2022 Edition
“The glass ceiling will go away when women help other women break through that ceiling.”
-Indra Nooyi
ABOUT US Here at AMWA UTD, we want to do our very best to inform you of all of the issues relevant to women and healthcare, together and separately. We hope that our monthly newsletter becomes an enlightening source to you all as we learn about the multitudes of important topics and issues that we all need to be aware of.
The Editor’s Take: Spring Break Edition
By: Shraddha Trehan
YAY for Spring Break AMWA! I want to start off by reminding everyone to fill out their officer applications and newsletter committee applications by THIS WEDNESDAY, March 16th, at 11:59 PM!! We are so excited to read all of your responses! Also, DON’T FORGET TO BUY your AMWA Banquet tickets! I can’t wait to celebrate all of you beautiful women!!
I sincerely hope this email is finding you somewhere warm, relaxed, and at peace. Take this time to reset and rejuvenate as we enter the home stretch of the semester. You have worked very hard to be where you are now, and I am sure the lessons (educational and the life-kind) you have learned this semester will see you through to the much-awaited, warm, and happy summer.
This March newsletter brings scary but relevant topics. Ones we must discuss, no matter how heartbreaking they might be. The Health Crisis in Ukraine, the intersection between Artificial Intelligence and Healthcare, the Misdiagnosis of Endometriosis, HIV Awareness, and A Personal Take on Chronic Pain in Young Adults.
Frankly, there is a lot happening right now. I remember when I thought “a lot” was going to be the newest variant of COVID. I remember when I thought “a lot” was COVID. Now, there is a full-on Hot-war happening, in the midst of a pandemic, during one of the worst inflation crises ever seen. When so much is happening outward, it is important to keep peace inward. Please find a way to pray and hope for those in Ukraine and those in Russia and for all of us who live on this miraculous, little blue earth. Much like you, I don’t know what comes next, but we just keep on, keepin’ on.
As usual, please feel free to email me at shraddha.trehan@utdallas.edu about any topic you feel needs to be included in future newsletters.
Until the next one, Shraddha :)
What’s Poppin’: The Ukraine Health Crisis
By: Amulya Bhaskara and Tanya Baiju
On Thursday, March 9, three people were killed in a Russian airstrike in a maternity and children’s hospital in the city of Mariupol (BBC News). The attack caused colossal damages within the building, which further caused many to be trapped in the rubble. “The whole city remains without electricity, water, food, whatever and people are dying because of dehydration” Olena Stokoz of Ukraine’s Red Cross states (BBC News). Essential resources, including medical supplies, are running short and people are succumbing to numerous diseases, apart from the ongoing pandemic.
Marie Connolly, a global health professor at the National University of Ireland Galway, states that “viruses and bacteria are happy to exploit those situations where human beings are put under pressure” (Morris). The risk of an outbreak is significantly higher when a community is dealing with the trauma of losing its home. Last year, Ukraine experienced the world’s highest rate of COVID-19 cases, and it is surrounded by countries that have low vaccination rates. Surges of the pandemic are said to be expected. Connolly also states that the threat of “Ukraine’s polio outbreak” and “resurgence of tuberculosis” is much higher during this conflict.
One of the greatest medical resource shortages in Ukraine is the low medical oxygen supplies. Numerous hospitals have already run out of their oxygen reserves while oxygen generator manufacturers are facing shortages to produce safe medical oxygen. Over the past few years, The World Health Organization has supported Ukraine in making great strides within its healthcare. An example of this is a “rapid scale-up of oxygen therapy capacity for severely ill patients during the COVID-19 pandemic” (WHO). However, this progress is being threatened by the ongoing crisis. In order to remedy the oxygen shortages, the World Health Organization has been working with other countries to move supplies into Ukraine via Poland, one of the NATO-protected countries. Some of the logistics the WHO is currently trying to work through are finding safe and sustainable ways to bring oxygen into the country, given its unique storage requirements. The hope is that these supplies, along with monetary aid from the United States to the tune of $54 million, will help revitalize the healthcare services for citizens still in Ukraine.
For those who are fleeing the country into neighboring states such as Poland, there are opportunities to receive COVID-19 vaccinations and tests. However, the relaxation of quarantine procedures to accommodate the influx of refugees has also placed a strain on pro-Ukraine countries. Alongside governments, there are a number of non-governmental organizations trying to improve the situation in Ukraine. Doctors Without Borders has been providing trauma supplies, training to Ukrainian nurses and doctors, emergency services, and even shelter in targeted cities. A Prague-based nonprofit called People in Need has also been sending supplies to the Eastern border of the country. Despite best efforts, unfortunately, Ukraine’s healthcare system will not have the chance to recover until this assault has ceased.
