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At least 217 records · Page 12Linked to original sources
PubMed2001

Effectiveness of hand-cleansing agents for removing methicillin-resistant Staphylococcus aureus from contaminated hands.

OBJECTIVE: The effectiveness of hand-cleansing agents in removing a hospital strain of methicillin-resistant Staphylococcus aureus from artificially contaminated hands of five volunteers was studied. DESIGN: The products used were plain liquid soap, ethyl alcohol 70% (by weight), 10% povidone-iodine liquid soap (PVP-I), and chlorhexidine gluconate (4%) detergent. The experiments were performed using a Latin square statistical design, with two 5x4 randomized blocks. The removal rates of S aureus cells from contaminated fingertips were estimated by analysis of variance, the response variable being the log10 reduction factor (RF), ie, log10 of the initial counts minus log10 of the final counts. In the first and second blocks, the fingertips of the volunteers were contaminated in mean with 3.76 log10 colony-forming units ([CFU] light-contamination hand) and 6.82 log10 CFU (heavy-contamination hand), respectively. RESULTS: In the first block, there were significant differences between treatments (P<.05). The 10% PVP-I (RF, 3.76) and 70% ethyl alcohol (RF, 3.51) had significantly higher removal rates than plain liquid soap (RF, 1.96) and 4% chlorhexidine (RF, 1.91). In the second block, 10% PVP-I (RF, 4.39) and 70% ethyl alcohol (RF, 3.27) also were significantly more effective than plain liquid soap (RF, 1.77) and 4% chlorhexidine (RF, 1.37; P<.05). Plain liquid soap was significantly more effective than chlorhexidine (4%) detergent. CONCLUSIONS: The results suggest that 10% PVP-I and 70% ethyl alcohol may be the most effective hand-cleansing agents for removing methicillin-resistant S aureus strain from either lightly or heavily contaminated hands.

Cross Infection↗
PubMed2006

Hand-arm vibration syndrome with concomitant arterial thrombosis in the hands.

BACKGROUND: Hand-arm vibration syndrome (HAVS) refers to the vascular, neurological and musculoskeletal effects that may occur in workers with prolonged exposure to vibrating tools. Hypothenar hammer syndrome (HHS) is a lesion of the ulnar artery at the level of the hamate bone secondary to single or repeated episodes of trauma to the hypothenar eminence. The literature suggests that digital arterial thrombosis and HHS may be associated with the use of vibrating tools. AIM: This study will familiarize investigators with the range of vascular abnormalities seen in workers using vibrating tools, and highlight the importance of screening for arterial thrombosis in the hand when assessing hand-arm vibration-exposed patients. METHODS: In the patients referred to our clinic for HAVS assessment, three were identified during the period 2001 to 2004 who had vascular occlusions in the hands in addition to HAVS. In addition to standardized HAVS vascular investigations, all three patients had arteriograms based on a significantly positive Allen's test. RESULTS: All three cases had documented HAVS based on vascular testing. Arteriograms revealed a spectrum of severity of arterial thromboses from severe HHS, to occlusion limited to the digital arteries. CONCLUSION: Our study reports three cases of HAVS with concomitant HHS and/or digital artery thrombosis. These findings support previous reports of an association between HAVS and vascular thrombosis in the hands. Screening for arterial occlusive problems in the hands should be included in the HAVS work up.

Adult↗
PubMed1989

Effect of hand splints on stereotypic hand behavior of girls with Rett syndrome: a replication study.

The purposes of this study were to replicate a recent report of the positive effects of hand splinting on the stereotypic hand movement of children with Rett syndrome and to evaluate the generality of these results to a different setting. Two 5-year-old girls diagnosed with early Stage-III Rett syndrome were introduced to hand splints in accordance with the multiple-baseline design used in the Naganuma and Billingsley study. Splint wear ranged from 30 to 50 days for the two subjects. Data were analyzed as a percentage of time and as actual time in minutes. Unlike the previous study, in which a decrease in hand-wringing behavior was noted, neither subject in our study demonstrated a decrease in stereotypic hand behavior or a subsequent increase in independent feeding skills when wearing the splints. There was also no evidence of increased hand wringing following withdrawal of the splints. The differences in ages of the subjects and different functional levels (stages) may have been contributing factors to the conflicting results and should be considered in managing this group of children.

