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Since each person has a different ability to break down alcohol, it is inappropriate to apply a uniform standard to everyone when evaluating drinking status. In Korea, there has been a guideline for moderate drinking based not only on sex and age but Koreans’ alcohol metabolism capabilities that can be predicted by presence of facial flushing response. So far, there have been no studies that have investigated drinking habits of Koreans in accordance with the guideline. This study tried to identify the current drinking status of Koreans according to the guideline. As a result, it was confirmed that about 1/3 of the total population was accompanied by facial flushing when drinking alcohol, and it was found that different drinking habits were shown even in the same age and gender groups according to the presence of facial flushing. It is difficult to accurately evaluate drinking habits because facial flushing has not yet been investigated in some large data or various medical examinations. In the future, it is necessary to ensure that the presence of facial flushing can be confirmed at the medical treatment or examination site so that accurate drinking habit evaluation and prevention and resolution of drinking problems can be achieved.
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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.
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Background@#Streptococcus pneumoniae is the main bacterial pathogen of community-acquired pneumonia in Korea. This study aimed to enhance the vaccination rate by evaluating the effectiveness of current methods of recommendation. @*Methods@#A retrospective analysis of the medical records of 143 patients with high risk of pneumonia among first-visit outpatients was conducted. High-risk patients for pneumonia are defined by the U.S. Advisory Committee on Immunization Practices. One hundred and twenty-seven patients, excluding 16 with pneumococcal 13-valent conjugate vaccination (PCV13) history prior to the first visit, were divided into three groups according to the method of vaccination recommendation: banner (B) group; banner+brochure (B+Br) group; banner+brochure+doctor's recommendation (B+Br+DR) group. The vaccination rates among patients in each group were compared. @*Results@#Patients with high risk of pneumonia showed 11.2% rate for PCV13 vaccination upon their first visit;however, this rate increased to 39.2% following counseling (P<0.001). Variation among the three groups was as follows: 9.0% in the B group, 20.0% in the B+Br group, and 75.0% in the B+Br+DR group (P<0.001). After adjusting for age, sex, high-risk group, occupation, and residence, a regression analysis was carried out. The odds ratio for the PCV13 vaccination rate compared to the B group was 2.49 (95% confidence interval [CI], 0.55-11.34) for the B+Br group and 43.72 (95% CI, 11.52-165.96) for the B+Br+DR group. @*Conclusions@#Among the available methods, we are thought to be more effective to add doctor's verbal recommendation in a clinical setting.
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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.
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Background@#This study aimed to examine the relationship between alcohol consumption and metabolic syndrome in Korean women as determined by facial flushing. @*Methods@#Of the female patients aged 4 standard drinks: OR, 4.16; 95% CI, 2.03–8.30) of the facial flushing group. The risk of metabolic syndrome was significantly high only in the subgroup of weekly alcohol consumption >4 standard drinks (OR, 2.20; 95% CI, 1.07–4.52) in the non-facial flushing group. @*Conclusion@#This study suggests that Korean women experiencing facial flushing when drinking have a higher risk of developing metabolic syndrome even with a low weekly drinking amount than those who do not experience face flushing.
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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.
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Background@#This study aimed to examine the relationship between alcohol consumption and metabolic syndrome in Korean women as determined by facial flushing. @*Methods@#Of the female patients aged 4 standard drinks: OR, 4.16; 95% CI, 2.03–8.30) of the facial flushing group. The risk of metabolic syndrome was significantly high only in the subgroup of weekly alcohol consumption >4 standard drinks (OR, 2.20; 95% CI, 1.07–4.52) in the non-facial flushing group. @*Conclusion@#This study suggests that Korean women experiencing facial flushing when drinking have a higher risk of developing metabolic syndrome even with a low weekly drinking amount than those who do not experience face flushing.
