TEDxProvidence
Alyson McGregor: Why medicine often has dangerous side effects for women
Alison Makgregor (Alyson McGregor): Zašto lekovi često imaju opasna neželjena dejstva za žene
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Većim delom prošlog veka, lekovi koji su odobreni i pušteni na tržište testirani su samo na muškim pacijentima, što je dovelo do neodgovarajućeg doziranja i neprihvatljivih neželjenih dejstava za žene. Važne fiziološke razlike između muškaraca i žena su tek nedavno uzete u obzir u medicinskim istraživanjima. Lekar za hitne slučajeve, Alison Mekgregor, proučava te razlike, a u ovom fascinantnom govoru priča o istoriji koja stoji iza toga kako je muški model postao naš okvir za medicinska istraživanja i kako razumevanje razlika između muškaraca i žena može da dovede do delotvornijih tretmana za oba pola.
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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Svi mi idemo kod lekara
00:16
And we do so with trust and blind faith
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i to činimo sa poverenjem i slepom verom
00:21
that the test they are ordering
and the medications they're prescribing
and the medications they're prescribing
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da su testovi koje oni naručuju
i lekovi koje prepisuju
i lekovi koje prepisuju
00:25
are based upon evidence --
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zasnovani na dokazima -
00:28
evidence that's designed to help us.
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dokazima koji su predviđeni
da nam pomognu.
da nam pomognu.
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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Međutim, u stvarnosti,
to nije uvek bio slučaj za svakog.
to nije uvek bio slučaj za svakog.
00:39
What if I told you
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Šta ako vam kažem
00:40
that the medical science discovered
over the past century
over the past century
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da je ono što je medicinska nauka otkrila
tokom proteklog veka
tokom proteklog veka
00:44
has been based on only
half the population?
half the population?
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zasnovano na svega polovini populacije?
00:48
I'm an emergency medicine doctor.
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Ja sam doktor urgentne medicine.
00:50
I was trained to be prepared
in a medical emergency.
in a medical emergency.
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Obučena sam da budem pripremljena
u slučaju medicinske hitnosti.
u slučaju medicinske hitnosti.
00:54
It's about saving lives. How cool is that?
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Radi se o spašavanju života.
Zar to nije kul?
Zar to nije kul?
01:00
OK, there's a lot of runny noses
and stubbed toes,
and stubbed toes,
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Okej, ima mnogo kijavica
i ozleda na nožnim prstima,
i ozleda na nožnim prstima,
01:03
but no matter who walks
through the door to the ER,
through the door to the ER,
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ali bez obzira na to ko ušeta
kroz vrata hitne službe,
kroz vrata hitne službe,
01:07
we order the same tests,
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zatražimo iste testove,
01:09
we prescribe the same medication,
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prepisujemo iste lekove,
01:11
without ever thinking about the sex
or gender of our patients.
or gender of our patients.
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a da nikada ne razmišljamo
o polu ili rodu naših pacijenata.
o polu ili rodu naših pacijenata.
01:17
Why would we?
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Zašto bismo?
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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Nikada nas nisu učili da postoje
ikakve razlike između muškaraca i žena.
ikakve razlike između muškaraca i žena.
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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Nedavna studija odgovornosti vlade
je pokazala da je 80 odsto lekova
je pokazala da je 80 odsto lekova
01:27
withdrawn from the market
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povučeno sa tržišta
01:29
are due to side effects on women.
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zbog neželjenih dejstava na žene.
01:33
So let's think about that for a minute.
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Hajde da razmislimo o tome na minut.
01:35
Why are we discovering
side effects on women
side effects on women
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Zašto otkrivamo neželjena dejstva na žene
01:39
only after a drug has been
released to the market?
released to the market?
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tek nakon što je lek pušten na tržište?
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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Da li znate da su potrebne godine
da bi lek prešao put od ideje
da bi lek prešao put od ideje
01:49
to being tested on cells in a laboratory,
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do testiranja na ćelijama u laboratoriji,
01:52
to animal studies,
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do studija na životinjama,
01:54
to then clinical trials on humans,
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do kliničkih ispitivanja na ljudima,
01:56
finally to go through
a regulatory approval process,
a regulatory approval process,
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da bi konačno prošao
kroz regulacioni proces odobravanja,
kroz regulacioni proces odobravanja,
02:00
to be available for your doctor
to prescribe to you?
to prescribe to you?
