МИНИСТЕРСТВО ЗДРАВООХРАНЕНИЯ РФ

САНКТ-ПЕТЕРБУРГСКАЯ ГОСУДАРСТВЕННАЯ

ПЕДИАТРИЧЕСКАЯ МЕДИЦИНСКАЯ АКАДЕМИЯ

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МЕТОДИЧЕСКОЕ ПОСОБИЕ

По английскому языку для студентов

Педиатрического и лечебного факультетов

П курс

САНКТ-ПЕТЕРБУРГ

2006

I. ТЕКСТЫ ДЛЯ АНАЛИТИЧЕСКОГО ЧТЕНИЯ

LACK OF APPETITE

One of the most frequent complaints mothers make to doctors is that their child has lost his appetite. The mother’s anxiety over her child‘s poor appetite is well-founded, as every mother knows that a healthy appetite is a sign of the child’s health. Lack of appetite is associated with many illnesses of childhood, but then there are also other signs which mother usually notices. If the cause is some illness the doctor will diagnose it and prescribe treatment, and the child’s appetite will improve as his health improves. However, feeding problems mostly arise in perfectly healthy children as the result of mismanagement of nutrition, feeding and care.

To understand the causes leading to loss of appetite one must understand the nature of appetite itself. To-day it has been proved by the experiments of Ivan Pavlov and his followers that digestion is regulated by the nervous system. There is in the child’s brain, as in the adult’s brain, a food centre the condition of which determines whether the individual feels hungry or full. If the food centre is in an excited state the person feels hungry. If the food centre is in a state of repression, or inhibition, the desire for food – the appetite - will deteriorate or disappear. Both excitation and inhibition of the food centre are associated with changes in the constituents of the blood flowing in this area of the brain. Depletion of the blood of nutritive substances stimulates the digestive centres; this stimulation or excitation is transmitted to the salivary glands and the glands secreting gastric juices, and also to the corresponding muscles.

It is important to feed children at definite times over strictly definite intervals differing in children of different ages. If a definite feeding schedule is not observed and the baby has his food irregularly, he will not be hungry and refuse his food at the feeding hours. A particularly harmful effect on appetite is produced by sugar and various sweets when given to children before or between meals. An important point in serving the meals of older children is setting the table. If mothers set the table attractively and make preparations for the meal, the activity of the digestive glands will be stimulated, and the child’s appetite will improve. Normal appetite depends to a great extent on a properly managed schedule. Children must play outdoors, sleep and eat at fixed hours. If children do not spend much time in the fresh air, they are commonly poor eaters.

Children must not be overfed, neither must they be given too much high-calorie food or fats in excess. Fat, if there is too much of it, will inhibit gastric juice secretion, disturb protein digestion, and thus finally will impair the appetite. Poor appetite may be connected with a decreased function of the salivary glands. In such cases children keep their food in the mouth for a long time, not being able to swallow it. These children should be taught to take their food in very small amounts at a time; they should also be given a little water to drink during the meal; the moistened food will be easier to swallow. As the child becomes older his appetite usually becomes normal; however all measures should be taken to ensure a healthy appetite at all meals.

Active Words to remember:

Lack; to lose appetite; to associate; to notice; nutrition; loss; to prove; to be excited; desire; inhibition; juice; harmful; to improve; to a great extent; impair; properly;

to manage; to feed (overfeed); to disturb; to decrease; to moisten; to ensure; meals; to flow.

EXERCISES

1. Answer the following questions:

1.Why are mothers anxious over the poor appetite of their children? 2. What may lack of appetite be connected with? 3. What is the nature of appetite? 4. When do we feel hungry or full? 5. What are excitation and inhibition of the food center associated with? 6. What stimulates the digestive center? 7. What factors does normal appetite depend on? 8. What may poor appetite be connected with? 9. Why is it not good to give children fats in excess?

II. Translate the following sentences into Russian (conditional sentences):

1. If the patient does not drink enough water his fluid balance will be disturbed. 2. The child will lose his appetite providing he is given excessive amounts of protein above established norms. 3. Unless a child is given water between meals in summer, excessive perspiration and evaporation of water may lead to “thirst fever” (elevation of temperature up to 38-39oC) and subsequent digestive trouble. 4. The child’s appetite will improve on condition that his ration includes fruit, vegetables and cod-liver oil. 5. Various vitamin deficiencies will develop unless a child gets vitamins.6. Vitamin B1 deficiency can develop in breast-fed infants providing their mothers’ diet lacks vitamin B1. 7. Rickets affects children who live in good houses on condition their rooms are stuffy and badly ventilated, and they are not out in the fresh air enough in autumn and winter.

III. Translate into Russian. Pay attention to the function of “one”.

1. Children over one year old are given four meals a day. 2. Protein-containing food should be given to the child in the morning and afternoon; the evening meal should be a light one, without meat or fish. 3. One must remember that the entire environment and the aspect of the food stimulate the secretion of the digestive juice. 4. Sleep is one of the forms of internal inhibitions. 6. Fresh vegetables are tastier and more useful than the ones which are stored for a long time.

IV. Translate the sentences into Russian. Pay attention to the clauses without conjunctions.

1. The state of our health depends to a great extent upon the environment we are surrounded by. 2. The vitamin B group the child usually gets with meat, kefir, cottage cheese and cereals is an important factor in the activity of the child’s nervous system. 3. In a network of children’s sanatoriums our country possesses children are given highly nourishing food and spend much time in the fresh air. 4. Internal medicines the pediatricians prescribe to sick children are usually given in solutions, mixtures and drops. 5. Lack of appetite is associated with many illnesses of childhood, but then there are also other signs the mother usually notices.

