Oral appliance for Obstructive Sleep Apnea: Prototyping and Optimization of the Mandibular Protrusion Device.

Obstructive Sleep apnea is a public health problem. This disease is associated with daytime sleepiness, increased motor vehicle accidents, heart failure and stroke. Treatment options include weight loss, positive airway pressure, pharyngeal and orthognatic surgery. However, selected patients have good response to oral appliances devices that intended to protrude and stabilize the mandible mechanically during the night in order to reduce the collapsibility of the upper airway. Selection of patients includes primary snoring, mild, moderate and positional apnea. The perfect mandibular advance device has not yet been designed. For these reasons, the objective of this paper is to present a new thermoadjustable chair-side oral appliance. Device integrates the best characteristics of custom made and boils and bite previous designs and minimizes inconveniences and possible side effects. The device is a titratable mandibular advancement appliance. It consists of two independent prefabricated trays adaptable to the shape of adult dental arch and linked to each other by a protrusion mechanism. Each tray contains a hard outer shell and a soft thermoplastic resin inner body. The position of the jaw can be adjusted by moving an aluminum rack into, or out from, the guide so the ratchet may get locked into a certain position ensuring the length of the mechanism. The protrusion mechanism is fixed to the splint using small rings that are articulated over a "t" button. Our prototype satisfies the requirements of an effective oral appliance, in terms of retention, comfort, safety and efficacy. It is easy to fit, durable, low cost, quickly titratable, not bulky and easy cleaning. Thermoplastic appliances are specially used like a predictor of treatment response in apnea patients. The device described is a cost-effective introduction to mandibular advancement technology. A qualified dentist or trained sleep doctor could mitigate dental side effects and reduce their incidence.

Design of a Functional Splint for Rehabilitation of Achilles Tendon Injury Using Advanced Manufacturing (AM) Techniques. Implementation Study.

The use of conventional immobilization splints can cause a lot of mishaps and discomfort in patients. In addition, it is common the generation of muscle, joint and vascular complications arising from the application of classic restraint devices in this phase of treatment. Currently, it is being observed that these problems could be solved with the use of Advanced Manufacturing techniques based on Additive Manufacturing (AM), industrial digitalization and reverse engineering for the realization of individualized immobilization splints. The present study proposes to give these splints a functional character in their design adapting them to a specific pathology, in this case to the partial rupture of Achilles tendon. It also provides a comparison against the use of conventional plaster splints as an improvement factor for their definitive implementation considering the initial sanitary use for which they were designed. In this way, there have been created therapeutic windows that allow the application of rehabilitation techniques, being the treatment that would be carried out developed in parallel. The designed splint has been made in FilaFlex and Polycarbonate, materials that guarantee comfort and resistance at the same time. In addition, an optimization in terms of material has been executed, lightening the splint and reducing environmental impact and manufacturing costs. As a result of this preliminary study, a prototype on scale printed in PLA has been generated.

Geometric Model for the Postural Characterization in the Sagital Plane of Lumbar Raquis.

The individual's posture is the physical expression of his body. It is modified throughout life and it is determined by the particular anatomical characteristics that directly affect the biomechanics of the spine. The typing of the spinal curvature is important for the knowledge of body posture. The possibility of having a method for the systematic postural characterization of the spine is an essential objective resource in order to obtain normal or control patterns of the spinal morphology of the population. A widely accepted methodology of morphological characterization of the spine is a necessary requirement for the establishment of preventive criteria for spinal pathologies based on epidemiological population studies. It also represents a necessary requirement for the classification of individuals, based on the biomechanical, orthopaedic or ergonomic criteria necessary for disciplines such as sports, industrial design or sports performance. The present study proposes the development of a morphological postural model of the spine in the lumbar region. The model is based on a system of measurement of objective and comparable parameters by means of X-ray analysis, in order to characterize its morphology in the sagittal plane. The comparison of the results in a population of 47 individuals allowed the possibility to carry out a statistical study on three morphological parameters: sacral angle (α1); reversal angle (α2) and degree of lordosis (DL). The statistical hypothesis that the results behave according to a normal distribution with p < 0.05 is relevant and allows the systematization and postural modelling of the individual.

Design of an Orthopedic Product by Using Additive Manufacturing Technology: The Arm Splint.

