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Najnoviji odgovori (93587)

  1. Postovani, zivimo u zajednici i cerkica od mog devera koja ima skoro 2 god je dobila sugu, tako kazu doktori u gracanici. Sada je imamo svi, meni je pocela po licu, mazemo sumpornu mast 15% . Molim vas pomozite nam i dali postoji neki drugi lek u slucaju da ovaj ne pomogne? Hvala unapred!

    Odgovoreno: 28. 01. 2019.
    • iz udžbenika. 

      Treatment

      • Topical permethrin or lindane

      • Sometimes oral ivermectin

      Primary treatment is topical or oral scabicides (see table Treatment Options for Scabies). Permethrinis the 1st-line topical drug.

      Older children and adults should apply permethrin or lindane to the entire body from the neck down and wash it off after 8 to 14 h. Permethrin is often preferred because lindane can be neurotoxic. Treatments should be repeated in 7 days.

      For infants and young children, permethrin should be applied to the head and neck, avoiding periorbital and perioral regions. Special attention should be given to intertriginous areas, fingernails, toenails, and the umbilicus. Mittens on infants can keep permethrin out of the mouth. Lindane is not recommended in children < 2 yr and in patients with a seizure disorder because of potential neurotoxicity.

      Precipitated sulfur 6 to 10% in petrolatum, applied for 24 h for 3 consecutive days, is safe and effective and usually used in infants < 2 mo of age.

      Ivermectin is indicated for patients who do not respond to topical treatment, are unable to adhere to topical regimens, or are immunocompromised with Norwegian scabies. Ivermectin has been used with success in epidemics involving close contacts, such as nursing homes.

      Close contacts should also be treated simultaneously, and personal items (eg, towels, clothing, bedding) should be washed in hot water and dried in a hot dryer or isolated (eg, in a closed plastic bag) for at least 3 days.

      Pruritus can be treated with corticosteroid ointments and/or oral antihistamines (eg, hydroxyzine 25 mg po qid). Secondary infection should be considered in patients with weeping, yellow-crusted lesions and treated with the appropriate systemic or topical antistaphylococcal or antistreptococcal antibiotic.

      Symptoms and lesions take up to 3 wk to resolve despite killing of the mites, making failed treatment due to resistance, poor penetration, incompletely applied therapy, reinfection, or nodular scabies difficult to recognize. Skin scrapings can be done periodically to check for persistent scabies.

      Treatment Options for Scabies

      Therapy
      Instructions
      Comments
      Permethrin* 5% (60 g) cream
      Apply to whole body; wash off after 8–14 h
      Repeat in 1 wk
      1st-line treatment
      Can cause stinging and itching
      Lindane 1% (60 mL) lotion
      Apply to whole body; wash off after 8–12 h in adults and 6 h in children
      Repeat in 1 wk
      Not recommended for children < 2 yr, pregnant or lactating women, people with extensive dermatitis, people with an uncontrolled seizure disorder, and those with severe skin conditions involving skin barrier compromise
      Potentially neurotoxic
      Ivermectin
      200 mcg/kg po for 1 dose
      Repeat in 7–10 days
      Indicated as a 2nd-line treatment to permethrin
      For use in institutional epidemics and immunocompromised patients
      Caution required when given to elderly patients with hepatic, renal, or cardiac disorders
      Not recommended for pregnant or lactating women; unproven safety in children < 15 kg or <5 yr
      May cause tachycardia
      Crotamiton10% cream/lotion
      Apply after bath to whole body, apply 2nd dose after 24 h, and bathe 48 h after 2nd dose
      Repeat both doses in 7–10 days

      Sulfur ointment 6–10%
      Apply to whole body at bedtime for 3 nights and leave each application on for 24 h
      Very effective and safe
      May be limited by its malodor
      *Pyrethrins are natural components of chrysanthemum flowers, with strong insecticidal activity; pyrethroids are synthetic and natural relatives of pyrethrin; and permethrin is a commonly used synthetic pyrethroid. Pyrethrins are combined with a piperic acid derivative (piperonyl butoxide) to enhance efficacy.

      Key Points

      • Risk factors for scabies include crowded living conditions and immunosuppression; poor hygiene is not a risk factor.

      • Suggestive findings include burrows in characteristic locations, intense itching (particularly at night), and clustering of cases among household contacts.

      • Confirm scabies when possible by finding mites, ova, or fecal pellets.

      • Treat scabies usually with topical permethrin or, when necessary, oral ivermectin.

  1. Treba mi misljenje dermatoloa. Imam dijagnozu onihomikoza na palcevima oba stopala, pa me interesuje da li je efikasnije odstraniti oba nokte, obzirom da je lecenje dugotrajno, a i moze se preneti na druge nokte. Takodje i lekovi koji se piju stete jetri. Pa tako i pitanje: da li je resenje odstraniti nokte na palcevima.

    Odgovoreno: 28. 01. 2019.
  1. Dete mi ima 3 godine i dobilo boginje varicele u nedelju 11. 07, ja sam u trudnoci 4 mesec, dete smo ostavili kod babe i dede u izolaciji od mene zanima me da li moze nesto da se desi sa plodom i sta da radim posto sam ja taj dan bila pre podne sa detetom u kontaktu

    Odgovoreno: 28. 01. 2019.
    • ako ste preležali kao dete, bezbedni ste i vi i beba, a ako niste, sačekajte inkubaciju do 21 dan,pa ako dobijete dobiće i plod, manje opasno ako je organogeneza završena, u drugom trimestru ( u kom ste), ipka nije sasvm bezopano (iz udžbenika: Because pregnant women are at high risk of varicella complications, some experts recommend oral acyclovir or valacyclovir for pregnant women with varicella. Acyclovir is a pregnancy category B drug. IV acyclovir is recommended for pregnant women with serious varicella disease.

  1. Dobar dan, postovanje. Hteo sam da vas zamolim da mi pomognete a pitanje je sledece. Otisao sam kod koznog lekara posle promene na kozi koju sam primetio pre par dana. . . Posle laboratorijske analize utvrdjeno je da se radi o gljivici trichohyton pa mi je doktorka rekla da mazem nekom tecnoscu, posto nije pokazalo neke rezultate zanima me da li mogu da koristim neki antimikotik u tabletama, i sta preporucujete? Unapred hvala marko

    Odgovoreno: 28. 01. 2019.
    • tinea corporis;

      Treatment of mild-to-moderate lesions is an imidazole, ciclopirox, naftifine, or terbinafine in cream, lotion, or gel. The drug should be rubbed in bid continuing at least 7 to 10 days after lesions disappear, typically at about 2 to 3 wk.

      Extensive and resistant lesions occur in patients infected with T. rubrum and in people with debilitating systemic diseases. For such cases, the most effective therapy is oral itraconazole 200 mg once/day or terbinafine 250 mg once/day for 2 to 3 wk.

       

  1. Postovani doktore, saznao sam da sam nosilac virusa hepatitisa b jos pre 25 godina. Ne osecam nikakve zdravstvene tegobe tegobe. Pre godinu dana, kontrolom krvi ustanovljne su normalne vrednosti u funkciji jetre a rezultat hbsag je 2373, 5, tv negativan<0, 05. Sta da preduzmem dalje?

    Odgovoreno: 28. 01. 2019.

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