Rheumatoid Arthritis
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 arteritis.
The patient underwent
treatment with a dietetic product named Refensal, 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
motive force.
June of 2008, Dr Yariv Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Gastric cancer (back)
Name: O.O.M.
Gender: Male
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 hospitalizations.
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 aproximatelly, but currently the patient reports that his pains are
unbereable and, when touched, the tumor is much bigger than it was originatelly,
according to what the patient reports.
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 differenciated, of hard,
ligneous consistency of 15x17 cm aproximately of de major diameter, no
peritoneal irritation, limbs without alterations, in reflex movements and
pulses, genitalia according to age and sex withoout 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 REFENSAL 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 smoller 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 examinated for the
last time after 5 months and his condition is satisfactory, it has not
changed.
September 2008, Dr Yariv
Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Carcinoma of the tongue
(back)
Patient: A.T.A.
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
anxiety.
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
tachycardia.
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 next day.
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 voluntarily.
Her parents purchased REFENSAL
and were remitted to Professor Yarif Malimovka, since Refensal 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 REFENSAL in doses of 6 nebulizations in deep inspiration
4 times per day.
June of 2008, Dr Yariv Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Fibromyalgia. Clinical
Case of Fibromyalgia (back)
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 Refensal 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 NAMED REFENSAL,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 examinatios made since this is not necessary in
case of fibromyalgia (there is no examination that confirms progression:
the evidence of the pain having dissapeared in tender points is enough).
Check up made alter four months: the patient has no symptoms, therefore
the Refensal dose is changed to three nebulizations each time, three times
per day.
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 Refensal 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.
May of 2008, Dr Yariv
Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Bronchial Asthma
(back)
Many physicians and
therapists in different countries are already aware of the great results
obtained with Refensal 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 Refensal, leaving
definitely the corticoids, bronchodilators. According to the development
of the condition, Krappelien has made the following rank:
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.
April of 2008, Dr Yariv
Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Liver metastasis
of colon cancer (back)
Name: I.G.L.
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 REFENSAL 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.
August of 2008, Dr
Yariv Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Emphysema (back)
Severe emphysema with COPD
proposed for lung transplantation, treated with Refensal 61 year-old male,
168 cm high, 45 kg weight, outpatient control.
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 improvement.
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 alterations.
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 generalyzed emphysema and because of
the low FEV1figures; it was considered to perform pulmonary trasplant,
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 trasplant. According to the clinical-functional parameters
the pulmonary trasplant would be feasible.
Treatment and evolution
with Refensal: Treatment with Refensal 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 treatament,
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 como back to the hospital.
June 2008, Dr Yariv
Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Scleroderma case (back)
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 REFENSAL 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 lesss prominent.
After three months
treatment, all the symptoms have almost dissapeared and the patient lives
a normal life now.
May 2008, Dr Yariv
Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
A case of sinusitis (back)
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 aforementioned findings.
DIAGNOSIS: Frontal, etmoidal
y maxillary right sinusitis.
TREATMENT: REFENSAL, 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.
February 2008, Dr Yariv Malimovka.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Diabetic patient with
peripheral vascular disease to be amputated treated with Refensal (back)
45 year-old male, no drug
allergies known. Past personal history: former smoker (over 30 packs/year),
diabetes mellitus type 2, hypercholesterolemia, a past record of circulant
antiphospholipid antibody with a history of two deep vein thrombosis. Past
history of vascular diseases before admission: in October 2004 he had been
implanted a left iliac stent plus a left to right femoro femoral bypass.
In February 2007 he underwent a dilatation with cryotherapy of left iliac
which is not effective, so he got a femoral popliteal bypass to first portion
in the left lower limb.
In February 2008 he was admitted
again to the Vascular Surgery Service Department for Clinic Claudication.
He first underwent a operation to place a bilateral iliac femoral bypass
with epidural catheter insertion for postoperative analgesia. As postoperative
results are not satisfactory, the patient is re-operated three days later:
common femoral bypass with internal safena in his left leg. After 24 hours
progress, he loses the epidural catheter, after treatment for intravenous
analgesia. Four days later, the progress is not adequate, his foot has
a ischemic appearance, he has cold fingers, pre-necrosis symptoms, and
strong pain, needing treatament with Fentanyl Transdermal, boluses of 5
mg of morphine hydrochloride subcutaneously every hour and oral corticoids
(Prednisone 60 mg/day), with possibility of small vessel microinfarcts
and considering the possible amputation of foot lower third given this
serious condition. Consultation is referred to Anesthesiology Service (Pain
Unit) who rules out inserting a new epidural catheter since the patient
is following therapy with oral anticoagulants. It is decided to place a
sciatic catheter (Stimulong-plus Plexos Catheter set 19 G-100 mm of Pajunk®)
which is done in operating room, with n neurostimulation and via proximal
transgluteal (Labat technique). A perfusion with bupivacaine 0.37 % a 3-5
ml/hour is started.
Given that any results are
obtained, the patient consults in September 2008 Dr. Malimovka, specialist
in cardiovascular surgery, who decided treat with REFENSAL in dosis of
6 nebulizations via respiratory, four times a day, the symptoms slowly
decreasing and claudication decreases, allowing him to walk big distances
without pain, the oscillometries improve slowly and the coloration of the
limbs turns normal, the pre necrosis signs disappear and so does ischemia
pain, even the coldness in fingers which now show normal temperature.
After a month and a half
of treatment, the patient is released, showing clinical normality not being
the amputation of the limb necessary, when it was already scheduled.
June 2008, Dr. Yariv Malimovka.
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Conclusions (back)
Refensal
has proved antitumor activity both in vivo and humans; improving quality
of life through direct effect on tumor. When we talk about improving quality
of life, we mean increasing appetite in anorexico patients, diminishing
pain, helping la cicatrization, cohíbe las hemorrhagies; moreover,
according to internacional literature, its components have a series of
effects, like diminishing the size of the tumor which is the main purpose,
inhibit of the angiogenesis and proliferation of neoplasic cell. It also
increases the immunity strengthening al husped and has antibacterian activity
which is also useful in case of opportunistic pathogenes. It has neither
side effects, nor contraindications and can be used together with traditional
anti neoplasic therapies without interfering with them in no way, but diminishing
the adverse effects of chemotherapy and radiotherapy in addition.
Its components are secure/safe,
well known and have been long used in non traditional medicine which backs
is quality to act together and combine the best properties of all these
components. Therefore, Refensal is a new weapon
against this hard to treat condition as is cancer, la cual es invalidante,
con tratamientos costosos y muchas veces ineficaces, con desagradables
efectos colaterales. That is why the use of this natural therapy gives
hope to achieve a better response to treatment and a better quality of
life.
Dr. Yarif Malimovka
Refensal:
Inhaled Glutathione Precursors
Glutathione/
Refensal: an Important Line of Defense Against Diseases, Toxins, Viruses,
Pollutants, Radiation and Oxidative Stress.
Do
you have a question or need guidance? Mindy Harris volunteers her
time to provide guidance and support in your quest to find relevant information.
She can be reached at 479-273-1706 (USA) If you prefer you can click
here to contact Shirley .
Dr. Jimmy Gutman, MD - "Your life depends
on glutathione. Without it, your cells would disintegrate from unrestrained
oxidation, your body would have little resistance to bacteria, viruses
and cancer, and your liver would shrivel up from the eventual accumulation
of toxins." Glutathione, taken as a supplement (capsule, tablet or
powder), may not be able to cross across the cell membrane of the
digestive track. The Whitaker Wellness Institute recently began utilizing
a safe new therapy that has shown great promise: inhaled
glutathione percusors.
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