TEDxProvidence
Alyson McGregor: Why medicine often has dangerous side effects for women
Alyson McGregor: Miks põhjustavad ravimid naistel tihti ohtlikke kõrvalnähte?
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1,594,282 views
Enamikku eelmisel sajandil heakskiidetud ja müügile lastud ravimeid on testitud ainult meessoost patsientidel, mis toob kaasa võimaliku vale-annustamise ja ootamatud negatiivsed kõrvalnähud naistel. Kliinilistes uuringutes on alles hiljuti hakatud arvestama oluliste füsioloogiliste erinevustega meeste ja naiste vahel. Erakorralise meditsiini arst dr Alyson McGregor neid erinevusi uuribki. Oma silmiavavas kõnes suunab ta meie tähelepanu sellele, kuidas meessoost katsealuste eelistamine on klinilistes uuringutes on mõjutanud ravimite toime ootamatuid kõrvalnähte naistel ja kuidas parem arusaamine meeste ja naiste erinevustest võimaldaks rakendada kõigi jaoks efektiivsemad ravimeetodeid.
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Alyson McGregor - Women's health pioneer
Alyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men. Full bio
Alyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men. Full bio
Double-click the English transcript below to play the video.
00:12
We all go to doctors.
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Me kõik käime arsti juures.
Usaldame oma arsti selles,
00:16
And we do so with trust and blind faith
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00:21
that the test they are ordering
and the medications they're prescribing
and the medications they're prescribing
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et analüüsid, mis määratakse
ja ravimid, mis välja kirjutatakse
ja ravimid, mis välja kirjutatakse
00:25
are based upon evidence --
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on vajalikud ja tõendatud toimega.
00:28
evidence that's designed to help us.
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Et on tõendatud, et nendest on abi.
00:32
However, the reality is that that hasn't
always been the case for everyone.
always been the case for everyone.
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Tegelikkuses aga ei
pruugi see alati nii olla.
pruugi see alati nii olla.
00:39
What if I told you
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Mis oleks, kui ütleksin,
00:40
that the medical science discovered
over the past century
over the past century
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et meditsiinis viimase sajandi
jooksul tehtud avastused
jooksul tehtud avastused
00:44
has been based on only
half the population?
half the population?
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põhinevad vaid poolte inimeste andmetel?
00:48
I'm an emergency medicine doctor.
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Ma olen kiirabiarst.
00:50
I was trained to be prepared
in a medical emergency.
in a medical emergency.
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Olen õppinud tegelema
erakorraliste haigetega.
erakorraliste haigetega.
00:54
It's about saving lives. How cool is that?
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See on ju elupäästmine, väga lahe töö!
01:00
OK, there's a lot of runny noses
and stubbed toes,
and stubbed toes,
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Ette tuleb ka palju nohuseid
ninasid ja äralöödud varbaid,
ninasid ja äralöödud varbaid,
01:03
but no matter who walks
through the door to the ER,
through the door to the ER,
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aga hoolimata sellest, kes EMOsse satub,
01:07
we order the same tests,
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teeme talle ikka samad analüüsid,
01:09
we prescribe the same medication,
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määrame samad ravimid,
01:11
without ever thinking about the sex
or gender of our patients.
or gender of our patients.
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mõtlemata pikemalt sellele,
mis soost meie patsient on.
mis soost meie patsient on.
Ja miks peakski?
01:17
Why would we?
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01:19
We were never taught that there were
any differences between men and women.
any differences between men and women.
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Meile pole õpetatud, et naiste ja
meeste vahel oleks mingeid erinevusi.
meeste vahel oleks mingeid erinevusi.
01:22
A recent Government Accountability study
revealed that 80 percent of the drugs
revealed that 80 percent of the drugs
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Värske riiklik audit näitas, et
et 80% ravimite puhul,
et 80% ravimite puhul,
01:27
withdrawn from the market
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mis on kasutusest tagasi kutsutud,
01:29
are due to side effects on women.
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on põhjuseks olnud kõrvaltoimete
ilmnemine just naistel.
ilmnemine just naistel.
01:33
So let's think about that for a minute.
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Mõtleme veidi selle üle.
