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PubMed1979

Regional cerebral blood flow comparison of right and left hand movement.

Regional cerebral blood flow measurements were made in normal right-handed subjects by the 133 xenon inhalation method at rest and during movement of either hand. Left hand movement evoked a prominent focal flow increase in the right hemisphere in the Rolandic region. During right hand movement, there was a smaller and not statistically significant increase in left hemisphere Rolandic region. This suggests that more effort is required of right-handed subjects to move the left hand than the right, or that motor organization differs for left and right hand movements. Of several flow indices tested, there was little difference among gray matter flow rate, the product of gray matter flow and relative weight, the mean regional flow, and the initial slope index, all reflecting the flow changes with nearly equal sensitivity. The gray matter weight and fractional flow did not change consistently during hand movement.

Adult↗

PubMed2006

Hand washing rituals in trauma theatre: clean or dirty?

INTRODUCTION: The aim of this study was to investigate the degree of contamination of a surgeon's hand following use of chlorhexidine gluconate or alcohol gel as disinfectants. MATERIALS AND METHODS: In this prospective, randomised trial, orthopaedic surgeons were allocated to one of two different hand-washing protocols using a randomisation table. The hand-washing protocol dictated that all surgeons should wash for 5 min with chlorhexidine for their first case. Thereafter, the surgeon was randomised to wash for 3 min with either alcohol gel or chlorhexidine. At the end of each procedure, the gloves of each surgeon were carefully removed and the fingertips from each hand were placed on an agar plate. The number of bacterial colonies present after 24 h and 48 h of incubation were recorded for each agar plate by a microbiologist blinded to the washing protocol used. RESULTS: Overall, 41 procedures and 82 episodes of hand washings were included in the study. Two episodes were discarded due to contamination at the time of glove removal. Four hands (8%) were contaminated in the chlorhexidine group compared to 19 (34%) in the alcohol group. Fisher's exact test confirmed a significantly higher risk of contamination using alcohol gel compared to chlorhexidine (P = 0.002). In addition, the average bacterial colony count was substantially higher in the alcohol group (20 colony forming units) compared to the chlorhexidine group (5 colony forming units). There was no relationship between the duration of surgery and the degree of contamination (P = 1.12). CONCLUSIONS: Alcohol gel disinfectant is not a suitable alternative to chlorhexidine when hand washing before surgery. This study has identified a higher risk of bacterial contamination of surgeons' hands washed with alcohol. This may lead to higher levels of postoperative infection in the event of glove perforation.

Anti-Infective Agents, Local↗

PubMed2003

Quantitative ultrasound evaluation of the hand: side dominance or overuse?

Mechanical loading is considered a very important factor affecting bone mass. To investigate the effect of heavy hand use on bone status in the dominant and nondominant hands, 17 ironers and a control group were evaluated with a new quantitative ultrasound system measuring the speed of sound (SOS). Both the dominant and nondominant hands were measured in all subjects, at both the proximal III phalanx and distal one-third radius. The ironers had significantly (p = 0.001) higher SOS values at the proximal III phalanx of the dominant hand than at the nondominant hand, whereas no difference was found between the hands in this group when measured at the distal one-third radius. There was no significant difference in SOS values as related to hand dominance in the control group. In conclusion, the SOS differences of the hands seems to be related to overuse rather than to side dominance.

Adolescent↗

PubMed2005

Tropical diabetic hand syndrome. Epidemiology, pathogenesis, and management.

The tropical diabetic hand syndrome (TDHS) is a complication affecting patients with diabetes mellitus in the tropics. The syndrome encompasses a localized cellulitis with variable swelling and ulceration of the hands, to progressive, fulminant hand sepsis, and gangrene affecting the entire limb. TDHS is less well recognized than foot infections and not generally classified as a specific diabetes complication. Hand infection was first described in Nigeria in 1984. Since then, the majority of cases have been reported in the African continent and more recently in India. There is often a history of antecedent minor hand trauma (e.g. scratches or insect bites). Presentation to hospital is often delayed due to the patients' unawareness of the potential risks, lack of concern because the initiating trauma might have been trivial, or decision to seek initial help from traditional healers. The first analytic study was done in Dar es Salaam, Tanzania, to characterize the epidemiology, clinical characteristics and risk factors of TDHS. Independent risk factors for TDHS include poorly controlled diabetes, neuropathy, insulin treatment or malnutrition. Clinicians should be aware of these complications and be prepared to immediately admit TDHS patients to hospital for aggressive surgical intervention (i.e. debridement, pus drainage or amputation) and high-dose, intravenous, broad-spectrum antibacterial therapy that includes anti-anaerobic activity. Without prompt, aggressive treatment TDHS can lead to permanent disability, limb amputation (13% of TDHS patients require major upper limb amputation), or death. Prevention strategies include patient and staff education that focuses on proper hand care, nutrition, and the importance of seeking medical attention immediately following hand trauma regardless of the severity of the injury, or at the earliest onset of hand-related symptoms, such as redness or swelling. Prevention of permanent disability and death due to TDHS will require improved management of glycemic levels in resource-limited countries, and surgical intervention during less severe stages of the condition.

