A rationale and recommendations for sexuality education in schools for students who are deaf.

The authors evaluate and advocate the need for comprehensive sexuality education that meets the unique needs of youth who are deaf or hard of hearing, while calling for the expansion of teacher preparation in this critical area. Effective comprehensive sexuality education is designed to prepare young people to become more comfortable with, and informed about, their sexuality. Teachers and parents are key adults in this process. However, the responsibility for preparing teachers to handle sexuality education lies with both the postsecondary teacher preparation program and the administrative team at the individual school; their willingness to provide comprehensive training, current resources, and continued support are crucial to the success of any comprehensive sexuality program. In the individual school, effective guidance of youth who are deaf or hard of hearing in making appropriate decisions about their sexuality is built upon a team that includes not only school staff, but also parents and deaf adults in the community.

Reduced P50 auditory gating response in psychiatrically normal chronic marihuana users: a pilot study.

BACKGROUND: Neurophysiological studies of marihuana (THC) often contain uncontrolled confounds [psychiatric diagnoses, polydrug use, central nervous system (CNS)-relevant injury, etc.] that can alter electrophysiological measures. This P50 sensory gating report is part of a larger neurophysiological and neurocognitive investigation of chronic THC exposure using rigorously screened medically and psychiatrically normal individuals without concurrent use of non-THC substances. METHODS: Following medical and psychiatric screening, including serial urine drug screens, technically adequate P50 paired auditory recovery tests were obtained on 19 chronic THC users and 14 control subjects. Fifty pairs of 80-dB auditory clicks (1 pair per 10 sec, 500-msec interclick separation) were delivered through earphones. The sensory gating measure was the ratio between the P50 amplitudes at the vertex elicited by the conditioning (first) and test (second) click. RESULTS: THC subjects had significantly higher sensory gating ratios (i.e., reduced suppression) than did control subjects. Among THC users, sensory gating ratios did not correlate with duration or frequency of THC use, although subjects with ratios above 40 had nearly twice the number of "joint-years" of THC exposure than did those with lower ratios. CONCLUSIONS: Reduced P50 suppression in the sensory gating paradigm may be a possible neurophysiological CNS sequela of long-term cumulative exposure to THC.

Benzodiazepines revisited.

At one time, benzodiazepines were the number one prescription drug in the United States and the world. While the use of benzodiazepines has declined since the Journal published an article about the use and misuse in 1989, benzodiazepines still have clinical efficacy and clinical misuse. This article details current epidemiology, indications, and precautions to prevent abuse.

Possible EEG sequelae of very long duration marihuana use: pilot findings from topographic quantitative EEG analyses of subjects with 15 to 24 years of cumulative daily exposure to THC.

In previous work we demonstrated and replicated a significant association between increased absolute and relative power and interhemispheric coherence of EEG alpha activity over the bilateral frontal-central cortex ("alpha hyperfrontality") in daily marihuana users as contrasted with nonusers. In this report we focused our analyses on subjects who reported smoking marihuana on a daily basis for 15 to 24 consecutive years. Compared to nonuser controls and subjects who had used marihuana on a daily basis for shorter periods of time, subjects with excessively long cumulative exposures to THC were found to have significantly elevated absolute power of theta activity over bilateral frontal-central cortex, as well as significantly increased interhemispheric coherence of theta activity across central and posterior regions. Concurrent reaction time studies conducted in our laboratory suggest that very long duration cumulative marihuana exposure might be associated with slowed cognitive processing.

Early and middle latency evoked potentials in medically and psychiatrically normal daily marihuana users: a paucity of significant findings.

The use of evoked potentials to study CNS effects of marihuana (THC) have produced inconsistent findings. Our previous pilot studies suggested that auditory P300 latencies and amplitudes, auditory P50 and somatosensory P30 amplitudes and brainstem auditory evoked potential latencies were altered in THC users. Because these findings were flawed by uncontrolled psychiatric diagnostic and medication variables, we undertook a controlled investigation of screened medically and psychiatrically normal THC users and controls. When age effects were controlled, THC related alterations of brain stem and both auditory and visual P300 responses could not be seen. This report extends our analyses to other auditory, somatosensory and visual evoked potentials. With the possible exception of an elevated auditory P50 amplitude, significant evoked potential correlates to daily THC use were not seen when normals were studied and age effects controlled.

Cocaine-induced ischemic cerebral infarction mistaken for a psychiatric syndrome.

We present the case of a 39-year-old woman who developed an ischemic cerebral infarction after using cocaine. Initially the patient was thought to suffer from a psychiatric disorder, and a computed tomography (CT) scan at the time of admission was entirely normal. Further evaluation of the patient by staff on the Psychiatric Unit led to the suspicion that she had suffered a stroke. A repeat CT scan on the third hospital day showed a large infarction in the left middle cerebral artery territory. We discuss the diagnosis of cerebral infarction with subtle presentations due to cocaine use.

Auditory and visual P300 event related potentials are not altered in medically and psychiatrically normal chronic marihuana users.

Attempts to use Event Related Potentials, particularly the cognitive or P300 evoked potential, as measures of CNS effects of THC use have been infrequent and have produced inconsistent results. We published a pilot study in which psychiatric patient THC users had significantly prolonged auditory P300 latencies and reduced amplitudes as contrasted with non-users. Because psychiatric diagnoses and medication effects could not be controlled, we repeated the study with medically and psychiatrically normal subjects selected with extremely stringent exclusion criteria and screening procedures. P300 latency differences between THC users and controls were not detected. Using all subjects, THC users displayed reduced auditory and visual P300 amplitudes. However, when age differences between THC users and controls were removed, all significant P300 amplitude differences were removed as well. The contaminating effect of using psychiatric patients in THC research is discussed and the importance of using carefully screened normal subjects in studies of neurophysiological abuse drug effects is stressed.

Premenstrual syndromes.

Premenstrual Syndrome and Late Luteal Phase Dysphoric Disorder are two commonly cited premenstrual syndromes. Some of the problems in research include prospective vs retrospective rating scales, lack of confirmation of treatment response by double-blind studies, and a large placebo response. Treatment is still largely empiric. Many patients who present with premenstrual complaints may benefit from psychiatric referral.

Asbestos-related disease from household exposure.

The importance of nonoccupational asbestos exposure has been emphasized recently. To illustrate this problem, we report 4 persons with asbestos-related disease from household exposure. There were 2 wives of asbestos workers, who cleaned their husbands' work clothes. One developed a mesothelioma and the other plaques, calcification, benign asbestos pleural effusion and subpleural parenchymal fibrosis. 2 men were exposed as children while playing in a cellar room which was also used for their father's muffler repair business. At ages 27 and 33, they had pleural and diaphragmatic calcifications.