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At least 1,333 records · Page 74Linked to original sources
PubMed2001

Open donor, laparoscopic donor and hand assisted laparoscopic donor nephrectomy: a comparison of outcomes.

PURPOSE: In experienced hands laparoscopic surgery has been shown to be safe for procuring kidneys for transplantation that function identically to open nephrectomy controls. While searching for a safer and easier approach to laparoscopic donor nephrectomy, hand assisted laparoscopic techniques have been added to the surgical armamentarium. We compare allograft function in patients with greater than 1-year followup who underwent open donor (historic series), classic laparoscopic and hand assisted laparoscopic nephrectomy. MATERIALS AND METHODS: The charts of 48 patients who underwent open donor, laparoscopic donor or hand assisted laparoscopic nephrectomy were reviewed. Only patients with greater than 1-year followup and complete charts were included in our study. Of these patients 34 underwent consecutive laparoscopic live donor nephrectomy and 14 underwent open donor nephrectomy. Mean patient age plus or minus standard deviation (SD) was 36.5 +/- 8.4 years for donors and 29 +/- 17 for recipients at transplantation (range 13 months to 69 years). In the laparoscopic group 11 patients underwent the transperitoneal technique, and 23 underwent hand assisted laparoscopic nephrectomy. RESULTS: Total operating time was significantly reduced with the hand assisted laparoscopic technique compared with classic laparoscopy, as was the time from skin incision to kidney removal and warm ischemic time. Average warm ischemic time plus or minus SD was 3.9 +/- 0.3 minutes for laparoscopic nephrectomy and 1.6 +/- 0.2 for hand assisted laparoscopy (p <0.05). Long-term followup of serum creatinine levels revealed no significant differences among the 3 groups. Comparison of those levels for recipients of open nephrectomy versus laparoscopic and hand assisted laparoscopic techniques revealed p values greater than 0.5. No blood transfusions were necessary. Complications included adrenal vein injury in 1 patient, small bowel obstruction in 2, abdominal hernia at the trocar site in 1 and deep venous thrombosis in 1. CONCLUSIONS: Classic laparoscopic donor and hand assisted laparoscopic donor nephrectomies appear to be safe procedures for harvesting kidneys. The recipient graft function is similar in the laparoscopic and open surgery groups.

Adolescent↗
PubMed1992

Changes in the cortical map of the hand following postnatal ulnar and radial nerve injury in monkeys: organization and modification of nerve dominance aggregates.

The ulnar and radial nerves to the hands of 12-31-d-old marmoset monkeys were transected and ligated, and the monkeys were subsequently reared for periods of 1.4-1.6 years with only median nerve innervation to the hand. Features of organization in the cortical area 3b hand map were then assessed with neurophysiological mapping procedures, and compared to features in monkeys that had undergone either a normal postnatal development with three intact hand nerves, or an abnormal development with two intact nerves due to postnatal injury of the median nerve. A systematic comparison of cortical organization in these monkeys led to three main findings. First, some features of organization show little or no change when monkeys are reared with one, two, or three hand nerves. These features include receptive field size and the overall size of the hand map. Second, other features are, in contrast, clearly altered in an injury-dependent manner. These features include cortical neuronal thresholds to light tactile stimuli, and the spatial location, size, shape, continuity, and somatotopic interfacing of representations of the parts of the hand. Finally, estimates of the peripheral innervation territories of the hand nerves, and of the corresponding distributions of cortical neurons activated by inputs from these territories, indicate that the normal hand map contains bandlike aggregates of neurons that are dominantly activated by inputs from each nerve. Postnatal nerve injuries alter the size of these nerve dominance aggregates.

Animals↗
PubMed2000

The 2nd:4th digit ratio and asymmetry of hand performance in Jamaican children.

