Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “DEXTERITY”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 667 records · Page 37Linked to original sources
PubMedDate not supplied

[Certain aspects of laterality research].

One-side dominance, known as morphological and functional asymmetry, in the limbs a human characteristic that is of genetic or of both genetic and environmental origin. There are several aspects investigating laterality in men. Altogether it is possible to distinguish morphological and functional asymmetries. A vast range of testing techniques have been used to assess handedness. Asymmetry in hand use takes two forms: differential hand preference and differential dexterity between the hands. Writing hand and self-report are two of the most popular techniques. Other preference measures include observation of how people use tools and questionnaires. Performance tests assess speed and accuracy in tasks stressing manipulative dexterity. Morphologic asymmetries are not so useful for the investigation of the handedness. This method should only be used in past mortem examinations. The literature on laterality is large, but there are only a few studies in the last years concerning the morphologic asymmetries compared to the studies on functional asymmetries.

Functional Laterality↗
PubMed1998

The effect of a static wrist orthosis on hand function in individuals with rheumatoid arthritis.

OBJECTIVE: To determine the effect of a wrist orthosis on work performance, hand dexterity, and pain during task performance, 40 individuals with rheumatoid arthritis were studied using a 2 period, crossover design. METHODS: Each patient was fitted with a Futuro wrist orthosis. Dexterity was measured with and without the orthosis using the Jebsen Hand Function Test. Work performance was assessed using 2 tasks (one simulating the use of shears, the other the use of a screwdriver) on a work simulator. All tasks were performed both with and without the orthosis, with the order of orthosis versus no orthosis randomly assigned. Pain before and after performing tasks was assessed using a 10 cm horizontal visual analog scale. RESULTS: While on the screwdriver task work performance was less with the orthosis (p = 0.0002); on the shears task there was no significant difference in work performance with and without the orthosis. The average pain after performing both tasks was significantly less with the orthosis on. A 2 factor analysis of variance model with repeated measures suggested that taking into account the reduced work performance during splint wear, pain was still significantly reduced with splint wear. The average time to complete all 7 tasks on the Jebsen Hand Function Test was longer when the subjects wore the splint compared to when they did not (62.0 vs 57.6 s, respectively; p = 0.0086). CONCLUSION: The results suggest that the effect of splint wear on work performance is highly task specific, and thus the ergonomic demands of the individual's daily life must be considered if a splint is to provide maximal effectiveness.

Adult↗
PubMed1997

Clinicophysiologic concepts of spasticity and motor dysfunction in adults with an upper motoneuron lesion.

Spasticity is a disorder of the sensorimotor system characterized by a velocity-dependent increase in muscle tone with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex. It is one component of the upper motoneuron syndrome, along with released flexor reflexes, weakness, and loss of dexterity. Spasticity is an important "positive" diagnostic sign of the upper motoneuron syndrome, and when it restricts motion, disability may result. The "negative" signs--weakness and loss of dexterity--invariably alter patient function when they occur. In an upper motoneuron syndrome, the alpha motoneuron pool becomes hyperexcitable at the segmental level. This hyperexcitability is hypothesized to occur through a variety of mechanisms, not all of which have yet been demonstrated in humans. Spasticity caused by spinal cord lesions is often marked by a slow increase in excitation and over-activity of both flexors and extensors with reactions possibly occurring many segments away from the stimulus. Cerebral lesions often cause rapid build-up of excitation with a bias toward involvement of antigravity muscles. Chronic spasticity can lead to changes in the rheologic properties of the involved and neighboring muscles. Stiffness, contracture, atrophy, and fibrosis may interact with pathologic regulatory mechanisms to prevent normal control of limb position and movement. In the clinical exam, it is important to distinguish between the resistance due to spasticity and that due to rheologic changes, because the distinction has therapeutic implications. Diagnostic nerve or motor point blocks and dynamic or multichannel EMG are useful to distinguish the contributions of spasticity and stiffness to the clinical problem.

Adult↗
PubMed1971

Pseudomonas aeruginosa in a regional burns centre.

