A Heuristic and Data Mining Model for Predicting Broiler House Environment Suitability.

The proper combination of environment and flock-based variables plays a critical role in broiler production. However, the housing environment control is mainly focused on temperature monitoring during the broiler growth process. The present study developed a novel predictive model to predict the broiler (Gallus gallus domesticus) rearing conditions' suitability using a data-mining process centered on flock-based and environmental variables. Data were recorded inside four commercial controlled environment broiler houses. The data analysis was conducted in three steps. First, we performed an exploratory and descriptive analysis of the environmental data. In the second step, we labeled the target variable that led to a specific broiler-rearing scenario depending on the age of the birds, the environmental dry-bulb temperature and relative humidity, the ammonia concentration, and the ventilation rate. The output (final rearing condition) was discretized into four categories ('Excellent', 'Good', 'Moderate', and 'Inappropriate'). In the third step, we used the dataset to develop tree models using the data-mining process. The random-tree model only presented accuracy for predicting the 'Excellent' and 'Moderate' rearing conditions. The decision-tree model had high accuracy and indicated that broiler age, relative humidity, and ammonia concentration play a critical role in proper rearing conditions. Using a large amount of data allows the data-mining approach to building up 'if-then' rules that indicate suitable environmental control decision-making by broiler farmers.

Paraconsistent Annotated Logic Algorithms Applied in Management and Control of Communication Network Routes.

This paper presents a computational method based on non-classical logic dedicated to routing management and information stream control in communication networks. Paraconsistent logic (PL) was used to create an algorithmic structure whose main property is to accept contradiction. Moreover, a computational structure, the denominated paraconsistent data analyzer (PDAPAL2v), was constructed to perform routing management in communication networks. Direct comparisons of PDAPAL2v with a classical logic system that simulates routing conditions were made in the laboratory. In the conventional system, the paraconsistent algorithms were considered as binary logic gates, and in the tests, the same adjustment limits of PDAPAL2v were applied. Using a database with controlled insertion of noise, we obtained an efficacy of 97% in the detection of deteriorated packets with PDAPAL2v and 72% with the conventional simulation system. Functional tests were carried out, showing that PDAPAL2v is able to assess the conditions and degradation of links and perform the analysis and correlation of various inputs and variables, even if the signals have contradictory values. From practical tests in the laboratory, the proposed method represents a new way of managing and controlling communication network routes with good performance.

Long-term follow-up of allograft reconstruction of segmental defects of the humeral head associated with posterior dislocation of the shoulder.

The purpose of this study is to report the long-term follow-up result of allograft reconstruction of segmental defect of the humeral head associated with posterior dislocation of the shoulder. Six men underwent operative management of defects of the humeral head involving 40% of the articular surface, following posterior dislocation of the humeral head. The period of time between dislocation and surgery ranged from 7 to 8 weeks. The defect in the head was filled with an allogeneic segment of humeral head contoured to restore the spherical shape. All the patients returned to their occupation 4 months later. All the cases were evaluated clinically and by radiographs and computed tomography (CT) scan at a mean of 122 (96-144) months after the operative procedure. Three men had no complaints of pain, instability, clicking or catching, whereas three had pain, clicking, catching and stiffness. The three patients with good clinical result showed also good radiographic result. The computed tomography (CT) confirmed incorporation of the allograft and no osteoarthrosis. Another patient had a good clinical and radiographic result until the eighth postoperative year. At 8-year follow-up examination, this patient developed shoulder osteoarthrosis and he had pain and stiffness. He needed an arthroplasty 10 years after the operation. The other two patients developed collapse of the graft and osteoarthrosis that were yet evident at 4-year follow-up. These patients required a shoulder arthroplasty 8 years after the procedure. We conclude that the treatment of segmental defects of the humeral head associated with posterior dislocations of the shoulder by allograft reconstruction has a good long-term follow-up result in 50% of the patients.

Single-row versus double-row arthroscopic repair in the treatment of rotator cuff tears: a prospective randomized clinical study.

