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I suffer from systemic lupus. I am 51 years old and I have not had menstruation for 3 months. The ultrasound indicates that I won't have it in the future. My gynaecologist recommended Feminal, but the rheumatologist has warned me not to use female hormones. Does this product contain female hormones? Can I take it or not? Greetings. Feminal capsules are a natural remedy containing red clover dry extract. The active ingredient of the extract are phytohormones, substances of plant origin with effects similar to estrogen, thus reducing menopause problems (sweating, hot flushes, tension, insomnia, etc.) Since the use of hormones can have a negative impact on your base condition, lupus, we think you should also avoid the plant hormones, i.e. phytohormones. Although phytohormones have a milder effect than synthetic hormones, their effect on lupus patients has not been researched, so we cannot guarantee its safe use in your case. Best regards, JGL Counseling I had a vaginal infection and took Lactogyn capsules with antibiotics. After the treatment, I took Lactogyn again in order to help with the recovery and stabilisation. Should I also use vaginal capsules or should I continue with this treatment for a few weeks? Thank you and kind regards. Dear Madam, after the treatment with antibiotics and Lactogyn capsules, it is recommended to continue with the use of Lactogyn peroral capsules 1x1 for another 2-3 weeks. Like you mentioned, the recovery and stabilisation of vaginal flora takes a certain amount of time. Lactogyn capsules can be taken for preventative purposes, 1x1 during 4 weeks, and discontinued when you are not experiencing symptoms. In case of discomfort, tingling, dryness, etc., you can repeat the probiotic treatment several times a year. The balance of vaginal flora is affected by bacterial and viral infections (diagnosed by the gynaecologist), as well as by stress, unhealthy diet, inadequate intimate hygiene soap, tight clothes. We recommend using Lactogyn soap (with lactic acid, calendula and chamomile) for your intimate hygiene. Best regards, JGL Counseling I am 33 years old and have severe PMS symptoms (sensitivity, crying spells, irritability, occasionally mild depression, general malaise, acne). Sometimes on the 1st day of my period I experience pain in the lower abdomen or back (however, this pain is not strong, so I am more concerned about the PMS). I will get my period two days prior to my wedding this fall. I have heard that menstruation can be postponed by using birth control pills. Do you recommend this and are there any adverse effects (on the body, complexion, etc.)? I suppose that this is not a solution for the treatment of my PMS problems (which is the goal of postponing my period)? Can I accelerate or postpone my period (perhaps even this summer), so that the PMS symptoms follow the new date of period? Also, do you have any recommendations for alleviating PMS (pills or natural solutions)? Any advice is welcome. Please respond as soon as possible. Thank you in advance and kind regards. Dear Madam, premenstrual syndrome or PMS is very common, however, its unclear cause has led to a wide range of advice for the treatment or alleviation of symptoms. PMS is often connected with stress (within family, in the workplace or society in general), which is why the first step is reducing the impact of stress. This can be accomplished through meditation, yoga, exercise, massage or quick walking (calming and relaxing activities). It is necessary to pay attention to the diet, seeing as research has discovered a negative impact of certain foods on PMS (chocolate, caffeine, sodas, candy, pastries, baked goods, hard cheese, milk, ice cream, red meat, alcohol, salty snacks). It is interesting that women with severe PMS symptoms crave these particular products. Meals should be regular, more frequent, smaller and healthy, which will maintain the blood glucose level, as a precondition for hormone stability. On the other hand, unhealthy meals such as candy cause a sudden increase of blood glucose levels and sudden insulin release, followed by a rapid decrease of blood sugar leading to unwanted symptoms (hunger, weakness, confusion, headache, Cow milk can be replaced by soy, rice or oat milk. Daily diet should include grains, fruits and vegetables. We recommend eating foods that contain tryptophan, an amino acid known for its beneficial effect on mood: oatmeal, bananas, fish, sesame, chickpea, sunflower and pumpkin seeds and poultry (particularly turkey). It is also useful to include foods rich in iron (liver, tuna, oysters, soy, pumpkin, oats, peas, yeast, figs, spinach) and zinc (clams, crabs, turkey, tuna, organ meats, brewer's yeast, soy, pumpkin seeds, peas). We recommend the following food supplements: calcium citrate with magnesium, ginkgo biloba (our Ginkalin capsules), Mega Omega 3 capsules 1x1 for 3 months. If your symptoms are not reduced, we suggest that you contact your gynaecologist, who can recommend birth control pills for the regulation of your menstrual cycle and the alleviation of PMS. Since your wedding date is still relatively far away, your cycle can move on its own, which would make postponing of your period unnecessary. We recommend that you contact your gynaecologist with regard to this issue in the beginning of August. Best regards, JGL Counseling My son has Helicobacter pylori and excess stomach acid. What food and herbal teas would you recommend for the treatment of his condition and the reduction of symptoms? Kind regards. It is estimated that Helicobacter pylori affects around 80% of people, however, it only causes health issues (excess acid, gastritis, peptic ulcers, pain, weight loss, nausea, etc.) in certain people. It is necessary to stop smoking and drinking alcohol, and a healthy diet can help reduce the symptoms. Meals should be smaller and taken more frequently and regularly, and processed food (dried meat products, pastries, fresh bread, milk, black coffee, chocolate, sugar, candy, sodas, canned food, processed soups, sauces, etc.) should be excluded from the diet. It is recommended to eat cooked vegetables and meat, fish, rice, apple compote. Fresh fruits and vegetables should be avoided for the duration of the symptoms. If the symptoms improve, your son can try eating ripe fruits after a meal - never on an empty stomach. Which vegetables to eat? Unfortunately, there is no ideal diet suitable for all patients. Each person should write a food diary and create a list of foods that he or she can tolerate based on personal experience. Food should be chewed for a while in order to soften and mix with saliva, so that it is tolerated better in the stomach. Hot and cold food should be avoided; medium food temperatures are advised. We recommend the following teas for your son: chamomile, mint, yarrow, fennel, thyme. If a healthy diet does not alleviate your son's problems, he should contact a doctor. Best regards, JGL Counseling Due to a clumpy discharge, tingling and itching I have contacted my gynaecologist, who has advised me to buy Canesten 3 combi and Lactogyn intimate hygiene soap - which I use regularly. However, I got my menstruation that evening, so I have not started the Canesten treatment. I also bought Lactogyn oral capsules, which I have been taking twice daily. My symptoms have diminished, so I'm not sure whether I should use Canesten after menstruation. Dear Madam, you should continue treatment with Canesten 3 cream for vaginal candidiasis like your gynaecologist recommended. You should also continue treatment with Lactogyn oral capsules, 2x1 in the first week, and 1x1 for the next 3 weeks. The stabilisation of vaginal flora and the settlement of useful probiotics which act against fungi and bacteria take a certain amount of time. We advise you not to eat candy, pastries, fresh bread, hard cheeses or processed meat during treatment, because these products stimulate candida growth. You can treat yourself to these foods occasionally after the treatment, however, you should try to eat as healthy as possible. Best regards, JGL Counseling I have troubles with recurrent herpes. Currently I have three herpes sores on my upper lip. Last month I had a large herpes outbreak below the nose, which has left a scar. In December 2012 I performed blood tests, but they showed normal values and iron levels. During the winter I decided to take the vitamin B complex and I take C vitamins regardless of the cold and flu season. I have also taken Encian royal jelly ampoules, but using them for three months as recommended in the instructions is too expensive for me. Every day during the winter I drink a glass of water with squeezed lemon juice, as well as three glasses of green tea (for immunity), also with squeezed lemon juice, on an empty stomach. I try to use these natural products for the benefit of my body, as well as eat a lot of fruit (oranges, lemons, apples). We've even been eating home-grown spinach and nettle, however, I still experience lip herpes every month. I apologise for a lengthy description and ask for your advice on what I should do in order to improve my immunity and reduce facial herpes outbreaks. Thank you for your answer. Dear Madam, unfortunately, infection with the herpes virus is chronic and lifelong. Once the virus enters the body (through the infected skin or mucosa), it stays dormant in the ganglions which are connected to the sensory nerves on the skin surface. This is the why the first symptom manifests as tingling and itching. The latent virus waits for suitable conditions to break out and cause acute symptoms. Its reactivation can be caused by fatigue, low temperatures, as well as sun exposure, wind, viral infections, menstruation (hormonal changes), loss of immunity and stress. Therefore, a lot of circumstances help its outbreak. For prevention purposes, we advise immediate reaction to even the smallest of symptoms and the use of acyclovir ointment on the infected place (in your case, the upper lip) every hour. You should use cotton swabs (ear buds) for application to prevent the transfer of viruses on your fingers and the ointment. Make sure not to transfer the virus on other places when washing your face. During the acute phase, we recommend using only damp cotton wools. It is a good idea to apply lip balm with UV protection during increased UV radiation. Paying attention to your diet and eating a lot of fruit and vegetables is certainly beneficial. However, you should not drink lemon juice on an empty stomach because it can irritate the gastric mucosa. From our range of products we recommend Mega Omega 3, which has a beneficial effect on inflammatory conditions, resilience and skin changes. Take 1 capsule after lunch during 3 months. Best regards, JGL Counseling I was advised to contact you regarding an allergy problem. My husband has been having problems with spring allergies for 3 years. He wasn't tested, but it all began when he worked in a pine forest. I hope you have a solution that will at least ease his problems. He can't breathe, his nose is congested, his eyes itch, he sneezes a lot, and sometimes he even experiences dizziness. Recently we have launched our new product Aqua Maris ectoine spray, a natural product without preservatives, which is very important for people suffering from allergies. Preservatives additionally irritate the nasal mucosa already damaged by the allergens. Aqua Maris ectoine spray contains two active components: ectoine which coats the mucosa in nasal airways and prevents the direct contact of antigens with cell membranes, thus reducing the allergic reaction, and seawater which reduces the swelling of the mucosa and clears the nose passage. In addition, sea water contains microelements which recover the mucous epithelium and accelerate its recovery. The Aqua Maris Ektoin spray can be used on its own for therapy and prevention. This spring it will have a therapeutic influence on your husband, seeing as the allergic reaction has already occurred, but next year he can take it for prevention, i.e. prior to the bloom and the symptoms of allergic rhinitis. If your husband uses antihistamines or corticosteroids, he can use the Aqua Maris ectoine spray to help reduce discomfort and accelerate recovery in a natural way. Aqua Maris ectoine spray should be sprayed into each nostril 15 minutes after taking the standard, prescribed treatment. It can be combined with our Meralys spray 0.1% (which contains sea water in addition to the drug xylometazoline), by spraying Meralys spray two times daily every 12 hours, followed after 15 minutes by spraying the Aqua Maris ectoine spray, which can also be used throughout the day. Meralys spray is used for 5 days, and Aqua Maris Ektoin can be used throughout the allergy season for therapy and prevention. Furthermore, patients with allergies can use Aqua Maris irrigation system for the nose and sinuses (the system and preservative-free salt sachets are enriched with myrtle and immortelle oils). The system is used to rinse out the allergens from the nasal airways, preferably 2-3 times a week (in the evening, before bedtime), which helps reduce allergic reactions. For patients who do not wish to irrigate their nose with this system, we recommend Aqua Maris nasal spray, 100 ml which can be carried in a pocket or a purse and sprayed into both nostrils throughout the day, followed by blowing the nose completely. Prior to standard treatment and Aqua Maris ectoine treatment we recommend cleaning the nose, so that the therapeutic substances can remain on the nasal mucosa as long as possible. Best regards, JGL Counseling Do you have any free probiotic samples? Currently I am using Lactogyn, but I would like to try other probiotics, so I would be grateful if you had any samples. We do not have free samples of probiotics seeing as they have to be kept in a refrigerator until use, which makes their storage more difficult. Besides, all probiotics have a positive influence, regardless of their kind (Prolife, Normia, Lactogyn). They should be taken for a specific period of time in order to notice an effect. You should ask the pharmacist for advice or contact us at savjetovaliste@jgl.hr regarding your current difficulties in order to choose the best probiotic for you. Each probiotic has certain indications (conditions for which it is recommended) and instructions for use. Best regards, JGL Counseling For the past 5 years I have taken Euthyrox for hypothyroidism. Prior to treatment I had a miscarriage. Two years later I went through a normal pregnancy and delivery, after which I had curettage and another miscarriage. I have been trying to conceive unsuccessfully for a year. What is the extent of thyroid impact on my condition and is there any help? The thyroid is a very important gland that affects the metabolism (exchange of substances in the body) and has a large influence on fertility and the proper course of pregnancy (possible cause of miscarriages). Hypothyroidism signifies that the thyroid has a reduced function, for which you have received hormone replacement. Hormone checks are required regularly in order to determine if your Euthyrox dose is adequate. We recommended regular physical activity, with the aim of speeding up the metabolism, and a healthy diet (fruit, vegetables, fish, whole grains, poultry, legumes and beans) rich in fibers to help improve digestion. Foods with the most beneficial effect on the thyroid that should be consumed often include carrots, spinach, apricots, asparagus, olive oil, avocado, sunflower seeds, whole grains, bananas and fish oil. Foods which impede iodine absorption, and should therefore be eaten only 2-3x a week, include cabbage, kale, broccoli, mustard, lima beans, flax seeds, sweet potatoes, peanuts and soy products. Caffeine and theine drinks (coffee, coca-cola, black tea) should also be avoided because they affect the normal thyroid function. Alcohol and tobacco also affect the thyroid negatively. Physical activity (quick walking, exercise, swimming etc.) reduces stress and has a beneficial impact on the thyroid function. It is a good idea to increase the daily intake of water in order to improve the secretion of toxins. Taking medication regularly, physical activity, stress reduction and a healthy diet can improve the thyroid function and ultimately help you to conceive. Best regards, JGL Counseling I need advice regarding the use of vitamin E concentrate. Can it be used to treat a C-section scar (I gave birth over a year ago, but the scar has remained red)? Will it help strengthen the skin of my stomach and breasts or do you recommend another product? In addition to the treatment of the sensitive skin of your face, you can use Holyplant vitamin E+ concentrate, 15 ml on the scar on your stomach by applying it and massaging it in gently. Use Holyplant almond oil on the rest of your body. The C-section scar will eventually change (become softer and fade). You can use Holyplant almond oil (in spray or bottle) on your whole body (stomach, breasts and thighs), seeing as it is also enriched with vitamin E. Regular application will make the skin soft, smooth and elastic. In addition to the local treatment of skin we also recommend everyday physical activity (quick walking, exercises for abdominal muscles) which will accelerate the strengthening of the entire abdominal wall. Best regards, JGL Counseling I have two questions - can I use Lactogyn vaginal tablets without taking oral capsules for less serious gynaecological problems (increased secretion), and can I use Lactogyn capsules and vaginal tablets at the same time as analgesics, vitamins and other dietary supplements? If you are experiencing an infection and secretion, we recommend performing a gynaecological exam in order to establish the cause of the infection (fungi, bacteria). Your gynaecologist will recommend a treatment (vaginal tablets or vaginal cream). If you have a strong infection, in addition to the vaginal antibiotics or mycotics, you should take one Lactogyn vaginal capsule daily (1x1) for 7 days, and two Lactogyn oral capsules daily (2x1) for 7 days, followed by only one Lactogyn oral capsule daily (1x1) for 3 more weeks. Probiotic treatment (with Lactogyn) will therefore last 4 weeks. If the secretion is caused by a hormonal imbalance (menopause), we recommend taking only one Lactogyn oral capsule daily (1x1) for 4 weeks. Treatment with Lactogyn oral capsules once daily (1x1) during 4 weeks in order to maintain an optimal balance of vaginal flora is recommended for preventative purposes every few months. Best regards, JGL Counseling Where can I purchase your toothache drops? The portfolio of our non-prescription programme includes Holyplant gum drops, a product against toothache. It is used to treat the inflammation of gums which results in the exposure of tooth necks, causing toothache and sensitivity to hot and cold stimuli and touch. You can find them at pharmacies, especially our pharmacy chain Pablo. Best regards, JGL Counseling After a flu I got pneumonia so I took antibiotics and Normia probiotic bags for 14 days. My doctor says I should keep taking them for another 2 weeks. Can I switch to capsules because they are more practical? Taking Normia probiotics with your antibiotic treatment was an excellent choice, seeing as they protect the intestinal flora. Unfortunately, antibiotics destroy not just the harmful bacteria, but also the beneficial bacteria in the intestines and vagina. We agree with your doctor's advice to continue the probiotic treatment. With regard to the dilemma between Normia bags and Normia capsules, you are free to choose the more practical solution. Normia bags are intended for people who find it difficult to swallow medication. Both forms contain the same probiotic strains: Lactobacillus rhamnosus GG® and Bifidobacterium BB-12® which protect the intestinal flora in the small and large intestine. We advise you to continue using Normia capsules once daily (1x1) for the next 4 weeks. For more information you can contact us at JGL Counseling. Best regards, JGL Counseling At the pharmacy where I bought my Vizol S drops, I was informed that they are suitable for people who wear contact lenses. Later I read on the packaging that removal of the lenses 15 minutes prior to application is recommended, which is not easy to accomplish during the day. You should have emphasized this fact better or at least informed your employees about the difference between removing the contact lenses prior to application (in which case I would have never bought your drops) or simply applying the drops with the lenses in place. To conclude, my wish to buy a local product only left me disappointed and I have wasted 60 kuna! There are two kinds of Vizol S eye drops on the market. One kind (with 0.21% hyaluronic acid) is intended for contact lens wearers, and the other (with 0.4% hyaluronic acid) is intended for people with severe dry eye disorders and for application over night. You should use the 0.21% concentration which also helps moisturise and lubricate the area between the lens and the eye. Unfortunately, you have been given the wrong product at the pharmacy. Sincerely, JGL Counseling Are Aqua Maris drops or spray suitable for a child of 15 months? Which ones do you recommend? Babies can be treated with Aqua Maris Baby nasal drops (in a 10 ml bottle), i.e. isotonic seawater (equally salty as tears, so it does not irritate the gentle nasal mucosa). AQM Baby drops keep the nasal mucosa moist and maintain the hygiene of the nasal cavity prior to breastfeeding or bottle feeding. The drops also help during infections of upper airways (colds, viral infections, allergies, ear infections), seeing as infections hinder normal breathing through the nose. Aqua Maris Baby drops clean the nose mechanically, and seawater with its microelements also has a favourable impact on the superficial layer of the mucosa (epithelium), regenerating the cilia which further clean the nasal airways. If the skin surrounding the nose is red or inflamed (often seen in babies), we suggest that you use Aqua Maris nasal ointment (with vitamins A and E and d-panthenol). Best regards, JGL Counseling My mother has been taking the drug Disopyramide for a few years, but it is no longer available for sale. I hear that it is no longer produced. Is there a substitute for this drug and what is it called? Thanks The antiarrhythmic drug Disopyramide tbl will not be produced in the future. We suggest that your mother contacts the family doctor for a referral to the cardiologist and a change of treatment. Best regards, JGL Counseling I am 35 years old. I weigh around 120 kg and have high blood pressure, 105/160. Lab tests have shown that I have a bacterial bladder infection. I was given a medication which I now take. Did this infection cause the elevated blood pressure or is something else to blame? Which tests should I have done? It appears you may be overweight, but we cannot say anything with certainty without knowing your height. Please contact us with this information in order for us to determine your BMI. This is important because obesity causes burden on joints, cardiovascular system and the heart, which often causes high blood pressure. We recommend you change your diet and reduce the intake of food. Also, it is essential you reduce the intake of salt, because salt also causes high blood pressure. Fast food, cured meats, snacks and sweets contain a lot of salt, which is detrimental to our health. After you have completed the treatment, have your urine checked (bacteriological test) to see if you have cured the bacterial infection. Long bladder infections that are left untreated may spread to the kidneys. The kidneys are very sensitive and prone to permanent damage, which also leads to high blood pressure. We recommend you take up daily exercise and walking, because the sedentary lifestyle also affects blood pressure and weight. In the meantime, control your blood pressure; if it continues to be elevated, you should take additional tests as recommended by your family doctor (CBC, urine, liver function tests, urea, Best regards, JGL Counseling Can children use the nasal irrigation system and how old should they be? My grandson is 10 years old and has had problems with the nasal mucosa for years. He has no allergies. Seeing as how your grandson has no allergies, he does not have to rinse allergens out of his nasal passages. We believe that regular application of the Aqua Maris isotonic nasal spray would help recover the nasal mucosa. The irrigation system is used 2 times a week, unlike the spray, which can be used several times a day (5x is enough to moisturize the mucosa, remove any dirt and add micro-nutrients essential to the revitalization of the tender epithelium). The Aqua Maris spray is practical because the boy can put it in his pocket, carry it to school and use it during recess. Best regards, JGL Counseling I need some information about Latanox eye drops that have been prescribed to me. It says they should be kept in a refrigerator before opening. What I would like to know is whether their composition will change if they are kept at room temperature for a few hours. Are they stored at a low temperature during their distribution to pharmacies? Latanox drops, which are a glaucoma medication, are transported to pharmacies in a refrigerator. Before opening, they are stored in refrigerators, and after they have been opened, they are kept at room temperature. If you need to transport them over several hours, and air temperature is above 8°C, put a frozen gel wrapped in fabric at the bottom of the carton bag, place some paper on the gel and finally put paper-wrapped Latanox on top. Thus it will be in a cold environment, but will not freeze. Best regards, JGL Counseling I am a teenage girl who has her period every two weeks. Is that normal? Could this be due to my weight; I am 170 cm high and I weigh only 45 kg. Contact your family doctor, who will probably recommend you speak to a gynaecologist. You should visit the gynaecologist with your mother. Support is very important. You have a shortened menstrual cycle, which is why you cannot recover from the bleeding (you must do blood tests to exclude anaemia; if you do have anaemia, you must take medications). Also, you are undernourished, which is another reason to visit a doctor. Best regards, JGL Counseling I have frequent bladder infections. Due to antibiotic therapies, I have been experiencing vaginal discomfort, which is why I started taking a probiotic, acidofilus. Can I also use the Lactogyn capsules? What would you recommend for genital tingling inside and outside the vagina? The pharmacist gave me Lactogyn gel, but the instructions say it is a moisturizing gel. You may take acidofilus and Lactogyn vaginal capsules (which you insert into the vagina at night, over seven days) simultaneously. Seeing as you experience frequent infections and imbalance of the vaginal and intestinal flora, after you have used the entire acidofilus, we recommend you continue taking oral Lactogyn capsules 1x1 for another 4 weeks. Lactogyn gel moisturises the vagina and the genital area. You may use it as necessary. If you once again start taking antibiotics, you should definitely use probiotics (such as Normia 2 capsules a day) at the same time. If you take the antibiotic every 12 hours, it is best to take the probiotic in between taking the antibiotic. Best regards, JGL Counseling Following antibiotic treatment (she has a throat infection), my 13-year old daughter is having a white discharge. She is experiencing tingling and itching. A year ago she had her first period. She refuses to go to the gynaecologists. How can I help her? According to your description, the discharge may be caused by candida. The diagnosis can be confirmed by a gynaecologist after examining a sample under the microscope. However, if you wish to solve the problem yourself, here's some advice. Cut all sweet foods (cookies, ice-cream, bagels, chocolate, etc.), ready-made juices, cured meat products, fresh bread and hard cheese from her diet. As far as dairy products are concerned, your daughter may take cottage cheese, yoghurt, etc. This will prevent the growth of candida, which thrives on sugar and yeast fungi (present in yeast, cured meats and hard cheeses). She should also pay attention to clothes. She should wear cotton pants, stockings and underwear and comfortable clothes. Also, your daughter may take a 4-week course of Lactogyn peroral capsules 1x1, after breakfast. Probiotics contained in Lactogyn have a positive effect on vaginal flora and thus reduce the predominance of candida (which is a normal inhabitant of the vagina, albeit in smaller quantities). Your daughter may also use the Lactogyn gel for intimate hygiene, once a day after bowel movement. For additional information contact our Couseling centre at 01 30 10 946 on Monday, Wednesday and Thursday between 3 and 7 p.m. Best regards, JGL Counseling Can pregnant women use Aqua Maris? An ear, nose and throat specialist recommended the product. He told me to take it separately for the throat and the nose. The pharmacist offered a single product and said it was used for both the throat and the nose (it comes in a slightly bigger bottle). Is that correct? Pregnant women may use AQM products, including the throat and nose spray. The pharmacist recommended a bigger packaging of the isotonic nose spray. The contents of the isotonic spray can in theory pour into the throat if you throw your head back. However, this quantity is smaller than when you apply the spray directly. A throat spray may be isotonic, but may also be hypertonic (stronger). We suppose that the ear, throat and nose doctor recommended an isotonic nose spray and a hypertonic throat spray if you have both a congested nose and a throat infection. Also, every one of these sprays has an appropriate pump - spray nozzle, which is another reason why you should take separate products for nose and throat. Best regards, JGL Counseling I was wondering whether a positive effect of red wine (in small quantities) on the cardiovascular system has been scientifically proven. When taking my medication for high blood pressure and heart, can I drink 1 dcl of red wine after lunch? I haven't tasted alcohol for the last 5 years, since I was diagnosed with high blood pressure and accelerated heart rate. My friends keep telling me I'm exaggerating. Thank you! There is an increasing amount of research and evidence in the literature that proves that small amounts of alcohol (1-2 dcl of white or red wine) have a positive effect on cardiovascular system, reducing the frequency of heart attacks etc. There is also evidence that more than 2 dcl a day can be harmful, resulting in high blood pressure and heart weakening in heart patients. I'll repeat what I tell my patients who consume wine - 1 dcl is good for your heart, 2 dcl is neutral, and more than that can be harmful. Exceptions are patients with arrhythmia attacks (atrial fibrillation) related to the consumption of alcohol and patients with advanced heart failure to whom I don't recommend alcohol consumption. Sincerely, Sandro Brusich, MD My blood pressure increased during pregnancy. I kept taking medication after I gave birth. I wonder if pregnancy was the 'trigger' for the occurrence of high blood pressure (some members of my family also have high blood pressure) or whether it is a result of my obesity (I gained 25 kg). I am so afraid I cannot even think about pregnancy again. Thank you in advance. Pregnancy causes various changes in the system. The blood volume increases, especially to the damage of plasma, which results in relative anaemia in the blood count due to a higher amount of fluid. Hormonal changes, changes of renal function etc. also occur. All of these changes can lead to fluid retention with the increase of blood pressure and weight gain. After giving birth, there is a gradual normalisation of blood pressure in most women within a few months. It is very important to regain your normal body weight and to regularly exercise (3045 min. of walking a day - not necessarily at once). Women with these issues in pregnancy are more susceptible to high blood pressure during their next pregnancy as well. If high blood pressure persists for more than 6 months after the pregnancy, this indicates that it is caused by other mechanisms , and not pregnancy, for example by obesity, diet high in salt, lack of physical activity etc. You should deal with these factors in order to normalise your blood pressure. Sincerely, Sandro Brusich, MD I am 70 years old. For the last 20 years I have been taking medication for high blood pressure and heart issues. When I was younger I also drank excessively. My cardiologist told me I was suffering from chronic cardiomyopathy. Can you explain what this means? Cardiomyopathy is a general term we use for heart muscle disease, typically manifested by the dilation and weaker contractions of the heart. Its most common cause is ischemic heart disease (clogging or stenosis of blood vessels of the heart), toxic (usually long consumption of large amounts of alcohol) or innate reasons. Besides the term itself, the severity of disease is also important - it is necessary to perform a heart ultrasound which will determine ejection fraction (force of contraction - in the test results it is indicated in %), size of the heart, competence of heart valves (do they malfunction and to what extent) etc. If it hasn't significantly advanced, cardiomyopathy can be successfully treated by changing your lifestyle and by taking medication your entire life. Sincerely, Sandro Brusich, MD My two-year old son has atopic dermatitis. He regularly sees a dermatologist who is not very articulate. He didn't explain anything, he just keeps changing prescriptions for creams and ointments. I eliminated milk and eggs and all allergenic food from our diet on my own, urged by a relative who had similar problems with her child. She also gave her child probiotics. Could you please tell me which probiotic we can use, in what dose and for how long? Will this condition affect my son forever? The diet change had a positive effect on my son's condition. Atopic dermatitis (dermatitis atopica, AD) occurs in persons with hereditary atopic constitution, with a tendency to allergic reactions to different allergens. The examination of patients includes allergy testing (for children - Clinical Hospital Rijeka - Department of Paediatrics, Kantrida). Approximately 50% of children recover by the age of 8, and about 80% by the age of 12. However, some children develop asthma or allergic rhinitis later in life. The approach to atopic dermatitis treatment depends on the patient's age and clinical manifestations of the disease. Since certain inhalation and alimentary allergens cause deterioration of atopic dermatitis, it is necessary to take appropriate measures for suppressing and eliminating house dust, dust mites, animal fur and feathers from the immediate surroundings of the patient and to eliminate foods to which the patient is hypersensitive. Basic clinical features of atopic dermatitis include dryness of the skin accompanied by severe itching, so it is extremely important to take proper care and hydration of the skin. During bathing and showering it is necessary to use oil baths or showering oils, and to apply emollients to the skin daily. Use other topic treatments (corticosteroid preparations, immunomodulators) upon consultation with your dermatologist. Sincerely, Professor Marija Kaštelan, MD I have very cracked heels and dry elbows. I tried various ointments and creams because I have had this problem for years. Recently I applied JGL children ointment on my heels and elbows completely by chance, because I didn't have anything else at hand and I was surprised by its effect. My heels stopped itching and burning, and my elbows became softer. This was a pleasant surprise because I didn't expect my granddaughter's tooshie ointment would help. I hope I can keep using it, because I suppose children's oitment doesn't contain any harmful chemicals. Since children's ointment is usually intended for everyday protection and care of delicate skin in infants and children, you can freely use it up to several times a day. Sincerely, Prof. Marija Kaštelan, MD I have fair complexion and fair hair. From May to September I use sun screen for my face and body. When I am on the coast, my skin gets very dry. I tried to nourish and moisturise it using various lotions and creams, but mostly without success. Several days ago the pharmacist suggested Pentexol lotion. Its application is very practical. I wonder if its composition is suitable for dry and irritated skin? Should I use any supplement? My family forces me to eat fish because it contains omega-3, but I cannot eat it more than once a week. Would it be good to take omega-3? On your website I noticed you offered MegaOmega3. Is it appropriate in my case? Pantexol lotion nourishes, maintains normal skin moisture and provides protection to dry and damaged skin. It contains B5 vitamin and pantothenic acid that additionally nourish the skin. It is important to apply it several times a day when you start using it. As far as MegaOmega3 is concerned, it primarily has a beneficial effect on cardiovascular diseases. Sincerely, Professor Marija Kaštelan, MD I use a computer at work non-stop. I noticed my eyes were dry, so I started using artificial tears. If the irritation does not calm, I also use Vizol drops. I was wondering if this is OK? I don't have time to visit an ophthalmologist. You can use artificial tears all the time, and occasionally Vizol drops as well, but no longer than three days. If longer treatment is necessary, you can use them again after 3 to 5 days. If the redness persists or some other symptoms appear, you should definitively see an ophthalmologist. Sincerely, Maša Mikuličić, MD I am 76 years old. My ophthalmologist advised me to take lutein in addition to my treatment for glaucoma because a cataract has begun to develop. The pharmacist gave me Oculoplus capsules. How long should I take them? Can I take them with my medication for high blood pressure and fat? You can freely use Oculoplus capsules with your other medication. For the prevention of cataracts, it is recommended to take Vitalia oculoplus capsules twice a year for three months, bearing in mind that one treatment has to be taken during the summer months. Sincerely, Maša Mikuličić, MD I underwent laser dioptre correction 5 years ago. In the meantime I gave birth twice. My nearsightedness returned, and is now -5 in both eyes. I had surgery at a private clinic, but was offered no information, in addition to their poor customer service. Could you please tell me what is the reason for vision deterioration? I am afraid to undergo surgery once again. Can I use lenses again? Since I do not have access to your medical documentation, it is difficult for me to determine the cause of your problem. The precondition for a patient to undergo laser dioptre correction surgery is that the dioptre has not changed for minimum of 1 year. I hope this was true in your case as well. As far as pregnancy is concerned, there is a small possibility of hormones influencing the change of dioptre. You can use contact lenses. Sincerly, Maša Mikuličić, MD I am 27 years old. For the last couple of years I have experienced migraines during my menstruation, which exhausts me completely. Could you recommend a dietary supplement that would reduce the severity of my headaches? I would like to get pregnant so I am avoiding medication. I avoid chocolate, coffee, cheese, processed meat, alcohol, and I do not smoke. I have heard that magnesium, omega-3 and B vitamin can help. What do you recommend? Everything you mentioned can contribute to severe headaches, and it is also believed that omega-3 and magnesium can reduce the intensity of headaches. Numerous women experience severe headaches during their menstruation, and fight them in a number of ways. Avoiding stressful situations, and quiet, calm surroundings can have