Feedback regarding students initial pharmaceutical internship from the University of Medicine and Pharmacy, Cluj-Napoca

Introduction/Aims: The purpose of the study is to evaluate the perception of the organization, the development and the evaluation of the initial stage in the internship of students, in order to improve these activities and to establish the adequate objectives in accordance with the changes concerning the concept of modern pharmacy. Materials and methods: An online survey was made using Google Docs ® -Create Form extension. All results were accumulated and computed using Microsoft Excel ®. The questionnaire consisted of 11 questions, structured on several levels: the objectives and how they can be achieved, internship organization, the internship training (effective participation in specific activities and integration in the pharmaceutical activity), the assessment, the profile of tutor / pharmacy. The questionnaire was completed by students from the Faculty of Pharmacy, University of Medicine and Pharmacy "Iuliu Haţieganu" Cluj Napoca, Romania. Results and discussions. The study was conducted on 308 students (60% of all students from the study years II-IV. 90% of the respondents had actually participated in the internship, whilst 10% only formally participated in this activity. The main responsibilities of the students were: storage and reception of pharmaceutical products (94%, respectively 79%) and working with the receipts (57%). Most of the students appreciate that they were integrated into the work in the pharmacy, this being due largely pharmacist tutor, who expressed interest and ability in mentoring activities. They appreciated that the role of tutor requires 3-5 years of professional experience. In terms of the internship objectives, these should aim at applying the knowledge gained until the graduation year, but also familiarization with activities which might turn into applications for the coming years. 43% of students believe that only 25% of the theoretical knowledge was useful during the internship. 90 % of the total questioned considered useful to develop a practice guideline adapted to the year of study. Conclusions. The professional training of the future pharmacist’s students depends largely on experience gained by students during the internship activity. Feed-back from the students’ shows that they are aware of the usefulness of the internship, but believe the objectives must be updated and a better correlation between work in pharmacy and theoretical knowledge has to be made. A first step is to develop a practical guide adapted to each year of study. The involvement of the tutor pharmacist is also essential to the success of this activityIntroduction/Aims: The purpose of the study is to evaluate the perception of the organization, the development and the evaluation of the initial stage in the internship of students, in order to improve these activities and to establish the adequate objectives in accordance with the changes concerning the concept of modern pharmacy. Materials and methods: An online survey was made using Google Docs ® - Create Form extension. All results were accumulated and computed using Microsoft Excel ®. The questionnaire consisted of 11 questions, structured on several levels: the objectives and how they can be achieved, internship organization, the internship training (effective participation in specific activities and integration in the pharmaceutical activity), the assessment, the profile of tutor / pharmacy. The questionnaire was completed by students from the Faculty of Pharmacy, University of Medicine and Pharmacy "Iuliu Haţieganu" Cluj Napoca, Romania. Results and discussions. The study was conducted on 308 students (60% of all students from the study years II - IV. 90% of the respondents had actually participated in the internship, whilst 10% only formally participated in this activity. The main responsibilities of the students were: storage and reception of pharmaceutical products (94%, respectively 79%) and working with the receipts (57%). Most of the students appreciate that they were integrated into the work in the pharmacy, this being due largely pharmacist tutor, who expressed interest and ability in mentoring activities. They appreciated that the role of tutor requires 3-5 years of professional experience. In terms of the internship objectives, these should aim at applying the knowledge gained until the graduation year, but also familiarization with activities which might turn into applications for the coming years. 43% of students believe that only 25% of the theoretical knowledge was useful during the internship. 90 % of the total questioned considered useful to develop a practice guideline adapted to the year of study. Conclusions. The professional training of the future pharmacist’s students depends largely on experience gained by students during the internship activity. Feed-back from the students’ shows that they are aware of the usefulness of the internship, but believe the objectives must be updated and a better correlation between work in pharmacy and theoretical knowledge has to be made. A first step is to develop a practical guide adapted to each year of study. The involvement of the tutor pharmacist is also essential to the success of this activity

