It is difficult to offer an alternative to an infective explanation for the present findings. A possible relation between leukaemia in children under 1 year and maternal use of drugs such as marijuana'7 cannot be relevant here, since the period in question long preceded any appreciable use of such drugs in Britain. Similarly, a hypothesis about mutations caused by delayed exposure to immunological challenges'8 cannot be invoked since it would apply only in leukaemia occurring later than the ages that show the excess in this study.The findings support the hypothesis that prompted this study-that the presence of large numbers of servicemen, particularly in rural districts, was conducive to an increase in the incidence of childhood leukaemia. They also point to an infection transmitted among adults, as also implied by a recent study of the effects of the population mixing associated with increases in commuting. ' Design-Randomised study of two treatment groups with a minimum follow up of nine months.Setting-Royal Berkshire Hospital, Reading. Subjects-51 of 78 menorrhagic women without pelvic pathology who were on the waiting list for abdominal hysterectomy.Treatment-Endometrial resection or abdominal hysterectomy (according to randomisation). Endometrial resections were performed by an experienced hysteroscopic surgeon; hysterectomies were performed by two other gynaecological surgeons.Main outcome measures-Length of operating time, hospitalisation, recovery; cost of surgery; short term results of endometrial resection.Results-Operating time was shorter for endometrial resection (median 30 (range 20-47) minutes) than for hysterectomy (50 (39-74) minutes). The hospital stay for endometrial resection (median 1 (range 1-3) days) was less than for hysterectomy (7 (5-12) days). Recovery after endometrial resection (median 16 (range 5-62) days) was shorter than after hysterectomy (58 (11-125) days). The cost was £407 for endometrial resection and £1270 for abdominal hysterectomy. Four women (16%) who did not have an acceptable improvement in symptoms after endometrial resection had repeat resections. No woman has required hysterectomy during a mean follow up of one year.Conclusion-For women with menorrhagia who have no pelvic pathology endometrial resection is a useful alternative to abdominal hysterectomy, with many short term benefits. Larger numbers and a longer follow up are needed to estimate the incidence of complications and the long term efficacy of endometrial resection. IntroductionEndometrial resection is gaining widespread acceptance as a surgical treatment for menorrhagia. A survey in August 1990 showed that 36 British centres had performed a total of over 4000 endometrial ablation procedures.' Seventy per cent of these were endometrial resections with the urological resectoscope.The technique was initially used for treating intractable uterine bleeding in women who were unfit for hysterectomy because of blood dyscrasias or extreme anaesthetic risk.2 Follow up showed that most remained amenorrhoeic. Tr...

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The authors evaluate and advocate the need for comprehensive sexuality education that meets the unique needs of youth who are deaf or hard of hearing, while calling for the expansion of teacher preparation in this critical area. Effective comprehensive sexuality education is designed to prepare young people to become more comfortable with, and informed about, their sexuality. Teachers and parents are key adults in this process. However, the responsibility for preparing teachers to handle sexuality education lies with both the postsecondary teacher preparation program and the administrative team at the individual school; their willingness to provide comprehensive training, current resources, and continued support are crucial to the success of any comprehensive sexuality program. In the individual school, effective guidance of youth who are deaf or hard of hearing in making appropriate decisions about their sexuality is built upon a team that includes not only school staff, but also parents and deaf adults in the community.

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The use of bone anchors as a superior fixation for suburethral slings is becoming popular. We present a case report of pubic osteomyelitis and granuloma after bone anchor placement. A 71-year-old woman underwent placement of a vaginal wall sling using pubic bone anchors placed through a suprapubic incision. Recurrent swelling of the mons pubis required re-exploration and removal of the anchors from an infected pubic bone. When symptoms persisted over the following 10 months, the patient underwent repeat surgery and excision of a pubic bone granuloma. The use of bone anchors in suburethral sling surgery is associated with possible increase in patient morbidity, and no benefit to the patient has been shown.

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