V. Translate into Russian. (Gerund)

Salivary digestion is important in preparing the food for the changes that follow after this

process. 2. In making thirst more insistent than hunger nature makes a constant and insistent demand for water in the diet. 3. In studying matters concerning health, it is very important to know the cause of the disease. 4. The bile consists mainly of certain complex salts and pigments, which assist in digesting the fats of the food, and partly consists of waste products removed from the blood. 5. When a person is occupied in doing some physical or mental work, zones of excitation arise in the cerebral cortex. 6. Interesting work may be continued for a long time without bringing about any feeling of tiredness. 7. Working physically is very useful as work brings about an active state in the organism. 8. All physical exercises, regularly performed every morning, harden the organism of a person and put him in a fit condition for the whole day by raising his working capacity.

VI. Put all possible questions in the following sentences:

1. Mothers often complain to doctors that their children have lost their appetite. 2. To understand the cause leading to loss of appetite one must understand the nature of appetite itself. 3. If the food center of the brain is in a state of inhibition the child does not feel hungry. 4. Children must play outdoors, sleep and eat at fixed hours. 5. It is most harmful to give children various sweets or sugar between or before meals. 6. The sight of the attractively set table stimulates the activity of the digestive glands and improves the child’s appetite. 7. Normal appetite depends on a properly managed daily feeding schedule.

VII. Translate into Russian:

A food center condition; gastric juices secreting glands; an attractively set table; the digestive glands activity; a properly managed daily feeding schedule; gastric juice secretion; the digestive center stimulation.

VIII. Group the following words in pairs with opposite meanings:

1. To decrease a. useful

2. To improve b. full

3. Healthy c. irregular

4. Harmful d. to disappear

5. inhibition e. to deteriorate

6. hungry f. to increase

7. regular g. seldom

8. to stimulate h. excitation

9. to appear i. to impair

10. frequently j. sick

DIGESTION

Digestion is one of the processes by which food is incorporated in the living body. In digestion, the food is softened and converted into a form which is soluble in the watery fluids of the body, or, in case of fat into very minute globules.

Salivary digestion begins as soon as the food enters the mouth. The object of chewing is not only to bruise the food and make it more permeable for gastric juice, but also to mix starchy parts thoroughly with saliva. This process goes on after swallowing, for the first twenty minutes or half-hour that the food remains in the stomach, after which the action of the saliva is checked by the acid of the gastric juice.

Gastric digestion begins a little time after the food enters the stomach. The gastric juice begins to be secreted even before the food enters the stomach, at the sight and smell of food. This juice contains two ferments named pepsin and rennin. There are also present free hydrochloric acid and acid salts. The main function of the stomach is to render the ingested food soluble, and mix it thoroughly with the gastric juice until it assumes a gruel-like consistency. This material, known as chyme, is then passed through the pylorus into the intestine. Gastric digestion requires from about an hour to six or seven hours depending on the food eaten.

Intestinal digestion. The softened food or chyme which leaves the stomach is exposed to the action of four factors – bile, pancreatic juice, intestinal juice, bacteria. The bile consists mainly of certain complex salts and pigments, which assist in digesting the fats of the food, and partly consists of waste products removed from the blood. The pancreatic juice contains four powerful ferments – lipase, chymotrypain, amilase and trypsin. Intestinal juice also contains ferments (enzymes). Bacteria are normal inhabitants of both small and large intestines. In the former they have a fermentative, in the latter – a putrefactive action. The intestinal bacteria also play an important and valuable role in the manufacture of certain components of the vitamin B complex.

Read and make theses of the text.

BLOOD DISORDERS

Anemia

Our blood has two basic parts: blood cells, which are also called blood corpuscles, and plasma, the fluid in which the blood cells are suspended.

Most of the blood cells are red blood cells. Their dimensions are very small: if these cells, invisible to the naked eye, were collected from the entire body and placed one-thick on a flat surface they would occupy an area of 1000 sq.m. The red colour of these cells which are called erythrocytes is due to the hemoglobin they contain, which combines with oxygen in the lungs and releases it to the tissues as the blood circulates through the body. The red cells also carry the waste product carbon dioxide from the tissues to the lungs so that it can be exhaled. The life span of one red blood cell is about three and a half or four months. New erythrocytes are formed in the red bone marrow, from whence they emerge into the blood to take up their work.

Our body also contains white blood cells, which protect the body from infection. There are several different kinds of white blood cells. Most of them are neutrophiles, which attack and engulf bacteria. Another kind, the lymphocyte, recognizes foreign cells, infectious agents, and participates in the body’s immune reaction against them.

A third type of blood cell is the platelet. Platelets gather wherever a blood vessel is injured, to plug the hole. This is the first stage in the blood clotting process.

Most blood cells are produced in the bone narrow. However, lymphocytes are made in the spleen or in the lymph glands, which are found in the neck, armpits, groin and many other parts of the body. The spleen and lymph glands, together with the channels and ducts connecting them, are called the lymphatic system. When red blood cells and platelets become old or defective they are filtered out of the bloodstream and broken down by the spleen, and also by the liver and lymph glands.

Disorders of the blood are grouped as follows: lack of hemoglobin, which causes anemia; disorders in clotting, which cause bleeding and bruising; cancerous changes in the white cells, which cause leukemia; disorders in the production of blood cells in the bone marrow; and disorders that affect the lymphatic system.

Anemia is defined as a decrease in either hemoglobin or the number of red blood cells to below the normal level. Iron is essential ingredient in hemoglobin. If there is not enough iron in the body, there cannot be made enough hemoglobin. This form of anemia is called iron-deficiency anemia. A severe shortage of vitamin B12 in the body also affects the production of red blood cells. This is called B12 deficiency anemia. Lack of folic acid in the body has the same effect, and this is called folic acid deficiency. In hemolytic anemia the red blood cells are destroyed more quickly than they normally would be and the number of red blood cells in the body may fall well below normal. Inherited defects of the blood such as sickle-cell anemia cause the body to produce abnormal hemoglobin.

