[Questionnaire of the Ryzhikh National Medical Research Centre for Coloproctology is a new tool for assessing chronic pelvic pain and pelvic organ dysfunction]. / Oprosnik NMITs koloproktologii imeni A.N. Ryzhikh ­ novyi instrument otsenki khronicheskoi tazovoi boli i narusheniya funktsii tazovykh organov.

The article presents the work of a multidisciplinary team of experts from various fields of medicine to optimize the «Questionnaire for assessing chronic pelvic pain and pelvic organ dysfunction (QCPPD) of the Ryzhikh National Medical Research Centre for Coloproctology¼ for use in clinical practice. The survey of respondents was conducted from June 28 to September 28, 2021. As a result of this survey, by repeatedly making edits and clarifications during communication with respondents, the final version was obtained, which allows assessing the patient's subjective sensations by the nature and localization of pelvic pain, sensitivity disorders and pelvic organ function. The main objective of this Questionnaire is to differentiate patients with neurogenic pain from a huge number of patients with chronic pelvic pain. This aspect will allow a more targeted approach to the diagnosis and pathogenetically justified treatment of patients, including after appropriate instrumental examinations. The work of a multidisciplinary team implies a higher degree of objectification and terminological accuracy of the Questionnaire under discussion. The presented version of the «Questionnaire for assessing chronic pelvic pain and pelvic organ dysfunction (QCPPD) of the Ryzhikh National Medical Research Centre for Coloproctology¼ will be primarily used in coloproctological patients with pelvic pain problems and anal incontinence and obstructive defecation. Further studies will be directed to the clinical evaluation of the results of the work carried out.

[Rehabilitation program for patients with low anterior resection syndrome]. / Reabilitatsionnaya programma dlya bol'nykh rakom pryamoi kishki s sindromom nizkoi perednei rezektsii.

Surgical treatment of rectal cancer and sphincter-preserving low anterior resection results to evacuation disorders («low anterior resection syndrome¼ - LARS). There are no clinical recommendations for the treatment of patients with LARS as well as a rehabilitation program for them. OBJECTIVE: To develop a rehabilitation program for patients with low anterior resection syndrome. MATERIAL AND METHODS: The investigation was performed at 2 stages. During the first stage, 29 patients with LARS (17 (58.6%) men, mean age of the participants' 61.5±9.5 years), 12 (41.4%) women (mean age 61.2±7.8 years) were examined and received the course of conservative treatment with the use of biofeedback-therapy performed by the standard protocol. On the second stage, 17 patients (mean age 61.4±12.7 years) - 9 (52.9%) men, 8 (47.1%) women received biofeedback therapy in combination with tibial neuromodulation (TNM). Functional state of the rectum and the locking apparatus in all patients were evaluated by anorectal manometry: sphincterometry and studies of the reservoir function of the rectum before and after treatment. RESULTS: The developed complex of rehabilitation measures led to improved treatment results for patients with rectal cancer by improving the quality of life after low anterior resection, reducing the manifestations of LARS (by 47.8%). Stable positive results of treatment were maintained in 36.4% of patients, positive dynamics from the treatment according to the LARS scale decreased slightly in 54.5%, deterioration of indicators in 3-6 months after conservative rehabilitation was registered in 9.1% of cases. At the first stage maximal squeeze pressure improvement was reached in the whole cohort (p=0.047), at the second stage these trend was seen only for women for the pressure values at rest (p=0.01) and during squeeze (p=0.025). The data obtained allowed us to recommend a repeat course of treatment to 63.6% of patients. The authors modified and optimized a special complex of physical therapy for the rehabilitation of patients both in a medical institution and at home. These exercises are aimed at improving the functional state of the pelvic floor muscles and sphincter apparatus. CONCLUSION: Rehabilitation program for patients with low anterior resection syndrome should include: 1) biofeedback therapy to improve the holding function; 2) biofeedback therapy aimed at improving the reservoir function and sensitivity of the rectum to filling; 3) tibial neuromodulation. This program may help improving the contractility of the anal sphincter and reservoir function of the rectum, as well as the appearance of the urge to defecate.

[Recommendations for the Protocol of functional examination of the anorectal zone and disorders classification: the International Anorectal Physiology Working Group consensus and Russian real-world practice].

This manuscript summarizes consensus reached by the International Anorectal Physiology Working Group (IAPWG) for the performance, terminology used, and interpretation of anorectal function testing including anorectal manometry (focused on high-resolution manometry), the rectal sensory test, and the balloon expulsion test. Based on these measurements, a classification system for disorders of anorectal function is proposed. Aim to provide information about methods of diagnosis and new classification of functional anorectal disorders to a wide range of specialists general practitioners, therapists, gastroenterologists, coloproctologists all who face the manifestations of these diseases in everyday practice and determine the diagnostic and therapeutic algorithm. Current paper provides agreed statements of IAPWG Consensus and comments (in italics) of Russian experts on real-world practice, mainly on methodology of examination. These comments in no way intended to detract from the provisions agreed by the international group of experts. We hope that these comments will help to improve the quality of examination based on the systematization of local experience with the use of the methods discussed and the results obtained. Key recommendations: the International Anorectal Physiology Working Group protocol for the performance of anorectal function testing recommends a standardized sequence of maneuvers to test rectoanal reflexes, anal tone and contractility, rectoanal coordination, and rectal sensation. Major findings not seen in healthy controls defined by the classification are as follows: rectoanal areflexia, anal hypotension and hypocontractility, rectal hyposensitivity, and hypersensitivity. Minor and inconclusive findings that can be present in health and require additional information prior to diagnosis include anal hypertension and dyssynergia.

