Retrospective study investigating naloxone prescribing and cost in US Medicaid and Medicare patients.

BACKGROUND: Opioid overdoses in the USA have increased to unprecedented levels. Administration of the opioid antagonist naloxone can prevent overdoses. OBJECTIVE: This study was conducted to reveal the pharmacoepidemiologic patterns in naloxone prescribing to Medicaid patients from 2018 to 2021 as well as Medicare in 2019. DESIGN: Observational pharmacoepidemiologic study SETTING: US Medicare and Medicaid naloxone claims INTERVENTION: The Medicaid State Drug Utilisation Data File was utilised to extract information on the number of prescriptions and the amount prescribed of naloxone at a national and state level. The Medicare Provider Utilisation and Payment was also utilised to analyse prescription data from 2019. OUTCOME MEASURES: States with naloxone prescription rates that were outliers of quartile analysis were noted. RESULTS: The number of generic naloxone prescriptions per 100 000 Medicaid enrollees decreased by 5.3%, whereas brand naloxone prescriptions increased by 245.1% from 2018 to 2021. There was a 33.1-fold difference in prescriptions between the highest (New Mexico=1809.5) and lowest (South Dakota=54.6) states in 2019. Medicare saw a 30.4-fold difference in prescriptions between the highest (New Mexico) and lowest states (also South Dakota) after correcting per 100 000 enrollees. CONCLUSIONS: This pronounced increase in the number of naloxone prescriptions to Medicaid patients from 2018 to 2021 indicates a national response to this widespread public health emergency. Further research into the origins of the pronounced state-level disparities is warranted.

Geochemical characteristics, hazards impact assessment and radiogenic heat production of the alkaline rocks.

This study primarily investigates the natural radioactivity level in alkaline rocks collected from the Wadi El-Dib ring complex (WDRC) in North Eastern Desert of Egypt, and assesses potential health risks associated with their use as decorative building materials. The work was accomplished using a high-purity germanium detector as well as ICP-MS and ICP-AES techniques. The WDRC composed essentially of trachyte, quartz syenite, granite and syenite. Geochemically, these rocks contain high SiO2 and alkalis with metaluminous to slightly peraluminous features. All rocks contain high concentrations of rare earth elements (∑REEs = 109-1075 ppm), with clear enrichment in light REEs compared to heavy REEs [(La/Yb)N = 8.3-25.3. Radiometrically, the concentrations of the natural radioisotopes (238U, 232Th, and 40K) in the studied rock types surpassed the worldwide average values assigned for building materials by UNSCEAR. This elevation of the radioisotope concentration values is due to the presence of supplement minerals such as monazite, zircon, allanite, and rutile. Granites exhibit the highest mean concentrations of 238U (av. 164.24 ± 14.76 Bq/kg) and 232Th (av. 214.37 ± 23.33 Bq/kg), while trachytes demonstrate the highest 40K (av. 1352.56 ± 65.56 Bq/kg) concentrations. In contrast, syenites exhibite the lowest mean concentrations for 238U (av. 54.51 ± 6.81 Bq/kg) and 232Th (av. 56.76 ± 6.25 Bq/kg), while quartz syenites display the lowest mean concentration of 40K (av. 1144.78 ± 96.19 Bq/kg). The radiogenic heat production (RHP) associated with U, Th, and K range between 1.41 to 9.33 µW/m3, exceeding the typical crustal mean value of 0.8 to 1.2 µW/m3. The radiological parameters and indices evaluating risks of the outdoor and indoor radiation doses due to the investigated rocks were assessed. The results indicated that these rocks meet globally accepted values and safety standards (approved by UNSCEAR, ICRP, and EC) for surface building materials, as well as they underscore the importance of adhering to safety protocols to safeguard workers from radiation exposure within the WDRC area. Ultimately, the data herein provide a valuable database for assessing the compatibility of geochemical data and natural radioactivity level in WDRC rocks. Additionally, it reveals that from the radiological perspective, the investigated rocks are considered safe for use as decorative construction materials.

The Effects of Bacterial Lipopolysaccharide (LPS) on Turkey Poults: Assessment of Biochemical Parameters and Histopathological Changes.

A lipopolysaccharide (LPS) is a large molecule and an outer membrane glycolipid found in Gram-negative bacteria, including Escherichia coli (E. coli). These molecules (LPS) target acute inflammatory responses and significant physiological changes. Importantly, E. coli is considered one of the most important bacterial causes of avian colibacillosis that affect domestic turkey industry. However, little information is available about the potential influence of LPS on the biochemical parameters and histopathological changes in turkey poults. Therefore, this study aimed to evaluate the influence of bacterial lipopolysaccharide (LPS) molecules on serum biomarkers and histopathological changes in turkey poults. The birds were randomly divided into five groups, as follows: group I did not receive any inoculation; group II was inoculated with sterile saline; and groups III, IV, and V were inoculated intraperitoneally with LPS at 0.01, 0.1, and 1 mg/kg of body weight (BW), respectively. The biochemical parameters and the histopathology of different organs were examined in all birds one day post-inoculation. Our results revealed hypolipidemia, hypoglycemia, a significant decrease in uric acid, and a significant increase in serum activities of aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and creatine kinase (CK), as well as cardiac troponin T concentrations in treated groups. Moreover, there was a significant increase in α1-, ß-, and γ-globulin concentrations and a decrease in albumin and α2-globulin concentrations in group V. However, a significant increase in α2- and γ-globulin levels and a decrease in albumin levels were detected in groups III and IV. In addition, significant decreases in the albumin/globulin ratio were recorded in all LPS-treated groups. Hepatocellular and cardiac muscle necrosis, slight renal changes, and massive pulmonary inflammatory reactions were recorded. This study provides valuable information about serum biomarkers, protein fractions, and histopathological changes in turkey poults treated with LPS for further investigations of pathophysiological mechanisms in avian medicine along with biomedical research.