Self-reported medication taking compliance behavior of 132 high blood pressure patients was analyzed using an expanded version of the health belief model. Subjects were selected through random sampling procedures from regular hypertension program sessions at a large urban hospital. A questionnaire was constructed to measure the model components, and interviews were conducted with each patient. Bivariate analysis showed that control over health matters, dependence on providers, perceived barriers, duration of treatment, and others' non-

Although there was no evidence that substance use was a major problem, a few of the students appeared to be at risk for drug or alcohol dependence. Appropriate intervention, support, and referral systems should be identified for the few who may be at risk, and increased educational efforts are needed to help all students address this issue with their peers and, ultimately, with their patients.

A model for provision of educational feedback based on communication skills used in the clinical encounter can be useful in the medical education setting. More robust evaluation of the construct validity is required in actual training program situations.

No abstract

Minoxidil is a new potent antihypertensive vasodilator. Although highly effective, its use is limited by the association of the drug with pericardial effusion. We examined possible relationships in 37 patients. There was no significant effusions identified by echocardiography in 22 patients under active treatment. Retrospective review of 15 additional patients no longer under treatment identified seven who had had effusion and one who had had transient pericarditis. Resolution of effusion accompanied withdrawal in five patients; rechallenge was followed by effusion in one patient. Ninety-one episodes of pericardial disease have been reported in 1,869 experimental subjects (4.8%). Pericardial tamponade occurred in 21, with eight associated deaths. There are no specific patient characteristics that predict the likelihood of effusion. Since the reaction is both idiosyncratic and potentially fatal, it seems appropriate to continue to limit the use of minoxidil.