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Women’s Health

Women’s Health Heroes

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FRIDAY, May 28th, was the International Day of Action for Women’s Health, with a call to all to stand up for women’s health rights – especially sexual and reproductive rights, which are an inalienable part of women’s human rights. The day was recognized and celebrated with multiple hashtags, including #WomensHealthMatters, as COVID-19 exposed and exacerbated longstanding problems around the world with women’s access to medical care and the right to good health.

It is not just a women’s struggle, however – the call is that advocates and allies begin and continue to mobilize to advance the well-being and well-being of women. Among those standing up for the cause are our own local men who practice medicine and other specialties who care deeply about and for women, some of whose stories we share this week.

When we invited men to attend this event, we realized that, through their daily duties, they have their own responsibility to protect the health of women.

Whether they are treating issues that affect fertility, childbearing potential, general health, or mental health of women, or doing a craft that is passionate about women’s health, they underscore that unwavering passion in our feature issue with their work and for women and families.

Dr. Daryl Anthony Daley, JP

Consultant to OBGYN at Gynae Associates Ltd / 3D Gynecology Ltd; Senior Registrar in the Obstetrics and Gynecology Department at May Pen Hospital; ACOG Vice Chairman of the West Indian Section; Employee of the Laser Vaginal Rejuvenation Institute of America

Job description:

At May Pen Hospital, I look after patients at the highest level in the high-risk pregnancy clinics, gynecological clinics, operating rooms, and gynecological and maternity wards. I also help teach interns and medical students. With the experience gained in the public sector, I am better equipped in the private practice to treat all obstetric and gynecological underlying diseases, to offer all women an international standard and, if necessary, to refer to other subspecialties.

Why did you fall in love with your job?

My father is an OBGYN. I grew up with his passion and enthusiasm for the field. He mastered his job effortlessly – made everything look simple and always did it with a smile. I told myself if this makes him smile all the time, I definitely want a piece of his happiness. So I knew very early on that it would only be obstetrics and gynecology.

What do you think is the most valuable contribution of your field to Jamaican women?

I would say the treatment of uterine fibroids. Jamaica and the Afro-Caribbean have high incidences of fibroids. They can cause heavy, prolonged periods that lead to anemia and can be linked to infertility. Our medical and surgical intervention annually helps thousands of women in Jamaica who suffer from it.

What makes it important for you to focus on women’s health?

Women are the be-all and end-all of humanity. Your role at home and in the office is secondary. I find most women are very open to their OBGYNEN about many events in their lives. Most recently, in the last five years, I’ve learned to understand women much better. As a woman’s doctor, it is important to promote suitable health and screening tools in patients so that not only the early detection of certain diseases (breast and cervical cancer, STI [sexually transmitted diseases]) but to ensure a long life. For me, there is great joy and fulfillment in making sure women are safe in every aspect of their reproductive and non-reproductive lives.

What makes your field particularly dynamic and interesting?

I have a great love for gynecology and aesthetics. I received formal training in cosmetic gynecology in Los Angeles from the “Godfather of Cosmetic Gynecology and Cosmetic Surgeon of the Stars” – Dr. I also perform non-surgical rejuvenation techniques of the female genital structures using PRP (platelet rich plasma), the HIFU (high intensity focused ultrasound) device and the fractionated C02 laser. These treatments can be very beneficial for stress incontinence, recurrent infections, increased lubrication and sensitivity, increased libido, and increased orgasms.

If you had any advice for Jamaican women, what would it be?

Visit your OBGYN once a year for a healthy female visit. Most women go to their OBGYN when there is a problem. It is important that you visit your OBGYN annually for an in-depth exam, Pap smear if necessary, STI screening, and contraception counseling. Any other problems you may have can also be discussed.

What’s an interesting thing that your patients probably didn’t know about you?

I love to travel and to network. People are always amazed when they hear about my job abroad and are always interested in getting to know me.

If you could trade that job for something, what would it be?

I always say if it wasn’t OBGYN, it would be a job in the music industry – most likely an A&R and talent advancement. My passion is OBGYN, but my love is music. I can’t operate or treat patients without music playing in the background.

Dr. Curtis Alphonso Pryce

Consultant pediatrician

Senior Pediatrician, May Pen Hospital; Lecturer, University Hospital of the West Indies (UHWI); Lecturer, Windsor School of Medicine, Caribbean School of Medical Sciences, and All American Institute of Medical Studies.

