Vol XXVI, No 3-4 (1994)

Soviet psychiatry was destined for a dramatic fate in the course of its development. As a result of ideological pressure, it was placed in an isolated position in world science. The ensuing excommunication from neuromorphology, genetics, and neurophysiology, with the latter being replaced by far-fetched schemes for the vulgarized and distorted beyond recognition Pavlovian concept of higher nervous activity, further aggravated the separation of Russian psychiatry from its general medical foundations.

The Morgagni-Stewart-Morel syndrome (frontal hyperostosis syndrome, metabolic craniopathy) according to the classical description includes a triad of symptoms: thickening of the internal plate of the frontal bone, obesity and virilism.
In 1762, Morgagni, opening the corpse of a 40-year-old woman, established a thickening of the inner plate of the frontal bone, and at the same time excessive obesity and male-type hairiness. He considered these signs not coexisting, but interconnected and described this observation.

In the Republic of Tatarstan, at present, the provision of medicines and medical products is mainly carried out by the state enterprise "Tatar stan pharmacy", which includes the republican pharmacy base, the Center for Controlling the Production and Quality of Medicines, the Republican Information Center, and a reference and information service for the population (003), as well as 298 self-supporting pharmacies, including 193 rural, 5 interhospital, 3 hospital pharmacies.

In recent years (Prague), scientific and practical interest in the problems of diseases with ankylosing spondylitis has increased significantly. During the development of the disease, when stiffness of the spine and joints occurs, but ankylosis (stages of preankylosis) has not yet been detected, pain syndromes and muscle spasms prevail in development, the mobility of the chest and joints increases significantly, and foci of changes are not detected.

This article is the first report on the long-term results of observations (follow-up up to 12 years) in symptomatic unruptured giant aneurysms treated conservatively only with antihypertensive therapy.

The problems of disabled people in Tatarstan and in Russia as a whole are the same. The situation remains the same when society does not hear about their needs, does not create elementary conditions for a normal human existence. Public places, transport, roads, entrances of houses are still inaccessible to them. There are no special lifts and descents in the transitions, there is not a single concert hall or theater where the presence of wheelchair users would be provided. Unfortunately, this indicates that Decree of the President of Russia “On measures to create an accessible living environment for the disabled” No. 1156 dated 02.10.92 has not yet become a guide to action for executive structures.

Actual aspects of rehabilitation of the patients with long-term disability and the invalids of the Republic of Tatarstan are presented. Structure of the causes of nervous system lesions causing the disability and invalidism, is shown. Critical evaluation of the rehabilitation service, origining in the Republic and of its basis is given. The main components of this service should be: a network of rehabilitation institutions equipped with up-to-date appu- ratus and equipment; specialists in the field of rehabilitation armed with a scientific-based programme of rehabilitation and with evaluative criteria of its effectiveness. The necessity of the creation of the republican public coordinative rehabilitation Council is emphasized.

TBe development pattern for tBe aracBnoidal syndrome and mental patBology without productive state was monitored on plentiful and homogeneous clinical material. TBe degree of tBe clinical expression of tBose patBologies correlated witB tBe seriousness of traumas tBat Bad been borne, the intensity of hemorrage and the duration of rehabilitation after it is shown. Direct dependence was established between the expression of the arachnoidal syndrome and the concentrations of biologically active compounds in liquor due to erythrocyte degradation. A system of treatment was elaborated and verified which included taking away small portions of blood-containing liquor, endolumbar introduction of lydaze, and oxygen insufflation into subarachnoidal space: Good direct and remote results of the treatment were obtained.

The analysis of rehabilitation of injured functions in patients with insult showed the advantages of early beginning of the rehabilitation measures. The early beginning of rehabilitation therapy enables to prevent the development of contractures and stereotypes of speech, to decrease expression of psychical disadaptation. Recovery of motor functions happens, in the general, within 6 month after insult, recovery of speech happens within 2 years after insult; it is these periods that determine duration of rehabilitation.

The results of detailed phenomenological analysis of self-consciousness disorders as consequences of endogenous psychoses are presented; the authors have examined a large number of patients within the last 15 years. The data have been evaluated in view of their role in rehabilitation. The conclusion has been made that the success of rehabilitation measures through formation of the most adequate self- appraisal in patients with acquired and labile alterations of self-consciousness is more probable in those with manic- depressive psychoses or periodical schizophrenia.

The paper is devoted to rehabilitation of teenagers suffering from narcomania or toxicomania. The theoretical basis for the study are the P.K.Anokhin Theory of Functional Systems and the P.VSimonov Demanding and Informational Theory of Emotions. The analysis of the results obtained in a complex examination of 1277 healthy teenagers made it possible to single out risk factors for formation of addicted activity. A stepwise rehabilitation is elucidated in the paper with respect to teenager patients, including pharmaco-, physio-, and psychotherapeutic treatment with favourable combination of «fractional» administration of tranquilizers, central electroreflex therapy, and training courses to reject leading motivations in deviated and addicted activity.

In the course of studying 120 patient-invalids of the second group because of schisophrenia and organic diseases of brain data were obtained, evidencing the priority of mebicar administration as a drug improving rehabilitation of patients. It is noticed, that psychoactive drugs (nootrops, tranquilizers, neuroleptics) give the opportunity to liquidate pharmacologically sensitive morbogenic causes of working ability disorders. New factors of working ability associated with the drug therapy do not appear. It has been revealed that the improvement of integration of balance of psychical functions and movement coordination is the most favourable effect.

In 58 patients with peripheral injury of face musculature (prosoparesis — 30, contracture of facial muscles — 28) at early and late recovery stages various rehabilitation measures were carried out: drug therapy, neuropsycho rehabilitation through «neuromotor re-training» including self- regulation of facial muscle functions with the help of electromyography, patient training for independent carrying out postisometric relaxation of injured muscles. Therapy effectiveness analysis in patients at early and late recovery stages definitly pointed out the effectiveness of rehabilitation methods.

The influence of Kazan medical schools not only on domestic, but also on foreign medicine is a well-known pattern, which is clearly manifested even now, in the year of the 180th anniversary of the higher medical educational institution of Kazan. An example of this is the book under review (with a dedication to the luminary of the Kazan neuro-histological school, B.I. Lavrentiev). We will not dwell on the analysis of the fundamental provisions of an embryological nature, displayed in the initial chapters of the book, and consider the main clinical aspects of the monograph, which are of interest to neurologists, cardiologists and other specialists in the field of clinical medicine.

On June 1, 1993, the IV International Cerebrolysin Symposium was held in Moscow, organized by the All-Russian Society of Neurologists and the EBEWE Drug Factory (Austria), in which neurologists from Russia, the CIS countries, Austria and Germany took part.

Dear readers! The next volume of the journal "Neurological Bulletin" brought to your attention is devoted mainly to the materials of the past in Kazan (September 5-10, 1994)