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Dominant Hand (dominant + hand)
Selected AbstractsNon-invasive bioengineering methods in an intervention study in 1020 male metal workers: results and implications for occupational dermatologyCONTACT DERMATITIS, Issue 5 2010Birgitta Kütting Background: Measurements of transepidermal water loss (TEWL) as an indicator of skin barrier function and colorimetry for quantifying erythema have been recommended for monitoring persons at risk of occupational hand dermatitis. Objective: This study examines the practicability and usefulness of biophysical measurements at the workplace. Patients/Material/Methods: A sample of 1020 male metal workers was enrolled; 800 participants were followed up for 1 year. TEWL results and colorimetry (a* value), respectively, were used as effectiveness outcomes, comparing the findings in the four study arms (skin care, skin protection, both combined, and control group). Results: At 1 year follow-up, the TEWL was slightly but significantly lower in the group of participants randomized for application of barrier cream alone, indicating a protective effect. However, addressing both the individual absolute change of a* value and the differences of TEWL (delta-TEWL) of the dominant hand over the study period, no significant difference was found between the four groups. Conclusions: Dermatological examinations at the workplace cannot be replaced by bioengineering techniques. The supplementary benefit is apparently low, possibly because of difficulties in achieving standardized measurement conditions and other technical reasons. [source] Improving Botulinum Toxin Therapy for Palmar Hyperhidrosis: Wrist Block and Technical ConsiderationsDERMATOLOGIC SURGERY, Issue 1 2001Ada Regina Trindade De Almeida MD Botulinum A exotoxin has become an excellent therapeutic option to treat focal hyperhidrosis, but when the problem affects the palmar region the technique has some drawbacks. Pain with injection is difficult to tolerate and the large dose needed to treat both hands are two concerns, as well as muscle weakness secondary to botulinum toxin diffusion and the possibility of antibody production. All these problems limit the number of patients treated. The author's suggestion is to treat only the dominant hand, after performing a wrist block. The use of a device adapted from a cartridge rubber may help to control the injection depth and the risk of muscular weakness. [source] Impaired Motor Function in Patients with Psychogenic PseudoseizuresEPILEPSIA, Issue 12 2001Dalma Kalogjera Sackellares Summary: ,Purpose: To evaluate motor speed and grip strength in patients with well-documented psychogenic pseudoseizures. Methods: We analyzed manual motor speed and grip strength in a group of 40 patients with confirmed psychogenic pseudoseizures (without evidence of concomitant epilepsy) and a group of 40 normal controls matched for handedness and gender, and of comparable age. The two groups were compared with respect to manual motor performance with the dominant hand, nondominant hand, and asymmetry between the dominant and nondominant hands. For the patient sample, we reviewed the neurologic history. Results: Patients with pseudoseizures performed more poorly than controls with both dominant and nondominant hands. In addition, pseudoseizure patients failed to demonstrate the dominant-hand advantage observed in the normal control subjects on both tasks. The patient group had a high incidence of head trauma and other antecedent neurologic risk factors, and the proportion of left-handers was 3 times higher than expected. Conclusions: Bilaterally reduced motor speed and grip strength, reduced intermanual performance asymmetry, the high percentage of left-handers, and historical evidence of antecedent insults to the brain indicate that frontal lobe impairment may be common in patients with psychogenic pseudoseizures. [source] Occupational exposures occurring in students in a UK dental school,EUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 3 2002D. A. Stewardson Background:, Students whilst training may encounter a number of incidents where infection from patient body fluids may occur, especially as their manual skills are underdeveloped and their clinical experience is limited. Purpose of study:, (a) To assess the nature of the occupational exposures occurring to students in a UK dental school, (b) to assess the rate of reporting of incidents, and (c) to evaluate the association of various factors with these exposures. Students in the third, fourth and final years of the 5-year undergraduate dental course at the University of Birmingham were asked to complete a questionnaire that enquired into personal details, number and nature of incidents, their reporting and follow-up. A 100% response rate was achieved. Results:, Across