a positive effect on headaches. Finally, if nothing of the above reduces pain, the only thing left is treatment with medication. Sincerely, Prof. Alemka Brnčić Fischer, MD I am 55 years old. For the last couple of years I have been suffering from vaginal dryness, which causes frequent inflammations (according to my gynaecologist). An additional problem is that vaginal tablets cannot dissolve in my vagina, and I feel this is why my infections cannot be cured. I wonder if Lactogyn vaginal capsules could help me? Do they dissolve more easily? As menopause approaches, and especially in postmenopause, vaginal dryness occurs as a result of oestrogen loss. Lactogyn vaginal capsules could help you, but the oral form of Lactogyn has the same effect as its vaginal form, provided that you use it for two months, which is recommended for achieving optimal stabilization of vaginal flora. Sincerely, Prof. Alemka Brnčić Fischer, MD My husband and I are in our late thirties. We have been married for two years, we do not use any contraception, but I cannot get pregnant. We underwent diagnostic testing, the spermiogram is regular, as well as my results. My husband quit smoking, stopped drinking alcohol and I am thinking how to 'improve' my reproductive system. Could you recommend anything in addition to a healthy diet and moderate physical activity? I have read about omega-3 as a high-quality supplement for many conditions, about probiotics.. But I am not sure exactly what can help us. Nowadays it is considered that there is a conception problem if a woman does not get pregnant within a year of continuous unprotected intercourse. I recommend that you continue with tests, and if they confirm the conception problem, I suggest you try the method of assisted insemination. Healthy diet, no smoking and alike are all praiseworthy life habits, but in your case assistance should be sought in a specialised fertility clinic. Sincerely, Prof. Alemka Brnčić Fischer, MD I am 63. I had breast cancer surgery 10 years ago. I underwent chemotherapy and radiation. I have regular follow-up exams and for now everything is fine. Since my surgery I haven't consumed milk, only fresh cow-milk cheese and occasionally yoghurt. Recently I have had a craving for milk, but when I drink it I experience strong intestinal pain, bloating and gases. I didn't have such problems 10 and more years ago. I haven't changed anything in my diet. Could probiotics help me? Your problems are probably caused by a deficiency of an enzyme secreted by the intestinal mucosa, whose purpose is to decompose milk sugar (lactose). Mild damage of intestinal mucosa cells is possible as a result of chemotherapy. People with such symptoms can often freely consume fermented milk products because the bacteria that ferment milk and turn it into yoghurt, cheese etc. use the very milk sugar for their functions, so cheese, for example, does not contain it. You can certainly try to take the Normia probiotic because the bacteria in the preparation will partially "consume" lactose, alleviating, and possibly completely eliminating your symptoms. The symptoms will probably depend on the amount of milk, so we can assume that smaller amounts of milk won't cause any problems for you. Sinerely, Goran Hauser, MD I am 55 years old. I don't smoke. I have rarely consumed alcohol. Two weeks ago I visited my family doctor because of heartburn and abdominal pain. I was directed to take laboratory tests, upper abdominal ultrasound, stool test for blood and examination with a gastroenterologist. Since I have to wait for my examination with the specialist for almost 2 months, my doctor suggested I do stool analysis for Helicobacter pylori at a private laboratory. The test result was positive, so she prescribed 2 antibiotics (Amoxiciklin and Mikacin) for 7 days and 40 mg Nexium for a month. After only 2 weeks, I'm already feeling better. However, I'm afraid I might have infected my wife, even though she is not experiencing any problems. If I have infected her, can I get reinfected by her? Can a person be immune to these bacteria? While I was taking antibiotics and for a week after treatment, upon recommendation from a pharmacist I started taking Normia capsules, so this time I handled the antibiotics more easily, without intestinal problems (pain, diarrhoea). Members of the same family are often simultaneously infected (infection is transmitted by contact), so the transmission from one family member to another is possible, but is not always the case. This happens very often, and after a family member is cured, new infection is possible because immunity that develops after an infection is short-lasting and inefficient. After receiving the planned treatment (at least two weeks after the last Nexium tablet), it is important that you check the treatment success and repeat it if it was unsuccessful. Normia is certainly a good supplement for infection treatment because it reduces the side effects of antibiotics, and probably increases treatment success. Sincerely, Goran Hauser, MD I am 60 years old. I have a typical body build. I do not smoke, and I occasionally consume a small amount of wine (1dcl). I have a sweet tooth. I had gastric problems 25 years ago as a result of Andol treatment. Since then I have paid attention to my diet, which is diverse and mostly Mediterranean. However, a month ago I was away on a trip, and for 5 days I was eating heavy food, grilled, fried and greasy. I experienced heartburn and heaviness in the abdomen. The ailments subsided until Easter, when I consumed heavy food again. Since then I have experienced a light burning sensation in the abdomen towards the oesophagus, and frequent belching. I feel as if an air bubble comes out of my stomach. It has no odour. When I have a stronger burning sensation, I eat toast, and it goes away. Now I pay a lot of attention to my diet; small meals, cooked, well-chewed... Sometimes I cannot sleep well due to the discomfort in my stomach. I'm afraid to take medication for reducing stomach acid because I have osteopenia, and this medicine 'draws' calcium out of the bones. If my doctor sends me for gastroscopy I will have to wait for several months. What should I do in the meantime? Should I do a stool analysis for Helicobacter pylori? This test is more affordable than the breath test. If the test is positive, could my doctor prescribe me a treatment? I am very concerned. Given your ailments, it is very likely you have gastritis with oesophagus inflammation (GERB). You can choose a treatment with medication for reducing stomach acid. For persons up to 50 years of age without symptoms of weight loss or anaemia, it is possible to prescribe the medication "offhand" and if efficient, it can be considered as both diagnosis and treatment. However, for persons over the age of 50 it is necessary to perform gastroscopy for an underlying more serious stomach or oesophagus disease. In Rijeka you have to wait 30 days for a gastroscopy, so I don't believe you will have to wait longer in Zagreb. If you experience ailments impossible to endure while waiting for your examination, you can start taking the medication for reducing acid until the examination. The issue of calcium and medicine is not that important, certainly for persons who are experiencing difficulties and who need this medicine. Sincerely, Goran Hauser, MD I am a 42-year-old professional driver. On longer journeys I sometimes feel a burning sensation and discomfort in the eyes. My eyesight is good and I have regular check-ups. I sometimes use artificial tears, and if the redness does not go away, I take Vizol drops. I am usually unable to contact my ophthalmologist immediately, and always two bottles with me. What do you advise? In your case the underlying problem is probably a mild irritation of the conjunctiva, which is induced by air-conditioning and long driving when blinking is less frequent. Specifically, air-condition (dry air) and rarely blinking affects the quality of the tear film. During the long drives you can use artificial tears to avoid eye irritation. If your eyes are still red - then you can shortly use Vizol drops. Vizol constricts the blood vessels in the conjunctiva of the eye thus making them white. If the redness persists, or new symptoms occur, I recommend an ophthalmologic examination. Sincerely, Maša Mikuličić, M.D. I have been taking Timalen drops for treating glaucoma for several years. I am 70 years old. I have regular check-ups. My ophthalmologist says everything is in order. I have recently read an article on lutein and its protective effect on the eyes. Would your Oculo plus help prevent complications of elevated intraocular pressure? Lutein helps prevent the progression of degeneration of yellow spots and cataract but there is no evidence that lutein affects the prevention or progression of glaucoma disease. What I suggest is to adhere to your prescribed therapy and have regular check-ups with your ophthalmologist. Sincerely, Maša Mikuličić, M.D. I am 61 years old. I work at the computer for more than 6 hours a day. I have light eyes. I wear glasses for far-sightedness. During a regular check-up my ophthalmologist discovered that my eyesight had deteriorated in one year. He recommended Vitalia oculoplus capsules. I take one a day. Should I take them constantly to prevent cataracts? For the prevention of cataracts it is recommended to take Vitalia oculoplus capsules twice a year for three months, bearing in mind that one treatment has to be taken be during the summer months. Sincerely, Maša Mikuličić, M.D. I came across MegaOmega 3 on your website, a preparation which has a beneficial effect on the cardiovascular system. My mother (65) takes it for 3 months, takes a 3-month break and then takes it again for months. I do not know whether this amount of omega 3 is enough for prevention because she does not eat any fish. What can you recommend as a natural remedy? Vitalia MegaOmega3 is excellent for the prevention of cardiovascular disease and she should continue taking it. If the values of cholesterol and triglyceride are normal, I would not recommend any other preparations, only a proper diet. Sincerely, Sandro Brusich, M I am 62 years old. I am 170 cm tall and weigh 66 kg; my waist circumference is 86 cm. Apart from mild rheumatic complaints I am in good health. I have noticed that my blood pressure has become slightly elevated during the last two years. I previously had low blood pressure, and now it is over 130/90. However, in extremely stressful situations it can go up to 140/100. I feeling pressure in my ears and warmth in my cheeks. With breathing exercises and sometimes Valeral drops I calm down and the pressure drops to 130/90. I exercise every day (muscles strengthening and stretching), race walk and try to eat healthy. I wonder if I'm at risk of heart disease? It is difficult to assess your overall cardiovascular risk because I do not have enough data. It is normal for women to have high blood pressure 5-10 years after menopause, when it becomes equal to that of men. Your body weight is normal, waist circumference does not exceed 88 cm, blood pressure is usually not high, you exercise regularly, all of which suggests that you do not face elevated cardiovascular risk. Additional risk factors that should be taken into account are smoking, genetic predisposition (a close family member who had a myocardial infarction or a stroke - men younger than 55 and women younger than 65), blood fat levels, diabetes, proper nutrition. Sincerely, Sandro Brusich, MD I am 70 years old. I have been taking Pigrel tablets for three years, ever since I almost suffered a heart attack. In the meantime I lost weight, changed my diet, became physically active and started taking medication to stabilize my blood pressure. Do I have to take the anticoagulant for the rest of my life? I tolerate it well. As a part of a preventive examination aimed at early discovery of bowel cancer, I have to do a stool test to see if there is any bleeding. I mustn't take my medication for 3 days; will that harm me? According to the guidelines of the European Society of Cardiology which provide the framework for Croatian guidelines for treating heart patients, Pigrel tablets are prescribed for a year after the patient suffers acute coronary syndrome (possible heart attack), after which the treatment can be stopped. Cardiologists often do not tell their patients to stop taking them if they tolerate them well because there are no conclusive studies on their effect after one year, or whether it is better to take it or not. In your case, I would stop taking it because I think you are not a high-risk patient. Sincerely, Sandro Brusich, MD I am 50 years old. Ever since I was young I have had very dry skin on my hands, elbows and heels. My heels are chapped and there are longitudinal cracks. My dermatologist always gave me cortisone ointments which would heal the cracks, but they would reoccur every time I stopped applying the ointment. The pharmacist recommended your calendula balm. Can I use it daily and for a long time or should I make breaks? You can use calendula balm every day, and it is especially efficient if you apply it several times a day and as often as possible. Sincerely, Professor Marija Kaštelan, MD A week ago I underwent an electrocoagulation treatment and had about 10 fibroma removed from my face and neck. Now there are scabs. Will I have scars? How does fibroma occur? Can I sunbathe? Fibroma are benign tumours of the connective tissue. After a electrocoagulation procedure they may leave small scars, depending on the depth of the procedure. After the changes heal, you can sunbathe. Sincerely, Professor Marija Kaštelan, MD My 16-month-old daughter still wears diapers. When changing her I always administer JGL's children's ointment. Sometimes she has slight redness, a rash that goes away after a couple of days. When this happens I change her more often and apply a thicker layer of the ointment. I noticed at the pharmacy that you also make a children's paste. Is that also intended for multiple daily usage? The children's paste can be used several times a day, but it is very thick and hard to wipe off the skin. For multiple daily usage I would recommend children's ointment with balm. Sincerely, Professor Marija Kaštelan, MD I am about to take a long trip to India with my wife. I would like to pack some probiotics, but I do not know which ones. The pharmacists suggested Prolife capsules to my wife and Normia capsules to me. What is the difference? Which one is more effective for diarrhoea during travel? Both Prolife and Normia have a similar effect, but given the convenience and the possibility that, due to various factors, diarrhoea can still occur, I would go with Normia ORS packets. They contain packets of oral rehydration salts (ORS) and packets of Normia probiotics. With diarrhoea it is necessary to compensate for lost fluids and electrolytes, which will be achieved by taking a solution of ORS. Packets of the Normia probiotics will contribute to a shorter duration of diarrhoea and a faster recovery of intestinal flora. Since you are travelling for a longer period of time, I think it would be helpful to take more than one pack of ORS Normia. I would also recommend medical charcoal, Carbo medicinalis, which should be taken immediately and according to the instructions, every two hours after Normia packets in case of diarrhoea. Do not forget that eating unpeeled fruit and raw, only washed vegetables and drinking anything other than packaged beverages certainly leads to disease... Sincerely, Goran Hauser, MD, PhD I recently went skiing and I got diarrhoea, so instead of enjoying the winter wonderland I starved and spent three days eating nothing but toast, crackers, and tea. A friend offered the Normia probiotic capsules. I took them for 3 days (he only had 6 capsules). Digestive disturbances stopped. I wonder if I should still do some tests. Would it be advisable to do a course of Normia capsules for a longer time? You probably contracted the acute or so-called traveller's diarrhoea. The usual treatment is exactly what you did (tea, toast, etc.), and probiotics can certainly be beneficial, which you yourself have noticed. They are usually taken for about 10 days during the acute stage, and now I think that there is no need for them unless you still have episodes of diarrhoea. Also, if the symptoms have stopped, further tests will not provide any new information. Sincerely, Goran Hauser, MD, PhD I am 45 years old. Three years ago I underwent surgery for perforated stomach ulcer and bleeding. On this occasion the doctors removed two thirds of my stomach. Since then, I have been eating smaller meals several times a day and haven't had any stomach problems. However, after lunch I feel tired, sleepy and have to sleep for an hour. I can afford that because I have a private company; after the nap I can continue to work until the evening. The other day I mentioned this to my doctor who told me that after eating I should not 'be horizontal' because it could extend the hiatal opening. I was really scared, because GERD is a serious condition. What is your advice? The feeling you get after eating is the body's way of adapting to the new physiology, that is, to the fact that you have lost a substantial portion of the stomach. Due to the rapid influx of food into the small intestine and the fact that normal processing in the stomach is not possible, sometimes the body reacts the way you have described for 1-3 hours, depending on the type of food. This is due to an increased secretion of insulin and decrease of blood sugar levels. For some people this may take on more drastic forms and lead to full-blown hypoglycaemia with sweating, palpitations and fainting. As for "being horizontal": your doctor is right, because it may allow the food to re-enter the oesophagus. However, if you do not have a sense of acid reflux when you lie down, I think you need not fear GERD. So, if being tired after a meal is a problem, but you do not have a burning sensation and do not burp when you lie down, I think you can continue with the usual practice of "being horizontal". Sincerely, Goran Hauser, MD, PhD I recently took antibiotics for a sinus infection. The doctor also recommended a probiotic, Normia capsules. I tolerated the antibiotics with probiotics well (I always used to have mushy stool or diarrhoea by the end of the treatment). I am writing because of my 12-year-old son who very often has purulent angina and takes antibiotics. Should I give him Normia? How many times a day and for how many days? I noticed several forms in the instructions. Which one is best suited for a 12-year-old? Antibiotics have many positive characteristics, but also lead to some undesired side effects. As for the digestive tract in children, these side effects occur in up to 30% of children taking antibiotics, while this percentage is lower for adults. He should definitely take a probiotic from the beginning of the antibiotic treatment and for two weeks after the treatments (this is the approximate period in which antibiotics can cause side effects). The recommended dosage is 1 Normia tablet a day, as indicated in the brochure. Sincerely, Professor Mladen Peršić, MD My four-year-old daughter often has bouts of intestinal infections. She has been going to kindergarten since infancy. I suppose that's where she contracts diarrhoea. I noticed Prolife products (capsules, liquid, pastilles) on your website. Our paediatrician always recommends a diet and a probiotic, but never specifies which one, so I buy them according to the recommendation of my pharmacist. I would like to know which one you would recommend and why. Which dosage should she take and for how long? Various probiotics have proven to be beneficial for acute diarrhoea, especially if it is caused by the Rota virus. However, in your situation I would recommend your daughter take probiotics for a longer period of time since the child is "prone" to diarrhoea; in other words, the intestinal flora is obviously disturbed and for this reason she is more prone to recurrences of the problem. Clearly, it is necessary to test her for some other diseases, such as celiac disease, etc., which should be done by your paediatrician. For a more precise diagnosis, the doctor must take an exhaustive anamnesis, thoroughly examine the child (percentile curves ...) and if necessary order laboratory tests. have already given a partial answer to your second question about the probiotic, but Prolife has proven to be very effective! recommend your daughter take an ampoule of Prolife every morning for 6-8 weeks. Sincerely, Professor Mladen Peršić, MD I am 60 years old. My mucosa and skin are dry. For intimate hygiene I use Lactogyn gel, but only around the anus, because I am worried that it might further dry out the vagina. I think that most bacteria come from the colon, so if I wash the area after a bowel movement with Lactogyn and take a shower with hot water, I hope I have cleaned my intimate parts properly. Or, am I wrong? Lactogyn liquid soap for intimate care will not dry out the vagina because of its degree of acidity (pH) and can be safely used for the overall intimate hygiene. It is important not to rinse the vagina (the so-called vaginal shower) because then you also wash out the beneficial bacteria. Sincerely, Alemka Brnčić Fischer, PhD A year ago I was diagnosed with CIN1. Since then I have had several Pap tests. A year ago my vaginal smears were positive for low risk HPV. I recently had a colposcopy. The doctor told me there was no need for a biopsy, but he did recommend crio therapy. Could you explain what this means? I have been in a serious relationship for six months. We use a condom. How long do you think we should use it? In 99.7% of all cases the HPV virus is the cause of premalignant cervical changes (the so-called CINs). CIN 1 is the lowest degree of change and usually only monitoring is suggested (especially in young women). Doctors also recommend colposcopy, based on which your doctor concluded that there is no need for a biopsy because the results of the test probably indicate a low degree of change consistent with CIN. A condom is recommended as long as their is a change in the Pap test. Crio therapy is a procedure used to freeze the surface of the cervix and destroy the tissue. The problem with crio therapy is that it does not yield a sample for a histopathological analysis. Sincerely, Alemka Brnčić Fischer, PhD My sister is 30 years old and has a cyst on her pituitary. A year and a half ago she gave birth to her son. My sister had to express milk for six months because the baby would not nurse. She then started feeding him with formula. She soon noticed that the child was developing slower than other babies his age. He is still not walking. He sits on his own and registers object and persons. Could my sister's pituitary condition have caused the child's slow growth and development? She regularly takes him to the paediatrician for check-ups, they ran some additional tests, but no one has explained the child's condition or given a prognosis to my sister. Your question is too complex for me to answer this way. In any case, your nephew needs a more complex and most probably hospital treatment (with a gastroenterology subspecialist). Sincerely, Professor Mladen Peršić, MD I would like to ask you for advice. I am 28 years old. I have regular gynaecological examinations and I have never had any problems. However, some six months ago I started noticing an increased yellowish-white thick discharge with a slight odour, but not accompanied by any itching. The last time I went to see my gynaecologist, which was 4 months ago, I mentioned this to her; she told me there was no inflammation, but that I may use Lactogyn for 2 months to regulate vaginal flora. I would like to know if a regular examination always shows whether there is a fungus and whether this is tested with a Pap smear. I do not know whether I should use Lactogyn since I take yoghurt and kefir daily in large quantities (minimum 0.5 L). Also, I thought I might do a course of Canesten, but I do not know if that is advisable since it has not been determined that I have a fungus. Thank you in advance. If the vagina is colonized with a considerable amount of fungi (usually it is Candida albicans), this is detected during the part of a regular gynaecological examination performed with a speculum, when the doctor notices patchy white deposits with no odour. Obviously, this was not your case, or the doctor would have told you so. Pap tests also routinely analyse the degree of purity and are used to detect increased concentrations of fungi, which is indicated in the result. The intake of yoghurt and kefir in no matter which amounts does not help establish the balance of vaginal flora because they do not contain probiotics that colonize the vagina or have an effect on its flora, which is why doctors recommend Lactogyn. If you gynaecologist has not prescribed it, I would not recommend the use of Canesten for prophylactic purposes. Sincerely, Alemka Brnčić Fischer, PhD I am 50 years old. For over 5 years I have had continuous problems with condylomas, despite treatment (podophyllin, electrocauterization). I have not been in any relationships during all this time, as I am afraid I would pass it on to my partner, who would pass it back to me, circulating the infection back and forth. That led me into a state of apathy. This is my latest attempt to try to solve this problem. If you still have a visible manifestation of clinical disease, condylomas should be treated with either electrocauterization, cryotherapy, or by applying some local preparations. New local therapy includes immunomodulators like imiquimod. Regarding the transmission of infection, use condom during sexual intercourse. Sincerely, Professor Marija Kaštelan, PhD My 2-year-old son still wears diapers. He has diaper rash more and more frequently, although I regularly administer your Baby ointment. Should I apply Pantexol ointment or cream on his behind? You can also use Pantexol cream and ointment, and if changes persist, contact your doctor for further treatment. Sincerely, Professor Marija Kaštelan, PhD I have been suffering form psoriasis since childhood. I am taking cortisone ointments since they are the only thing that helps me. I am thinking about pregnancy, because I am already 30 years old, but I am afraid. Can this local therapy harm the developing foetus? What is the probability that the child would suffer from psoriasis too? In my family I am the only one with psoriasis. When it flares up, it virtually covers my entire body. I live on the coast, I sunbathe and feel fine during the summer. Besides corticosteroid topical preparations, psoriasis can be treated with other topical preparations such as calcipotriols, retinoids, etc. Systemic drugs can be used for more severe forms, naturally under supervision of a dermatologist. It is wise to use neutral preparations like Pantexol lotions, ointments or other similar preparations. The application of local corticosteroids is possible during pregnancy. However, any form of treatment, including topical preparations, must be supervised by a physician. Sincerely, Professor Marija Kaštelan, PhD I have been taking Timalen glaucoma eye drops for 5 years. I have regular check-ups with an ophthalmologist, but since the doctor is not talkative, I do not dare ask about an over-the-counter preparation which might help me, instead of a prescription drug. I am wondering about Oculoplus capsules, which my husband is using as recommended by a doctor, since he has macular degeneration. Would that work for me since I am 78 years old? Regular checks for glaucoma are essential. As far as Oculoplus capsules are concerned, they contain lutein and zeaxanthin, which may reduce the risk of occurrence and progression of macular degeneration and senile cataracts. Feel free to take them. Sincerely, Ophthalmologist Maša Mikuličić, MD I am 63 years old. For the last several years I have occasionally had a sensation of dry eye. I still work with on a computer. Should I take artificial tears daily, or as needed when I feel this dryness? I occasionally use Vizol drops. I recently visited an ophthalmologist. He prescribed new lenses for my glasses, but paid no attention to eye dryness. It would be good to use artificial tears every day because of the type of work that you do, especially in winter when we spend most of the time in dry, warm areas. Sincerely, Ophthalmologist Maša Mikuličić, MD A gastroenterologist advised me to take a breath test after gastroscopy and a threefold treatment of Helicobacter pylori. I still take Normia capsules (it was recommended that I take them for 6 weeks). I wonder if this test should be done after treatment with probiotics, or whether I can do it right away? I feel fine otherwise. The urea breath test should be administered two weeks after completing therapy with a proton pump inhibitor. This is a drug which, in contrast to the two antibiotics, is taken for 4 weeks. After this therapy, wait for at least two weeks before having the test. Normia will not affect the result of urea breath test. Sincerely, Goran Hauser, PhD I am 25 years old. I am healthy, I do not smoke, and I eat a healthy diet. I engage in recreational sports. I have had an unpleasant breath for several years. I avoid people at work and elsewhere. If this continues I will become a lone wolf, because I do not know how to help myself. What do you recommend? Bad breath should primarily be reported to a dentist. If there is nothing wrong with your mouth cavity, the next step is to undergo gastroscopy. Unfortunately, sometimes all these tests remain inconclusive. I am not sure that probiotics would help, especially if a specific cause has not been found. Sincerely, Goran Hauser, PhD I am 55 years old. My last physical suggested that I have a "fatty liver". I had no severe illnesses, and I rarely took any medications. My test results are regular. I do not have any digestive problems. I consume a healthy diet, I eat regular meals, and enjoy Mediterranean cuisine. In regards to alcohol I consume only wine on occasion (at a family celebration), but not more than 1 dcl. I found that the fatty liver is a condition often associated with chronic alcoholics. Can you explain what this means? Do I need to get additional tests done? Fatty liver is not solely related to excessive alcohol consumption. It is actually common in people who do not drink alcohol, or those who consume small amounts. Another name for the disease is non-alcoholic steatohepatitis (non-alcoholic fatty liver disease, abbreviated - NAFLD). Possible causes are numerous, and are often associated with excessive weight, abnormal blood lipid values, diabetes, or viral liver disease. If routine liver probes are normal, no further tests are necessary, but your weight and blood lipids should be checked. In general, the disease is relatively harmless and does not lead to serious consequences, unless caused by alcohol or viral disease. Sincerely, Goran Hauser, PhD After hip surgery, I was diagnosed with thrombosis of the left thigh. I have been taking Pigrel pills for a year. I have regular follow-up exams with a phlebotomist. I no longer feel pain, just a tightening sensation in the leg. Will I eventually be able to stop taking Pigrel? Is there a natural way to boost circulation? Given that the thrombosis was induced by surgery and rest, and that you had no complications, it is likely that you will eventually be able to terminate therapy. But this decision must be made by your doctor, depending on your risk for complications and on ultrasound findings of the lower leg. The circulation is stimulated by exercise - walking, and other measures recommended by your phlebotomist who is more knowledgeable about the indicated treatment (hot/cold baths, elastic stockings, etc). Sincerely, Sandro Brusich, MD My mother suffered from angina pectoris. Several years after her diagnosis she suffered a myocardial infarction after which she recovered. She died from a brain haemorrhage two years later. I am 62 years old. I have been on treatment for high blood pressure for the last five years, which has mostly remained within normal limits. However, I am worried about the genetics and whether I am prone to a heart attack or a brain stroke, which my the mother had. Is this fear rational, or I am only panicking? Genetics is one of the factors which increase the risk of disease, but if other risk factors are regular (blood pressure, lipids, smoking), then the overall risk is low. The risk can also be determined from relevant tables, so please consult your doctor about it. Sincerely, Sandro Brusich, MD I am 45 years old. Six months ago I was prescribed Atenolol tablets to slow down my heart rate. The heart rate has stabilized. My blood pressure is slightly lower than before the therapy. Can that be the reason why I feel so tired and sleepy? Do I have to take it forever? Atenolol and other beta-blockers can induce a feeling of fatigue and drowsiness, especially if blood pressure is lower. If the dosage is small (12.5 - 25 mg) you doctor may discontinue the medicine, and in case of a higher dose, the dosage should be reduced by half. Discontinuation of the drug depends on several factors: on whether the rate is normal or accelerated - the decision about discontinuation depends on the symptoms - it is a symptomatic therapy. If there is some underlying heart disease like angina pectoris, heart failure, it would be better to continue the treatment with this drug. Sincerely, Sandro Brusich, MD I am three months pregnant. I became pregnant with CIN with 1. Would it help to take Lactogyn oral and vaginal capsules? Is HPV infection dangerous for a child? Can a child be infected during vaginal delivery? Is C-section advised in this case? Lactogyn has no effect on cervical dysplasia (CINs). Infection with HPV is not dangerous for the child and does not require delivery by C-section. Sincerely, Alemka Brnčić Fischer, PhD I am prone to vaginal candidiasis. As instructed by my gynaecologists I am on therapy supplemented with Lactogyn capsules, but inflammations persist despite that. So, less than 2 months since my last inflammation, I am again experiencing discomfort, burning sensations and mild itching. I took Lactogyn vaginal and oral capsules on my own, because I have to wait for three weeks to be examined by my doctor. I am debating an anti-candida diet. What do you recommend? Infections of the lower genital tract, which include vaginal candidiasis, are one of the most common reasons for gynaecological visits. The reason is that they recur frequently, while treatment requires patience and persistence. Lactogyn can definitely help you before your gynaecological examinations, but you have to see a doctor, since this may be caused by another infection. Sincerely, Alemka Brnčić Fischer, PhD I am 30 years old. Two years ago I was diagnosed with an enlarged pituitary gland. Tumour was eliminated as a cause. My menstrual cycles are regular but I cannot get pregnant. I have been married for more than 3 years. Can you tell me whether the pituitary gland is causing my infertility? Unfortunately, I cannot determine the reason for your infertility in this manner. It is necessary to perform a number of diagnostic procedures which would determine the reason for your infertility. You should definitely contact your gynaecologist who should run the necessary tests. Sincerely, Alemka Brnčić Fischer, PhD My three-year-old daughter often has a stuffy nose, with a profuse flow of mucus. It is usually not accompanied by fever, which is around 37°C. This lasts about a week. I rinse her nose with a saline solution before bedtime and apply the Aqua Maris nasal spray 3 times a day. During this period she usually eats poorly, so I worry that her immunity will be impaired. How can I help her? It is possible that your child has allergic rhinitis, or more frequently, an inflammation of the third tonsil, which requires an examination by a paediatric allergist and an ENT specialist. Sincerely, Professor Mladen Peršić, PhD We have two boys, 4 and 6 years old. They often catch colds, they have a runny nose, sore throat, and occasionally earache. They had strep throat on several occasions. Usually they both get sick. They have a good appetite, and their development is normal. I have a feeling that infection spreads in kindergarten, but I cannot exclude the grandparents as possible sources of infection. My parents take care of the kids a lot. I noticed that they are frequently sick and I am worried we may have a "bug" circulating among members of our household. Would it help if they had throat and nasal swabs? My husband and I have done this, and the results are OK. I think it is common to have frequent viral infections at their age, especially in kindergarten children. The possibility of catching a cold from the elderly is small, but it will not hurt to make throat swabs like you suggested. I reckon that this is not an unusual or dangerous situation for the health of your children. Sincerely, Professor Mladen Peršić, PhD A few months ago I donated a kidney to my 12-year son. The surgery went well, and so did postoperative recovery. He had kidney problems since the birth. He emotional development is good, he is an excellent student, but his growth is slow, his height now corresponds to 6-year-old boys. He has not been on dialysis. Laboratory tests of blood, urine, creatinine, SE have improved immediately after surgery. I wonder whether he will grow. There is a chance that this is the case of so-called Renal nanism - i.e. all chronic diseases, including chronic kidney disease can lead to slower growth. If the situation has improved, it takes time to see whether growth will accelerate to reach normal height. Otherwise other causes of slow growth have to be looked into, which is, in my opinion, less likely. Sincerely, Professor Mladen Peršić, PhD My six-year-old son sometimes has diarrhoea during respiratory tract infections. In addition to a specific diet he also took Prolife suspension, which had a beneficial effect. Now I see that you have a new probiotic - Normia powder. Is it better? Is it recommended for acute diarrhoea? Or are those probiotics only good for protecting intestinal flora during an antibiotic treatment? The basic answer to your question is WHY CHANGE SOMETHING THAT IS EFFECTIVE? But curiosity never ends, so, here is an additional remark. Respiratory infection, and the drugs that are often, too often, prescribed in these cases cause changes in intestinal flora. This is why taking probiotics is very important for the prevention or treatment of this imbalance (disorder) when administered later. Even though we are trying to establish specific probiotics, it is usually very difficult or simply theoretical. Prolife was effective for your child, so it should not be replaced. Normia is a good-quality probiotic (combination of probiotics) and can be used in this case as well, so if necessary, you can try giving your son Normia for preventive/treatment purposes. Sincerely, Professor Mladen Peršić, PhD My five-year old daughter is prone to airways infections. I think it has something to do with kindergarten. A sore throat and/or runny nose are often accompanied with diarrhoea. Is there a virus that simultaneously attacks the digestive system as well? Would it be good to give her probiotics when the cold starts to prevent diarrhoea? Viruses can cause respiratory and digestive difficulties. Respiratory symptoms are often treated with medicine (unfortunately more and more with antibiotics) that can cause further problems in the digestive tract, due to an imbalance of intestinal flora. This is why it is necessary to take probiotics which can also improve respiratory symptoms (even if digestive symptoms are not present). Hence, your consideration and inclination for preventive use of probiotics in the course of respiratory illnesses is entirely justified. Sincerely, Professor Mladen Peršić, PhD I have a 10 month-old son whom