. Sullivan P.F. The dice are rolling for schizophrenia genetics / P.F. Sulli¬van // Psychol. Med. – 2008. – P. 1-4.
52. Tunbrige E.M. Catechol-o-menthyltransferase, cognition, and psychosis: Val158Met and beyond / E.M. Tunbrige, P.J. Harrison, D.R. Weinberger // Biol. Psychiatry. – 2006. – Vol.60(2). – P. 141-151.
53. Focal gray matter changes in schizophrenia across the course of the ilness: a 5-year follow-up study / N.E. Van Haren, H.E. Pol Hulshoff, H.G. Schnack et al. // Neuropsychopharmacology. – 2007. – Vol.32(10). – P. 2057-2066.
54. Van Os J. Salience syndrome replaces schizophrenia in DSM-V and ICD¬11: psychiatry’s evidence-based entry into the 21st century? / J. Os Van // ActaPsychiatr Scand. – 2009. – №120(5). – Р. 363-72.
55. Van Os J. A salience dysregulation syndrome / J. Os Van // Br. J. Psychiatry. – 2009. – № 194(2). – Р. 101-103.
56. Van Os J. Schizophrenia / J. Os Van, S. Kapur // Lancet. – 2009. – №374(9690). – Р. 635-45.
##submission.downloads##
Опубліковано
2019-07-10
Як цитувати
Винник, М. І., Бежук, Ю. М., Ромаш, І. Р., Бондар, О. М., & Краснопольська, І. І. (2019). ДЕЯКІ АКТУАЛЬНІ ПРОБЛЕМИ ДІАГНОСТИКИ, КЛАСИФІКАЦІЇ, ПСИХОПАТОЛОГІЇ ШИЗОФРЕНІЇ. ПРИКАРПАТСЬКИЙ ВІСНИК НТШ Пульс, (4(24), 128–138. вилучено із https://pvntsh.nung.edu.ua/index.php/pulse/article/view/840
Номер
Розділ
КЛІНІЧНА МЕДИЦИНА
