[Leish-l] Re : Re: Re : Re: inquiry
buffet pierre
pierre.buffet at psl.aphp.fr
Sat Jun 18 15:40:08 BRT 2011
Dear Anthony
a paromomycin ointment applied under a semiocclusive dressing gave goood results in L. major CL in Tunisia and France. So a simple unexpensive method is available to maintain the drug on the lesion and help diffusion of the active principle to the deep layers of it has been tested against placebo with success in a Phase 2 trial (publication attached). Isn't this is a step in the right direction?
Pierre
Pierre Buffet MCU-PH
Service de Parasitologie Mycologie Pr. Mazier
Hôpital Pitié Salpêtrière
+ 33 (0)1 42 16 01 31 + 33 (0)6 23 21 43 00
Adresse postale Mailing address:
Groupe Hospitalier Pitié-salpêtrière
47 Boulevard de l'hôpital
75651 Paris Cedex 13
France
Visite our webside: http://www.umrs945.upmc.fr/fr/equipe_dominique_mazier.html
----- Message d'origine -----
De: Anthony Bryceson <a.bryceson at doctors.org.uk>
Date: Samedi, Juin 18, 2011 6:44 pm
Objet: Re: [Leish-l] Re : Re: inquiry
À: John David <jdavid at hsph.harvard.edu>
Cc: buffet pierre <pierre.buffet at psl.aphp.fr>, "Satoskar, Abhay" <Abhay.Satoskar at osumc.edu>, vishwamohan_katoch at yahoo.co.in, "Magill, Alan J COL MIL USA MEDCOM WRAIR" <ALAN.MAGILL at US.ARMY.MIL>, Raj <raj at cellabs.com.au>, leish-l at lineu.icb.usp.br
> We seem to be running the heat debate on two channels; I'll stick to
> this one.
> John, on this channel, you are right. Applying heat to disadvantage
> parasites and advantage lymphocytes requires temperatures around 40oC
> , precisely maintained for long periods of time. KP, I did try heated
> pads made from the stuff that is used for heated gloves for patients
> with arthritis, powered by a portable rechargeable battery pack; but
> the temperature could not be controlled. Perhaps someone could modify
> the product by incorporating a thermistor?
> Temperatures of 50oC burn, however you generate the heat, and are
> fine for destroying tissue.
>
> John, on the other channel, relax!. I have nothing against your
> Thermomed machine; and I agree that intralesional SSG, which I have
> used a lot, has many drawbacks. Neither method solves all the problems
> of managing simple self-healing CL.
>
> An effective ointment would be preferable; but the drug needs to be
> potent and of low molecular weight so that it can penetrate unbroken
> skin. We also need a method of application that will hold the ointment
> against the lesion, which may be thick and deep, unlike superficial
> bacterial infections. I don't believe we are anywhere near this goal
> yet .
>
>
> Anthony
>
> On 17 Jun 2011, at 20:28, John David wrote:
>
> > Dear KP
> > There is a fundamental point that needs to be noted Applying heat
> to the area and using Thermomed treatment to stimulate radiowave is
> not the same. We do not apply heat but generate heat at the molecular
> level. I don’t think that the same effects are occurring at the
> cellular level when heat is being applied versus agitating the
> molecules to where they generate heat. I understand that what occurs
> at the cellular level using radio waves is being studied currently at
> the VA Hospital in Arizona.
> > John
> >
> > On Jun 16, 2011, at 2:35 AM, buffet pierre wrote:
> >
> >> There was also a very nice poster at the last ASTMH Meeting from a
> colleague from Tulasne in collaboration with Alejandro LLanos-Cuentas
> using inexpensive plastic bags of sodium acetate that reach
> temperatures close to 50°C. For an enhancing effect a few seconds of
> contact would probably be enough.
> >>
> >> Pierre
> >>
> >> Pierre Buffet MCU-PH
> >> Service de Parasitologie Mycologie Pr. Mazier
> >> Hôpital Pitié Salpêtrière
> >> + 33 (0)1 42 16 01 31 + 33 (0)6 23 21 43 00
> >>
> >> Adresse postale Mailing address:
> >> Groupe Hospitalier Pitié-salpêtrière
> >> 47 Boulevard de l'hôpital
> >> 75651 Paris Cedex 13
> >> France
> >> Visite our webside: http://www.umrs945.upmc.fr/fr/equipe_dominique_mazier.html
> >>
> >> ----- Message d'origine -----
> >> De: "Chang, Kwang-Poo" <KwangPoo.Chang at rosalindfranklin.edu>
> >> Date: Jeudi, Juin 16, 2011 12:48 am
> >> Objet: Re: [Leish-l] inquiry
> >> À: John David <jdavid at hsph.harvard.edu>, "Magill, Alan J COL MIL
> USA MEDCOM WRAIR" <ALAN.MAGILL at US.ARMY.MIL>
> >> Cc: "Satoskar, Abhay" <Abhay.Satoskar at osumc.edu>,
> vishwamohan_katoch at yahoo.co.in, Raj <raj at cellabs.com.au>, leish-l at lineu.icb.usp.br
> >>
> >>
> >>> 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.
> >>>
> >>>
> >>> _______________________________________________
> >>> Leish-l mailing list
> >>> Leish-l at lineu.icb.usp.br
> >>> http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l
> >>>
> >
> > _______________________________________________
> > Leish-l mailing list
> > Leish-l at lineu.icb.usp.br
> > http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l
>
>
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