Collaborative manufacturing of ergonomic personal protective equipment (PPE) accessories to prevent infectious disease.

Throughout history there have been epidemics and pandemics of all kinds, however the most recent ones have been respiratory diseases that have had a significant effect on the society and that have caused high mortality rates. The preventive measures to minimize the risk of contagion by contact with infected surfaces include ergonomic accessories including personal protective equipment (PPE) to prevent hands to be in contact with surfaces that could be infected by viruses, bacteria, fungi, etc., thus avoiding infection by the usual entry routes (mouth, nose, and eyes) to the human body of highly contagious diseases such as COVID-19. The collaborative manufacture of these safety accessories at the site of consumption is a current option that minimizes infectious diseases and reduces costs. Accessories such as the so-called "ear saver" and "anti-contact keys" can be produced by 3D printing with a general CAD/CAM and allow users in hospitals, and schools, such as medical and teaching staff and society in general to extend the life of N95 respirator fasteners (protective masks) and avoid contagion. These devices can be used to open doors and windows and control elevators, etc. The accessories can be optimized ergonomically for individual use by providing a custom design. The collaborative manufacture of these elements allows the product design stages to be carried out autonomously. In the manufacturing stage, 3D printers can be used to produce the devices at the point of use, thus saving on transport and distribution costs. This paper describes a comparative analysis of their design, manufacture and use in hospitals, schools, universities, and commercial areas with the aim of improving the current design.

[Bone marrow edema syndrome of the hip]. / Síndrome de edema de la médula ósea de cadera.

BACKGROUND: Bone marrow edema syndrome (BMES) is a rare clinical condition. Its etiology is unknown and it can be seen in different locations. In the case of the hip, avascular necrosis is the main differential diagnosis. AIM: To present our experience of BMES of the hip and a review of the literature. PATIENTS AND METHODS: Retrospective analysis of clinical records of patients with hip pain that met clinical, radiological, and magnetic resonance imaging criteria for BMES. Clinical outcome and clinical and radiological follow up are presented. RESULTS: Two men and two women (one of them pregnant) aged 42, 48, 36 and 26 years old, fulfilled criteria. Treatment included limited weight bearing, non steroidal antiinflammatory drugs, intranasal calcitonin and physical therapy. Complete remission of symptoms was observed within five to seven months. At an average follow up of 36 months, all patients presented complete function of the hip, returning to their previous activity levels, with no new episodes of BMES. CONCLUSIONS: It is important to be aware of this condition as part of the differential diagnosis of hip pain to avoid aggressive and unnecessary diagnostic and therapeutic procedures.

[Total knee arthroplasty in patients with rheumatoid arthritis]. / Artroplastia total de rodilla en pacientes con artritis reumatoide.

BACKGROUND: Approximately 90% of patients with rheumatoid arthritis (RA) will have one or both knees involved during the course of the disease. Total knee arthroplasty (TKA) allows restoring function and relieving pain satisfactorily, but these patients perform in a different way than those with primary knee osteoarthritis. AIM: To evaluate the clinical and radiographic results of TKA in patients with RA. PATIENTS AND METHODS: We analyzed retrospectively the data of 25 posterior stabilized total knee prostheses in 19 patients, available to an average follow-up of 6 years. The scores of Hospital for Special Surgery and of the Knee Society were used for clinical assessment. RESULTS: The mean Hospital for Special Surgery score increased from 44 points (range 27-58) preoperatively to 80 points (range 58-91) at the final follow-up examination. Two prostheses required revision and removal of the implants because of deep infection, and two had clinical failure as defined by the Knee Society score. There were no cases of implant loosening. DISCUSSION: Even though it is not free of complications, TKA is a good choice in patients with RA in the medium term follow up, with 80% of excellent and good results in our series.