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At least 415 records · Page 23Linked to original sources
PubMed2003

Use of an alcohol-based hand rub and quality improvement interventions to improve hand hygiene in a Russian neonatal intensive care unit.

BACKGROUND: Hand hygiene (HH) is critical to infection control, but compliance is low. Alcohol-based antiseptics may improve HH. HH practices in Russia are not well described, and facilities are often inadequate. SETTING: Four 6-bed units in a neonatal intensive care unit in St. Petersburg, Russia. METHODS: Prospective surveillance of HH compliance, nosocomial colonization, and antibiotic administration was performed from January until June 2000. In February 2000, alcohol-based hand rub was provided for routine HH use. Eight weeks later, a quality improvement intervention was implemented, consisting of review of interim data, identification of opinion leaders, posting of colonization incidence rates, and regular feedback. Means of compliance, colonization, and antibiotic use were compared for periods before and after each intervention. RESULTS: A total of 1,027 events requiring HH were observed. Compliance was 44.2% before the first intervention, 42.3% between interventions, and 48% after the second intervention. Use of alcohol rose from 15.2% of HH indications to 25.2% between interventions and 41.5% after the second intervention. The incidence of nosocomial colonization (per 1,000 patient-days) with Klebsiella pneumoniae was initially 21.5, decreased to 4.7, and then was 3.2 in the final period. Rates of antibiotic and device use also decreased. CONCLUSIONS: HH may have increased slightly, but the largest effect was a switch from soap and water to alcohol which may have been associated with decreased cross-transmission of Klebsiella, although this may have been confounded by lower device use. Alcohol-based antiseptic may be an improvement over current practices, but further research is required.

Adult↗
PubMed1983

Reconstruction of the hand with free microneurovascular toe-to-hand transfer: experience with 54 toe transfers.

Over a period of 6 years, 54 toe-to-hand transfers were performed, 24 for thumb and 30 for finger reconstruction. Refinements in evaluation, preparation, and surgical technique are detailed. Forty-nine toes (90.7 percent) survived. Exploration was required for circulatory compromise following 13 transfers (34.2 percent), to good effect in 9 (69.2 percent). Secondary surgery was performed in 26 cases, consisting of tendolysis, osteotomy, and deepening of the first web space. Review was undertaken at an average of 1 year and 9 months after transfer. Power grip averaged 28.5 percent of the normal hand and pinch strength 26.6 percent, great toe transfer giving 35.7 percent and second toe transfer to thumb giving 15.6 percent strength compared with normal. Static two-point discrimination of less than 10 mm was present in 37.5 percent of those studied under 2 years after surgery and in 75 percent of those studied more than 2 years later. The choice of procedure for thumb reconstruction is discussed in detail, as are supplementary skin cover, vascular considerations, and the high exploration rate.

Accidents, Home↗
PubMed2000

Short latency inhibition of human hand motor cortex by somatosensory input from the hand.

1. EMG responses evoked in hand muscles by transcranial stimulation over the motor cortex were conditioned by a single motor threshold electrical stimulus to the median nerve at the wrist in a total of ten healthy subjects and in five patients who had electrodes implanted chronically into the cervical epidural space. 2. The median nerve stimulus suppressed responses evoked by transcranial magnetic stimulation (TMS) in relaxed or active muscle. The minimum interval between the stimuli at which this occurred was 19 ms. A similar effect was seen if electrical stimulation was applied to the digital nerves of the first two fingers. 3. Median or digital nerve stimulation could suppress the responses evoked in active muscle by transcranial electrical stimulation over the motor cortex, but the effect was much less than with magnetic stimulation. 4. During contraction without TMS, both types of conditioning stimuli evoked a cutaneomuscular reflex that began with a short period of inhibition. This started about 5 ms after the inhibition of responses evoked by TMS. 5. Recordings in the patients showed that median nerve stimulation reduced the size and number of descending corticospinal volleys evoked by magnetic stimulation. 6. We conclude that mixed or cutaneous input from the hand can suppress the excitability of the motor cortex at short latency. This suppression may contribute to the initial inhibition of the cutaneomuscular reflex. Reduced spinal excitability in this period could account for the mild inhibition of responses to electrical brain stimulation.

