SEARCH · PubMed Health

Results for “DEXTERITY”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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

At least 1,477 records · Page 82Linked to original sources

PubMed1993

Depression and neuropsychological performance in asymptomatic HIV infection.

OBJECTIVE: The authors examined the effect of depression on neuropsychological performance in HIV-infected men. Previous studies have suggested that depression may account for the neuropsychological abnormalities observed in some patients with HIV infection, but few studies have specifically examined this question. METHOD: An extensive neuropsychological test battery was administered to 121 HIV-seropositive asymptomatic men and 42 HIV-seronegative comparison subjects. The seropositive subjects were grouped into depressed and non-depressed groups on the basis of scores on the Beck Depression Inventory, Hamilton Rating Scale for Depression, and Structured Clinical Interview for DSM-III-R. RESULTS: Statistical comparisons revealed very few measures on which the depressed seropositive subjects scored significantly worse than either of the nondepressed comparison groups. The nondepressed seropositive group differed consistently from the seronegative comparison subjects on measures of verbal memory and dexterity. CONCLUSIONS: These data indicate that the subtle neuropsychological abnormalities observed in some asymptomatic HIV-seropositive subjects cannot be attributed to depression. These data also indicate the advantages of a multifaceted approach to assessment of depression.

Adult↗

PubMed2004

The effect of previous alcohol abuse on cognitive function in HIV infection.

OBJECTIVE: The authors' goal was to study the potential effect on cognitive function of an interaction of HIV infection and a history of alcohol abuse. METHOD: The subjects were 30 HIV-negative and 50 HIV-positive men with and without a past history of alcohol abuse. Thirty-three of the men (12 HIV negative and 21 HIV positive) had a past history of alcohol abuse, and 47 (18 HIV negative and 29 HIV positive) had never abused alcohol. Each subject's history of alcohol use was obtained by using a syndromal approach based on the Structured Clinical Interview for DSM-III-R and a quantitative approach. Each subject was given a battery of neuropsychological tests assessing verbal reasoning, reaction time, intelligence, memory, and dexterity. The subjects were then compared on a summary neuropsychological impairment rating. RESULTS: There were no significant differences in CD4 level, age, education, depression, anxiety, or other drug abuse history between the HIV-positive and HIV-negative groups with and without a history of alcohol abuse. Significant effects on cognitive function were found for past alcohol abuse and HIV infection, with significant interactions in verbal reasoning, auditory processing, and reaction time. This demonstrates that HIV infection and a history of alcohol abuse have independent effects on some aspects of higher cognitive function but may have synergistic effects on other cognitive domains. In the HIV-negative subjects there were no differences in cognitive function between subjects with and without a history of alcohol abuse. Among the HIV-positive subjects, those with a history of alcohol abuse performed more poorly on tests of verbal IQ, verbal reasoning, and reaction time. CONCLUSIONS: There are both additive and interactive effects of previous alcohol abuse and HIV infection on cognition. Individuals with a history of past alcohol abuse may be at greater risk for cognitive dysfunction in the context of HIV infection.

Adult↗

PubMed1999

Dose-related neurobehavioral effects of chronic cocaine use.

Although cocaine use is a significant public health problem, there is a paucity of scientific data on long-term neurobehavioral effects. This study examined the dose-related association between chronic cocaine use and neurobehavioral performance. A battery of neuropsychological tests was administered to 30 abstinent chronic cocaine abusers and 21 non-drug-using control subjects matched for age, education, and intelligence. After controlling for age, education, and intellectual ability, greater use of cocaine (grams per week) was associated with larger decrements on tests measuring executive functioning, visuoperception, psychomotor speed, and manual dexterity. These results suggest that chronic cocaine use is associated with persistent decrements in cognitive function that are most pronounced in heavy users. Knowledge of specific cognitive processing deficits in chronic cocaine users would be useful for designing individually tailored drug treatment programs.

Adult↗

PubMed1994

Duration of illness and neuropsychological performance in asymptomatic HIV infection.