PURPOSE: The purpose of this study was to compare arthroscopic rotator cuff repair with single-row and double-row techniques because research has demonstrated the superiority of double-row repair from a biological and mechanical point of view but there is no evidence of clinical superiority. METHODS: A total of 160 patients with a full-thickness rotator cuff tear underwent arthroscopic repair with suture anchors. They were randomised into two groups of 80 patients according to the repair technique: single-row (group 1) and double-row (group 2). Results were evaluated by use of the University of California, Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES) and Constant questionnaires, the Shoulder Strength Index (SSI) and range of motion. Follow-up time was two years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and two years after repair. RESULTS: One hundred per cent of the patients were followed up. All measurements showed significant improvement compared with the preoperative status. The UCLA score showed significant improvement in group 2. In over 30-mm tears UCLA and ASES showed significant differences. SSI showed significant improvement in group 2. Range of motion showed significant improvements in flexion and abduction in group 2. In under 30-mm tears group 2 showed also significant improvement in internal and external rotation. In MRI studies there were no significant differences. CONCLUSIONS: At two years follow-up the double-row repair technique showed a significant difference in clinical outcome compared with single-row repair and this was even more significative in over 30-mm tears. No MRI differences were observed.

The use of the Lima reverse shoulder arthroplasty for the treatment of fracture sequelae of the proximal humerus.

BACKGROUND: Experience treating proximal humerus fracture sequelae with reverse total shoulder arthroplasty is limited. We report our results. PATIENTS: Forty-four patients with sequelae of a proximal humeral fracture were treated with a reverse total shoulder prosthesis. There were 26 women and 18 men, with a mean age of 77 years (range, 74-84 years). The mean follow-up after reverse arthroplasty was 48 months (range, 40-84 months). RESULTS: The mean Constant score increased from 28 preoperatively to 58 postoperatively (p < 0.0001). The average anterior elevation increased from 40° to 100° (p < 0.0001), abduction from 41° to 95° (p < 0.0001), external rotation from 15° to 35° (p < 0.0001) and internal rotation from 25° to 60° (p < 0.0001). The average subjective shoulder score increased from 13% preoperatively to 56% postoperatively (p < 0.0001). All but six patients would undergo the same procedure again if faced with the same problem. Twenty-four patients were very satisfied, 14 satisfied and 6 unhappy with the operation. Six prosthetic dislocations occurred (13.6%). Two of them were successfully treated by adding an extension to the humeral neck component to increase the offset and tension. In the other four dislocations this procedure failed, and the prosthesis was revised and converted to a hemiarthroplasty. There was one case of glenoid component loosening that was converted to a hemiarthroplasty. CONCLUSIONS: The reverse total shoulder arthroplasty improves function and motion in patients with proximal humeral fracture sequelae. However, the dislocation rate is high.

Arthroscopic treatment for malunions of the proximal humeral greater tuberosity.

The purpose of this article was to report an arthroscopic treatment method for greater tuberosity malunion. Eight patients with malunion of the greater tuberosity were treated by arthroscopic acromioplasty, detachment of rotator cuff, tuberoplasty of the greater tuberosity and repair of the rotator cuff. On the basis of the UCLA rating scale, the overall score increased from 11.1 (range 9-14) to 30.2 (range 25-35) postoperatively, with one excellent result, six good results, and one poor result. All patients had less pain than preoperatively. Full activity level was achieved in two patients, five patients had only slight functional restriction, and one patient had mild limitation in activities of daily living. Seven patients returned to their previous occupations without restrictions. One patient did not return to work because of residual upper extremity weakness. We conclude that arthroscopic tuberoplasty is a good method for the treatment of greater tuberosity malunion.

Two-plate fixation for humeral shaft non-unions.

PURPOSE. To review 22 patients who underwent 2-plate fixation for non-union of the humeral shaft. METHODS. 13 women and 9 men aged 32 to 76 (mean, 48) years underwent fixation for non-union of the humeral shaft, using a 2-plate construct, together with decortication, debridement, and bone grafting. The two 3.5-mm reconstruction plates were parallel and lying at 90 degrees to each other and fixed with screws purchasing into at least 6 cortices of each fragment for both plates. Fractures were located in the upper third (n=8) or middle third (n=14) of the humerus. Initial treatments included casting (n=9), coaptation splinting (n=8), multiple retrograde pinning (n=4), and Marchetti-Vicenzi nailing (n=1). 18 non-unions were atrophic and 4 were hypertrophic. Shoulder and elbow range of motion as well as functional results were evaluated. RESULTS. The time for union was 4.6 (range, 4-6) months. No implants were loose or broken. No nonunion or infection was noted. Functional results were excellent in 17 and good in 5 patients. One patient had iatrogenic radial nerve palsy that recovered within 3 months. CONCLUSION. Two-plate fixation achieves good results for humeral shaft non-unions.

