Glutathione Precursors Inhaler
Glutathione tablets are ineffective in increasing glutathione levels in the
tissues and organs (such as the lung) because they are digested in the stomach
and never reach the blood stream or the tissues of the body. Oral GSH simply
is metabolized as a protein (digested). Small hydrophobic molecules are thought
to be rapidly absorbed (within seconds) throughout the lungs
by passive diffusion through the plasma membrane.
Glutathione in the epithelial lining fluid of the
lower respiratory tract is thought to be the first line of defense against
. The ELF concentration of GSH is 140 times that of serum
concentrations with a redox ratio of 9 : 1. In fact, alternations in
alveolar and lung GSH metabolism are widely recognized as a
central feature among many inflammatory lung diseases.
In healthy lungs, the oxidant burden is balanced by local antioxidant defenses. However, in lung
diseases cellular damage and injury is mediated by an increased oxidant burden
and/or decreased antioxidant defenses. Given that inhalation is the only known
method that increases GSH levels in the ELF for a significant duration, a review
of the literature was conducted to examine the clinical effectiveness of inhaled
GSH as a treatment for various pulmonary diseases and respiratory-related conditions.
Only reports involving human subjects were included in the analysis. The clinical
and theoretical indications for GSH inhalation were summarized and potential
concerns with this treatment reported. Other pertinent details such as its presumed
mechanisms of action and optimal doses to be administered were compiled and evaluated.
Rheumatoid Arthritis Greatly Improved
A generalized disease, occurring more often in women,
which primarily affects connective tissue; arthritis is the dominant clinical manifestation, involving many joints,
especially those of the hands and feet, accompanied by thickening of articular soft tissue,
with extension of synovial tissue over articular cartilages, which become eroded; the course is
variable, but often is chronic and progressive, leading to deformities and disability.
We introduce the case of a 42 year-old woman with advanced and
complicated arthritis deformans
in which the symptoms and signs were appearing gradually
along the years. She had great deformities and suffered from intense pain. She
had undergone all kind of treatments without any improvement. The first symptoms
that appeared were: pain, edema and difficulty to move the affected area. It
started in hands, knuckles and fingers, then wrists, elbows, shoulders, feet,
knees and, sometimes, in the jaw joint. She had fever, flush and swollen joints
stiffness. As long as the disease developed, certain deformities appeared, together
with edema, and persistent pain which gradually made it difficult to move and
to perform her daily tasks. Later, she showed emotional symptoms like depression,
anxiety, fear of the future, uncertainty, bad temper, lack of security and desire
to be left alone. Subcutaneous nodules in elbows, hands and feet and even in
scalp appeared. Diffuse interstitial fibrosis and nodular disease appeared in
the lungs, as well as pleuritis, pneumonitis, and arthritis.
The patient underwent treatment with a dietetic Glutathione Precursors Inhaler,
with the dosing schedule of 6 nebulizations via oral rote, deep inspiration,
four times per day. After 15 days, the pain lessened significantly, and, after
30 days, it disappeared completely. The nodules disappeared after two months
and, although the deformities in fingers and joints did not disappear completely,
they diminished significantly their size, recovering their function and their
Age: 62 y/o
Family History: Negative for neoplasia or chronic-degenerative conditions.
Non pathologic personal history: Low socioeconomic background. Regular dietetic
and hygiene habits in quality and amount. Occasional smoker (around one cigarette
per week), occasional alcohol drink, never up to intoxication. No drug use habits.
