Periodontal disease and the special needs patient.

Individuals with special needs are at more risk of dental disease, including periodontal diseases, and have a greater prevalence and incidence of periodontal diseases than the rest of the population. Genetic or medical conditions, and/or the use of prescription medication or recreational substances, may further increase the risk for susceptibility to periodontal disease. The success of preventing or controlling periodontal diseases amongst this group of patients has not been established. Even those individuals who access regular and comprehensive dental care appear to develop periodontal diseases as they age, and this development occurs at a rate comparable to the natural history of the disease. The reasons behind the lack of success of interventions in reducing the incidence of periodontal diseases are complex and part of the lack of success may relate to the professional challenges in treating individuals with special needs.

Effects from changes to the Medicare Benefits Schedule in 2014 on cone beam computed tomography and panoramic radiography scans across Australia.

INTRODUCTION: This study examines the effects of the new Medicare Benefits Schedule (MBS) operating from 1st November 2014 on the number of Medicare rebated panoramic radiography (PR) and cone beam computed tomography (CBCT) scans. METHODS: Data for rebated PR and CBCT scans were extracted from Medicare Australia Statistics online for four 12-month periods: November 2011-October 2012, November 2012-October 2013, November 2013-October 2014 and December 2014-November 2015. RESULTS: There was a reduction in the number of CBCT scans rebated across Australia under the new MBS. Nationally, December 2014-November 2015 showed a 65.3% reduction in the number of CBCT scans when compared to the peak in the previous 12 months under the old MBS. The number of rebated PR scans remained constant. CONCLUSION: The new MBS implemented on 1st November 2014 resulted in a reduction in the number of rebated CBCT scans, but had no effect on rebated PR scans. Overall, there has been considerable cost savings for Medicare due to the change in MBS. Additionally, the reduction in the number of rebated CBCT scans has resulted in a substantial reduction in the ionising radiation load to the Australian community as a whole, but especially the younger age groups.

Stability of inhibin A and unconjugated oestriol in the second trimester of pregnancy.

BACKGROUND: The introduction of a second trimester quadruple test for fetal Down's syndrome adds the measurement of serum inhibin A (InhA) and unconjugated oestriol (UE3) to the existing repertoire of alphafetoprotein and intact human chorionic gonadotrophin. The aim of this study was to assess the stability of InhA and UE3 in whole blood and serum. METHODS: To determine whole blood stability, five extra blood specimens were obtained from each of 10 women attending an antenatal clinic. Samples were stored at room temperature for either two hours, one, three, five or seven days and centrifuged prior to analysis. Serum stability was studied by the analysis of surplus serum from 14 routine second trimester screening samples: seven stored at room temperature and seven stored at 4°C. An aliquot from each specimen was analysed two hours, one, three, five or seven days post centrifugation. Specimens were analysed for InhA and UE3 using the Beckman Access 2(®) Immunoassay analyser. RESULTS: No significant difference (P > 0.05) was shown in InhA or UE3 concentrations between the initial time point on the day of venepuncture and each of the subsequent analyses at one, three, five and seven days following collection for either whole blood or serum. CONCLUSIONS: InhA and UE3 are stable in whole blood and serum for seven days.

Effect of delay in sampling on haemoglobin determined by faecal immunochemical tests.

BACKGROUND: Faeces must be sampled directly onto guaiac-based faecal occult blood test (FOBT) cards since analysis of specimens collected in traditional faeces containers is inappropriate because degradation of haemoglobin continues after faeces have been passed. Newer faecal immunochemical tests (FIT) are replacing FOBT, but it is likely that the practice of obtaining specimens in traditional faeces collection containers for later analysis will continue. The aim of this study was to assess the effect of delay in stool sampling on FIT. METHODS: Five specimens of faeces from healthy volunteers, all qualitatively FIT negative, were supplemented with whole blood haemolysate to three different FIT positive concentrations. Each sample was analysed daily after 1-14 days delay using a quantitative latex immunoturbidimetric-based FIT and also after five and ten days delay using a qualitative FIT. RESULTS: Haemoglobin concentrations fell each day, the rate being generally proportional to the original haemoglobin concentration. After eight days delay, no sample had a haemoglobin concentration >100 ng/mL and, after nine days, no sample had a haemoglobin concentration >50 ng/mL. After five days delay, five of the 15 supplemented faeces with initially positive qualitative FIT had negative FIT; after 10 days, none had positive FIT. CONCLUSION: False-negative results will occur if sampling of fresh faeces into or onto FIT collection devices is delayed. Laboratories that undertake FIT analyses on faeces collected into traditional containers are likely to miss significant neoplasia. FIT collection devices must be used for sampling fresh faeces.

Assay validation and biological variation of serum receptor for advanced glycation end-products.

BACKGROUND: The analytical performance characteristics of an enzyme-linked immunosorbent assay for the receptor for advanced glycation end-products (RAGE) were evaluated. The within- and between-subject components of biological variation were also estimated. METHODS: Blood was sampled from healthy volunteers into K(2)-ethylenediamine tetraacetic acid (EDTA) and serum separator tubes (SST) and the stability of RAGE in whole blood, plasma and serum examined. Performance characteristics of the assay were assessed using quality control materials. Three samples were obtained from each of 21 healthy volunteers one-week apart, RAGE measured and components of biological variation estimated. RESULTS: RAGE concentrations in blood specimens collected into K(2)-EDTA and SST were stable for at least 6 hours and, after centrifugation, both plasma and serum were stable for at least 24 hours. The RAGE assay had the following characteristics: inter-assay imprecision: coefficient of variation