Genotoxicity and heating Performance of VxFe3-xO4 nanoparticles in Health applications.

The applications of magnetic nanoparticles (MNPs) as biocatalysts in different biomedical areas have been evolved very recently. One of the main challenges in this field is to design affective MNPs surfaces with catalytically active atomic centres, while producing minimal toxicological side effects on the hosting cell or tissues. MNPs of vanadium spinel ferrite (VFe2O4) are a promising material for mimicking the action of natural enzymes in degrading harmful substrates due to the presence of active V5+ centres. However, the toxicity of this material has not been yet studied in detail enough to grant biomedical safety. In this work, we have extensively measured the structural, compositional, and magnetic properties of a series of VxFe3-xO4 spinel ferrite MNPs to assess the surface composition and oxidation state of V atoms, and also performed systematic and extensive in vitro cytotoxicity and genotoxicity testing required to assess their safety in potential clinical applications. We could establish the presence of V5+ at the particle surface even in water-based colloidal samples at pH 7, as well as different amounts of V2+ and V3+ substitution at the A and B sites of the spinel structure. All samples showed large heating efficiency with Specific Loss Power values up to 400 W/g (H0 = 30 kA/m; f = 700 kHz). Samples analysed for safety in human hepatocellular carcinoma (HepG2) cell line with up to 24h of exposure showed that these MNPs did not induce major genomic abnormalities such as micronuclei, nuclear buds, or nucleoplasmic bridges (MNIs, NBUDs, and NPBs), nor did they cause DNA double-strand breaks (DSBs) or aneugenic effects-types of damage considered most harmful to cellular genetic material. The present study is an essential step towards the use of these type of nanomaterials in any biomedical or clinical application.

Direct Polyphenol Attachment on the Surfaces of Magnetite Nanoparticles, Using Vitis vinifera, Vaccinium corymbosum, or Punica granatum.

This study presents an alternative approach to directly synthesizing magnetite nanoparticles (MNPs) in the presence of Vitis vinifera, Vaccinium corymbosum, and Punica granatum derived from natural sources (grapes, blueberries, and pomegranates, respectively). A modified co-precipitation method that combines phytochemical techniques was developed to produce semispherical MNPs that range in size from 7.7 to 8.8 nm and are coated with a ~1.5 nm thick layer of polyphenols. The observed structure, composition, and surface properties of the MNPs@polyphenols demonstrated the dual functionality of the phenolic groups as both reducing agents and capping molecules that are bonding with Fe ions on the surfaces of the MNPs via -OH groups. Magnetic force microscopy images revealed the uniaxial orientation of single magnetic domains (SMDs) associated with the inverse spinel structure of the magnetite (Fe3O4). The samples' inductive heating (H0 = 28.9 kA/m, f = 764 kHz), measured via the specific loss power (SLP) of the samples, yielded values of up to 187.2 W/g and showed the influence of the average particle size. A cell viability assessment was conducted via the MTT and NRu tests to estimate the metabolic and lysosomal activities of the MNPs@polyphenols in K562 (chronic myelogenous leukemia, ATCC) cells.

Impact of a COVID-19 Outbreak in an Elderly Care Home after Primary Vaccination.

Elderly care home residents are particularly vulnerable to COVID-19 due to immune-senescence, pre-existing medical conditions, and the risk of transmission from staff and visitors. This study aimed to describe the outcomes of a COVID-19 outbreak in a long-term care facility for elderly persons following the initial vaccination. A single-center, retrospective, observational design was used to analyze the variables associated with hospitalization and death rate by logistic regression. Adjusted odds ratios (aOR) and their 95% confidence intervals (CI) were calculated. Sixty-eight residents received the first dose of the COVID-19 vaccine. Despite being negative six days after vaccination, the performance of a second test 4 days later revealed 51 positives (75.0%) among residents and 18 among workers (56.3%). A total of 65 of the 68 residents (95.58%) had positive results with symptoms, whereas 34.9% required hospitalization, and 25.8% died. The best-fitting model to explain the distribution of cases reflects three points at the time of infection.. The time from vaccination to symptom onset explains the hospitalization and mortality rates since a day elapsed halves the risk of hospitalization (aOR = 0.57; CI = 0.38-0.75) and the risk of death by a quarter (aOR = 0.74; CI = 0.63-0.88). Nursing homes present an elevated risk of transmission and severity of SARS-CoV-2 infection. Although vaccination reduces the risk of hospitalization and death, extreme prevention and control measures are essential in these institutions despite the high vaccination coverage.