Liquid biopsy for early detection of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is a highly prevalent and lethal cancer globally. Over 90% of HCC cases arise in the context of liver cirrhosis, and the severity of the underlying liver disease or advanced tumor stage at diagnosis significantly limits treatment options. Early diagnosis is crucial, and all guidelines stress the importance of screening protocols for HCC early detection as a public health objective. As serum biomarkers are not optimal for early diagnosis, liquid biopsy has emerged as a promising tool for diagnosis, prognostication, and patients’ stratification for personalized therapy in various solid tumors, including HCC. While circulating tumor cells (CTCs) are better suited for personalized therapy and prognosis, cell-free DNA (cfDNA) and extracellular vesicle-based technologies show potential for early diagnosis, HCC screening, and surveillance protocols. Evaluating the added value of liquid biopsy genetic and epigenetic biomarkers for HCC screening is a key goal in translational research. Somatic mutations commonly found in HCC can be investigated in cfDNA and plasma exosomes as genetic biomarkers. Unique methylation patterns in cfDNA or cfDNA fragmentome features have been suggested as innovative tools for early HCC detection. Likewise, extracellular vesicle cargo biomarkers such as miRNAs and long non-coding RNAs may serve as potential biomarkers for early HCC detection. This review will explore recent findings on the utility of liquid biopsy for early HCC diagnosis. Combining liquid biopsy methods with traditional serological biomarkers could improve the overall diagnostic accuracy for early HCC detection

Is measuring serum ammonia helpful in patients with liver cirrhosis?

Background. Ammonia has been traditionally viewed as one of the main culprits for the development of hepatic encephalopathy. In the setting of liver cirrhosis or portal-systemic shunting, hepatocytes fail to metabolize ammonia, and thus excess ammonia reaches the systemic circulation, and from there, the brain. Material and methods. We performed a descriptive study involving 28 adult patients with liver cirrhosis. None of the patients had overt hepatic encephalopathy at the time of assessment, as judged by the West Haven criteria. Severity of liver cirrhosis was measured through the Child-Pugh and MELD scores. Serum ammonia was measured by venous sampling. Results. Mean age of the patients was 50±10 years-old. There were 68% males (n=19). Mean MELD score was 17±5 points. Mean Child-Pugh score was 8±2 points. Mean serum ammonia level was 76±37 μmol/L (range: 34-204 μmol/L). Serum ammonia levels correlated significantly with both scores of liver disease severity, more so with MELD (R=0.61, p=0.0005), than with the Child-Pugh score (R=0.38, p=0.04) Conclusions. We reaffirm the importance of measuring blood ammonia in patients with liver cirrhosis, since it is a helpful biomarker which correlates with liver disease severity and hepatic encephalopathy

Quality of life in sarcopenia measured with the SarQoL questionnaire: A meta-analysis of individual patient data.

peer reviewedAge-related sarcopenia, resulting from a gradual loss in skeletal muscle mass and strength, is pivotal to the increased prevalence of functional limitation among the older adult community. The purpose of this meta-analysis of individual patient data is to investigate the difference in health-related quality of life between sarcopenic individuals and those without the condition using the Sarcopenia Quality of Life (SarQoL) questionnaire. A protocol was published on PROSPERO. Multiple databases and the grey literature were searched until March 2023 for studies reporting quality of life assessed with the SarQoL for patients with and without sarcopenia. Two researchers conducted the systematic review independently. A two-stage meta-analysis was performed. First, crude (mean difference) and adjusted (beta coefficient) effect sizes were calculated within each database; then, a random effect meta-analysis was applied to pool them. Heterogeneity was measured using the Q-test and I2 value. Subgroup analyses were performed to investigate the source of potential heterogeneity. The strength of evidence of this association was assessed using GRADE. From the 413 studies identified, 32 were eventually included, of which 10 were unpublished data studies. Sarcopenic participants displayed significantly reduced health-related quality of life compared with non-sarcopenic individuals (mean difference = -12.32; 95 % CI = [-15.27; -9.37]). The model revealed significant heterogeneity. Subgroup analyses revealed a substantial impact of regions, clinical settings, and diagnostic criteria on the difference in health-related quality of life between sarcopenic and non-sarcopenic individuals. The level of evidence was moderate. This meta-analysis of individual patient data suggested that sarcopenia is associated with lower health-related quality of life measured with SarQoL