Testosterone, particularly prenatal testosterone, has been implicated in the aetiology of many extragenital sexually dimorphic traits. It is difficult to test directly for the effect of prenatal testosterone in humans. However, Manning, Scutt, Wilson, and Lewis-Jones (1998b) have recently shown that the ratio of the length of the 2nd and 4th digits (2D:4D) in right hands negatively predicts testosterone levels in men. As digit ratios are fixed in utero it may be that the 2D:4D ratio is associated with many prenatally determined sexually dimorphic traits. We tested this for one case by examining the relationship between lateralised hand performance (LHP), as measured by an Annett peg board, and 2D:4D ratio in rural Jamaican children. 2D:4D ratio was measured from photocopies and X rays of hands. A low 2D:4D ratio in the right hand of boys and girls (photocopies) and the right hand of boys only (X rays) was associated with a reduction in rightward performance asymmetry. In both samples the difference in 2D:4D ratio between the hands (2D:4D left hand-2D:4D right hand) showed the strongest relationship with LHP i.e. high ratio in the left and low in the right correlated with a tendency towards a fast performance with the left hand. It is suggested that the 2D:4D ratio may be associated with the expression of other sexually dimorphic behavioural traits.

Journal Article↗
PubMed1995

[Left-handed painters].

The role of the right hemisphere in the building of our visual space is now well established. The purpose of the present research was to determine the proportion of left handed painters, and to identify famous painters which were left-handed. The methods were as follows. First, the study of the portraits of the painters; but self-portraits were worthless (right-handed painters often painting themself as observed in the mirror, i.e. left-handed). Therefore, only portraits of painters made by another painter or by photography were used. Secondly, the orientation of the hatchings used by the artist for the representation of the shadows in the drawing: the right-handed artist making hatchings descending from right to left, and the left-handed artist making hatchings descending from left to right. Thirdly, the study of the relevant literature about history of art. The studied population included 500 painters divided in two groups: a population of 127 painters studied by portraits and hatchings; and a population of 373 painters studied only by hatchings. In the first population, the proportion of left-handed painters was 4.7%. In the second population, the proportion of left-handed painters was 2.1%. Among the 500 painters they were 14 left-handed subjects, i.e. 2.8%. These 14 painters were, in alphabetical order: Cambiaso, Dufy, Escher, Füssli, Grandville, Holbein, Klee, De La Patellière, Léonard de Vinci, Menzel, Montelupo, Papety, Regnault, Van Goyen.(ABSTRACT TRUNCATED AT 250 WORDS)

Europe↗
PubMed1998

Hand assisted laparoscopic nephrectomy: comparison to standard laparoscopic nephrectomy.

PURPOSE: We report our initial experience with hand assisted laparoscopic nephrectomy, and compare it to our results of standard laparoscopic nephrectomy. MATERIALS AND METHODS: The results of 21 hand assisted and standard laparoscopic nephrectomies (15 simple and 4 radical nephrectomies, and 2 nephroureterectomies) were reviewed. Hand assisted laparoscopic nephrectomy was performed with a hand placed intra-abdominally using the Pneumo Sleeve,* in addition to standard laparoscopic instruments manipulated through laparoscopic ports. Standard laparoscopic nephrectomy was performed using laparoscopic instruments alone. Perioperative data were recorded and questionnaires, including visual analog pain scales, were administered prospectively to 17 of 21 cases. RESULTS: The average operative time for 13 hand assisted laparoscopic nephrectomies was 240 minutes, which was significantly less than the 325-minute average for 8 standard laparoscopic nephrectomies (p = 0.04). Major complications tended to be more frequent in the standard group (38 versus 8%, p = 0.10). Hospital stay, return to normal activity and corrected 2-week abdominal/flank pain score in the hand assisted group (3.1 days, 14 days and 0.8, respectively) were not significantly different from the standard group (3.0 days, 10 days and 0.2, respectively). CONCLUSIONS: Compared to standard laparoscopic techniques, hand assistance appears to facilitate the operative speed and safety of laparoscopic nephrectomy without sacrificing the benefits of minimally invasive surgery. Hand assistance may make laparoscopic nephrectomy more appealing to urologists without advanced laparoscopic experience, may facilitate the laparoscopic management of demanding pathological conditions and is particularly useful when intact specimens are required. Hand assistance, by improving manipulative ability and tactile sense, is helpful for select cases of laparoscopic nephrectomy.

