ABSTRACT
Purpose: To describe the reverse shoulder arthroplasty angle (RSA angle) in magnetic resonance imaging (MRI) and compare the angle formed using bony landmarks (Bony RSA angle or B-RSA angle) with another angle formed using the cartilage margin as reference (Cartilage RSA angle or C-RSA angle). Methods: Adult patients with a shoulder MRI obtained in our hospital between July 2020 and July 2021 were included. The C-RSA angle and B-RSA angle were measured. All images were independently assessed by 4 evaluators. Intraclass correlation coefficient (ICC) was determined for the B-RSA and C-RSA to evaluate interobserver agreement. Results: A total of 61 patients were included with a median age of 59 years (17-77). C-RSA angle was significantly higher than B-RSA (25.4° ± 0.7 vs 19.5° ± 0.7, respectively) with a P-value <.001. The overall agreement was considered "good" for C-RSA (ICC = 0.74 [95% CI 0.61-0.83]) and "excellent" for B-RSA angle (ICC = 0.76 [95% CI 0.65-0.85]). Conclusions: C-RSA angle is significantly higher than B-RSA angle. In cases without significant glenoid wear neglecting to account for the remaining articular cartilage at the inferior glenoid margin may result in superior inclination of standard surgical guides.
ABSTRACT
Chilean geography exposes the country to high-level risks such as earthquakes and tsunamis. The disasters of 1930, 1960, 2010, and 2014 testify to the continuous link between human survival and disasters. However, new hazards have appeared ever since -i.e. flood waterlogging, wildfires, and landslides-, highlighting the relationship between current land uses and space occupation with increasing levels of disaster risk. This research aims to determine relations and responsibilities of the Chilean developmental approach in urban planning and territorial governance processes that have created new territories prone to disaster risk. We resort to a longitudinal analysis from 1930 to 2018 at the Gran Concepción metropolitan area as a proxy of Chilean industrialization and economic development approaches. To do so, we developed mixed-approach descriptive research, for which we collected data from national development policies and documented land occupation processes during pre-dictatorship, dictatorship and post-dictatorship periods. Semi-structured interviews with decision-makers involved in current territorial policy were also carried out. The findings show how territorial governance resulted from political visions around different development paths, wherein the concept of risk is weakly perceived among decision-makers. This perception is linked to narrow economic goals and the understanding of land as a barely regulated marketable asset, profoundly affected by segregated urban planning.
ABSTRACT
Introduction: Aspergillosis is the second most frequent opportunistic fungal infection of the pa-ranasal sinuses. It primarily affects the maxillary sinus and occurs mainly in immunocompromi-sed individuals. Infection is caused by inhalation of spores or by an oro-sinusal communication. Aspergillosis is classified into an invasive and non-invasive form or Aspergilloma, which usually affects immunocompetent patients. Violaceous lesions, ulcers, necrosis and tissue destruction can be manifested clinically. Patients may experience pain, paresthesias, increases in the vo-lume of purulent or bloody nasal discharge and congestion. Case report: A 62-year-old female patient, immunocompetent, with a condition evolving for about six years. Condition began after a dental extraction, and consisted of absence of scarring and recurrent episodes of symptoma-tology suggestive of maxillary sinusitis with poor response to antibiotics. The patient was referred to the maxillofacial care unit, presenting an increase of volume in the right genial region, pain and paraesthesia of infraorbital region. The CT scan showed the presence of a radiopaque foreign body in the right maxillary sinus. A surgical procedure was carried out using the Caldwe-ll-Luc technique and biopsy; the case was diagnosed with Aspergillosis. The patient was treated without antifungal therapy because she had a good immune status. Conclusion: Aspergilloma is the most common form of Aspergillosis in immunocompetent individuals. It is usually diagnosed late, as its clinical picture is similar to bacterial sinusitis. In most cases, patients respond well to surgical treatment, and systemic antifungal therapy is not necessary.
