The Importance of Gender-Specific Research

The Importance of Gender-Specific Research

While there has been considerable publicity about the gender pay gap, it’s by no means the only inequality that women face on a widespread basis. We’ve learned that gender differences matter in all aspects of health and disease and we should not assume that study results for men are the same as for women. Historically, there has been a lack of gender-specific research which has had an impact on the ability of women to obtain accurate diagnosis and treatment. Because females have been generally excluded from research participation, they unfortunately have been overlooked in research findings.

Encouraging Researchers to Enroll More Women in Studies

There have been significant strides to encourage more gender-specific research which is enabling healthcare professionals to provide more specialized, effective care for women. More than 20 years ago, the National Institutes of Health (NIH) made a ruling that every study they funded had to state whether women and minorities were included and in what proportions. If women were not included, an explanation was required. In 2016, the Food and Drug Administration (FDA) Office of Women’s Health, in partnership with the NIH Office of Research on Women’s Health, launched the Diverse Women in Clinical Trials Campaign to further raise awareness about the importance of diverse women participating in clinical trials. The NIH, the FDA and the Centers for Disease Control and Prevention (CDC) continue to develop new policies, programs and procedures to mandate and implement the inclusion of more women, as well as racial and ethnic minorities, in research.

The Challenge of Gender Disparity in Medical Research

Despite efforts to enroll more women in studies, there continues to be an under representation of female participants. According to the NIH, only one-third of cardiovascular clinical trial participants are female. Yet, cardiovascular disease is the number one killer of both men and women, and their presenting symptoms and response to treatments are different.

“Large gender gaps in research participation limit our findings on the difference between men’s and women’s health,” says Dr. Christina Brennan, MD, MBA, Vice-President, Clinical Research, Northwell Health. “Even when women are enrolled, the data is not analyzed and reported separately which can limit our understanding of findings.”

More recently, in the cases of heart disease, as well as lung cancer, there has been increased inclusion of women in research and clinical trials. This has led to greater knowledge and better tools for clinicians to provide optimal care for women.

Participating in a Clinical Trial

Although many women participate in clinical trials, there is still the need for greater involvement. Women from all ages, racial and ethnic groups can participate in trials, including those with disabilities or chronic health conditions. Through participation, women can make a difference by helping doctors learn more about women’s health.

Want to learn more about gender-specific research? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

hyperthermia heatstroke

Heatstroke – What You Need to Know

It’s that time of year when there’s plenty of sun, and temperatures are at their peak. While it’s ideal weather for vacations, barbecues and beach getaways, it’s also when cases of heatstroke dramatically increase. Throughout the warm summer months, it’s important for all of us to take proactive steps to prevent heatstroke as it can happen at any age. In some cases, an ounce of prevention can even save a life!

What Is Heatstroke?

Caused by the body overheating, heatstroke, also called hyperthermia, is typically a result of prolonged exposure to or physical exertion in high temperatures. Symptoms can include:

  • Dizziness
  • Disorientation
  • Agitation
  • Confusion
  • Sluggishness
  • Seizure
  • Loss of consciousness
  • Rapid heartbeat
  • Hallucinations

The most serious form of heatstroke occurs when body temperature rises to 104 degrees or higher. Heatstroke is a medical emergency that can damage the brain, heart, kidneys and muscles. In some cases, it can lead to serious complications and even death.

Protecting Yourself

Anyone can develop heatstroke. However, there are certain factors that can put you at greater risk. These include:

Age – Both the very young and adults over 65 have less ability to cope with changes in body temperature.

Exertion in hot weather – Exercise and other types of physical exertion in hot weather, such as yardwork, can lead to a heatstroke.

Sudden exposure to hot weather – You’re more susceptible to heat-related illness if you’re suddenly exposure to high temperatures, such as during an early summer heatwave or when traveling to a hotter climate.

Certain medications – Some medications can affect your ability to stay hydrated and respond to high temperatures. These include vasoconstrictors, blood pressure medication, beta blockers, diuretics and antidepressants.

Health conditions – Chronic illnesses, such as heart or lung disease and obesity, can increase your risk of heatstroke.

Children’s Health Risk

Sadly, one of the biggest summer dangers for children is heatstroke. On average, every eight days a child dies from heatstroke in a vehicle (source: Safe Kids). Hundreds more children are rescued. Many are surprised to learn that heatstroke is the leading cause of non-crash, vehicle related deaths for children.