Health conditions of Hitnü indigenous people potentially exposed to crude oil in Arauca, Colombia / Condiciones de salud de los indígenas hitnü potencialmente expuestos a petróleo crudo (Arauca, Colombia)

Introduction: The Hitnü indigenous people live in precarious sanitary conditions, with food insecurity and being victims of sociopolitical violence in Arauca, Colombia. In addition, it is possible that they may be affected by exposure to hydrocarbons found in oil. Objective: To identify the health outcomes of morbidity and mortality profiles of the Hitnü people that could be associated with the exposure to crude oil. Materials and methods: A cross-sectional study was carried out with Hitnü indigenous people, during February and March, 2021, time of drought. A household questionnaire was applied, and one individual to collect data from the environment around the house, occupations and other activities, as well as data from sociodemographic, signs, symptoms, and findings of a medical examination. The potential association with hydrocarbons was explored considering three groups: inhabitants in Arauca city, Aspejaná reserve (not exposed), and San José del Lipa and La Vorágine reserves (exposed by the Ele river and tributaries). With free listings, causes of death were explored. The study incorporated a rigorous intercultural management in all its components. Results: A total of 576 indigenous people from 16 settlements participated. The water consumed could serve as means of exposure to hydrocarbons. Health problems were very varied, including infectious and chronic diseases, malnutrition, and trauma. The masses on the neck were associated with residing in the ancestral reserves (PR = 3.86; CI95% 1.77-8.39), territories with potential exposure to crude-oil. The most relevant causes of death were homicide, tumors, and tuberculosis. Conclusion: For its possible association with exposure to hydrocarbons, it is a priority to start the intercultural study of lymphadenopathies in indigenous communities potentially exposed to crude oil.

Introducción. El pueblo hitnü vive en condiciones sanitarias precarias, con inseguridad alimentaria y víctima de la violencia sociopolítica en Arauca (Colombia). Además, se sospecha que pueden estar afectados por la exposición a los hidrocarburos del petróleo. Objetivo. Identificar los eventos de salud del perfil de morbilidad y mortalidad de los indígenas hitnü que podrían asociarse con la exposición a petróleo crudo. Materiales y métodos. Se realizó un estudio transversal con indígenas hitnü, durante febrero y marzo de 2021, época de sequía. Se aplicó un cuestionario de hogares y uno individual para recolectar datos del ambiente peridomiciliario, ocupaciones y otras actividades, así como datos sociodemográficos, signos, síntomas y hallazgos de un examen médico. La potencial asociación con los hidrocarburos se exploró considerando tres grupos, según su localización: cabecera de Arauca, resguardo Aspejená (no expuestos) y resguardos de San José del Lipa y La Vorágine (expuestos por su cercanía al río Ele y afluentes). Con listados libres, se exploraron las causas de muerte. El estudio incorporó un riguroso manejo intercultural en todos sus componentes. Resultados. Participaron 576 indígenas de 16 asentamientos. El agua consumida pudo servir como medio de exposición a los hidrocarburos. Los problemas de salud fueron muy variados e incluían enfermedades infecciosas y crónicas, malnutrición y trauma. Las masas en el cuello se asociaron con residir en los resguardos ancestrales (RP=3,86; IC95% 1,77-8,39), territorios potencialmente expuestos al petróleo. Las causas de muerte más relevantes fueron el homicidio, los tumores y la tuberculosis. Conclusión: Por su posible asociación con los hidrocarburos, es prioritario el estudio intercultural de linfoadenopatías entre indígenas potencialmente expuestos al petróleo.

