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Am Fam Physician. 2002;66(4):552

“Who knew?” Although accidental exposure through ingestion of peanuts and tree nuts is common, a Letter to the Editor in the New England Journal of Medicine says that there have also been several reports of transmission of allergens through kissing. Of 379 patients with self-reported histories compatible with food allergy to nuts or seeds, 20 reported a reaction from kissing less than a minute after the kiss. The 17 patients available for questioning reported localized itching and swelling or urticaria in the kissed area. Four patients also reported wheezing. And four patients had reactions even though their partner had just used a toothbrush.

According to a case report in The Lancet, a secretary and her colleagues became nauseated and developed headaches and sore throats after working most of a day in an office permeated by a garlic-like smell. The secretary had noticed the smell when approaching the office in the morning. Her colleagues had opened the windows until the weather worsened. When the smell increased, her boss called the fire crew, who, on arrival, suspected phosphine contamination. While evacuating the surrounding businesses, the firefighters discovered that the tobacco store next door was using pellets of 57 percent aluminum phosphide to eliminate tobacco flies. Phosphine, generated from aluminum phosphide and water, is a highly toxic, colorless gas with a fishy or garlic-like odor. When firefighters attempted to measure the phosphine level in the office, the reading exceeded the instrument's upper limit of 25 ppm.

To burn fat, you may need to walk more slowly. Most people are comfortable walking about 3 mph. Although many scientists believe we are comfortable because our bodies are most energy efficient at this speed, a study published in U.S. News & World Report showed that the body depletes only fat (not carbohydrates) at this speed. When walking at 3 mph on a treadmill, study participants drew only on fat. Total energy costs rose slightly when they increased their speed to 4 mph. Still, the key to weight loss is to use as much energy as possible, regardless of the source.

Researchers at the University of Texas Southwestern Medical Center at Dallas are encouraged by results from early clinical trials showing that a topical skin cream used to treat genital warts may be effective in the treatment of basal cell carcinoma. According to one of the researchers, the cream (imiquimod) does not act on the lesion itself but helps to increase cells that promote immunity. If the cream proves safe in treating skin cancer, it may one day provide an alternative to surgical excision of lesions or current procedures that cause toxic reactions and destroy tissue.

It really is a small world. The Food and Drug Administration (FDA) has approved a pocket-sized 12-lead electrocardiograph (ECG) machine to be marketed in the United States, according to the FDA Consumer. The device, called the Pocketview, serves the same function as its larger counterpart but can go anywhere the heart desires. Data can be stored on the machine for viewing or can be sent to a computer by way of a mobile phone. And as if one set of data isn't enough for its size, the machine, developed by MicroMedical Industries Ltd, can hold numerous ECGs and display up to four results for comparison.

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