The potency of native postbiotics and paraprobiotics in modulating inflammation by affecting the gut-kidney axis.

Alcohol use disorder (AUD) contributes significantly to disease burden, healthcare costs, hospitalization, and resource use for emergency departments (ED) throughout the United States. It is estimated that alcohol accounts for $249 billion in healthcare costs annually with heavy episodic drinking accounting for most of that cost at $191.1 billion. – Additionally, patients with AUD are more likely to be frequent users of the ED and emergency medical services. , Providing effective treatment to patients with AUD in the ED is difficult due to limitations of clinicians’ understanding of pharmacotherapy options available, the lack of continuity of care, time constraints, and costs. – Naltrexone is approved by the U.S. Food and Drug Administration (FDA) for treating AUD. Naltrexone is an opioid receptor antagonist, thought to reduce the opioid-mediated pleasure response from ethanol use. , Randomized studies in outpatient settings of naltrexone for AUD have shown mixed results with trends toward improvement in reduction in heavy drinking days, particularly when combined with behavioral therapy. – This poses great potential for benefit in patients presenting to the ED with AUD and, more specifically, in those who report “binge-drinking.” A limited number of feasibility studies have demonstrated increases in quality of life and reduction in alcohol cravings for patients starting naltrexone in the ED, suggesting the need for further study. – There have been no studies evaluating naltrexone’s effect on ED visits and recidivism. In this study, we evaluated a quality program with insurers to provide naltrexone to patients with suspected AUD in the ED. Our hypothesis was that subjects who received ED-initiated naltrexone as part of the quality program would have associated reduced recidivism. We performed a retrospective chart review of naltrexone in an AUD quality program. Our primary outcome was ED visits by subjects with suspected AUD in the 30 days prior to ED-initiated naltrexone compared to ED visits in the 30 days following. Secondary outcome measures were a subject’s visits with non-high ED use (defined as fewer than four ED visits in the preceding 90 days) and high ED use (more than four ED visits in the preceding 90 days).