A Low-Cost Calibration Method for Low-Cost MEMS Accelerometers Based on 3D Printing.

A ubiquitous sensor in embedded systems is the accelerometer, as it enables a range of applications. However, accelerometers experience nonlinearities in their outputs caused by error terms and axes misalignment. These errors are a major concern because, in applications such as navigations systems, they accumulate over time, degrading the position accuracy. Through a calibration procedure, the errors can be modeled and compensated. Many methods have been proposed; however, they require sophisticated equipment available only in laboratories, which makes them complex and expensive. In this article, a simple, practical, and low-cost calibration method is proposed. It uses a 3D printed polyhedron, benefiting from the popularisation and low-cost of 3D printing in the present day. Additionally, each polyhedron could hold as much as 14 sensors, which can be calibrated simultaneously. The method was performed with a low-cost sensor and it significantly reduced the root-mean-square error (RMSE) of the sensor output. The RMSE was compared with the reported in similar proposals, and our method resulted in higher performance. The proposal enables accelerometer calibration at low-cost, and anywhere and anytime, not only by experts in laboratories. Compensating the sensor's inherent errors thus increases the accuracy of its output.

Lightweight Authentication Protocol for M2M Communications of Resource-Constrained Devices in Industrial Internet of Things.

The Industrial Internet of Things (IIoT) consists of sensors, networks, and services to connect and control production systems. Its benefits include supply chain monitoring and machine failure detection. However, it has many vulnerabilities, such as industrial espionage and sabotage. Furthermore, many IIoT devices are resource-constrained, which impedes the use of traditional security services for them. Authentication allows devices to be confident of each other's identity, preventing some security attacks. Many authentication protocols have been proposed for IIoT; however, they have high computing requirements not viable to resource-constrained devices, or they have been found insecure. In this paper, an authentication protocol for resource-constrained IIoT devices is proposed. It is based on the lightweight operations xor, addition, and subtraction, and a hash function. Also, only four messages are exchanged between the principals to authenticate. It has a low execution-time and communication-cost. Its security was successfully assessed with the formal methods Automated Validation of Internet Security Protocols and Applications (AVISPA) tool and Burrows-Abadi-Needham (BAN) logic, together with an informal analysis of its resistance to known attacks. Its performance and security were compared with state-of-the-art protocols, resulting in a good performance for resource-constrained IIoT devices, and higher security similar to computational expensive schemes.

A Case of Acute Pemphigus Vulgaris Relapses Associated with Cocaine Use and Review of the Literature.

Pemphigus is a bullous autoimmune disease that affects the skin and mucous membranes. It is very difficult to establish the etiology and the triggering factors that influence reactivations in pemphigus vulgaris (PV). The case of a 33-year-old male with chronic history of intranasal cocaine consumption is presented in this report. We present the clinical case of the patient, followed for a total of 86 weeks, with ten relapses secondary to probable cocaine use. The patient was admitted to the emergency department after presenting polymorphic dermatosis characterized by blisters, vesicles, and excoriations extending from the oral cavity to the thorax, and to the inguinal and genital regions, affecting approximately 35 % of the body surface area with a score of 56 on the Pemphigus Skin Disorder Index. Skin biopsies were compatible with PV diagnosis. The patient had clinical improvement with a combination of methylprednisolone 500 mg intravenously (IV) and cyclophosphamide 500 mg IV every 15 days, along with prednisone 50 mg orally (PO) q24 h and mycophenolic acid 500 mg PO q6 h. Persistent cocaine use is highly likely to be the factor triggering lesion reactivation and responsible for the torpid evolution. We cannot definitively conclude whether the change from azathioprine to mycophenolic acid after the tenth relapse was the adjuvant medication responsible for the end of the consolidation phase and complete remission on therapy. This case study could potentially serve as a guide for management of patients who continuously persist with cocaine use, leading to a clinical picture refractory to multiple therapeutic schemes.

