Pulmonary dysfunction in 'freebase' cocaine users.

Of 19 consecutive smokers of cocaine, "freebase" cocaine users, admitted to a chemical dependence program, 12 (63%) had respiratory symptoms and ten (58%) noted dyspnea. Abnormalities of carbon monoxide diffusing capacity were also seen in ten of the subjects, although responses to steady-state exercise testing were normal in subjects undergoing exercise. We believe that freebase cocaine use frequently produces pulmonary gas exchange abnormalities that appear after relatively brief periods of abuse. These abnormalities may persist after cessation of freebase cocaine use. A history of this form of drug abuse should be sought when evaluating patients with appropriate symptoms or abnormalities of diffusing capacity.

Accelerated development of pulmonary complications due to illicit intravenous use of pentazocine and tripelennamine.

To gain information concerning the natural history and prevalence of pulmonary gas exchange abnormalities resulting from intravenous drug abuse, 45 intravenous drug users were studied. Twenty subjects used a mixture of the synthetic opiate pentazocine and the antihistamine tripelennamine, which, under the street name T's and B's, has become very popular in some urban areas as an available substitute for heroin. Compared with the 19 heroin addicts studied, the pentazocine and tripelennamine users had a significantly shorter mean duration of intravenous drug abuse (2.7 +/- 0.4 years versus 7.6 +/- 0.9 years, p less than 0.01), a greater frequency of respiratory symptoms (75 percent versus 36 percent, p less than 0.05), a significant reduction in the mean diffusing capacity of the lung for carbon monoxide (58.4 +/- 3.3 percent predicted versus 75.5 +/- 5.6 percent predicted, p less than 0.01), and abnormal responses to submaximal steady-state exercise testing. The intravenous use of pentazocine and tripelennamine and probably most other drug preparations intended for nonparenteral use represents a particularly noxious form of drug abuse that may lead to early respiratory complications in a large proportion of users.

Self-determination in nursing students: an empirical investigation.

The purpose of this descriptive study was to examine nursing students' perceptions of student self-determination in a Finnish health-care institute and to find out whether background data were in any way associated with these perceptions. To do this we developed a 56-item Students Self-Determination Questionnaire (SSDQ), which was completed by 435 nursing students. The results showed that self-determination is important for nursing students and that they are willing to exercise self-determination in their training. In practice, however, the students were not very active in this respect, nor did they feel that they were getting very much support from teaching staff. The meaning of self-determination increased with age and with increasing experience.