Africa↗

PubMed2006

Tapping speed asymmetry in drummers for single-hand tapping with a stick.

The purpose of this study was to investigate tapping speed asymmetry in 13 right-handed drummers and 13 right-handed nondrummers. The participants executed single-hand tapping with a stick as fast as possible for 10 sec. with the left and right hand. There was no significant difference in the tapping speed of the right hand between the drummers and the nondrummers, whereas in the left hand, the drummers tapped significantly faster than the nondrummers. Drummers showed less tapping speed asymmetry than nondrummers. These results suggest that the tapping speed of the nonpreferred hand progressed nearly to the level of the preferred hand through daily drum training.

Acceleration↗

PubMed2001

Motor control of the hands: the effect of familial sinistrality.

Left- and right-handed subjects, selected on the basis of degree of hand preference and for the presence or absence of familial sinistrality, responded to monaurally presented tonal stimuli (440 Hz note played on four different instruments) using their right and left hands on separate occasions. It was found that in both the strong left-handers and the inconsistent strong right-handers, motor control of the hands was related to familial sinistrality (FS). Specifically, strong left-handers and inconsistent strong right-handers with FS have a difference in the motor control of the hands in the left hemisphere, with a left hemisphere-left hand advantage. Strong left-handers and inconsistent strong right-handers with no FS have a difference in the motor control of the hands in the right hemisphere, with a right hemisphere-left hand advantage.

Adult↗

PubMedDate not supplied

The relationship between serum testosterone level and Hoffmann reflex from the long flexor thumb muscle in right-handed young adults.

The relationship between serum testosterone level and Hoffmann (H) reflex from right to left thumb flexors was studied in right-handed young men and women. The subjects were divided into two subgroups: fast and slow in right-hand skill, but no difference in left-hand skill (peg moving). The mean serum testosterone level was found to be significantly lower in subjects with fast right hand than those with slow right hand. The mean H reflex from right was significantly smaller in subjects with fast right hand than those with slow right hand. There was a negative, linear relationship between serum testosterone level and amplitude of H-reflex from right thumb. This was more pronounced in females than males. The H reflex from left was not significantly associated with serum testosterone levels. It was concluded that testosterone may affect the somatomotor system of the left brain during adolescence impairing the right-hand skill especially in females. These results also appear to be in accord with the testosterone theory of cerebral lateralization.

Adolescent↗

PubMed1996

Cutaneous representations of the hand and other body parts in the cuneate nucleus of a primate, and some relationships to previously described cortical representations.

Dynamic properties of primate somatosensory maps are dependent on normal central adjacencies of cutaneous representations. The cuneate nucleus is an important brainstem processing center of cutaneous information. Surprisingly, there are no descriptions of functional representations of the skin in the primate cuneate nucleus; as a result, the relationships of functional representations at the brainstem level and other levels of the somatosensory neuraxis remain obscure. The present neurophysiological study indicates that the main cuneate nucleus of marmoset monkeys (Callithrix jacchus) contains organized representations of cutaneous inputs from the hand, forelimb, and adjacent body between the lateral face and proximal hindlimb. Inputs from the glabrous hand are represented continuously across transverse planes in the cuneate, whereas inputs from the hairy hand are represented discontinuously. Inputs from distal to proximal, and radial to ulnar, parts of the hand are mapped in an organized manner. At rostrocaudal levels where the cuneate nucleus is near its largest transverse area, the map of the hand is about 2600 times smaller than the hand skin area it represents. Cuneate representations of the forelimb and trunk are represented both medial and lateral to the hand representation, and interface with representations in the adjacent gracile and trigeminal nuclei. These findings provide a starting point for understanding functional representations of the skin in the cuneate nucleus of primates. Furthermore, they provide a basis for understanding relationships of cutaneous representations at different levels of the neuraxis. In this regard, comparisons of the present results to previously defined representations in the somatosensory (area 3b) cortex indicate that cuneate hand representations are several times smaller than cortical representations, and that there are similarities and differences in adjacencies of cuneate and cortical representations.

