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<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Dear Carlos<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Thanks for the detailed and updated
information. We all cross the fingers for the improvement of Mrs Cleudimar. Keep
us informed.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Congratulations for all your efforts.
Superb example!<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Best personal regards<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'>Philippe<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
style='font-size:12.0pt;color:blue'><o:p> </o:p></span></font></p>
<div>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Dr Philippe Desjeux</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Senior program Officer</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>Institute for OneWorld Health</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>899 rue Jean de Gingins</span></font><font
color=blue><span style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'>0122</span></font><font size=2 color=blue
face=Arial><span lang=FR style='font-size:10.0pt;font-family:Arial;color:blue'>0
<st1:place w:st="on"><st1:City w:st="on">Divonne</st1:City>, <st1:country-region
w:st="on">France</st1:country-region></st1:place></span></font><font
color=blue><span lang=FR style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
lang=FR style='font-size:12.0pt;color:blue'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span lang=IT
style='font-size:10.0pt;font-family:Arial;color:blue'>Tel: +33 4 50 20 44 61</span></font><font
color=blue><span lang=IT style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span lang=IT
style='font-size:10.0pt;font-family:Arial;color:blue'>Mobile: +33 6 73 52 99 44</span></font><font
color=blue><span lang=IT style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 color=blue face="Times New Roman"><span
lang=IT style='font-size:12.0pt;color:blue'> <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'><a
href="mailto:pdesjeux@oneworldhealth.org"><span lang=IT>pdesjeux@oneworldhealth.org</span></a></span></font><font
color=blue><span lang=IT style='color:blue'><o:p></o:p></span></font></p>
<p class=MsoNormal><font size=2 color=blue face=Arial><span style='font-size:
10.0pt;font-family:Arial;color:blue'><a href="http://www.oneworldhealth.org"><span
lang=IT>www.oneworldhealth.org</span></a></span></font><span lang=IT><o:p></o:p></span></p>
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<div>
<div class=MsoNormal align=center style='text-align:center'><font size=3
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<hr size=2 width="100%" align=center tabindex=-1>
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<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'> Carlos Costa
[mailto:chncosta@gmail.com] <br>
<b><span style='font-weight:bold'>Sent:</span></b> Sunday, November 06, 2011
9:35 AM<br>
<b><span style='font-weight:bold'>To:</span></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><span style='font-weight:bold'>Subject:</span></b> Update on Cleudimar case</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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>Dear all</span></font><span class=apple-style-span><font
size=5 face=Verdana><span style='font-size:18.0pt;font-family:Verdana'> those
who are following and helping the patient Mrs. Cleudimar with diffuse
leishmaniasis, in <st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region>,</span></font></span><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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>She is clinically stable both in respect to leishmaniasis
and to the renal failure, but has not started the treatment yet.</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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>According to many suggestions, mostly from Dr. Anthony
Bryceson, but also from so many others, the protocol has been set as:</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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>1. To combine miltefosine with paramomycin for prolonged
therapy.</span></font><o:p></o:p></p>
</div>
<div>
<p class=MsoNormal><font size=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>2. To use heat therapy as adjuvant by: a) heating by
radiofrequency and b) using sauna.</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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>We already received miltefosine, gently donated by Paladin
(with the help pf Fernando Koreblum, and others), shipped from <st1:country-region
w:st="on">Germany</st1:country-region> by Daniella Schreiner, from <st1:country-region
w:st="on">Germany</st1:country-region>, and from Ivan Velez, from <st1:country-region
w:st="on"><st1:place w:st="on">Colombia</st1:place></st1:country-region>.
(However, just for three months - we will need much more for a prolonged
therapy).</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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>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 <st1:country-region w:st="on">India</st1:country-region> to <st1:country-region
w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region> by </span></font><span
class=apple-style-span><font size=5 face=Verdana><span style='font-size:18.0pt;
font-family:Verdana'>Pritu Dalaria.</span></font></span><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><span class=apple-style-span><font size=5 face=Verdana><span
style='font-size:18.0pt;font-family:Verdana'>Thermosurgery Technologies already
sent the instrument and it is ready to use. Hopefully, we will start tomorrow.
The mediation by John David an</span></font></span><font size=4 face=Verdana><span
style='font-size:13.5pt;font-family:Verdana'>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 <st1:City w:st="on">Uberaba</st1:City>, <st1:country-region
w:st="on">Brazil</st1:country-region>, and from Rotary Club, <st1:place w:st="on"><st1:City
w:st="on">Teresina</st1:City>, <st1:country-region w:st="on">Brazil</st1:country-region></st1:place>.</span></span></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><span class=apple-style-span><font size=4 face=Verdana><span
style='font-size:13.5pt;font-family:Verdana;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 <st1:country-region w:st="on"><st1:place w:st="on">Brazil</st1:place></st1:country-region>.</span></font></span><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><span class=apple-style-span><font size=4 face=Verdana><span
style='font-size:13.5pt;font-family:Verdana;background:white'>After everything
is set, let's cross fingers for the good luck of Mrs Cleudimar.</span></font></span><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><span class=apple-style-span><font size=4 face=Verdana><span
style='font-size:13.5pt;font-family:Verdana;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></font></span><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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>Best wishes and thanks to 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=4 face=Verdana><span style='font-size:13.5pt;
font-family:Verdana'>Carlos.</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=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=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></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>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>Carlos H. N. Costa, MD, DSc.</span></font></b><o:p></o:p></p>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>Sociedade Brasileira de Medicina Tropical </span></font></b><o:p></o:p></p>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>(Brazilian Society of Tropical Medicine)</span></font></b><o:p></o:p></p>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>President</span></font></b><o:p></o:p></p>
<p class=MsoNormal align=center style='text-align:center'><font size=3
face="Times New Roman"><span style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>Universidade Federal do Piauí</span></font></b><o:p></o:p></p>
<div>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>Instituto de Doenças Tropicais Natan Portella</span></font></b><o:p></o:p></p>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>Rua Artur de Vasconcelos 151-Sul</span></font></b><o:p></o:p></p>
<div>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>64001-450 Teresina-PI</span></font></b><o:p></o:p></p>
<p class=MsoNormal align=center style='text-align:center'><st1:country-region
w:st="on"><st1:place w:st="on"><b><font size=3 face=Verdana><span
style='font-size:12.0pt;font-family:Verdana;font-weight:bold'>Brazil</span></font></b></st1:place></st1:country-region><font
face=Verdana><span style='font-family:Verdana'><o:p></o:p></span></font></p>
<p class=MsoNormal align=center style='text-align:center'><b><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana;font-weight:
bold'>Telephones: +55 86 3221-3413 (work); +55 86 8838-3303 (mobile).<o:p></o:p></span></font></b></p>
<p class=MsoNormal align=center style='text-align:center'><font size=3
face=Verdana><span style='font-size:12.0pt;font-family:Verdana'><o:p> </o:p></span></font></p>
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