Hysteroscopic endometrial ablation was superior to hysterectomy in terms of operative complications and postoperative recovery. Satisfaction after hysterectomy was significantly higher, but between 70% and 90% of the women were satisfied with the outcome of hysteroscopic surgery. Hysteroscopic surgery can be recommended as an alternative to hysterectomy for dysfunctional uterine bleeding.
Objective: To compare levels of particulate matter, as a marker of secondhand smoke (SHS) levels, in pubs before and 2 months after the implementation of Scottish legislation to prohibit smoking in substantially enclosed public places. Design: Comparison of SHS levels before and after the legislation in a random selection of 41 pubs in 2 Scottish cities. Methods: Fine particulate matter ,2.5 mm in diameter (PM 2.5 ) was measured discreetly for 30 min in each bar on 1 or 2 visits in the 8 weeks preceding the starting date of the Smoking, Health and Social Care (Scotland) Act 2005 and then again 2 months after the ban. Repeat visits were undertaken on the same day of the week and at approximately the same time of the day. Results: PM 2.5 levels before the introduction of the legislation averaged 246 mg/m 3 (range 8-902 mg/m 3 ). The average level reduced to 20 mg/m 3 (range 6-104 mg/m 3 ) in the period after the ban. Levels of SHS were reduced in all 53 post-ban visits, with the average reduction being 86% (range 12-99%). PM 2.5 concentrations in most pubs post-ban were comparable to the outside ambient air PM 2.5 level.Conclusions: This study has produced the largest dataset of pre-and post-ban SHS levels in pubs of all worldwide smoke-free legislations introduced to date. Our results show that compliance with the Smoking, Health and Social Care (Scotland) Act 2005 has been high and this has led to a marked reduction in SHS concentrations in Scottish pubs, thereby reducing both the occupational exposure of workers in the hospitality sector and that of non-smoking patrons. 2 Data on exposure to SHS across a wide range of entertainment establishments indicated that airborne nicotine concentrations were up to 18.5 times higher than in offices or domestic residences.3 Studies have shown that non-smoking bar workers have salivary cotinine levels four times those of non-smokers who live with partners who smoke. 4 Data from New Zealand indicate that non-smoking hospitality workers in establishments that permit smoking have salivary cotinine levels between 3 and 4 times those of non-smoking workers in smoke-free premises.5 One estimate indicates that between 1500 and 2000 non-smokers' deaths per year in Scotland can be attributed to SHS exposure. 6 It has been suggested that SHS exposure may lead to the deaths of over 50 hospitality sector workers in the UK each year. The introduction of smoke-free legislation in other countries has been shown to dramatically reduce SHS levels. A recent analysis of the effect of the Norwegian legislation 8 showed that total dust levels in 13 bars and restaurants reduced from an average level of 262 to 77 mg/m 3 , a 70% reduction, whereas a study in the USA indicated that respirable dust levels in a selection of 8 hospitality venues reduced to approximately 9% of the pre-ban level.9 Similar work in New York State in a mixture of bars and restaurants measured levels of particulate matter ,2.5 mm in diameter (PM 2.5 ), and found that mean levels decreased from 412 to 27 mg/m 3 (93.5%). Alth...
Objective-To evaluate the effectiveness and safety of endometrial laser ablation and transcervical resection of the endometrium compared with hysterectomy in the surgical treatment of women with dysfunctional uterine bleeding.Design-Prospective randomised controlled trial.
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