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Background@#This study aims to examine the association between alcohol consumption and the risk of pre- or type 2 diabetes mellitus (T2DM) by alcohol-induced flushing response in Korean male adults, particularly based on their body mass index (BMI). @*Methods@#This study selected 1,030 (158 non-drinkers, 364 flushers, and 508 non-flushers) male adults who had medical checkups. A logistic regression analysis was used to compare the association between alcohol consumption and the risk of pre- or T2DM. @*Results@#In both the normal-weight group (BMI 4 and ≤8 drinks: 2.64, 1.10–6.36; >8 drinks: 2.42, 1.11–5.27). However, obese non-flushers had only a significant higher risk of pre- or T2DM when consuming more than 8 drinks of alcohol per week than the non-drinkers (2.72, 1.39–5.30) @*Conclusion@#These results suggest that obese flushers have an increased risk of developing pre- or T2DM even with less alcohol consumption.
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The clinical philosophy of family medicine is to provide warm-hearted health care to every human being as opposed to the modern subspecialized carecalled “inhuman medicine.” One of the strategies to implement this philosophy is comprehensive care. Comprehensive care uses the biopsychosocialmodel approach to health problems. Comprehensive evaluation and management of biopsychosocial dimensions is unique to family medicine, andit is difficult to achieve through subspecialized care. Family-oriented health care is a specific tool to practice comprehensive care based on thebiopsychosocial approach. For family-oriented medical care, the family physician needs to understand “family” from two perspectives: structural anddevelopmental. From the structural perspective, family is a group of small entities called holons. From the developmental perspective, family is anentity that keeps changing and developing through the family life cycle and events. Family-oriented care, in these two contexts, tries to understandand address the communication and behavior patterns of the family members.
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BACKGROUND: This study analyzed the relationship between health behaviors and marital adjustment in multicultural couples to evaluate their health status. METHODS: Married couples (70 Korean men and their immigrant wives) completed a structured interview on health behaviors and sociodemographic factors, the Revised Dyadic Adjustment Scale (RDAS), and the Marital Intimacy Scale. Based on the cutoff value of the RDAS, respondents were classified into two groups: high or low dyadic adaptation groups. The collected data were compared with health behavior regarding smoking, alcohol consumption, exercise, and weight. RESULTS: The odds ratio (OR) (95% confidence interval [CI]) by logistic regression with adjustment for age, educational level, career, occupation, length of residence in Korea, nationality, religion, age difference between couple, number of children, monthly income, and proficiency in Korean was 1.279 (1.113–1.492) for unhealthy exercise and 1.732 (1.604–1.887) for unhealthy body weight in female immigrants with low marital adjustment. In Korean husbands with low marital adjustment, the OR (95% CI) was 1.625 (1.232–2.142) for smoking and 1.327 (1.174–1.585) for unhealthy exercise. No significant relationship was found between marital intimacy and health behaviors in female immigrants or Korean husbands. CONCLUSION: More desirable health behaviors were observed in highly adapted couples. Therefore, family physicians should be concerned with marital adjustment and other associative factors to evaluate and improve multicultural couples' health status.
Subject(s)
Child , Female , Humans , Male , Alcohol Drinking , Body Weight , Cultural Diversity , Emigrants and Immigrants , Ethnicity , Family Characteristics , Health Behavior , Korea , Logistic Models , Marital Status , Occupations , Odds Ratio , Physicians, Family , Smoke , Smoking , Spouses , Surveys and QuestionnairesABSTRACT
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.
