<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:st1="urn:schemas-microsoft-com:office:smarttags" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<meta http-equiv=Content-Type content="text/html; charset=iso-8859-1">
<meta name=Generator content="Microsoft Word 11 (filtered medium)">
<!--[if !mso]>
<style>
v\:* {behavior:url(#default#VML);}
o\:* {behavior:url(#default#VML);}
w\:* {behavior:url(#default#VML);}
.shape {behavior:url(#default#VML);}
</style>
<![endif]--><o:SmartTagType
namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="City"
downloadurl="http://www.5iamas-microsoft-com:office:smarttags"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="PlaceType"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="PlaceName"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="country-region" downloadurl="http://www.5iantlavalamp.com/"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="place" downloadurl="http://www.5iantlavalamp.com/"/>
<o:SmartTagType namespaceuri="urn:schemas-microsoft-com:office:smarttags"
name="PersonName"/>
<!--[if !mso]>
<style>
st1\:*{behavior:url(#default#ieooui) }
</style>
<![endif]-->
<style>
<!--
/* Font Definitions */
@font-face
{font-family:Tahoma;
panose-1:2 11 6 4 3 5 4 4 2 4;}
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman";}
a:link, span.MsoHyperlink
{color:blue;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{color:blue;
text-decoration:underline;}
p
{mso-margin-top-alt:auto;
margin-right:0in;
mso-margin-bottom-alt:auto;
margin-left:0in;
font-size:12.0pt;
font-family:"Times New Roman";}
p.ecxmsonormal, li.ecxmsonormal, div.ecxmsonormal
{mso-margin-top-alt:auto;
margin-right:0in;
mso-margin-bottom-alt:auto;
margin-left:0in;
font-size:12.0pt;
font-family:"Times New Roman";}
span.EmailStyle21
{mso-style-type:personal-reply;
font-family:Arial;
color:navy;}
@page Section1
{size:8.5in 11.0in;
margin:1.0in 1.25in 1.0in 1.25in;}
div.Section1
{page:Section1;}
/* List Definitions */
@list l0
{mso-list-id:725757330;
mso-list-type:hybrid;
mso-list-template-ids:-1800215204 67698705 67698713 67698715 67698703 67698713 67698715 67698703 67698713 67698715;}
@list l0:level1
{mso-level-text:"%1\)";
mso-level-tab-stop:.5in;
mso-level-number-position:left;
text-indent:-.25in;}
ol
{margin-bottom:0in;}
ul
{margin-bottom:0in;}
-->
</style>
<!--[if gte mso 9]><xml>
<o:shapedefaults v:ext="edit" spidmax="1026" />
</xml><![endif]--><!--[if gte mso 9]><xml>
<o:shapelayout v:ext="edit">
<o:idmap v:ext="edit" data="1" />
</o:shapelayout></xml><![endif]-->
</head>
<body bgcolor=white lang=EN-US link=blue vlink=blue>
<div class=Section1>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>Dear Dr Basu,<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>This sounds like a complicated and
challenging case. In summary this is a 42 year old with multiple episodes of
relapse that is now showing incomplete parasitological response at end of
treatment.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>There are a few issues to consider:<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'><span style='mso-list:Ignore'>1)<font size=1 face="Times New Roman"><span
style='font:7.0pt "Times New Roman"'> </span></font></span></span></font><![endif]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>Does the patient have evidence of another important co-infection: particularly
HIV or TB? I would screen for both. In the case of HIV, there may be little
chance of ever achieving sterile cure even if on ART. In HIV co infected cases,
patients have often been managed by maintenance treatment or secondary prophylaxis.
