Speculations on neurogenic pulmonary edema (NPE)
Speculations on neurogenic pulmonary edema (NPE)
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关于神经源性肺水肿（NPE）的推测
DOI：
10.1164/arrd.1976.114.4.814
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发表时间：
1976
期刊：
影响因子：
--
通讯作者：
C. Bredin
中科院分区：
文献类型：
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作者：
C. Bredin
必须认真对待理查德·莱利博士提出的肺结核发病率增加的可能性。然而，他没有提出的一些观点值得考虑。在抗击结核病方面取得的大部分进展都是在传统的医患关系之外取得的。生活水平得到了提高，并制定了一项连贯的国家政策，认识到该疾病的传染性及其传播方式。在化疗出现之前，肺结核的发病率已经在稳步下降。因此，在结核病管理方面，政治和经济因素与医学进步同样重要。最近结核病管理的革命（即，将患者从公共部门转移到prhatc部门，并通过门诊管理提前出院）是相当合理的，如果实施得当，应该会奏效。但是，必须记住某些基本事实：（1）全国各地结核病的发病率并不相同。在市中心和印第安人保留地仍然存在某些高发区。一项关于结核病的国家政策，如果没有根据这些发病率的变化进行区域化，将导致严重的错误。(2)今天，肺结核发病率最高的是那些得不到私人药品的群体。贫穷的穷人、居住在市中心的少数民族、酗酒者和文盲以及美洲印第安人，
The possibility of an increased incidence of tuberculosis brought up by Dr. Richard Riley must be taken serioush·. There are some points he did not make, however, which deserve some consideration. Much of the progress in fighting tuberculosis was made outside of the traditional doctor-patient relationship. Living standards improved and a coherent national policy was developed which recognized the contagiousnes~ of the disease and its mode of spread. The incidence of tuberculosis was already declining steadily befOl'e the advent of chemotherapy. Thus, political and economic factors are just as important as medical advances with regard to tuberculosis management.The recent revolution in tuberculosis management (ie, transferring the patient from the public to the prhatc sector and early discharge with out-patient management) is quite logical and, given proper implementation, should work. However, certain basic facts must be kept in mind:(1) The incidence of tuberculosis is not the same throughout the country. Certain pockets of high incidence still exist in inner cities and Indian reservations. A national policy concerning tuberculosis, which is not regionalized with respect to these incidence variations, is going to lead to serious mistakes.(2) The highest incidence of tuberculosis today is among groups who do not have access to private medicine. The indigent poor, the minority groups who live in the inner cities, the alcoholics and derelicts, and the American Indians have depended for