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Biomedical subjects

T Lithman

Publications and source records attributed to T Lithman.

14 recordsLinked to original sources

Impairment of grip function in rheumatoid arthritis--studies with a simple hand test.

A new, simple and quick method for assessment of impaired grip function was evaluated in a rheumatology department, 208 of 211 patients with definite rheumatoid arthritis were unable to do the test, 48 of these patients had regarded their hands as unaffected when questioned. The impairment of grip function was closely related to clinical and functional observations but not related to the most common laboratory tests. The study confirms the hypothesis that almost all patients with RA are unable to do the hand test, even those who consider their hand function as normal.

Arthritis, Rheumatoid

Hand handicap and rheumatoid arthritis in a fish-eating society (the Faroe Islands).

In the county of Klaksvik, the Faroes, a simple hand test was used for screening all inhabitants between the ages of 40 and 74 years. With its high sensitivity and specificity it revealed a diagnostic panorama entirely different from that seen in previous investigations in other nordic countries. In Klaksvik the prevalence of hand handicap was about 40%, which is due to the high incidence of osteoarthrosis. The prevalence of rheumatoid arthritis was 1.1%. The high functional capacity and the lower occurrence of rheumatic nodules and erosions found in the patients with rheumatoid arthritis as compared with previous studies suggest that the disease takes a milder course in Klaksvik. This should support the hypothesis that RA patients benefit from a diet rich in fish.

Adult

Construction of a simple test for assessment of hand function in primary care. Theories and experimental trials for the test situation.

This paper describes a hand test consisting of three steps to test the subject's ability to grasp firmly another person's hand to hold a pencil firmly with fingers II-V with straight knuckles and maximally flexed finger joints, while the investigator pulls the pencil to hold on to a piece of paper with a rounded pinch grip between thumb and index finger while the investigator pulls the paper with a rounded pinch grip with submaximal strength. All three steps must be performed with each hand without causing pain. The test was an adequate parameter for the grip function, and at the same time could register work-load elicited pain, strength, and mobility. The test can be carried out by healthy subjects, but not by patients with rheumatoid arthritis. The test is logically constructed and has a high validity and reliability.

Adult

Chronic arthritis. Prevalence, severity and distribution between primary care and referral centres in a defined rural population.

By a simple self-administered hand test, hand handicap was revealed in 689 out of a population of 5262 individuals aged 40-70 years. Subsequent medical examination showed inflammatory hand disease in 119, 67 of whom had previously been in contact with the public health service at some level because of hand dysfunction. These 67 patients formed the material for our study, whose purpose was to analyse the distribution, treatment and follow-up of patients with inflammatory joint disease on different health care levels. In primary health care, rheumatoid arthritis (RA) was found to be underreported. For half the cases the interval between onset of disease and assessment by a rheumatologist exceeded 5 years, and follow-ups were few and far between. In the referral centres, RA cases were dealt with more adequately. The prevalence of definite and probable RA was found to be 0.7 and 0.4%, respectively.

Adult

Detection of suspected inflammatory joint disease with a new simple self-administered hand test.

A self-administered hand test was used to screen 5262 persons aged 40-70 living in a rural district in southern Sweden. It revealed evidence of hand impairment in 13%. The prevalence of RA was 1.1%. At the screening procedure a subgroup of 48 previously unrecognized individuals with inflammatory joint disease was identified. They were assessed by a rheumatologist, who established the following diagnoses: four definite RA, eight probable RA, three psoriatic arthritis, one unclassifiable arthritis, 10 osteoarthritis and 22 non-specific arthralgia. No advanced RA was detected. Two were seropositive and another was erosive. One with RA, one with psoriatic arthritis and three with arthralgic symptoms were unable to work. Most had only a minor need for further medical aid. The test was thus able to identify persons with hand impairment. Follow-up studies will address the practical implications of the screening procedure.

Activities of Daily Living

Utility of a population-based case-control study model with a limited number of patients in estimating risks of hypertension.

A population-based case-control study of the risks of hypertension was carried out in a primary care district where data on all patients have been registered in out- and in-patient computer schemes and where extensive studies and treatment programs regarding blood pressure have been performed for more than a decade. The results of the study, which comprised a limited number of patients, accord with those of more extensive and prospective studies. The hypertensives had high risks of developing myocardial infarction and stroke even though they were treated according to internationally accepted norms regarding blood pressure. The estimated population-attributable risk of hypertension in men was 30% with regard to myocardial infarction and 68% with regard to stroke. Smoking and hypertension were found to be independent risk indicators of myocardial infarction in men and hypertension was a strong risk indicator of stroke. Thus, a case-control study carried out in this way in a primary care district gives valid results regarding the efficacy of an antihypertensive treatment program and may therefore serve as a model for future studies in primary health care.

Aged