<div class="gmail_extra"><div class="gmail_quote">---------- Forwarded message ----------<br>From: <b class="gmail_sendername">Marco Tulio Antonio Garciazapata</b> <span dir="ltr"><<a href="mailto:mctulianglobal@gmail.com">mctulianglobal@gmail.com</a>></span><br>
Date: 2012/4/15<br>Subject: Re: [Tropmed-l] LV patiente 92y old<br>To: Kleber Luz <<a href="mailto:klebergluz@gmail.com">klebergluz@gmail.com</a>><br>Cc: <a href="mailto:tropmed-L@lineu.icb.usp.br">tropmed-L@lineu.icb.usp.br</a><br>
<br><br><div>Kleber,</div><div> </div><div><span>Your case</span> <span>can be</span> <span>a</span> <span>"</span><span>Record"</span> <span>in the literature.</span> W<span>e have to</span> <span>offer some kind of</span> <span>solution and</span> <span>quickly.</span> Due<span> we do not</span> <span>have much experience</span> <span>in the treatment</span> <span>of leishmaniasis</span> <span>in the elderly population</span><span>.</span> <span>Worried</span><span>, I</span><span> found that</span> <span>there are</span> <span>few studies</span> <span>that deal with</span> <span>the issue</span><span>.</span></div>
<span></span><div><br> <span>It is well</span> <span>known</span> <span>effectiveness</span> <span>in the treatment</span> <span>of leishmaniasis</span><span>,</span> <span>in general, with</span> <span>the group of</span> <span>antimonial</span> <span>drugs</span> <span>and /</span> <span>or</span> <span>derivatives</span> <span>of amphotericin B</span><span>,</span> <span>but without</span> <span>doubt,</span> <span>are very</span> <span>toxic and</span> <span>not recommended</span> <span>in these patients</span><span>.</span></div>
<span></span><div><br> <span>In the treatment of</span> <span>invasive fungal infections</span> <span>in the elderly</span> <font size="1"><span>(</span><span>Aging and</span> <span>infectious diseases</span><span>, 15 August, CID</span> <span>2001:33</span><span>)</span></font><span><font size="1">,</font> <strong>lipid formulations of</strong></span><strong> <span>amphotericin</span> <span>B</span></strong> <font size="1"><span>(</span><span>liposome/"Ambisome"</span><span>,</span> <span>lipid complex/"Abelcet" and</span> <span>colloidal dispersion</span> <span>B/"Amphotec" or "Amphocil"</span><span>)</span><span>,</span></font> <span>would be</span> the drugs <span>recommended</span><span>,</span> <span>but at</span> <span>high cost</span><span>,</span> <span>are not</span> <span>the</span> <span>choice</span><span>.</span> E<span>xpected</span> <span>in the coming</span> <span>years, the</span> goianan <span>pharmaceutical industry</span> <span>available at the</span> national<span> market</span> <span>such</span> <span>formulations</span> <span>result of</span> <span>promising</span> <span>studies</span> <span>in nanotechnology</span> <span>made by</span> <span>Faculty of Pharmacy /</span> <span>Federal University of Goias, Brazil</span><span>.</span></div>
<span></span><div><br> <span>In this case</span> <span>the recommendation</span> <span>is to use</span> <span><strong><font size="4">alternative drug</font></strong></span><span>, in spite</span> <span>of being</span> <span>less toxic and</span> <span>less effective,</span> <span>can be</span> <span>invaluable</span> <span>in such</span> <span>patients.</span> <font color="#3333ff"><strong><span>"</span><span>Primum non</span> <span>nocere"!!!</span></strong></font> <span>Draws</span> <span>attention to</span> <span>the</span> <span>subject with</span> <span>very little experience</span> <span>using</span> <span><strong><font size="4">MILTEFOSINE</font></strong></span><span>, the 1st</span> <span>anti</span><span>-</span><span>leishmania</span> <span>drugs</span> <span>more effective</span> <span>oral</span> <font size="1"><span>(Expert</span> <span>Review of</span> <span>Anti</span><span>-</span><span>infective</span> <span>Therapy</span><span>, April</span> <span>2006</span><span>,</span> <span>Vol</span> <span>4</span><span>, No. 2</span><span>, Pages</span> <span>177-185</span><span>)</span></font>. <span>But</span> <span>I found</span> <span>a review</span> <span>in this sense</span> <font size="1"><span>(Am.</span> <span>J.</span> <span>Trop</span><span>.</span> <span>Hyg</span><span>.</span><span>,</span> <span>78 (5)</span><span>,</span> <span>2008</span><span>, p</span><span>.</span> <span>745-749</span><span>)</span></font> <span>and mainly a report</span> <span>of</span> <span>three</span> <span>cases in the</span> "<span>Triangulo Mineiro"</span> <span>-</span> <span>MG</span><span>, Brazil,</span> of unforgettable <span>Prof.</span> <span>Aluizio Prata (RIP)</span> <span>who along with</span> <span>Mario</span> <span>Leon</span> <font size="1"><span>(</span><span>Rev.</span> <span>Inst</span><span>.</span> <span>Trop.</span> <span>S.</span> <span>Paulo</span><span>, May-</span><span>June,</span> <span>200,</span> <span>46</span> <span>(</span><span>3</span><span>)</span> <span>:175</span><span>-</span><span>177</span><span>)</span></font> <span>successfully used</span><span>,</span> <strong><font color="#3333ff" size="4">AZITHROMYCIN</font></strong> <span>(500</span> <span>mg/dia/10</span> <span>days</span> <span>oral) in</span> <span>patients aged</span> <span>76-80</span> <span>years of age.</span><br>