However there is perhaps less chance of success if initial parasitological cure
is not achieved.<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'><span style='mso-list:Ignore'>2)<font size=1 face="Times New Roman"><span
style='font:7.0pt "Times New Roman"'> </span></font></span></span></font><![endif]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>Nutritional deficiencies (both macro and micronutrients) should be
addressed through appropriate therapeutic feeding/ nutritional supplementation
depending on severity.<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'><span style='mso-list:Ignore'>3)<font size=1 face="Times New Roman"><span
style='font:7.0pt "Times New Roman"'> </span></font></span></span></font><![endif]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>You mention that the patient has been treated with Lipid Complex
Amphotericin B? Do you specifically mean Ambisome or is it some other
formulation of amphotericin B. If it’s the latter (i.e. not given AmBisome),
it may be worth trying a course of Ambisome 5mg/kg over 4 doses (e.g. higher
dose for this case) if you can get hold of the stuff.<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-left:.5in;text-indent:-.25in;mso-list:l0 level1 lfo1'><![if !supportLists]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'><span style='mso-list:Ignore'>4)<font size=1 face="Times New Roman"><span
style='font:7.0pt "Times New Roman"'> </span></font></span></span></font><![endif]><font
size=2 color=navy face=Arial><span style='font-size:10.0pt;font-family:Arial;
color:navy'>In the event there is no evidence of any overt co-infection: if the
patient is clinically will, one could consider a repeat visit in one month. I
think the next course of treatment in this scenario could perhaps be a
combination of drugs (on a compassionate basis: e.g. AmBisome and Miltefosine).
Since this is a case of multiple unresponsiveness, one could try full courses
of both, depending on how well tolerated this is (perhaps this may be controversial-
but there is very little guidance . You could also consider trying paramomycin
(though availability will be difficult since I understand it is not yet registered
and available in <st1:country-region w:st="on"><st1:place w:st="on">Nepal</st1:place></st1:country-region>).
<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>I am not sure how useful this feedback is.
I wonder if any of the other clinicians out there have any other opinions?<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'>regards<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=navy face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:navy'><o:p> </o:p></span></font></p>
<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center tabindex=-1>
</span></font></div>
<p class=MsoNormal><b><font size=2 face=Tahoma><span style='font-size:10.0pt;
font-family:Tahoma;font-weight:bold'>From:</span></font></b><font size=2
face=Tahoma><span style='font-size:10.0pt;font-family:Tahoma'>
leish-l-bounces@lineu.icb.usp.br [mailto:leish-l-bounces@lineu.icb.usp.br] <b><span
style='font-weight:bold'>On Behalf Of </span></b>Dr.Basu Pandey<br>
<b><span style='font-weight:bold'>Sent:</span></b> Tuesday, April 20, 2010 5:12
PM<br>
<b><span style='font-weight:bold'>To:</span></b> leish-l@lineu.icb.usp.br;
Sinval Pinto Brandão Filho<br>
<b><span style='font-weight:bold'>Subject:</span></b> Re: [Leish-l] name</span></font><o:p></o:p></p>
</div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Dear all</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>We have a 42 years old patients with VL here in <st1:country-region
w:st="on"><st1:place w:st="on">Nepal</st1:place></st1:country-region> treated
initially with Amphotoricin B in another center incompletely. This
patients also received Meltefosine for 28 days few months back. He was
referred to our hospital 2 months ago with fever and spleenomegaly. Bone
marrow aspiration showed positive for LD bodies. We treated the patients with
Lipid complex ambhotoricin 5 mg/kg alternate daily for five days. The spleen
size reduced and patients was discharged and asked him to come hospital
after month. During his hospital visit we performed Bone marrow aspiration
showed planty of LD bodies. Since we have no other choice we started
Ambhotoricn B 1mg/kg daily for 21 days. The spleen size almost not palpable and
on 22 days after the treatment we performed bone marrow which shows
scanty LD bodies. </span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Anyone can suggest for the furthere plan.</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Thanks,</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>Dr. Basu Dev Pandey, MD, PhD<br>
Sukra Raj Infectious and <st1:place w:st="on"><st1:PlaceName w:st="on">Tropical</st1:PlaceName>
<st1:PlaceName w:st="on">Disease</st1:PlaceName> <st1:PlaceType w:st="on">Hospital</st1:PlaceType></st1:place><br>
Teku, <st1:place w:st="on"><st1:City w:st="on">Kathmandu</st1:City>, <st1:country-region
w:st="on">Nepal</st1:country-region></st1:place><br>
Tel: 977-1-4253395<br>
Email: <a href="mailto:basupandey@wlink.com.np">basupandey@wlink.com.np</a></span></font><o:p></o:p></p>
</div>
<blockquote style='border:none;border-left:solid black 1.5pt;padding:0in 0in 0in 4.0pt;
margin-left:3.75pt;margin-top:5.0pt;margin-right:0in;margin-bottom:5.0pt'>
<div>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'>----- Original Message ----- <o:p></o:p></span></font></p>
