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D. Match each fixed phrase in the table with the type of information that can follow.
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| Fixed phrase | Followed by… |
| 1.An important concept (is)… | a different way to think about the topic |
| 2.What do I mean by…? | an imaginary example |
| 3. As you can see, … | a key statement or idea |
| 4.Say… | a concluding comment giving the result of something |
| 5.Looking at it another way, … | a new idea or topic that the lecturer wants to discuss |
| 6.The point is… | a comment about a diagram or picture |
| 7.In financial terms,… | an explanation of a word or phrase |
| 8.In this way,… | A general idea put into a financial context |
E. Read Part 3 of the lecture.
- Make note after each phrase in D.
Now, an important concept in the smooth running of any hospital and one which frequently raises concern in the popular press in is the notion of Integrated Care Pathway or ICP. O, what do I mean by Integrated Care Pathway exactly?
Well, to help you understand this concept, can you look for a moment at the patient leaflet that I have just handed out? As you can see, a patient typically arrives in admissions and then passes through several departments meeting different members of the emergency team before being discharged at the end of his or her stay.
Let’s look at an example of this. Say a patient arrives with a suspected fracture hip. After being admitted, the patient may spend time in the waiting room before being sent by the triage nurse who will assess their symptoms and vital signs. They will be then be sent for an x-ray before going to the Surgical Assessment Unit. Just prior to the operation the anesthetist will make an assessment of the patient’s fitness for operation.
Immediately after the operation the patient will spend time in the recovery room, then go back to the orthopedic ward. And then, finally, the patient is discharged back to the care of their GP or family doctor. Despite significant advances in technology and increased specialization, the organization of these departments has changes very little. However, looking at it another way, changes in the patient mix and profile, an ageing population in effect, has brought about certain problems, notably an increase in admissions to acute care hospitals. And that’s for both emergency and planned care. The point is that the resulting flow of patients is often inefficient and poorly coordinated. This is a phenomenon that has been noted in small regional hospitals as well as the larger teaching hospitals/ in financed terms, hospital wards are under pressure to close and the number of beds to be reduced. But why is ‘patient flow’ so important? Well, with hospitals that are capable of functioning to their optimal capacity, patient waiting times are reduced, the quality of care is improved and hospitals become more cost-effective; in this way maximizing the benefits of hospital care for all those who need it.
SURGICAL TREATMENT.
A. The operating theatre.
Surgery is carried out in an operating theatre. Great care is taken to make sure that operations take place in sterile conditions – free from microorganisms. The surgeon and his or her assistant wash or scrub up, and put on surgical gowns, masks, and gloves. The patient’s skin is prepared by disinfecting it with an antiseptic solution. This is known as prepping (preparing) the patient. They are then covered with sterile drapes, so that the only area of the operation is exposed.
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B. Instruments.
С. The operation.
The operation begins when the surgeon makes an incision or cut. Control of bleeding is very important. A swab is a pad of cotton or other material use to soak up blood from the operation site. A sucker is a mechanical device which aspirates blood. Bleeding vessels are tied with ligatures or sealed by an electric current (diathermy).
Drains may be inserted to carry away fluid which might act as a culture medium for bacteria. Various methods are used to close the wound, for example sutures (also known as stitches), or staples. Finally, the wound is covered with a dressing.
D. An operation report.
1.
Which of the instruments above is needed for each of the following procedures?
- making an incision
- keeping the sides of the wound open
- cutting sutures
- holding the cut ends of blood vessels before they are tied
2.
A surgeon is talking to a medical student about assisting at operations. Complete his advice using words from A, B and C above.
An ____must be able to carry out the following tasks to help the surgeon. Firstly, he or she must help in ___the patient and putting the ____in place to provide _______conditions. Expert handling of a ___is essential to allow the surgeon to see what he is doing. The assistant must also keep the operation site free of blood, by careful use of the tying and cutting _____, and with the insertion of a _____, if necessary. Finally, the assistant may be asked to close the wound with ____or other devices.
3.
Find words in C and D opposite with the following meanings:
- cut into pieces
-correct (something that was damaged)
- freed from surrounding tissues
- removed by cutting out
- spread of liquid into an area
- making sure something is not damaged
- small metal devices to hold the edge of a wound together
- unnecessary
- sewing up of the wound
- flat, thin pieces of tissue that lie on top of one another
IN PARTICULAR…
DENTISTRY
Management of acute dental pain
General medical practitioners are often called upon to manage acute dental pain in emergency situations, for example, out of hours or in rural areas, where it may not be possible for a dentist to provide immediate treatment. Common acute oral problems are usually easy to diagnose. Simple management can alleviate pain and further discomfort until a dentist can be called upon.