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da bi bio na raspolaganju doktoru
da vam ga prepiše?
da vam ga prepiše?
02:06
Not to mention the millions and billions
of dollars of funding
of dollars of funding
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Da ne pominjemo finansiranje
od miliona i milijardi dolara
od miliona i milijardi dolara
02:09
it takes to go through that process.
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koje je potrebno da prođe kroz taj proces.
02:13
So why are we discovering
unacceptable side effects
unacceptable side effects
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Pa zašto otkrivamo
neprihvatljive nuspojave
neprihvatljive nuspojave
02:16
on half the population
after that has gone through?
after that has gone through?
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kod polovine populacije
nakon što se prošlo kroz sve to?
nakon što se prošlo kroz sve to?
02:23
What's happening?
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Šta se dešava?
02:24
Well, it turns out that those cells
used in that laboratory,
used in that laboratory,
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Pa, ispostavilo se da su ćelije
koje su korišćene u toj laboratoriji
koje su korišćene u toj laboratoriji
02:28
they're male cells,
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muške ćelije,
02:30
and the animals used
in the animal studies were male animals,
in the animal studies were male animals,
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a životinje korišćene
u životinjskim studijama su mužjaci,
u životinjskim studijama su mužjaci,
02:34
and the clinical trials have been
performed almost exclusively on men.
performed almost exclusively on men.
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a klinička ispitivanja se sprovode
skoro isključivo na muškarcima.
skoro isključivo na muškarcima.
02:41
How is it that the male model became
our framework for medical research?
our framework for medical research?
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Kako to da je muški model postao
naš okvir za medicinska istraživanja?
naš okvir za medicinska istraživanja?
02:46
Let's look at an example that has been
popularized in the media,
popularized in the media,
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Hajde da pogledamo primer
koji je popularizovan u medijima,
koji je popularizovan u medijima,
02:50
and it has to do
with the sleep aid Ambien.
with the sleep aid Ambien.
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a radi se o Ambienu,
pomoćnom sredstvu za uspavljivanje.
pomoćnom sredstvu za uspavljivanje.
02:53
Ambien was released on the market
over 20 years ago,
over 20 years ago,
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Ambien je pušten na tržište
pre više od 20 godina
pre više od 20 godina
02:58
and since then, hundreds of millions
of prescriptions have been written,
of prescriptions have been written,
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i od tada su napisane
stotine miliona recepata,
stotine miliona recepata,
03:03
primarily to women, because women
suffer more sleep disorders than men.
suffer more sleep disorders than men.
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naročito ženama, jer žene više pate
od poremećaja sna nego muškarci.
od poremećaja sna nego muškarci.
03:09
But just this past year,
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Međutim, prošle godine,
03:11
the Food and Drug Administration
recommended cutting the dose in half
recommended cutting the dose in half
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Uprava za hranu i lekove je preporučila
smanjivanje doze upola
smanjivanje doze upola
03:14
for women only,
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samo za žene,
03:17
because they just realized
that women metabolize the drug
that women metabolize the drug
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jer su upravo shvatili
da žene metabolišu lek
da žene metabolišu lek
03:20
at a slower rate than men,
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sporije od muškaraca,
03:23
causing them to wake up in the morning
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što uzrokuje da se probude ujutru
03:25
with more of the active drug
in their system.
in their system.
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sa više aktivnog leka u svom sistemu.
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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Tada su pospane, a sednu da voze
03:32
and they're at risk
for motor vehicle accidents.
for motor vehicle accidents.
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i u riziku su od saobraćajnih nesreća.
03:36
And I can't help but think,
as an emergency physician,
as an emergency physician,
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Ne mogu da ne pomislim,
kao lekar za hitne slučajeve,
kao lekar za hitne slučajeve,
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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koliko je mojih pacijenata
o kojima sam brinula svih ovih godina
o kojima sam brinula svih ovih godina
03:45
were involved in a motor vehicle accident
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bilo u nesrećama u motornom vozilu
03:48
that possibly could have been prevented
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koje su mogle biti sprečene
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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da je ovakva analiza sprovedena
i da se postupalo u skladu sa njom
i da se postupalo u skladu sa njom
pre 20 godina,
kada je lek pušten u prodaju.
kada je lek pušten u prodaju.