Personal Pathologic History/Record: Systemic arterial hypertension of one year
process, controlled with diet and captopril, 25 mg every 12 hours. No previous
Current ailment of 15 month progress characterized by the presence of burning
pain in the epigastric region with irradiation towards the right hypochondriumderecho,
without irritating or accompanying phenomena, developing progressively its duration
and intensity, later related to a adinamyc asthenia, as well as occasional hyperthermia
not quantified, reporting also a weight loss of 6 kg in one year approximately,
but currently the patient reports that his pains are unbearable and, when touched,
the tumor is much bigger than it was originally, according to what the patient
In the last two months: feeling of heaviness, as well as postprandial fullness
and appearing of epigastric tumor much bigger than it was originatelly as well
as anal bleeding (melenas). Physical examination reveals a male patient who
looks older than he chronologically is, forced attitude, pained facial expression,
mesomorphic body build and average size with the following vital signs: blood
pressure (BP) of 130/80 mm Hg, heart rate of 75 beats per minute, respiratory
rate, 16 per minute, temperature, 36.5 degrees, 1.67 mts height and 63 kg weight.
Karnofsky index, 80%.
Normocephalic head without sinking, hair properly implanted, no alterations
in ear pavilions, eyes, oral cavity and oropharix, no adenophaties in the neck,
normal pulse and trachea and thyroid without alterations. Thorax: normal. Clean
and well ventilated pulmonary fields, regular cardiac rhythm without murmurs
or added phenomenaados, no pleuropulmonary syndrome, negative armpits. Abdomen:
soft plane, yielding, no pain, oloroso, palpable tumor, located in right epigastrium
and hypochondrum with edges not well differentiated, of hard, ligneous consistency
of 15x17 cm approximately of the major diameter, no peritoneal irritation, limbs
without alterations, in reflex movements and pulses, genitalia according to
age and sex without alteration.
The patient has previously undergone chemotherapy treatment in order to decrease
his tumor mass and later operate; but, not achieving this goal, the patient
rejects the operation. He undergoes treatment with Glutathione Precursors Inhaler
in doses of 6 nebulizations in deep inspiration 4 times per day and, after 15
days of treatment the pain and the melena disappear, and the tumor size is smaller
when touched. After one month of treatment, the patient recovers his appetite,
gains 8 kg, without any symptoms and the tumor size is of 5x7cm when touched.
After two months of treatment there is no tumor and the clinical condition is
wonderful, he has recovered his lust for life. He is asked to go back to his
clinical center for a check up, but refuses. He is examined for the last time
after 5 months and his condition is satisfactory, it has not changed.
Carcinoma of the Tongue
Age: 13 years and 6 months.
It started 3 months and two weeks before being admitted. A month later, the
patient reports continuous fever, up to 38º, left otalgia and rising volume
in the left rear triangle of the neck, with pain when touched. A week before
admission, the patient reports difficulty to breath during sleeping which provokes
The patient is admitted with 39.5 kg weight and 152 cm tall. Facies is typical
with the mouth constantly open, facial asymmetry due to an increase in the discrete
volume of the left semiface. In the oral cavity, the palate is not altered,
the tongue shows a volume increase from its base that hinders its movements,
especially leftwards, with no color changes, being the left amygdala hypertrophic
(grade 3). The patient shows a nodal mass in the left rear cervical region,
both in the submaxillary region and in the rear triangle, indurated, painful
when touched and fixed to deep sections. The trachea was midline, with vesicular
murmur. Regular cardiac rythm of good intensity and no adventitus sounds (clear
respiration). No adenomegalies in axillary. No visible findings in the abdomen.
Normal genitalia (Taner II). Limbs are intact and keep full mobility. Neurologically
intact. Aspiration biopsy with fine needle in submaxillary lymph node made on
August 3, 2001, reporting few ductal salivary cells without alterations. On
August a cone biopsy is made on his lateral and lower left face, of which the
histopathological examination reports a malignant neoplasia that substitutes
the tongue muscle and which consists of small cells pequeñas of oval basal ganglia
of scanty cytoplasm scattered in a loose or myxoid stroma.
