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WHEC
WOMEN'S HEALTH AND EDUCATION CENTER

Sexually Transmitted Diseases

September 23, 2009

Sexually transmitted diseases (STDs) represent a prevalent and compelling problem for women. As such, healthcare providers need to take a proactive approach in identifying vaginal symptoms, diagnosing infections, treating these conditions effectively, and maintaining careful follow-up with patients to help reduce the risk of recurrence or re-exposure. We hope that these materials provide valuable information and ideas that can be used to enhance the everyday care of the patients. Clinicians treating female adolescents should be prepared to offer confidential and comprehensive counseling, screening, and treatment according to established guidelines. They should also work within their communities and at the state and national levels to ensure access to medical care for all adolescents. Most importantly, clinicians can help to address this problem when caring for adolescent patients. Specifically, when providing health care for adolescents who have not yet become sexually active, abstinence from all risky behaviors should be encouraged.

Health Literacy, e-Health and Sustainable Development

July 26, 2010

Literacy is a human right and can be considered a tool of personal empowerment: a means for social and human development. Health literacy and e-Health are valuable tools in empowering women and communities to improve their health status and achieve sustainable development by reaching the indicators of the Millennium Development Goals (MDGs). In today’s world, the local and global are inextricably linked. Action on one cannot ignore the influence of or impact on the other. e-Health is a global phenomenon. The Women’s Health and Education Center’s (WHEC’s) strategy on e-Health focuses on strengthening health systems in countries; fostering public-private partnerships in information and communication technologies (ICT) research and development for health; supporting capacity building for e-Health application worldwide; and the development and use of norms and standards. Long-term government commitment, based on a strategic plan, is a prerequisite for the successful implementation of e-Health activities. Health is both a fundamental human right and a sound social investment.

Cervical Cancer Prevention: Managing High-Grade Cervical Neoplasia

August 30, 2012

Given that infections with the human papillomavirus (HPV) can lead to cervical cancer, screening and diagnostic programs involving Papanicolaou smears (Pap test) and colposcopy are the standard of care in North America. As more than 80% of cervical cancers are preventable by routine screening, the United States has clearly been successful in reducing HPV-related cancers with the implementation of the cervical cancer screening programs. The purpose of this review is to discuss the current management and summarize recommendations for managing high-grade cervical neoplasia (CIN2, 3+). Areas in which improvement can be made in the recognition of high-risk features during colposcopy are also discussed. Once colposcopic technique is improved, accuracy for detection of high-risk premalignant disease increases. Carcinogenic or “high-risk” human papillomavirus (high-risk HPV) testing has become the standard triage worldwide for women with atypical squamous cells of undermined significance (ASC-US) cytology and is designated as a stand-alone follow-up option in a number of post-colposcopy and post-treatment clinical management scenarios.

Sickle Cell Disease in Pregnancy

December 17, 2014

Pregnancy complicated by sickle cell disease is high-risk for both mother and fetus. Surveillance helps manage problems such as vaso-occlusive crises and alloimmunization. Maternal problems can arise from chronic underlying organ dysfunction such as renal disease or pulmonary hypertension, from acute complications of sickle cell disease such as vaso-occlusive crises and acute chest syndrome, and/or from pregnancy-related complications. Fetal problems include alloimmunization, opioid exposure, growth restriction, preterm delivery, and stillbirth. Couples should be counseled that a pregnancy with sickle cell disease is high risk for both fetus and mother and be made aware of the increased risks of adverse pregnancy outcome. Risks of adverse fetal outcomes are reduced but not eliminated with fetal surveillance. This review provides recommendations, screening and clinical management during prenatal and puerperium of patients with sickle cell disease. Genetic screening can identify couples at risk for offspring with sickle cell disease and other hemoglobinopathies and allow them to make informed decisions regarding reproduction and prenatal diagnosis.

Inherited Thrombophilias in Pregnancy

June 4, 2012

Identification of inherited thrombophilias has increased our understanding of one potential etiology for venous thromboembolism and of hypercoagulability in general. Over the past 10 years, some studies have suggested that inherited thrombophilia may be associated with preeclampsia and other adverse outcomes in pregnancy. There is limited evidence to guide screening for and management of these conditions in pregnancy. This document reviews common thrombophilias and their association with maternal venous thromboembolism risk and adverse pregnancy outcomes, indications for screening to detect these conditions, and management options in pregnancy. The literature on fetal thrombophilia and its role in explaining some cases of perinatal stroke that lead, ultimately, to cerebral palsy are also discussed.