Child, Preschool↗
PubMed1992

Changes in hand function in the aging adult as determined by the Jebsen Test of Hand Function.

The Jebsen Test of Hand Function is used to assess a broad range of hand functions required for activities of daily living. The time needed to complete a variety of subtests is measured, with high scores indicative of abnormality. Normative values have been established for men and women in two age groups: 20 to 59 years and 60 to 94 years. The purpose of this study was to determine whether hand function, as measured by the Jebsen test, declines with age in subjects over the age of 60 years. A total of 121 men and women were given the test and grouped into the following age categories: (1) 60 to 69 years, (2) 70 to 79 years, and (3) 80 to 89 years. Hand function decreased with age in both men and women. There were significant positive correlations between age and time needed to complete the various subtests, and analyses of variance revealed significant differences between subjects in their 80s and those in their 60s and 70s. In only a few tasks were there significant differences between men and women within any age group. Because of the decrease in normal function with age, measurements obtained with the Jebsen test in the elderly should be compared with normative values that are obtained from similarly aged subjects. [Hackel ME, Wolfe GA, Bang SM, Canfield JS. Changes in hand function in the aging adult as determined by the Jebsen Test of Hand Function.

Aged↗
PubMed2002

Perforator-based forearm and hand adipofascial flaps for the coverage of difficult dorsal hand wounds.

The author presents several case studies of alternative therapy for large and small dorsal hand and finger defects. These alternatives avoid the need for a lengthy free flap procedure, avoid the meticulous dissection required by the posterior interosseous flap, and avoid the loss of radial artery required by the reverse radial forearm flap. Distally based hand and forearm adipofascial flaps consist of the subcutaneous fat and fascia of the hand and/or forearm. They are easy to elevate, with operative times typically less than 2 hours, and can cover surfaces ranging from an individual finger to the entire dorsum of the hand. The blood supply is based on the rich profusion of perforators that exist in the hand and wrist. If desired, a skin paddle can be included with these flaps. These techniques are an important addition to the plastic and hand surgeon's armamentarium.

Adult↗
PubMed2002

The "beggar's" hand and the "unshakable" hand in children with total obstetric brachial plexus palsy.

A total 12 consecutive children with secondary deformities following total obstetric brachial plexus palsy were included in this retrospective study. In all patients, the main complaints were two socially disabling hand postures: the "beggar's" hand and/or the "unshakable" hand. All children had a supinated forearm with no active pronation and were teased by their friends, who called them "beggars." When the impairment was severe and involved the right hand and wrist, children also complained that they were not able to shake hands. The management approach to these children was described, with the main aim of surgery being the correction of the abnormal posture. Other simultaneous tendon transfers were also performed to improve hand function if there were suitable musculotendinous units. Successful reconstruction was accomplished in all patients. Preoperatively, some children refused to go to school because of teasing, and most did not want to interact socially. After surgery, all children attended school regularly, and parents reported much better social interaction. However, the functional gain was never enough to dramatically improve the daily use of the limb. The contralateral normal limb remained the dominant one for all daily activities, including writing and eating.

Elbow↗
PubMed1998

Cutaneous reactivity of the hands in nickel-sensitive patients with hand eczema.