The immunohistochemistry reports vimentin (+) in neoplasic and stroma cells,
and also actin and desmin, myoglobin (+) weakly in the neoplasic cells. The
extended examinations report as follows: bone marrow biopsy, negative for neoplasy,
neck USG Doppler reports a tumor depending of the root of the tongue of 6.5
x 5.7 cm, solid with significant increase in the vessels, pulmonar CAT test
not evidencing any metastatic lesion, bone scintigram with 99 mTc-MDP of normal
charactristics. The patient underwent neoadjuvant chemotherapy treatment on
August 29, 2001 with protocol IRS-III, four sessions with the next schedule:
Vincristine1.5 mgm2 x 1, Adriamicine 35 mgm2 x 2, Cielofosfamida 500 mgm2 x
2, Cisplatino 65mgm2 x 1. After the first session, gastrostomy and tracheostomy
are made without complications. Alter the first and third sessions, the patient
shows two neutropenic and fever symptoms which develop favorably. After the
neoadjuvancy (4 sessions) the response, clinically with complete response is
assessed, (CAT) shows decrease of 80%, lung negative.
A partial glossectomy is made on December 17, 2001, reporting extensive fibrosis,
negative sample for feasible neoplasic tissue, surgical borders negative for
neoplasia. In the assesement of radiotherapy a left cervical adenomegaly is
found in the jugular chain, reason why a root disection is to be tried before
starting radiotherapy. During the anaesthesic induction the patient shows extrasystoles
(to the trigeminy), so the proceeding is delayed. Given this tumor progress,
on January 21, 2002 four sessions of chemotherapy are scheduled, alternating
the use of VAI/VIE (Vincristine, Actinomicine D, Ifosfamide / Vincristine, Ifosfamide,
Etoposide). In the assessment of May 8, 2002, the patient shows complete response
clinically and by image, so radiotherapy is started with doses of 50 Gy to the
tumor bed and 45 to the neck (May 8, 2002). After a week from starting la radiotherapy,
the patient reports blackouts, cardiology rules out pump failure. An echocardiogram
is performed on May 29 reporting pericardial effusion 386cc without auricular
collapse, an Holter monitor is also made, reporting ectopic foci, both ventricular
and supraventricula, so a treatment with diuretic is started without symptoms,
and ECG without alterations. On June 6, 2002 a new echocardiogram is performes
reporting a increase of the effusion of 600cc aproximately and supraventricular
We start treatment with amiodarone and pericardiocentesis, draining 160ml
of serohaematic fluid, subsequent to proceeding the ejection fraction is of
79%. The cytochemical reports hematic without film, erythrocytes +11+, microproteins
4280, glucose 87, celullarity 702, PMN 76%, monocites 24%. Probable secondary
serositis considered, to radiotherapy, so a steroid anti inflammatory is added
to the treatment. On June 23 the patient consults to an emergency servicer for
dyspnea, corroborating adequate permeability of the tracheostomy cannule with
no radiologic evidence of obstruction, reason why the aspiration of a foreign
body, probably toitlet paper that he uses to clean his cannule, is suspected.
On June 24 he ends the radiotherapy sessions. On that day, the patient reports
tachycardia and low tension tendency, severe asthenia and adynamia, an echocardiogam
is made revealing increase of pericardic effusion of 950cc aproximately, so
a new pericardiocentesis is performed, draining 840cc of a material with the
same traces of the former pericardiocentesis, with the draining, removed on
The cytochemical reports hematic aspect, no film, microproteines 2420, glucose
81, cells 297, PMN 22%, MN 78%. The cytochemical of June 15 reports hematic
aspect, no film, microproteines 3693, glucose 50, cells 450, PMN 72%, MN 28%.
On June 2 another echocardiogram is made evidencing pericardic effusion of 200cc,
no incidence in the myocardic function, so the patient receives esa outpatient
treatment based on diuretico. He is admitted on June 8 due to symptoms as fever,
racterizado por fiebre, productive cough (or Morton’s cough) and with fits and
wheezing; thorax RX shows erva cephalization of vessels, pulmonary congestion
data, without evidence of pneumonia. A new echocardiogram shows increasement
of the effusion to 600cc, so that on July 10, 2002 a pericardic window is performed
placing mediastinal probes and finding also the pericardium in tension with
hemorrhagic content, the epicardium had edema with fatty fibrin. The cytochemical
reports hematic aspect, no film, microproteines 2420, glucose 81, cells 297,
PMN 22%, MN 78%. On July 15, the cytochemical reports slightly blurred aspect,
no film, microproteines 944, glucose 99, cells 20, PMN 36%, MN 3%, lymphocytes
58%. All the culturing of pericardic fluid reported negative. The histopathologic
examination reports fragments of tissue with infiltration for neoplasia of medium
size cells, scanty cytochemical and ovoid core, amorphous protein material.
