INTRODUCTIONGallstone disease (GSD) is one of the most common diseases in developed countries. Recent studies indicate varying prevalence of GSD with several predisposing factors in different study populations [1][2][3][4][5][6][7][8][9] . From a medical economic perspective, the direct and indirect costs of treating GSD patients were estimated at $16 billion and account for more than 800 000 hospitalizations yearly in the United States [9,10] . In Taiwan, the prevalence of GSD in the general population was 4.3% in 1989 [8] while another voluntary screening revealed that the prevalence of GSD was 10.7% among healthy subjects in 1995 [2] . For this reason, due to westernization of the diet and the environment, GSD is not rare in the Chinese population and has become one of the major health problems in Taiwan [7] . Without an appropriate and effective screening program for symptomatic GSD, the medical treatment of GSD and related complications contributes substantially to health care costs.From the viewpoint of preventive medicine, it is RAPID COMMUNICATION RESULTS:The overall prevalence of GSD among this study-population was 5.3%, including 1.7% (n = 40) having a single stone, 2.3% (n = 55) having multiple stones, and 1.3% (n = 31) having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age (P < 0.0001). Females exhibited a greater prevalence of multiple stones than did males (3.0% vs 1.7%, P = 0.04). Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD: older

In conclusion, the average time for the development of diabetic retinopathy from nonexistence to blindness was approximately 26.5 years. The present recommendation for annual screening in type 2 diabetics with nonproliferative diabetic retinopathy should be retained only for the mild form, not for the moderate or severe forms.

BackgroundTo explore any gender-related differences in the prevalence of conditions-associated with non-alcoholic fatty liver disease (NAFLD) among Taiwanese taxi drivers in Taipei, Taiwan.MethodsWe studied 1635 healthy taxi drivers (1541 males and 94 females) who volunteered for physical check-ups in 2006. Blood samples and ultrasound fatty liver sonography results were collected.ResultsThe prevalence of NAFLD was 66.4% and revealed no statistically significant decrease with increasing age (p = 0.58). Males exhibited a greater prevalence of NAFLD than did females (67.5% vs 47.9%, p < 0.0001). Gender-related differences for associated factors were found. For males, hypertension, hyperuricemia, higher AST, higher ALT, hypertriglyceridemia, and higher fasting plasma glucose were significantly related to NAFLD. These conditions were not sigfinicantly related to NAFLD in females.ConclusionSeveral gender-related differences were noted for NAFLD among Taiwanese taxi drivers.

BackgroundThis 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.MethodsA 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.ResultsFor 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$) 20962, NT$ 24990, NT$ 30847, NT$ 37435, NT$ 44449, and NT$ 83411, respectively. The cost per quality-adjusted life year gained by the annual screening, biennial screening, 3-year screening, 4-year screening, 5-year screening, and control groups were NT$ 21924, NT$ 25319, NT$ 30098, NT$ 35106, NT$ 40037, and NT$ 61542, respectively. Threshold values indicate that the screening programs are highly sensitive to screening cost in the plausible range.ConclusionScreening for DR is both medically and economically worthwhile. Annual screening for DR among Chinese with type 2 diabetes should be conducted. Prevention programs aimed at improving eye care for patients with type 2 diabetes result in both substantial federal budgetary savings and highly cost-effective health care.

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