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Female , Humans , Cholecalciferol , Education , Osteoporosis , Postmenopause , Retrospective Studies , Sunlight , Vitamin D Deficiency , Vitamin D , VitaminsABSTRACT
BACKGROUND: This study aimed to examine the relationship between alcohol consumption and intraocular pressure (IOP) according to facial flushing in Korean men with obesity. METHODS: The study included 479 Korean men with a body mass index of ≥25 kg/m² (75 non-drinkers, 174 with drinking-related facial flushing, and 230 without facial flushing) who underwent health check-ups between October 1, 2016 and March 31, 2017. Multivariate logistic regression was used to assess the relationship between alcohol consumption and high IOP (≥21 mm Hg). RESULTS: Flushers consuming ≤16 drinks per week had a significantly higher risk of high IOP than non-drinkers, depending on alcohol consumption (≤8 standard drinks: odds ratio [OR], 4.49; 95% confidence interval [CI], 1.05–19.25; >8 but ≤16 standard drinks: OR, 8.14; 95% CI, 1.37–48.45). However, when the consumption was >16 drinks per week, the high IOP risk did not significantly increase (OR, 0.71; 95% CI, 0.05–10.69). In addition, there was no significant relationship between alcohol consumption and high IOP among non-flushers consuming ≤8 drinks per week (OR, 2.07; 95% CI, 0.52–8.19). However, a significantly increased risk of high IOP was observed among non-flushers consuming >8 drinks per week, depending on alcohol consumption (>8 but ≤16 standard drinks: OR, 4.84; 95% CI, 1.14–20.61; >16 standard drinks: OR, 4.08; 95% CI, 1.02–16.26). CONCLUSION: This study suggests that obese men with alcohol flush reactions may have an increased risk of high IOP with the consumption of smaller amounts of alcohol than non-flushers.
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Humans , Male , Alcohol Drinking , Body Mass Index , Flushing , Intraocular Pressure , Logistic Models , Obesity , Odds RatioABSTRACT
This study investigated advantages and potential risks associated with drinking alcohol in Koreans based on the alcohol flush reaction. Our investigation reviewed published studies and examined moderate-drinking levels for Koreans based on modified National Institute on Alcohol Abuse and Alcoholism guidelines. Fourteen articles out of a total 198 publications were searched using PubMed, EMBASE, KoreaMed, and RISS (Research Information Sharing Service) databases and selected for review. Individuals without alcohol flush reaction (non-flushers) exhibited lower risks associated with insulin resistance, metabolic syndrome, and hyperhomocysteinemia and their 10-year cardiovascular disease risk when alcohol consumption was ≤8 drinks/wk. Conversely, risks associated with insulin resistance, metabolic syndrome, high blood pressure, prediabetes or type-2 diabetes, and high intraocular pressure and increases in carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels were present when >8 drinks were consumed. For individuals with flushing reaction (flushers), advantages were reported in relation to risks of hyperhomocysteinemia when alcohol consumption was ≤4 drinks/wk, whereas consumption of >4 drinks/wk increased the risk of insulin resistance, metabolic syndrome, high blood pressure, pre-diabetes or type-2 diabetes, high-risk colorectal adenoma, and high intraocular pressure and increased carbohydrate-deficient transferrin, gamma glutamyl transferase, and blood glucose levels. The moderate drinking level for Koreans is ≤8 drinks/wk for men aged ≤65 years and ≤4 drinks/wk for men aged over 65. For women, these limits should be half of those for men. Furthermore, individuals with flushing reaction should maintain an alcohol consumption level half of that for non-flushers.
Subject(s)
Female , Humans , Male , Adenoma , Alcohol Drinking , Blood Glucose , Cardiovascular Diseases , Drinking , Flushing , Hyperhomocysteinemia , Hypertension , Information Dissemination , Insulin Resistance , Intraocular Pressure , Prediabetic State , Transferases , TransferrinABSTRACT
BACKGROUND: Cigarette smoking increases the risk of atherosclerosis, which often develops as vascular calcification on radiologic examinations. This study evaluated the relationship between smoking-related factors and incidental abdominal aorta calcification (AAC) detected by computed tomography (CT) among middle-aged and elderly men. METHODS: We assessed the abdominal CT findings of 218 men aged 40 to 81 years who underwent health checkups. The associations between smoking factors and AAC were analyzed using logistic regression analysis to adjust for confounding variables such as age, lifestyle factors, and chronic diseases. RESULTS: Adjusting for confounding variables, the risk of AAC was significantly increased in association with smoking for at least 20 years (adjusted odds ratio [AOR], 5.22; 95% confidence interval [CI], 1.82–14.93), smoking 10+ pack-years (10–20 pack-years: AOR, 4.54; 95% CI, 1.07–5.68; >20 pack-years: AOR, 5.28; 95% CI, 2.10–13.31), and a history of smoking (former smoker: AOR, 2.10; 95% CI, 1.07–5.68; current smoker: AOR, 5.05; 95% CI, 2.08–12.26). In terms of the daily smoking amount, even a low smoking level increased the risk of AAC. CONCLUSION: These findings suggest that smoking for 20+ years, smoking 10+ pack-years, and even a low level of smoking daily increases the likelihood of developing AAC. Clinicians should recommend that patients quit smoking and stress the importance of smoking duration when promoting health in middle-aged and elderly patients.
