Adrenal exhaustion and fatigue due to chronic stress

Adrenal fatigue is a symptom complex occurring when chronic stress overwhelms one's own adaptation reserve. Morning fatigue, decreased performance, irritability, depressed mood, poor concentration, general myalgia, insomnia, cravings for stimulants, hypoglycemia, postural dizziness are the main symptoms. Adrenal fatigue or exhaustion is not a new concept. Selye presented the concept as a general adaptation syndrome to stress nearly 70 years ago, but it is still a valuable one. It is not easy to measure adrenal function; nowadays salivary cortisol/dehydroepiandrosterone levels taken many times in a day has developed and used frequently. A lot of psychological methods and relaxation techniques including relaxation response, proper nutrition with supplements/herbs, deep sleep and rest, graded exercises and social supports make the patients recover from the state. Diagnostic methods or managements must be developed more to handle this syndrome easily because this syndrome has become much more prevalent than during the last century due to rapid changes and instability of modern societies.

The multi-center study of the comprehensive geriatric assessment in the Korean elderly

BACKGROUND: Comprehensive geriatric assessment is identified as a dynamic process responsive to the changes on health status that occurs over time in the context of extremely increasing trend in the numbers of the elderly people, their office visit, and the medical cost universally. We completed the comprehensive geriatric assessment and applied it to the Korean elderly through the multi-center trials. METHODS: We performed studies variables using questionnaires, with interviewing, physical examination to the number of total 312 elderly people who visited the department of family medicine or physical medicine and rehabilitation of the 11 university hospital or general hospital in Korea from July 1, 1999 through October 31, 1999. We, the geriatrician, met and discussed 3 times to complete the comprehensive geriatric assessment through the consensus panel. RESULTS: We found the sex ratio of 312 subjects was 1 to 2 (104 males and 208 females) and the average age was 73.2 years old. The orders of more frequency of self-reported health status of the respondents were hypertension, arthritis, cataract, gastrointestinal disturbance, diabetes mellitus, urinary/fecal incontinence, depression, cerebrovascular accident, anemia, and heart disease. Nearly 15% of those showed depression, 41.6% of those were in the status of socially isolation. We found 43.1% of those showed hypertension, 3.7% isolated systolic hypertension, and 20.2% orthostatic hypotension. Of those, cognitive impairment were measured in 37.1%, gait disturbance 13.0%, and the risk of malnutrition 39.6%. Geriatrician spent 21.1 minutes per person during the process of comprehensive geriatric assessment. CONCLUSION: We realized we could diagnose and intervene effectively certain hidden conditions/diseases, particularly urinary incontinence, falls, visual impairment, hearing impairment, pain, depression, social isolation, cognitive impairment, and orthostatic hypotension, with using the comprehensive geriatric assessment. These results reflected the fact that the comprehensive geriatric assessment might be necessary for the care of the elderly.

The general characteristics and states of family of chemical-abusers in an adolescent jail

BACKGROUND: The drug abuse has become one of social problems especially in the adolescents. It has been well known that the drug abuse is concerned with interaction of biopsychosocial factors and farnily relation factors. So I have studied the general characteristics and rearing attitude and family state of the adolesents who were in a jail because of drug abuse and have intended to give some help for establishing effective strategies for family education and therapy. METHODS: The study was done for adolescents who were in a jail because of violation the illegal drug control law. The group was total 55 men and the age distribution was frorn 15 to 20 years. The Questionnaire was used in Mar 1996 for study and I analyzed 53 cases excluding 2 cases because they were nearly illiterate. The FACES III(Family Adaptability and Cohesion Evaluation Scales), family APGAR score and PBI(Parental Bonding Instrument) were used for evaluating the characteristics of family function and the parental rearing attitude. Statistical management with SAS was executed for data analysis. RESULTS: The average age of the group was 6.9+/-1.4. 48.1% of them lived in the metropolitan area, 40.4% lived in the middle-sized cities and 11.5% lived in the small country towns. The education level of 91.8% was under middle-school graduate. They have use drugs since the age of 14.6+/-1.8, they began to use glue sniffing at the first time in 78.8% and butane gas inhalation in 17.3%. The state of family showed the death of father in 28.9% and the death of mother in 13.5 % and 76.9% of deaths occured before they have become 13 years. Their parents divorced in 25 %. The mean APGAR score was 4.56+/-2.6, which means moderately dysfunctional state of family. In FACES III adaptability score was 20.3+/-5.7 and cohesion score was 26.2+/-6.9. According to the family type by FACES III, there were 5 cases(9.4%) in balanced, 19 cases(35.9%) in midrange, and 29 cases(54.7%) in extreme. In PBI mother overprotection score was 16.24+/-4.59, mother care score was 22.5+6.8, father overprotection score was 16.71+/-5.1 father care was 21.94+/-6.24. CONCLUSIONS: The drug abused adolescents in a jail were in hadicapped family because of deaths and divorce of parents. Their family function score was low and more than half of them had the extreme type of family. Therefore it is wise for us to have a concern for the family problem when understanding and managing drug abused adolescents.

A Survey on Status of Pregnancy and Delivery at a Rural Village, Napal(Dolakha Bazar Area) / 예방의학회지

This study was conducted to investigate the status of pregnancy and delivery and relationship among knowledge, attitude and practice about pregnancy and delivery in poor country, Nepal. A questionnaire survey by interviewer was conducted to examine the general characteristics, knowledge about pregnancy and delivery, attitude about pregnancy and delivery, the rate of prenatal care and delivery condition of women who had an experience of delivery during last year(1994. 4. 13~1995. 4. 12) at a rural area, nepal(Dolakha Bazar Area). The major findings are as follows; Among respondents, 87.5 percentage never had health education and the degree of knowledge about pregnancy and delivery was low. Among respondents, 56.6 percentage had the attitude that they didn't want antenatal care, 42.8% of respondents answered that they wouldn't visit hospital or health center when vaginal bleeding occurred and 82.9% thought that the delivery itself was dirty. The proportion of women who experienced antenatal care was 28.3%, the proportion of health facilities delivery was 5.3%, which was very low and 82.6% of home delivery case didn't sanitate the tool to cut the umbilical cord. The women who had positive attitude about antenatal care and health facility utilization experienced more antenatal care and health facilities delivery. On consideration of above findings, health education for pregnancy and delivery is required to improve mother-child health status in poor country. To make efficient health education, the target population group, such as the uneducated, inhabitants far from health center or medical facility, must be chosen. To help the poor countries in medical field, the study on health status and its related factors on these countries like this article would be required.