Safety and efficacy of memantine and trazodone versus placebo for motor neuron disease (MND SMART): stage two interim analysis from the first cycle of a phase 3, multiarm, multistage, randomised, adaptive platform trial.

Background: Motor neuron disease represents a group of progressive and incurable diseases that are characterised by selective loss of motor neurons, resulting in an urgent need for rapid identification of effective disease-modifying therapies. The MND SMART trial aims to test the safety and efficacy of promising interventions efficiently and definitively against a single contemporaneous placebo control group. We now report results of the stage two interim analysis for memantine and trazodone.

Providing a specialty trainee teaching programme over long distances.

Background: Today's teaching programmes must be interesting, relevant to the surgical curriculum, as defined in the UK by the Intercollegiate Surgical Curriculum Programme (ISCP), and attractive enough to the trainee so that they encourage attendance without compromising operative experience.

Methods: Our aim was to achieve the objectives of the ISCP and to provide high-quality teaching to the trainees. We devised a 2-year rolling programme of events to cover the knowledge and skills required for general surgical training for both the Membership of the Royal College of Surgeons (MRCS) and Fellowship of the Royal College of Surgeons (FRCS) examinations.

Patient preferences for surgical techniques: should we invest in new approaches?

Background: The face of surgery has changed over the past two decades with the introduction of laparoscopic techniques. The majority of surgical specialties now perform minimally invasive procedures hence decreasing the scarring, pain, and infection historically associated with open surgery. To further reduce the invasiveness of surgery, new surgical techniques like Natural Orifice Transluminal Endoscopic Surgery (NOTES) and Single-Port Surgery (SPS) are under development.

"Single-port" laparoscopic cholecystectomy--the Aberdeen technique.

Introduction: Laparoscopic cholecystectomy remains the most frequently performed minimally invasive operation for general surgeons. The next step toward "scar-less" surgery uses a modified single multichannel port inserted through the umbilicus.

Methods: The use of a single port requires modification of the currently established technique for laparoscopic cholecystectomy with a single-port protocol.

Are automated blood pressure monitors accurate enough to calculate the ankle brachial pressure index?

Objective: Conventional sphygmomanometers are being replaced by automated devices; can they be used to accurately calculate ABPI?

Method: Thirty-six volunteers (72 legs) attending a vascular clinic had their ankle, brachial blood pressure and ABPIs calculated using each of these 3 methods. (1) Conventional aneuroid BP cuff with hand held doppler. (2) OMRON HEM 705CP portable automated BP monitor.