03:57
when this drug was first released.
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04:01
How many other things need
to be analyzed by gender?
to be analyzed by gender?
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Koliko još stvari treba analizirati
kroz polne razlike?
kroz polne razlike?
04:05
What else are we missing?
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Šta još propuštamo?
04:09
World War II changed a lot of things,
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Drugi svetski rat je promenio mnogo toga,
04:13
and one of them was this need
to protect people
to protect people
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a doneo je i potrebu da se ljudi zaštite
da ne bi postali žrtve
da ne bi postali žrtve
04:16
from becoming victims of medical research
without informed consent.
without informed consent.
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medicinskih istraživanja
bez davanja informacija i saglasnosti.
bez davanja informacija i saglasnosti.
04:21
So some much-needed guidelines
or rules were set into place,
or rules were set into place,
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Stoga su preko potrebne smernice
ili pravila postavljeni na svoje mesto,
ili pravila postavljeni na svoje mesto,
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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a deo toga je bila želja
da se zaštite žene u plodnim godinama
da se zaštite žene u plodnim godinama
04:30
from entering into any
medical research studies.
medical research studies.
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od uključivanja u bilo kakve studije
medicinskih ispitivanja.
medicinskih ispitivanja.
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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Postojao je strah: šta ako se nešto dogodi
fetusu za vreme studije?
fetusu za vreme studije?
04:39
Who would be responsible?
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Ko bi bio odgovoran?
04:41
And so the scientists
at this time actually thought
at this time actually thought
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Tako su naučnici u tom trenutku pomislili
04:44
this was a blessing in disguise,
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da je ovo bila sreća u nesreći,
04:47
because let's face it -- men's bodies
are pretty homogeneous.
are pretty homogeneous.
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jer, budimo realni - tela muškaraca
su prilično homogena.
su prilično homogena.
04:52
They don't have the constantly
fluctuating levels of hormones
fluctuating levels of hormones
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Kod njih ne postoji stalno fluktuiranje
nivoa hormona, koje može da poremeti
nivoa hormona, koje može da poremeti
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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čiste podatke koje mogu da dobiju
ako imaju samo muškarce.
ako imaju samo muškarce.
05:01
It was easier. It was cheaper.
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Bilo je lakše. Bilo je jeftinije.
Da ne napominjem da je u ovo vreme
postojala opšta pretpostavka
postojala opšta pretpostavka
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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da su muškarci i žene
jednaki u svakom pogledu,
jednaki u svakom pogledu,
05:12
apart from their reproductive organs
and sex hormones.
and sex hormones.
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izuzev njihovih reproduktivnih organa
i polnih hormona.
i polnih hormona.
05:17
So it was decided:
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Tako je odlučeno:
05:21
medical research was performed on men,
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medicinska istraživanja su sprovođena
na muškarcima,
na muškarcima,
05:24
and the results were later
applied to women.
applied to women.
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a rezultati su
kasnije primenjivani na ženama.
kasnije primenjivani na ženama.
05:29
What did this do to the notion
of women's health?
of women's health?
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Šta je ovo učinilo
sa poimanjem zdravlja žena?
sa poimanjem zdravlja žena?
05:32
Women's health became synonymous
with reproduction:
with reproduction:
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Zdravlje žena je postalo sinonim
za reprodukciju:
za reprodukciju:
05:37
breasts, ovaries, uterus, pregnancy.
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grudi, jajnici, materica, trudnoća.
05:42
It's this term we now refer
to as "bikini medicine."
to as "bikini medicine."
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To je termin o kome sada govorimo
kao o „bikini medicini“.
kao o „bikini medicini“.
05:46
And this stayed this way
until about the 1980s,
until about the 1980s,
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To je ostalo tako otprilike do '80-ih,
05:49
when this concept was challenged
by the medical community
by the medical community
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kada je ovaj koncept dovela u pitanje
medicinska zajednica
medicinska zajednica
05:52
and by the public health policymakers
when they realized that
when they realized that
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i donosioci odluka u javnom zdravstvu
kada su shvatili da smo ženama,
kada su shvatili da smo ženama,
05:56
by excluding women
from all medical research studies
from all medical research studies
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isključujući ih
iz svih medicinskih istraživanja,
iz svih medicinskih istraživanja,
06:01
we actually did them a disservice,
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učinili medveđu uslugu,
06:04
in that apart from reproductive issues,
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time da se osim reproduktivnih problema
06:06
virtually nothing was known
about the unique needs
about the unique needs
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praktično ništa nije znalo
o jedinstvenim potrebama
o jedinstvenim potrebama
06:09
of the female patient.