I breastfeed twice a day. He always nurses so quickly that milk sometimes flows through his nose. He is later bothered by pieces of sour milk stuck in his nose. Can I apply Aqua Maris baby drops to moisten his nose before the cleaning? Otherwise he cannot breathe or sleep. There are no contraindications to applying Aqua Maris nasal drops before cleaning. However, I would advise you to slow down feeding (if possible) or perhaps feed the child smaller quantities more frequently, because the child probably has a gastroesophageal reflux, which is still physiological at that age, but can lead to the "problems" indicated. Clearly these disorders require no special diagnosis. Sincerely, Professor Mladen Peršić, PhD I am breastfeeding my 6-month old daughter. I had a sinus infection and was prescribed the antibiotic Amoxil. The doctor advised me to take the Normia probiotic. Will this treatment affect the child? I think your doctor gave you great advice since the side effects of antibiotics can be prevented. A possible effects on the child can only be positive. Sincerely, Professor Mladen Peršić, PhD My 12-year-old son lately complains of pain in his knees. He says that they are not connected with strain (school exercise). His knees are not swollen. We have older family members suffering from rheumatic diseases, so I was instantly worried about him developing the same problem. On the other hand, I heard that children can feel pain in the legs as their grow. What should I do? Pain in the legs (joints) in children can occur during growth, and we call them growing pains. But given the family history, I think it is necessary to make an appointment with your paediatrician to conduct some basic tests. Provided laboratory tests are not fine or if the pain increases, contact a paediatrician at the rheumatology department in a children's hospital. Sincerely, Professor Mladen Peršić, PhD My husband who is 40, spends more than 10 hours a day in front of the computer. At home, his leisure time consists of watching TV, which, I believe, puts additional strain on the eyes. For now, he has no problem with sight, he does not wear glasses, but I think he should protect his eyes. What is the best thing to use, vitamins, artificial tears...? What is your opinion? Your husband is at an age when short-sightedness can occur, but it is also necessary to control ocular pressure. I definitely recommend a complete ophthalmologic examination. The examination will show what your husband really needs. Sincerly, Ophthalmologist Maša Mikuličić, MD I take medication for glaucoma. A cataract has begun to develop in my right eye. I am 62. Which dietary supplements can I take to prevent complications of glaucoma and to slow down the development of cataracts? I recommend regular ophthalmological examinations as well as adherence to the prescribed therapy. To slow down cataracts you can take formulations specially prepared for the eyes. I would advise taking Mega Omega 3 for 3 months, followed by a 3 month break and permanent use of Oculoplus capsules. Sincerely, Ophthalmologist Maša Mikuličić, MD I am 30 and 6 months pregnant. Everything is fine for now. However, my close friend, who gave birth several years ago said that due to straining during childbirth her eyesight got worse. We are both short-sighted, but my case is a little worse - I have -5 in one eye, and -6 in the other. Can I avoid a deterioration of my eyesight? I would recommend a fundus exam (dilatation of pupils) to detect potentially weak spots on the retina. Sincerely, Ophthalmologist Maša Mikuličić, MD I am 60 years old. I have been farsighted for 10 years. At first, I used glasses for reading (my arms were "too short"). Now I have three pairs. I use one pair for reading, another for working on a computer, and the third pair for watching TV. I do not wear glasses only when I am outside, or for simple household tasks. I wear them all day, I take one pair off, then I try to find the other pair and so on, which is why I would like to simplify my life. I was wondering if 'combined glasses', with 3-dioptre lenses can solve my problem, whether soft lenses are a better solution or if the dioptre removal operation would be the best option. Please explain what would work best for me. I think at your age the best thing would be to get progressive glasses. You can see well with them at all distances. If you want to remove dioptre, your lens would be removed in surgery, and replaced by an artificial multifocal lens, ensuring good eyesight for all distances. But prior to surgery, you have to undergo a preoperative ophthalmological examination to determine whether this type of lens can be implanted in your case. Sincerely, Ophthalmologist Maša Mikuličić, MD Upon advice of an ophthalmologist and due to my advanced age, I take lutein for preventive purposes. Can I stop taking lutein during the winter as there is no UV radiation, which adversely affects the eyes? Lutein can be taken throughout the year, but since you are taking it for prevention, you can stop taking it for a while. Sincerely, Ophthalmologist Maša Mikuličić, MD My older sister (70 years old) has been suffering from macular degeneration. Unlike me, she has never paid attention to her diet, furthermore, she smoked all of her life. Despite the problem she persists in her habits. I am very concerned about her condition. My diet is based on Mediterranean food, I take Omega 3 and lutein. I regularly attend medical gymnastics. My eyesight is good for the time being, I wear glasses for farsightedness. What is your opinion about the impact of omega-3 and lutein on eye health? Several studies have shown a positive effect of lutein and Omega 3 on eye health, and in 2008 a major study called AREDS2 was initiated. The study is aimed precisely at researching the impact of lutein and Omega 3 in the treatment of macular degeneration and cataract. The results are expected in 2013 or 2014. Sincerely, Ophthalmologist Maša Mikuličić, MD After a couple of years of ineffective treatment of high risk HPV, I had cervix conization performed a couple of months ago. I am 30 years old. I would like to know whether I now have better chances for pregnancy, as it had not been possible earlier because of the inflammation. Or are my chances smaller because of the operation? The conization was probably performed because of dysplastic cervix changes (CIN 1, 2, 3) caused by high risk HPV. After the removal of the dysplastic changes and a regular Pap smear control upon consultation of your gynaecologist, there are no obstacles to your pregnancy. Sincerely, Alemka Brnčić, MD, DSc I am 66 years old. I have a 'lowered' bladder. The urine often escapes. I frequently feel a tingling sensation in the genital region and thus often use creams (Canesten, Plimycol). Would Lactogyn help me? I was proposed an operation, however, I have not decided yet. My relative solved the problem with exercise. Could you describe in more detail how they are performed? How long is it necessary to exercise to notice an improvement? Exercise can not solve every problem linked to lowered bladder. Exercise assists in solving some milder problems. Your gynaecologist should definitely instruct you on which form of treatment is the most adequate and how it is performed. If the urinoculture finding is sterile and there is no inflammation in the vagina, Lactogyn capsules can definitely help in maintaining the stability of the vaginal microflora. Sincerely, Alemka Brnčić, MD, DSc I am 45 years old. My menstrual cycle is regular. I do not have any health problems, but I suffer from dryness of the vagina. The problem is so strong that I avoid sexual intercourse, which has disturbed my marital relationships. What is your advice? I believe that you previously consulted your gynaecologist, but that the problem persists. Lactogyn capsules might help you restore and establish balance of the vaginal flora, and there is also Lactogyn gel which prevent dryness. Sincerely, Alemka Brnčić, MD, DSc Four months ago, I gave birth by C-section. A very strong dryness of my vagina occurred since the birth, which significantly affects the quality of sexual intercourse. My gynaecological findings are regular. Sexual intercourse has become very painful and unpleasant, and the burning and irritation sensation lasts for long after the intercourse. I am currently breastfeeding. I would like to hear your advice about what to do, because the condition does not improve as time passes. In any case, I recommend you to undergo a gynaecological examination and possibly, if necessary, have bacteriological smears taken. Lactogyn capsules can help you with the renewal of vaginal flora, however, in order to achieve a complete effect, they should be taken for two months. Sincerely, Alemka Brnčić, MD, DSc I am 70 years old. I have had a sensitive stomach my whole life. Whenever I become upset or sad, my stomach begins to hurt, which then perseveres for a while. This also happened a month ago, when I had a major family problem. My doctor prescribed to me Controloc tablets which I take regularly, but I do not feel any improvement. For this reason, I was directed to see a gastroenterologist and be subjected to gastroscopy, because my doctor has suspicions for the Helicobacter bacteria. Some acquaintances of mine took a blood analysis or a breath test, when there were suspicions for this bacteria. If I am prescribed antibiotic therapy, would it be good if I took probiotics? Which would you advise? How are they taken and for how long? According to the symptoms you state, and also considering the fact that Controloc is not helping you, I am not sure whether this is a stomach disease after all, and especially if it is a disease caused by increased secretion of stomach acid. These stress-related problems seem to me more like irritable bowel syndrome. If your gastroenterologist, however, still prescribes you an antibiotic therapy against Helicobacter pylori, I would recommend you to take Normia (probiotic) with your antibiotic in the dose of 2x1 a day for 30 days. Sincerely, Goran Hauser, MD I am 32 years old. During the last ten years I have felt all my problems, but also pleasant surprises 'going through' my heart. If I am upset, scared, made happy or sad, my heart always starts beating. My pulse is usually somewhat more rapid, about 85/min. I performed ECG several times, which was within normal limits, as were the other laboratory findings. I think it would be stupid to take tranquilizer pills in order to calm my heart. Is there a natural way? As of recently, when I feel that my pulse has accelerated, I perform a short breathing exercise (slow, deep breathing) and it helps. I arrived at this spontaneously, no one advised me to do it, and so I would like to know whether what I am doing is correct? All measures which aid to calm you down and relieve you of stress are good and you may freely continue to apply them. It is well known that women have a far greater frequency of physical manifestations as a consequence of stress. They are most frequently manifested as chest contractions, rapid heartbeats, loss of air, numbness of various body parts, stomach pain etc. There are also cases when they lead to clear changes of ECG, which may look similar to the changes in "real" heart patients. Apart from the measures you are already taking, I also recommend a physical activity, which frequently causes stress relief and alleviates the problems. Sincerely, Sandro Brusich, MD I am 55 years old. Ten years ago, I was diagnosed Heberden's arthrosis. The joints on my fingers are thickened and sometimes painful. I have been noticing changes on my fingernails for a while already. Their surface is not smooth, but longitudinally grooved. Is this part of the arthrosis or a separate disease? Longitudinal grooves on nails (onychorrhexis) may accompany some rheumatological diseases, like yours, but also hypovitaminosis, iron deficiency or hyperthyreosis. Sincerely, Goran Hauser, MD I am 45 years old. I am 190 m tall and weigh 120 kg, a smoker. I consulted my doctor because of strong heartburn which does not decrease. He has suspicions of GERD. He did not explain to me what that meant. He wants me to perform a gastroscopy. I am afraid of this examination. Can the cause of heartburn be established by a more simple examination? In persons under 50 years of age with the suspicion of GERD (disease of esophageal mucosal inflammation caused by acid coming up from the stomach), experimental treatment can be performed with medications against stomach acid, e.g. Larona 2x 30 mg for 7 days, and if the troubles are reduced after a couple of days, it can be continued with 1x30 mg for 6 to 8 more weeks. Gastroscopy is usually definitely the best way of proving esophageal and stomach diseases. There are also some other ways, but they nowadays already belong to the history of medicine. Sincerely, Goran Hauser, MD I had surgery two years ago for Crohn's disease, when it was also diagnosed. I will soon be 35. I am undernourished. I have a feeling that I am intolerant to all foodstuffs. Would it be good if I took the food intolerance test? I personally do not have much experience with food tests, because most of them are non-specific and too general. Food intake disturbances are probably a consequence of your disease and the surgical procedure. On my opinion, the activity of your disease is far more important here. If you are undernourished, I believe it would be necessary to consult your gastroenterologist, in order to establish the activity of the disease and correct the therapy. If the inflammation is calmed, I believe that the food "intolerance" will disappear. Sincerely, Goran Hauser, MD I am preparing to take a longer trip to Africa, which means that I am also thinking about a 'pocket' pharmacy. Regardless of the fact that I will perform all of the prescribed vaccinations, I think that I should take something with me to alleviate a possible intestinal infection/s. I read about probiotics, activated carbon... What do you advise? I would primarily recommend to you Carbo medicinalis (medicinal charcoal), at best in granules, but the tablets are more simple to carry. Rehydration powders should definitely be used in addition. These powders are stirred in water and drank in case of profuse diarrhoea. They contain electrolytes which are lost in the case of strong diarrhoea. You can definitely take probiotics in the case of diarrhoea, however, as much as I know African agents, I am not sure how effective they will be in the acute stage. They will be far more useful in the stage of recovery from a possible infection. Sincerely, Goran Hauser, MD My husband had to go to a surgery because of colon carcinoma. He had unregulated defecation. He alternately had diarrhoea and constipation, regardless of his diet. I have been cooking to him according to the recommendation he obtained at the hospital. His pharmacist advised him to take Normia capsules for the recovery of intestinal flora. His stool stabilized after only a week. He has been taking the capsules for three weeks now. I would like to know for how long he can take them and in which dosage? He is afraid to stop taking them, lest the diarrhoea would return. There are no specific limitations in taking probiotics. I most frequently recommend patients to take the Normia therapy (2x1 a day) for 30 days, which can be repeated several times a year. Sincerely, Goran Hauser, MD My brother is 45 years old. He underwent laboratory tests due to irregular heartbeat. He was told that he suffered from the WPW syndrome. Can you explain to me what this is? My brother has understood that it is a very grave diagnosis. He is terrified. The WPW syndrome belongs to the preexcitation syndromes. It is a disease with an anomalous connection between the auricles and the ventricles in the heart, for which reason the impulse does not spread through the heart in the normal way. Most of these persons have no troubles, while a smaller number have arrhythmia attacks. Most persons with arrhythmia suffer from less dangerous arrhythmia, while only a small number of persons suffer from life endangering arrhythmia. Warning signs which demand examination and treatment are rapid heartbeat attacks accompanied by dizziness or loss of consciousness - in this case, he should consult a cardiologist arrythmologist. Treatment consists of taking medicine or, upon necessity, electrophysiological treatment - this aberrant streak is then "scorched" by electricity. Sincerely, Sandro Brusich, MD I have recently retired, I am 65 years old. Since then, my problems with high blood pressure have begun. It seems that my heart starts beating as soon as I come to the infirmary, and my blood pressure soars. I tried to explain to my doctor how I felt, however she insists that I take medications even before the processing. Can blood pressure grow for fear of the examination? High blood pressure only at the doctor's office, called "white coat hypertension", is a known and proved condition, which is, however, not as frequent as some patients might desire. I believe that your doctor is aware of this. However, there are many more persons with mild hypertension, who experience additional leaps of blood pressure at the doctor's office above the level they usually have at home, and I believe your doctor thinks that this is your condition. In order to solve this dilemma, you can take the examination called KMAT - continuous blood pressure measuring for 24 hours, by means of which you will objectively prove your daily range of blood pressure. Sincerely, Sandro Brusich, MD I am 28 years old. During a physical examination, I was diagnosed with rapid pulse, 100 per minute. The blood pressure is regular (except that it is lower in the morning, immediately after waking up, the thyroid gland hormones are within normal limits, while the ECG finding is regular, as well as Holter. I do not drink any more black coffee or cola beverages. As I feel good now, should I take medication for pulse regulation at all? A rapid pulse is usually found in younger girls with an otherwise healthy heart, for no particular reason (we perform the examination in order to exclude some underlying disease). I usually recommend treatment if the person has some problems in terms of heart palpitations or shortness of breath, otherwise not. We often try to explain such a condition with increased stress levels, persons who are vegetatively unstable (sensitive) are more susceptible to it, however, this has not been scientifically proved, and most frequently passes over time. If you experience shortness of breath or find it difficult to stand an effort, it would be useful in any case to perform an ultrasound of the heart. Sincerely, Sandro Brusich, MD I am 60 years old. I have had high blood pressure for 15 years, for which reason I have been taking antihypertensives. I was recently discovered a tumor of the adrenal gland. I am awaiting surgery. I would like to know whether the removal of my adrenal gland will permanently regulate my blood pressure, or will I continue to take antihypertensives? My doctor said that the surgery can be classical or endoscopic. What is your opinion? Which are the advantages and disadvantages of these methods? There are several types of adrenal gland tumors. If the tumour is active and secretes substances which elevate blood pressure, then its removal will also cause the regulation of blood pressure. However, this can also be a non-active tumor or a tumor secreting some other substances, in which case there will be no regulation of blood pressure - which is unfortunately the most frequent kind. Endoscopic (as I presume, laparoscopic) surgery has the advantage of a smaller incision and a much faster recovery of the patient. classic surgery provides the surgeon with a better overview and the possibility to more radically remove the formation - the decision is on the surgeon - while it may also occur that the surgeon begins an endoscopic surgery, but for some reason (bleeding or intraoperative finding) has to switch to classic operation. Sincerely, Sandro Brusich, MD I am 63 years old. A year ago, a keratosis was surgically removed from the ridge of my nose. After the surgery, the skin on my nose was red, sensitive and prone to cracking for a long time. It has now calmed down, however, I am worried by the warning of my dermatologist that it may return. I use sun screen with SPF +50 and I do not expose myself to the sun when the UV radiation is high. A couple of years ago, my friend had keratosis removed from her cheek with ice. She is well for now. I am afraid of a new operation. I kindly ask for your opinion. Actinic keratoses are the most frequent precanceroses occurring in consequence of cumulative yearlong UVB ray exposure. They are treated with cryotherapy, the application of cream with 5% fluoride-uracile or with photodynamic therapy. They occur more frequently in persons of a lighter complexion and those who spent their working life outdoors. Relapse is possible. Photoprotection is important in the prevention, along with the application of protective creams with SPF50. If you have noticed a renewed appearance of such a change, have a dermatological examination for the purpose of applying appropriate therapy. Sincerely, Professor Marija Kaštelan, MD, PhD I have had an acne problem for years, which, apart from my face, also appeared on my back. I performed a complete laboratory processing (allergological testing and hormonal status). All findings are within normal limits. I regularly visit the dermatologist and the beautician. On my own initiative, I excluded milk and milk products from my diet. After two weeks, I noticed an improvement, while now, after two months, my complexion has never been better. It is obvious that I am lactose intolerant, but I do not understand how it could not be seen from the allergological test. It is not difficult for me to give up milk and milk products permanently, even though those were my favourite foodstuffs; however, I am thinking about calcium. I am 35 years old. How can it be substituted? With pills? Or other foodstuffs? I am honestly afraid of trying milk, in order to avoid a new eruption of acne. I also took antibiotics a couple of times in order to calm the inflammation. Hereditary factors, hormones and a specific type of bacteria play an important role in the occurrence of acne. The therapy depends on the form of acne, and local and systemic therapy is used depending on the gravity of the disease. As diet does not influence the occurrence and deterioration of the disease, you may therefore freely re-introduce milk products into your diet. Sincerely, Professor Marija Kaštelan, MD, PhD Three months ago, my forearms were scalded by hot water. I was treated at the burns department. I was advised to apply anti-scar cream which I ordered from Germany. It is expensive, so I must give it up. In the pharmacy, they offered me the Combusten cream which contains olive oil. Its price is acceptable to me. Will its application reduce my scars? How is it applied? It is not visible from your question whether this is a hypertrophic scar or a keloid. If it is a keloid, therapy with highly potent corticosteroid preparations with occlusion or intralesional application of corticosteroids might be considered. Combusten cream is intended for skin treatment from lower degree burns and sunburns. Sincerely, Professor Marija Kaštelan, MD, PhD After depilation, the skin on my lower and upper legs is irritated. I used various lotions and creams, however, they had no lasting effect. Should I try Pantexol? Which do you advise, the cream or the lotion? I recommend the usage of antiseptic lotions immediately after depilation and of Pantexol cream more times a day. Should the problems persist, I recommend a dermatological examination. Sincerely, Professor Marija Kaštelan, MD, PhD I know that sunglasses are useful and even a fashionable, but I somehow can not acquire the habit of wearing them. I am 20 years old. I spend the whole summer at the seaside. Do UV rays really permanently damage the eye? I must admit that I feel as if my eyes were dry. I do not know whether that is a consequence of my summer sin, or do I spend too much time in front of the computer? It is desirable to wear sunglasses, because excessive sun exposure might cause damage to the cornea, lens and retina. Wearing sunglasses which follow the form of the face almost completely blocks UV rays. If you can not acquire the habit of wearing sunglasses, you should wear a hat or a baseball cap. As regards the dryness of your eyes, it is most likely the consequence of long work in front of the computer. Sincerely, Maša Mikuličić, M.D. My mother suffered from yellow spot degeneration. I am 62 years old. I use glasses for reading and watching TV and I do not have any other problems. I would like to know whether it would be useful for me to preventively take the Oculoplus preparation. A friend told me that her ophthalmologist advised her about it because lutein had a favourable impact on the eye. Can you tell me whether it slows down the loss of eyesight? I am very worried about my late mother's eye problems and the possible hereditary susceptibility. As your mother suffered from yellow spot degeneration, you have a somewhat higher probability for the occurrence of this disease. advise you to undergo regular ophthalmological examinations in order to notice the first symptoms of the disease in time. Antioxidants reduce the advancement of the dry form of the disease, as well as its transition into the milder, more aggressive form. Sincerely, Maša Mikuličić, M.D. I am 27 years old. I wear glasses for near-sightedness (-1.0 dioptre) and I work in front of a computer for more than eight hours. I have a feeling that my eyes are dry and very tired. What should I do? I saw the Vizol eyedrops on your website, or should I search for artificial tears? What is your advice? Longer work in front of the computer, as well as spending time in air conditioned rooms, affects the tear film. I recommend the application of artificial tears without BAK preservatives, more frequent blinking and moistening of the room. Should the problems persist, I recommend an examination by an ophthalmologist. Sincerely, Maša Mikuličić, M.D. I did not breast-feed my child because of sepsis after childbirth. My girl is a year and a half old. She is very sensitive and frequently has colds. Additionally, a red rash appears on her face. The pediatrician says that her immune system is weak. How can it be improved? She does not like to eat and refuses new foodstuffs. In my childhood, my parents administered fish oil to me, I remember the awful taste. They say that it helped, that I gained appetite. Is there a preparation which might help my little daughter? I did not breast-feed my child because of sepsis after childbirth. My girl is a year and a half old. She is very sensitive and frequently has colds. Additionally, a red rash appears on her face. The pediatrician says that her immune system is weak. How can it be improved? She does not like to eat and refuses new foodstuffs. In my childhood, my parents administered fish oil to me, I remember the awful taste. They say that it helped, that I gained appetite. Is there a preparation which might help my little daughter? Fish oil is actually vitamin D, which is required in the first year, as well as in the winter months of the 2nd and 3rd year. You should try it; however (as she refuses new foodstuffs), it would be good to consult a psychologist, in order to prevent stronger feeding disorders. Sincerely, Professor Mladen Peršić, MD, DSc My three-year-old daughter often has colds. Upon recommendation of a specialist, she will have surgery of the 3rd tonsil. We are waiting for a period of stability, without increased temperature. Meanwhile can she use Aqua Maris nasal drops? Operil was limited to five days, after which I do not know what to do. For a while, I instilled saline, however it does not seem to help any more. You can instill AM, but if the ORL recommended to perform an adenotomy, then I advise you to do it as soon as possible. Sincerely, Professor Mladen Peršić, MD, DSc My one-year-old son is showing symptoms of constipation. He eats a diverse diet, i breastfeed him at night, he is developing well, however, for the last couple of months, he has been crying during the emptying of his bowels, and I notice that he hides in a corner, prances on his toes, crosses his legs and stands that way. I try my best to make him occupied in order to squat, because I believe it would help him. He wears a diaper, and we do not insist on a potty. I am sometimes forced to place a suppository in his anus, which is followed by defecation, but the stool is in balls, without any traces of blood. However, I am afraid that his bowels might slow down. How often can I repeat this in a week? I believe your child has a functional disorder very frequent at that age, and related to hard stool and mild constipation. He might possibly also have a mildly "damaged" anus in the form of a fissure, and for a start, an examination is required. Regarding the therapy, along with diet containing extra fruit and vegetables, plum juice etc., a probiotic therapy should be attempted (e.g. Prolife), and if defecation is still hard, Portalak should also be introduced. Occasional administration of Prolax is not damaging, but does not solve the problem on the long run. You can thus begin with probiotics and a more adequate diet, whereas you should consult your doctor for further therapy. Sincerely, Professor Mladen Peršić, MD, DSc I have been having discussions with my daughter (20 y. old) for a while, because she wants to have her -4 dioptre corrected by laser. I do not consider it a harmless surgery and I do not think anyone mentions the complications. For this reason, young people decide to take this surgery so light-headedly. I do not know how to talk her out of it. Do you have any suggestions? I would also like to ask you whether lutein as a prevention of diseases of the elderly is taken during the whole year or in therapies. My father is 78 years old and takes it occasionally. When speaking of laser dioptre correction, it must be emphasized that it is an elective surgery, ie. a surgery chosen and desired by the patient. Any patient older than 18 and with a stable dioptre can be a favourable candidate for laser dioptre correction, but they must previously undergo a detailed ophthalmological preoperational examination, in order to see whether there are any contraindications for the surgery. The dioptre of your daughter can be corrected by laser. An absolute contraindication for this surgery is keratoconus, a corneal disease characterized by a thin and deformed cornea. Other contraindications are: glaucoma, dry eyes, pregnancy, any active eye disease, any active autoimmune disease, diabetes. The complications in this procedure might be a partial return of the dioptre (10 % of the preoperative dioptre) or the occurrence of a scar which can be cleared by instilment of corticosteroid drops. For the intake of lutein, it is important not to exceed the prescribed daily dosage. Sincerely, Maša Mikuličić, M.D. My mother is 75 years old and takes glaucoma medication. She frequently undergoes medical control. Her doctor told her that one of lenses was slightly cloudy. Is this the beginning of cataract? Can it be slowed down by lutein or omega-3? A slightly clouded lens means the beginning of cataract. With respect to the age of your mother, this is nothing unusual or a cause for concern. Performed studies show that the intake lutein and omega-3 capsules may slow down the advancement of cataract. definitely recommend regular controls because of glaucoma. Sincerely, Maša Mikuličić, M.D. I am 36 weeks pregnant. For the previous month, I have had problems with candida. Apart from the therapy prescribed by my gynaecologist (Plymicol), I also try to have a positive influence on the treatment with my diet. Without any success, however. My blood sugar is normal. I gained 8 kg during pregnancy. The baby is developing well. As the term for giving birth draws near, I am beginning to panic what will happen if I do not get rid of the inflammation. A couple of days ago, I was recommended Lactogyn capsules. I saw information on the internet that they can also be taken by pregnant women. Is there any chance that they help me in getting rid of candida? Candida is a usual present of the vaginal flora. Problems occur when their total number grows, causing an imbalance between the so-called "good" and "bad" vaginal bacteria. Your gain in physical weight during pregnancy is ideal. Candidiasis does not affect the intrauterine development of the fetus. The treatment of ailments is sometimes lengthy and requires persistence. The Lactogyn capsules might help you as a supplement to the treatment recommended by your gynaecologist. Sincerely, Alemka Brnčić, M.D., D. I am 55 years old and I do not have a partner, but I am susceptible to vaginal infections. In the last two years, they have been occurring very frequently (enterococcus, escherichia, streptococcus). As I have used suppositories and vaginal creams too often, I feel dryness and a burning sensation in my vagina. My doctor advised me to use Lactogyn vaginal and oral capsules. I took only the oral capsules, because I am already afraid to put anything else in my vagina. I felt improvement after only a week. I have been taking them for two weeks, how long does the therapy last? I am afraid to stop taking them lest my problems would reappear. Urogenital infections are the most frequent reason for visiting gynaecologists. In a very high percentage, the infections reappear because of the unfavourable micro-environment in the vagina. The application of suppositories removes the cause of infection, but also destroys the so-called good bacteria, which are a constituent part of the normal vaginal flora. In order to populate the vagina with healthy micro-organisms, it is recommendable to use Lactogyn capsules for two weeks. Should the problems persist, a gynaecological examination is necessary. Sincerely, Alemka Brnčić, M.D., D. About a month ago, I visited the gynaecologist for the annual Pap test (I am 60 years old). Upon taking the smear, the doctor also performed an ultrasound examination, which was very painful. I felt a pain in the lower part of my abdomen for days. For the first couple of days, I also felt a fever, not accompanied by increased temperature. After a week, a profuse yellow discharge with an unpleasant smell appeared, accompanied by a burning sensation. As I am not sexually active, I link these problems entirely to the examination. I did not have any problems with urination. I reported to the doctor, who viewed the smear through the microscope, but could not find any inflammation agents. Why did she prescribe an antibiotic vaginal cream to me, if there are no bacteria in the mucus? Is it possible that I have picked up an infection on the gynaecological table, or might the gel used in the ultrasound examination have irritated me? I began taking Lactogyn capsules on my own and took 2x1 for a week, while I am now taking 1x1. I feel better now. How long should I use them? In postmenopause, the vaginal epithelium becomes thinner, while the muscles lose their tone. The wall of the vagina is pale, with weaker blood circulation, the glycogen level and the quantity of lactobacilli drop, while the pH grows. When this protection is lost, the vaginal wall becomes permanently susceptible to inflammations, ulcerations and injuries. A gynaecological examination also represents a trauma for such a sensitive mucosa, and, consequently, the feeling of pain after the examination is not a rare occurrence. The Lactogyn capsules aid in populating the vagina with lactobacilli and the creation of a favourable micro-environment in the vagina. We recommend taking Lactogyn capsules for two months, which means for six more weeks. Use Lactogyn gel to prevent dryness. Sincerely, Alemka Brnčić, M.D., D. I am 35 years old. Because of repeated short-term loss of consciousness and low blood pressure, I was recommended a tilt-up test. Can you explain to me what kind of test this is? The tilt table test attempts to induce the reflex of loss of consciousness in persons considered to suffer from reflex fainting (the so-called neurocardiogenic syncope). It is a painless test during which you lie down on a special table which can be put in a vertical position and has fastening belts for fixation to prevent possible falling down and injury in case you faint. After your have been fastened, you are set up to a position of about 60-70 degrees, your blood pressure is measured and your heartbeat is monitored on a screen for 45 minutes. The test is interrupted if you lose consciousness or if nothing happens after 45 minutes. In some protocols, medications are also administered, e.g. nitroglycerin, under the tongue after approximately 20 minutes (which may cause a slight headache afterwards). If you lose consciousness, the test is positive, proving that the fainting is reflex in nature. If the test is negative, it has no special meaning whatsoever. The test is painless, but may be unpleasant if you lose consciousness - the same feeling you usually have when fainting. Sincerely Sandro Brusich, MD I am 67 years old. Apart from rheumatic problems, I am in good health. I recently read an article in which experts claim that all elderly persons should be prescribed medication for the reduction of blood pressure, regardless of whether their blood pressure is high or not. That confused me, as all medications have side effects. What is your opinion on that? Medications for high blood pressure are recommended only to persons with high blood pressure, if the administration of general measures during couple of months has not regulated blood pressure. A difference is made between the blood pressure levels to be reduced, depending on the associated diseases. In persons without any other diseases, the recommended blood pressure level is < However, if the person is a kidney patient, has had a stroke or heart attack, or is diagnosed with diabetes with any complication, a more rigid blood pressure control and values < od 120/80 mmHg are recommended. Thus, if you do not have associated diseases and your blood pressure is lower than 140/90 mmHg, I do not recommend any medications for the treatment of high blood pressure. Sincerely Sandro Brusich, MD At a physical examination, my husband was diagnosed with high blood pressure. He is also has about extra ten kilograms. His other findings were regular. His doctor prescribed him medications for treatment of high blood pressure. However, in the leaflet of one medication, my husband saw that impotence was indicated as a possible side effect. There is no way that I can talk him into taking the medication. Is there a natural way? I have read that omega-3 and ginkgo have favourable effects on the heart and reduce blood pressure. What is your advice? A natural means of reducing blood pressure, which should be the beginning of every treatment, is to avoid salt in diet, regulate body weight and regular exercise. This is also the most effective and best way of reducing blood pressure. If the above measures do not lead to favourable results, then medication therapy is introduced. There are six basic groups of medications used in the treatment of high blood pressure. One group is beta blockers, which may have impotence as a side effect. It might be recommended to your husband to take a medication from any of the other five groups without the above side effect. Other preparations (ginkgo, omega-3 etc.) do not lower blood pressure. Sincerely Sandro Brusich, MD I am 40. My father was this age when he died of a heart attack. Unlike him I do not smoke and I maintain the ideal body weight by walking almost every day. However, I have a stressful job. I cannot change that. My annual check-up came back normal. Should I be worried? Would you recommend that I take a dietary supplement for my heart for preventive purposes? You cannot