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tory oliguria, and the development of generalized myalgia and respiratory muscle weakness.No known drug(s) associated with rhabdomyolysis, itself rare, 4 were administered, nor were any metabolic factors present that are capable of potentiating this event. When rhabdomyolysis has been reported in patients undergoing longterm therapy, no acute causative factor is apparent. 3,4 Rosenberg and colleagues, 5 however, have documented intraoperative rhabdomyolysis associated with pravastatin in cases in which the operation was thought to be the trigger. Although speculative, 7 years of uneventful simvastatin therapy in this case, together with the report by Rosenberg's group, indicates to us that the timing of this complication and operation were not coincidental.

Dynamic cardiomyoplasty was performed in a patient using a new cardio-myostimulator (LD-PACE II) designed to enable a novel stimulation regimen that utilizes a new range of stimulation options, including cessation during sleep. After treatment, left ventricular ejection fraction improved in 24 months from 15% to 25% and New York Heart Association classification improved from class IV to II.

Objectives.  TARGET randomised 376 children with persistent OME to 3 regimens: watchful waiting (WW), ventilation‐tubes only (VTO), and ventilation tubes‐adenoidectomy (VTA). At 2‐year follow‐up, the demonstrated greater benefits of VTA than VTO in terms of respiratory problems and hearing thresholds were still present. Records from the largest centre were examined to determine how long benefits of +adenoidectomy continue beyond 2 years. Methods.  Retrospective records analyses of Leicester children captured consultations and treatments outside the TARGET protocol, plus pure‐tone‐average (0.5–4 kHz) at latest clinical entry. Results.  Ninety‐four of 95 notes (99%) were available, with time‐lags of 7.5–11.6 years. On intention‐to‐treat analysis, children receiving treatment additional to allocation comprised 61% of WW, 59% of VTO, and 44% of VTA, with average surgical procedures numbering 1.0, 2.1, and 1.7. Proportions of children requiring >1 additional procedure were 13%, 34%, and 15%. Differences (VTO‐VTA) for consultations, operations and combined were marginal for this single centre but consistent with the significant all‐centre data for 3–6 years from randomisation. Mean latest pure‐tone‐averages were 15.84, 11.73, and 12.44 dBHL. Conclusions.  (1) Additional adenoidectomy has enduring benefits over VTO, although most clinical benefit appears to arise in the early years. (2) The two fifths of children randomised to WW not requiring surgery merit detailed epidemiological characterisation. (3) The benefits of surgery in OME are modest, requiring large‐number trials, but are genuine.