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Crohn Disease: HELP
Articles by Giulia D'Arcangelo
Based on 3 articles published since 2008

Between 2008 and 2019, Giulia D'Arcangelo wrote the following 3 articles about Crohn Disease.
+ Citations + Abstracts
1 Review Inflammatory Bowel Disease-Unclassified in Children: Diagnosis and Pharmacological Management. 2017

D'Arcangelo, Giulia / Aloi, Marina. ·Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. · Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. marina.aloi@uniroma1.it. ·Paediatr Drugs · Pubmed #28150131.

ABSTRACT: Inflammatory bowel diseases are chronic disorders of the gastrointestinal tract that include Crohn's disease (CD), ulcerative colitis (UC) and inflammatory bowel disease-unclassified (IBDU). The latter defines a subgroup of patients with clinical and endoscopic evidence of chronic colitis, without specific features of either CD or UC. These patients will possibly be re-classified as having UC or CD during the follow-up, although a significant percentage of them will keep the diagnosis of IBDU. IBDU is the rarest subtype of IBD, both in children and in adults, although it is twice as common among the pediatric population, especially in the younger ages. The diagnosis can only be made after a comprehensive diagnostic work-up, combining clinical history, physical and laboratory examination, upper and lower gastrointestinal endoscopy, with histology and imaging of the small bowel. The therapeutic strategy is borrowed from that of UC and CD, although recent data suggest that IBDU has a lower therapeutic burden with a generally mild disease course and a good response to mesalamine. Since there are only few published data on pediatric IBDU, and no guidelines on its management are available, this review aims at summarizing the most recent evidence for the diagnostic work-up with a specific focus on medical and surgical options in the treatment of IBDU.

2 Article Aortic Intima-Media Thickness as an Early Marker of Atherosclerosis in Children With Inflammatory Bowel Disease. 2015

Aloi, Marina / Tromba, Luciana / Rizzo, Valentina / D'Arcangelo, Giulia / Dilillo, Anna / Blasi, Sara / Civitelli, Fortunata / Kiltzanidi, Dimitra / Redler, Adriano / Viola, Franca. ·*Pediatric Gastroenterology and Liver Unit, Department of Pediatrics †Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. ·J Pediatr Gastroenterol Nutr · Pubmed #26039941.

ABSTRACT: OBJECTIVES: The aims of this study were to determine the presence of endothelial dysfunction by measuring aortic intima-media thickness (aIMT) and carotid intima-media thickness (cIMT) and to evaluate the role of traditional risk factors for premature atherosclerosis in children with inflammatory bowel disease (IBD). METHODS: Thirty-four children with IBD (25 Crohn disease [CD] and 9 ulcerative colitis [UC]; mean age 11.1 years) and 27 healthy subjects matched for sex and age were enrolled. In all of the patients, demographic characteristics and risk factors for atherosclerosis (age, sex, body mass index, blood pressure, dyslipidemia, active and passive smoking, and family history for cardiovascular diseases), CD and UC clinical activity scores, and inflammatory markers were evaluated. aIMT and cIMT were measured by high-resolution B-mode ultrasound. RESULTS: aIMT was significantly higher in patients than in controls (P < 0.0005). No significant differences were found for cIMT, although the carotid thickness was higher in patients with IBD than in healthy subjects. At a univariate analysis, inflammatory markers levels and tobacco smoking exposure were significantly related to higher aIMT values, whereas in a multivariate regression model, the inflammatory status was the only independent variable correlated with high aIMT. CONCLUSIONS: aIMT is an earlier marker of preclinical atherosclerosis than cIMT in young children with active IBD. The inflammatory status and the smoking exposure are significantly correlated with the premature endothelial dysfunction. These data emphasize the importance of controlling the chronic intestinal inflammation and endorsing smoke-free environments for children and adolescents with IBD.

3 Article Disease course and efficacy of medical therapy in stricturing paediatric Crohn's disease. 2013

Aloi, Marina / Viola, Franca / D'Arcangelo, Giulia / Di Nardo, Giovanni / Civitelli, Fortunata / Casciani, Emanuele / Oliva, Salvatore / Nuti, Federica / Dilillo, Anna / Cucchiara, Salvatore. ·Department of Pediatrics, Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Italy. ·Dig Liver Dis · Pubmed #23465684.

ABSTRACT: BACKGROUND: Stricturing is the most common complicated phenotype in paediatric Crohn's disease, but only few studies have described its course, while data on the outcome of medical treatment are scanty. AIM: To retrospectively describes the course of paediatric stricturing Crohn's disease and assess clinical and imaging response to medical therapy. PATIENTS AND METHODS: Thirty-six patients with stricturing Crohn's disease were identified by our department database. Paediatric Crohn's disease activity index, need of surgery and magnetic resonance were evaluated as outcomes at 6, 12, 18 and 24 months after detection of stenosis. RESULTS: Strictures were ileal, ileocolonic and colonic in 61%, 28% and 11% of patients. Thirteen (36%) had stricturing disease at the diagnosis of Crohn's disease, while 64% developed it at the follow-up. At baseline, 89% had medical treatment, while 11% surgery. At 6, 12, 18, and 24 months, 53%, 50%, 42%, and 35% had complete response to medical treatment, respectively. Overall, 44% were unresponsive to medical therapy and required surgery at the follow-up. Responders and non-responders significantly differed for inflammatory imaging findings at the stenosis detection. CONCLUSIONS: A stricturing phenotype is not uncommon at the diagnosis of Crohn's disease in children. Medical therapy seems poorly effective in avoiding intestinal resection. Magnetic resonance imaging is valuable in identifying patients who will benefit from medical therapy.