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The comprehensive medical care delivered by family physicians should involve education and practice of health-sustaining habits such as diet, exercise, relaxation etc. as well as drug prescription. Among those, problem drinking is one of the most frequent issues encountered in health promoting sessions. However they are not competent to cover the realm of counseling in problem drinking in a continuous way. The drinking problems go up, unnoticed and uninhibited, to the self-destructive stages by the process of denial and avoidance on the part of patient as well as therapists. The explanation by which moderate drinking can't be easily embedded into healthy life styles and the practical strategies for dealing with problem drinkers and alcohol dependents will be presented in the context of health-sustaining habits.
Background Breakfast consumption is related not only with foods and nutrients intake, but also obesity, chronic diseases, school performance, and cognitive function. This study is to assess factors associated with breakfast skipping and its effects on food and nutrients intake in 5th grade children from the obesity and metabolic disorders cohort. Methods: BMI percentile was used as an obesity index. Overnight fasting blood was collected to measure blood lipids, and glucose level. Dietary habits and physical activity levels were assessed with a self-fi lled questionnaire. If a student said "yes" to the question, "Have you taken all breakfast during previous seven days?," he or she was considered as 'breakfast consumer,' if a respondent said "no," he or she was considered as 'breakfast skipper.' Nutrients intake was estimated from a three-day 24-hour recall including two weekdays and one weekend. Results: Among 1,536 students, 30.1% (n = 235) of boys and 31.3% (n = 231) of girls were the breakfast skipper. The breakfast skippers were more obese (P = 0.011), from families with lower household income (P = 0.037), went to bed late (P = 0.001), had a longer screen time (P = 0.003) than breakfast consumers. All macronutrients intake and the adequacy of micronutrients (iron, zinc, vitamin B1, vitamin B2, vitamin B6, vitamin C, niacin, and folate) intake were lower in breakfast skipper. Conclusion: The breakfast skipping was associated with a lower socioeconomic state and a longer screen time. We confi rmed breakfast skipping is a risk factor of nutrients defi ciency (quantity) and is also related with food intake quality.
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Background Obesity is a disease state which should be prevented and managed. However, attempting unhealthy weight control can be related to psychologic problem like depression. This study was conducted to investigate the relationship between weight control methods and the depressive symptom among adults who have had weight control experience within recent 1 year.Methods: This study is a cross-sectional study on 10,285 adults (age, 25 to 69 years), who had weight control experience within recent 1 year, from the Community Health Survey, Seoul, 2009. Depressive symptom, tried weight control methods, weight, height, smoking status, alcohol intake and socioeconomic status were surveyed through face-to-face interview. The Center for Epidemiological Studies-Depression Scale is used for assessment of depressive symptom. Results: Depressive symptom was diagnosed in 5.2% (male: 2.9%, female: 7.0%) of study subjects and the most frequent method for weight control within 1 year was exercise (77.9%). Among men, depressive symptom was related to high likelihood of trying one-food diet (odds ratio [OR], 3.27; 95% confi dence interval [CI], 1.62 to 6.62), fasting (OR, 3.59; 95% CI, 1.61 to 8.02), dietary supplements (OR, 2.57; 95% CI, 1.40 to 4.73), Korean herbal medicine (OR, 2.85; 95% CI, 1.24 to 6.51), self-medication (OR, 5.50; 95% CI, 1.53 to 19.80). Among women, depressive symptom have relationship with high likelihood of trying one-food diet (OR, 1.83; 95% CI, 1.14 to 2.94), fasting (OR, 1.69; 95% CI, 1.10 to 2.59), prescribed medicine (OR, 2.28; 95% CI, 1.48 to 3.52) and low likelihood of trying exercise (OR, 0.65; 95% CI, 0.51 to 0.83). Conclusion: This study shows the difference of tried weight control methods depending on depressive symptom. Depressive symptom was related to high likelihood of trying weight control methods such as one-food diet, fasting and taking a diet-pill. In addition, that symptom was also related to low likelihood of trying exercise in women.