Adolescent↗
PubMed2005

Effects of a hand training programme in five patients with myotonic dystrophy type 1.

The aim of this study was to evaluate hand function and self-rated occupational performance before and after specific hand training in five participants with myotonic dystrophy (MD) type 1. MD is the commonest of the muscular dystrophies with adult onset and is associated with muscle weakness, wasting and myotonia. Compensatory techniques and strategies are mostly offered as the only intervention therapy. In the present study, the participants were their own controls using pre- and post-test measures. Each participant was tested at intervals a total of nine times before and nine times after hand training. A hand-held myometer (Microfet2), Grippit, Purdue Pegboard and self-rated myotonia were used as outcome measures. Occupational performance was assessed pre- and post-test using the Canadian Occupational Performance Measurement (COPM) in which the participants rated their own performance and satisfaction in five self-chosen occupational performance areas. The participants performed hand training for a total of three months, three times per week using a specific resistance training programme including Theraputty, a silicone-based putty. Hand function was significantly increased and a positive change in self-rated occupational performance was noted after the training period. This study indicates that hand training has a positive effect on hand function, i.e. motor function and occupational performance. The present results need to be replicated in a controlled study including a larger number of patients and over a longer period of time.

Adult↗
PubMed1991

Investigations into the efficacy of different procedures for surgical hand disinfection between consecutive operations.

In order to examine whether thorough surgical hand disinfection (handwashing plus hand disinfection) between consecutive operations is necessary, tests were carried out simulating normal clinical conditions. The tests were performed according to the guidelines for the evaluation of disinfection procedures of the German Society for Hygiene and Microbiology. Surgical hand disinfection was as follows: handwashing with soap without antimicrobial additives and subsequent 5-min disinfection with 60% n-propanol. This was followed by simulated operations of 30 or 120 min duration with a 30-min break between operations, during which half of the test group kept on the surgical gloves, while the other half removed them. The second surgical hand disinfection was done without prior handwashing by 50% of the test group. The disinfection time was reduced from 5 to 1 min by 50% of the test group. The results were evaluated by means of explorative data analysis and inductive statistical methods. Removing the surgical gloves during the interoperative break did not result in significantly higher numbers of colony forming units (cfu) compared with retaining the gloves. This was also the case after a subsequent handwashing. At the second surgical hand disinfection, after a simulated operation of 60 min duration (including break), there was no significant difference in the numbers of cfus between the test group who had washed their hands and those who had not. Reducing the disinfection time from 5 min to 1 min was not associated with a significant increase in the number of cfus. However, after a simulated operating time of 150 min (including the break), the second surgical hand disinfection with handwashing resulted in a significantly lower number of microorganisms than disinfection alone. In half the tests, the numbers of cfu were significantly lower when the test group disinfected their hands for 5 min rather than 1 min.

1-Propanol↗
PubMed2006

Epidemiology of bacterial hand infections.