All these types of anemia may be found in children but the most common one is iron-deficiency anemia. Insufficient iron in the body causes an adequate production of hemoglobin, and therefore leads to iron-deficiency anemia.

Normally, extra iron is stored in the body and then used to produce hemoglobin in newly developed red blood cells. Most of this iron is recovered as old red blood cells are destroyed. The small amount of iron lost from the body is replaced by iron absorbed from the diet. If the person loses more iron than he is able to absorb he may become anemic. There are three general causes for a lack of iron reserves: there may not be enough iron in the diet; the digestive system is unable to absorb iron, even though there may be enough of it in the diet; the iron reserves may become depleted through excessive loss of blood.

The most frequently observed type of anemia among very young children is anemia caused by faulty nutrition. Such anemia is rarely seen in breast-fed infants. If an infant receives a monotonous milk or cereal dietary and has not enough vitamins he will develop anemia; therefore bottle-fed babies chiefly suffer from anemia.

Anemia associated with some disease is not uncommon in young children Such anemias are either a result of the direct action of the bacterial toxin on the bone marrow, or are caused by the monotonous and restricted diet employed for the treatment of the basic disease.

The most typical form of anemias among children of preschool ages are those caused by a worm diseases or by faulty hygiene.

The disease in older children would not have developed provided they had not neglected fresh air and sun, physical training and sports.

The characteristic symptoms of anemia include paleness, fatigue, weakness, fainting, breathlessness and palpitations. And no doctor will ever risk diagnosing anemia unless he first does blood test.

Anemia is treated by means of numerous excellent preparations the pharmaceutic industry provides us with. However one form of treatment is irreplaceable in all types of more or less far-gone anemia: this is blood transfusion.

Anemia, as any other disease, is easier to prevent than to cure. A most important condition for preventing anemia is proper management of nutrition from the very first days of the baby’s life. The best food for infants is breast milk. As the child grows older his food must become varied. No less important are proper hygiene, hardening procedures and fresh air.

Words to remember:

Pallor, skin, invisible, entire, surface, life span, to carry, to develop, faulty, to neglect, to harden, to explain, numerous, to prevent, to cure, therefore.

EXERCISES

I. Answer the following questions:

1.What is blood? 2. What does blood consist of ? 3. What is anemia? 4. In what way are the red blood cells related to anemia? 5. How is anemia diagnosed? 6. What are the most frequently observed types of anemia in very young children? 7. What types of anemia are typical for preschool ages? 8. What does the treatment of anemia depend on? 9. What measures usually prevent anemia?

II. Define the types of conditional sentences and translate them into Russian:

A. 1. The child’s appetite will improve, if his health improves. 2. The child’s appetite would improve, if his health improved. 3. The child’s appetite would have improved, if his health had improved.

B. 1. If children are given sugar or sweets before or between meals, their appetite will deteriorate or even disappear. 2. If children were given sugar or sweets before or between meals, their appetite would deteriorate or even disappear. 3. If children had been given sugar or sweets before or between meals, their appetite would have deteriorated or even disappeared.

C. 1. If poor appetite is connected with a decreased function of the salivary glands, the child will take his food in very small amounts at a time. 2. If the child had fallen ill, he would have lost his appetite. 3. Unless treatment and care had been properly managed, he would not have recovered so quickly. 4. If you spend much time in the fresh air, you will never lose your appetite or sleep. 5. Were the child given high-energy food and kept out in the fresh air as long as possible, his condition would improve quite rapidly. 6. Had the patient desired to stay in the hospital 10-12 days longer, he would have greatly improved his condition. 7. Protein digestion will be disturbed provided a child is given too much fat. 8. Had the child had a severe form of anemia, he would have been treated under hospital conditions. 9. But for faulty diet anemia would have never developed in the baby. 10. Should pallor of the skin, poor appetite and general weakness develop in the child, the doctor would immediately suspect anemia. 11. Could you make blood tests essential for diagnosing anemia quickly, we should explain the case quite definitely. 12. Unless this ointment relieved skin irritation, the doctors would not prescribe it.

III. Translate into Russian:

1.The blood’s consisting of corpuscles in addition to the fluid is well known. 2. People are divided into four groups of blood. Their being divided into these groups depends upon the capacity of the serum of one person’s blood to agglutinate. 3. This child’s lying in bed during two months resulted very badly, the doctor had to send him to the children’s sanatorium. 4. The professor insisted on their continuing the experiments and receiving positive results. 5. The student told the ward doctor about her having written the case history of patient Petrov. 6. Doctor’s gathering complete clinical findings helped him to treat this patient and soon the patient was discharged from the hospital. 7. The mother objected to her son’s being operated upon because he was very weak. 8. The serums used to produce passive immunity are made by giving repeated injections of the specific causative bacteria or their soluble toxins into animals. 9. This patient’s having been made x-ray examination in time helped to find free abdominal air under the diaphragm. 10. Whenever possible the staff assigned to the immediate care of patients suffering from a communicable disease should be immune by reason of having had the diseases or by having been artificially immunized.

IV. Translate into Russian:

1.Gastric digestion requires from about an hour to six or seven hours depending on the food eaten. 2. Moistening food with saliva enables it to be rolled into a plastic mass and gives it a lubricant ( смазочное масло) coating which facilitates swallowing. 3. The chief way of eliminating waste nitrogen from the body is by means of the water passing through the kidneys. 4. The amount of water necessary for proper waste elimination and for feeding the tissues in a person of average weight is four or five pints (=0.568 l) per day. 5. The observation of the action of the salivary glands can be made quantitative, by recording the number of drops of saliva secreted. 6. By applying various kinds of fistulae, Pavlov studied the work of the whole digestive tract, thus making clear the interconnection and interaction between its different parts. 7. Hemoglobin acts as a medium of interchange between the oxygen of the air in the lungs and the tissues requiring it. 8. The reaction of agglutination depends on antigens in the red corpuscles and antibodies in the serum. There are two of each, the antigens being known as A and B.9. Nowadays blood transfusion is being used on a large scale, having been found useful in the treatment of quite a number of diseases.

