[Leish-l] inquiry

[Satoskar, Abhay]

KP 
The key is that the temperature in deep tissue reaches > 400C since lesion surface is the tip of the iceberg. 
Heat packs or application of heat on the surface is unlikley to result in desiedd temparture in deep tissue.

Abhay R Satoskar MD, PhD
Professor
Departments of Pathology and Microbiology
129 Hamilton Hall
1645 Neil Avenue
The Ohio State University
Columbus, Ohio
Tel: 614-366-3417
________________________________________
From: Chang, Kwang-Poo [KwangPoo.Chang at rosalindfranklin.edu]
Sent: Thursday, June 09, 2011 2:16 PM
To: John David; Magill, Alan J COL MIL USA MEDCOM WRAIR
Cc: Satoskar, Abhay; vishwamohan_katoch at yahoo.co.in; Raj; leish-l at lineu.icb.usp.br; Anthony Bryceson
Subject: RE: [Leish-l] inquiry

I put my index finger into a 50 C water bath and can only stand the heat
for ~15 seconds.

I wonder if someone might have tried air-activated heat pads/wraps,
which are inexpensive and readily available in Walgreen/CVS drug stores
for treating muscle pains. The temperature probably doesn't go much
above 40 C, but it lasts for hours and can be repeatedly applied. I used
such items without experiencing any problem.

KP

-----Original Message-----
From: John David [mailto:jdavid at hsph.harvard.edu]
Sent: Wednesday, June 08, 2011 5:34 PM
To: Magill, Alan J COL MIL USA MEDCOM WRAIR
Cc: Chang, Kwang-Poo; Satoskar, Abhay; vishwamohan_katoch at yahoo.co.in;
Raj; leish-l at lineu.icb.usp.br
Subject: Re: [Leish-l] inquiry

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.