influence the genetic aspect, but the right life style significantly lowers your overall cardiovascular risk. It is important to eliminate risk factors such as smoking, elevated concentrations of fat in the blood, elevated blood pressure, etc. Seeing that you have no other risk factors, I would not recommend any dietary supplements other than a regular diet. Physical activity is the most efficient way of releasing the accumulated stress, so keep it up. Sincerely, Sandro Brusich, MD I am 62 years old. As recommended by my cardiologist, I have been taking Andol and drugs for lowering blood pressure for preventive purposes since the age of 50. As a result, my blood pressure is within a normal range. Can I also use MegaOmega 3 as a dietary supplement? I read that it protects the heart and blood vessels. I do not like fish, so Omega 3 is not in my diet. Epidemiological research has shown that the presence of fish polyunsaturated Omega-3 fatty acids in our diet coincides with a lower risk of cardiovascular diseases, so we recommend them for patients with an increased risk of cardiovascular diseases, and particularly for patients who have had a myocardial infarction. If you are at a higher risk of cardiovascular diseases (blood pressure is one of the factors), you would certainly benefit from Omega 3 products such as Vitalia MegaOmega. If you have elevated levels of fat, you might also consider taking other medications (statins) before Omega 3. Sincerely, Sandro Brusich, MD A few years ago my mother had colon cancer surgery. She had an anus praeter. She has regular check-ups, and her tests are within normal limits. However, she has problems with bowel movements. She is attentive to her diet and eats mostly cooked foods. Her stools are not formed, but are rather mushy and watery. I have read that probiotics can help regulate bowel movements not only during constipation, but also during irregular bowel movements. I would try a probiotic, but I cannot give it to my mother without an expert opinion. In your mother's case mushy stool is a consequence of having had a part of the intestine removed (you have not specified which part), so the intestine is shorter. That is why excess fluid is lost through stool, which is then mushy or watery. So, the changes in the stool consistency are a consequence of the surgery and unfortunately, probiotics would not be of much use in this case. If you do decide to try a probiotic, it will do no harm, because these are safe medications with hardly any side effects. Sincerely, Goran Hauser, MD I have been travelling over the course of last year for work. My meals are irregular. I often eat in restaurants. I try to eat fruit regularly. I have digestive disorders and suffer from constipation. I recently took antibiotics for inflammation of the sinuses and the Normia probiotic because the doctor said it would improve my intestinal flora. At the time I had regular (daily) bowel movements. After a week, everything returned back to normal. I did not take laxatives because I am worried that I could get the lazy bowel syndrome. Should I continue taking the probiotic, it that what I may be lacking? Probiotics play a significant role as one of the hygienic dietary measures to improve the bowel rhythm (along with the intake of fresh fruits and vegetables, plenty of fluids and exercise). You may repeat the 30-day course of Normia more than once a year and it should have a positive effect on bowel movements. Traditional laxatives should be avoided as much as possible. Sincerely, Goran Hauser, MD I am 36 years old. I have been treated for Heliobacter pylori a few times. I was given a strong antibiotic every time. After treatment I always had problems with candida. I have a feeling that I am in a vicious circle. Whenever I get rid of candida, the symptoms related to Heliobacter p. return. (nausea, flatulence, heartburn, epigastrium and stomach pain). While I was taking the last course of antibiotics, I also took Normia for two weeks. Should I have taken the probiotic longer? Can I overdose on a probiotic? Where does Heliobacter come from? Can I get infected through my partner or can I pass it on to him? We usually recommend that patients take Normia for 30 days if taken together with the triple therapy for eradication of H. pylori. In theory you cannot overdose, particularly not if you take it over a longer period of time. H. pylori infection is very common, and it is estimated that approximately 65-70% of adults in Croatia have it. It is transmitted by contact, so family members are frequently infected. It should be stressed that testing positive for HP does not necessarily mean that you have to eradicate it (take therapy), or that it is always responsible for symptoms in the digestive tract. Also, the way you were tested (type of test) which yielded a positive result is also questionable. Please note that serological testing (providing blood samples) is unreliable and should not be used as it often provides false positive results. Sincerely, Goran Hauser, MD I have a twin brother; we are approaching 40. My brother has had psoriasis since our childhood. We both have two children each. This spring my younger son (8 years old) had a case of strong dandruff, which looked like cradle cap. It was also very itchy. He spent the entire summer at the seaside and the dandruff went away. A few days ago I noticed that he scratches his head and that the dandruff is back. I am scared to even think abut the possibility of my child having psoriasis. My brother's children are healthy. I know you will advise me to see a dermatologist, and we will do that. I would like to know if there is a natural way of treating this problem, such as a dietary solution or herbal preparation recommended in such a case. Psoriasis is a chronic inflammatory disease that can affect the skin, scalp and nails. The specific cause of psoriasis is not fully known, but it is assumed that the disease occurs due to the interaction of hereditary factors and different environmental factors. Regarding the inheritance of psoriasis, if one parent suffers from the condition, the risk of occurrence of the disease in the offspring is 28%. Helio-marine therapy or sunbathing and swimming in the sea is highly effective in treating the disease. On the basis of the data provided, which is very scarce, it is difficult to determine what this is. Therefore, I advise as dermatological examination for your child to establish the diagnosis and, if necessary, appropriate treatment. Sincerely, Prof. Dr. Marija Kaštelan, MD Last summer I fell asleep in the sun. When I came home I realized that my back was burned. I had Jecol ointment at home (for milder burns), so I applied it to the affected area on my back, from neck to waist. Since it was a weekend and I could not visit my family doctor, so I continued to use Jecol. Seeing that the burns withdrew, I did not even go to the doctor's office. I have recently read an article on UV radiation and skin cancer, which alarmed me because it seems that the damage occurring after prolonged exposure to the sun is irreparable. Is the situation really so bleak? Skin cancers, basalioma and spinalioma appear in mid age, usually between the ages of 50 and 70. A cumulative dose of UVB rays or prolonged exposure to UV rays which goes on for years plays a part in its onset. Therefore, if you are normally cautious about sun exposure there is no reason for concern. I recommend that during the summer, when the intensity of UVB rays is the strongest, you avoid excessive exposure to sun between 11 am and 5 pm and apply the appropriate photo-protective preparations with a combination of UVA and UVB filters. Sincerely, Prof. Dr. Marija Kaštelan, MD For over ten years I have suffered from eczema on the chin which is very visible after shaving. As a result, I do not shave regularly. I have used a variety of corticosteroid creams, as recommended by the doctor. In the beginning they helped, but soon not only did they stop working, but my condition deteriorated. Two years ago a friend of mine recommended your Pantexol cream. Sadly, after this relatively long period its effect has weakened. I saw on the Internet that you also had Pantexol plus cream. Should I try it? What is the difference? Does it contain corticosteroids? In chronic forms of non-allergic dermatitis, skin damage occurs as a result of cumulative effects of substances that are harmless in a single application. In this way, the protective barrier of the skin is gradually changed and damaged, above all the protective lipid film on the surface of the corneous layer, the acidic pH of the film, and the corneous layer of skin itself. Pantexol Plus cream contains 5% dexpanthenol and chlorhexidine digluconate (it does not contain corticosteroids), it has antiseptic effect, nourishes, protects and renews dry, sensitive and damaged skin. It is recommended as a form of neutral therapy for chronic eczema which restores the oiliness of the skin, and with it, its resistance. I recommend multiple applications during the day. Sincerely, Prof. Dr. Marija Kaštelan, MD My girlfriend has HPV (detected by Pap test, CIN 3), so I probably have it too. She took a regular Pap test, although she had experienced no problems. She was given a treatment, and I was not. The gynaecologist did not provide any instructions regarding sexual relations, but instructions on the vaginal suppositories say that sex is not recommended during treatment. I have no problems. How long should we abstain? I have read somewhere that treatment could last for several years. Should we use a condom or not? Before she was diagnosed, we had been intimate without a condom. We are in a serious relationship and it is important to me that my girlfriend is cured because we are planning a family. Would vitamins, probiotics or anything else which would avoid surgery help her (the doctor told her that surgery was an option as well)? She quit smoking. CIN 1, CIN 2 and CIN 3 changes indicated by the Pap test cause no visible symptoms. For men there are no analogue changes in the Pap test, so there is no need for treatment. Of course, in order to prevent a HPV infection it is recommended to use a condom, although it does not provide complete protection (virus is not transmitted only through penetration, but also by skin contact). Vitamins and particularly probiotics specific to vaginal microflora can help maintain the stability of the vaginal microflora. However, they do not affect the healing of the already present changes discovered by the Pap test. Further regular check-ups are necessary; if the CIN 3 change persists, the infection is treated surgically. Sincerely, Alemka Brnčić-Fischer I am 27 years old. This spring I was diagnosed with CIN 1 following a Pap test, and a cervical smear revealed high-risk HPV. My gynaecologist prescribed vaginal suppositories, after which I took Lactogyn capsules 1x1 for a month without having consulted the doctor. The follow-up Pap test showed the same result: CIN 1. I was given Betadine vaginal suppositories, followed by Albothyl ovules. I would like to know whether it would be a good idea to continue taking Lactogyn capsules, and after treatment with ovules to do a course with Lactogyn vaginal capsules? The doctor told me that the first vaginal suppositories have an anti-inflammatory effect, while the others contribute to the peeling of the surface of cervix. I have come to the conclusion that the treatment will damage the lining of the mucosa and the vaginal flora. This is why I am interested in the use of Lactogyn capsules. Naturally, I would like to know if it would heal my HPV infection as well. Today it is considered that almost 80% of women come in contact with the HPV virus during their sex life. In almost 50% of the cases we are dealing with high-risk HPV virus which can cause changes shown by the Pap test. However, it is important to stress that in 90% of the cases these infections are temporary and pass on their own, without leaving any trace or without us even knowing we had them.. CIN 1 is the mildest degree of pre-malignant changes in the cervix that the Pap test can reveal. In 50% of the cases CIN 1 regresses spontaneously. Regular visits to the gynaecologist are necessary in order to detect a possible progression to a higher degree of changes (CIN 2, CIN 3) over time. Lactogyn capsules will help restore the vaginal flora, populate the vagina with healthy micro-organisms and thus reduce the impact of the "unfavourable micro-environment" in the vagina, which commonly accompanies changes indicated by the Pap test. Sincerely, Alemka Brnčić-Fischer My husband often has eczema on his chin. He recently took two Normia capsules a day for a week because of diarrhoea. After a long time, the eczema was gone. He read on the Internet that probiotics help with skin diseases. Do they have direct effect on the skin or rather stimulate a process which affects the skin? If they work directly on the skin, could you tell me if there is a probiotic preparation that can be applied to the skin? The effect of probiotics on skin diseases is extensively investigated in numerous studies, but so far the data from the literature has been contradictory. There is proof of positive effects, but some studies have observed no effects. Much depends on the strains of probiotics used, because not all strains affect the same symptoms and diseases. According to the "Recommendation for the use of probiotics" from 2008, published by Yale University in USA, LGG and BB12 strains are recommended as the strains whose effects rated well in the treatment and prevention of atopic eczema associated with allergy to cow's milk. I have no personal experience with the use of probiotics in the treatment. In your husband's case it would be good idea to perform tests in order to clarify the cause of eczema and establish the necessary therapy in which probiotics may play a role as well. Sincerely, Prof. Dr. Marija Kaštelan, MD I have been in the menopause for five years. Since that time my skin and mucosa have been very dry. I started taking more fluids, I eat enough fruits and vegetables, use oily creams and moisturisers and occasionally artificial tears. However, the problem persists. Is there a dietary supplement you would recommend? I regularly have check-ups and everything seems to be fine. My gynaecologist has recommended that I occasionally take Lactogyn capsules, which turned out to be beneficiary. Due to reduced secretion of oestrogen and progesterone, one of the symptoms of menopause, changes in the structure and appearance of the skin occur. Skin becomes dry, it is thinner and loses its elasticity; new wrinkles are formed and the existing ones become deeper, while hair becomes thinner and loses its shine. Daily care of such skin is extremely important, as it helps improve its humidity, restore the lipid layer, and strengthen the defensive function of its corneous layer. It is recommended that you use soap-free syndets, showering oils or oil baths and apply emollients, which make the skin soft and smooth. Preparations with 5-15% of urea or those with omega fatty acids have a very good hydrating effect. Sincerely, Prof. Dr. Marija Kaštelan, MD My mother was diagnosed with colon cancer at the age of 65. She lived to be 86 with anus praeter (she died of cerebral haemorrhage). I am approaching the age of 60, and I have never had a colonoscopy. I am scared. Everyone who has had the examination complained of pain. Can it be done under anaesthesia? Where in Zagreb can I undergo this examination? I have no problems with digestion. I feel healthy. In many European countries the screening for colorectal cancer begins at the age of 50, regardless of the history of disease in the family. Hence, considering your age, you are certainly a candidate for colonoscopy. If an immediate family member had colon cancer after 60 - this is not considered an additional risk. Additional genetic risk exists for people whose family members contracted cancer before the age of 50. In that case, it is recommended that screening be done five years earlier than the cancer appeared in the family (for example, if a sick member was 40 years old at the time of diagnosis, his or her children need to have a colonoscopy at 35). You can contact departments of gastroenterology in a number of hospitals in Zagreb. Sincerely, Goran Hauser, MD I am 55 years old. I have been treated for Helicobacter pylori twice with three different antibiotics. I did not do well on them. For months I suffered from heartburn and occasional diarrhoea. My general practitioner established that the antibiotics had destroyed my intestinal flora. She advised me to start taking a probiotic. The pharmacist gave me Normia capsules. I took them 2x1 for a week, and then 1x1 for two weeks. I feel much better now. My stool is back to normal, and I have less problems with heartburn (when I eat heavy foods). Should I have taken the probiotic for a longer time? Can I repeat the course? I usually recommend treatment with Normia for approximately 30 days 2x1 a day. If the patient shows a positive response to treatment, but his or her ailment reoccurs, it is a good idea to repeat treatment with Normia after a while and to do so 3 to 4 times a year. Most patients do not respond well to the triple therapy for eradication of Helicobacter pylori, so I usually prescribe Normia during and after antibiotic therapy. Sincerely, Goran Hauser, MD Our son is five. He often suffers from ear infections and is frequently prescribed antibiotics. We have noticed that after every course of antibiotics he has diarrhoea, which exhausts him even more. Is there any way to avoid this? The doctor did not advise a probiotic as a means of preventing diarrhoea. Can I give him a probiotic on my own? I have read that it contains useful bacteria living in the intestines. I have read about Normia on you website. He is to young to take capsules, but he might take the powder. By all means, you should (and I dare say must) give your child a probiotic in addition to antibiotic protection, particularly since in your child's case the side effects of antibiotics are clear. You may give him Prolife ampoules while administering the antibiotic 2x1, and after the antibiotic course 1x1 for the next 15 days. Sincerely, Prof. D. Mladen Peršić, MD My two year old daughter often has colds. Her paediatrician has recommended cleansing her nose with saline solution. I came across a flier about the Aqua Maris Baby drops and spray in a pharmacy. Given that they contain sea water, would these products be more effective in cleansing the nose and contribute to its recovery? Definitely - feel free to give your little girl Aqua Maris products for children. Although the incidence of colds is not etiologically related to them, you might also consider testing for allergies. Sincerely, Prof. D. Mladen Peršić, MD Dear Sir or Madam, I am 65 years old now. Two years ago I had elevated blood pressure caused by stress. I took a herbal tranquilizer, I walked every day for about an hour, reduced salt intake, quit smoking, I do not drink alcohol, I lost weight and my blood pressure had normalised. I occasionally check it and it does not exceed 140/90. I feel well. Have I resolved my blood pressure problem? Congratulations, this the only effective way of lowering blood pressure, but also the hardest. Besides lowering the blood pressure, you have reduced your overall cardiovascular risk, which is even more important than the blood pressure values. For now it is enough to occasionally check blood pressure. Unfortunately, ageing blood vessels become stiffer and it is possible that in future, despite these measures, your blood pressure will increase (above 160/90), in which case it would be advisable to take high blood pressure medication. In conclusion, you have resolved your blood pressure problem, so continue with these measures. Once again, congratulations. Sinceraly, Sandro Brusich, MD Dear Madam, I am a mother of a four-year-old boy who has had neurodermatitis since he was born. He was treated with corticosteroid ointments. The situation gets worse every time his immunity is low. Would it be useful to give him a course of probiotics? What are your experiences with Normia? How is it taken and for how long? Atopic dermatitis (dermatitis atopica, AD) is a chronic or a chronic-relapsing inflammatory skin disease characterized by general dryness of the skin, severe itching, excoriations and lichenification. It occurs in people with a hereditary atopic predisposition, with a tendency to cause allergic reactions to different allergens. The treatment of atopic dermatitis depends on the patient's age and clinical manifestations of disease. Since the fundamental features of atopic dermatitis are general dryness of the skin accompanied by severe itching, it is extremely important to take proper care of the skin and to keep it hydrated. Regarding the use of probiotics in the treatment of AD, professional data sources are contradictory, and there is insufficient evidence to support the use of probiotics in treatment of AD in children in clinical practice. I personally have no experience with the use of probiotics in the treatment of AD. Sinceraly, Prof. Marija Kaštelan, MD, PhD Hello, I am worried about my ten-year-old son. He became very restless, can not concentrate and forgets things. He is doing increasingly worse in school. I consulted the school psychologist, who told me that this is all within normal limits. I learned that Omega 3 has a beneficial effect on the mental state, that it improves memory, and relax. Unfortunately, we consume fish only once a week, which is why I am sure that we do not get enough Omega 3. I will try to introduce linseed as bread spread. Would you advise to take Omega 3 as a dietary supplement? Before you start taking Omega 3 you should have your child examined to eliminate other possible causes (like Celiac disease which can have the same symptoms, or liver diseases - M. Wilson ...), and the child would certainly need to be examined by a psychologist. The supplements you mentioned are not a contraindication, on the contrary, there are many papers discussing the positive effects of omega3 acids on mood and concentration, but it is necessary to exclude organic or psychogenic causes of these problems. Sinceraly, Prof. Mladen Peršić, MD, PhD Dear Sir or Madam, I am 35 years old. I am taking triple antibiotic therapy for stomach ulcers with Helicobacter pylori. I feel better, but my stool is a problem. I have more frequent bowel movements which bothers me at work. Could probiotics help me? Which ones? How should I take them? A friend tells me that it is too late to start with probiotics, that I should have taken them at the time when I was on antibiotics. At present there is growing evidence that the triple therapy for eradication of H. pylori should include probiotics to alleviate an imbalance in the intestinal flora caused by taking two types of antibiotics. It is not too late to take Norma 2x1 for 30 days and I think that it will help normalize your stool. Sinceraly, Goran Hauser, MD, PhD Dear Sir or Madam, my five-year-old daughter in kindergarten is prone to respiratory infections. She is commonly prescribed antibiotics and Operil nose drops. Her appetite is good, and her weight is normal. Is there a natural way to help my child? I read about probiotics which boost immunity, propolis, seawater which cleanses and alleviates inflammation of the nose and throat, but I do not dare to give this to my own child. I was embarrassed to ask our paediatrician. Giving probiotics over a slightly longer period of time (2-4 months) can only have beneficial effects on respiratory symptoms. However, it is necessary to exclude allergy as a cause and to check whether adenoids or tonsils are the cause of these disorders (ENT exam), while severe immunological causes are unlikely since the child has a regular growth and development pattern. To conclude, the use of probiotic - yes, I recommend one to two Normia bags a day, but it is necessary to undergo an exam by an ear, nose and throat specialist and an allergologist during the treatment. Sinceraly, Prof. Mladen Peršić, MD, PhD Hello, I am 62 years old. Occasionally I feel discomfort, dryness and a burning sensation around the genitals. I was taking hormonal vaginal tablets for some time, but due to the side effect of significant discharge and inflammation I stopped taking the pills. How can I alleviate this discomfort? In postmenopausal women vaginal mucosa is thinner, due to which less glycogen and acid is produced. They are produced with help of lactobacilli in the vagina, and have a protective purpose. There are strains of probiotics with the ability to populate the interior of the vagina, stick to the walls and secrete hydrogen peroxide, bacteriocins, lactic acid, and create favourable conditions for the recovery of vaginal flora. The time needed to stabilize the vaginal system or the time necessary for the vagina to be populated by protective microorganisms is approximately 2-6 weeks. The role of probiotics is to stabilize vaginal flora, to prevent urogenital infections, and to support treatment. Naturally, regular gynaecological exams are also recommended. Healthy vaginal flora is the best natural protection for women against infection, but if the amount of "good" bacteria is insufficient, then its role in preventing the development of pathogen infection is diminished, which it is a good basis for developing the disease. This is another reason to use Lactogyn. Use Lactogyn gel to prevent dryness. Sinceraly, Alemka Brnčić, MD, PhD Dear Madam, is it better to use Lactogyn vaginal pills or to just take probiotics? How should I take probiotics - in the morning or evening, how often and should I take them with meals, before or after eating ? Thank you and best regards. Lactogyn vaginal pills and Lactogyn capsules, which are taken orally, are probiotics. For faster colonization of the vagina with lactobacilli it is advisable to start therapy with vaginal pills for one week and then continue with oral Lactogyn tablets. To maintain a balance of urogenital flora it is advisable to take one capsule a day, preferably with a meal. As an aid in the treatment of pre-existing vaginal conditions and during and after antibiotic therapy the recommended dose is two capsules a day. Improvement of the vaginal flora quality is expected after two weeks of taking 1 capsule a day, and at the latest after 4-6 weeks. Sinceraly, Alemka Brnčić, MD, PhD Dear Madam, after the age of 50 I noticed that my eyes were "dry" with a "burning" sensation. I wear glasses for farsightedness. Occasionally, I use artificial tears. What do you recommend? Dry-eye syndrome is a common problem, particularly in advanced age. Usage of artificial tears, frequent blinking and air humidification can alleviate the symptoms. I recommend an ophthalmological examination in any case, to establish the type and severity of the condition. Sinceraly, Maša Mikuličić, MD I am 25 years old and am suffering from psoriasis. During the summer my condition improved because I spent almost a month on the seaside. I've heard from people who were treated for psoriasis and other chronic skin diseases that they had a good experience with Omega 3 treatment. If it helps, for how long should it be taken and in which dose? I am currently not taking any medications. Thank you. Psoriasis is a chronic inflammatory skin disease characterized by the appearance of red spots covered with scales. Depending on severity of the disease, mild forms of psoriasis are treated locally, while severe forms of the disease are treated both locally and systemically. Sunbathing and swimming in the sea, also called helio-marine therapy, is very effective in the treatment of psoriasis. Omega 3 fatty acid have demonstrated certain efficiency if taken in an appropriate dose - as a concomitant therapy in case of various dermatologic diseases such as atopic dermatitis, psoriasis, acne vulgaris, etc... It is fine to use 1-2 capsules a day for the period of several months. We recommend Mega omega-3 since they contain 65% of omega-3 acids in one capsule. They should be used as concomitant therapy with local or systemic therapy as recommended by a dermatologist. Application of omega 3 capsules without adequate dermatological treatment will not cure the disease. Sinceraly, Prof. Marija Kaštelan, MD, PhD Dear Sir or Madam, I have a question - I am 21 years old, occasionally I have a vaginal discharge which has an odour and is at times accompanied with a burning sensation. I wanted to ask how and for how long I should take your product Lactogyn? And can it be taken without consultation with my gynaecologist? In addition to these oral probiotics, should I perhaps use Lactogyn gel for intimate care, since I now use a Nivea product? My gynaecologist frequently prescribed Daktanol vaginal tablets, which made the problem only slightly better. My gynaecologist always says that my immune system is weak, but that does not solve the problem. By the way, I am also a student, and I've been quite tense over the last three months because of exams. Could stress be causing my yeast infection? I have also lost a lot of weight. Thank you in advance and best regards. It is believed that only 30-40% of women have a healthy vaginal flora. Stress, a weakened immune system due to various diseases, common cold or more serious conditions, use of medications such as antibiotics or birth control pills, all can lead to an imbalance of vaginal flora. About 300 million women around the world today get some kind of urogenital infection, most of which are bacterial vaginosis (a vaginal microflora imbalance: a significantly reduced number of lactobacilli and an increased number of anaerobic bacteria, especially Gardnerella vaginalis) and vaginal candidiasis. Problems are manifested as itching, burning and increased discharge from the vagina, often accompanied with an unpleasant odour. Infections can often be asymptomatic, but if left untreated complications such as sterility, inflammation of pelvic organs, premature birth and others can develop. It is important to emphasize that such infections frequently reoccur. Infection therapy includes the use of antibiotics or antifungal drugs that destroy pathogens. But these drugs also have an adverse effect on the protective microorganisms in the vagina. Therefore, in addition to standard therapy, and for the protection of vaginal flora, we can add probiotics - micro-organisms with a positive effect on the health of the host. It is important to know that all probiotics are not the same and do not have the same effect. The time needed for stabilization of the vaginal system or the time necessary for the vagina to be colonised by protective microorganisms is approximately 2-6 weeks. Therefore, probiotics not only stabilize vaginal flora and prevent urogenital infections, but also support treatment. In case there are signs of infection, Lactogyn may be taken as supplemental therapy along with that prescribed by a doctor (antimycotics, antibiotics), for at least two to six weeks. To achieve healthy vaginal flora it is best to use Lactogyn vaginal pills as well during the first week (apply one a day). In case of repeated infections it is recommend taking one capsule a day for several months. In case of repeated infections it is recommend using one capsule a day for several months. Sinceraly, Alemka Brnčić, MD, PhD Hello, for years, I have been struggling with constipation. I reached the age of 42. I sit at work, and have a long commute to work. I also do not engage enough in athletic activities. As for diet, I think I am consuming everything that is recommended (liquids, fruits, vegetables). My colleague told me that she solved the problem with probiotics. There is so many of them, I cannot decide. I read an article about Normia. Does it help with constipation? Chronic constipation is one of the most persistent problems in gastroenterology. Once you take all hygienic and dietary measures, which you did from what I can gather, then the only recourse left is medication. The problem with medicines is that they do not stimulate the stool physiologically, which is why they should be avoided or applied to the minimum possible extent. Probiotics should also be considered, since they have a stronger physiological effect than laxatives. Although they are prescribed primarily for diarrhoea, probiotics have shown to help with constipation as well. I would recommend taking Normia for 30 days, which can be repeated 3-4 times a year. Sinceraly, Goran Hauser, MD, PhD I am 80 years old. I am taking pills for elevated blood sugar. I'm also on a diet due to gout. I have cataracts in both eyes. Could Oculo plus capsules help me? How are they taken? Oculo plus capsules can slow the progression of cataracts because they contain powerful antioxidants. They are taken once a day. I suggest that you get an ophthalmological examination to establish the degree of lens clouding. Since you also have diabetes, it is important to get a fundus examination at least once a year. Sincerely, Maša Mikuličić, MD Can Lactogyn vaginal capsule be used during menstruation? Since Lacotgyn are supposed to be used only one week, we suggest that you don't take during the period (use it before or after the bleeding). If you use them during your period, most of the probiotics would be excreted with the menstrual blood and the effect would be weaker. During the period you can take the oral capsules, 1x1 a day. Sincerely, JGL Counseling Dear Sir/Madam, I have repeatedly taken Lactogyn pills and I'm really pleased with them. Now I see that there are vaginal capsules, so I wonder what is the difference between them. Vaginal capsules act more quickly and are advised for acute conditions, with stronger disturbances. After a week of vaginal capsules administration it is good to continue with Lactogyn oral capsules 1 a day, for 1-3 weeks. In case of antibiotic treatment it is possible to combine 1 Lactogyn oral capsule a day after breakfast, and insert 1 Lactogyn vaginal capsule at bedtime for a period of 7 days, then continue the treatment with 1 oral capsule a day for another 3 weeks. Sincerely, JGL Counselling Dear Sir/Madam, I have a problem. I'm 26 years old and I've been fighting with one problem for 8 years that neither of my doctors can explain. In the middle of menstruation period I have the discharge similar to the menstruation but it lasts usually about 3-4 days, and sometimes even until the next period so I wonder if Lactogyn would help? Thank you in advance. Sometimes, in the time of ovulation, in the middle of the cycle a slight bleeding appears but it cannot be affected with Lactogyn capsules. However, it would be beneficial to use them for the regulation of vaginal flora during and after antibiotic treatment and in times of increased stress. Sincerely, JGL Counselling Hello! I have a problem with unpleasant smells and secretion for months. I have done a pap smear and the results are OK, there is no bacteria or infection, but the unpleasant smells appear after the intercourse with my partner. I have used vaginal tablets acidosalus and the doctor recommended to use lacotgyl and vaginal tablets acidosalus. I am asking this to figure out if I have a huge problem, or if a massive infection occurred because of the intercourse, and what can I do to prevent it? How long should I take Lactogyl and should it be used by my partner for the treatment too? Is it normal for this unpleasant smell to appear? Thanks and regards During the intercourse and ejection of the semen, pH in the vagina changes which can lead to changes in the flora and an unpleasant odour. We recommend to use 1 Lactgogyn vaginal capsule a day before bedtime in duration of for 7 days. In addition, take Lactogyn oral capsules and use 1 a day for 4 weeks. By this means you will enter the lactobacilli in the vagina which will regulate flora and reduce or solve your problems. We suggest that your partner makes urethra swabs in order to exclude possible infection. Sincerely, JGL Counselling Dear Sir/Madam, I am 39 years old, 165 cm tall, and i weight 69 kg, I have a chronic diseases - chronic pericardium, problems with the veins on the right leg (visible and with the swelling), I got my first periods at the age of 12. I am interested whether I can use the Lactogyn concomitantly with the drug Cyclo Progynova which consists of norgestrel-0, 5mg, and 2mg of estradiol? Thanks and best regards, Lidija. Dear Madam; You can take Lactogyn capsules with the treatment you received from a gynaecologist, there is no contraindication. Take 2 Lactogyn capsules a day for a period of 2 weeks, and then continue with one capsule a day for 6 weeks. They will stabilize the vaginal flora. As far as your weight is concerned it is almost perfect. But, if you could put an effort and loose 5 kg in the next 6 months, it would be a relief for the heart and the veins. Try to eliminate candies from the menu. Include more fruits and vegetables. Sincerely, JGL Counselling Dear Sir/Madam, I heard that your cream Adrience Oligosource is excellent, and I really wanted to try it and use it, but unfortunately I can not get your testers. Do you perhaps send testers to home address? Dear Madam; We suggest that you contact the Pablo pharmacy, where you can get testers and talk to our professional staff. Sincerely, JGL Counselling I would like to ask you to for a brief advice about Prolife capsules. Specifically, I plan to give them to my 1.5 years old child since he is currently taking antibiotics, in order to "recover" the digestive system. Since I do not know what kind of flavour does Prolife in a bottle have and whether he would want to drink it, I was thinking to buy capsules and dissolve them in a tea or juice. Does this reduce the effectiveness of the product? How long Prolife products can be used, or is it better to administer treatment over a certain time period, or taken as needed? Dear Madam; The form of Prolife probiotic is designed for a specific children age and mode of application. A suspension which can be mixed with tea (cooled down to room temperature, high temperatures would destroy the probiotic) is intended for children. Probiotic powder is protected in a capsule for reason and it is not advised to open it. The content of one bottle is sufficient for your kid, mix it with half-decilitre of the tea which the child usually drinks, offer him the drink half an hour before breakfast. It would be advisable to carry out the treatment for 10 days. Sincerely, JGL Counselling Hello, my daughter (22 months) was diagnosed with atopic dermatitis 2 weeks ago, it is not itchy, and in my estimation it is not very pronounced. As recommended by a dermatologists we rubbed elocoom 40% cream in cream base for 7 days and we have still been giving her 3x7 drops of Fenistil. A few days ago I started giving her Normia powder so I wonder how long is recommended to take it in this case? Dear Madam; Carry out the treatment with Normia powder for 4 weeks, 1 bag a day with breakfast (or any other meal that you can control). It would be good to eliminate pre-cooked meals and snacks, because they are full of additives (preservatives, flavour enhancers, colour), eggs and milk from a child's menu for the duration of the rash. Rice milk is recommended as substitution Soy milk is not recommended due to common allergic reaction to soy. Also do not wash the girl's garments with conditioner. Sincerely, JGL Counselling Dear Sir/Madam, I use a drug Contral which relieves my allergy to dust mites. If I take the medicine every day, my symptoms are decreased, so I wonder if I can use the drug constantly, and I would like to note that I took Contral on my own initiative, because the other drugs I used did not help. Otherwise, I constantly sneeze and have a runny nose and watery eyes, and only Contral can alleviate these symptoms. Best regards, Enes Đono Dear Mr. Đono, The administration of loratadine (Contral) is effective in treatment of allergies and alleviates the symptoms you specified, it has a rapid