V. Translate into Russian. State the function of the verb “should”:

It is important that children should be fed at definite time. 2. All measures should be taken to ensure proper growth and development of a child. 3. Children should be never overfed. 4. The doctor recommended that the patient should not keep late hours. 5. I assured the pediatrician that I should follow his instructions in order to prevent the development of rickets in my baby. 6. It is necessary that the child should get his vitamin C with raw fruits and vegetables and their juices. 7. The child should be given water to drink during his meals in case that he is unable to swallow it. 8. Pediatrician insisted that the boy should be sent to a special sanatorium to recuperate. 9. It is usually recommended that the antimeasles serum should be injected not later than the fourth day after the contact.

VI. Define the function of the word “provided”, translate into Russian:

1. In acute infections the patient must be provided with a sufficient amount of food with high dietary values. 2. In prolonged cases of influenza coughs and subfebrile temperature will disappear much sooner, provided the patient spends much time in the fresh air. 3. Each pediatric hospital where children are hospitalized for prolonged periods is usually provided with its staff of schoolteachers. 4. Infants provided with breast-feeding grow and develop well, are better protected against contagious diseases. 5. Vaccination is considered positive provided on control examination day, there is a clearly marked nodule, vesicle or crust. 6. When the anemia patient is provided with nutritious food and kept out in the fresh air as long as possible, his condition improves quite rapidly. 7. The personnel of the hospital have provided an efficient treatment for anemia patients.

VII. Complete the following sentences choosing the right parts from below:

Anemia may be caused by…

specific microorganism; b) contact with infected persons; c) faulty nutrition and faulty hygiene; d) ingestion of contaminated food;

The most important method for early diagnosis of anemia is …

clinical history; b) X-ray examination; c) physical examination: d) blood test;

3. Treatment of anemia requires …

surgical intervention; b) special pharmaceutic preparations; c) physiotherapy; d) bed regimen and good nursing;

VIII. Write down the summary of the text.

BLOOD TRANSFUSION

The transfer of blood from a donor to a recipient is one of the most widely used procedures in medical treatment. When severe hemorrhage has resulted in a great loss of blood, a transfusion will restore the circulating blood volume and the red blood cells which provide oxygen and food to the body tissue.

Blood transfusion is invaluable supporting treatment for surgical shock, to replace an excessive loss of blood at childbirth or in such condition as leukemia.

In some cases, even when the circulating blood volume is normal, transfusion is used to replace a deficiency in one of the constituents of the blood, thus providing red cells in cases of acute anemia or in hemophilia which is due to the lack of a specific clot-promoting factor in the blood plasma.

The first recorded transfusion is believed to have been performed between two dogs in 1665. However, the results in human beings were disastrous.

The existence of human blood types was established only in 1902 when the scientists began a study to determine why fatalities occurred following some blood transfusions. It was discovered that the cause was in an incompatibility between the blood of the donor and that of the recipient. Progress was made in this field. For many years only direct transfusions were made, because no means of keeping fresh blood from clotting were known.

However in 1914 it was found that sodium citrate served this purpose and by this discovery an incalculable number of lives were saved during the First World War.

Since that time methods have been perfected for obtaining and storing human blood for future use. Blood banks for emergency use have become a part of many hospitals. All blood which is to be used for transfusions is obtained under the most exacting sanitary conditions completely free from germs or other contaminating influences.

As a safety measure, before a patient receives a whole blood transfusion, the compatibility of his blood with the donor blood is checked by a cross-match test.

Small samples of red blood cells and sera of the two bloods are combined and examined under a microscope for signs of incompatibility or clumping.

Notes:

hemophilia –кровоточивость

sodium citrate –лимоннокислый натрий – цитрат натрия

cross-match test –проба на перекрестную совместимость

clumping –склеивание, агглютинация

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Active Words to remember:

To transfer, transfusion, to result in, to restore, to lose (lost, lost); loss, food, to replace, deficiency, clot-promoting factor; field, to serve, purpose, a cross-match test.

EXERCISES

I. Translate the sentences into Russian, pay attention to the functions of the Infinitive.

1.In some cases blood transfusion is used to replace a deficiency in one of the constituents of the blood. 2. From the capillary system of liver, collecting veins emerge and these combine to form larger vessels which ultimately leave the liver as the hepatic veins. 3. Some germs, called aerobic, must have air to live. 4. When the patient was brought to the hospital he was too weak to be operated upon. 5. To diminish the chances of pneumonia it is necessary to keep children in bed during any attacks of bronchitis. 6. Transfusions of both blood and plasma are usually instituted to bring the patient out of the shock state. 7. In case of peritonsillar abscess frequent examinations of the throat must be made to establish the diagnosis. 8. The patient to be examined by the doctor came to the polyclinic and went to the registering clerk where he was first asked to give his name, age and address. 9. Measures which have been taken to save the child are very efficient. 10. It is important that the streptomycin sensitivity of the specific organism causing the infection should be determined at the earliest opportunity, preferably before treatment is begun. 11. Some of the important functions of the blood are to convey nutritive particles to the tissues and take the waste products away from them; to supply the tissues with oxygen and relieve them of their carbon dioxide and to play an important part in the regulation of the body temperature. 12. About one billion red cells per minute are given off into the blood stream to balance the cells which are constantly disintegrating. 13. The liver and the spleen both aid in disintegration and in the conversion of the red cells constituents into substances that can be used again in the body. 14. Before administration blood should be warmed to body temperature, but overheating has to be avoided as it adds to the risk of reactions.