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Aged , Humans , Male , Aorta, Abdominal , Atherosclerosis , Chronic Disease , Life Style , Logistic Models , Odds Ratio , Smoke , Smoking , Tomography, X-Ray Computed , Vascular CalcificationABSTRACT
BACKGROUND@#This study was designed to investigate the effects of usual negative emotional experiences on biological aging progression of human.@*METHODS@#A total of 237 subjects who visited the Health Promotion Center at Chungnam National University Hospital from May 2013 through September 2013 was enrolled. Each subject had been drawn up a structured questionnaire about usual experiences of depression, anxiety, anger, and anger expression. The degree of biological aging progression of each subject was computed by a specific formula which consisted of chronological age and biological age reflecting obesity and aging of main organs.@*RESULTS@#Trait anger and low education level showed the significant correlations with biological aging (r=0.160, P=0.014, and r=−0.189, P=0.024, respectively). Trait anger and low education level solely displayed the significant R2s for biological aging in consequence of multivariate analyses; R2=0.044, P=0.020, and R2=0.022, P=0.038, respectively.@*CONCLUSIONS@#This study suggests that the significant relationship between usual anger experience (i.e., trait anger) and biological aging would be present. In addition, lower education level may be related with biological aging.
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BACKGROUND: There is a distinction in alcohol consumption behavior between adults and college students. This study aims to verify the usability and the optimal cutoff point of Alcohol Use Disorders Identification Test–Korean revised version (AUDIT-KR) for screening alcohol use disorder in college students when the diagnostic and statistical manual of mental disorders (DSM), 5th edition diagnostic criteria is applied. METHODS: A total of 922 college students living in Daejeon were enrolled and divided into two groups based on how many items they corresponded to among DSM-5 alcohol use disorder diagnostic criteria: those who corresponded to ≥2 of the 11 items were classified into the patient group (107 males, 89 females) while the others into the control group (311 males, 415 females). The participants were evaluated using AUDIT-KR to find the optimal cutoff point for screening alcohol use disorder, sensitivity, and specificity. RESULTS: The mean±standard deviation scores in the AUDIT-KR were 12.76±7.27, 10.72±4.62 for males and females, respectively, in the patient group. In contrast, in the control group the scores were 6.26±5.23 and 3.95±3.59 in males and females, respectively. The area under the receiver operating characteristic curve (95% confidence interval) regarding alcohol use disorder screening by AUDIT-KR was 0.768 (0.715–0.821) and 0.883 (0.848–0.919) for males and females, respectively. The optimal cutoff point of alcohol use disorder for males was >9, sensitivity 64.49%, and specificity 76.85%. The optimal cutoff point for females was >6, sensitivity 82.02%, and specificity 80.48%. CONCLUSION: This study suggested that AUDIT-KR can be used as a screening tool for alcohol use disorder in groups of college students when DSM-5 diagnosis criteria are applied.