Due to the condition being so developed, her parents ask to discharge the patient
Her parents purchased Glutathione Precursors Inhaler. Since this is a natural
product without contraindications. The girl is treated with doses of 6 nebulizations
in deep inspiration / breath 4 times per day. The situation was desperate, all
seemed lost, the girl was dying. After 15 days, the girl starts improving, unexpectedly.
After one month, the girl is asymptomatic and in good condition in general,
she has gained weight. After three months, Professor Yarif Malimovka releases
the patient prescribing her a conservative treatment with Glutathione Precursors
Inhaler in doses of 6 nebulizations in deep inspiration 4 times per day.
Clinical Case of Fibromyalgia
Fibromyalgia is a conditions whose causing mechanisms are unknown, lacking
a pathologic anatomy, and not having a precise treatment. The results obtained
in conventional medicine are very poor, and even there are many existing cases
without been diagnosed and, very ofter labeled as rheumatologics condition cases.
At the present moment, the condition is a set on uncertainties; nevertheless,
virtually all the cases treated with Glutathione Precursors Inhaler have had
a good outcome.
In Spain the incidence has been estimated in some 2.37 per cent of the population
over 20 y/o. According to the foregoing data, there are significant differences
between urban and country population, with a bigger prevalence of fibromyalgia
between the country population (4.1 per cent against 1.7 per cent), and of several
associated factors being the female gender more significant (male/female rate
= 20/1). There is not a treatment that can be considered as curative, together
with a high incidence, so that there is a high number of consultations by these
patients to the Primary Care Center.
R.A. consults for frequent aches (in the clinical histoy, that reflects quite
accurately the different events in the last five years, it appears that the
patient is hypertensive and suffers from dyslipemia as well as a basal intolerance
to glucose. It also appears the diagnosis of a depression five years ago, as
well as rheumatic problems of diverse location, also five years ago, as well
as infections of the ENT region, gastroenteritis… which is quite significant,
especially because these conditions develop slowly).
The past clinical record on the computer database regarding the pathology
of the musculoskeletal system, shows in almost all consultations "osteomuscular"
pain more or less intense, orders for X-rays reporting as "incipient signs of
arthrosis" and history of epicondylitis, persistent muscular contractions, almost
every year the patient was remitted to Traumatology Services, but the only diagnosis
from the Specialist is "possible sponduloarthrosis". The patient was referred
as well because of epicondylitis, but, since the wait list was so long, she
decided to consult a private doctor. We know that she improved thank to the
infiltrations, but there is no report; she did not go to see the trauma specialist.
The following adjectives come from the report: incurable, disabling, misunderstood.
There is a marginal mention to the utility of psychoterapy and physical exercise
in the treatment. Depite of the first probability, it is essential to carry
out a physical examination aimed to assert the diagnosis. The patient reports
pain when pressed in 13 from 18 pressure points, so the fibromyalgia diagnosis
is confirmed. The patient goes to consult Professor Yarif Malimovka who decides
to ADMINISTER A DIETETICO SUPPLEMENT Glutathione Precursors Inhaler, doses of
6 nebulizations three times a day.
The patient agrees to come back for checkup in 4 weeks and to plan to do
some aerobic exercise that she likes during this time 40 minutes each day...
We must bear in mind that fibromyalgia is considered as primary when it does
not co-exist with another rheumatologic condition; secondary when it coexists
with conditions like rheumatoid arthritis or lupus. However, the diagnosis of
fibromyalgia does not lead to rule out another associated condition. There are
not laboratory tests or X-ray data for the diagnosis. In order to have a differential
diagnosis, this must be done from the clinical history data.
