{"id":9868,"date":"2023-02-14T11:15:13","date_gmt":"2023-02-14T09:15:13","guid":{"rendered":"https:\/\/primaderma.ro\/?page_id=9868"},"modified":"2023-04-04T15:05:23","modified_gmt":"2023-04-04T13:05:23","slug":"dr-georgiana-mihaila","status":"publish","type":"post","link":"https:\/\/pdi.ro\/2023\/dr-georgiana-mihaila\/","title":{"rendered":"Dr. Mih\u0103il\u0103 Georgiana"},"content":{"rendered":"

[et_pb_section fb_built=”1″ fullwidth=”on” disabled_on=”on|off|off” _builder_version=”4.19.4″ custom_margin=”||” custom_padding=”15px||29px” top_divider_style=”waves2″ top_divider_color=”#F0622A” top_divider_flip=”horizontal|vertical” bottom_divider_style=”waves2″ bottom_divider_color=”#fcdedb” bottom_divider_height=”105px” bottom_divider_flip=”vertical” global_module=”9062″ saved_tabs=”all” collapsed=”off” global_colors_info=”{}”][et_pb_fullwidth_header title=”@ET-DC@eyJkeW5hbWljIjp0cnVlLCJjb250ZW50IjoicG9zdF90aXRsZSIsInNldHRpbmdzIjp7ImJlZm9yZSI6IiIsImFmdGVyIjoiIn19@” disabled_on=”on|on|off” _builder_version=”4.19.4″ _dynamic_attributes=”title” title_font=”Kaushan Script||||||||” title_text_align=”left” title_text_color=”#f0622a” title_font_size=”55px” content_font=”|600||on|||||” content_text_align=”center” content_text_color=”#686766″ content_font_size=”15px” subhead_font=”||||||||” background_enable_color=”off” background_image=”https:\/\/pdi.ro\/2023\/wp-content\/uploads\/2022\/12\/PDI2023_header__-scaled.jpg” background_blend=”luminosity” background_layout=”light” custom_margin=”||-5px||false|false” custom_padding=”150px||150px||true|false” content_font_size_tablet=”” content_font_size_phone=”15px” content_font_size_last_edited=”on|desktop” global_colors_info=”{}”][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ global_colors_info=”{}”][et_pb_row column_structure=”2_5,3_5″ _builder_version=”4.16″ locked=”off” global_colors_info=”{}”][et_pb_column type=”2_5″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_image src=”https:\/\/pdi.ro\/2023\/2022\/wp-content\/uploads\/2022\/04\/Georgiana-Mihaila-circle.png” title_text=”Georgiana Mihaila-circle” align=”center” align_tablet=”center” align_phone=”” align_last_edited=”on|desktop” _builder_version=”4.17.0″ max_width=”25%” border_radii=”on|100px|100px|100px|100px” global_colors_info=”{}”][\/et_pb_image][\/et_pb_column][et_pb_column type=”3_5″ _builder_version=”4.16″ custom_padding=”|||” global_colors_info=”{}” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.19.5″ global_colors_info=”{}”]<\/p>\n

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Dr. Mih\u0103il\u0103 Georgiana
Sec\u021bia Dermatologie, Spitalul de Urgent\u0103 E. Beldiman, B\u00e2rlad, Vaslui<\/strong><\/span><\/h4>\n

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10 ani de provoc\u0103ri terapeutice la un pacient cu psoriazis vulgar<\/span><\/p>\n

