評(píng)論
打印
I'd looked at toxicity earlier, So I'm not going to spend any more time on it today
之前我講過(guò)毒性，今天我就不再細(xì)講了
Just to reassure you that we don't have to worry about toxicity. The experience of Dr. Wagner Wagner,
請(qǐng)放心，毒性不需要操心太多。醫(yī)生經(jīng)驗(yàn)說(shuō)明，
good doses in pregnant women without the slightest in the hypercalcemia or any other types of excessive problems
給孕婦較大量的維生素D，沒(méi)有出現(xiàn)任何高鈣血癥這樣的過(guò)量問(wèn)題
You know just trumps all the rest of this
所有這些都沒(méi)有問(wèn)題
So the preponderance of the evidence indicates that 32 is needed for a full benefits of vitamin D
大量證據(jù)顯示，維生素D發(fā)揮全部效果需要32納克
In some systems observation studies supports this conclusion
一些系統(tǒng)中，觀測(cè)研究支持這個(gè)結(jié)論
Now I want to stress the working together of randomized trials and observational studies
下面強(qiáng)調(diào)下隨機(jī)試驗(yàn)同觀測(cè)研究的結(jié)合
Randomized trials have very poor generalizability because the people in trials are not like the ones in youroffice
隨機(jī)試驗(yàn)的一般性很差，接受試驗(yàn)的人沒(méi)有足夠的代表性
They're not. So you can prove that stuff works
你可以證明東西有效
You just can't prove that works in your patients
但無(wú)法證明對(duì)所有患者有效
And so when you've got positive evidence from randomized trials plus concordant evidence from observation studies. You've got the best of both worlds
所以，隨機(jī)試驗(yàn)中獲得正面證據(jù)后，還需要觀測(cè)研究的證據(jù)配合，兩者都需要
So instead of throwing out the observations. We need them for generalizability
不能撇開(kāi)觀測(cè)，因?yàn)樗鼈兙哂幸话阈?/div>
So, for some endpoints that is cancer, the data suggests that even 32 is not high enough, So 40 to 60 is a range we've been talking about today
對(duì)于一些極端情況，如癌癥，數(shù)據(jù)顯示32納克還不夠，40到60才是足夠的范圍
and I stress once again I don't need to because everybody else has that such levels are physiological and they're safe
我再?gòu)?qiáng)調(diào)一次，雖然大家都講過(guò)這個(gè)水平有生理學(xué)依據(jù)而且安全
So this has to be what our goal is and once again as I said this morning
所以，這就是我們的目標(biāo)，早上說(shuō)的話我再說(shuō)一次
I'd like to think about it with a single number 75 international units per kilogram per day
我喜歡只考慮一個(gè)數(shù)字75國(guó)際單位/千克/天
just about approximates what you have to use for most of your patients whether they're fat or thin, young orold
是大多數(shù)患者的合適劑量，不論胖瘦，不論老少
It pretty much covers it at all
基本都覆蓋了
You have to look at them too because there's this huge variability in vigil response
你當(dāng)然需要監(jiān)控，監(jiān)控反應(yīng)差異性會(huì)非常大
I wouldn't watch it that the average value works in your patient, it doesn't
平均值不可能合適每個(gè)患者，
but we still have to work around some averages, so I thank you with that
不過(guò)仍然需要給出一個(gè)平均值。謝謝大家
