The cost of omeprazole versus open anti-reflux surgery in the long-term management of reflux esophagitis

1998 ◽  
Vol 114 ◽  
pp. A238 ◽  
Author(s):  
HE Myrvold ◽  
L Lundell ◽  
B Liedman ◽  
J Hatlebakk ◽  
P Miettinen ◽  
...  
Keyword(s):  
Reflux Esophagitis ◽  
The Cost ◽  
Term Management

scholarly journals Cost-effective Analysis of Proton Pump Inhibitors in Long-term Management of Gastroesophageal Reflux Disease: A Narrative Review

2019 ◽  
Vol 55 (5) ◽  
pp. 292-305
Author(s):  
Shazia Jamshed ◽  
Akshaya Srikanth Bhagavathula ◽  
Sheikh Muhammad Zeeshan Qadar ◽  
Umaira Alauddin ◽  
Sana Shamim ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Gastroesophageal Reflux Disease ◽  
Cost Effective ◽  
The Other ◽  
Cost Effectiveness Ratio ◽  
On Demand ◽  
Step Down ◽  
The Cost ◽  
Term Management

Background: Gastroesophageal reflux disease (GERD) is a common gastrointestinal disorder that results from regurgitation of acid from the stomach into the esophagus. Treatment available for GERD includes lifestyle changes, antacids, histamine-2 receptor antagonists (H2RAs), proton pump inhibitors (PPIs), and anti-reflux surgery. Aim: The aim of this review is to assess the cost-effectiveness of the use of PPIs in the long-term management of patients with GERD. Method: We searched in PubMed to identify related original articles with close consideration based on inclusion and exclusion criteria to choose the best studies for this narrative review. The first section compares the cost-effectiveness of PPIs with H2RAs in long-term heartburn management. The other sections shall only discuss the cost-effectiveness of PPIs in 5 different strategies, namely, continuous (step-up, step-down, and maintenance), on-demand, and intermittent therapies. Results: Of 55 articles published, 10 studies published from 2000 to 2015 were included. Overall, PPIs are more effective in relieving heartburn in comparison with ranitidine. The use of PPIs in managing heartburn in long-term consumption of nonsteroidal anti-inflammatory drug (NSAID) has higher cost compared with H2RA. However, if the decision-maker is willing to pay more than US$174 788.60 per extra quality-adjusted life year (QALY), then the optimal strategy is traditional NSAID (tNSAID) and PPIs. The probability of being cost-effective was also highest for NSAID and PPI co-therapy users. On-demand PPI treatment strategy showed dominant with an incremental cost-effectiveness ratio of US$2197 per QALY gained and was most effective and cost saving compared with all the other treatments. The average cost-effectiveness ratio was lower for rabeprazole therapy than for ranitidine therapy. Conclusion: Our review revealed that long-term treatment with PPIs is effective but costly. To achieve long-term cost-effective approach, we recommend on-demand approach to treat heartburn symptoms, but if the symptoms persist, treatment with continuous step-down therapy should be applied.

OPTIMIZATION AND VALIDATION OF A CHEMICAL PROCESS FOR URANIUM, MERCURY AND CESIUM LEACHING FROM CEMENTED RADIOACTIVE WASTES

2015 ◽  
Vol 4 (2) ◽  
pp. 131-139
Author(s):  
Nicolas Reynier ◽  
Rolando Lastra ◽  
Cheryl Laviolette ◽  
Nabil Bouzoubaâ ◽  
Mark Chapman
Keyword(s):  
Sulfuric Acid ◽  
Chemical Process ◽  
Management Strategy ◽  
Fission Products ◽  
Concentrated Sulfuric Acid ◽  
Direct Leaching ◽  
The Cost ◽  
Optimized Conditions ◽  
Term Management

Canadian Nuclear Laboratories (CNL) is developing a treatment and long-term management strategy for a legacy cemented radioactive waste that contains uranium, mercury, and fission products. Extracting the uranium would be advantageous for decreasing the waste classification and reducing the cost of long-term management. The chemical leachability of 3 key elements (U, Hg, and Cs) from a surrogate cemented waste (SCW) was studied with several lixiviants. The results showed that the most promising approach to leach and recover U, Hg, and Cs is the direct leaching of the SCW with H2SO4 in strong saline media. Operating parameters such as particle size, temperature, pulp density, leaching time, acid and salt concentrations, number of leaching/washing steps, etc. were optimized to improve key elements solubilization. Sulfuric leaching in saline media of a SCW (U5) containing 1182 ppm of U, 1598 ppm of Hg, and 7.9 ppm of Cs in the optimized conditions allows key elements solubilisation of 98.5 ± 0.4%, 96.6 ± 0.1%, and 93.8 ± 1.1% of U, Hg, and Cs, respectively. This solubilization process was then applied in triplicate to 7 other SCWs prepared with different cements, liquid ratios, and at different aging times and temperatures. Concentrated sulfuric acid is added to the slurry until the pH is about 2, which causes the complete degradation of cement and the formation of CaSO4. Sulfuric acid is particularly useful because it produces a leachate that is amenable to conventional ion exchange technology for the separation and recovery of uranium.

Childhood Asthma's Self-Efficacy Scale--Parental Long-Term Management

2012 ◽  
Author(s):  
Misa Iio ◽  
Kosuke Maeba ◽  
Takashi Shimazaki ◽  
Yukihiro Ohya ◽  
Koji Takenaka
Keyword(s):  
Self Efficacy ◽  
Term Management

Primary varicose veins

Phlebologie ◽  
2010 ◽  
Vol 39 (03) ◽  
pp. 133-137
Author(s):  
H. Partsch
Keyword(s):  
Varicose Veins ◽  
Compression Therapy ◽  
Daily Practice ◽  
Clinical Severity ◽  
Compression Stockings ◽  
Primary Varicose Veins ◽  
The Cost ◽  
Convincing Data ◽  
Long Term Studies

SummaryBackground: Compression stockings are widely used in patients with varicose veins. Methods: Based on published literature three main points are discussed: 1. the rationale of compression therapy in primary varicose veins, 2. the prescription of compression stockings in daily practice, 3. studies required in the future. Results: The main objective of prescribing compression stockings for patients with varicose veins is to improve subjective leg complaints and to prevent swelling after sitting and standing. No convincing data are available concerning prevention of progression or of complications. In daily practice varicose veins are the most common indication to prescribe compression stockings. The compliance depends on the severity of the disorder and is rather poor in less severe stages. Long-term studies are needed to proof the cost-effectiveness of compression stockings concerning subjective symptoms and objective signs of varicose veins adjusted to their clinical severity. Conclusion: Compression stockings in primary varicose veins are able to improve leg complaints and to prevent swelling.

Sign in / Sign up

Export Citation Format

Share Document