ABSTRACT
We would like to replace Table 3 of the original paper with a revised version. We sincerely apologized to the readers.
ABSTRACT
BACKGROUND: Hypertension is highly prevalent among patients who visit primary care clinics. Various factors and lifestyle behaviors are associated with effective blood pressure control. We aimed to identify factors and lifestyle modifications associated with blood pressure control among patients prescribed antihypertensive agents. METHODS: This survey was conducted at 15 hospital-based family practices in Korea from July 2008 to June 2010. We prospectively recruited and retrospectively assessed 1,453 patients prescribed candesartan. An initial evaluation of patients' lifestyles was performed using individual questions. Follow-up questionnaires were administered at 4, 8, and 12 weeks. We defined successful blood pressure control as blood pressure <140 mm Hg systolic and <90 mm Hg diastolic. RESULTS: Of the 1,453 patients, 1,139 patients with available data for initial and final blood pressures were included. In the univariate analysis of the change in performance index, weight gain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.52 to 3.11; P<0.001), physical inactivity (OR, 1.195; 95% CI, 1.175 to 3.387; P=0.011), and increased salt intake (OR, 1.461; 95% CI, 1.029 to 2.075; P=0.034) were related to inadequate blood pressure control. Salt intake also showed a significant association. Multivariate ORs were calculated for age, sex, body mass index, education, income, alcohol consumption, smoking status, salt intake, comorbidity, and family history of hypertension. In the multivariate analysis, sex (OR, 3.55; 95% CI, 2.02 to 6.26; P<0.001), salt intake (OR, 0.64; 95% CI 0.43 to 0.97; P=0.034), and comorbidity (OR, 1.82; 95% CI, 1.23 to 2.69; P=0.003) were associated with successful blood pressure control. CONCLUSION: Weight gain, physical inactivity, and high salt intake were associated with inadequate blood pressure control.
Subject(s)
Humans , Alcohol Drinking , Antihypertensive Agents , Blood Pressure , Body Mass Index , Comorbidity , Education , Family Practice , Follow-Up Studies , Hypertension , Korea , Life Style , Motor Activity , Multivariate Analysis , Primary Health Care , Prospective Studies , Retrospective Studies , Smoke , Smoking , Weight GainABSTRACT
BACKGROUNDS: In terminally ill cancer patients, delirium must be considered to be important clinically and for the quality of life. We reviewed cases of delirium in hospitalized cancer patients with the aim to recognize and treat delirium. METHODS: We reviewed retrospectively the medical records of patients admitted with terminal cancer from April 2003 to April 2004 in the department of family medicine, National Health Insurance Corporation Ilsan Hospital. A total of 71 patients were evaluated with age, sex, oncological diagnosis, metastases, morphine (oral morphine equivalents/day, OME) use and amount, sedatives use, duration from delirium to death, and laboratory fi ndings. Analysis was conducted to fi nd the characteristics of delirium patients and to quantify the relationship between delirium and predicting factors. RESULTS: Among 71 cases, those patients who developed delirium were 41 (57.7%). Among them, gastric cancer was the most common diagnosis with 10 patients (24.4%), followed by colon and lung cancers (9: 22%, 5: 12.2%). The patients receiving sedatives or morphines were 24 (58.5%) and 28 (68.3%), respectively. The mean amount of morphine was 168.6 +/- 125.5 mg OME/day. Hyperbilirubinemia (4.2 +/- 9.2 mg/dL) and hyponatremia (132.5 +/- 4.5 mM/L) were found. Not only bone metastasis and the use of morphine or sedatives but serum Na were significant (P = 0.047; P < 0.001; P = 0.069; P = 0.029). By logistic regression analyses, the occurrence of delirium was increased with decreased serum Na (odds ratio [95% CI] 0.798 [0.649-0.981]) and increased use of sedatives (5.955 [1.080-32.835]). CONCLUSION: In terminally ill cancer patients, the risk factors of delirium were bone metastasis, the use of morphine or sedatives, and serum Na level. Among these, the use of sedatives and serum Na level were independent risk factors.
Subject(s)
Humans , Colon , Delirium , Hyperbilirubinemia , Hypnotics and Sedatives , Hyponatremia , Logistic Models , Lung Neoplasms , Medical Records , Morphine , National Health Programs , Neoplasm Metastasis , Quality of Life , Retrospective Studies , Risk Factors , Stomach Neoplasms , Terminally IllABSTRACT
BACKGROUND: Because doxylamine succinate (DS) is an over-the-counter medicine, it can be obtained easily and is frequently used in suicidal attempts. Patients usually recover without serious complications, but occasionally rhabdomyolysis and even death can occur in DS intoxication. In this study, the authors tried to find out the independent predictors of high peak serum CK levels, i.e. probable rhabdomyolysis in DS intoxication. METHODS: The medical records of 41 patients who visited a hospital for DS intoxication from January 1, 2002 to April 30, 2003, were reviewed retrospectively. RESULTS: In the group of DS only, initial occult blood of urine (P=0.003), initial WBC count (P=0.003) and confusion (P=0.007) were the best predictors of the peak serum CK level (2=0.724). In the group of DS with other drugs intoxication, initial creatinine level (P=0.003) and initial occult blood of urine (P=0.007) were the best predictors of the peak serum CK level (r2=0.784). In the cases of rhabdomyolysis patients, the time taken for the CK level to be increased over 1,000 IU/L was 1.9level to be increased over 1,000 IU/L was 1.9+/-0.6 days. CONCLUSION: In DS only intoxication, occult blood in initial urine analysis, initial high WBC count and confusion can be thought of as useful clinical predictors for high peak serum CK level case. In DS with other drugs intoxication, initial creatinine level and initial occult blood of urine can be considered as the best predictors. More than 2 days will be needed for the observation of serious complications in DS intoxication.
