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Medicina
Special Issues
Gastrointestinal and Inflammatory Disorders: Current and Future Directions
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Gastrointestinal and Inflammatory Disorders: Current and Future Directions

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 6581

Special Issue Editors

Dr. Tawfik Khoury

E-Mail Website
Guest Editor
Department of Gastroenterology, Faculty of Medicine in the Galilee, Bar-Ilan University, Nahariya 2210001, Israel
Interests: endoscopic ultrasound; endoscopic retrograde cholangiopancreatography; inflammatory bowel disease; cholangitis; pancreatitis; common bile duct stone; pancreatic cysts; non-alcoholic fatty pancreatic disease; advanced endoscopy
Dr. Wisam Sbeit

E-Mail Website1 Website2
Guest Editor
Galilee Medical Center, Department of Gastroenterology, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 13100, Israel
Interests: fatty pancreas; endoscopic ultrasound; endoscopic retrograde cholangiopan-creatography; pancreatic tumors; pancreatic cysts; common bile duct stones; pancreatitis; cholan-gitis; inflammatory bowel disease; percutaneous endoscopic gastrostomy

Special Issue Information

Dear Colleagues,

In recent years, we have witnessed breakthroughs in several gastroenterological diseases which have drastically improved our understanding of disease pathogenesis, risk factors, diagnosis, predictors of outcome, and response to treatment, contributing to improved patient management and outcomes. Gastrointestinal diseases such as inflammatory bowel disease (IBD), pancreatitis, cholangitis, pseudomembranous colitis, diverticulitis, and general helicobacter-related diseases are the focus of research to better explore the above-mentioned targets.

The aim of this Special Issue is to offer an opportunity to researchers to publish outstanding manuscripts focusing on general gastrointestinal and inflammatory disorders. Priority will be given to high-quality original articles, but well-designed, systematic reviews (with or without metanalysis) and narrative reviews addressing the latest updated insights on a specific topic will definitely be welcomed.

Dr. Tawfik Khoury
Dr. Wisam Sbeit
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Inflammatory bowel disease
  • Cholangitis
  • Acute or chronic pancreatitis
  • Gastritis
  • Helicobacter related diseases
  • Diverticulitis
  • Pseudomembranous colitis
  • General gastrointestinal inflammatory disorders

Published Papers (3 papers)