Artificial Intelligence and Healthcare
By: Tanya Baiju
Artificial Intelligence is a concept that has piqued the interest of people for a long time. From movies like The Terminator and Wall-E, AI has been an expected reality in all realms of life. Medicine is a prime example. This reality may be closer to existence than expected.
Physician-scientists in the Smidt Heart Institute at Cedars-Sinai have recently developed an artificial intelligence tool that can diagnose hypertrophic cardiomyopathy and cardiac amyloidosis. These two heart conditions are considered to be the hardest life-threatening heart diseases to diagnose, as they are often easy to miss since the symptoms of both conditions are similar to one another and that to benign conditions.
Artificial Intelligence has come a long way since the American Association for AI was established in 1980. AI is defined as a field that combines computer science and robust datasets to enable problem-solving (IBM). There are two types of AI - physical and virtual. Physical AI is depicted when devices and robots assist in delivering care. Virtual AI involves deep learning, where algorithms are created through repetition and experience. The AI system developed at Cedars-Sinai utilizes a two-step, novel algorithm that identifies specific features like “the thickness of the hearts walls and the size of the heart chambers” (Cedars-Sinai). This technology could be revolutionary, especially with conditions that are diagnosed way too late.
However, there are still issues with AI that need to be perfected before it’s placed within our everyday life. Some of these issues include the fact that AI reflects the biases in the data it was trained on. Presently, AI algorithms still need to go through a rigorous process with the FDA. AI systems still depend on human intervention. AI also requires training, which includes anyone interfacing with AI. Errors can always occur and to avoid as many as possible, the dataset needs to have “as many cases as possible while using the correct size cohort” (Quest).
Researchers at the Smidt Heart Institute are planning to launch clinical trials for the patients flagged by the AI algorithm for suspected cardiac amyloidosis (Cedars-Sinai). Patients enrolled will be seen by experts in the cardiac amyloidosis program at the Institute (Cedars-Sinai). The future for AI in healthcare is getting closer and includes the possibility to avoid common medical errors that lead to death. As Susan Cheng, MD and a director within the Department of Cardiology at the Smidt Heart Institute and co-senior author of the study state, “These remarkable strides–which span research and clinical care–can make a tremendous impact” in the lives of patients (Cedars-Sinani).
Gender Bias and the Misdiagnosis of Endometriosis
By: Hibah Rasool and Zoe Du
Cramps. Bloating. Bleeding. Periods are generally an unenjoyable perk of being born as a biological female, but for some women, the symptoms are more severe. Endometriosis is a condition characterized by uterine tissue growth outside of the uterus, most commonly in the fallopian tubes and tissues lining the pelvis. While there is no direct correlation between the severity of symptoms and the severity of the condition, endometriosis can be incredibly debilitating with a range of symptoms including dysmenorrhea (painful periods) with abnormally heavy bleeding, dyspareunia (painful intercourse), pelvic and abdominal pain, and gastrointestinal issues.
An estimated 4 million women have been diagnosed with endometriosis in the United States, but alarmingly, an estimated 6 million more cases are undiagnosed. Even worse, the process of receiving a diagnosis is often an arduous journey, lasting on average 4-11 years. So how has the medical system failed women so horribly?
Part of the blame falls on endometriosis itself. Many women are completely unaware that they may have endometriosis because they experience no symptoms at all. Endometriosis is a complex condition with many overlapping symptoms; the most common symptoms include pain during menstruation and/or sex and infertility, which can accompany many conditions. Due to lesions and scarring caused by this chronic condition, the pain may not only occur during menstruation but can even occur daily. Endometriosis can also cause non-gynecologic symptoms as varied as chronic shoulder pain, diarrhea, brain fog, nerve pain, depression, and even shortness of breath. The variation of symptoms and the effects on multiple organs often results in many women being referred to several specialists and receiving incorrect diagnoses. Furthermore, endometriosis can only be diagnosed through laparoscopic procedures, and many patients and physicians are not keen on directly jumping to an invasive procedure for a possible diagnosis.
However, the process is also significantly exacerbated by the persistence of gender bias in medicine. As mentioned earlier, pain is a common symptom of endometriosis, but as many of us have probably experienced, this pain is either expected as periods tend to be painful to some degree, or downplayed by societal and cultural expectations. As a result, the debilitating pain is often brushed off as “normal” or “a bad period”. Too often, women presenting with pain are perceived as “emotional” and their pain as imaginary. Studies have shown that women are less likely to feel heard by their providers, and pain experienced by women is often assumed to be psychological in the absence of obvious physical presentation of illness. The dismissal by the same people who are supposed to provide treatment can be incredibly demoralizing and invalidating.
