[Leish-l] inquiry

[Nuha Nuwayri-Salti]

Dear sir 
I agree fully with the fact that deeper seated parasites may not be affected but also the fact that in some cases they invades the blood stream and blood forming organs which makes local treatment insufficient.

Nuha Nuwayri-Salti MD                                                                                                                                                                                                                                                                                                   AOA Medical Honor Society 
Professor
Department of Pediatrics                                                                                                                              Rafik Hariri Lebanese University Hospital                                                                                                                                                                                                          

-----Original Message-----
From: leish-l-bounces at lineu.icb.usp.br [mailto:leish-l-bounces at lineu.icb.usp.br] On Behalf Of Satoskar, Abhay
Sent: Thursday, June 09, 2011 9:26 PM
To: Chang, Kwang-Poo; John David; Magill, Alan J COL MIL USA MEDCOM WRAIR
Cc: Raj; vishwamohan_katoch at yahoo.co.in; leish-l at lineu.icb.usp.br
Subject: Re: [Leish-l] inquiry

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.
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