No abstract available.
Iron*

BACKGROUND: The purpose of this study was to find out whether primary physicians know the new guidelines (JNC VII) of target BP (blood pressure) and whether they educate their patients properly or not. METHODS: We made calls to local clinicians (family medicine (FM), internal medicine (IM), oriental medicine (OM)) under the disguise of the patient's caretaker and asked them the target BP for patients with hypertension without any cardiovascular disease and those with hypertension and DM (diabetes mellitus). We categorized the participants according to sex, age and departments. RESULTS: Out of the 145 clinics, 88 clinics responded (28 clinicians of FM, 30 clinicians of IM, 30 clinicians of OM). Questions on systolic target BP for patients with hypertension without cardiovascular disease, 87 clinicians answered. Among them, 64 clinicians (73.6%) answered correctly to the target BP (< or =140 mmHg), in the order of FM, IM, and OM. Questions on the diastolic pressure (< or =90 mmHg), 78 clinicians answered and all of them answered correctly. On the question of the target BP for the patients and hypertension and DM, 55 clinicians (63.2%) answered correctly to the systolic target BP (< or =130 mmHg) in the order of IM, FM, and OM. Only 19 clinicians (32.4%) answered correctly to the diastolic target BP (< or =90 mmHg) in the order of FM, IM, and OM. CONCLUSION: The clinicians have given less correct answers on the target BP in the patients and hypertension and DM than those with only essential hypertension. In conclusion, local clinicians should be fully aware of the target BP in patients with hypertension associated with cardiovascular disease or other complications. Also they should educate their patients properly.
Blood Pressure* ; Cardiovascular Diseases ; Humans ; Hypertension ; Internal Medicine ; Medicine, East Asian Traditional

BACKGROUND: Throughout the past 20 years in the Korean academy of family medicine seasonal conference, on-going study is done to promote overall development and satisfaction of the conference participants and to overlook the trend of the conference subject, the number of classes, the number of participants, etc. METHODS: About 2,132 topics during the conference from the year 1992 to 2007 collected from the Korean academy of family medicine website were categorized by subject based on the standard of the contents of the latest textbook. There were a total of 7 main classifications including 5 categories like 'principles of family medicine', 'disease prevention and health promotion', 'symptoms', 'clinical procedures', 'diseases' and adding 2 categories such as each committee's classes and other subjects. The scope of the changes of the main and sub-titles were categorized as in the 1990s and 21 century. RESULTS: The number of attendees has increased during the past 20 years, especially the residents were the main portion of the participants. On the proportion of the clinical topics, there was a remarkable increase of geriatric medicine, palliative medicine, obesity, exercise, nutrition, gastroscopy, and colonoscopy procedure in the later half rather than the former half period. In the field of the main category, the core principle subjects of family medicine seemed to be decreased in contrast to disease category. CONCLUSION: During the last 20 years, the titles of family medicine conference are changing with the trend of practice. The core knowledge of family medicine should be maintained and balanced for the future of family medicine conference.
Colonoscopy ; Gastroscopy ; Humans ; Obesity ; Palliative Care ; Seasons

Hypereosinophilic syndrome is a rare disease characterized by marked peripheral eosinophilia and eosinophilic infiltration of many organs such as heart, lung, central nervous system, liver and spleen. This disease is defined by following criteria. First, sustained blood eosinophilia is greater than 1,500/mm3 longer than 6 months. Second, other apparent etiologies for eosinophilia must be absent, including parasitic infestation and allergic disease. Third, patients must have signs and symptoms of organ involvement. In Korea, some cases that eosinophil infiltrated lung, liver, gastrointestinal tract or skin were reported. In this report, we found a case showing myalgia, fatigue and eosinophilia in periodic health examination, and diagnosed hypereosinophilic syndrome.
Central Nervous System ; Eosinophilia ; Eosinophils ; Fatigue ; Gastrointestinal Tract ; Heart ; Humans ; Hypereosinophilic Syndrome* ; Korea ; Liver ; Lung ; Myalgia ; Preventive Health Services ; Rare Diseases ; Skin ; Spleen