The construction of a Regional Burns Centre in Pinderfields General Hospital, Wakefield, presented an opportunity to study Pseudomonas aeruginosa infection in patients with extensive burns. During the first year (Barclay & Dexter, 1968) a system of disinfection and bacteriological control created conditions permitting more detailed studies to be undertaken which resulted in a significant reduction of infection and cross-infection.

Air Microbiology↗
PubMed2002

Statistical power analysis to estimate how many months of data are required to identify PACU staffing to minimize delays in admission from ORs.

When each nurse in the Phase I setting is caring for the maximum number of patients allowed by hospital staffing standards (typically 2 per ASPAN standards), patients may have to be held in the OR until a PACU nurse becomes available. Previously, the authors described a statistical method to determine the process of scheduling existing nurses without increasing staffing hours (Dexter et al. Anesth Analg. 92:947-949, 2001). The end result was to minimize the percentage of future workdays during which at least one patient would wait in his or her OR for Phase I PACU admission. In this study, the authors performed a statistical power analysis to determine how many months of PACU workload data are needed to optimize PACU staffing by using this "set covering" algorithm. One year (232 workdays) of data was available from a PACU employing up to 10 nurses working a total of 72 clinical hours a day. The data were divided into 2 subsets. Using the first subset, which varied in size between 20 and 140 days of data, the authors identified the optimal staffing solutions. These solutions were tested on the second subset of data. This process then was repeated thousands of times. There was a marked improvement in the performance of the staffing solutions at preventing "PACU hold" by increasing from 20 to 80 historical workdays of data, a slight but statistically significant improvement between 80 and 100 workdays, but no significant improvement in further increasing the number of workdays of data. PACU nurse managers should use at least 4 months of data when choosing a staffing solution to minimize the chance of patients waiting in ORs for PACU admission. Tampering with PACU staffing more often than every 4 months is unlikely to result in improvements in OR efficiency and may harm recruitment and retention of nursing staff.

Operating Rooms↗
PubMed1981

Induction by butyrate of differentiated properties in cloned murine rhabdomyosarcoma cells.

A cell line derived from the murine rhabdomyosarcoma BW10139 (Dexter, Cancer Res. 37: 3136, 1977) was subcloned and examined with respect to growth and myogenic characteristics in the presence and absence of 1 mM butyrate. Without butyrate, these cells behave as typical transformed cells: they grow rapidly and chaotically, do not form multinucleated muscle fibers and have little or no creatine kinase activity. In the presence of 1 mM sodium butyrate or butyric acid, growth slows, cells become arranged in whorl patterns, and creatine kinase activities increase to levels comparable to those found in normal chick myoblasts immediately prior to cell fusion. The increase in creatine kinase activity is detectable within 2 h exposure to butyrate, reaches a maximum by 24 h, and the elevated level can be maintained for at least six weeks. The induction is reversible upon sequential addition, deletion, and readdition of butyrate to the culture medium. Isoenzyme analyses demonstrated that only the BB form of creatine kinase is induced; MM creatine kinase was not detected. Although formation of multinucleated cells increases after exposure to butyrate, no typical myotubes form. The results suggest that this rhabdomyosarcoma cell line can, under appropriate conditions, re-express some properties characteristic of skeletal muscle, but not the complete muscle phenotype.

Animals↗
PubMed1988

Interleukin-3-specific modification of cell membrane "fluidity" of haemopoietic cells.

The work reported here clearly demonstrates that a specific growth factor, interleukin-3 (IL-3), which acts on multipotent haemopoietic stem cells as well as on committed myeloid progenitor cells of different lineages (Schrader, 1988; Whetton and Dexter, 1986), specifically induces a modification of the physical state ("fluidity") of the cell membranes of two IL-3-responsive and apparently normal haemopoietic cell lines. Furthermore, in a derived IL-3 independent myeloid leukaemic cell line, no such physical response to IL-3 binding was observed. The rapidity of the "normal" response suggests further that it may be associated with, or even constitute per se a critical early effect elicited by IL-3 in sensitive cells, the necessity for which is abrogated in the malignant derivative.

Animals↗
PubMed1990

Dealing with the dilemma.

