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In the article the case of achalasia of cardia and diagnostic algorithm of this pathology are presented.

Aim: To make prognosis of ulcer morbidity and lethality from its complications for the near future basing on the trends in ulcer morbidity and lethality for the last 10 years; to assess ulcer patients' followup quality and coverage., Material and Methods: Time series statistics of general, primary ulcer morbidity and lethality from ulcer complications in the Udmurt republic for the last 10 years have been analysed as well as expert evaluation of the treatment quality and follow-up of ulcer patients by 156 outpatients' cards and 118 disease histories., Results: General and primary gastrointestinal ulcer incidence in Udmurt republic in 1992-2001 decreased significantly but ulcer morbidity did not change. Lethality from ulcer complications rose 1.8-fold. The predicted lethality rise in 2003-2006 proved valid., Conclusion: If social and economic conditions in the republic do not change and public health service reforms remain low effective, further deterioration of the above lethality is predicted.

The objective of this research was a study of the condition of parodentium tissues in patients with ulcer. 51 ulcer patients were studied. As a result of complex studies (hemorrhage coefficient, crevicular liquid, papilloalveolar marginal index, complex periodontal index and thermometry), apparent inflammatory processes were discovered in parodentium tissues. Inflammatory parodentium changes do not disappear completely with the complex anti-ulcer therapy that forms a basis for the simultaneous application of local therapeutic measures to eliminate inflammatory processes in parodentium tissues.

Aim: To study pathogenetic factors underlying development of ulcer disease and its course in different age periods., Material and Methods: Clinical, psychoemotional, endoscopic device, biochemical and radioimmunological examinations were used in the study of 283 patients with gastroduodenal ulcer. By age, the patients were divided into four groups: 15-18, 19-35, 36-60 and 61 and older., Results: Some age-specific clinical and endoscopic characteristics were found in the examinees. Risk factors (hereditary predisposition, high gastric juice acidity, the presence of Helicobacter pylori, etc.) occurred almost with the same frequency at different ages. Older patients had deficient defense-protection properties of gastric mucus. Most of the examinees's psycho-emotional state was characterized by moderate reactive and high personality anxiety. In all the age groups reactions of the hormonal system were of the same type--hypophyseo-adrenal hyperfunction and hypophyseo-thyroid hypofunction., Conclusion: The above findings may help in design of differentiated by age therapeutic and diagnostic measures for ulcer patients of different age.

We studied the dynamics of morbidity of the digestive apparatus including peptic ulcer, gastritis, duodenitis and mortality in the Udmurt Republic from 1992 to 2002. We revealed the decrease of morbidity of the digestive apparatus and stable data for peptic ulcer but the increase of mortality from the digestive apparatus pathologies on the whole and from complications of peptic ulcer. The mortality from the digestive apparatus diseases and peptic ulcer is forecasted to increase in the next years if the same social and economic conditions are preserved and there are no changes in the health-care system.

We examined 215 patients, 98 of them being with gastric and duodenal erosions, 52 being with erosions of the gastroduodenal zone combined with duodenal ulcers, and 65 being with duodenal ulcers. Endoscopic, radiological, biochemical, pH measurement studies and abdominal gastroduodenal manometry were used for the evaluation of the functional state of the gastroduodenal system. It was established that impaired pyloric and cardiac functions, duodenogastric reflux, dyskinesia of the stomach and duodenum, stomach deformation and gastroduodenoptosis are observed more frequently in cases of erosive lesions as compared to ulcers. The obtained data allow us to assume that gastric and duodenal erosions are an independent nosological form with their own pathogenic mechanisms, clinical presentation and complications including ulcers.

Gastroenterological examination of 910 adolescents in rural outpatient clinic revealed gastroduodenal disorders (gastritis, erosive gastrobulbitis, gastroduodenitis, gastroduodenal ulcer) in 101 of them (11.1%). Immediate and long-term responses showed that anti-relapse treatment on the individual basis may appear highly beneficial for adolescents with gastrointestinal diseases.