Bee products as a source of promising therapeutic and chemoprophylaxis strategies against COVID-19 (SARS-CoV-2).

The emergence of novel coronavirus (SARS-CoV-2) in 2019 in China marked the third outbreak of a highly pathogenic coronavirus infecting humans. The novel coronavirus disease (COVID-19) spread worldwide, becoming an emergency of major international concern. However, even after a decade of coronavirus research, there are still no licensed vaccines or therapeutic agents to treat the coronavirus infection. In this context, apitherapy presents as a promising source of pharmacological and nutraceutical agents for the treatment and/or prophylaxis of COVID-19. For instance, several honeybee products, such as honey, pollen, propolis, royal jelly, beeswax, and bee venom, have shown potent antiviral activity against pathogens that cause severe respiratory syndromes, including those caused by human coronaviruses. In addition, the benefits of these natural products to the immune system are remarkable, and many of them are involved in the induction of antibody production, maturation of immune cells, and stimulation of the innate and adaptive immune responses. Thus, in the absence of specific antivirals against SARS-CoV-2, apitherapy could offer one hope toward mitigating some of the risks associated with COVID-19.

Prophylactic management for taxane-induced nail toxicity: A systematic review and meta-analysis.

OBJECTIVE: This meta-analysis was performed to assess the efficacy of cryotherapy and nail solution (NS) use in preventing nail toxicity (NT) induced by taxane-based chemotherapy. METHODS: PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov registry databases were searched for relevant studies published up to December 2018. The primary outcome was taxane-induced NT. Secondary outcomes were skin toxicity (ST), time to toxicity and patient comfort. RESULTS: We reviewed three randomised control trials and six prospective studies with 708 patients. For meta-analysis, taxane-induced NT grading was compared. NT and ST were significantly lower in the cryotherapy patients than in the controls (grade 1 NT: risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.30-0.89; grade 2-3 NT: RR = 0.36, 95% CI = 0.11-1.12; total NT: RR = 0.49; 95% CI = 0.30-0.79; ST: RR = 0.46, 95% CI = 0.33-0.64). The NS-treated patients exhibited significantly lower NT than the controls. CONCLUSIONS: Nail solution-treated or cryotherapy patients exhibited lower NT incidence and severity associated with taxane-based chemotherapy than the controls. For patients who can afford and comply with NS use or cryotherapy, these measures represent effective prophylactic management for taxane-induced NT and improve their quality of life and functional statuses. Further studies are needed to establish the routine usage protocols, long-term efficacy and safety for these interventions.

Usage of Bone Wax to Facilitate Percutaneous Endoscopic Cervical Discectomy Via Anterior Transcorporeal Approach for Cervical Intervertebral Disc Herniation.

BACKGROUND: Currently, anterior transdiscal access and posterior interlaminar approach are the main approaches for percutaneous endoscopic cervical discectomy (PECD). To overcome access shortcomings, we previously described a novel anterior endoscopic transcorporeal approach on a migrated cervical disc. We innovatively introduced bone wax into endoscopic surgery to aid hemostasis and facilitate the process of drilling an intracorporeal tunnel. METHODS: Five patients with cervical intervertebral disc herniation (CIDH) were treated by PECD via the anterior transcorporeal approach. During the operation, we marked the punctured tunnel with bone wax containing indigo carmine as a guide and smeared bone wax on the endoscopic burr to aid hemostasis. RESULTS: A satisfactory clinical outcome was observed in all 5 patients postoperatively; pain and neurologic condition were dramatically improved. Surgery-related complications, such as esophageal injury, vascular rupture, hematoma, intervertebral disc infection, or postoperative headache, were not encountered. A computed tomography scan was used to observe the process of bone healing. At 3-month postoperative follow-up, the bone defect within the drilling tunnel had partially shrank and was completely healed at 6 months postoperatively. CONCLUSIONS: The anterior endoscopic transcorporeal approach for PECD is a novel, valuable alternative for the treatment of CIDH. Bone wax could indeed facilitate the operation by guiding the drilling process and instantly controlling the bleeding without obvious interference with bone healing. Long-term follow-up is warranted in further clinical studies.

Bone Wax in Neurosurgery: A Review.