This study compares the cutaneous reactivity between the hand and the back for 7 female patients with active hand eczema, who were found to be nickel-sensitive on routine patch testing with the European standard series. Patients were patch tested to a dilution series of nickel sulfate on the back in order to determine the threshold concentration for elicitation of allergic contact dermatitis, and based upon this result a lower concentration of nickel was then used for patch tests on the hand. We found that in the majority of patients (6/7) the cutaneous responsiveness of the hand was not increased compared with that of the back. However, the hand of 1 patient was more sensitive to nickel and patch testing was accompanied with a flare of her eczema, which suggests that cutaneous hyperreactivity may be important in individual patients with hand eczema.

Adolescent↗
PubMed2000

Assessing the prevalence of hand osteoarthritis in epidemiological studies. The reliability of a radiological hand scale.

OBJECTIVE: The hands are often involved in the osteoarthritic disease process. A radiological grading scale is presented, derived from a published atlas, to assess the prevalence of hand osteoarthritis (OA) involvement in clinical and epidemiological studies and its reproducibility is studied. METHODS: This hand scale is based on the radiological feature "joint space narrowing", which represents the macromorphological process of cartilage loss. Osteophytes and sclerosis are less important unless seen in conjuction with joint space narrowing. Nine individual joints per hand (four proximal interphalangeal joints (PIP), four distal interphalangeal joints (DIP), first carpometacarpal joint (CMC-1)) are scored dichotomously for the presence of OA. To save time and to increase reliability a severity grading of radiological features is not performed. To determine inter-rater and intra-rater reliability of the individual joints and the presence of OA in two separate joint groups (>/= 2 PIP or DIP and at least one CMC-1, used to define "generalised OA" in the ongoing Ulm Osteoarthritis Study) 50 pairs of anteroposterior hand radiographs were read by two investigators twice within one month. The kappa coefficient was calculated to quantify the strength of associations. RESULTS: On average five minutes were needed to score one hand radiograph. Both raters were able to reproduce their own readings in all individual joints and for the presence of OA in two separate joint groups after one month. Reliability was highest for the PIP joints (kappa: 0.56-1. 00) it was slightly lower for the DIP joints (0.38-0.87), for the CMC-1 joints (0.58-0.69) and for OA in two separate joint groups (0. 54). The values for inter-rater agreement were good as well, kappa coefficients ranged from 0.52 to 0.92. CONCLUSION: This grading scale was shown to be reliable within and between readers for all the individual joints as well as for the presence of OA in two separate joint groups. Scoring a limited number of joints dichotomously makes this scale efficient and therefore useful for clinical and epidemiological trials, when dealing with large patient samples.

Aged↗
PubMed1998

Manual dexterity and keyboard use in spastic hemiparesis: a comparison between the impaired hand and the 'good' hand on a number of performance measures.

OBJECTIVE: To assess the functional deficits in tapping performance of subjects with spastic hemiparesis. DESIGN: In a pilot study, typing performance on a computer keyboard was examined on a number of performance measures. SETTING: Department of Research and Development at the Werkenrode Institute. SUBJECTS: Four subjects (mean age 16.4 years, standard deviation 1.8 years) with cerebral palsy and diagnosed as having spastic hemiparesis. INTERVENTIONS: Subjects had to type a sequence of one or more keys as quickly as possible within an 8 second period with the fingers of both hands separately. MAIN OUTCOME MEASURES: The average number of good and false responses were calculated. Within the false response category, four, mutually exclusive, types of errors were distinguished; wrong key, repetition, registrations under 75 ms and holding. Speed and regularity of the typing responses were also established. RESULTS: The 'good' hand outperformed the impaired hand on all performance measures except on the amount of repetition errors made. The holding error was only present for the impaired hand, and there was an increase in holding errors from the index to the little finger in this hand. In addition, the impaired hand performed the task with a slower speed and in a more irregular fashion. CONCLUSIONS: The results are discussed with reference to keyboard design. It is concluded that the standard 'QWERTY' keyboard hampers typing performance extensively, especially for subjects with left spastic hemiparesis. A learning method is presented in which the role of an external pacer (e.g. metronome) is discussed. This device can initially be used to decrease movement variability and, eventually, for increasing movement speed.

