Pharmacy students' knowledge, perceptions, and satisfaction in a nutrition course.

Background And Purpose: Little is known about nutrition education in pharmacy programs. This study reports on the outcomes assessment of pharmacy students' knowledge, perceptions, and satisfaction in a clinical nutrition course.

Educational Activity And Setting: A 2-credit required course in clinical nutrition and diet therapy provides third-year professional pharmacy students with knowledge on various diet and nutrition topics.

Entrustable professional activities-based objective structured clinical examinations in a pharmacy curriculum.

Background: The integration of Objective Structured Clinical Examinations (OSCEs) within the professional pharmacy program, contributes to assessing the readiness of pharmacy students for Advanced Pharmacy Practice Experiences (APPEs) and real-world practice.

Methods: In a study conducted at an Accreditation Council for Pharmacy Education (ACPE)-accredited Doctor of Pharmacy professional degree program, 69 students in their second professional year (P2) were engaged in OSCEs. These comprised 3 stations: best possible medication history, patient education, and healthcare provider communication.

An elective course on career opportunities for pharmacy students.

Background And Purpose: There is limited literature describing the outcomes of formal career guidance in pharmacy programs. This study assessed the course outcomes including students' satisfaction, achievement of the learning objectives and scoring on assignments.

Educational Activity And Setting: A 1-credit elective course aims at providing second- and third-year professional pharmacy students (P2 and P3) to career guidance.

Emotional intelligence and professional identity formation in pharmacy education.

Introduction: Considering the various professional roles of pharmacists, pharmacy students and pharmacists have had difficulty identifying with a clear professional identity. Thereby there is a need for a professional identity formation (PIF) that conveys a consistent message about the role and value of pharmacists. Having a clear professional identity may also be a driver to advance the pharmacy profession.

Mapping and assessment of personal and professional development skills in a pharmacy curriculum.

Background: Health sciences programs are increasingly expanding their curricula to bridge foundational scientific knowledge with needed skills to practice and patient care. The primary objectives of this study are to 1) assess whether the personal and professional development (PPD) subdomains (self-assessment, leadership, innovation and entrepreneurship, and professionalism) are integrated in a pharmacy curriculum; and 2) identify any gaps related to the subdomains' learning objectives.

Methods: Four different mapping activities were completed to create a comprehensive mapping plan regarding the integration of the PPD subdomains in the curriculum.

Infectious complications with nondaily versus daily infusion of intravenous fat emulsions in non-critically ill adults.

Background: Increased risk for infection has been associated with the administration of intravenous fat emulsion (IVFE). Typically, IVFE is infused daily as part of the parenteral nutrition (PN) regimen. However, a national IVFE shortage in 2010 compelled institutions to restrict administration to nondaily.

Neurologic dysfunction and pancytopenia secondary to acquired copper deficiency following duodenal switch: case report and review of the literature.

The duodenal switch (DS) procedure is a type of restrictive-malabsorptive bariatric surgery that is typically reserved for severe morbidly obese people (body mass index >50 kg/m(2)) with obesity-related comorbidities, when diet, lifestyle changes, and pharmacologic therapy fail to achieve adequate weight loss. Patients who undergo the DS procedure are at risk for malabsorption, malnutrition, and nutrient deficiencies. Copper deficiency is a commonly reported long-term complication of Roux-en-Y gastric bypass (RYGB) surgery.

Dosing and monitoring of trace elements in long-term home parenteral nutrition patients.

Background: Trace elements (TEs) dosing and monitoring in home parenteral nutrition (PN) patients vary with their underlying conditions.

Methods: This retrospective observational study evaluated parenteral TE dosing, serum TE concentrations and monitoring, and dose-concentration relationships between TE doses and serum TE concentrations in 26 adult and adolescent home PN patients.

Results: There was a total of 40,493 PN days.

The effects of needleless connectors on catheter-related thrombotic occlusions.

Needleless connectors have been introduced into clinical practice to prevent accidental needlestick injuries and associated bloodborne infections. Needleless connectors include the split-septum devices and the mechanical valves that are classified as neutral-, negative-, and positive-displacement types on the basis of their internal membrane or valve function. Some studies have reported that mechanical valves, especially positive-displacement valves, may decrease thrombotic catheter occlusions based on their valve function that prevents blood reflux into the intravascular catheter.

The effects of needleless connectors on catheter-related bloodstream infections.

Needleless connectors, including the standard split septum and the luer-activated mechanical valve connectors, have been introduced into clinical practice to eliminate the risk of needlestick injuries by avoiding the use of needles when accessing the intravascular catheters. Negative and positive displacement mechanical valves have been associated with increased rates of catheter-related bloodstream infections as compared with split septum connectors. Based on available data, split septum connectors should be preferentially used instead of mechanical valves.

Critical illness, gastrointestinal complications, and medication therapy during enteral feeding in critically ill adult patients.