Neurophysiology Of The Lower Urinary Tract

February 9, 2009

Discussing the normal function and neurologic control of the lower urinary tract in women. The nervous system is arranged into the central and the peripheral systems. The central nervous system includes the brain and spinal cord. Twelve paired cranial and 31 paired spinal nerves with their ganglia compose the peripheral nervous system. The somatic component of the peripheral system innervates skeletal muscle, and the autonomic division innervates skeletal muscle, and the autonomic division innervates cardiac muscle, smooth muscle, and glands. Historically, urologic complications were the main cause of death in spinal cord injury patients. Now their life expectancy is almost normal. Urodynamic diagnosis and guidance toward proper treatment is a key reason for the improved survival. Lifelong urologic surveillance is a central component to the routine care of the spinal cord injury patient. The article outlines neurologic pathways.

Cervical Glandular Carcinomas: Early Detection & Prevention

June 24, 2009

When different histologic types of cervical cancer are considered and trends are reexamined, it becomes apparent that observed declines are reflective of squamous cell carcinomas predominately; the rates for adenocarcinomas continue to rise. This rise in incidence may be due to the greater difficulty in screening for glandular precursor lesions that often arise high within the endocervical canal.  These strategies reflect new information concerning the natural history of cervical carcinogenesis and the performance of screening and diagnostic tests, and they take into account the cost and efficacy of various treatment and follow-up options. This document will describe staging criteria and treatment for cervical glandular carcinomas. For practical purposes, it will focus on the glandular cells and adenocarcinoma histologies only

Breastfeeding Guidelines for Healthcare Providers

August 6, 2009

The promotion of breastfeeding is an ongoing priority of the Women’s Health and Education Center (WHEC). The purpose of this document is to promote breastfeeding and work with national and international organizations dedicated to promoting the health of infants worldwide to formulate guidelines for breastfeeding. Where breastfeeding practices are suboptimal, simple one-encounter antenatal education and counseling significantly improve breastfeeding practice up to 3 months after delivery. Healthcare providers should make every effort to have at least one face-to-face encounter to discuss breastfeeding with expectant mothers before they deliver. Human milk provides developmental, nutritional, and immunologic benefits to the infant that cannot be duplicated by formula feeding.

Diagnosis of Vaginitis & Pelvic Inflammatory Disease

September 23, 2009

Vaginal infections represent an enormous, yet often underestimated element of female healthcare. Each year millions of women report symptoms of vaginitis to their clinician. Vaginitis can create a great deal of discomfort, stress, and anxiety in patients; furthermore these conditions may exert untoward and long-term effects on well-being, reproductivity and even mortality. The success with which vaginitis is managed depends largely on the counseling methods used by the healthcare provider. The purpose of this document is to understand three most common vaginal infections: bacterial vaginosis; candida vaginitis (yeast); and trichomonas vaginitis. Pelvic inflammatory disease (PID) and its management are also discussed to understand its causes and appropriate treatment. Vaginal infections can raise very serious concerns for patients. The manner in which women respond to the information about their infection, and how well they succeed with practices to treat it and prevent recurrences, depends largely on their healthcare provider’s counseling methods.

Women’s Health and Human Rights

December 7, 2009

Human rights are used by international organizations, governments, non-governmental organizations (NGOs), civil society groups and individuals in their work with respect to health in many different ways. The right to life is a fundamental human right, implying not only the right to protection against arbitrary execution by the state but also the obligations of governments to foster the conditions essential for life and survival. Human rights are universal and must be applied without discrimination on any grounds whatsoever, including sex. For women, human rights include access to services that will ensure safe pregnancy and childbirth. The right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant is essential. This has been the focus of an initiative developed by the Women’s Health and Education Center (WHEC) with various partners, to provide all those working for Safe Motherhood, with a way of analyzing the impact in an understanding of both health and human rights.