the years, there was no significant correlation (p > 0.01) between sex, dominant hand, use of protective glasses or time of day. Slightly more exposures occurred in males, right-handed students, and in the afternoon. A significant decrease in exposures (p < 0.01) occurred within final year, and when an assistant was employed. Significantly more incidents occurred while a patient was being treated than during operational clean-up procedures. A substantial number of dental students had experienced one or more occupational exposures during training. Of these, percutaneous injuries predominated. Junior students appear to be more likely to experience exposures, and in these students, needlestick injuries are the most common source. Conclusions:, To reduce the incidence of these exposures, more instruction and training may be required in the earlier clinical years and more chairside assistance. Improvements are required in the monitoring of post-screening for seroconversion after HBV immunization, and in the reporting of test results in the event of an exposure incident. Under-reporting of incidents is common and ways to encourage and facilitate reporting should be sought. [source] Asymmetrical lateral ventricular enlargement in Parkinson's diseaseEUROPEAN JOURNAL OF NEUROLOGY, Issue 4 2009M. M. Lewis Background:, A recent case report suggested the presence of asymmetrical lateral ventricular enlargement associated with motor asymmetry in Parkinson's disease (PD). The current study explored these associations further. Methods:, Magnetic resonance imaging (3T) scans were obtained on 17 PD and 15 healthy control subjects at baseline and 12,43 months later. Baseline and longitudinal lateral ventricular volumetric changes were compared between contralateral and ipsilateral ventricles in PD subjects relative to symptom onset side and in controls relative to their dominant hand. Correlations between changes in ventricular volume and United Parkinson's disease rating scale motor scores (UPDRS-III) whilst on medication were determined. Results:, The lateral ventricle contralateral to symptom onset side displayed a faster rate of enlargement compared to the ipsilateral (P = 0.004) in PD subjects, with no such asymmetry detected (P = 0.312) in controls. There was a positive correlation between ventricular enlargement and worsening motor function assessed by UPDRS-III scores (r = 0.96, P < 0.001). Discussion:, There is asymmetrical lateral ventricular enlargement that is associated with PD motor asymmetry and progression. Further studies are warranted to investigate the underlying mechanism(s), as well as the potential of using volumetric measurements as a marker for PD progression. [source] Is it possible to identify early predictors of the future cost of chronic arthritis?FUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 1 2009The VErA project Abstract This study was conducted to identify early predictors of the total cost of inflammatory arthritis (IA). One hundred and eighty patients affected by undifferentiated arthritis (UA) or rheumatoid arthritis (RA) were included in the French Very Early rheumatoid Arthritis (VErA) cohort between 1998 and 2001. Health economic data for 2003 were collected using a patient self-questionnaire. Results were analysed in terms of direct, indirect and total costs in 2003 euros (2003,) for the population as a whole and in diagnostic subgroups. A payor perspective (the French National Health Insurance, in this case) was adopted. Multiple linear regression models were used to identify predictors of total cost from among the criteria assessed on recruitment. Results of the study showed that for the study population as a whole, the mean total cost was ,4700 per patient. The costs attributable to the RA and UA sub-groups were ,5928 and ,2424 per patient, respectively. In a univariate analysis, certain parameters were significantly correlated with a higher cost of illness. In the multivariate analysis, some of these parameters were further identified as being predictive of higher cost. Two strong significant, early predictors of total cost were identified: higher pain (P = 0.002) and the presence of rheumatoid factor (P = 0.004). In the RA sub-group, lower grip strength of the dominant hand (P = 0.039) was another predictor of the illness's subsequent economic impact. In conclusion, our data show that simple clinical and laboratory parameters can be used early in the course of IA to predict the condition's impact on healthcare budgets. [source] Quantitative Ultrasound Assessment in Children With Fractures,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 8 2004Johannes Schalamon Abstract BMD of children with fractures was compared with healthy controls using QUS. We found significantly lower SOS values in children suffering from fractures. None of the