II. Find the word differing in its meaning from the given series of words:

a) many; b) a great deal of; c) a lot of; d) a number of; e) a few.

a) large; b) extensive; c) considerable; d) adequate; e) colossal.

a) similar; b) alike; c) artificial; d) the same; e) analogous.

a) to provide; b) to supply; c) to change; d) to equip; e) to furnish.

a) to result in; b) to bring to; c) to lead to; d) to carry out; e) to end.

a) to perform; b) to appear; c) to carry out; d) to fulfill; e) to make.

a) to think; b) to suppose; c) to believe; d) to receive; e) to consider.

a) to report; b) to announce; c) to defend; d) to inform; e) to tell.

a) recent; b) ancient; c) modern; d) new; e) fresh.

a) to record; b) to receive; c) to write down; d) to note; e) to register.

III. Fill in the blanks with one of the four words given under the sentence:

Human bloods are divided into four groups, the serum of one group … and haemolyse the corpuscles of another group.

a) may become b) may agglutinate c) may associate d) may complete

The group test is used to select donors of particular group … to match a particular recipient … to stock a blood bank.

a) either … or b) neither … nor c) not only … but also d) apart from

The donor should be in a good health and … malaria, syphilis or other

communicable diseases.

due to b) result from c) free from d) apart from

In withdrawing the blood full antiseptic precautions must be used and … to the air must be reduced to the minimum.

future b) temperature c) pressure d) exposure

Before … blood should be preferably warmed to body temperature.

transfusion b) distension c) eruption d) resolution

The method of administration of plasma is … as for whole blood.

some b) sometimes c) the same d) several

IV. Find the corresponding Russian equivalent to the following English words

and word combinations:

widely used procedure 1. количество циркулируемой крови

condition 2. группы крови у человека

the transfer of blood 3. несовместимость

clot-promoting factor 4. заболевание

the circulating blood volume 5.широко распространенная процедура

human blood types 6. способы хранения свежей крови

incalculable number 7. переливание крови

cross-match test 8.фактор, способствующий образованию сгустка

incompatibility 9. проба на перекрестную совместимость

means of keeping fresh blood 10. несметное количество

V. Translate into Russian. Pay attention to the pronouns.

1. Like any other symptom a cough is a manifestation of a disease or abnormality. 2. An abscess may form in any part of the body when staphylococcic or streptococcic bacteria invade an area and produce a local infection. 3. The hands should be washed before eating, especially after prolonged soiling or contact with anything in which dangerous bacteria are likely to live. 4. In grippe no period of life is immune. 5. Vitamin B12 is the only vitamin which contains a metal in its very complicated molecule. It seems to be synthetized only by microorganism, yet in our diet it exists virtually exclusively in foods of animal origin. 6. Any disease may become dangerous to life if you do not treat it from the very onset. 7. It was decided to explore the abdomen as there were some signs suggesting peritonitis. 8. It is through the nervous system that the organism is able to orientate itself in the world surrounding it and to adapt itself to the ever changing conditions of life. 9. In perfectly normal states the eruption of teeth is unattended by any symptoms whatever. 10. While inspecting the child nothing can be determined if the child is at all excited. 11. To anyone who has taken an interest in the surgery of early life, it must have become apparent that the child is subject to almost all the diseases of adult life and to many other conditions not found in the adult. 12. Any infant particularly prematurely born one requires special care and attention. 13. Roentgenograms of the chest and upper gastrointestinal tract showed no abnormality. 14. No changes in the infant’s general appearance, weight, appetite, behaviour should escape the mother’s notice.

VI. Find the word nearest in meaning to the one in bold type

Lack of vitamins in food may lead to metabolic changes and retardation of the development in a growing organism.

a) efficiency b) deficiency c) inhibition d) elevation

In childhood there are various conditions which may produce cough, cold in the head and other catarrhal symptoms

different b) extreme c) excessive d) common

Nowadays many childhood diseases end in complete recovery.

perish b) delay c) terminate d) convert

The muscles contain nearly one half of the body water.

hardly b) only c) about d) above

A number of diseases of respiratory system are attended by cough of various types.

a) aggravated b) associated c) accompanied d) affected

The child’s pulse becomes more rapid during fever, following exercise, anemia or other causes.

throughout b) before c) after d) without

There are many methods and procedures employed to disclose a disease or a defect in a human organism.

to check b) to aggravate c) to prove d) to reveal

VII. Find the word differing in its meaning from the given series of words.

a) infectious b) contagious c) contaminating d) catching e) promoting f) communicable.

a) to require b) to replace c) to call for d) to want e) to need f) to demand.

a) to decrease b) to reduce c) to result in d) to subside e) to diminish f) to abate.

a) important b) valuable c) significant d) vital e) loose f) considerable.

a) to assist b) to support c) to help d) to offer e) to aid f) to back.

a) regularly b) systematically c) punctually d) largely e) uniformly f) steadily.

a) to consult b) to answer c) to question d) to ask e) to interrogate f) to inquire.

VIII. Suggested topics for oral narration.

Describe the work of blood transfusion station

Describe the history of blood transfusion

Describe the administration of blood transfusion in medical practice.

Describe the conditions under which blood for transfusion is obtained and stored.

RICKETS

Rickets is a deficiency disease of infancy and childhood characterized by a disturbance of the normal process of ossification of bones with resultant deformity. Rickets is a systemic disease and most commonly occurs during the first year of life.