The relationship between duration of illness and neuropsychological performance was examined in 25 asymptomatic HIV-infected men with an estimated date of seroconversion. Mean duration of illness was approximately 2 years. After controlling for CD4 level at the time of neuropsychological examination, duration of illness was correlated with measures of visual attention, mental flexibility, dexterity, auditory information processing, and response fluency, as well as an overall measure of neuropsychological performance. Although these patients performed within normal limits, these data suggest that duration of infection may be related to subtle alterations in neuropsychological performance. These results are discussed with regard to possible mechanisms that implicate gradual accumulation of neurotoxins.

AIDS Dementia Complex↗

PubMed1997

Neuropsychological findings in a sample of Operation Desert Storm veterans.

In response to ongoing complaints of memory, attention, and problem-solving difficulties among veterans of Operation Desert Storm and Shield (ODSS), a sample of 44 male veterans of ODSS underwent a comprehensive neuropsychological evaluation. Deficits relative to normative data were observed only on finger dexterity (Grooved Pegboard, bilaterally) and the Stroop Color and Word Test. Those with impaired Pegboard performance had lower performance on other tasks requiring psychomotor speed. Those with impaired Stroop had significantly lower motor and set-shifting performance. Scores of both impaired groups were higher on many clinical and supplemental scales of the MMPI. Despite subjective cognitive complaints reported in 39% of the overall sample, veterans with cognitive complaints differed from their peers primarily in greater psychological distress as depicted on the MMPI. The data are presented as preliminary clinical findings.

Adult↗

PubMedDate not supplied

Consequences of comorbidity of developmental coordination disorders and learning disabilities for severity and pattern of perceptual-motor dysfunction.

Children with developmental coordination disorder (DCD) have difficulty learning and performing age-appropriate perceptual-motor skills in the absence of diagnosable neurological disorders. Descriptive studies have shown that comorbidity of DCD exists with attention-deficit/hyperactivity disorder (ADHD) and learning disabilities (LD). This study examined the consequences of the comorbidity of DCD and LD for the severity and pattern of perceptual-motor dysfunction. Compared to children with DCD without LD, children with comorbid DCD and LD performed lower on a standardized assessment of perceptual-motor ability. Furthermore, it appeared that children with combined DCD and LD have particular difficulty performing manual dexterity and balance tasks but not ball-skill tasks. Implications for understanding the relationship between LD and perceptual-motor problems are discussed. We conclude that the comorbidity of DCD and LD not only affects the severity of perceptual-motor dysfunction but also is associated with a distinctive pattern of perceptual-motor dysfunction.

Adolescent↗

PubMed1999

The influence of drugs upon testimony.

A wide range of drugs (medicines) are used currently, many of which are designed to affect brain function. Others do so as a side-effect. The effects depend on how the body deals with the drug (pharmacokinetics) and how the drug affects the body, including the brain (pharmacodynamics). An extensive range of effects on the brain and psychological functioning can ensue, including effects on intellectual functioning, dexterity, memory, learning and subjective effects. Individual factors are important and can profoundly influence both the type and extent of drug effects. Relevant drugs can be divided into: 1. Those prescribed primarily to treat psychiatric disorders. These include sleeping tablets, tranquillizers, antidepressants and antipsychotics. 2. Those used to treat neurological disorders that have psychological side-effects. Examples are anticonvulsants and anti-parkinsonian drugs. 3. Those used to treat non-nervous disorders that may have psychological side-effects. 4. Illicit drugs used in the non-medical context by drug addicts. Drug-induced states that can influence testimony are mainly sedation, disinhibition, paradoxical reactions and alterations in memory. A list of pointers was given in this paper with respect to practical considerations in assessing the possible effects of drugs on testimony.

Cognition↗

PubMed1992

The role of the fifth digit in music: discussion paper.