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Research

9 pages, 680 KiB  
Article
Adding Low-Dose Propofol to Limit Anxiety during Target-Controlled Infusion of Remifentanil for Gastrointestinal Endoscopy: Respiratory Issues and Safety Recommendations
by Cyrus Motamed, Frederique Servin and Valerie Billard
Medicina 2022, 58(9), 1285; https://doi.org/10.3390/medicina58091285 - 15 Sep 2022
Viewed by 1746
Abstract
Backgroundand Objectives: Remifentanil-based sedation is one of many protocols proposed for endoscopy procedures in spontaneous ventilation, alone or in combination with propofol. However, the effect of these small doses of propofol on the efficacy and safety of remifentanil target-controlled infusion (TCI) [...] Read more.
Backgroundand Objectives: Remifentanil-based sedation is one of many protocols proposed for endoscopy procedures in spontaneous ventilation, alone or in combination with propofol. However, the effect of these small doses of propofol on the efficacy and safety of remifentanil target-controlled infusion (TCI) deserves to be examined in this context. The objective of this study was to assess the adverse respiratory and cardiovascular effects of small boluses of propofol combined with remifentanil, in comparison with remifentanil alone, and balanced with the quality of sedation and recovery. Materials andMethods: This was an observational bicenter study, representing a subgroup of a larger study describing remifentanil-based procedural sedation. In center 1, patients scheduled for gastrointestinal (GI) endoscopy had remifentanil TCI alone. In center 2, patients had a 10 mg propofol bolus before TCI and other boluses were allowed during the procedure. Remifentanil TCI was started at a target of 2 ng/mL then adapted by 0.5 ng/mL steps according to patient response to endoscopy stimulations. Results: Center 1 included 29 patients, while center 2 included 60 patients. No difference was found in the patients’ characteristics, incidence of success, average remifentanil consumption, or cardiovascular variables. Light sedation was achieved when propofol was added. The incidence of respiratory events, such as bradypnea, desaturation < 90%, and apnea requiring rescue maneuvers, were significantly higher with propofol. Conclusions: Adding propofol boluses to a remifentanil TCI for GI endoscopy ensures light sedation that may be necessary for anxiolysis but increases respiratory events, even after administration of small-dose boluses. Its safety is acceptable if the procedure is performed in an equipped environment with sedation providers trained to manage respiratory events and drugs titrated to minimal doses. Full article
(This article belongs to the Special Issue Gastrointestinal and Inflammatory Disorders: Current and Future Directions)
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8 pages, 537 KiB  
Article
The Yield of Endoscopy and Histology in the Evaluation of Esophageal Dysphagia: Two Referral Centers’ Experiences
by Amir Mari, Fadi Abu Baker, Helal Said Ahmad, Ali Omari, Yazed Jawabreh, Rand Abboud, Amir Shahin, Fahmi Shibli, Wisam Sbeit and Tawfik Khoury
Medicina 2021, 57(12), 1336; https://doi.org/10.3390/medicina57121336 - 7 Dec 2021
Cited by 1 | Viewed by 2578
Abstract
Background and Objectives: The initial diagnostic test required to evaluate esophageal dysphagia is upper endoscopy (EGD) to assess the structure of the esophagus and the esophageo-gastric junction (EGJ). Taking biopsies during EGD has become a common practice in patients with dysphagia to [...] Read more.
Background and Objectives: The initial diagnostic test required to evaluate esophageal dysphagia is upper endoscopy (EGD) to assess the structure of the esophagus and the esophageo-gastric junction (EGJ). Taking biopsies during EGD has become a common practice in patients with dysphagia to rule out eosinophilic esophagitis (EoE). The aims of this study were to evaluate the endoscopic findings of patients who underwent EGD for esophageal dysphagia, to assess the rate of biopsy taking from the esophagus to diagnose/exclude EoE, and to report histology outcomes of these biopsies. Materials and Methods: This was a retrospective multicenter study that included individuals ≥18 years who underwent EGD due to esophageal dysphagia between the years 2015 and2020, (with no other alarm signs, such as weight loss, new iron deficiency anemia, and lymphadenopathy). We obtained data from patients’ electronic files. The endoscopy and histology findings were obtained from endoscopy reports saved in our electronic files. Results: A total of 209 patients were included in the study. The average age was 57.1 ± 17.1 years. The most common endoscopic findings were normal endoscopy in 76 patients (36.4%) and erosive esophagitis in 75 patients (35.9%). Barrett’s esophagus and esophageal malignancy were encountered in 11 patients (5.3%) and 2 patients (0.95%), respectively. Esophageal biopsies were taken in 50.2% of patients, and one patient had histological evidence of EoE (0.5%). On univariate analysis, there was a trend for association between proton pump inhibitors (PPIs) use and a normal EGD, but it was not statistically significant (OR 0.28, 95% CI 0.07–1.11, p = 0.07). Conclusions: Endoscopic findings were prevalent in dysphagia patients even when no other alarm symptoms exist. Neoplastic lesions and EOE were rare in our study. Full article
(This article belongs to the Special Issue Gastrointestinal and Inflammatory Disorders: Current and Future Directions)
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10 pages, 273 KiB  
Article
Predictors of Clinical Course and Outcomes of Acute Diverticulitis: The Role of Age and Ethnicity
by Randa Taher, Yael Kopelman, Abdel-Rauf Zeina, Amir Mari and Fadi Abu Baker
Medicina 2021, 57(11), 1269; https://doi.org/10.3390/medicina57111269 - 19 Nov 2021
Viewed by 1641
Abstract
Background and Objectives: Acute diverticulitis (AD) is the leading and most burdensome complication of colonic diverticulosis. However, risk factors for its development and predictors of its course are still poorly defined. In this regard, the association of a young age with a [...] Read more.
Background and Objectives: Acute diverticulitis (AD) is the leading and most burdensome complication of colonic diverticulosis. However, risk factors for its development and predictors of its course are still poorly defined. In this regard, the association of a young age with a complicated course and worse outcome are still controversial. Moreover, little research has addressed the effect of ethnicity on the course of AD. The current study aimed to evaluate the impact of these variables on AD’s course and outcome in the diverse and unique ethnic landscape of Israel. Materials and Methods: We performed a retrospective review of the charts of patients with a radiologically confirmed diagnosis of AD. Patients’ outcomes and disease course, including hospitalization duration, complications, and recurrent episodes, were documented and compared among different age and ethnic groups. Multivariate analysis was performed to identify predictors of complicated AD. Results: Overall, 637 patients with AD were included, the majority (95%) had distal colon AD, and almost one quarter of them were aged less than 50 years. The majority of patients in the young age (<50) group were males (69.7%). Nonetheless, the rate of recurrent episodes (35.3% vs. 37.3%, p = 0.19), hospitalization duration (5 ± 4.7 vs. 6 ± 3.2, p = 0.09) and complications rate (17.3% vs. 13.7%; p = 0.16) were similar for both age groups. In the ethnicity group analysis, Arab minority patients had a first episode of AD at a significantly younger age compared to their Jewish counterparts (51.8 vs. 59.4 years, p < 0.001). However, factors such as a complicated course (16% vs. 15%; p = 0.08) and relapsing episode rates (33% vs. 38%; p = 0.36) did not differ significantly between groups. None of the variables, including young age and ethnic group, were predictors of complicated AD course in the multivariate analysis. Conclusion: AD is increasingly encountered in young patients, especially in ethnic minority groups, but neither ethnicity nor young age was associated with worse outcomes. Full article
(This article belongs to the Special Issue Gastrointestinal and Inflammatory Disorders: Current and Future Directions)
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