Questions and answers p. 6

Hello! For many years I have been suffering from chronic cystitis, which periodically develops into pyelonephritis. I am constantly monitored by urologist, but the doctor can offer me nothing but a new course of antibiotics. I heard that there is a surgical treatment for cystitis, please tell me more about this procedure.
Answer: 14.05.2021

There is a surgical treatment, but not for all forms of cystitis, and with leukoplakia of bladder, the inner surface of this organ begins to change, areas of so-called flat cells appear, over time these foci can become covered with microcracks and keratinized. Urine, getting on the affected areas, causes stinging and burning. In such cases, transurethral resection of bladder affected areas is performed using a special resectoscope instrument, which is inserted into the bladder through the urethra.

Vovk Valeriy Anatoliyovych
Surgeon. Doctor of Medical Sciences. The highest category. Work experience 26 years.
Hello. For the last couple of months, my breasts began to enlarge and discharge from the right nipple appeared. My wife says that I just drink a lot of beer, but my weight is stable - only my breasts have increased, and the right one is bigger. Tell me, which doctor should I see with this and what can I do? Is it possible to surgically reduce breasts to their normal size?
Answer: 14.05.2021

The described complaints are characteristic of such a disease as gynecomastia - an enlarged breast in men. However, malignant neoplasm is also possible. With such complaints, it is necessary to contact a surgeon, oncologist, mammologist, endocrinologist to clarify the diagnosis. With the subsequent referral to surgical treatment, as a result of which the appearance will return to its usual state.

Voychuk Bogdan Dmitrievich
Urologist, surgeon. Work experience is 4 years.
Good afternoon. I was in close contact with a person who was diagnosed with measles. I have not been revaccinated against measles for many years. Could you tell me what to do? Does the measles vaccine still make sense or will I get sick anyway?
Answer: 12.05.2021

Hello. Measles vaccination is not included in the vaccination schedule for adults (considering that you were vaccinated according to the schedule as a child). However, if in doubt, it makes sense to do measles IgG, if the titer is low, consider revaccination. It is also possible to administer the vaccine in the first 72 hours after contact with a patient with measles. However, it should be noted that such preventive vaccination provides limited protection.

Kudrinskaya Maria Fedorovna
General physician. The second category. Work experience is 5 years.
ello. My child started to attend kindergarten, and there they declared quarantine for chickenpox. I know that it is no big deal for a child, but my husband and I did not have this illness in childhood. I've heard that as an adult, chickenpox can be dangerous and is much more difficult to tolerate than in childhood. Could you tell me, can my husband and I get vaccinated against chickenpox, and how long after vaccination will we be protected?
Answer: 12.05.2021

Good afternoon. Indeed, in adulthood, chickenpox is characterized by a more severe course and the possibility of secondary complications. Vaccination against chickenpox is indicated for both children and adults who have not previously been ill. An “urgent” vaccination against the disease is possible, which will help for limited protection, provided it is administered no later than 72 hours after exposure to a person with chickenpox. Vaccination implies the introduction of 2 doses with an interval of 6 weeks (at least 4). In this case, the protection will be maximum.

Kudrinskaya Maria Fedorovna
General physician. The second category. Work experience is 5 years.
Hello! What vaccinations are recommended for adults if I have not done any vaccinations since childhood? I am 30.
Answer: 12.05.2021

Good afternoon. If there is documentary evidence of the lack of vaccination in childhood, it is worth developing your vaccination schedule, which will include both mandatory vaccinations (MPR, DTaP, etc.) and recommended (pneumococcal infection, chickenpox, etc.). It is worth considering the concomitant pathology, infectious history. At the appointment, the family doctor will carry out the patient intake and draw up an individual vaccination schedule.

Kudrinskaya Maria Fedorovna
General physician. The second category. Work experience is 5 years.
Hello. I am 26 years old and I am at high risk for cervical cancer – my mother and grandmother were diagnosed. The gynecologist advises to get HPV vaccine for prevention, but I doubt it because I heard that at my age it is no longer effective. Tell me please, whether it is reasonable to get vaccinated against HPV after 20 years and what is its effect?
Answer: 12.05.2021

Hello! Vaccination against HPV is carried out after 20 years, and in some cases even up to 45 years, if there is an indication for it. The anti-HPV vaccine operates as follows: vaccination produces antibodies that penetrate the cervix and neutralize the virus and prevent its entry into cells, the virus is in the mucous membrane and does not cause immune response.

