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Three-in-one: Aldehyde-, alcohol- and phenol-free cleaning, disinfection and removal eng of grease from medical devices acc. to MDD ; and surfaces acc. to BPD ; 3 en 1: Limpieza libre de aldehdos, alcoholes y fenoles, desinfeccin y disolucin de grasas de productos medicinales de acuerdo con MDD ; y de superficies de acuerdo con BPD ; es Abstract 1216 Abstract 1051 USING PAPER-AND-PENCIL SURVEYS ON THE WEB TO ASSESS QOL; SHOULD WE EXPECT DIFFERENCES IN RELIABILITY? David Litaker, Penny Ott, Linda Muscatello, The Cleveland Clinic Foundation, Cleveland, OH Introduction: Web-based surveys are commonly used to access large populations at minimal costs in obtaining research data. Although many factors make this method of data acquisition attractive, the reliability of responses, especially in assessments of latent constructs such as quality of life QoL ; , is unclear even if previously validated paper-based surveys are used without alteration. Methods: The Rhinoconjunctivitis Quality of Life Questionnaire RQLQ ; and the allergy-specific Work Productivity and Activity Impairment WPAI ; were formatted into a single paper-and-pencil form P ; and two computer-assisted interfaces: touch screen TS ; , and web-based WB ; . Employees at a tertiary care medical institution completed the survey sequentially in two of the three formats, assigned randomly and in random order. Responses for each individual were compared on an item-byitem basis using Pearsons correlation and kappa coefficients; composite scores were compared within groups using paired T tests and between groups using one way ANOVA. Results: 75 volunteers completed 150 questionnaires in one of three possible format pairs P-TS, P-WB, and TS-WB ; . 54 72% ; of respondents were female; median age was 40-49 years. Individual item responses were highly correlated and concordant for all formats p 0.001 ; . Between group comparisons of the composite score calculated from responses in the RQLQ or WPAI showed no significant differences in QoL or work impairment due to allergies among administration formats. Within group comparisons, however, demonstrated significant differences between paper- and internet-based forms in allergy-related work impairment p 0.001, corrected for multiple comparisons ; . Conclusions: Although response concordance and correlation is similar, important differences in reliability may arise when different formats of administration are used. This study re-emphasizes the importance of establishing instrument reliability when new survey technology is used. INTERPRETATION OF QOL-CHANGES IN INPATIENT REHABILITATION PROGRAMS FOR CANCER PATIENTS Michael T. Moser, Joachim Weis, Dorothee Fachinger, Hans Helge Bartsch, Institute for Rehabilitation Research, Tumorbiology Center, Freiburg, Germany Clinical significance is a major issue in the discussion about the meaningfulness of QoL-changes. Several concepts were outlined in the literature. Medical and psychosocial rehabilitation programs for women with breast cancer were recognized as important interventions because positive effects on QoL, relapse and survival were reported. 161 women with nonmetastatic breast cancer were included. Qol was assessed by the EORTCQLQ-C30 breast module at admission and discharge approx. four weeks later ; . All women participated in interdiciplinary medical and psychosocial treatment programs. Changes in Qol were analysed with MANOVA procedures. Four concepts of clinical significance were compared: 1 ; effect size statistics, 2 ; reliable change statistics, 3 ; subjective significance measures and 4 ; normative comparisons. Statistical significant improvements in all functional domains and significant decreases in most symptom scales were found p .02 ; . Effect size calculations show large effects in the domains emotional functioning EF ; and general QoL GQoL ; and moderate effects in the domains physical PF ; -, role- and social functioning SF ; , fatigue, breast symptoms and therapy side effects according to Cohens classification ; . Reliable change statistics show reliable GQoL-improvements in 52% contrasted with 6% reliable deteriorations. A crossvalidation of QoLchanges with patients subjective significance self-ratings indicate large improvement in EF mean change score MCS 20.3 points ; and moderate improvements in PF MCS 3.8 ; , SF MCS 13.3 ; and GQoL MCS 13.2 ; . Normative comparisons and equivalency tests provide information about the comparability of QoL-profiles between our sample and women in general population. Methods for determination of clinical significance are an important dilation of classical hypothesis-testing procedures in QoL-research. Our findings suggest strong evidence for the efficacy of oncological inpatient rehabilitation programs. Oral - 9.

The invention includes a kit for improving at least one kidney function in a subject with a disease or condition that causes kidney malfunction or failure, comprising i ; an effective amount treprostinil or its derivative, or a pharmaceutically acceptable salt thereof, ii ; one or more pharmaceutically acceptable carriers and or additives, and iii ; instructions for improving at least one kidney function and triazolam. The metabolism of drugs in the human body plays an important role in their pharmacological actions. The parent drug and or its metabolites are often present in the biological fluid at very low concentrations; hence reliable, sensitive and specific analytical techniques are required for their detection and characterization. Capillary LC coupled to ion trap mass spectrometry was performed to allow for the rapid and effective identification of metabolites in urine following oral administration of a novel human neutrophil elastase inhibitor, which structure is given in Figure 1.

Oral estrogen administration to Turner's girls and postmenopausal women increased circulating GH levels 94, 95 ; . However, the treatment effects of estrogen on IGF-I were variable, with reports of no change 96 ; and even a fall in IGF-I levels 94, 95 ; . An early study using a large estrogen dose also reported suppression of IGF-I activity in postmenopausal women 97 ; . Thus, data reporting estrogen effects on GH IGF-I in women seem confusing in that estrogen treatment augmented GH secretion but was accompanied by variable and even suppressive effects on circulating IGF-I. Many studies have since reported that hormone replacement therapy reduces IGF-I levels 98 100 ; . The liver is a sex steroid-responsive organ, as well as the major site of GH-regulated metabolism and the principle source of IGF-I 101 ; . Many aspects of hepatic function are perturbed by supraphysiological concentrations of estrogen in the portal circulation after oral administration. Because estrogen is actively metabolized by the hepatic cytochrome system, a dose severalfold in excess of daily production rates must be administered orally to achieve an adequate systemic effect. The delivery of such a large dose into the portal system creates a pharmacological concentration not seen in the natural state. This so-called first-pass effect results in stimulation of the synthesis of angiotensinogen, clotting factors and trimethobenzamide.

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