Job description:

I am a trained specialist in pediatric and adolescent medicine. I work in primary and secondary care, so I can see a broad overview of pediatric issues in the community in which I work. Hence, I am able to take a balanced approach to treatment strategies. From this perspective, I deal with young girls, young girls, young women and of course their mothers on a daily basis.

I treat medical issues related to women on a daily basis, ranging from physical problems, including physical and sexual abuse, to emotional abuse, neglect, and anxiety. I also deal with women’s health care issues, which include vaccination for cervical cancer prevention, family planning, focusing on a biblical approach to stable family life, promoting sexual purity and withholding sexual exposure to a spouse for life, as well as early intervention in Regarding advice on sexual activity.

Why did you fall in love with your job?

I am very fond of paediatrics. Children are happy, hopeful, malleable, giving, and grateful. It is the area in medicine where you can get the most impact before chronic, permanent physical and psycho-emotional problems emerge in adulthood. Children sincerely say thank you, they say what they say from the heart. If you do your best, they’ll return the favor with answers like “You’re the best doctor ever” or “I love you, Dr. Pryce!”

What do you think is the most valuable contribution of your field to Jamaican women?

Pediatricians interact with children from birth and beyond. We have contributed to women’s health through early interventions related to vaccination and improving the quality of life of women in society. This is done by managing and promoting the HPV. illustrated [human papillomavirus] Vaccine that helped greatly reduce cervical cancer in Jamaica. We are able to discuss the benefits of this vaccine with parents and their teenagers prior to coitus.

We also play an important role in monitoring issues that affect women and girls in society. Spikes in sexual abuse cases are usually picked up and highlighted by pediatricians and presented to the various stakeholders so that appropriate action can be taken. We play a huge role in counseling, guiding, and encouraging young girls to make choices that will give them a better chance of living happier and safer lives. We are committed to career counseling and promotion.

What makes it important for you to focus on women’s health?

Women play a major role in the stability of a society and especially of Jamaica, where women play a major role in our predominantly matriarchal structure. In most households in Jamaica, and especially households of lower socioeconomic status, women are the leaders. If we can make women’s lives more stable and meaningful, we will definitely be able to make a big difference in society as a whole.

If you had any advice for Jamaican women, what would it be?

Be brave.

Be strong.

Be independent while dependent on one another.

Be the strong, godly, resilient person you were made to be.

Love your spouse.

Love your children

Love yourself, but most importantly, love God and rely completely on your strength.

What’s an interesting thing that your patients probably didn’t know about you?

That I never started seeing a child without first praying for them.

If you could trade that job for something, what would it be?

Nothing. I was led to this job by divine guidance and would not trade it for price or penny.

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Women’s Health

First, do no harm? Medicine’s unbelievable, sometimes horrific treatment of women

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Hippocrates, the founder of modern medicine, believed that women were controlled by their uterus. The father of modern gynecology, James Marion Sims, experimented with enslaved black women without anesthesia in the mid-19th century and believed they felt less pain than white women. (His statue stood in New York’s Central Park for more than a century before it was removed in 2018.) Doctors claimed that women’s suffrage would harm the fragile bodies and diminished minds of women. Such examples cast a hideous shadow on “first, do no harm”.

The history of medicine is as social and cultural as it is scientific, and male dominance is firmly anchored in its foundations. But even the author Elinor Cleghorn, who last year dealt with the history of women’s relationships with medicine, was surprised “how deliberate and insidious it was,” she says. “Biological theories about female bodies have been used to strengthen and perpetuate restrictive societal ideas about women.”

Doctors could tell me what was happening in my body, but they couldn’t tell why I got systemic lupus or why I am more prone to it as a woman

Cleghorn’s new book, Unwell Women, enumerates a litany of ways in which women’s minds and bodies have been misunderstood and misdiagnosed throughout history. From the wandering uterus of ancient Greece (the idea that a displaced uterus caused a lot of women’s diseases) and the witch trials of medieval Europe, to the onset of hysteria to modern myths about menstruation, she lays out the incredible and sometimes terrible treatment of women for millennia in the name of medicine.

A former Oxford researcher with a background in feminist culture and history, Cleghorn meticulously constructs an often terrifying framework to show how and why the patriarchal medical world is so harmful to women, especially underserved women and women of color. And Unwell Women shows how the legacy of disenfranchisement and discrimination continues today, resulting in women being underrepresented in medical studies, women’s pain being psychological or emotional, and an inadequate, sometimes hostile system that women tend to be Offers antidepressants and sedatives as a referral for further diagnosis and more targeted care.

