A set of building blocks based on the 4,5,6,7‐tetrahydro‐pyrazolo[1,5‐a]pyrazine scaffold is synthesized in a multigram scale in a cost‐efficient manner. The possibility of the introduction of different substituents, neutral or functionalized in different positions of pyrazole and/or piperazine rings, is shown. The efficacy of using NH‐pyrazole carbonic acids as a key intermediate of the process is demonstrated. The regioselectivity for direct insertion of the substituent to the 4,5,6,7‐tetrahydro‐pyrazolo[1,5‐a]pyrazine core is discussed. The synthetic perspectives for using the functionalized 4,5,6,7‐tetrahydro‐pyrazolo[1,5‐a]pyrazine as a bifunctional scaffold is discussed. The utilizing of building blocks obtained for the different region‐ and/or stereoselective synthesis, including sole transformations or modifications of functional groups, is demonstrated. The advantages of the proposed approach are proven compared with the other known methodologies.
The present article revealed the results on evaluation of medical care quality in 430 patients with parodontologic diseases provided in 14 municipal and city dental policlinics in 2014-2016 under the compulsory health insurance (CHI) in Saint Petersburg. The performed analysis allows to compare the possibilities of therapeutic and diagnostic assistance to treat periodontitis, provided under CHI and regulated by the clinical recommendations developed by Russia Dental Association. Due to the developed clinical recommendations the quality dental care under CHI could be provided only on the initial and supportive treatment stages and considered to be therapeutic, thus the surgical treatment could not be fully provided. The types of medical services provided under CHI restrict the use of clinical recommendation (Russia Dental Association) to treat patients with periodontal diseases in dental policlinics and do not ensure the provision of entirely quality dental care under CHI. Therefore, the development of new criteria to include the full range of treatment and diagnostic dental services into the basic CHI is of high importance.
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