The increasing digital skill made manifest in the development of instrumental music is reviewed and supports the hypothesis that the fifth digit was belatedly used even when a suitable instrument had already become established. With notable exceptions, such as the harp, it appears that progressive improvements in instrument design was influenced by the need to utilize the fifth digits. Its greater use was accomplished in overlapping stages of increasing dexterity, of which the highest is exemplified by the left hand of the violinist. The apparent evolutional background of these observations is discussed. It is proposed that man has an inherent atavistic tendency to ignore the fifth digit and this view agrees with its neglect in gesture and sign language.

Fingers↗

PubMedDate not supplied

Diabetes aids and products for people with visual or physical impairment.

Common complications of diabetes include visual impairment and problems with manual dexterity because of peripheral neuropathy. These conditions make diabetes self-care activities difficult unless techniques and equipment can be individually modified. To help diabetes educators and their clients locate aids and products to meet their special needs, this paper presents a compilation of aids and products and how and where to obtain them. A complete bibliography is included.

Diabetes Mellitus↗

PubMedDate not supplied

Verbal and visual memory improve after choline supplementation in long-term total parenteral nutrition: a pilot study.

BACKGROUND: Previous investigations have demonstrated that choline deficiency, manifested in low plasma-free choline concentration and hepatic injury, may develop in patients who require long-term total parenteral nutrition (TPN). Preliminary studies have suggested lecithin or choline supplementation might lead to improved visual memory in the elderly and reverse abnormal neuropsychological development in children. We sought to determine if choline-supplemented TPN would lead to improvement in neuropsychological test scores in a group of adult, choline-deficient outpatients receiving TPN. METHODS: Eleven subjects (8 males, 3 females) who received nightly TPN for more than 80% of their nutritional needs for at least 12 weeks before entry in the study were enrolled. Exclusion criteria included active drug abuse, mental retardation, cerebral vascular accident, head trauma, hemodialysis or peritoneal dialysis, (prothrombin time [PT] >2x control), or acquired immune deficiency syndrome (AIDS). Patients were randomly assigned to receive their usual TPN regimen (n = 6, aged 34.0 +/- 12.6 years) over a 12-hour nightly infusion or their usual TPN regimen plus choline chloride (2 g) (n = 5, aged 37.3 +/- 7.3 years). The following neuropsychological tests were administered at baseline and after 24 weeks of choline supplementation (or placebo): Weschler Adult Intelligence Scale-Revised (WAIS-R, intellectual functioning), Weschler Memory Scale-Revised (WMS-R, two subtests, verbal and visual memory), Rey-Osterrieth Complex Figure Test (visuospatial functioning and perceptual organization), Controlled Oral Word Association Test (verbal fluency), Grooved Pegboard (manual dexterity and motor speed), California Verbal Learning Test (CVLT, rote verbal learning ability), and Trail Making Parts A & B (visual scanning, psychomotor speed and set shifting). Scores were reported in terms of standard scores including z scores and percentile ranks. Mean absolute changes in raw scores were compared between groups using the Wilcoxon rank sum test, where p values < .05 constituted statistical significance. RESULTS: Significant improvements were found in the delayed visual recall of the WMS-R (7.0 +/- 2.7 vs -.33 +/- 5.7, p = .028), and borderline improvements in the List B subset of the CVLT (1.0 +/- 0.8 vs -2.0 +/- 2.4, p = .06) and the Trails A test (-3.8 +/- 8.1 vs 3.7 +/- 4.5 seconds, p = .067). No other statistically significant changes were seen. CONCLUSIONS: This pilot study indicates both verbal and visual memory may be impaired in patients who require long-term TPN and both may be improved with choline supplementation.

Adult↗

PubMedDate not supplied

The Leyla retractor: use in acoustic neuroma and neurotologic surgery.

The Leyla retractor is a self-retaining retractor used in the translabyrinthine removal of acoustic neuroma and middle fossa surgery. It is used to maintain constant, even pressure on a decompressed sigmoid sinus and cerebellum in translabyrinthine surgery and the temporal lobe in middle fossa surgery. The Leyla retractor provides excellent exposure and greater freedom and dexterity for the neurotologist.