01:35
Why are we discovering
side effects on women
side effects on women
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Miks avastatakse, et ravim tekitab
naistel kõrvaltoimeid alles siis
naistel kõrvaltoimeid alles siis
01:39
only after a drug has been
released to the market?
released to the market?
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kui see on juba müügile lastud?
01:43
Do you know that it takes years
for a drug to go from an idea
for a drug to go from an idea
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Kas teadsite, et võtab aastaid
enne kui ravim jõuab ideest
01:49
to being tested on cells in a laboratory,
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katsetusteni laborites,
01:52
to animal studies,
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seejärel loomakatseteni,
01:54
to then clinical trials on humans,
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siis kliiniliste uuringuteni inimeste peal,
01:56
finally to go through
a regulatory approval process,
a regulatory approval process,
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ja lõpuks tuleb saada heakskiit
ravimiameti poolt,
ravimiameti poolt,
02:00
to be available for your doctor
to prescribe to you?
to prescribe to you?
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enne kui arstid saavad
hakata rohtu välja kirjutama.
hakata rohtu välja kirjutama.
02:06
Not to mention the millions and billions
of dollars of funding
of dollars of funding
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Rääkimata nendest miljonitest
ja miljarditest dollaritest,
ja miljarditest dollaritest,
02:09
it takes to go through that process.
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mis see kõik maksma läheb.
Aga miks avastatakse ravimi
soovimatud kõrvalähud
soovimatud kõrvalähud
02:13
So why are we discovering
unacceptable side effects
unacceptable side effects
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02:16
on half the population
after that has gone through?
after that has gone through?
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poolte inimeste jaoks alles siis,
kui kogu see kadalipp on läbitud?
Mis toimub?
02:23
What's happening?
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02:24
Well, it turns out that those cells
used in that laboratory,
used in that laboratory,
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Tuleb välja, et need rakud,
millega ravimid testitakse,
millega ravimid testitakse,
02:28
they're male cells,
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on meeste rakud,
02:30
and the animals used
in the animal studies were male animals,
in the animal studies were male animals,
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ja loomad, keda kasutatakse
loomakatsetustel, on isased.
loomakatsetustel, on isased.
02:34
and the clinical trials have been
performed almost exclusively on men.
performed almost exclusively on men.
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Ja kliinilised uuringud on reeglina
läbiviidud vaid meeste peal.
läbiviidud vaid meeste peal.
02:41
How is it that the male model became
our framework for medical research?
our framework for medical research?
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Kuidas on võimalik, et meditsiinilised
uuringud põhinevad vaid meestel?
uuringud põhinevad vaid meestel?
02:46
Let's look at an example that has been
popularized in the media,
popularized in the media,
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Vaatame meedias suurt
kajastust leidnud juhtumit
kajastust leidnud juhtumit
02:50
and it has to do
with the sleep aid Ambien.
with the sleep aid Ambien.
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mis oli seotud unerohuga Ambien.
02:53
Ambien was released on the market
over 20 years ago,
over 20 years ago,
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Ambien tuli müügile
enam kui 20 aasta eest.
enam kui 20 aasta eest.
02:58
and since then, hundreds of millions
of prescriptions have been written,
of prescriptions have been written,
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Selle aja jooksul on seda
kirjutatud välja miljoneid kordi,
kirjutatud välja miljoneid kordi,
03:03
primarily to women, because women
suffer more sleep disorders than men.
suffer more sleep disorders than men.
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peamiselt just naistele, sest naistel on
sagedamini unehäireid kui meestel.
sagedamini unehäireid kui meestel.
Aga viimasel aastal on
USA toidu- ja ravimiamet
USA toidu- ja ravimiamet
03:09
But just this past year,
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03:11
the Food and Drug Administration
recommended cutting the dose in half
recommended cutting the dose in half
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soovitanud vähendada ravimi
annust poole võrra
annust poole võrra
03:14
for women only,
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ainult naiste puhul.
Alles nüüd saadi aru,
03:17
because they just realized
that women metabolize the drug
that women metabolize the drug
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et naised omastavad seda ravimit
03:20
at a slower rate than men,
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aeglasemalt kui mehed,
03:23
causing them to wake up in the morning
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mistõttu hommikul üles ärgates
03:25
with more of the active drug
in their system.
in their system.