studied environmental factors could explain the difference in BMD measurements. Introduction: The aims of this study were to compare the results of quantitative ultrasound (QUS) in children with fractures with the respective values in children without fractures and to identify possible environmental factors influencing speed of sound (SOS) in our study cohort. Materials and Methods: BMD was measured by QUS in 50 children who had sustained an acute fracture and in 154 healthy children as controls. SOS values were obtained from the proximal phalanges of the last four fingers of the dominant hand. Nutritional habits and activity level of the children were documented by a standardized questionnaire. Results: Children with fractures had a significantly lower SOS compared with children without a history of fractures. This difference in SOS could not be explained by differences in diet, body mass index, or physical activity. Conclusions: Previous studies have suggested that low BMD levels might contribute to an increased prevalence of fractures in patients with systemic diseases. Our study showed that, in an otherwise healthy pediatric population, the SOS values are lower in children with fractures compared with healthy controls. Despite statistical significance, the biological impact of the results remains unclear. The difference in SOS values could not be explained by any of the studied environmental factors. [source] Cerebral dominance and schizophrenia-spectrum disorders in adults with intellectual disabilityJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 6 2000D. Rowe Abstract Studies of the general population without intellectual disability have suggested an association between atypical handedness and schizophrenia-spectrum disorders (SSDs). Mixed handedness is taken as an index of diminished cerebral dominance or laterality. The present study addressed the question of whether such findings extend to the neurodevelopmentally ,at risk' population of adults with intellectual disability and SSDs compared with appropriate controls. Fourteen patients with a dual diagnosis of intellectual disability and SSD were compared with 14 controls with intellectual disability alone. Assessments of self-reported hand preference and relative hand skill were completed. Self-report of hand preference revealed highly significantly greater mixed-handedness in the SSD group. Furthermore, relative hand skill performance was significantly diminished for the dominant hand. The discrepancy between dominant and non-dominant hand functioning was lower in the SSD group and this association was highly significant. The results of the present study support the usefulness of such detailed laterality assessment in this population. Mixed laterality, over and above that of the population with general intellectual disability and developmental disorder, was associated with SSD. These results are consistent with the neurodevelopmental hypothesis of schizophrenia and its cognitive neuropsychiatric/neuropsychological sequelae. [source] Recruitment of Additional Brain Regions to Accomplish Simple Motor Tasks in Chronic Alcohol-Dependent PatientsALCOHOLISM, Issue 6 2010Mitchell H. Parks Background:, Chronic alcohol-dependent patients (ALC) exhibit neurocognitive impairments attributed to alcohol-induced fronto-cerebellar damage. Deficits are typically found in complex task performance, whereas simple tasks may not be significantly compromised, perhaps because of little understood compensatory changes. Methods:, We compared finger tapping with either hand at externally paced (EP) or maximal self-paced (SP) rates and concomitant brain activation in ten pairs of right-hand dominant, age-, and gender-matched, severe, uncomplicated ALC and normal controls (NC) using functional magnetic resonance imaging (fMRI). Results:, Mean tapping rates were not significantly different in ALC and NC for either task, but SP tapping variances were greater in ALC for both hands. SP tapping was more rapid with dominant hand (DH) than non-dominant hand (NDH) for both groups. EP and SP tapping with the non-dominant hand demonstrated significantly more activation in ALC than NC in the pre and postcentral gyri, inferior frontal gyrus, inferior parietal lobule, and the middle temporal gyrus. Areas activated only by ALC (not at all by NC) during NDH tapping included the inferior frontal gyrus, middle temporal gyrus, and postcentral gyrus. There were no significant group activation differences with DH tapping. No brain regions activated more in NC than ALC. SP tapping in contrast to EP activated fronto-cerebellar networks in NC, including postcentral gyrus, anterior cingulate, and the anterior lobe and vermis of the cerebellum, but only parietal precuneus in ALC. Conclusions:, These findings with NDH finger tapping support previous reports of