Korean Journal of Family Medicine最新文献

{"title":"Causal effects of type 2 diabetes, obesity, gout, and hypothyroidism on carpal tunnel syndrome: a univariable and multivariable Mendelian randomization study.","authors":"Heng Tian, Ling Hong, Wenlai Guo, Quanzhe Liu","doi":"10.4082/kjfm.25.0263","DOIUrl":"https://doi.org/10.4082/kjfm.25.0263","url":null,"abstract":"<p><strong>Background: </strong>Carpal tunnel syndrome (CTS) is a prevalent peripheral neuropathy with unclear pathogenesis. This study investigated the causal relationships between metabolic diseases and CTS using univariable and multivariable Mendelian randomization (MR) analyses.</p><p><strong>Methods: </strong>Single nucleotide polymorphisms from large genetic databases served as instrumental variables. Genome-wide data on type 2 diabetes (T2D), obesity, gout, hypothyroidism, and CTS were obtained from the IEU OpenGWAS Project (Integrative Epidemiology Unit Open Genome-Wide Association Studies Project). Univariable MR analysis assessed individual causal effects, and multivariable MR evaluated combined effects. Sensitivity analyses examined heterogeneity and pleiotropy.</p><p><strong>Results: </strong>The univariable MR analysis identified significant associations of CTS with obesity (odds ratio [OR], 1.0135; 95% confidence interval [CI], 1.0118-1.0151; P<0.001), T2D (OR, 1.0028; 95% CI, 1.0011-1.0045; P=0.0011), gout (OR, 1.0559; 95% CI, 1.0152-1.0982; P=0.0067), and hypothyroidism (OR, 1.0517; 95% CI, 1.013-1.0919; P=0.0084). The multivariable MR analysis confirmed obesity (OR, 1.0129; 95% CI, 1.0088-1.0171; P<0.001) and T2D (OR, 1.002; 95% CI, 1.0006-1.0033; P=0.0042) as significant independent risk factors. Gout and hypothyroidism lost significance after adjustment. No notable pleiotropy was observed.</p><p><strong>Conclusion: </strong>Obesity and T2D independently increase CTS risk, whereas the univariable associations for gout and hypothyroidism were attenuated after adjustment for other metabolic conditions, suggesting mediation by or confounding with obesity and glucose metabolism in this dataset.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dermatology rotation on the diagnostic accuracy of family medicine residents for skin lesions: a cross-sectional study in Türkiye.","authors":"Serap Dogan, Ülker Gül, Cenk Aypak","doi":"10.4082/kjfm.25.0073","DOIUrl":"https://doi.org/10.4082/kjfm.25.0073","url":null,"abstract":"<p><strong>Background: </strong>Although family physicians frequently encounter dermatological conditions, the effect of dermatology rotations on their diagnostic competency remains underexplored. We aimed to determine the effect of a mandatory 1-month dermatology rotation on the diagnostic accuracy of family medicine (FM) residents for skin lesions.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among FM residents from September 1 to December 1, 2023. We assessed participants' ability to identify 54 dermatological lesions using a structured, face-to-face questionnaire. A multivariable linear regression model was used to identify independent predictors of diagnostic knowledge scores.</p><p><strong>Results: </strong>A total of 260 residents participated; 121 (46.5%) had completed the dermatology rotation, whereas 139 (53.5%) had not. Mean diagnostic knowledge scores were significantly higher among residents who completed the rotation (79.17±8.69 vs. 73.06±8.94; P<0.001). In the multivariable model, completing the dermatology rotation was the only independent predictor of higher diagnostic scores (P<0.001).</p><p><strong>Conclusion: </strong>Completing a dermatology rotation improves the diagnostic accuracy of FM residents for skin lesions, underscoring the value of structured dermatological training within FM curricula.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulatory policies for online alcohol access control: a comparative scoping review of international approaches.","authors":"Wiwat Sungkhabut, Kaitsuda Saiprom, Chalermporn Devahastin Na Ayudhya, Saowanee Viboonsanti, Pasitpon Vatcharavongvan","doi":"10.4082/kjfm.25.0122","DOIUrl":"https://doi.org/10.4082/kjfm.25.0122","url":null,"abstract":"<p><p>The rapid growth of online alcohol sales, delivery services, and digital marketing has increased alcohol availability and heightened public health concerns, particularly among adolescents. However, regulatory responses remain inconsistent and vary significantly across regions. This scoping review synthesizes global regulatory approaches to online alcohol access, encompassing both established Western models and emerging Asian