Kucher Daria Nikolaevna
Obstetrician-gynecologist. Second category. Robots experience 5 years.
Yesterday I went to the gym and did leg exercises, I was very tired and barely made it home. Today I could not get out of bed, the leg muscles hurt very much, this has never happened before. I want to ask a traumatologist online how to treat muscle pain? What is the correct name of the injury?
Answer: 01.03.2021

During training, ATP begins to decompose in muscle tissue and blood, which is the most important source of energy. Because of this, there is a burning sensation. After intense leg training, muscle soreness occurs. It occurs 6-8 hours after physical activity and reaches a maximum in 2-3 days. As a rule, its appearance is the result of unusual or excessively increased physical activity. The pain is caused by microscopic damage or even tearing of muscle fibers. Such pains are relieved by massage, taking a hot bath or sauna, or repeating exercises with less stress after 1-2 days. If the pain persists, after 3-4 days, this is the reason for seeing a traumatologist and it implies traumatic muscle injury.

Nizhivenko Dmitriy Sergeevich
Traumatologist-orthopedist. The highest category. Work experience is 18 years.
I twisted my leg a couple of days ago, now my ankle is swollen and it hurts to stand on my leg. I smeared the sore spot with ointment and tied it with an elastic bandage. What should I do next? First to undergo an X-ray, and then visit a traumatologist or vice versa? Can I get a doctor's consultation online? Now every going out is torture for me.
Answer: 01.03.2021

Ankle injury requires a careful and urgent visit to a traumatologist. Make an X-ray, before that the traumatologist must examine the patient to determine the scan area and refer to the X-ray. Depending on the results of the clinical and the X-ray examination, a diagnosis will be established and treatment prescribed, as well as the immobilization method.

Nizhivenko Dmitriy Sergeevich
Traumatologist-orthopedist. The highest category. Work experience is 18 years.
There was some pain in the heel area, it began to hurt to step on and there was a feeling of heat in that area. I didn't seem to hit anywhere, I wear comfortable, good shoes. Maybe I need to buy orthopedic insoles so that the heel does not hurt? Can I get a consultation by a traumatologist online? I have a very busy schedule.
Answer: 26.02.2021

If there is a pain in the heel while walking, the most common cause is a heel spur. It is necessary to take an X-ray of the foot in stress, after which examination by an orthopedic traumatologist is required, if necessary, additional tests should be carried out. After examination, a course of conservative treatment is prescribed. With a heel spur, the method of shock wave therapy is widely used, in combination, comfortable shoes and wearing of insoles-instep support also play an important role.

Nizhivenko Dmitriy Sergeevich
Traumatologist-orthopedist. The highest category. Work experience is 18 years.
Recently I hit my elbow very hard, I anointed my elbow with a cooling gel, the first days it was painful to unbend, but after 3-4 days the pain disappeared. Now I hear some kind of unpleasant crunch when bending and unbending my elbow. There is absolutely no time to visit a doctor due to a busy work schedule, is it possible to consult a doctor online?
Answer: 26.02.2021

Hello! In your situation, it is still recommended to find time and consult a clinic for examination and an X-ray in order to exclude bone traumatic changes.

Orlov Stanislav Yurievich
Orthopedic traumatologist. First category. Work experience 21 years.
Recently, I have had a strange sensation in my knee, as if there is something in it and interferes me walking. The skin is red and swollen, but overall the knee does not hurt much. What is this disease and how can I treat it? Is it possible to get a consultation by a traumatologist online or house-call a traumatologist?
Answer: 26.02.2021

Hello! According to your complaints, you can suspect a problem with the meniscus and ligamentous apparatus of the knee joint. You will have to find an opportunity to visit the clinic for a more detailed examination by an orthopedic traumatologist and additional examination to confirm this condition.

Orlov Stanislav Yurievich
Orthopedic traumatologist. First category. Work experience 21 years.
I began to notice joint pain after physical exertion. I have been going in for sport for a long time, I lead an active lifestyle. Maybe constant training has worsened the condition of my joints? Also, after sport, my knees swell and become hot. Very unpleasant sensations, I do not know how to deal with it, I have already tried various alternative treatment methods, but I would like to get a medical opinion from a traumatologist.
Answer: 26.02.2021

Of course, you can get a consultation from an orthopedic traumatologist and undergo the necessary examination at our clinic. The symptoms that you describe can correspond to degenerative-destructive joint diseases. In order to confirm or exclude this, it is necessary to do a visual examination and additional examination (an X-ray, ultrasound of joints).

Orlov Stanislav Yurievich
Orthopedic traumatologist. First category. Work experience 21 years.

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