Successful treatment of generalized refractory chronic periodontitis through discontinuation of waxed or coated dental floss use: A report of 4 cases

BACKGROUND AND OVERVIEW

Generalized refractory chronic periodontitis is a periodontal condition that is resistant to conventional therapy. Management of this condition often is frustrating to both the patient and the clinician.

CASE DESCRIPTIONS

The authors present 4 cases of generalized refractory chronic periodontitis characterized by an inflammatory gingival response and progressive bone loss that did not respond to extensive periodontal treatments and regular periodontal care. Histologic examination of affected gingival tissue revealed an abundance of plasma cells, a feature seen in certain oral contact hypersensitivity reactions. The authors suspected that waxed or coated dental floss was the offending contactant, and its removal from the patients' oral hygiene regimens resulted in a dramatic improvement of the periodontal characteristics.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

In cases of periodontal disease as described in this report, dental practitioners should consider the possibility of a contact hypersensitivity reaction to waxed or coated dental floss, whereby the floss exacerbates the condition instead of assisting in its resolution.

Estimation of total soluble solids in grape berries using a hand-held NIR spectrometer under field conditions

BACKGROUND

Recent studies have reported the potential of near infrared (NIR) spectral analysers for monitoring the ripeness of grape berries as an alternative to wet chemistry methods. This study covers various aspects regarding the calibration and implementation of predictive models of total soluble solids (TSS) in grape berries using laboratory and in-field collected NIR spectra.

RESULTS

The performance of the calibration models obtained under laboratory conditions indicated that at least 700 berry samples are required to assure enough prediction accuracy. A statistically significant error reduction (ΔRMSECV = 0.1°Brix) with P < 0.001 was observed when measuring berries without epicuticular wax, which was negligible from a practical point of view. Under field conditions, the prediction errors (RMSEP = 1.68°Brix, and SEP = 1.67°Brix) were close to those obtained with the laboratory dataset (RMSEP = 1.42°Brix, SEP = 1.40°Brix).

CONCLUSION

This work clarifies several methodological factors to develop a protocol for in-field assessing TSS in grape berries using an affordable, non-invasive, portable NIR spectral analyser. © 2015 Society of Chemical Industry.

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.

Endoscopic management of cerebrospinal fluid leak associated with the use of bone wax in skull-base surgery

OBJECTIVE

To alert otolaryngologists to consider the possibility that bone wax may be associated with cerebrospinal fluid leaks that occur immediately after skull-base craniotomy approaches.

STUDY DESIGN AND SETTING

Clinical report from surgical experience in a tertiary care setting.

RESULTS

Three patients presented with brisk cerebrospinal fluid leak after craniotomy. Sinus endoscopy revealed bone wax within a small parasphenoid defect in all 3 cases.

CONCLUSIONS

Bleeding from areas of the skull base adjacent to the paranasal sinuses during craniotomy can signal a small breach of the skull base. Bone wax may control bleeding from edges of transected bone but also stent the skull-base defect open, preventing fibrin deposition and spontaneous healing and closure.

SIGNIFICANCE

Otolaryngologists repairing a cerebrospinal fluid leak after a skull-base craniotomy approach should consider the possibility of encountering bone wax and be able to identify it to better treat their patient.

Bone Wax as a Risk Factor for Surgical-Site Infection Following Neurospinal Surgery

Surgical-site infection occurred in 6 of 42 neurospinal cases in which bone wax was used and in 1 of 72 cases in which it was not used during a 3-month period (P< .01). Increased risk of infection should be considered when using bone wax as a hemostatic agent.

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.

Does bone wax induce a chronic inflammatory articular reaction?

BACKGROUND

Bone wax is used to control femoral neck bleeding during open femoroacetabular impingement (FAI) surgery. Despite its widespread use, only a few case reports and small case series describe side effects after extraarticular use. It is unclear whether intraarticular use of bone wax leads to such complications. However, during revision FAI surgery, we have observed various degrees of articular inflammatory reactions.

QUESTIONS/PURPOSES

We therefore investigated whether the bone wax used intraarticularly to control femoral neck bleeding during FAI surgery could be associated with the inflammatory reactions observed at revision surgery.

METHODS

We visually inspected the area and analyzed biopsy specimens from all 14 patients undergoing revision surgery from March 2005 to March 2006, 11 of whom had bone wax used at the time of original surgery. The three patients who did not have bone wax were used as controls.