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Adult , Female , Humans , Male , Alcohol Drinking , Alcohols , Diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Mass Screening , ROC Curve , Sensitivity and SpecificityABSTRACT
BACKGROUND: This study was designed to investigate the effects of usual negative emotional experiences on biological aging progression of human. METHODS: A total of 237 subjects who visited the Health Promotion Center at Chungnam National University Hospital from May 2013 through September 2013 was enrolled. Each subject had been drawn up a structured questionnaire about usual experiences of depression, anxiety, anger, and anger expression. The degree of biological aging progression of each subject was computed by a specific formula which consisted of chronological age and biological age reflecting obesity and aging of main organs. RESULTS: Trait anger and low education level showed the significant correlations with biological aging (r=0.160, P=0.014, and r=−0.189, P=0.024, respectively). Trait anger and low education level solely displayed the significant R2 s for biological aging in consequence of multivariate analyses; R2 =0.044, P=0.020, and R2 =0.022, P=0.038, respectively. CONCLUSIONS: This study suggests that the significant relationship between usual anger experience (i.e., trait anger) and biological aging would be present. In addition, lower education level may be related with biological aging.
Subject(s)
Humans , Aging , Anger , Anxiety , Depression , Education , Health Promotion , Multivariate Analysis , ObesityABSTRACT
BACKGROUND: This research investigated the usefulness of heavy drinking standards of ‘guidelines for moderate alcohol drinking amount for Koreans’ for diagnosis of Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) alcohol use disorder. METHODS: This retrospective study was conducted with 976 adults who visited an health screening center in Daejeon for health check-up in 2015. Daily drinking amount, drinking frequency per week, and weekly drinking amount were investigated. Using the heavy drinking criteria of Korean guideline, participants were grouped by age and gender and classified as normal or heavy drinkers. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), Positive likelihood ratio (LR+), Negative likelihood ratio (LR-), odds ratio (OR) and Youden's Index of heavy drinking according to Korean guideline for diagnosis of DSM-5 alcohol use disorder were calculated. RESULTS: The Area under the receiver operating characteristic (ROC) curve of a model screening DSM-5 alcohol use disorder by weekly drinking amount were 0.812 in males up to age 65 years and 0.931 in males over age 65 years and females respectively. The sensitivity, specificity, PPV and NPV of Korean guideline heavy drinking group for diagnosis of DSM-5 alcohol use disorder were 61.0%, 89.7%, 67.0%, and 87.05% respectively. The LR+, LR-, OR and Youden's Index of those were 5.917 (4.704-7.435), 0.434 (0.379-0.497), 13.623 (9.607-19.317), and 0.507 respectively. CONCLUSIONS: This research shows the Korean heavy drinking standard is useful for diagnosis of DSM-5 alcohol use disorder in Korean people.
Subject(s)
Adult , Female , Humans , Male , Alcohol Drinking , Diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Drinking , Mass Screening , Odds Ratio , Retrospective Studies , ROC Curve , Sensitivity and SpecificityABSTRACT
BACKGROUND: Carbohydrate-deficient transferrin (CDT) is a useful biomarker to identify excessive alcohol consumption; however, few studies have validated the %CDT cut-off value in elderly men. This study estimated the optimal %CDT cut-off value that could identify excessive alcohol consumption in men aged ≥65 years. METHODS: This retrospective study included 120 men who visited the department of family medicine at Chungnam National University Hospital for health check-up between January 2010 and August 2013. At-risk drinking included heavy- and binge drinking. Heavy drinking was defined as more than seven standard drinks/wk, and binge drinking was defined as more than three standard drinks/d. The cut-off %CDT values for at-risk drinking were determined using receiver operating characteristic (ROC) curves. RESULTS: Based on the ROC curves, the optimal %CDT cut-off values in ≥65-year-old men were 1.95% for at-risk drinking, 1.81% for heavy drinking, and 2.07% for binge drinking. The sensitivity, specificity, and positive and negative predictive values were 58.7%, 83.6%, 69.2%, and 76.2% for at-risk drinking, respectively. The AUROC were >0.7 for all three evaluated cut-offs. CONCLUSION: Our results suggest that the %CDT cut-off value for at-risk drinking in elderly Korean men (≥65 years) should be readjusted to a lower value of 1.95%.
Subject(s)
Aged , Humans , Male , Alcohol Drinking , Binge Drinking , Biomarkers , Drinking , Mass Screening , Retrospective Studies , ROC Curve , Sensitivity and Specificity , TransferrinABSTRACT
No abstract available.