The traditional fabrication process of custom-made splints has hardly undergone any progress since the beginning of its use at the end of the eighteenth century. New manufacturing techniques and the new materials can help to modernize this treatment method of fractures. The use of Additive Manufacturing has been proposed in recent years as an alternative process for the manufacture of splints and there has been an increase in public awareness and exploration. For this reason, in this study a splint model printed in 3D, that replaces the deficiencies of the cast maintaining its virtues, has been proposed. The proposed methodology is based on three-dimensional digitalization techniques and 3D modeling with reverse engineering software. The work integrates different scientific disciplines to achieve its main goal: to improve life quality of the patient. In addition, the splint has been designed based on the principles of sustainable development. The design of splint is made of Polycarbonate by technique of Additive Manufacturing with fused deposition manufacturing, and conceived with organic shapes, customizing openings and closing buttons with rubber. In this preliminary study the final result is a prototype of the 3D printed arm splint in a reduced scale by using PLA as material.

Analysis and Fem Simulation Methodology of Dynamic Behavior of Human Rotator Cuff in Repetitive Routines: Musician Case Study.

The majority of musculoskeletal injuries located in the shoulder are often due to repetitive or sustained movements that occur in work routines in different areas. In the case of musicians, such as violinists, who have long and daily training routines, the repetitive movements they perform are forced and sometimes the postures are not natural. Therefore, this article aims to study and simulate the dynamic behavior of the glenohumeral joint under repetitive conditions that represent the different postures assumed by a violinist during his daily training. For this purpose, the criteria provided by the RULA (rapid upper limb assessment) method have been used. Subsequently, by using as a reference geometry that of the articulation under study generated and modeled in CATIA®[VERSIÓN 5R21], a FEM analysis has been proposed with the software ANSYS®[VERSIÓN 17.1] simulating the short and cyclic movements of the Humerus of the violinists. With the analysis carried out, thanks to linear and isotropic approximations of the joint, it has been possible to know the approximate dynamic behavior of tissues, muscles and tendons, and the response of the joint in terms of fatigue.

Dispositivo de fijación, cierre y acoplamiento para catéter de perfusión intravenosa / Fixing device for closing and coupling an intravenous catheter

Introducción: los medios de fijación a la piel de un catéter venoso periférico, de un catéter venoso central o de un catéter arterial central presentan los siguientes graves inconvenientes: ser la sede de infecciones a nivel del lugar de la punción, provocar una saturación de la zona anatómica, la cual resulta muy difícil de soportar e incómodo para el paciente portador, y suponer un riesgo para el personal de enfermería cuando se usan hilos de sutura para fijar el soporte del catéter. Objetivo: por lo anteriormente expuesto, se ha detectado la necesidad de diseñar un dispositivo que reduzca la complejidad y aparatosidad de los sistemas conocidos y empleados en la actualidad, favoreciendo la asepsia y la movilidad del paciente. Método: el desarrollo presentado en este artículo se refiere a un sistema mecánico de fijación, cierre y acoplamiento para catéter de perfusión intravenosa. El sistema dispone de una pieza circular de pequeño espesor con al menos dos orificios para su fijación subcutánea, centralmente de uno o más conductos para acoplar lúmenes, y de una parte cilíndrica hueca que sobresale a uno de los lados, exteriormente roscada e interiormente lisa con un tetón de posición. Para uso domiciliario se dispone de un tapón de estanqueidad con uno o más tubos de pequeño diámetro que se acoplan en los orificios para lúmenes, una ranura de posición, un tirador y un tapón roscado ciego para el cierre hermético con la parte roscada. Para uso hospitalario se dispone de un tapón intermedio con una o más entradas para lúmenes, así como de un tapón roscado hueco que permite su acoplamiento hermético con la parte roscada. Resultados: el desarrollo descrito en este artículo va a ser utilizado en dos ambientes: ambiente domiciliario y ambiente hospitalario. Además, reduce el riesgo de infección y saturación de la zona anatómica de los pacientes en los que se realiza la punción cutánea en la que se fijan catéteres venosos periféricos, catéteres venosos centrales o catéteres arteriales centrales (AU)

