EMBOLIC MYOCARDIAL INFARCTION. EXPERIENCE IN DIAGNOSIS AND MANAGEMENT

Acute myocardial infarction (AMI) is one of the main causes of morbidity and mortality, both in the Russian Federation and around the world. Approximately, in up to 10% of patients with clinical diagnostic features of AMI, early angiography does not reveal an occluded vessel or possibly any evidence of coronary artery disease. These patients constitute an intriguing subgroup referred to as “Myocardial Infarction with Non-Obstructive Coronary Arteries” (MINOCA). MINOCA is a collective concept that unites many different pathologies, which determines the essential heterogeneity of the etiological factors. Coronary artery embolism is recognized as an important non-atherosclerotic cause of AMI. In turn, the most common underlying disease in those with coronary embolism is the atrial fibrillation. The advantages of reperfusion strategy and cardioprotective therapy in the treatment of obstructive arteriosclerosis are well studied, widely presented in the literature and supported by a strong evidence base, while the issues of diagnosis and treatment of patients with MINOCA are currently widely discussed We present two clinical cases of embolic myocardial infarction in patients with atrial fibrillation, diagnosed in our clinic in 2017.

On the Implications of Essential Heterogeneity for Estimating Causal Impacts Using Social Experiments

The standard model of essential heterogeneity, whereby program take up depends on unobserved costs and benefits of take up, is generalized to allow the source of latent heterogeneity to influence counterfactual outcomes. The standard instrumental variables (IV) estimator is shown to still be preferable to the naïve, ordinary least squares (OLS), estimator for mean impact on the treated. However, under certain conditions, the IV estimate of the overall mean impact will be even more biased than OLS. Examples are given for stylized training, insurance and microcredit schemes.

Rupture propagation in strong earthquake sources and tectonic stress field

Problems of physical basis of earthquake source mechanics are discussed. Results of stress state reconstruction based on the cataclastic analysis of discontinuous dislocations in some seismotectonic active earth crust domains are presented. Common features of the stress state in areas of preparation of strong earthquake in this century are revealed. It is demonstrated that the distribution of the effective isotropic pressure and of the maximal shear stress in areas of earthquake source preparation is characterized by essential heterogeneity. The main part of the source is always associated to crust domain under low effective confining pressure. Specific role of crust domains characterized by high stress gradients is recognized. The nucleation point of the earthquake is usually associated to such domains. Based on some strong earthquake case studies it is demonstrated that usually the rupture propagates from the region of high gradients of stresses toward the crust domains characterized by low effective compression.

Zonal and Zoogeographic Characteristic of the Ant Fauna (Hymenoptera, Formicidae) of Ukraine

Zonal and Zoogeographic Characteristic of the Ant Fauna (Hymenoptera, Formicidae) of UkraineOne hundred fourty ant species belonging to 38 genera of 5 subfamilies are known to occur in Ukraine nowadays. All the species are attributed to 16 zoogeographic complexes that are grouped into three faunogenetic classes. Comparative zonal and zoogeographical analysis of the fauna of different geographical regions of Ukraine has revealed their essential heterogeneity. The ant fauna of the Forest-Steppe zone is not original. At the same time, it is not transitive between the faunae of the Forest and Steppe zones. Ant fauna of the Forest-Steppe is related to those not the Steppe but the Forests zones, and the Forest-Steppe can be included in the southern subzone of a Forest zone of t Europe.