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The purpose of this article is to analyze the reasons for the withdrawal from the market of certain drugs, to determine whether this creates difficulties in the treatment and diagnostic process and, if so, to reflect the approaches to overcoming them. For the purposes of the research, a questionnaire was created, with which hospital pharmacists were interviewed. The results show that the withdrawal of drugs from the market is a serious problem and challenge for medical institutions and the general security of the health care system. Legislation has provided significant opportunities to address this issue, but the issue of funding for these therapies has not been resolved and remains a serious problem, especially in cases where cofinancing and full reimbursement of drug therapy by the patient is required. It is extremely important for the system to analyze such problems and to create targeted policies to overcome them, while minimizing the individual participation and commitment of medical institutions in dealing with problems/needs. It is necessary to consider preventive measures for the exclusion of well-established medicinal products from the market and even with simple regulatory authorizations similar to those under Art. 11 of the LMPHM to create guarantees for the stability of the drug supply processes. It is probably possible to consider creating a list of protected medicinal products which, in addition to being excluded from price revision systems, can also enjoy preferential status with regard to the reimbursement regulations of the National Health Insurance Fund, taxation with various discounts and even going through the regimes of maintaining an active file. The creation of such a list should, of course, be based on extremely clear criteria for the selection of medicinal products in order to ensure full transparency in this process.

Mentalizing is a historical synonym of Freud’s idea of what he called “binding” – the process of connecting ideas to one another in order to establish stable forms which leads to associative pathways in order to adapt to outside environment better and also have a stable representations of self and others. Developed mentalizing functioning allows the human being to be aware of the representational nature of the mind in connection to reality, emphasizing both cognitive and affective life. Good mentalizing capacity carries significant stability facing stressful events with good perspectives on life. In this dissertation mentalizing processes are assessed as capacity for implicit and subjective understanding of psychological and affective states of self and others in normative sample and in experimental sample with anxious-depressive symptomatology and its impact of the processes of curiosity and inspiration., Ментализирането е исторически синоним на концепцията на Фройд за т.нар. от него “bindung”, а именно процесът на свързване на идеи една с друга с цел създаване на по-устойчиви форми, водещ до установяване на асоциативни пътища, с цел адаптация към външната реалност посредством създаване на устойчиви репрезентации на себе си и другите. Развитото ментализационно функциониране позволява на човек да е в осъзнатост за репрезентационната природа на ума във връзка с реалността, подчертавайки както когнитивния, така и афективния живот. Добрият ментализационнен капацитет носи значителна устойчивост пред стресови събития и добре изградени перспективи към живота. В дисертационен труд се изследват ментализационните процеси като капацитет за имплицитно и субективно разбиране на психични и афективни състояния на себе си и другия при нормативна извадка и при група с тревожно-депресивна симптоматика и влиянието им върху процесите на любопитство и вдъхновение.

The term "executive function" is used as a common term that includes various complex cognitive processes. They are evolutionary features related to survival and are based on the ability to trace the current behaviour, to track the reactions of others and to achieve a change in behaviour according to the situation. Executive functions provide the ability to plan, organize, prioritize, focus on a specific task, use information and past experience when solving current problems. The executive function is a "product of the coordinated work of various processes, to achieve a specific goal in a flexible manner". These complex processes are not separate structures but chains. Executive functions provide a buffer so as to rethink the current information, to create a plan and to choose a specific course of action. Executive function disorders in children cause a wide range of symptoms. The term "executive function" includes a number of cognitive, emotional and behavioural difficulties. Executive functions have been studied in various developmental disorders — developmental dyslexia, ADHD, autism spectrum disorders. Deficits related to the development of the higher cortical functions and linguistic system lie at the core of executive dysfunctions in developmental dyslexia. This strengthens the opinion that executive dysfunctions have a secondary character and affect, above all, the abilities related to shifting, decision-making, planing, initiating and time management. The main executive dysfunctions in children with ADHD are related to difficulties in task organization, estimating the duration of task performance, prioritizing and initiating, maintaining the focus, making efforts for processing, regulating the sleep-wake cycleand problems withemotional control, working memory, monitoring and regulation of the activity. Children with Autistic spectrum disorders have significant difficulties in analytical thinking, in selfmonitoring and in mental and behavioural flexibility. Behavioural problems are related to insufficient initiation of new actions or behaviours and a tendency to fix on a particular activity. Despite the growing interest towards executive functions in various developmental disorders, there is still no convincing evidence for the presence of a specific executive profile for the different nosologies. The therapy of executive dysfunctions in childhood requires interventions in three main directions — providing a protective environment for the child, therapy with the parents and therapy aimed at the children themselves., «Исполнительные (экзекутивные) функции» — общий термин для обозначения разнообразных сложных когнитивных процессов. Они развились в ходе эволюции для выживания и основываются на способности отслеживать текущее поведение, реакции окружающих и изменять поведение в зависимости от ситуации. Исполнительные функции дают возможность планировать, организовывать, расставлять приоритеты и концентрироваться на конкретной задаче, использовать информацию и прошлый опыт для решения проблем. Исполнительная функция — это результат совместной скоординированной работы нескольких процессов, направленных на достижение цели посредством приспосабливания. Эти сложные процессы состоят во взаимосвязи и не представляют собой обособленных структур. Исполнительные функции выступают в роли буфера и позволяют обдумать имеющуюся на руках информацию, составить план поочередных действий и выбрать их дальнейшую последовательность. Нарушения исполнительных функций в детском возрасте могут проявляться во множестве симптомов. Термин «исполнительная дисфункция» включает в себя ряд когнитивных, эмоциональных и поведенческих расстройств. Исполнительные функции были исследованы в разных расстройствах развития: дислексии развития, СДВГ, аутистических нарушениях. Проблемы, связанные с развитием высших корковых функций и языковой системы, лежат в основе нарушений исполнительных функций при дислексии развития. Это подтверждает мнение о том, что данные нарушения относятся к вторичным признакам и влияют, прежде всего, на способности, связанные с умением меняться, с принятием решений, планированием, инициативностью и эффективным использованием времени. Основные нарушения исполнительных функций у детей с СДВГ связаны с трудностями в организации деятельности, в оценке времени, необходимого для выполнения той или иной задачи, в расстановке приоритетов и проявлении инициативы, удержании внимания, приложении усилий для совершения каких-либо действий, поддержании цикла сна-бодрствования. Отмечаются также проблемы с контролем над эмоциями, рабочей или оперативной памятью, контролем над своими действиями. У детей с расстройствами аутистического спектра наблюдаются значительные трудности с аналитическим мышлением, самоконтролем, а также психической и поведенческой гибкостью. Поведенческие трудности связаны с недостаточной инициативностью по отношению к новым формам деятельности или поведения и склонностью к одному конкретному виду деятельности. Несмотря на повышенный интерес к исполнительной дисфункции в разных нарушениях развития, не существует убедительных данных, подтверждающих существование определенного психологического профиля для разных нозологий. Лечение исполнительных дисфункций в детском возрасте требует вмешательства по трем основным направлениям — это предоставление безопасной среды для ребенка, лечение вместе с родителями и лечение, направленное на самого ребенка.