A Lightweight Cipher Based on Salsa20 for Resource-Constrained IoT Devices.

The Internet of Things (IoT) paradigm envisions a world where everyday things interchange information between each other in a way that allows users to make smarter decisions in a given context. Even though IoT has many advantages, its characteristics make it very vulnerable to security attacks. Ciphers are a security primitive that can prevent some of the attacks; however, the constrained computing and energy resources of IoT devices impede them from implementing current ciphers. This article presents the stream cipher Generador de Bits Pseudo Aleatorios (GBPA) based on Salsa20 cipher, which is part of the eSTREAM project, but designed for resource-constrained IoT devices of Class 0. GBPA has lower program and data memory requirements compared with Salsa20 and lightweight ciphers. These properties allow low-cost resource-constrained IoT devices, 29.5% of the embedded systems in the market, to be able to implement a security service that they are currently incapable of, to preserve the user's data privacy and protect the system from attacks that could damage it. For the evaluation of its output, three statistical test suites were used: NIST Statistical Test Suite (STS), DIEHARD and EACirc, with good results. The GBPA cipher provides security without having a negative impact on the computing resources of IoT devices.

Barbed Suture as a Treatment Approach in Complex Degloving Injuries.

In the late 19th century, French physician Morel-Lavallée was challenged with a group of patients who sustained similar patterns of degloving injuries, which today carry his eponym. In 1853, he reported a series of cases as well as proposed strategies for the management of these complex degloving injuries. Treatment strategies have not varied significantly over the years, and these lesions continue to plague surgeons today with failure rates in excess of 50%. We present 2 case series using barbed suture in the management of these complex injuries.

Wingate Anaerobic Test Percentile Norms in Colombian Healthy Adults.

The Wingate Anaerobic Test (WAnT) became one of the most convenient tests used to evaluate anaerobic capacity and the effectiveness of anaerobic training programs for a variety of power sports. However, its use and interpretation as an evaluative measurement are limited because there are few published reference values derived from large numbers of subjects in nonathletic populations. We present reference values for the WAnT in Colombian healthy adults (aged 20-80 years old). The sample comprised 1,873 subjects (64% men) from Cali, Colombia, who were recruited for the study between 2002 and 2012. The 30-second WAnT was performed on a Monark ergometer. The WAnT resistance was set at 0.075 kp · kg(-1) body mass (BM). The mean absolute peak power (PP), relative PP normalized to the BM, and the fatigue index (FI%) were calculated using the LMS method (L [curve Box-Cox], M [curve median], and S [curve coefficient of variation]) and expressed as tabulated percentiles from 3 to 97 and as smoothed centile curves (P3, P10, P25, P50, P75, P90, P97). Mean ± SD values for the patients' anthropometric data were 38.1 ± 11.7 years of age, 72.7 ± 14.2 kg weight, 1.68 ± 0.09 m height, and 25.6 ± 4.2 body mass index. Our results show that mean absolute PP value, relative PP relative values normalized to BM, and FI were 527.4 ± 131.7 W, 7.6 ± 2.3 W · kg(-1), and 29.0 ± 15.7%, respectively. Men performed better than women in terms of PP and FI values. Nevertheless, the mean PP decreased with age and sex. Age-specific PP and FI normative values among healthy Colombian adults are defined. A more specific set of reference values is useful for clinicians and researchers studying anaerobic capacity in healthy adults.

Actualización del reporte de biopsiapor aspiración con aguja fina de mama / Report of breast fine needle aspiration biopsy: an update

Las recomendaciones para la biopsia por aspiración con aguja fina de mama se desarrollaron y aprobaron en 1997 por el Instituto Nacional de Cáncer en Bethesda, Estados Unidos y fueron adaptadas a nuestro país en 2007, sin embargo, en los últimos años no se han realizado cambios formales en estas indicaciones. El objetivo de este módulo es presentar la actualización del reporte de biopsia por aspiración con aguja fina de mama, usando el sistema de reporte Bethesda, realizado por consenso con un grupo de patólogos, clínicos, radiólogos, cirujanos de mama y otros profesionales de la salud de Colombia y otros países, y con base en la experiencia realizando biopsia por aspiración con aguja fina de mama del Hospital Pablo Tobón Uribe y de Dinámica IPS.