</div>
<div style='font-color:black'>
<p class=MsoNormal style='background:#E4E4E4'><b><font size=2 face=Arial><span
style='font-size:10.0pt;font-family:Arial;font-weight:bold'>From:</span></font></b><font
size=2 face=Arial><span style='font-size:10.0pt;font-family:Arial'> <a
href="mailto:sinval@cpqam.fiocruz.br" title="sinval@cpqam.fiocruz.br">Sinval
Pinto Brandão Filho</a> <o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>To:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> <a
href="mailto:leish-l@lineu.icb.usp.br" title="leish-l@lineu.icb.usp.br">leish-l@lineu.icb.usp.br</a>
<o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>Sent:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> Sunday, April 18,
2010 1:52 AM<o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><b><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial;font-weight:bold'>Subject:</span></font></b><font size=2
face=Arial><span style='font-size:10.0pt;font-family:Arial'> Re: [Leish-l] name<o:p></o:p></span></font></p>
</div>
<div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
</div>
<p><font size=3 color="#1f497d" face="Times New Roman"><span style='font-size:
12.0pt;color:#1F497D'>There is a consensus in the different opinions, perfectly
explained in the messages of professors Killick, Ashford and Bryceson: anthroponotic
visceral leishmaniasis and zoonotic visceral leishmaniasis. The name calazar
used in <st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region>
is only an neologism derived of kala-azar to the common name for the
clinical form of the disease visceral leishmaniasis, also used in the
classical book “Calazar Canino” of professor Joaquim Alencar for
the disease form in dogs. </span></font><o:p></o:p></p>
<div>
<p class=ecxmsonormal><font size=3 color="#1f497d" face="Times New Roman"><span
style='font-size:12.0pt;color:#1F497D'>According the WHO technical report,
leishmani<strong><b><font face="Times New Roman">a</font></b></strong>sis, not
leishmani<strong><b><font face="Times New Roman">o</font></b></strong>sis.</span></font><o:p></o:p></p>
<p class=ecxmsonormal><font size=3 color="#1f497d" face="Times New Roman"><span
style='font-size:12.0pt;color:#1F497D'>Sinval</span></font><o:p></o:p></p>
<p class=ecxmsonormal><font size=3 color="#1f497d" face="Times New Roman"><span
style='font-size:12.0pt;color:#1F497D'> </span></font><o:p></o:p></p>
<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>
<p class=ecxmsonormal><strong><b><font size=2 face="Times New Roman"><span
style='font-size:10.0pt'>De:</span></font></b></strong><font size=2><span
style='font-size:10.0pt'> leish-l-bounces@lineu.icb.usp.br
[mailto:leish-l-bounces@lineu.icb.usp.br] <strong><b><font
face="Times New Roman">Em nome de </font></b></strong>Carlos Costa<br>
<strong><b><font face="Times New Roman">Enviada em:</font></b></strong>
quinta-feira, 8 de abril de 2010 08:14<br>
<st1:place w:st="on"><strong><b><font face="Times New Roman">Para</font></b></strong></st1:place><strong><b><font
face="Times New Roman">:</font></b></strong> Christopher Peacock<br>
<strong><b><font face="Times New Roman">Cc:</font></b></strong> <st1:PersonName
w:st="on">Leish-L</st1:PersonName><br>
<strong><b><font face="Times New Roman">Assunto:</font></b></strong> Re:
[Leish-l] name</span></font><o:p></o:p></p>
</div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Dear,<o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Now, urban kala-azar is endemic in many Brazilian
state capitals, and everybody, doctors and the media, calls it as <em><i><font
face="Times New Roman">"calazar"</font></i></em>. However, in
most Brazilian scientific papers, "visceral leishmaniasis" ("<em><i><font
face="Times New Roman">leishmaniose visceral"</font></i></em>, in
Portuguese) is preferred, specially when the text is written in
English.<o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Another point is that if one says just
"leishmaniose" in <st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region>
it will be generally understood as cutaneous leishmaniasis. To be understood as
the systemic disease one must say "<em><i><font
face="Times New Roman">calazar"</font></i></em> or "<em><i><font
face="Times New Roman">leishmaniose visceral"</font></i></em>. <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Another intriguing spelling is the use of both <strong><b><font
face="Times New Roman">leishmaniasis</font></b></strong> and <strong><b><font
face="Times New Roman">leishmaniosis, </font></b></strong>in English
texts. Are there rules for it?<o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Cheers,<o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal style='margin-bottom:12.0pt'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>Carlos. <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>2010/4/8 Christopher Peacock <<a
href="mailto:cpeacock@cyllene.uwa.edu.au">cpeacock@cyllene.uwa.edu.au</a>><o:p></o:p></span></font></p>
<div>
<div>
<p class=ecxmsonormal><font size=2 color="#1f497d" face="Times New Roman"><span
style='font-size:11.0pt;color:#1F497D'>Interesting that the Hindi name (Kala =
black azar = fever) has been taken up and brazlianised so effectively, when I
was in the North East of Brasil researching VL in 1992-94 don’t
recall anyone using the term calazar, they generally called it leishmaniose. It
is also odd that L chagasi doesn’t darken the skin in the same way L.