Another challenge is the limited information we have about endometriosis. A large reason for this knowledge gap is gender bias in research. Women have historically been excluded from studies because of “hormones” and there simply has not been enough research done to understand endometriosis. Despite the prevalence of this chronic condition and the effect it has on an individual’s quality of life, the cause of endometriosis remains a mystery. The immense gap in research and understanding of women's health-related issues, such as endometriosis can be linked to only a few decades ago when women were excluded from medical research. It was argued that due to hormonal changes, women's bodies were more complex. Following 1993, the NIH began to require medical research to include women. Due to this, there has been a significant lack of research into endometriosis.
Despite the growth of medicine in the past century, there is much more progress to be made when it comes to equity. As women with aspirations in medicine, it is so important for us to be compassionate and change the narrative in medicine. We have the power to provide care to patients who have been left behind by medicine.
National Women and Girls HIV/AIDS Awareness Day
By: Hibah Rasool
In 2020, 1 in 5 of every new HIV diagnosis was a woman. That means women made up 18% of all new HIV diagnoses. HIV infects CD4 white blood cells, then copies itself releasing more HIV into the blood. It weakens the immune system making an infected individual susceptible to other infections and viruses. If left untreated this virus develops into AIDS. I want to shed light on the impact of HIV on women and the very concerning inequities.
HIV can result in other health concerns that are unique to women. Women with HIV may experience health problems such as:
Heart Disease: Among those living with HIV, this is the leading cause of death. This is especially more concerning for HIV-infected women, who are three times more likely to have a heart attack compared to women without HIV.
Pelvic Inflammatory Disease: PID is more common and harder to treat in women living with HIV.
Nevirapine and Ritonavir side effects: According to studies, there is a link between these medications and rashes, liver problems, and nausea for women.
Cervical Cancer: HPV is more common in women with HIV, so frequent pap tests are extremely important to ensure changing cervical cells are found.
Inconsistent Menstrual Cycle: Many women may experience heavy bleeding, and missed periods.
Vaginal Yeast Infections and Bacterial Vaginosis: These conditions are harder to treat and can become a recurring issue.
The high levels of HIV-infected CD4 cells can also result in depression, early menopause, osteoporosis, a higher risk for pancreas problems, and much more. The distinctive factors affecting women are currently still undergoing research.
Preventative care is the most important step in working towards ending the HIV epidemic. PrEP is a highly effective preventative for HIV caused by sex and injection drug use. Despite being widely available, there is a massive disproportion in how often it is prescribed to females and males. In 2019 only 10% of the women who could benefit were prescribed this preventative. This lag is extremely problematic. In addition, there are many racial disparities in the use of PrEP as well as HIV care. There has been improvement within the past years, but the disproportionate HIV infection of women of color still remains. For example, as of 2020 Hispanic women represented 9% of the U.S. population, but were 17% of the new HIV diagnoses among females. Raising awareness towards these issues is essential to the improvement of quality preventative care, treatment, and lessening of the spread of this epidemic.
18 Going on 80: Chronic Pain in Young Adults
By: Zoe Du
When we hear arthritis or joint pain, many of us probably think of an elderly individual, perhaps a bit hunched over and creaky - like Carl from Up. You would not be wrong either. Chronic joint pain conditions do overwhelmingly affect older populations, with nearly half (49.6%) of people over 65 reporting doctor-diagnosed arthritis. However, chronic pain affects and can be debilitating to people of all ages, a fact that can unintentionally be overlooked due to the perception of young adults as fit and healthy.
This perception certainly impacted my own experience with chronic pain. Throughout middle school, I was on the track and cross country teams; I was always active and moving. However, when I started high school, I began experiencing joint pain that I initially just dismissed as growing pains; I thought to myself that I was young and healthy - it would go away on its own. Except it never did. The next three years consisted of being told that the pain was nothing to worry about or that I was exaggerating. Finally, I found out that I had scoliosis and joint hypermobility syndrome (a condition in which flexible joints cause pain).
I am fortunate that my pain, while inconvenient and certainly nonideal, does not usually prevent me from going about my everyday life, but my experience helped me realize the harm of misconceptions we have, even stereotypes that may seem positive. I repeatedly came across the perception that young people should not have health issues, yet several of my friends and I have creaky joints. Our knees crack when we sit down, our hips sometimes pop when we shift in our seats, and my joints hurt before cold fronts or rainy weather. In fact, a review of 43 studies with a combined 97,437 respondents between the ages of 15-34 found the prevalence rate of chronic pain in young adults to be 11.6%. That’s more than 1 in 9 young adults worldwide. Chronic pain in young adults is fairly common, and it serves as a reminder for us all to examine our biases and also do not discount any health concerns, even if it does not fit the norm.
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