Evaluation of service learning in a school of nursing: primary care in a community setting.

The evolving system of health care delivery, emphasizing prevention and early intervention, presents challenges to schools that educate health care professionals. Nursing faculty in a rural mid-Atlantic state initiated a service-learning project, relating education and service through primary care in the surrounding community. The purpose of the present study was to evaluate the project outcomes. The 45 students involved in the project responded to Beliefs Related to Professional Nursing Competencies, a quantitative measure (Cronbach's alpha = .84), based on the Pew Health Commission's "Competencies Needed by Practitioners for 2005," and to a second measure, Qualitative Questions for Students in Service Learning. Results of quantitative analysis revealed subjects' acceptance of the competencies as nursing responsibilities. Qualitative analysis revealed that students were involved in increasing consumer access to community-based primary care; curricula relating learning to existing problems and rewarding critical thinking was evident; and students were receiving preparation for a health care environment that will rely on their ability to respond to its changing needs.

Pharmacokinetics of nicotine tartrate after single-dose liquid enema, oral, and intravenous administration.

Ulcerative colitis is predominantly a disease of nonsmokers, and transdermal nicotine is therapeutic but often results in adverse reactions. Colonic administration of nicotine tartrate as a liquid enema could decrease systemic nicotine absorption and adverse reactions. The purpose of the current study was to determine the bioavailability and pharmacokinetic parameters of nicotine after administration by hydrophilic liquid enema (acidic and basic), hydrophobic liquid enema (acidic and basic), and by oral and intravenous routes. Thirty healthy volunteers received 45 micrograms nicotine base/kg (as nicotine tartrate) in one of five formulations (each n = 6): hydrophilic acidic liquid enema, hydrophilic basic liquid enema, hydrophobic acidic liquid enema, hydrophobic basic liquid enema, and oral solution. All participants also received 15 micrograms nicotine base/kg (as nicotine tartrate) intravenously during a separate study period. Serum concentrations of nicotine were determined by gas chromatography with mass spectrometry. The mean (+/-SD) bioavailabilities of nicotine after administration in the liquid enema formulations (hydrophilic acidic 17 +/- 18%, hydrophilic basic 16 +/- 16%, hydrophobic acidic 25 +/- 17%, hydrophobic basic 15 +/- 12%) were similar to the bioavailability of nicotine after administration by oral solution (20 +/- 25%). The bioavailabilities of nicotine for all five nonintravenous formulations were significantly less than for intravenous nicotine (100%). Serum concentrations of nicotine did not predict adverse reactions. Nicotine tartrate administered as either a liquid enema or as an oral solution had low bioavailability and was well tolerated. The therapeutic potential of nicotine tartrate liquid enemas, which can potentially limit toxicity by local (colonic) delivery of high doses of nicotine should be investigated in patients with left-sided ulcerative colitis.

A dose-ranging study of azathioprine pharmacokinetics after single-dose administration of a delayed-release oral formulation.

6-Mercaptopurine and its prodrug azathioprine are an effective treatment for inflammatory bowel disease, but widespread use has been limited by concern about toxicity. Ileocolonic delivery of azathioprine as a 50-mg delayed-release oral capsule has been shown to decrease bioavailability, thus potentially decreasing toxicity. This study aimed to determine the bioavailability and pharmacokinetic parameters of delayed-release oral azathioprine capsules at doses of 200 mg, 400 mg, and 600 mg relative to 100 mg of standard oral azathioprine tablets. Thirty healthy human volunteers each received delayed-release oral azathioprine at one of the three doses (n = 10 for each group). All participants also received a 100-mg tablet of standard oral azathioprine. Plasma concentrations of 6-mercaptopurine were determined by high-pressure liquid chromatography. The relative bioavailabilities of 6-mercaptopurine after ileocolonic azathioprine administration via delayed-release oral capsules at doses of 200 mg, 400 mg, and 600 mg (means of 15%, 15%, and 12%, respectively) were all significantly less than 100% compared with standard oral azathioprine at a 100-mg dose. Ileocolonic delivery of azathioprine by a delayed-release oral capsule formulation at doses up to 600 mg considerably reduces 6-mercaptopurine bioavailability, relative to standard oral azathioprine tablets. The therapeutic potential of this ileocolonic delivery formulation, which can limit toxicity by local delivery of azathioprine, should be investigated in patients with inflammatory bowel disease.

Simultaneous determination of azathioprine and 6-mercaptopurine by high-performance liquid chromatography.

A specific, sensitive, single-step solid-phase extraction and reversed-phase high-performance liquid chromatographic method for the simultaneous determination of plasma 6-mercaptopurine and azathioprine concentrations is reported. Following solid-phase extraction, analytes are separated on a C18 column with mobile phase consisting of 0.8% acetonitrile in 1 mM triethylamine, pH 3.2, run on a gradient system. Quantitation limits were 5 ng/ml and 2 ng/ml for azathioprine and 6-mercaptopurine, respectively. Peak heights correlated linearly to known extracted standards for 6-mercaptopurine and azathioprine (r = 0.999) over a range of 2-200 ng/ml. No chromatographic interferences were detected.

Purification of serologically active phosphoinositides of Mycobacterium tuberculosis.

Glycolipids extracted with pyridine from three strains of Mycobacterium tuberculosis were fractionated. Phosphatidyl inositol, two phosphatidyl inositol dimannosides (A and M), and two phosphatidyl inositol pentamannosides (G and K) were separated and purified by a combination of solvent fractionations and chromatography on silicic acid. In each of these lipids, palmitic and tuberculostearic acids accounted for more than 90% of the total fatty acids. Mole ratios of fatty acid to P were: for phosphatidyl inositol, 2; for G and M, 3; for A and K, 4. Certain mixtures of A or M with G fixed complement with human sera from cases of tuberculosis. Two serologically inactive dimannosides, each containing two fatty acid ester groups per atom of P, were also present.