Diapozitiv 1

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Celiac disease in Slovenia
University medical centre Maribor Dušanka
Micetic-Turk, Miro Palfy, Jernej Dolinšek
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National task forces
Proposed National Celiac Disease Task Force
National Co-ordinator Prof. Dušanka
Micetic-Turk, MD, PhD Styria Jernej
Dolinšek, MD, PhD Miroslav Palfy, PhD Ksenija
Kozorog, MD Central Slovenia Jernej Brecelj,
MD Rado Janša, MD Coastal region Ivica
Smajla, MD Carniola Jasna Wolfand, MD Lower
Carniola Lidija Žalec, MD Carinthia Ljuba
Gangl, MD
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Building national task forces how it is composed
and which are the plans

• State of the art in the training and
  dissemination at national level
• 1. 14 days Training course in CD for young
  doctors during pediatric training
• 2. Life long learning in CD half day course on
  etiology, epidemiology, clinical picture,
  diagnostics and treatment of CD (general
  practitioners, nutritionists, nurses,
  pediatricians, internal medicine
  gastroenterologists, psychologists, pathologists,
  biochemists)?
• 3. Undergraduate and postgraduate education at
  University of Maribor, Ljubljana, Koper and
  Politechnic health schools
• 4. Publication on the field of CD in national
  health journals, congress proceedings,
  professional articles in publications of Slovene
  Celiac Society, and articles in national media
  (newspapers, TV, radio, interviews with experts)
  addressing general population
• 5. Informational material (books, brochures,
  newsletters, pamphlets, dietary guidelines, web
  based material)?
• 6. Internet publications at Slovene Celiac
  Society web page

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Building national task forces how it is composed
and which are the plans

• Work with Institution and Professional Societies
• 1. Work with Ministry of health in adopting
  programs for improving QoL of celiac patients on
  national level
• 2. Co-operation with National Health Insurance
  rehabilitation programs for children and adults
• 3. Co-operation with National Institute for
  Public Health
• 4. Supervising of Slovene Celiac Society

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Building national task forces how it is composed
and which are the plans

• Dissemination tailored to the General
  Practitioners
• Lectures at national medical congresses, symposia
  and meetings (mostly concerning gastroenterology,
  pediatrics, internal medicine, dermatology,
  nutrition, general practice, and family
  medicine)?
• 2. Invited lectures at different medical and
  educational institutions
• 3. Invited lectures organized by pharmaceutical
  and nutritional industry
• 4. Organized lectures and meetings for allied
  health professionals (nutritionists, clinical
  dietitians), and education and other
  professionals working with preschool and school
  children, as well as students

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The Diagnostic guidelines

• How they are applicable in your country
• ESPGHAN guidelines are fully applied in Slovenia.
  
• Diagnosis is in majority of cases confirmed with
  small bowel biopsy.
• New diagnostic tools are immediately applied in
  routine practice in major laboratories.
• Almost all patients coming from NE Slovenia have
  also been genetically tested.
• The status of your contribution to the
  retrospective study

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Starting a pilot study in the field far from
reference centers

• Have you considered a geographically limited
  field where such study could be planned?
• We have already planned such a study. Since
  Slovenia is rather small country with good road
  and railway connections this will not be hard
  logistically to organize.
• Pomurje region (plain region along the Mura river
  between Austria, Hungary and Croatia about
  60-100 km from Maribor main celiac center) is a
  region where CD is still underdiagnosed, and is
  lacking from our network. Therefore the first
  pilot study will be done in this geographic area.
• Have you considered the logistic of such a study?
  

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The Celiac Risk Factors genetics and environment

• Have you ever collected biological samples from
  families?
• Yes.
• We always screen all family members genetically
  and serologically in University Medical Centre
  Maribor. There is an initiative to do the same in
  all other regional medical centers, too.
• Do you have DNA stored?
• Yes.
• In University Medical Centre Maribor, Genetic
  laboratory.
• Would you participate to a Mediterranean bank of
  families, in order to study genetic risk factors?
  
• Yes.

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Helping Coeliac a program across the
Mediterraneum

• What is the progress of the Celiac Association in
  your country?
• Slovene Celiac Society was established in 1988 in
  Maribor, where it still has it domicile.
• In this period the complete network of regional
  celiac branches was developed.
• In this way the health care for celiac patients
  is on the same level in whole country, this means
  diagnostic procedures and the treatment, as well
  as socio-economic care for patients is equally
  dispersed.
• Slovene society is under the professional
  supervision of Expert board, consisting of
  specialists with the experience in CD.
• It is also a strong member of AOECS.
• What do you need as support from Helping the
  Celiacs by AOECS?

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Gluten Free Diet

• The situation of the gluten free diet in
  Slovenia, in relation to cultural and traditional
  attitudes
• Major gluten-free companies from Europe are
  present on Slovene market, as well as some minor
  local producers.
• Traditional naturally gluten free foods are
  potatoes, corn, buckwheat