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on neil organismis rohkem
aktiivset toimainet.
aktiivset toimainet.
03:28
And then they're drowsy and they're
getting behind the wheel of the car,
getting behind the wheel of the car,
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Siis istuvad nad uimastena rooli
03:32
and they're at risk
for motor vehicle accidents.
for motor vehicle accidents.
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ja on risk sattuda avariisse.
03:36
And I can't help but think,
as an emergency physician,
as an emergency physician,
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Kiirabiarstina hakkan
paratamatult mõtlema,
paratamatult mõtlema,
03:40
how many of my patients
that I've cared for over the years
that I've cared for over the years
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kui paljud mu patsientidest,
keda olen aastate jooksul ravinud,
03:45
were involved in a motor vehicle accident
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sattusid autoavariisse,
03:48
that possibly could have been prevented
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mis oleks võinud olemata olla,
03:52
if this type of analysis was performed
and acted upon 20 years ago
and acted upon 20 years ago
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kui oleks tehtud vastavad
uuringud 20 aastat tagasi,
uuringud 20 aastat tagasi,
03:57
when this drug was first released.
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mil see ravim esimest korda müügile tuli.
Mida kõike veel tuleks
analüüsida soo põhjal?
analüüsida soo põhjal?
04:01
How many other things need
to be analyzed by gender?
to be analyzed by gender?
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04:05
What else are we missing?
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Mis on veel kahe silma vahele jäänud?
04:09
World War II changed a lot of things,
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II maailmasõda tõi kaasa suured muutused,
04:13
and one of them was this need
to protect people
to protect people
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sealhulgas vajaduse
kaitsta inimesi selle eest,
kaitsta inimesi selle eest,
04:16
from becoming victims of medical research
without informed consent.
without informed consent.
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et neid ei kasutataks
kliinilistes uuringutes
kliinilistes uuringutes
ilma nende teadliku nõusolekuta.
04:21
So some much-needed guidelines
or rules were set into place,
or rules were set into place,
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Kehtestati vajalikud reeglid,
04:25
and part of that was this desire
to protect women of childbearing age
to protect women of childbearing age
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osalt ka seetõttu, et kaitsa
viljakas eas naisi selle eest,
viljakas eas naisi selle eest,
04:30
from entering into any
medical research studies.
medical research studies.
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et nendega ei tehtaks mingeid
kliinilisi katsetusi.
kliinilisi katsetusi.
04:34
There was fear: what if something
happened to the fetus during the study?
happened to the fetus during the study?
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Kardeti, et uuringute ajal
võib lootega midagi juhtuda.
võib lootega midagi juhtuda.
Kes siis vastutab?
04:39
Who would be responsible?
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04:41
And so the scientists
at this time actually thought
at this time actually thought
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Teadlaste jaoks oli see tollal
ka omamoodi kergendus,
ka omamoodi kergendus,
04:44
this was a blessing in disguise,
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04:47
because let's face it -- men's bodies
are pretty homogeneous.
are pretty homogeneous.
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sest olgem ausad,
meeste kehad on enam-vähem ühesugused.
04:52
They don't have the constantly
fluctuating levels of hormones
fluctuating levels of hormones
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Nende hormoonitase ei kõigu pidevalt,
mis segaks ühetaoliste
selgete tulemusteni jõudmist,
selgete tulemusteni jõudmist,
04:56
that could disrupt clean data
they could get if they had only men.
they could get if they had only men.
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mida saab siis, kui testida ainult mehi.
05:01
It was easier. It was cheaper.
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Nii oli lihtsam ja ka odavam.
Rääkimata, et tol ajal üldiselt eeldati,
05:05
Not to mention, at this time,
there was a general assumption
there was a general assumption
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05:08
that men and women
were alike in every way,
were alike in every way,
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et mehe ja naise organism on
igas mõttes täpselt samasugused,
igas mõttes täpselt samasugused,
05:12
apart from their reproductive organs
and sex hormones.
and sex hormones.
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välja arvatud suguelundid ja hormoonid.
05:17
So it was decided:
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Niisiis otsustati,
05:21
medical research was performed on men,
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et kliinilisi uuringuid
viiakse läbi meeste peal,
viiakse läbi meeste peal,
05:24
and the results were later
applied to women.
applied to women.
