Measuring and benchmarking the quality of two different organizational ways in delivering infant vaccination.

The aim of this study was the quality of service evaluation of two different organizational ways in delivering infant vaccination according to a Regional Vaccination Plan. Eleven vaccination centres were selected in two Local Health Units (ASLs) belonging to the Regional Health Service of the Lazio Region, Italy. The services offering paediatric vaccinations for children under three years of age, delivered without an appointment (VACP) or with the need for an appointment (VACL), were investigated. The quality aspects under evaluation were communicational efficiency, organisational efficiency and comfort. Subjective data were collected from different stakeholders and involve the elicitation of best and worst feasible performance conditions for the ASLs when delivering VACP/VACL services. Objective data consists in the observation of current performances of the selected vaccination centres. Quality scorecards were obtained from the combination of all data. Benchmarking between VACP and VACL, i.e., two different organisational ways in delivering infant vaccination, can be performed as a result of the probabilistic meaning of the evaluated scores. An expert of vaccination services, i.e., a virtual combination of patients, doctors and nurses, claims the quality of service delivery of the ASLs under investigation with probability 78.03% and 69.67% for VACP and VACL, respectively. In other words, for short, the quality scores of the ASLs were 78.03% for VACP and 69.67% for VACL. Furthermore our results show how to practically improve the current service delivery. The QuaVaTAR approach can result in improvements of the quality of the ASLs for the two different ways of delivering paediatric vaccinations in a simple and intuitive way.

Heat-shock-proteins-antibodies in patients with Helicobacter pylori associated chronic gastritis.

Twenty eight patients (15 F, 13 M mean age 37.7 SD +/- 9.93 range 22-55) affected by Helicobacter Pylori infection associated gastritis were studied. HSP 70 Antibodies were found in 21.4% of patients and their mean values were significantly higher in the patients than in the subjects affected by gastritis HP negative used as controls (p = 0.05). This datum was confirmed by Western blotting. The presence of HSP 70 antibodies in the sera of those patients may support the link between the protein and the development and persistence of chronic inflammation in the gastric mucosa.

Type 2 autoimmune hepatitis and hepatitis C viraemia.

We present 10 Italian patients with type 2b autoimmune hepatitis (anti-LKMI positivity) and HCV infection. 6 patients had IgG concentrations above the upper limit of normal and all had histological features of chronic autoimmune hepatitis or chronic persistent hepatitis or cirrhosis. ANA and SMA were positive in 2 patients, pANCA in 3 patients. Anti-GOR were negative in all patients, 6 of them were HLA B8 DR3 and 2 HLA B8 DR4. Antibodies to HCV (tested by ELISA 2nd and 3rd generation) were positive in all patients and in 9 subjects were detected HCV RNA. The two patients with positivity for ANA and SMA were treated successfully with corticosteroids, but they relapsed after the drug withdrawal; the others received interferon, that had to be suspended in 2 patients because inducing an autoimmune thyroiditis. Although, at present, it is still not known if HCV is a really trigger factor in developing autoimmunity or if the two diseases are coincidental, the authors suggest that it is important for clinicians to use appropriate treatment strategies on the basis of the predominant illness.

Anti 70 kDa heat shock protein antibodies in sera of patients affected by autoimmune and non-autoimmune thyroid diseases.

Twenty eight patients (25F, 3M) affected by autoimmune and non-autoimmune thyroid diseases were studied. HSP 70 antibodies were present in 21.4% of patients. Five of them were affected by Graves' disease and one by De Quervain's thyroiditis. The HSP 70 antibodies mean values of patients were significantly higher than the normals (p < 0.05). This datum was confirmed by Western blotting. The presence of HSP 70 antibodies in the sera of those patients may support the link between the protein and the thyroid autoimmune processes.