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</o:shapelayout></xml><![endif]--></head><body lang=EN-IN link=blue vlink=purple><div class=WordSection1><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'>Dear Dr Carlos<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'>Thank you for the update. We look forward to a complete recovery of Mrs Cleudimer from the disease.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'>Pritu will intimate you as soon as we are ready to ship the drug.<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'><o:p> </o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'>Best Wishes<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'><br>Raj Shankar<o:p></o:p></span></p><p class=MsoNormal><span style='font-family:"Comic Sans MS";color:#8064A2'><o:p> </o:p></span></p><p class=MsoNormal><b><span lang=EN-US style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'>From:</span></b><span lang=EN-US style='font-size:10.0pt;font-family:"Tahoma","sans-serif"'> Carlos Costa [mailto:chncosta@gmail.com] <br><b>Sent:</b> 07 November 2011 01:35<br><b>To:</b> Leish-L; Raj Shankar Ghosh; Jarbas Barbosa da Silva Júnior; <gzischke@thermosurgery.com>; Pritu Dhalaria; Richard Chin; Cláudio Maierovitch Pessanha Henriques; Ezequias Costa Filho; Schreiner, Daniela; Fernando Koremblum; Ivan Dario Velez; Philippe Desjeux; Rosalia Morais Torres; Jaime Costa da Silva<br><b>Subject:</b> Update on Cleudimar case<o:p></o:p></span></p><p class=MsoNormal><o:p> </o:p></p><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>Dear all</span><span class=apple-style-span><span style='font-size:18.0pt;font-family:"Verdana","sans-serif"'> those who are following and helping the patient Mrs. Cleudimar with diffuse leishmaniasis, in Brazil,</span></span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>She is clinically stable both in respect to leishmaniasis and to the renal failure, but has not started the treatment yet.</span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>According to many suggestions, mostly from Dr. Anthony Bryceson, but also from so many others, the protocol has been set as:</span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>1. To combine miltefosine with paramomycin for prolonged therapy.</span><o:p></o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>2. To use heat therapy as adjuvant by: a) heating by radiofrequency and b) using sauna.</span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>We already received miltefosine, gently donated by Paladin (with the help pf Fernando Koreblum, and others), shipped from Germany by Daniella Schreiner, from Germany, and from Ivan Velez, from Colombia. (However, just for three months - we will need much more for a prolonged therapy).</span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>After the contact with the Institute of One Health (Richard Chin, Raj Shankar Ghosh, Philippe Desjeux among so many) the batch of paramomycin will be produced this November by Gland Pharma and gently shipped from India to Brazil by </span><span class=apple-style-span><span style='font-size:18.0pt;font-family:"Verdana","sans-serif"'>Pritu Dalaria.</span></span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span class=apple-style-span><span style='font-size:18.0pt;font-family:"Verdana","sans-serif"'>Thermosurgery Technologies already sent the instrument and it is ready to use. Hopefully, we will start tomorrow. The mediation by John David an</span></span><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>d <span class=apple-style-span><span style='background:white'>Gena Zischke was decisive. I found in the internet a portable sauna which I already bought with the help of donations from the participants of the Meeting of Applied Research in Leishmaniasis, in Uberaba, Brazil, and from Rotary Club, Teresina, Brazil.</span></span></span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span class=apple-style-span><span style='font-size:13.5pt;font-family:"Verdana","sans-serif";background:white'>The Brazilian Government with the actions led by Dr. Jarbas Barbosa has strongly supported this salvage therapy, and which has been decisive to get the drugs and equipment in Brazil.</span></span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span class=apple-style-span><span style='font-size:13.5pt;font-family:"Verdana","sans-serif";background:white'>After everything is set, let's cross fingers for the good luck of Mrs Cleudimar.</span></span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span class=apple-style-span><span style='font-size:13.5pt;font-family:"Verdana","sans-serif";background:white'>How decisive Leish-L has shown to be. Looks like a new important route, outside the formal paths, that should be explored more frequently for humanitarian actions.</span></span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>Best wishes and thanks to all,</span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><span style='font-size:13.5pt;font-family:"Verdana","sans-serif"'>Carlos.</span><o:p></o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p></div><div><p class=MsoNormal><o:p> </o:p></p><div><div><p class=MsoNormal><o:p> </o:p></p></div><p class=MsoNormal>-- <o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Carlos H. N. Costa, MD, DSc.</span></b><o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Sociedade Brasileira de Medicina Tropical </span></b><o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>(Brazilian Society of Tropical Medicine)</span></b><o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>President</span></b><o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><o:p> </o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Universidade Federal do Piauí</span></b><o:p></o:p></p><div><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Instituto de Doenças Tropicais Natan Portella</span></b><o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Rua Artur de Vasconcelos 151-Sul</span></b><o:p></o:p></p><div><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>64001-450 Teresina-PI</span></b><o:p></o:p></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Brazil</span></b><span style='font-family:"Verdana","sans-serif"'><o:p></o:p></span></p><p class=MsoNormal align=center style='text-align:center'><b><span style='font-family:"Verdana","sans-serif"'>Telephones: +55 86 3221-3413 (work); +55 86 8838-3303 (mobile).<o:p></o:p></span></b></p><p class=MsoNormal align=center style='text-align:center'><span style='font-family:"Verdana","sans-serif"'><o:p> </o:p></span></p><p class=MsoNormal align=center style='text-align:center'><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"'>Aviso: 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.<o:p></o:p></span></p><p class=MsoNormal align=center style='text-align:center'><span style='font-size:10.0pt;font-family:"Verdana","sans-serif"'>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></p></div></div><p class=MsoNormal><o:p> </o:p></p></div></div></div></body></html>