Search

Importance: Psilocybin shows promise as a treatment for major depressive disorder (MDD)., Objective: To evaluate the magnitude, timing, and durability of antidepressant effects and safety of a single dose of psilocybin in patients with MDD., Design, Setting, and Participants: In this phase 2 trial conducted between December 2019 and June 2022 at 11 research sites in the US, participants were randomized in a 1:1 ratio to receive a single dose of psilocybin vs niacin placebo administered with psychological support. Participants were adults aged 21 to 65 years with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of MDD of at least 60 days' duration and moderate or greater symptom severity. Exclusion criteria included history of psychosis or mania, active substance use disorder, and active suicidal ideation with intent. Participants taking psychotropic agents who otherwise met inclusion/exclusion criteria were eligible following medication taper. Primary and secondary outcomes and adverse events (AEs) were assessed at baseline (conducted within 7 days before dosing) and at 2, 8, 15, 29, and 43 days after dosing., Interventions: Interventions were a 25-mg dose of synthetic psilocybin or a 100-mg dose of niacin in identical-appearing capsules, each administered with psychological support., Main Outcomes and Measures: The primary outcome was change in central rater-assessed Montgomery-Asberg Depression Rating Scale (MADRS) score (range, 0-60; higher scores indicate more severe depression) from baseline to day 43. The key secondary outcome measure was change in MADRS score from baseline to day 8. Other secondary outcomes were change in Sheehan Disability Scale score from baseline to day 43 and MADRS-defined sustained response and remission. Participants, study site personnel, study sponsor, outcome assessors (raters), and statisticians were blinded to treatment assignment., Results: A total of 104 participants (mean [SD] age, 41.1 [11.3] years; 52 [50%] women) were randomized (51 to the psilocybin group and 53 to the niacin group). Psilocybin treatment was associated with significantly reduced MADRS scores compared with niacin from baseline to day 43 (mean difference,-12.3 [95% CI, -17.5 to -7.2]; P <.001) and from baseline to day 8 (mean difference, -12.0 [95% CI, -16.6 to -7.4]; P < .001). Psilocybin treatment was also associated with significantly reduced Sheehan Disability Scale scores compared with niacin (mean difference, -2.31 [95% CI, 3.50-1.11]; P < .001) from baseline to day 43. More participants receiving psilocybin had sustained response (but not remission) than those receiving niacin. There were no serious treatment-emergent AEs; however, psilocybin treatment was associated with a higher rate of overall AEs and a higher rate of severe AEs., Conclusions and Relevance: Psilocybin treatment was associated with a clinically significant sustained reduction in depressive symptoms and functional disability, without serious adverse events. These findings add to increasing evidence that psilocybin-when administered with psychological support-may hold promise as a novel intervention for MDD., Trial Registration: ClinicalTrials.gov Identifier: NCT03866174.

Objective: Activities that require increased load bearing are known to cause bony hypertrophy. This phenomenon has been documented in the dominant arm of athletes in sports requiring significant utilization of a single limb. The literature addressing this effect in rodeo athletes, however, is minimal. Studies evaluating rodeo athletes are primarily focused on acute injury management rather than chronic symptoms resulting from changes in bone and soft tissue. We designed a study to evaluate bony hypertrophy in athletes without acute injury., Method: Rodeo bareback riders presented with frequent pain in their grip arm, no radiographic evidence of injury, and clinical signs of peripheral nerve compression. Anteroposterior and lateral X-rays taken for initial evaluation in 17 bareback rodeo athletes were retrospectively reviewed. The diameter of bilateral ulnas was measured at its longitudinal midpoint. Ratio of Ulnar Diameters (grip arm/free arm) and Percentage Diameter Difference were calculated. An independent samples t -test was used to assess differences in diameters of grip and non-grip arms., Result: The mean ulnar diameter was 18.4 ± 3.5 in the grip arm and 16.6 ± 3.5 in the non-grip arm ( p  < 0.001). The mean ratio of grip to free arm ulnar diameter was 1.42 ± 0.21 (range = 1.05-1.92). The mean diameter percent difference measured 42.3% (range = 4.7%-92.0%), and the grip arm was observed to have a greater ulnar diameter compared to the non-grip arm., Conclusion: There are significant anatomic differences in the grip arm of bareback rodeo athletes compared to the contralateral arm. In cases of persistent pain in the grip arm and no evidence of acute injury, these differences may be relevant to pain symptoms and should be considered as part of the assessment and treatment algorithm., Competing Interests: Declaration of conflicting interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Although they are not directly funding this report, the authors would like to disclose the following support for B.J.M.: paid teaching for TriMed. Paid teaching and consulting, as well as research support from AxoGen. Paid consulting for Baxter/Synovis and GLG. The remaining authors have nothing to disclose., (© The Author(s) 2022.)

Case: A 13-year, 6-month-old boy sustained a Delbet type III femoral neck fracture with postoperative femoral head avascular necrosis (AVN) and subsequent capital femoral physeal separation (CFPS). Preoperative angiography revealed a patent artery of the ligamentum teres to the femoral head epiphysis, allowing our patient to undergo a modified Dunn procedure to maintain this artery and preserve his native hip., Conclusion: Preoperative angiography allows for real-time identification of femoral head epiphyseal blood supply in patients with femoral head AVN complicated by CFPS and guides surgical treatment for hip preservation.

