Synthesis of 1,2,3-triazole-substituted coumarins and also 1,2,3-triazolyl or 1,2,3-triazolylalk-1-inyl-linked coumarin-2,3-furocoumarin hybrids was performed by employing the cross-coupling and copper catalyzed azide-alkyne cycloaddition reaction approaches. The synthesized compounds were evaluated for their in vitro antibacterial activity against Staphylococcus aureus, Bacillius subtilis, Actinomyces viscosus and Escherichia coli bacterial strains. Coumarin-benzoic acid hybrids 4с, 42с and 3-((4-acetylamino-3-(methoxycarbonyl)phenyl)ethynyl)coumarin (29) showed promising activity against S. aureus strains, and the 1,2,3-triazolyloct-1-inyl linked coumarin-2,3-furocoumarin hybrid 37c was endowed with high selectivity against B. subtilis and E. coli species. The in vitro antibacterial activity of 4с, 29, 37c and 42с can potentially be compared with that of a number of modern antibiotic drugs used in the clinic, suggesting promising prospects for further research. A detailed study of the molecular interactions with the targeted protein MurB was performed using docking simulations and the obtained results are quite promising.

Objective. To study the prognostic value of echocardiographic parameters of early cardiac remodeling in patients with hypertension (HTN) and obstructive sleep apnea (OSA). Design and methods. The study included 59 men with HTN and OSA (with an apnea/hypopnea index > 15 per hour). At baseline, all patients underwent polysomnography and echocardiography with an additional assessment of the global longitudinal strain (GLS). At baseline and at 12-month follow-up, a 6-minute walk test was performed. After 12 months, the clinical course of the disease was assessed. The criteria for an unfavorable course were episodes of hospitalization, the development of acute coronary syndrome, cerebral stroke, paroxysmal atrial fibrillation, worsening of chronic heart failure with a transition to a higher NYHA functional class. Results. In groups with favorable and unfavorable clinical course, some baseline echocardiographic parameters differed significantly: interventricular septal thickness (p = 0,037), left ventricular myocardial mass index (LVMI) (p = 0,003), tricuspid annular plane systolic excursion (TAPSE) (p < 0.001), GLS (p = 0,019), peak tricuspid regurgitation (p = 0,027), left atrial volume index (p = 0,048). Regression analysis showed that baseline TAPSE and LVMI had predictive value for an unfavorable clinical course. Conclusions. Our results confirm that certain echocardiographic parameters, in particular, LVMI and TAPSE, are predictors of the development and progression of cardiovascular complications in OSA patients.

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Objective. To analyze clinical and morphological features of neurogenic hourglass tumors in the thoracic spine and their impact on outcomes of treatment through posterior surgical approaches.Material and Methods. The results of surgical treatment of 295 patients with tumors growing from the nerve roots of the thoracic spinal cord were studied. In 63 (21 %) of them, tumors of the spinal nerves were diagnosed. The vast majority of neoplasms were represented by Grade 1 neuromas – in 57 (90 %) patients, Grade 1 neurofibromas were found in 3 (5 %) patients, and High-grade malignant tumors – in 3 (5 %). Intracanal neoplasms were found in 42 (66.7 %) cases and intraextravertebral (hourglass) – in 21 (33.3 %).Results. Microsurgical removal of tumor was performed using two types of low-traumatic surgical approaches: 1) posterior median approach – in 56 (89.0 %) cases, of which hemilaminectomy was performed in 36 (64.4%) cases, interlaminectomy – in 15 (26.8 %) cases, and laminectomy – in 5 (8.1 %) cases; 2) paravertebral approach – in 7 (11.0 %) out of 63 cases with partial facetotomy or facetectomy and resection of part of the head and upper or lower edge of the rib at the same level. Tumors were removed totally in 56 (88.9 %) patients and subtotally – in 7 (11.1%). Intracanal tumors were removed totally in 40 (95.2 %) patients. A similar totality was achieved in removal of 16 (76.2 %) of hourglass neurinomas. Surgical interventions performed in the early postoperative period improved the functional state of  patients: the Karnofsky Performance Scale (KPS) index increased from 70–80 to 90 %, the VAS pain score decreased from 5–6 to 2 points. Good clinical outcomes were achieved in 42 (66.7 %) patients, satisfactory – in 17 (27.0 %), and unsatisfactory – in 6 (6.3 %). Twenty nine patients had symptoms of myelopathy, complete regression of which occurred in 3 (10.3 %) cases, partial – in 9 (34.6 %), in 13 (50.0 %) cases they remained at the preoperative level, and in 4 (15.4 %) – worsened.Conclusion. The use of modern neurointroscopy, microsurgical techniques and low-traumatic posterior surgical approaches for resection of tumors of the spinal nerve roots in the thoracic spine provides good clinical outcomes of treatment in the early postoperative period. The existing hourglass tumor in the thoracic spine reduces the likelihood of its total removal when performing a low-traumatic posterior approach.

Parkinson’s disease (PD) is a multifactorial neurodegenerative disease. Consequently, there has been growing interest in identifying early preclinical disease symptoms and searching for their laboratory markers in recent decades.Objective: to studythe relationship between vitamin D levels, phosphorus-calcium metabolism and clinical manifestations of PD.Patients and methods. Serum levels of total vitamin D (VD), as well as total calcium, ionized calcium, alkaline phosphatase (AP), inorganic phosphorus, and parathyroid hormone (PTH) were assessed in 138 patients with PD. The severity of the disease was verified according to the Hoehn-Yar criteria, the clinical symptoms of the disease were verified using the Unified PD Rating Scale (UPDRS), the evaluation also included the quality of life (QoL) scales for patients with PD (PDQ-39), anxiety and depression (HADS), and Beck depression inventory, assessment of cognitive functions (CF) according to MoCA. Then, we analyzed the effect of vitamin D levels and other indicators of phosphorus-calcium metabolism on the severity of PD clinical symptoms.Results and discussion. Patients with PD had a significant impact of phosphorus-calcium metabolism on CF, assessed by MoCA scale and the PDQ-39 subscale “Cognitive functions”. A joint direct impact of vitamin D levels (β=0.111; p=0.002), PTH (β=0.02; p=0.037) and the indirect effect of AP (β=-0.028; p=0.027) on CF was revealed. A direct effect of the level of inorganic phosphorus (β=5.932; p=0.001) and AP (β=0.055; p=0.025) on the QoL of patients with PD was observed.Conclusion. Cognitive decline in PD patients is directly related to vitamin D and PTH levels. At the same time, the lower the QoL of patients with PD, the lower the serum vitamin D level was, serving as an early predictor of cognitive decline in patients with PD.