When the patient come for checkup the symptoms have dissapeared and tender
points are negative when pressed, having recovered her lust for life and being
her condition satisfactory. No futher examinations made since this is not necessary
in case of fibromyalgia (there is no examination that confirms progression:
the evidence of the pain having disapeared in tender points is enough). Check
up made alter four months: the patient has no symptoms, therefore the Glutathione
Precursors Inhaler dose is changed to three nebulizations each time, three times
PROFESSOR YARIF MALIMOVK HAS TREATED MANY PATIENTS DIAGNOSED OF FIBROMYALGIA
IN SEVERAL COUNTRIES FOR WHOM THE CONVENTIONAL TREATMENT FAILED AND NEVERTHELESS
IN ALL OF THE RESEARCHED CASES THERE WERE AMAZING RECOVERIES.
In order to help the patients we list next the symptoms which are more common
in a fibromyalgia patient and that can be relieved by Glutathione Precursors
Inhaler treatment (dietetic supplement with no contraindications or adverse
effects) according to previous experiences. Fibromyalgia causes generalized
musculoskeletal pain, intense lack of strength or vigor (Adynamia) and even
incapacitating (Asthenia); sleeping disorders, alterations of bowel rhythm,
stiffness in upper and lower limbs and, very frequently, depressive episodes
of anxiety crisis.
Fibromyalgia shows usually in the lumbar region (low back), neck, thorax
and thighs. The alteration of the muscles refers to a painful, located cramp
which occasionally is associated to other problems (i.e., pregnancy). In some
cases it appears a located muscle spasm. Sleeping disorders are quite frequent
in patients with this pathology. These disorders are basically frequent nightmares,
non refreshing sleep that can cause a disorder named day hypersomnia and great
amount of painful discharges in the muscles during sleep.
Other additional symptoms may include urinary incontinence, headache, migraines,
abnormal periodic movements of the limbs (paroxysmal movements), especially
of the limbs (Restless Legs Syndrome), concentration problems and difficulty
to remember things (poor memory). It is also frequent an increase of the tactile
feeling, generalized burning, dryness of eyes and mouth, and buzzing (auditory
hallucinations), alterations of the sight (phosphenes) and some neurological
symptoms of motor incoordination.
Diagnosis: In order to diagnose fibromyalgia, the physician must consider
the history of the patient, as well as the symptoms and the existence of the
so called tender points, a total amount of 18 points. A case of fibromyalgia
exists when the patient has 12 or more points. These points are located all
over the human body: knees, shoulders, neck, gluteus, elbows, hips, and so on.
In any case, this criterion was initially followed as a way to “define the case”,
and this was the reason why the diagnosis requires a detailed examination performed
by a specialist in rheumatic diseases (rheumatologist). There are not laboratory
tests available to get the diagnosis of the fibromyalgia. Fibromyalgia is often
mistaken for other different rheumatic conditions, like Lupus Erythematosus,
Polymyalgia Rheumatic or the Sjogren Disease, so the differential diagnosis
is paramount for the patient since both the diagnosis approach and the prognosis,
and even the therapy are different for each patient.
Treatment: The complete cure for this condition remains unknown, although
there are symptom treatments. Initially, the symptoms are relieved applying
local heat, massages, renting, and, for more severe cases, the recommended treatments
differ depending on the patient’s condition. In general, an interdisciplinary
treatment is recommended, including psychological support adapted to each patient’s
needs, assessment and treatment of the sleeping disorders, analgesic therapy
with physical means, and pharmacologic therapy, including NSAIDSs (non steroidal
anti anti-inflammatory), reduced doses of antidepressants or benzodiazepines.
Another alternative to pain treatment is to block the painful points by means
of anesthesia, or to remit the patient to a clinic or to a pain management unit.
Prognosis (Complications and Sequel). This condition can often appear as chronic
or have an interval recurrence of changeable intensity. There is no evidence
that this condition increases the mortality rate of the population.
