Tao-Hsin Tung

Community-based multiple screening model†‡§¶

Multiple disease screening may have several advantages over single disease screening because of the economics of scale, with the high yield of detecting asymptomatic diseases, the identification of multiple diseases or risk factors simultaneously, the enhancement of the attendance rate, and the efficiency of follow‐up.

Community-based multiple screening model: design, implementation, and analysis of 42,387 participants.

Multiple disease screening may have several advantages over single disease screening because of the economics of scale, with the high yield of detecting asymptomatic diseases, the identification of multiple diseases or risk factors simultaneously, the enhancement of the attendance rate, and the efficiency of follow‐up.

Music Training Improves Pitch Perception in Prelingually Deafened Children With Cochlear Implants

OBJECTIVE: The comparatively poor music appreciation in patients with cochlear implants might be ascribed to an inadequate exposure to music; however, the effect of training on music perception in prelingually deafened children with cochlear implants remains unknown. This study aimed to investigate whether previous musical education improves pitch perception ability in these children. METHODS: Twenty-seven children with congenital/prelingual deafness of profound degree were studied. Test stimuli consisted of 2 sequential piano tones, ranging from C (256 Hz) to B (495 Hz). Children were asked to identify the pitch relationship between the 2 tones (same, higher, or lower). Effects of musical training duration, pitch-interval size, current age, age of implantation, gender, and type of cochlear implant on accuracy of pitch perception were evaluated. RESULTS: The duration of musical training positively correlated with the correct rate of pitch perception. Pitch perception performance was better in children who had a cochlear implant and were older than 6 years than in those who were aged ≤6 years (ie, preschool). Effect of pitch-interval size was insignificant on pitch perception, and there was no correlation between pitch perception and the age of implantation, gender, or type of cochlear implant. CONCLUSIONS: Musical training seems to improve pitch perception ability in prelingually deafened children with a cochlear implant. Auditory plasticity might play an important role in such enhancement. This suggests that incorporation of a structured training program on music perception early in life and as part of the postoperative rehabilitation program for prelingually deafened children with cochlear implants would be beneficial. A longitudinal study is needed to show whether improvement of music performance in these children is measurable by use of auditory evoked potentials.

A population-based study of the association between areca nut chewing and Type 2 diabetes mellitus in men (Keelung Community-based Integrated Screening programme No. 2)

Aims/hypothesisThe aim of this study was to assess whether the diabetogenicity of areca nut (Areca catechu or ‘betel-nut’), which has previously been demonstrated experimentally in mice, independently contributes to the risk of hyperglycaemia or Type 2 diabetes in men in Taiwan, where the habit has become established relatively recently.MethodsWe used data from a population-based cross-sectional survey and a multiple-disease-screening programme that tested for hyperglycaemia, Type 2 diabetes and risk factors related to Type 2 diabetes. Data on habitual areca nut chewing were available for 14,816 men. Multiple logistic regression models were used to determine whether areca nut chewing was an independent risk factor for Type 2 diabetes.ResultsCompared with non-chewers, areca nut chewers had higher age-adjusted prevalence rates for hyperglycaemia (11.4% vs 8.7%) and Type 2 diabetes (10.3% vs 7.8%). Areca nut chewing independently increased the risk of hyperglycaemia (adjusted odds ratio [OR] 1.19, 95% CI 0.97–1.45) and Type 2 diabetes (adjusted OR 1.29, 95% CI 1.04–1.60). The independent effects of duration of chewing were dose-dependent for Type 2 diabetes (adjusted OR 1.32 for the duration of 10–19 years and 1.41 for the duration of ≥20 years), as were the effects of increased rates of areca nut chewing (adjusted OR 1.14 for <10 pieces/day, 1.30 for 10–19 pieces/day and 2.02 for ≥20 pieces/day); similar findings were noted for hyperglycaemia.Conclusions/interpretationThe habit of chewing areca nut independently contributes to the risk of both hyperglycaemia and Type 2 diabetes in Taiwanese men. This association is dose-dependent with respect to the duration of areca nut use and the quantity of areca nut chewed per day.

A Community-Based Epidemiologic Study on Gallstone Disease among Type 2 Diabetics in Kinmen, Taiwan

Background: This study was conducted to assess the prevalence and associated risk factors of gallstone disease (GSD) among type 2 diabetics in Kinmen, Taiwan. Methods: Based on a total of 858 type 2 diabetics ascertained in 1991–1993, an ultrasound sonography screening was performed by a panel of specialists in 2001. A total of 440 (51.3%) subjects were examined. Results: Sixty-three out of 440 type 2 diabetics were diagnosed with GSD. The overall prevalence of GSD was 14.4%, including single stone 8.0% (n = 35), multiple stones 3.2% (n = 14), and cholecystectomy 3.2% (n = 14). The significant risk factors of GSD based on multiple logistic regression analysis were age (OR = 1.06, 95% CI: 1.02–1.10) and BMI (OR = 1.11, 95% CI: 1.01–1.22). Conclusions: Our results found that older age and higher BMI may increase the risk of developing GSD in type 2 diabetics.