Animals↗

PubMed1999

Localization of hand motor activation in Broca's pli de passage moyen.

OBJECT: The object of this study was to identify a reliable surface landmark for the hand motor area and to demonstrate that it corresponds to a specific structural component of the precentral gyrus. METHODS: Positron emission tomography (PET) activation studies for hand motor function were reviewed in 12 patients in whom magnetic resonance imaging results were normal. Each patient performed a hand opening and closing task. Using a computer-assisted three-dimensional reconstruction of the surface of each hemisphere studied, the relationship of the hand motor area with cortical surface landmarks was evaluated. CONCLUSIONS: The region of hand motor activation can be reliably identified on the surface of the brain by assessing anatomical relationships to nearby structures. After identification of the central sulcus, the superior and middle frontal gyrus can be seen to arise from the precentral gyrus at a perpendicular angle. A bend or genu in the precentral gyrus is constantly seen between the superior and middle frontal gyrus, which points posteriorly (posteriorly convex). The location of hand motor function, identified using PET activation studies, is within the central sulcus at the apex of this posteriorly pointing genu. The apex of the genu of the precentral gyrus leads to a deep cortical fold connecting the pre- and postcentral gyri and elevating the floor of the central sulcus. This deep fold was described by Paul Broca as the pli de passage fronto-parietal moyen, and the precentral bank of the pli de passage represents the anatomical substratum of hand motor function. Observers blinded to the results of the activation studies were able to identify the hand motor area reliably after instruction in using these surface landmarks.

Adolescent↗

PubMed1991

Stimulus-response compatibilities between vertically oriented stimuli and horizontally oriented responses: the effects of hand position and posture.

Stimulus-response (S-R) compatibility effects between vertically oriented stimuli (above or below fixation) and horizontally oriented responses (left or right switch deflections by a single hand) have been shown to depend both on which hand responds (Bauer & Miller, 1982) and on the location at which the response is made (eccentricity on a frontoparallel line; Michaels, 1989). In the latter study, hand position and hand posture were confounded, so it is unclear which variable determined the compatibility effect. In Experiment 1, the importance of effector position was tested. Vertically oriented stimuli were paired with a horizontal response solicited at different locations but always involving the same hand posture. Compatibility effects emerged, and their direction depended on position. In Experiment 2, the compatibilities were not evident in a simple reaction time paradigm, so the effect was not due to differential ease of responses. In Experiment 3, a change in hand posture (palm up or palm down) at the same location (the body midline) also affected the compatibilities. It was concluded that the S-R compatibility of orthogonally oriented stimuli and responses is influenced by (1) which hand responds, (2) the location of that hand, and (3) its posture. The results imply that both postural and positional states of the action system affect S-R compatibility.

Fixation, Ocular↗

PubMed2004

Vision of a pictorial hand modulates visual-tactile interactions.

The participants in this study discriminated the position of tactile target stimuli presented at the tip or the base of the forefinger of one of the participants' hands, while ignoring visual distractor stimuli. The visual distractor stimuli were presented from two circles on a display aligned with the tactile targets in Experiment 1 or orthogonal to them in Experiment 2. Tactile discrimination performance was slower and less accurate when the visual distractor stimuli were presented from incongruent locations relative to the tactile target stimuli (e.g., tactile target at the base of the finger with top visual distractor) highlighting a cross-modal congruency effect. We examined whether the presence and orientation of a simple line drawing of a hand, which was superimposed on the visual distractor stimuli, would modulate the cross-modal congruency effects. When the tactile targets and the visual distractors were spatially aligned, the modulatory effects of the hand picture were small (Experiment 1). However, when they were spatially misaligned, the effects were much larger, and the direction of the cross-modal congruency effects changed in accordance with the orientation of the picture of the hand, as if the hand picture corresponded to the participants' own stimulated hand (Experiment 2). The results suggest that the two-dimensional picture of a hand can modulate processes maintaining our internal body representation. We also observed that the cross-modal congruency effects were influenced by the postures of the stimulated and the responding hands. These results reveal the complex nature of spatial interactions among vision, touch, and proprioception.

Adult↗

PubMed2003

Hand decontamination practices in paediatric wards.