frameworks, and identifies key cross-national patterns and policy gaps. This scoping review followed PRISMA-ScR (preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews) and Joanna Briggs Institute guidance. Searches of four electronic databases were complemented by a supplementary gray literature search targeting specific Asian jurisdictions to minimize geographic bias. The identified sources included policies and peer-reviewed studies on online alcohol sales, delivery practices, age-verification procedures, and digital marketing regulations. Data were systematically organized by regulatory domain and analyzed using a comparative socio-political framework (liberalism vs. paternalism) to interpret cross-national differences. The analysis of 34 documents across five regulatory domains revealed a distinct global divide. Western nations predominantly rely on co-regulatory models that frequently suffer from significant enforcement gaps, whereas Asian jurisdictions employ strict structural barriers. These include mandatory digital real-name authentication, \"Smart Order\" systems, and joint platform liability, designed to effectively restrict underage access where Western self-regulation has historically failed. To address global enforcement gaps, future policies must evolve from \"soft\" co-regulation to \"hard\" technical mandates. Integrating Asian-style digital identity systems with strict platform liability offers a viable pathway to effectively restrict underage access and reduce alcohol-related harm.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum vitamin D level is inversely associated with non-high-density lipoprotein/high-density lipoprotein ratio: a cross-sectional study utilizing Korea National Health and Nutrition Examination Survey 2022-2023 data.","authors":"Yoojung Choi, Hyang Rae Lee, Da Eun Choung, Nam-Seok Joo","doi":"10.4082/kjfm.25.0267","DOIUrl":"https://doi.org/10.4082/kjfm.25.0267","url":null,"abstract":"<p><strong>Background: </strong>Recent evidence has underscored the crucial metabolic role of vitamin D. An increased non-high-density lipoprotein (non-HDL)/HDL ratio has been identified as a meaningful marker of metabolic risk. This study aimed to examine the relationship between serum 25-hydroxyvitamin D (25(OH)D) concentration and non-HDL/HDL ratio in a cohort of Korean adults.</p><p><strong>Methods: </strong>For analysis, 10,864 participants aged 19 years or older were selected from the 2022-2023 Korea National Health and Nutrition Examination Survey (KNHANES). Serum 25(OH)D concentrations were classified into three groups: deficient (<20 ng/mL), insufficient (20-30 ng/mL), and sufficient (≥30 ng/mL). Non-HDL/HDL ratio was derived from total cholesterol and HDL cholesterol values. One-way analysis of variance and separate multiple regression analyses were conducted to assess differences in metabolic parameters between the 25(OH)D groups in both the general and diabetes subgroups (glycated hemoglobin ≥6.5%).</p><p><strong>Results: </strong>Triglycerides, low-density lipoprotein cholesterol, and non-HDL/HDL ratio values were significantly lower in the group with sufficient vitamin D levels. Serum 25(OH)D and non-HDL/HDL ratio showed an inverse correlation in both general (r=-0.09) and diabetes (r=-0.15) subgroups. Across all regression models, a statistically significant inverse association persisted even after comprehensive adjustments for potential confounders.</p><p><strong>Conclusion: </strong>A significant inverse correlation exists between serum 25(OH)D concentration and non-HDL/HDL ratio in Korean adults, with a more pronounced effect observed in individuals with diabetes.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between substance use disorder and risky behavior among students in Indonesia: a cross-sectional study.","authors":"Rachmalina Soerachman, Irfan Ardani, Oktarina Oktarina, Dwi Hapsari Tjandrarini, Setia Pranata, Tin Afifah, Betty Roosihermiatie, Diah Yunitawati, Anissa Rizkianti, Yurika Fauzia Wardhani","doi":"10.4082/kjfm.25.0237","DOIUrl":"https://doi.org/10.4082/kjfm.25.0237","url":null,"abstract":"<p><strong>Background: </strong>Substance use is prohibited in Indonesia; however, adolescents continue to consume these substances, creating a significant public health challenge. This study examines behavioral and demographic factors associated with general drug use, including cannabis and amphetamine use, among Indonesian adolescents, using nationally representative data.