Most problems can be identified by the history and examination. Several dental conditions have typical symptoms with different types of pain.
When investigating acute dental pain, the history should focus on the pain's: location, type, frequency and duration, onset, exacerbation and remission (for example the response to heat or cold), severity, area of radiation.
Associated pathology and referred pain should also be considered.
Common types of oro-facial pain likely to cause a patient to seek emergency care are categorised in the box below. The character of the pain can point to a diagnosis.
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There are several simple tests that may assist in diagnosis of dental pain.
Some of the most commonly used tests are the following
-Pulp sensitivity test
Dry ice, or an ordinary ice stick (made in a plastic or glass tube), is placed on the cervical third (neck region) of the tooth crown. A response to the stimulus indicates that the pulpal tissue is capable of transmitting nerve impulses. No response may indicate pulp necrosis.
-Percussion test
Using an instrument handle, the tooth is tapped in the longitudinal axis. A painful response suggests possible periapical inflammation.
If it is possible to obtain a screening radiograph, such as an orthopantomograph (OPG), this may assist in the diagnosis and localization of the cause of the pain. The radiograph should show clearly the apical and periapical structures of teeth and associated tissues. The relationship of the maxillary molars and premolars to the floor of the maxillary sinus can be examined, and radiographs may reveal recurrent caries or periapical radiolucencies associated with an established infection.
While antibiotics are appropriate in the management of certain dental infections, they are not indicated if the pain results from inflammatory (non-infective) or neuropathic mechanisms. The degree of pain is not a reliable indicator of acute infection.
⃰ Acute Dental Trauma
Acute dental trauma is a serious injury to one or more parts of your mouth. Your injury may include damage to any of your teeth, the tooth socket, the tooth root, or your jaw. You can also have injuries to the soft tissues of your mouth. These include your tongue, cheeks, gums, and lips. Severe injuries can expose the soft pulp inside the tooth.
Dental trauma usually occurs from a direct hit to your mouth or jaw. Accidents, such as falling off a bicycle or a car accident can cause dental trauma. A direct hit can also happen during sports activities.
The signs and symptoms of acute dental trauma are the following: tooth damage, bleeding or bruising, facial fracture, tooth or bite change.
Treatment will depend on the type of dental trauma. A tooth that moves slightly may heal on its own. A soft tissue wound may be closed using stitches.
Tooth repair procedures can be beneficial as well as any of the following: pain medicine, antibiotics, Td vaccine (diphtheria and tetanus) and mouthwash.
Without treatment, you an infection may develop. A tooth may also become discolored or stay out of place. A chipped tooth with a sharp edge may cut the tongue or other soft tissues around it or the patient may lose one or more teeth.
IN PARTICULAR…
PEDIATRICS
Acute Respiratory Infections in Children
Acute respiratory infections (ARIs) are classified as upper respiratory tract infections (URIs) or lower respiratory tract infections (LRIs). The upper respiratory tract consists of the airways from the nostrils to the vocal cords in the larynx, including the paranasal sinuses and the middle ear. The lower respiratory tract covers the continuation of the airways from the trachea and bronchi to the bronchioles and the alveoli. ARIs are not confined to the respiratory tract and have systemic effects because of possible extension of infection or microbial toxins, inflammation, and reduced lung function. Diphtheria, pertussis (whooping cough), and measles are vaccine-preventable diseases that may have a respiratory tract component but also affect other systems.
Except during the neonatal period, ARIs are the most common causes of both illness and mortality in children under five, who average three to six episodes of ARIs annually. The World Health Organization (WHO) estimates that 2 million children under five die of pneumonia each year.
Upper Respiratory Tract Infections
URIs are the most common infectious diseases. They include rhinitis (common cold), sinusitis, ear infections, acute pharyngitis or tonsillopharyngitis, epiglottitis, and laryngitis—of which ear infections and pharyngitis cause the more severe complications (deafness and acute rheumatic fever, respectively). The vast majority of URIs have a viral etiology. Rhinoviruses account for 25 to 30 percent of URIs; respiratory syncytial viruses (RSVs), parainfluenza and influenza viruses, human metapneumovirus, and adenoviruses for 25 to 35 percent; corona viruses for 10 percent; and unidentified viruses for the remainder.
