Perception of Special Needs Dentistry education and practice amongst Australian dental auxiliary students.

INTRODUCTION: The role of dental auxiliaries in collaborative care of patients with special needs is compelling. This study was undertaken to investigate the perceptions of Special Needs Dentistry (SND) education and practice amongst students enrolled in Australian programmes in dental auxiliary, namely dental hygiene, dental therapy and oral health therapy (DH/DT/OHT). MATERIALS AND METHODS: All Australian institutions offering DH/DT/OHT programmes (n = 14) were invited to participate in a self-administered questionnaire survey, conducted online, involving students across all academic years. Twelve institutions agreed to participate, but only five institutions were included in the final analysis, with a student response rate of 31.1%. Answers to open-ended questions were coded and grouped for measurement of frequencies. Quantitative data were analysed via chi-squared and Fisher's exact tests (significance taken as P < .05). RESULTS: The majority of students could not define SND (87.0%) were not aware of the existence of this specialty (53.5%) and did not have clinical experience treating patients with special needs (68.9%). Nevertheless, they felt comfortable and positive about treating these patients independently. Most agreed that they should receive clinical and didactic education in SND, with many of them expressing interest in pursuing a specialty training in this field. CONCLUSION: DH/DT/OHT students' comfort levels, positive attitudes and supportiveness for SND suggested positive implications for these practitioners to partake in multidisciplinary management of patients with special needs, thus indicating the need for standardised training requirements and practice guidelines in this area of care.

[Local recidives after rectal tumour operations]. / Lokalni recidivi kod bolesnika operisanih od karcinoma rektuma.

Patients with recidives after operations for rectal tumours have better prognosis than those with recidives of other gastro-intestinal tumours. Over the period from 1 January 1983 to 1 January 1990 165 patients were operated for rectal tumours (76 females and 89 males) in Dr. Dragisha Mishovitsh Clinical and Hospital Centre. On the basis of the size of rectal tumours, their position, penetration into the wall and intraoperative status surgical treatment was carried out: local ecxision (15), posterior proctotomy (37), anterior resection (64) and rectal amputation (49). In our practice we used the international classification of the tumours (pathohistology and clinical stages), UNIA INTERNATIONALIS CONTRA CANCRUM, internationally recognized on 1.1.1984. We quarterly controlled our operated patients during the first two years: rectoscopic, laboratory, EMG anal sfincter, EHO and CT abdomen, IVP examinations were performed. In patients with rectal adenocarcinoma we performed immunological examinations (CEA and CA 50) before operation, after operation and in the second year (first month and sixth month). All postoperative control examinations were important in the early detection of recidives and future treatment. We detected recidives in our patients during the first year (12), and only two in the second year after operation. We established four recidives after rectal amputation: one UICC stage II and 3 UICC stage III; 5 recidives after anterior resection: 4 UICC stage II and 1 UICC stage III; 3 recidives after posterior proctotomy: 2 UICC stage I and 1 UICC stage II, and 2 recidives after transanal excision: both recidives UICC stage I.

[Diagnostic value of the NBT-PABA test in the functional evaluation of the exocrine pancreas]. / Dijagnosticka vrednost testa "NBT-PABA" u proceni funkcije egzokrinog pankreasa.

N benzoyl-L-tyrosil PABA was orally administered to 13 controls and 35 patients with pancreatic disease: 7 with chronic exocrine pancreatic disease, 7 patients after an attack of acute pancreatitis, 3 with carcinoma of the pancreas, 8 with biliary tract disease and 10 with diabetes. The amount of PABA excreted serves as parameter exocrine pancreatic function. PABA excretion in patients with chronic pancreatitis (p < 0.01) and diabetes (p < 0.05) was significantly less then in controls. The present data justify further investigation of this procedure as a possible new oral test of exocrine pancreatic function.

[Serum gastrin in patients with diabetes]. / Gastrinemija kod bolesnika sa dijabetesom]

We evaluated the basal and postprandial circulating levels of gastrin in 20 diabetic patients and in 20 normal subject. The basal gastrin concentrations were not statistically different in comparison to controls. The blood tests provoked increased circulating levels of gastrin. In our study diabetes significantly enhanced that response, particularly in diabetics with severe disease, peripheral neuropathy and in untreated patients. Histologic evidence of antral hyperplasia was obtained in 7 patients; atrophic gastritis and intestinal metaplasia were found in 3 diabetics. We postulate that postprandial gastrin levels raised secondary to achlorhydria, common in diabetics.

[Serum antithyroid antibodies in patients with pernicious anemia]. / Antitireodna antitela u serumu bolesnika sa pernicioznom anemijom.