When we first thought of this series we agreed that there was one man who could do justice to the main theme of the series - the actual dilemma many new graduates face immediately on going into general practice. So we approached Colin Dexter and asked him if he would write our introductory article. But, like many creative people, Colin's hectic timetable meant we had to wait for his thesis. And thesis it turned out to be. But, despite the wait and the length of his article, we feel we have a superb example in words of the true dilemma that so many people experience, and so many authorities try to deny. So settle down for a thought-provoking and stimulating read...

Dental Care↗
PubMed2003

Quality dimensions that most concern people with physical and sensory disabilities.

BACKGROUND: People with physical and sensory disabilities face important challenges in obtaining high-quality health care. We examined whether persons who are blind or have low vision, who are deaf or hard of hearing, or who have mobility impairments or manual dexterity problems are satisfied with the technical and interpersonal aspects of their care. METHODS: By using a 1996 nationally representative survey of 16 403 community-dwelling elderly and disabled Medicare beneficiaries, we identified persons with disabling conditions. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) controlled for demographic characteristics and managed care membership in predicting dissatisfaction with 12 dimensions of care. RESULTS: Of an estimated 33.58 million noninstitutionalized Medicare beneficiaries, 64.1% (an estimated 21.51 million) reported at least 1 potential disability and 29.5% (an estimated 9.89 million) reported more than 1 potential disability. Roughly 98% of people with and without disabilities believed their physicians were competent and well trained. But statistically significantly more people with disabilities reported dissatisfaction with care for 10 of the 12 quality dimensions. Persons reporting any major disability were more likely to be dissatisfied with physicians completely understanding their conditions (AOR, 2.4; 95% CI, 1.9-3.1), physicians completely discussing patients' health problems (AOR, 2.4; 95% CI, 1.9-2.9), physicians answering all patients' questions (AOR, 2.3; 95% CI, 1.7-3.1), and physicians often seeming hurried (AOR, 1.6; 95% CI, 1.4-1.9). CONCLUSIONS: Persons with disabilities generally reported positive views of their care, although they were significantly more likely to report poor communication and lack of thorough care. These findings held regardless of the disabling condition. Thoughtful systematic approaches are required to improve communication and to reduce time pressures that might compromise the health care experiences of people with disabilities.

Adolescent↗
PubMed1977

Motor performance after unilateral hemisphere damage in patients with tumor.

Hemispheric asymmetry of sensory-motor control has been hypothesized on the basis of clinical and experimental data, but discrepant data indicate asymmetry may vary with task requirements. To examine this possibility, the performance of normal controls and patients with right or left hemispheric tumors were compared on a variety of motor tasks of varying complexity. Group differences were significant only for the two most complex of six tasks; since these two tasks differ in quality (proximal steadiness and distal dexterity), it is unlikely that quality differences are crucial. On these tasks, the group with left hemisphere damage demonstrated bilateral impairment while the right hemisphere group's deficits were contralateral to lesion site. These results support previous data and Liepmann's hypothesis of hemispheric asymmetry of sensory-motor control. Task complexity and the more specific hypothesis of sensory-motor sequencing are important factors influencing hemispheric asymmetry of control.

Adult↗
PubMed1980

Psychological profiles in patients with multiple sclerosis. A preliminary investigation.

Most psychological and psychiatric studies of patients with multiple sclerosis (MS) have failed to take into account the varying demographic and disease-related factors that may be expected to play a role in patients' adjustment to this disease. We describe the psychological response of patients to MS as a function of age, sex, educational level, disease state, length of disease, physical disability, manual dexterity, and abstract reasoning. Several resulting response patterns are discussed.

Age Factors↗
PubMed2005

Antioxidant treatment of patients with Friedreich ataxia: four-year follow-up.

