Teaching emerging diseases: a strategy for succeeding with nonmajors.

A nonmajors course on emerging diseases served to introduce students to basic concepts in microbiology and to improve scientific literacy. The course used a range of learner-centered approaches to encourage students to take responsibility for their own learning. Evaluations demonstrated both student satisfaction and an increased understanding of important issues in microbiology.

Selection of a derivative of the antiviral agent 9-[(1,3-dihydroxy-2-propoxy)-methyl]guanine (DHPG) with improved oral absorption.

Various diesters of 9-[(1,3-dihydroxy-2-propoxy)-methyl]guanine (DHPG) were screened in order to identify a derivative with improved oral absorption. The solubilities and dissolution rates decreased with increasing chain length and branching of the ester group. However, the dipropionate ester showed an anomalously faster dissolution rate. The rates of hydrolysis to DHPG in the presence of intestinal homogenates were found to increase with increasing carbon number for the straight-chain alkyl esters and decreased with branching. The shorter-chain alkyl esters were relatively more stable in intestinal homogenates than in liver homogenates. Therefore they may have a better membrane permeability than DHPG due to their intact ester group. The hydrolysis rates in human blood increased with increasing carbon number for the straight-chain alkyl esters. The dipropionate ester appeared to be the most promising derivative because of its rapid dissolution rate, slower hydrolysis in the intestine, and rapid conversion to DHPG in liver and blood.

A Radioimmunoassay Procedure for the Determination of the Antiviral Nucleoside DHPG (9-[(l,3-Dihydroxy-2-propoxy)-methyl]guanine) in Plasma or Serum.

A procedure is described that is suitable for the radioimmunoassay (RIA) of 9-[(l,3-dihydroxy-2-propoxy)-methyl]guanine (DHPG) in plasma or serum at concentrations as low as 0.7 ng/ml (2.75 × 10(-9) M). Antiserum was prepared by coupling DHPG monohemisuccinate to bovine serum albumin and immunizing rabbits with the resulting conjugate. The antibodies did not show significant cross-reactivities with structurally related endogenous compounds. For RIA, tritium-labeled DHPG was used as the tracer and charcoal-dextran was used to separate the free and bound fractions. No purification of samples was required prior to RIA. The accuracy of the method was assessed by adding known quantities of DHPG to DHPG-free plasma and determining the ratio of measured to added analyte. Linear regression analysis for the concentration range 0.0007 to 15.0 µg/ml yielded the following equation; y = 0.90 x + 0.033 (r = 0.999). Additional validation was obtained from studies in which DHPG was administered to a monkey, mice, dogs, and rats, and plasma-clearance profiles were determined by RIA and high-performance liquid chromatography (HPLC). The results obtained by RIA were in good agreement with those obtained by HPLC.

Evaluation of family health education to build social support for long-term control of high blood pressure.

Sustaining patient motivation for long-term adherence to drug therapies remains a substantial problem for physicians, other health care providers, the patients themselves, and their families. Other therapeutic requests such as dietary changes and weight control may be even more difficult to maintain than taking pills. As part of a controlled experimental design implemented in an outpatient teaching hospital, an educational program was implemented to improve family member support for medical compliance among hypertensive patients. Family members were interviewed, counseled, and provided with a booklet for the purpose of educating and involving them in the home management of high blood pressure. The booklet identified ways the family member could assist the patient with medication compliance, appointment keeping, as well as diet and weight control. These items were identified and recorded as behavioral objectives in the booklet. Patients were followed for three years to assess long-term outcomes. Results showed a strong statistically significant difference between the experimental and control groups, with the experimental group demonstrating higher levels of appointment-keeping behavior, weight control, and BP under control (all p values less than .001). Analysis of the main effects of the educational program demonstrated that the family member support intervention accounted for the greatest decrease in diastolic blood pressure variability, R2 = .20, p less than .001.

Liquid chromatography of codeine in plasma with fluorescence detection.

This analytical method for easier determination of codeine in human plasma is based on "high-performance" liquid chromatography for separation and the natural fluorescence of codeine for detection. Codeine is extracted from alkalinized plasma with a mixture of hexane and dichloromethane, and the extract is further purified and chromatographed. The method can be used for routine assay of codeine at the concentrations of 10 micrograms/L or greater in human plasma. As little as 4 micrograms/L can be detected. Coefficients of variation for the assay of codeine in the concentration range of 10 to 100 micrograms/L were 2.2-7.4% (n = 6). We used this method to establish a concentration/time profile for plasma from a human volunteer after a 60-mg oral dose of codeine sulfate.

Reversed-phase high-pressure liquid chromatographic analysis of sulconazole in plasma.

A sensitive and specific analytical method for the measurement of sulconazole in plasma is described. The compound was extracted from plasma at pH 10 with hexane-methylene chloride. Samples were subjected to high-pressure liquid chromatography (HPLC) using an acetonitrile-phosphate buffer mixture as the mobile phase. The components of interest were measured using a variable-wavelength detector at 229 nm. Sulconazole concentrations of greater than or equal to 0.5 microgram/ml can be measured with confidence using this method. Linear calibration curves were constructed over the concentration range of 0.5-5 microgram/ml for sulconazole from dog plasma. A dog was administered a single oral 1000-mg dose of tritiated sulconazole nitrate; total plasma radioactivity and sulconazole plasma levels determined by HPLC are reported.

Nurses' perceptions of themselves, cancer nurses, typical, ideal and cancer patients.

The Activity Vector Analysis was administered to four independent samples of hospital staff nurses (40 working on surgical floors, 40 on medical floors, 10 cancer specialists, and 10 in an outpatient department) to investigate differences in how nurses perceived themselves versus the type of nurse who works best with cancer patients, as well as differences in the perceptions of typical hospital patients, ideal patients, and cancer patients. Highly congruent stereotype clusters for the perception of the typical patient and cancer patient were found along with two less congruent stereotype clusters of the ideal patient and a stereotype cluster of perceptions of the cancer nurse. Both typical patients and typical cancer patients were seen as significantly below average in terms of their potential for action and were perceived as exercising less foresight, planning ability, moral judgment, and ethical conduct than nurses.