[Leish-l] inquiry

[John David]

Local anesthesia must be given when using heat therapy. I should  
mention that some have advocated local lesion injection of pentavalent  
antimony. This, usually given without anesthesia, is very painful. I  
have seen it given in a clinic where adults winced terribly and it was  
complete bedlam with the loud piercing screams of  children.
And they had to return weekly for at least five times. I can't  
recommend that.
John David



On Jun 8, 2011, at 3:45 PM, Magill, Alan J COL MIL USA MEDCOM WRAIR  
wrote:

> John certainly knows well..
>
> 50C is not tolerable to human skin. All potential lesions to be  
> treated need to be appropriately cleaned and anesthetized with  
> intradermal and subQ injection of lidocaine. I have never tried the  
> newer lidocaine creams such as EMLA, they might work as well. This  
> can be somewhat rate limiting for multiple lesions as each lesion  
> needs to be prepared, injected, and you need to wait about 10 plus  
> minutes for the lidocaine to work.
>
> Trying the Thermomed device on normal skin (try on yourself) will  
> show that most people can only get to about 43 or 44 C before  
> quickly removing the device from their skin.
>
> Alan Magill
>
>
> ________________________________
> From: leish-l-bounces at lineu.icb.usp.br [leish-l-bounces at lineu.icb.usp.br 
> ] On Behalf Of Chang, Kwang-Poo [KwangPoo.Chang at rosalindfranklin.edu]
> Sent: Monday, June 06, 2011 12:02 PM
> To: John David
> Cc: Satoskar, Abhay; vishwamohan_katoch at yahoo.co.in; Raj; leish-l at lineu.icb.usp.br
> Subject: Re: [Leish-l] inquiry
>
> Any chance to make it available for additional trials elsewhere ?
>
> I recall your statement in our conversation about the advantage of  
> this instrument over the heating lamp. That is to maintain the  
> specific elevated temperature uniformly throughout the skin lesion  
> for a sustained period. The 50 C must be the effective temperature  
> that has been experimentally determined. It seems to be a tolerable  
> temperature to human skin ?  Dr. Sharma may comment on this  
> medically as a dermatologist ?
>
> KP
>
> ________________________________
> From: John David [mailto:jdavid at hsph.harvard.edu]
> Sent: Sunday, June 05, 2011 11:18 PM
> To: Chang, Kwang-Poo
> Cc: Sharmanl; Satoskar, Abhay; Raj; Petr Volf; leish-l at lineu.icb.usp.br 
> ; hgoto at usp.br; elfadil_abass at yahoo.com; vishwamohan_katoch at yahoo.co.in
> Subject: Re: [Leish-l] inquiry
>
> The Themomed instrument shown below can produce accurate 50 degrees  
> C  plus or minus 0.2 degrees temperature by radio wave.
> from Themorsurgery Technologies. Picture below.
> Two papers of a trial in Brazil and one in Afghanistan on CL below.