The purpose of this study was to determine and describe hand decontamination practices of health care professionals in the paediatric wards of an academic hospital in Johannesburg. The purpose was addressed within a survey design and through the use of descriptive and comparative methods. Data were collected through direct observation conducted with the use of a researcher-administered checklist. A sample of sixty-six health professionals was obtained through convenience sampling. Results indicated that significantly fewer health professionals did not decontaminate their hands on entering the ward (16.6%), prior to making patient contact (34.8%) and prior to donning gloves (9.1%). Significantly more health professionals did decontaminate their hands following contact with the patient (63.6%) and following removal of gloves (77.8%). More health professional did not wash their hands after leaving the ward (51.5%). More than half (57.6%) of the health professionals who decontaminate their hands used the correct hand washing technique. Compliance with standard hand decontamination practices of health professionals was found to be poor with only 83.4% of health professionals decontaminating their hands at the start of work.

Child↗

PubMed2002

Effects of wearing knitted or rubber gloves on the transfer of Escherichia cohi between hands and meat.

On eight occasions, five volunteers each handled five pieces of meat with bare hands or while wearing dry or wet knitted gloves or rubber gloves after hands had been inoculated with Escherichia coli or after handling a piece of meat inoculated with E. coli. On each occasion, after all meat was handled, each piece of meat, glove, and hand were sampled to recover E. coli. When hands were inoculated, E. coli was recovered from all meat handled with bare hands, in lesser numbers from some pieces handled with knitted gloves, and from only one piece handled with rubber gloves. When pieces of inoculated meat were handled, the numbers of E. coli transferred to uninoculated meat from bare hands or rubber gloves decreased substantially with each successive piece of uninoculated meat, but decreases were small with knitted gloves. The findings indicate that, compared with bare hands, the use of knitted gloves could reduce the transfer of bacteria from hands to meat but could increase the transfer of bacteria between meat pieces, whereas the use of rubber gloves could largely prevent the first and greatly reduce the second type of bacteria transfer.

Bacterial Adhesion↗

PubMed2003

A comparison of hand washing techniques to remove Escherichia coli and caliciviruses under natural or artificial fingernails.

Compared with other parts of the hand, the area beneath fingernails harbors the most microorganisms and is most difficult to clean. Artificial fingernails, which are usually long and polished, reportedly harbor higher microbial populations than natural nails. Hence, the efficacy of different hand washing methods for removing microbes from natural and artificial fingernails was evaluated. Strains of nonpathogenic Escherichia coli JM109 and feline calicivirus (FCV) strain F9 were used as bacterial and viral indicators, respectively. Volunteers with artificial or natural nails were artificially contaminated with ground beef containing E. coli JM109 or artificial feces containing FCV. Volunteers washed their hands with tap water, regular liquid soap, antibacterial liquid soap, alcohol-based hand sanitizer gel, regular liquid soap followed by alcohol gel, or regular liquid soap plus a nailbrush. The greatest reduction of inoculated microbial populations was obtained by washing with liquid soap plus a nailbrush, and the least reduction was obtained by rubbing hands with alcohol gel. Lower but not significantly different (P > 0.05) reductions of E. coli and FCV counts were obtained from beneath artificial than from natural fingernails. However, significantly (P < or = 0.05) higher E. coli and FCV counts were recovered from hands with artificial nails than from natural nails before and after hand washing. In addition, microbial cell numbers were correlated with fingernail length, with greater numbers beneath fingernails with longer nails. These results indicate that best practices for fingernail sanitation of food handlers are to maintain short fingernails and scrub fingernails with soap and a nailbrush when washing hands.

Alcohols↗

PubMed1984

Hand strength and prone extension in right-dominant, 6 to 9 year olds.

A stratified random sample of 153 right-dominant children (6 to 9 years of age) with normal or above intelligence was selected to study the development of hand strength, and the quality and duration of prone extension as a function of age, sex, height, and weight of the child. The Jamar hand dynamometer was used to measure hand strength, and a new scale for rating the quality of prone extension was presented. Both right- and left-hand strength increased monotonically with age, with the right being significantly higher than the left. Duration of prone extension increased monotonically with age, but quality of prone extension did not correlate with age. Sex differences were found only on the variable left-hand strength (males greater than females). Hand strength demonstrated weak correlation with duration of prone extension. Both height and weight exhibited strong positive correlations with hand strength, weaker positive correlations with duration of prone extension, and no correlation with quality of prone extension. The results suggest hand strength can be an index of normal development, and children ages 6 to 9 can attain the prone extension position; however, the meaning of duration greater than 30 seconds needs to be researched further.

Age Factors↗

PubMed1994

Prevalence of hand dermatoses among Finnish farmers.

