Effectiveness of National Residential Smoking Cessation Program

We aimed to investigate the effectiveness of the Korean national five-day residential smoking cessation program and the factors affecting the long-term smoking cessation of participants. The residential smoking cessation program (2017–2018) recruited smokers with a smoking duration ≥ 20 years and who have attempted to quit smoking more than twice and/or smokers with chronic morbidities. Participants underwent an intensive intervention, including individual psychological therapy, group therapy, medical counseling, and pharmacotherapy. The 6-month continuous abstinence rate (CAR) was assessed via self-reports, the urine cotinine levels, and/or expired-air carbon monoxide levels. Logistic regression was used to analyze the adjusted odds ratio (aOR) to assess factors related to smoking cessation. Overall, 484 participants who completed the residential program and questionnaire were evaluated. The 3- and 6-month CAR were 81.82% and 63.22%, respectively. The aOR of 6-month continuous abstinence was lower among participants with severe nicotine dependence (aOR: 0.46, 95% confidence interval [CI]: 0.26–0.81) and higher among participants with combination therapy of varenicline with short-term nicotine replacement therapy (NRT) (aOR: 1.64, 95% CI: 1.07–2.51), with higher self-efficacy (aOR: 1.97, 95% CI: 1.15–3.37). The residential smoking cessation program was effective. High self-efficacy, combination therapy of varenicline with short-term NRT, and low nicotine dependence were associated with a high 6-month CAR

Atypical Clinical Presentation of Geriatric Syndrome in Elderly Patients With Pneumonia or Coronary Artery Disease

Background : Atypical symptoms often occur in elderly patients due to impaired homeostasis associated with age-related physiological changes and multiple pathologies. These atypical symptoms make diagnosis difficult and may partially increase morbidity and mortality. This study aimed to determine the incidence of atypical clinical presentation and to identify the effects of age and comorbidities on illness presentation in the elderly. Methods : Medical charts of 6,057 elderly patients (≥60 years) with pneumonia or coronary artery disease (CAD) admitted to 4 university hospitals were retrospectively reviewed. Determinants of atypical symptom presentation was evaluated using logistic regression analysis. The definition of atypical presentation was adapted from a previous study on atypical symptoms of pneumonia and CAD. Results : Among the 6,057 participants, 4,773 (78.8%) and 1,284 (21.2%) presented with typical and atypical symptoms, respectively. Among the participants, 24.8% CAD and 18.8% pneumonia patients had atypical presentations. Logistic regression analysis showed that factors associated with atypical presentation in CAD patients were age (≥85 years; odds ratio [OR], 2.7; 95% confidence interval [CI], 1.81-4.03), higher pulse rate (OR, 1.01; 95% CI, 1.00-1.01), and number of comorbidities ≥4 (OR, 1.62; 95% CI, 1.13-2.32). In pneumonia patients, age (≥85 years; OR, 2.22; 95% CI, 1.49-3.31), body mass index (OR, 0.97; 95% CI, 0.94-0.99), and 1 comorbidity (OR, 1.53; 95% CI, 1.01-2.36) were statistically significant factors that increased atypical presentation. Conclusion : This study suggested that older patients frequently present atypical geriatric syndrome with acute illness, and age and comorbidity are statistically significant factors associated with atypical symptoms in CAD or pneumonia patients

Relationship between Dietary Habits and Control of Lipid Profiles in Patients with Dyslipidemia Using Pravastatin

We investigated the association between dietary habits, evaluated using the modified Mini Dietary Assessment Index for Koreans (MDA), and lipid control among patients aged ≥20 years who had used pravastatin for dyslipidemia for 6 months. Participants were administered questionnaires regarding sociodemographic characteristics and lifestyle factors. Odds ratios and 95% confidence intervals for the control of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC) at 6 months for each category of the modified MDA items were calculated through multivariate logistic regression analysis. The odds for controlled LDL-C was higher among those who consumed cholesterol-rich foods <1 time/week (3.27, 1.25–8.57) than for those who did so ≥4 times/week. The odds for controlled TG was higher among those who always consumed dairy products (2.96, 1.36–6.44), ate protein-rich foods three times/day (2.94, 1.06–8.10), and had a regular eating schedule (3.02, 1.30–7.00) than among those who did not have any of these. The odds for controlled TC was higher among those with a regular eating schedule (3.47, 1.55–7.76) than among their counterparts. Patients with dyslipidemia should consume less cholesterols, consume more dairy and protein-rich foods, and follow a regular eating schedule to control lipid profiles