Vinyl imidates in cycloaddition reactions: a formal synthesis of (+/-)-reserpine.

[reaction: see text] The intramolecular Diels-Alder reaction of N-acylvinylimidates provides an efficient entry into cis-fused perhydroisoquinoline ring systems. This is demonstrated by the preparation of isoquinoline 2, an intermediate, which has been previously transformed to reserpine.

2-Amino-6-arylsulfonylbenzonitriles as non-nucleoside reverse transcriptase inhibitors of HIV-1.

A series of 2-amino-5-arylthiobenzonitriles (1) was found to be active against HIV-1. Structural modifications led to the sulfoxides (2) and sulfones (3). The sulfoxides generally showed antiviral activity against HIV-1 similar to that of 1. The sulfones, however, were the most potent series of analogues, a number having activity against HIV-1 in the nanomolar range. Structural-activity relationship (SAR) studies suggested that a meta substituent, particularly a meta methyl substituent, invariably increased antiviral activities. However, optimal antiviral activities were manifested by compounds where both meta groups in the arylsulfonyl moiety were substituted and one of the substituents was a methyl group. Such a disubstitution led to compounds 3v, 3w, 3x, and 3y having IC50 values against HIV-1 in the low nanomolar range. When gauged for their broad-spectrum antiviral activity against key non-nucleoside reverse transcriptase inhibitor (NNRTI) related mutants, all the di-meta-substituted sulfones 3u-z and the 2-naphthyl analogue 3ee generally showed single-digit nanomolar activity against the V106A and P236L strains and submicromolar to low nanomolar activity against strains E138K, V108I, and Y188C. However, they showed a lack of activity against the K103N and Y181C mutant viruses. The elucidation of the X-ray crystal structure of the complex of 3v (739W94) in HIV-1 reverse transcriptase showed an overlap in the binding domain when compared with the complex of nevirapine in HIV-1 reverse transcriptase. The X-ray structure allowed for the rationalization of SAR data and potencies of the compounds against the mutants.

Type 2 intramolecular nitroso Diels-Alder reaction. Synthesis and structure of bridgehead oxazinolactams.

[reaction--see text] The type 2 intramolecular Diels-Alder cycloaddition utilizing N-acylnitroso dienophiles provides an efficient entry into bridged oxazinolactams. In contrast to the bimolecular counterpart, the reaction is completely regioselective. Structural characterization of the cycloadducts allows for evaluation of the olefin distortion and the degree of pyramidalization of the bridgehead oxazinolactam.

World Wide Web search tools.

This article describes and compares five popular general search tools and two popular general metasearch tools. The tools and their related files in February 1998 are the source of information and illustrations. A MEDLINE(R) search no longer guarantees retrieval of the most current, relevant, appropriate, and useful information. To meet demands for current information, the World Wide Web (WWW) must be searched. However, the enormous size of the WWW makes finding relevant information a difficult task. Fortunately, there are many automated search tools that can assist in locating relevant information quickly. Choosing the most appropriate tool depends on the type of information being sought.

Changes in bacterial flora associated with skin damage on hands of health care personnel.

In a prospective observational study of 40 nurses (20 with diagnosed hand irritation and 20 without), nurses with damaged hands did not have higher microbial counts (P = .63), but did have a greater number of colonizing species (means: 3.35 and 2.63, P = .03). Although numbers were small, nurses with damaged hands were significantly more likely to be colonized with Staphylococcus hominis (P = .03). Fifty-nine percent of S hominis isolates from nurses with damaged hands were resistant to methicillin compared with 27% of isolates from those with healthy skin (P = .14). Twenty percent of nurses with damaged hands were colonized with Staphylococcus aureus compared with none of the nurses with normal hands (P = .11). Nurses with damaged hands were also twice as likely to have gram-negative bacteria (P = .20), entercocci (P = .13), and Candida (P = .30) present on the hands. Antimicrobial resistance of the coagulase-negative staphylococcal flora (with the exception of S hominis) did not differ between the 2 groups, nor did a trend toward increasing resistance exist when compared with other studies during the past decade. Skin moisturizers and protectant products were used almost universally by nurses at work, primarily products brought from home. Efforts to improve hand condition are warranted because skin damage can change microbial flora. Such efforts should include assessment or monitoring of hand care practices, formal institutional policy adoption and control of use of skin protectant products or lotions, and prudent use of latex gloves or more widespread use of powder-free and nonlatex products.

Twenty care components: an educational strategy to teach nursing science.

The HHCC System's twenty care components and nomenclature provide a framework for the development of teaching strategies to prepare nurses for practice in the 21st century. The use of an integrated system of instruments accessible to students on-line allows for a smooth transition from course to course and later to clinical nursing practice. Faculty and/or instructors at Georgetown University School of Nursing use this innovative educational strategy and conceptual approach to facilitate collaboration with other healthcare providers and to model professional behavior for students.

Noun phrases for nursing diagnoses.

TOPIC: The use of noun phrases for nursing diagnoses instead of the current mixture of phrases and clauses PURPOSE: This article reviews the current list of qualifiers; discusses language clarity, precision, grammatical concerns; and defines noun phrases. SOURCE: Literature review CONCLUSIONS: The author proposes a list of qualifiers to replace the current list, and recommends a revised list of nursing diagnoses using noun phrases to improve their clinical usefulness, allow for alphabetization, and enhance clarity.

Using the Internet for nursing administration.

The Internet offers unique communication opportunities that can be used advantageously by nurse administrators. The Internet supports electronic mail, file transfer protocol, telnet, Gopher, and World Wide Web protocols. Examples of nursing administration resources for each protocol are given. Issues involving the Internet include quality of the resource, confidentiality and privacy, taking advantage of the vision and support of nurse executives, licensure and reimbursement.

Use of the Internet for infection control and epidemiology.

Infection control professionals are taking advantage of the Internet for the rapid transmission and distribution of information that includes sounds, still and motion images, and text to their peers, colleagues, patients, and the public. This article provides some background information on the Internet and examples of some electronic resources and offers suggestions of additional applications of the Internet for infection control and epidemiology.

Using the Internet for urology nursing.

Nurses can take advantage of the Internet for information on diseases, diagnosis, and treatment, patient teaching, and collaboration with colleagues. The Internet is briefly described in this article. Several specific Internet addresses are given. Issues such as quality of resources, confidentiality and privacy, professional licensure and reimbursement of services rendered, and cost are discussed. Search tools for finding information you want on the Internet are included.

Modification of the diagnostic content validity model.

Diagnostic content validation of nursing diagnoses is a recommended means to confirm the defining characteristics necessary to establish a specific nursing diagnosis. The diagnostic content validity model has been used in numerous studies to develop lists of major and minor defining characteristics recommended by experts as being present in patients with specific diagnoses. The authors provide an overview of the diagnostic content validity model, review the meaning and purposes of content validity, discuss problems with information processing, and suggest revisions to the diagnostic content validity model. Incorporation of these changes may improve the usability of nursing diagnoses in clinical practice, education, and research.