The predisposing factors of the development of rickets are rapid growth, prematurity and increased susceptibility to the disease. The disease may be caused by the deficiency of vitamin D and calcium in the diet, by the deficiency of sunlight and fresh air. Common early symptoms may include profuse sweating, particularly during sleep, vomiting and diarrhea. The children’s appetite is diminished and they do not gain in weight. Softening of the bones of the skull in the first few months of life may be an early sign. It is the change of the structure of the ends of the long bones in the region of epiphysis that is a common finding. The diagnosis is easily made by X-ray examination of the ends of the long bones. The head of the rachitic child is large in its upper part, the teeth appear late and fall out or decay early, the face is small. The child’s development is inhibited.

Commonly the disease does not terminate in recovery. Complications associated with rickets include bronchitis, pneumonia, gastroenteric disturbances, muscular weakness, enlargement of the liver and spleen and anemia.

The prevention of rickets should be thought of before the baby is born The future baby must get vitamin D, sunlight and a sufficient amount of mineral salts through his mother’s body. Consequently, prospective mothers have to spend more time outdoors, eat more raw vegetables, fruits, berries. Breast milk, juices, fresh air, sunlight, suitable clothing and physical activity – all these antirachitic factors may prevent rickets in children. But if the disease does not develop, the doctor prescribes ultraviolet light, vitamin D or cod-liver oil.

It is the Russian scientists who have obtained good results in curing infantile rickets by means of the direct action of the sun’s rays.

The physicians exposed infants to their action from half an hour to several hours depending on the intensity of the sun and the sensitiveness of the skin and noticed marked improvement of the symptoms of the disease and the patient’s general condition

Active words to remember:

Rickets; during; susceptibility; sweating; vomiting; to diminish; to gain in weight; enlargement; to decay; sufficient; consequently; raw; suitable; cold liver oil.

EXERCISES

I. Translate the sentences into Russian. Point out emphatic construction It is (was) …that (who).

1.It is the infection of the lungs that is the most serious complication after influenza. 2. Therapeutic failures do occur in the treatment of venous thrombosis. 3. It was the great Russian surgeon Pirogov who applied anaesthetization by ether for the first time in the world. 4. It is the haemolytic streptococcus that mostly causes acute tonsillitis.5. The onset of rickets does occur almost always insidiously. 6. It is a deficient material diet that causes rare instances of congenital rickets. 7. It is constipation that is frequently seen in the early stages of rickets. 8. It is hemoglobin, an iron-containing protein, that gives the blood its red colour. 9. It is only in extreme cases of rickets that almost every bone in the body is affected. 10. The arterial and venous blood do differ in colour, the former has a scarlet tint, the latter a bluish-red one. 11. It is microbes or germs that are the causative agents of congenital agents of many diseases.

II. Translate into Russian. Pay attention to the verbs in the Passive Voice.

1. The great achievements of scientists in curing infantile rickets by means of the direct action of the sun’s rays are much spoken about. 2. The onset of many infectious diseases is often followed by bad headache and vomiting. 3. The importance of water to living things is so evident that it need not be insisted upon here. 4. The infants obtaining the sunlight treatment were carefully looked upon by the nurses. 5. The works of I. Pavlov, I. Sechenov and other scientists are often referred to by research workers. 6. Rickets is usually followed by pneumonia, bronchitis and anemia. 7. Children are taken care of at our sanatoriums. 8.The final diagnosis of peritonitis was agreed to by all the doctors. 9. The most common early symptom of rickets which is usually complained of is sweating of the head. 10. The problem of the heart and liver transplantations is dealt with in a number of articles. 11. The method of treatment of thrombosis by anticoagulants can be relied upon, as many cases of complete recovery have been reported. 12. This information must not be ignored. 13. It is clear that a child cannot be looked upon as being an adult with a less weight and size. 14. Medical students are advised to read the following journals: Pediatrica, Mother and Child Welfare, Obstetrics and Gynecology. 15. The infant was not given any medication at home. 16. They were offered to study the problem of pediatrics. 17. He was helped by his assistants. 18. I was asked to create favourable conditions for those coming. 19. We were informed that a new method of treatment had been set forth. 20. Some cases of influenza have been reported in a neonatal unit. 21. N. Filatov is regarded as the father of Russian Pediatrics. 22. A severe attack of influenza was followed by pneumonia. 23. The pediatrician’s questions were answered by the parents in detail. 24. The infant was affected by cold. 25. Child mortality and morbidity are combated by both pediatricians and obstetrician.

III. Translate the sentences paying attention to rendering the impersonal construction.

It is expected that … It is thought that … It is known that … It must be stressed that … It cannot be denied that … It should be remembered that … It was considered possible … It must be born in mind … It must be added that … It must be remembered.

1. It must be stressed that the family history is taken with great detail. 2. It should be remembered that the information of the development of the baby in the first year of life is of importance. 3. It must be added that careful questioning will show whether diarrhea and cough were provoked by some definite cause. 4. It must be born in mind that the present age of parents, the state of their health, the health of the relatives are of significance for making the family history. 5. It is thought that the course of therapy must be repeated as needed. 6. Let it be stressed that the journals Pediatrica, Mother and Child Welfare play an important part in training medical staff in the spirit of high principles necessary for everyday practical work.

IV. Group the words with the same root.

During, common, to inhibit, recovery, to appear, to enlarge, prevention, insufficient, large, appearance, uncommonly, duration, resultant, disappearance, to prevent, to recover, commonly, inhibition, result from, enlargement, sufficiently, uncommon, result in, disappear, insufficiently, preventive, sufficient.

V. Choose the appropriate adjectives for the nouns in the right column:

a. direct 1. sweating

b. rapid 2. bone

c. fresh 3. vegetables

d. profuse 4. light

e. long 5. action

f. sufficient 6. amount

g. raw 7. air

h. ultraviolet 8. growth

i. common 9. finding

VI. Group the synonyms:

1. disease; to occur; commonly; rapid; finding; to have to; to terminate; to associate with; prevention; amount.

