Korean Journal of Family Medicine最新文献

Background: Menstrual hygiene is crucial to a woman's physical, social, and mental well-being. The menstrual cup offers a safe and effective solution but still requires wider adoption. This study aims to assess awareness, practices, and barriers regarding the use of menstrual cups among women of reproductive age.

Methods: A cross-sectional study was conducted among 246 participants, randomly selected from outpatient settings of a tertiary care hospital in 2022. Non-pregnant menstruating women were included, while those with pelvic infections or cognitive impairments were excluded. After explaining the study's purpose and ensuring anonymity, data were collected using a structured questionnaire adapted from previous studies conducted in India and abroad. Knowledge and practices were depicted using descriptive statistics, while factors affecting awareness were analyzed using a multivariable binary logistic regression analysis approach.

Results: Approximately 64.2% of participants were aware of menstrual cups, but only three were users. Participants living in urban areas, practicing Hinduism, and marrying after the age of 20 years showed higher awareness. Users rated the cup as comfortable, with no skin irritation, foul odor, or dryness. The primary barrier to use was insufficient knowledge.

Conclusion: There is a gap in awareness and usage of menstrual cups, especially in low- and middle-income countries like India. Preliminary feedback from users is encouraging, suggesting that menstrual cups could offer a cost-effective, eco-friendly, and sustainable way to improve menstrual hygiene.

Background: Updated reports on the population-based analysis of atopic dermatitis (AD) in Korea are rare. This study aimed to investigate the nationwide prevalence and systemic medication prescription trends of AD in Korea.

Methods: Based on the Korean National Health Insurance database, the prevalence of AD and systemic medication prescription trends in patients with AD were analyzed according to age groups and regional districts from 2010 to 2015.

Results: The prevalence of AD was the highest among patients aged 0-1 year (18.6%-24.5%), decreasing rapidly with increasing age (<2% in patients aged ≥20 years). From 2010 to 2015, the prevalence of AD decreased in children but increased slightly in adolescents and adults. In 2015, the proportion of systemic steroid prescriptions increased from 11.2% in the 0-9 years age group to 41.1% in the 50-59 years age group, while that of systemic antibiotic prescriptions gradually decreased from 6.2% in the 0-9 years age group to 1.8% in the 80-89 years age group. The proportion of systemic steroid prescriptions by region remained consistently high in Gyeongbuk (34.2%- 34.9%) and low in Daejeon (20.2%-22.5%). The annual proportion of systemic cyclosporine prescriptions increased significantly from 0.6% in 2010 to 1.2% in 2015, with the highest rates observed in patients in their 30s (1.5%-2.4%), followed by those in their 20s (1.3%-2.3%) and 40s (1.1%-2.0%).

Conclusion: From 2010 to 2015, the prevalence of AD decreased in children but increased slightly in adolescents and adults. Approximately one-fourth of the patients with AD were prescribed systemic steroids, and the percentage of cyclosporine prescriptions doubled during the study period.

Background: The use of heated tobacco products (HTPs) among Korean adults has been steadily increasing since they were first introduced in 2017. It is known that smoking combustible cigarettes (CCs) adversely affects the serum lipid profile and increases the risk of cardiovascular disease. However, the health impacts of HTPs remain under- researched. This study, therefore, aims to explore the effects of HTP use on serum lipid levels.

Methods: This study involved 10,309 participants, selected from the Korea National Health and Nutrition Examination Survey VII-1 and VIII conducted between 2018 and 2021. Participants were categorized based on their smoking status: "HTPs ever user" included dual, triple, and past HTP users; "current HTPs only user" for those exclusively using HTPs; "current CCs only user" for those exclusively smoking CCs; and "never smoker." Logistic regression analysis was used to assess the impact of smoking type on serum lipid concentrations.

Results: The analysis revealed that the "HTPs ever user" group had a higher odds ratio (OR) for elevated total cholesterol compared to the "never smoker" group (OR, 1.40; 95% confidence interval [CI], 1.03-1.92). The likelihood of having high low-density lipoprotein (LDL)-cholesterol was greatest in the "current HTPs only user" group when compared to "never smokers" (OR, 1.71; 95% CI, 1.01-2.89).

Conclusion: The findings indicate that exclusive use of HTPs is linked to an increased level of serum LDL-cholesterol. Further longitudinal studies are necessary to fully determine the health risks associated with HTPs.

The global increase in the incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), which affects more than one-third of the general population and up to 70% of individuals with type 2 diabetes or obesity, is a critical public health challenge. Given that liver steatosis is often asymptomatic until the advanced stages of disease, early detection is essential to prevent its progression to fibrosis, cirrhosis and, ultimately, hepatocellular carcinoma. However, liver biopsy, the gold-standard diagnostic method, is invasive, costly, and unsuitable for large-scale screening. As a result, noninvasive tests have emerged as practical alternatives, particularly in primary care settings, where early identification is most feasible. The present study explored current perspectives of noninvasive liver disease screening tools and their implementation in primary care. Serum-based indices, along with imaging techniques, have demonstrated promise in identifying patients with advanced fibrosis. Novel biomarkers, including the enhanced liver fibrosis test and Pro-C3, as well as emerging artificial intelligence-assisted diagnostic platforms, yield improved accuracy and risk stratification potential. Despite accumulating evidence supporting the clinical utility and cost-effectiveness of noninvasive tests, several barriers hinder their routine use in primary care settings, which include limited funding, lack of standardized guidelines, insufficient clinician training, and disparities in access to diagnostic tools. The implementation of structured stepwise screening models has demonstrated improved diagnostic efficiency and reduced unnecessary referrals. Future research should emphasize the integration of artificial intelligence, portable diagnostic devices, and personalized risk models to enhance early detection. Ensuring widespread adoption requires coordinated efforts in policy development, provider education, and health-system investment. Noninvasive screening tools offer a feasible and cost-effective pathway for the early detection of MASLD in primary care; however, their successful implementation depends on addressing logistical, educational, and systemic barriers.