It has been 125 years since the so-called initial use of bone wax (BW) by Sir Victor Horsley, and a review of this age-old hemostatic agent seems appropriate. The first use of BW for hemostasis occurred in the eighteenth century, when modeling or candle wax was used for hemostasis. Although the pioneers in the use of BW in craniofacial surgeries were Jean Louis Belloq, Khristian Khristianovich Salomon, and François Magendie, the first successful use in neurosurgery was demonstrated by Henri Ferdinand Dolbeau in 1864 after extirpation of a frontal osteoma. This technique was further popularized by Sir Victor Alexander Haden Horsley, the father of British neurosurgery, who is often incorrectly mentioned as the inventor of BW. Originally derived from beeswax, the currently available commercial preparation also contains paraffin wax and isopropyl palmitate. The main action being mechanical tamponade, BW has found several other uses in neurosurgery, other than being a hemostatic agent. Although it is cost-effective, the use of BW is associated with several complications also, including ineffective bone healing and infection. Several alternatives are being developed, but none are yet a full replacement for "Horsley's wax."

Physeal Bar Resection Under Guidance With a Navigation System and Endoscopy for Correction of Distal Radial Deformities After Partial Growth Plate Arrest.

Partial growth plate arrest caused by trauma may lead to severe deformity and dysfunction. The Langenskiöld method is a surgical technique that involves resection of the physeal bar causing partial growth plate arrest. However, it is a technically demanding procedure. We used the Langenskiöld method under guidance with a navigation system and endoscopy and obtained good results in 2 cases. We consider that use of these tools can be a helpful adjunct to the carrying out this procedure.

An Unusual Complication of Bone Wax Utilization.

Bone wax is a commonly used hemostatic agent with minimal complications. Some of the known complications include inflammation, granuloma formation, infection, and impaired osteogenesis. Several clinical reports of bone wax migration have also been reported. In this paper, the authors present a rare patient of bone wax migration intracranially in a 6-year-old patient who initially underwent craniotomy for the evacuation of subdural hematoma and repair of depressed skull fracture. The patient then underwent craniotomy scalp scar revision several months later. Postoperatively he developed short-term memory loss, apraxia, and word finding difficulties. The imaging findings were consistent with the presence of a foreign body centered in the posterior aspect of the left middle temporal gyrus, which was surgically removed and found to be bone wax. The patient recovered well with complete improvement of his neurologic symptoms.

Novel Sternal Protection Device for Cardiac Surgery Via Median Sternotomy Incision.

OBJECTIVE: Sternal bleeding during cardiac surgery is currently controlled using bone wax or other chemical substances that may result in adverse effects and affect wound healing and recovery. The purpose of this study was to identify a safe, cost-effective, and easy-to-use technique to reduce sternal bleeding and sternal trauma during cardiac surgery. METHODS: After sternotomy, a sternal protection device was placed over each hemisternal section before insertion of the retractor and remained in situ until the end of surgery. Sternal bleeding and ease of use were assessed and recorded during surgery. Sternal trauma was assessed and recorded within 5 minutes of removal of the device, and overall satisfaction (Global Impression) and any intraoperative adverse events or device malfunction were reported at surgery completion. Patients were followed up 24 hours and 4 weeks after surgery. RESULTS: Twelve patients completed the study. Adverse events reported were not considered related to the device. No sternal trauma was identified in any patient. In 9 of 11 patients, sternal bleeding was reduced after insertion of the device. The device was generally considered easy to use, although some difficulty was encountered when used with the Internal Mammary Artery retractor. CONCLUSIONS: Our data suggest that the device is safe and able to reduce sternal bleeding during surgery using sternal retractors. We recommend further studies in a larger population of patients with a control group to evaluate the device's ability to reduce the morbidity associated with sternal bleeding and sternal trauma.

The effect of a beeswax, olive oil and Alkanna tinctoria (L.) Tausch mixture on burn injuries: An experimental study with a control group.