donovani does so the entire meaning has been lost.</span></font> <o:p></o:p></p>
<p><font size=3 face="Times New Roman"><span style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<p class=ecxmsonormal><font size=2 color="#1f497d" face="Times New Roman"><span
style='font-size:11.0pt;color:#1F497D'>Cheers</span></font><o:p></o:p></p>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<p class=ecxmsonormal><font size=2 color="#1f497d" face="Times New Roman"><span
style='font-size:11.0pt;color:#1F497D'>Chris</span></font><o:p></o:p></p>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>
<p class=ecxmsonormal><strong><b><font size=2 face="Times New Roman"><span
style='font-size:10.0pt'>From:</span></font></b></strong><font size=2><span
style='font-size:10.0pt'> Carlos Costa [mailto:<a
href="mailto:chncosta@gmail.com">chncosta@gmail.com</a>] <br>
<strong><b><font face="Times New Roman">Sent:</font></b></strong> Wednesday, 7
April 2010 5:44 PM<br>
<strong><b><font face="Times New Roman">To:</font></b></strong> Christopher Peacock<br>
<strong><b><font face="Times New Roman">Cc:</font></b></strong> <st1:PersonName
w:st="on">Leish-L</st1:PersonName> </span></font><o:p></o:p></p>
<div>
<p class=ecxmsonormal><font size=2 face="Times New Roman"><span
style='font-size:10.0pt'><br>
<strong><b><font face="Times New Roman">Subject:</font></b></strong> Re:
[Leish-l] name</span></font><o:p></o:p></p>
</div>
</div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Interestingly, kala-azar has been adopted plenty in <st1:country-region
w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region> as
"calazar", since the earlier scientific papers. However, it was
adopted by authors from the Northeast, which is the main endemic area, like Prata
and Alencar. Today, both names are normally use, but one
may feel that visceral leishmaniasis could stand as more educated and
kala-azar (calazar), as more informal, although, in my view both are
interchangeable.<o:p></o:p></span></font></p>
</div>
<div>
<div>
<div>
<p class=ecxmsonormal style='margin-bottom:12.0pt'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>Carlos.<o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>2010/4/6 Christopher Peacock <<a
href="mailto:cpeacock@cyllene.uwa.edu.au">cpeacock@cyllene.uwa.edu.au</a>><o:p></o:p></span></font></p>
<div>
<div>
<p class=ecxmsonormal><font size=2 color="#1f497d" face="Times New Roman"><span
style='font-size:11.0pt;color:#1F497D'>Kala-azar is the Indian name for
visceral leishmaniasis so used extensively in the Indian sub continent, it
literally means black skin in Hindi I believe. Visceral leishmaniasis is the
proper generic name for systemic leishmaniasis caused by L. donovani, L.