RESULTS

Bone wax was identified macroscopically on the femoral neck at the time of the revision surgery in all 11 patients. In all 11 patients, biopsy results indicated a foreign body-type chronic synovial inflammation. Five patients also had an associated synovial lymphoplasmacytic inflammatory reaction. No inflammatory reaction was observed in the biopsy specimens obtained from the three patients in whom bone wax was not originally used.

CONCLUSIONS

Our findings suggest a synovial foreign body reaction, with or without an associated lymphoplasmacytic chronic inflammatory reaction, may be associated with intraarticular use of bone wax.

Bone wax can cause foreign body granuloma in the medulla oblongata

Bone wax is commonly used in neurosurgical practice as a haemostatic and sealing agent. It is a safe agent, but may lead to adverse effects such as infection, epistaxsis, allergic reaction or foreign body granuloma. There are very few reported cases of the neurological complications of remnant bone wax in the subdural or subarachnoid space. The authors report the case of a foreign body granuloma infiltration through the medulla oblongata due to remnant bone wax in the subarachnoid space after posterior fossa decompressive surgery.

A case review of patients presenting to Royal North Shore Hospital, with hair removal wax burns between January and November 2006

To date there is no published literature on the dangers of hair removal wax burns. This case review illustrates the steady influx of patients presenting to Royal North Shore Hospital (RNSH) with hair removal wax burns. Between January and December 2006, 10 patients out of 395 with burns (2.5%) presented to our dressing clinic with hair removal wax burns. All sustained burns under 5% total body surface area (TBSA) and two required debriding and split skin grafting (SSG). The mechanism of the burns was re-heating the hair removal wax in the microwave for too long.

Severe Complications of a "Brazilian" Bikini Wax

A 20-year-old Australian woman with poorly controlled type 1 diabetes presented with life-threatening Streptococcus pyogenes and Herpes simplex infection of her external genitalia following a routine perineal "Brazilian" bikini wax. Extensive pubic hair removal is now common among young adults in Australia and elsewhere. However, the infectious risks of these practices, particularly among immunosuppressed individuals, are often underappreciated.

Allergic Contact Dermatitis Caused by Colophony in an Epilating Product

Considering the widespread use of colophony-containing epilating products and the frequency of sensitization to colophony, it is somewhat surprising that reports of allergic contact dermatitis from these products are so infrequent. Reactions to colophony can be severe, and they may present even after initial exposure (primary sensitization). Consequently, health care practitioners should be aware of potential colophony-induced allergic contact dermatitis in patients exposed to epilating products. Patch testing with commercially available colophony unmodified rosins often fails to detect reactions to the modified-rosin derivatives found in the actual epilating products. Therefore, the evaluation of colophony allergy may require testing with the patient's own products as well as additional modified colophony rosins. We describe a case of allergic contact dermatitis caused by colophony found in an epilating product.

Bone wax as a cause of foreign body reaction after lumbar disc surgery: a case report

This report describes a 45-year-old patient who was admitted to the hospital with complaints of low-back pain, lower extremity weakness, and difficulty in walking for the previous 6 mo. The patient's history revealed 2 lumbar-disc surgeries that were performed 1 y earlier. The patient underwent surgery at our hospital because of clinical symptoms and radiologic findings on magnetic resonance imaging. During the operation, 1 x 1 x 1 cm of bone wax that was compressing the dural sac and spinal root was extirpated from the surgical area. Bone wax use should be limited in spinal surgery because of the potential for compression and chronic inflammation.

« Abcès atypique » jugal après extraction de dents de sagesse: complication de l'utilisation de cire hémostatique

Bleeding is a common complication after third molar extraction. Hemostatic agents can be helpful in controlling intraoperative bleeding. Infection is another common complication. Horseley's wax is frequently used for bone surgery and less often for dental surgery. We report an unusual case of abscess formation in the jaw after third molar extraction. Surgical exploration of the abscess disclosed the presence of surgical wax in the center of a foreign body granuloma. We discuss the use of surgical wax and other local hemostatic agents and the subsequent risk of complications.

Haemostatic agents used in periradicular surgery: an experimental study of their efficacy and tissue reactions

AIM

To evaluate the haemostatic efficacy and the histologic tissue responses after the application of different haemostatic agents used in periradicular surgery.