Cleghorn was inspired to write the book after years of being discharged from doctors before she was finally diagnosed with systemic lupus, a difficult-to-diagnose disease that is nine times more common in women than men. (Pop star Selena Gomez has spoken openly about her struggles with the complex, incurable disease.)

“I was trying to understand why none of my doctors could really explain much about it. They could tell me what was happening in my body, but they couldn’t tell why I got it or why I am more prone to it as a woman. I started digging through the history of medicine and finding women who really felt like me in case studies. ”(Cleghorn began writing the book during the lockdown, relying on online medical archives and the extensive ones Wellcome Library digital collections. “Fortunately for me, the men who wrote about women’s bodies love to write a lot about them,” she chuckles.)

There is a quiet radicalism in using women’s knowledge of themselves to transform the culture of medical inequality

These “related women” brought Cleghorn to learn about other chronic, incurable diseases that affect more women than men. One of these diseases is endometriosis, which affects an estimated one in ten women worldwide and whose diagnosis takes an average of seven to nine years. Although it was named in the 1920s, all of its diagnostic secrets remain to this day, notes Cleghorn. “Endometriosis was described by a doctor in the 1920s as the enigma of etiology, and we still don’t know what causes it. Tracking this lack of progress over 100 years has been a real example of how little progress we have made. I wanted to go back and find out why these conditions are still surrounded by so many question marks and where these gaps, injustices and discrimination actually come from. “

Today’s booming wellness industry, which, according to Cleghorn, benefits most from women and whose popularity is related to the prevalence of such confusing diseases, has fallen into the breach. “The industry knows that women with these health problems are being let down by traditional medicine, so it adapts to being caring, listening, and seeing you as an individual. A lot of language in the wellness industry strikes me as frightening the 19th century with its conditions and syndromes. “

Throughout the book, Cleghorn highlights the increasing effects of race, access, and privilege on gender. “In the UK, we have faced our health failures in black, Asian and ethnically diverse women, who have far greater health disparities than white women, especially in reproductive health,” she notes. But she is dismayed by the “very reassuring” response from the British government. “It’s annoying and shocking that there is no more money, strategy, funding, research, and urgent prioritization of issues like the maternal mortality of black women.”

It is probably the first time in history that women’s subjective experiences and voices are used. This is an important start because women are not a monolith

Parallel to this story of frustrations and injustices, there is an empowering alternate story of resistance and beneficial contributions from women. She quotes the pioneering American doctor Mary Putnam Jacobi, who in the 1870s denied the idea that women need rest during menstruation. “At that time, men doctors only used anecdotes and guesses, but Putnam Jacobi used the subjective knowledge of women to conclusively refute them. There is a quiet radicalism in using women’s knowledge of themselves to change the culture of medical inequality. “

Cleghorn relies on this with a final chapter entitled Believe Us. For a long time women were considered to be unreliable narrators of their own bodies. Although modern medicine today enables women to educate themselves about their bodies (a luxury that has been banned for centuries) and offers women the opportunity to enter the medical community, Cleghorn believes that understanding women’s health continues to be a problem remains.

But getting started with a solution is easy, she says. “It’s really important to prioritize women’s voices. I don’t think all of this is a grand patriarchal conspiracy – implicit, unconscious bias is so ingrained, even in the very establishment of doctor-patient interaction. When I have the opportunity to speak freely without feeling rushed or judged, I feel better cared for. “

The UK government’s recent women’s health strategy, in which they seek evidence from women about their treatment by the health system, is groundbreaking, she notes. “It is probably the first time in history that the subjective experiences and voices of women are used. This is an important start because women are not a monolith. “

Cleghorn hopes her book will help anyone who has had a difficult or painful health experience “feel validated and valued because it can be so isolating, so demoralizing, and dehumanizing. But having a disease also makes sense insofar as you are part of that production of very important knowledge. I hope readers can relate to this story, which we hope we can change now. ”- Wächter

Unwell Women, by Elinor Cleghorn, is published by Weidenfeld & Nicolson

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Women’s Health

Plant-based diet appears to offer protection against hypertension and preeclampsia

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A plant-based diet appears to offer significant protection for rats bred to become hypertensive on a high-salt diet, scientists report. If the rats become pregnant, the whole grain diet also protects the mothers and their offspring from fatal preeclampsia.

While we’ve all heard about avoiding the salt shaker, an estimated 30-50% of us have significant increases in blood pressure in response to high salt intake, percentages even higher and more effective in blacks.

