Spontaneous Coronary Artery Dissection Presenting As ST-Segment Elevation Myocardial Infarction.

Spontaneous coronary artery dissection (SCAD) is a non-traumatic spontaneous separation of a coronary wall that can present as acute myocardial infarction. Pregnant females are already at a considerably higher risk of acute myocardial infarction when compared to non-pregnant women of child-bearing age, and dissection explains the majority of these cases. Here, we present a 36-year-old female at 36-weeks gestation who experienced ventricular fibrillation arrest after ST-segment elevation myocardial infarction (STEMI) secondary to spontaneous dissection of the left anterior descending (LAD) coronary artery.

Synthesis of novel antioxidant and antitumor 5-aminopyrazole derivatives, 2D/3D QSAR, and molecular docking.

5-Aminopyrazole serves as a vital precursor for several biologically active pyrazoloazines, including pyrazolopyridine, pyrazolopyrimidine, and pyrazolotriazine, as well as Schiff bases, thiourea, and phthalimide derivatives. In this study, we structurally characterized novel pyrazole derivatives by spectral IR, 1H and 13C NMR, and MASS spectroscopy. We also evaluated antioxidant activity of various derivatives using ABTS and DPPH methods and cytotoxicity in the hepatocellular carcinoma Hep-G2 cells by SRB assay. The most potent antitumor molecules were 5-aminopyrazole derivative 3, chloroacetanilide derivative 8, maleimide derivative 10a, pyrazolopyrimidine 16, and enamine 19, with IC50 values of 41, 3.6, 37, 24.4, and 17.7 µM, respectively. Complementary computational studies predicted QSAR and bioactivity of these molecules. Interestingly, the most effective compounds were also predicted to be kinase inhibitors; in addition, molecular docking with liver receptors (3MBG, 4XCU, and 4G9C) predicted promising interactions.

Premorbid echocardiography and risk of hospitalization in COVID-19.

BACKGROUND: COVID-19 has caused a global pandemic unprecedented in a century. Though primarily a respiratory illness, cardiovascular risk factors predict adverse outcomes. We aimed to investigate the role of baseline echocardiographic abnormalities in further refining risk in addition to clinical risk factors. METHODS: Adults with COVID-19 positive RT-PCR test across St Luke's University Health Network between March 1st 2020-October 31st 2020 were identified. Those with trans-thoracic echocardiography (TTE) within 15-180 days preceding COVID-19 positivity were selected, excluding severe valvular disease, acute cardiac event between TTE and COVID-19, or asymptomatic patients positive on screening. Demographic, clinical, and echocardiographic variables were manually extracted from patients' EHR and compared between groups stratified by disease severity. Logistic regression was used to identify independent predictors of hospitalization. RESULTS: 192 patients met inclusion criteria. 87 (45.3%) required hospitalization, 34 (17.7%) suffered severe disease (need for ICU care/mechanical ventilation/in-hospital death). Age, co-morbidities, and several echocardiographic abnormalities were more prevalent in those with moderate-severe disease than in mild disease, with notable exceptions of systolic/diastolic dysfunction. On multivariate analysis, age (OR 1.039, 95% CI 1.011-1.067), coronary artery disease (OR 4.184, 95% CI 1.451-12.063), COPD (OR 6.886, 95% CI 1.396-33.959) and left atrial diameter ≥ 4.0 cm (OR 2.379, 95% CI 1.031-5.493) predicted need for hospitalization. Model showed excellent discrimination (ROC AUC 0.809, 95% CI 0.746-0.873). CONCLUSIONS: Baseline left atrial enlargement is an independent risk factor for risk of hospitalization among patients with COVID-19. When available, baseline LA enlargement may identify patients for (1) closer outpatient follow up, and (2) counseling vaccine-hesitancy.

Synthesis, characterization, antibacterial evaluation, 2D-QSAR modeling and molecular docking studies for benzocaine derivatives.

Possible application of incorporating a well-known drug (benzocaine) with cyanoacetamide function to get a powerful synthon ethyl 4-cyanoacetamido benzoate. This synthetic intermediate was used as a precursor for the synthesis of triazine, pyridone, thiazolidinone, thiazole and thiophene scaffolds containing the benzocaine core. Facile coupling, Michael addition, condensation and nucleophilic attack reactions were used to synthesize our targets. The structural features of the synthesized scaffolds were characterized using IR, 1H NMR, 13C NMR and mass spectroscopy. The antibacterial activities against Gram-positive (Staphylococcus aureus, Bacillus subtilis) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) were evaluated using ampicillin as a reference drug. DNA/methyl-green colorimetric assay of the DNA-binding compounds was also performed. Theoretical studies of the newly synthesized compounds based on molecular docking and QSAR study were conducted. The molecular docking studies were screened by MOE software for the more potent antibacterial agent 28b and each native ligand against four of S. aureus proteins 1jij, 2xct, 2w9s and 3t07.