BACKGROUND: Decreased mitochondrial respiratory chain function and increased oxidative stress have been implicated in the pathogenesis of Friedreich ataxia (FRDA), raising the possibility that energy enhancement and antioxidant therapies may be an effective treatment. OBJECTIVE: To evaluate the long-term efficacy of a combined antioxidant and mitochondrial enhancement therapy on the bioenergetics and clinical course of FRDA. DESIGN: Open-labeled pilot trial over 47 months.Patients Seventy-seven patients with clinical and genetically defined FRDA. Intervention A combined coenzyme Q(10) (400 mg/d) and vitamin E (2100 IU/d) therapy of 10 patients with FRDA over 47 months. MAIN OUTCOME MEASURES: Clinical assessment using echocardiography and the International Cooperative Ataxia Rating Scale and cardiac and skeletal muscle bioenergetics as assessed using phosphorus P 31 magnetic resonance spectroscopy. RESULTS: There was a significant improvement in cardiac and skeletal muscle bioenergetics that was maintained throughout the 47 months of therapy. Echocardiographic data revealed significantly increased fractional shortening at the 35- and 47-month time points. Comparison with cross-sectional data from 77 patients with FRDA indicated the changes in total International Cooperative Ataxia Rating Scale and kinetic scores over the trial period were better than predicted for 7 patients, but the posture and gait and hand dexterity scores progressed as predicted. CONCLUSION: This therapy resulted in sustained improvement in mitochondrial energy synthesis that was associated with a slowing of the progression of certain clinical features and a significant improvement in cardiac function.

Adolescent↗
PubMed2004

Health-related quality of life at age 10 years in very low-birth-weight children with and without threshold retinopathy of prematurity.

OBJECTIVE: To describe parental perspectives on health status and health-related quality of life (HRQL) at age 10 years in children with birth weights less than 1251 g who participated in the multicenter Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) study. METHODS: In 244 participants in the randomized CRYO-ROP trial and 102 CRYO-ROP participants who did not develop ROP, the Health Utilities Index (HUI) system was used to characterize health status for the following 8 attributes: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain. Using a utility formula, HRQL was determined for each child on a scale from 0.0 (dead) to 1.00 (perfect health). RESULTS: The proportion of the ROP-randomized group with limitations in 4 attributes or more was 20.6% compared with 2.0% for the no-ROP group. Within the ROP-randomized group, the proportion of "sighted" children with limitations in 4 attributes or more was 6.4% vs 46.5% in the "blind/low vision" group. The median HRQL score for the ROP-randomized children was lower than for the no-ROP children (0.72 vs 0.97, P<.001); the median HRQL score for the sighted-randomized children was 0.87 vs 0.27 for the blind/low vision children (P<.001). CONCLUSIONS: Threshold ROP was associated with functional limitations in health attributes and reduction in HRQL scores at age 10 years. Furthermore, among children who developed threshold ROP, a greater reduction in HRQL scores was found among children with a poor visual outcome compared with those with better sight.

Activities of Daily Living↗
PubMed2002

Tracheoesophageal speech in a developing world community.

OBJECTIVES: To determine the tracheoesophageal speech results in a Third World medical practice; to examine the impact of socioeconomic status, literacy, and proximity to specialist services on tracheoesophageal speech; to assess whether these factors should affect patient selection for fistula speech; and to determine guidelines for voice prosthesis selection. DESIGN: Retrospective analysis. SETTING: Groote Schuur Hospital, Cape Town, South Africa, which serves a Third World community. PATIENTS: Ninety-seven consecutive patients who underwent total laryngectomy between January 1, 1996, and October 1, 1998. Patients who undergo total laryngectomy routinely have a primary tracheoesophageal fistula created for speech. MAIN OUTCOME MEASURES: Speech outcomes after total laryngectomy; tracheoesophageal speech in relation to social class, literacy, and proximity to specialist services; and experience with removable and indwelling valves. RESULTS: Fifty-nine (81%) of 73 patients acquired useful speech. Speech outcome was not affected by employment status or proximity to specialist services. Although speech was affected by literacy and housing, several illiterate shack dwellers acquired good speech. Average device life of removable prostheses was 16 weeks (>4 months in 35% [64/183]). Indwelling prostheses had an average life of 28 weeks. CONCLUSIONS: Tracheoesophageal speech results in a Third World community equate with those in the Developed World. All patients who undergo laryngectomy and have adequate manual dexterity and cognitive function should be given a trial of fistula speech. Removable voice prostheses can successfully be used as indwelling prostheses.