</p><p><strong>Methods: </strong>A cross-sectional study used data from the 2023 Indonesia Global School-based Student Health Survey, which included 10,059 students aged 13 to 17 years. A two-stage cluster sampling was applied, and descriptive and regression analyses were conducted to identify factors associated with substance use.</p><p><strong>Results: </strong>Overall, 3.03% of students reported drug use, 1.45% reported cannabis use, and 1.33% reported amphetamine use. Age and school level were not significantly associated with substance use. However, male sex, residence outside the Java-Bali region, alcohol use, and tobacco use were consistently linked to higher odds of drug, cannabis, and amphetamine use. Alcohol consumption was the strongest predictor for all types of substance use. These findings indicate that risky behaviors tend to cluster, supporting the pattern of polysubstance use among youth.</p><p><strong>Conclusion: </strong>The study findings highlight the need for risk-specific, gender-responsive, school-based prevention programs that actively involve parents and regulate adolescents' access to alcohol and tobacco. Enhancing life skills and character education in both school and family settings may also help students avoid risky behaviors.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cutoff value of serum triglyceride/high-density lipoprotein cholesterol ratio of high pericardial adipose tissue in Korean: a retrospective study.","authors":"Da Eun Choung, Beom Hee Choi, Jisoon Im, Yoojung Choi, Nam Seok Joo","doi":"10.4082/kjfm.25.0236","DOIUrl":"https://doi.org/10.4082/kjfm.25.0236","url":null,"abstract":"<p><strong>Background: </strong>Recently, the triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio and pericardial adipose tissue (PAT) have emerged as important indicators of metabolic syndrome (MS). We aimed to evaluate the relationship between the TG/HDL ratio and PAT.</p><p><strong>Methods: </strong>We retrospectively analyzed the data of 627 patients who underwent coronary multidetector computed tomography to assess metabolic parameters. Subjects were stratified into two groups based on the PAT volume cutoff associated with MS, specifically 142.2 cm3, and metabolic parameters were compared between these groups. The TG/HDL ratio was divided into tertiles according to the logarithm of TG/HDL, and differences in PAT-related parameters among the tertiles were assessed using analysis of variance. Logistic regression was performed to estimate the odds ratios (ORs) for high PAT (≥142.2 cm3) across tertiles and receiver operating characteristic (ROC) analysis was performed to determine the optimal TG/HDL ratio cutoff for linking with high PAT.</p><p><strong>Results: </strong>The mean TG/HDL ratio in the high PAT group was 3.6. The TG/HDL ratio demonstrated a strong positive correlation with several metabolic parameters. Individuals in the higher log (TG/HDL) tertiles exhibited a greater prevalence of metabolic disturbances, including increased PAT, and displayed higher ORs for high PAT (second tertile OR, 3.51; third tertile OR, 3.26) after adjusting for age, sex, smoking, hypertension, type 2 diabetes, and dyslipidemia status. ROC analysis identified a TG/HDL ratio of 1.918 (P<0.001) as the threshold for elevated PAT levels.</p><p><strong>Conclusion: </strong>The TG/HDL ratio was positively correlated with high PAT volume, and the TG/HDL ratio cutoff for association with high PAT was determined to be 1.918.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic determinants and comorbidities associated with polypharmacy among the adult population in Korea: a nationwide claim analysis.","authors":"Woo-Young Shin, Tae-Hwa Go, Jung-Ha Kim","doi":"10.4082/kjfm.24.0328","DOIUrl":"10.4082/kjfm.24.0328","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy poses a growing challenge to healthcare systems because of its association with adverse effects and the misuse of medication. This study aimed to identify the sociodemographic factors and comorbidities associated with polypharmacy.</p><p><strong>Methods: </strong>We selected patients aged ≥30 years registered in the National Health Information Database in 2018 who were prescribed at least one medication for ≥180 days. Multivariate logistic regression analyses were performed to evaluate the associations between polypharmacy, sociodemographic characteristics, and comorbidities.