УДК 616-001-031.82:616.151]-036-085.451.2

Тяжка травма є однією зі значимих причин смерті серед дорослих пацієнтів, а 40% в структурі цієї летальності займають кровотечі. Коагулопатія в таких пацієнтів є наслідком комбінації різнопланових чинників. Зокрема, виникає експозиція прокоагулянтів і білків, що активують тромбоцити та відщеплюються компоненти глікокаліксу, і, як наслідок, розвивається коагулопатія споживання з гіпокоагуляцією. Крім того, в системний кровотік
вивільняються фібринолітичні фактори [3]. Все це разом з гіпотермією, ацидозом та коагулопатією розведення призводить до клінічних проявів кровоточивості. 

The rapid development of modern scientific medicine and practice (development of genetic engineering, coronary angiography, use of microprocessors (microminiature implant in eye retina, 3D-print of implants, prostheses) is connected with the scientific-technical progress in recent years, which gave impetus to introduction of extremely complex treatment and diagnostic methods. The use of high-tech medical equipment requires the implementation of modern sanitary and antiepidemic measures of disinfection and sterilization after each manipulation to prevent in-hospital infection/infectious diseases which are related to the grant of medicare (IHI/IPNMD). Every year in the USA, up to 2 million patients who received medical services are registered with IHI/IPNMD cases. IHI/IPNMD is the cause of increased mortality, disability, lengthens stay period of patients in hospitals, increases the financial burden on both patients and healthcare system. According to WHO data mortality from IHI/IPNMD among adult patients ranges from 18.5% to 29.6% and in countries with low- and middle-income level fluctuate in the range of 8.8%-88.9%. Thus, the vital issue today is to strengthen the control system over IHI/IPNMD at all stages of its spread, namely: early detection of sick persons and carriers among patients and medical personnel, monitoring resistance to antibiotics and control over their use in patients treatment, expanding the range of scientific research in the development of new groups of antibacterial drugs, compliance with the sanitary-epidemic regime in hospitals, including the elaboration of modern disinfectants and sterilization agents.

This article discusses the characteristics of the design of thermoelectric generators (TEGs) for cold climates. Since the thermocouples of thermoelectric batteries are produced from different materials, their major properties are studied. Particular attention is given to nanostructured materials regarding the modern class of thermoelectric materials. Two-, three-, and four-component alloys (metallic glasses) of the Fe-Ni(Cu)-P-B system are chosen based on the experience of thermoelectric thermometry. The close chemical composition of two thermoelectrodes enables their compatibility in thermocouple production and satisfactory thermoelectric efficiency of batteries during long-term operation. The improvement of the thermoelectric battery characteristics related to a unit of mass is evaluated. The materials studied are distinguished by the absence of toxic components harmful to the environment at the manufacturing and operating stages.

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

Мігрень — первинний головний біль, що призводить до інвалідизації та уражає понад мільярд осіб у світі. Нині діагностування та лікування цього неврологічного захворювання лишаються недостатньо ефективними.
До вашої уваги представлено огляд статті A. K. Eigenbrodt et al. «Diagnosis and management of migraine in ten steps» видання Nat Rev Neurol (2021 Aug; 17 (8): 501–514), де відображено 10-етапний підхід до діагностування та лікування мігрені на основі рекомендацій, схвалених Європейською федерацією фахівців із головного болю та Європейською академією неврології (EHF/EAN, 2021).