Relationship between Alcohol Consumption and Testosterone Deficiency according to Facial Flushes among Middle-Aged and Older Korean Men / 가정의학회지

Background@#This study examined the relationship between alcohol consumption and total testosterone deficiency based on facial flushing among Korean men. @*Methods@#A total of 314 men were included in this study and divided into non-drinkers (n=78) and drinkers (n=236). Drinkers were also divided into flushers (n=96) and non-flushers (n=140). Flushers and non-flushers were separated into two groups based on the amount of alcohol consumed: moderate drinkers (≤8 standard drinks per week) and heavy drinkers (>8 standard drinks per week). Total testosterone 8 drinks per week) who flush compared to that in non-drinkers.

Validation of the Simplified Palliative Prognostic Index to Predict Survival for Advanced Cancer Patients in Home Hospice Setting / 가정의학회지

Background@#The simplified Palliative Prognostic Index (sPPI) substitutes a single item from the Communication Capacity Scale (CCS) for the delirium item of the original PPI. This study aimed to examine the validity of the sPPI for patients with advanced cancer in a home-based hospice care setting. @*Methods@#This study included 75 patients with advanced cancer who received home-based hospice care. We used medical records maintained by professional hospice nurses who had visited the patients in their homes. Based on their sPPI score, patients were divided into three groups—A (<4), B (≥4 and <6), and C (≥6)—to compare survival. Further, we investigated the sPPI’s accuracy using the area under the receiver operating characteristic curve (AUC) and sensitivity and specificity for 3- and 6-week survival. We used three sPPIs including different substitutions for the delirium item (two methods using the CCS and one using the Korean Nursing Delirium Screening Scale). @*Results@#The median survival was 60–61 days for group A, 27–30 days for group B, and 12–16 days for group C. The difference in survival was significant (P<0.05). The AUC was 0.814–0.867 for 3-week survival and 0.736–0.779 for 6-week survival. For 3- and 6-week survival, prognostic prediction showed sensitivities of 76.2%–90.9% and 76.3%–86.8%, and specificities of 64.2%–88.7% and 51.4%–70.3%, respectively. @*Conclusion@#The sPPI, which is measured by professional hospice nurses, has acceptable validity to predict survival for patients with advanced cancer in a home hospice setting in South Korea.

Validation of the Simplified Palliative Prognostic Index to Predict Survival for Advanced Cancer Patients in Home Hospice Setting / 가정의학회지

Background@#The simplified Palliative Prognostic Index (sPPI) substitutes a single item from the Communication Capacity Scale (CCS) for the delirium item of the original PPI. This study aimed to examine the validity of the sPPI for patients with advanced cancer in a home-based hospice care setting. @*Methods@#This study included 75 patients with advanced cancer who received home-based hospice care. We used medical records maintained by professional hospice nurses who had visited the patients in their homes. Based on their sPPI score, patients were divided into three groups—A (<4), B (≥4 and <6), and C (≥6)—to compare survival. Further, we investigated the sPPI’s accuracy using the area under the receiver operating characteristic curve (AUC) and sensitivity and specificity for 3- and 6-week survival. We used three sPPIs including different substitutions for the delirium item (two methods using the CCS and one using the Korean Nursing Delirium Screening Scale). @*Results@#The median survival was 60–61 days for group A, 27–30 days for group B, and 12–16 days for group C. The difference in survival was significant (P<0.05). The AUC was 0.814–0.867 for 3-week survival and 0.736–0.779 for 6-week survival. For 3- and 6-week survival, prognostic prediction showed sensitivities of 76.2%–90.9% and 76.3%–86.8%, and specificities of 64.2%–88.7% and 51.4%–70.3%, respectively. @*Conclusion@#The sPPI, which is measured by professional hospice nurses, has acceptable validity to predict survival for patients with advanced cancer in a home hospice setting in South Korea.

The Effect of Education and Vitamin D Supplementation on the Achievement of Optimal Vitamin D Level in Korean Postmenopausal Women