Adult↗
PubMed2004

Augmented reality in surgery.

OBJECTIVE: To evaluate the history and current knowledge of computer-augmented reality in the field of surgery and its potential goals in education, surgeon training, and patient treatment. DATA SOURCES: National Library of Medicine's database and additional library searches. STUDY SELECTION: Only articles suited to surgical sciences with a well-defined aim of study, methodology, and precise description of outcome were included. DATA SYNTHESIS: Augmented reality is an effective tool in executing surgical procedures requiring low-performance surgical dexterity; it remains a science determined mainly by stereotactic registration and ergonomics. Strong evidence was found that it is an effective teaching tool for training residents. Weaker evidence was found to suggest a significant influence on surgical outcome, both morbidity and mortality. No evidence of cost-effectiveness was found. CONCLUSIONS: Augmented reality is a new approach in executing detailed surgical operations. Although its application is in a preliminary stage, further research is needed to evaluate its long-term clinical impact on patients, surgeons, and hospital administrators. Its widespread use and the universal transfer of such technology remains limited until there is a better understanding of registration and ergonomics.

Forecasting↗
PubMed1978

Nicolo Paganini. Musical magician and Marfan mutant?

The thesis is advanced that Nicolo Paganini of Genoa (1782 to 1840), the greatest violin virtuoso of all time, owed his incomparable violin virtuosity to a fortuitous and fortunate coincidence of three factors: a soaring musical genius, a flair for the dramatic and ostentatious, and manual dexterity conferred by being born with the long fingers and hyperextensible joints of Marfan's syndrome. Ordinarily, an inborn connective tissue disorder is a calamity for the patient and a burden for society. In this particular instance, however, Marfan's syndrome bequeathed to posterity a legacy that will ennoble the human spirit for innumerable generations yet to come.

Famous Persons↗
PubMed2001

Minimally invasive and robotic surgery.

Advances in surgery have focused on minimizing the invasiveness of surgical procedures, such that a significant paradigm shift has occurred for some procedures in which surgeons no longer directly touch or see the structures on which they operate. Advancements in video imaging, endoscope technology, and instrumentation have made it possible to convert many procedures in many surgical specialties from open surgeries to endoscopic ones. The use of computers and robotics promises to facilitate complex endoscopic procedures by virtue of voice control over the networked operating room, enhancement of dexterity to facilitate microscale operations, and development of virtual simulator trainers to enhance the ability to learn new complex operations. Future research will focus on delivery of diagnostic and therapeutic modalities through natural orifices in which investigation is under remote control and navigation, so that truly "noninvasive" surgery will be a reality.

Forecasting↗
PubMed2005

Blood mercury levels and neurobehavioral function.

CONTEXT: Due to its cardiovascular benefits, fish consumption is widely encouraged among older Americans. However, this fast-growing population is at increased risk of cognitive impairment and may be particularly sensitive to methylmercury, a neurotoxicant found in fish. OBJECTIVE: To describe associations of blood mercury levels with neurobehavioral test scores in an urban adult population. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional analysis to determine the effect of mercury levels on neurobehavior in 474 randomly selected participants in the Baltimore Memory Study, a longitudinal study of cognitive decline involving 1140 Baltimore residents aged 50 to 70 years. We measured total mercury in whole blood samples and used multiple linear regression to examine its associations with neurobehavioral test scores. First-visit data were obtained in 2001-2002. MAIN OUTCOME MEASURES: Twenty scores from 12 neurobehavioral tests. RESULTS: The median blood mercury level was 2.1 microg/L (range, 0-16 microg/L). After adjustment for covariates, increasing blood mercury was associated with worse performance on Rey complex figure delayed recall, a test of visual memory (beta, -0.224; 95% confidence interval, -0.402 to -0.047). However, increasing blood mercury levels were associated with better performance on finger tapping, a test of manual dexterity (beta for dominant hand, 0.351; 95% confidence interval, 0.017-0.686). CONCLUSION: Overall, the data do not provide strong evidence that blood mercury levels are associated with worse neurobehavioral performance in this population of older urban adults.

Adult↗