Introduction: skin fixing devices in peripheral, central or arterial catheters have several important drawbacks: site infection, stacking of material in the anatomical area which is very annoying for the patient and medical staff risk when fixating stitches are used. Objective: to develop a fixing device that simplifies presently used systems, favoring asepsis and motility. Methods: the device herein described is composed by a mechanical fixation, a closing system and coupling for intravenous catheters. The system has a thin circular piece with at least two holes for subcutaneous fixation, one or several conducts for lumina and a hollow cylindrical part in one side, screwed exteriorly and flat inside, with an oriented protuberance. A watertight plug with one or several thin tubes that adapt to the lumina, a positional slot, a handle and a solid screwed tap for perfect closure are available for at home use. An intermediate plug with one or several lumina and a screwed hollow plug are provided for in hospital use. Results: the above described device is intended to be used in two settings: in hospital and at home. It is supposed to reduce the risk of infection and stacking of the anatomical site where cutaneo us puncture with fixation of peripheral, central or arterial catheters is performed (AU)

[FIXING DEVICE FOR CLOSING AND COUPLING AN INTRAVENOUS CATHETER]. / DISPOSITIVO DE FIJACIÓN, CIERRE Y ACOPLAMIENTO PARA CATÉTER DE PERFUSIÓN INTRAVENOSA.

INTRODUCTION: skin fixing devices in peripheral, central or arterial catheters have several important drawbacks: site infection, stacking of material in the anatomical area which is very annoying for the patient and medical staff risk when fixating stitches are used. OBJECTIVE: to develop a fixing device that simplifies presently used systems, favoring asepsis and motility. METHODS: the device herein described is composed by a mechanical fixation, a closing system and coupling for intravenous catheters. The system has a thin circular piece with at least two holes for subcutaneous fixation, one or several conducts for lumina and a hollow cylindrical part in one side, screwed exteriorly and flat inside, with an oriented protuberance. A watertight plug with one or several thin tubes that adapt to the lumina, a positional slot, a handle and a solid screwed tap for perfect closure are available for at home use. An intermediate plug with one or several lumina and a screwed hollow plug are provided for in hospital use. RESULTS: the above described device is intended to be used in two settings: in hospital and at home. It is supposed to reduce the risk of infection and stacking of the anatomical site where cutaneo us puncture with fixation of peripheral, central or arterial catheters is performed.

Introducción: los medios de fijación a la piel de un catéter venoso periférico, de un catéter venoso central o de un catéter arterial central presentan los siguientes graves inconvenientes: ser la sede de infecciones a nivel del lugar de la punción, provocar una saturación de la zona anatómica, la cual resulta muy difícil de soportar e incómodo para el paciente portador, y suponer un riesgo para el personal de enfermería cuando se usan hilos de sutura para fijar el soporte del catéter. Objetivo: por lo anteriormente expuesto, se ha detectado la necesidad de diseñar un dispositivo que reduzca la complejidad y aparatosidad de los sistemas conocidos y empleados en la actualidad, favoreciendo la asepsia y la movilidad del paciente. Método: el desarrollo presentado en este artículo se refiere a un sistema mecánico de fijación, cierre y acoplamiento para catéter de perfusión intravenosa. El sistema dispone de una pieza circular de pequeño espesor con al menos dos orificios para su fijación subcutánea, centralmente de uno o más conductos para acoplar lúmenes, y de una parte cilíndrica hueca que sobresale a uno de los lados, exteriormente roscada e interiormente lisa con un tetón de posición. Para uso domiciliario se dispone de un tapón de estanqueidad con uno o más tubos de pequeño diámetro que se acoplan en los orificios para lúmenes, una ranura de posición, un tirador y un tapón roscado ciego para el cierre hermético con la parte roscada. Para uso hospitalario se dispone de un tapón intermedio con una o más entradas para lúmenes, así como de un tapón roscado hueco que permite su acoplamiento hermético con la parte roscada. Resultados: el desarrollo descrito en este artículo va a ser utilizado en dos ambientes: ambiente domiciliario y ambiente hospitalario. Además, reduce el riesgo de infección y saturación de la zona anatómica de los pacientes en los que se realiza la punción cutánea en la que se fijan catéteres venosos periféricos, catéteres venosos centrales o catéteres arteriales centrales.