The two new studies provide further evidence that the gut microbiota, which contains trillions of microorganisms that help us digest food and play a key role in regulating the response of our immune system, also plays a role in the unhealthy response to salt, so the researchers from The Medical College of Georgia and the Medical College of Wisconsin report in the journals ACTA PHYSIOLOGICA and Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health.

The results provide further evidence of the “potential power” of nutritional interventions in improving gut microbiota and, consequently, our long-term health, says Dr. David L. Mattson, chairman of the MCG Department of Physiology, Georgia Research Alliance Eminent Scholar in Hypertension and senior author of the two studies.

They result from the unexpected observation that the protection works even on a well-established model of salt-sensitive hypertension: the salt-sensitive dahl rat.

As the name suggests, these rodents are bred to develop high blood pressure and progressive kidney disease on a high-salt diet. In 2001, the Medical College of Wisconsin shared its colony of Dahl SS rats fed a milk-based protein diet with Charles Rivers Laboratories. When the rats arrived at Charles River Laboratories, based in Wilmington, Massachusetts, they were switched to a grain-based diet. Both diets are relatively low in sodium, although the protein or casein-based diets actually contain a little less salt.

It was soon discovered that when high salt content was added to their food, the relocated rodents developed significantly less hypertension and associated kidney damage than the rat colonies remaining in Wisconsin.

People ordered them and used them with the idea that they would study hypertension and they developed next to none. “

Dr. David L. Mattson, chairman, MCG Department of Physiology

More than a decade of research has documented these differences, write Mattson and his colleagues at MCG and MCW, and have now shown that developing salt-sensitive hypertension is not just about sodium consumption.

“The animal protein enhanced the effects of the salt,” says Mattson, a long-time hypertension researcher who, along with Dr. Justine M. Abais-Battad, Physiologist and Postdoc Dr. John Henry Dasinger, joined MCG from Wisconsin two summers ago.

“Because the gut microbiota is implicated in chronic diseases such as high blood pressure, we have assumed that dietary changes shift the microbiota to mediate the development of salt-sensitive hypertension and kidney disease,” they write in the journal ACTA PHYSIOLOGICA.

The intestinal microbiome is supposed to metabolize and break down what we eat and transform it into a form that gives us nourishment, says first author Abais-Battad, and conversely, it reflects what we eat.

When they looked at the microbiomes in the rats, “Of course they were different,” she says.

They sequenced the genetic material from both rat colonies and found they were “virtually identical”, but their response to a high-salt diet was far from, Mattson says.

As expected at the time, the Wisconsin rats developed kidney damage and inflammation – both indicators of high blood pressure – but on the same high-salt diet, the Charles River rats experienced significantly less of these unhealthy results. The marked differences they saw in their microbiota reflected the difference in the incidence and severity of the disease.

When given the protected rats some of the signature gut microbiota of Wisconsin rats via a stool transplant, the rats experienced spikes in blood pressure, kidney damage, and the number of immune cells that migrate to the kidneys, organs that play a big role in regulating blood pressure by regulating blood pressure Fluid balance, in part by determining sodium retention. It also changed the makeup of their microbiota.

But when they shared the protected rats’ microbiota with the Wisconsin rats, it didn’t have much of an impact, possibly because the new microorganisms couldn’t thrive in the face of the animal protein diet, the scientists say.

Preeclampsia is a potentially fatal problem during pregnancy in which the mother’s blood pressure, which was previously normally normal, increases and organs such as the kidneys and liver show signs of damage. There is evidence that even on a low-salt diet, Dahl salt-sensitive rats tend to develop preeclampsia.

To study the effects of diet in this scenario, the Dahl SS rats were kept on their respective plant or animal protein diets, which in turn are each relatively low in salt, and both groups had three separate pregnancies and births.

Whole-grain diet rats were protected from preeclampsia, while about half of the rats dieted on animal cheese developed this significant pregnancy complication, says Dasinger, lead author of the preeclampsia study. They experienced a significant increase in the amount of protein secreted in their urine, an indicator of kidney problems that worsened with each pregnancy; increased inflammation, a driver of high blood pressure; increased pressure in the renal artery; and showed significant signs of kidney destruction when organs were examined at follow-up. They died from problems like stroke, kidney disease, and other cardiovascular problems.

“This means that it is helpful during pregnancy, but also for their long-term health and can protect their children, if mom is careful what she eats during pregnancy,” says Dasinger. The scientists note that this reinforces the message that doctors and scientists have been sending expectant mothers for decades.

