Background Knee osteoarthritis is highly prevalent, especially among the elderly. However, its risk factors have not been well identified, especially in the Korean population. This study aimed to assess the epidemiologic characteristics and risk factors of knee osteoarthritis in the Korean population.
Methods Data of 2,280 (1,295 women) participants of the 2013 Korea National Health and Nutrition Examination Survey aged ≥50 years who underwent knee radiography were analyzed. According to the American College of Rheumatology clinical/radiographic classification criteria, knee osteoarthritis was defined as knee pain and radiographic knee osteoarthritis. The association between risk factors and knee osteoarthritis was analyzed using the chi-square test and binominal logistic regression.
Results The participants had an average age of 62.6 years; 56.8% of them were women. The average body mass index was 24.2 kg/m2 , and 296 (13%) participants were diagnosed with knee osteoarthritis. After adjustment for multiple risk factors, age of ≥65 years (adjusted odds ratio [OR], 2.552; 95% confidence interval [CI], 1.868–3.486), female sex (OR, 2.050; 95% CI, 1.275–3.295), obesity (body mass index, ≥25.0 kg/m2 ; OR, 1.563; 95% CI, 1.191–2.051), hypertension (OR, 1.394; 95% CI, 1.052–1.846), low educational level (lower than or equal to elementary school: OR, 4.761; 95% CI, 2.131–10.635; middle school: OR, 3.184; 95% CI, 1.375–7.369), and low strength exercise frequency (<2 times/wk; OR, 1.829; 95% CI, 1.202–2.784) increased the risk of knee osteoarthritis.
Conclusion Old age, sex, obesity, hypertension, low educational level, and low strength exercise frequency were found to be risk factors for knee osteoarthritis.
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Background C-reactive protein (CRP) is a nonspecific, but sensitive marker of systemic immune response. Many studies have suggested that CRP levels are associated with obesity and cardiovascular risk factors not only in adults, but also in children. We assessed the inter-relationships between CRP, obesity, and cardiovascular risk factors in Korean children aged 7 years old. Methods: A total of 126 children (40 overweight and 86 normal weight children) were recruited from seven elementary schools in Seoul and Gyeonggi-do. Physical examinations including various obesity parameters were done. Fasting and post-prandial venous blood was withdrawn for the chemistry. The hsCRP was measured by the Nephelometry. Results: The hsCRP was associated with body weight, body fat (%), body mass index (BMI), waist circumferences, hip circumferences and waist/hip ratio (P＜0.05). From the lowest to the highest quartile groups of hsCRP, mean fasting insulin levels (2.7⁑3.1μIU/mL, 2.6⁑2.1μIU/mL, 3.4⁑3.7μIU/mL, and 4.2⁑3.6μIU/mL, respectively)(P＜0.05) and HOMA-IR levels (0.60⁑0.70, 0.59⁑0.49, 0.74⁑0.84, and 0.95⁑0.83, respectively)(P＜0.05) increased. Serum lipid profiles were not associated with the hsCRP levels. Conclusion: In children aged 7 years old, the hsCRP was significantly associated with obesity and cardiovascular risk factors. (J Korean Acad Fam Med 2007;28:509-514)
Background Recently, the prevalence of childhood obesity has increased dramatically, but the cause still remains incompletely understood. The goal of this study was to present a direction for treatment and prevention of childhood obesity on the basis of the data of physical activity energy expenditure, inactive time and dietary habits of Korean children. Methods: A total of 56 children were selected from 8 elementary schools in Seoul and Gwacheon-city. Children's physical activity pattern and dietary habits were obtained by questionnaire. The children wore accelerometer on their wrists from Friday to Tuesday over the whole weekend. Then, we calculated the activity energy expenditure using the activity counts recorded on the accelerometer. Results: Neither the physical activity energy expenditure (kcal/kg) nor the activity pattern showed a significant difference between the normal weight group and the overweight group. The overweight children spent more time watching TV and using the computer. The overweight group did not have breakfast and ate much more and faster in terms of dietary habit. Conclusion: This study suggests that bad habituations in diet and increase of inactivity time can play more important role than physical activity in causing overweight in 7-year-old children. (J Korean Acad Fam Med 2007;28: 195-203)
Background : It has been known that the prevalence of depression is increasing and depressive mood is accompanied with various physical symptoms in the elderly. In this research, we studied various physical symptoms of the elderly patients and how many of those symptoms were associated to depressive mood. We also investigated how much their doctors were concerned about depressive symptoms of the patients.
Methods : The subjects were 135 patients over 60 years old, who visited geriatric center and department of family medicine in a university hospital from December 2002 to May 2003. Individual interviews were conducted among the subjects and all symptoms who suffered from within a month from the time of interview, depression score, stress score, functional status and their sociodemographic factors were assessed. Finally, doctor's diagnosis or comments on depressive mood were assessed based on the medical documents of the elderly patients with depression.
Results : 56% of the subjects had depressive mood. Common symptoms of subjects were memory impairment, visual disturbance, fatigue, arthralgia, and thirsty sense. The more depressive mood the elderly have, the more physical symptoms they have. The physician paid their attention to depressive mood in 13% of the cases among the elderly with depressive mood. Depressive mood was affected by whom they lived together with, regular exercise and stress.
Conclusion : This study shows that most of the elderly patients had depressive mood and their common symptoms were associated to depressive mood. The stress and living together with their children were risk factors for depression of the elderly. However, depressive mood was less found among those patients who had spouse and who exercised regularly. Though physicians more likely recognize the depressive mood of the elderly as depression was severer, still little attention was paid to depressive mood in the elderly.
Background : Most recently, there is an increased use of EGD (esophagogastroduodenoscopy) for primary care among family physicians, which tends to promote EGD training programs in the course of Family Practice Residency. This study determined to survey current status of EGD training programs among residents in family medicine, identify relevant problems, and present some suggestions for their improvement.
Methods : The subjects were residents selected among family medicine training hospitals, which were registered in the KAFM (Korean Academy of Family Medicine). The residents were in their 3rd year of training or had already completed the EGD training program. Surveys were sent out to those hospitals by mail and electronic mail surveys were performed by researchers.
Results : Among 66 subject hospitals a total of 27 surveys (40.9%) were returned. Most EGD training were performed in the department of internal medicine. The mean duration of training period was 8 weeks. The averale number of hands on experience of the procedure was 62. It was found that most residents thought that EGD training period and the number of hands on experience of the procedure were insufficient. The longer period of actual experience of the procedure and the more number of EGD caseloads they had, the more they were satisfied with their EGD training programs. It was also found that there was a high demand for a follow-up learning opportunities for EGD (p＜.05), because the residents who had already had many EGD caseloads further wanted to receive continuous education even, after they acquired license. There were no relationships observation period, period of actual experience of the procedure, and number of EGD caseloads during residency with demand for follow-up learning opportunities.
Conclusion : In summary, there was insufficient EGD training period and actual experience of the EGD procedure in family practice residency. There was low satisfaction of EGD training programs and high demand for continuous education. Therefore, it is recommended to establish EGD training program, proper practice training, and regular continuing education after completing residency.
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