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Background Alcohol Use Disorders Identification Test (AUDIT) is effective in identifying problem drinking. This study purposed to evaluate the usefulness of AUDIT in identifying problem drinking among Korean university students whose drinking characteristic is different from adults.Methods: The subjects were 235 students who had visited the Health Service Center of Chungnam National University. All subjects had a diagnostic interview for the presence of at-risk drinking and alcohol use disorder. At-risk drinking was defi ned according to the criteria of the National Institute on Alcohol Abuse and Alcoholism. Alcohol use disorder was diagnosed by the criteria of Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV TR). At-risk drinking or alcohol use disorder was classified into problem drinking. At the same time, a survey was conducted using three screening tools: AUDIT, cut down, annoyed, guilty feelings, eye opener (CAGE), and cut down, under infl uence, guilty feelings, eye opener (CUGE). Area under receiver operating characteristic curve (AUROC) of the questionnaires to the results of interviews were compared. Results: Seventy one students were at-risk drinkers and 46 had alcohol use disorder, and 75 were classifi ed into problem drinkers. For identifi cation of problem drinking, AUROC of AUDIT was 0.970 in men and 0.989 in women. For CAGE, it was 0.650 in men and 0.747 in women. For CUGE, it was 0.689 in men and 0.745 in women.Conclusion: Above results suggest that AUDIT is most effective in identifying university students' problem drinking.
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Background The value of endoscopy is more increasing as a tool of the cancer screening, and many studies are now progressed for decreasing the inconvenience of patients who undergo the endoscopy. There are some overseas studies that the video-education before procedures like colonoscopy or coronary angiography increases the satisfaction and decreases the anxiety of the patients. But in Korea, there is lack of studies about the methods of decreasing the anxiety of the patients before procedures especially endoscopy.Methods: We carried out the survey with 95 patients underwent the endoscopy in the medical health checkup center of National Health Insurance Medical Center during 19 July 2008 to 8 September 2008. The patients who had the medical history of gastrectomy, had pains due to another diseases and had a prescription about psychiatric medicine including hypnotics were excluded.Results: Statistically there are no differences between two groups of the video-education and the paper-education according to age, sex, height, weight, body mass index, numbers of former endoscopy, smoking history and educational standard. The video-education is more effective than the paper-education in decreasing the anxiety index between before and after the education.Conclusion: The prior video-education for the patients awaiting endoscopy can decrease the anxiety about procedure. Moreover, it can decrease the suffi cation of the patients and increase the satisfaction of physicians. If the patients feeling the prior anxiety are educated with the video before undergoing endoscopy, the video-education is very effective to decrease the prior anxiety of the patients.
Background We studied the association of sagittal abdominal diameter (SAD) and metabolic syndrome and insulin resistance in Korean adults.Methods: This is a cross-sectional study by 190 patients who visited a Health Promotion Center of National University of Pusan from 11 November to 14 November, 2008. We analyzed the association of anthropometry (waist circumference, BMI, SAD), insulin resistance (homeostatic model assessment-insulin resistance, HOMA-IR), insulin sensitivity (quantitative insulin sensitivity check index, QUICKI), and plasma concentrations of glucose, insulin, total cholesterol, LDL, HDL, triglyceride. SAD was categorized into quartiles and assessed odds ratio of metabolic syndrome adjusted for age, sex, lifestyle factors.Results: SAD showed significance correlation to HOMA-IR than BMI. Quartiles of SAD showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, HOMA-IR and obesity but hypertriglyceridemia, low HDL-cholesterolemia did not show signifi cant association. In men QUICKI was signifi cantly high. A multivariate model, adjusted for age, sex, smoking status, physical activity, heavy drinking, HOMA-IR and QUICKI, revealed a progressively increased odds ratio of metabolic syndrome, 3rd quartile (odds ratio [OR]; 9.467; 95% confi dence interval [CI], 3.225 to 27.789; P < 0.001) and 4th quartile (OR, 7.253; 95% CI, 2.437 to 21.586; P < 0.001), with increasing SAD.Conclusion: As shown above, SAD was a strong anthropometric marker of insulin resistance, risk of metabolic syndrome and decreased insulin sensitivity in Korean adults.
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We report three cases of iron defi ciency anemia due to long-time bloodletting using cupping. Case 1 was a 52-year-old man who sought evaluation at the Health Promotion Center in our hospital due to fatigue and dyspnea on exertion (DOE). There were no abnormal fi ndings on his general health examination, except anemia. He has performed self-bloodletting for a long time with cupping on his back and extremities for fatigue, myalgias, or polyarthralgias. Case 2 was a 52-year-old woman with fatigue and DOE. The physical examination revealed a systolic murmur at her left lower anterior chest and pale conjunctiva. The initial hematocrit was 22.4% and the hemoglobin was 6.4 g/dL. She has self-bloodletted using cupping 2 to 3 times a week when she felt tired or had myalgias. Case 3 was a 35-year-old man with sudden onset fatigue and DOE. He had severe DOE during a challenging physical test. He frequently received bloodletting using cuppings on his back and extremities by a doctor of Oriental medicine. There were no abnormal findings on the general health examination, except anemia. All three patients were diagnosed with iron defi ciency anemia due to chronic blood loss. We recommended stopping bloodletting using cupping and prescribed oral iron supplements.
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