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ja tulemusi kohaldatakse
seejärel ka naistele.
seejärel ka naistele.
Mida see tõi kaasa
naiste tervise vaatenurgast?
naiste tervise vaatenurgast?
05:29
What did this do to the notion
of women's health?
of women's health?
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05:32
Women's health became synonymous
with reproduction:
with reproduction:
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Naiste tervist hakati vaatama vaid
reproduktsiooni aspektist:
reproduktsiooni aspektist:
05:37
breasts, ovaries, uterus, pregnancy.
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rinnad, munasarjad, emakas, rasedus.
05:42
It's this term we now refer
to as "bikini medicine."
to as "bikini medicine."
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Seda nimetatakse bikiinimeditsiiniks.
Selline mõtteviis valitses kuni 80ndateni
05:46
And this stayed this way
until about the 1980s,
until about the 1980s,
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05:49
when this concept was challenged
by the medical community
by the medical community
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mil nii meditsiiniringkondades
kui tervishoiupoliitika kujundajate seas
05:52
and by the public health policymakers
when they realized that
when they realized that
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hakati aru saama, et naisi
kliinilistest uuringutest kõrvale jättes
kliinilistest uuringutest kõrvale jättes
05:56
by excluding women
from all medical research studies
from all medical research studies
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tehakse neile tegelikult karuteene.
06:01
we actually did them a disservice,
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Naise organismi eripäradest
ei teatud praktiliselt midagi
ei teatud praktiliselt midagi
06:04
in that apart from reproductive issues,
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06:06
virtually nothing was known
about the unique needs
about the unique needs
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kui see ei puudutanud otseselt
reproduktiivorganeid.
reproduktiivorganeid.
06:09
of the female patient.
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06:12
Since that time, an overwhelming amount
of evidence has come to light
of evidence has come to light
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Sellest ajast alates on ilmnenud
tohutul hulgal tõendeid selle kohta,
06:18
that shows us just how different
men and women are in every way.
men and women are in every way.
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et mehed ja naised on kõikvõimalikes
aspektides väga erinevad.
aspektides väga erinevad.
06:29
You know, we have this saying in medicine:
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Meedikute seas on selline ütlus,
06:32
children are not just little adults.
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et lapsed ei ole lihtsalt
väikesed täiskasvanud.
väikesed täiskasvanud.
06:36
And we say that to remind ourselves
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Seda öeldakse, et tuletada meelde,
06:38
that children actually have
a different physiology than normal adults.
a different physiology than normal adults.
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et lapsel on täiskasvanuga võrreldes
hoopis teistsugune füsioloogia.
hoopis teistsugune füsioloogia.
06:44
And it's because of this that the medical
specialty of pediatrics came to light.
specialty of pediatrics came to light.
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Tänu sellele sai alguse
pediaatria valdkond.
pediaatria valdkond.
06:49
And we now conduct research on children
in order to improve their lives.
in order to improve their lives.
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Kaasajal teeme lastega uuringuid
selleks, et neid paremini aidata.
selleks, et neid paremini aidata.
06:57
And I know the same thing
can be said about women.
can be said about women.
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Olen veendunud, et sama
võib öelda naiste kohta.
võib öelda naiste kohta.
06:59
Women are not just men
with boobs and tubes.
with boobs and tubes.
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Naised ei ole nagu mehed,
ainult et rindade ja aukudega.
ainult et rindade ja aukudega.
Naistel on oma eripärane
anatoomia ja füsioloogia,
anatoomia ja füsioloogia,
07:06
But they have their own
anatomy and physiology
anatomy and physiology
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07:10
that deserves to be studied
with the same intensity.
with the same intensity.
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mis väärib sama põhjalikku uurimist.
07:15
Let's take the cardiovascular
system, for example.
system, for example.
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Võtame näiteks kardiovaskulaarse süsteemi.
07:18
This area in medicine has done the most
to try to figure out
to try to figure out
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Selles meditsiini valdkonnas on
tehtud kõige enam selleks, et mõista,
tehtud kõige enam selleks, et mõista,
07:22
why it seems men and women have
completely different heart attacks.
completely different heart attacks.
