Hypercalcaemia with topical calcipotriol.
Hypercalcaemia with topical calcipotriol.
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局部用卡泊三醇治疗高钙血症。
DOI：
10.1136/bmj.306.6888.1344-b
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发表时间：
1993
影响因子：
--
通讯作者：
P. Hutchinson
中科院分区：
文献类型：
--
作者：
J. Bourke;J. Berth‐Jones;P. Hutchinson
遵循作者在他的信后面的建议。许多关心老年人福利的人。苏格兰的痴呆症患者及其家属认为，在精神疾病服务部门提供合理数量的医院床位，用于对这类有时被忽视的患者群体进行调查、临时护理和临终护理，是维持最低护理标准的一个重要因素。将我们对老年痴呆症患者住院治疗的专业承诺解释为“对苏格兰医疗保健的悲伤反映”是无益的。我们很难对我们的研究与纽恩斯及其同事未发表的研究之间可能存在的差异的来源进行信息评论。虽然他们有很多关于两项研究中使用的方法的信息，但我们只能知道我们自己的方法。正如他们所断言的那样，我们并没有将特里夫斯等人的发现与我们的性别效应发现相一致。我们详尽地检查了苏格兰老年痴呆症患者的所有调查和护理模式，并得出结论，精神病医院的入院已经确定了相当大的一部分。Newens等人认为他们在复杂护理模式下的专家转诊起始点的数据与我们在就诊后任何时间的精神病入院观察不一致，这是误导。支持这种推断的信息太少了。他们指出，“患有痴呆症的女性比男性更有可能被送入精神病院接受长期护理，因为老年女性的丧偶率一般更高”，但这是对老年痴呆症的真实情况，而不是老年疾病，因为大多数夫妇都是中年，还没有丧偶。无论如何，在发病率的研究中，两性之间的生存差异不会产生任何差异。但我们的研究结果表明，多因素痴呆患者的性别比例相反，这并不是原因。我们期待着Newens等人的研究发表，并建议如果我们的方法具有可比性，研究之间的差异可能有助于更好地了解阿尔茨海默病的危险因素。
follows the writer's recommendations later in his letter. Many of those concerned for the welfare of presenile. dementia sufferers and their families in Scotland believe that the provision of a reasonable number of hospital beds within the mental illness services for the investigation, respite care, and terminal care of this sometimes neglected group of patients is an essential factor in maintaining minimum standards of care. It is unhelpful to interpret our professional commitment to the well supported option of inpatient care for presenile demential patients as a "sad reflection on health care in Scotland." It is difficult for us to comment informatively on the likely source of differences between our study and the unpublished work of Newens and his colleagues. While they have much information about methods used in both studies we can know only our own. We did not, as they assert, state the findings of Treves et al to be consistent with our finding of a sex effect. We examined exhaustively all patterns of investigation and care available to presenile dementia sufferers in Scotland and concluded that admission to psychiatric hospital had identified the considerable majority. It is misleading for Newens et al to infer that their data on initial point of specialist referral within a complex pattern of care are inconsistent with our observations on psychiatric admissions at any time after presentation. There is too little information to support that inference. They state that "women with dementia are more likely than men to be admitted to psychiatric hospital for long term care because [of] the higher rate of widowhood among elderly women in general" but this is true for senile dementia, not presenile disease, where most couples are middle aged and not yet widowed. A difference in survival between the sexes would anyway make no difference in a study of incidence. But our findings of a reversed sex ratio in multiinfact dementia indicate that this was not the cause. We look forward to reading Newens et al's study when it is published and suggested that if our methods are comparable the differences between studies may contribute to a better understanding of risk factors for Alzheimer's disease.