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247 cases of patients suffering from chronic liver diseases were reviewed. These cases were divided according to "risk areas" (viral, alcoholic, viral and alcoholic, cryptogenic) and diagnosis (CAH, compensated cirrhosis, decompensated cirrhosis). Differences found in clinical and laboratory aspects of liver diseases from different risk areas are described but it is concluded that no single aetiology affects the liver functional reserve more than the others. Laboratory tests give more information in the early stages of chronic liver diseases while clinical analysis is more varied in the terminal ones. Literature on the subject is reviewed. Our data neither confirm nor disprove that HBsAg+ Alcohol+ patients display a characteristic clinical picture and this hypothesis should be further investigated.

An epidemiological study has been carried out on a group of 622 students (10 to 13 years old) from a secondary school in Naples. Aims of the present work were: the evaluation of the prevalence of hypertension in an adolescent population; the association with familial hypertension and obesity; the persistence of high blood pressure values at follow-up. Blood pressure data obtained in these subjects by the use of a standard evaluation scale based on body surface percentiles were compared with those obtained by two major current methods used for the definition of "normal" blood pressure values in pediatric age. The method based on body surface percentiles has shown the highest specificity. The prevalence of hypertension, as detected by this method, has been of 3,5% as compared to 12,9% and to 9,5% of the other two methods. In a follow-up at one year, while the percentage of hypertensive students remained unchanged in the group detected by the method of body surface percentiles, it decreased from 12,9% to 9,3% and from 9,5% to 7,8% in the other two groups. The high prevalence of obesity and familial hypertension observed in these young hypertensive subjects suggest the possibility of selecting, by body surface percentiles, well defined group of subjects at risk, characterized by borderline hypertension, high grade of familial aggregation, high prevalence of obesity and by the persistence of hypertension at the follow-up.

Sensitivity and specificity of physical and laboratory findings have been evaluated for the purpose of establishing a differential diagnosis between cirrhosis and chronic active hepatitis on clinicolaboratory grounds. Data from 213 patients from southern Italy with biopsy-proven chronic active hepatitis or cirrhosis have been studied retrospectively. Splenomegaly, hypocholesterolemia, and decreased sulfobromophthalein-Ki were among the most sensitive individual findings in cirrhosis, whereas decreased platelet count, jaundice, and hypoprothrombinemia were the most specific ones. The presence in the same patient of both one of the former and one of the latter findings yields a correct diagnosis of cirrhosis with at least 90% likelihood. Advantages of the proposed diagnostic technique and comparison with data from an American series are discussed.

A series of clinical steps in the severity of chronic liver disease (CLD) has been arranged to represent the case history of chronic active hepatitis and cirrhosis retrospectively. The 'steps' in such series of clinical stages have been chosen on the basis of physiopathological considerations, the state of health of the patients, and their ability to work. For every 'step' the laboratory findings were studied in order to verify the hypothesis that a laboratory case history exists, which is parallel to the clinical history of CLD. With the exception of serum albumin and, to a lesser extent, sulfobromophthalein-ki, which seem to reflect the progressive deterioration in hepatocellular function, the results suggest that most conventional tests do not seem to be of any value in monitoring a CLD patient in cases where the diagnosis is already known, whereas a physical examination provides a physician with more, and cheaper, information than laboratory tests.