METHODOLOGY

The study was conducted in the calvarium of six rabbits. Standardized bone defects (diameter 4 mm) were trephined, and different haemostatic agents were applied and compared with control defects: bone wax (left for 10 min), Stasis (ferric sulphate, left for 5 s), Expasyl (aluminium chloride, left for 2 min and left permanently in situ), and a combination of Expasyl (2 min) and Stasis (5 s). The sites were photographed before the application and after the removal of the haemostatic agents. Three independent examiners judged the initial and final bleeding (on the photographs) using a bleeding score for each site and treatment. The results were compared using Wilcoxon's signed rank test. For the histologic analysis, three animals were killed after 3 weeks and three animals after 12 weeks. Transverse, nondecalcified sections were stained with combined basic fuchsin and toluidine blue for descriptive histology.

RESULTS

The most efficient haemorrhage control was provided by Expasyl in combination with Stasis and by Expasyl alone, whereas bone wax had the weakest bleeding reduction effect. The histologic analysis after 3 weeks demonstrated an inflammatory and foreign body tissue response towards all haemostatic agents. At 12 weeks, this tissue response was less pronounced but still present in sites treated with bone wax or Expasyl. In general, the inflammatory tissue reactions were limited to the bone defects, and never extended into the surrounding tissues.

CONCLUSIONS

Expasyl alone or in combination with Stasis appeared to be the most efficient of tested agents to control the bleeding within the bony defects created in a rabbit calvarium model.

Bee and bee products allergy in Turkish beekeepers: determination of risk factors for systemic reactions

BACKGROUND

The prevalence of allergic reactions due to bee stings in beekeepers varies in different regions of the world. The aim of this study was to evaluate the characteristics of sting reactions and the risk factors for developing systemic reactions in Turkish beekeepers.

METHODS

A self-administered questionnaire was distributed to 1250 beekeepers to be completed in seven different cities of Turkey. A total of 494 (39.6 %) questionnaires were returned.

RESULTS

There were 444 subjects (89.9 %) with a history of sting exposure in the previous 12 months. Systemic reactions were present in 29 subjects (6.5 %) and nine (2 %) reactions were anaphylactic. Fifty-five percent of beekeepers reported more than 100 bee stings in the previous year. When systemic reactions were controlled by age and duration of beekeeping in a logistic regression model, seasonal rhinitis (OR: 4.4, 95 % CI: 1.2-11.5), perennial rhinitis (OR: 4.6, 95 % CI: 1.2-18.2), food allergy (OR:7.0, 95 % CI: 2.0-25.0), physician-diagnosed asthma (OR: 8.0, 95 % CI: 2.5-25.6), having an atopic disease of any type (OR: 3.3, 95 % CI: 1.2-8.7) and having two or more atopic diseases (OR: 10.9, 95 % CI: 3.5-33.8) were significantly associated with systemic reactions due to bee sting in the previous 12 months.

CONCLUSION

The incidence of systemic reactions in Turkish beekeepers is low, which might be due to the protective effect of a high frequency of bee stings. The risk of systemic reactions increases approximately three-fold when one atopic disease is present and eleven-fold when two or more concurrent atopic diseases are present with respect to no atopic disease.

Histologically verified bone wax (beeswax) granuloma after median sternotomy in 17 of 18 autopsy cases

AIM

To evaluate the sternum from ordinary or forensic autopsy cases with a midline sternal cutaneous scar macro- and microscopically and using computed tomography (CT) to detect if the haemostatic bone sealant bone wax (beeswax) had been applied after median sternotomy and if the bone wax had elicited inflammation.

METHODS

During a 3-year period, the sterna of 18 consecutive cadavers (15 ordinary autopsies, 3 forensic) who prior to death had undergone surgery with median sternotomy were examined macro- and microscopically and with CT. In addition, one virgin sternum was smeared with bone wax at the upper half after bench sternotomy, sutured and examined with CT. Unused bone wax was examined with CT for attenuation measurements.

RESULTS

Macroscopically, bone wax was seen in 17 of 18 sterna. Acute inflammation was found in one, chronic inflammation and foreign body multinucleated giant cells were seen around the bone wax in 17 sterna. No inflammation was found in one. CT could only detect foci in the operated sterna with attenuation values from -45 to +20 Hounsfield units (HU) and values about -80 HU were found in the virgin sternum. Unused bone wax measured about -100 HU.

CONCLUSIONS

Bone wax is non-resorbable and induces chronic inflammation in the operated sternum up to 10 years after application. Measurement of Hounsfield units with CT of the operated sterna could not verify bone wax granuloma.