onset, a simple application (taken once a day) and non-sedating effects. However, since this is not a seasonal rhinitis, and the allergy to dust mites is present all year round, it is necessary that you consult your doctor (allergist) about the duration of the treatment. Sincerely, JGL Counseling Is Aqua Maris safe for use for a congested nose if a person is pregnant? Dear Madam; Aqua Maris can be used without fear both by pregnant and lactating women because it is a natural medicinal product. Sincerely, JGL Counseling Dear Sir/Madam, I would like to ask you for an information / explanation regarding your product AntiOx. It is mentioned that AntiOx contains Tocopherzyl acetate. I found the following information in an article on the website http://www.coolinarika.com/clanak/vitamin-e-manji-rizik-od-bolesti-srca: There is another "catch" with vitamin E, i.e. "tocopherol" or "tocopheryl" form. Many people find it confusing and it should be explained. Which wording will be used depends on how the vitamin E is chemically connected (acetate, succinate). There is no big difference among them, except that the absorption of the "tocopherol" form is somewhat better, but the "tocopheryl" form has a somewhat better sustainability. Both forms are active when taken orally, but "tocopheryl" form cannot be absorbed by the skin. So if you then hold the cream with tocopheryl acetate, zou should know it will do nothing." I would be verz interested to hear your opinion / explanation. Crljen Dear Mrs. Crljen Developing a product Holyplant Antiox cream we considered the expert facts to use the vitamin E in a form of tocopheryl acetate. It is known that vitamin E in the form of tocopherol has a stronger antioxidant activity on the skin, however, the given fact is compensated by using higher concentrations of tocopheryl acetate, which is proven in the literature to have the antioxidant activity in the used concentration. In addition, the vitamin E in the form of tocopheryl acetate is incorporated into the cream in the form of "water in oil", which means that the fat (oil) phase is the one in direct contact with the skin which makes the cream to stay longer on the site of application giving the tocopheryl acetate more time to interact with the skin. There is a variety of dermatological studies confirming that the tocopheryl acetate is absorbed into the surface layers of the skin, and after the absorption it transfers into the form of tocopherol. An additional fact which influenced the choice of this form of the vitamin E in Holyplant AntiOx cream is the fact that tocopherol has a stronger irritation potential than tocopheryl, which means that it is more likely to cause side effects such as redness, itching, peeling of the top layers of skin, etc. Also an important issue is that the tocopheryl form of vitamin E has a longer shelf life and with its use in the Holyplant AntiOx cream we be sure that tocopheryl acetate concentrations remained unchanged during the full shell life. It should be noted that the antioxidant activity on the skin is not achieved only by the form of the vitamin E but its combination with vitamin C, which is also an ingredient in Holyplant Antiox cream. In conclusion, we can say that Holyplant AnitOx cream which contains the vitamin E as tocopheryl acetate has an antioxidant activity provided during the whole declared period of the product validity, and that the product is safe for use. If you have any further questions, please do not hesitate to contact us. Sincerely, Aleksandar Posavec, prof. Brand Manager, Consumer Health Programme Can Lactogyn capsules be used during menstruation? Dear Madam; Lactogyn capsules can be taken regularly, without interruption even during menstruation. Sincerely, JGL Counseling Dear Sir/Madam, due to a painful inflammation of the bladder I occasionally take Cefixim antibiotic. One of these side effects is vaginal itching, which occurred in my case as well. I'm interested if it is appropriate to consume antibiotics and probiotics in the same period, since I have heard that antibiotics cancel the effect of probiotics, so is it better to wait for the completion of antibiotic therapy. Thank you for your response! Dear Madam; probiotics should be used during an antibiotic treatment, but at least 2 hours before or after the antibiotic. In addition, if you decide to take Lactogyn capsules we suggest to take 2 capsules a day for 2 weeks, and then one capsule a day for at least another two weeks. It is advisable to eliminate sweets, sugar, honey, yeast, and processed meat products from the menu because they alter pH, and stimulate the growth of candida. Sincerely, JGL Counselling I have a question concerning the use of Lactogyn tablets. Is it a sufficient to take one dose, i.e. one package, to solve the problems which i think the Lactogyn will help me? Please send me answer to e-mail. Thank you in advance Dear Madam; Lactogyn capsules are helpful in treating a bacterial, fungal and viral vaginal infection. They are taken over a longer period of time. At least 4 weeks in mild candidiasis, and with infection with HPV for months, until the smear test becomes regular. Sincerely, JGL Counselling Hello, I have 28 years and I gave birth 3 years ago. It happens to me that after having sex with my husband, I feel abdominal pains sometimes accompanied by a white discharge. What should I do? Thanks in advance Dear Madam, please go to see a gynaecologist, because it is necessary to determine why you have the pins. Besides, it should be seen whether this discharge is normal - if the composition adequate for a certain period of the menstrual cycle and contains if it contains the bacteria that need to be treated. In any case, we suggest taking the two Lactogyn capsules for 2 weeks, and then one capsule a day for 6 weeks, in order to regulate the vaginal flora. Sincerely, JGL Counselling Hello! I sometimes have problems with candida, and constantly used Canestea or something like that, but I never tried to treat it with a probiotic. Please, could you tell me how would they help my problem if I start the treatment - and for how long they should be taken? Also I would like to know if with this treatment can increase weight? Thank you very much Dear Madam; infection with Candida often returns, because the Candida is a usual inhabitant in the vagina and intestine. However, in some situations it rapidly multiplies, disrupt the flora in the vagina and the intestines and causes the inflammation. Treatment is time-consuming, requires a lot of patience, changing of habits, and reduction of stress. It is necessary to implement a strict anticandida diet (eliminate sugar, white flour, sweets, honey, processed meat, yeast, dried fruits, alcohol). Take two Lactogyn capsules a day for a month, and then 1 capsule a day for 2 more months. Of course, it is adjuvant therapy to the drugs that you get from your gynaecologists. You should give up sex for at least 4 weeks. Your partner should use Canesten cream for external application as described in the leaflet. Every time you take antibiotics, it is desirable to take a probiotic (Normia 2x1 - 2 hours before or after antibiotics) to maintain normal gut flora. Because, if a gut flora is impaired the problems occur in the vagina (due to closeness near). Lactogyn capsules have no effect on increased body weight. Sincerely, JGL Counselling Due to past experiences I will not go to see a gynaecologist so I ask you. I'm 23, I was treated for candida infection twice so far and I took Lactogyn as an adjuvant therapy. I was satisfied with them but something is happening again. A few days ago I saw an increased, vaginal discharge white in colour and a burning sensation during a sexual intercourse. My partner also felt a burning sensation. I maintain intimate hygiene with water and chamomile, I have sex with one partner for 5 years already, I avoid sweets and sugar. Please advice what should I do? P.S. Sorry for my language, I am from Macedonia :) Dear Madam, your Croatian is great. You said that you took Lactogyn capsules taken as a adjuvant therapy, which is correct. You would have to take an antifungal medicine in form of vaginal pills, and your partner in a form of a cream. These medicine can be prescribed by a gynaecologist. Take 2 Lactogyn capsules a day for two weeks, then 1 capsule a day for another 6 weeks. Avoid fresh bread, pastries, processed meat products and sweets. Sincerely, JGL Counselling Dear Sir/Madam, for the last two years I have been constantly fighting with inflammations and cheesy discharge, i.e. Candida because I have been constantly struggling with a weak immune system. I wanted to check with you, for how long should I use Lactogyn because I believe that one box will not make me better? Kind regards, Petra Dear Petra, Lactogyn capsules are an aid in candida treatment. This means that you should take them along with the treatment prescribed by your gynaecologist. However, Lactogyn capsules should be continued after a local therapy (with a vaginal tablets or cream). We suggest that you take two capsules a day for two weeks and then another 1 capsule a day for 6 more weeks. Pay attention to diet, eliminate sweets, fresh bread, processed meat, because they stimulate the growth of candida. It would be advisable to carry out a treatment with quality vitamins to increase general immunity. For more info you can contact us in our counselling centre by phone. Sincerely, JGL Counselling Dear Sir/Madam; my skin is mixed, oily t-zone, and the cheeks, especially in this winter weather, are dry. What would you recommend for face care? Is there a possibility to get the testers of your products? Regards, Vlatka Dear Mrs. Vlatka, we suggest that you contact the pharmacy Pablo where our expert staff would suggest an appropriate care for you face. You can also get the testers there. Sincerely, JGL Counselling
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Imala sam upalu rodnice i uz antibiotike sam pila Lactogyn kapsule. Završila sam terapiju i opet sam uzela Lactogyn da se to sve malo vrati u normalu. Bih li još uz to trebala uzimati i vaginalete ili da ovo koristim još nekoliko tjedana? Poštovana, nakon provedene terapije antibiotikom i Lactogyn kapsulama dobro je nastaviti s Lactogyn peroralnim kapsulama 1x1 još 2 do 3 tjedna. Kao što kažete, potrebno je određeno vrijeme da se mikroflora u rodnici oporavi i stabilizira. Lactogyn kapsule možete piti i preventivno, 1x1 tijekom 4 tjedna, zatim napraviti pauzu dok god se dobro osjećate. U slučaju da osjetite nelagodu, peckanje, suhoću i sl., terapiju probiotikom možete ponavljati nekoliko puta godišnje. Mikroflora u rodnici se poremeti za vrijeme bakterijskih i virusnih upala (koje potvrđuje ginekolog, ali i kao posljedica stresa, nezdrave prehrane, neadekvatnog intimnog sapuna, tijesne odjeće). Za intimnu higijenu predlažemo Lactogyn sapun (sadrži mliječnu kiselinu, neven i kamilicu). Srdačan pozdrav, JGL Savjetovalište 33 su mi godine i imam velikih problema s PMS-om (preosjetljivost, plačljivost, razdražljivost, ponekad blaga depresija, opća malaksalost organizma, loš ten) i ponekad na 1. dan menstruacije imam bolove u donjem dijelu trbuha ili leđima (ali bolovi nisu jaki, pa to ne smatram velikim problemom, već mi je najveći problem PMS). Udajem se na jesen, a dva dana prije vjenčanja trebala bih dobiti menstruaciju. Čula sam da se menstruaciju može odgoditi kontracepcijskim pilulama. Preporučujete li to i mogu li imati kakve štetne posljedice od toga (za organizam, ten i sl.)? Pretpostavljam da se na taj način ne može riješiti problem PMS-a (a to mi je cilj odgode). Mogu li ikako ubrzati ili odgoditi dolazak menstruacije (možda već ovog ljeta) pa da mi PMS prati novi datum dolaska menstruacije? Također, možete li mi preporučiti nešto za suzbijanje PMS-a (prirodnim putem ili tabletama)? Svaki savjet je dobrodošao. Ljubazno vas molim za što brži odgovor. Unaprijed zahvaljujem. Poštovana, predmenstrualni sindrom ili PMS je vrlo raširen, ali nejasnog uzroka pa se u liječenju ili smanjivanju neželjenih simptoma preporučuje cijela lepeza savjeta. PMS se često povezuje sa stresom (u obitelji, na radnom mjestu, u društvu općenito), pa je prvi korak smanjiti učinke stresa. To se postiže meditacijom, jogom, tjelovježbom, masažom ili brzim hodanjem (aktivnostima koje opuštaju). Neophodno je obratiti pozornost na prehranu, jer su istraživanja pokazala da neke namirnice pojačavaju PMS (čokolada, kofein, gazirana pića, slatkiši, pekarski proizvodi, tvrdi sir, mlijeko, sladoled, crveno meso, alkohol, slane grickalice). Zanimljivo je da za tim namirnicama žene s izraženim simptomima PMS-a imaju izrazitu potrebu. Neophodno je uvesti redovite, češće, manje, zdrave obroke. Na taj se način osigurava stabilna razina šećera u krvi što je preduvjet za hormonalnu stabilnost. U suprotnom, poslije nezdravog obroka, npr. slatkiša naglo poraste razina šećera u krvi, naglo se izluči inzulin, poslije čega razina šećera brzo pada što dovodi do neželjenih simptoma (glad, slabost, smušenost, glavobolja i Kao zamjenu za mlijeko možete koristiti sojino mlijeko ili rižino ili zobeno mlijeko. Jelovnik svakodnevno treba sadržavati žitarice, voće i povrće. Poznato je da triptofan, aminokiselina, podiže raspoloženje. Predlažemo da konzumirate namirnice koje ga sadrže, kao što su zobene pahuljice, banane, riba, sezam, slanutak, sjemenke suncokreta i bundeve te perad (najviše puretina). Također je korisno u jelovnik uvrstiti namirnice bogate željezom (jetra, tuna, ostrige, soja, bundeva, zob, grašak, kvasac, smokva, špinat) i cinkom (školjke, rakovi, puretina, tuna, iznutrice, pivski kvasac, soja, sjemenke bundeve, grašak). Od dodataka prehrani dobro bi vam došao kalcijev citrat s magnezijem, ginko biloba (naš Ginkalin), MegaOmega 3 kapsule 1x1 kroz 3 mjeseca. Ako se simptomi ne ublaže, predlažemo da se obratite ginekologu koji će vam možda savjetovati kontracepcijske pilule koje reguliraju ciklus i smanjuju PMS. Vaš datum vjenčanja još je relativno daleko pa se sam ciklus može pomaknuti te neće trebati odgađati menstruaciju, stoga predlažemo da se u vezi s tim obratite ginekologu početkom kolovoza. Srdačan pozdrav, JGL Savjetovalište Moj sin ima Helicobacter pylori i pojačanu kiselinu u želucu. Molim za savjet kakvu biste hranu i prirodne čajeve preporučili za uspješno liječenje i ublažavanje boli. Pozdrav Poštovana gospođo, procjenjuje se da je oko 80% ljudi zaraženo Helicobacter pylori, ali samo kod manjeg broja dovodi do zdravstvenih problema (pojačana kiselina, gastritis, vrijed na želucu, bolovi, gubitak tjelesne težine, mučnine i dr.). U svakom slučaju, potrebno je prestati pušiti i konzumirati alkohol. Smetnje se mogu smanjiti sa zdravom prehranom. Poželjno je da su obroci redoviti, količinski manji a češći, da se iz prehrane isključi gotova hrana (suhomesni proizvodi, kolači, svježi kruh, mlijeko, crna kava, čokolada, šećer, bomboni, gazirana pića, hrana konzerve, gotove juhe, umaci i sl.). Preporučuje se kuhano povrće, kuhano meso, riba, riža te kompot od jabuke. Svježe voće i povrće treba izbjegavati dok god se smetnje ne povuku. U slučaju poboljšanja, može se napraviti proba sa zrelom voćkom poslije obroka, ali nikako na prazan želudac. Koje povrće? Na žalost, nema idealne dijete za sve pacijente. Svaki bolesnik mora voditi kalendar jelovnika i na osobnom iskustvu napraviti popis namirnica koje mu ne smetaju. Hrana se mora dugo žvakati da bi se razmekšala i natopila slinom pa će manje opteretiti želudac. Treba izbjegavati vruću i hladnu hranu, poželjno je da je ugodno temperirana. Od čajeva predlažemo da vaš sin proba kamilicu, mentu, stolisnik ( http://www.prirodnolijecenje.net/stolisnik.htm ), komorač te majčinu dušicu. Ako uz zdravu prehranu smetnje budu i dalje prisutne, neophodno je da se vaš sin javi liječniku. Srdačan pozdrav, JGL Savjetovalište Poštovani, zbog grudastog iscjetka, peckanja i svrbeža kontaktirala sam sa svojim ginekologom (budući da studiram 300 km dalje), koji mi je rekao da si kupim Canesten 3 combi i Lactogyn intimni sapun, koji stalno i koristim. No, navečer sam dobila menstruaciju, tako da liječenje Canestenom nisam započela. Osim toga, kupila sam si Lactogyn oralne kapsule i koje pijem 2x1. Sad mi se povlače simptomi pa me zanima trebam li nakon menstruacije koristiti Canesten ili ne? Poštovana, provedite terapiju poslije menstruacije Canesten 3 kremom kao što vam je ginekolog savjetovao, jer je zaključio da imate vaginalnu kandidijazu. Nastavite i terapiju Lactogyn oralnim kapsulama, prvi tjedan 2x1, a u nastavku 1x1 još 3 tjedna. Potrebno je da prođe određeno razdoblje da se mikroflora u rodnici stabilizira i da se nasele korisni probiotici koji su protuteža gljivicama i bakterijama. Bilo bi dobro da za vrijeme terapije ne konzumirate slatkiše, kolače, svježi kruh, tvrde sireve i suhomesne proizvode jer potiču rast kandidi. Poslije terapije povremeno si možete priuštiti "zabranjene" namirnice. Međutim, pokušajte se hraniti što zdravije. Srdačan pozdrav, JGL Savjetovalište Imam problema s prečestim herpesima. Trenutno na gornjoj usni imam tri herpesa. Prije mjesec dana sam imala jedan veliki ispod nosa, od kojeg još uvijek imam ožiljak. U 12. mjesecu 2012. sam provjeravala krvnu sliku i sve vrijednosti. Željezo je bilo u granicama normale. Cijelu zimu sam „na svoju ruku“ uzimala B kompleks, a C vitamine pijem neovisno o sezoni prehlade i gripe. Uzimala sam i ampule matične mliječi od Enciana, ali bilo mi je skupo koristiti sva tri mjeseca, kako piše u uputama. Cijele sam zime natašte pila čašu vode s iscijeđenim limunom, a isto tako dnevno popijem tri šalice zelenog čaja (radi imuniteta) u koji također iscijedim limun. Nastojim unositi te prirodne proizvode u organizam, kao i puno voća (naranče, limun, jabuke). Sad već jedemo i domaći špinat i koprivu, međutim, ne prođe ni mjesec dana a da nemam herpes na usni. Oprostite što sam oduljila s objašnjenjem. Molim vas da me posavjetujete što mi je činiti kako bih popravila imunitet, odnosno smanjila pojavu herpesa na licu. Zahvaljujem na odgovoru. Poštovana, infekcija virusom herpesa je na žalost kronična, doživotna. Jednom kada virus dođe u organizam (na mjestu oštećene kože ili sluznice), ostaje pritajen u živčanim čvorićima koji su povezani s osjetilnim živcima na koži, zato je prvi simptom peckanje, odnosno svrbež. S mjesta gdje se smjestio virus čeka pogodnu situaciju da izbije i izazove akutne simptome. Njegov povratak može provocirati umor, hladnoća, ali i izlaganje suncu, vjetar, viroza, menstruacija (hormonalne promjene), pad imuniteta i stres. To znači da mu puno okolnosti ide na ruku. Što se tiče prevencije, dobro je reagirati na najmanji znak, odmah svaki sat na zahvaćeno mjesto (kod vas je to gornja usna) nanositi mast s aciklovirom. Pri tome se služite štapićem s vatom (štapić za uho) da viruse ne biste prenijeli na prste i mast. Morate obratiti pažnju da prilikom umivanja ne prenesete viruse na druga mjesta. Predlažemo da se u akutnoj fazi samo brišete vlažnim tuferima. vrijeme pojačanog UV zračenja dobro je premazivati usne balzamom koji sadrži UV zaštitu. Dobro je što vodite računa o prehrani i što redovito konzumirate voće i povrće. Što se limuna tiče, bilo bi dobro da sok ne pijete na prazan želudac jer bi mogao iziritirati sluznicu želuca. Od svojih proizvoda predlažemo Mega Omegu 3 koja, između ostalog, djeluje na upalna stanja, otpornost i kožne promjene. Uzimajte po 1 kapsulu poslije ručka tijekom 3 mjeseca. Srdačan pozdrav, JGL Savjetovalište Dobila sam preporuku da se javim upravo vama zbog problema alergije! Moj suprug već 3 godinu muči muku s tom proljetnom alergijom! Nije bio na testiranju, ali sve je počelo kad je radio u borovoj šumi! Nadam se da imate neko rješenje, barem da mu se olakšaju ti problemi! Ne može disati, nos mu je začepljen, oči ga svrbe, puno kiše, a zna imati i vrtoglavice! Nedavno smo lansirali svoj novi proizvod Aqua Maris ektoin sprej, prirodni pripravak bez konzervansa, što je jako važno kod osoba koje pate od alergije jer konzervans dodatno iritira sluznicu nosa koja je oštećena od alergena. Aqua Maris ektoin sprej sadrži dvije djelatne komponente, ektoin, koji oblaže sluznicu u nosnim hodnicima i sprječava direktni kontakt antigena na staničnim membranama pa se smanjuje alergijska reakcija te morsku vodu koja smanjuje oteklinu sluznice pa nos postaje prohodan. Osim toga, morska voda sadrži mikroelemente koji oporavljaju epitel na sluznici i tako ubrzava njen oporavak. Aqua Maris Ektoin sprej se može koristiti sam u preventivne i terapijske svrhe. Kod vašeg će supruga ovog proljeća imati terapijsko djelopvanje jer je alergijska reakcija već nstupila, a sljedeće godine ga može uzeti prije cvatnje, prije pojave simptoma alergijskog rinitisa, dakle za prevenciju. U slučaju da vaš suprug koristi antihistaminike ili kortikosteroide, njima može dodati Aqua Maris ektoin sprej da smanji smetnje i da na prirodan način ubrza oporavak. Aqua Maris ektoin sprej će si ušpricati u svaku nosnicu 15 minuta nakon što je uzeo standardnu, već propisanu terapiju. Može ga kombinirati s našim Meralys sprejem 0,1% (koji osim lijeka ksilometazolina sadrži morsku vodu), na način da Meralys sprej ušpricava 2x dnevno u razmaku od 12 sati, nakon 15 minuta može ušpricati Aqua Maris ektoin sprej, koji osim toga može ušpricavati tijekom dana. Meralys sprej koristi se 5 dana, a Aqua Maris ektoin može se korisiti tijekom cijele alergijske sezone, u terapijske i preventivne svrhe. Nadalje, pacijenti s alergijama mogu koristiti i Aqua Maris sustav za ispiranje nosa i sinusa (sustav i vrećice soli bez aditiva obogaćene uljima mirte i smilja). Sa sustavom se ispiru alergeni iz nosnih hodnika te i na taj način smanjuje alergijska reakcija, a preporučuje se 2 - 3 puta tjedno (navečer, prije spavanja). Za pacijente koji ne žele ispirati nos sa sustavom preporučujemo Aqua Maris sprej za nos od 100 ml koji mogu nositi u džepu ili torbi i povremeno, tijekom dana, ušpricati u obje nosnice i dobro ispuhati nos. Čišćenje nosa se preporučuje prije standardne terapije i terapije s Aqua Maris ektoinom kako bi ljekovite supstance ostale što duže na sluznici nosa. Srdačan pozdrav, JGL Savjetovalište Imate li kakvih probiotika možda za testirati budući da sad koristim Lactogyn, ali bih htjela vidjeti i isprobati ostale, pa ako imate uzorak, bila bih jako zahvalna. Gratis uzorke probiotika nemamo jer se do upotrebe moraju držati u hladnjaku što otežava njihovo čuvanje. Osim toga, svaki probiotik čini dobro, bez obzira o kojem se radi (Prolife, Normia, Lactogyn). Treba ga uzimati određeno vrijeme da bi pokazao učinak. Potrebno je posavjetovati se s magistrom u ljekarnici ili možete kontaktirati s nama na savjetovaliste@jgl.hr u vezi s aktualnim teškoćama da se odabere najpodesniji. Svaki probiotik ima određene indikacije (stanja u kojima se preporučuje) i uputu o korištenju. Srdačan pozdrav, JGL Savjetovalište Zadnjih 5 godina sam pod terapijom eutyroxom zbog hipotireoze. Prije početka lječenja sam imala jedan spontani pobačaj. Poslije dvije godine prošla sam urednu trudnoću i porod, nakon koje sam imala kiretažu i još jedan spontani pobačaj. Sada već godinu dana pokušavam ostati trudna bez uspjeha. Koliko štitnjača utječe na to i ima li kakve pomoći? Štitnjača je jako važna žlijezda koja utječe na metabolizam (izmjenu tvari) u organizmu, ima veliki utjecaj na plodnost i pravilan razvoj trudnoće (mogući uzrok pobačaja). Hipotireoza znači njen oslabljen rad pa ste dobili nadoknadu hormona. Potrebne su češće kontrole hormona da vidite odgovara li vam doza Eutiroxa Savjetuje se redovita tjelesna aktivnost, da se ubrza metabolizam, zdrava prehrana (voće, povrće, riba, cjelovite žitarice, perad, mahunarke i grahorice), prehrana bogata vlaknima da se pospiješi rad probavnog sustava. Namirnice koje najpovoljnije djeluju na štitnjaču - mrkva, špinat, marelice, šparoge, maslinovo ulje, avokado, suncokretove sjemenke, cjelovite žitarice, banane, riblje ulje treba često konzumirati. Namirnice koje ometaju upijanje joda : kupus, kelj, brokula, gorušica (senf), lima grah, lanene sjemenke, slatki krumpir, kikiriki, proizvodi od soje pa ih trebate ograničiti na 2 - 3 puta tjedno. Napitke s kofeinom i teinom ( kava, coca-cola, crni čaj) također treba izbjegavati jer otežavaju rad štitnjače. Alkohol i duhan također štetno utječu na štitnjaču. Fizička aktivnost (brzo hodanje, vježbanje, plivanje i sl.) smanjuje stres pa time povoljno djeluje na funkciju štitnjače. Dobro je povećati unos vode, kako bi se pospješilo izlučivanje štetnih tvari. Uz redovito uzimanje lijekova, fizičku aktivnost, redukciju stresa, zdravu prehranu možete pospješiti rad štitnjače i u konačnici ostvariti željenu trudnoću. Srdačan pozdrav, JGL Savjetovalište Molim vas za savjet vezan uz upotrebu koncentrata vitamina E. Mogu li njime mazati ožiljak od carskog reza (rodila sam prije godinu dana, ali ožiljak je i dalje crven)? Također, hoće li mi koristiti za učvršćivanje kože trbuha i grudi ili mi možete savjetovati neki drugi proizvod? Ako ste kupili Holyplant vitamin E+ koncetrat, 15 ml možete ga, osim za njegu osjetljive kože lica, nanositi i na ožiljak na trbuhu, lagano umasirati, a ostatak tijela njegujte Holyplant bademovim uljem. Ožiljak od carskog reza će se s vremenom promijeniti (omekšati i izblijediti). Za njegu cijelog tijela (trubuha, grudi i bedara) koristite Holyplant bademovo ulje (u spreju ili u bočici ) jer je i ono obogaćeno vitaminom E. Uz redovitu primjenu koža postaje meka, glatka i elastična. Uz lokalnu njegu kože preporučujemo i svakodnevnu fizičku aktivnost (brzo hodanje, vježbe za trbušne mišiće) koja će ubrzati učvršćivanje kompletne trbušne stijenke. Srdačan pozdrav, JGL Savjetovalište Imala bih dva pitanja – možemo li uzimati Lactogyn vaginalete bez uzimanja oralnih kapsula kod lakših ginekoloških problema (pojačani sekret) i mogu li se uzimati Lactogyn kapsule i vaginalete u isto vrijeme kad i analgetici, vitamini i ostali dodaci prehrani? Ako se radi o upali i sekretu, predlažemo da obavite ginekološki pregled da se ustanovi uzrok upale (gljivice, bakterije). Ginekolog će vam savjetovati terapiju (vaginalete ili vaginalnu kremu). Ako je upala jaka, uz vaginalne antibiotike ili mikotike uzmite i Lactogyn vaginalnu kapsulu 1x1, tijekom 7 dana te Lactogyn oralne kapsule 2x1kroz 7 dana, a zatim samo Lactogyn oralnu kapsulu 1x1 još 3 tjedna.To znači da terapija s probioticima (Lactogynom) traje 4 tjedna. U slučaju da je sekret prisutan zbog hormonalnog dizbalansa (klimakterij, menopauza), dovoljno je uzeti Lactogyn oralnu kapsulu 1x1 kroz 4 tjedna. Preporučuje se u preventivne svrhe svakih nekoliko mjeseci ponoviti kuru Lactogyn oralnim kapsulama, 1x1 tijekom 4 tjedna kako bi se mikroflora u rodnici optimalno održavala. Srdačan pozdrav, JGL Savjetovalište Gdje se mogu nabaviti vaše kapi protiv zubobolje? U portfelju našeg Bezreceptnog programa postoje Holyplant kapi za desni, preparat koji djeluje na zubobolju. Koristi se kod upale zubnog mesa jer dolazi do ogoljavanja zubnih vratova što izaziva zubobolju, osjetljivosti na vruće, hladno i dodir. Možete ih pronaći u ljekarnama, posebice našem lancu Pablo. Srdačan pozdrav, JGL Savjetovalište Poslije gripe sam dobila upalu pluća pa sam pila antibiotike 14 dana i probiotike – Normiu iz vrećica. Moja doktorica kaže da ih trebam uzimati još 2 tjedna. Mogu li nastaviti s kapsulama jer mi je to praktičnije? Dobro je da ste uz antibiotsku terapiju uzeli i probiotike - Normiu, jer ste na taj način zaštitili crijevnu mikrofloru. Antibiotici uništavaju štetne bakterije, ali, na žalost i korisne bakterije u crijevima i rodnici. Slažemo se s vašom liječnicom koja vam je savjetovala da produžite kuru s probiotikom. Što se tiče dileme uzimati li Normiu iz vrećica ili Normiu u kapsulama, slobodno izaberite što vam više odgovara, što vam je praktičnije. Normia u vrećicama je namijenjena osobama koje teško gutaju lijekove. Jedan i drugi oblik sadrži iste sojeve probiotika: Lactobacillus rhamnosus GG® i Bifidobacterium BB-12® koji štite mikrofloru u tankom i debelom crijevu. Predlažemo da nastavite piti Normiu kapsule 1x1 još 4 tjedna. Za dodatne informacije možete se javiti i u JGL Savjetovalište. Srdačan pozdrav, JGL Savjetovalište Kupila sam kapi Vizol S i savjetovali su mi u ljekarnici da su dobre i za one koji koriste leće. Sada na kutiji čitam kako se preporučuje skinuti leće na 15 minuta kod ukapavanja, što je poprilično nekomotno i neizvedivo tijekom dana. Malo ste to bolje trebali naglasiti ili bar educirati svoje zaposlenike jer nama koji nosimo leće nije svejedno trebamo li ih skidati svaki put kod ukapavanja (i u tom slučaju vaše kapi ne bih nikako kupila) ili se jednostavno kapne kao kod nekih drugih kapi. Uglavnom, u želji da kupim lokalni proizvod, samo sam se razočarala, nažalost! Bačenih 60 kuna! U ponudi postoje dvije vrste kapi za oko Vizol S. Jedne su namijenjene nositeljima leća (one s koncentracijom hijaluronske kiseline od 0,21%) te one koje su namijenjene osobama s težim poremećajem suhoće oka te za ukapavanje preko noći (one s koncentracijom hijaluronske kiseline od 0,4%). U vašem slučaju se koristi koncentracija od 0,21% te ona vlaži i podmazuje i površinu između leće i oka. Na žalost, očito su vam u ljekarni dali krivi proizvod. S poštovanjem, JGL Savjetovalište Mogu li djetetu od 15 mjeseci dati Aqua maris kapi ili sprej i koje? Bebi možete ukapavati Aqua Maris Baby kapi za nos (u bočici od Radi se o izotoniziranoj morskoj vodi (slana je jednako kao i suze, pa ne nadražuje nježnu nosnu sluznicu). Pomoću AQM Baby kapi održavate vlažnost nosne sluznice, provodite higijenu nosne šupljine prije dojenja ili hranjenja na bočicu. Osim toga, kapi pomažu za vrijeme bolesti gornjih dišnih puteva (prehlada, viroza, alergija, upale uha), jer upale ometaju normalno disanje kroz nos. Aqua Maris Baby kapi s jedne strane mehanički očiste nos, a s druge strane morska voda sa svojim mikroelementima povoljno djeluje na površinski sloj sluznice (epitel) te oporavlja cilije koje dodatno čiste nosne hodnike. Ako je koža oko nosa crvena i upaljena (često se vidi u beba) predlažemo Vam da je njegujete s Aqua Maris mast za nos (sadrži vitamine A i E i d-pantenol). Srdačan pozdrav, Savjetovalište JGL Moja majka već nekoliko godina pije lijek Disopyramide, ali ga više nema u prodaji, navodno se ne proizvodi. Molim vas da mi kažete postoji li zamjena za taj lijek i kako se zove? Hvala. Lijek Disopyramide tbl, antiaritmik, nećemo više proizvoditi. Predlažemo da se vaša majka javi obiteljskom liječniku koji će je uputiti kardiologu radi promjene terapije. Srdačan pozdrav, JGL Savjetovalište Primijetila sam da mi Vitalia Valeral kapsule smanjuju menstrualne bolove, ali to niste nigdje naveli u uputama. Zahvaljujem na objašnjenju. Valeral kapsule sadrže suhi ekstrakt valerijane (odoljena) te se preporučuju kod nemira, napetosti ili stresa. Istovremeno valerijana djeluje blago distenzivno, opuštajuće, na mišiće te ste vjerojatno zbog toga osjetili olakšanje kod bolova. Iako proizvod nije posebno namijenjen ublažavanju menstrualnih bolova, valerijana će i tu pokazati svoje dobre učinke. Uostalom, mnogo je primjera u narodnoj medicini kad se valerijana koristila upravo za ublažavanje menstrualnih tegoba. S poštovanjem, Aleksandar Posavec Viši brand manager Bezreceptni program Prije 5 godina sam bila na laserskom skidanju dioptrije. U međuvremenu sam dvaput rodila. Moja kratkovidnost se vratila, sada je na oba oka -5. Javila sam se u privatnu kliniku gdje je operacija obavljena, ali osim neljubaznosti, nisam dobila nikakvo objašnjenje. Molim Vas da mi kažete zašto je došlo do slabljenja vida. Bojim se ponovno ići na operaciju. Mogu li ponovno koristiti leće? Poštovana, budući da nemam uvid u Vašu medicinsku dokumentaciju, teško mi je odgovoriti o razlozima. Uvjet pod kojim pacijent može pristupiti laserskoj operaciji skidanja dioptrije je da se dioptrija nije mijenjala minimalno jednu godinu. Nadam se da je to kod Vas bio slučaj. Što se trudnoće tiče, postoji izuzetno mala vjerojatnost da će pod utjecajem hormonskih utjecaja doći do promjene dioptrije. Možete koristiti kontaktne leće. Srdačan pozdrav, Maša Mikuličić, dr. med. U trudnoći mi se povisio krvni tlak. Nastavila sam uzimati lijekove i nakon poroda. Zanima me je li trudnoća bila „okidač“ za javljanje povišenog tlaka (imam tlakaše u obitelji) ili je to posljedica debljine (dobila sam 25 kg). Od straha i ne pomišljam na drugu trudnoću. Unaprijed hvala. Poštovana, u trudnoći se događaju velike promjene u organizmu trudnice. Volumen krvi se povećava, osobito na račun plazme, tako da imamo relativnu anemiju u krvnoj slici zbog veće količine tekućine. Također, dolazi i do hormonskih promjena, promjena u funkciji bubrega i sl. Te sve promjene mogu dovesti i do zadržavanja tekućine u tijelu uz povišenje krvnog tlaka i dobivanje na težini. Nakon poroda u većine žena dolazi do postupne normalizacije krvnoga tlaka kroz period od nekoliko mjeseci. Vrlo je bitno ponovno postizanje normalne tjelesne težine i redovito kretanje (30 - 45 min hodanja dnevno - ne mora biti u komadu). Takve osobe su sklonije ponovnom visokom tlaku u sljedećoj trudnoći. Ako tlak zaostaje nakon trudnoće duže od 6 mj., znači da je on uzrokovan drugim mehanizmima a ne trudnoćom, tj. prekomjernom tjelesnom težinom, slanom ishranom, nedostatkom tjelesne aktivnosti i sl. Trebalo bi djelovati na navedene čimbenike da bi se tlak normalizirao. Srdačan pozdrav, Sandro Brusich, dr. med. 27 mi je godina. Već nekoliko godina uz mjesečnicu dobivam i migrenu koja me potpuno iscrpi. Možete li mi savjetovati neki dodatak prehrani da smanjim jačinu glavobolja jer bih voljela zatrudnjeti, stoga izbjegavam lijekove. Izbjegavam čokoladu, kavu, sireve, suhomesnate proizvode, alkohol, ne pušim. Čula sam da magnezij, omega-3, i B vitamin mogu biti od koristi. Što mi Vi savjetujete? Poštovana, sve što ste naveli može doprinijeti jakoj glavobolji, a isto tako, smatra se da omega-3 i magnezij mogu smanjiti intenzitet glavobolje. Brojne žene nastupom mjesečnice imaju izrazitu glavobolju i bore se protiv nje na razne načine. Izbjegavanje stresnih situacija i tiha, mirna prostorija mogu povoljno utjecati na glavobolju. Na kraju, ako ništa od navedenog ne smanjuje osjećaj boli, tada jedino preostaje medikamentozno liječenje. Srdačan pozdrav, dr. sc. Alemka Brnčić Fischer, dr. med. Moj dvogodišnji sin ima atopijski dermatitis. Redovito ga kontrolira dermatolog koji nije rječit. Nije mi ništa objasnio, samo mijenja recepte za kreme i masti. Na svoju sam ruku iz prehrane izbacila mlijeko i jaja te svu gotovu hranu, na nagovor rođakinje koja je s djetetom imala slične probleme. Ona je djetetu dala i probiotik. Molim Vas da mi odgovorite koji probiotik, u kojoj dozi i koliko dugo? Je li to oboljenje koje će ga pratiti cijeli život? Promjenom prehrane mom se sinu stanje popravilo. Poštovana, atopijski dermatitis (dermatitis atopica, AD) se pojavljuje u osoba s nasljednom atopijskom konstitucijom koja uvjetuje sklonost alergijskim reakcijama na različite alergene. U obradi bolesnika potrebno je učiniti alergološko testiranje (za dječju dob - KBC - Klinka za pedijatriju, Kantrida). Oko 50% djece ozdravi do 8. godine života, a njih čak 80% ozdravi do 12 godine. Međutim, u neke se djece u kasnijoj životnoj dobi razvije astma, odnosno alergijski rinitis. Pristup liječenju atopijskog dermatitisa ovisi o dobi bolesnika i kliničkim manifestacijama bolesti. Budući da pojedini inhalatorni i alimentarni alergeni uzrokuju pogoršanje atopijskog dermatitisa, potrebno je provesti odgovarajuće mjere suzbijanja ili uklanjanja kućne prašine, grinja, životinjskih dlaka i perja iz neposredne okoline bolesnika te iz prehrane izbaciti hranu na koju je bolesnik preosjetljiv. Klinički, temeljna obilježja atopijskog dermatitisa je generalizirana suhoća kože praćena jakim svrbežom, stoga je osobito važna pravilna njega i hidratacija kože. Pri kupanju i tuširanju potrebno je primjenjivati uljne kupke ili ulja za tuširanje te na kožu svakodnevno primjenjivati emolijense. Ostala topička terapija (kortikosteroidni pripravci, imunomodulatori) treba biti provedena u dogovoru s dermatologom. Prema literaturi najviše pozitivnih dokaza učinka kod atopijskog dermatitisa ima soj LGG, naročito u kombinaciji sa sojem BB12, pa preporučujem da pokušate s proizvodom koji sadrži te sojeve. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Imam 76 godina. Oftalmolog mi je savjetovao da uz terapiju za glaukom uzimam i lutein jer imam i početak mrene. U ljekarni su mi dali Oculo plus kapsule. Koliko dugo da ih uzimam? Mogu li se uzimati uz lijekove za povišeni tlak i masnoće? Poštovani, Oculo plus kapsule možete slobodno koristiti uz Vaše lijekove. Za prevenciju mrene preporučuje se uzimanje Vitalia Oculo plus kapsula dva puta godišnje po tri mjeseca, uz napomenu da jedna kura mora biti tijekom ljetnih mjeseci. Srdačan pozdrav, Maša Mikuličić, dr. med. Suprug i ja smo u kasnim 30-ima. U braku smo 2 godine, ne koristimo zaštitu, ali trudnoća se ne događa. Bili smo na pretragama, suprugov spermiogram je uredan, moji nalazi također. Suprug je prestao pušiti i konzumirati alkohol, a ja razmišljam kako „popraviti“ svoj reproduktivni sustav. Osim zdrave prehrane i umjerene tjelesne aktivnosti, možete li mi savjetovati još nešto? Čitala sam o omega-3 masnoj kiselini kao kvalitetnom dodatku za mnoga stanja, probioticima... Ali, ne znam što bi konkretno nama pomoglo. Poštovana, danas se smatra da, ako uz redovite nezaštićene odnose nakon godinu dana ne dolazi do trudnoće, postoji problem zanošenja te Vam svakako preporučujem nastavak obrade. Stoga, ako se ne ustanovi zanošenje, preporučujem liječenje metodama asisitirane oplodnje. Zdrava prehrana, prestanak pušenja..., sve su to pohvalne životne navike, ali u Vašem slučaju pomoć treba potražiti u specijaliziranim ustanovama za obradu neplodnosti. Srdačan pozdrav, dr. sc. Alemka Brnčić Fischer, dr. med. Navršila sam 63 godine. Prije 10 godina sam operirala karcinom dojke. Primila sam kemoterapiju i zračenje. Redovito se kontroliram i za sada je sve u redu. Od operacije nisam konzumirala mlijeko, samo svježi kravlji sir i ponekad jogurte. Odnedavno se javila jaka želja za mlijekom, međutim, kada ga popijem, imam jake bolove u crijevima, osjećam nadutost uz vjetrove. Takve smetnje nisam imala 10 i više godina. U prehrani nisam ništa promijenila. Bi li mi pomogli probiotici? Poštovana, tegobe koje navodite mogu vjerojatno biti uzrokovane nedostatkom enzima koji luči crijevna sluznica, a svrha mu je razgradnja mliječnog šećera (lakotoze). Kao posljedica kemoterapije moguće je i blaže oštećenje stanica crijevne sluznice. Osobe s takvim simptomima često mogu neometano konzumirati fermentirane mliječne proizvode jer bakterije koje fermentiraju mlijeko i pretvaraju ga u jogurt, sir i sl. za svoj rad koriste upravo taj mliječni šećer, tako da ga, primjerice, u siru nema. Vi svakako može probati uzimati probiotik Normia jer će bakterije koje se nalaze u preparatu djelomično "potrošiti" laktozu i time barem umanjiti, ako već ne i potpuno ukloniti smetnje. Smetnje će vjerojatno biti ovisne o dozi mlijeka pa je za pretpostaviti da manje količine mlijeka neće uzrokovati probleme. Srdačan pozdrav, Goran Hauser, dr. med. Svakodnevno koristim računalo, tijekom cijelog radnog vremena. Primijetio sam da su mi oči suhe pa koristim umjetne suze. Ako se iritacija ne smiri, koristim i Vizol kapi. Zanima me je li to u redu. Ne stignem otići oftamologu. Poštovani, umjetne suze možete koristiti cijelo vrijeme, a povremeno i Vizol kapi čija primjena ne bi trebala biti dulja od 4 dana, a ukoliko je potrebno dulje liječenje može se nastaviti nakon pauze od 3-5 dana. Ako crvenilo ne prolazi ili se jave neke nove smetnje, svakako Vam savjetujem oftalmološki pregled. Srdačan pozdrav, Maša Mikuličić, dr. med. Imam jako ispucale pete i suhe laktove. Koristila sam brojne masti i kreme jer taj problem imam godinama. Nedavno sam sasvim slučajno namazala pete i laktove s JGL dječjom masti jer ništa drugo nisam imala pri ruci i iznenadila se efektom. Pete su me prestale svrbjeti i peći, a laktovi su se smekšali. Ugodno sam se iznenadila jer nisam očekivala da će mi unukina mast za guzu pomoći. Nadam se da je smijem koristiti i dalje, jer pretpostavljam da dječja mast ne sadrži štetne kemikalije. Poštovana, budući da je dječja mast i inače namijenjena svakodnevnoj zaštiti i njezi nježne kože novorođenčadi i djece, možete je bez zapreka rabiti svakodnevno, i to više puta dnevno. Srdačan pozdrav, prof. dr. sc. Marija Kaštelan, dr. med. Imam 55 godina. Ne pušim. Alkohol sam konzumirao vrlo rijetko. Prije 2 tjedna javio sam se obiteljskom liječniku zbog žgaravice i bolova u žličici. Dobio sam uputnice za laboratorijske pretrage, UZ gornjeg abdomena, pregled stolice da se utvrdi ima li krvi i pregled kod gastroenterologa. Budući da na pregled kod specijalista moram čekati gotovo 2 mjeseca, liječnica mi je predložila da u privatnom laboratoriju napravim analizu stolice na Helicobacter pylori. Nalaz je bio pozitivan pa mi je ordinirala 2 antibiotika (Amoxicillin i Mikacin) u trajanju od 7 dana i Nexium od 40 mg kroz mjesec dana. Osjećam se bolje već nakon 2 tjedna. Međutim, brine me jesam li zarazio suprugu, iako ona nema smetnje. Ako sam je zarazio, mogu li se ja ponovno zaraziti od nje? Postoji li imunitet na tu bakteriju? Za vrijeme uzimanja antibiotika i tjedan poslije sam na preporuku magistre iz ljekarne uzimao Normia kapsule pa sam ovaj put lakše podnio antibiotike, odnosno izostali su problemi s crijevima (bolovi, proljev). Poštovani, članovi iste obitelji su često istovremeno zaraženi (infekcija se prenosi kontaktom) i moguć je prijenos s jednog člana na drugi, ali nije nužno. To se često događa i nakon što jedan član obitelji izliječi infekciju. Moguća je ponovna infekcija jer je imunitet koji nastaje nakon preboljele infekcije kratak i neučinkovit. Za vas je najvažnije da, nakon što prođete predviđenu terapiju (barem dva tjedna od zadnje tablete Nexiuma), provedete provjeru uspješnosti liječenja te ponovite liječenje ako je bilo neuspješno. Normia je svakako dobra nadopuna liječenju infekcije jer umanjuje nuspojave antibiotske terapije, a vjerojatno i povećava stupanj uspješnosti liječenja. Srdačan pozdrav, Goran Hauser, dr. med. Zanima me je li uistinu znanstveno ustanovljeno pozitivno djelovanje crnog vina (u maloj količini) na krvožilni sustav? Isto tako, zanima me bih li ja uz tabletu za tlak i srce mogao popiti 1 dl vina poslije ručka? Već 5 godina, otkad mi je otkriven povišeni tlak i ubrzani srčani ritam, nisam ni okusio alkohola. Međutim, prijatelji mi govore da pretjerujem. Hvala! Poštovani, u literaturi postoji sve više istraživanja i dokaza koji doista pokazuju da male količine alkohola (1 - 2 dl bijelog ili crnog vina) pozitivno djeluju na kardiovaskularni sustav, smanjuju učestalost infarkta srca i sl. Također, postoje i dokazi da je više od 2 dl dnevno štetno jer dovodi do povišenja krvnog tlaka i slabljenja srca u srčanih bolesnika. Pacijentima koji su do sada konzumirali vino kažem da je 1 dl dobar za srce, 2 dl je neutralno, a više od toga je štetno. Iznimka su bolesnici s napadima aritmija (fibrilacije atrija) povezanih s konzumiranjem alkohola i bolesnici s uznapredovalim srčanim zatajenjem kojima ipak ne preporučujem konzumiranje alkohola. Srdačan pozdrav, Sandro Brusich, dr. med. imam 60 godina. Normalne sam tjelesne konstitucije. Ne pušim, a prigodno konzumiram malu količinu vina (1 dl). Sklona sam slatkišima. Želučane tegobe sam imala prije 25 godina kao posljedicu terapije Andolom. Otada pazim na prehranu, koja je raznovrsna i uglavnom mediteranska. Međutim, prije mjesec dana bila sam na putu, gdje sam u gostima tijekom 5 dana jela tešku hranu – prženo, pohano, masno. Javile su se žgaravica i težina u žličici. Smetnje su se smirile do Uskrsa, kad sam opet konzumirala tešku hranu. Otada imam osjećaj blagog pečenja u žličici prema jednjaku i vrlo često podrigivanje. Imam osjećaj kao da mi balončić zraka izleti iz želuca. Bez mirisa je. Kad osjetim jače pečenje, pojedem dvopek i to mi prođe. Sada jako pazim na prehranu; mali obroci, kuhani, dobro sažvakani... Ponekad loše spavam zbog osjećaja nelagode u želucu. Bojim se uzimati lijekove za smanjenje želučane kiseline jer imam osteopeniju, a oni „izvlače“ kalcij iz kostiju. Ako me moja doktorica pošalje na gastroskopiju, morat ću čekati nekoliko mjeseci. Što učiniti u međuvremenu? Bi li bilo dobro napraviti analizu stolice na Helicobacter pylori? Taj mi je test po cijeni dostupniji od izdisajnog testa. Ako bi test bio pozitivan, bi li mi doktorica mogla propisati terapiju? Sve više sam zabrinuta. Poštovana, obzirom na Vaše smetnje, vrlo je lako moguće da imate gastritis uz upalu jednjaka (GERB). Terapija je odabir nekog lijeka za želučanu kiselinu. Za osobe do 50 godina starosti bez simptoma gubitka težine ili slabokrvnosti moguće je te lijekove propisati "napamet" i ako djeluje, to je onda ujedno i dijagnostika i terapija. Međutim, kod starijih od 50 nužno je napraviti gastroskopiju kako se ne bi maskirala neka ozbiljnija bolest želuca ili jednjaka. Na gastroskopiju se u Rijeci čeka 30 dana, stoga ne vjerujem da je u Zagrebu dulje. Ako imate namjeru čekati pregled, a imate tegobe koje ne možete trpjeti, vi svejedno možete početi uzimati lijek protiv kiseline do samog pregleda. Priča o kalciju i lijekovima koju ste spomenuli i nije baš najsigurnija, odnosno nije bitna za osobe koje imaju tegobe i kojima su ti lijekovi neophodni. Srdačan pozdrav, Goran Hauser, dr. med. Imam 55 godina. Nekoliko godina me muči suhoća rodnice, radi čega se javljaju upale (tako mi je objasnio ginekolog). Problem je i u tome što se vaginalete ne mogu otopiti u rodnici pa imam osjećaj da se zato upale i ne rješavaju. Zanima me bi li mi Lactogyn vaginalna kapsula pomogla? Otapa li se ona lakše? Poštovana, približavanjem menopauze, a posebice u postmenopauzi javlja se suhoća rodnice kao posljedica gubitka estrogena. Lactogyn vaginalna kapsula mogla bi Vam pomoći. No, oralni oblik Lactogyna ima jednaki učinak kao i vaginalni, uz uporabu kroz dva mjeseca, koliko se preporučuje za postizanje optimalne stabilizacije vaginalne mikroflore. Srdačan pozdrav, dr. sc. Alemka Brnčić Fischer, dr. med. Svijetle sam puti i svijetle kose. Od svibnja do rujna koristim zaštitne kreme za lice i tijelo. Kad sam na moru, koža mi se jako isuši. Pokušavala sam je nahraniti, zamastiti raznim losionima i kremama, ali uglavnom bezuspješno. Neki dan su mi u ljekarni ponudili Pantexol losion. Praktičan je što se tiče nanošenja. Zanima me odgovara li on po sastavu suhoj iziritiranoj koži? Bih li trebala uzimati neki suplement? Ukućani me tjeraju da jedem ribu jer sadrži omega-3, ali ne mogu je jesti više od jednom tjedno. Bi li bilo dobro da počnem uzmati omega-3? Na vašim sam internetskim stranicama vidjela da imate MegaOmega-3. Je li namijenjena za slučajeve poput mojeg? Poštovana, Pantexol losion njeguje, održava normalnu vlažnost kože te pruža zaštitu suhoj i oštećenoj koži. Sadrži vitamin B5 i pantotensku kiselinu, koji dodatno njeguju kožu. Bitno ga je u početku nanositi više puta dnevno. Glede MegaOmega-3 kapsula, one ponajprije imaju povoljno djelovanje na bolesti srca i krvnih žila. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Imam 70 godina. Već 20-ak godina uzimam lijekove za povišeni tlak i za srce. U mladosti sam i prekomjerno pio. Kardiolog mi je rekao da bolujem od kronične kardiomiopatije. Možete li mi objasniti o čemu se radi? Poštovani, kardiomiopatija je opći pojam kojim označavamo bolest srčanog mišića, a najčešće se manifestira uvećanjem srca koje se slabije stišće. Najčešći uzroci su: ishemijska bolest srca (začepljenja ili suženja krvnih žila srca), toksični (najčešće dugotrajno konzumiranje većih količina alkohola) ili prirođeni. Osim samog termina, bitna je i težina bolesti - potrebno je obaviti ultrazvuk srca kojim se određuje istisna frakcija (snaga kontrakcije - u nalazu je označena u postocima), veličina srca, kompetentnost zalistaka (propuštaju li i u kojem stupnju) i sl. Kardiomiopatija, ako nije jako uznapredovala, može se uspješno liječiti promjenom stila života i lijekovima koje treba uzimati cijeli život. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 42 godine i profesionalni sam vozač. Na dužim putovanjima ponekad osjećam peckanje, nelagodu u očima. Vid mi je dobar, redovito idem na sistematske preglede. Povremeno koristim umjetne suze, a ako mi se crvenilo ne povuče, koristim Vizol kapi. Najčešće nisam u mogućnosti javiti se oftalmologu pa su te dvije bočice uvijek sa mnom na putu. Što mi Vi savjetujete? Kod vas se najvjerojatnije radi o blagoj iritaciji spojnice oka koja je provocirana klimom i dugotrajnom vožnjom prilikom koje rjeđe trepćemo. Naime, klima (suhi zrak ) i rjeđe treptanje utječu na kvalitetu suznog filma. Prilikom dužih vožnji možete koristiti umjetne suze da izbjegnete iritaciju oka. Ukoliko se oči ipak zacrvene - tada možete kratkotrajno koristiti Vizol kapi. Vizol stišće krvne žile na spojnici oka i na taj način oko bijeli. Ukoliko crvenilo potraje, ili se jave novi simptomi, preporučam oftalmološki pregled. Srdačan pozdrav, Maša Mikuličić, dr. med Već nekoliko godina koristim Timalen kapi za liječenje glaukoma. Imam 70 godina. Redovito idem na kontrole. Oftalmolog je zadovoljan nalazom. Nedavno sam pročitala članak o luteinu i njegovu zaštitnom djelovanju na oči? Bi li mi Vaš Oculo plus pomogao u prevenciji komplikacija od povišenog očnog tlaka? Uzimanje luteina pomaže u prevenciji i napredovanju degeneracije žute pjege i sive mrene no nema dokaza da lutein utječe na prevenciju ili napredovanje glaukomske bolesti. Ono što Vam svakako savjetujem jest pridržavanje propisane terapije i redovne kontrole kod vašeg oftalmologa. Srdačan pozdrav, Maša Mikuličić, dr. med Navršila sam 61 godinu. Radim na računalu više od šest sati dnevno. Svijetlih sam očiju i nosim naočale za dalekovidnost. Na sistematskom pregledu oftalmolog je otkrio da mi se dioptrija u godinu dana pogoršala. Savjetovao mi je Vitalia oculoplus kapsule. Uzimam jednu dnevno. Trebam li ih preventivno stalno uzimati? Za prevenciju mrene preporuča se uzimanje Vitalia oculoplus kapsula dva puta godišnje po tri mjeseca, uz napomenu da jedna kura mora biti tijekom ljetnih mjeseci. Srdačan pozdrav, Maša Mikuličić, dr. med Imam 62 godine. Visoka sam 170 cm, a teška 66 kg, opseg struka iznosi 86 cm. Osim blažih reumatskih tegoba, zdrava sam. Primjećujem da mi se tlak u posljednje dvije godine lagano povisio. Ranije sam bila niskotlakašica, a sada se ne spušta ispod vrijednosti od 130/90. Međutim, u ekstremno stresnim situacijama zna se povisiti i na 140/100. To osjetim kao pritisak u ušima i toplinu u obrazima. Smirim se vježbama disanja i eventualno Valeral kapima pa se i tlak spusti na 130/90. Svakodnevno vježbam (za jačanje mišića i istezanje), brzo hodam i trudim se zdravo hraniti. Zanima me jesam li u rizičnoj skupini za srčano oboljenje? Teško mi je procijeniti vaš ukupni kardiovaskularni rizik jer nemam dovoljno podataka. Normalno je da 5 - 10 godina nakon menopauze u žena počinje rasti krvni tlak i rizik se izjednačava s onim muške populacije. Tjelesna težina vam je normalna, opseg struka ne prelazi 88 cm, krvni tlak većinom nije visok i redovito se krećete, što upućuje na to da nemate povišeni kardiovaskularni rizik. Dodatni čimbenici rizika koje treba uzeti u obzir su pušenje, genetska sklonost (bliski član obitelji koiji je imao infarkt miokarda ili moždani udar - muškarci mlađi od 55 i žene mlađe od 65 godina), masnoća u krvi, šećerna bolest, pravilna prehrana. Srdačan pozdrav, Sandro Brusich, dr. med. Prije tjedan dana su mi na Dermatologiji elektrokoagulacijom odstranili desetak fibroma s lica i vrata. Sad se vide kraste. Hoće li mi ostat ožiljci? Kako fibromi nastaju? Smijem li se sunčati? Fibromi su benigni tumori vezivnog tkiva. Nakon postupka elektrokoagulacije ne moraju, ali isto tako i mogu, zaostati sitni ožiljci, ovisno o dubini samog zahvata. Nakon što promjene zacijele, možete se sunčati. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Nedavno sam uzimala antibiotike zbog upale sinusa. Liječnica mi je savjetovala i probiotik Normiu u kapsulama. Dobro sam podnijela kombinaciju antibiotika s probiotikom (prije sam uvijek pred kraj terapije imala kašaste ili proljevaste stolice). Javljam Vam se zbog svojega dvanaestogodišnjeg sina koji ima vrlo često gnojnu anginu, zbog čega koristi antibiotike. Trebam li i njemu dati Normiu? Koliko puta dnevno i koliko dana? U uputi sam vidjela da lijek dolazi u nekoliko oblika. Koji je najprikladniji za dvanaestogodišnjaka? Antibiotici, uza sve svoje dobre karakteristike, dovode i do niza neželjenih nuspojava. Što se tiče probavnog trakta u djece, te se nuspojave javljaju u do 30% djece koja uzimaju antibiotike, dok je postotak u odraslih niži. Uz antibiotik bi svakako trebalo uzimati i probiotik, i to od prvog dana pa još dva tjedna po prestanku terapije (to je okvirno razdoblje tijekom kojega antibiotici još mogu uzrokovati nuspojave. Preporučujem dozu od jedne tablete Normije dnevno, kako je naznačeno i u prospektu. Srdačan pozdrav, prof. dr. Mladen Peršić, dr. med. Već godinu dana imam CIN 1. U tom sam razdoblju napravila nekoliko papa testova. Brisovi rodnice prije godinu dana bili su pozitivni na HPV niskog rizika. Nedavno sam bila na kolposkopiji. Liječnik mi je rekao da nema potrebe raditi biopsiju, ali je predložio krioterapiju. Možete li mi objasniti o kakvoj se metodi radi? U ozbiljnoj sam vezi koja traje šest mjeseci, a prilikom odnosa koristimo kondom. Dokad preporučujete njegovo korištenje? HPV virus je u 99,7% uzrok svih premalignih promjena vrata maternice (tzv. CIN-ovi). CIN 1 je najblaži stupanj promjene i uglavnom (posebno ako se radi o mlađoj životnoj dobi) se preporučuje samo njegovo praćenje. Naravno, preporučuje se i kolposkopija na temelju koje je liječnik i zaključio da ne treba raditi biopsiju jer vjerojatno i kolposkopski nalaz ukazuje na to da se radi o blažem stupnju promjene koji odgovara CIN-u1. Krioterapija je postupak kojim se površina vrata maternice zaledi i na taj se način tkivo destruira, tj. uništi. Problem pri krioterapiji je taj što nema uzorka za patohistološku analizu. Kondom se preporučuje dok god postoji promjena u papa nalazu. Srdačan pozdrav, dr. sci. Alemka Brnčić Fischer Moja šesnaestomjesečna kći još uvijek nosi pelene. Prilikom promjena pelena redovito je mažem dječjom masti JGL-a. Povremeno joj se pojavi diskretno crvenilo i osip koje se povuče za dan ili dva. Tada joj češće mijenjam pelene i nanosim deblji sloj masti. Na policama u ljekarni vidjela sam da imate i dječju pastu. Je li i ona namijenjena za svakodnevnu, višekratnu upotrebu? Dječja se pasta može upotrebljavati svakodnevno, no vrlo je gusta pa ju je stoga teško skinuti s kože. Za svakodnevnu višekratnu uporabu bolje bi bilo primjenjivati dječju mast s balzamom. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Sa suprugom se spremam na duži put po Indiji. U priručnu apoteku stavio bih i probiotik, ali ne znam koji. Supruzi su u ljekarni sugerirali Prolife kapsule, a meni Normiu kapsule. Koja je razlika? Što je djelotvornije za putne proljeve? I Prolife i Normia imaju sličan učinak, ali, s obzirom na praktičnost i mogućnost da zbog raznih čimbenika ipak dođe do proljeva, ja bih izabrao ORS Normia vrećice. One sadržavaju vrećice oralne rehidracijske soli (ORS) i vrećice probiotika Normia. Kod proljeva je neophodno nadoknaditi izgubljenu tekućinu, ali i elektrolite, što ćete postići uzimanjem otopine ORS-a. Upotreba vrećica probiotika Normije skratit će trajanje proljeva i ubrzati oporavak crijevne flore. S obzirom na to da putujete na duže vrijeme, mislim da bi bilo korisno uzeti više od jedne kutije ORS Normie. Preporučio bih i medicinski ugljen, Carbo medicinalis, koji bi, ako do proljeva ipak dođe, trebalo uzeti odmah, prema priloženoj uputi, ali u razmaku od dva sata u odnosu na Normia vrećice. Nemojte zaboraviti ni činjenicu da jedenje neoguljenog voća te sirovog, samo opranog, povrća, kao i pijenje bilo čega osim originalno zapakiranih napitaka dovodi do sigurne zaraze. Srdačan pozdrav, dr. sci. Goran Hauser, dr. med. Navršila sam 60 godina. Sluznice i koža su mi suhe. Za intimnu higijenu koristim Lactogyn sapun, ali samo oko anusa jer se bojim da će mi dodatno isušiti rodnicu. Mislim da najviše bakterija dolazi iz debelog crijeva pa se nadam da ispravno obavljam higijenu intimnog dijela ako to područje operem Lactogynom poslije pražnjenja crijeva i otuširam se toplom vodom. Griješim li? Lactogyn tekući sapun za intimnu njegu neće isušiti rodnicu zbog svojeg stupnja kiselosti (pH) te ga bez ustručavanja možete koristiti za cjelokupnu intimnu toaletu. Važno je samo da ne ispirete rodnicu (tzv. tuširanje rodnice) jer se tako ispiru i korisne bakterije. Za bolju vlažnost intimnog područja možete koristiti i Lactogyn gel. Srdačan pozdrav, dr. sci. Alemka Brnčić Fischer Imam 70 godina i već tri godine, od prijetećeg infarkta, uzimam Pigrel tablete. U međuvremenu sam smršavio, promijenio način prehrane, fizički se aktivirao te lijekovima stabilizirao krvni tlak. Moram li doživotno uzimati antikoagulans? Dobro ga podnosim, ali moram obaviti test stolice na prikriveno krvarenje u okviru preventivnog pregleda za rano otkrivanje karcinoma crijeva pa tri dana ne smijem uzimati lijek. Hoće li mi to naškoditi? Prema smjernicama Europskoga kardiološkog društva, na kojima se temelje i hrvatske smjernice za liječenje srčanih bolesnika, uzimanje Pigrel tableta nakon akutnoga koronarnog sindroma (prijetećeg infarkta) indicirano je u trajanju od godine dana, nakon čega se uzimanje može ukinuti. No, kardiolozi ih na kontrolama često ne ukidaju ako ih bolesnici dobro podnose jer nema jasnih studija o njihovu učinku nakon godine dana, odnosno nema rezultata o tome je li bolje piti ga ili prestati s uzimanjem. Vašem bih ih slučaju ukinuo jer smatram da niste bolesnik visokog rizika. Srdačan pozdrav, Sandro Brusich, dr. med. Nedavno sam na skijanju dobio proljev pa sam ,umjesto zimskih radosti, gladovao i proveo tri dana na čaju, dvopeku, krekerima. Prijatelj mi je ponudio probiotik Normiu u kapsulama. Uzimao sam ih tri dana (imao je samo šest kapsula) i probavne su se smetnje smirile. Zanima me bih li naknadno trebao napraviti dodatne pretrage? Je li uputno da napravim kuru s Normia kapsulama tijekom dužeg vremena? Vjerojatno se radilo o akutnom proljevu, tzv. putničkoj dijareji. Uobičajeni je tretman upravo ono što ste i napravili (čaj, dvopek i sl.), a probiotici svakako mogu blagotvorno utjecati, kao što ste i sami primijetili. Probiotik se uobičajeno uzima desetak dana u akutnoj fazi, a mislim da za to u Vašem slučaju nema potrebe osim ako Vam se i dalje ne javljaju proljevi. Također, daljnjim se pretragama neće dobiti nikakvi novi podaci ako su simptomi prestali. Srdačan pozdrav, dr. sci. Goran Hauser, dr. med. Moja je četverogodišnja kći sklona crijevnim infekcijama. Od jasličke dobi ide u vrtić pa pretpostavljam da tamo i pokupi proljeve. Na Vašim sam stranicama zapazio Prolife proizvode (kapsule, tekućinu, pastile). Budući da pedijatar svaki put savjetuje dijetu i probiotik, ali ne precizira koji, kupujem ga po preporuci u ljekarni. Zanima me koji biste mi probiotik Vi savjetovali i zašto? Koju dozu da uzima i koliko dugo? Pokazalo se da više vrsta probiotika ima pozitivan učinak u smirivanju akutnih proljeva, posebice onih izazvanih rotavirusom. Međutim, u Vašoj bih situaciji preporučio dugotrajnije uzimanje probiotika jer je dijete "sklono" proljevima. Drugim riječima, crijevna je flora očito narušena i zato sklonija recidivima smetnji. Jasno, neophodno je vidjeti je li moguće da se radi o nekim drugim bolestima, poput celijakije itd., što je u domeni Vašega izabranog pedijatra. Za bližu dijagnozu potrebna je iscrpna anamneza, dobar pregled djeteta (percentilne krivulje ...) te, po potrebi, i laboratorijske pretrage. Na pitanje o tome koji probiotik uzimati već sam djelomice odgovorio. Prolife se pokazao vrlo učinkovitim pa preporučujem uzimanje jedne ampule Prolifea ujutro tijekom 6 do 8 tjedana. Srdačan pozdrav, prof. dr. Mladen Peršić, dr. med. Imam 50 godina i još od mladosti imam vrlo suhu kožu na rukama, laktovima i petama. Pete su ispucale, vide se uzdužne pukotine. Dermatolog mi je davao kortizonske masti od kojih bi se pukotine povlačile, ali bi se, po prestanku terapije, vrlo brzo i vraćale. Magistra u ljekarni savjetovala mi je Vaš balzam od nevena. Mogu li ga koristiti svakodnevno tijekom dužeg razdoblja ili moram pauzirati? Balzam od nevena možete koristiti svakodnevno, a učinkovitiji je ako ga primjenjujete nekoliko puta dnevno, odnosno što češće. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Na Vašim sam stranicama pronašla MegaOmegu3, pripravak koji povoljno djeluje na krvožilni sustav. Moja ga majka (65 godina) uzima tri mjeseca, potom pauzira tri mjeseca pa opet tri mjeseca uzima pripravak. S obzirom na to da uopće ne jede ribu, ne znam je li to dovoljno omege 3 za preventivu? Što joj savjetujete od prirodnih lijekova? Vitalia MegaOmega3 je odličan pripravak za prevenciju bolesti krvožilnog sustava i neka ga slobodno nastavi uzimati. Ako su vrijednosti kolesterola i triglicerida uredne, ne bih preporučivao druge pripravke, već samo pravilnu prehranu. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 45 godina i prije tri godine operiran sam zbog perforacije vrijeda na želucu i obilna krvarenja. Tom mi je prilikom odstranjeno 2/3 želuca. Otada jedem manje obroke više puta na dan i nemam želučane smetnje. Međutim, poslije ručka osjetim umor i pospanost pa sam prisiljen odspavati jedan sat . To si mogu priuštiti jer imam privatnu tvrtku pa poslije odmora nastavim raditi do navečer. Prije nekoliko sam dana to spomenuo svojoj liječnici koja mi je rekla da poslije jela nikako ne bih smio „u horizontalu” jer će mi se proširiti hijatalni otvor. Uistinu me uplašila jer GERB je ozbiljno stanje. Što mi savjetujete? Vaš osjećaj nakon jela rezultat je prilagodbe organizma na novu "fiziologiju", tj. na činjenicu da nemate znatan dio želuca. Vašem slučaju izostaje uobičajena obrada hrane u želucu pa ona brzo dolazi u tanko crijevo (ovisno o vrsti hrane, radi se o razdoblju od jednog do tri sata), rezultat čega je to da Vaš organizam katkad reagira na opisani način. To je uvjetovano povećanim lučenjem inzulina i padom razine šećera u krvi. U nekih ljudi to može imati i drastičnije oblike pa nastaju prave hipoglikemije s preznojavanjem, lupanjem srca i nesvjesticom. Što se tiče "horizontale" ,Vaša liječnica ima pravo jer ležanje može pogodovati vraćanju hrane u jednjak. Međutim, ako nemate osjećaj vraćanja kiseline kada legnete, mislim da se ne trebate plašiti GERB-a. Dakle, ako Vam umor nakon obroka predstavlja problem, a nemate osjećaj pečenja i podrigivanja kada legnete, mislim da možete nastaviti s uobičajenom praksom "horizontale". Srdačan pozdrav, dr. sci. Goran Hauser, dr. med. Imam 28 godina. Redovito idem na ginekološke preglede i nikad nisam imala probleme. Sad mi se već otprilike šest mjeseci pojavljuje pojačani bijelo-žućkasti sirasti iscjedak blaga mirisa koji nije popraćen nikakvim svrbežom. Zadnji sam put bila kod ginekologinje prije 4 mjeseca i spomenula sam joj to. Doktorica mi je rekla da nemam upalu, ali da bih dva mjeseca mogla koristiti Lactogyn za regulaciju vaginalne flore. Zanima me vidi li se pri običnom pregledu da se radi o gljivicama te kontrolira li se i to prilikom uzimanja brisa za papa test? Ne znam je li potrebno da koristim Lactogyn jer svakodnevno konzumiram jogurte i kefir u zaista velikim količinama (minimalno 0,5 l). Također sam razmišljala o kuri Canestenom, ali ne znam koliko je to preporučljivo ako nije utvrđeno da su uistinu gljivice u pitanju. Ako je rodnica kolonizirana gljivicama u većoj količini (uglavnom se radi o Candidi albicans), to se prilikom pregleda spekulumom na ginekološkom pregledu detektira kao obilne krpičaste bjelkaste naslage, bez mirisa. Očito to u Vas nije slučaj jer bi vam ginekolog to i rekao. Pri analizi papa testa također se rutinski analizira stupanj čistoće i detektira se povećana koncentracija gljivica, što se i označava u nalazu. Upotreba jogurta i kefira, makar i u povećanoj količini, ne utječe na uspostavu ravnoteže vaginalne flore jer oni ne sadrže probiotike koji koloniziraju rodnicu i ne djeluju na njezinu floru. Stoga se preporučuje uporaba Lactogyna. Ako ginekolog to nije preporučio, ne savjetujem uporabu Canestena radi profilakse. Srdačan pozdrav, dr. sci. Alemka Brnčić Fischer Mojoj sestri je 30 godina. Ima cistu na hipofizi. Prije godinu i pol rodila je sina. Izdajala se šest mjeseci jer beba nije prihvatila sisanje. Zatim je u bebinu prehranu uvela adaptirano mlijeko. Ubrzo je primijećeno da dijete zaostaje u rastu za svojim vršnjacima. Ne hoda, ali samostalno sjedi, prati predmete i osobe. Je li bolest hipofize moje sestre uzrok djetetova sporijeg rasta i razvoja? Redovito ga vodi na preglede kod pedijatra, obavljene su i neke dodatne pretrage, ali mojoj sestri nitko nije objasnio stanje djeteta niti dao prognozu. Vaše je pitanje presloženo da bi se odgovorilo na ovaj način. svakom slučaju, Vašem je nećaku potrebna kompleksnija, vjerujem i bolnička, obrada (kod supspecijalista gastroenterologa). Srdačan pozdrav, prof. dr. Mladen Peršić, dr. med. Imam 50 godina. Više od 5 godina imam problem s kondilomima koji se vraćaju unatoč terapiji (podofilin, elekrokauterizacija). Cijelo to vrijeme nisam u vezi jer se bojim da ću zaraziti partnericu pa onda ona mene i da će se infekcija vrtiti u krug. To me dovelo u stanje apatije. Kako da riješim svoj problem? Ako i dalje imate vidljive kliničke manifestacije bolesti, potrebno ih je liječiti elektrokauterizacijom, krioterapijom ili primjenom nekoga lokalnog pripravka. Nova lokalna terapija uključuje i imunomodulatore poput imiquimoda. Glede prijenosa infekcije, tijekom spolnog odnosa treba koristiti kondom. Srdačan pozdrav, prof. dr. Marija Kaštelan Moj dvogodišnji sinčić još uvijek nosi pelene. U posljednje vrijeme češće ima pelenski osip iako redovito stavljam vašu dječju mast. Trebam li mu guzu mazati i s Pantexol masti ili kremom? Možete koristiti i Pantexol kremu i mast, a ako se promjene ne povuku, obratite se liječniku radi daljnje terapije. Srdačan pozdrav, prof. dr. Marija Kaštelan Od djetinjstva se liječim od psorijaze. Iz godine u godinu uzimam kortizonske masti jer mi jedino one pomažu. Razmišljam o trudnoći jer mi je već 30 godina, ali strah me. Može li terapija koju uzimam lokalno naštetiti plodu u razvoju? Kolika je vjerojatnost da i dijete oboli od psorijaze? U mojoj obitelji samo ja imam psorijazu. Kada bukne, zahvati gotovo cijelo tijelo. Živim na moru, sunčam se i ljeti nemam problema. Psorijaza se, osim kortikosteroidnim lokalnim pripravcima, može liječiti i drugim topičkim pripravcima poput calcipotriola, retinoida i sl. te, u težim oblicima, sistemskim lijekovima - dakako, uz nadzor dermatologa. Također treba što češće koristiti neutralne pripravke poput Pantexol losiona, masti ili sličnih pripravaka. Primjena kortikosteroidnih lokalnih pripravaka moguća je i tijekom trudnoće. Međutim, svaki oblik liječenja, pa tako i lokalnim pripravcima, mora nadzirati liječnik. Srdačan pozdrav, prof. dr. Marija Kaštelan Već 5 godina zbog glaukoma uzimam Timalen kapi za oči. Redovito idem na kontrole kod oftalmologa koji nije razgovorljiv pa se ne usudim pitati ga o preparatu koji bi mi možda pomogao, a ne izdaje na recept. Radi se o Oculoplus kapsulama koje moj suprug koristi po preporuci liječnika jer ima makularnu degeneraciju. Zanima me bi li one i meni pomogle s obzirom na moju dob (78 mi je godina)? Najvažnije od svega su redovne kontrole zbog glaukoma. Što se tiče Oculoplus kapsula, one sadrže lutein i zeaksantin koji mogu smanjiti rizik od nastanka i napredovanja degeneracije makule i staračke mrene. Slobodno ih možete uzimati. Srdačan pozdrav, dr. med. Maša Mikuličić, oftalmolog Imam 63 godine. U posljednjih nekoliko godina povremeno osjećam suhoću oka. Još uvijek radim za računalom. Trebam li umjetne suze uzimati svakodnevno ili po potrebi, kad osjetim suhoću? Povremeno koristim i Vizol kapi. Nedavno sam bila kod oftalmologa koji mi je promijenio dioptrijske naočale, dok se na suhoću oka nije ni osvrnuo. Bilo bi dobro da umjetne suze koristite svakodnevno zbog tipa posla kojim se bavite, a pogotovo u zimskim mjesecima kada većinu vremena provodimo u suhim, toplim prostorima. Srdačan pozdrav, dr. med. Maša Mikuličić, oftalmolog Liječnik-gastroenterolog savjetovao mi je da poslije gastroskopije i liječenja Helicobacter pylori trojnom terapijom napravim izdisajni test. Još uvijek uzimam Normia kapsule (savjetovano mi je uzimati ih tijekom 6 tjedana). Zanima me trebam li taj test napraviti poslije terapije s probiotikom ili mogu odmah? Osjećam se dobro. Ureja izdisajni test treba se učiniti dva tjedna nakon završetka terapije s inhibitorom protonske pumpe. To je onaj lijek koji, za razliku od dva antibiotika, uzimate 4 tjedna. Kada s njim završite, pričekajte barem dva tjedna i tada možete učiniti test. Normia neće utjecati na rezultat ureja izdisajnog testa. Srdačan pozdrav, dr. sc. Goran Hauser Imam 25 godina. Zdrav sam i nepušač. Zdravo se hranim,a rekreativno se bavim sportom. Već nekoliko godina imam neugodan zadah iz usta. Izbjegavam ljude na poslu, ali i privatno. Pretvorit ću se u vuka samotnjaka jer ne znam kako si pomoći. Što mi Vi savjetujete? O neugodnom zadahu iz usta prvenstveno treba obavijestiti nadležnog stomatologa. Ako je stomatološki sve u redu, u obzir dolazi pregled želuca, gastroskopija. Nažalost, često se i nakon svih pretraga ne pronađe jasan uzrok. Nisam siguran hoće li Vam probiotici pomoći, pogotovo ako nije pronađen konkretan uzrok. Srdačan pozdrav, dr. sc. Goran Hauser Imam 55 godina. Na sistematskom pregledu ustanovljena mi je „masna jetra”. Nisam teže bolovala, rijetko sam uzimala lijekove. Laboratorijski su nalazi uredni. Ne osjećam smetnje probavnog sustava. Pazim na prehranu, obroci su mi redoviti, volim mediteransku kuhinju. Od alkohola konzumiram isključivo vino, i to prigodno (uz obiteljske proslave), ne više od 1 dcl. Na internetu sam pronašla podatak da je masna jetra česta u kroničnih alkoholičara. Možete li mi objasniti o čemu se radi? Trebam li napraviti neku dodatnu pretragu? Masna jetra nije isključivo vezana uz prekomjernu konzumaciju alkohola. Dapače, često se javlja i kod osoba koje minimalno ili uopće ne piju alkohol pa se ta bolest još i naziva nealkoholni steatohepatitis (engleska kratica: NAFLD). Brojni su mogući uzroci, a često je vezana uz prekomjernu tjelesnu masu, poremećene vrijednosti masnoća u krvi, šećernu bolest ili virusne bolesti jetre. Ako su rutinski nalazi jetrene funkcije uredni, nije nužna daljnja obrada, ali treba vidjeti što je s tjelesnom masom i kakve su Vam masnoće u krvi. U principu, bolest je relativno bezopasna i ne dovodi do težih posljedica ako osnovni uzrok nije alkohol ili virusna bolest. Srdačan pozdrav, dr. sc. Goran Hauser Nakon operacije kuka dobila sam trombozu lijeve potkoljenice. Već godinu dana uzimam Pigrel tablete. Redovito se kontroliram kod flebologa. Sada ne osjećam bolove, samo zatezanje u potkoljenici. Hoću li s vremenom prestati uzimati Pigrel? Može li se cirkulacija potaknuti na neki prirodniji način? S obzirom na to da je tromboza bila potaknuta operacijom i mirovanjem i da niste imali komplikacija, terapija će se s vremenom vjerojatno moći ukinuti. To mora odlučiti liječnik koji vas vodi, a odluka ovisi o vašem riziku od komplikacija i nalazu ultrazvuka potkoljenice. Cirkulacija se potiče tjelovježbom - šetnjom - i ostalim mjerama koje vam preporuči flebolog koji je više upućen u navedeno liječenje (toplo-hladne kupke, elastične čarape i Srdačan pozdrav, Sandro Brusich, dr. med. Moja je majka bolovala od angine pektoris, a nakon nekoliko godina imala je i srčani infarkt od kojeg se oporavila. Umrla je od moždanog krvarenja nakon 2 godine. Meni su 62 godine. Proteklih 5 godina uzimam terapiju za povišeni krvni tlak koji je uglavnom u prihvatljivim granicama. Međutim, počeo sam se opterećivati razmišljanjem o naslijeđu i o tome kolika je vjerojatnost da i ja, kao i moja majka, obolim od infarkta, odnosno moždanog inzulta. Je li taj strah osnovan ili je samo plod moje panike? Genetika je jedan od čimbenika koji povisuje rizik za navedene bolesti ali ako su ostali rizikočimbenici uredni (tlak, masnoće, pušenje), onda je ukupni rizik maleni. On se može i izračunati iz tablica. Posavjetujte se sa svojim liječnikom. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 45 godina. Prije 6 mjeseci dobila sam Atenolol tablete zbog ubrzanoga srčanog ritma. Srčani se rad stabilizirao. Tlak mi je nešto niži nego prije terapije. Osjećam li zbog toga umor i pospanost? Hoću li ih doživotno morati uzimati? Kao i ostali lijekovi iz skupine beta-blokatora, Atenolol može izazivati osjećaj umora i pospanosti, pogotovo ako je istovremeno krvni tlak niži. Ako je doza mala (12,5 - 25 mg) lijek se može probati ukinuti, a ako je doza viša, onda najprije prepoloviti dozu. Ukidanje lijeka ovisi o više čimbenika: ako je ritam normalan i samo ubrzan - odluka o ukidanju ovisi o tegobama bolesnika, to je simptomatska terapija. Ako je u podlozi neka srčana bolest kao angina pektoris, zatajenje srca, onda bi lijek ipak trebalo zadržati u terapiji. Srdačan pozdrav, Sandro Brusich, dr. med. U 3. sam mjesecu trudnoće. Kad sam zatrudnjela, imala sam CIN-om 1. Bi li bilo dobro da napravim kuru s Lactogyn oralnim i vaginalnim kapsulama? Je li infekcija s HPV-om opasna za dijete? Hoće li se zaraziti za vrijeme vaginalnog poroda? Prakticira li se u tom slučaju carski rez? Lactogyn nema utjecaja na displazije vrata maternice (CIN-ovi), ali pomaže brzoj uspostavi i dugotrajnoj zaštiti zdrave vaginalne mikroflore koja je važan čimbenik u zaštiti zdravlja vaginalne sluznice. Infekcija HPV-om nije opasna za dijete i ne zahtijeva carski rez. Srdačan pozdrav, dr. sc. Alemka Brnčić Fischer Sklona sam vaginalnoj kandidi. Po uputi ginekologa, uzimam terapiju, uz dodatak Lactogyn kapsula, ali upala se svejedno vraća. Nakon nepuna 2 mjeseca opet osjećam nelagodu, peckanje, blagi svrbež. Na svoju sam ruku uzela Lactogyn vaginalne i oralne kapsule jer pregled moram čekati tri tjedna. Razmišljam i o antikandida dijeti. Što mi Vi savjetujete? Infekcije donjega spolnog sustava, u što spada i kandidijaza vagine, jedan su od najčešćih razloga posjeta ginekološkim ordinacijama. Razlog je to što se one vrlo često ponavljaju i liječenje zahtijeva strpljenje i upornost. Lactogyn Vam može pomoći do ginekološkog pregleda koji morate svakako obaviti jer razlog mogu biti i neke druge infekcije. Srdačan pozdrav, dr. sc. Alemka Brnčić Fischer Imam 30 godina. Prije dvije godine ustanovljena mi je proširena hipofiza. Otklonjena je sumnja na tumor. Menstruacijski ciklusi su mi redoviti, a ne mogu zatrudnjeti. U braku sam više od 3 godine. Možete li mi reći je li hipofiza uzrok moje neplodnosti? Na žalost, ovako Vam ne mogu reći što je razlog Vaše neplodnosti. Potrebno je obaviti niz dijagnostičkih postupaka na temelju kojih se može ustanoviti razlog neplodnosti. Svakako se morate javiti svom ginekologu koji će Vas uputiti na potrebnu obradu. Srdačan pozdrav, dr. sc. Alemka Brnčić Fischer Moja trogodišnja djevojčica često ima začepljen nos, uz obilno curenje sluzi. Uglavnom, nema povišenu temperaturu, a, ako se i pojavi, iznosi oko 37 °C. Smetnje se povlače za tjedan dana. Nosić joj prije spavanja ispirem fiziološkom otopinom, triput dnevno ukapavam joj Aqua Maris kapi za nos. U tom razdoblju slabo jede pa se brinem da će joj pasti imunitet. Kako da joj pomognem? Kod Vašeg se djeteta može raditi o alergijskom rinitisu ili, eventualno, o učestalijoj upali trećeg krajnika, što zahtijeva pregled pedijatra alergologa i ORL specijalista. Srdačan pozdrav, prof. dr. Mladen Peršić Imamo dva dječaka od 4 i 6 godina. Često su prehlađeni, curi im nos, boli grlo, a ponekad i uho. U nekoliko im je navrata izoliran streptokok u grlu. Najčešće se obojica razbole. Dobrog su apetita, razvijaju se u skladu s dobi. Imam osjećaj da se infekcije šire u vrtiću, ali kao moguće izvore zaraze ne isključujem ni djeda i baku. Moji se roditelji često, a primijetila sam da su i oni sada češće bolesni pa sam počela razmišljati da se ne „vrti” li se neki uzročnik među ukućanima? Bi li bilo dobro da i oni naprave brisove grla i nosa? Suprug i ja smo to obavili, nalaz je uredan. Mislim da je uobičajeno u toj dobi imati česte virusne infekcije, posebice za "vrtićku" djecu. Mogućnost prijenosa od starijih osoba je mala, ali nije na odmet učiniti brisove ždrijela kako ste predložili. Što se tiče zdravlja vaše djece, ne mislim da se radi o neuobičajenoj ili opasnijoj situaciji. Srdačan pozdrav, prof. dr. Mladen Peršić Prije nekoliko sam mjeseci darovala bubreg svom 12-godišnjem sinu. Operacija je protekla dobro, kao i poslijeoperacijski tijek. Od rođenja je imao problema s bubrezima. Psihički se dobro razvijao, odličan je učenik, ali zaostajao je u rastu pa je sad visok poput 6-godišnjaka. Nije bio na dijalizi. Laboratorijski nalazi krvi, urina, kreatinina, SE popravili su se odmah poslije operacije. Zanima me hoće li narasti? Postoji velika mogućnost da se radi o tzv. renalnom nanizmu. Drugim riječima, kod svih kroničnih bolesti, pa tako i kod kroničnih bubrežnih bolesti, može doći do usporenijeg rasta. Ako se stanje poboljšalo, treba vremena da se vidi hoće li doći do ubrzanijeg rasta do normalne visine ili će se tražiti drugi uzroci slabijeg rasta, što je, po mom mišljenju, manje moguće. Srdačan pozdrav, prof. dr. Mladen Peršić Moj šestogodišnji sin ponekad za vrijeme infekcija dišnih putova ima i proljev. Osim što je bio na dijeti, uzimao je i Prolife suspenziju koja mu je pomogla. Sada vidim da imate i novu probiokulturu - Normiu u prahu. Je li ona bolja? Preporučuje li se kod akutnog proljeva ili ona samo štiti crijevnu mikrofloru tijekom terapije antibioticima? Osnovni odgovor na Vaše pitanje jest: Zašto mijenjati nešto što ima dobar učinak? Međutim, znatiželje nikad dosta pa evo i dodatnog komentara. Uz svaki respiratorni infekt, ali i uz lijekove koje vrlo često, prečesto, dajemo u tim trenucima, dolazi do kakve-takve promjene crijevne flore te je davanje probiokultura vrlo važno u prevenciji, odnosno ako se daje kasno, u liječenju tog disbalansa (poremećaja). Iako se pokušava ustrojiti specifičnost probiokultura, najčešće je to vrlo teško ili samo teoretski. Prolife je za Vaše dijete bio učinkovit i nije ga potrebno mijenjati. Normia predstavlja izuzetno kvalitetnu probiokulturu (kombinaciju probiotika) i može je se upotrebljavati i u situaciji u kojoj se nalazi Vaš sin te, ako je potrebno, i njome možete pokušati prevenirati (liječiti) svog sina. Srdačan pozdrav, prof. dr. Mladen Peršić Moja je petogodišnja kći sklona upalama dišnih putova, što povezujem s njezinim boravkom u vrtiću. Često uz grlobolju ili curenje iz nosa dobije i proljev. Radi li se o virusima koji istovremeno napadaju i probavni sustav? Da li bi bilo dobro dati joj probiokulturu odmah na početku prehlade da bi se prevenirao proljev? Virusi mogu biti uzrokom i probanih i respiratornih teškoća. Međutim, uz respiratorne se simptome često uzimaju lijekovi (nažalost, sve češće i antibiotici) koji dodatno mogu uzrokovati smetnje probavnog trakta zbog poremećaja crijevne flore. Iz tog je razloga neophodno uzimanje probiokultura koji mogu djelovati i na poboljšanje respiratornih smetnji (ako probavnih i nema). Dakle, razmišljanje i želja za preventivnim uzimanje probiokultura tijekom respiratornih tegoba u potpunosti je opravdana. Srdačan pozdrav, prof. dr. Mladen Peršić Imam 10-mjesečnog sina kojeg dojim dvaput dnevno. Od rođenja siše jako brzo, da ne kažem pohlepno, pa mu mlijeko zna poteći kroz nosić. Poslije u nosu ima grudice ukiseljenog mlijeka koje mu smetaju. Ako mu ne očistim nosić, ne može disati ni zaspati. Zanima me mogu li mu nosić prije čišćenja ovlažiti Aqua Maris kapima za bebe? Nema razloga ni kontraindikacija za davanjem Aqua Marisa prije čišćenja nosa. Ipak, savjetovao bih da se dijete hrani sporije (ako je to moguće) i možda češće u manjim količinama jer vjerojatno ima gastroezofagealni refluks koji je u toj dobi još fiziološki, ali može dovesti do ovakvih "problema". Jasno, za ovakve smetnje nije potrebna nikakva posebna dijagnostika! Srdačan pozdrav, Prof. dr. Mladen Peršić Dojim 6-mjesečnu kćerkicu. Zbog upale sinusa, dobila sam antibiotik