OBJECTIVE: The aim of the study was to delineate and update the bacteriological spectrum, characterize patterns and sites of injury, evaluate laboratory tests and possible causes of complications in patients with bacterial hand infections. METHODS: All hand infections operated on in the department of orthopedics at Odense University Hospital during the period 1992-2001 were reviewed retrospectively. A standard protocol was used to collect data for each patient. We also examined all laboratory reports and recorded the identity of the etiologic organism, if known, for all cases of bacterial hand infections. RESULTS: Four hundred and eighteen patients (296 men and 122 women) with hand infections were operated on between 1992 and 2001 in our department. The median age of the patients was 40 years (range 1-93). The average interval from primary injury to operation was 10 days (range 1-50). The etiology was laceration/puncture in 35%. The site of infection was subcutaneous in 45% followed by tendon, joint and bone in 27, 18 and 5%, respectively. The bacteria isolated from the patients showed that 184 cultures (44%) were pure Staphylococcus aureus followed by 49 cultures (11.7%) of mixed organisms. Body temperature and C-reactive protein (CRP) were normal in three quarters of all patients with hand infections in our series. However the erythrocyte sedimentation rate (ESR) was elevated in 50% of the patients and was a significantly better test for infection in this study than CRP (p = 0.002). Neither the severity of infection nor the etiology of infection was related in any way to the initial temperature, CRP or ESR in this study. Complications were noted in 14.8% of all patients, and were especially related to diabetes, and mixed infection. CONCLUSION: Despite modern antibiotics, hand infections with a variety of organisms continue to be a source of morbidity and possible long-term disability. Most hand infections are the result of minor wounds that have been neglected. A complete history and physical examination is necessary to exclude other associated medical conditions (diabetes, arthritis, immunosuppression) that may compromise therapy. Furthermore, our study confirms that Staphylococcus aureus is responsible for most instances of hand infection, followed by mixed organisms. Gram-negative organisms are frequently cultured in patients with diabetes and intravenous drug abuse.

Adolescent↗
PubMed2003

Cognitive representations of hand posture in ideomotor apraxia.

Ideomotor apraxia (IM) is a disorder of skilled action characterized by spatiotemporal errors in pantomiming object use and in using objects. Recent evidence suggests that at least some patients with IM may exhibit particular deficits in forming hand configurations appropriate for object use. Sirigu et al. [Cortex 31 (1995) 41] reported an apraxic who positioned her hand inappropriately when attempting to use objects in accordance with stored knowledge of object-specific manipulation, but in reaching tasks could grasp the same objects appropriately in response to their structure. To this point, however, apraxics' ability to respond to functional and structural attributes of objects has not been empirically assessed. We investigated the hypothesis that patients with IM (n=9) due to left inferior parietal damage would be impaired in producing and recognizing hand postures associated with familiar objects, indicating deficient memorial representations for object-specific hand postures. In contrast, we predicted relatively unimpaired ability to produce and recognize appropriate hand postures with novel objects, indicating integrity of "on line" spatiomotor procedures coding hand position in response to object structure. Apraxics' performance was contrasted with 10 healthy controls and 8 brain-lesioned non-apraxics. Consistent with our predictions, the apraxics responded abnormally with familiar objects but normally in recognizing hand postures appropriate for novel objects. In addition, performance with objects calling for a prehensile response (pinch or clench) was superior to that with objects evoking a non-prehensile response (palm or poke). These data suggest degradation of inferior parietally-mediated representations of the precise hand postures associated with familiar objects. Furthermore, they are consistent with possible over-reliance upon dorsal system procedures for calculating precision and power grip in response to object structure.

Aged↗
PubMed1997

Distribution of bacteria on hands and the effectiveness of brief and thorough decontamination procedures using non-medicated soap.

Our perception of the role of hand washing in the clinical situation is based on experimental studies in which test-bacteria are usually inoculated onto the skin surface and removed using hand washing preparations containing antiseptics. In this study, we have investigated the distribution of bacteria on the hands of volunteers and the effectiveness of long (3 minute) and brief (10 second) washes in removing both naturally-occurring and artificially-inoculated bacteria (Micrococcus sp.), using only soap and water. There was a tenfold reduction in median counts of artificially inoculated bacteria following both long and brief washes. However, less than 50% of naturally-occurring bacteria were removed and, for hands previously disinfected by immersion in 70% ethanol, the washing procedure increased bacterial counts. In both unwashed hands, and hands washed following a strict protocol, the mean variation in counts of naturally-occurring bacteria at different sites (wrists, dorsal surface, palmar surface, fingertips and interdigital spaces) was only two-fold. The efficiency of recovery of naturally-occurring organisms was estimated by repeated swabbing, to be more than 60%. The data question the value of typical hand wash procedures recommended by many authorities for use in clinical situations and of the perfunctory hand washes frequently adopted by nursing staff in busy wards. Experimental evidence is required to justify procedures and to identify the precise circumstances in which they are of value.