Brain↗

PubMed1986

Stapedectomy for the home temporal bone dissection laboratory.

During the last 15 years, there has been a steady decline in the number of stapedectomies performed. Suggestions have been made to limit the residents' training in stapes surgery as well as to determine who is qualified to perform stapedectomies. It is well recognized that the skills and precision required for a stapedectomy are different from those used in chronic ear surgery and, if these precise techniques are not used on a regular basis, one will lose the dexterity required for this operation. A technique has been developed that enables the resident or infrequent operator to improve his skills with stapedectomy in the laboratory, prior to being confronted with a patient. It should help to improve the residents' surgical experience as well as maintain the surgical skills required for this operation.

Dissection↗

PubMed2006

Hand function in Charcot Marie Tooth: test retest reliability of some measurements.

OBJECTIVE: To evaluate the reliability of some measurements of hand function in people with Charcot Marie Tooth disease. DESIGN: Test retest study. SETTING: University, hospitals/clinics in northern Sweden. SUBJECTS: Twenty people with Charcot Marie Tooth disease. MAIN OUTCOME MEASURES: Measures of (1) dexterity; Box and Block Test and Nine-Hole Peg Test, (2) strength; Grippit instrument (grip and pinch), (3) tactile sensation; Shape Texture Identification Test. Statistics used: intraclass correlation (ICC 2.1), limits of agreement, coefficient of repeatability, coefficient of variation, and linear weighted kappa. RESULTS: The ICC for the Box and Block Test was very high (0.95). The limits of agreement, coefficient of repeatability (CR) (11.5 blocks/min) and coefficient of variation (CV) (8.4%) were acceptable. There was bias towards a better result on the second occasion. For the Nine-Hole Peg Test, the reliability was good if performance was within 2 min (ICC =0.99, CR = 4.3 s, CV = 3.9%). Grip strength proved to be reliable (ICC = 0.99, CR = 26.7 N, CV = 6.6%), while pinch strength was less reliable. The kappa value of the Shape Texture Identification Test was 0.87, which was considered very good although the test has limitations in terms of how well it can describe patients either performing very well or very poorly. CONCLUSIONS: The tested instruments can all be used to evaluate hand function in people with Charcot Marie Tooth. Certain factors, however, like limited time aspects for the Nine-Hole Peg Test and the number of trials used, should be taken into consideration. Pinch strength evaluation should be interpreted with caution.

Adult↗

PubMedDate not supplied

Options for handling missing data in the Health Utilities Index Mark 3.

BACKGROUND: The Health Utilities Index Mark 3 (HUI3) is a tool composed of 41 questions, covering 8 attributes: vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain. Responses to these questions can define more than 972,000 health situations. This tool allows respondents to answer "Don't Know," for which there is no scoring instruction, to any given question. This situation creates a break in the scoring algorithm and leads to considerable amounts of missing data. The goal of this study is to develop strategies to deal with HUI3 scores for participants who have missing data. METHODS: The authors used data from 248 individuals enrolled in the Cataract Management Trial, focusing on the HUI3 vision and ambulation attributes, which had 19% and 10% of attribute levels missing, respectively. Inspection and deduction were used to fill in values independent of the value of the missing data, then alternative analytic techniques were compared, including mean substitution, model scoring, hot deck, multiple imputation, and regression imputation. RESULTS: Inspection and logical deduction reduced the percentage of missing information in the HUI3 by 49% to 87%. A comparison of analytic techniques used for the remaining HUI3 vision data missing demonstrated the value of building models based on internal response patterns and that simple analytic techniques fare as well as more complicated ones when the number of missing cases is small. CONCLUSION: Analyzing the pattern of responses in cases where the attribute level score is missing reduces the amount of missing data and can simplify the analytic process for the remaining missing data.

Activities of Daily Living↗

PubMed2003

A black technician and blue babies.

