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Heating device could cure leishmaniasis in soldiers, study says

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A heating device that uses radio frequency energy to heat parasites and kill them could provide a new way to treat soldiers who develop cutaneous leishmaniasis in Iraq, Afghanistan and elsewhere, military researchers reported Monday. Leishmaniasis is caused by a protozoan that is transmitted by sand fleas. The most common form is called cutaneous leishmaniasis and is characterized by sores on the skin, runny nose and breathing and swallowing difficulties. The infection is generally self-limiting and is cured by the immune system in six months to a year, but it can leave behind severe scarring. If the parasites invade internal organs, however, the infection can be much more serious and, in some cases, even lethal. The most common treatments are antimony-containing drugs, particularly sodium stibogluconate, which is sold in some countries under the brand name Pentostam but is not yet approved in the United States.

At least 1,300 American soldiers and civilian employees have contracted cutaneous leishmaniasis in Iraq and Afghanistan. Treatment generally involves a 10-day course of daily infusions of Pentostam, which has many side effects, including pancreatitis and damage to blood vessels. Some parasites are becoming resistant to it as well.

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The new device, called ThermoMed, uses radio frequency radiation to heat the area of the lesion, killing the parasite without damaging nearby healthy cells. To test it, Dr. Naomi E. Aronson of the Uniformed Services University of the Health Sciences in Bethesda, Md., and her colleagues studied 56 military personnel who contracted the disease in Iraq and were brought to the United States for treatment. Half were given a 10-day course of Pentostam and half were given one treatment with ThermoMed. They were then checked at two, six- and 12-month intervals to assess the efficacy of treatment. The team reported in the online journal PLoS Neglected Tropical Diseases that the two treatments had comparable rates of healing, but that the drug had more side effects. Those using Pentostam perceived that their sores healed faster, but blinded observers confirmed that both treatments healed at the same rate.

The researchers concluded that a portable, battery-powered version of the device could be very useful for treating soldiers on site, allowing them to return to combat immediately. It could also be used by non-governmental agencies for treatment of indigenous peoples with the disease, eliminating the need for repeat visits to the doctor for daily doses of drugs.

The research was funded by the military and none of the researchers had any association with Thermosurgery Technologies Inc. of Phoenix, which manufactures the device.

-- Thomas H. Maugh II

The ThermoMed device could provide a quick, efficient way to treat cutaneous leishmaniasis. Photo credit: Thermosurgery Technologies Inc.

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