Utiliser les psychédéliques pour « guérir » des adolescents homosexuels ? Essai de thérapie de conversion,France, 1960

Between 1960 and 1962, a children's judge placed two French adolescents in a psychiatric hospital in Alsace. Described as “delinquent sexual perverts”, Michel, 15, and Bernard, 18, were in fact two young homosexuals. However, at the time, homosexuality was considered a psychiatric disorder that should be “cured”. With this in mind, psychiatrists set up shock or disgust therapies to push patients to become heterosexual. In this hospital, the chief doctor tested two new substances on them: mescaline and LSD. Injected in very high doses, the idea was to cause a powerful psychological shock in the hope of changing the adolescents’ sexual orientation. This type of placement as well as the treatment inflicted were then common (lobotomies or electroshocks were part of the “therapeutic” possibilities to “cure” homosexuality). Two aspects of these experiments are however particularly original: on the one hand, the use of substances such as mescaline and LSD, on the other hand, the very type of “therapy” implemented. It would thus seem, in the current state of knowledge on the use of LSD and mescaline in psychiatric therapy, that these experiences were isolated facts: the literature remains silent on the subject of the use of mescaline to “cure” homosexuality, and the few known therapies carried out using LSD were offered to adults and above all volunteers. Finally, these therapeutic methods were the opposite: psychotherapies in which particular attention was paid to patients and their well-being in the United States or in England and “psychic shocks” in Alsace. This hospital is the only French example of an attempt to “treat” homosexuality using psychedelics. The use of these substances by the French team therefore began in 1960; it involved administering mescaline or LSD in high doses (an exceptional characteristic in Europe where psychiatrists were in favor of therapy with low doses known as “psycholytic”) and in injections, ranging from 200 to 1200 mg for mescaline and for LSD from 100 to 800 micrograms. By way of comparison, a recreational dose is 300 to 500 mg for mescaline and 100 micrograms for LSD, administered orally. In order to create “psychic shock”, the effects of the substances were immediately stopped by the injection of chlorpromazine, a powerful neuroleptic. The authors noted that for all patients, “two modes of behavior are common: stupor and agitation”. They sometimes tore their sheets or pajamas or grabbed the examiner, asking for support. The sessions were linked: in 118 days, Bernard would undergo 16 of these sessions, one every 7 days on average. Michel, during one of the sessions, felt like he had been killed by his psychiatrists. Neither would subsequently become heterosexual. Elsewhere in the world, other forms of LSD conversion therapy have emerged. However, these were benevolent psychotherapies; the product was not injected but taken orally (therefore with more progressive effects), and the approach was not the same. Thus, acceptance of their homosexuality by patients was considered as desirable an option for therapists as was conversion to heterosexuality. For French practitioners, on the contrary, “healing” was the only objective. This article will highlight a double French specificity in the use of psychedelics: first, the refusal to introduce the new method of administering these substances, called “set and setting”, theorized from the late 1950s in Anglo-Saxon countries, and yet known and discussed by French experimenters. Then, it will show the use of these substances in shock therapy, particularly in the treatment of homosexuality.     

多形式健康教育提高青少年性知识的效果观察

目的:探讨多形式健康教育提高青少年性知识的效果。方法:选取本辖区青少年400例为观察组,另选400例青少年为对照组,观察组实施多形式健康教育,对照组接受常规健康教育,对两组青少年的性知识情况、紧急避孕知识进行观察。结果:教育前,两组青少年的性知识了解程度无明显差异(P0.05),观察组青少年经教育后的性知识了解程度明显高于对照组,差异有统计学意义(P0.05);两组青少年教育前的紧急避孕知识知晓率无明显差异(P0.05),观察组教育后的知晓率显著较对照组高,差异有统计学意义(P0.05)。结论:多形式健康教育能提高青少年的性知识了解程度,也能提高青少年对紧急避孕知识的知晓率,对降低青少年非意愿妊娠、性传播疾病发生率具有显著作用,值得临床推广。     

Adolescents’ perceptions of sexual health education programs: An integrative review

IntroductionAdolescents are key stakeholders in sexual health education, yet they are rarely consulted when developing sexual health programs. Their voices are integral to improving the delivery of relevant and appropriate school-based sexual health education to promote safer adolescent sexual behaviors.MethodsAn integrative review was conducted utilizing three databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL) Complete, PubMed, and Education Resources Information Center (ERIC). The PRISMA and matrix method were used to search the literature and synthesize the findings from 16 articles regarding adolescent perceptions of school-based sexual health education.ResultsThe main themes that emerged from this review included: (a) factors influencing adolescent perceptions of sexual health education programs, (b) characteristics of good sexual health education programs, and (c) areas of improvement in sexual health education programs.ConclusionAdolescents overwhelmingly requested honest, comprehensive content delivered by nonjudgmental, well-educated health professionals in a comfortable environment.     