Adult↗
PubMedDate not supplied

Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand.

Hand and wrist injuries in sports are some of the most common injuries reported. This review discusses common overuse injuries of the wrist including tendon injuries such as de Quervain's syndrome, subluxation of the extensor carpi ulnaris, and the common dorsal carpal impingement syndrome. The main focus of this section is the discussion of traumatic injuries to the hand in the athlete. Included is a discussion and review of fractures of the phalanges and metacarpals, common proximal interphalangeal joint injuries, and thumb carpal metacarpal and metacarpophalangeal joint injuries. Emphasis is placed on more common injuries seen regarding diagnosis, indications for non-operative versus operative treatment, and time to return to athletic competition.

Athletic Injuries↗
PubMed1975

Hand surgery and the development of hand prostheses.

Hand surgery has shown that afferent impulses to conscious level are essential for control and effective use of any advanced grip. Control of position, motion and load (proprioception) is possible to obtain without joint receptors, by cutaneous receptors alone. Further advances in the construction of hand prostheses must be based on this premise. The value of the key grip is outlined.

Artificial Limbs↗
PubMed1979

Blood flow in the contralateral hand during vibration and hand grip contractions of lumberjacks.

Pulse wave changes were examined among 63 professional lumberjacks. The tests were carried out in connection with an annual health examination. A photoelectric plethysmographic method was used to measure pulse wave changes during contralateral muscle work and vibration exposure from a dynamic shaker with a strain-gauge dynamometer. The relative changes in pulse wave amplitude were counted, and the changes were classified as dilatations, constrictions, or constant pulse wave amplitude. Contralateral muscle work caused vasodilatation, but vibration exposure could cause vasoconstrictions in the right hand. Most of the vasospasms were recorded at 60 and 100 Hz. The strongest vasospasms were seen at 200 Hz. The occurrence of vasospasms in the contralateral hand correlated with the severity of white finger symptoms rated according to an index for traumatic vasospastic disease.

Adult↗
PubMed2004

A two-year study of chondroitin sulfate in erosive osteoarthritis of the hands: behavior of erosions, osteophytes, pain and hand dysfunction.

The aim of this study was to evaluate the effect of 800 mg/die of chondroitin sulfate (CHS) per os plus naproxen versus naproxen over 2 years in patients with erosive osteoarthritis (EOA) of the hands. Joint count for erosions, Heberden and Bouchard nodes, Dreiser's algofunctional index and physicians' and patients' global assessment of disease activity were studied. A total of 24 consecutive patients (22 women and 2 men, mean age 53.0 +/- 6) suffering from symptomatic OA with radiographic characteristics of EOA were evaluated. The patients were divided into two groups of 12 patients each. The first group took naproxen 500 mg only. The second group was treated with CHS 800 mg orally plus naproxen 500 mg. Joint counts, radiological hand examinations and assessment of disease activity were performed at baseline, at 12 months and at 24 months. In the second year the treated group showed significant worsening in erosion, Heberden, Bouchard and Dreiser scores was recorded. Physician and patient global assessments of disease activity showed no significant difference from baseline scores. The untreated group showed significant worsening in erosion, Heberden and Bouchard nodes, Dreiser index and physician and patient global assessment scores. This study confirms the partial efficacy of oral CHS in improving some aspects of EOA.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1991

Practical approaches to obtaining hand radiographs and special techniques in hand radiology.

Radiography of the hands and joints involves a certain amount of decision making by the radiographer. Many disorders of the wrists are evaluated with radiography, and the positions and radiographic technique factors should be adjusted to reveal as much of the desired anatomy as possible. Immobilizing the patient can be of significant value in obtaining good quality radiographs. It is essential that the processed radiograph contains all pertinent anatomy and that all structures have been demonstrated anatomically as well as radiographically. A number of radiographic positions and procedures are useful in identifying specific structures. The knowledge of the radiographer is essential in obtaining these projections. Other special imaging methods, such as tomography, xeroradiography, and magnification radiography, permit the study of those structures too small to be noted on conventional radiographs. Fine-grain mammography film and rare earth screens in carbon fiber cassettes are essential tools in obtaining high-quality detailed images of the hand. A proper quality assurance program of scheduled and preventative maintenance will ensure an efficient radiology service with the least radiation dose to the patient.

