УДК 615.274:582.991:582.943].07

Мeтa. Mеmoю дoслідження булo oпрацювання меmo- дичнoгo підхoду дo визначення анmиoксиданmнoї ак- mивнoсmі насmoйoк із mрави мoнарди mрубчасmoї mа квіmів і кoренів ехінацеї пурпурoвoї, а mакoж рoзрoб- лення їх mехнoлoгії в лабoраmoрних умoвах.

Мaтepiaли i мeтоди. Bикoрисmанo меmoди аналізу, синmезу, сисmемаmизації mа пoрівняння інфoрмації наукoвих даних; визначення рoзміру часmинoк лікар- ськoї рoслиннoї сирoвини; меmoди мацерації mа ре- мацерації для вигomoвлення дoсліджуваних насmo- йoк; mесm DPPH для oцінки загальнoї анmиoксиданm- нoї акmивнoсmі рoзрoблених насmoйoк.

Рeзультaти й обговоpeння. Опрацьoванo меmoдич- ний підхід дo визначення анmиoксиданmнoї акmивнoс- mі насmoйoк із mрави мoнарди mрубчасmoї mа квіmів і кoренів ехінацеї пурпурoвoї, суmь якoгo пoлягала в підбoрі відпoвіднoгo рoзведення насmoйoк. Hасmoйки вигomoвляли за дoпoмoгoю мацерації mа/абo рема- церації в лабoраmoрних умoвах. Співвіднoшення пo- дрібненoї mрави мoнарди mрубчасmoї дo насmoйки були близькими дo співвіднoшень, які викoрисmoвуюmь у фармацевmичній прoмислoвoсmі, а саме 1 дo 5 і 1 дo 10. Кoефіціснmи спирmoпoглинання 70% еmанoлу для кoренів ехінацеї пурпурoвoї (рoзмір 2-5 мм), квіmів ехінацеї пурпурoвoї (рoзмір 1-3 мм), mрави мoнарди mрубчасmoї (рoзмір 0,5-3 мм) дoрівнювали 1,2, 2,25 mа 5,0 мл/г відпoвіднo. Дoслідження пoказали, щo на- сmoйки ехінацеї пурпурoвoї вміщуюmь спoлуки з ан- mиoксиданmними власmивoсmями. Загальна анmиoк- сиданmна акmивнісmь цих насmoйoк сmанoвила у ме- жах від 254,8 дo 815,8 мг руmин-екв. в 1 л насmoйки абo 1,12-4,43 мг руmин-екв. в 1 г сирoвини залежнo від часmини рoслини, рoзміру часmoк і mипу ексmрак- ції. Анmиoксиданmна акmивнісmь насmoйoк mрави мo- нарди mрубчасmoї дoрівнювала 2203,6 мг руmин-екв. в 1 л насmoйки для співвіднoшення 1 дo 9,5 і 20,3 мг руmин-еквіваленmів в 1 г сирoвини mа 2119,4 мг руmин- екв. для насmoйки у співвіднoшенні 1 дo 4,5 і 1 : 9,7 мг руmин-екв. в 1 г сирoвини.

Висновки. Опрацьoванo підхід для визначення анmи- oксиданmнoї акmивнoсmі рoзрoблених насmoйoк, а са- ме експерименmальнo всmанoвленo рoзведення на- сmoйoк для аналіmичнoї меmoдики визначення анmи- oксиданmнoї акmивнoсmі. Резульmаmи дoсліджень пo- казали, щo насmoйки ехінацеї пурпурoвoї вoлoдіюmь анmиoксиданmнoю акmивнісmю. Hасmoйки mрави мo- нарди mрубчасmoї mакoж багаmі спoлуками з анmиoк- сиданmними власmивoсmями. Опрацьoванo лабoраmoр- ну mехнoлoгію шесmи насmoйoк. Пoдальші дoсліджен- ня буде спрямoванo на вивчення вищезгаданих насmoйoк на мікрooрганізмах і лабoраmoрних mваринах

Aim. The aim of the study was to develop the methodical approach to determine the antioxidant activity of the tinctures of Monarda fistulosa herb and flowers and roots of Echinacea purpurea, as well as to develop their technology in laboratory conditions.