There are many circumstances that contribute to this increasingly common children’s health risk. Over 50 percent of the time, a child is “forgotten” by a caregiver. When you consider that the temperature in a car can rise more than 20 degrees in just ten minutes, time is critical when a child is left in a hot car.

Rosemarie Ennis, Assistant Vice President, Community Health Education, Office of Community and Public Health at Northwell Health stresses that parents and caregivers must actively protect children from heatstroke. “One of the best ways to do this is to remember to ACT,” says Ennis.

A – Avoid heatstroke-related injury and death by never leaving a child alone in a car, not for one minute. And, make sure to keep your car locked when you’re not in it so kids don’t get in on their own.

C – Create reminders by putting something in the back of your car next to your child such as a purse or a cell phone. This is particularly important if you’re not following your normal routine.

T – Take action if you see a child alone in a car. Call 911. Emergency personnel are trained to respond to these life-threatening situations.

To help decrease the tragic consequences of children being left in hot cars, Wednesday, July 31st has been designated National Child Vehicular Heatstroke Prevention Day.

Preventing Heatstroke

Fortunately, there are many ways to reduce your chance of developing heatstroke this summer. Smart strategies to stay cool include:

  • Wear loose-fitting, light-weight clothing that enables your body to cool properly.
  • Protect against sunburn by using an SPF, wearing a hat and sunglasses.
  • Staying hydrated by drinking plenty of fluids.
  • Taking precautions with medications.
  • Avoiding direct sunlight during the hottest times of the day.

“With greater awareness of the dangers of heatstroke, we can work together to prevent the tragedy of more children dying from heatstroke in hot cars,” says Ennis. “Simple preventive steps, such as ACT, can help save lives.”

Katz Institute for Women’s Health is here to answer your questions about heatstroke and other heat-related illnesses. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

Understanding the Benefits and Risks of Dietary Supplements

Understanding the Benefits and Risks of Dietary Supplements
If you’ve walked through the health food aisle of your local grocery store lately, you’ve probably been amazed by the wide variety of dietary supplements on the shelves. The options are vast and growing – from traditional tablets and capsules to energy bars, shakes, drops and more. With the majority of women in the United States now taking one or more dietary supplements every day, marketers have certainly seen an opportunity when it comes to introducing new products containing vitamins, minerals, fatty acids and botanicals.

Are Dietary Supplements Necessary?
There is scientific evidence showing that some dietary supplements can be beneficial for managing certain health conditions and for maintaining overall health. For example, folic acid taken during pregnancy can decrease the risk of neural tube birth defects. Omega-3 fatty acids have been shown to help maintain both brain and heart health. And, calcium and vitamin D may help reduce the risk of developing osteoporosis later in life.

“A multivitamin can be a good nutritional insurance policy for some women when it’s combined with a healthy diet and exercise to ensure they meet their daily nutritional requirements,” says Robert E. Graham, MD, MPH, FACP, Director of Integrative Health & Wellness at North Shore-LIJ Health System. “However, it’s important to remember that they’re only intended to supplement the diet not to be meal replacements.”

Safety and Risk
The U.S. Food and Drug Administration (FDA) has established a set of quality standards for dietary supplements to ensure their identity, composition, strength and purity. However, unlike prescription and over-the-counter medication, the FDA does not determine the efficacy of dietary supplements before they are marketed. Quality can be variable, and this is why it’s wise to carefully choose products that have been third-party tested for quality. Organizations that provide this type of testing include ConsumerLab.com and NSF International.

Along with potential quality issues, there are other risks when it comes to taking dietary supplements. One of the most common problems is experiencing side effects from combining herbal supplements or other types of dietary supplements with either prescription or over-the-counter medication. Some supplements can increase the risk of bleeding or affect one’s response to anesthesia and shouldn’t be taken before or after surgery. St John’s Wort can reduce the effectiveness of both antidepressants and birth control pills. Even commonly-taken antioxidant supplements like vitamin C and E may reduce the effectiveness of some types of cancer chemotherapy.

There can also be dosage issues with dietary supplements. Getting sufficient amounts of vitamin B6 and vitamin B12 can help women feel their best. Yet, taking too much can be dangerous. High intakes of vitamin B6 can cause nerve problems, gastrointestinal symptoms and sensitivity to the sun. High dose B12 vitamins have been linked to blood clots, diarrhea and damage to the optic nerve, which can even lead to blindness.

What’s the Best Way to Leverage the Benefits of Dietary Supplements?
If you are considering adding a supplement to your diet, the first step is to discuss benefits and possible side effects with your doctor.

