Daniela-Lucia Muntean

Background/Objectives: Cognitive impairment in alcohol use disorder (AUD) may reflect alcohol exposure, withdrawal, nutritional disruption, systemic illness, and social vulnerability. We evaluated prioritized human-adult evidence linking nutritional exposures with objective cognition and examined separately whether AUD severity modifies nutrition–cognition associations and whether nutritional disruption mediates the relationship between alcohol exposure and cognitive outcomes. Methods: This structured narrative review used documented multi-database retrieval, pre-access prioritization, full-text adjudication, evidence appraisal, and qualitative sensitivity scenarios. A targeted vitamin B12 update supplemented the baseline corpus. Results: Thiamine had the broadest and most clinically actionable evidence, but biomarker thresholds, optimal cognitive dosing, and independent treatment effects remained uncertain. Evidence for folate, vitamin B12, niacin outside pellagra, other micronutrients, diet, body mass index, and albumin was sparse, mixed, or nonspecific. The targeted B12 evidence was null or contradictory rather than supportive. Cognitive improvement during detoxification could not be separated from abstinence and bundled care. No included study verified causal mediation by nutrition or a formal nutrition-by-severity interaction. Conclusions: Nutritional assessment and prompt treatment of recognized deficiency remain clinically important, but the prioritized retrieved corpus does not justify nutrient-specific causal claims for typical AUD-related cognitive impairment. Longitudinal studies should align repeated nutrition, alcohol exposure, cognition, and function and prespecify interaction and mediation tests.

Background: The modern pharmacist is no longer just a person who prepares medicines, but has become an important health care provider involved in public health, including pharmaceutical care, prevention, chronic disease management and digital health. Such a transition requires the need for professional independence, supported by effective regulation. Deontological codes guarantee this independence and duties but variability in legal frameworks across Europe limits consistent innovation in pharmaceutical care. Objectives: The study analyses the deontological framework for pharmacist professional independence across 30 European jurisdictions and evaluates how effectively each national framework protects independence as a precondition for the development of pharmaceutical care, taking into account professional mobility and changes in healthcare system requirements. Methods: A comparative analysis examined deontological codes and professional ethics from 27 EU countries, the UK, Norway, and Switzerland. Data were collected using a 14-criterion protocol on topics like legal status, professional independence, conscientious objection, confidentiality, advertising, inter-professional relations, competition, errors, telepharmacy, digitalization, continuity of care, professional development, salary regulation, pharmaceutical services, and incompatibilities. These criteria were organized into five thematic clusters for comparison. Results: Three regulation models were identified regarding the legal status of deontological codes: (a) incorporation into primary health legislation, (b) delegation to professional bodies to establish binding corporatist codes, and (c) implementation of soft-law professional standards. While all models share an ethical focus, emphasizing patient priority and confidentiality, they differ considerably in terms of legal bindingness, sanctions, and structural safeguards of professional independence—such as pharmacists’ salaries, ownership rights, and incompatibilities. Telepharmacy is governed by different regulatory frameworks, whereas the application of AI in pharmacy practice has not yet been incorporated into existing deontological codes. Conclusions: The current deontological framework affirms professional independence but offers uneven protection; its effectiveness relies more on the legal structure, enforceability, and safeguards than on explicitly enshrined independence. EU-wide harmonization is neither legally feasible nor essential; instead, a shared minimum standard advocated by professional organizations could facilitate European coordination. The digital and AI gap is the most urgent area for deontological updates.

Skin ageing is associated with oxidative stress, mitochondrial dysfunction, extracellular matrix alterations, and impaired barrier function, supporting interest in antioxidant cosmeceuticals for mature skin. This study investigated the antioxidant activity of melatonin and N-acetylcysteine, the in vitro permeation of melatonin from different cream formulations, and their preliminary clinical performance in women aged 55–65 years. Antioxidant activity was assessed using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)/Trolox equivalent antioxidant capacity (ABTS/TEAC) assays. Melatonin permeation across Strat-M^® membranes was evaluated using Franz diffusion cells and quantified by a validated high-performance liquid chromatography method coupled with a photodiode-array detection (HPLC-PDA) method. Clinical changes were assessed over 28 days using the Glogau wrinkle scale and a lower facial ptosis scale. N-acetylcysteine exhibited greater antioxidant activity than melatonin in the DPPH assay, with half-maximal inhibitory concentration (IC₅₀) values of 5.96 ± 1.02 and 530.11 ± 48.63 µg/mL, respectively. Melatonin permeation varied according to formulation composition, with cumulative amounts after 24 h ranging from 81.27 ± 17.47 to 1043.48 ± 33.43 µg/cm². Reductions in periocular wrinkle and lower facial ptosis scores were observed after 28 days. These preliminary findings support further investigation of melatonin–N-acetylcysteine creams for mature skin. However, the present membrane model did not assess cutaneous retention, and the clinical observations require confirmation in larger, controlled studies.