OBJECTIVES: This study was planned to investigate the effect of a mixture of beeswax, olive oil and A. Tinctoria (L.) Tausch on burn wounds to determine the impact on burn healing, pain during dressing changes and duration of hospital stay. METHODS: The study was conducted between May 2014 and August 2015 in the Burn Unit of Ataturk University Research Hospital. The sample of this experimental study consisted of 64 patients (31 experimental group and 33 control group) who met its inclusion criteria. While the specially prepared dressing material was applied to the experimental group, the control group was administered the clinic's routine dressing. The injuries were photographed before each dressing. Each picture was uploaded to a computer for measurement with ImageJ software. Numbers, percentages, chi square, Independent samples t-test and Mann-Whitney U tests were used to assess the data. RESULTS: The patients in the experimental and control groups had similar descriptive characteristics and burn injury features (p>0.05). The average age of the patients in the control group was 5.52±0.64years, and 6.68±1.09years in the experimental group. The majority of the patients were male (control: 54.5%, experimental: 58.1%). Boiling liquids were the most common cause of both groups' burns (control: 93.9%, experiment: 83.9%). The most common first aid practice used was the application of cold water (control: 75.0%, experimental: 43.6%). The epithelization initiation time average of the experimental group patients (3.00±0.85days) was found to be earlier than that of the control group patients (6.90±1.77days), and this difference was statistically significant (p<0.05). The mean pain scores experienced by the patients in the experimental group during dressing (8.12±1.38) were determined to be lower than those of the control group (9.39±1.05), and this difference was statistically significant (p<0.05). It was also found that mean hospitalization durations of the patients in the experimental group (8.22±3.05) were shorter than those of the control group (14.42±7.79), and this difference was also found to be statistically significant (p<0.05). CONCLUSION: When a beeswax, olive oil and A. tinctoria (L.) Tausch mixture was applied to second degree burns, this accelerated epithelization, reduced the pain experienced during dressing changes and shortened the hospital stay durations of the patients.

The Effect of Waxing Versus Shaving on the Efficacy of Laser Hair Removal.

BACKGROUND: Excessive hair is undesirable and represents both a social and emotional burden, especially among females. Laser hair removal (LHR) has gained popularity in the past 2 decades. It is a common practice to instruct patients not to pluck or wax their hair before undergoing LHR; only shaving is allowed to improve the efficacy of the LHR. OBJECTIVE: To compare the percentage of hair reduction in preshaved versus prewax epilated axillae after LHR in healthy adult Saudi females. METHODS AND MATERIALS: This study is a quantitative experimental pilot clinical trial. Twenty female volunteers were enrolled into this study; all underwent 3 laser sessions using a long-pulsed alexandrite laser. Their left axilla was prewaxed and right axilla was preshaved immediately before laser treatment. Hair was counted manually before and 6 months after the third laser session. RESULTS: The right and left axillae both showed significant hair reduction, between the first session and the hair count 6 months after the third laser session. However, there was no statistically significant difference between these 2 means (p = .44). CONCLUSION: There is no statistical difference in hair reduction after LHR whether the area is preshaved or prewax epilated.

Characterization of an eye prosthesis using monopoly syrup.

The eye is a vital organ and an important component of facial expression. Loss of an eye has a crippling effect on the psychology of the patient. Maxillofacial prostheses restore and replace stomatognathic and associated facial structures with artificial substitutes. The objectives of eye prosthesis is to improve the patient esthetics, restore and maintain the health of the remaining associated structures, consequently provide physical and mental well-being. The primary purpose of an ocular prosthesis is to maintain the volume of eye socket and create the illusion of a healthy eye and surrounding tissue. A custom ocular prosthesis is a good option when reconstruction is done by plastic surgery, and osseointegrated implants are either not possible or not desired. A case of a custom-made ocular acrylic prosthesis is presented with acceptable fit, good retention, and esthetics.

Clinical safety evaluation of marine oil derived from Calanus finmarchicus.

Marine oils are rich in polyunsaturated fatty acids (PUFAs), including docosahexaenoic and eicosapentaenoic acid. These PUFAs are associated with health benefits and additional sustainable sources of marine oils are desirable. One of the source organisms is Calanus finmarchicus, a copepod endemic to the North Atlantic. PUFAs in the lipid fraction of this organism are largely in the form of wax esters. To assess the safety of these wax esters as a source of PUFAs, a randomized, double-blinded, placebo-controlled clinical trial was conducted whereby 64 subjects consumed 2 g Calanus oil in capsule form daily for a period of one year. A group of 53 subjects consumed placebo capsules. At baseline, 6-, and 12-months, series of evaluations were conducted, including: vital signs, clinical chemistry and hematological evaluations, and adverse event reporting. Food intake and physical exercise were controlled by means of a questionnaire. There were no effects on Calanus oil treatment on any of the safety parameters measured. A slight increase in the incidence of eczema was reported in the Calanus oil group, but the response was minor in nature, not statistically significant after controlling for multiple comparisons, and could not be attributed to treatment.