Amoxil. Liječnica mi je savjetovala i Normiu. Hoće li ta terapija štetno djelovati na dijete? Mislim da je savjet Vaše liječnice vrlo dobar jer će moguće nuspojave antibiotika biti spriječene. Mogući učinak na dijete može biti samo pozitivan. Srdačan pozdrav, Prof. dr. Mladen Peršić Moj se 12-godišnji sin u posljednje vrijeme žali na bolove u koljenima. Ne povezuje ih s naporom (tjelovježbom u školi). Koljena mu nisu otečena. Stariji članovi obitelji pate od reumatskih bolesti pa me uhvatila panika događa li se to i njemu. S druge strane, načula sam da za vrijeme rasta djeca mogu osjećati bolove u nogama. Što mi je činiti? Bolovi u nogama (zglobovima) često se mogu javiti u djece tijekom rasta i zovemo ih bolovima rasta. Međutim, s obzirom na porodičnu anamnezu, mislim da je neophodno da ga pregleda pedijatar ("njegov" liječnik). Mislim da treba učiniti i osnovne pretrage koje Vaš liječnik zna. U slučaju da laboratorijske pretrage ne budu uredne i/ili da se smetnje pojačaju, obratite se pedijatru reumatologu na Klinici za dječje bolesti. Srdačan pozdrav, Prof. dr. Mladen Peršić Moj suprug, 40-godišnjak, više od 10 sati dnevno provede za računalom. Kod kuće mu je razonoda gledanje TV programa što, vjerujem, dodatno opterećuje oči. Zasad dobro vidi i ne nosi naočale, no mislim da bi trebao zaštititi oči vitaminima, umjetnim suzama ili nečim trećim. Što Vi mislite? Vaš je suprug u dobi kada se javlja potreba za naočalama na blizinu, ali je potrebno kontrolirati i očni tlak. Svakako preporučujem kompletan oftalmološki pregled koji će pokazati što je Vašem suprugu doista potrebno. Srdačan pozdrav, Dr. med. Maša Mikuličić, oftalmolog Imam 62 godine i uzimam lijekove za glaukom. Imam početak mrene na desnom oku. Što bih mogla uzimati od dodataka prehrani da izbjegnem komplikacije glaukoma i da usporim razvoj mrene? Preporučujem Vam redovne oftalmološke preglede, kao i pridržavanje propisane terapije. Za usporavanje mrene možete uzimati formule koje su posebno pripravljene za oči. Savjetovala bih Vam i Mega Omegu 3 u kurama od 3 mjeseca i s pauzama od 3 mjeseca te stalnu upotrebu Oculoplus kapsula. Srdačan pozdrav, Dr. med. Maša Mikuličić, oftalmolog Imam 30 godina, trudna sam 6 mjeseci. Zasad je sve u redu. Međutim, bliska prijateljica rekla mi je prije nekoliko godina da joj se pri napinjanju tijekom poroda jako pogoršao vid. Obje smo kratkovidne, ja mnogo više – trenutačna dioptrija na jednom mi oku iznosi -5, a na drugom -6. Može li se to pogoršanje kako izbjeći? Savjetujem Vam pregled očne pozadine u midrijazi (proširenih zjenica) kako bi se detektirala potencijalno slaba mjesta na retini. Srdačan pozdrav, Dr. med. Maša Mikuličić, oftalmolog U 60-oj sam godini. U posljednjih sam 10 dalekovidna. Naočale sam najprije koristila samo za čitanje (ruke su mi bile „prekratke”), a sada imam tri para. Jedne koristim za čitanje za blizu, druge za rad na računalu, a treće za gledanje TV-a. Bez naočala jedino hodam po vani i obavljam jednostavnije kućanske poslove. Po cijeli dan nosim, skidam, tražim odgovarajuće naočale pa sam počela razmišljati o tome kako si pojednostaviti život. Zanima me može li se moj problem riješiti „kombiniranim naočalama” koje u jednoj leći imaju 3 dioptrije. Razmišljala sam i o mekanim lećama koje bih stavljala i o operaciji skidanja dioptrije. Molim Vas da mi objasnite što bi na mome mjestu bilo nabolje učiniti. Mislim da bi u Vašoj dobi najbolje bile progresivne naočale. njima vidite dobro na svim udaljenostima. Ako se dioptrije želite riješiti operativnim putem, preporučila bih operaciju kojom se uklanja vaša leća, a umjesto nje se implantira multifokalna umjetna leća, čime dobivate dobar vid na svim udaljenostima. Naravno, prije toga treba učiniti predoperativne oftalmološke preglede kako bi se utvrdilo jeste li kandidat za ovakvu vrstu leće. Srdačan pozdrav, Dr. med. Maša Mikuličić, oftalmolog Po savjetu oftalmologa, zbog kasne životne dobi preventivno uzimam lutein. S obzirom na to da zimi nema UV zračenja koje dodatno štetno djeluje na oči, mogu li tijekom zime pauzirati s uzimanjem luteina? Lutein možete uzimati tijekom cijele godine, ali, ako ga uzimate radi prevencije, možete i pauzirati. Srdačan pozdrav, Dr. med. Maša Mikuličić, oftalmolog Moja starija sestra (70 godina) boluje od makularne degeneracije. Za razliku od mene, nikada nije pazila na prehranu. Uz to, cijeli život puši. Unatoč problemu, ne mijenja navike. Njezino me stanje jako brine. Osim što se hranim po mediteranskoj prehrani, uzimam omegu-3 i lutein. Redovito idem na medicinsku gimnastiku. Moj je vid zasad dobar, nosim naočale radi dalekovidnosti. Što vi mislite o utjecaju omege-3 i luteina na zdravlje oka? Više studija pokazalo je pozitivno djelovanje luteina i Omege 3 na zdravlje očiju, a 2008. godine započela je velika studija pod nazivom AREDS2 koja istražuje upravo utjecaj luteina i omege-3 u liječenju makularne degeneracije i katarakte. Rezultati se očekuju tijekom 2013. ili 2014. godine. Srdačan pozdrav, Dr. med. Maša Mikuličić, oftalmolog Nakon nekoliko godina bezuspješnog liječenja HPV-a visokog rizika, prije nekoliko mjeseci mi je učinjena konizacija grlića maternice. Imam 30 godina. Zanima me imam li sada veće šanse za trudnoću jer to ranije zbog upale to nije bilo moguće ili su mi šanse zbog operacije manje? Konizacija je vjerojatno učinjena zbog displastičnih promjena vrata maternice (CIN 1, 2, 3) uzrokovanih HPV-om visokog rizika. Nakon odstranjenja displastičnih promjena i kontrolnog urednog PAPA testa, u dogovoru s ginekologom, nema zapreka za trudnoću. Srdačan pozdrav, dr. sc. Alemka Brnčić, dr. med. 66 mi je godina. Imam spušteni mjehur pa mi bježi mokraća. Često osjećam peckanje u stidnom dijelu pa često koristim kreme (Canesten, Plimycol). Bi li mi pomogao Lactogyn? Predložena mi je operacija, ali se na nju još nisam odlučila. Moja rođakinja je taj problem riješila vježbama. Možete li mi pobliže reći kako se izvode? Koliko dugo treba vježbati da se osjeti poboljšanje? Vježbama se ne može riješiti svaki problem vezan uz spušteni mjehur. Vježbe pripomažu pri rješavanju blažih tegoba, a u to koji je oblik liječenja najprikladniji i kako se on izvodi svakako bi Vas trebao uputiti Vaš ginekolog. Uz sterilan nalaz urinokulture i odsustvo upale u rodnici, Lactogyn kapsule svakako mogu pomoći u održavanju stabilnosti vaginalne mikroflore. Srdačan pozdrav, dr. sc. Alemka Brnčić, dr. med. Imam 45 godina. Menstruacijski ciklus mi je uredan. Nemam zdravstvenih tegoba, ali muči me suhoća rodnice. Problem je izražen do te mjere da izbjegavam spolne odnose, što je poremetilo odnose u braku. Što mi savjetujete? Vjerujem da ste se prethodno javili svom ginekologu, ali da problem postoji i dalje. Lactogyn kapsule mogu pomoći u obnovi i uspostavi ravnoteže vaginalne flore, a tu je i Lactogyn gel koji pomaže i uspostavi vlažnosti izvana i unutar rodnice. Srdačan pozdrav, dr. sc. Alemka Brnčić, dr. med. Prije 4 mjeseca rodila sam carskim rezom. Rodnica mi je sada izrazito suha, što bitno utječe na kvalitetu spolnih odnosa. Ginekološki nalaz je uredan. Spolni su odnosi postali jako bolni i neugodni, a osjećaj peckanja i iritacije traje dugo nakon odnosa. Dojim. Zanima me Vaš savjet o tome što učiniti jer vrijeme prolazi, a stanje se ne popravlja. U svakom slučaju, preporučujem da najprije obavite ginekološki pregled i da se eventualno, bude li potrebno, uzmu bakteriološki brisevi. Lactogyn kapsule mogu pomoći u obnovi vaginalne flore, no za postizanje potpunog učinka trebaju se uzimati dva mjeseca. Srdačan pozdrav, dr. sc. Alemka Brnčić, dr. med. Navršila sam 70 godina. Cijeli život imam osjetljiv želudac. Kad god se uzrujam ili rastužim, zaboli me želudac i onda to traje duže vrijeme. To se dogodilo i prije mjesec dana, kada sam imala veliki obiteljski problem. Od liječnice sam dobila Controloc tablete koje redovito uzimam, ali ne osjećam poboljšanje. Zato sam dobila uputnicu za gastroenterologa i gastroskopiju jer moja liječnica sumnja na bakteriju Helicobacter. Znam da su neki moji znanci išli na krvno testiranje ili izdisajni test kada se sumnjalo na tu bakteriju. Ako dobijem antibiotsku terapiju, bi li bilo dobro da uzmem probiokulture? Koje mi savjetujete? Kako se uzimaju i koliko dugo? Prema simptomima koje navodite, a i prema činjenici da vam Controloc ne pomaže, nisam siguran radi li se uopće o bolesti želuca, a pogotovo je li u pitanju bolest uzrokovana povećanim lučenjem želučane kiseline. Te tegobe koje su povezane sa stresom više mi nalikuju na sindrom iritabilnog crijeva. Ako Vam gastroenterolog ipak propiše antibiotsku terapiju protiv bakterije Helicobacter pylori, preporučio bih vam da uz antibiotik uzimate i Normiju (probiokultura), u dozi od dvije kapsule ili dvije vrećice dnevno tijekom dva tjedna. Srdačan pozdrav, dr. sc. Goran Hauser, dr. med. Imam 32 godine. Unatrag 10-ak godina osjećam da svi moji problemi, ali i ugodna iznenađenja, „prolaze” kroz srce. Ako se uznemirim, preplašim, razveselim, rastužim, uvijek se i srce uzlupa. Puls mi je inače malo brži, oko 85 otkucaja/min. Nekoliko sam puta radila EKG koji je bio u granicama normale, kao i ostali laboratorijski nalazi. Glupo mi je piti tablete za smirenje srca. Postoji li neki prirodni način? U posljednje vrijeme, kad osjetim da mi je puls ubrzan, izvedem kraću vježbu disanja (sporo, duboko disanje) i to mi pomaže. Do toga sam došla spontano, nitko mi to nije savjetovao, pa me zanima postupam li ispravno? Sve su mjere koje vam pomažu pri smirivanju i rješavanju stresa dobre i slobodno ih možete nastaviti primjenjivati. Poznato je da su u žena tjelesne manifestacije kao posljedica stresa mnogo učestalije. One se najčešće manifestiraju kao stezanje u prsima, lupanje srca, nedostatak zraka, trnuće raznih dijelova tijela, bolovi u želucu i slično. Ima i slučaja kada one dovedu i do jasnih promjena u EKG-u koje mogu sličiti promjenama "pravih" srčanih bolesnika. Osim mjera koje provodite, preporučujem i fizičku aktivnost koja često dovodi do oslobađanja od stresa i smanjivanja tegoba. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 55 godina, a prije 10 godina dijagnosticirana mi je Heberdenova artroza. Zglobovi na prstima su mi zadebljani, ponekad bolni. Duže vrijeme primjećujem promjene na noktima. Površina im nije glatka nego uzdužno izbrazdana. Je li i to posljedica artroze ili je riječ o zasebnom oboljenju? Uzdužne brazde na noktima (onychorrhexis) mogu se pojaviti uz neke reumatološke bolesti, poput Vaše, no i uz hipovitaminozu, deficit željeza ili hipertireozu. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Imam 45 godina. Visok sam 190, a težak 120 kg, pušač sam. Javio sam se liječniku zbog jake žgaravice koja ne popušta. On je posumnjao na GERB. Nije mi objasni što to znači. Šalje me na gastroskopiju. Bojim se te pretrage. Može li se uzrok žgaravice ustanoviti jednostavnijom pretragom? Kod osoba ispod 50 godina starosti kod kojih se sumnja na GERB (bolest upale sluznice jednjaka uslijed vraćanja kiseline iz želuca) može se provesti pokusno liječenje s lijekovima protiv želučane kiseline, npr. Laronom (2 x 30 mg tijekom 7 dana), a, ako se tegobe smanje nakon nekoliko dana, može se nastaviti s terapijom od 1 x 30 mg tijekom još 6 do 8 tjedana. Inače, gastroskopija je definitivno najbolji način dokazivanja bolesti jednjaka i želuca. Postoje neki drugi načini, ali oni danas već spadaju u povijest medicine. Srdačan pozdrav, dr. sc. Goran Hauser, dr. med. Prije 2 godine dijagnozirana mi je Chronova bolest, zbog koje sam tada i operirana. Uskoro ću navršiti 35 godina. Pothranjena sam i imam osjećaj da mi smetaju sve namirnice. Bi li bilo dobro da se podvrgnem testu intolerancije na hranu? Osobno baš nemam pozitivnih iskustava s testovima na hranu jer je većina njih nespecifična i preopćenita. Smetnje s uzimanjem hrane vjerojatno su posljedica Vaše bolesti i operativnog zahvata. Prije bih si postavio pitanje aktivnosti Vaše bolesti. Ako ste pothranjeni, mislim da bi bilo nužno javiti se gastroenterologu kako bi se utvrdila aktivnost bolesti te korigirala terapija. Ako se upala smiri, mislim da će nestati i "nepodnošljivost" hrane. Srdačan pozdrav, dr. sc. Goran Hauser, dr. med. Spremam se na duži put u Afriku, što znači da razmišljam i o „džepnoj” ljekarni. Bez obzira na to što ću obaviti sva propisana cijepljenja, mislim da bih trebao ponijeti nešto čime bi olakšao eventualnu crijevnu/e infekciju/e. Čitao sam o probioticima, aktivnom ugljenu, ... Što mi savjetujete? Na prvom mjestu bih Vam preporučio Carbo medicinalis (medicinski ugljen) - granule su bolje, ali su tablete jednostavnije za nošenje. Uz to, svakako biste trebali imati rehidratacijske praškove koji se, u slučaju obilnijih proljeva, razmute u vodi i piju, a u sebi sadrže elektrolite koji se kod jakih proljeva gube. U slučaju proljeva, svakako možete uzimati probiotike, ali, poznavajući afričke uzročnike, nisam siguran koliko će oni biti korisni u akutnoj fazi. Mnogo će više koristiti u fazi oporavka od eventualne infekcije. Srdačan pozdrav, dr. sc. Goran Hauser, dr. med. Moj je suprug operiran zbog karcinoma debelog crijeva. Imao je neregulirane stolice - izmjenjivali su se proljevi i opstipacija, bez obzira na prehranu. Kuham mu po preporuci koju je dobio u bolnici. U ljekarni mu je magistra savjetovala Normia kapsule za oporavak crijevne flore. Već nakon tjedan dana stolica se stabilizirala. Sada ih uzima 3 tjedna. Zanima me koliko ih dugo može uzimati i u kojoj dozi? Boji se prekinuti da se ne vrate proljevi. Konkretno ograničenje za uzimanje probiotika ne postoji. Moja je najčešća preporuka pacijentima uzimanje kure Normie (2 x 1 na dan) u trajanju od 30 dana, a to se onda može ponoviti nekoliko puta godišnje. Srdačan pozdrav, dr. sc. Goran Hauser, dr. med. Nedavno sam otišao u mirovinu, 65 mi je godina. Od tada su počeli moji problemi s povišenim tlakom. Čini mi se da mi srce počne lupati čim dođem u ambulantu, a tlak rasti u visine. Pokušao sam svojoj doktorici objasniti kako se osjećam, ali ona inzistira da uzimam lijekove i prije obrade. Može li tlak porasti zbog straha od pregleda? Povišeni krvni tlak koji se javlja samo tijekom posjeta liječniku zove se "hipertenzija bijelog mantila". Ovo je stanje poznato i dokazano, no ne javlja se onoliko često koliko bi to bolesnici htjeli. Vjerujem da Vaša liječnica to zna. Međutim, mnogo je više osoba koje imaju blago povišeni krvni tlak koji kod liječnika dodatno skoči iznad razine koju inače imaju kod kuće pa vjerujem da liječnica misli da je to stanje i kod Vas. Da biste riješili dilemu, možete napraviti pretragu koja se zove KMAT - kontinuirano mjerenje tlaka kroz 24 h - i kojom ćete objektivno dokazati koliki je Vaš dnevni raspon tlaka. Srdačan pozdrav, Sandro Brusich, dr. med. Moj brat ima 45 godina. Zbog nepravilnog rada srca bio je na obradi. Rečeno mu je da boluje od WPW sindroma. Možete li mi objasniti o čemu se radi? Brat je shvatio da se radi o jako teškoj dijagnozi. Prestrašen je. WPW sindrom spada među sindrome preekscitacije. To je bolest u kojoj postoji anomalni spoj između pretklijetki i klijetki u srcu te se impuls ne širi normalnim putem kroz srce. Većina tih osoba nema tegoba, dok manji broj ima napade aritmija. Među osobama koje imaju aritmije većina ima manje opasne aritmije, a samo mali broj osoba ima po život opasne aritmije. Znakovi upozorenja koji zahtijevaju obradu i liječenje su napadi brzog lupanja srca praćeni omaglicama ili gubitkom svijesti - u tom bi se slučaju trebao javiti kardiologu aritmologu. Liječenje se sastoji od uzimanja lijekova ili, po potrebi, elektrofiziološkog liječenja tijekom kojeg se strujom "sprži" taj aberantni tračak. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 28 godina. Na sistematskom pregledu ustanovljen mi je ubrzani puls, 100 otkucaja u minuti. Krvni je tlak uredan (osim što je ujutro, odmah nakon buđenja, niži), hormoni štitnjače u granicama normale, nalaz EKG-a uredan, kao i Holter. Ne pijem više crnu kavu ni kola napitke. Budući se osjećam dobro, trebam li uopće piti lijekove za regulaciju pulsa? Na ubrzani puls bez određenog razloga češće nailazimo kod mlađih djevojaka koje inače imaju zdravo srce (obradu radimo da bismo isključili neku bolest). Liječenje preporučujem samo ako osoba ima nekakve tegobe poput lupanja srca ili zaduhe. Takvo stanje često pokušavamo objasniti povećanom razinom stresa, a sklonije su mu tzv. vegetativno labilne (osjetljive) osobe iako to nije znanstveno dokazano. Ono najčešće vremenom prođe. Ako imate zaduhu ili slabije podnosite napor, u svakom bi slučaju bilo korisno napraviti i ultrazvuk srca. Srdačan pozrdav, Sandro Brusich, dr. med. Imam 60 godina. Već 15 godina imam povišeni krvni tlak zbog čega uzimam antihipertenzive. Nedavno mi je otkriven tumor nadbubrežne žlijezde. Čekam operaciju. Zanima me hoću li odstranjenjem nadbubrežne žlijezde trajno regulirati tlak ili ću i dalje uzimati antihipertenzive? Liječnik mi je rekao da se može napraviti klasična ili endoskopska operacija. Što Vi mislite? Koje su prednosti, odnosno nedostaci, tih oblika operacija? Postoji više vrsta tumora nadbubrežne žlijezde. Ako je tumor aktivan i luči tvari koje povisuju krvni tlak, onda će odstranjenjem tog tumora doći i do regulacije tlaka. Međutim, može se raditi i o neaktivnom tumoru ili o tumoru koji luči neke druge supstance i tada neće doći do regulacije tlaka - na žalost, većina tumora spada u ovu skupinu. Endoskopska (pretpostavljam laparoskopska) operacija nudi prednost manjeg reza i mnogo bržeg oporavka za pacijenta. Klasična operacija nudi bolji pregled za kirurga i mogućnost radikalnijeg odstranjenja tvorbe, o čemu odlučuje kirurg. Može se i desiti da kirurg započne s endoskopskom operacijom, ali se zbog nekog razloga (krvarenje ili intraoperativni nalaz) mora prebaciti na klasičnu operaciju. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 63 godine. Prije godinu dana kirurški mi je odstranjena keratoza s hrpta nosa. Nakon operacije koža na nosu bila je dugo crvena, osjetljiva, sklona pucanju. Sada se smirila, no muči me upozorenje dermatologa da se to može vratiti. Po ljeti koristim UV zaštitnu kremu +50 i ne izlažem se suncu kada je UV zračenje visoko. Mojoj su prijateljici prije nekoliko godina ledom s obraza odstranili keratozu i zasad je dobro. Bojim se ponovnog zahvata. Molim Vas za mišljenje. Aktiničke keratoze najčešće su prekanceroze koje nastaju kao posljedica kumulativnog dugogodišnjeg izlaganja UVB zrakama. Liječe se krioterapijom, primjenom kreme s 5%-tnim fluorouracilom ili fotodinamskom terapijom. Češće su u osoba svijetle puti i onih koji su radni vijek proveli na otvorenom. Mogući su recidivi. prevenciji je bitna fotozaštita, uz primjenu zaštitnih krema sa Ako ste primijetili ponovnu pojavu takve promjene, javite se na dermatološki pregled radi provođenja odgovarajuće terapije. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Godinama imam problem s aknama koje se javljaju i po licu i po leđima. Napravila sam kompletnu laboratorijsku obradu (alergološko testiranje i hormonalni status). Svi su nalazi u granicama normale. Redovito sam kod dermatologa i kozmetičarke. Samoincijativno sam iz prehrane isključila mlijeko i mliječne proizvode i nakon dva tjedna zapazila poboljšanje. Sada, nakon 2 mjeseca, moj ten nije nikada bio bolji. Očito je da mi mlijeko smeta, ali mi nije jasno kako se to nije vidjelo na alergološkom testiranju. Nije mi teško trajno odustati od konzumiranja mlijeka i mliječnih proizvoda iako su to bile moje najdraže namirnice, ali razmišljam o kalciju jer imam 35 godina. Na koji ga način mogu nadomjestiti? Tabletama ili drugim namirnicama? Iskreno, bojim se kušati mlijeko da mi akne opet ne buknu jer sam u nekoliko navrata uzimala i antibiotike kako bi smirila upalu. U nastanku akni važnu ulogu imaju nasljedni čimbenici, hormoni te određena vrsta bakterija. Terapija ovisi o obliku akne, a koristi se lokalna i sistemska terapija, ovisno o težini bolesti. Prehrana ne utječe na nastanak i pogoršanje bolesti, stoga u prehranu možete uvesti mliječne proizvode. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Prije 3 mjeseca opekla sam se vrućom vodom po podlakticama. Liječena sam na odjelu za opekotine. Savjetovana mi je krema protiv ožiljaka koju sam naručivala iz Njemačke. Skupa je pa moram odustati. U ljekarni su mi ponudili Combusten kremu koja sadrži maslinovo ulje, a koja mi je cijenom prihvatljiva. Hoću li njezinom primjenom smanjiti ožiljke? Kako se primjenjuje? Prema poslanom upitu, nije jasno je li riječ o hipetrofičnom ožiljku ili keloidu. Ako je riječ o keloidu, dolazi u obzir terapija visokopotentnim kortikosteroidnim pripravcima, uz okluziju ili intralezionalna primjena kortikosteroida. Combusten krema namijenjena je za tretman kože uslijed opeklina nižeg stupnja te sunčevih opeklina. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Nakon depilacije, koža na potkoljenicama i natkoljenicama mi je iziritirana. Koristila sam razne losione i kreme, ali njihov je učinak kratkotrajan. Trebam li pokušati s Pantexolom? Što mi savjetujete, kremu ili losion? Preporučujem Vam uporabu antiseptičkih losiona odmah nakon depilacije i Pantexol kreme nekoliko puta na dan. Ako se smetnje ne povuku, preporučujem dermatološki pregled. Srdačan pozdrav, prof. dr. Marija Kaštelan, dr. med. Moja je majka bolovala od degeneracije žute pjege. Imam 62 godine, koristim naočale za čitanje i gledanje TV-a i nemam drugih problema. Zanima me bi li bilo korisno da preventivno uzimam preparat Oculoplus? Prijateljica mi kaže da joj je to savjetovao oftalmolog jer lutein povoljno djeluje na oko. Možete li mi reći usporava li gubljenje vida? Opterećena sam očnim problemima pokojne majke i mogućim nasljednim sklonostima. Poželjno je nositi sunčane naočale jer prekomjerno izlaganje suncu može uzrokovati oštećenje rožnice, leće i mrežnice. Nošenje sunčanih naočala koje prate oblik lica gotovo u potpunosti blokira UV zračenje. Ako ne možete steći naviku nošenja sunčanih naočala, nosite šešir ili šiltericu. Što se tiče suhoće očiju, ona je najvjerojatnije posljedica dugotrajna rada na računalu. Srdačan pozdrav, Maša Mikuličić, dr. med. Imam 27 godina. Nosim naočale za kratkovidnost (dioptrija mi je -1) i više od 8 sati dnevno radim na računalu. Imam osjećaj da su mi oči suhe i jako umorne. Što da radim? Na Vašim sam stranicama vidjela Vizol kapi za oči. Savjetujete li mi da probam s njima ili da potražim umjetne suze? Dugotrajan rad na računalu, kao i boravak u klimatiziranim prostorima, utječe na suzni film. Preporučujem korištenje umjetnih suza bez BAK konzervansa, učestalije treptanje i ovlaživanje prostora. Ako se smetnje nastave, savjetujem Vam oftalmološki pregled. Srdačan pozdrav, Maša Mikuličić, dr. med. Zbog sepse nakon poroda nisam dojila dijete. Djevojčica sad ima godinu i pol. Vrlo je osjetljiva, svako malo je prehlađena. Uz to, javlja se crveni osip po licu. Pedijatar kaže da ima slab imunološki sustav. Kako joj ga popraviti? Nerado jede, a nove namirnice odbija. Meni su roditelji u djetinjstvu davali riblje ulje, sjećam se njegova grozna okusa. Kažu da mi je pomoglo, da sam dobila apetit. Postoji li kakav pripravak koji bi mojoj kćerkici pomogao? Riblje je ulje zapravo vitamin D koji je neophodan u prvoj godini te u drugoj i trećoj godini tijekom zimskih mjeseci. Pokušajte s time. No, da ne bi došlo do jačih poremećaja u hranjenju (s obzirom na to da Vaša djevojčica odbija nove namirnice), bilo bi dobro obratiti se psihologu. Srdačan pozdrav, prof. dr. sc. Mladen Peršić, dr. med. Moja je trogodišnja djevojčica često prehlađena. Po preporuci specijalista, ići će na operaciju trećeg krajnika. Čekamo neko stabilno stanje, bez temperature. Može li u to vrijeme koristiti Aqua Maris kapi za nos? Operil su joj ograničili na 5 dana, poslije čega ne znam što činiti. Neko vrijeme sam joj ukapavala fiziološku, ali čini mi se da joj više ne pomaže. Možete ukapavati Aqua Maris, ali, ako je preporuka ORL-a adenotomija, podvrgnite je zahvatu čim prije. Srdačan pozdrav, prof. dr. sc. Mladen Peršić, dr. med. Moj jednogodišnji sin pokazuje znakove opstipacije. Jede raznovrsno, još dobiva večernji podoj, dobro se razvija. Međutim, unatrag nekoliko mjeseci plače za vrijeme pražnjenja crijeva. Primjećujem i da se skriva u kut, propinje na prste, prekriži noge i tako stoji. Činim sve da ga zaokupiram kako bi čučnuo jer mislim da bi mu to pomoglo. Nosi pelene, ne inzistiramo na tuti. Prisiljena sam mu ponekad staviti Prolax čepić, nakon čega uslijedi stolica u „kuglicama”, bez tragova krvi. No, bojim se da će mu se crijeva tako ulijeniti. Koliko mu često tijekom tjedna mogu stavljati čepiće? Vjerujem da se kod Vašeg djeteta radi o funkcionalnom poremećaju koji je vrlo čest u toj dobi, a vezan je uz tvrdu stolicu i blažu opstipaciju. Moguće je da ima i blaže "oštećenje" anusa, odnosno fisuru, te je za početak neophodan pregled. Glede terapije, uz prehranu s više voća i povrća te sokova od šljive, valja pokušati s probioticima (npr.: Prolife). Ako stolica i dalje bude tvrda, treba uvesti i Portalak. Povremeno davanje Prolaxa nije štetno, ali dugoročno ne rješava problem. Dakle, možete započeti probioticima i adekvatnijom prehranom, a za daljnju terapiju obratiti se svom liječniku. Srdačan pozdrav, prof. dr. sc. Mladen Peršić, dr. med. Već duže vrijeme vodim razgovore s kćerkom (20 godina) jer želi laserski otkloniti dioptriju od -4. Mislim da to nije bezazlen zahvat i da nitko ne govori o komplikacijama pa se mladi ljudi tako lakomisleno odlučuju na zahvat. Ne znam kako da je od toga odgovorim. Imate li kakav prijedlog? Uz to, zanima me i uzima li se lutein u prevenciji bolesti starijih osoba tijekom cijele godine ili u kurama? Moj otac, koji ima 78 godina, uzima ga povremeno. Svaki pacijent koji ima 18 godina i više i stabilnu dioptriju može biti pogodan kandidat za lasersko skidanje dioptrije, ali je prethodno potrebno učiniti detaljan oftalmološki predoperativni pregled da bi se vidjelo postoje li neke kontraindikacije za zahvat. Dioptrija Vaše kćeri može se riješiti laserom. Kada govorimo o laserskom skidanju dioptrije, treba naglasiti da je to elektivan zahvat, odnosno zahvat koji bira i želi pacijent. Apsolutna je kontraindikacija ovom zahvatu keratokonus. To je bolest rožnice koju karakterizira tanka i deformirana rožnica. Ostale kontraindikacije su: glaukom, suho oko, trudnoća, aktivna bolest oka, aktivna autoimuna bolest, dijabetes. Komplikacije ovog zahvata mogu biti vraćanje dijela dioptrije (10% predoperativne) ili javljanje ožiljka koji se može razbistriti kapanjem kortikosteroidnih kapljica. Što se tiče uzimanja luteina, preporučam uzimanje dva puta godišnje po tri mjeseca uz napomenu da jedna kura mora biti tijekom ljetnih mjeseci. Srdačan pozdrav, Maša Mikuličić, dr. med. Moja majka ima 75 godina, uzima lijekove za glaukom. Redovito se kontrolira. Doktorica joj je rekla da joj je jedna leća lagano zamućena. Radi li se o početku katarakte? Može li je se usporiti luteinom ili omega 3? Lagano zamućena leća označava početak nastanka mrene. S obzirom na godine Vaše majke, to i nije ništa neuobičajeno i zabrinjavajuće. Provedene studije govore da uzimanje luteina i omega 3 kapsula može usporiti napredovanje mrene. Svakako preporučujem redovne kontrole zbog glaukoma. Srdačan pozdrav, Maša Mikuličić, dr. med. U 36. sam tjednu trudnoće, već me mjesec dana muči kandida. Terapijom ginekologa (Plymicol) i prehranom nastojim povoljno utjecati na liječenje. No, bez uspjeha. Šećer u krvi mi je normalan. U trudnoći sam dobila 8 kilograma. Beba se dobro razvija. Kako mi se bliži termin poroda, hvata me panika što će se dogoditi ako ne riješim upalu. Prije nekoliko su mi dana preporučili Lactogyn kapsule. Na internetu sam vidjela informaciju o tome da ih mogu koristiti i trudnice. Ima li šanse da mi pomogne u rješavanju kandide? Kandida je uobičajeni sastojak vaginalne flore. Tegobe se jave kada naraste njihov ukupan broj i kada dođe do neravnoteže između tzv. "dobrih" i "loših" bakterija u rodnici. Prirast Vaše tjelesne težine u trudnoći je idealan. Kandidijaza ne utječe na intrauterini razvoj ploda. Liječenje tegoba ponekad je dugotrajno i zahtijeva upornost. Lactogyn kapsule mogu Vam pomoći kao dodatak liječenju koje će preporučiti Vaš ginekolog. Srdačan pozdrav, dr. sc. Alemka Brnčić, dr. med. Imam 55 godina, nemam partnera, ali sam sklona vaginalnim infekcijama. U posljednje dvije godine dogode se svako malo (enterokok, ešerihija, streptokok). Prečesto sam koristila vaginalete i vaginalne kreme pa osjećam suhoću i peckanje u rodnici. Doktorica mi je savjetovala Lactogyn vaginalne i oralne kapsule. Uzela sam samo oralne jer se već bojim išta stavljati u rodnicu. Već sam nakon tjedan dana osjetila poboljšanje, a uzimam ih 2 tjedna. Koliko dugo traje terapija? Bojim se prestati da se ne suočim s istim problemom. Prije mjesec dana bila sam kod ginekologa, na godišnjem papa testu (60 mi je godina). Nakon uzimanja brisa, doktorica je napravila i ultrazvučni pregled koji je bio jako bolan. Danima sam osjećala bol u donjem dijelu trbuha. Prvih nekoliko dana imala sam i groznicu, bez temperature. Nakon tjedan dana pojavio se obilan žuti iscjedak neugodna mirisa, uz osjećaj peckanja. Nisam spolno aktivna tako da te smetnje povezujem isključivo s pregledom. Nisam imala smetnje pri mokrenju. Javila sam se doktorici koja je pogledala bris na mikroskopu, ali nije našla uzročnika upale. Zašto mi je dala antibiotsku vaginalnu kremu ako nema bakterija u sluzi? Je li moguće da sam na ginekološkom stolu pokupila neku infekciju ili da je riječ o iritaciji zbog gela koji se koristi tijekom ultrazvučnog pregleda? Na svoju sam ruku uzela Lactogyn kapsule, uzimala sam ih 2 x 1 tjedan dana, a sada uzimam 1 x 1. Osjećam se bolje. Koliko ih dugo trebam koristiti? Epitel rodnice u postmenopauzi postaje tanji, a mišići gube tonus. Stijenka rodnice je blijeda, slabije prokrvljena, opada razina glikogena i količina laktobacila te raste pH vrijednost. Kada se izgubi ta zaštita tanka stijenka, rodnica postaje podložna stalnim upalama, ulceracijama i ozljedama. Ginekološki pregled također predstavlja traumu za tako osjetljivu sluznicu te osjećaj boli nakon pregleda, nažalost, nije rijedak slučaj. Lactogyn kapsule pomoći će u naseljavanju rodnice laktobacilima te stvaranju povoljnog mikrookoliša u rodnici. Preporučuje se Lactogyn kapsule uzimati tijekom dva mjeseca, dakle još 6 tjedana. Također, prema potrebi preporučujem korištenje Lactogyn gela koji će smanjiti suhoću. Srdačan pozdrav, dr. sc. Alemka Brnčić, dr. med. Imam 35 godina. Zbog ponovljenih kratkotrajnih gubitaka svijesti i niskog tlaka, preporučen mi je tilt-up test. Možete li mi objasniti o kakvom se testu radi? Tilt-table test jest test kojim se pokušava izazvati refleks gubitka svijesti u osoba za koje se smatra da imaju refleksne nesvjestice (tzv. neurokardogene sinkope). Test je bezbolan, a sastoji se u tome da legnete na poseban stol koji se može uspraviti i koji ima pojaseve za fiksaciju u slučaju da, ako izgubite svijest, ne padnete i ne ozlijedite se. Nakon što Vas se priveže, ispravit će Vas se na položaj od oko 60-70 stupnjeva i tijekom 45 minuta mjerit će Vam se krvni tlak i pratiti rad srca na monitoru. Test se prekida ako izgubite svijest ili nakon 45 minuta ako se ništa ne desi. Neki protokoli koriste i davanje lijekova, npr. nitroglicerina, pod jezik nakon oko 20 minuta (od njega možete imati laganu glavobolju). Ako izgubite svijest, test je pozitivan i time se dokazuje da su nesvjestice refleksne prirode. Ako je test negativan, nema nekog značenja. Zaključno, test je bezbolan, ali može biti neugodan ako izgubite svijest. Srdačan pozdrav, Sandro Brusich, dr. med. Imam 67 godina. Osim reumatskih tegoba, zdrav sam. Neki sam dan pročitao članak u kojem stručnjaci tvrde da bi svim starijim osobama trebalo dati lijek za snižavanje krvnog tlaka, bez obzira na to imaju li visoki krvni tlak ili ne. To me zbunilo jer svi lijekovi imaju nuspojave. Što Vi mislite o tome? Lijekovi za povišeni krvni tlak preporučuju se samo osobama s povišenim krvnim tlakom nakon što primjena općih mjera u trajanju od nekoliko mjeseci ne dovede do regulacije krvnog tlaka. Ono što se razlikuje jest razina krvnog tlaka koji treba snižavati ovisno o pridruženim bolestima. Osobama koje nemaju drugih bolesti preporučuje se razina krvnog tlaka < 140/90 mmHg. Međutim, ako je osoba bubrežni bolesnik, ako je preboljela moždani ili srčani udar, ima šećernu bolest s nekom komplikacijom, preporučuje se mnogo stroža kontrola krvnog tlaka i vrijednosti od < 120/80 mmHg. Prema tome, ako nemate pridruženih bolesti i ako Vam je krvni tlak manji od 140/90 mmHg, ne savjetujem Vam lijekove za sniženje krvnog tlaka. Srdačan pozdrav, Sandro Brusich, dr. med. Suprugu (58 godina) su na sistematskom pregledu otkrili povišeni krvni tlak. Ima i desetak kilograma viška. Ostali su mu nalazi bili uredni. Liječnik mu je dao lijekove protiv visokog tlaka. Međutim, suprug je u uputi jednog lijeka vidio da je moguća nuspojava impotencija. Nema šanse da ga nagovorim na lijek. Postoji li neki prirodni način? Čitala sam da omega 3, ginko i glog povoljno djeluju na srce i snizuju tlak. Koji je Vaš savjet? prirodni načini snižavanja krvnog tlaka kojima bi obavezno trebalo započeti liječenje uključuju izbjegavanje dodatka soli u prehrani, reguliranje tjelesne težine i redovitu tjelovježbu. To je ujedno i najefikasniji i najbolji način rješavanja povišenoga krvnog tlaka. Ako navedene mjere ne dovedu do povoljnih rezultata, onda se uvodi medikamentozna terapija. Postoji šest osnovnih skupina lijekova kojima se služimo za liječenje povišenoga krvnog tlaka. Jedna od tih skupina su beta-blokatori čija nuspojava može biti impotencija. Suprugu se može preporučiti neki lijek iz ostalih pet skupina koji nema navedenu nuspojavu. Ostali preparati (ginko, omega 3 i sl.) ne snižavaju krvni tlak. Srdačan pozdrav, Sandro Brusich, dr. med. Moja je majka prije par godina operirana zbog karcinoma debelog crijeva. Ostavljen joj je anus preter. Odlazi redovito na kontrole, nalazi su u granicama normale. Međutim, nju muči pražnjenje crijeva. Pazi na prehranu, jede uglavnom kuhano. Stolice joj uglavnom nisu formirane, nego su kašaste, vodenaste. Pročitala sam negdje da probiokulture reguliraju stolicu ne samo za vrijeme proljeva, nego i kada je poremećena. Ja bih isprobala probiokulture, ali, ne mogu majci dati bez stručnog mišljenja. Kašaste stolice kod vaše majke posljedica su odstranjenja dijela crijeva (niste naveli koji dio crijeva je operiran) tako da je crijevo skraćeno. Zbog toga se stolicom gubi prekomjerna količina tekućine koja joj onda daje kašastu ili tekuću formu. Dakle, promjene konzistencije stolice su posljedica operacije i skraćenja crijeva i bojim se da probiokulture tu neće biti od velike pomoći. Ukoliko se ipak odlučite za probiokulture naškoditi nećete jer se radi o sigurnim lijekovima koji gotovo da i nemaju nuspojava. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Zbog posla unatrag godinu dana često putujem. Obroci su mi neredoviti. Često jedem u restoranima. Trudim se jesti redovito voće. Poremetila mi se i probava. Muči me zatvor. Nedavno sam uzimao antibiotike zbog upale sinusa i Normiu jer je doktorica rekla da će popraviti crijevnu floru. U to sam vrijeme imao redovite (svakodnevne) stolice. Nakon tjedan dana opet sve po starom. Nisam uzimao laksative, jer se bojim da mi se ne zalijene crijeva. Da li da napravim kuru s probiokulturom, možda mi to nedostaje? U sklopu higijensko dijetetskih mjera za poboljšanje ritma stolice (unos svježeg voća i povrća, puno tekućine, kretanje) probiokulture imaju značajnu ulogu. Kuru liječenja Normiom (30 dana) možete ponoviti i više puta godišnje i za očekivati povoljan učinak na pražnjenje stolice. Klasične laksative je potrebno izbjegavati koliko god je to moguće. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Imam 36 godina. Više puta sam liječena radi Helicobacter pilory. Svaki put sam dobivala jake antibiotike. Poslije njih sam u pravilu imala problem s kandidom. Imam osjećaj da sam u začaranom krugu. Jer, kad se riješim kandide, vrate mi se tegobe vezane uz Helicobacter p. (mučnine, nadutos, žgaravica, bolovi u žličici i trbuhu). Pri zadnjoj kuri antibiotika uzela sam Normiu, u trajanju od dva tjedna. Da li sam probiokulturu trebala uzimati duže? Može li se s probiokulturom predozirati? Zanima me od kuda dolazi Helicobacter? Da li se mogu zaraziti od partnera ili mogu njemu prenijeti? Normiu obično preporučujemo kroz 30 dana ukoliko se uzima uz trojnu terapiju za eradikaciju H. Pylori, a u principu se ne možete predozirati, pogotovo ne u smislu predugog uzimanja. H.pylori infekcija je vrlo česta i smatra se da je u Hrvatskoj njome inficirano oko 65-70% odraslih ljudi. Prenosi se kontaktom tako da su članovi iste obitelji često svi zaraženi. Potrebno je reći da pozitivnost na HP ne znači nužno da se ista mora eradicirati (piti terapiju) i da je ona uvijek odgovorna za simptome u probavnom traktu. Također je upitno kojim ste načinom (testom) dokazali pozitivan nalaz. Valja istaći da je serološko testiranje (davanje uzorka krvi ) nepouzdano i da ga ne bi trebalo rabiti jer je često lažno pozitivno. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Imam brata blizanca, blizu smo 40-te godine. Brat od djetinjstva ima psorijazu. Obojica imamo dvoje djece. Moj mlađi sin (8 godina) je proljetos imao jaku prhut, kao tjemenjaču. Osjećao je jaku svrbež. Cijelo ljeto je proveo na moru, prhut se povukla. Unatrag nekoliko dana primjećujem da se svrbi, da se prhut vraća. Strah me i pomisliti da dijete ima psorijazu. Djeca od mog brata su zdrava. Znam da ćete mi reći da se javimo dermatologu što ću i učiniti. Zanima me ima li neki prirodni način da se problem riješi. Mislim na prehranu, biljne pripravke koji se preporučaju u tom slučaju Psorijaza je kronična upalna bolest koja uz kožu može zahvatiti vlasište i nokte. Specifični uzrok psorijaze nije u cijelosti poznat, ali se pretpostavlja da bolest nastaje međudjelovanjem nasljednih čimbenika i različitih čimbenika okoliša. Glede nasljeđivanja psorijaze, ukoliko jedan od roditelja boluje od psorijaze, rizik razvoja bolesti u potomstva iznosi 28%. liječenju bolesti vrlo je učinkovita heliomarinoterapija odnosno sunčanje i kupanje u moru. Na temelju poslanih podataka, koji su vrlo šturi, teško je reći o čemu se radi. Stoga vam savjetujem da s djetetom dođete na dermatološki pregled kako bi se postavila dijagnoza te ukoliko je potrebno, preporučilo odgovarajuće liječenje. Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. Poštovani, prošlo sam ljeto slučajno zaspala na suncu. Kad sam se vratila kući vidjela sam da su mi leđa izgorjela. U kućnoj ljekarni sam imala Jecol mast (za manje opekotine u kućanstvu) pa sam je namazala na zahvaćenu površinu leđa, od vrata do struka. Narednih dana, bio je vikend, nisam se mogla javiti obiteljskom liječniku pa sam nastavila s Jecolom. Kako se opeklina povukla nisam se ni javljala u ambulantu. Neki dan me uplašio članak o UV zračenju i karcinomu kože jer čini se da se poslije prekomjernog izlaganja suncu ne može popraviti učinjena šteta. Ili, nije sve tako crno? Karcinomi kože, bazaliomi i spinaliomi, pojavljuju se u srednjoj životnoj dobi, najčešće između 50. i 70. godine života. U njihovom razvoju ulogu ima kumulativna doza UVB zraka, odnosno višegodišnje prekomjerno izlaganje UV zrakama. Stoga, ukoliko ste inače oprezni pri izlaganju suncu nema razloga za zabrinutost. Preporučam Vam da tijekom ljetnih mjeseci, kada je intenzitet UVB zraka najjači, izbjegavate izlaganje suncu između 11-17 sati te primjenjujete odgovarajuće foto-zaštitne pripravke s kombinacijom UVA i UVB filtera. Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. Već desetak godina me muči ekcem na bradi koji je jako vidljiv poslije brijanja. Zato se brijem neredovito. Koristio sam po preporuci liječnika razne kortikosteroidne kreme. U početku mi je od njih bilo bolje, ali, ubrzo mi nisu pomagale, dapače, došlo bi do pogoršanja. Prije dvije godine mi je netko od prijatelja savjetovao vašu Pantexol kremu. Bojim se da je nakon tog relativno dužeg perioda slabijeg učinka. Na internetu sam vidio da imate Pantexol plus kremu? Da li da probam? U čemu je razlika? Sadrži li kortikosteroide? Kod kroničnog oblika nealergijskog dermatitisa, oštećenje kože nastaje kao posljedica kumuliranja utjecaja tvari koje su pri jednokratnoj primjeni bezopasne. Na taj način postepeno se mijenja i oštećuje zaštitna barijera kože ponajprije lipidni zaštitni film na površini rožnatog sloja, kiseli ph tog filma, pa i sam rožnati sloj kože. Pantexol Plus krema sadrži 5% dekspantenola i klorheksidin diglukonat (ne sadrži kortikosteroide) te uz antiseptičko djelovanje, njeguje, štiti i obnavlja suhu, osjetljivu i oštećenu kožu. Stoga se preporuča kao neutralna terapija kroničnog ekcema koja koži vraća masnoću, a time i otpornost. Preporučam višekratnu primjenu tijekom dana. Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. Moja djevojka ima HPV (otkriveno papa testom, CIN 3), pa ga vjerojatno imam i ja. Išla je na redoviti papa test, iako nije imala smetnje. Ona je dobila terapiju, a ja nisam. Ginekolog joj nije dao nikakve upute u vezi spolnih odnosa, ali smo pročitali na uputi od vaginaleta da se ne preporučaju spolni odnosi za vrijeme njihovog uzimanja. Ja nemam smetnje. Koliko se dugo treba suzdržavati ? Negdje sam pročitao da liječenje može potrajati i nekoliko godina. Da li koristiti kondom ili ne? Jer, bili smo intimni bez kondoma prije postavljanja dijagnoze. Veza nam je ozbiljna, stalo mi je da se djevojka izliječi jer planiramo obitelj. Da li joj mogu pomoći vitamini, probiotici ili bilo što da izbjegne operaciju (doktorica joj je rekla da je i to opcija). Prestala je pušiti. Promjene u PAPA testu CIN 1, CIN2, CIN 3 ne uzrokuju subjektivne smetnje. Kod muškarca nema analogne promjene PAPA testu, te nema potrebe za liječenjem. Naravno, za zaštitu od HPV infekcije preporučuje se uporaba kondoma iako on ne pruža potpunu zaštitu (virus se ne prenosi samo kod penetrantih odnosa, već i pri kontaktu koža-koža). Vitamini, a posebno probiotici specifični za vaginalnu mikrofloru, mogu pomoći u održavanju stabilnosti vaginalne mikroflore međutim ne utječu na izlječenje kod već prisutnih promjena koje se otkrivaju PAPA testom. Neophodne su daljnje redovite kontrole i ukoliko promjena tipa CIN 3 perzistira liječenje je kirurško. Srdačan pozdrav, Dr.sc. Alemka Brnčić-Fischer Imam 27 godina. Proljetos mi je na papa testu otkriven CIN1, a bris grlića maternice je otkrio HPV visokog rizika. Dobila sam terapiju od ginekologa, vaginalete, poslije kojih sam na svoju ruku uzela Lactogyn kapsule 1x1 kroz mjesec dana. Kontrolni papa pokazuje isti nalaz: CIN1. Dobila sam Betadine vaginalete, a kada to potrošim Albothyl ovule. Zanima me da li bi bilo dobro da paralelno pijem Lactogyn kapsule, a nakon ovula da napravim kuru s Lactogyn vaginalnim kapsulama? Liječnica mi je rekla da prve vaginalete djeluju protuupalno, a druge da ljušte grlić maternice. Zaključujem da će mi se oštetiti sluznica i vaginalna flora. Zato me zanima upotreba Lactogyn kapsula. Naravno, zanima me i da li ću na taj način riješiti infekciju HPV-om. Danas se smatra da gotovo 80% žena tijekom svog spolnog života dođe u kontakt s virusom HPV-a. Gotovo u 50% radi se o HPV virusu visokog rizika koji mogu uzrokovati promjene u PAPA testu. Međutim, važno je naglasiti da su u 90% slučajeva te infekcije prolazne, prođu same od sebe, bez ikakvog traga ili saznanja da smo ju imali. CIN 1 je najblaži stupanj premalignih promjena vrata maternice koje se otkrivaju PAPA testom. U 50% slučajeva CIN 1 spontano regredira. Neophodne su redovite kontrole ginekologa kako bi se na vrijeme otkrila eventualna progresija u viši stupanj promjene (CIN 2, CIN 3). Lactogyn kapsule pomoći će u obnovi vaginalne flore, naseliti rodnicu tzv. zdravim mikroorganizmima i na taj način smanjiti utjecaj "nepovoljnog mikrookoliša" rodnice koji je čest pratitelj promjena u PAPA testu. Srdačan pozdrav, Dr.sc. Alemka Brnčić-Fischer Suprug često ima ekcem na bradi. Nedavno je radi proljeva pio Normia kapsule 2x1 tjedan dana. Ekcem mu se nakon dugog vremena povukao. Na internetu je pronašao podatak da probiokulture pomažu kod kožnih bolesti. Da li djeluju direktno na kožu ili potiču neki proces koji ima utjecaj na kožu? Ako djeluju direktno zanima me ima li neki pripravak s probiokulturama koji se može nanijeti na kožu? Učinak probiokultura na kožne bolesti se uvelike ispituje u brojnim istraživanjima, međutim za sada su podaci iz literature kontradiktorni. Postoje dokazi o pozitivnom učinku, ali i studije prema kojima nisu uočeni učinci. Mnogo ovisi o sojevima probiokultura koji se koriste, jer ne djeluju svi sojevi na iste simptome i bolesti. Prema "Preporuci za korištenje probiokultura" iz 2008. godine, koju je objavio Univerzitet Yale, SAD, sojevi LGG i BB12 preporučuju se kao sojevi čije je djelovanje dobro ocijenjeno u liječenju i prevenciji atopijskog ekcema povezanog s alergijom na kravlje mlijeko. Osobno nemam iskustva s primjenom probiokultura u liječenju. Kod vašeg supruga bilo bi dobro napraviti obradu kako bi se pojasnio uzrok nastanka ekcema i preporučila terapija u kojoj će možda i probiokulture imati svoje mjesto . Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. U menopauzi sam već pet godina. Od tada imam jako suhu kožu lica, tijela i sluznice. Povećala sam količinu tekućine, jedem dovoljno voća i povrća, koristim masne i hidratantne kreme, povremeno umjetne suze, međutim, problem je i dalje prisutan. Da li mi savjetujete neki dodatak prehrani? Redovito obavljam sistematske preglede koji su uredni. Ginekolog mi je savjetovao povremeno uzimanje Lactogyn kapsula, što se pokazalo dobro. U menopauzi, uslijed smanjenog lučenja estrogena i progesterona, između ostalog dolazi i do promjena u strukturi i izgledu kože. Koža postaje suha, tanja je i gubi elastičnost, produbljuju se i pojavljuju nove bore, a kosa se prorjeđuje i gubi sjaj. Vrlo je važna svakodnevna njega takve kože kako bi se poboljšala njena vlažnost, obnovio lipidni sloj te ojačala obrambena funkcija rožnatog sloja kože. Preporuča se uporaba sindeta bez sapuna, ulja za tuširanje ili uljnih kupki te nanošenje tzv. emoliensa koji koži daju mekoću i glatkoću. Izrazito hidratacijsko djelovanje imaju pripravci s dodatkom 5-15% ureje ili pak oni s dodatkom omega masnih kiselina. Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. Moja majka je u dobi od 65 godina oboljela od karcinoma debelog crijeva. S anusom praeterom je doživjela 86 godina (umrla je od moždanog krvarenja). Ja sam sada blizu 60-te, a još nisam napravio kolonoskopiju. Bojim se. Tko god je bio na tom pregledu se žalio na bolove. Može li se to napraviti u anesteziji? I gdje u Zagrebu? Nemam smetnje s probavom. Osjećam se zdravo. U brojnim europskim zemljama probir za kolorektalni karcinom počinje u 50-toj godini života bez obzira na postojanje bolesti u obitelji. Po tome ste vi svakako kandidat za kolonoskopiju obzirom na vašu dob. Ukoliko je član bliže obitelji imao karcinom debelog crijeva iza 60-te godine - to se ne smatra dodatnim rizikom. Dodatni genetski rizik postoji za one osobe koje su u obitelji imale slučajeve karcinoma prije 50-te godine i tada se preporuča probir pet godina ranije nego se pojavio karcinom u obitelji (npr. oboljeli član je u trenutku dijagnoze imao 40 godina, njegova djeca trebaju na kolonoskopiju u 35-toj godini). Možete se javiti u neki od Kliničkih zavoda za gastroenterologiju većih zagrebačkih bolnica. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Imam 55 godina. U 2 sam navrata liječen sam radi Helicobacter pilory s tri antibiotika. Teško sam ih podnio. Mjesecima poslije me mučila žgaravica, povremeno proljev. Liječnica opće prakse je zaključila da su mi antibiotici uništili crijevnu floru. Rekla mi je da uzmem probiokulturu. U ljekarni su mi dali Normia kapsule. Pio sam ih tjedan dana 2x1, a poslije 1x1 još dva tjedna. Sada se puno bolje osjećam. Stolica se normalizirala, a žgaravica me manje muči (kada pojedem neku težu namirnicu). Da li sam trebao duže uzimati probiokulturu? Mogu li tu kuru ponoviti? Obično preporučam liječenje Normiom u trajanju od oko 30 dana 2x1 na dan. Ukoliko je pacijent imao pozitivan odgovor na terapiju, a tegobe mu se vrate, nakon nekog vremena dobro je ponoviti kuru liječenja Normiom 3 do 4 puta godišnje. Inače, trojna terapija za eradikaciju Helicobacter pilory većini je pacijenata teško podnošljiva tako da ja rutinski propišem Normiu tijekom i nakon provedene antibiotske terapije. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Našem sinu je pet godina. Sklon je upalama uha. Često je na antibioticima. Primjećujemo da svaka kura antibiotika završi s proljevom što ga dodatno iscrpi. Možemo li to kako izbjeći? Liječnica nije savjetovala probiokulturu kao prevenciju proljeva. Mogu li mu dati probiokulturu na svoju ruku? Čitam da sadrže korisne bakterije koje se inače nalaze u crijevima. Na vašim sam stranicama vidjela Normiu. Kapsule još ne može popiti, ali, onaj oblik u prahu bi mogao. Svakako možete (čak bih rekao da i morate) davati probiokulturu uz antibiotsku zaštitu posebice jer su nuspojave antibiotika u Vašeg djeteta jasno izražene. Možete davati Prolife ampule i to u vrijeme davanja antibiotika 2x1, a nakon prestanka još 15 dana Srdačan pozdrav, Prof.dr.sc. Mladen Peršić, dr.med. Poštovani, sada mi je 65 godina. Prije dvije godine u stresnom životnom periodu povisio mi se krvni tlak. Uzeo sam biljni preparat za smirenje, svakodnevno hodao oko sat vremena, smanjio unos soli u prehrani, odbacio cigarete, alkohol ne pijem, smanjio tjelesnu težinu i tlak se normalizirao. Povremeno ga kontroliram, ne prelazi 140/90. Osjećam se dobro. Da li sam na taj način riješio problem s tlakom? Čestitam, to je jedini pravi način za snižavanje krvnoga tlaka, ali ujedno i najteži. Osim što ste snizili krvni tlak, na taj način smanjili ste vaš ukupni kardiovaskularni rizik što je mnogo bitnije od same vrijednosti krvnoga tlaka. Za sada je dovoljno povremeno mjeriti krvni tlak. Nažalost, starenjem krvne žile postaju kruće i moguće je da u budućnosti, unatoč navedenim mjerama, krvni tlak dodatno poraste (iznad 160/90) te je onda preporučljivo uzimati lijekove za snižavanje krvnog tlaka. Zaključno, za sada ste riješili problem krvnog tlaka i samo nastavite s navedenim mjerama. Još jednom bravo! Srdačan pozdrav, Sandro Brusich, dr. med. Moja dvogodišnja djevojčica je često prehlađena. Pedijatrica preporuča da joj nos ispirem s fiziološkom otopinom. U ljekarni sam našla letak o Aqua Maris Baby kapima i spreju. Da li bi ovi proizvodi bili djelotvorniji u čišćenju i oporavku nosića obzirom da sadrže morsku vodu? Vašoj djevojčici slobodno dajte Aqua Maris proizvode namijenjene djeci, a iako učestalost prehlada nije etiološki vezana uz alergiju, dodatak bi eventualno mogla biti alergološka obrada. Srdačan pozdrav, Prof.dr.sc. Mladen Peršić, dr.med. Poštovani, majka sam dječaka od 4 godine koji od rođenja ima neurodermitis. Liječen je kortikosteroidnim mastima. Stanje se pogorša svaki put kada mu padne imunitet. Da li bi bilo korisno da mu dam kuru probiotika? Kakva su vaša iskustva s Normiom? Kako se uzima, koliko dugo? Atopijski dermatitis (dermatitis atopica, AD) je kronična ili kronično-recidivirajuća upalna bolest kože obilježena generaliziranom suhoćom, jakim svrbežom, ekskorijacijama i lihenifikacijom. Pojavljuje se u osoba s nasljednom atopijskom konstitucijom koja uvjetuje sklonost alergijskim reakcijama na različite alergene. Pristup liječenju atopijskog dermatitisa ovisi o dobi bolesnika i kliničkim manifestacijama bolesti. Budući da su temeljna obilježja atopijskog dermatitisa generalizirana suhoća kože praćena jakim svrbežom, neobično je važna pravilna njega i hidratacija kože. Glede uporabe probiotika u liječenju AD-a, podaci iz literature su kontradiktorni, odnosno za sada nema dovoljno dokaza koji bi poduprli uporabu probiotika u liječenju AD-a u djece u kliničkoj praksi. Osobno nemam iskustva s primjenom probiotika u liječenju AD-a. Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. Pozdrav, zabrinuta sam za svog sina, 10 mu je godina. Postao je vrlo nemiran, dekoncentriran, zaboravljiv. Popustio je u školi. Konzultirala sam školskog psihologa koji mi je rekao da je to sve u granicama normale. Došla sam do podatka da omega 3 povoljno djeluje na psihičko stanje, da popravlja pamćenje, umiruje. Ribu nažalost jedemo samo jednom tjedno pa sam sigurna da omegu 3 ne unosimo dovoljno. Pokušat ću uvesti i laneno sjeme kao namaz na kruh. Da li savjetujete omegu 3 kao gotovi proizvod, dodatak prehrani? Prije započinjanja dodatka omega 3 trebalo bi dijete pregledati i utvrditi moguće druge uzroke (npr. celijakija koja može ići samo s tim simptomima, ili bolesti jetre - M. Wilson...), a svakako bi trebao i pregled psihologa. Dodaci prehrani koje navodite nisu kontraindikacija, dapače, postoje brojni radovi koji govore o pozitivnim učincima omega3 kiselina na raspoloženje i koncentraciju, ali prvo je potrebno isključiti moguće organske ili psihogene uzroke smetnjama. Srdačan pozdrav, Prof.dr.sc. Mladen Peršić, dr.med. Poštovani, imam 35 godina. Za čir na želucu sam dobio trojnu terapiju antibiotika jer je pronađen Helicobacter pilory. Osjećam se bolje, ali, poremetila mi se stolica. Češće imam potrebu što me smeta na poslu. Da li bi mi pomogla probiokultura? Koji? Kako ga trebam uzimati? Prijatelj mi kaže da je kasno, da sam ga trebao uzimati za vrijeme antibiotika. U današnje vrijeme sve je više dokaza da se uz trojnu terapiju za eradikaciju H.pylori trebaju uzimati probiokulture kako bi ublažili disbalans u crijevnoj flori uzrokovan uzimanjem dvije vrste antibiotika. Nikako nije kasno i da sada uzmete Normiju 2x1 kroz 30 dana i mislim da će Vam to izregulirati stolicu. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Poštovani, moja petogodišnja kćerka je sklona respiratornim infekcijama, ide u vrtić. Često dobiva antibiotike, Operil kapi za nos. Dobrog je apetita, normalno je uhranjena. Postoji li prirodni način da se djetetu pomogne? Čitala sam o probioticima koji podižu otpornost, propolisu, morskoj vodi koja ispire i ublažava upalu nosa, grla, ali se ne usudim na svoju ruku dati djetetu. Neugodno mi je pitati našeg pedijatra. Davanje probiotika kroz nešto duži period (2-4 mjeseca) može imati samo povoljan učinak na respiratorne tegobe. Međutim, trebalo bi isključiti moguću alergijsku prirodu smetnjama, pitanje je da li su adenoidi ili krajnici uzrok ovih smetnji (pregled ORL), dok mogućnost težih imunoloških bolesti nije vjerojatna s obzirom na uredan rast i razvoj djeteta. U zaključku probiotici - da, preporučujem jednu do dvije Normia vrećice na dan, ali prije ili u tijeku davanja svakako napraviti pregled kod ORL i alergologa. Srdačan pozdrav, Prof.dr.sc. Mladen Peršić, dr.med. Pozdrav, imam 62 godine. Povremeno osjećam nelagodu, suhoću i peckanje oko spolovila. Kraće vrijeme sam uzimala vaginalne hormonske tablete, međutim, radi nuspojave jakog iscjetka i upale sam prekinula. Na koji način mogu ublažiti ovu nelagodu? Kod žena u postmenopauzi sluznica rodnice je stanjena te je zbog toga i smanjena količina glikogena i kiselina koji se proizvode uz pomoć laktobacila u svrhu zaštite rodnice. Postoje sojevi probiotika koji imaju sposobnost naseliti unutrašnjost rodnice, zalijepiti se na stjenku lučiti vodikov peroksid, bakteriocine, mliječnu kiselinu, odnosno stvoriti povoljne uvjete za oporavak vaginalne flore. Vrijeme koje je potrebno da bi se eko sustav rodnice stabilizirao, odnosno da se rodnica naseli zaštitnim mikroorganizmima, je oko 2- 6 tjedana. Dakle uloga probiotika je kako stabilizacija vaginalne flore, tako i prevencija nastanka urogenitalnih infekcija te potpora liječenju, naravno uvijek uz redovite ginekološke preglede. Zdrava vaginalna flora je najbolja prirodna zaštita žene od infekcije, no ako u njoj nema dovoljno "dobrih" bakterija koje stvaraju negativne uvijete za razvoj uzročnika infekcije, tada je to dobra podloga za razvoj bolesti. To je ujedno i razlog za primjenu Lactogyna. Za sprječavanje suhoće možete koristiti Lactogyn gel. Srdačan pozdrav, Dr. sci Alemka Brnčić, dr. med. Poštovani, da li je bolje da koristim Lactogyn vaginalete ili da uzimam baš probiokulturu? I kako bi trebala uzimati probiokulturu - ujutro, navečer, koliko na dan i da li to tijekom jela, poslije ili prije...? Hvala Vam! Srdačan pozdrav! Lactogyn vaginalete su probiokultura kao i Lactogyn kapsule koje se piju. Radi brže kolonizacije vagine laktobacilima preporučljivo je terapiju započeti vaginaletama kroz tjedan dana, a nakon toga nastaviti piti Lactogyn kapsule. Za održavanje ravnoteže urogenitalne mikroflore preporučuje se uzimanje jedne Lactogyn kapsule dnevno, po mogućnosti uz jelo. Kao pomoć u terapiji već postojećih vaginalnih smetnji te za vrijeme i nakon antibiotske terapije - preporučuje se uzeti dvije kapsule dnevno. Poboljšanje kvalitete vaginalne mikroflore očekuje se nakon dva tjedna primjene 1 kapsule dnevno, a najkasnije nakon 4-6 tjedana. Srdačan pozdrav, Dr. sci Alemka Brnčić, dr. med. Poštovani, poslije 50-te godine primijetila sam da su mi oči „suhe“, da me peckaju. Nosim naočale radi dalekovidnosti. Povremeno koristim umjetne suze. Što mi vi savjetujete? Sindrom suhih očiju čest je problem posebno u starijoj populaciji. Korištenje umjetnih suza, češće treptanje i ovlaživanje prostora mogu ublažiti smetnje. U svakom slučaju preporučam oftalmološki pregled da bi se ustanovio tip i stupanj težine stanja. Srdačan pozdrav, Maša Mikuličić, dr. med. Imam 25 godina, bolujem od psorijaze. Tijekom ljeta stanje se popravilo jer sam boravila skoro mjesec dana na moru. Čula sam dobra iskustva ljudi u liječenju psorijaze i drugih kroničnih bolesti kože s omegom 3. Ako pomaže, koliko se dugo i u kojoj dozi uzima? Sada ne uzimam nikakve lijekove. Hvala unaprijed. Psorijaza je kronična upalna bolest kože obilježena pojavom crvenih ploča prekrivenih ljuskama. Psorijaza se, ovisno o težini bolesti, liječi lokalno, a ukoliko se radi o blagom obliku bolesti, ili u slučaju težih oblika, lokalno i sistemski. Sunčanje i kupanje u moru tzv. heliomarinoterapija vrlo je učinkovita u liječenju psorijaze. Omega 3 masne kiseline pokazale su određenu učinkoviotost ako se u prikladnoj dozi koriste - kao dodatna terapija mnogih dermatoloških bolesti, primjerice atopijskog dermatitisa, psorijaze, acne vulgaris itd. Stoga se mogu koristiti 1-2 kapsule dnevno tijekom više mjeseci. Preporučuju se Mega omega-3 jer sadrže čak 65% omega-3 kiselina u jednoj kapsuli. Svakako ih je potrebno koristiti uz odgovarajuću lokalnu ili sistemsku terapiju po preporuci dermatologa. Primjena omega 3 kapsula bez odgovarajuće dermatološke terapije neće izliječiti bolest. Srdačan pozdrav, Prof. dr. Marija Kaštelan, dr. med. Poštovani, htela bih vas pitati - imam 21. god. i imam povremeno iscedak, neprijatnog mirisa, ponekad i peckanje. Htela bih pitati kako i koliko dugo bi trebala piti Vaš proizvod Lactogyn? Da li to mogu piti ovako bez savetovanja svog ginekologa? Da li i pored oralnih tih probiotika treba da koristim možda i Lactogyn gel za intimnu negu, pošto koristim neki Nivea? Često su mi kod ginekologa davali Daktanol vaginalete, ali to mi nije baš pomoglo da se toga rešim, možda malo. I uvek je odgovor ginekologa da je oslabljen imunitet, ali ja svoj problem tako ne rešavam. Inače studiram, a u zadnja tri meseca sam napeta zbog ispita. Da li je možda stres uzrok mojih gljivica, stvarno ne znam...inače sam i dosta smršavila... Unapred hvala! Srdačan pozdrav! Smatra se da svega 30-40% žena ima zdravu vaginalnu floru. Stres, oslabljen imunološki sustav, uslijed različitih bolesti, obične prehlade ili ozbiljnijih stanja, korištenje lijekova kao što su antibiotici ili kontracepcijske pilule, sve to može dovesti do neravnoteže vaginalne flore. U svijetu danas oko 300 milijuna žena oboli od neke urogenitalne infekcije, a najčešće su to bakterijske vaginoze (neravnoteža vaginalne mikroflore: jako smanjen broj laktobacila i povećan broj anaerobnih bakterija, posebno Gardnerelle vaginalis) i vaginalne kandidijaze. Tegobe se očituju kao svrbež, peckanje i pojačan iscjedak iz rodnice, nerijetko neugodnog mirisa. Infekcije često mogu biti asimptomatske, no ako se ne liječe moguć je razvoj komplikacija poput steriliteta, upale zdjeličnih organa, prijevremenog poroda i sl. Važno je naglasiti da su takve infekcije sklone ponavljanju. Terapija infekcija uključuje primjenu antibiotika ili lijekova protiv gljivica koji uništavaju uzročnika bolesti. No takvi lijekovi ujedno i nepovoljno djeluju na zaštitne mikroorganizme u rodnici. Stoga standardnoj terapiji možemo pridružiti i potporu u zaštiti vaginalne flore u obliku probiotika - mikroorganizama s pozitivnim učinkom na zdravlje domaćina. Važno je znati da svi probiotici nisu isti i nemaju jednako djelovanje. Vrijeme koje je potrebno da bi se eko sustav rodnice stabilizirao, odnosno da se rodnica naseli zaštitnim mikroorganizmima je oko 2-6 tjedana. Dakle uloga probiotika je kako stabilizacija vaginalne flore tako i prevencija nastanka urogenitalnih infekcija te potpora liječenju.Ukoliko imamo znakove infekcije tada Lactogyn koristimo kao dodatak terapiji koju nam je prepisao liječnik (antimikotici, antibiotici), najmanje dva do šest tjedana. Za brže postizanje zdrave vaginalne mikroflore najbolje je prvi tjedan koristiti i Lactogyn vaginalete (stavljati jednu na dan). Kod ponavljanih inefkcija preporuča se piti jednu kapuslu dnevno više mjeseci. Kod ponavljanih infekcija preporuča se uporaba jedne kapusle dnevno više mjeseci. Srdačan pozdrav, Dr. sci Alemka Brnčić, dr. med. Pozdrav, godinama se mučim s opstipacijom. Navršila sam 42 godine. Na poslu sjedim, vozim se na posao duže vrijeme, premalo se krećem. Što se tiče prehrane mislim da sam napravila sve što se savjetuje (tekućina, voće, povrće).Kolegica mi je rekla da je taj problem riješila s probiokulturama. Ima ih puno, ne mogu se odlučit. Pročitala sam članak o Normiji.Da li je savjetujete i kod opstipacije? Kronična opstipacija je jedan od najteže rješivih problema u gastroenterologiji. Nakon higijensko-dijetetskih mjera, koje ste već kako čitam promjenili, ostaju medikamentozna sredstva. Njihov je problem stimulacija stolice na ne baš fiziološki način tako da ih treba izbjegavati ili primjenjivati u najmanjoj mogućoj mjeri. Probiokulture također imaju mjesto, a smatra se da su puno fiziološkiji nego laksativi. Iako je njihovo područje primjene puno izraženije u slučaju proljeva, pokazalo se da mogu pomoći i kod opstipacije. Preporučio bih Vam uzimanje Normie kroz 30 dana, a to se može ponoviti 3 do 4 puta godišnje. Srdačan pozdrav, Dr. sci. Goran Hauser, dr. med. Poštovani, imam 80 godina. Uzimam tablete za povišeni šećer. Na dijeti sam i radi gihta. Imam kataraktu na oba oka. Da li bi mi Oculoplus kapsule pomogle? Kako se uzimaju? Poštovana, Oculo plus kapsule mogu usporiti napredovanje katarakte budući da sadrže snažne antioksidanse. Uzimaju se jednom dnevno. Savjetujem vam kompletan oftalmološki pregled da bi se ustanovio stupanj zamućenja leće. Budući da ste dijabetičar, pregled očne pozadine najmanje jednom godišnje je od izuzetnog značaja. Srdačan pozdrav, Maša Mikuličić, dr. med. Poštovanje, imam 35 godina i već godinama imam problem sa suhoćom rodnice i vagine. Pokušavam s raznim lijekovima, travama. Sad trenutno koristim Lactogyn kapsule. Da li će mi ovaj proizvod pomoći i koliko traje terapija. Hvala unaprijed Suhoća rodnice problem je koji se javlja uglavnom u menopauzi, ali nije rijedak slučaj kada je prisutna i u reproduktivnom razdoblju žene. Najčešći uzrok je smanjena razina hormona estrogena koja obilježava menopauzu. Razlozi mogu biti i psihičkog porijekla; obično su povezani s traumatskim spolnim iskustvom, stresom, depresijom, nezadovoljstvom u vezi. Višekratna upotreba agresivnih sapuna koji oštećuju sluznicu vagine može pridonijeti njenoj suhoći. Pojedini lijekovi za alergiju i prehladu te antidpresivi kao i oralna hormonska kontracepcija mogu djelovati na pojavu suhoće u rodnici kao i tzv. Sjogrenov sindrom (autoimuna bolest karakterizirana pojavom suhih očiju i/ili usta, može se pojaviti i suhoća rodnice). Lactogyn kapsule i vaginalete pridonose obnovi i stabilizaciji vaginalne flore (smatra se da svega 30-40% žena ima zdravu vaginalnu mikrofloru) , a obnovljena vaginalna flora vraća prirodnu zaštitu sluznice vagine. Poboljšanje kvalitete vaginalne mikroflore očekuje se nakon dva tjedna primjene 1 kapsule dnevno, a najkasnije nakon 4-6 tjedana. Terapija traje dva mjeseca. vašem bih slučaju preporučila i uporabu vaginalnih lubrikanata na bazi vode u rodnicu prije spolnog odnosa kako bi on bio što manje neugodan zbog problema suhoće rodnice. Svakako preporučujem i obvezatno savjetovanje sa ginekologom. Srdačan pozdrav, Dr.sc. Alemka Brnčić-Fischer, specijalista ginekologije i opstetricije Mogu li se Lactogyn vaginalne kapsule koristiti tijekom menstruacije? Budući da se uzimaju samo tjedan dana, predlažemo da to bude izvan menstruacije (prije ili poslije krvarenja). Ako biste ih koristili za vrijeme menstruacije, veći dio probiotika bi se izbacio s menstrualnom krvi pa bi učinak bio slabiji. Za vrijeme menstruacije možete uzimati kapsule koje se piju 1x1 dnevno. Srdačan pozdrav, JGL Savjetovalište Poštovani, u više sam navrata uzimala Lactogyn tablete i uistinu sam njima zadovoljna. Sada sam vidjela da su se pojavile i vaginalne kapsule, pa me zanima koja je razlika između njih i oralnih kapsula. Vaginalne kapsule djeluju brže pa se savjetuju u akutnom stanju, kod izraženih smetnji. Nakon tjedan dana dobro je nastaviti s Lactogyn oralnim kapsulama 1x1 još 1-3 tjedna. U slučaju antibiotske terapije mogu se kombinirati, Lactogyn kapsule oralne 1x1 poslije doručka, a vaginalnu staviti u rodnicu prije spavanja kroz 7 dana, zatim nastaviti terapiju još 3 tjedna s oralnim kapsulama 1x1. Srdacan pozdrav, JGL Savjetovalište Poštovani, imam jedan problem. Imam 26 god i borim se već 8 godina s jednim problemom koji niti liječnici mi ne znaju objasniti. Na pola mjeseca za vrijeme plodnih dana pojavi mi se kao da imam menstruaciju koja traje oko 3-4 dana, a ponekad i do sljedeće menstruacije pa vas pitam da li bi mi LACTOGYN pomogao? Unaprijed hvala. Ponekad se u vrijeme ovulacije, otprilike na sredini ciklusa pojavi lagano krvarenje na koje ne možete djelovati s Lactogyn kapsulama. Međutim, dobro će vam doći u regulaciji vaginalne flore za vrijeme i poslije uzimanja antibiotika i u vrijeme pojačanog stresa. Srdačan pozdrav, JGL Savjetovalište Pozdrav. Mesecima veke imam problem so neprijatna mirizba i sekrecija. Imam napraveno pap test vo poveke kliniki rezultatot mi e super nema nekoja bakteria ili infekcija, no neprijatnata mirizba mi se pojavuva sekoj pat posle sto ke imam odnosi so partnerot. Imam koristeno vaginaletki acidosalus i seka doktorkata mi preporacuva da zemam Lactogyn i vaginaltekti acidosalus. Sakam da znam dali moze da imam nekoj golem problem ili nekoja golema infekcija sto mi se pojavuva sekoj pat sto ke imam odnosi, i kako mozam da go sprecam? Kolku vreme treba da zemam Lactogyn i dali treba i partnerot isto taka da se leci? I dali e normalno da se pojavuva ova neprijatna mirizba? Hvala i pozdrav Prilikom odnosa i izbacivanjem sjemene tekućine se mijenja ph u vagini što može dovesti do promjene mikroflore i neugodnog mirisa. Napravite kuru s Lactogyn vaginalnim kapsulama 1x1, prije spavanja kroz 7 dana. Uz to uzmite i Lactogyn oralne kapsule koje ćete piti 1x1 kroz 4 tjedna. Na taj ćete način u vaginu unijeti laktobacile koji će regulirati mikrofloru i smanjiti ili riješiti vaše smetnje. Predlažemo da vaš partner napravi briseve mokraćne cijevi da se isključi eventualna infekcija. Srdačan pozdrav, JGL Savjetovalište Poštovani, imam 39 godina, visoka 165 cm, teška 69 kg, kronične bolesti - kroničan perikard, problemi s venama na desnoj nozi (vidljivo s otokom), prvu mjesečnicu sam dobila s 12 godina. Zanima me mogu li uz lijek Cyclo Progynova koji se sastoji se norgestrela-0,5mg i estradiola-2mg, piti i Lactogyn? Hvala i srdačan pozdrav, Lidija Poštovana, uz terapiju koju ste dobili od ginekologa možete uzimati Lactogyn kapsule, nema kontraindikacija. Napravite kuru s Lactogyn kapsulama koje ćete piti 2x1 kroz 2 tjedna, a zatim nastaviti 1x1 još 6 tjedana. One će stabilizirati vaginalnu floru. Što se tiče tjelesne težine skoro je pa idealna. Da se potrudite u 6 mjeseci biste mogli skinuti 5 kg, to bi bilo olakšanje za srce i za vene. Pokušajte iz jelovnika izbaciti slatkiše. Uključiti više voća i povrća. Srdačan pozdrav, JGL Savjetovalište Poštovani, čula sam da je Vaša krema Adrience oligosource odlična, zbilja bi ju htjela probati i koristiti, no nažalost nikako ne mogu doći do Vaših testera. Da li vi možda šaljete testere na kućne adrese? Poštovana gospođo, predlažemo da se javite u Pablo ljekarnu, bilo koju, gdje vam je na raspolaganju naše stručno osoblje i testeri. Srdačan pozdrav, JGL Savjetovalište Molila bih vas za kratki savjet u vezi Prolife kapsula. Naime, planiram ih dati svojem 1,5 god. djetetu s obzirom da je trenutno na antibiotiku, pa da se malo probavni sustav „oporavi“. S obzirom da ne znam kakvog je okusa Prolife u bočicama i da li bi mi to htio popiti, mislila sam kupiti kapsule i otopiti u čaju ili soku. Da li se time smanjuje učinkovitost proizvoda? Koliko dugo se mogu koristiti Prolife proizvodi, odnosno da li napraviti jedan tretman u određenom vremenskom trajanju ili uzimati po potrebi? Poštovana, Prolife probiotik je svojim oblikom namijenjen određenom uzrastu i načinu primjene. Za djecu je namijenjena suspenzija koju možete pomješati s čajem (rashlađenim na sobnoj temperaturi, visoka temperatura bi uništila probiotik). Probiotik u prahu je zaštićen kapsulom s razlogom, pa se ne savjetuje otvarati je. Za vašeg sina je dovoljan sadržaj jedne bočice, pomiješajte je s pola decilitra čaja kojeg dijete inače pije, ponudite mu pola sata prije doručka. Bilo bi uputno da terapija taje 10 dana. Srdačan pozdrav JGL Savjetovalište Poštovani, mojoj kćerki (22 mj.) je prije 2 tjedna dijagnosticiran atopijski dermatitis koji nije praćen svrbežom i prema mojoj procjeni nije izrazito jako izražen. Prema preporuci dermatologa 7 dana smo je mazali elocoom 40% kremom u belobazi i još uvijek joj dajemo 3x7 kapi Fenistila. Prije nekoliko dana sam joj počela davati Normiu u prahu pa me zanima koliko dugo se preporuča njeno uzimanje u ovom slučaju? Poštovana, napravite kuru s Normiom prahom tijekom 4 tjedna, 1x1 vrećica uz doručak (ili neki drugi obrok koji možete kontrolirati). Bilo bi dobro iz djetetovog jelovnika isključiti gotova jela i grickalice, jer su puni dodataka (konzervansa, pojačivača okusa, boja), jaja i mlijeko za vrijeme trajanja osipa. U zamjenu možete djetetu dati rižino mlijeko. Sojino se također ne preporuča, jer su česte alergije na soju. Isto tako rublje od djevojčice nemojte prati s omekšivačem. Srdačan pozdrav JGL savjetovalište Poštovani, koristim lijek Contral koji mi ublažava alergiju na grinje. Ako pijem lijek svaki dan simptomi su mi manji, pa vas pitam da li lijek smijem koristiti stalno i napominjem da sam Contral uzeo samoinicijativno jer lijekovi koje sam koristio nisu pomagali. Inače stalno kišem i curi mi nos i suze oči, a Contral mi jedino ublaži ove simptome. Srdačan pozdrav, Enes Đono Poštovani g. Đono, Liječenje loratadinom (Contral), koji zbog svoje učinkovitosti u terapiji alergija, brzog početka djelovanja, jednostavne primjene (uzima se jednom na dan) i nesedativnih učinaka, olakšava simptome koje navodite. Međutim, kako se ne radi o sezonskom rinitisu, nego alergiji na grinje koje su prisutne cijelu godinu, neophodno je da se o dužini uzimanja lijeka savjetujete sa svojim liječnikom (alergologom). Srdačan pozdrav JGL Savjetovalište Da li je Aqua Maris siguran za upotrebu kod začepljenog nosa kod trudnica? Poštovani, Aqua Maris trudnice i dojilje mogu koristiti bez straha, jer se radi o prirodnom ljekovitom proizvodu. Srdačan pozdrav JGL Savjetovalište Poštovani, molila bih Vas informaciju-objašnjenje vezano uz Vaš proizvod AntiOx. U sastavu AntiOx-a je navedeno da sadrži Tocopherzyl acetate. Na internetskoj stranici http://www.coolinarika.com/clanak/vitamin-e-manji-rizik-od-bolesti-srca u navedenom članku sam pronašla ovaj podatak: “Postoji još jedna "kvaka" kod vitamina E, tj. "tokoferol" i "tokoferil" oblik. Mnoge to zbunjuje pa treba objasniti. Što će stajati, ovisi o tome kako je E vitamin kemijski povezan (acetat, sukcinat). Među njima nije velika razlika, osim što je apsorpcija kod "tokoferol" oblika nešto bolja, ali je zato kod "tokoferil" oblika nešto bolja održivost. Oba su oblika aktivna kada se uzmu na usta, ali "tokoferil" oblik nije moguće apsorbirati kožom. Ako, dakle, u ruci držite kremu s dodanim tokoferil acetatom, znajte da ništa ne koristi.“ Zanimalo bi me Vaše mišljenje/objašnjenje. Crljen Poštovana gđo. Crljen, Razvijajući proizvod Holyplant AntiOx krema odvagali smo stručne činjenice za korištenje vitamina E u obliku tokoferil acetata. Poznato je da vitamin E u tokoferol obliku ima jače antioksidativno djelovanje na kožu međutim navedena činjenica je kompenzirana korištenjem veće koncentracije tokoferil acetata koja u literaturi ima osnovu da u korištenoj koncentraciji posjeduje antioksidativno djelovanje. Dodatno je vitamin E u obliku tokoferil acetata ugrađen u kremu oblika "voda u ulju", što znači da je masna (uljna) faza ta koja je u direktnom kontaktom s kožom i zbog koje krema ostaje duže na mjestu primjene te tokoferil acetat ima više vremena za interkaciju s kožom. Postoje razne dermatološke studije koje potvrđuju da se tokoferil acetat apsorbira u površinskim slojevima kože te da se nakon apsorbcije u koži pretvara u tokoferol oblik. Dodatna činjenica koja je utjecala na odabir oblika vitamina E u Holyplant AntiOx kremi je ta da tokoferol oblik ima snažniji iritacijski potencijal od tokoferil oblika, što bi značilo da češće može izazvati nuspojave poput crvenila, svrbeža, ljuštenja gornjih slojeva kože i sl. Također bitna stavka je da tokoferil oblik vitamina E ima duži rok valjanosti tako da njegovim korištenjem u Holyplant AntiOx kremi možemo tijekom cjelokupnog roka valjanosti biti sigurni da koncentracija tokoferil acetata ostaje nepromijenjena. Za napomenuti je i da se antioksidativno djelovanje u koži ne postiže korištenjem samo oblika vitamina E već kombinacijom istog s vitaminom C, koji je također ugrađen u Holyplant AntiOx kremu. Zaključno možemo reći da Holyplant AnitOx krema koja u sastavu sadrži vitamin E u obliku tokoferil acetata posjeduje antioksidativno djelovanje koje je osigurano tijekom cjelokupnog deklariranog roka valjanosti proizvoda te da je proizvod siguran za primjenu. Ukoliko postoje dodatna pitanja stojimo Vam na raspolaganju. Srdačan pozdrav Aleksandar Posavec, prof. Brand manager, Consumer Health Programme Da li se Lactogyn kapsule mogu koristiti i za vrijeme mjesečnice? Poštovana, Lactogyn kapsule se piju redovito, bez prekida i za vrijeme mjesečnice. Srdačan pozdrav JGL Savjetovalište Poštovani, radi bolne upale mjehura pijem antibiotik Cefixim. Jedna od navedenih nuspojava je vaginalni svrab, kojem sam i ja podlegla. Zanima me je li uputno u istom periodu konzumirati antibiotike i probiotike, s obzirom da sam čula da antibiotici pobijaju učinak probiotika, ili je bolje sačekati završetak terapije antibioticima. Hvala na odgovoru! Poštovana, probiotike treba piti za vrijeme antibiotske terapije, ali barem 2 sata prije ili poslije antibiotika. Osim toga, ako se odlučite za Lactogyn kapsule savjetujemo 2x1 kroz 2 tjedna, a zatim 1x1 jos barem 2 tjedna. Uputno je iz jelovnika isključiti slatkiše, šećer, med, kvasac, suhomesnate proizvode, jer mijenjaju ph, i potiču porast kandide. Srdačan pozdrav JGL Savjetovalište Ja imam pitanje vezano za korištenje tbl. Lactogyn. Da li je dovoljna jedna doza, odnosno jedno pakovanje, da riješim svoje probleme za koje mislim da će mi Lactogyn pomoći? Molim vas da mi pošaljite odgovor na e-mail. Hvala vam unaprijed Poštovana, Lactogyn kapsule su pomoć u liječenju bakterijskih, gljivičnih i virusnih upala rodnice.Uzimaju se duže vrijeme. Najmanje 4 tjedna kod blaže kandidijaze, a kod infekcije s HPV-om mjesecima, dok se papa nalaz ne normalizira. Srdačan pozdrav JGL Savjetovalište Poštovani, imam 28 godina i rodila sam prije 3 godine. Dešava mi se da poslije seksualnog odnosa sa suprugom imam bolove u stomaku koji su ponekad praćeni bijelim iscjetkom. Što da radim? Hvala unaprijed Poštovana, javite se ginekologu, jer potrebno je ustanoviti zašto imate bolove.Osim toga, treba vidjeti da li je taj iscjedak normalan - odgovara li po svom sastavu određenom periodu u ciklusu ili sadrži bakterije koje treba liječiti. U svakom slučaju, savjetujemo uzimanje Lactogyn kapsula 2x1 kroz 2 tjedna, a zatim 1x1 još 6 tjedana, kako bi se regulirala mikroflora u rodnici. Srdačan pozdrav JGL Savjetovalište Zdravo, povremeno imam problema sa candidom pa stalno koristim Canestea ili nesto slično, ali nikad nisam probala da to saniram s probiotokom. Molim vas recite mi kako bi oni pomogli mojim problemima i ukoliko počnem tu terapiju - koliko vremena se pije? Isto htjela bih da znam da li je s ovom terapijom moguće povećanje kilaže? Hvala Vam puno Poštovana, infekcija s kandidom se često vraća, jer kandida je normalna stanovnica u rodnici i crijevu. Međutim, u nekim situacijama naglo se razmnoži, poremeti mikrofloru u rodnici i crijevima te izazove upalu. Liječenje je dugotrajno, zahtjeva puno strpljenja, promjene navika, smanjenje stresa. Neophono je provesti strogu antikandida dijetu (izbaciti šećer, bijelo brašno, slatkiše, med, suhomesnate proizvode, kvasac, suho voće, alkohol). Lactogyn kapsule uzmite 2x1 mjesec dana, a zatim 1x1 jos 2 mjeseca. Naravno, to je pomoćna terapija uz lijekove koje ćete dobiti od ginekologa. Morali bi odustati od spolnih odnosa barem 4 tjedna. Vaš partner bi trebao koristiti kremu Canesten, za vanjsku primjenu kako je opisano u uputi. Svaki puta kada uzimate antibiotik poželjno je da uzimate i probiotik (Nprmia 2x1 - 2 sata prije ili poslije antibiotika) da se održi normalna flora u crijevima. Jer, ako se ona naruši dolazi do problema i u rodnici (blizina). Lactogyn kapsule nemaju utjecaj na povišenu tjelesnu težinu. Srdačan pozdrav JGL Savjetovalište Zbog dosadašnjih iskustva neću ići ginekologu pa vas pitam. Imam 23 godine, liječila sam kandidu dva puta do sada i uzimala sam Lactogyn kao dodatak terapija. Zadovoljna sam od njih ali evo opet se nešto dešava. Prije nekog dana zabilježila sam povećan vaginalni iscjedak, bijel, i peckanje tokom seksualnog odnosa. Moj partner je isto osjetio peckanje. Redovno održavam intimnu higijenu s vodom i kamilicom, seksualne odnose s jednim partnerom imam već 5 godina, izbjegavam slatkiše i šećer. Molim vas za savjet, što trebam učiniti? Poštovana, odlično govorite hrvatski. Sami ste rekli da ste Lactogyn kapsule uzimali kao pomoćnu terapiju, što je ispravno. Morali biste uz njega uzeti i antimikotik u vaginaletama, a vaš partner u obliku kreme.To vam može prepisati na recept ginekolog. Prva dva tjedna uzmite 2x1 Lactogyn kapsule, a zatim 1x1 još 6 tjedana. Izbjegavajte svježi kruh, peciva, suhomesnate proizvode i slatkiše. Srdačan pozdrav JGL Savjetovalište Poštovani, zadnjih dvije godine stalno se borim s upalama i sirastim iscjetkom, tj. Candidom jer se stalno borim s padom imuniteta. Htjela sam provjeriti s Vama, koliko bi se dugo trebalo trošiti Lactogyn jer vjerujem da mi od jedne kutije neće biti bolje? Lp Petra Poštovana Petra, Lactogyn kapsule su pomoć u liječenju kandide.To znači da ih uzimate uz th koju vam savjetuje ginekolog. Međutim, Lactogyn kapsule nastavljate uzimati i poslije lokalne terapije (s vaginaletama ili kremom). Predlažemo da 2 tjedna uzmete 2x1 kapsulu, a zatim još 6 tjedana 1x1.Obratite pozornost na prehranu, isključite slatkiše, svježi kruh, suhomesnate proizvode, jer potiču rast kandide. Bilo bi uputno napraviti kuru s kvalitetnim vitaminima za podizanje općeg imuniteta. Za dodatne informacije možete se javiti i u naše telefonsko savjetovalište. Srdačan pozdrav JGL Savjetovalište Poštovani, koža mi je mješovita, t-zona masna, dok su obrazi, pogotovo u ovo zimsko vrijeme suhi. Što bi mi preporučili za njegu lica? Da li postoji mogućnost da dobijem testere vaših proizvoda? Lijep pozdrav, Vlatka Poštovana gospođo Vlatka, predlažemo da se javite u Pablo ljekarnu gdje će vam naše stručno osoblje sugerirati odgovarajuću njegu za lice. Tamo možete dobiti i testere. Srdačan pozdrav JGL Savjetovalište