BACKGROUND: Despite daily vitamin D recommendations, women with osteoporosis may not achieve optimal 25-hydroxy-vitamin D (25[OH]D) levels. We retrospectively evaluated the effect of education and vitamin D supplementation (1,000 IU/day) in Korean women with osteoporosis. METHODS: Sixty-one women with osteoporosis who were taking cholecalciferol (800–1,000 IU/day) were enrolled during 2011 to 2012. Forty patients (education only, Edu group) were educated on the importance of >30 min sunlight exposure daily while taking vitamin D. Twenty-one patients (education with vitamin D supplementation, Add group) were prescribed 1,000 IU/day cholecalciferol (total 1,800–2,000 IU/day) plus education. Patients were divided into 3 groups according to serum 25(OH)D status: deficiency (<20 ng/mL), insufficiency (20–30 ng/mL), and sufficiency (≥30 ng/mL). Furthermore, 25(OH)D levels were compared at baseline and after intervention for 3 months. RESULTS: The median (interquartile range) serum 25(OH)D concentration at baseline was 25.10 (18.95–33.60) ng/mL. The mean (±standard error) differences in 25(OH)D levels from baseline to post-intervention were 19.85±3.86 and 31.73±4.82 ng/mL in the Edu group and Add group, respectively. Eighteen patients (29.5%) had vitamin D deficiency, 25 (41.0%) had insufficiency, and 18 (29.5%) had sufficient levels. Optimal 25(OH)D (30 ng/mL or more) was achieved in 54.5% and 95.2% patients in the Edu group and Add group, respectively (P=0.003). CONCLUSIONS: We consider that vitamin D concentration should be measured on a regular basis in order to maintain an optimal level of vitamin D concentration, and education and supplementation is needed if not sufficient.

Development of a Simple Tool for Identifying Alcohol Use Disorder in Female Korean Drinkers from Previous Questionnaires / 가정의학회지

BACKGROUND: This study aimed to develop a simple tool for identifying alcohol use disorders in female Korean drinkers from previous questionnaires. METHODS: This research was conducted on 400 women who consumed at least one alcoholic drink during the past month and visited the health promotion center at Chungnam National University Hospital between June 2013 to May 2014. Drinking habits and alcohol use disorders were assessed by structured interviews using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria. The subjects were also asked to answer the Alcohol Use Disorders Identification Test (AUDIT), AUDIT-Consumption, CAGE (Cut down, Annoyed, Guilty, Eye-opener), TWEAK (Tolerance, Worried, Eye-opener, Amnesia, Kut down), TACE (Tolerance, Annoyed, Cut down, Eye-opener), and NET (Normal drinker, Eye-opener, Tolerance) questionnaires. The area under receiver operating characteristic (AUROC) of each question of the questionnaires on alcohol use disorders was assessed. After combining two questions with the largest AUROC, it was compared to other previous questionnaires. RESULTS: Among the 400 subjects, 58 (14.5%) were identified as having an alcohol use disorder. Two questions with the largest AUROC were question no. 7 in AUDIT, "How often during the last year have you had a feeling of guilt or remorse after drinking?" and question no. 5 in AUDIT, "How often during the past year have you failed to do what was normally expected from you because of drinking?" with an AUROC (95% confidence interval [CI]) of 0.886 (0.850-0.915) and 0.862 (0.824-0.894), respectively. The AUROC (95% CI) of the combination of the two questions was 0.958 (0.934-0.976) with no significant difference as compared to the existing AUDIT with the largest AUROC. CONCLUSION: The above results suggest that the simple tool consisting of questions no. 5 and no. 7 in AUDIT is useful in identifying alcohol use disorders in Korean female drinkers.

Relationship between Alcohol Consumption and Obesity according to Facial Flushing in Korean Males

BACKGROUND: This study was performed to examine the relationship between alcohol consumption and obesity according to facial flushing in Korean males. METHODS: The 1,198 men in this study were divided into four groups according to the amount of alcohol they consumed: non-drinkers (ND), lower moderate drinkers (LM, 14 drinks per week). They were also separated into two groups according to facial flushing: non-flushers and flushers. Obesity and abdominal obesity were defined as body mass index of 25 kg/m2 or higher and waist circumference of 90 cm or higher, respectively. RESULTS: In LM and HM groups without flushing, the risks of obesity and abdominal obesity were not significantly increased compared to those of non-drinkers. However, in the HD group without flushing, those risks were significantly increased [OR, 1.55; confidence interval (CI), 1.01 to 2.40, and OR 1.63; CI 1.02 to 2.58, respectively]. In the LM group with flushing, those risks were not significantly increased. However, in HM and HD groups with flushing, the risks of obesity and abdominal obesity were significantly increased (OR, 2.10; CI, 1.07 to 4.16, and OR, 2.06; CI, 1.05 to 4.06, respectively, in HM; and OR, 2.16; CI, 1.08 to 4.34, and OR, 2.50; CI, 1.26 to 4.98, respectively, in HD). CONCLUSION: This study suggests that the risk of obesity is increased in moderate flushing drinkers compared to non-drinkers and in heavy non-flushing drinkers.