Recommendations for breast fine needle aspiration biopsy were developed and approved in 1997 by The National Cancer Institute of Bethesda, United States, , and were adapted to our country on 2007, however, in last years these indications have not changed in a formal manner. The purpose of this review was to provide an update of the report for breast fine needle aspiration biopsy using the Bethesda system. This guide was made by consensus with pathologists, clinicians, radiologists, breast surgeons and other health professionals of Colombia and other countries. The update was basis on the experience of Hospital Pablo Tobon Uribe and Dinamica IPS in performing breast fine needle aspiration biopsy.

Occupational exposure to air pollutants: particulate matter and respiratory symptoms affecting traffic-police in Bogotá / Exposición ocupacional a contaminantes atmosféricos: material particulado y síntomas respiratorios en policías de tránsito de Bogotá

Objectives Quantifying personal exposure to particles less than 10 micrometres in diameter (PM10) and determining the prevalence of respiratory symptoms in traffic-police officers working in Bogotá's metropolitan area. Methods This was a cross-sectional study of 574 traffic-police officers divided into two groups (477 traffic-police and 97 police working in an office). They were given a questionnaire inquiring about respiratory symptoms, toxicological medical evaluation, lung function tests and personal PM10 monitoring. The differences between groups were found using stratified analysis (i.e. comparing odds ratios). Multivariate analysis of factors related to symptoms and diagnosis of respiratory alteration was also performed. Results Respiratory symptoms concerned a higher prevalence of cough, expectoration and rhinosinusitis in the traffic-police group. Medical examination revealed that the traffic-police group had higher nasal irritation prevalence; lung function tests showed no difference. Mean PM10 levels were higher for the traffic-police group (139.4 μg/m³), compared to the office work group (86.03 μg/m³). Discussion PM10 values in both groups did not exceed allowable limits for respirable particles in the workplace according to ACGIH standards. Traffic-police exposed to air pollution had an increased risk of developing respiratory symptoms and signs, thereby agreeing with the results of this and other studies. Personal monitoring is a valuable tool when quantifying the concentration of PM10to which an individual has been exposed during a normal workday. This study contributes towards further research in to the effects of PM10 in populations at risk.

Objetivos Cuantificar la exposición personal a partículas menores de 10 micras (PM10) y determinar la prevalencia de síntomas respiratorios en policías de tránsito que trabajan en el área metropolitana de Bogotá. Métodos Estudio transversal de 574 policías divididos en dos grupos (477 policías de tránsito y 97 policías de oficina). Se les aplicó cuestionario sobre síntomas respiratorios, evaluación médica toxicológica, pruebas de función pulmonar y monitoreo personal a PM10. Las diferencias entre los grupos se hallaron mediante análisis estratificado y calculo Odds Ratio. Se realizó análisis multivariado de factores relacionados con los síntomas y diagnósticos de alteración respiratoria. Resultados Síntomas respiratorios como tos, expectoración y rinosinusitis tuvieron mayor prevalencia en los policías de tránsito. El examen médico mostró mayor prevalencia de signos de irritación nasal en los policías de tránsito. Pruebas de función pulmonar no mostraron diferencias. Los niveles promedio de PM10 fueron mayores en el grupo de tránsito (139,4 g/m³) comparados con el de oficina (86,03 g/m³). Discusión Los valores de PM10 en ambos grupos no exceden los límites permisibles de partículas respirables en el lugar de trabajo por la ACGIH. Los policías de tránsito expuestos a la contaminación del aire tienen mayor riesgo de desarrollar síntomas y signos respiratorios, como lo muestran este y otros estudios. El monitoreo personal es una herramienta valiosa para cuantificar la concentración de PM10a la cual un individuo está expuesto durante la jornada laboral. Este estudio contribuye a una mayor investigación sobre los efectos de PM10 en las poblaciones en riesgo.