Stability of 50mg-Beeswax alcohols tablets (Abexol®) packed in high-density polyethylene flasks

Introduction: beeswax alcohols, consisting in a reproducible mixture of six primary fatty alcohols from 24 to 34 carbon atoms purified from Apis mellifera beeswax, has been shown to produce antioxidant and gastroprotective effects. This substance is used to manufacture Abexol® 50 mg tablets, the finished form used in clinical studies and in routine practice. Objective: to determine the stability of 50 mg‒Beeswax alcohols tablets (Abexol®) packed in high‒density polyethylene flasks. Methods: samples from three batches of Abexol® 50 mg tablets packed in white high density polyethylene flasks (Rainbow & Nature, Sydney, Australia) were put into cardboard boxes and kept under climatic conditions of the zone IV (30±2 ºC, 70±5 percent of relative humidity) for five years. Results: all parameters tested were within specifications throughout the whole study: appearance (white round tablets with intact surfaces), average weight (initial average weight±7,5 percent), total content of the six fatty alcohols (50±3.75 mg), disintegration time (<15 min), hardness (˃3 kg/cm2) and microbiological content (≤1 000 bacteria/g and ≤100 fungi/g, absence of E. coli,S. aureus, Pseudomonas, Salmonella and C. albicans). This result is consistent with the data of a previous stability study of Abexol® 50 mg tablets manufactured in Cuba and packed in blisters of polyvinyl chloride and aluminum. Conclusions: the results of the present study support that Abexol®50mg tablets packed in white high density polyethylene flasks and stored at the conditions of the climatic zone IV have a shelf life of 5 years(AU)

Introducción: los alcoholes de la cera de abejas constituyen una mezcla reproducible de seis alcoholes grasos primarios de 24 a 34 átomos de carbono purificados de la cera de Apis mellifera. Esta sustancia, con efectos antioxidantes y gastroprotectores, es empleada para la elaboración de las tabletas de Abexol® con dosis de 50 mg de alcoholes, forma farmacéutica terminada utilizada en los ensayos clínicos y en la práctica de rutina. Objetivo: determinar la estabilidad de las tabletas con 50 mg de alcoholes de cera de abejas (Abexol®) en frascos de polietileno de alta densidad. Métodos: muestras de tres lotes de tabletas de Abexol® con dosis de 50 mg envasadas en frascos de polietileno de alta densidad ( Rainbow & Nature, Sydney, Australia) se pusieron en cajas de cartón y se mantuvieron en las condiciones de la zona climática IV (30±2 ºC, 70±5 por ciento de humedad relativa) durante cinco años. Resultados: los parámetros evaluados se mantuvieron dentro de sus especificaciones de calidad durante todo el estudio: apariencia (tabletas blancas redondas con superficies enteras), peso promedio (inicial±7,5 por ciento), contenido total de los seis alcoholes grasos (50±3,75 mg), tiempo de desintegración (<15 min), dureza (˃3 kg/cm2) y contenido microbiológico (≤1 000 bacterias/g y ≤100 hongos/g, ausencia de E. coli, S. aureus, Pseudomonas, Salmonella y C. albicans). Este resultado es consistente con los datos de un estudio previo de estabilidad de tabletas de Abexol® con dosis de 50 mg, fabricadas en Cuba y envasadas en blísteres de cloruro de polivinilo y aluminio. Conclusiones: los resultados del presente estudio sustentan que las tabletas de Abexol® con dosis de 50 mg, envasadas en frascos de polietileno de alta densidad y almacenadas en las condiciones de la zona climática IV, presentan un tiempo de vida útil de cinco años(AU)

Canalplasty for Exostoses With Maximal Skin Preservation With Temporoparietal Fascia Grafting and Use of Bone Wax for Skin Flap Protection: A Retrospective Case Series.