Allograft reconstruction of segmental defects of the humeral head associated with posterior dislocations of the shoulder.

Six men underwent operative management of defects of the humeral head involving at least 40% of the articular surface, following posterior dislocation of the humeral head. The cause of dislocation was a grand mal seizure in three and a fall in three cases. In five cases the dislocation was reduced under general anaesthesia, and in all the posterior dislocation recurred early. Time between dislocation and surgery ranged from 7 to 8 weeks. The defect in the head, revealed by CT, was filled with an allogeneic segment of humeral head contoured to restore the spherical shape. All the patients returned to their occupation 4 months later. The mean duration of follow-up was 62.6 (60-68) months. At discharge, four of the men had no complaints of pain, instability, clicking or catching; two had pain, clicking, catching and stiffness. Radiographs and CT revealed no failures of fixation or of incorporation of the allograft. In four cases the contour and volume of the graft were maintained, but in the two with a bad clinical result, flattening and collapse of the graft and osteoarthrosis were observed. If the procedure fails, prosthetic reconstruction should be simple because the skeletal anatomy has not been distorted.

Fracture of a ceramic femoral head after ceramic-on-ceramic total hip arthroplasty.

A case of fracture of the ceramic head of a total hip arthroplasty is presented, which was a total cementless arthroplasty with ceramic-on-ceramic articulation. No history of trauma was observed. The arthroplasty was revised, and a new cementless arthroplasty with a polyethylene insert and a metal head was inserted. The result has been satisfactory.

Management of types III and IV acetabular deficiencies with the longitudinal oblong revision cup.

Thirty-five longitudinal oblong revision (LOR) cups were used to reconstruct 29 type III and 6 type IV acetabular defects. Intraoperatively, we considered that cup contact was complete when we achieved a continuous contact between the cup periphery and the acetabular rim. When there were areas with a lack of contact, we considered that the contact was partial or incomplete. All patients were followed up for 4 to 8 years (mean = 6.3 years). At the latest follow-up, 30 cups were stable (85.8%) and 5 had migrated (14.2%). We found a significant relation between incomplete cup contact with the acetabular rim and subsequent failure (P = .042). The abduction angle was significantly increased in the group of unstable cups (P = .032) because of the migration of the acetabular component that became more vertical. Pain, limp, use of walking aids, functional level, and limb-length discrepancy significantly improved postoperatively (P < .0001). The Harris hip score improved from a mean preoperative score of 37 points to that of 79 points (P < .01). This implant showed satisfactory stability at early to midterm follow-up.

Epidemiology of osteoporotic hip fractures in Spain.

We conducted a multicentre study, divided into a retrospective and a prospective portion. The retrospective study evaluated osteoporotic hip fractures that occurred during 2002. The prospective study evaluated osteoporotic hip fractures that occurred during May 2003. The study was conducted in 77 hospitals in Spain and comprised patients 60 years of age and over. In the retrospective study we registered 13,195 hip fractures. Of the patients, 74% were women and 26% were men. The mean age was 80.7+/-8.4 years. The average incidence was 6.94+/-0.44 hip fractures per 1,000 inhabitants/year (95% CI, 6.07-7.82). In the prospective study, we registered 1,399 hip fractures. This represents a monthly incidence of 0.60+/-0.04 hip fractures per 1,000 inhabitants/year (95% CI, 0.51-0.69). Of the subjects, 74% were women and 26% were men. The mean age was 81.4+/-8.1 years. Using these data, we calculated the average annual prevalence in 2003 to be 7.20 fractures per 1,000 inhabitants. Thirty-three percent had previously suffered a hip fracture. Prior to the fracture, only 18% had received medical treatment for osteoporosis. After discharge from the hospital, only 26% were receiving pharmacological treatment for osteoporosis.

Spinal hydatidosis.