The complement system is an evolutionary old and crucial component of innate immunity, which is key to the detection and removal of invading pathogens. It was initially discovered as a liver-derived sentinel system circulating in serum, the lymph, and interstitial fluids that mediate the opsonization and lytic killing of bacteria, fungi, and viruses and the initiation of the general inflammatory responses. Although work performed specifically in the last five decades identified complement also as a critical instructor of adaptive immunity-indicating that complement's function is likely broader than initially anticipated-the dominant opinion among researchers and clinicians was that the key complement functions were in principle defined. However, there is now a growing realization that complement activity goes well beyond "classic" immune functions and that this system is also required for normal (neuronal) development and activity and general cell and tissue integrity and homeostasis. Furthermore, the recent discovery that complement activation is not confined to the extracellular space but occurs within cells led to the surprising understanding that complement is involved in the regulation of basic processes of the cell, particularly those of metabolic nature-mostly via novel crosstalks between complement and intracellular sensor, and effector, pathways that had been overlooked because of their spatial separation. These paradigm shifts in the field led to a renaissance in complement research and provide new platforms to now better understand the molecular pathways underlying the wide-reaching effects of complement functions in immunity and beyond. In this review, we will cover the current knowledge about complement's emerging relationship with the cellular metabolism machinery with a focus on the functional differences between serum-circulating versus intracellularly active complement during normal cell survival and induction of effector functions. We will also discuss how taking a closer look into the evolution of key complement components not only made the functional connection between complement and metabolism rather "predictable" but how it may also give clues for the discovery of additional roles for complement in basic cellular processes.

Anti-neutrophil cytoplasmic antibody vasculitis is a systemic autoimmune disease with glomerulonephritis and pulmonary haemorrhage as major clinic manifestations. The name reflects the presence of autoantibodies to myeloperoxidase and proteinase-3 which bind to both neutrophils and monocytes. Evidence of the pathogenicity of these autoantibodies is provided by the observation that injection of anti-myeloperoxidase antibodies into mice causes a pauci-immune focal segmental necrotising glomerulonephritis which is histologically similar to the changes seen on renal biopsy in patients. Previous studies in this model have implicated the alternative pathway of complement activation and the anaphylatoxin C5a. Despite this progress, the factors that initiate complement activation have not been defined. In addition, the relative importance of bone marrow-derived and circulating C5 is not known. This is of interest given the recently identified roles for complement within leukocytes. We induced anti-myeloperoxidase vasculitis in mice and confirmed a role for complement activation by demonstrating protection in C3-deficient mice. We showed that neither MASP-2 nor properdin deficient mice were protected, suggesting that alternative pathway activation does not require properdin or the lectin pathway. We induced disease in bone marrow chimeric mice and found that circulating and not bone marrow-derived C5 was required for disease. We have therfore excluded properdin and the lectin pathway as initiators of complement activation and this means that future work should be directed at other potential factors within diseased tissue. In addition, in view of our finding that circulating and not bone marrow-derived C5 mediates disease, therapies that decrease hepatic C5 secretion may be considered as an alternative to those that target C5 and C5a.