Background: The use of e-cigarettes is increasing globally, particularly among young adults. Although several use them to quit smoking, their effects are controversial. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess nicotine dependence in the smoking cessation process. This study examined changes in FTND scores among young adults using different types of cigarettes over a 1-year period.

Methods: Prospective cohort data were collected from cigarette users at higher education institutions in the lower northern region of Thailand to analyze changes in FTND scores over a 1-year period. E-cigarette users and combined users were compared with conventional cigarette users. A marginal structural model (MSM) with an inverse probability of weighting (IPW) was used to adjust for time-dependent and time-independent confounders.

Results: Of the 133 participants, 58 were e-cigarette users (43.6%), 33 were combined cigarette users (24.8%), and 42 were conventional cigarette users (31.6%). The results revealed that when both time-dependent and time-independent confounders were adjusted using MSM with IPW, e-cigarette users had a 0.20 decrease in the mean FTND score, and combined users had a 0.47 decrease in the mean FTND score compared to conventional cigarette users. However, the difference was not statistically significant.

Conclusion: The use of e-cigarettes or combined cigarettes did not significantly affect nicotine dependence levels in young adults over a 1-year period. Consequently, e-cigarettes should not be recommended to reduce nicotine dependence among young adult cigarette users. Further studies are required to determine whether e-cigarettes affect smoking cessation rates.

Background: Good glucose control is an indicator of treatment adherence and insulin therapy. However, insulin rejection has become an increasingly concerning phenomenon and is underdiscussed in health modules. The effects of incomplete exploration and suboptimal analysis requirements have led to the problem of insulin rejection, which needs to be identified by considering the broader perceptions of informal caregivers and patients with type 2 diabetes mellitus. Photo-elicitation, a technique that combines images and interviews, has gained traction for in-depth exploration. This study aimed to explore insulin rejection using photo-elicitation in this population.

Methods: This study employed a qualitative phenomenological design. The photo-elicitation interview involved ten photographs, which were taken and discussed narratively. This involved 10 families of informal caregivers and patients with type 2 diabetes mellitus between 20 and 60 years of age as purposive sampling at the Hospital Sultanah Nur Zahirah, Kuala Terengganu. Glycated hemoglobin levels (%) were between 6.3% and 14.8% in patients with type 2 diabetes mellitus. Atlas.ti version 25 and an Excel spreadsheet were used to analyze qualitative data through thematic analysis based on Maslow's hierarchy of needs.

Results: Four main themes were revealed: (1) financial challenges, (2) public stigma related to insulin therapy, (3) improving self-efficacy for self-action, and (4) improving glycemic levels for quality of life.

Conclusion: Photo-elicitation successfully explored trends in the management of type 2 diabetes mellitus in this population. This study provides insights into the use of needs analyses to create more engaging experiences when designing comprehensive evidence- and need-based interventions.

Background: This study aimed to evaluate the effectiveness and engagement of an interactive simulation-based online smoking prevention program compared to a traditional offline program for Korean adolescents.

Methods: A total of 1,008 adolescents from elementary, middle, high, and alternative schools in Chungcheongnam-do Province, South Korea participated in this study from October 1 to 31, 2021. The offline program consisted of 2-hour lectures by teachers, whereas the online program included six interactive peer-oriented video modules. The evaluation compared and analyzed the survey results measuring changes in smoking-related knowledge and attitudes before and after each program, as well as the level of interest in and satisfaction with education.

Results: When comparing the pre- and post-intervention scores between the two groups, no statistically significant differences were found except for a decreased belief that smoking helps relieve stress (F=12.125, P=0.001). However, withingroup comparisons revealed that the online smoking prevention program led to positive changes in most smokingrelated knowledge and attitude items, including reduced beliefs about smoking as a stress reliever (P<0.001) and lower misconceptions about the harm of e-cigarettes (P<0.001). In terms of engagement and satisfaction, the online program received significantly higher scores for interest (P<0.001), knowledge improvement (P<0.001), and program recommendations (P=0.021).

Conclusion: The online smoking prevention program was as effective as the traditional offline approach in enhancing smoking-related knowledge and attitudes. Moreover, its superior engagement and time efficiency highlight its strong potential as an effective alternative or complementary strategy to conventional school-based programs.

Artificial intelligence (AI) technologies are increasingly being integrated into clinical practice, offering potential enhancements in diagnostic accuracy and clinical efficiency. In this case report, a diagnostic attempt assisted by ChatGPT-4o in a 51-year-old female patient presenting with hand arthralgia is described. The AI-generated interpretation demonstrated hallucination-namely, the fabrication of unsupported or inaccurate information-in the analysis of radiologic and laboratory findings, as well as in treatment recommendations. This case underscores the importance of exercising caution when applying AI tools in clinical contexts. To ensure diagnostic accuracy, patient safety, and ethical responsibility, expert oversight and multi-step verification processes are essential in the deployment of AI-generated clinical outputs.