Metástasis pulmonar por coriocarcinoma / Lung metastasis due to choriocarcinoma

Se presenta el caso clínico de una fémina de 29 años de edad, que asistió al Servicio de Neumología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba con falta de aire constante que evolucionó a la insuficiencia respiratoria aguda. Teniendo en cuenta los antecedentes patológicos personales, la clínica, el examen físico y los resultados de los exámenes complementarios efectuados, se corroboró que la paciente presentaba lesiones metastásicas pulmonares como consecuencia de una enfermedad trofoblástica: el coriocarcinoma. Se realizó legrado terapéutico y se indicó tratamiento con citostáticos, luego de lo cual mejoró. Por la rareza del caso se comparten estos hallazgos con la comunidad científica en general.

The case report of a 29 year female is presented who attended the Pneumology Service of "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba with persistent dyspnea which became an acute respiratory failure. Keeping in mind the personal pathological history, the clinic, the physical examination and the results of the made complementary tests, it was corroborated that the patient presented metastatic lung lesions as consequence of a trophoblastic disease: the choriocarcinoma. A therapeutic curettage was carried out and the treatment with cytostatic was indicated, after which she improved. Due to the rareness of the case these findings are shared with the scientific community in general.

Effectiveness of "primary bereavement care" for widows: a cluster randomized controlled trial involving family physicians.

Thirty-one family physicians, from 19 primary care teams in Biscay (Spain), were randomly assigned to intervention or control group. The 75 intervention family physicians, after training in primary bereavement care, saw 43 widows for 7 sessions, from the 4th to 13th month after their loss. The 16 control family physicians, without primary bereavement care training, saw 44 widows for 7 ordinary appointments, with the same schedule. Outcome measures were collected at 4, 10, 16, and 24 months after the loss. A linear mixed model was used. No significant differences were found in favor of the intervention group on grief and indeed control group widows experienced more improvement in somatisation, general health, and general emotional outcomes.

Occupational exposure to air pollutants: particulate matter and respiratory symptoms affecting traffic-police in Bogotá.

OBJECTIVES: Quantifying personal exposure to particles less than 10 micrometres in diameter (PM10) and determining the prevalence of respiratory symptoms in traffic-police officers working in Bogotá's metropolitan area. METHODS: This was a cross-sectional study of 574 traffic-police officers divided into two groups (477 traffic-police and 97 police working in an office). They were given a questionnaire inquiring about respiratory symptoms, toxicological medical evaluation, lung function tests and personal PM10 monitoring. The differences between groups were found using stratified analysis (i.e. comparing odds ratios). Multivariate analysis of factors related to symptoms and diagnosis of respiratory alteration was also performed. RESULTS: Respiratory symptoms concerned a higher prevalence of cough, expectoration and rhinosinusitis in the traffic-police group. Medical examination revealed that the traffic-police group had higher nasal irritation prevalence; lung function tests showed no difference. Mean PM10 levels were higher for the traffic-police group (139.4 µg/m³), compared to the office work group (86.03 µg/m³). DISCUSSION: PM10 values in both groups did not exceed allowable limits for respirable particles in the workplace according to ACGIH standards. Traffic-police exposed to air pollution had an increased risk of developing respiratory symptoms and signs, thereby agreeing with the results of this and other studies. Personal monitoring is a valuable tool when quantifying the concentration of PM10to which an individual has been exposed during a normal workday. This study contributes towards further research in to the effects of PM10 in populations at risk.