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Many physicians and therapists in different countries are already aware of
the great results obtained with Glutathione Precursors Inhaler in Bronchial
Asthma. These results are so important that many, or almost all of the patients
treated were able to leave definitely the corticoids, bronchodilators and other
medications, being they in excellent clinic conditions and without symptoms.
All the patients were treated with a dose of 6 nebulizations 4 times per day
and some of them needed maintenance dose of 3 nebulizations per day when the
symptoms disappeared, but, in other cases, the maintenance was not necessary.
Some conditions are not labeled as asthma (asthmatic bronchitis), especially
in the case of children, sometimes very young children who suffer from dry cough
and recurrent bronchitis with whistling and who improve drastically thanks to
Glutathione Precursors Inhaler, leaving definitely the corticoids, bronchodilators.
According to the development of the condition, Krappelien has made the following
GRADE I: If the patient has reported 5 crises, no admissions.
GRADE II: Between 5-10 crises during the year.
GRADE III: More than 10 crises or admission history in the last year.
The clinical manifestations of asthma are quite precise, appearing as prodromes:
dry cough, nasal tickling, tearing, thoracic tightness, sneezing, coryza, and
flatulence among others. Once this symptoms appear, there is more or less intense
dyspnea, (respiratory suffocation), cough that can become stifling with viscous,
sticky and scanty expectoration. The physical examination reports tachycardia
(heart rate that exceeds the normal range per minute), tachypnea (rise of the
breathings per minute), thoracic hyperinflation, paradoxical pulse, lowering
of the accessory respiratory muscles activity and auscultation hoarse and dispersed
sibilant rales (whistlings) in both pulmonary fields. The laboratory research
is not necessary in general, but it can be noted the following: Respiratory
function tests (spirometry), allergens establishing, thorax X-ray, perinasal
sinuses and others.
Liver Metastasis of Colon Cancer
Age: 81 years old.
Current condition: Starting March, 2005 with a intestinal pattern disorder.
Treated since September with diet, not getting any response. Remitted to hospital
to consult specialists. Admission to research protocole for constipation. A
colonoscopy is performed, reporting a tumor of 22 cm del MA found, so rear resection
(HGR) is performed, with histopathologic examination of adenocarcinoma slightly
differenciated with infiltration up to the serose and 5/7 lymph nodes positive
for metastasis, reason why he is referred to HO CMN SXXI. Extension research
made: CSA normal without any evidence of metastasis. He receives 3 cycles of
QT on a 5FU + Leucovorin basis.
During follow up CSA detected, of 154.92 ng/ml so another colonoscopy study
is made, resulting, abdominal US and TC where nodular image is detected in VI
hepatic segment suggesting metastasis. Underwent a LapE on 04/04/02 finding
hepatic metastasis in segments V-VI, of 4x3 cm and of 1 cm in segment VIII.
Bisegmentectomy of V-VI made, as well as precise metastasectomy of segment VIII.
Post operation progress satisfactory, with CSA of 1.23 ng/ml at 3 weeks from
PO [post operation].
After one year follow up without clinical evidence of locorregional recurrence
or at distance, but an increasement of CSA of 7.69 ng/ml is found. Research
made for extension, showing hepatic metastasis in segment VII. The patient starts
the treatment with Glutathione Precursors Inhaler under these circumstances,
given that he refuses to undergo conventional treatment and, according to follow
up examination made a month and a half later, the metastasis has disappeared.
Severe Emphysema with COPD proposed for Lung Transplantation
Severe emphysema with COPD proposed for lung transplantation, treated with
Glutathione Precursors Inhaler 61 year-old male, 168 cm high, 45 kg weight,
Clinical History: Former smoker two years and six months ago (some 60 packs
per year), referring bronchopneumonia episode when he was a teenager, habitual
cough and expectoration and dyspnea upon effort since 4 years ago.
Case description: Patient consults for the first time in 2005 due to a rise
in his habitual dyspnea in the last two months. After a functional-clinical
evaluation he is diagnosed severe COPD, being started beta2 adrenergic long
action and anticholinergic treatment. In the next months he was treated in the
Emergency Services due to a intensification of his condition, being corticoids
added to the treatment; later, he reports 2-3 intensifications per year, most
of them severe, needing further treatment or even referral to the hospital.