BACKGROUND: The purpose of this study was to assess the quality of primary care by patient-completed questionnaire, and to investigate whether the results of the assessment were different among the specialties of doctors (especially family medicine) and according to the existence of a family doctor. METHODS: The questionnaire, which covers 7 components of primary care (accessibility, continuity, accountability, comprehensiveness, integration, sustained partnership with patients, whole person orientation), was administered to the applicants of health screening center of a university hospital, and factory workers in Cheonan, and residents living in Seoul. Statistic analysis was performed through the collected samples. RESULTS: Total of 574 subjects were analyzed. The mean score (%) of each component of the total sample was as follows; accessibility 45.8, continuity 47.8, comprehensiveness 22.5, accountability 55.5, integration 41.8, sustained partnership with patients 48.9, and whole person orientation 31.8. The mean score (%) of all components were 42.0. Doctors were classified into internists, general surgeons, family physicians, general physicians, and others. Family physicians had the best score in accessibility (P=0.01). The mean score of all components of family physicians was better than that of internists and the other specialties (P<0.05). The respondents who had a family doctor was 129 (22.5%). The mean score of each component was higher than those without a family doctor (P<0.05). CONCLUSION: Family physicians are providing high quality primary care compared to internists and other specialists. Patients who have a family doctor are provided with higher quality primary care than those who do not. Especially, comprehensiveness and whole person orientation need to be improved.
Chungcheongnam-do ; Surveys and Questionnaires ; Humans ; Mass Screening ; Physicians, Family ; Primary Health Care* ; Seoul ; Social Responsibility ; Specialization

BACKGROUND: Hemoglobin A1c (HbA1c) was adopted as a new standard criterion for diagnosing diabetes. We investigated the diagnostic utility of HbA1c by comparing the 2003 American Diabetes Association (ADA) diagnostic criteria of diabetes with HbA1c of 6.5%. Furthermore, the cut-off value for HbA1c was investigated using receiver operating characteristic curves. METHODS: This study included 224 subjects without a history of diabetes that had a fasting plasma glucose level of above 100 mg/dL. The subjects had undergone a 75 g oral glucose tolerance test, and diabetes was defined as according to 2003 ADA criteria. RESULTS: The prevalence of newly diagnosed diabetes was 58.2% by the 2003 ADA criteria, and 47.8% by HbA1c of 6.5%, which underestimated the prevalence of diabetes. Compared with the 2003 ADA criteria, the sensitivity and specificity of HbA1c of 6.5% were 73.5% and 89.1%, respectively. The kappa index of agreement between 2003 ADA and HbA1c criteria was 0.60. The cut-off point of HbA1c for diagnosing diabetes was 6.45% (sensitivity, 73.3%; specificity, 88.2%; area under the curve, 0.85). HbA1c was significantly associated with fasting glucose (r = 0.82, P < 0.01), postprandial glucose (r = 0.78, P < 0.01), and homeostasis model assessment of insulin resistance (r = 0.16, P < 0.05). CONCLUSION: For high risk patients whose fasting glucose was more than 100 mg/dL, HbA1c criterion underestimated the prevalence of newly diagnosed diabetes compared to the 2003 ADA criteria, and showed moderate agreement. The cut-off value for HbA1c was 6.45%, which was similar to the recommended diagnostic criterion of HbA1c by the 2009 ADA.
Fasting ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated ; Hemoglobins ; Homeostasis ; Humans ; Insulin Resistance ; Plasma ; Prevalence ; ROC Curve ; Sensitivity and Specificity

BACKGROUND: The primary concern of a family physician is the healthcare of patients and their families, with the patient's disease itself being secondary. Family physicians should make efforts to discuss personal issues with their patients. This study examined how many patients were counseled about their private problems, especially family or sexual issues in the private clinics of Cheonan. METHODS: The subjects were the patients who visited a practice-based network from April to June in 2003. The data were collected through simple questionnaire about sociodemographic features of patients and their family and sexual problems. RESULTS: Eighty eight patients were studied for a total of 107 cases that consisted of 67 cases of family problems (62%) and 40 cases of sexual matters (38%). The common issues about family problems were `the partners' (23 cases, 21%) and `the patients` children' (29 cases, 27 %). The most frequent sexual problems were 'sexually transmitted diseases' (13 cases, 32.5%), `impotence' (7 cases, 17.5%), 'loss of libido, and unsatisfaction' (6 cases, 15.0%). Most physicians were involved in family and sexual issues with medications, and simple counseling with reassurance. Simple counseling was given for 14 cases (21.0%) for family issues and 18 cases (44.0%) for sexual issues. The patients were treated with medications in 47 cases (70.0%) for sexual and 15 cases (38.0%) for family problems. CONCLUSION: The most common issue for family problems was their partners and for sexual problems was 'sexually transmitted diseases'. Most family physicians were involved with both simple counseling and medications.
Chungcheongnam-do ; Counseling ; Delivery of Health Care ; Family Relations ; Humans ; Libido ; Physicians, Family* ; Sexual Partners