Mucormicosis rinocerebral asociada a agranulocitosis más diabetes mellitus: presentación de un caso / Rhinocerebral mucormycosis associated with agranulocytosis and diabetes mellitus: a case report

La mucormicosis es una infección oportunista, poco frecuente y potencialmente letal causada por hongos del orden mucorales. Pueden ser de varias formas: rinocerebral, (que es la más frecuente), pulmonar, cutánea, gastrointestinal, del sistema nervioso central y la miscelánea. Comienza habitualmente en las fosas nasales, senos paranasales o paladar.Caso clínico: paciente de 71 años de edad, de piel blanca, femenina que presentó la forma rinocerebral asociada a agranulocitosis más diabetes mellitus.Conclusiones: en la paciente se observaron lesiones localizadas en las fosas nasales, seno maxilar, etmoidal y órbita. Se demuestra que por su especificidad como método para el diagnóstico, el uso de la tomografía axial computarizada es de gran valor, lo que permite una correcta orientación terapéutica, junto a la debridación quirúrgica amplia de áreas anatómicas afectadas y el uso adecuado del anfotericina b así como el resto de los medicamentos, permitieron una evolución satisfactoria con una recuperación completa en un tiempo corto

Mucormycosis is an opportunist; rare, potentially lethal infection caused by fungi of the order of Mucolares. They may be of several forms: rhinocerebral, (which is the most common), pulmonary, cutaneous, gastrointestinal, central nervous system and miscellaneous. It usually begins in the nasal pits, paranasal sinuses, or palate.Case report: a white skin, female patient of 71 years old, who presented the rhinocerebral form associated with agranulocytosis and diabetes mellitus.Conclusions: the patient showed lesions in the nasal pits, maxillary and ethmoidal sinus, and orbit. It is demonstrated by its specificity as a diagnostic method, the great value of the computerized axial tomography, allowing a proper therapeutic orientation, with the comprehensive surgical procedure of the anatomical areas and the proper use of the amphotericin B as well as the rest of the drugs, enabled a satisfactory evolution with a total recovery in a short time

Changes in eyebrow position and shape with aging.

BACKGROUND: Lack of an objective goal for brow-lift surgery may explain why several articles in the plastic surgery literature conclude that brow lifts produce eyebrows with shape and position that are not aesthetically pleasing. By comparing eyebrow shape and position in both young and mature women, this study provides objective data with which to plan forehead rejuvenating procedures. METHODS: Two cohorts of women aged 20 to 30 years and 50 to 60 years were photographed to determine eyebrow position. Measurements were made from a horizontal plane between the medial canthi to three points at the upper eyebrow margin. Exclusion criteria included prior surgery, plucked eyebrows, and botulinum toxin. RESULTS: The eyebrow in the 20- to 30-year-old group (n = 36) was 15.7, 19.8, and 21.3 mm above the medial canthus, pupil, and lateral canthus, respectively. Lateral brow position was significantly higher than the mid brow (p < 0.05). In the 50- to 60-year-old group (n = 34), the brow was 19.1, 22.4, and 22.4 mm above the medial canthus, pupil, and lateral canthus, respectively. At all three points, the brow was higher in older compared with younger subjects. This difference was significant at the medial and mid brow (p < 0.05). CONCLUSIONS: Unlike other areas of the body where there is descent of soft tissues, there is paradoxical elevation of eyebrows with aging. These findings explain why surgical elevation of the mid and medial brow provides results that are neither youthful nor aesthetically pleasing. Techniques that selectively elevate the lateral brow are more likely to have a rejuvenating effect on the upper third of the female face.

Purse-string closure of scalp defects following tissue expansion: an effective aesthetic alternative.

Primary closure of scalp defects under tension can be complicated by scar widening and alopecia, and large defects usually require the use of local flaps, skin grafts or free flaps. Tissue expansion facilitates the use of local flaps to cover large defects, but multiple expanders and complex flaps with extensive incisions may cause significant scars and alopecia. We describe a purse-string closure of expanded scalp tissue following excision of a large congenital nevus sebaceous. This scalp reconstructive technique minimises iatrogenic scars and uses the predictable forces of scar contracture and skin re-draping to achieve a superior aesthetic result.