neurocognitive inefficiencies in ALC. Inferior frontal activation with EP in ALC, but not in NC, suggests engagement of regions needed for planning, organization, and impulse regulation; greater contralateral parietal lobe activation with SP in ALC may reflect right hemispheric impairments in visuospatial performance. Contrasting brain activation during SP and EP suggests that ALC may not have enlisted a fronto-cerebellar network as did NC but rather employed a higher order planning mode by recruiting parietal lobe functions to attain normal mean finger tapping rates. Elucidation of the compensatory neural mechanisms that allow near normal performance by ALC on simple tasks can inform functional rehabilitation of patients in recovery. [source] Neuromotor effects of short-term and long-term exposures to trichloroethylene in workers,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 9 2010Katsuyuki Murata MD Abstract Background Health effects of long-term exposure to organic solvents at low levels are a major concern in industrialized countries. To assess the neuromotor impact of trichloroethylene objectively, static postural sway and hand tremor parameters, along with urinary trichloroethanol (TCOH) and trichloroacetic acid (TCAA) levels, were investigated in 57 workers without obvious neurological disorders and 60 control subjects. Methods The workers had been occupationally exposed to trichloroethylene for 0.1,37 years. The cumulative exposure index (CEI) was calculated from their occupational history and total trichloro-compounds (TCOH,+,TCAA). Results Median levels in the workers were 1.7,mg/L for TCOH and 2.5,mg/L for TCAA, and the maximum ambient trichloroethylene concentration was estimated to be <22,ppm from the previously reported equation using TCOH,+,TCAA. Sway parameters with eyes open and tremor intensity in dominant hand were significantly larger in the exposed workers than in the control subjects when adjusting for possible confounders. A significant dose,effect association was seen between two sway parameters and urinary TCOH level in the workers. Tremor intensities in non-dominant hand differed significantly among three groups of the workers divided according to the CEI. Conclusions These findings suggest that trichloroethylene exposure, even at low levels of less than the short-term exposure limit by the ACGIH, can affect the neuromotor function of workers. The postural instability appears to result from recent exposure, and the increased tremor may occur due to short-term and long-term exposures. Hereafter, such objective measures, along with subjective symptoms, should be carefully used for the occupational exposure limit setting. Am. J. Ind. Med. 53:915,921, 2010. © 2010 Wiley-Liss, Inc. [source] Elucidation of the relationship between synovitis and bone damage: A randomized magnetic resonance imaging study of individual joints in patients with early rheumatoid arthritisARTHRITIS & RHEUMATISM, Issue 1 2003Philip G. Conaghan Objective To simultaneously image bone and synovium in the individual joints characteristically involved in early rheumatoid arthritis (RA). Methods Forty patients with early, untreated RA underwent gadolinium-enhanced magnetic resonance imaging (MRI) of the second through fifth metacarpophalangeal joints of the dominant hand at presentation, 3 months, and 12 months. In the first phase (0,3 months), patients were randomized to receive either methotrexate alone (MTX) or MTX and intraarticular corticosteroids (MTX + IAST) into all joints with clinically active RA. The MTX-alone group received no further corticosteroids until the second phase (3,12 months), when both groups received standard therapy. Results In the first phase, MTX + IAST reduced synovitis scores more than MTX alone. There were significantly fewer joints with new erosions on MRI in the former group compared with the latter. During the second phase, the synovitis scores were equivalent and a similar number of joints in each group showed new erosions on MRI. In both phases, there was a close correlation between the degree of synovitis and the number of new erosions, with the area under the curve for MRI synovitis the only significant predictor of bone damage progression. In individual joints, there was a threshold effect on new bone damage related to the level of synovitis; no erosions occurred in joints without synovitis. Conclusion In early RA, synovitis appears to be the primary abnormality, and bone damage occurs in proportion to the level of synovitis but not in its absence. In the treatment of patients with RA, outcome measures and therapies should focus on synovitis. [source] The contribution of the palmaris longus muscle to the strength of thumb abductionCLINICAL ANATOMY, Issue 4 2010Hope Gangata Abstract The palmaris longus muscle (PLM) is described as a weak flexor of