“It’s important to consider all medications, as well as other factors such as age, diet, current health status and exercise regimen before taking any supplement,” says Dr. Graham. “For many women, dietary supplements can be incorporated into a healthy diet to add to what is needed to thrive.”

Do you want to learn more about dietary supplements? Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak with a women’s health specialist.

Staying Health Literate

Staying Health Literate

Have you ever found it difficult to understand instructions on a prescription medication bottle or had trouble reading the fine print of a consent form? Do you have difficulty reviewing lab test results or locating health resources? If so, you’re by no means alone! According to the National Assessment of Adult Literacy, nearly nine out of ten adults may be lacking in the necessary literacy skills required to effectively manage their health and prevent disease.

“Health literacy is an incredibly important issue for both patients and healthcare providers,” says Fallon Williams, MPH, Project Manager, Health Literacy & Patient Education, North Shore-LIJ Health System. “It is something that we should all be striving to achieve and should be continuously monitoring, especially with the many changes and advances happening in healthcare.”

Defining Health Literacy

Health literacy is commonly defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services required to make appropriate health decisions. Both healthcare providers and patients play vital roles in health literacy. Healthcare providers have a responsibility to enhance their patients’ health literacy in a variety of ways, including:

  • Helping patients feel comfortable by treating them with dignity and respect and encouraging them to talk openly
  • Listening to what patients have to say
  • Asking the patient’s preferred language to discuss healthcare
  • Speaking in plain language and avoiding medical jargon
  • Using visual models to explain a procedure or condition
  • Asking patients to “teach back” information provided to them

Patients are often given complex information and difficult-to-understand treatment options. This requires the ability to:

  • Analyze risks and benefits
  • Calculate dosages
  • Communicate with healthcare providers
  • Evaluate information to determine credibility and quality
  • Interpret test results
  • Search for appropriate health resources

To effectively manage these responsibilities, patients need to have a variety of skills including the ability to read, comprehend, analyze, ask questions and make decisions related to specific health situations. While language and cultural differences can play a part in health illiteracy, it can also be a result of visual impairment, a lack of computer skills or even an inability to calculate or reason numerically.

Older adults are particularly vulnerable when it comes to health literacy. Individuals over 65 not only make nearly twice as many physician office visits per year than those ages 45 to 65, they are much more likely to have difficulty using technology, print materials, forms and charts, as well as interpreting numbers and performing calculations.

The Impact of Low Health Literacy

Health literacy can have a profound effect on patients, their loved ones and the healthcare system. Individuals with low health literacy are less likely to use preventative care and read medical labels and instructions, according to the Agency for Healthcare Research and Quality Report. Because of this, they are more likely to be hospitalized and have poor disease outcomes. This contributes to higher inpatient spending. Just how much? The annual cost of low health literacy is estimated to be between $106 billion and $238 billion!

Low health literacy was once considered to be primarily a patient problem. However, this way of thinking has shifted substantially, and it is now thought of as a system-wide issue that is largely caused by the complexity of the healthcare system and the presentation of health information.

Several federal policy initiatives have been put in place to help address the problem of low health literacy including the Affordable Care Act, which includes several provisions that specifically address the need for improved health literacy.

Healthcare providers are also playing a more direct role in improving patients’ health literacy in a number of ways. This includes training healthcare staff in the principles of health literacy and plain language, providing more patient access to understandable health information, developing health literacy programs and working with advocate organizations to help those in the most vulnerable populations.

With health literacy becoming an increasing focus for healthcare providers, patients will undoubtedly benefit from improvements made that will help them better manage their own health. This will ultimately lead to better choices and improved outcomes.

Find out more about health literacy and patient education at the Katz Institute for Women’s Health Resource Center. Call 855-850-KIWH (5494) to speak with a woman’s health specialist.

Eye Health: Beyond Carrot Crunching

You may have heard that if you avoid reading in dim light and nosh on plenty of carrots, you can keep your eyes healthy for life. But according to the National Eye Institute (NEI), part of the National Institutes of Health, the first tip is a myth and the second is only one factor among many.

“Now that so many people spend so much time on their phone, computer and tablet screens, there are a few eye disorders that we’re seeing more of,” explains Dr. Anne Steiner, Director, Ocular Surface Center of Ophthalmology, Long Island Jewish Medical Center.

The NEI also estimates that about 38 million Americans suffer from these common but potentially serious eye conditions. Luckily, these disorders are generally treatable if caught early. To start, Dr. Steiner recommends that everyone have a yearly eye exam beginning at age 40 – sooner, if you have an underlying eye condition or have a family history of eye conditions.