Autor: Georgiana Mih\u0103il\u0103<\/span><\/p>\n

Cuvinte cheie: psoriazis vulgar, comorbidi\u021bi, terapii noi<\/p>\n

Introducere: Psoriazisul vulgar este o afec\u021biune autoimun\u0103 ,inflamatorie, cu determinism genetic, care a beneficiat \u00een ultimii 10 ani de posibilit\u0103\u021bi terapeutice multiple.
Material \u0219i metod\u0103 : Prezent\u0103m cazul unei paciente care prezenta \u00een 2013 leziuni caracteristice de psoriasis, asocia artropatie psoriazic\u0103 de ani de zile, cu tratament cronic cu metotrexat 15mg\/spt, dar f\u0103r\u0103 ameliorarea leziunilor cutanate sau a simptomatologiei articulare. \u00cen ianuarie 2013 pacienta este introdus\u0103 pe terapie biologic\u0103 cu adalimumab dup\u0103 ce a \u00eenceput profilaxia cu HIN , la indica\u021bia medicului pneumolog; dup\u0103 7 luni de tratament cu adalimumab acesta este \u00eentrerupt deoarece pacienta descoper\u0103 c\u0103 este \u00eensarcinat\u0103; dup\u0103 ce na\u0219te o feti\u021b\u0103 s\u0103n\u0103toas\u0103 se reia terapia cu adalimumab deoarece pacienta prezenta leziuni de psoriazis \u0219i dureri articulare. Pacienta nu mai prezenta leziuni cutanate \u0219i nici simptome articulare dar \u00een iunie 2016 dezvolt\u0103 TBC pulmonar ; se \u00eentrerupe terapia biologic\u0103 \u0219i pacienta urmeaz\u0103 9 luni de tratament antituberculos; dup\u0103 \u00eencheierea tratamentului antituberculos pacientei \u00eei revine simptomatologia articular\u0103 \u0219i cutanat\u0103 motiv pentru care se reia metotrexat 15 mg\/spt, dar far\u0103 o ameliorare satisf\u0103c\u0103toare a simptomatologiei. Deoarece PASI-39,6 si DLQI -30 se hot\u0103r\u0103\u0219te reintroducerea terapiei biologice tot cu un anti TNF-alpha (etanercept) dar la analizele hepatice efectuate Ac anti HBc-pozitiv, Ac anti Hbs < 10 mUIpe ml, iar consultul de boli infec\u021bioase indica necesitatea ini\u021bierii tratamentului cu entecavir. Evolu\u021bia cutanat\u0103 \u0219i articular\u0103 a fost bun\u0103, cu remiterea leziunilor cutanate \u0219i diminuarea simptomatologiei articulare, inclusive pe perioada de pandemie c\u00e2nd pacienta a fost supus\u0103 la multipli stresori; \u00een noiembrie 2022 pacienta pierde r\u0103spunsul \u0219i la aceasta terapie \u00een urma unor stresuri cumulative \u0219i se decide switch pe guselkumab, la care pacienta are un r\u0103spuns rapid \u00een doar 3 luni .
Rezultate : \u00cen 10 ani pacienta cu psoriazis \u0219i artropatie psoriatic\u0103 beneficiaz\u0103 de terapii biologice inovative, dar factorii stresan\u021bi aleatorii ai vie\u021bii reale fac ca aceasta s\u0103 piard\u0103 r\u0103spunsul terapeutic de mai multe ori.
Concluzii: Provoc\u0103rile vie\u021bii reale sunt multiple iar terapiile chiar dac\u0103 sunt de ultim\u0103 genera\u021bie trebuie fie adaptate fiec\u0103rui pacient \u00een parte, lu\u00e2nd \u00een calcul toate variabilele asociate vie\u021bii pacientului \u0219i s\u0103 \u021bin\u0103 cont \u0219i de faptul ca ace\u0219ti pacien\u021bi au nevoie de tratament sus\u021binut, eficient \u0219i sigur pentru toat\u0103 via\u021ba.<\/p>\n

10 years of therapeutic challenges in a pacient with psoriasis vulgaris <\/span><\/p>\n

Author: Georgiana Mih\u0103il\u0103<\/span><\/p>\n

Keywords: psoriasis vulgaris, comorbidities, new biological theraphies<\/p>\n

Introduction: Psoriasis vulgaris is o chronic, inflammatory condition, with genetic determination, with multiple modern possibilities of treatment.
Methods and materials: We present the case of a patient who presented in 2013 lesions characteristic of psoriasis, associated with psoriatic arthritis for years, with chronic treatment with methotrexate 15 mg\/week , but without improvement of skin lesions or joint symptoms. In January 2013 the patient started biological therapy with adalimumab after starting prophylaxis with HIN, at the indication of pulmonologist. After 7 months of treatment with adalimumab it is interrupted because the patient discovers that she is pregnant. After a healthy baby girl is born, adalimumab therapy is resumed because the lesions have reappeared, as have the joint symptoms.The patient has no longer skin lesions or joint symptoms, but in June 2016 she developed pulmonary TB. The biological therapy is interrupted and the patient follows 9 month of tuberculostatic treatment. After end of this treatment , methotrexate treatment is resumed because the pacient had lesions, but without a satisfactory therapeutic result.
Because PASI-39,6 si DLQI-30, it is decided to introduce etanerceptum but anti HbC-positive and anti Hbs<10 mUI\/ml, entecavir is indicated by the infectious disease specialist. The evolution is favourable, including during the pandemic , but in November 2022, following some cumulative stress, the patient loses her therapheutic response again and is switched to guselkumab , to witch she responds with PASI-0, DLQI-0 after 3 month of treatment .
Results: In 10 years, a patient benefits from innovative theraphies, but the random stressful factors of real life cause her to lose the therapeutic response several times.
Conclusions: The challenges of real life are multiple and the theraphies, even if they are of the latest generation, must be adapted to each individual patient, taking into account the various variables and bearing in the mind that these patients needs sustained , effective, safe treatment for the rest of their lives .<\/p>\n