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ženskih pacijenata.
06:12
Since that time, an overwhelming amount
of evidence has come to light
of evidence has come to light
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Od tada, ogroman broj dokaza
je izašao na videlo
je izašao na videlo
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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koji nam pokazuju koliko su muškarci
i žene različiti u svakom pogledu.
i žene različiti u svakom pogledu.
06:29
You know, we have this saying in medicine:
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Znate, imamo ovu izreku u medicini:
06:32
children are not just little adults.
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deca nisu samo mali odrasli.
06:36
And we say that to remind ourselves
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To kažemo da bismo se podsetili
da deca zapravo imaju
da deca zapravo imaju
06:38
that children actually have
a different physiology than normal adults.
a different physiology than normal adults.
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različitu fiziologiju
od normalnih odraslih osoba.
od normalnih odraslih osoba.
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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Zbog toga je medicinska specijalizacija
pedijatrije izašla na svetlost dana
pedijatrije izašla na svetlost dana
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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i sada sprovodimo istraživanja na deci
kako bismo poboljšali njihove živote.
kako bismo poboljšali njihove živote.
06:57
And I know the same thing
can be said about women.
can be said about women.
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Znam da isto to može da se kaže za žene.
06:59
Women are not just men
with boobs and tubes.
with boobs and tubes.
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Žene nisu samo muškarci
sa grudima i jajovodima,
sa grudima i jajovodima,
07:06
But they have their own
anatomy and physiology
anatomy and physiology
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već imaju i sopstvenu
anatomiju i fiziologiju
anatomiju i fiziologiju
07:10
that deserves to be studied
with the same intensity.
with the same intensity.
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koja zaslužuje da se izučava
istim intenzitetom.
istim intenzitetom.
07:15
Let's take the cardiovascular
system, for example.
system, for example.
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Uzmimo kardiovaskularni sistem, na primer.
07:18
This area in medicine has done the most
to try to figure out
to try to figure out
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Ova oblast medicine je najviše uradila
pokušavajući da otkrije
pokušavajući da otkrije
07:22
why it seems men and women have
completely different heart attacks.
completely different heart attacks.
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zašto se čini da muškarci i žene imaju
potpuno različite srčane udare.
potpuno različite srčane udare.
07:27
Heart disease is the number one killer
for both men and women,
for both men and women,
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Srčana oboljenja su ubica broj jedan
i za muškarce i za žene,
i za muškarce i za žene,
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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ali više žena nego muškaraca umire u toku
prve godine od dobijanja srčanog udara.
prve godine od dobijanja srčanog udara.
07:39
Men will complain
of crushing chest pain --
of crushing chest pain --
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Muškarci se žale
na pritiskajući bol u grudima,
na pritiskajući bol u grudima,
07:43
an elephant is sitting on their chest.
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kao da im slon sedi na grudima,
07:46
And we call this typical.
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a to nazivamo tipičnim.
07:49
Women have chest pain, too.
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Žene takođe imaju bolove u grudima.
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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Međutim, više žena
nego muškaraca požaliće se
nego muškaraca požaliće se
da se „ne osećaju baš najbolje“,
da „ne mogu da uhvate dovoljno vazduha“,
da „ne mogu da uhvate dovoljno vazduha“,
08:00
"can't seem to get enough air in,"
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da su „baš umorne u poslednje vreme“.
08:03
"just so tired lately."
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08:07
And for some reason we call this atypical,
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Iz nekog razloga to nazivamo atipičnim,
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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iako, kao što sam pomenula,
žene sačinjavaju polovinu populacije.
žene sačinjavaju polovinu populacije.
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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Dakle, koji su dokazi koji mogu poslužiti
u objašnjenju nekih od ovih razlika?
u objašnjenju nekih od ovih razlika?