Here’s what else you need to know about four common eye conditions:

Common Eye Condition #1:  Dry Eye Syndrome

Eyes need a robust tear film to cover their surface and keep them moist. When there is not enough of a tear coating, the cornea gets dry, causing dry eye syndrome.

Symptoms include:

  • Foreign body sensation – you feel like something is poking your eye or you have a grain of sand in it
  • Fluctuations in vision
  • Light sensitivity
  • Inflammation and redness on the conjunctiva, or white part of the eye

You are more susceptible to dry eye syndrome as you age and also if you have any of the following conditions:

Treatment includes supplementing tears using preservative-free drops, ointments or gels. These can be over-the-counter or prescription strength, depending on the extent of your condition. Steroids can help reduce inflammation, as well.

“Lots of people don’t address dry eye syndrome, but it’s treatable and treatment really improves quality of life,” explains Dr. Steiner.

Common Eye Condition #2: Cataracts

When you’re born, the lens in your eye is crystal clear. As you get older, proteins accumulate in the lens. These changes are normal but can become a problem if they affect your vision.

“Some people may experience blurred vision or notice that colors seem less vibrant. People come in to see me when they are bothered by glare or halos, and especially if they are having trouble driving at night,” says Dr. Steiner.

The treatment for cataracts is outpatient surgery under local anesthesia.

“This is generally a very successful surgery that comes with the added benefit of correcting people’s vision, so they may no longer even need glasses,” explains Dr. Steiner.

Common Eye Condition #3: Glaucoma

Your eyes constantly make and drain fluid to maintain a certain pressure level. High pressure damages the optic nerve, which connects the eye to the brain. This condition, called glaucoma, can significantly affect your vision.

“Glaucoma is a silent condition,” explains Dr. Steiner. “Most people don’t even realize they have it.” That makes it critical to have a regular eye pressure check with every exam.

Risk factors for glaucoma include:

  • Increasing age
  • Use of steroid medications
  • Having a family history of glaucoma

Treatment involves lowering the pressure in your eye, which slows or halts the progression of the disease. Drops, lasers or surgery can get the job done.

Common Eye Condition #4: Macular Degeneration

Macular degeneration is a condition that results in damage to your macula, the most sensitive part of your retina. The retina is the tissue in the back of your eye that transmits images to your brain. With a damaged macula you can experience difficulty seeing, including distorted vision and blind spots.

Dr. Steiner advises that all eye exams include an evaluation of the health of your retina. “It used to be much harder to treat macular degeneration, but we’ve come a long way in the last 15 years. Now, there are treatments available to treat macular degeneration.”

Treatment aims to slow the progression of the disease through vitamin supplements, medication and laser treatments.

So while the vitamin A in carrots certainly helps promote healthy eyes, crunching them alone isn’t enough. To set your sights high, make sure to pay attention to bothersome symptoms, and see your doctor regularly.

To make an appointment with Dr. Steiner or one of her colleagues, call 516-470-2020.

For questions related to women’s health, call the Katz Institute for Women’s Health Resource Center at 855-850-KIWH (5494) to speak with a women’s health specialist.

Taming the Irritable Bowel Syndrome Beast

If you’ve ever had butterflies, a nervous stomach or felt your stomach tied in knots, you know how much your emotions can take a toll on your gut. In fact, stomach discomfort is one of the most common health complaints women have.

Dr. Bethany DeVito, Director, Gastroenterology Health Center for Women, North Shore University Hospital and Long Island Jewish Medical Center, says, “if I had a dollar for every time I hear a woman come in complaining about gas, bloating and cramps, I’d be a millionaire.” Together, these symptoms, along with changes in bowel movements – either diarrhea, constipation or a combination of both – are known as irritable bowel syndrome (IBS).  Fortunately, IBS is a totally treatable condition.   “I tell my patients not to worry – we can figure out what causes the symptoms and how to address them.”

Diagnosing IBS mostly involves ruling out other issues, including celiac disease, thyroid problems, anemia, colon cancer, Crohn’s disease and ulcerative colitis. A blood test and colonoscopy can detect these more serious conditions. Dr. DeVito recommends that all women get a colonoscopy at age 50 – earlier if you have any history of colon cancer in your family or any alarm symptoms, such as unexplained abdominal pain or rectal bleeding.

But for most women, there are three main causes for IBS, all of which are pretty manageable:

IBS Cause #1: Diet

Surprisingly, our ability to tolerate different foods changes with age.  Foods you have enjoyed for years can suddenly begin to bother you. “If we delve into a woman’s diet history, we can usually find the problem,” says Dr. DeVito. Turns out, the number one culprit is dairy.