Scurt CV<\/span><\/p>\n

Studii:<\/strong>
Septembrie 2015- medic primar dermatolog
Ianuarie 2010 \u2013 specialist \u00een dermatologie
Noiembrie 2003 \u2013 admitere \u00een reziden\u021biat specialitatea dermatovenerologie
1997-2003 \u2013 cursurile Universit\u0103\u021bii \u201cGrigore T. Popa\u201d, Ia\u015fi
1992-1996 \u2013 cursurile Colegiului Na\u021bional \u201cGh. Ro\u015fca Codreanu\u201d, B\u00e2rlad<\/p>\n

Specializ\u0103ri:<\/strong>
Octombrie 2021- Congresul Na\u021bional de Dermatologie (online)
Iulie 2021- DUBAI DERMA
Iulie 2021- Prim\u0103vara Dermatologic\u0103 Ie\u0219ean\u0103 (online)
Noiembrie 2020- Psoriasis Masterclass: from theory to practice (virtual)
August 2020- 5 Continent Congres (virtual)
Iulie 2020- Prim\u0103vara Dermatologic\u0103 Ie\u0219ean\u0103- Dermatologia la interfa\u021b\u0103 cu alte specialit\u0103\u021bi (online)
Iunie 2019- Congresul Mondial de Dermatologie, Milano, Italia
Mai 2019- Congresul European de Dermato-Pediatrie, Dubrovnik, Croa\u021bia
Aprilie 2019- Laser Europe 2019, Ia\u0219i, Rom\u00e2nia
Aprilie 2019 \u2013 Prim\u0103vara Dermatologic\u0103 Ie\u0219ean\u0103 \u2013 Dermatologia la interfa\u021b\u0103 cu alte specialit\u0103\u021bi
Noiembrie 2017- curs: Rela\u021bionarea eficien\u021ba cu pacientul; formator- Bogdan Joca
Octombrie 2017-17th ESPD Annual Meeting, Palma de Mallorca, Spania
Septembrie 2017- EADV, Geneva, Elve\u021bia
Mai 2017- 14th Spring Symposium of EADV, Brussels, Belgia
Aprilie 2017- Prim\u0103vara Dermatologic\u0103 Ie\u0219ean\u0103 \u2013 curs postconferin\u021b\u0103: Patologia cutanat\u0103 infec\u021bioas\u0103 din perspective multiple-dermatologie, boli infec\u021bioase \u0219i microbiologie.
Martie 2017- Skin Cancer – Curs de dermatoscopie cu participare interna\u021bional\u0103, Bucure\u0219ti, Rom\u00e2nia
Martie 2017- Prim\u0103vara Dermatologic\u0103 Ie\u0219ean\u0103 – lector: Larva migrans cutanata<\/p>\n

Afilieri profesionale:<\/strong>
Societatea Rom\u00e2n\u0103 de Dermatologie
European Academy of Dermato-Venereology (EADV)<\/p>\n

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Contacteaz\u0103 operatorul PDI 2023<\/p>\n

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Operatorul PDI 2023<\/p>\n

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\"\"<\/span><\/p>\n

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Adresa: Str. A. Panu nr. 13, Iasi<\/span>
Tel.: 0332.40.88.00-05<\/span>
E-mail: contact@pdi.ro<\/a>
<\/span>Website:\u00a0<\/span>www.eventernet.ro<\/a><\/p>\n

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Dr. Mih\u0103il\u0103 GeorgianaSec\u021bia Dermatologie, Spitalul de Urgent\u0103 E. Beldiman, B\u00e2rlad, Vaslui 10 ani de provoc\u0103ri terapeutice la un pacient cu psoriazis vulgar Autor: Georgiana Mih\u0103il\u0103 Cuvinte cheie: psoriazis vulgar, comorbidi\u021bi, terapii noi Introducere: Psoriazisul vulgar este o afec\u021biune autoimun\u0103 ,inflamatorie, cu determinism genetic, care a beneficiat \u00een ultimii 10 ani de posibilit\u0103\u021bi terapeutice multiple.Material \u0219i […]<\/p>\n","protected":false},"author":2,"featured_media":11418,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[12],"tags":[],"class_list":["post-9868","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-lectori"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/9868","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/comments?post=9868"}],"version-history":[{"count":12,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/9868\/revisions"}],"predecessor-version":[{"id":13063,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/posts\/9868\/revisions\/13063"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/media\/11418"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/media?parent=9868"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/categories?post=9868"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pdi.ro\/2023\/wp-json\/wp\/v2\/tags?post=9868"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}