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Because most URIs are self-limiting, their complications are more important than the infections. Acute viral infections predispose children to bacterial infections of the sinuses and middle ear, and aspiration of infected secretions and cells can result in LRIs.
Acute Pharyngitis
Acute pharyngitis is caused by viruses in more than 70 percent of cases in young children. Mild pharyngeal redness and swelling and tonsil enlargement are typical. Streptococcal infection is rare in children under five and more common in older children. Acute pharyngitis in conjunction with the development of a membrane on the throat is nearly always caused by Corynebacterium diphtheriae in developing countries. However, with the almost universal vaccination of infants with the DTP (diphtheria-tetanus-pertussis) vaccine, diphtheria is rare.
Lower Respiratory Tract Infections
The common LRIs in children are pneumonia and bronchiolitis. The respiratory rate is a valuable clinical sign for diagnosing acute LRI in children who are coughing and breathing rapidly.
Currently, the most common causes of viral LRIs are RSVs. They tend to be highly seasonal, unlike parainfluenza viruses, the next most common cause of viral LRIs. The epidemiology of influenza viruses in children in developing countries deserves urgent investigation because safe and effective vaccines are available. Before the effective use of measles vaccine, the measles virus was the most important viral cause of respiratory tract–related morbidity and mortality in children in developing countries.
Both bacteria and viruses can cause pneumonia. Bacterial pneumonia is often caused by Streptococcus pneumoniae (pneumococcus) or Haemophilus influenzae, mostly type b (Hib), or other streptococci. Just 8 to 12 of the many types of pneumococcus cause most cases of bacterial pneumonia, although the specific types may vary between adults and children and between geographic locations.
Interventions to control ARIs can be divided into four basic categories: immunization against specific pathogens, early diagnosis and treatment of disease, improvements in nutrition, and safer environments. The first two fall within the purview of the health system, whereas the last two fall under public health and require multisectoral involvement.
⃰Acute Stress Disorder Common in Children and Parents After Traffic Accident
In 90 percent of families with children injured in a traffic crash, the child or a parent is most likely to suffer at least one significant acute stress symptom. And 25 percent of children and parents experience more pervasive symptoms that warrant clinical attention. It is normal for parents to be very distressed in the aftermath of a child's injury, yet parents' own acute stress symptoms may influence a child's response to the traumatic event.
Acute stress disorder is a group of symptoms and reactions that may occur within the first month after a traumatic experience. ASD symptoms include re-experiencing the trauma (unwanted and upsetting thoughts or memories), avoiding reminders of the trauma, hyperarousal (jumpiness), and dissociation (numbing, feelings of unreality).
Post-traumatic stress disorder (PTSD) is diagnosed when these symptoms persist for a long time (at least one month) and begin to impair the individual's everyday functioning. The Children's Hospital researchers found that acute stress symptoms were common within the first month after injury. Among injured children and their parents, more than four-fifths experienced at least one significant acute stress symptom.
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Health care providers thus need to identify effective ways to support distressed parents, so that parents in turn can most effectively help their child to cope with a traumatic injury, researchers say.
3. Лексические опоры для понимания медицинских текстов.
3.1. Слова общего корня в английском, латинском и русском языках .
В медицинской терминосистеме на долю интернационализмов приходится до 85% от общего количества терминов. Следовательно, в научных медицинских текстах содержится много слов, которые имеют общий корень с русскими словами. Очень важными являются графические совпадения слов общего корня, так как в книжной лексике графическая сторона имеет первостепенное значение.
Некоторые английские слова, имеющие общий корень с латинскими или русскими, графически почти полностью совпадают:
| Английский assistant canal contact culture fact material period vacuum vitamin | Русскийассистент канал контакт культура факт материал период витамин витамин |
Большинство английских терминов совпадает с латинскими, различия наблюдаются, как правило, только в окончании слов:
| Английский abdomen apex chronic adult bilateral cause malignant exterior septum superior vertebra | Латинский abdomen apex chronicus adultus bilateralis causa malignus exterior septum superior vertebra |
Различие в последней букве или буквах слов общего корня встречается гораздо чаще.
При этом вместо конечного немого -е в английских словах встречается нулевое окончание русских существительных мужского рода
(appetite — аппетит, microbe — микроб, nerve — нерв)
и окончание -а (я) существительных женского рода
(amplitude — амплитуда, date — дата, minute —минута).
Английское -у в конце слова часто соответствует русскому -ия
(analogy —аналогия, artery —артерия, category — категория).