We investigated the incidence of thyroid auto-antibodies and their relationship to antigastric antibodies in 20 euthyroid patients with pernicious anaemia. To evaluate possible thyroid dysfunction we also measured total level of thyroid hormones (TT3 and TT4) and TSH in our patients. Histologic evidence of autoimmune atrophic gastritis and intestinal metaplasia was obtained in 15 patients. We found that it was surprisingly high incidence of thyroid auto-antibodies in patients with pernicious anaemia, particularly in the group with intestinal metaplasia (antithyreoglobulin antibodies 71% and antimicrosomal antibodies 100%). The incidence of antigastric antibodies in these patients was similar to that of those with significant antithyroid antibodies (16/18). Total triiodo thyronine and TSH were significantly higher in the patients with pernicious anaemia than in the control group (p less than 0.05), in the normal range. The results of our study suggest that this upset in immunological physiology is due to a more generalized defect in immune tolerance.

[Apolipoprotein A in patients with alcoholic liver disease]. / Koncentracija apolipoproteina A u plazmi bolesnika sa alkoholnom cirozom jetre.

The aim of the present study was to determine the apolipoprotein A (APO-A) an the high density lipoprotein (HDL) plasma concentrations in 25 patients with alcoholic liver cirrhosis. To evaluate the severity of liver disease serum albumin, bilirubin and total bile acids were measured. The serum level of APO-A and HDL was significantly lower in patients with alcoholic liver cirrhosis than in normal controls (p < 0.01) and markedly lower in patients with advanced liver cirrhosis. Apolipoprotein A concentrations in plasma correlated positively with serum albumin (p < 0.01) and negatively with serum bilirubin (p < 0.01) and bile acids (p < 0.01). Thus, he apoliprotein A level seems to reflect the severity of liver disease.

[Lipids and total bile acids in the blood of patients with inflammatory bowel diseases]. / Lipidi i ukupne zucne kiseline u serumu bolesnika sa zapaljenskim oboljenima creva.

We evaluated the total plasma bile acids, total lipids, total cholesterol, total triglicerides, LDL-cholesterol, HDL-cholesterol, phospholipids and lipoproteins (APOA-A and APO-B) in 25 patients with inflammatory bowel disease: 20 with ulcerative colitis (UC) and 5 with Crohn's disease. In comparison to 17 healthy volunteers, the total plasma bile acids were decreased in all patients. The serum level of total cholesterol, LDL-Ch, HDL-ch and APO-A was significantly lower in patients with Crohn's disease and ulcerative colitis (p less than 0.01) than in normal controls; total triglycerides and APO-B were decreased only in the group with Crohn's disease (p less than 0.05). Thus, decreased values of total plasma bile acids malabsorption, and they suggest a more important romalabsortion, and they suggest a more important role of the colon in the preservation of bile acids.

[Hormone levels in patients with alcoholic liver cirrhosis]. / Koncentracija hormona kod bolesnika sa alkoholnom cirozom jetre.

The purpose of the study was to evaluate some of the hormones in 20 patients with alcoholic cirrhosis. We investigated the diurnal rhythmicity of some of the hormones (cortisol, follicle-stimulating hormone-FSH, luteinizing hormone-LH, growth hormone-LH, prolactin-PRL) and basal serum concentrations of thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4) and testosterone, as well as gastrin and insulin, using provocative tests. Statistical analysis of the results obtained from the observed patients compared with controls, showed significantly lower concentrations of T3 (p less than 0.05), cortisol (p less than 0.05), testosterone (p less than 0.05) and FSH (p less than 0.05), and significantly higher (p less than 0.01) serum concentration of prolactin. Then, in the cirrhotic group the serum concentrations of gastrin and insulin increased significantly (p less than 0.01), together with the disorders of carbohydrate metabolism (impaired glucose tolerance and diabetes mellitus. The described disturbances of some of the observed hormones are complex, particularly in their relationship by which the clinical picture of the cirrhotic patients can be explained.

[Serum cholesterol and triglycerides in patients with benign and malignant tumors of the colon and rectum]. / Holesterol i trigliceridi u serumu bolesnika sa benignim i malignim tumorima kolona i rektuma.

There are many epidemiological papers on the relation of lipids especially of cholesterol, and the incidence of colorectal adenoma and cancer. In the studies of pathogenesis of the cancer of the large intestine attention is paid to the role of certain lipoproteins of bile acids and certain gastrointestinal hormones. We examined 30 patients: 10 were healthy subjects (the control group), 9 with colorectal adenoma, 2 with villous adenoma and 9 with adenocarcinoma of the colon and the rectum. The study concerned: total lipids, total cholesterol, total triglycerides, LDL cholesterol, HDL cholesterol, phospholipids, gastrinaemia and insulinaemia. Statistical analysis of the obtained results showed that hypocholesterolemia followed the incidence of adenocarcinoma. This is in accordance with the most frequently quoted literature. The incidence of hypergastrinaemia, however, was found primarily in the patients with villous adenoma, which indicates possible secretory function of the studied tumours.