Disinfectants↗
PubMed2003

Comparison of maximal voluntary isometric contraction and hand-held dynamometry in measuring muscle strength of patients with progressive lower motor neuron syndrome.

Context. Maximal voluntary isometric contraction, a method quantitatively assessing muscle strength, has proven to be reliable, accurate and sensitive in amyotrophic lateral sclerosis. Hand-held dynamometry is less expensive and more quickly applicable than maximal voluntary isometric contraction. Objective. To investigate if hand-held dynamometry is as reliable and valid as maximal voluntary isometric contraction in measuring muscle strength in patients with an adult-onset, non-hereditary progressive lower motor neuron syndrome. Design. Two testers performed maximal voluntary isometric contraction and hand-held dynamometry measurements in six muscle groups bilaterally in patients with progressive lower motor neuron syndrome to assess reliability and validity of both the methods. Setting. Outpatient units of an academic medical center. Patients. A consecutive sample of 19 patients with non-hereditary progressive lower motor neuron syndrome (median disease duration 32.5 months, range 10-84) was tested. Outcome measures. Comparison between maximal voluntary strength contractions as measured by hand-held dynamometry and maximal voluntary isometric contraction. Results. Low intra- and interrater variation in all muscle groups were found, intraclass correlation coefficients vary between 0.86 and 0.99 for both methods. Both methods correlated well in all muscle groups with Pearson's correlation coefficients ranged between 0.78 and 0.98. Scatter plots indicated a trend to under-estimate muscle strength above 250 N by hand-held dynamometry as compared with maximal voluntary isometric contraction. Conclusions. For longitudinal evaluation of muscle strength in patients with progressive lower motor neuron syndrome (i.e. between 0 and 250 N), muscle strength can be accurate quantified with both hand-held dynamometry and maximal voluntary isometric contraction. Hand-held dynamometry has the advantage of being cheap and quickly applicable. However, our results indicate that hand-held dynamometry is less sensitive than maximal voluntary isometric contraction in detecting subnormal muscle strength in strong muscle groups (i.e. >250 N), due to limited strength of the tester.

Adult↗
PubMed2006

Quantifying repetitive hand activity for epidemiological research on musculoskeletal disorders--part I: individual exposure assessment.

An exposure measurement approach is described for quantifying repetitive hand activity of individual workers in a prospective epidemiological study on work-related upper extremity musculoskeletal disorders. A total of 733 subjects were involved in this study at the baseline. Hand activities were quantified by force and repetition. Force levels were measured by workers' self-reports, ergonomists' estimates based on observation and measurements with instrumentation. Repetition levels were measured by detailed time-motion analyses using two repetitive hand activity definitions and ergonomists' estimates using scales for the American Conference of Governmental Industrial Hygienists hand activity level and the Strain Index. Results showed that the present exposure assessment approach seems to be able to quantify force level and repetitiveness of hand activities. Repetitive hand activity is quantified differently depending on whether forceful hand exertion or repetitive muscle activity is used as the definition. These hand activity definitions may quantify different physical exposure phenomena. Individual exposure assessment is important in epidemiological research of musculoskeletal disorders as there are interactions between the individual subjects and the measured parameters. These interactions may vary between exposure parameters.

Adolescent↗
PubMed1999

Incidences of asymmetries for the palmar grasp reflex in neonates and hand preference in adults.

It was hypothesized that adult handedness might be predicted from the neonatal grasp reflex. Grasp reflex was measured from right and left hand (10 trials for each hand) in neonates. According to significance for the difference between the mean grasp reflex strength from the right and left hands, the subjects were designated as right-, left-, and mixed-handers. Adult hand preference was assessed by Edinburgh Handedness Inventory. The percentage of left-handedness (8.3%) in neonates coincided with adult left-handedness (6.3-9.2%). The percentage of consistent right-hand preference in adults coincided with percentage of right-handedness in neonates (25.7%). The high percentage of neonatal mixed-handedness was similar to that to be expected from the right shift model of hand preference. It was concluded that left-handedness and consistent right-handedness may be determined prenatally, under genetic and/or hormonal control, and that a large majority of neonatal handedness, mixed-handers, might change their hand preference in favor of right-handed-ness under socio-cultural and developmental influences of speech centres.