2.quick; to end; prophylaxis; disturbance; must; usually; to take place; sign; to connect with; quantity.

VII. Group the antonyms:

A) normal; commonly; rapid; to increase; susceptibility; early; to include; long; upper; to appear; sufficient; more.

B) To diminish; slow; late; abnormal; insufficient; less; unusually; to disappear; resistance; to exclude; lower; short.

VIII. Give English equivalents of the following word-combinations:

Желудочно-кишечные расстройства; увеличение печени; достаточное количество; проводить больше времени на свежем воздухе; характеризоваться чем-либо; в настоящее время; нарушение нормального процесса окостенения; встречаться наиболее часто; в течение первых лет жизни; получать хорошие результаты; при лечении рахита; мышечная слабость; недостаток витамина Д; подвергать действию; чувствительность кожи; заметное улучшение; общее состояние больного.

IX. Translate the following sentences into English:

1.Рахит чаще всего встречается у детей именно в первые годы жизни. 2.Причины заболевания рахитом очень разнообразны Недостаток витамина Д и кальция в питании, а также солнечного света и свежего воздуха самые главные из них. 3. При появлении потливости, рвоты, поноса, при отсутствии аппетита ребенка нужно немедленно показать врачу. 4. Обычное явление при рахите – изменение структуры концов длинных костей в эпифизе. 5. После рахита могут быть серьезные и опасные осложнения – воспаление легких, бронхит, желудочно-кишечные расстройства, увеличение печени, селезенки, мышечная слабость, анемия. 6. Рахит можно предотвратить. Дети должны как можно больше находиться на свежем воздухе и есть как можно больше свежих фруктов и овощей. 7. Врачи прописывают облучение ультрафиолетовыми лучами, витамин Д или рыбий жир именно при рахите.

X. Make up your own situations on the following topics using the given words and expressions:

1. You are a pediatrician. One of your patients was a rachitic baby. Make up a case-report of his illness: (family history, premature, to stay indoors, to be afraid of her child catching cold, physical examination revealed…, symptoms, X-ray examination, to prescribe a course of treatment, improvement in the child’s condition).

2. A mother brought her sick child to the clinic. Having examined the child the doctor diagnosed rickets and prescribe the proper treatment: (complain of, poor appetite, profuse sweating, to change clothes, to examine carefully, to prescribe cod liver oil, to advise).

3.Two mothers are talking in the waiting-room. One of them whose child has been cured for rickets is comforting the other one who has a baby suffering from it: ( not to worry, to obtain good results, to expose to the action of the sun’s rays, to prescribe, one teaspoonful twice a day, raw vegetables, fresh air).

Vitamins and their significance

Vitamin is a term applied to a group of substances which exist in minute quantities in natural foods, and which are necessary to normal nutrition, especially in connection with growth and development. Vitamins are widely used for medical purposes; many of them are produced synthetically. Different kinds of vitamins are designated by letters of the Latin alphabet. There are several groups of vitamins. All of them are very necessary for the life of the organism.

Vitamin A is found in cod-liver oil, eggs, liver, milk, butter and most green vegetables. Deficiency of vitamin A is considered to be responsible for serious inflammation of the eyes, various skin eruption, defective development of the teeth.

Vitamin B is present in the seeds of grains. The best sources of this vitamin are believed to be flour, bacon, liver, eggs. Its deficiency may result in a form of neuritis with muscular weakness, heart failure, etc., which is known as beri-beri.

Vitamin C is available in fresh fruits, berries, green vegetables, milk, meat and other fresh foods. It is quickly destroyed by high temperature. The deficiency of vitamin C leads to scurvy.

Vitamin D is of special importance for the growth of children. Only a few foods contain vitamin D naturally, viz. cod-liver oil, caviar, egg yolk, fresh vegetables and milk to a greater or lesser degree.

Cod-liver oil is a product with a high vitamin D content. Vitamin D is manufactured in very large amounts at the plants. The deficiency of this vitamin in children may cause rickets. Since vitamin D is known to be preventive as well as curative for rickets the doctors often prescribe the course of vitamin D treatment.

A lack of vitamins in food or an insufficient amount of them results in a serious breakdown in the organism. Prolonged deficiency of any vitamin is sure to result in a disease known as avitaminosis, e.g. scurvy, beri-beri, rickets. Most avitaminoses are accompanied by reduced working capacity, rapid fatigue, a sharp decrease in the resistance of the organism to infection, incorrect development and retarded growth (in children), etc. To prevent avitaminoses infants should be daily given cod-liver oil and fresh fruit and vegetable juices.

Any person using a diet containing such foods as milk, eggs, butter, cheese, fat, fish,

bread, fresh vegetables and fruit obtains a sufficient amount of vitamins to be protected from avitaminoses.

Explanatory Notes:

viz. – videlicet = namely

etc. – et cetera = and so on; eg. – exempli gratia = for example

Active Words to remember:

Substance; connection; growth; development; kind; responsible; various; eruption; source; heart failure; a few; as well as; capacity; to reduce; fatigue; sharp; to obtain.

EXERCISES.