Survival patterns in teenagers and young adults with cancer in the United Kingdom: Comparisons with younger and older age groups

AimsWe aimed to describe and compare survival in teenagers and young adults (TYAs) with cancer to that of younger children and older adults, to identify sub-populations at greater or lesser risk of death.MethodsWe compared survival in cancer patients diagnosed in the United Kingdom aged 13–24 years (TYAs) to those aged 0–12 (children) and 25–49 years (adults) using the National Cancer Data Repository. All cases had a first cancer diagnosis between 1st January 2001 and 31st December 2005 with censor date 31st December 2010 or death if earlier.ResultsWe found six distinct statistically significant survival patterns. In pattern 1, the younger the age-group the better the 1- and 5-year survival (acute lymphoid leukaemia, carcinoma of ovary and melanoma). In pattern 2, TYAs had a worse 5-year survival than both children and young adults (bone and soft tissues sarcomas). In pattern 3, TYAs had a worse 1-year survival but no difference at 5-years (carcinoma of cervix and female breast). In pattern 4, TYAs had better 1-year survival than adults, but no difference at 5 years (carcinoma of liver and intrahepatic bile ducts, germ cell tumours of extra-gonadal sites). In pattern 5, the younger the age-group the better the 5-year survival, but the difference developed after 1-year (acute myeloid leukaemia, carcinoma of colon and rectum). In pattern 6, there was no difference in 1- and 5-year survival between TYAs and adults (testicular germ cell tumours, ovarian germ cell tumours and carcinoma of thyroid).ConclusionTYAs with specific cancer diagnoses can be grouped according to 1- and 5-year survival patterns compared to children and young adults. To further improve survival for TYAs, age-specific biology, pharmacology, proteomics, genomics, clinician and patient behaviour studies embedded within clinical trials are required.     

儿童及青少年患者靶向抗肿瘤药皮肤不良反应的系统评价

摘 要 目的：系统评价儿童及青少年患者应用靶向抗肿瘤药的皮肤不良反应,为后续研究及临床实践提供参考。方法: 检索PubMed（http:∥www.ncbi.nlm.nih.gov/pubmed/）、美国临床肿瘤学会年会摘要集（http:∥www.asco.org/）与ClinicalTrials.gov（http:∥www.clinicaltrials.gov）以获取涉及靶向药物（单药或多种靶向药物联合治疗）用于儿童及青少年患者,并有皮肤不良反应报告的临床试验。对入选研究进行质量评价（非随机对照试验用MINORS量表,随机对照试验用Cochrane偏倚风险评价工具）,并提取资料。以各类皮肤不良反应（皮疹、皮肤干燥、瘙痒与黏膜炎）发生率为结局指标进行Meta分析。结果: 共纳入24项研究,涉及960名患者。研究疾病涉及多种实体瘤与白血病。共涉及14种不同的靶向抗肿瘤药。绝大多数研究为高质量研究。Meta分析结果显示,皮疹的合并事件率及其95%置信区间（CI）为0.19[0.12～0.28],皮肤干燥为0.24[0.06～0.51],瘙痒为0.12[0.04～0.24]以及黏膜炎为0.21[0.07～0.39]。发表偏倚分析提示皮疹之结局指标的报道可能存在发表偏倚（Egger’s P=0.007）。结论:靶向抗肿瘤药应用于儿童或青少年人群可引起部分患者出现皮疹、皮肤干燥等不良反应。这些不良反应影响生活质量并可能导致残疾,临床应用时需予重视。     

Impact of a sports project centered on scuba diving for adolescents with type 1 diabetes mellitus: New guidelines for adolescent recreational diving,a modification of the French regulations

Background

Recreational scuba diving has been authorized for type 1 diabetics over 18 years old – the age of majority in France – since 2004, but it remained forbidden for younger diabetics by the French underwater federation (FFESSM). Here, we present a study to evaluate:– the conditions under which diving could be authorized for 14- to 18 year olds with type 1 diabetes;– the value of continuous glucose monitoring (CGM) while diving. A secondary objective was to monitor the impact of diving on the teenagers’ quality of life.

Ulcerative colitis with inflammatory polyposis in a teenage boy:A case report

Ulcerative colitis in addition to inflammatory polyposis is common.The benign sequel of ulcerative colitis can sometimes mimic colorectal carcinoma.This report describes a rare case of inflammatory polyposis with hundreds of inflammatory polyps in ulcerative colitiswhich was not easy to distinguish from other polyposis syndromes.A 16-year-old Chinese male suffering from ulcerative colitis for 6 mo underwent colonoscopy,and hundreds of polyps were observed in the sigmoid,causing colonic stenosis.The polyps were restricted to the sigmoid.Although rectal inflammation was detected,no polyps were found in the rectum.A diagnosis of inflammatory polyposis and ulcerative colitis was made.The patient underwent total colectomy and ileal pouch anal anastomosis.The patient recovered well and was discharged on postoperative day 8.Endoscopic surveillance after surgery is crucial as ulcerative colitis with polyposis is a risk factor for colorectal cancer.Recognition of polyposis requires clinical,endoscopic and histopathologic correlation,and helps with chemoprophylaxis of colorectal cancer,as the drugs used postoperatively for colorectal cancer,ulcerative colitis and polyposis are different.