STUDY DESIGN: Retrospective study. OBJECTIVES: To revise the treatment of spinal hydatidosis. SUMMARY OF BACKGROUND DATA: About 50% of cases of bone hydatidosis are spinal. METHODS: Twenty patients with spinal hydatidosis were treated. There were 13 men and 7 women, with a mean age of 53.1 years. The median follow-up was 4.8 years. The infected area was the cervical spine in 1 patient, the dorsal spine in 7, the lumbar spine in 7, and the sacrum in 5. Curettage and resection of the infected bone were performed. The spine was exposed posteriorly in all but 2 patients. An additional posterior decompression and fusion with instrumentation were performed after removing the involved posterior elements in 8 patients. An anterior approach was used in 2 patients: a total corpectomy was performed and a bone graft was added. Two weeks later, a posterior decompression and fixation with instrumentation was done. No preoperative drugs were used. Medical antihelmintic treatment was used after surgery in all but 8 patients. RESULTS: Thirteen patients had spinal cord injury at the moment of surgery. The neurologic damage recovered only in 1 case. Repeated curettage was necessary in 13 cases: in 12 of them because of recurrence and in 1 because of surgical wound infection. In 6 cases of recurrence, there was also chronic wound infection. At last follow-up, 17 patients were free of disease. CONCLUSIONS: The treatment of choice of spinal hydatidosis is surgical removal of the affected vertebrae combined with posterior stabilization, followed by postoperative adjuvant chemotherapy. Recurrence is very frequent.

Minifragment plating for fractures of the distal radius.

Twelve patients with fracture of the distal radius were treated by open reduction and internal fixation with titanium minifragment plates. There were 8 women and 3 men, with a mean age of 42 years. The mean follow-up was 18 months. According to the score of Gartland and Werley, 11 patients had an excellent result and one patient had a good result. All patients reported no pain in their activities of daily living and were satisfied with the result. All workers returned to work. One patient developed reflex sympathetic dystrophy which resolved with treatment. No patients needed plate removal because of irritation of the tendons. The results obtained with this technique appear promising, although more cases are needed to achieve a definitive conclusion.

Marchetti nailing of humeral shaft delayed unions.

The purpose of this study is to present the results of Marchetti nailing in humeral shaft delayed unions. Fifteen humeral shaft delayed unions were treated with the Marchetti nail. The average age of patients was 52.3 years. All had been treated initially by conservative methods. Delay from trauma to surgery averaged 4.8 months. The nailing technique was retrograde, and reaming of the fracture focus was always performed. Bone graft was not added. Thirteen patients achieved union, in an average of 3.3 months. Two patients require further surgery to gain union. Shoulder and elbow motion was excellent in 10 patients, moderate in four and poor in one. The functional result was excellent in nine patients, good in two, fair in two, and poor in two. Marchetti nailing seems to be an acceptable alternative for humeral shaft delayed unions.

The floating metatarsal: first metatarsophalangeal joint dislocation with associated Lisfranc dislocation.

The authors report a case of an irreducible dorsal dislocation of the first metatarsophalangeal joint, with concomitant Lisfranc dislocation and fractures of the second, third, and fourth metatarsals. This combination has been reported only once in the literature. This extremely rare combined injury results in a floating metatarsal. Open reduction of the metatarsophalangeal joint dislocation and fixation of Lisfranc joint and metatarsal fractures with Kirschner wires was performed. One year after surgery, the patient is active and the first metatarsophalangeal joint is asymptomatic, but there is mild pain in the Lisfranc joint.

Carpal tunnel syndrome due to heterotopic ossification.

We report a rare case of carpal tunnel syndrome due to heterotopic ossification in the carpal tunnel in a 34-year-old woman without antecedents of neurological injury, musculoskeletal trauma, or metabolic disorder. To our knowledge, this is the first reported case. Incomplete excision of heterotopic ossification resulted in partial relief of symptoms.

Redução da incidência de complicações da hipertensão arterial do PSF São Geraldo em São João Del Rei

A Hipertensão Arterial Sistêmica é a mais frequente das doenças cardiovasculares. É também o principal fator de risco para as complicações mais comuns como acidente vascular cerebral e infarto agudo do miocárdio, além da doença renal crônica terminal. É uma doença crônica não transmissível de ordem multifatorial. Acredita-se que o desenvolvimento deste projeto possa contribuir para identificação dos fatores de risco que influenciam direta e indiretamente o controle da hipertensão através de práticas individuais e coletiva de educação em saúde. E assim provocar mudanças nos fatores determinantes e condicionantes apontados pelos pacientes. A importância deste trabalho consiste em que nunca antes na área de abrangência da equipe de São Geraldo (São João del Rey, MG) tinha-se realizado um estudo contextualizado sobre os fatores de risco da hipertensão arterial nem se tinham proposto ações para controlá-los.