Análisis del ajuste de mascarillas autofiltrantes en combinación con las mascarillas quirúrgicas para la protección del profesional sanitario en su atención a pacientes afectos de SARS-COV-2 a partir de un estudio experimental / Analysis of the adjustment of self-filtering masks in combination with surgical masks for the protection of health professionals in the care of patients sffected by SARS-COV-2 from an experimental study

Introducción: Un componente importante del equipo de protección individual (EPI) frente al SARS-CoV-2 son las mascarillas quirúrgicas y las mascarillas autofiltrantes (FFP). La norma europea EN 149 establece y clasifica las mascarillas autofiltrantes en tres niveles de protección dependiendo del porcentaje de fuga del total de partículas en suspensión del aire exterior hacia el aire interior FFP1, FFP2, FFP3. El objetivo de este e ensayo de laboratorio es determinar y cuantificar el nivel de ajuste de las mascarillas autofiltrantes FFP2 combinadas con las mascarillas quirúrgicas mediante series de pruebas de ajuste (fit test). Material y Métodos: Se utilizó el equipo medidor de ajuste de mascarillas FFP modelo PortaCount® Pro + 8038 compatible con las normas y metodología de la OSHA (Occupational Safety and Health Administration) de los EEUU. Se realizaron series de pruebas de ajuste sobre diferentes modelos de mascarillas autofiltrantes FFP2 con y sin mascarilla quirúrgica para diferentes situaciones de respiración del trabajador participante en este experimento. Resultados: El uso de la mascarilla quirúrgica sobre una mascarilla autofiltrante FFP2 aporta una mejora en la protección respiratoria determinante, incrementando el factor de ajuste hasta de +200 (el factor de ajuste mínimo debe ser 100). Conclusiones: Las mascarillas quirúrgicas cuando se usan conjuntamente con las mascarillas autofiltrantes, podrían mejorar significativamente el grado de ajuste de todas las mascarillas autofiltrantes proporcionando una mayor eficacia de filtración y una mayor protección al usuario frente a la exposición a aerosoles (AU)

Introduction: Frontline healthcare workers have a high risk of exposure to SARS-CoV-2 coronavirus, which causes COVID-19. The use of appropriate personal protective equipment (PPE) is essential to prevent this occupational disease. Surgical masks and filtering face piece (FFP) respirators are important parts of this PPE. European standard EN 149 establishes three protection levels for FFP respirators (FFP1, FFP2, FFP3), depending on the particle infiltration degree through their materials, and these, in turn, are based on their filtration effectiveness. The aim of this laboratory test is to determine and quantify the filtration and fit rate of different FFP respirators, singly and in combination with surgical masks, by performing a series of fit tests and consequently, to check whether this combination improves protection levels for healthcare workers who care for COVID-19 patients. Material and Methods: Several FFP respirators and surgical masks, singly and in combination, were fit tested with a PortaCount Pro + 8038, which fulfills OSHA standards, in a series of tests performed on healthcare workers in seven different breathing situations when taking care on COVID-19 patients, in order to determine and quantify their fit to the workers' face. Results: Wearing a surgical mask together with a highly efficient FFP respirator provided increased respiratory protection. Interestingly, one of these highly efficient FFP models, combined with a surgical mask, achieved a protection factor over 200 (whereas 100 is the minimum required protection factor). Conclusions: Surgical masks, when used together with a FFP2 respirator, could significantly improve the degree of fit of all self-filtering face piece by providing greater filtration efficiency and greater user protection from exposure to aerosols (AU)

[Analysis of the Adjustment of Self-Filtering Masks in Combination with Surgical Masks for the Protection of Health Professionals in the Care of Patients Affected by SARS-COV-2 from an Experimental Study]. / Análisis del ajuste de mascarillas autofiltrantes en combinación con las mascarillas quirúrgicas para la protección del profesional sanitario en su atención a pacientes afectos de SARS-COV-2 a partir de un estudio experimental.

