[Hypophosphatemia and tumor-induced osteomalacia]. / Hypophosphatémie et ostéomalacie oncogénique.

In this article, we will discuss about hypophosphatemia due to tumor-induced osteomalacia. This disease is characterized by severe muscular and articular tenderness inducing profound walking limitation. Clinical chemistry results show severe hypophosphatemia due to hyperphosphaturia. Fibroblast growth factor 23 (FGF-23) is abnormally high. Physiological role of FGF-23 is examined. We also consider the pathophysiology of tumor induced osteomalacia, the use of different investigations to localize the tumor and therapies available to treat this rare disease.

An in-patient behavioural psychotherapy unit. Description and audit.

An in-patient behavioural psychotherapy unit is described that emphasises self-treatment, teaching relatives to become cotherapists while resident in the unit, routine collection of outcome data, minimising use of medication, and absence of night nurses. Patients are referred from all over the UK, mostly with chronic disabling OCD. Treatment includes self-exposure and self-imposed response prevention. A year's cohort (52 patients) showed substantial improvement that consolidated during six-month follow-up (83% decrease in total ritual time per day, 58% fall in target ritual scores, better social adjustment), and families noted relief of burden; eight patients dropped out. Further such units are needed in the UK, perhaps on a regional basis; they could be run as specialist hostels.

[Hemodynamics and massive pulmonary embolism]. / Hémodynamique et embolie pulmonaire massive.

In massive pulmonary embolism, the hemodynamic evaluation means a Swan-Ganz catheter and echocardiography, may be indicated as a hemodynamic assessment in correlation to the degree of obstruction and as a therapeutic guideline. Some figures demonstrate the importance of some hemodynamic parameters in order to choice the adequate therapy. Inconvenience and precautions of the method are shortly mentioned.

A true experiment evaluating adult skill training for severely mentally retarded secondary students.

Skill acquisition by secondary-level severely mentally retarded students was assessed on functional community and living skills task analyses. Students were trained in natural settings according to a behavioral analysis of the curriculum into systematic teaching and error-correction procedures. Classroom training in the district high school supported the teaching that occurred in the community. The evaluation of student performance on specific skills was done using random assignment to training and control conditions in a cross-over design. Students showed significantly greater gains on those tasks for which they were trained than on those for which they were not. In addition to this specific skill training, a daily checklist showed significant progress by all students on a broad array of skill sequences. Discussion stressed the contribution of the project to ideologically appropriate public school programs for severely mentally retarded students, to behaviorally based instructional technology, and to evaluation using true experimental designs.