Kim, Dong-Sik;Kim, Hyun-Sun;Cho, Young-Tae;Cho, Sung-Il
Journal of Preventive Medicine and Public Health
/
v.41
no.5
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pp.323-330
/
2008
Objectives : This study was conducted to examine the mediating function of body weight perception (BWP) on the relationship between body mass index (BMI) and unhealthy weight control behaviors (UWCB: e.g., fasting, or taking diet pills or laxatives) and between BMI and depressed mood, and to explore the effect of distorted BWP on UWCB and depressed mood among adult women. Methods : A regionally representative sample of 8,581 women aged 20-64 years residing in Seoul, the capital of Korea, completed the 2001 Seoul Citizens Health Indicator Survey which provides self-reported information about height, weight, BWP, UWCB, depressed mood, demo graphic/socioeconomic characteristics, and health-related behaviors. Data were analyzed using bivariate and multivariate logistic regression. Results : BMI was significantly associated both with UWCB and depressed mood, even controlling for all covariates. However, the magnitude and significance of each association was considerably attenuated when BWP was taken into account, indicating that BWP functioned, in part, as a mediator between BMI and UWCB and between BMI and depressed mood, respectively. Among the combinations of BMI and BWP, women who perceived themselves to be heavier than their actual BMls appeared more likely to use UWCB, whereas women who had a distorted BWP, either underestimation or overestimation as compared with their BMIs, tended to be at greater risk for depressed mood than those who had an undistorted BWP. Conclusions : These findings suggest that how women perceive their body weight may be an important predictor and/or mediator of UWCB and depressed mood among adult Korean women.
Metabolic syndrome is increasing nowadays and one of causes is obesity. Therefore prevention and treatment of obesity is very important to decrease of Metabolic syndrome. However currently many pharmacotherapy for obesity are popular in Korea and it may be dangerous. The aim of this study is to evaluate the purpose and relevance of obese treatment in two areas (capital & local) of Korea and suggest to guide for the right directions of pharmacotherapy in obesity treatment. We selected and surveyed 90 patients (88 females, 2 males, age of $23{\sim}60$) at random who received a prescription after consulting with a doctor at several clinics of Cheongju-area and Seoul-area, from May thru June, 2007. And we evaluated their prescriptions. In results, only 26.7% were obese (13.3%, 2325), most 73.3% patients were normal (65.6%, 18.5$m^2$). The purpose of treatment was for appearance (38.9%), health (41.1%) or both (18.9%, p<0.01). 94% patients had the past history of obese treatment. Prescriptions were consisted of CNS stimulant, anticonvulsants, antidepressant, laxatives, diuretics, or antianxietics. Obese treatment is very important for health to prevent disease such as Metabolic Syndrome. However it should not be abused. In conclusion, some patients of obese treatment is not relevant to obesity and pharmacist role is important to guide them for the right directions in obesity treatment.
Pediatric surgeons are familiar with the posterior sagittal approach to the rectum at sacrococcygeal area and well oriented with the anatomy because of the Penal procedure for imperforate anus. The author utilized the posterior vertical elliptical incisions in 12 cases of sacrococcygeal teratoma since 1987. For presacral tumor(type IV)$^2$, the incision was exactly same as the posterior sagittal procedure for imperforate anus. But the out-growing(type I) or dumbbell-shaped(type II & III) tumors, a vertical elliptical incision was required. For the laterally deviated tumors, a vertical and half-chevron incision was utilized in one case, but an unbalanced vertical elliptical incision was acceptable for the remaining two cases, with shrinkage of the overlying skin. In dumbbell-shaped tumors(type II & III), the narrow waist of the tumor was at the level of the levator muscle, which formed a muscle-belt on the tumor waist. A careful dissection to save the muscle-belt seemed to be the most important point during this procedure, utilizing the nerve-stimulator. After complete removal of the tumor and the coccyx, the levator muscles and the skin were closed in vertical fashion along the midline. For the caudally extending tumors in 3 cases, the muscle complex was divided in midline. Nothing by mouth and total parenteral nutrition was maintained for 1 week and then laxatives were given for 2 weeks in order to give the sphincters rest. Operative scars were acceptable resembling natural vertical midline folds, and the sphincter function was continent in all cases. In conclusion, vertical elliptical incision in sacrococcygeal teratoma is recommended because of the acceptable scar, functional restoration, and because it is a familiar procedure particularly for the pediatric surgeons who are accustomed performing posterior sagittal approach for imperforate anus.
Purpose: To evaluate the correlation between colon transit time (CTT) test value and initial maintenance dose of polyethylene glycol (PEG) 4000 or lactulose. Methods: Of 415 children with chronic functional constipation, 190 were enrolled based on exclusion criteria using the CTT test, defecation diary, and clinical chart. The CTT test was performed with prior disimpaction. The laxative dose for maintenance was determined on the basis of the defecation diary and clinical chart. The Shapiro-Wilk test and Pearson's and Spearman's correlations were used for statistical analysis. Results: The overall group median value and interquartile range of the CTT test was 43.8 (31.8) hours. The average PEG 4000 dose for maintenance in the overall group was $0.68{\pm}0.18g/kg/d$; according to age, the dose was $0.73{\pm}0.16g/kg/d$ (<8 years), $0.53{\pm}0.12g/kg/d$ (8 to <12 years), and $0.36{\pm}0.05g/kg/d$ (12 to 15 years). The dose of lactulose was $1.99{\pm}0.43mL/kg/d$ (<8 years) or $1.26{\pm}0.25mL/kg/d$ (8 to <12 years). There was no significant correlation between CTT test value and initial dose of laxative, irrespective of the subgroup (encopresis, abnormal CTT test subtype) for either laxative. Even in the largest group (overall, n=109, younger than 8 years and on PEG 4000), the correlation was weak (Pearson's correlation coefficient [R]=0.268, p=0.005). Within the abnormal transit group, subgroup (n=73, younger than 8 years and on PEG 4000) correlation was weak (R=0.267, p=0.022). Conclusion: CTT test value cannot predict the initial maintenance dose of PEG 4000 or lactulose with linear correlation.
Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.
The purpose of this study was to investigate the drug use of middle aged women. The subject consisted of 330 middle aged women who ranged in age from 40 to 60 years. They were selected in Seoul. Kyung-Ki province, Korea. Data were collected by using guestionnaires, from April, 10th to 30th 2001 and analyzed by the SPSS PC+ program using qui-square The results are summarized as follows : 1. The proportion of drinking and smoking experience was 42.4%, 3.7%. The motivation of drug use was advised family and relatives (46.1%), doctor's order(39.4%), magazine and advertisement(14.5%). Most of middle aged women get the information on knowledge of drug from hospital (47.3%), magazines and advertisement(30.3%), advised family and relatives(22.4%). And 57.9% of the middle aged women didn't know side effect of the using drug and 13.9% of the middle aged women have had experienced with side effect. And the level of attitude on drug abuse in middle aged women was 43%. Most of the subjects(93.9%) didn't use alternative drugs, and they used more than 3 kinds of drugs(47%). 2. They used digestives(44.2%), applying ointments (41.8%), drinks (39.4%), analgesics (39.1%), laxatives(8.8%), anti hypertension drugs (33%), and anti-anemic drugs(8.8%) in their orders.
Purpose : The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 4000 without electrolytes and lactulose, evaluating the efficacy and safety for the treatment of constipation in children. Methods : Fifty-six children with chronic functional constipation were randomly assigned to receive polyethylene glycol 4000 (24 patients) or lactulose (32 patients). Patients or their parents reported defecation frequency, stool consistency, abdominal pain, stool incontinence and side effects after 1, 3, 6 and 12 months of treatment. Percentage of recovered patients were compared with each group. Results : Defecation frequency, abdominal pain and stool incontinence were improved in each group. At 12 months of follow up, 60% of patients treated with polyethylene glycol and 57.7% of patients treated with lactulose were considered as recovered. Conclusion : In this study, both polyethylene glycol and lactulose were equally effective and safe in the long-term treatment of constipation in children. There were no significant differences in recovery rates between 2 groups.
The aim of this study was to investigate the dietary habits and the factors related to lifestyles in female college students with constipation. A survey was conducted using a self-administered questionnaires. Two hundred ninety one subjects participated in this study. All respondents were divided into three groups based on their frequency of stool evacuation: 129 subjects (44.3%) comprised the normal group, 109 (37.5%) the mild constipated group and 53 (18.2%) the severely constipated group. Abdominal pain and ailment during evacuation were higher and the feeling of relief after evacuation was lower in the normal group than in the two constipated groups. The greater the symptoms of constipation, the more laxatives were taken. The prevalence of constipation was lower in students who lived at home than in those who lived in other types of residences. The more pocket money the subject had, the more complaints they had about constipation symptoms. Forty three percent of the subjects ate meals regularly. The less frequently they ate meals and the greater the rate of skipping breakfasts and dining-out, the greater were their constipation symptoms. Rice and most of the food items in the vegetable food group were consumed less frequently in the two constipated groups than in the normal group. The severely constipated group ate food items in the fat group less frequently than the normal and mildly constipated groups. The beverage intake of the normal group tended to be lower than those of the two constipated groups; the constipated groups consumed fruits and vegetable juices less frequently and coffee and tea more frequently. The severely constipated group ate the least number of food items in the vegetable & fruit and fat food groups. Therefore, dietary habits and factors related to lifestyles should be changed through nutrition education programs aimed at improving the symptoms of constipation in young women.
BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.
Purpose: Few studies have reported non-acute long-term morbidity rates in children with intestinal malrotation. The aim of this study was to investigate the rate of constipation in children undergoing Ladd's procedure for isolated intestinal malrotation. Methods: This retrospective study included children aged <15 years who underwent Ladd's procedure for intestinal malrotation between 2001 and 2016. Demographics, presence of volvulus perioperatively, need for bowel resection, short term (<30 days) and long-term complications, including mortality were recorded. Constipation was defined as treatment with laxatives at 1-year follow-up. Results: Of the 43 children included in the study, 49% were boys. The median age at surgery was 28 days (0-5, 293 days). Volvulus occurred in 26 children (60.5%), and bowel resection was required in 4 children (9.3%). Short-term complications categorized as grades II-V according to the Clavien-Dindo classification occurred in 13 children (30.2%). Of these, 5 children (11.6%) required re-operation. Constipation was observed in 9 children (23.7%) at the 1-year follow-up. No difference was observed in the rate of perioperative volvulus between children with and without constipation (44% vs. 65%, p=0.45). Excluding re-operations performed within 30 days after surgery, 3 children (6%) underwent surgery for intestinal obstruction during the study period. Conclusion: Many children undergoing Ladd's procedure require bowel management even at long-term follow-up, probably secondary to constipation. It is important to thoroughly evaluate bowel function at the time of follow-up to verify or exclude constipation, and if treatment of constipation is unsuccessful, these children require evaluation for dysmotility disorders and/or intestinal neuronal dysplasia.
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