Carpal Bones↗
PubMed1989

Hand-to-hand transmission of herpes simplex virus type 1.

Droplets of tissue culture fluid containing herpes simplex virus type 1 were placed on the palm of the hand. Each 0.01 ml droplet was taken from a stock virus suspension with a titre of 10(7.5) TCID50/0.1 ml. At 0, 15, 30, 60 and 120 min a droplet was firmly touched with the middle finger of the right hand, after which, attempts were made to recover virus from the finger. At 0 min, when the virus-containing droplet was in a liquid state, there was a 100% rate of virus recovery. By 15 min the droplets had dried out, and after touching dried out droplets there was a 40% virus recovery rate, even though experimental procedures demonstrated that infectious virus was present in the dried out droplets at all test times. If the finger was moistened with tap water or saliva, there was a 100% recovery rate of virus after touching dried out droplets, as well as after touching droplets in a liquid state.

Cell Line↗
PubMed1978

[Evaluation of procedures for hygienic disinfection of hands: comparison of two methods, for artificially contaminating hands and use of an automatic colony-counter (author's transl)].

Testing procedures for the Hygienic Disinfection of hands, two kinds of artificial contamination have been compared: Application of one drop of bacterial suspension onto each fingertip as described in the DGHM-"Richtlinien" and immersion of hands as described in our previous papers. When using our method, fingertips released higher numbers of testbacteria. Since pre- as well as post-values were elevated, disinfection-tests applying one of each contamination method resulted in log10 reductions which did not differ significantly. Using an automated scanning colony counter we were able to save 2/3 of time otherwise required for manual counts. Up to 10(2) colonies per plate manual counts were practically identical with the counters results, whereas with higher colony-numbers the counter showed an increasing tendency to under-estimate the numbers of colonies. Since colonies of skin-staphylococci are not recognised by the automated counter, we cultured our rinsing-fluids on nutrient agar containing 0.05% of sodium-desoxycholate in order to inhibit the autochthonous skin flora. This supplement influenced the colony counts of our test-bacterium to a very minor degree only, the reduction factors were not at all altered.

Bacteriological Techniques↗
PubMed1993

Robinow syndrome: with special emphasis on dermatoglyphics and hand malformations (split hand).

Fourteen cases of Robinow syndrome are described with special emphasis on dermatoglyphics and hand malformations (split hands were detected in two, ectrodactyly with nail hypoplasia in one and hypoplastic extra middle finger in another one). Dermatoglyphic studies were performed on ten cases. Increased whorl patterns of the finger tips and a single large palmar hypothenar whorl pattern associated with distally displaced axial triradii were detected. These have not previously been described.

Abnormalities, Multiple↗
PubMed1993

Evolution of EF-hand calcium-modulated proteins. V. The genes encoding EF-hand proteins are not clustered in mammalian genomes.

The chromosomal assignments of genes belonging to the EF-hand family which have a common origin are compiled in this article. So far data are available from 27 human gene loci belonging to 6 subfamilies and 8 murine loci belonging to 4 subfamilies. Chromosomal localization has been obtained by somatic-cell hybrid analysis using the Southern blot technique or PCR amplification, metaphase spread in situ hybridization, or isolation of the particular genes from chromosome-specific libraries. Except for genes of the S-100 alpha proteins which are grouped on human chromosome 1q12-25 and mouse chromosome 3, no linkage has been found for genes encoding EF-hand proteins, indicating absence of selective pressure for maintaining chromosomal clustering. Six of these genes map to known syntenic groups conserved in the human and mouse genomes. This suggests that chromosomal translocations occurred before divergence of these species. The possible significance of chromosomal positioning with respect to nearby located known genes and genetic disease loci is discussed.