08:21
If we look at the anatomy,
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Ako pogledamo anatomiju,
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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krvni sudovi koji okružuju srce su manji
kod žena u poređenju sa muškarcima,
kod žena u poređenju sa muškarcima,
08:30
and the way that those blood vessels
develop disease is different
develop disease is different
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a način na koji ti krvni sudovi
razvijaju oboljenje se razlikuje
razvijaju oboljenje se razlikuje
08:35
in women compared to men.
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kod žena u poređenju sa muškarcima.
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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A testovi koje koristimo
da bismo ustanovili
da bismo ustanovili
da li je neko pod rizikom
od srčanog udara,
od srčanog udara,
08:43
well, they were initially designed
and tested and perfected in men,
and tested and perfected in men,
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pa, oni su prvobitno osmišljeni,
testirani i usavršeni na muškarcima,
testirani i usavršeni na muškarcima,
08:47
and so aren't as good
at determining that in women.
at determining that in women.
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tako da nisu toliko dobri
u utvrđivanju toga kod žena.
u utvrđivanju toga kod žena.
08:52
And then if we think
about the medications --
about the medications --
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Zatim, ako razmišljamo o lekovima -
08:55
common medications
that we use, like aspirin.
that we use, like aspirin.
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uobičajenim lekovima koje koristimo,
kao što je aspirin.
kao što je aspirin.
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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Dajemo aspirin zdravim muškarcima
da bismo im pomogli
u sprečavanju da dobiju srčani udar,
u sprečavanju da dobiju srčani udar,
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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ali da li ste znali da je,
ako date aspirin zdravoj ženi,
ako date aspirin zdravoj ženi,
09:08
it's actually harmful?
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to zapravo štetno?
09:12
What this is doing is merely telling us
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Ovo nam naprosto govori
09:14
that we are scratching the surface.
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da smo tek zagrebali površinu.
09:19
Emergency medicine
is a fast-paced business.
is a fast-paced business.
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Urgentna medicina je posao
koji se radi brzim tempom.
koji se radi brzim tempom.
09:23
In how many life-saving areas of medicine,
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U koliko oblasti medicine
od životnog značaja,
od životnog značaja,
09:26
like cancer and stroke,
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kao što su rak i šlog,
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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postoje značajne razlike
između muškaraca i žena
između muškaraca i žena
koje možemo iskoristiti?
09:36
Or even, why is it that some people
get those runny noses
get those runny noses
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Ili čak, zašto neki ljudi
dobijaju kijavicu češće od drugih,
dobijaju kijavicu češće od drugih,
09:41
more than others,
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ili zašto lekovi za bolove koje dajemo
za ozleđene prste na nogama
za ozleđene prste na nogama
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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deluju kod nekih, a kod drugih ne?
09:53
The Institute of Medicine has said
every cell has a sex.
every cell has a sex.
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Institut za medicinu kaže
da svaka ćeija ima pol.
da svaka ćeija ima pol.
09:59
What does this mean?
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Šta to znači?
10:02
Sex is DNA.
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Pol je DNK.
10:04
Gender is how someone
presents themselves in society.
presents themselves in society.
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Rod je kako se neko predstavlja u društvu,
10:09
And these two may not always match up,
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a ta dva se ne poklapaju uvek,
10:12
as we can see with our
transgendered population.
transgendered population.
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kao što možemo videti
kod transrodne populacije.
kod transrodne populacije.
10:16
But it's important to realize
that from the moment of conception,
that from the moment of conception,
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Ipak, važno je shvatiti da,
od trenutka začeća,
od trenutka začeća,
10:21
every cell in our bodies --
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svaka ćelija u našem telu -
10:23
skin, hair, heart and lungs --
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koža, kosa, srce i pluća -
10:27
contains our own unique DNA,
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sadrži našu sopstvenu jedinstvenu DNK,
10:30
and that DNA contains
the chromosomes that determine
the chromosomes that determine
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a ta DNK sadrži hromozome koji određuju
10:34
whether we become
male or female, man or woman.
male or female, man or woman.
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da li ćemo postati muško ili žensko,
muškarac ili žena.
muškarac ili žena.