The safety and efficacy of a mixture of honey, olive oil, and beeswax for the management of hemorrhoids and anal fissure: a pilot study

We have found that a mixture of honey, olive oil, and beeswax was effective for treatment of diaper dermatitis, psoriasis, eczema, and skin fungal infection. The mixture has antibacterial properties. A prospective pilot study was conducted to evaluate the therapeutic effect of topical application of the mixture on patients with anal fissure or hemorrhoids.Fifteen consecutive patients, 13 males and 2 females, median age 45 years (range: 28—70), who presented with anal fissure (5 patients) or first- to third-degree hemorrhoids (4 with first degree, 4 with second degree, and 2 with third degree), were treated with a 12-h application of a natural mixture containing honey, olive oil, and beeswax in ratio of 1:1:1(v/v/v). Bleeding, itching, edema, and erythema were measured using a scoring method: 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. The pain score was checked using a visual analog scale (minimum = 0, maximum = 10). Efficacy of treatment was assessed by comparing the symptoms' score before and after treatment; at weekly intervals for a maximum of 4 weeks. The patients were observed for evidence of any adverse effect such as appearance of new signs and symptoms, or worsening of the existing symptoms. The honey mixture significantly reduced bleeding and relieved itching in patients with hemorrhoids. Patients with anal fissure showed significant reduction in pain, bleeding, and itching after the treatment. No side effect was reported with use of the mixture. We conclude that a mixture of honey, olive oil, and beeswax is safe and clinically effective in the treatment of hemorrhoids and anal fissure, which paves the way for further randomized double blind studies.

Polymethylmethacrylate causes prolonged pulmonary hypertension during fat embolism: a study in sheep

BACKGROUND

Fat embolism (FE), the release of bone marrow contents into the circulation and the subsequent cardiovascular changes, is still a potentially fatal com-plication during orthopedic surgery. Different causative factors have been suggested, but the exact pathomechanism of FE still remains unclear. We investigated the role of polymethylmethacrylate (PMMA) in FE during vertebroplasty in sheep.

METHODS

In 8 sheep, two vertebral bodies were augmented alternatively with PMMA or bone wax. Pulmonary and cardiovascular parameters were monitored during the procedure.

RESULTS

The peak response was similar for both groups and characterized by hypotension, a drop in cardiac output and pulmonary hypertension. However, the recovery in pulmonary arterial pressure and pulmonary vascular resistance was quicker in the wax group.

INTERPRETATION

The injection of PMMA may cause prolonged pulmonary hypertension during vertebro-plasty and also arthroplasty. Surgeons should be aware of this potential cardiovascular complication, especially in patients with impaired pulmonary and cardiovascular function.

The use of local agents: bone wax, gelatin, collagen, oxidized cellulose

The use of local agents to achieve hemostasis is an old and complex subject in surgery. Their use is almost mandatory in spinal surgery. The development of new materials in chemical hemostasis is a continuous process that may potentially lead the surgeon to confusion. Moreover, the more commonly used materials have not changed in about 50 years. Using chemical agents to tamponade a hemorrhage is not free of risks. Complications are around the corner and can be due either to mechanical compression or to phlogistic effects secondary to the material used. This paper reviews about 20 animal and clinical published studies with regard to the chemical properties, mechanisms of action, use and complications of local agents.

Bone wax as a cause of a foreign body granuloma in a cranial defect: a case report

Bone wax was used to stop bleeding of the diploic vessels after harvesting cranial bone for reconstruction of an orbital floor defect. After five months a fistula in the overlying skin of the donor site appeared and was eventually surgically explored. Remnants of bone wax and surrounding inflammatory tissue were removed and the fistula was excised. Histological examination revealed a foreign body granuloma. The use of bone wax and possible alternative local haemostatic agents and their complications are discussed.

