Korean Journal of Family Medicine最新文献

Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8-12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine's clinical guideline development process, this is South Korea's first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.

Background: To determine the association between type 2 diabetes mellitus and the consumption of various fruits.

Methods: The Korean Genome And Epidemiology Study is an ongoing prospective longitudinal cohort study of community dwellers and participants (men and women, aged 40-69 years) recruited from the national health examinee registry of Korea. Their individual consumption habits for 12 different fruit types were recorded using food frequency questionnaires. The fruits were then divided into three groups according to their glycemic indexes and glycemic loads. Participants with extreme caloric intakes, pre-existing type 2 diabetes mellitus, chronic kidney diseases, chronic liver diseases, and ongoing cancer treatments were excluded. The incidence of type 2 diabetes in the cohort was identified through self-reporting and supplemented by glycated hemoglobin and fasting blood glucose levels.

Results: A total of 2,549 cases of type 2 diabetes were documented during 283,033.8 person-years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors for diabetes, the pooled hazard ratio of type 2 diabetes for every serving per week of total whole fruit consumption was 1.02 (95% confidence interval [CI], 0.99-1.06; P=0.2). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every serving per week were 0.94 (95% CI, 0.88-1.00; P=0.039) for bananas, and 0.90 (95% CI, 0.84-0.96; P<0.001) for grapes.

Conclusion: Our findings suggest associations between the consumption of certain fruits and the risk of developing type 2 diabetes. A greater consumption of grapes was significantly associated with a lower risk of type 2 diabetes in our cohort, but the total amount of fruit consumption was not associated with a reduced risk.

Background: Alternative and complementary medicines are widely used to treat migraine headaches. This review aimed to determine the effectiveness of essential oils as an alternative treatment approach.

Methods: A structured search was conducted to identify randomized trials comparing essential oils with a placebo for migraine headaches, using databases (MEDLINE and CENTRAL) to search for articles published between 1966 and 2021. We included trials involving adult males and females diagnosed with migraine headaches according to the International Headache Society. The outcomes included number of attacks, headache severity, associated symptoms, number of days of limited activity, headache duration, use of analgesics, and adverse effects. Seven trials were included with a total of 558 participants.

Results: No difference was observed in the number of migraine headache attacks compared to placebo (mean difference [MD], -1.34; 95% confidence interval [CI], -3.31 to 0.64; I2=94%; P=0.190; four trials, 242 participants; moderate- quality evidence). There was no difference in this outcome between the essential oils treated group and the placebo (MD, -0.38; 95% CI, -1.76 to 0.99; I2 statistics=86%; P=0.580; five trials, 240 participants; moderate-quality evidence).

Conclusion: We found no significant difference between the use of essential oils and placebo in managing migraine headaches.

Manifestations of gender-based violence although many, and sometimes more pronounced in areas of armed conflict, go unnoticed due to multiple factors. Gender-based violence targeted towards women, affect their overall health negatively, particularly the reproductive well-being. Major conflicts arising in the Middle East over the past 10-15 years, ranging from the Arab uprising to the Syrian civil war, have drawn attention world-wide. This study aims to shed light on the importance of recognizing violence against women, its effect on their reproductive health, and the policies that should be implemented to limit its adverse impact. Towards this end, we have highlighted the important role played by all healthcare professionals, epidemiologists, and surveyors working in peace and war areas to recognize such atrocities towards women.

The simultaneous development of diabetic ketoacidosis (DKA) and thyroid storm (TS) is a rare but potentially lifethreatening condition that requires immediate and targeted treatment. However, their combined diagnosis poses a serious challenge because of the similarities between their clinical manifestations. To date, only a few dozen cases have been described; most of which have been linked to the progression of thyrotoxicosis or uncontrolled hyperglycemia as contributing factors. We present the case of a 37-year-old woman with type 1 diabetes mellitus and Graves' disease who presented with both TS and DKA. She was initially admitted to the emergency department as a suspected case of stroke. Severe hypoglycemia significantly lowered her alertness to TS and probably provoked a sharp hyperthyroid decompensation, thereby leading to subsequent DKA development.

Background: Appropriate nutrition is necessary for maintaining good health in the general population. During primary physician training, it is important to educate residents on the basic concepts of nutrition and methods to manage nutritional aspects according to various disease. However, little is known about the perception of nutritional education among Korean family medicine residents. This study analyzed the recognition of the importance of nutritional education, the amount received, and satisfaction with it as well as self-perceived competency in various nutrition topics among residents.

Methods: Web-based questionnaires were sent via mobile messages to all the residents registered with the Korean Academy of Family Medicine (KAFM). Out of 566 residents, 68 voluntarily participated in the study. The questionnaire consisted of 41 items related to perceptions of nutrition education, self-perceived competency in nutrition topics, and demographic characteristics.

Results: The response rate was 12.01%. Residents rated their satisfaction with nutrition education at 4.78 out of 10, and 83.3% considered it important. However, only 13.24% of the participants felt that it was adequate. The most common training method for nutrition education was lectures at KAFM conferences. Among the 29 nutritional topics, the residents reported highest confidence in subjects related to chronic diseases such as obesity (77.94%), diabetes (75%), cardiovascular disease (67.65%), gastrointestinal disorders (67.65%), and weight loss management (67.65%). Conversely, topics related to women (36.76%), children and adolescents (38.23%), drug-nutrient interactions (39.7%), eating disorders (42.64%), and food labels (42.64%) showed low self-perceived confidence rates.

Conclusion: Korean family medicine residents value nutrition education but believe that more education is necessary and they demonstrate differences in self-perceived competency in various nutrition topics.

Background: Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report recommends making sexual and reproductive health and rights of women living with HIV a priority. This article explores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia's women living with HIV (WLHIV).

Methods: A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) "What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?" (2) "What are your experiences in accessing contraception?" (3) "What are your day-to-day experiences as a woman living with HIV?" Data were analyzed using thematic analysis.

Results: Four themes emerged from the study findings: "lack of negotiation," "idealism in pregnancy," "coping with restrictions," and "past and future fears." The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.

Conclusion: The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers' focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malaysia, which include establishing a reproductive health counseling program.