Cocaine use by senior medical students.

The authors studied 589 senior medical students' attitudes about and use of cocaine. Reported use was 36% in the students' lifetimes, 17% in the past year, and 6% in the past month. Overall, these rates were lower than those of an age-matched cohort.

Risk factors for diabetic retinopathy in youth.

Retinal microvascular abnormalities were evaluated in 74 insulin-dependent diabetic youths by fluorescein angiography on two or more occasions spanning at least 4 years. Half of this group showed progression of the retinal vascular abnormalities from a stage of no significant abnormalities to at least background retinopathy with more than ten microaneurysms. Proliferative retinopathy requiring laser photocoagulation occurred in 14% (10/74). Insulin administration (once or twice a day) and glycemic control as reflected by hemoglobin A1C were identical in those with progression and in those with no progression of retinopathy. More females than males in this age group developed progressive retinopathy (P less than .036). Human lymphocyte antigen (HLA) types DR3 and DR4 in combination occurred more frequently (P less than .001) in those with progression of retinopathy than in those without progression. Teenaged , female, insulin-dependent diabetics with both HLA DR3, and DR4, were at increased risk for developing proliferative retinopathy.

Computer simulation of Freud's counterwill theory: extension to elementary social behavior.

A model is presented describing decision processes of a living system at the level of the individual, together with its interpersonal relationship context (organism, subsystems, and suprasystem). The beginning point was the 1977 system dynamics model of Wegman, which was itself characterized by quantitative cross-level hypotheses concerning both physiological and psychological levels of functioning within the individual personality system. The extension process was accomplished by synthesizing concepts from many different theories in personality and social psychology into equations linking two multiple-loop feedback systems to form a suprasystem. Each individual model was found to have several distinct operational modes, and the dyadic model had a number of interesting combinations of these modes which correlated with clinical descriptions of steady-state behavior and subjective experience in human marital dyads. For example, under certain conditions an individual operating in an unstable mode could achieve personal system stability within a dyadic relationship. In some cases, two unstable individuals could form a stable system. The process of extending the original model supports the utility of a synthetic approach to the construction of quantitative theories concerning small social systems. This process also suggests new approaches to planning future empirical research on small social systems using methods more appropriate to the study of complex, dynamic systems.

Substance use and abuse among senior medical students in 23 medical schools.

The current study represents the first large-scale study of substance use and abuse among 2,046 senior medical students at 23 nationally distributed medical schools. With the exception of alcohol and tranquilizers, medical students use less of all such substances than do age-related cohorts from the general population.

Substance use by fourth-year students at 13 U.S. medical schools.

Fourth-year medical students at 13 medical schools in different regions of the United States received an anonymous questionnaire designed to examine their current and prior use of 11 substances and their attitudes toward substance use among physicians. Of 1,427 questionnaires distributed, 41 percent were returned. The questionnaire and distribution method were derived from an ongoing survey on drug use in order to permit comparison of the medical students with a national sample of age- and sex-matched cohorts. The rates of substance use during the 30 days preceding receipt of the questionnaire were: alcohol, 87.8 percent; marijuana, 17.3 percent; cigarettes, 9.0 percent; cocaine, 5.6 percent; heroin, 0.0 percent; other opiates, 0.9 percent; LSD, 0.2 percent; other psychedelics, 0.5 percent; barbiturates, 0.5 percent; tranquilizers, 2.2 percent; and amphetamines, 1.2 percent. Compared with their age and sex cohorts nationally, the medical students reported less use of marijuana, cocaine, cigarettes, LSD, barbiturates, and amphetamines. However, their use of other opiates was approximately the same and their use of tranquilizers and alcohol was slightly higher than that of the other cohorts. Data on their sources of knowledge about drug abuse indicate the need for greater attention to this issue in the medical curriculum.