Nilutamide is a nonsteroidal antiandrogen with affinity for androgen receptors but not for progestogen, estrogen, or glucocorticoid receptors. Consequently, nilutamide blocks the action of androgens of adrenal and testicular origin which stimulate the growth of normal and cancerous prostatic tissue. Nilutamide has a long half-life which permits once-daily administration. Nilutamide is usually given in combination with surgical or chemical castration using gonadotrophin-releasing hormone (GnRH) [luteinising hormone-releasing hormone (LHRH)] agonists. In castrated patients the addition of nilutamide improves objective response rates, bone pain, urinary symptoms, tumour markers and time to disease progression. The tolerance of nilutamide is generally acceptable. Adverse effects are usually mild and reversible and consistent with androgen depletion. Unexpected but reversible adverse effects of nilutamide include delayed adaption to dark after exposure to bright light, transient increases in transaminases, and more severe but rare interstitial pneumonitis. Thus, nilutamide is a welcome treatment option that may be particularly useful in patients to whom the convenience of once-daily administration is seen as a worthwhile benefit.

Aged↗

PubMedDate not supplied

Changing the role of the nurse in the hematology-oncology outpatient setting.

Changing healthcare economics, advances in technology, and consumer preferences have escalated the growth of outpatient hematology-oncology services and expanded the scope of professional decision making. Currently, 80%-90% of cancer care is delivered in the outpatient setting. Moreover, third-party payers are encouraging an even greater frequency of out-of-hospital hematology-oncology services. Oncology nurses are in key positions to change the outpatient healthcare setting in ways that promote quality care and improved use of professional nursing knowledge and expertise. This article describes a nurse manager's use of Lewinian theory to develop and implement plans for needed change in an outpatient Hematology-Oncology Department.

Ambulatory Care Facilities↗

PubMedDate not supplied

Practical considerations in the use of hydrogen peroxide disinfection systems.

Three studies were conducted to evaluate the effectiveness of hydrogen peroxide (H2O2) neutralization in returning the pH of the soft contact lens soaking solution to that of tears (pH 7.4). In the initial study, we evaluated seven different brands of H2O2 disinfection systems. The final pH of the seven systems ranged from 6.15 to 7.74, with two systems having values outside the threshold for ocular discomfort. The final residual H2O2 concentrations ranged from 0 to 70 ppm (parts per million), five of the seven having residual concentrations of 0 to 3 ppm. In the second part of the study, we evaluated the pH of four H2O2 systems over 4 weeks of daily use. The end-point pH of the H2O2 systems did not change significantly over the 4-week period, although two of the systems were consistently closer to the physiologic pH of tears than were the other two. In the third part of the study, four brands of over-the-counter (OTC) 3% H2O2 were substituted into six different H2O2 disinfection systems. The manufacturer's recommended H2O2 was used as a control. There were wide variations in initial pH and significantly lower end-point pH levels with the OTC preparations.

Contact Lenses, Hydrophilic↗