10:40
It used to be thought
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Nekada je smatrano
10:42
that those sex-determining
chromosomes pictured here --
chromosomes pictured here --
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da ti hromozomi koji određuju pol
prikazani na slici ovde -
prikazani na slici ovde -
10:46
XY if you're male, XX if you're female --
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XY ako ste muško, XX ako ste žensko -
10:49
merely determined whether you
would be born with ovaries or testes,
would be born with ovaries or testes,
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određuju samo da li ćete biti rođeni
sa jajnicima ili testisima
sa jajnicima ili testisima
10:54
and it was the sex hormones
that those organs produced
that those organs produced
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i da su polni hormoni
koje ti organi proizvode
koje ti organi proizvode
10:58
that were responsible for the differences
we see in the opposite sex.
we see in the opposite sex.
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odgovorni za razlike
koje vidimo kod suprotnog pola.
koje vidimo kod suprotnog pola.
11:04
But we now know that
that theory was wrong --
that theory was wrong --
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Sada znamo da je ta teorija pogrešna -
11:09
or it's at least a little incomplete.
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ili makar da je nepotpuna.
11:12
And thankfully, scientists like Dr. Page
from the Whitehead Institute,
from the Whitehead Institute,
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Na sreću, naučnici poput dr Pejdža
sa Vajthed Instituta,
sa Vajthed Instituta,
11:16
who works on the Y chromosome,
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koji radi sa Y hromozomom,
i dr Janga sa Univerziteta Kalifornije,
Los Anđeles,
Los Anđeles,
11:18
and Doctor Yang from UCLA,
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11:21
they have found evidence that tells us
that those sex-determining chromosomes
that those sex-determining chromosomes
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pronašli su dokaz koji nam govori
da ti hromozomi koji određuju pol
da ti hromozomi koji određuju pol
11:26
that are in every cell in our bodies
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koji postoje u svakoj ćeliji u našem telu
11:29
continue to remain active
for our entire lives
for our entire lives
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ostaju aktivni celog našeg života
11:36
and could be what's responsible
for the differences we see
for the differences we see
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i moguće je da su odgovorni
za razlike koje vidimo
za razlike koje vidimo
11:40
in the dosing of drugs,
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u doziranju lekova,
11:42
or why there are differences
between men and women
between men and women
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ili za to što postoje razlike
između muškaraca i žena
između muškaraca i žena
11:45
in the susceptibility
and severity of diseases.
and severity of diseases.
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u pogledu podložnosti bolestima
i težini bolesti.
i težini bolesti.
11:51
This new knowledge is the game-changer,
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Ovo novo saznanje preokreće stvari,
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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i na tim naučnicima je da nastave
da pronalaze te dokaze,
da pronalaze te dokaze,
12:00
but it's up to the clinicians
to start translating this data
to start translating this data
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ali je na kliničarima da počnu
sa prenošenjem tih podataka
sa prenošenjem tih podataka
12:05
at the bedside, today.
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na bolničku postelju, danas.
12:09
Right now.
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Upravo sada.
12:13
And to help do this, I'm a co-founder
of a national organization
of a national organization
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Da bih pomogla u tome, ja sam suosnivač
nacionalne organizacije
nacionalne organizacije
12:16
called Sex and Gender
Women's Health Collaborative,
Women's Health Collaborative,
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pod nazivom Polna i rodna saradnja
za zdravlje žena,
za zdravlje žena,
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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i mi prikupljamo sve te podatke
tako da budu dostupni za podučavanje
tako da budu dostupni za podučavanje
12:24
and for patient care.
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i za negu pacijenata.
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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I radimo na tome da okupimo
medicinske edukatore za jednim stolom.
medicinske edukatore za jednim stolom.
12:31
That's a big job.
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To je veliki posao.
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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Ovo menja način na koji se sprovodi
medicinska obuka još od njenog početka.
medicinska obuka još od njenog početka.
12:41
But I believe in them.
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Ipak, ja verujem u njih.
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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Znam da će videti vrednost
uključivanja rodne perspektive
uključivanja rodne perspektive
12:49
into the current curriculum.
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u aktuelni nastavni program.
12:52
It's about training the future
health care providers correctly.
health care providers correctly.
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Radi se o ispravnoj obuci
budućih zdravstvenih radnika.
budućih zdravstvenih radnika.
