The novel coronavirus outbreak was declared a pandemic in March 2020. We are reviewing the COVID-19 vaccines authorized for use in the United States by discussing the mechanisms of action, administration, side effects, and efficacy of vaccines developed by Pfizer, Moderna, and Johnson & Johnson. Pfizer and Moderna developed mRNA vaccines, encoding the spike protein of SARS-CoV-2, whereas Johnson & Johnson developed an adenovirus vector-based vaccine. Safety has been shown in a large cohort of participants in clinical trials as well as the general population since emergency approval of vaccine administration in the US. Clinical trial results showed the Pfizer and Moderna vaccines to be 95.0%, and the Johnson & Johnson vaccine to be 66.0% effective in protecting against moderate and symptomatic SARS-CoV-2 infection. It is important to keep medical literature updated with the ongoing trials of these vaccinations, especially as they are tested among different age groups and upon the emergence of novel variants of the SARS-CoV-2 coronavirus.
This study demonstrates injectate volumes needed to reach specific anatomic landmarks in L-TFEIs. A volume of 4.0 mL of injectate reaches both the superior aspect of the superior IVD and the inferior aspect of the inferior IVD 93% of the time.
Introduction:
Physiotherapy is a management option for the treatment of femoroacetabular impingement (FAI) syndrome. This study examines the influence of changes in pelvic tilt and hip adduction on the range of motion (ROM) of the hip.
Methods:
Ten FAI hips were used to simulate impingement at two positions: (1) 20° internal rotation (IR) with 100° flexion and 10° adduction and (2) 40° IR with 35° flexion and 10° adduction; the amount of IR was measured at the point of bony impingement or to the defined limit. Each simulation was performed at neutral and 5° and 10° anterior and posterior pelvic tilt. Then, the hip was placed in 10° of abduction, and all simulations were repeated.
Results:
With neutral pelvic tilt, impingement occurred at 4.3 ± 8.4° of IR at the high-flexion position. An increase in anterior pelvic tilt led to a loss of IR, that is, earlier occurrence of FAI, whereas an increase in posterior pelvic tilt led to an increase in IR, that is, later occurrence of FAI. At the high-flexion position, abduction provided more IR before impingement (neutral: 9.1 ± 5.7°, P < 0.01; 10° anterior tilt: 14.6 ± 5.2°, P < 0.01; 10° posterior tilt: 4.2 ± 3.7° IR, P = 0.01). Placing the hip in abduction and posteriorly tilting the pelvis produce a combined effect that increased IR relative to the neutrally tilted pelvis (5° posterior tilt: 11.4 ± 7.6°, P = 0.01; 10° posterior tilt: 12.8 ± 7.6°, P < 0.01). The ROM in the mid-flexion position was not affected by any combination of pelvic tilt and hip abduction or adduction (average IR: 37.4 ± 5.0°, P > 0.05).
Conclusions:
Abduction and posterior pelvic tilt increased the impingement-free ROM in the hips with FAI. Thus, rehabilitation aimed at altering the tilt of the pelvis may reduce the frequency of impingement and limit further joint damage.
Knee osteoarthritis (OA) is a degenerative process that slowly destroys the joints producing pain and loss of function, and diminishes the quality of life. Current treatments alleviate this symptomatology but do not stop the disease, being total knee arthroplasty the only definitive solution. Among the emerging treatments, Platelet-Rich Plasma (PRP) has shown promising results in the treatment of OA. However, to improve its effectiveness, it is necessary to approach this pathology targeting the whole joint, not only the cartilage, but including other tissues such as subchondral bone. The pathological processes that occur in the subchondral bone have influence of the cartilage loss, aggravating the disease. The combination of intraarticular infiltrations with intraosseous infiltrations regulates the biological processes of the tissues, reducing the inflammatory environment and modulating the overexpression of biomolecules that generate an aberrant cellular behavior. Although the first clinical results using this technique are promising, further research and developing adequate protocols are necessary to achieve good clinical results.
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