Many women love milk, cheese and yogurt, and these are great sources of protein and calcium. But the lactose in these dairy products can cause uncomfortable gas and bloating.

“The first thing I do is recommend an elimination diet. We do a two-week trial where you take milk, cheese, yogurt, ice cream and other dairy products out of your diet. And we see if your symptoms improve,” Dr. DeVito explains.

If the symptoms do improve, then Dr. DeVito identifies lactose intolerance as the cause of the IBS. She recommends replacing regular milk with lactaid milk, which tastes the same but lacks the problematic lactose. You can also find lactose-free cheeses, ice cream and other substitutes that are just as delicious as the originals but won’t leave you doubled over in pain and running for the nearest bathroom.

Another common sensitivity is celiac disease, which is an allergy or intolerance to gluten, a protein found in wheat, rye or barley. Some women may experience bloating or stomach pain in response to gluten even if they don’t have celiac disease. Blood work will determine whether you have the full-blown condition. But either way, eliminating gluten from your diet can improve symptoms.

Other food triggers can include heavy meals, fast foods, caffeine and carbs. So overall, Dr. DeVito reminds women that “you are what you eat. Avoid the junk and include fiber and water in your daily diet.”

A nutritionist can help you learn new ways to improve your diet to avoid IBS symptoms. The Katz Institute for Women’s Health (KIWH) Resource Center will work with you to find a nutritionist to meet your needs.  To learn more, you can call us at (855) 850-KIWH (5494).

IBS Cause #2: Stress

If you can’t pinpoint the source of your IBS with diet changes and blood work, then stress could be the underlying cause. If you’re upset, nervous or anxious, your stomach can take a real hit.

“It can be hard for some women to manage their stress, especially in times of big life transitions, like going through a divorce,” says Dr. DeVito. “The stomach is a sensitive part of your body, and you can really feel it in there.”

Finding ways to manage stress – through exercise, meditation and therapy – can make a difference.  The KIWH Resource Center can also connect with you with services and professionals to promote your psychological health.  You can speak to a women’s health specialist by calling (855) 850-KIWH (5494).

IBS Cause #3: Hormones

Finally, Dr. DeVito explains that hormone changes, such as those that come with your monthly period, can play a big role in causing IBS symptoms. But she assures patients that while the symptoms are uncomfortable, they are completely normal.

“The fluctuations during your cycle can make you feel gassy, crampy and bloated, especially around your period. And, if you’re premenopausal, it’s normal to feel gassy and bloated, too.”

The symptoms should ease up as you move through your cycle.

Finally, Dr. DeVito warns women to avoid colon cleanses and other do-it-yourself treatments to deal with symptoms. “IBS doesn’t lead to anything bad – you can manage it through lifestyle changes and you’ll be just fine.”

Make an appointment with Dr. DeVito or her team.

For questions related to women’s health, call the Katz Institute for Women’s Health Resource Center at 855-850-KIWH (5494) to speak with a women’s health specialist.

Health Tips, April 1, 2015

No gain from joint pain: Rheumatoid arthritis (RA) affects about 1.3 million Americans and nearly three times as many women as men. If you have a family history of RA and suffer joint pain, talk to your doctor. Early diagnosis can prevent the development of RA’s more severe complications. Learn more about rheumatology care.

Ward off worry:  If you worry constantly, often feel restless, irritable, tense, and have trouble breathing or sleeping, you may be suffering from an anxiety disorder. Deep breathing, medication and exercise can help, as can seeing a therapist. Learn more about behavioral health.

Less is more: Large, heavy meals can trigger a host of uncomfortable reactions, including stomach pain and heartburn. Stick to small, frequent meals instead.  Learn more about healthy nutrition.

Health Tips, March 22, 2015

3 Easy Ways to Stay Healthy

Control your weight, control your destiny: About half of all women who had diabetes during pregnancy will develop Type 2 diabetes later in life. You can reduce your risk by exercising and keeping your weight down. Learn more ways to lower your diabetes risk through our endocrinology program.

Take it to heart: Depression and anxiety can affect women who suffer from heart disease, so let your doctor know if you’re feeling down. As you adjust to life after a cardiac event, make sure to get the support you need to create a healthy work-life balance and minimize stress. Learn more about keeping your heart healthy.

Fill ‘er up: Drinking water is just as important in the winter months as in the summer. We can get parched without realizing it and staying hydrated helps boost our immune system to stave off nasty colds and flu. Learn more about healthy nutrition.