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miks naiste ja meeste infarktid
paistavad olevat nii erinevad.
paistavad olevat nii erinevad.
07:27
Heart disease is the number one killer
for both men and women,
for both men and women,
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Südameinfark on kõige sagedasem
surma põhjustaja nii meestel kui naistel,
surma põhjustaja nii meestel kui naistel,
07:33
but more women die within the first year
of having a heart attack than men.
of having a heart attack than men.
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kuid esimesel aastal peale infrakti
sureb naisi rohkem kui mehi.
sureb naisi rohkem kui mehi.
07:39
Men will complain
of crushing chest pain --
of crushing chest pain --
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Mehed kurdavad rõhuva valu üle rindkeres,
07:43
an elephant is sitting on their chest.
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justkui elevant istuks neil rinnal.
07:46
And we call this typical.
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Sellist valu peetakse tüüpiliseks.
07:49
Women have chest pain, too.
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Naistel on ka valu rindkeres.
07:52
But more women than men
will complain of "just not feeling right,"
will complain of "just not feeling right,"
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Aga naised pigem kurdavad,
et midagi juskui oleks valesti,
et midagi juskui oleks valesti,
08:00
"can't seem to get enough air in,"
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et nad ei saa piisavalt õhku hingata,
08:03
"just so tired lately."
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et nad on viimasel ajal nii väsinud.
08:07
And for some reason we call this atypical,
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Millegipärast peetakse
seda ebatüüpiliseks,
seda ebatüüpiliseks,
08:09
even though, as I mentioned,
women do make up half the population.
women do make up half the population.
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kuigi, nagu ütlesin, on pooled
rahvastikust ju naised.
rahvastikust ju naised.
08:15
And so what is some of the evidence
to help explain some of these differences?
to help explain some of these differences?
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Millised on aga uurimistulemused,
mis selgitavad neid erinevusi?
mis selgitavad neid erinevusi?
08:21
If we look at the anatomy,
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Kui me vaadata anatoomiat,
08:24
the blood vessels that surround the heart
are smaller in women compared to men,
are smaller in women compared to men,
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siis on südant ümbritsevad veresooned
naistel väiksemad kui meestel,
naistel väiksemad kui meestel,
08:30
and the way that those blood vessels
develop disease is different
develop disease is different
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ja haigestumine mõjutab naiste ja
meeste veresooni erinevalt.
meeste veresooni erinevalt.
08:35
in women compared to men.
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08:37
And the test that we use to determine
if someone is at risk for a heart attack,
if someone is at risk for a heart attack,
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Samas on test, millega hinnatakse
infarkti tekkimise riski
infarkti tekkimise riski
08:43
well, they were initially designed
and tested and perfected in men,
and tested and perfected in men,
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algselt väljatöötatud, testitud
ja täiendatud meeste peal
ja täiendatud meeste peal
08:47
and so aren't as good
at determining that in women.
at determining that in women.
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ja seega ei toimi naistel sama täpselt.
08:52
And then if we think
about the medications --
about the medications --
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Kui nüüd vaadata ravimeid -
08:55
common medications
that we use, like aspirin.
that we use, like aspirin.
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tüüpilised ravimeid, mida
kasutatakse, näiteks aspiriini,
kasutatakse, näiteks aspiriini,
siis aspiriini antakse tervetele
meestele, et ennetada infarkti.
meestele, et ennetada infarkti.
08:59
We give aspirin to healthy men to help
prevent them from having a heart attack,
prevent them from having a heart attack,
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09:04
but do you know that if you
give aspirin to a healthy woman,
give aspirin to a healthy woman,
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Aga kas teadsite, et tervele naisele
võib aspiriin hoopis kahjulik olla?
09:08
it's actually harmful?
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09:12
What this is doing is merely telling us
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Siit näeme vaid ainult
09:14
that we are scratching the surface.
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jäämäe veepealset osa.
09:19
Emergency medicine
is a fast-paced business.
is a fast-paced business.
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Erakorralise meditsiini puhul
on alati kiire.
on alati kiire.
09:23
In how many life-saving areas of medicine,
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Kui paljudes meditsiinivaldkondades,
kus on küsimus elus ja surmas,
kus on küsimus elus ja surmas,
09:26
like cancer and stroke,
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näiteks vähk ja insult,
09:30
are there important differences between
men and women that we could be utilizing?
men and women that we could be utilizing?
