Immunization is the most effective and cost-beneficial means to prevent infectious diseases in adults as well as in children. However, adult immunization has been beyond the center of attention relatively to children's immunization in Korea. Since the Korean Academy of Family Medicine had published "Vaccination for Adults" in 1994, a recent update was done in this field by the Korean Centers for Disease Control and Prevention and the Korean Society of Infectious Diseases. This paper reviews standard immunization for healthy persons and supplementary immunization for persons with underlying diseases based on those recent recommendations. General information, indications, dosage, route of administration, efficacy and safety were reviewed for vaccination of influenza, pneumococcal infection, tetanus, hepatitis A, hepatitis B, human papilloma virus, varicella and measles/mumps/rubella.
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Background Varenicline is known to have higher effect for smoking cessation than existing pharmacotherapies, including Bupropion and Nicotine replacement therapy, however, it can also bring about adverse effects such as problems in compliance due to the complicated dosage, side effects of high frequency, and financial burden resulted from a long term treatment. Moreover, the effect for smoking cessation with group program and non-pharmacotherapy, including financial. incentives, E-mails or SMS is well known, but, the study on their combination is rare. Therefore, in the present study, we tried to evaluate two things; the effect for smoking cessation with multi-modal intervention, and the compliance of Varenicline Methods: From July 2008 to February 2009, we conducted the multi-modal smoking cessation program for 30 volunteers in Dankook university. This program consisted short course of Varenicline, financial incentives, E-mail and short messageservice. Results: The continuous abstinence rate for weeks 9 throught 12 was 76.7% and for weeks 9 through 24 was 43.3%. Multivariate analysis revealed that duration of Varenicline treatment was significant factor affecting 12-week continuous abstinence rate. The average duration of Varenicline treatment was 17.1 (±10.8) days and 54.0% took Varenicline as directed. The most common adverse events were nausea (40.0%) and insomnia (23.3%).Conclusion: Multi-modal intervention (short course of Varenicline, financial incentive, E-mail and short message service) was effective for smoking cessation with high continuous abstinence rates in a university. We suggest multi-modal intervention because compliance of Varenicline seems to be low in real setting.
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Interventions to increase adherence to medications for tobacco dependence Gareth J Hollands, Felix Naughton, Amanda Farley, Nicola Lindson, Paul Aveyard Cochrane Database of Systematic Reviews.2019;[Epub] CrossRef
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Background This study aimed to examine the factors related to eating behavior subscales and change of eating behavior subscales among obese patients received weight reduction management. Methods: Eating behavior subscales (restrained eating, emotional eating, and external eating) were assessed using the Korean version of Dutch Eating Behavior Questionnaire in 76 obese female patients at obesity clinic and 83 female visitors at health promotion center. Fifty nine patients received weight reduction management and completed followup survey after 2-3 months. Demographics, physical activity, health behaviors, diet experience, BMI, and weight change were assessed. Results: The score of restrained eating was significantly higher in obese patients compared to controls, while scores of other subscales were not different between the two groups. Diet experience, score of emotional eating, and BMI explained 15% of variance of restrained eating score after adjustment for covariates. Likewise, increase of restrained and external eating scores and younger age explained 27% of variance of emotional eating score. External eating score was associated with increase in emotional eating score, higher education, regular exercise, and frequent overeating (R2 = 30%). Among obese patients, the follow-up score of restrained eating was significantly higher compared to that score at baseline, while the scores of emotional and external eating were not significantly changed. After adjustment for covariates, only irregular eating habit was associated with the change of restrained eating score. Conclusion: Restrained eating score was associated with BMI regardless of subjects group, while, among obese patients, the change of restrained eating score was associated with frequent irregular eating habit.
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Background The social problems of cigarette smoking and obesity are increasing and they threaten the health and dailylife of the both the young and old adults. Therefore, we evaluated the relationship between cigarette smoking and obesity. Methods: The study subjects were recruited from the middle and high school located in Ansan city. We used the selfques tionnaire to evaluate their general information including cigarette smoking at enrollment and 8,589 students informations were gathered. Data were classified into three groups (normal body weight, over weight and obesity). Smoking status was classified into past, current, and non smoker and analyzed the relationship with obesity and some life-style patterns. Results: Body weight and body mass index of the girls were significantly higher in the current smokers (52.4 ± 12.2 kg, 19.8 ± 3.5 kg/m2) than in the non-smokers (49.5 ± 7.7kg, 19.3 ± 2.6 kg/m2) and in the boys, body weight was higher in the current smokers (60.3 ± 10.7 kg, 20.4 ± 3.1 kg/m2) than in the non-smokers (57.5 ± 12.1 kg, 20.3 ± 3.3kg/m2), which was not significant. The odds ratios of having obesity were 2.33 (P <0.001; 95% confidence interval [CI], 1.24 to 3.34) in the current smokers and 2.04 (P < 0.001; 95% CI, 1.36 to 4.0) in the past smokers compared with the non-smokers in the girls. In the boys, there were no significance. Also, all students of the dietary pattern (breakfast, fast food, instant noodle, snack, soft drink) were associated with smoking status significantly. Conclusion: The current smokers showed higher prevalence of obesity and obesity-related dietary pattern than in the nonsmokers. Cigarette smoking may be associated with obesity in the school girls.
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Background This study evaluated how the alcohol drinking motives and alcohol drinking expectancies, as the internal factors, would relate to university students' alcohol drinking problems. Methods: The general characteristics, the alcohol drinking problems, the motives to drink, and drinking expectancy were surveyed with 197 university students (106 males, 91 females) who visited the Health Center of Chungnam National University. Results: The alcohol drinking amount per drink (P < 0.001), weekly alcohol drinking frequency (P < 0.001), alcohol drinking problem score (P < 0.001), the score of drinking expectancy (P < 0.001) and motives to drink for each domain (P < 0.05) for male students were significantly higher or larger than those of the female students. The distribution of the number of binge, heavy and at risk drinkers didn't show significant difference between sexes. The drinking problem score, the score of drinking expectancy and motives to drink for each domain showed significant (P < 0.001) positive correlation and male students displayed a higher positive correlation than that of female. Stepwise multiple regression analysis was conducted to evaluate the influence on drinking problem score. The male students' drinking problem score was associated with the score of coping motive, lower grade, the score of enhancement motive and drinking expectancy (R2, 0.325; P < 0.05) whereas those of female students were related to the score of social and coping motive (R2, 0.477; P < 0.001). Conclusion: The common factor that related to drinking problem for both male and female students was the coping motive to resolve negative feeling. In addition, the enhancement motive and drinking expectancy in male students and the social motive in female students were the associated factors.
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The overall prognosis of acute pyelonephritis is good, but the infections by extended spectrum Ղ-lactamase (ESBL) producing Escherichia coli (E.coli) cause poor responses to empirical antibiotic treatment, and consequently increase mortality. ESBL can hydrolyze the antibiotics with a Ղ-lactam ring and confer resistance to oxyimino-cephalosporins and monobactams. If the patient shows poor responses to empirical antibiotics or severe septic conditions, physicians must switch the antibiotics to other antibiotics covering resistant strains without delay. We report a case of acute pyelonephritis by extended-spectrum Ղ-lactamase producing E.coli in a 29-year-old woman who was empirically treated with oral ciprofloxacin as an initial treatment, but progressed to sepsis.