OBJECTIVES: The goal of this study was to determine the prevalence and risk factors of hand dermatosis among farmers. METHODS: A questionnaire survey was carried out in a geographically defined sample of the Finnish farming population between the ages of 18 and 64 years (N = 10,847). RESULTS: The one-year prevalence of self-reported hand and forearm dermatoses was 16% for the women and 7% for the men. These figures were similar to the prevalence of hand eczema in two large Scandinavian questionnaire surveys. The highest one-year prevalence of hand dermatoses was found for women on farms with more than nine dairy cows (20%). Atopy (both the personal history of atopic dermatitis and respiratory atopy), female gender, and, among the women, also age under 35 years were the most important risk factors for the occurrence of hand dermatosis. Work-related risk factors were handling disinfectants daily, handling silage preservatives, milking cows, and machine servicing. CONCLUSIONS: Occupational risk factors for hand dermatoses were found, especially for dairy farming. The results may be useful for the prevention of hand dermatoses in farming since they direct attention to related occupational hazards, and they may also aid vocational guidance for the atopic population. In order to lower the prevalence of hand dermatoses in dairy farming, both preventive and protective measures should become everyday practice in farming work.

Adult↗

PubMed1999

Scintigraphic hand osteoarthritis (OA)--prevalence, joint distribution, and association with OA at other sites.

OBJECTIVE: To assess the information available from routine bone scans on prevalence and joint distribution of osteoarthritis (OA), particularly of the hand. METHODS: Consecutive whole body bone scans of 414 patients, including a special hand projection, were analyzed for evidence of OA related uptake. After exclusions for various reasons, 297 scans were considered "representative" with regard to hand OA (108 male and 189 female patients). Kappa values for interreader agreement ranged from 0.61 to 0.82 for hand joints and was slightly lower for other joints. RESULTS: The prevalence of positive hand joints was low before the age of 40, but increased rapidly in the 5th and 6th decade to reach a plateau. Women had a higher prevalence of uptake than men in the carpometacarpal-1 (CMC1) joint and patella. Uptake was similar on the dominant and non-dominant sides in all joints with the exception of the shoulder. Subchondral knee uptake prevalence tended to decrease in the oldest age groups, but other joint sites showed a steadily increasing prevalence throughout life. Hand symptoms were related to distal interphalangeal (DIP) and CMC1 uptake, thumb symptoms with first metacarpophalangeal joint (MCP1) CMC1 uptake, and knee symptoms with the subchondral knee uptake pattern. Affected hand joint distribution was characterized by a strong bilateral concordance within rows, and an association was seen between subchondral knee uptake and hand involvement, particularly in the DIP joints, but to a lesser degree also with CMC1 and proximal interphalangeal (PIP) uptake. Association between spinal sites and between the forefoot and the knee was also observed. CONCLUSION: Bone scintigraphy is valuable method in epidemiological studies of OA, with acceptable interreader reproducibility and relation to joint symptoms. Although much of the current findings seem comparable with previous radiologic studies, they provide new ideas about age related patterns and joint subsets, possibly indicating a difference in pathogenetic mechanisms among joints in OA.

Adult↗

PubMed1999

Hand-eye dominance in a population with mental handicaps: prevalence and a comparison of methods.

BACKGROUND: The primary purpose of this study was to investigate hand-eye dominance in a population with mental handicaps and how the distribution compared with the general population. In addition, this study investigated the correlation between two methods of hand-eye dominance testing. METHODS: Two methods were used to determine eye dominance: the hole-in-the-hand method and the eye dominance wand. Hand dominance was determined by the subject's choice of accepting hand. The sample was comprised of a population of 421 athletes participating in the 1997 Special Olympic Games in Toronto. All subjects unable to give a dominant hand or unable to perform either of the ocular dominance tests were eliminated from analysis. Athletes who demonstrated strabismus or a difference in visual acuity between the two eyes of greater than 1 line were separated in the analysis, reducing the sample population to 191. RESULTS: The hole-in-the-hand method of eye dominance showed that 40.3% of this population exhibited crossed dominance. The eye dominance wand found crossed dominance in 36.6% of this population. The eye dominance wand demonstrated moderate agreement with the hole-in-the-hand method; however, there was some crossover of eye dominance between tests, when the tests were compared on a case-by-case basis. CONCLUSIONS: The prevalence rate of this population of persons with mental handicaps agrees with the prevalence rates found by Robison et al., in which 41% of a general nonhandicapped population demonstrated crossed dominance. The results suggest that persons with mental handicaps have prevalence rates of crossed dominance similar to those found in the general population.

Adolescent↗