Two years ago the patient was referred to respiratory rehabilitation to undergo
treatment, improving slightly. In the last year he has had multiple severe intensifications,
being admitted to the hospital and reporting clinical functional worsening with
accelerated lose of FEV1 (forced expiratory volume in one second) and basal
dyspnea upon small efforts. Theophyline was added to the treatment without significant
Physical examination: Patient conscious and oriented with acceptable skin
and mucus color; tachypnea (rise of the breathings per minute); no adenopathies
(lymph nodes); jugular plethora (jugular ingurgitation); cardiac auscultation:
rhytm at 95 beats per minute; pulmonar auscultation: important generalyzed decrease
in vessel murmr with with prolonged spiration; flat abdomen, muscular atrophy
in the limbs.
Comment: Functional respiratory examination shows severe respiratory obstructive
condition with air compression, pulmonary overinflation and severe diminishing
of the diffusion.
Comment: Typical COPD exploration with non reversible obstruction. Thorax
X-ray: Comment: Shows air compression, generalyzed hyperlucency with vascularized
peripheric loss; residual right upper lobe infiltration, images compatible with
con bullas bilaterales.
Hematology and biochemistry: Comment: Hemoglobin: 15.9g/dL; hematocrite:
47.3%; platelets and white blood cells normal; biochemical with no significative
Other tests: Description and comment: High resolution thorax CAT: severe
changes of pulmonary emphysema, big bullae in posterior fields of both hemithorax;
important loss of pulmonary parenchima; pulmonary nodule right upper lobe with
pleural tracts. AngioTAC of pulmonary arteries: no data of pulmonary embolism;
important data of COPD with bullae in posterior segments of both lungs and apexees.
– Analyisis of night arterial blood gas: Oxygen saturation = 94.8% - Echocardiogram:
right ventricle hipertrophy with conserved systolic function.
Diagnosis: Pulmonary emphysema with severe COPD. Chronic Cor pulmonale.
Treatment: Corticoids, inhaled + long action beta2 adrenergic; long action
anti cholinergic; theophylline; pulmonary rehabilitation; inluenza virus and
pneumococcal vaccines; diet supplements.
Discussion and conclusion: Patient with severe emphysema and important loss
of pulmonary parenchima showing a severe COPD and developed with progressive
increase of his dyspnea and accelerated loss of FEV1, all despite having undergone
a proper treatment. Given that the patient reports great physical handicap,
the scanty therapeutic response and the development of his condition, a therapeutic
option was to tratamiento quirúrgico de su COPD; surgery to reduce size was
ruled out since the patient had a generalized emphysema and because of the low
FEV1figures; it was considered to perform pulmonary transplant, but his malnutrition
has avoided that option to be considered, since it is essential to have previously
solved those condition in order to perform a pulmonary transplant. According
to the clinical-functional parameters the pulmonary transplant would be feasible.
Treatment and evolution with Glutathione Precursors Inhaler: Treatment with
Glutathione Precursors Inhaler in dosage of 6 nebulizations with deep inspiration
4 times/day is started.
After 15 days his breathing is more normal, diminishing the taqypnea and
the respiratory suffocation, heartbeat almost normal and jugular ingurgitation
disappears, the patient is able to walk big distances at normal pace without
getting tired, thorax insufflation disappears.
After two months treatment, the patient has improved significantly to the
extent he lives normally now, having gained over 15 kg weight.
There are no further X-rays or other tests since the patient refuse to come
back to the hospital.