BACKGROUND: External auditory canal exostoses are benign, bony overgrowths that arise in patients who experience chronic cold water exposure. While considerable advancement has been made in canalplasty techniques in recent decades, many patients continue to experience prolonged healing periods and recurrent stenosis following surgery. OBJECTIVE: To perform a retrospective outcomes analysis of our experience with a skin-preserving canalplasty technique with temporoparietal fascia grafting and use of bone wax for skin flap protection. STUDY DESIGN: Retrospective review. SUBJECTS AND METHODS: Thirty-four patients (41 ears) underwent canalplasty from 2008 to 2014 at a tertiary referral center. Primary outcome measures included rates of prolonged healing and restenosis, need for revision surgery, and audiometric results. Rates of intraoperative and postoperative complications were also tabulated. RESULTS: No patient experienced recurrent stenosis or required a revision surgery within the follow-up period. All but one patient (97%) achieved complete healing within 8 weeks. Minimal intraoperative complications were found. Statistically significant improvements in air pure tone averages and air-bone gaps were achieved. CONCLUSION: The proposed technique is a safe and effective method of canalplasty for exostoses that imparts accelerated wound healing and minimizes the rate of recurrent stenosis.

The effect of haemostatic devices on bone healing 6 months postoperatively in sternotomized pigs.

OBJECTIVES: Bone wax is frequently used to diminish bleeding after sternotomy. Water-soluble polymer wax has been shown to diminish postoperative bleeding and, unlike traditional bone wax, to be absorbed and removed by the organism in an unchanged state. We have previously shown that bone wax impairs early bone healing after sternotomy, whereas polymer wax does not. This difference was observed 6 weeks postoperatively and questions arose as to whether these effects were long term. Therefore, we hypothesized that bone wax impairs bone healing in sternotomized pigs 6 months postoperatively, whereas polymer wax does not. METHODS: Fourteen Landrace/Yorkshire pigs were sternotomized and then randomly assigned to haemostasis by either bone wax (WAX-group) or water-soluble polymer wax (POL-group). After 6 months, the pigs were euthanized and the sternum was removed and prepared for further assessment. Bone fracture strength and bone stiffness were determined using a modified three-point bending test, whereas bone healing was examined by means of quantitative histology. Six pigs died before the end of the study due to failure to thrive, valve prosthesis endocarditis and coronary artery occlusion. RESULTS: The mechanical testing showed no difference between groups with regard to fracture strength [WAX-group versus POL-group; 214.8 (85.5-478.5) vs 203.8 (90.4-478.5) N, P = 0.986] or maximum stiffness [213.0 (81.5-409.5) vs 348.5 (23.3-689.5) N/mm, P = 0.128]. Histology showed predominance of fibroblast-covered surfaces [10.6% (1.8-23.3%) vs 4.1% (0.0-13.0%), P < 0.001] and fibrous tissue volume [45.4% (6.9-82.0%) vs 17.4% (2.9-55.0%), P < 0.001] in animals treated with bone wax. The volume fraction of calcified bone tended to be higher in the POL-group [26.8% (4.3-35.8%) vs 16.7% (1.5-35.8%), P = 0.065]. Granulomas comprised 12.5% (0.0-78.9%) of the volume fraction in the WAX-group compared with 0.0% (0.0-0.0%) in the POL-group (P < 0.001). CONCLUSION: Bone wax and water-soluble polymer wax had similar long-term effects on bone mechanical properties. Histology confirmed our hypothesis and showed a more extensive foreign body reaction in animals treated with bone wax than in those treated with water-soluble polymer wax.

Safety and efficacy of bone wax in patients on oral anticoagulant therapy.

