No association was found between augmentation mammoplasty exposure and various connective tissue diseases and/or their related features. However, axillary adenopathy and low titre ANA were detected more frequently in the exposed cohort. Women with axillary adenopathy were more likely to have breast capsular contracture and report digital vasospasm post-dating surgery. Given comparable frequencies of higher titre ANA of both cohorts, the finding of elevations of low titre ANA is of dubious clinical significance.
Cluster analysis suggested the existence of a multisystem disorder occurring more commonly in the exposed cohort and characterized by night sweats, lethargy, breast pain, impaired mentation, reflux, paraesthesiae, hand muscle weakness and myalgia. The argument against this being a new disease entity --"silicone-osis"-- however, was its presence, albeit at lower frequency, in the silicone-unexposed cohort. Thus this study did not confirm the existence of a new disease entity "silicone-osis" uniquely and causally associated with silicone exposure. The possible interpretations of these findings are discussed.
No association was found between augmentation mammoplasty exposure and various connective tissue diseases and/or their related features. However, axillary adenopathy and low titre ANA were detected more frequently in the exposed cohort. Women with axillary adenopathy were more likely to have breast capsular contracture and report digital vasospasm post-dating surgery. Given comparable frequencies of higher titre ANA of both cohorts, the finding of elevations of low titre ANA is of dubious clinical significance.
We are attempting to do the job which our legislature mandated for public agencies. The legislature did not mandate the money to allow these agencies to effectively fulfill their responsibilities, nor were provisions made for a coordinating individual or agency to supervise and administer the procedures which were mandated.
Until these deficiencies are corrected, the hospital must assume a much broader role in child abuse. The hospital is the logical agency which can immediately bridge the wide gap now existing in long-term protection and rehabilitation. That hospitals may be willing to step in and perform this function is suggested by the fact that as of June 1, 1971, 18 hospitals formed Child Abuse Committees at the request of the County Medical Society of New York.
If under the present laws of New York state the hospitals are to take on this added burden–and we believe that they should–it is imperative that their work be given support and that recommendations of the hospitals' Child Abuse Committees carry great weight in the deliberations and decisions of the Bureau of Child Welfare and the Family Court.
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