(1) Background: Regulations governing food supplements vary considerably across countries, allowing products that are prohibited in one jurisdiction to be legally sold in another. Furthermore, online sales enable and facilitate this practice. Regarding pharmaceutical malpractice, the absence of a standardized European framework complicates the evaluation of pharmacist liability. As a result, the specific elements of the liability framework are defined by the national legislation of each Member State. The aim of our review is to map the global regulatory landscape of food supplements and to examine the pharmacist’s professional responsibilities, including instances of malpractice related to this area. (2) Methods: A literature review covering publications from January 2020 to December 2024 was performed using four databases: Scopus, PubMed, Embase, and Web of Science. The search retrieved 8243 records, of which 77 studies fulfilled the eligibility criteria. The extracted data were organized into five main themes: pharmacist responsibility and malpractice, food supplement regulation, consumer safety, health claims, and pharmacist knowledge. (3) Results: The literature reviewed indicated a relatively low number of malpractice cases within the pharmacy profession compared to other professions. A higher incidence of cases is observed among male pharmacists and those practicing in the private sector. Notably, no cases have been identified addressing pharmacists’ responsibilities in the dispensing of food supplements. In the context of food supplement regulation, the reviewed literature highlights a lack of standardized terminology and harmonized legislation across different jurisdictions. Therefore, products may be classified differently across jurisdictions. Another observed barrier is the considerable variation in market access requirements across countries. Regarding consumer safety, several irregularities have been observed. Substantial non-compliance in both product composition and labeling has been observed, reflecting insufficient quality control measures. Concerning health claims, significant regulatory non-compliance with European Union regulations has been documented. In addition, widespread misleading advertising practices have been observed. With respect to pharmacists’ knowledge, the reviewed literature identifies several professional challenges within pharmacy practice, particularly those concerning the dispensing of food supplements. (4) Conclusions: This research offers a comprehensive analysis of the literature published over the past five years concerning pharmaceutical malpractice cases, as well as an examination of food supplement regulation and the professional responsibilities of pharmacists. A recurring barrier identified is the absence of unified regulatory frameworks worldwide. This results in uncertainty concerning the pharmacist’s professional role and responsibilities.

The increasing demand for advanced cosmetic formulations based on natural biopolymers has stimulated the design of multifunctional and sustainable skin care products. Hyaluronic acid (HA) and silk proteins are widely recognized for their hydrating, barrier-supportive, and biocompatible properties. This study aimed to develop a novel topical formulation, integrating low- and medium molecular weight hyaluronic acid (LMW-HA and MMW-HA), encapsulated sodium hyaluronate (NaHA), silk, and hydrolyzed silk as active components, aiming to enhance skin barrier function and biocompatibility. The formulation was subjected to comprehensive physicochemical characterization including evaluation of appearance, odor, color, pH, viscosity, and stability, all assessed over 30 days and microbiological stability testing under controlled storage conditions. Safety evaluation followed a dual-phase strategy: (i) in silico toxicological screening of individual ingredients, including sensitization, and mutagenicity predictions, and (ii) in vivo skin compatibility assessment in 25 human volunteers using a semi-occlusive patch test. The formulation demonstrated good physicochemical stability, as pH remained stable, and viscosity showed no significant changes, confirming structural integrity, indicating preserved structural and microbiological stability throughout the study period. The in silico assessment indicated no mutagenic and/or sensitizing alerts and favorable safety margins for all components, confirming the safety profile of each ingredient, supporting their suitability for dermocosmetic use, while in vivo evaluation revealed no significant adverse effects, with irritation scores indicating no skin reaction (erythema or edema) across the test population. These findings support the potential of this novel biopolymer-based formulation as a safe and well-tolerated dermocosmetic product, aligning with principles of sustainable development and biomimetic design.

Medical education is the paradigm of 21st century education and the current changes involve the adoption of integrative and comprehensive patient-centered teaching and learning approaches. Thus, curricular developers from George Emil Palade University of Medicine, Pharmacy, Sciences, and Technology of Targu Mures (G.E. Palade UMPhST of Targu Mures) have recently designed and implemented an innovative medical curriculum, as well as two valuable assessment tools for both theoretical knowledge and practical skills. Thus, during the first three preclinical years, the students will benefit from an organ- and system-centered block teaching approach, while the clinical years will focus on enabling students to achieve the most important practical skills in clinical practice, based on a patient bedside teaching system. In terms of theoretical knowledge assessment, the UNiX center at G.E. Palade UMPhST of Targu Mures, a recently designed center endowed with the latest next-generation technology, enables individualized, secured multiple-choice question-based assessments of the student’s learning outcomes. Moreover, an intelligent assessment tool for practical skills was also recently implemented in our branch in Hamburg, the Objective Structured Clinical Examination (O.S.C.E). This system uses direct observations for testing the student’s practical skills regarding anamnesis, clinical exams, procedures/maneuvers, the interpretation of laboratory tests and paraclinical investigations, differential diagnosis, management plans, communication, and medical counselling. The integrative, comprehensive, patient-centered curriculum and the intelligent assessment system, implemented in G.E Palade UMPhST of Targu Mures, help define innovation in education and enable the students to benefit from a high-quality medical education.