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60 year-old male who reports polyarticular pain of three years progress;
and five months ago, generalized and progressive cutaneous stiffness; cyanosis
and distal pallor when exposed to cold, dysphagia (difficulty swallowing) 20
kg weight loss and progressive dyspnea to functional class III. He consulted
in his locality, starting a treatment with corticoids (methylprednisolone 40
mg per day). Renal function was normal three months prior to consult to the
hospital where the patient had been remitted for functional dyspnea class IV,
generalized cutaneous stiffness that impeded him to move, abdominal pain and
vomits. Physical examination reported: tachypnea, normal arterial pressure;
turgor and diminished elasticity and moist in skin, generalized cutaneous stiffness,
sclerodactylia, pale and cold distal limbs, diminishing of pulmonary expansion
of vessel murmur, tight abdomen due to cutaneous stiffness. Additional tests:
hematocrit 35%, hemoglobin 11.1 g/dl, white blood cells 11,200 /mm3, platelets
65,000/mm3, urea 1.94gr%, kreatinine 3.9mg%, normal serum electrolytes and amylase,
gases in blood ( FiO2 0.21): 7.49/33/70/24.1/2.3/95%. Urine sediment: pH 6,
protein ++, Hb+ and granular casts; ANF (antinuclear factor) positive and antibody
anti Scl-70 positive. Thorax X-ray: infiltrated interstitial diffuse bilateral.
Renal ultrasound: both kidneys in size and shape kept with discrete increasement
of bilateral cortical echogenicity. Esophagic transit: reduction of peristalsis
in midlle third. Echocardiogram: septal basal hipertrofy, fibrosis and calcificación
of the aorta walls, increasement of the left atrium diameter of 42.6 mm. Spirometry:
severe restrictive pattern with CFV: 1.70 litres (56%), VEF1: 1.57 litres (64%)
VEF1/CVF: 92%. The symptoms are interpreted as a crisis of renal scleroderma
and, despite having normal blood pressure figures, he was treated with angiotensin-converting
enzyme inhibitors (ena-lapril 5mg /día) without any results.
The patient consults Dr Yarif Malimovka, who suggests the possibility of
undergoing treatment with Glutathione Precursors Inhaler dada la inocuidad del
mismo, but he does not promise any result, and recommends not to give up the
treatment that his doctors had prescribed him. He starts with 6 nebulizaciones
by mouth 4 times a day. After one moth treatment, all cutaneous and articular
symptoms have improved significantly, the dysphagia has diminished to fifty
per cent and the respiratory capacity is much higher, the patient has gained
15 kg weight, the abdominal pain and vomits have faded and the sclerodactylia
is less prominent.
After three months treatment, all the symptoms have almost disappeared and
the patient lives a normal life now.
A Case of Sinusitis
An 11 year-old boy with no morbid history of importance, who started, 10
days before consultation in the Urgent Care Service a set of symptoms consisting
of serosal rhinorrhea with abnormal odor and nasal obstruction in addition to
fever (up to 39°C axillary), and night cough in the last 48 hours, plus halitosis.
The physical exam reports a boy in good condition in general, febrile (38.5°C
axillary) with evident nasal obstruction that made the boy breath through his
mouth. The pharynx was slightly congestive and showed a discharge of thick secretions
in the back region. The rest of the physical exam was normal. X-ray of paranasal
cavities asked (Anteroposterior projection, or Caldwell’s; and Water’s projection).
Figure 1 shows diffuse opacification of the frontal sinus and the ethmoid
cells of the rigth side; there is also opacification of the right maxillary
sinus, although this is not so evident in this projection. Normal transparency
of the left side paranasal sinuses what is useful for comparative effect. Figura
2 shows diffuse opacification of the right maxillary sinus and normal transparency
of the left maxillary sinus. No bone injuries observed; neither deviated nasal
septum. It is not necessary to perform further image studies because of the
DIAGNOSIS: Frontal, etmoidal y maxillary right sinusitis.
TREATMENT: Glutathione Precursors Inhaler, dosage of 6 nebulizations by mouth
and two by nose 4 times per day.
PROGRESS: In a few days the purulent secretion increases, delivering blood
mixed with mucus. After 20 days have passed, all the secretions have disappeared
and so have the pains he was suffering. He has control X-rays taken, appearing
the front and paranasal sinus clean and well contrasted: the boy is released.
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