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on meeste ja naiste vahel erinevusi,
mida saaks patsiendi kasuks pöörata?
mida saaks patsiendi kasuks pöörata?
09:36
Or even, why is it that some people
get those runny noses
get those runny noses
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Või miks mõnedel tuleb nohu
kergemini kui teistel,
kergemini kui teistel,
09:41
more than others,
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või miks valuvaigistid, mida anname
äralöödud varba puhul,
äralöödud varba puhul,
09:43
or why the pain medication that we give
to those stubbed toes
to those stubbed toes
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09:46
work in some and not in others?
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mõnele mõjuvad ja teisele mitte?
09:53
The Institute of Medicine has said
every cell has a sex.
every cell has a sex.
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Meditsiini Instituut on öelnud,
et igal rakul on sugu.
et igal rakul on sugu.
09:59
What does this mean?
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Mida see tähendab?
10:02
Sex is DNA.
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Bioloogiline sugu on DNA.
10:04
Gender is how someone
presents themselves in society.
presents themselves in society.
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Sotsiaalne sugu tähistab rolli ühiskonnas.
10:09
And these two may not always match up,
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Ja need ei pruugi alati kokkulangeda,
10:12
as we can see with our
transgendered population.
transgendered population.
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nagu näiteks transseksuaalide puhul.
10:16
But it's important to realize
that from the moment of conception,
that from the moment of conception,
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Aga on tähtis mõista, et
alates eostamise hetkest,
alates eostamise hetkest,
10:21
every cell in our bodies --
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sisaldab iga meie keharakk -
10:23
skin, hair, heart and lungs --
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nahk, juuksed, süda, kopsud -
10:27
contains our own unique DNA,
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meie unikaalset DNAd,
10:30
and that DNA contains
the chromosomes that determine
the chromosomes that determine
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ja see DNA sisaldab kromosoome,
mis määravad ära selle, kas meist saab
isane või emane, mees või naine.
isane või emane, mees või naine.
10:34
whether we become
male or female, man or woman.
male or female, man or woman.
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10:40
It used to be thought
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Vanasti arvati,
10:42
that those sex-determining
chromosomes pictured here --
chromosomes pictured here --
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et need sugu määravad
kromosoomid siin pildil -
kromosoomid siin pildil -
10:46
XY if you're male, XX if you're female --
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XY meestel ja XX naistel -
10:49
merely determined whether you
would be born with ovaries or testes,
would be born with ovaries or testes,
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määravad vaid selle, kas inimene sünnib
munasarjade või munanditega,
munasarjade või munanditega,
10:54
and it was the sex hormones
that those organs produced
that those organs produced
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ja nendest organiste poolt
toodetud suguhormoonid
toodetud suguhormoonid
10:58
that were responsible for the differences
we see in the opposite sex.
we see in the opposite sex.
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tingivad soolised erinevused.
11:04
But we now know that
that theory was wrong --
that theory was wrong --
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Nüüd aga teame, et see teooria oli vale -
11:09
or it's at least a little incomplete.
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või vähemalt puudulik.
11:12
And thankfully, scientists like Dr. Page
from the Whitehead Institute,
from the Whitehead Institute,
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Õnneks on teadlased nagu
dr Page Whiteheadi Instituudist,
dr Page Whiteheadi Instituudist,
11:16
who works on the Y chromosome,
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kes uurib Y kromosoomi,
11:18
and Doctor Yang from UCLA,
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ja dr Yang California Ülikoolist,
11:21
they have found evidence that tells us
that those sex-determining chromosomes
that those sex-determining chromosomes
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leidnud tõendeid selle kohta,
et sugu määravad kromosoomid,
et sugu määravad kromosoomid,
11:26
that are in every cell in our bodies
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mis on igas meie keharakus,
11:29
continue to remain active
for our entire lives
for our entire lives
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on aktiivsed kogu eluea vältel
11:36
and could be what's responsible
for the differences we see
for the differences we see
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ja nendest võivad olla tingitud
erinevused ravimitele reageerimisel
erinevused ravimitele reageerimisel
11:40
in the dosing of drugs,
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11:42
or why there are differences
between men and women
between men and women
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või naiste ja meeste erinevused
11:45
in the susceptibility
and severity of diseases.
and severity of diseases.
