Biomedical subjects
M R Norton
Publications and source records attributed to M R Norton.
Replacement arthroplasty in the weight-bearing shoulder of paraplegic patients.
We review the early results of shoulder arthroplasty in the weight-bearing shoulder of long-term paraplegic patients. We have been unable to find previously published results of this subgroup of shoulder arthroplasty patients in the literature. Five paraplegic, female patients who had undergone shoulder arthroplasty were analyzed. All patients had been prospectively assessed with the American Shoulder and Elbow Surgeons (ASES) function score and the Constant score. The mean age at the time of surgery was 70 years. Three shoulders had full-thickness rotator cuff tears, and two were repaired at the time of shoulder arthroplasty. The mean preoperative Constant score was 30 out of 100, improving to 52 out of 100 at a mean follow-up of 30 months (range, 24-36 months). The mean preoperative ASES function score was 28 out of 55, improving to 37 out of 55. One patient was pain-free after surgery, and the mean postoperative pain score was 10 out of 15. There were no features of progressive radiolucency around the glenoid or the humeral components at last review apart from one case in which glenoid implant migration occurred. In view of the satisfactory improvement in terms of pain, mobility, and independence, we believe that it is reasonable to continue to offer this procedure to this subgroup of patients. We will, however, remain vigilant with regard to any further complications arising in these prostheses in the medium to long term as a result of increased loading.
Chewing sticks versus toothbrushes in West Africa. A pilot study.
Chewing sticks are used for tooth cleaning by many populations. Despite the fact that they contain antimicrobial substances that could conceivably benefit oral hygiene, there have been few attempts to evaluate properties in vivo. This pilot, cross-sectional study recorded the oral hygiene and gingival health of adult Ghanaens who used chewing sticks, toothbrushes, or a combination of both for tooth cleaning. Plaque and gingivitis scores were higher in the chewing stick users, although these were primarily due to differences in men. Men had poorer oral hygiene and gingival health than women, irrespective of the oral hygiene regimen. The same differences were apparent for city and rural dwellers, with no overall differences observed between these two groups. The longer time that is necessary for cleaning with chewing sticks may explain the apparent reduced cleaning efficiency in men. The antimicrobial substances contained in chewing sticks appear to provide no additional benefits to those produced by the antimicrobial activity of commercially available toothpastes.