Adolescent↗
PubMed2006

Reproducibility and responsiveness of the Symptom Severity Scale and the hand and finger function subscale of the Dutch arthritis impact measurement scales (Dutch-AIMS2-HFF) in primary care patients with wrist or hand problems.

BACKGROUND: To determine the clinimetric properties of two questionnaires assessing symptoms (Symptom Severity Scale) and physical functioning (hand and finger function subscale of the AIMS2) in a Dutch primary care population. METHODS: The first 84 participants in a 1-year follow-up study on the diagnosis and prognosis of hand and wrist problems completed the Symptom Severity Scale and the hand and finger function subscale of the Dutch-AIMS2 twice within 1 to 2 weeks. The data were used to assess test-retest reliability (ICC) and smallest detectable change (SDC, based on the standard error of measurement (SEM)). To assess responsiveness, changes in scores between baseline and the 3 month follow-up were related to an external criterion to estimate the minimal important change (MIC). We calculated the group size needed to detect the MIC beyond measurement error. RESULTS: The ICC for the Symptom Severity Scale was 0.68 (95% CI: 0.54-0.78). The SDC was 1.00 at individual level and 0.11 at group level, both on a 5-point scale. The MIC was 0.23, exceeding the SDC at group level. The group size required to detect a MIC beyond measurement error was 19 for the Symptom Severity Scale. The ICC for the hand and finger function subscale of the Dutch-AIMS2 was 0.62 (95% CI: 0.47-0.74). The SDC was 3.80 at individual level and 0.42 at group level, both on an 11-point scale. The MIC was 0.31, which was less than the SDC at group level. The group size required to detect a MIC beyond measurement error was 150. CONCLUSION: In our heterogeneous primary care population the Symptom Severity Scale was found to be a suitable instrument to assess the severity of symptoms, whereas the hand and finger function subscale of the Dutch-AIMS2 was less suitable for the measurement of physical functioning in patients with hand and wrist problems.

Activities of Daily Living↗
PubMedDate not supplied

Can alcohol hand rubs increase compliance with hand hygiene?

A review of the literature indicates that alcohol hand rubs reduce microbial load, are less irritant to the skin of healthcare workers, and are more easily accessible than conventional methods of hand hygiene. The review also indicates that using alcohol hand rub increases compliance to hand hygiene guideline rates by 25%. This study examines whether making alcohol hand rubs readily available to healthcare workers will increase and maintain compliance with hand hygiene protocols and guidelines, thereby reducing nosocomial infection, or whether the methods of staff education on the use and benefits of products and other interventions need to be examined.

Alcohols↗
PubMed2006

Improving hand-washing performance - a crossover study of hand-washing in the orthopaedic department.

INTRODUCTION: Effective hand-washing is essential for reducing the spread of infection in hospitals. We aimed to evaluate hand-washing performance of hospital personnel and to determine if this could be improved by education. MATERIALS AND METHODS: A total of 55 personnel working in the orthopaedic department were asked to clean their hands using an alcohol gel containing a clear fluorescent substance. They were unaware of the assessment method. Performance was assessed by examining their hands under UV light to identify areas that had been neglected. Subjects could visualise which areas they had missed and were then educated regarding hand-washing technique and retested after 7 days. RESULTS: Of the 55 subjects, 53 completed the study. Individual performance varied widely. Following a simple educational intervention, 49 out of 53 subjects improved from an average of 7.8% to 2.3% area missed (P < 0.001). CONCLUSIONS: We suggest that hand-washing effectiveness needs to be improved and that a simple educational intervention can be effective.

Adult↗
PubMed1999

Men and women holding hands: II. Whose hand is uppermost?

