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Abstract Implant removal comprises 5% of all orthopaedic surgery procedures performed annually. Surgical indications range from implant failure, infection, non-union, and symptomatic hardware. Intra-operatively, surgeons need to prepare for complications including bony overgrowth, cold-welding, broken screws, and stripped screw heads. Large anatomic dissections required for complete hardware removal place the patient at increased risk of complications due to increased operating time and larger dissections. The authors present a safe and effective technique for the partial removal of surgical implants. The technique utilizes a high-speed burr to cut surgical plates, minimizing the total dissection and operative time. Sterile surgical laps covered in water-based lubricant capture metal debris to reduce tissue contamination as well as surgeon exposure to metal particles. [ABSTRACT FROM AUTHOR]

Only two trials have compared acceptance and commitment therapy (ACT) and traditional cognitive behavior therapy (tCBT) in the treatment of social anxiety disorder (SAD), with both finding no significant differences. These trials did not examine effects on observer-rated behavioral outcomes and did not explicitly quantify the dose of exposure therapy within each treatment. In a replication trial, one hundred and two individuals with SAD (per DSM-IV criteria) were randomized to 12 sessions of ACT ( n  = 49) or tCBT ( n  = 53) controlling for exposure dose and assessing behavioral outcomes. Assessments were completed at pre- and post-treatment using clinician-rated and self-report measures of social anxiety, quality of life, and overall functioning. Observer-rated behavioral measures of social performance were completed for a subsample of participants. Results indicated that participants across conditions received equivalent doses of exposure. Those who received tCBT evidenced greater improvements in self-reported social anxiety symptoms and overall functioning, which contrasts with prior studies finding no differences between tCBT and ACT in the treatment of social anxiety. Medium effect sizes, while not statistically significant, indicate that ACT participants may have had greater improvements in observer-rated social behavior than tCBT participants. The discrepancy between these symptom and behavioral outcomes, building upon prior literature, calls for more research to assess the differences between tCBT and ACT treatments in behavioral domains. [ABSTRACT FROM AUTHOR]

In recent years, with scientific advances and growing understanding of neurobiological processes, biomedical explanations of psychiatric disorders, including obsessive-compulsive disorder (OCD), have become more prominent in research and in clinical care. Patient perceptions of biomedical models of OCD have been understudied, particularly in how they relate to patients’ beliefs about prognosis and treatment expectancy. The current study measured self-identified OCD patients’ (N = 130) current beliefs about their own prognosis and treatment and how believable they found two explanatory models of OCD: 1) a biomedical model that attributes OCD to biological functioning in the brain and 2) an integrative biopsychopsychocial model. Correlational results indicated that patients who found the biomedical model to be highly believable expected that their OCD would be chronic and require long-term treatment. In contrast, ratings of believability in the model that integrated biological, psychological and social factors in explaining OCD were not associated with prognostic pessimism. Instead, we observed a trend in which stronger belief in the biopsychosocial model was associated with the belief that behavioral changes could improve symptoms of OCD. Notwithstanding limitations inherent in the correlational nature of this study, the current findings highlight the need to further investigate the clinical implications of OCD causal models [ABSTRACT FROM AUTHOR]

We investigated how the biodistribution of cannabidiol (CBD) within the central nervous system (CNS) is influenced by two different formulations, an oil-in-water (O/W) nanoemulsion and polymer-coated nanoparticles (PCNPs). We observed that both CBD formulations administered were preferentially retained in the spinal cord, with high concentrations reaching the brain within 10 min of administration. The CBD nanoemulsion reached C max in the brain at 210 ng/g within 120 min (T max), whereas the CBD PCNPs had a C max of 94 ng/g at 30 min (T max), indicating that rapid brain delivery can be achieved through the use of PCNPs. Moreover, the AUC 0 – 4 h of CBD in the brain was increased 3.7-fold through the delivery of the nanoemulsion as opposed to the PCNPs, indicating higher retention of CBD at this site. Both formulations exhibited immediate anti-nociceptive effects in comparison to the respective blank formulations. Image representation of cannabidiol formulated in two distinct nanoparticle formulations (polymer coated nanoparticles and nanoemulsion), followed by an intrathecal injection in Sprague-Dawley rats through a laminectomy surgery. The anti-nociceptive effect of the formulations was assessed through electromyography recordings after the application of von Frey filaments. Furthermore, the biodistribution of cannabidiol in the CNS was analysed through HPLC. [Display omitted] [ABSTRACT FROM AUTHOR]

We describe the development of a novel, Internet-based, self-help intervention for social anxiety disorder (SAD) in adults, and report data on the preliminary efficacy of the program when administered with minimal therapist support delivered via a common videoconferencing platform. Participants ( n = 13) completed the intervention, which consists of 8 weekly modules and a brief weekly videoconferenced check-in with a therapist. The intervention program is derived from an acceptance-based CBT program that utilizes traditional behavioral interventions (e.g., exposure) within the context of a model emphasizing mindful awareness and psychological acceptance of distressing subjective experiences. Assessments revealed that participants experienced a significant reduction in SAD symptoms and improvements in psychosocial functioning, and that treatment gains were maintained over a 3-month follow-up period. The effect sizes for the main outcome measures were large to very large ( d = 0.90 to 1.47), and comparable to other Internet-based treatment programs as well as in-person trials for SAD (e.g., Feske & Chambless, 1995; Tulbure, 2011). Participants also rated the treatment program as highly acceptable. This pilot study provides preliminary evidence that an Internet-based intervention grounded in basic behavioral and acceptance-based principles is effective for the treatment of SAD, and that videoconferenced therapist support may be useful in enhancing treatment compliance. Implications and future directions are discussed. [ABSTRACT FROM AUTHOR]