Transcript How to really implement a control quality? Virtut Velmishi

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SERVICE OF PEDIATRIC
GASTROHEPATOLOGY
How to really implement a control quality ?
Virtut Velmishi
« Mother Teresa Hospital »
Tirana-Albania
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What are people thinkıng ?
Brain tumor or
leukemia are
« true » disease
What kind of
disease is CD
whose
treatement is
only diet
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Money or idea ???
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Different countries, different economies
GDP ( per capita)
• France
• Italy
• Spain
• Turkey
• Montenegro
• Tunisia
• Albania
(nominal)
42793 $
36267 $
32360 $
10522 $
7316 $
4351 $
3992 $
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How much cost the diagnostic of CD in Albania?
Public health care
• Ig A t TG
•
•
•
•
•
- Free
IgA totale - Free
IgA anti EMA- not performed
HLA DQ2/DQ8-not performed
Intestinal biopsy- free ( children > 3 y)
Biopsy interpretation –free
Private (clinics and hospitals)
20 euros
13 euros
40euros
50 euros
90 euros
30 euros
243
euros
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What can we do?
1. Collaboration with specialised centers abroad
• Sending blood samples or saliva for HLA
• Sending images of intestinal biopsy
• Training for biopsy by capsule (for children< 3 y)
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First collaboration with Naples
This is a biopsy of a child
who is suspected for coeliac
disease.Biopsy is performed
in Albania and the images are
interpreted in Naples
The biopsy is within the normal limit.
The ratio villi/criptae is difficult to measure, because of
orientation problem of the sample, but in the observed
villi it appears normal,
The number of Intra-Epithelial Lymphocytes if around
20% : quite normal.
The mitosis in the crypts are rare (slow proliferation).
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Collaboration is necessary for small centers
Naples
Tirana
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Great news from Albania!
• In March 2012 we have created the first Albanian
Coeliac Association (ACA)
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THANK YOU!
Thank you!