Cardiovascular conditions, apart from neoplastic diseases, remain the major cause of death in developed countries; therefore, the number of patients receiving oral anticoagulants is constantly increasing. Anticoagulant therapy considerably reduced mortality in patients with history of myocardial infarction among others. Although many interventions may be performed without withdrawal of the anticoagulant and tooth extraction was qualified as a procedure of low hemorrhage risk, a majority of dentists refer the patient to a cardiologist several days before the elective tooth extraction to withdraw anticoagulants. The aim of the study was to evaluate the efficacy and safety of bone wax used to stop bleeding after dental procedures in a group of patients on chronic anticoagulant therapy and find an answer to a question, whether it is justified to temporarily withdraw anticoagulants for this type of procedures. The study involved 176 patients on chronic anticoagulant therapy undergoing tooth extraction (154 subjects) or surgical extraction of a retained tooth (48 subjects). After the procedure, in each case the alveolus was filled with bone wax to stop bleeding. In all patients involved in the study bleeding from the alveolus was successfully stopped during the procedure. None of the subjects reported increased bleeding from the operational site after coming back home. Bone wax is a good, efficient, and safe material to block bleeding from the alveolus following tooth extractions, also in patients on chronic anticoagulant therapy. The study demonstrated that withdrawal or adjustment of anticoagulant therapy is not necessary before an elective tooth extraction.

Ethmoidal encephalocele associated with cerebrospinal fluid fistula: indications and results of mini-invasive transnasal approach.

Anterior skull base defects with encephalocele in adults are quite rare and can be a cause of spontaneous rhinoliquorrhea; however, cerebrospinal fluid (CSF) fistula can be not rarely misdiagnosed for several months or years. Five adult patients affected by ethmoidal encephalocele with CSF fistula were treated in our institute from 2006 through to 2011. Onset of clinical history was represented by rhinoliquorrhea, which was precociously recognized in only 1 patient; in the other 4, it was misdiagnosed for a period ranging from 11 months to 5 years. After clinical diagnosis of CSF fistula and after brain magnetic resonance imaging, ethmoidal encephalocele was evident in all patients; preoperative study was completed by spiral computed tomography scan, to clearly identify the skull base bone defect. All patients were operated on by transsphenoidal endonasal endoscope-assisted microsurgical approach through 1 nostril. The herniated brain was coagulated and removed, and reconstruction of cranial base was performed. Postoperative rhinoliquorrhea or other complications did not occur in any patient at short and late follow-up. All patients were discharged after a few days. Endonasal endoscope-assisted microsurgical approach was effective in exposing and repairing the ethmoidal bone defect; tridimensional vision and wide lateral and superior exposition of the operative field were possible in each patient, thanks to the use of microscope and angulated endoscope.

Efficacy and safety of bone wax to reduce sternal bleeding following coronary bypass surgery.

OBJECTIVE: To elucidate the effect of bone wax on postoperative bleeding, infection and wound healing. METHODS: This study included two independent groups, consisting of 94 patients who were treated with bone wax and 90 patients who received nothing after median sternotomy and just before sternal closure. Demographic and postoperative data were recorded. Both groups were compared with respect to the amount of postoperative drainage, blood transfusion requirement, re-exploration because of bleeding, and mortality rates. RESULTS: Demographic measurements did not differ between the groups. In the first two months of the postoperative period, mediastinitis was not seen in any of the patients in both groups. Superficial wound infection was detected in six patients (6.4%) in Group A. Eight patients (8.9%) suffered from superficial wound infection in Group B (p >0.05). In the first postoperative 24 hours, the average amount of postoperative drainage was 536.89 ml in Group A, whereas it was 529.67 ml in Group B (p >0.05). Three patients in both groups died in the early phase of the postoperative period (p >0.05).There was not any statistically significant difference between groups considering bleeding quantity, mortality, re-exploration, amount of blood used and deep sternal infection. CONCLUSION: Bone wax does not reduce bleeding on sternal sides. No evidence was found that application of bone wax causes deep sternal infection in patients having median sternotomy for coronary bypass surgery.

Gentamicin-enriched, water-soluble polymer wax reduces the burden of infection after sternotomy in pigs.