In this paper, I discuss the many contributions of a versatile black technician, Vivien Thomas, to surgical animal research between 1930 and 1979 at Vanderbilt University and Johns Hopkins University. Thomas' experimental work led to a surgical solution for a life-threatening heart defect, called tetralogy of Fallot. Children with this condition lack sufficient oxygenation and were referred to as 'blue babies'. Following Thomas' research trajectory and his relationship with surgeon Dr Alfred Blalock, I review the conditions under which differing expectations towards race and occupation clashed, creating a status dilemma for Thomas. While the torsion originated in the laboratory where technical skills are valued, the research locale also facilitated a temporary, fragile solution for the status dilemma, because it separated Thomas from public view. Yet, Thomas' dexterity as a laboratory researcher enhanced his dilemma, because credit kept eluding him. In order to track the dynamics of race and occupational subordination as lived experience in the laboratory, I argue for an analysis of the process of crediting people for their scientific accomplishments.

Black or African American↗

PubMed2006

Facilitating learning in the operating theatre and intensive care unit.

Almost every aspect of anaesthetic and intensive care practice can be taught within the operating theatre and intensive care unit. This includes knowledge in the areas of medicine, anatomy, pharmacology, physiology, measurement and statistics, invaluable psychomotor and global skills and abilities, as well as the many important non-clinical aspects of anaesthesia and intensive care including effective communication, leadership, management, ethics and teaching. The operating theatre and intensive care unit offer many advantages and pose numerous challenges to education. This paper briefly discusses what can be taught in the operating theatre and intensive care unit, the educational challenges and benefits of teaching in these unique environments, implications for teaching and what consultants and trainees can do to positively influence the educational activity. The paper concludes with suggestions for facilitating learning in the operating theatre and intensive care unit including the Soldier's Five, practice vivas, skills training, endoscopic dexterity, interesting article exchange, in-service sessions, electronic resources and use out of hours.

Anesthesiology↗

PubMed1997

Evidence-based medicine and anaesthesia: uneasy bedfellows?

The term "evidence-based medicine" first appeared in the medical literature in 1992 and is in widespread use today. It is timely to examine the concept's relevance to anaesthetic practice as well as the validity of the premises on which it rests. An important difference between anaesthesia and the specialties which treat disease is that in anaesthesia there is very little research done with real outcomes as its end-point. Surrogate or intermediate outcomes predominate as the end-points of anaesthetic research, which is a weakness when the results serve as the evidence on which to base clinical decisions. Furthermore, in interventions which require personal skill, dexterity or decision-making, caution must be exercised in assuming that equally good outcomes are achievable by all. Key members of the Cochrane Collaboration, among the most prominent advocates of evidence-based medicine, promote the belief that much valid scientific evidence is to be found in sources outside the peer-reviewed published literature. This assertion must be treated with caution. Furthermore, some techniques central to the search for the evidence on which to base practice, including meta-analysis and multicentre trials, are prone to errors through incorrect application. Evidence-based medicine appears to have less to offer anaesthesia than it does to the "treating" specialties.

Anesthesiology↗

PubMedDate not supplied

Internal fixation of acute stable scaphoid fractures in the athlete.

Our study evaluated the results of surgical repair of acute carpal scaphoid fractures in athletes and the time required for the athletes to return to play. Although playing casts are a nonsurgical option, they reduce the effectiveness of the athlete in sports that require maximal manual dexterity; thus, the management of scaphoid fractures is challenging when early return to sports is desired. Twelve athletes with 12 acute midthird scaphoid fractures were treated with Herbert screw fixation. All patients were in-season athletes in sports that precluded the use of a playing cast. Return to sports averaged 5.8 weeks. Nine of the 12 athletes had range of motion equal to the uninjured side. The grip strength was equal to the unaffected side in 10 of the 12 athletes. Clinical and radiographic union was evident in 11 subjects at an average followup of 2.9 years. The healing rates were comparable with other treatment modalities. We concluded that internal fixation of a scaphoid fracture allows safe and early return to sports when a playing cast is not an acceptable option and when an athlete accepts the risks of surgery.

Adolescent↗