infantum and L. (infantum) chagasi. Leishmaniasis has a vast array of names
depending on the type and geographical location, there was a post on the number
of names a few years ago.</span></font><o:p></o:p></p>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<div style='border:none;border-top:solid #B5C4DF 1.0pt;padding:3.0pt 0in 0in 0in'>
<p class=ecxmsonormal><strong><b><font size=2 face="Times New Roman"><span
style='font-size:10.0pt'>From:</span></font></b></strong><font size=2><span
style='font-size:10.0pt'> <a href="mailto:leish-l-bounces@lineu.icb.usp.br">leish-l-bounces@lineu.icb.usp.br</a>
[mailto:<a href="mailto:leish-l-bounces@lineu.icb.usp.br">leish-l-bounces@lineu.icb.usp.br</a>]
<strong><b><font face="Times New Roman">On Behalf Of </font></b></strong>Carlos
Costa<br>
<strong><b><font face="Times New Roman">Sent:</font></b></strong> Wednesday, 24
March 2010 7:02 AM </span></font><o:p></o:p></p>
<div>
<p class=ecxmsonormal><font size=2 face="Times New Roman"><span
style='font-size:10.0pt'><br>
<strong><b><font face="Times New Roman">To:</font></b></strong> <st1:PersonName
w:st="on">Leish-L</st1:PersonName><br>
<strong><b><font face="Times New Roman">Subject:</font></b></strong> [Leish-l]
name</span></font><o:p></o:p></p>
</div>
</div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
<div>
<p class=ecxmsonormal><strong><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Visceral leishmaniasis or kala-azar? Which, when, how?</span></font></b></strong> <o:p></o:p></p>
</div>
<div>
<div>
<div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> <o:p></o:p></span></font></p>
</div>
<div>
<p class=ecxmsonormal style='margin-bottom:12.0pt'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>Carlos.<br>
<br>
-- <br>
Carlos H. N. Costa, MD, DSc.<br>
Instituto de Doenças Tropicais Natan Portella<br>
Universidade Federal do Piauí<br>
<st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region><br>
Telephone: +55 86 3221-3413<o:p></o:p></span></font></p>
</div>
</div>
</div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'><br>
-- <br>
This message has been scanned for viruses and <br>
dangerous content by <a href="http://www.mailscanner.info/"><strong><b><font
face="Times New Roman">MailScanner</font></b></strong></a>, and is <br>
believed to be clean. <o:p></o:p></span></font></p>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center>
</span></font></div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>This e-mail message has been scanned for Viruses and
Content and cleared by <strong><b><font color="#400080" face="Times New Roman"><span
style='color:#400080'>MailMarshal </span></font></b></strong><o:p></o:p></span></font></p>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center>
</span></font></div>
</div>
</div>
</div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'><br>
<br>
<br>
-- <br>
Carlos H. N. Costa, MD, DSc.<br>
Instituto de Doenças Tropicais Natan Portella<br>
Universidade Federal do Piauí<br>
<st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region><br>
Telephone: +55 86 3221-3413<br>
<br>
As informações contidas nesta mensagem são CONFIDENCIAIS, protegidas pelo
sigilo legal, por direitos autorais e destinadas exclusivamente à pessoa ou
organização para a qual a mensagem foi destinada.<br>
Warning: This message is meant only for the intended recipient of the
transmission. It is forbidden any unauthorized use, alteration,
reproduction and distribution. If you are not the correct recipient, please
notify us immediately by return e-mail and delete this message from your
system. <o:p></o:p></span></font></p>
</div>
</div>
</div>
</div>
</div>
<p class=ecxmsonormal><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'><br>
<br>
<br>
-- <br>
Carlos H. N. Costa, MD, DSc.<br>
Instituto de Doenças Tropicais Natan Portella<br>
Universidade Federal do Piauí<br>
<st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region><br>
Telephone: +55 86 3221-3413<br>
<br>
As informações contidas nesta mensagem são CONFIDENCIAIS, protegidas pelo
sigilo legal, por direitos autorais e destinadas exclusivamente à pessoa ou
organização para a qual a mensagem foi destinada.<br>
Warning: This message is meant only for the intended recipient of the
transmission. It is forbidden any unauthorized use, alteration,
reproduction and distribution. If you are not the correct recipient, please
notify us immediately by return e-mail and delete this message from your
system. <o:p></o:p></span></font></p>
</div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'>
<hr size=2 width="100%" align=center>
</span></font></div>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'>_______________________________________________<br>
Leish-l mailing list<br>
Leish-l@lineu.icb.usp.br<br>
http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/leish-l<o:p></o:p></span></font></p>
</blockquote>
</div>
</body>
</html>