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vastuvõtlikkuses erinevatele haigustele.
11:51
This new knowledge is the game-changer,
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See uus teadmine on pöördelise tähtsusega.
11:57
and it's up to those scientists
that continue to find that evidence,
that continue to find that evidence,
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Edasine tõendamine on teadlaste töö,
12:00
but it's up to the clinicians
to start translating this data
to start translating this data
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aga arstide ülesanne on hakata neid
avastusi rakendama ravivõtetesse
avastusi rakendama ravivõtetesse
12:05
at the bedside, today.
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patsientide ravis juba täna.
Kohe ja praegu.
12:09
Right now.
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12:13
And to help do this, I'm a co-founder
of a national organization
of a national organization
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Et seda ellu viia käivitasime
üleriikliku initsiatiivi,
üleriikliku initsiatiivi,
12:16
called Sex and Gender
Women's Health Collaborative,
Women's Health Collaborative,
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mis kannab nime Sex and Gender
Women's Health Collaborative.
Women's Health Collaborative.
12:19
and we collect all of this data
so that it's available for teaching
so that it's available for teaching
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Kogume kokku teaduslikud uurimused,
et neid saaks kasutada arstide
väljaõppes ja patsientide ravis
väljaõppes ja patsientide ravis
12:24
and for patient care.
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12:26
And we're working to bring together
the medical educators to the table.
the medical educators to the table.
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Korraldame arstiteaduse õppejõudude
kaasamist sellesse teemasse.
kaasamist sellesse teemasse.
12:31
That's a big job.
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See on suur ettevõtmine.
See tähendab suurt muutust selles,
12:34
It's changing the way medical training
has been done since its inception.
has been done since its inception.
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kuidas arstiteadust on seni õpetatud.
12:41
But I believe in them.
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Kuid mul on neisse usku.
12:43
I know they're going to see the value
of incorporating the gender lens
of incorporating the gender lens
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Ma tean, et nad oskavad näha kasu,
mida annab sooliste erinevuste arvestamine
12:49
into the current curriculum.
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arstiteaduse õppekavades.
12:52
It's about training the future
health care providers correctly.
health care providers correctly.
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Selle eesmärk on anda tulevastele
tervishoiutöötatele õige väljaõpe.
tervishoiutöötatele õige väljaõpe.
13:00
And regionally,
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Kohalikul tasandil olen
uue õppesuuna kaasasutaja
uue õppesuuna kaasasutaja
13:01
I'm a co-creator of a division within
the Department of Emergency Medicine
the Department of Emergency Medicine
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siinse Browni Ülikooli
erakorralise meditsiini osakonnas,
erakorralise meditsiini osakonnas,
13:05
here at Brown University,
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õppesuuna nimi on "Soolised
erinevused erakorralises meditsiinis".
erinevused erakorralises meditsiinis".
13:07
called Sex and Gender
in Emergency Medicine,
in Emergency Medicine,
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13:09
and we conduct the research to determine
the differences between men and women
the differences between men and women
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Uurime erinevusi meeste ja naiste vahel
erakorralise meditsiini sekkumist
nõudvates situatsioonides,
nõudvates situatsioonides,
13:14
in emergent conditions,
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13:16
like heart disease and stroke
and sepsis and substance abuse,
and sepsis and substance abuse,
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nagu näiteks infarkt, insult, sepsis
ja narkootikumide kuritarvitamine.
ja narkootikumide kuritarvitamine.
13:21
but we also believe
that education is paramount.
that education is paramount.
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Oleme veendunud, et vastav
haridus on võtmetähtsusega.
haridus on võtmetähtsusega.
13:27
We've created a 360-degree
model of education.
model of education.
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Selleks oleme pannud kokku
360-kraadise väljaõppemudeli.
360-kraadise väljaõppemudeli.
13:31
We have programs for the doctors,
for the nurses, for the students
for the nurses, for the students
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Oleme koostanud programmid
arstidele, õdedele,
arstidele, õdedele,
üliõpilastele ja ka patsientidele.
13:37
and for the patients.
