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Objective: To identify wellness-related needs and assess the impact of wellness-related offerings among first professional year pharmacy students. Innovation: A survey tool was developed and offered to P1 students at the beginning and end of their fall and spring semesters. Additional biometric data was also collected to help identify wellness needs. Data from the first academic year (AY1) was used to develop targeted wellness interventions offered to P1 students during the subsequent academic year (AY2). Assessment strategies from AY1 were repeated with minor modifications in AY2 to identify changes in baseline needs and changes in markers across the academic year. Critical Analysis: AY1 survey response rates varied from 20.1% to 47.4% across the semester. Frequent dissatisfaction was reported with diet, weight, and exercise. AY2 survey response rates varied from 15.8% to 58.3% across the semester. The AY2 cohort demonstrated similar dissatisfaction data; however, also demonstrated lower baseline stress scores as compared to the AY1 cohort, higher baseline BMI, and higher systolic and diastolic blood pressure. Individual interventions offered to AY2 students were attended by as many as 16.5% of the academic cohort. Nutrition classes exhibited stronger attendance than fitness classes. Next Steps: The process used in this study was easily implemented and provided understanding of wellness gaps, which helped to identify interventions that were implemented and assessed. The process also demonstrated that wellness needs can vary from one population to another, reinforcing the value of periodic assessment to identify changing needs.   Type: Note

INTRODUCTION:Neuromuscular disorders such as Guillain-Barre syndrome (GBS) and myasthenia gravis (MG) can be rare, life-threatening adverse reactions induced by immune checkpoint inhibitors (ICIs). These conditions are characterized by skeletal muscle weakness that may quickly progress to involve the diaphragm, resulting in respiratory failure requiring invasive mechanical ventilation.DESCRIPTION: An 86-year-old male patient with metastatic renal cell carcinoma was started on adjuvant ICI treatment, nivolumab and ipilimumab, following radical left nephrectomy. After one month (two cycles) of ICI treatment, he presented to his ophthalmologist with complaint of new onset diplopia and severe bilateral ptosis. Ophthalmology recommended emergency department evaluation due to the additional discovery of rapidly progressing bilateral lower extremity weakness. He was admitted to the general medicine ward for further evaluation of suspected ICI-induced MG or GBS. After one day of hospitalization, he was transferred to the intensive care unit (ICU) for worsening respiratory muscle weakness and potential need for invasive mechanical ventilation. Treatment with intravenous immunoglobulin (IVIG) and high-dose corticosteroids was initiated. The patient's condition stabilized, and he did not require invasive mechanical ventilation. After two days of ICU admission, he was transferred to the step-down unit where he completed five days of IVIG and corticosteroid treatment. Due to persistent weakness, treatment with plasma exchange (PLEX) was initiated. After five sessions of PLEX, clinical improvement was seen with gradual restoration of strength and resolution of symptoms. The patient was able to be discharged home after two weeks of hospitalization.