the wrist and a tensor of the palmar aponeurosis, but not a thumb abductor. The PLM is believed to aid thumb abduction through its insertion onto the thenar eminence. Two groups, both right hand dominant, were selected from 1,200 sampled participants. The first group comprised of 38 subjects with unilateral presence of the PLM and was used to determine the strength of thumb abduction. The second group comprised of 30 subjects, with bilateral presence of the PLM, and it was used to calculate the effects of hand dominance. A significant number of subjects with bilateral absence of the PLM were observed and undocumented. Using a dynamometer in subjects with unilateral presence of the PLM, the force of thumb abduction was significantly greater on the hand with a PLM than the one without it (P = 0.014), irrespective of hand dominance. In the second sample with bilateral PLM, thumb abduction on the dominant hand was 10% stronger than on the nondominant hand and was similar to the universally accepted average of 10% increase in grip strength of the dominant hand. Thus, 10% was deducted from all the dominant hands, and the force of thumb abduction remained greater on the hand with PLM than the hand without it (P = 0.049). The results of this study demonstrated the PLM to be involved in thumb abduction, and the authors therefore recommend that this action of the muscle be universally accepted by anatomists and hand surgeons. Clin. Anat. 23:431,436, 2010. © 2010 Wiley-Liss, Inc. [source] Norms for grip strength in children aged 4,16 yearsACTA PAEDIATRICA, Issue 6 2002C Häger-Ross The aim of this study was to provide norms for grip strength in children. A total of 530 Swedish 4,16-y-olds was tested with the instrument Grippit®. The instrument estimates peak grip strength over a 10 s period, and sustained grip strength averaged across the 10 s. The increase in grip strength with age was approximately parallel for boys and girls until 10 y of age, after which boys were significantly stronger than girls. Strong correlations existed between grip strength and the anthropometric measures weight, height and, in particular, hand length. Right-handed children were significantly stronger in their dominant hand, while left-handers did not show any strength difference between the hands. It is therefore suggested that when evaluating grip strength in left-handed children both hands should be assumed to be about equally strong, while right-handed children are expected to be up to 10% stronger with their right hand. Sustained grip strength was consistently about 80,85% of peak grip strength, with somewhat lower values in younger children. The present normative data for peak grip strength were slightly lower than 1980s' data from the USA and Australia, probably because of divergences in age grouping and in instruments used. Conclusion: Norms for grip strength including estimates of variation were provided for children aged 4,16 y. These data will enable therapists and physicians to compare a patient's score with the scores of normally developed children according to age, gender, handedness and body measures. [source] The contribution of the palmaris longus muscle to the strength of thumb abductionCLINICAL ANATOMY, Issue 4 2010Hope Gangata Abstract The palmaris longus muscle (PLM) is described as a weak flexor of the wrist and a tensor of the palmar aponeurosis, but not a thumb abductor. The PLM is believed to aid thumb abduction through its insertion onto the thenar eminence. Two groups, both right hand dominant, were selected from 1,200 sampled participants. The first group comprised of 38 subjects with unilateral presence of the PLM and was used to determine the strength of thumb abduction. The second group comprised of 30 subjects, with bilateral presence of the PLM, and it was used to calculate the effects of hand dominance. A significant number of subjects with bilateral absence of the PLM were observed and undocumented. Using a dynamometer in subjects with unilateral presence of the PLM, the force of thumb abduction was significantly greater on the hand with a PLM than the one without it (P = 0.014), irrespective of hand dominance. In the second sample with bilateral PLM, thumb abduction on the dominant hand was 10% stronger than on the nondominant hand and was similar to the universally accepted average of 10% increase in grip strength of the dominant hand. Thus, 10% was deducted from all the dominant hands, and the force of thumb abduction remained greater on the hand with PLM than the hand without it (P = 0.049). The results of this study demonstrated the PLM to be involved in thumb abduction, and the authors therefore recommend that this action of the muscle be universally accepted by anatomists and hand surgeons. Clin. Anat. 23:431,436, 2010. © 2010 Wiley-Liss, Inc. [source] | |||||||||||||||||||