Vol XXVI, No 3-4 (1994)
Original article
The state of neurorehabilitation service and prospects of its development in the republic of tatarstan
Abstract
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.
Rehabilitation of mental patients and invalids in the republic of tatarstan
Abstract
Features of rehabilitation work with mental patients are stated, the necessity of carrying out this process stepwise, special importance of resocialization of patients are mentioned. The analysis of rehabilitation service in the Republic of Tatarstan is given, advantages of semistationary forms of treatment are pointed out, especially to prevent hospitalism. The conclusion has been made that the former mental patient rehabilitation system was negatively influenced by the crisis in the system's structure, when special workshops for invalids at enterprises were closed due to social and economical difficulties. The question is raised on the necessity of elaborating a state programme for mental patient and invalid rehabilitation.
Psychoneurologic lesions in patients with the brain contusion complicated by the subarachnoidal apoplexy and certain ways of their correction
Abstract
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.
Memory disorders in patients with early signs of cerebrovascular insufficiency
Abstract
The results of short-term verbal memory and associative memory study of 40 patients with early signs of cerebrovascular insufficiency and 20 normal persons with registration on phonoosciilogram are described. Decrease of the both kinds of memory, changing of some time parameters of memorizing processes (duration of latent states, decrease of rate of adaptation, changing of uniformity and equilibrium of time parameters) were found in patients with early signs of cerebrovascular insufficiency. The analysis of short-term verbal memory dynamics makes it possible to differentiate between normal and pathologic states. Investigational findings may be used in rehabilitation of middle-aged and elderly patients.
Duration of motor function and speech rehabilitation after insult
Abstract
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.
About the factors influencing the indicators of social prognosis in mental illness
Abstract
The results of clinical and epidemiological research are given (506 patients were examined). The analysis has shown that social involvement prognosis depends not only on the pathology character but also on the practice of mental patient working ability evaluation, on cultural and social factors which are especially important at the present period of historical development of our country. The number of working patients tends to lower while the number of patients recognized as invalids has increased. The conclusion has been made that a social involvement prognosis in psychiatry relates with many factors while factors of clinical and biological nature can obtain social meaning, and it should be taken into account in evaluating the influence of up- to-date patient conducting methods on patient fates.
Rehabilitation measures with patients having self-consciousness disorders as consequences of endogenous psychoses
Abstract
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.
Psychopharmacotherapy of mental disorders in patients with chronic pain
Abstract
Findings of psychopathologic examination of 134 patients with chronic pain syndrome are given. Variants of verging mental pathology, arising in persons with chronic pain syndrome, their correlation with duration of pain syndrome and premorbid personal peculiarities of patients are described. Principles of individual use of psychotropic drugs in the described category of patients, taking into account the structure of mental disorders, are proved.
Pharmaco- and psychorehabilitation of teenagers with deviated and addicted activities
Abstract
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.
Reablement of alcoholism patients at various stages of the disease
Abstract
Some features of patient reablement at the three variants of prealcoholism stage conducted at a medical- and-sanitary institution are summarized. The research was carried out with the purpose of preventing further alcoholism development in 300 patients at the stage of predisease. The necessity of long term stepwise reablement at the late alcoholism stages at a narcomanial dispensary or medical-and;-working preventorium, has been substantiated (269 patients).. We also present the data obtained in our research of the influence of personal alteration type due to alcoholism both before and after the attack with the delirium-oneiric syndrom on the success of the reablement (28 patients).
Mebicar and nootropic drug administration aimed at increasing the effectiveness of mental invalid rehabilitation: the results of study
Abstract
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.
Some clinical and social-psychological aspects of reablement in solitary elderly mental patients
Abstract
The results of examination of solitary elderly unadapted mental patients are given. Of great interest might be description of variants in loneliness taking by patients, which depend on nosologic forms of disease and social- psychological components of a patient state. In particular, it was definitely shown that the majority of schizophrenics took loneliness as a positive thing, while patients suffering organic lesions or maniac-depressive psychoses took it as a negative one. It is noted in the paper that such patients are all more or less unadapted socially and need a special complex reablement programme.
Current rehabilitation aspects in patients with facial nerve neuropathy
Abstract
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.
Reviews
Blink-Stuart-Morel syndrome
Abstract
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.
Наблюдения из практики
Syndrome of the vertebral artery due to the abnormal structure of the cervical spine
Abstract
To the clinic of vertebrogenic diseases of the nervous system, the posterior cervical sympathetic syndrome (Barré-Lieu syndrome, or cervical migraine) occupies a significant place. The disease manifests itself more often in the third decade of life in the form of unilateral or bilateral headaches, spreading from the occipital to the parietotemporal region, and cochleovestibular disorders.
Lectures
Energetic and architectural principle of understanding the mechanisms of mental illness
Abstract
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.
Experience exchange
Disabled people of the Republic of Tatarstan: life and problems
Abstract
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.
Psychoneuroimmunomodulation - an immunotherapy strategy in complex neurorehabilitation
Abstract
The successes achieved by clinical immunology over the past decade have made it possible to solve various problems of a purely medical nature in the therapeutic and surgical clinics, and have stimulated the practical interest of many physicians in understanding the basic patterns of body reactivity. Understanding these regularities is already becoming essential in the daily work of physicians dealing with neurosurgical pathology.
Brief communications
Organization of drug supply for patients with neuropsychological rehabilitation in the context of the transition to market relations
Abstract
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.
Back pain: evolutionary aspects and problems of rehabilitation
Abstract
Existing ideas about the obligatory accompaniment of degenerative-dystrophic changes in the spinal motion segment (SDS) by clinical syndromes of the lesion are currently considered erroneous. Sanogenetic reactions of the whole organism in response to a change in the load on a separate SMS cause initial functional and subsequent structural changes.
Dynamics of clinical manifestations of myofascial trigger points. In the rehabilitation of patients with ankylosing arthritis with pondylo
Abstract
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.
Information support of medical science and practical healthcare
Abstract
A well-established system of scientific information is one of the conditions for the successful development of medical science and practical public health. The extreme workload of doctors with daily current work, the inability to independently follow all the latest special literature make it necessary to help information services.
Abstracts
Shvalev V. N., Sosunov A. A., Guski G. Morphological bases of cardiac innervation. — M.: Nauka, 1992. — 336 p.
Abstract
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.
Troshin VD, Troshin VM Acute disorders of cerebral circulation. - Lower. Novgorod: Sarpi. - 1993. - 270 p.
Abstract
The book under review is devoted to an urgent problem of modern medicine — acute cerebrovascular accident, which is the main cause of high mortality, leading to severe disability of the population. Improving the phased system of medical care for patients with vascular lesions of the brain is the most important task of the nationwide program to combat cardiovascular diseases.
Congresses, Symposiums, Conferences
About the International Symposium on Cerebrolysin June 1, 1993, Moscow
Abstract
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.
Decision of the I International Symposium on Rehabilitation of Neurological and Mental Patients
Abstract
Diseases of the nervous system and mental illnesses that affect millions of people in Russia often lead to severe functional defects, severe social and mental maladaptation, and drastically reduce the quality of life of patients. The use of rehabilitation measures allows the vast majority of neurological patients to restore the skills of self-care and independent movement and return a significant part of neurological and mental patients to work. This makes the rehabilitation of neurological and mentally ill patients one of the most important medical and social problems. However, we have to state that in Russia there is no unified rehabilitation system that would make it possible to cover all patients and disabled people who need it with rehabilitation treatment.