Beyond posing a major health crisis,the COVID-19 pandemic has inflicted profound psychological,social,and economic impacts on populations worldwide.Mass quarantines and social isolation have affected the mental health...Beyond posing a major health crisis,the COVID-19 pandemic has inflicted profound psychological,social,and economic impacts on populations worldwide.Mass quarantines and social isolation have affected the mental health of the wider population,exacerbating other stressors,including fear of the virus and its repercussions,general uncertainty,and financial insecurity.The pandemic has challenged the broader delivery of healthcare––ranging from the need to triage limited hospital resources to balancing risk mitigation with maintaining medical care.Specific to gastroenterology,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has not only been associated with complicating extant medical conditions of the gastrointestinal(GI)tract,but has also forced a shift in the practice of gastroenterology by patients,families,and healthcare providers alike.The gastroenterology field has been required to adapt its practices to minimize the possibility of viral spread while still upholding patient care.Healthcare practitioners in GI have helped to treat COVID-19 patients,stratified inpatient and outpatient visits and procedures,and shifted to telemedicine.Still,as is the case with much of the general population,healthcare providers working in GI practice or endoscopy have faced personal and professional stressors,mental health difficulties,social isolation,financial pressures,and familial burdens––all of which can take a toll on practitioners and,by extension,the provision of GI care overall.This article will highlight how the COVID-19 pandemic has affected the psychological wellbeing,social engagement,and economic conditions of the public,healthcare providers,and GI professionals specifically.Recommendations for strategies that can continue GI services while maintaining safety for both caregivers and patients are put forth to help uphold critical GI care during this worldwide crisis.展开更多
OBJECTIVE: To provide survival estimates of people living with human immunodeficiency virus(PLHIV) after treatment with Traditional Chinese Medicine(TCM) in rural China, to identify the prognostic factors at enrollmen...OBJECTIVE: To provide survival estimates of people living with human immunodeficiency virus(PLHIV) after treatment with Traditional Chinese Medicine(TCM) in rural China, to identify the prognostic factors at enrollment, and to explore the effectiveness of TCM intreating PLHIV.METHODS: PLHIV who enrolled in national TCM HIV treatment trial program in October 2004 were analyzed in this study and followed up to October 2010. Survival time was estimated by the Kaplan-Meier curve and hazard ratios, and identifying prognostic factors were computed through Cox proportional hazard models.RESULTS:A total of 1666 PLHIV were included with 102 591 person-months of follow-up. Overall, 312(18.7%) patients died. The total mortality rate over the study period was 3.6 per 100 person-years,which was lower than the worldwide rate. The cumulative survival rate was 95.9% at 1 year[95% confidence interval(CI)(94.8-96.8)] and 80.4% at 6years [95% CI(78.4-82.3)]. Elevated death risks emerged among males, older individuals, and thosewithlowerCD4+T-cellcounts.CONCLUSION: TCM could increase survival and lengthen the life span of PLHIV in Henan province of China, as shown by our retrospective cohort study. Factors such as sex, age, education, and CD4+ T-cell counts correlated to survival. However,retrospective cohorts bias the data, so more prospective studies should be performed to confirm our primary results.展开更多
文摘Beyond posing a major health crisis,the COVID-19 pandemic has inflicted profound psychological,social,and economic impacts on populations worldwide.Mass quarantines and social isolation have affected the mental health of the wider population,exacerbating other stressors,including fear of the virus and its repercussions,general uncertainty,and financial insecurity.The pandemic has challenged the broader delivery of healthcare––ranging from the need to triage limited hospital resources to balancing risk mitigation with maintaining medical care.Specific to gastroenterology,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has not only been associated with complicating extant medical conditions of the gastrointestinal(GI)tract,but has also forced a shift in the practice of gastroenterology by patients,families,and healthcare providers alike.The gastroenterology field has been required to adapt its practices to minimize the possibility of viral spread while still upholding patient care.Healthcare practitioners in GI have helped to treat COVID-19 patients,stratified inpatient and outpatient visits and procedures,and shifted to telemedicine.Still,as is the case with much of the general population,healthcare providers working in GI practice or endoscopy have faced personal and professional stressors,mental health difficulties,social isolation,financial pressures,and familial burdens––all of which can take a toll on practitioners and,by extension,the provision of GI care overall.This article will highlight how the COVID-19 pandemic has affected the psychological wellbeing,social engagement,and economic conditions of the public,healthcare providers,and GI professionals specifically.Recommendations for strategies that can continue GI services while maintaining safety for both caregivers and patients are put forth to help uphold critical GI care during this worldwide crisis.
基金Supported by Research Project for Practice Development of National Traditional Chinese Medicine Clinical Research Bases(No.JDZX2012023)Henan province colleges and universities key youth teachers scheme(No.2013GGJS-095)+1 种基金National Special Science and Technology Program on Major Infectious Diseases(No.2012ZX10005010-001)China Academy of Traditional Chinese Medicine Item(No.ZZ060813)
文摘OBJECTIVE: To provide survival estimates of people living with human immunodeficiency virus(PLHIV) after treatment with Traditional Chinese Medicine(TCM) in rural China, to identify the prognostic factors at enrollment, and to explore the effectiveness of TCM intreating PLHIV.METHODS: PLHIV who enrolled in national TCM HIV treatment trial program in October 2004 were analyzed in this study and followed up to October 2010. Survival time was estimated by the Kaplan-Meier curve and hazard ratios, and identifying prognostic factors were computed through Cox proportional hazard models.RESULTS:A total of 1666 PLHIV were included with 102 591 person-months of follow-up. Overall, 312(18.7%) patients died. The total mortality rate over the study period was 3.6 per 100 person-years,which was lower than the worldwide rate. The cumulative survival rate was 95.9% at 1 year[95% confidence interval(CI)(94.8-96.8)] and 80.4% at 6years [95% CI(78.4-82.3)]. Elevated death risks emerged among males, older individuals, and thosewithlowerCD4+T-cellcounts.CONCLUSION: TCM could increase survival and lengthen the life span of PLHIV in Henan province of China, as shown by our retrospective cohort study. Factors such as sex, age, education, and CD4+ T-cell counts correlated to survival. However,retrospective cohorts bias the data, so more prospective studies should be performed to confirm our primary results.
