That Toasty Feeling May Be Real
No one likes to sit on an icy car seat in winter, but the sensation may be preferable to erythema ab igne -- also known as toasted skin syndrome -- which afflicted two patients described this week in Archives of Dermatology.
The cases involved two women, ages 40 and 67, who came to their dermatologists with reticulated red-brown patches on the backs of their thighs. Both women had been driving long distances in winter weather with heated car seats.
Erythema ab igne is not a burn, but rather the result of chronic exposure to moderate heat. It was first noticed in people exposed for long periods to open fires. Although malfunctioning car seat heaters have been known to cause burns, the seat heaters in the women's cars appeared to be working normally. The physicians could find no other explanation for the women's dermal conditions.
The reports' authors suggested that warnings to car owners may be needed.
Bathtub Refinishing Chemical Is a Killer
Methylene chloride, a common paint-stripping chemical, appears to have killed at least 13 workers who used it to refinish bathtubs, a group of occupational health researchers said in the CDC's Morbidity and Mortality Weekly Report.
The deaths occurred from April 2000 to last September. Most victims were relatively young -- only three were older than 50 -- but nine had a documented history of cardiovascular disease.
Methylene chloride vapors are denser than air and may have pooled in the tubs where the victims were working, the researchers speculated. They noted that the chemical can also be absorbed through the skin. Moreover, bathrooms are usually small and may not have been well-ventilated.
"Both OSHA [Occupational Safety and Health Administration] and NIOSH [National Institute of Occupational Safety and Health] are issuing communications regarding the risk for death from bathtub refinishing using methylene chloride strippers and the availability of safer products," the MMWR report indicated.
"In a small, enclosed bathroom, it is unlikely that a methylene chloride stripping agent can be used safely."
Bird Flu Less Deadly than Thought?
More than half of the H5N1 avian influenza infection cases listed by the World Health Organization have been fatal, prompting near-panic about the possibility that, with a few mutations, the virus could become a massively deadly pandemic agent.
But some researchers have questioned the WHO infection count's accuracy, pointing out that only the most severe cases may enter the healthcare system. Most H5N1 cases reported so far have been in rural southeast Asia where people with mild flu infections seldom see a doctor, let alone undergo diagnostic tests to identify the specific pathogen.
A new analysis published this week in Science bolsters the doubters. Peter Palese, MD, PhD, of Mount Sinai School of Medicine in New York City and colleagues analyzed test results from 12,677 participants in 20 studies of the seroprevalence of H5N1 exposure.
They found that 1% to 2% of participants were seropositive, suggesting that the number of people who have been infected with the avian flu virus is vastly higher than the 587 listed by the WHO since 2003 -- probably in the millions worldwide, Palese and colleagues suggested, although they also noted that the death count could be underestimated as well.
"We hypothesize that the stringent criteria for confirmation of a human case of H5N1 by WHO does not account for a majority of infections, but rather the select few hospitalized cases that are more likely to be severe and result in poor clinical outcome," the authors stated.
FDA to Review Caffeine Popper
Prodded by Sen. Charles Schumer (D-N.Y.), the FDA is looking into the safety and legality of a lipstick-sized device that blows lime-flavored, powdered caffeine and B-vitamins into users' mouths for a quick buzz.
The product is called Aeroshot and, according to its manufacturer, the active agents dissolve quickly in the mouth. But it's also labeled as "breathable energy" and many users may inhale the powder inadvertently or on purpose.
Schumer said this week that the FDA would review the product after he had written to FDA Commissioner Margaret Hamburg, MD, in December.
The senator said that, while the product by itself might not be dangerous for adults, it would likely be used "to facilitate excessive drinking" and could be hazardous to preteen users, in whom the effects of inhaled caffeine have never been studied.
From Hero to Goat in Two Days
Just hours after congratulating Fresenius Kabi's APP Pharmaceuticals unit for its role in alleviating a serious shortage of preservative-free methotrexate, the FDA sent the company a warning letter about deficiencies at its factory.
On Tuesday, APP's vice president for quality assurance, Mitchell Ehrlich, sat alongside Hamburg at a media briefing during which she thanked his company for agreeing to produce preservative-free methotrexate. The drug had been in short supply after the product's biggest maker shut its factory last year because of quality-control problems, and a few weeks ago it appeared that it might become completely unavailable.
At the briefing, Ehrlich said his firm had become a major supplier of several chemotherapy drugs that have lately been in shortage.
The very next day, according to an announcement from Fresenius, the FDA's New York district office sent APP a warning letter about problems at its production facility in Grand Island, N.Y. The letter referred to an inspection last summer, with the company promising at the end of July to take corrective action.
Although the company said it had made "significant progress" in remedying the unspecified problems, apparently the FDA was not satisfied with the pace.
APP said it expected that production would continue uninterrupted at the plant while it addressed the FDA's concerns.