The current status of visual disability in the elderly population of Taiwan

PurposeThis study was conducted to explore the prevalence and the associated factors of visual impairment and blindness among the elderly Taiwanese population.MethodsA nationwide population-based visual health care screening program of elderly people aged 65 years or older was conducted between 1 July 2002 and 31 December 2002 in Taiwan. Based on the same standardized protocol used by the Bureau of Health Promotion, Department of Health, and a stratified random sampling design, 3160 out of 5000 elderly subjects were selected by a two-stage visual care screening method. The overall response rate was 63.2%.ResultsThe mean age of the elderly participants was 72.4 ± 5.1 years. The overall prevalence of glaucoma, corneal diseases, trauma, cataracts, myopic or diabetic retinopathy, and age-related macular degeneration among the elderly population was 2.1%, 6.3%, 0.9%, 60.2%, 7.5%, and 2.9%, respectively. The overall prevalence of visual disability (visual acuity of the better eye <0.5) was 17.7%, including 17.1% with visual impairment and 0.6% with blindness. Based on logistic regression, the significant independent factors of visual disability (visual impairment plus blindness) were sex (male vs. female, odds ratio (OR) = 0.62, 95% confidence interval (CI), 0.51–0.76), age (70–74 years vs. 65–69 years, OR = 1.60, 95% CI, 1.24–2.06; 75–79 years vs. 65–69 years, OR = 2.52, 95% CI, 1.92–3.32, ≥80u2009yrs vs. 65–69u2009yrs, OR = 4.86, 95% CI, 3.52–6.70), corneal diseases (OR = 2.26, 95% CI, 1.61–3.16), myopic or diabetic retinopathy (OR = 1.69, 95% CI, 1.20–2.39), age-related macular degeneration (OR = 4.96, 95% CI, 3.16–7.78), and cataract (OR = 3.40, 95% CI, 2.67–4.33).ConclusionsThe geographic difference in the prevalence of vision-related eye disease, visual impairment, and blindness point to the importance of taking actions that suit local circumstances. Our results also revealed that visual impairment and blindness are important visual health problems in the elderly Taiwanese population. Age-related macular degeneration, cataracts, corneal diseases, myopic or diabetic retinopathy, female sex, and aging were the leading causes of visual disability. Further organized preventive strategies for eye care are recommended in this population.

Clinical predictors of incident gallstone disease in a Chinese population in Taipei, Taiwan

BackgroundGallstone disease (GSD) is a common gastrointestinal disorder throughout the world. The authors explored the incidence of GSD in Taiwan and its condition-associated predictive factors.MethodsThe initial study cohort comprised 2386 healthy adult participants, who were voluntarily admitted to a teaching hospital for a physical check-up in 2002 in Taipei, Taiwan. After excluding 126 patients who exhibited prevalent GSD, 2260 non-GSD participants received annual follow-up screenings for GSD until 31 December, 2007. Of those, 1296 (57.3%) patients were re-examined to collect blood samples and conduct ultrasound sonography.ResultsAmong the 1296 participants who exhibited no GSD at the first screening, 23 patients developed GSD during 3640 person-years of follow-up. The incidence was 0.632% per year (95% CI: 0.292%–2.009%). After conducting a Cox regression, increased age (50–59 years versusu2009<u200940xa0years, RRu2009=u20092.16 [95% CI: 1.09–5.97], 60+ years versusu2009<u200940xa0years, RRu2009=u20093.81 [95% CI: 2.77–8.63]), high body mass index (≥27xa0kg/m2 versusu2009<u200924xa0kg/m2, RRu2009=u20091.64 [95% CI: 1.07–2.98]), high fasting plasma glucose levels (≥126xa0mg/dL versusu2009<u2009110xa0mg/dL, RRu2009=u20091.68, 95% CI: 1.10–3.87), and nonalcoholic fatty liver disease (yes versus no, RRu2009=u20091.44, 95% CI: 1.21–1.90) appeared to be significantly related to developing GSD.ConclusionIncreased age is a well-established risk factor for developing GSD. The current findings indicated that high body mass index, elevated fasting plasma glucose levels, and nonalcoholic fatty liver disease were also associated with GSD.

Economic evaluation of screening for diabetic retinopathy among Chinese type 2 diabetics: a community-based study in Kinmen, Taiwan.

Background This community-based study conducted in Kinmen aimed to discover whether screening for diabetic retinopathy (DR) among Chinese with type 2 diabetes was economically feasible and clinically effective. Methods A total of 971 community-dwelling adults previously diagnosed with type 2 diabetes in 1991-1993 underwent DR screening in 1999-2002 by a panel of ophthalmologists, who used on-site indirect ophthalmoscopy and 45-degree color fundus retinal photographs. Economic evaluation included estimates for cost effectiveness and the cost utility of screening for DR. Results For each DR case, screening efficacy and utility decreased, while cost increased with the length of the screening interval. The cost per sight year gained in the annual screening, biennial screening, 3-year screening, 4-year screening, 5-year screening, and control groups were New Taiwan dollars (NT

Prevalence and associated factors of nocturia among adult residents of the Matsu area of Taiwan.

) 20962, NT

Assessing the Natural Course of Diabetic Retinopathy: A Population-Based Study in Kinmen, Taiwan

24990, NT