INTRODUCTION: Frontline healthcare workers have a high risk of exposure to SARS-CoV-2 coronavirus, which causes COVID-19. The use of appropriate personal protective equipment (PPE) is essential to prevent this occupational disease. Surgical masks and filtering face piece (FFP) respirators are important parts of this PPE. European standard EN 149 establishes three protection levels for FFP respirators (FFP1, FFP2, FFP3), depending on the particle infiltration degree through their materials, and these, in turn, are based on their filtration effectiveness. The aim of this laboratory test is to determine and quantify the filtration and fit rate of different FFP respirators, singly and in combination with surgical masks, by performing a series of fit tests and consequently, to check whether this combination improves protection levels for healthcare workers who care for COVID-19 patients. MATERIAL AND METHODS: Several FFP respirators and surgical masks, singly and in combination, were fit tested with a PortaCount Pro + 8038, which fulfills OSHA standards, in a series of tests performed on healthcare workers in seven different breathing situations when taking care on COVID-19 patients, in order to determine and quantify their fit to the workers' face. RESULTS: Wearing a surgical mask together with a highly efficient FFP respirator provided increased respiratory protection. Interestingly, one of these highly efficient FFP models, combined with a surgical mask, achieved a protection factor over 200 (whereas 100 is the minimum required protection factor). CONCLUSIONS: Surgical masks, when used together with a FFP2 respirator, could significant ly improve the degree of fit of all self-filtering face piece by providing greater filtration efficiency and greater user protection from exposure to aerosols.

INTODUCCIÓN: Un componente importante del equipo de protección individual (EPI) frente al SARS-CoV-2 son las mascarillas quirúrgicas y las mascarillas autofiltrantes (FFP). La norma europea EN 149 establece y clasifica las mascarillas autofiltrantes en tres niveles de protección dependiendo del porcentaje de fuga del total de partículas en suspensión del aire exterior hacia el aire interior FFP1, FFP2, FFP3. El objetivo de este e ensayo de laboratorio es determinar y cuantificar el nivel de ajuste de las mascarillas autofiltrantes FFP2 combinadas con las mascarillas quirúrgicas mediante series de pruebas de ajuste (fit test). MATERIAL Y MÉTODOS: Se utilizó el equipo medidor de ajuste de mascarillas FFP modelo PortaCount® Pro + 8038 compatible con las normas y metodología de la OSHA (Occupational Safety and Health Administration) de los EEUU. Se realizaron series de pruebas de ajuste sobre diferentes modelos de mascarillas autofiltrantes FFP2 con y sin mascarilla quirúrgica para diferentes situaciones de respiración del trabajador participante en este experimento.  RESULTADOS: El uso de la mascarilla quirúrgica sobre una mascarilla autofiltrante FFP2 aporta una mejora en la protección respiratoria determinante, incrementando el factor de ajuste hasta de +200 (el factor de ajuste mínimo debe ser 100). CONCLUSIONES: Las mascarillas quirúrgicas cuando se usan conjuntamente con las mascarillas autofiltrantes, podrían mejorar significativamente el grado de ajuste de todas las mascarillas autofiltrantes proporcionando una mayor eficacia de filtración y una mayor protección al usuario frente a la exposición a aerosoles.

Traumatic quadruple amputee rehabilitation: from amputation to prosthetic functionality: a case report.

INTRODUCTION: Traumatic quadruple amputations limit daily living activities; however, the current literature regarding rehabilitation treatment for multi-limb amputations is scant. The patient showed adaptation to prosthetic fittings, acquiring a level of functional independence that enabled the patient to lead a nearly independent life. METHODS: The patient's therapeutic intervention was divided into a pre-prosthetic phase, which consisted of functional physical adaptation to the amputation and preparation for the prostheses, and a prosthetic phase, in which different myoelectric and microprocessor limb prostheses were integrated to be used functionally. Its functional use was favored by the training with contact electromyography feedback carried out with the Biometrics E-Link System® for the upper extremities that has made it possible to obtain many grip options in a natural way, for the lower extremities the use of the intelligent passive prostheses has overcome the functional capacity achieved in this type of patients referenced in the literature who had used prostheses of previous generations such as mechanical passive prostheses. RESULTS: With rehabilitation, the patient showed improvements in the following scales and questionnaires (initial vs. final values): Disabilities of the Arm, Shoulder, and Hand Questionnaire; Functional Independence Measure; Berg Balance Scale; Locomotor Capabilities Index in Amputees (an assessment of overall motor capacity); and Special Interest Group in Amputee Medicine scale (an assessment of the degree of mobility). CONCLUSIONS: The patient's age, psychological status, and family and personal support, in addition to technical and economic resources used for next-generation prostheses adapted to this clinical case, were crucial for his progress. IMPLICATIONS FOR REHABILITATION The use of next-generation myoelectric and microprocessor prostheses makes it possible to achieve greater end functionality in quadruple amputees. Proximal amputation levels present greater difficulty in achieving good functionality. Early and intensive rehabilitation could favour and contribute towards improving psychological states. Age, psychological status, and pain management are aspects to take into account during the rehabilitation process.