Materials and Methods. The following methods were used: analysis, synthesis, systematization, and comparison for processing of published scientific data on antioxidant activity; method for measuring the particle size of raw herbal materials; maceration and remaceration methods for obtaining the tested tinctures; DPPH test for the valuation of the antioxidant activity of the developed tinctures.

Results and Discussion.

The methodical approach to determining the antioxidant activity of the tinctures of Monarda fistulosa herb and flowers and roots of Echinacea purpurea was elaborated, the essence of which consisted in the selection of the appropriate dilution of the tinctures. The six liquid tinctures were prepared with the help of maceration or/ and remaceration in laboratory conditions. The ratios of herbal raw materials (HRM) to the final tincture were close to ratios that are widely employed in the pharmaceutical industry, namely 1 to 5 and 1 to 10. The coefficients of alcohol absorption for the roots of Echinacea purpurea (size 2-5 mm), flowers of Echinacea purpurea (size 1-3 mm), herb of Monarda fistulosa (size 0.5-3 mm) were measured. They were measured as 1.2, 2.25, and 5.0 ml/g, respectively, for 70% ethanol. The studies revealed that Echinacea purpurea tinctures are a valuable source of antioxidant compounds. The antioxidant activity of these tinctures was 254.8-815.8 mg rutin-equivalents in 1 L of the tinctures or 1.12-4.43 mg rutin-equivalents in 1 g of the HRM depending on the part of the plant, particle size and extraction type. The antioxidant activity of the tinctures of the Monarda fistulosa herb was equal to 2203.6 mg eq-rutin/L and 20.3 mg eq-rutin/g for the tincture at a ratio of 1 to 9.5 and 2119.4 mg eq-rutin/L and 9.7 mg eq-rutin/g for the tincture at a ratio of 1 to 4.5.

Conclusions. The approach to the determination of the antioxidant activity of the tested tinctures was elaborated, namely the dilutions of the tinctures were established for the analytical procedure of the determination of the antioxidant activity. Our studies demonstrated that tinctures of Echinacea purpurea contained compounds with antioxidant activity. The tinctures of Monarda fistulosa herb are very rich in compounds with antioxidant properties. The laboratory technology of six tinctures was elaborated. Further studies will be directed at laboratory studies on microorganisms and animals

Abstract
Purpose: Treatments in medicine impact individuals beyond their intended effects, due to phenomena such as the
placebo and nocebo effects. The placebo effect arises from the positive expectation of a treatment being beneficial, while the nocebo effect stems from the negative expectation of a treatment causing harm. Both in real-world practice and clinical trials, treatments can lead to outcomes unrelated to their intended mechanism of action, which we categorize as placebo and nocebo responses. These responses, combined with the inherent fluctuation in a condition’s natural progression, regression to the mean, and random comorbidities, make up a significant part of the therapeutic experience. Particularly in pain management, placebo and nocebo effects play a substantial role. By addressing modifiable contextual factors such as patient expectations, lifestyle choices, and the therapeutic relationship, healthcare providers can enhance the effectiveness of migraine treatments, paving the way for a more comprehensive, individualized approach to patient care. We must also consider non-modifiable factors like personal experiences, beliefs, and information from social media and the internet.
Conclusion: This review offers a summary of our current understanding of the placebo and nocebo effects in migraine management.
Keywords
Migraine, contextual effects, placebo, nocebo, headache

Hematohidrosis (bloody sweat) is a symptom of trophic damage to the vascular wall, in which sweat mixes with blood and seeps onto undamaged areas of the skin in the form of red or pink liquid (depending on the ratio of sweat to blood). In our study we have analyzed 25 case reports of hematohidrosis in children, reported throughout the world using PubMed, ResearchGate with detailed description and opened access. We took into consideration: 
age of the patient, sex, location of bloody excretion, cause or trigger, treatment and its effectiveness. Our clinical case present a 9-year-old girl complained of a periodic bleeding from the intact skin of the face, neck, thighs (without visible damage to the skin) manifested by red or pink liquid, nosebleeds, and  bloody discharge from the mucous membrane of the eyes. The secretions were of varying intensity and lasted up to several hours. Most of all episodes are associated with a strong emotional exertion. One of the theories of hematohidrosis pathogenesis is evident vasoconstriction of the blood vessels surrounding the sweat glands, provoked by hyperactivation of the sympathetic nervous system, which is followed by their excessive vasodilation up to rupture and blood entering the sweat gland ducts. Capillary endothelial cells are known to contain β2-adrenoceptors, which, through the modulation of nitric oxide release, cause endotheliumdependent vasodilation. Blocking β-adrenoceptors (for example, propranolol) prevents excessive vasodilation of blood vessels and, accordingly, their rupture and blood flow to the sweat gland. We managed to find out that the patient’s bloody sweat was a manifestation of a separate pathological phenomenon, and not one of the symptoms of another disease. A properly formed treatment complex and the great trust of the parents enabled to stabilize the child’s condition, and later to cure her. Currently, hematohidrosis is recognized as an independent disease that requires in-depth study of the triggering mechanisms of development, pathogenetic and clinical features.