Subject(s)
Humans , Creatinine , Doxylamine , Medical Records , Occult Blood , Retrospective Studies , Rhabdomyolysis , Succinic AcidABSTRACT
BACKGROUND: Family physicians in their on primary practice frequently encounters patients with fever, welch is one of the common symptoms. Fever is an important symptom and can occur in mild disease, common cold, influenza, acute pharyngotonsillitis or can originate from a particular severe disease, such as bacterial endocarditis, malignant lymphoma and SLE, which need more aggressive management. Therefore, we studied patients who were admitted with short-term fever or long-term fever to find out their causes of febrile disease and to compare the differences with previous other studies. METHODS: 601 patients with fever above 37.2 degree centigrade or those who were transferred from other hospitals due to long-term fever were enrolled from Jan. 1991 to Jun. 1997. Patients' medical records reviewed and were classified according to disease, sex, age. Standardization of Petersdorf's rule for F.U.O. was used. RESULTS: 601 patients were randomly selected among which 301 were males and 300 females. Males were 147 and females 147 young adult patients as compared to 154 males and 153 females were elderly patients. According to disease category, the number of infections, connective tissue diseases, neoplastic diseases and other diseases were 442(73.5%), 14(2.3%), 87(14.5%) and 21(3.5%), respectively. The number of diseases of undetermined case was 37(6.2%). The most frequent disease was pneumonia with 103(31.1%). UTI and tuberculosis were the 2nd and 3rd most common diseases. The total number of F.U.O. patients was 82(13.6%). According to the disease categories there were 29(35.4%) in infections, 2(2.4%) in connective tissue diseases, 12(14.6%) in neoplasms, 2(2.4%) in others and 37(45.2%) in unknown origin. The most common disease was tuberculosis. Infection and tuberculosis were common disease category and disease in the classification of sex and age of F.U.O.. CONCLUSIONS: In the clinical study of febrile patients admitted from Jan. 1991 to Jun.1997 through medical record review, the disease category in the order of frequency was infection, neoplasm, collective tissue disease and the distribution of F.U.0. was same result. In comparison with other study, the order of connective tissue disease and neoplasm was different in other hospital study but same result was taken In comparison with Petersdorf's study.
Subject(s)
Aged , Female , Humans , Male , Young Adult , Classification , Common Cold , Communicable Diseases , Connective Tissue Diseases , Endocarditis, Bacterial , Fever of Unknown Origin , Fever , Influenza, Human , Lymphoma , Medical Records , Physicians, Family , Pneumonia , TuberculosisABSTRACT
BACKGROUND: Obesity is a risk factor for developing hyperlipidemia and cardiovascular diseases. Various diagnostic methods and criteria of obesity have been developed. The predictive values of health risk factors(hyperlipidemia, hypertension, diabetes mellitus, and body fatness) were different for cardiovascular diseases. We reviewed the medical records to assess the relation of health risk factors to waist-hip ratio(WHR) and body mass index (BMI). METHODS: We gathered 5100 cases who have taken medical examination from March 1995 to February 1996 at Ajou University Hospital and measured BMI, WHR, body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar etc.. Except 1350 abnormal cases on current illness and laboratory study, 3750 healthy cases were analysed. First we divided the healthy cases into obese and non-obese group according to BMI 25kg/m2 in men and women. And then, the obese and non-obese group was divided into central and non-central obese type by WHR 0.8 in women and 0.9 in men. RESULTS: Except only diastolic blood pressure in male, other lab data such as body fat, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, systolic and diastolic blood pressure, fasting blood sugar in male and female were significantly different between the two groups divided by WHR in BMI_0.9. Women had higher(P_0.8. CONCLUSIONS: We thought that the increase of WHR was risk factor for hyperlipidemia, hypertension, diabetes mellitus in men and women when BMI was less than 25kg/m2. In obese group(BMI>_225kg/m2), increase of WHR was risk factor for hyperlipidemia in men and hyperlipidemia and hypertension in women.
Subject(s)
Female , Humans , Male , Adipose Tissue , Blood Glucose , Blood Pressure , Body Mass Index , Cardiovascular Diseases , Cholesterol , Cholesterol, HDL , Cholesterol, LDL , Diabetes Mellitus , Fasting , Glucose , Hyperlipidemias , Hypertension , Medical Records , Obesity , Risk Factors , Triglycerides , Waist-Hip RatioABSTRACT
No abstract available.