Analysis of wax burn cases presenting to an Emergency Department in Hong Kong during the Chinese Mid-Autumn festival

Records of patients presenting to the Emergency Department (ED) of the Prince of Wales Hospital with wax burns during Mid-Autumn festival from 1998 to 2001 were retrieved and analyzed. There were 26 patients in total (21 males, 5 females). Annual attendances from 1998 to 2001 were 11, 7, 4 and 4, respectively. Age ranged from 1 to 33 years (median age: 11.5). Most patients were injured by molten wax (n=23, 88.5%), the rest were burnt by flame (n=3, 11.5%). Partial thickness burn (superficial and deep) was the most common (n=23, 88.4%). Superficial burn accounted for the rest (n=3, 11.5%). No patient had full thickness burn. All patients had <5% of body surface area (BSA) burnt, with the majority only involving <1% BSA (n=16, 61.5%). The commonest sites of injury were the lower limbs (n=15, 57.7%), the upper limbs (n=8, 30.8%) and face (n=7, 26.9%). Three patients (11.5%) had multiple sites burnt. Only eight patients (30.8%) required burns surgeon's consultation, out of which seven (26.9%) required in-patient treatment. Most burns caused by or related to boiling wax were minor. The declining incidence is the combined result of legislation, product modification, education and publicity.

An epidemic of allergic contact dermatitis due to epilating products

Over a period of 19 months, 33 cases of acute allergic contact dermatitis from Veet epilating waxes and/or the accompanying tissue (Reckitt Benckiser, Massy, France) were observed in France and Belgium. The lesions started on the legs and spread to other parts of the body, especially the face, and were sometimes so severe that hospitalization and/or systemic corticosteroids were required. Primary sensitization occurred as early as after the first application in several patients. Patch tests were performed in 26 of the patients and produced strong positive reactions to the tissue (25 times) and/or the wax (13 times). The allergenic culprits in the wax were modified-colophonium derivatives (colophonium in the standard series testing negatively in all except 4 patients), while methoxy PEG-22/dodecyl glycol copolymer and to a lesser degree lauryl alcohol turned out to be the main causal allergens in the tissue.

Bone wax foreign body granuloma in the mastoid

The sue of bone wax is commonly used to control bleeding during mastoid surgery. An unusual case of bone wax granuloma in the mastoid, with sigmoid sinus thrombosis, is reported. Although the use of bone wax in and around the mastoid is generally considered safe with few complications, caution should be exercised, particularly in infected fields and in patients known to have general immunohypersensitivity.

Is Bone-wax an injectable urologic material?

OBJECTIVE

Injection of endoscopic material for reflux and incontinence therapies became popular in urology because of its simplicity and repeatability. Research is going on to develop an ideal injectable material. In this experimental study we investigated whether the bone wax used for osteotomy hemostasis in orthopedic and neurosurgical operations could be used as an injectable material.

MATERIALS AND METHODS

A total of 20 rabbits were included in the study: 6 underwent a sham operation, and in the remaining 14 rabbits, 0.5 ml bone wax liquefied with n-butyl acetic acid was injected submucosally via a 20-gauge needle at three different points on the anterior bladder wall. Cystectomy was performed on the 15th day in 2 rabbits (group I), on the 60th day in 2 (group II) and on the 150th day in 10 (group III). 0.20 ml bone wax was also injected subcutaneously and intramuscularly 7 days before cystectomy in group III. Bladders were examined macroscopically and histopathologically. All animals' lungs, livers, kidneys, spleens and brains were also removed and examined histologically.

RESULTS

Submucosal swellings of bone wax maintained their localizations and shapes in all groups and all of the 42 bone-wax injection sites could be easily identified. Histologically, slight edema around the implant was seen in group I. In group II, collagen was increased around the implants and minimal hyperplasia of the epithelium overlaying bone wax was noted. 150 days after the injections, moderate collagen production and a mild increase in vascularity were seen around the implants. There was no macroscopic or microscopic evidence that implants migrated to locations other than the injection sites.

CONCLUSIONS

When injected to the bladder submucosa, bone wax seems to be inert and biocompatible, encouraging further research to develop it as an alternative agent in the endoscopic treatment of vesicoureteral reflux and sphincteric incontinence.

[Skin reaction after St Lucia holiday celebration]

A 37-year-old man developed contact dermatitis on the front head after being exposed to dripping candles. The candles were placed in a crown on his head as he played St. Lucia in the traditional Lucia Day (13th December) pageant, trying to entertain the administrative staff of the University of Bergen where he was employed. Afterwards he washed his head with a soap he normally did not use. Probably the contact dermatitis is a skin reaction to the soap, but it is difficult to say whether the reaction was irritative or allergic. A similar case has not been reported earlier. It is of importance that noone stops celebrating the Lucia Day. However, proper precautions must be taken, with routines for avoiding exposure to stearine or unfamiliar soaps on the head of Lucia.