Critically ill patients who are subjected to high stress or with severe injury can rapidly break down their body protein and energy stores. Unless adequate nutrition is provided, malnutrition and protein wasting may occur, which can negatively affect patient outcome. Enteral nutrition (EN) is the mainstay of nutrition support therapy in patients with a functional gastrointestinal (GI) tract who cannot take adequate oral nutrition.

Oxandrolone treatment in adults with severe thermal injury.

Severe thermal injury is associated with hypermetabolism and hypercatabolism, leading to skeletal muscle breakdown, lean body mass loss, weight loss, and negative nitrogen balance. Muscle protein catabolism in patients with severe thermal injury is the result of stress-induced increased release of cytokines and counterregulatory hormones. Coupled with decreased serum anabolic hormone concentrations such as testosterone and growth hormone along with the presence of insulin resistance, anabolism in patients with severe thermal injury is inefficient or impossible during the acute postburn period.

Continuous venovenous hemodiafiltration trace element clearance in pediatric patients: a case series.

Continuous renal replacement therapy (CRRT) is used to treat critically ill children with acute kidney injury. The effect of CRRT on trace element clearance is poorly characterized. The purpose of this study was to quantify the transmembrane clearance of chromium, copper, manganese, selenium and zinc during continuous venovenous hemodiafiltration (CVVHDF).

Oxandrolone in pediatric patients with severe thermal burn injury.

Objective: To review the role of oxandrolone in pediatric patients with severe thermal burn injury.

Data Sources: MEDLINE (1950-April 2008) and Science Citation Index (1900-April 2008) searches were performed using the key terms oxandrolone, burn, and children.

Study Selection And Data Extraction: All English-language articles that evaluated the efficacy and safety of oxandrolone in pediatric patients with severe thermal burn injury were included in this review.

Amino Acid requirements in critically ill patients with acute kidney injury treated with continuous renal replacement therapy.

Acute kidney injury in critically ill patients is often a complication of an underlying condition such as organ failure, sepsis, or drug therapy. In these patients, stress-induced hypercatabolism results in loss of body cell mass. Unless nutrition support is provided, malnutrition and negative nitrogen balance may ensue.

Ursodiol in patients with parenteral nutrition-associated cholestasis.

Objective: To review the role of ursodeoxycholic acid (ursodiol) in treating parenteral nutrition-associated cholestasis (PNAC).

Data Sources: A MEDLINE (1950-May 2007) search was performed using the key terms parenteral nutrition, cholestasis, ursodeoxycholic acid, and ursodiol.

Study Selection And Data Extraction: All English-language articles that evaluated the safety and efficacy of ursodiol for PNAC were included in this review.

Trace element removal during in vitro and in vivo continuous haemodialysis.

Background: Continuous renal replacement therapy (CRRT) increasingly is being used to treat critically ill patients with renal disease. CRRT removes waste products but also nutrients. Our understanding of trace element CRRT clearance has been limited by poor assay sensitivity.

Review of the refeeding syndrome.

Refeeding syndrome describes a constellation of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who are starved or severely malnourished. Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications. We reviewed literature on refeeding syndrome and the associated electrolyte abnormalities, fluid disturbances, and associated complications.

Metabolic and nutritional aspects of acute renal failure in critically ill patients requiring continuous renal replacement therapy.

Acute renal failure (ARF) is rarely an isolated process but is often a complication of underlying conditions such as sepsis, trauma, and multiple-organ failure in critically ill patients. As such, concomitant clinical conditions significantly affect patient outcome. Poor nutritional status is a major factor in increasing patients' morbidity and mortality.

Treatment of electrolyte disorders in adult patients in the intensive care unit.

Purpose: The treatment of electrolyte disorders in adult patients in the intensive care unit (ICU), including guidelines for correcting specific electrolyte disorders, is reviewed.

Summary: Electrolytes are involved in many metabolic and homeostatic functions. Electrolyte disorders are common in adult patients in the ICU and have been associated with increased morbidity and mortality, as has the improper treatment of electrolyte disorders.

Relationship between hyperglycemia and infection in critically ill patients.

Hyperglycemia is a common problem encountered in hospitalized patients, especially in critically ill patients and those with diabetes mellitus. Uncontrolled hyperglycemia may be associated with complications such as fluid and electrolyte disturbances and increased infection risk. Studies have demonstrated impairment of host defenses, including decreased polymorphonuclear leukocyte mobilization, chemotaxis, and phagocytic activity related to hyperglycemia.

Metabolic complications of parenteral nutrition in adults, Part 2.

Purpose: Common metabolic complications associated with parenteral nutrition (PN) are reviewed, and the consequences of overfeeding and variables for patient monitoring are discussed.

Summary: Although PN is a lifesaving therapy in patients with gastrontestinal failure, its use may be associated with metabolic, infectious, and technical complications. The metabolic complications associated with PN in adult patients include hyperglycemia, hypoglycemia, hyperlipidemia, hypercapnia, refeeding syndrome, acid-base disturbances, liver complications, manganese toxicity, and metabolic bone disease.