Adult↗
PubMedDate not supplied

The evolution: Handwashing to hand hygiene guidance.

Handwashing is a fundamental principle and practice in the prevention, control, and reduction of healthcare-acquired infection. Advocated by Semmelweiss (Nursing, The Finest Art: An Illustrated History. St Louis: Mosby; 1985:204) from the 1800s to resolve an obstetric morbidity and mortality occurrence, the simple act of hand cleansing portrays the intuitive benefits to basic hygiene, health continuum, and, most important, disease prevention. According to recently published guidance (MMWR Morb Mortal Wkly Rep. October 25, 2002;51:32-34), the term handwashing is replaced by the new term hand hygiene, which includes hand cleansing, hand disinfecting, and surgical hand scrub. This article focuses on the published guidance, blending the salient aspects of hand hygiene practices from noted champions, reinforcing the aesthetics of meticulous cleansing, to guidance on its practice in healthcare settings. In healthcare, the principle of "clean hands are healing hands" bears value and demands compliance in order to prevent and control infectious processes while protecting the person from acquiring infectious diseases.

Antisepsis↗
PubMedDate not supplied

Effect of 3M Coban Self-Adherent Wraps on edema and function of the burned hand: a case study.

Edema and limited function are common acute problems associated with hand burns. This case study examined the effects of 3M Coban Self-Adherent Wraps on edema and function in a 59-year-old male (46% TBSA flame injury) with newly skin grafted dorsally burned hands. At the time of each dressing change, circumferential measurements were taken of both hands and weekly active range of motion and grip strength measurements were recorded. The nine-hole peg test was used to appraise dexterity. During the 4-week study period, there was less edema, greater active range of motion and grip strength, and greater dexterity in the hand with 3M Coban Self-Adherent Wraps as compared with the control hand. This case study suggests that 3M Coban Self-Adherent Wraps were effective in reducing edema in the skin-grafted hand after skin grafting. It further appeared that the reduced edema may have contributed to improved hand function and that 3M Coban Self-Adherent Wraps as a compressive dressing do not impede hand function

Burns↗
PubMed2005

Gram-negative bacilli associated with catheter-associated and non-catheter-associated bloodstream infections and hand carriage by healthcare workers in neonatal intensive care units.

