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Objective: The determinants that cause impaired quality of life (QOL) in patients in long-term remission of Cushing's syndrome (CS) are unknown. The aim of this study was to get more insight into the patient and disease characteristics related to impaired QOL in these patients. Design: Cross-sectional study. Methods: The QOL of 123 patients in remission of CS (age 52.2±12.0 years, 106 women, duration of remission 13.3±10.4 years, 80% pituitary CS), assessed with seven validated questionnaires, was compared with the QOL of an age- and sex-matched control group (n=105). To investigate the influence of the aetiology of CS on QOL, patients in remission of pituitary and adrenal CS were compared. Furthermore, the influence of hormonal deficiencies, treatment strategy, duration of remission, gender and age on QOL was investigated. Results: QOL in the total patient group and each patient subgroup was significantly worse on practically all dimensions of questionnaires compared with the control group (P<0.05), except for patients in remission of pituitary CS without hormonal deficiencies who had an impaired QOL on 50% of the QOL dimensions. Subgroup analysis revealed no difference in QOL between different patient groups, especially no difference between patients in remission of adrenal and pituitary CS. Female gender and a shorter duration of remission had a negative influence on QOL in the patient group. Conclusions: QOL remains impaired in patients in long-term remission of CS regardless of aetiology, presence of hormonal deficiencies and treatment strategies. More research is needed to establish the causes. [ABSTRACT FROM AUTHOR]

During the past nine years, each of the plots of a pear tree orchardwere treated annually with the same herbicide treatment. The following herbicide treatments were compared, each being made by applicationof a mixture of two or three herbicides: 1a, no herbicide at all, weeds being hoed (control 1a); 2, diuron + paraquat 3 + 1 kg/ha; 3, simazine + paraquat 2 + 1 kg/ha; 4, isoxaben + diuron + paraquat 0.5 + 1.6 + 1 kg/ha; and 5, isoxaben + simazine + paraquat 0.5 + 1.25 + 1 kg/ha. In March 1996, one year after the final orchard herbicide treatment, isoxaben could not be detected in the soils of any field plots; isoxaben was incorporated at 0.74 mg/kg in the loamy soils sampled separately in each of the field plots, and the soils were incubated in the laboratory. Isoxaben soil half-lives were 92 days in the soils treated previously with herbicide treatments 1a, 2, or 3 and 42 days inthe soils treated with herbicide treatments 4 and 5. The repeated isoxaben treatments applied in the past thus enhanced the isoxaben soilbiodegradation; diuron, simazine, and paraquat had no influence on this rate enhancement. On the other hand, herbicide treatments 4 and 5were applied in the orchard in April 1996 on the corresponding plotstreated in this manner for the last nine years. Isoxaben + paraquat 0.5 + 1 kg/ha was applied simultaneously on other plots (control 1b) not treated in the past with isoxaben. During the growth season in the orchard, the isoxaben soil half-lives in the control plots 1b was 101 days, and 41 days in the plots where herbicide treatments 4 or 5 were applied. [ABSTRACT FROM AUTHOR]