Purpose: Hardware infections in orthopedic surgery, specifically those involving biofilm producing bacteria, are troublesome and are highly resistant to systemic antibiotics. The purpose of this study was to demonstrate the power of rifampin and vancomycin solutions in inhibiting as well as eliminating in vitro on staphylococcus aureus ( S. aureus ) biofilm in vitro on stainless-steel implants., Methods: A suspension of either S. aureus or a S. aureus containing a plasmid that cods for the green fluorescence protein containing fluorescent protein plasmid was applied to 1 × 1cm sterile stainless steel orthopedic plating material (coupon). Biofilm development was confirmed by; the quantitative assay (colony forming unit [CFU/coupon]) and visualized using confocal laser scanning microscopy. With this established method of biofilm development, we determined the minimum biofilm inhibitory concentration (MBIC) and the minimum biofilm eradication concertation (MBEC) of Rifampicin and Vancomycin. To determine the MBIC, stainless steel plates were subjected to different concentrations of antibiotic solution and inoculated with overnight cultures of S. aureus . After 24 h of incubation at 37 °C, the biofilms on the untreated and antibiotic-treated coupons were quantified. To determine the MBEC, partial S. aureus biofilms were developed on the coupons and then treated with the different concentrations of each antibiotic for 24 h. The number of bacteria within the control untreated as well as treated coupons was determined., Results: Both rifampin and vancomycin solutions inhibited biofilm production of S. aureus on stainless steel mediums; the MBIC for rifampin and vancomycin were 80 ng/mL and 1 μg/mL respectively. The MBEC for Rifampicin was similar to the MBIC. However, the MBEC for Vancomycin was 6 mg/ml., Conclusions: When applied to orthopedic stainless steel hardware in vitro , solutions of rifampin and vancomycin powder separately or in combination can completely prevent and eliminate biofilm produced by S. aureus ., Level of Evidence: II., Competing Interests: The authors have no conflicts of interest to disclose.

Background: Due to the lack of verifiable iliotibial band elongation in response to stretching, the anatomical, biomechanical, and physiological responses to treatment of iliotibial band syndrome remain unclear. The lateral intermuscular septum, consisting of multiple myofibroblasts, firmly anchors the iliotibial band to the femur., Purpose and Hypothesis: The purpose of this in-situ study was to examine the constraining effect of the lateral intermuscular septum on available passive hip adduction range of motion in un-embalmed cadavers. It was hypothesized that an iliotibial band-septum-complex release would significantly increase passive hip adduction., Design: Within-specimen repeated measures in-situ design., Setting: Anatomy laboratory., Methods: Metal markers were inserted into selected anatomical landmarks in eleven (11) un-embalmed human cadavers. With the specimen supine, the test-side lower limb was passively adducted until maximum passive hip adduction was reached. This movement was repeated three times each within two conditions: (1) band-septum-complex intact and (2) band-septum-complex dissected. Digital video of marker displacement was captured throughout each trial. Still images from a start and an end position were extracted from each video sequence. A custom Matlab program was used to calculate frontal plane hip adduction angle changes from obtained images., Results: Mean change in passive hip adduction after band-septum-complex release was -0.3 ° (SD 1.6 °;95% CI: -1.33,0.76). A paired samples t-test revealed a non-significant difference (t=-.611; p=.555) in passive hip adduction for the band-septum-dissected condition (18.8 ± 3.9 °) versus the band-septum-intact condition (18.5 °±4.7 °)., Conclusion: The lateral intermuscular septum does not appear to have a constraining effect on passive hip adduction in un-embalmed cadavers. Future research should evaluate the constraining effect of other selected tissues and conditions on hip adduction. Furthermore, inflammatory, metabolic, viscoelastic, and sensorimotor control properties within the iliotibial band in response to stretching should be investigated., Level of Evidence: 3., Competing Interests: Conflict of Interest: None to declare. Funding: There was no funding received for this study. Medical devices: No medical devices have been used in this study., (© 2020 by the Sports Physical Therapy Section.)

Background: The desire to immobilize, encapsulate, or entrap viable cells for use in a variety of applications has been explored for decades. Traditionally, the approach is to immobilize cells to utilize a specific functionality of the cell in the system., Scope of Review: This review describes our recent discovery that living cells can organize extended nanostructures and nano-objects to create a highly biocompatible nano//bio interface [1]., Major Conclusions: We find that short chain phospholipids direct the formation of thin film silica mesophases during evaporation-induced self-assembly (EISA) [2], and that the introduction of cells alter the self-assembly pathway. Cells organize an ordered lipid-membrane that forms a coherent interface with the silica mesophase that is unique in that it withstands drying-yet it maintains accessibility to molecules introduced into the 3D silica host. Cell viability is preserved in the absence of buffer, making these constructs useful as standalone cell-based sensors. In response to hyperosmotic stress, the cells release water, creating a pH gradient which is maintained within the nanostructured host and serves to localize lipids, proteins, plasmids, lipidized nanocrystals, and other components at the cellular surface. This active organization of the bio/nano interface can be accomplished during ink-jet printing or selective wetting-processes allowing patterning of cellular arrays-and even spatially-defined genetic modification., General Significance: Recent advances in the understanding of nanotechnology and cell biology encourage the pursuit of more complex endeavors where the dynamic interactions of the cell and host material act symbiotically to obtain new, useful functions. This article is part of a Special Issue entitled Nanotechnologies - Emerging Applications in Biomedicine., (2010 Elsevier B.V. All rights reserved.)