</p><p><strong>Results: </strong>Polypharmacy was significantly associated with increasing age, with the strongest association observed in adults aged ≥65 years. Compared with medical aid recipients, higher-income groups had a weaker association with polypharmacy. After adjusting for covariates, significant associations with polypharmacy were found for specific comorbidities, such as Parkinson disease (odds ratio [OR], 3.804; 95% confidence interval [CI], 3.733-3.876; P<0.001) and chronic ischemic heart disease (OR, 3.199; 95% CI, 3.178-3.221; P<0.001).</p><p><strong>Conclusion: </strong>These findings may help reduce the burden of polypharmacy by facilitating the development of targeted strategies tailored to patients.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"171-177"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145390744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sarcopenia considerations when prescribing glucagon-like peptide-1 agonists to older adults.","authors":"Azwan Aziz Mohamad","doi":"10.4082/kjfm.25.0397","DOIUrl":"10.4082/kjfm.25.0397","url":null,"abstract":"","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"184-186"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146064244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hallucination in artificial-intelligence-assisted diagnosis of arthritis: a case report.","authors":"DaeHyun Kim","doi":"10.4082/kjfm.25.0147","DOIUrl":"10.4082/kjfm.25.0147","url":null,"abstract":"<p><p>Artificial intelligence (AI) technologies are increasingly being integrated into clinical practice, offering potential enhancements in diagnostic accuracy and clinical efficiency. In this case report, a diagnostic attempt assisted by ChatGPT-4o in a 51-year-old female patient presenting with hand arthralgia is described. The AI-generated interpretation demonstrated hallucination-namely, the fabrication of unsupported or inaccurate information-in the analysis of radiologic and laboratory findings, as well as in treatment recommendations. This case underscores the importance of exercising caution when applying AI tools in clinical contexts. To ensure diagnostic accuracy, patient safety, and ethical responsibility, expert oversight and multi-step verification processes are essential in the deployment of AI-generated clinical outputs.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"178-181"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the drivers associated with maternal delivery choices: comparative study between urban and rural women in Indonesia.","authors":"Tety Rachmawati, Stefanus Supriyanto, Debri Rizki Faisal, Ingan Ukur Tarigan, Endang Indriasih, Rukmini Rukmini, Novia Susianti, Gurendro Putro, Iin Nurlinawati, Tin Afifah, Selma Siahaan, Halimatus Sakdiah Minhat","doi":"10.4082/kjfm.24.0145","DOIUrl":"10.4082/kjfm.24.0145","url":null,"abstract":"<p><strong>Background: </strong>Indonesia faces significant maternal and child health challenges, including a high maternal mortality ratio. The country's vast geography results in disparities in healthcare facility availability. This study aimed to identify factors influencing maternal delivery choices in health facilities across Indonesia's rural and urban areas.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the 2017 Indonesia Demographic Health Survey. The study population included women aged 15-49 who had given birth within 5 years preceding the survey. A total of 14,162 women were included, with 6,339 from urban and 5,009 from rural areas. Logistic regression was performed to identify factors associated with maternal delivery locations.</p><p><strong>Results: </strong>The findings showed that 91.37% of urban and 69.33% of rural mothers delivered in healthcare facilities. All analyzed variables were significantly correlated with maternal delivery in health facilities across both areas. In rural areas, the sex of the household head (adjusted odds ratio [AOR], 1.32; 95% confidence interval [CI], 1.02-1.71; P=0.031) and the absence of barriers to healthcare access (AOR, 1.31; 95% CI, 1.07-1.60; P=0.008) were significant factors. Conversely, in urban areas, only maternal age was significantly associated with delivering in health facilities.</p><p><strong>Conclusion: </strong>Determinants of maternal delivery choices vary between rural and urban settings. In rural areas, healthcare access and household head sex are key factors, while maternal age is significant in urban areas. The government should prioritize equitable healthcare facility distribution, particularly in rural areas, and promote family involvement, especially among husbands, during antenatal care to encourage facility-based deliveries.</p>","PeriodicalId":17893,"journal":{"name":"Korean Journal of Family Medicine","volume":" ","pages":"119-126"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}