Lip cosmetics

Throughout the centuries, the beauty of lips has been extolled by poets, and painters; and people in many different cultures decorate their lips. Modern cosmetics are designed not only to beautify the lips but also to moisturize and protect them from environmental hazards. Familiarity with the ingredients used in lip cosmetics is essential to recognizing and diagnosing the adverse reactions that are associated with these products.

A retroperitoneal tumor as a late complication of the use of bone wax

Ordinary bone wax was used to stop bleeding from the iliac crest after procurement of autogenous bone graft harvesting. This gave rise to a large, symptomatic retroperitoneal tumor, which had to be removed operatively 19 years later. Microscopically, a bone wax granuloma was diagnosed. As far as the authors know this is the first case reported with such late and severe clinical complications after the use of bone wax.

Granuloma annulare following waxing induced pseudofolliculitis-resolution with isotretinoin

We report a case of localized granuloma annulare, successfully treated with isotretinoin, which occurred as a consequence of waxing-induced pseudofolliculitis. To our knowledge this is the first reported clearance of localized granuloma annulare with isotretinoin and the first reported case of granuloma annulare as a sequel to pseudofolliculitis.

Boiling wax burn in mid-autumn festival in Hong Kong

An unusual cause of burn, contact with boiling wax by children and adolescents during the annual mid-autumn festival in Hong Kong is presented. 57 patients who suffered from hot wax burn over the period 1986-1996 were admitted to the Burns Unit of the Prince of Wales Hospital. This special burn should be preventable by public education.

Acute effects of ski waxing on pulmonary function

The objective of this study was to determine whether pulmonary function is acutely affected by moderate exposure to ski waxing. Ten healthy nonsmoking young adult volunteers were exposed to 45 min of ski waxing in a small unventilated room. The exposure occurred in pairs with one individual performing the waxing while the other overlooked the waxing process. During the period of waxing, two pairs of cross-country skis were waxed with a paraffin wax and then scraped and brushed, and two pairs of cross-country skis were waxed with a fluorinated wax and then brushed. Spirometry and single-breath carbon monoxide lung diffusion capacity (DLCO) were measured immediately before and after exposure to ski waxing, and again 5-6 h after waxing. A subset of five subjects repeated the measurements on a separate day without receiving exposure to ski waxing. Data were analyzed with repeated measures ANOVA. Exposure to ski waxing induced no significant changes in spirometry and DLCO measurements. We conclude that moderate exposure to ski waxing has no significant acute effect on lung function.

Bee health and international trade

The international trade in bee products is a complex issue as a result of the diverse uses of these products. This is especially true with regard to honey. In most cases, honey is imported for human consumption: the high purchase and shipping costs preclude the use of honey as feed for bees. For these reasons, the risk of transmitting disease through honey is minimal. However, this risk should not be ignored, especially in those countries where American foulbrood is not known to occur. The importation of pollen for bee feed poses a definite risk, especially since there are no acceptable procedures for determining whether pollen is free from pathogens, insects and mites. Routine drying of pollen would reduce the survival of mites and insects, but would not have any impact on bacterial spores. Phytosanitary certificates should be required for the importation of honey and pollen when destined for bee feed. The declaration on the phytosanitary certificate should include country of origin, and should state whether the following bee diseases and parasitic mites are present: American foulbrood disease, European foulbrood disease, chalkbrood disease, Varroa jacobsoni and Tropilaelaps clareae.

Adverse effects of bone wax in surgery of the orbit

The goal of this article is to establish the incidence and scope of adverse reactions to bone wax in a large orbital surgical series. We report two patients with bone wax granulomas of the orbit as a remote surgical complication. These are the first reported cases of adverse reactions to bone wax in the ophthalmic literature. A chart review was conducted on all patients from the University of British Columbia Orbit Clinic that had surgery with temporary or permanent removal of orbital bone. Two patients with bone wax granulomas were identified. In one case, intraoperative cultures grew Staphylococcus aureus, confirming that the wax may indeed act as a nidus for infection. No cases of pseudoarthrosis have occurred. This syndrome of chronic granulomatous giant cell foreign body inflammation has characteristic clinical, radiologic, and histopathologic features. The literature regarding adverse reactions to bone wax is reviewed, and specific implications for orbital surgery are discussed.

Surgical bone wax causing epistaxis

A case of recurrent epistaxis caused by bone wax in the nasal cavity is reported. This is the first reported case of a nasal complication due to surgical bone wax.