Animals↗
PubMed1997

Proposal for hand-arm vibration exposure limits adopted for Japanese workers operating hand-held vibration tools.

On the basis of data presented in our previous, reports, the current study was undertaken to estimate frequency-weighted hand-arm vibration exposure limits for various daily exposure times. The procedures for the present study were as follows. (1) The prevalence of vibration-induced white finger (VWF) as well as the vibration exposure were investigated in various groups of workers operating hand-held vibrating tools. The vibration magnitude of various tools was measured and the results were presented as the energy-equivalent frequency-weighted root-mean-square (m/s2 rms) acceleration. There was a statistically significant positive correlation between the prevalence of VWF and the measured vibration magnitude (R2 = 0.5, P < 0.05). Hence, it was concluded that in decisions concerning quantitative recommendations for vibration exposure, the prevalence of VWF should be considered. (2) By a careful selection of available publications which contain useful information on duration of vibration exposure of < or = 2 h/day and the occurrence of VWF, a significant correlation between the prevalence of VWF and the vibration magnitude could be observed. The regression equation was estimated as: y = -18.5 + 4.6 (x), R2 = 0.8. On the basis of this equation, it was speculated that the prevalence of VWF in workers using vibrating tools might be restricted to the prevalence of Raynaud's phenomenon in the Japanese general population if the 2-h daily vibration exposure is about 4.5 m/s2 rms. (3) Regarding this speculation, the equation provided in the documentation of ISO 5349 was used and modified as: [alpha h,w)eq,t = (alpha h,w)eq,2(2/t)1/2 (m/s2 rms)] and then the vibration limit values for daily exposure of 1 min to 8 h were calculated. (4) In order to achieve compatibility with standards of other countries, and to formulate an easy method for using the recommended values presented here, the daily exposure time of 8, 4, 2, 1 and 0.5 h were selected. The correspondence vibration magnitudes were in the range 22-9.0 m/s2 rms, and the lower limit (2.2 m/s2 rms) was assumed as the permissible vibration exposure limit for an 8-h working period. The proposed daily vibration limits were then compared with those recommended by other institutions.

Adult↗
PubMed1991

Point mutations that lock Salmonella typhimurium flagellar filaments in the straight right-handed and left-handed forms and their relation to filament superhelicity.

We have determined the nucleotide sequence of two mutant and the parent fliC genes, encoding the protein flagellin (serotype i), of Salmonella typhimurium. The flagellar filaments of the two mutants, SJW1655 and SJW1660, are locked in the straight-right-handed (R) and straight-left-handed (L) conformations, respectively. Their normal, wild-type, parent strain is SJW1103. These mutant strains differ from the wild-type by only one base-pair: the mutation of SJW1655 occurs at nucleotide 1346 in the flagellin gene, changing a C.G pair to T.A (alanine 449 to valine). The mutation of SJW1660 occurs at nucleotide 1277, changing a G.C pair to C.G (glycine 426 to alanine). The resulting amino acid substitutions are near the C terminus predicted to form an alpha-helical coiled coil. The region contains six heptad repeats. Similar alpha-helical segments (three and four repeats long) are present near the N terminus. Alignment of the 17 flagellin sequences available to date confirms the generality of these segments. The mutations are within that portion of the sequence assigned, by proteolytic cleavage, to the middle flagellin domain whose length corresponds to the six heptad repeats found in the sequence (approximately 50 A). We have shown that these mutations are the sole cause of the straight phenotype by replacing the mutated segments with a wild-type one and restoring both superhelicity and motility.

Amino Acid Sequence↗
PubMed1983

Incidence of left-handed writing in a college population with reference to family patterns of hand preference.

Hand preference data were obtained for 1816 university students, 4793 siblings and 3632 parents. Results support the following conclusions. (1) There is currently a 13.8% incidence of left handedness among young adults, representing a dramatic increase over past generations. (2) Left and right-handed respondents do not differ in terms of familial sinistrality. (3) Mother's left-handedness is associated with an increase in the incidence of sinistrality for sons and daughters, while father's left handedness is related only to sons.

Adult↗