Browsing by Author "Hakim, GD"

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    A Multicenter Randomized Controlled Trial of Microbiome-Based Artificial Intelligence-Assisted Personalized Diet vs Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet: A Novel Approach for the Management of Irritable Bowel Syndrome
    Tunali, V; Arslan, NC; Ermis, BH; Hakim, GD; Gündogdu, A; Hora, M; Nalbantoglu, OU
    INTRODUCTION: Personalized management strategies are pivotal in addressing irritable bowel syndrome (IBS). This multicenter randomized controlled trial focuses on comparing the efficacy of a microbiome-based artificial intelligence-assisted personalized diet (PD) with a low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet (FODMAP) for IBS management. METHODS: One hundred twenty-one patients participated, with 70 assigned to the PD group and 51 to the FODMAP diet group. IBS subtypes, demographics, symptom severity (IBS-SSS), anxiety, depression, and quality of life (IBS-QOL) were evaluated. Both interventions spanned 6 weeks. The trial's primary outcome was the within-individual difference in IBS-SSS compared between intervention groups. RESULTS: For the primary outcome, there was a change in IBS-SSS of -112.7 for those in the PD group vs -99.9 for those in the FODMAP diet group (P = 0.29). Significant improvement occurred in IBS-SSS scores (P < 0.001), frequency (P < 0.001), abdominal distension (P < 0.001), and life interference (P < 0.001) in both groups. In addition, there were significant improvements in anxiety levels and IBS-QOL scores for both groups (P < 0.001). Importantly, PD was effective in reducing IBS SSS scores across all IBS subtypes IBS-Constipation (IBS-C; P < 0.001), IBS-Diarrhea (IBS-D; P = 0.01), and IBS-Mixed (IBS-M; P < 0.001) while FODMAP diet exhibited comparable improvements in IBS-C (P = 0.004) and IBS-M (P < 0.001). PD intervention significantly improved IBS-QOL scores for all subtypes (IBS-C [P < 0.001], IBS-D [P < 0.001], and IBS-M [P = 0.008]) while the FODMAP diet did so for the IBS-C (P = 0.004) and IBS-D (P = 0.022). Notably, PD intervention led to significant microbiome diversity shifts (P < 0.05) and taxa alterations compared with FODMAP diet. DISCUSSION: The artificial intelligence-assisted PD emerges as a promising approach for comprehensive IBS management. With its ability to address individual variation, the PD approach demonstrates significant symptom relief, enhanced QOL, and notable diversity shifts in the gut microbiome, making it a valuable strategy in the evolving landscape of IBS care.
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    Acute pancreatitis in Turkey: Results of a nationwide multicenter study
    Koksal, AS; Tozlu, M; Sezgin, O; Oguz, D; Kalkan, IH; Altntas, E; Yaras, S; Bilgic, Y; Yildirim, AE; Barutcu, S; Hakim, GD; Soytuerk, M; Bengi, G; Ozseker, B; Yurci, A; Koc, DO; Irak, K; Kasap, E; Cindoruk, M; Oruc, N; Ünal, NG; Sen, I; Gokden, Y; Saruc, M; Ünal, H; Eminler, AT; Toka, B; Basir, H; Saglam, O; Erguel, B; Guel, O; Bueyuektorun, I; Ozel, M; Sair, U; Kosem, G; Nedirli, F; Tahtaci, M; Parlak, E
    Background: Acute pancreatitis (AP) is the most common gastrointestinal disease requiring hospitalization, with significant mortality and morbidity. We aimed to evaluate the clinical characteristics of AP and physicians ' compliance with international guidelines during its management. Methods: All patients with AP who were hospitalized at 17 tertiary centers in Turkey between April and October 2022 were evaluated in a prospective cohort study. Patients with insufficient data, COVID-19 and those aged below 18 years were excluded. The definitions were based on the 2012 revised Atlanta criteria. Results: The study included 2144 patients (median age:58, 52 % female). The most common etiologies were biliary (n = 1438, 67.1 %), idiopathic (n = 259, 12 %), hypertriglyceridemia (n = 128, 6 %) and alcohol (n = 90, 4.2 %). Disease severity was mild in 1567 (73.1 %), moderate in 521 (24.3 %), and severe in 58 (2.6 %) patients. Morphology was necrotizing in 4.7 % of the patients. The overall mortality rate was 1.6 %. PASS and BISAP had the highest accuracy in predicting severe pancreatitis on admission (AUC:0.85 and 0.81, respectively). CT was performed in 61 % of the patients, with the majority (90 %) being within 72 h after admission. Prophylactic NSAIDs were not administered in 44 % of the patients with post-ERCP pancreatitis (n = 86). Antibiotics were administered to 53.7 % of the patients, and 38 % of those received them prophylactically. Conclusions: This prospective study provides an extensive report on clinical characteristics, management and outcomes of AP in real -world practice. Mortality remains high in severe cases and physicians ' adherence to guidelines during management of the disease needs improvement in some aspects. (c) 2023 IAP and EPC. Published by Elsevier B.V. All rights reserved.
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    Turkish Society of Gastroenterology: Pancreas Working Group, Acute Pancreatitis Committee Consensus Report
    Koç, DÖ; Bengi, G; Gül,Ö; Alahdab, YÖ; Altintas, E; Barutçu, S; Bilgiç, Y; Bostanci, B; Cindoruk, M; Çolakoglu, K; Duman, D; Ekmen, N; Eminler, AT; Gökden, Y; Günay, S; Hakim, GD; Irak, K; Kacar, S; Kalkan, IH; Kasap, E; Köksal, AS; Kuran, S; Oruç, N; Özdogan, O; Özseker, B; Parlak, E; Saruç, M; Sen, I; Sisman, G; Tozlu, M; Tunç, N; Ünal, NG; Ünal, HÜ; Yaras, S; Yildirim, AE; Soytürk, M; Oguz, D; Sezgin, O
    Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP.