[The detectability and risk factors of peptic ulcer in a rural population (an epidemiological screening trial)]. / Vyiavliaemost' i nekotorye faktory riska iazvennoi bolezni u sel'skogo naselennia (opyt épidemiologicheskogo obsledovaniia).

The authors have conducted an epidemiological survey in rural population of Estonia. Of 3088 examinees 2304 answered questions of a specially designed questionnaire (72 questions on risk factors, disease history, family diseases, hereditary load, complaints, etc.). 568 respondents of 556 females and 298 males with gastroenterological complaints agreed to be examined endoscopically. Ulcer was found in 71 (8.3% of those with complaints) examinees. In 1/3 of them the diagnosis was primary. Proportion of males to females made up 2.4:1.0. Duodenal ulcer was registered 2.2 times more frequently than gastric ulcer. Risk to develop ulcer became greater with age. Compared to controls without endoscopic evidence of ulcer, males with ulcer smoked, had hereditary predisposition and previous nervous stress significantly more frequently.

[Errors in the diagnosis of diseases of the large intestine]. / Oshibki v diagnostike zabolevanii tolstoi kishki.

The quality of the diagnosis of colonic diseases was analyzed in 395 patients. Comparisons were made of the diagnoses on admission to and discharge from hospital: in irritated colon and its dyskinesias, ulcerous colitis and Crohn's disease, carcinoma, polyps, other forms of colitis and so forth. Errors in the basic diagnosis constituted 51.0 +/- 1.8%; including 25.4 +/- 1.6% of cases of overdiagnoses; in 25.6 +/- 1.6%, the disease was not recognized. The main colonic diseases were coupled with other intestinal diseases in 42.3 +/- 2.5%, with other diseases of the alimentary organs in 37.2 +/- 2.5% of cases. The quality of the diagnosis is affected by wrong medical thinking, insufficient application of colonoscopy as well as polymorbidity of modern patients, growing with their age. Approaches to the improvement of the quality of the diagnosis of colonic diseases are determined by the causes and mechanisms of the errors made.

[Errors in the diagnosis of peptic ulcer]. / Oshibki v diagnostike iazvennoi bolezni.

The diagnosis made at the polyclinics and at the gastroenterology clinic were studied and compared. There were 2515 patients admitted to or discharged from hospital with a diagnosis of peptic ulcer. In gastric ulcer (630 patients), the erroneous diagnoses accounted for 24.8 +/- 1.1% including 7.7 +/- 0.7% of cases undiagnosed at the polyclinics and 17.0 +/- 1.0% of cases with an overdiagnosis. In duodenal ulcer, the respective figures were 15.1 +/- 0.6, 5.7 +/- 0.4 and 9.3 +/- 0.5%. The level of gastric ulcer diagnosis was lower than that of duodenal ulcer (p less than 0.01), the rate of overdiagnoses in both cases was, respectively 2.2- and 1.6-fold higher than that of underdiagnoses. The erroneous diagnoses mostly fall within faulty ulcer localization, chronic gastritis, chronic duodenitis, and chronic biliary diseases. Three groups of factors were distinguished among the causes of errors in the diagnosis of peptic ulcer: underestimation by the physicians of the pathomorphism and changed symptomatology; erroneous assessment of the disease history and examination data; not taking into sufficient account of the disease course determined by the sex, age and polymorbidity of the today's patient. The causes of errors were not infrequently found to go together.

[Family physician: problems and realities]. / Semeinyi vrach: problemy i real'nost'.

The experience gained in the Soviet Union and abroad with family physician service is reviewed. The scope of his duties is outlined which are to be adjusted for specific conditions of rural and city health care. The family physician is to be neither a particular specialist nor an expert in all fields of medicine, rather a broad-minded and skilled internist informed about social and psychological matters and able to attend both adults and adolescents. The chief goal of his practice should be prophylaxis medicine, regular check-ups. Extensive experimental research is needed to adopt the system of family physician in this country as it necessitates revision of conventional principles of industrial, school, outpatient services, training of medical staff, etc.

[Current problems of dispensary care in the work of therapists]. / Aktual'nye voprosy dispanserizatsii v rabote terapevtov.

The author provides an analysis and prospects of the problems of prophylactic medical examination in physicians' activities with due account of tasks put forward at the 27th CPSU Congress. Experience of physicians of the Estonian SSR is considered. Particular attention has been drawn to the quality of prophylactic medical examination, the detection of diseases at early stages, the continuity of health care and the role of the population and social organizations in prophylactic medical examination.

[Features of the current course of gastroenterologic diseases]. / Osobennosti sovremennogo techeniia gastroénterologicheskikh zabolevanii.

The author analyses the course taken by some diseases of the alimentary organs, which has changed over the recent decades. Characterizes some common clinical features of the course taken by gastroenterological diseases today: the chronic pattern, the combination of lesions, frequent occurrence of central nervous system disorders (neuroses, personality accentuation, etc), proneness to overweight and obesity, not infrequent allergization of the patients and a high rate of the patients' affection with a focal infection. The features described should be taken into consideration while training gastroenterologists.