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13:39
Because this cannot just be left up
to the health care leaders.
to the health care leaders.
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Sest sellega ei saa tegeleda
ainult tervishoiujuhid.
ainult tervishoiujuhid.
13:44
We all have a role in making a difference.
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Meil kõigil tuleb aidata
kaasa, et asjad muutuksid.
kaasa, et asjad muutuksid.
13:48
But I must warn you: this is not easy.
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Aga pean hoiatama, et see pole kerge.
13:53
In fact, it's hard.
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Kui aus olla, on see väga keeruline.
13:57
It's essentially changing the way
we think about medicine
we think about medicine
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Sisuliselt tuleb muuta senist
arusaama meditsiinist,
arusaama meditsiinist,
14:01
and health and research.
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tervisest ja teadusest.
14:05
It's changing our relationship
to the health care system.
to the health care system.
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See muudab meie suhet
kogu tervishoiusüsteemiga.
kogu tervishoiusüsteemiga.
14:09
But there's no going back.
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Aga tagasiteed siin ei ole.
14:13
We now know just enough
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Praeguseks võime juba kindlalt väita,
14:17
to know that we weren't doing it right.
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et seni ei tehtud asju päris õigesti.
14:21
Martin Luther King, Jr. has said,
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Martin Luther King on öelnud,
14:24
"Change does not roll in
on the wheels of inevitability,
on the wheels of inevitability,
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et muutused ei teki iseenesest,
14:28
but comes through continuous struggle."
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vaid sünnivad läbi sihikindla võitluse.
14:32
And the first step
towards change is awareness.
towards change is awareness.
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Esimeseks sammuks muutuse
teel on teadvustamine.
teel on teadvustamine.
14:36
This is not just about improving
medical care for women.
medical care for women.
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Asi pole lihtsalt naiste paremas ravis.
14:40
This is about personalized,
individualized health care for everyone.
individualized health care for everyone.
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Eesmärk on tagada kõigile
talle sobiv individuaalne ravi.
talle sobiv individuaalne ravi.
14:47
This awareness has the power to transform
medical care for men and women.
medical care for men and women.
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Läbi teadlikkuse saab meditsiini muuta
meeste ja naiste vajadusi arvestavaks.
14:54
And from now on, I want you
to ask your doctors
to ask your doctors
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Tahan, et edaspidi küsiksite oma arstidelt
15:00
whether the treatments you are receiving
are specific to your sex and gender.
are specific to your sex and gender.
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kas see ravi, mis teile määratakse,
ikka arvestab teie sooga.
ikka arvestab teie sooga.
15:06
They may not know the answer --
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Nad ei oska ehk vastata -
15:08
yet.
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veel.
15:11
But the conversation has begun,
and together we can all learn.
and together we can all learn.
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Aga teema on lauale toodud
ja koos on võimalik targemaks saada.
ja koos on võimalik targemaks saada.
15:15
Remember, for me
and my colleagues in this field,
and my colleagues in this field,
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Ärge unustage, et minu ja
mu ametikaaslaste jaoks,
mu ametikaaslaste jaoks,
15:20
your sex and gender matter.
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on teie sugu oluline.
15:23
Thank you.
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Aitäh.
15:24
(Applause)
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(Aplaus)
ABOUT THE SPEAKER
Alyson McGregor - Women's health pioneerAlyson McGregor studies women's health, especially as it relates to emergency care -- when time-sensitive, life-or-death decisions are made using drugs and treatments mainly tested on men.
Why you should listen
Alyson J. McGregor MD is co-founder and director for the Sex and Gender in Emergency Medicine (SGEM) Division (formerly Women’s Health in Emergency Care) within the Department of Emergency Medicine at Warren Alpert Medical School of Brown University.
Her group's aim is to establish research and educational endeavors that promote sex- and gender-specific medicine and women’s health as they relate to emergency care. Dr. McGregor received her medical degree at Boston University School of Medicine and residency training at Brown, where she continues to work as an attending physician at RI Hospital Emergency Department. Dr. McGregor is an Associate Professor of Emergency Medicine and also serves as co-director for the SGEM Fellowship and co-founder of the national organization Sex and Gender Women’s Health Collaborative.
Alyson McGregor | Speaker | TED.com