Psychosocial problems in primary care. Pilot study of a new taxonomy.

Background: In this study, the Massachusetts Academy of Family Practice Research Network (MAFP ReNet) was used to test a new taxonomy of psychosocial problems presenting to family physicians and to examine physician variability in determining when a psychosocial problem plays a role in a patient's visit.

Methods: Thirty physicians completed a form listing the taxonomy of psychosocial issues for 19 standard case vignettes. These physicians then completed the same form for every patient seen in their practices over a 2-week period.

Hepatic venography and wedge hepatic vein pressure measurements in diffuse liver disease.

Ninety patients with chronic diffuse liver disease were evaluated with free hepatic venography, wedge hepatic venography, hepatic vein pressure measurements, and liver biopsy. Free hepatic venograms were normal and minimally pruned in patients with hepatic sarcoidosis and fatty liver due to alcohol, and their biopsies showed little or no fibrosis. Pruning of hepatic vein branches on free hepatic venography correlated well with the corrected wedged hepatic vein pressure and with the degree of fibrosis in patients with alcoholic hepatitis, alcoholic cirrhosis, and postnecrotic cirrhosis.

Hepatic Venography and Hemodynamics in Patients with Alcoholic Hepatitis.

Fourteen patients with alcoholic hepatitis were evaluated serially by free (FHV) and wedge (WHV) hepatic venogrpahy and corrected hepatic wedge pressure (CWP). Cardiac output was determined and liver biopsy performed before and after 30 days of medical therapy in 11 and 6 patients, respectively. The CWP and FHV correlated well with the severity of hepatitis.