13:00
And regionally,
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A regionalno,
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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ja sam suosnivač jedinice
u okviru Odeljenja urgentne medicine
u okviru Odeljenja urgentne medicine
13:05
here at Brown University,
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ovde na Univerzitetu Braun,
13:07
called Sex and Gender
in Emergency Medicine,
in Emergency Medicine,
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pod imenom Pol i rod u urgentnoj medicini,
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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i mi sprovodimo istraživanja da bismo
ustanovili razlike između muškaraca i žena
ustanovili razlike između muškaraca i žena
13:14
in emergent conditions,
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u hitnim situacijama,
13:16
like heart disease and stroke
and sepsis and substance abuse,
and sepsis and substance abuse,
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kao što su srčana oboljenja,
šlog, sepsa, zloupotreba supstanci,
šlog, sepsa, zloupotreba supstanci,
13:21
but we also believe
that education is paramount.
that education is paramount.
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ali takođe verujemo
da je obrazovanje od najvećeg značaja.
da je obrazovanje od najvećeg značaja.
13:27
We've created a 360-degree
model of education.
model of education.
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Napravili smo model obrazovanja
od 360 stepeni.
od 360 stepeni.
13:31
We have programs for the doctors,
for the nurses, for the students
for the nurses, for the students
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Imamo programe za doktore,
bolničare, studente
bolničare, studente
13:37
and for the patients.
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i pacijente.
13:39
Because this cannot just be left up
to the health care leaders.
to the health care leaders.
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Jer ovo ne može samo da se prepusti
liderima zdravstvene zaštite.
liderima zdravstvene zaštite.
13:44
We all have a role in making a difference.
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Svi imamo ulogu u donošenju promena.
13:48
But I must warn you: this is not easy.
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Ipak, moram da vas upozorim:
ovo nije lako.
ovo nije lako.
13:53
In fact, it's hard.
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U stvari, teško je.
13:57
It's essentially changing the way
we think about medicine
we think about medicine
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To je u suštini menjanje načina
na koji razmišljamo o medicini,
na koji razmišljamo o medicini,
14:01
and health and research.
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zdravlju i istraživanju.
14:05
It's changing our relationship
to the health care system.
to the health care system.
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To je promena našeg odnosa
sa sistemom zdravstvene zaštite.
sa sistemom zdravstvene zaštite.
14:09
But there's no going back.
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No, nema povratka.
14:13
We now know just enough
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Sada znamo tek toliko
14:17
to know that we weren't doing it right.
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da znamo da nismo radili kako treba.
14:21
Martin Luther King, Jr. has said,
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Martin Luter King mlađi je rekao:
14:24
"Change does not roll in
on the wheels of inevitability,
on the wheels of inevitability,
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„Promena se neće dokotrljati
na točkovima neizbežnosti,
na točkovima neizbežnosti,
14:28
but comes through continuous struggle."
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već kroz neprekidnu borbu.“
14:32
And the first step
towards change is awareness.
towards change is awareness.
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A prvi korak ka promeni je svesnost.
14:36
This is not just about improving
medical care for women.
medical care for women.
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Ovde se ne radi samo
o poboljšanju medicinske nege za žene.
o poboljšanju medicinske nege za žene.
14:40
This is about personalized,
individualized health care for everyone.
individualized health care for everyone.
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Radi se o personalizovanoj,
individualizovanoj
zdravstvenoj zaštiti za sve.
zdravstvenoj zaštiti za sve.
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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Ova svest ima moć da transformiše
medicinsku negu za muškarce i žene
medicinsku negu za muškarce i žene
14:54
And from now on, I want you
to ask your doctors
to ask your doctors
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i hoću da od sada pitate svoje lekare
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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da li je lečenje koje dobijate
specifično namenjeno vašem polu i rodu.
specifično namenjeno vašem polu i rodu.
15:06
They may not know the answer --
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Možda ne znaju odgovor -
15:08
yet.
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još.
15:11
But the conversation has begun,
and together we can all learn.
and together we can all learn.
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No, razgovori su otpočeli
i zajedno možemo da učimo.
i zajedno možemo da učimo.
15:15
Remember, for me
and my colleagues in this field,
and my colleagues in this field,
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Upamtite, za mene
i moje kolege u ovom polju,
i moje kolege u ovom polju,
15:20
your sex and gender matter.
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vaš pol i rod su bitni.
15:23
Thank you.
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Hvala.
15:24
(Applause)
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(Aplauz)
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