Sex differences in the way men and women hold hands were investigated in a series of six studies. Specifically, it was hypothesized that men would have the uppermost hand in male-female couples holding hands in public significantly more often than women. Also, the American couples observed in Study 1 were classified by height, those in Study 2 by age, those in Study 3 by hand preference, those in Study 4 by ethnic group, and those in Study 6 by sex of initiator of the handholding; the handholding couples in Study 5 were Japanese adults. A combined total of 15,008 handholding couples were observed in these six studies, and across differences in height, age, hand preference, ethnicity, culture, and sex of the initiator of handholding in public, men were significantly more likely than women to have the uppermost hand.

Adult↗
PubMed1990

A close relationship exists between hand skill and the excitability of motor neurons innervating the postural soleus muscle in right-handed male subjects.

The claim that there is no consistent inhibition of the H-reflex from the dominant leg was examined and rejected. Hand preference was assessed by the Edinburgh Inventory, and hand skill by the peg moving task. It was re-established that there is an inverse relationship between hand skill and the excitability of motoneurons innervating the postural soleus muscle in right-handed subjects without familial sinistrality. There was no significant difference between the recovery curves from the right and left sides in subjects with familial sinistrality. There was a positive linear correlation between the asymmetry index for hand skill greater than zero (right-hand dominance) and the asymmetry index for the H-reflex recovery curve greater than zero (left dominance in motoneuronal excitability). It was concluded that there is indeed a spinal motor asymmetry in postural leg muscles related to handedness.

Adult↗
PubMed1990

Relation of spatial reasoning ability to hand performance in male and female left-handers to familial sinistrality and writing hand.

The relation of mental ability for spatial reasoning to hand performance was studied in male and female left-handers considering familial sinistrality and writing hand. Hand performance was assessed by a dot-filling test; hand preference was assessed by the Edinburgh Handedness Inventory (Geschwind scores). Nonverbal intelligence (spatial reasoning) was measured by the Cattell's Culture Fair Intelligence Test. The relationship between IQ and hand performance was found to be more complicated than expected. This was associated with sex, familial sinistrality, and writing hand, which created different patterns in interactions between motor and cognitive systems. It was concluded that the brain benefits from different strategies by using both hemispheres in a competitive and complementary manner where necessary to achieve a high visual-spatial performance depending upon genetic preprograms.

Adult↗
PubMed1978

"Hand gym" for patients with arthritic hand disabilities: preliminary report.

To improve function and to delay the tendency toward deformities of the rheumatoid arthritic hand, a new device was evaluated which enables patients to perform range of motion and isometric exercises in their home. Eighteen patients (35 hands) exercised daily for four months. Strength and range of motion showed statistically significant gains. Grip strength increased in 28 hands, volar pinch in 22 hands, lateral pinch in 21 hands. Of 140 PIP joints, 77% increased in range, indicating loosening of intrinsic muscles. Improvement in hand function was reported by most of the patients.

Activities of Daily Living↗
PubMed1999

[Hand transplantation and implantation of nerve chips. New developments within hand surgery].

Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open up new perspectives in the coming millennium.

Amputation, Surgical↗
PubMed2000

[Hand transplantation and implantation of nerve chips. New developments within hand surgery].

Injuries and diseases of the hand naturally have an enormous impact on hand function and on quality of life, both occupational and social. The majority of hand-injury patients are under 30 years of age. Hand surgery, an established specialty in Sweden since 1969, is of great importance in terms of clinical developments, education and research. In the coming decade, scientific and clinical advances are to be expected in several fields such as nerve injuries including brachial plexus lesion, microsurgery, flexor tendon injuries and tendon transfer. Bioimplant research and new advances at the biotechnological interface will yield new options in nerve reconstruction, microchip implants in the nervous system, and the restoration of muscle-tendon function following injury. Artificial limbs with advanced motor and sensory functions will be important future aids in the rehabilitation of amputees. Transplantation of human hands is another promising reconstructive procedure which may open iup new perspectives in the coming millennium.

Amputation, Surgical↗