Breast Implant Illness: where are we and where are we going?

ABSTRACT Despite more than 60 years of history, numerous studies and large population samples, in recent years, several patients have returned to the plastic surgeons office. They have doubts about the silicone, some due to the recent reports of BIA-ALCL, but the vast majority due to the possibility of systemic symptoms related to the implants and which arouse the desire for its removal. Procedure known as explant. This phenomenon, whose doubts are numerous and the responses are minimal, is known in the world literature as Breast Implant Illness (BII). On the Internet and social networks, hundreds of signs and symptoms have been related to silicone implants, usually nonspecific. The most common symptoms reported by patients are chronic fatigue, arthralgia, mental confusion, myalgia, memory loss, difficulty concentrating and dry eyes. So far, there are no diagnostic tests for BII, no method based on scientific evidence to differentiate it from other conditions, and there is very little knowledge about its onset, course, risk factors, causes and proper management. The option for removing the implants has been growing dramatically in recent years, being one of the ten most performed surgeries in the United States last year. The literature shows variable improvement rates after the explantation and the patients are, as a rule, satisfied with their aesthetic result and have lower levels of anxiety and stress after the procedure. Prospective, well-designed randomized studies correlating different periods are necessary, from the preoperative period of the implant until after the explantation

OS DIREITOS URBANÍSTICOS DE JORDI BORJA: OS DESAFIOS DO URBANISMO DEMOCRÁTICO E DESENVOLVIMENTO HUMANO

O urbanismo é tema de ampla discussão no meio acadêmico e nas arenas de conflitos sociais justamente por ser nas cidades que vive a maior parte das pessoas, sendo nesses locais que se desenvolve a vida desses indivíduos que compartilham esse habitat urbano. Esse modo de vida nas cidades traz consigo uma série de desafios que necessitam ser enfrentados pelos gestores políticos, tais como o déficit habitacional, a gentrificação, a formação de guetos e favelas, a segregação social e o afastamento dos cidadãos das discussões públicas e das tomadas de decisão que digam respeito à sua cidade. Surge desse contexto de crise do meio urbano o seguinte questionamento: a promoção de políticas públicas, pelo ente local, pode alterar o arranjo organizacional da cidade de modo a reduzir as desigualdades e promover o desenvolvimento humano? A fim de responder a esse questionamento se buscou, através da análise dedutiva, do método monográfico e da técnica de pesquisa bibliográfica das obras de Jordi Borja, Amartya Sen, dentre outros, demonstrar que a adoção de políticas públicas tais como as de participação política cidadã, utilização compulsória de imóveis subutilizados e, principalmente, do aluguel social, são capazes de mitigar os efeitos nocivos originados pela crise do urbanismo, bem como promover o desenvolvimento humano, combatendo as injustiças sociais disseminadas na sociedade

Breast silicone explant: a multicenter longitudinal study

Introduction: Following silicone breast implant placement, some patients present symptoms described as breast implant illness and seek explant surgery. This study aims to analyze the historical symptoms and ascertain breast explant patients’ impressions at three different times: before breast implant placement while having the implants, and after the explant surgery. Methods: This survey was designed as a multicenter longitudinal observational study using an online voluntary participation questionnaire sent by e-mail. Results: 156 patients were analyzed, 84% had three or more symptoms, and 66.1% improved their symptoms after the explant (p<0.001). Before the placement of silicone, the median self-body satisfaction was 7, while with the implants, the median became 9, and after the explant surgery, the median remained up to 9 (p<0.001). Support groups on social networks helped in the decision to explant in 87.2% of the patients. Conclusion: Patients presenting symptoms after silicone placement show improvement with breast implant removal. Body self-satisfaction increases with the placement of breast implants and remains increased after their removal. Patients who undergo the explant surgery usually regret having implanted silicone; they are very satisfied with the decision to remove them and equally satisfied with the result of the breast explant surgery. Support groups on social networks were important in the decision-making of these patients