They plan to study more directly the effects of diet on the offspring and see if the protection is passed on to the babies through breast milk, Dasinger says. Since they know that the function of immune cells is influenced by diet, they also want to take a closer look at the function of the emerging immune cells and already have some evidence that T cells, drivers of the immune response, are a factor in the development of preeclampsia.

The work that Abais-Battad, Dasinger, and Mattson have already done shows that a major difference between the various diets is that the protein-based diet leads to the production of more pro-inflammatory molecules, while the plant-based diet actually appears to suppress these factors .

They also study the impact of diet on the renin-angiotensin system, which helps regulate blood pressure. You also want to better dissect the blood pressure increasing bacteria and the factors they produce.

High blood pressure is the largest modifiable risk factor for developing cardiovascular disease and according to the latest guidelines from groups like the American Heart Association that say a systolic or peak of 120+ is elevated and peaks of 130-139 high blood pressure in the first Stage, almost half of us are hypertensive. Diet – including a high-salt diet – is one of the most important modifiable risk factors for high blood pressure and cardiovascular disease, according to scientists. It has been found that people and animals with hypertension alike have an imbalanced, less diverse gut microbiota than people with normal blood pressure.

Source:

Medical College of Georgia at Augusta University

Journal references:

  • Dasinger, JH et al. (2021) The dietary protein source contributes to the risk of developing maternal syndrome in the salt-sensitive Dahl rat. Pregnancy hypertension. doi.org/10.1016/j.preghy.2021.04.002.
  • Abais-Battad, JM, et al. (2021) Dietary influences on the gut microbiota of the Dahl SS rat and its effects on salt-sensitive hypertension and kidney damage. ACTA PHYSIOLOGICS. doi.org/10.1111/apha.13662.
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Women’s Health

Mississipi’s People Should Choose its Abortion Laws

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By
Lynn Fitch

June 14, 2021 6:27 p.m. ET

A clinic escort at a women’s clinic in Jackson, Miss., May 20.


Photo:

Rogelio V. Solis / Associated Press

Jackson, miss.

When the Supreme Court hears from the parties in the Dobbs v Jackson Women’s Health Organization case in its next term, the arguments will concern the constitutionality of an abortion law in Mississippi that protects life after 15 weeks of gestation. At stake is the right of the people to speak up through their elected leaders on the protection of the endangered life and health of women.

The Supreme Court recognized a right to an abortion in 1973 and the court made it clear that this right is not absolute. But that’s not the end of the story. The people act for legitimate interests through their elected lawmakers who pass laws and their elected governors who sign them. The elected officials protect women’s health by making sure women have the information to make informed decisions and receive adequate medical care. They protect the sanctity of life by, for example, banning abortion simply because of the disability of a baby.

States also enact laws to protect the environment and consumers; support religious expression, free speech and the right to bear arms; promote access to education and health care; to define criminal offenses and set criminal penalties and much more. In any case, the legislature must carefully weigh the competing and legitimate interests of the people it represents. The elected executive, which is also accountable to the people, ensures that the interests of the people are enforced and controls the law by either signing the law or exercising its veto.

According to the wisdom of the Founding Fathers, the Supreme Court was given the task of providing guideposts to the legislative bodies to help them safeguard legitimate interests without violating fundamental constitutional rights.

When it comes to regulating abortion, the nearly 50-year history of the jurisdiction since Roe does not provide a clear guide. Rules based on the viability of the unborn child are fluid. It has long been considered impossible to have a baby outside the uterus before 28. Now we read more and more about babies born at 21 weeks of age who survive and go home to celebrate their first Christmas with their families.

The rapid progress in medical technology has made the measure of economic efficiency increasingly unstable. If we know anything about the advancement of science, medicine will not retreat; it will continue to move forward. All the more important is the question before the Supreme Court in Dobbs: Can the people through their state legislation impose restrictions on abortion – restrictions that protect the legitimate interests of the state – against this uncertain and crumbling line called viability?

As the Mississippi attorney general, it is my duty to defend the laws of my state, and I enjoy doing that here. We are simply asking the court to reaffirm citizens’ right to the protection of their legitimate interests and to clarify how they can do so.

Ms. Fitch is the Mississippi Attorney General.

Copyright © 2020 Dow Jones & Company, Inc. All rights reserved. 87990cbe856818d5eddac44c7b1cdeb8

Appeared in the print edition of June 15, 2021 as “Abortion and the People”.

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