Нулевое окончание английского существительного обычно соответствует русским существительным женского рода на –а
(clinic — клиника, diet — диета, form — форма, problem — проблема).
Английские окончания -ium, -eum соответствуют русским ~ий (-ия), -ей
(barium — барий, bacterium,— бактерия, museum — музей).
Редукция или опускание звуков в конце слов русского или английского языка также нередко имеет место
(botany — ботаника, grade — градус, cone — конус, iodine — иод, narcosis — наркоз).
При сравнении слов общего корня в английском и латинском языках следует отметить, что различия наблюдаются, как правило, только в окончании слов, так как корни и большая часть аффиксов обычно имеют почти полное графическое совпадение.
Использование этого фактора дает возможность распознавать и понимать слова общего корня на основе анализа сходных явлений английского и латинского языков, что также способствует оптимизации процесса перевода.
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1.
Сопоставьте следующие английские слова с однокоренными русскими. Обратите внимание на совпадение или расхождение объема значений:
different, family, person, repetition, square, start, agent, value, progressive, administer, pressure, liquid, accompany, fetal, specific, history, record, realize, institution, press, department, recognize, technique, routine, examine, equip, valuable, note, utilize, test, restore, control, physical, attack, conduct, collect, preparation, permanent, course, positive, term, reduction, intervention, application, negative, object.
2.
Сопоставьте английское и русское произношение следующих слов (при необходимости используйте транскрипции в словаре):
psychology, biology, author, appetite, special, serious, basis, variation, cultivate, nature, epithelium, mucus, palpation, identical, hygiene, period, elementary, parasite, procedure, strichnine, haemoglobin, gynecology, endothelial, sterile.
3.
Назовите русские термины общего корня:
therapeutic, special, especially, centre, pathology, physiology, sympathetic, anaesthesis, pneumonia, nervous, vein, inadequate, oedema, variety, square, nephritis, haemorrhage, osteomyelitis, equipment, associate.
4.
Переведите без словаря:
lethal, liver, hepatic, column, serum, respiratory, abdominal, diagnosis, oxygen, parotid, caloric, protein, substance, toxin, separation, lateral, spinal, per cent, pressure, intensity, extraordinary, adaptation, occasion, palpation, cervical, intravenously, hospitalization, liquid, examine, collect, positive.
5.
Назовите английские слова одного корня со следующими латинскими словами:
| conditio, onis origo produco, ere tabula, ae ductus, i vita, ae numerus, i patients, entis humanus, a, ura intestinum, i generalis, e suffero, ferre contractio, onis irritatio, onis constitutio, onis evidens, entis minutus, a, um | digestio, onis involvo, are praescribo, ere expecto, are incisio, onis conscientia, ae injuria, ae purus, a, um irrito, are efficiens, -entis imago,- ginis; differens, -tis actus, a, um necessairus, a, um repeto, ere singularis, -e transfusio, onis | fluidis, a, um injectio, onis simplex, icis sensus, us musculus, i fibra, ae infiltratio, onis functio, onis saliva, ae liegamentum, -i respiratio, -onis status, us vitalis, e vario, are dependeo, ere obstruсtio, onis. |
6.
Укажите форму множественного числа следующих английских терминов, которые сохранили свои латинские или греческие окончания:
datum, erratum, medium, memorandum, ovum, serum, bacillus, coccus, focus, analysis, basis, crisis, criterion, hypothesis, phenomenon.
7.
Назовите английские слова одного корня со следующими русскими словами:
инфекционный, модификация, профессия, микстура, симптом, микробиолог, эпидемический, пенициллин, диета, мышечный, характерный, эволюция, меню, педиатр, профилактический, эмбрион, лейкоцит, нервный, патологический, пневмония, этиология.
8.
Выпишите из текста все слова, значение которых вы определили по сходству со словами латинского или русского языков и проверьте по словарю совпадение или расхождение их значений:
Summary.
Case reports of 56 patients with a pseudocyst of the pancreas have been reviewed. Thirty-six of these patients underwent surgical treatment. In eight a diagnosis of pseudocyst was made at autopsy, and in 12 patients the clinical impression was never confirmed. Cystojejunotomy was the most commonly utilized form of drainage and had good results.
Analysis of urinary amylase levels in 25 of the patients was done. A patient with a pseudocyst may have normal urinary amylase values. It is more common to have an elevated amylase level which may be persistent but often returns to normal prior to surgical drainage. After surgical drainage of the pseudocyst, amylase promptly returns to normal.
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