Korean Journal of Family Medicine最新文献

Background: The Korean Journal of Family Medicine (KJFM), which is an official journal of the Korean Academy of Family Medicine, is an English-text medical journal published since 2009. Although nearly 15 years have passed since the journal was launched, to the best of our knowledge, no study has reviewed articles published in the KJFM. Accordingly, we analyzed articles published in the KJFM for the first time.

Methods: Articles published in the KJFM between January 2018 and November 2023 were categorized according to article type. Information about author affiliations, study subjects, research methods, and modes of data collection was then scrutinized. Moreover, we compared the frequencies of subjects, research methods and modes of data collection before, during, and after the coronavirus disease 2019 pandemic.

Results: Original article was the most common article type. Approximately 52% of the articles were published by authors affiliated with departments other than family medicine, and 40% were published by family medicine. Approximately 60% and 38% of the articles were published by Korean authors and authors of international affiliations, respectively. Throughout the pandemic periods, research subjects focusing on "diseases & symptoms" have diminished, while "principles of family medicine" have progressively increased. Additionally, the use of cross-sectional study methods has declined. In terms of data collection, the use of "big data," "medical records," and "questionnaires" has decreased, whereas the use of "study results" has increased.

Conclusion: KJFM is journal with wide and international participation covering various research subjects and study methods. We believe that our study provides valuable data for the future direction and development of the KJFM.

Background: Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.

Methods: This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.

Results: E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=9.35; never: mean=9.18; P<0.001). The ecigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03-1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03-2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14-12.30).

Conclusion: Our findings suggest that e-cigarette use is significantly associated with insulin resistance.

Background: No disease-specific, reliable, and valid self-assessment tools exist for athletes with mild coronavirus disease (COVID-19) to self-return to sports. This study aimed to develop a self-assessment screening method for athletes with mild COVID-19.

Methods: Item generation, item reduction, and pretesting were used to develop a questionnaire that served as a screening tool to detect severe post-COVID-19 complications. The questionnaire was validated by both internal and external reviewers, and the final version consisted of 11 items. Face validity was assessed through direct interviews with 11 athletes. Severe COVID-19 complications were identified for criterion validity and correlation analysis. A total score of 11 indicates that there is no risk of severe COVID-19 complications and gradual return to play is recommended; results <11 indicate a need for further evaluation by trained medical personnel. For reliability test, 50 respondents were chosen and asked to answer the questionnaires 7 days after their first responses.

Results: Physical Activity Readiness Questionnaires for post-COVID-19 athletes (PAR-COVID-Q) demonstrated excellent internal consistency (r=1, P<0.05) and test-retest reliability (r=1, P<0.05). A total of 118 athletes scored 11, had normal health screening, normal electrocardiogram and chest X-ray, and successfully returned to sports without any reported complications (r=1, P<0.05). Two athletes scored <11 and underwent further medical evaluation.

Conclusion: The PAR-COVID-Q is a valid and reliable self-assessment tool with a low burden for athletes to return to sports following mild COVID-19.

Background: Whether land- or aquatic-based rehabilitation is more effective in improving knee osteoarthritis (OA) is still unclear. This study assessed the effectiveness of aquatic-based treatments in patients with knee OA.

Methods: The participants were divided into a land-based exercise group (G1, n=30) and a water-based exercise group (G2, n=30). The exercises were performed for 8 weeks. The primary endpoint was a response to physical therapy, defined as a 20% decrease in the summed score for the Western Ontario and McMaster Universities-Osteoarthritis Index (WOMAC) pain subscale from T1 (before the start of the rehabilitation program) to T2 (8 weeks later). The secondary endpoints included the Visual Analog Scale (VAS) for pain, WOMAC functional and stiffness subscales, Lequesne Index, and Medical Outcome Study Short Form (SF-12) for physical and mental health.

Results: A 20% decrease in the summed WOMAC pain subscale score was noted in 33% of patients in G1 (n=10) and 93% in G2 (n=28) (P<0.001). VAS scores at walking decreased by 14% in G1 vs. 37% in G2 (P<0.001), WOMAC stiffness subscale decreased by 18% in G1 vs. 53% in G2 (P<0.001), and the Lequesne index decreased by 10% in G1 vs. 33% in G2 (P<0.001). Quality of life improvement was greater in G2 than in G1; SF-12 (physical) increased by 2.3 in G1 vs. 5.4 in G2 (P=0.023), and SF-12 (mental) increased by 6.3 in G1 vs. 10.9 in G2 (P=0.022).

Conclusion: Both aquatic and land-based exercises improved pain intensity, functional impairment, degree of handicap, and quality of life impairment caused by OA. However, the improvement was more significant in the aquatic-based exercises group.

Menopause is a natural part of the aging process that every woman experiences at some point in life. Menopausal symptoms have a negative impact on the quality of life. Common menopausal symptoms include vasomotor symptoms, mood swings, concentration issues, vaginal dryness, atrophy of secondary sexual traits, libido loss, musculoskeletal discomfort, osteopenia, and osteoporosis. The most effective treatment for the relief of menopausal symptoms is estrogen, with or without. Hormone replacement therapy (HRT) is most beneficial before 60 years of age or within 10 years of menopause. Other menopause-related symptoms including mood swings, sleep disturbance, sexual dysfunction, and myalgia may improve with HRT. HRT is also effective in preventing bone loss associated with menopause and in reducing the incidence of all osteoporosis-related fractures, including those of the vertebrae and hip.

Semaglutide, a medication used for type 2 diabetes and weight loss, may have unexpected side effects such as sarcopenia and age-related loss of muscle mass and strength. A 74-year-old male patient with type 2 diabetes and dyslipidemia presented with progressive fatigue over 2 years. He experienced a significant decline in walking endurance and speed despite the absence of joint pain or other obvious causes. He had a history of ocular myasthenia gravis and localized prostate cancer, both of which were well-managed. Further investigation revealed a weight loss of 8 kg after starting semaglutide treatment for diabetes. Physical examinations revealed reduced muscle bulk and strength. Extensive investigations, including blood tests, imaging, and cardiopulmonary exercise testing, have ruled out other potential causes of fatigue. The patient's fatigue improved after reducing the semaglutide dose and implementing a tailored exercise program that focused on muscle strengthening. This case highlights the potential contribution of semaglutide to muscle mass loss and subsequent fatigue, particularly among older adults.

Noncommunicable diseases (NCDs), including cancer, diabetes, hypertension, cardiovascular diseases, and chronic respiratory conditions, are the leading global causes of morbidity and mortality. Depression frequently co-occurs with these conditions, and may significantly reduce medication adherence, thereby worsening health outcomes. This narrative review examines the relationship between depression and medication adherence in patients with NCDs. It also highlights the current challenges in managing this comorbidity and explores potential strategies for improving adherence outcomes. Most studies have reported a significant negative association between depression and medication adherence in diverse NCD populations. Depressive symptoms impair motivation, memory, and executive functioning, which are essential for the maintenance of treatment regimens. However, inconsistencies across studies have been observed due to variability in the measurement of depression and adherence, study design, and control of confounding factors. Despite evidence from high-income countries supporting integrated care models such as collaborative care and cognitive behavioral therapy, implementation of these models in low- and middle-income countries remains limited. Emerging strategies, including task shifting, digital health tools (e.g., mobile health apps and telemedicine), and community-based support systems, offer promising avenues for intervention. Addressing this issue requires integrated and scalable interventions tailored to local contexts. Future research should focus on longitudinal and interventional studies, particularly in resource-limited settings, to inform policies and practices.