Cost Savings of Reduced Constipation Rates Attributed to Increased Dietary Fibre Intakes in Europe: A Decision-Analytic Model
Pages 14-23
Jordana K. Schmier, Vanessa Perez, Susan Cloran, Carolyn Hulme-Lowe and Kathryn O’Sullivan
DOI: http://dx.doi.org/10.6000/1927-5951.2015.05.01.3
Published: 28 January 2015

Abstract: Mounting evidence shows that functional constipation contributes to increased healthcare utilization, impairment in quality of life, and lost work productivity. Among those with functional constipation, relatively small dietary changes may alleviate symptoms and result in considerable constipation-related healthcare cost savings. The study objective was to estimate the economic impact of increased dietary fibre consumption on direct medical costs associated with constipation from a payer perspective. A decision-analytic spreadsheet model was created to perform the analysis. Literature searches identified sources for input parameters, including prevalence of functional constipation, dietary fibre intakes, proportion of the population meeting recommended intakes, and the percentage that would be expected to benefit from increased dietary fibre consumption. The model assumes that 25% of adults make no change in fibre intake, 25% increase intake by 3 g/day, 15% increase intake by 4 g/day, 25% increase intake by 5 g/day, and 10% increase intake by 11 g/day. A dose-response analysis of published data was conducted to estimate the percent reduction in constipation prevalence per 1 g/day increase in dietary fibre intake. Annual direct medical costs for constipation were derived from the literature and updated to 2014. Sensitivity analyses explored robustness of the model. Under base case assumptions, annual cost savings were estimated at ₤127,037,383 in the United Kingdom, €8,791,992 / ₤7,244,513 in Ireland, and €121,699,804 in Spain. Increasing dietary fibre consumption is associated with considerable cost savings, with these estimates being conservative given the exclusion of lost productivity costs in the model.

Effect of Topical Application of Hydro-Ethanolic Extract of Acacia nilotica Pods on Second-Degree Cutaneous Infected Burns
Pages 24-29
Kossi Metowogo, Tchin Darré, François Daubeuf, Povi Lawson-Evi, Kwashi Eklu-Gadegbeku, Kodjo A. Aklikokou, Gado Napo-Koura, Nelly Frossard and Messanvi Gbeassor
DOI: http://dx.doi.org/10.6000/1927-5951.2015.05.01.4
Published: 28 January 2015

Abstract: Acacia nilotica is a medicinal plant used traditionally in Togo to treat various diseases including burn wounds. The aim of this study was to evaluate experimentally Acacia nilotica burn wound healing effect.

Cutaneous burn wounds were symmetrically caused on depilated areas of rat skin through contact with an aluminum bar (r = 10 mm), preheated at 80°C for 30 sec. Five groups of animal were constituted and each group contained 8 mice. Four groups of animal’s burn wounds were infected by Staphylococcus aureus. One group burn wound is uninfected and serves as negative control. Burn wounds were assessed by planimetry and histological parameters of healing. Twelve days after burn wound induction, wound contraction in the uninfected groups (negative control) was 19.9% for topical application against -2.43% for infected control. In the infected groups treated with extract, wound contraction was generally stimulates. Histological examination showed granulated tissue developing over the wounds treated with the extract of A. nilotica at 2.5% and 5% where the proliferation of fibroblasts and neo-blood vessels was very marked.

In conclusion, A. nilotica pod contents tannin, flavonoids, alkaloids and protein reduces DPPH solution and significantly accelerates wound healing of burns, and this is the case even if wounds are infected with 10⁹CFU/mL of S. aureus.