<br> <span>Hopefully</span> <span>this information can</span> <span>help you</span><span>.</span></div><div><span></span> </div><div><span>Best regards,</span></div><div><span></span> </div>
<div style="text-align:center"><span><strong>Prof. Marco Tulio A Garcia-Zapata, MD, PhD</strong></span></div><div style="text-align:center"><span><font size="1"><strong>Medical Tropicalist / Head Professor / Principal Researcher</strong></font></span></div>
<div style="text-align:center"><span><font size="1">Tropical Medicine & Dermatology Department (DMTD)</font></span></div><div style="text-align:center"><span><font size="1"><span>Center for Studies</span> <span>and Research in</span> (Re)Emerging Diseases (NUPEREME)</font></span></div>
<div style="text-align:center"><span><font size="1">Reference Sentry for International and Travel Medicine (USCREMIVI)</font></span></div><div style="text-align:center"><span><font size="1">IPTSP / UFG</font></span></div>
<div style="text-align:center"><span><font size="1"></font></span> </div><div style="text-align:center">
<span><font size="1">Caixa Postal 12911 - Setor Leste Vila Nova</font></span></div><div style="text-align:center"><span><font size="1">Goiania - GO, 74643-970, Brazil</font></span></div><div style="text-align:center"><span><font size="1">Phone(=<a href="tel:62%293269-8219" target="_blank" value="+16232698219">62)3269-8219</a>, Fax <a href="tel:%28%2B62%293521-1839" target="_blank" value="+6235211839">(+62)3521-1839</a></font></span></div>
<div style="text-align:center"><span><font size="1">E-mail: <a href="mailto:nupereme@gmail.com" target="_blank">nupereme@gmail.com</a> </font></span></div><div style="text-align:center"><span><font size="1"><a href="mailto:medicinadeviagem.hc.hdt@gmail.com" target="_blank">medicinadeviagem.hc.hdt@gmail.com</a></font></span></div>
<div style="text-align:center"><span><font size="1"> <a href="mailto:mctulianglobal@gmail.com" target="_blank">mctulianglobal@gmail.com</a></font></span></div><div style="text-align:center"><span><font size="1"></font></span> </div>
<div>
<span></span> </div><div><span></span> </div><div><br><br></div><div class="gmail_quote">2012/4/9 Kleber Luz <span dir="ltr"><<a href="mailto:klebergluz@gmail.com" target="_blank">klebergluz@gmail.com</a>></span><br>
<blockquote style="margin:0px 0px 0px 0.8ex;padding-left:1ex;border-left-color:rgb(204,204,204);border-left-width:1px;border-left-style:solid" class="gmail_quote"><div><div class="h5">
Hello every body! Today i had done a diagnose of VL in a patient 92 y old, test fast test was positive and the bone marrow aspireted was positive with a lot of leishmanias. Does anyone had a patient like this. He was HIV negative.<span><font color="#888888"><br clear="all">
<br>-- <br>Prof.Adjunto III - Kleber Giovanni Luz - DEPARTAMENTO DE INFECTOLOGIA/UFRN/HOSPITAL GISELDA TRIGUEIRO<br>
Rua Cônego Monte, 110 - QUINTAS<br>CEP 59037-170<br>NATAL-RN<br><b>FONE (FAX): <a value="+18432151603">(84) - 3215-1603</a><br>FONE: <a value="+18432327948">(84) - 3232-7948</a><br>CEL: (84) - 9193 - 6208</b><br> <div style="display:inline">
</div><br>
</font></span><br></div></div><div class="im">_______________________________________________<br>
TropMed-L mailing list<br>
<a href="mailto:TropMed-L@lineu.icb.usp.br" target="_blank">TropMed-L@lineu.icb.usp.br</a><br>
<a href="http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/tropmed-l" target="_blank">http://lineu.icb.usp.br/cgi-bin/mailman/listinfo/tropmed-l</a><br>
<br></div></blockquote></div><br>
</div><br><br clear="all"><br>-- <br><div style="text-align:center"><strong>Prof. Marco Tulio A Garcia-Zapata, MD, PhD</strong></div><div style="text-align:center"><strong><font size="1">Medical Tropicalist / Head Professor / Principal Researcher</font></strong></div>
<div style="text-align:center"><font size="1">Tropical Medicine & Dermatology Department (DMTD)</font></div><div style="text-align:center"><font size="1">Center for Studies and Research in (Re)Emerging Diseases (NUPEREME)</font></div>
<div style="text-align:center"><font size="1">Reference Sentry Unit for International and Travel Medicine (USCREMIVI)</font></div><div style="text-align:center"><font size="1">Tropical Pathology & Public Health Institute (IPTSP)</font></div>
<div style="text-align:center"><font size="1">Federal University of Goias (UFG)</font></div><div style="text-align:center"><font size="1">Goiania - GO, BRAZIL</font><br><font size="1"> </font></div><div style="text-align:center">
<font size="1">Caixa Postal 12911 - Setor Leste Vila Nova</font></div><div style="text-align:center"><font size="1">Goiania - GO, 74643-970, Brazil</font></div><div style="text-align:center"><font size="1">Phone: (+2)3269-8219, Fax (+62)3521-1839</font></div>
<div style="text-align:center"><font size="1">E-mail: <a href="mailto:nupereme@gmail.com" target="_blank">nupereme@gmail.com</a> </font></div><div style="text-align:center"><a href="mailto:medicinadeviagem.hc.hdt@gmail.com" target="_blank"><font size="1">medicinadeviagem.hc.hdt@gmail.com</font></a></div>
<div style="text-align:center"><a href="mailto:mctulianglobal@gmail.com" target="_blank"><font size="1">mctulianglobal@gmail.com</font></a> </div><br>
</div>