The aim: The purpose of this literature review is to shed light on the development of biochemical knowledge in the Lviv region and on prominent figures in the development of biochemistry during the Second World War.
Materials and methods: Review of literature published before 2020. We searched the literature using the search terms ‘biochemists’, ‘ Lviv National Medical University’, ‘second World War’.
Conclusions: The development of biological research in Lviv can be divided into two historical stages: 1) from the beginning of the founding of Lviv University in 1661 to the First World War; 2) between the First and Second World Wars and after the Second World War. Biochemical research was initiated at the Medical Faculty of Lviv University. In 1939, the Lviv State Medical Institute was established on the basis of the Medical Faculty of the University, where a powerful department of biochemistry functioned, which was headed by a worldclass biochemist – Jakub Parnas. 

The differences in vascular risk factors’ and stroke burden across Europe are notable, however there is limited understanding of the influence of socioeconomic environment on the quality of secondary prevention and outcome after acute ischemic stroke.

Patients and methods: In this observational multicenter cohort study, we analyzed baseline characteristics, reperfusion treatment, outcome and secondary prevention in patients with acute ischemic stroke from three tertiary-care teaching hospitals with similar service population size in different socioeconomic environments: Bern/CH/n=293 (high-income), Gdansk/PL/n=140 (high-income), and Lutsk/UA/n=188 (lower-middle-income).

Results: We analyzed 621 patients (43.2% women, median age=71.4years), admitted between 07 and 12/2019. Significant differences were observed in median BMI (CH=26/PL=27.7/UA=27.8), stroke severity [(median NIHSS CH=4(0-40)/PL=11(0-33)/UA=7(1-30)], initial neuroimaging (CT:CH=21.6%/PL=50.7%/UA=71.3%), conservative treatment (CH=34.1%/PL=38.6%/UA=95.2%) (each p<0.001), in arterial hypertension (CH=63.8%/PL=72.6%/UA=87.2%), atrial fibrillation (CH=28.3%/PL=41.4%/UA=39.4%), hyperlipidemia (CH=84.9%/PL=76.4%/UA=17%) (each p<0.001) and active smoking (CH=32.2%/PL=27.3%/UA=10.2%) (p<0.007). Three-months favorable outcome (mRS=0–2) was seen in CH=63.1%/PL=50%/UA=59% (unadjusted-p=0.01/adjusted-p CH-PL/CH-UA=0.601/0.981), excellent outcome (mRS=0–1) in CH=48.5%/PL=32.1%/UA=27% (unadjusted-p<0.001/adjusted-p CH-PL/CHUA=0.201/0.08 and adjusted-OR CH-UA=2.09). Three-months mortality was similar between groups (CH=17.2%/ PL=15.7%/UA=4.8%) (unadjusted-p=0.71/adjusted-p CH-PL/CH-UA=0.087/0.24). Three-months recurrent stroke/TIA occurred in CH=3.1%/PL=10.7%/UA=3.1%, adjusted-p/OR CH-PL=0.04/0.32). Three-months follow-up medication intake rates were the same for antihypertensives. Statin/OAC intake was lowest in UA=67.1%/25.5% (CH=87.3%/39.2%/ unadjusted-p<0.001/adjusted-p CH-UA=0.02/0.012/adjusted-OR CH-UA=2.33/2.18). Oral intake of antidiabetics was lowest in CH=10.8% (PL=15.7%/UA=16.1%/unadjusted-p=0.245/adjusted-p CH-PL/CH-UA=0.061/0.002/adjustedOR CH-UA=0.25). Smoking rates decreased in all groups during follow-up.