A Study of factors affecting alpha-(N-carbamoyl)alkylcuprate chemistry.

The effect of Cu(I) salt (i.e., CuCN, CuCN.2LiCl, CuI), cuprate reagent, sec-butyllithium quality, solvent, and temperature upon the chemical yields obtained in the reactions of alpha-(N-carbamoyl)alkylcuprates [i.e., N-Boc-protected alpha-aminoalkylcuprates] with (E)1-iodo-1-hexene, 5,5-dimethyl-2-cyclohexenone, methylvinyl ketone, crotonate esters, and an acid chloride has been examined. Cuprate conjugate addition and vinylation reactions can succeed with low-quality sec-butyllithium, presumably containing insoluble lithium hydride and lithium alkoxide impurities, although yields are significantly lower than those obtained with high-quality s-BuLi. alpha-(N-Carbamoyl)alkylcuprates prepared from high-quality sec-butyllithium are thermally stable for 2-3 h at room temperature and are equally effective when prepared from either insoluble CuCN or THF-soluble CuCN.2LiCl. Use of the latter reagent permits rapid cuprate formation at -78 degrees C, thereby avoiding the higher temperatures required for cuprate formation from THF-insoluble CuCN that are problematic with solutions containing thermally unstable alpha-lithiocarbamates.

A community-based, interagency approach by dietitians to provide meals, medical nutrition therapy, and education to clients with HIV/AIDS.

Dietitians have the opportunity to be leaders in providing medical nutrition therapy and home-delivered meals for people with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) in the community setting. Four community agencies developed the Visiting Nurse Service HIV/Home Delivered Meals Program. Fifty clients with the diagnosis of HIV and/or AIDS were served for a 6-month period. The program provided convenient, energy-enhanced nutritious meals. Participants received daily hot and cold, energy- and protein-enhanced home-delivered meals; weekly high-energy, high-protein, shelf-stable Snack Packs; a Medical Nutritional Supplement Sampler Pack; and two home visits from dietitians. Different diet options were available. Dietitians completed 47 initial nutrition assessment and food safety education visits 1 to 2 weeks after meal delivery began, and 35 participants received follow-up nutrition counseling visits 4 to 8 weeks later. Participant data (including weights) were self-reported. Dietitians reported that 13 of 35 participants gained weight (mean = 6 lb), 11 of 35 remained the same weight, and 11 of 35 lost weight (mean = 5 lb). Initially, 14 of 35 participants were considered to be "doing well"; this improved to 19 of 35 participants 1 to 2 months later. Snack Packs were effective means to help participants meet some of their increased nutrient needs. The Medical Nutritional Supplement Sampler Pack was effective in familiarizing each participant with available products. Medical nutrition therapy by registered dietitians helped most participants improve their food consumption.