Various bacteriae, viruses, fungi, parasites may cause community acquired pneumonia and out of them, S. pneumoniae is the most common cause. As finding out causative pathogen in community acquired pneumonia which is common in primary care is often difficult, empiric antibiotic therapy is initiated. For ambulatory patients with community acquired pneumonia: 1) Ղ-lactam alone; 2) combination of Ղ-lactam and macrolides; or 3) respiratory quinolone are recommended. For inpatients without a risk of P. aeruginosa, Ղ-lactam plus macrolide or respiratory fluoroquinolone are recommended. The successful treatment of community-acquired pneumonia requires appropriate, empirical antimicrobial therapy.
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Background To collect basic data which of conceptions about cold by age, sex, education state, economic state, this survey was carried out in a workers' periodic health examination. Methods: 1,056 workers who are working at the one company were included for this survey from Jun 1 to July 7 2006. We obtained self-reported questionnaire from them. The contents of the questionnaire were the general characteristics of workers, the cause and the management of cold. We analyzed true recognition ratio of conception about cold by age, sex, education state, and economic state. Results: According to sex and economic state, true recognition ratio was not different. According to age, 'Virus', 'Germ', 'Cold weather' were lowest above fifties about the cause of cold. 'Self-limited disease', 'Flu vaccination prevents cold', 'Percussion to chest is helpful to remove sputum', 'Inhaling warm steam is helpful to decrease nasal obstruction', 'Washing hands is helpful to prevent cold', 'Many people crowd in a area are susceptible to cold' were lowest above fifties about the management of cold. According to education state, 'Virus', 'Food' were highest above fifties. Except 'Medicine cures fast', 'Injection therapy cures fast', 'Tonsillectomy prevents cold', the others were highest in the above college education. According to education state by age group, only 'Virus' in the forties and 'Virus, 'Food' in the above fifties were highest. 'Flu vaccination prevents cold' in the twenties, 'Injection therapy cures fast' in the forties, 'Medicine cures fast' and 'Injection therapy cures fast' were lowest in the above college education. Conclusion: Age, education level were significantly related to true recognition ratio of conception about cold. So we had to educate low recognition ratio of conceptions.
Background Alcoholism screening tests are commonly used in primary medical care. This study examined how much the level of insight of alcohol-dependent patients would impact on the sensitivity of alcoholism screening tests. Methods: The sample consisted of 122 subjects who had been diagnosed with alcohol dependence and who completed Alcohol Use Disorders Identification Test (AUDIT), and CAGE questionnaire. AUDIT positive was defined as a score of 20 points or above and CAGE positive, 3 points or above. Insight level was classified as poor, fair, and good using the Hanil Alcohol Insight Scale (HAIS). Positive rates on the AUDIT and CAGE were analyzed according to the level of insight. Results: In good insight group, the sensitivity of AUDIT and CAGE identified 96.9% and 96.9% of the participants as alcohol dependence, respectively. In fair insight group, those were 92.7% and 96.4%, respectively. However, in poor insight group, these decreased substantially to 62.9% and 65.7%, respectively. After adjusting for general characteristics on the basis of good insight group, we found that the possibility of positive on the AUDIT was significantly lower in poor insight group (Odd ratios [OR], 0.025; 95% confidence interval [CI], 0.002 to 0.411). Also, the possibility of positive on the CAGE was significantly lower in poor insight group (OR, 0.016; 95% CI, 0.001 to 0.358). Conclusion: Alcohol-dependent patients with poor insight showed a high rate of false negatives in alcoholism screening tests. These suggest that primary care physicians should be careful in interpreting the results of alcoholism screening tests.
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Background Obesity is known to influence on physical, mental, functional health problems but there have been no study of relationship between body mass index (BMI) and quality of life (QOL) in Korean elderly. Methods: A total of 216 elderly who had been attending two geriatric welfare facilities in Seoul answered the Korean version of obesity-related quality of life (KOQOL) questionnaire. Height, weight, waist circumference were measured. Body fat (%) was measured with HTM20 by impedance technique. Sociodemographic and medical factors were interviewed. QOL was assessed using KOQOL (ver.1) after excluding two sexual life related questions and one work related question. The total score is 48 points. The higher is the score, the poorer is the QOL. Results: In multivariable analysis, BMI, age, history of diabetes mellitus, history of osteoarthritis were associated with KOQOL score. Especially, BMI was significantly associated with KOQOL score after adjusting for waist circumference, body fat (%) (P = 0.002). Conclusion: The more BMI increases, the worse the obesity related QOL is in Korean ambulatory elderly.
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