OBJECTIVE: Bloodstream infections caused by Gram-negative bacilli are a substantial cause of morbidity and mortality in infants in neonatal intensive care units. This study describes the species of Gram-negative bacilli causing bloodstream infections in two neonatal intensive care units, compares characteristics of catheter-related and non-catheter-related bloodstream infections, and compares species and antibiotic resistance patterns of these organisms with those isolated from the hands of nurses working in the same neonatal intensive care units. DESIGN: Interventional study. SETTING: Two high-risk neonatal intensive care units. PATIENTS: Neonates hospitalized for >or =24 hrs. INTERVENTIONS: Prospective surveillance for bloodstream infections was performed in two neonatal intensive care units from March 2001 to January 2003. Hand cultures were obtained quarterly from participating nurses immediately after they performed hand hygiene. MEASUREMENTS AND MAIN RESULTS: There were 298 episodes of bloodstream infections among 2,935 admissions (5.75 episodes per 1,000 patient-days); 77 of 298 (26%) episodes were caused by Gram-negative bacilli. Among these, 47 (61.0%) were catheter-related bloodstream infections (2.61 episodes per 1,000 catheter-days). Eleven and 24 Gram-negative bacilli species were isolated from neonates and nurses, respectively. The most common Gram-negative bacilli causing bloodstream infections were Klebsiella pneumoniae (38.7%), Escherichia coli (21.2%), Enterobacter cloacae (11.2%), and Serratia marcescens (11.2%). In contrast, Acinetobacter lwoffi (18.1%), K. pneumoniae (11.7%), E. cloacae (10.6%), K. oxytoca (10.6%), and Pseudomonas spp. (7.4%) were most commonly isolated from hands of nurses. E. coli, P. aeruginosa, E. cloacae, and E. aerogenes were significantly more likely to cause bloodstream infections than to be isolated from nurses' hands (all p < .001). Although 39% of bloodstream infections were non-catheter-related, there were no significant differences in types of organisms or antimicrobial resistance patterns between catheter-related bloodstream infections and non-catheter-related bloodstream infections (all p > or = .35). Resistance patterns were similar between Gram-negative bacilli isolates from neonates and nurses' hands except for a significantly higher proportion of resistance to cefotaxime and gentamicin among neonatal isolates of K. pneumoniae (p < .05). CONCLUSIONS: Gram-negative bacilli species isolated from neonatal bloodstream infections and nurses' hands varied significantly. Clean hands of providers are an unlikely source of endemic Gram-negative bacilli, suggesting that prevention strategies should focus more on control of endogenous neonatal flora or environmental sources.

Bacteremia↗
PubMed2006

Surgical hand scrubs in relation to microbial counts: systematic literature review.

AIM: This paper reports a systematic review whose objective was to determine the effectiveness of surgical hand scrubs in relation to bacterial growth on the hands of operating room staff members. BACKGROUND: Despite the need for surgical hand scrubs, evidence shows that frequent and prolonged use of antiseptics and brushes may damage the skin. Consequently, lesions may appear, become more heavily colonized by microorganisms and increase the risk of transmitting infection to patients. Recommendations about surgical hand scrubs vary widely and their effectiveness in relation to microbial counts is unknown. METHOD: A variety of healthcare databases were searched covering the period between January 1990 and December 2004. Based on selection criteria, the abstracts of studies identified were checked to determine whether they fulfilled the inclusion criteria. All studies were assessed as having adequate methodological quality. Using Cochrane Review Manager 4.2 software, weighted mean difference and 95% confidence intervals were calculated. FINDINGS: Three studies were included in this review. Two studies compared the effectiveness of surgical hand scrubs using an alcohol-based product and a 6-minute scrub using 4% chlorhexidine gluconate; meta-analysis showed a statistically significant difference (weighted mean difference = -0.63, 95% confidence intervals = -0.99 to -0.27, P = 0.0006). One study compared the effectiveness of 2- and 3-minute surgical hand scrubs using 4% chlorhexidine gluconate; meta-analysis showed no difference (weighted mean difference = 0.29, 95% confidence intervals = -0.13 to 0.71, P = 0.18). CONCLUSION: Surgical hand scrubs using an alcohol-based product were more effective than a 6-minute scrub using 4% chlorhexidine gluconate. There is no evidence to support a 2-minute surgical hand scrub as being more effective than a 3-minute one using 4% chlorhexidine gluconate.

Alcohols↗
PubMed2004

Two multiarticulated hydraulic hand prostheses.

PURPOSE: Consumers want new prosthetic hand designs that have increased functionality, better cosmetic appearance, and lower weight. METHODS: New lightweight hands that fulfill these demands can be designed by integrating a hydraulic system with small fluidic actuators at the digit joints. RESULTS: Two different designs of lightweight experimental prosthetic hand are presented. The weight of the first hand is reduced by 50% compared to a conventional prosthetic hand, whereas the functionality of the second hand is increased by additional prehension types. Optionally, a tactile feedback system can be integrated. Due to multiple articulated digits and flexible materials, both hands are able to conform to the shape of an object held. This significantly reduces the necessary grip force and results in stable holding of an object. For a natural appearance, the hands are covered with a cosmetic silicone rubber glove.

Artificial Limbs↗