OBJECTIVES: One of the most frequent complications in cardiac surgery is postoperative bleeding from the sternum. To diminish the risk of bleeding, bone wax is frequently used for haemostasis. However, we have previously shown that bone wax impairs bone healing and induces inflammation in the sternum. A new, water-soluble polymer wax enriched with gentamicin has haemostatic properties similar to bone wax and may diminish the risk of infection. The purpose of this study was to determine whether the gentamicin-enriched, water-soluble polymer wax could reduce infection rates when compared with bone wax in a porcine model. METHODS: Thirty-two Landrace/Yorkshire pigs were sternotomized and randomized to haemostasis by gentamicin-enriched, water-soluble polymer wax (Gen group) or bone wax (Wax group). After 4 weeks the pigs were euthanized. Blood samples were analysed for the fraction and concentration of neutrophil granulocytes and C-reactive protein and the surgical site was biopsied. Stereology was performed on histological samples, and the magnitude of infection was quantified as the areas of microabscesses, granulomas and tissue with acute inflammation compared with the total tissue area. RESULTS: The temperature was 38.2 °C in the Gen group vs 38.6 °C in the Wax group, P < 0.05. No animals in the Gen group and three in the Wax group showed a temperature >39.3 °C. Neutrophil granulocyte concentration was 5.00 × 10(9)/l in the Gen group and 6.92 × 10(9)/l in the Wax group, P = 0.277, with a leucocyte fraction of 20.9% vs 29.3%, P = 0.119. C-reactive protein (CRP) was 142 mg/l in the Gen group compared with 318 mg/l in the Wax group, P = 0.106. Histological samples showed acute inflammatory changes in 5.0% of the tissue in the Gen group vs 18.3% in the Wax group, P < 0.001. Microabscesses were present in 0.3% of the sample tissue in the Gen group vs 2.2% in the Wax group, P < 0.001. Concentrations of gentamicin were >100 mg/l in mediastinal fluid and <2 mg/l in venous blood. CONCLUSIONS: When used for haemostasis after sternotomy in a porcine model, gentamicin-enriched, water-soluble polymer wax reduces sign of infection when compared with bone wax and therefore appears to be a more suitable choice for preventing postoperative, sternal osteomyelitis.

Wax esters from the marine copepod Calanus finmarchicus reduce diet-induced obesity and obesity-related metabolic disorders in mice.

We showed previously that dietary supplementation with oil from the marine zooplankton Calanus finmarchicus (Calanus oil) attenuates obesity, inflammation, and glucose intolerance in mice. More than 80% of Calanus oil consists of wax esters, i.e., long-chain fatty alcohols linked to long-chain fatty acids. In the present study, we compared the metabolic effects of Calanus oil-derived wax esters (WE) with those of purified eicosapentaenoic acid (EPA) + docosahexaenoic acid (DHA) ethyl esters (E/D) in a mouse model of diet-induced obesity. C57BL/6J mice received a high-fat diet (HFD; 45% energy from fat). After 7 wk, the diet was supplemented with either 1% (wt:wt) WE or 0.2% (wt:wt) E/D. The amount of EPA + DHA in the E/D diet was matched to the total amount of n-3 (ω-3) polyunsaturated fatty acids (PUFAs) in the WE diet. A third group was given an unsupplemented HFD throughout the entire 27-wk feeding period. WE reduced body weight gain, abdominal fat, and liver triacylglycerol by 21%, 34%, and 52%, respectively, and significantly improved glucose tolerance and aerobic capacity. In abdominal fat depots, WE reduced macrophage infiltration by 74% and downregulated expression of proinflammatory genes (tumor necrosis factor-α, interleukin-6, and monocyte chemoattractant protein-1), whereas adiponectin expression was significantly upregulated. By comparison, E/D primarily suppressed the expression of proinflammatory genes but had less influence on glucose tolerance than WE. E/D affected obesity parameters, aerobic capacity, or adiponectin expression by <10%. These results show that the wax ester component of Calanus oil can account for the biologic effects shown previously for the crude oil. However, these effects cannot exclusively be ascribed to the content of n-3 PUFAs in the wax ester fraction.

Intraoral curettage without presurgical endovascular embolization: a simple but controversial treatment of arteriovenous malformations of the mandible.

Arteriovenous malformation of the mandible is a rare and life-threatening lesion. The gold standard treatment is to extirpate the lesion surgically after endovascular embolization. Preoperative endovascular embolization is widely accepted, but there are limitations to the treatment. The authors introduce a technique in which the lesion is divided into parts and filled with bone wax, then curetted step by step. This gradual curettage method is effective and could be used instead of the standard treatment especially in hospitals with limited facilities for endovascular embolization.