Skin disorders constitute a persistent health problem, covering both acute and chronic conditions that manifest in patients of all ages. Betulinic acid (BA) is a triterpene previously studied as an efficient treatment of skin ailments due to its innate pharmacological properties. Nonetheless, due to its lipophilic nature and low bioavailability, topical delivery systems are necessary for its proper administration. Oleogels are efficient carriers for the incorporation of hydrophobic biomolecules; however, their use for the delivery of BA remains scarce. Therefore, this study was designed to develop, characterize, and evaluate a BA-containing oleogel (BA-O) regarding its cutaneous safety profile as a potential pharmaceutical formulation targeting dermatologic issues. The findings illustrated the efficient formulation of BA as oleogel, the product presenting the specific conditions of topical semi-solid formulations in terms of physico-chemical characteristics and high biocompatibility in vitro and in ovo, as BA-O lacked a cytotoxic effect in HaCaT and JB6 Cl 41-5a skin cells (cell viability percentages being > 70%) and was categorized as non-irritant in EpiDerm™ tissues (viability > 80%) and on the chorioallantoic membrane (Irritation Score = 0.186). These results present the preclinical biosafety profile of BA-O with prospective potential for cutaneous applications that should be investigated in future studies.

Adolescence represents a critical developmental stage where diet, gut microorganisms, and mental health are strongly interconnected. The current literature evidences the bidirectional role between dietary habits and psychological well-being, which is mediated by the gut–brain axis. The purpose of this review is to highlight the importance of dietary habits in adolescence period and the impact of different food choices on microbiota and secondary on mental health. Gut microbiota plays a vital role in the synthesis of neurotransmitters such as serotonin, dopamine, noradrenaline, and metabolites like short-chain fatty acids (SCFAs). The disruption in the composition of microbiota is called dysbiosis, which has been associated with a systemic inflammation state and chronic stress. They contribute to the onset of psychiatric disorders including MDD, anxiety, ADHD, and autism. Diets with a high quantity of sugar and low fiber contribute to alteration of microbiota and poor mental health. Additionally, early-life stress, antibiotic usage, and chronic inflammation may alter bacterial communities, with long-term implications for adolescents mental health. Dietary interventions, including the intake of prebiotics, probiotics, SCFAs, and micronutrients could restore microbial balance and improve psychiatric symptoms. This literature review highlights the critical role of diet and gut microbiota for adolescent mental health and emphasizes the need for integrative strategies to promote psychological resilience through microbiome regulation.

Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and disproportionate emotional response to specific sounds or associated visual stimuli. Triggers include human-generated sounds, mainly sounds related to feeding and breathing processes, and repetitive mechanical sounds. In response to the triggering stimulus, the patient experiences immediate, high-intensity, disproportionate physical and emotional reactions that affect their quality of life and social functioning. The symptoms of misophonia can occur at any age, but onset in childhood or adolescence is most common. Affected children live in a constant state of anxiety, suffer continuous physical and emotional discomfort, and are thus exposed to significant chronic stress. Chronic stress, especially during childhood, has consequences on the main biological systems through the dysregulation of the hypothalamic–pituitary–adrenal axis, including the gastrointestinal tract. Here, we provide arguments for a positive correlation between misophonic pathology and gastrointestinal symptoms, and this hypothesis may be the starting point for further longitudinal studies that could investigate the correlations between these childhood vulnerabilities caused by misophonia and their effect on the gastrointestinal system. Further research to study this hypothesis is essential to ensure correct and timely diagnosis and optimal psychological and pharmacological support.

This study aimed to investigate Romanian physicians’ awareness, recommendation practices, and opinions regarding the use of Foods for Special Medical Purposes (FSMPs) products. A total of ten physicians were interviewed using a structured questionnaire, and their responses were analysed using thematic content analysis. The study found that physicians were aware of FSMPs and recommended them to their patients based on nutritional deficits, weight loss, or deglutition impairments. In addition, disease stage, treatment scheme, taste, affordability, and availability were identified as factors influencing the recommendation and use of FSMPs. While physicians generally did not consult clinical trials, clinical experience was deemed essential for recommending FSMPs to patients. Patients’ feedback regarding the usage and sourcing of FSMPs was generally positive, with some expressing concerns about the availability of different flavours and the costs of purchasing the products. This study concluded that physicians play a vital role in recommending FSMPs to patients and ensuring they have the necessary nutritional support during treatment. However, it may be imperative to consider the provision of additional patient education materials and fostering collaborative efforts with nutritionists in order to optimise the prospects of positive outcomes in oncology treatment, while simultaneously alleviating the financial burdens faced by patients.