Background: Gastro-oesophageal reflux disease (GERD) can be effectively treated pharmacologically or surgically. As GERD is often a chronic condition, we compared the long-term costs of medical and surgical management.
Methods: The medical regimens were ranitidine (150 or 300 mg/day), omeprazole (20 or 40 mg/day), and lansoprazole (30 mg/day), with costs calculated for total life expectancy after diagnosis and for one-third of that time. Costs for open or laparoscopic surgery (Nissen fundoplication) included pre- and post-operative investigations, sick leave, and calculated financial loss due to fatal outcome.
Results: Costs were lowest with ranitidine, 150 mg/day, for one-third of the patient's lifetime and highest with lifelong omeprazole, 40 mg/daily. The cost of open or laparoscopic operation was less than that of lifelong daily treatment with proton pump inhibitors or ranitidine, 300 mg daily.
Conclusion: In Finland, antireflux surgery for GERD is cheaper than lifetime treatment with proton pump inhibitors.
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http://dx.doi.org/10.3109/00365529708996532 | DOI Listing |
Neurogastroenterol Motil
January 2025
Division of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
Background: Proton pump inhibitors (PPI) for gastroesophageal reflux disease (GERD) are associated with a high failure rate. Our uncontrolled feasibility study aimed determining the effect of a transcutaneous electrical stimulation system (TESS) on GERD symptoms and acid exposure time (AET).
Methods: Recruited patients with heartburn and regurgitation.
Pediatr Surg Int
January 2025
Department of Pediatric Surgery, Cleveland Clinic Children's Hospital, 8950 Euclid Avenue, Mail Code R3, Cleveland, OH, 44106, USA.
Background: Long-gap esophageal atresia (LGEA) can complicate the management of esophageal atresia (EA) with or without a tracheoesophageal fistula (TEF). This series describes a short interval, staged, thoracoscopic internal traction approach for LGEA with distal TEF to manage complex anastomotic tension or an anatomically impossible esophageal anastomosis.
Methods: A retrospective review (2018-2024) was performed across four tertiary centers to identify patients with LGEA and distal TEF, managed with a staged, thoracoscopic internal traction approach.
Drugs
January 2025
Oxford NIHR Biomedical Research Centre, Churchill Hospital, Oxford, UK.
The incidence of gastroesophageal cancers is rising, driven, in part, by an increasing burden of risk factors of obesity and gastroesophageal reflux. Despite efforts to address these risk factors, and a growing interest in methods of population screening, the bulk of these tumours are unresectable at diagnosis. In this setting, effective systemic treatments are paramount to improve survival and quality of life.
View Article and Find Full Text PDFJAMA Psychiatry
January 2025
Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, New York.
Importance: Intermittent explosive disorder (IED) is an understudied psychiatric condition marked by impulsive aggression and poorly regulated emotional control, often resulting in interpersonal and societal consequences. Better understanding of comorbidities can improve screening, diagnosis, and treatment.
Objective: To investigate the prevalence of IED and its associations with psychiatric, neurological, and somatic disorders.
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