[The clinical efficacy of Korinfar-retard in combination with Cordanum, triampur and Capoten in patients with arterial hypertension]. / Klinicheskaia éffektivnost' korinfar-retard v sochetanii s kordanumom, triampurom, kapotenom u bol'nykh s arterial'noi gipertoniei.

Corinfar-retard as a base of different combinations with triampur, Cordanum, Capoten were studied in 52 patients with stable arterial hypertension (systolic pressure > 180 mm Hg, diastolic pressure > 105 mm Hg). In the above combinations pharmacokinetics of corinfar-retard did not change. Good response was noted in corinfar-retard combination with Cordanum in patients with moderate hemodynamic changes, hypertonicity of sympathoadrenal system, tachycardia. In patients with impaired myocardial contractility, elevated total peripheral vascular resistance, noticeable hypotensive effects was registered in combination with triampur. The absence of hypotensive effect in the above combination required the addition of Capoten which was absolutely indicated in patients with stable increase in plasma renin activity.

[A pharmacokinetic study of korinfar-retard in monotherapy and in combination with cordanum and triampur in patients with arterial hypertension]. / Izuchenie farmakokinetiki korinfara-retard v monoterapii i v sochetanii s kordanumom i triampurom u bol'nykh s arterial'noi gipertenziei.

The long-acting corinfar formulation, corinfar-retard tablets, 20 mg (AWD, Germany), was studied for pharmacokinetics in single and course use in 40 patients with arterial hypertension, as well as for its effects of cordanum and triampur. Patients' plasma corinfar was measured by high performance liquid chromatography. There were no changes in the pharmacokinetics of the agent when it was used in its course use. Cordanum and triampur was demonstrated to have no effects on the pharmacokinetics of corinfar during their application.

[The pharmacodynamics of proxodolol when administered once and in a course of doses to patients with stenocardia of effort]. / Farmakodinamika proksodolola pri odnokratnom i kursovom naznachenii bol'nym stenokardiei napriazheniia.

The effects of placebo and proxodolol, a new hybrid (beta-, alpha-) adrenoblocking agent, on exercise tolerance, hemodynamics and the conduction system were compared in 28 patients with coronary heart disease, Functional Class II-III exercise-induced angina pectoris at rest and during bicycle ergometric exercise test. Proxodolol was shown to exert a significant dose-dependent antianginal effect without producing any negative effect on atrioventricular and intraventricular conduction.

[The pharmacokinetic and pharmacodynamic characteristics of foridon during interaction with the metabolic oxidation inhibitor dopegit]. / Osobennosti farmakokinetiki i farmakodinamiki foridona pri vzaimodeistvii s ingibitorom metabolicheskogo okisleniia dopegitom.

The paper deals with some aspects of the effects produced by dopegite on the pharmacokinetics and pharmacodynamics of foridone from a group of calcium antagonists. Nineteen patients with essential hypertension received a single doses of foridone of 40 mg, then its course therapy in a dose of 90 mg/day for 2 weeks, then it was supplemented with dopegite in a dose of 750 mg/day for 2 weeks too. Supplementation of dopegite caused statistically significant changes as higher plasma concentrations of foridone and increased concentration-time curve areas, decreased total peripheral resistance and regional, and a lower spasm index. Dopegite can be used to enhance the antihypertensive effect of foridone.

[The clinical pharmacology and efficacy of the new Soviet calcium antagonist foridon]. / Klinicheskaia farmakologiia i éffektivnost' novogo otechestvennogo antagonista kal'tsiia foridona.

A total of 56 patients with coronary heart disease (CHD), angina pectoris of effort, functional classes II-III, were placed under observation. All the patients received 20 mg foridon (F), 20 mg corinfar (C), 80 mg anapriline (A). 24 patients were subjected to the continuous treatment with F (20 mg 4 times a day). The antianginal action of the drug was compared to the blood concentration on days 7, 14, 21, 28, 43 and 57 of the treatment with F. In 14 patients with angina pectoris and in 18 patients with essential hypertension, the efficacy of F and C was cross correlated. It has been demonstrated that F can be successfully used for the treatment of patients with CHD, angina pectoris of effort and (or) essential hypertension. The increase of the single dose of foridon from 20 to 40 mg does not result in the potentiation of its hypotensive effect. F and C provoke the highest rise of exercise tolerance with combined angina pectoris. Continuous concomitant administration of F and C with A leads to the potentiation of the antianginal action.

[Use of the new hypotensive agent Minipress (prazosin hydrochloride]. / Primenenie nocogo gipotenzivnogo sredstva minipress )prazosin hydrochloride).

Efficacy of minipress in patients with hypertension stage II and its haemodynamic effects were studied after a single administration and during a course of treatment. It is shown that its main mechanism is in vasodilatation caused by relaxation of the muscular component of arterioles. The authors suggest that minipress can produce redistribution of the blood through peripheral venoconstriction. Decrease of the index of the external work of the heart points indirectly to decreased oxygen utilization by the myocardium which may reflect changes in haemodynamics under the influence of minipress or through direct action of the drug on the heart. Hypotensive effect of minipress is recorded already by the 5th day of its administration (p less than 0.001), however, its further effect is unstable. Increase of the circadian dose becomes necessary and also its combined use with thiazide diuretics. Positive chronotropic effect of Minipress has been recorded, with maximum towards the end of the 2nd week of treatment and seen as increased rate of cardiac contractions by 13.2% (p less than 0.01). To decrease this effect authors advise to use minipress in combination with beta-adrenoblockers.