I. Translate the sentences. Pay attention to the Subjective Infinitive Construction.

1. Children’s diet early in life is thought to have profound effects on their brain development, muscular coordination and behaviour. 2. A course of combined treatment, including physiotherapy and hormones is certain to have given positive results in curing disorders of internal secretion glands. 3. Protoplasm is known to be a living substance and to have a cellular structure. 4. Rheumatic fever and acute nephritis are most likely to occur when the infecting organism is the haemolytic streptococcus. 5. In animals heparin has been shown to reduce the severity of lesions. 6. Rickets is believed to be largely, if not entirely, the result of a deficiency of vitamin D. 7. The reduced amount of oxygen in the blood of anemic patients is stated to be a major cause of the dysfunction of the heart, skeletal muscles and brain. 8. Rheumatoid arthritis is sure to be more complex as well as more frequent than other forms. 9. Codein is known to be an efficient pain killer as well as cough remedy. 10. The right lung has been proved to be more frequently affected by pneumonia than the left one. 11. The great Russian scientist I. Mechnikov is considered to be one of the founders of comparative embryology. 12. Anemia in some pregnant women is seen to be due to a deficiency in folic acid, one of the B vitamins. 13. A large cerebral cyst which was supposed to be the result of an old hemorrhage was in the left frontal lobe. 14. Smallpox is known to have been entirely eliminated in our country. 15. The most prominent function of blood is known to be carrying oxygen to the tissue. 16. The pain in the stomach is likely to persist after administration of atropin. 17. Generalized convulsions are stated to be followed by complete weakness of the patient’s body.

II. Translate the sentences. Pay attention to the subordinate clauses.

1. That prolonged deficiency of any vitamin results in avitaminosis is known to everybody nowadays. 2. Whether the bronchitis was primary or whether it was the complication after some disease should be cleared. 3. The fact is that grippe is dangerous for its complications. 4. That the microbes exist everywhere is a well-known fact. 5. The doctor’s opinion was that the appendix should be removed immediately. 6. That the fungi are capable of fermentation was spoken about at the last lecture. 7. The thing is that chemical structure of vitamins remained unknown for a long time. 8. The doctor’s supposition is that the sudden eruption on the skin of the patient was associated with the large dose of streptomycin. 9. That vitamins are of vast importance is well-known. 10. That sunshine is necessary nearly to all forms of plant life has been recognized for a very long time. 11. That sunshine has a definite influence on certain body tissues has been demonstrated with striking vividness.

III. Group the following nouns, adjectives and adverbs:

Nutrition, natural, different, connection, especially, growth, development, responsible, deficiency, serious, widely, various, defective, inflammation, eruption, naturally, weakness, available, special, importance, preventive, quickly, treatment, resistance.

IV. Give Russian equivalents of the following word-combinations:

In connection with; to be responsible for; minute quantities; skin eruptions; to be present in; to a greater or lesser degree, to result in, to be available in, cod-liver-oil; to be of importance; as well as; to be used for; a lack of vitamins; reduced working capacity; rapid fatigue; insufficient amount; retarded growth; a breakdown in the organism.

V. Form nouns adding the following suffixes to the given words, translate them into Russian:

(-ment, -th, -ence, -(t)ion, -sion, -ness, -ity)

Restless, treat, infect, resist, connect, responsible, exist, mortal, develop, grow, enlarge, erupt, disturb, prevent, ail, appear, contribute, anxious, congest, hoarse, occur, irritable, transmit.

VI. Form adjectives adding the following suffixes to the given words, translate them:

(-al, -ant, -ent, -ic, -ive, -ous)

Differ, vary, connect, infect, resist, system, result, prevent, experiment.

VII. Form adverbs adding ‘ly’ to the following adjectives, translate them:

Wide, natural, serious, necessary, easy, correct, particular, active, severe, sufficient, consequent, gradual, total, vital, constant.

VIII. Give the singular of the following words:

Teeth, feet, children, quantities, cavities, possibilities, varieties, foci, data, bacteria, bases, fungi, analyses, strata, bacilli, phenomena, cocci, avitaminoses.

IX. Find the word nearest in the meaning to the given one:

to continue: a) to last, b) to shorten, c) to terminate, d) to diminish.

to complete: a) to decrease, b) to delay, c) to check, d) to finish.

nowadays: a) whenever, b) any way, c) at present, d) by means of.

to care for: a) to watch, b) to take care of, c) to note, d) to train.

direction: a) incidence, b) institution, c) contribution, d) contraction.

immediately: a) gradually, b) regularly, c)at once, d) promptly.

available: a) obtainable, b) considerable, c)suitable, d) advisable.

to cause: a)to produce, b)to obtain, c) to reach, d) to require.

efficiently: a) largely, b) effectively, c) consequently, d) particularly.

to vary: a) to offer, b) to involve, c) to change, d) to include. :

OBESITY

Obesity in children is actually more frequent than the number of overweight children who came for treatment. Parents are inclined to overlook obesity in a young child and to resent having attention to it.

Pathogenesis. Children grow fat when they persistently eat more than they need. At the same time there is usually marked physical inactivity. Obesity is only the symptomatic expression of some underlying disturbance in the weight-regulatory mechanism. In most children the reflex tends to persist into adult life.

Symptoms. Physical complaints due directly to the burden of weight are relatively rare in otherwise normal obese children. However, we know obesity to be a troublesome complication in children with cardiac conditions, diabetes and orthopedic disorders. Increase in blood pressure is frequently associated with severe degrees of obesity. Fatigue, perspiration, poor coordination and shortness of breath may be due to overweight, but these symptoms may also be related to emotional factors. The real suffering is experienced in the field of social relations. They often become objects of ridicule and are excluded from the activities of their age group. The social and psychological problems which obesity creates for a child become more serious with increasing age. Obesity in an adolescent may lead to complete withdrawal.

Treatment. As a physiological problem the treatment of the obese child is simple. Doctors suppose restriction alone or combined with increased physical activity to invariably result in a predictable loss of weight. In a rapidly growing child who is only moderately overweight, it may not be necessary or desirable to plan for weight reduction. It may be preferable merely to retard or arrest the rate of gain until the child grows up to his weight. Caution should be exercised in employing complete starvation, a procedure that has been recently recommended.

Active words to remember:

Obesity, to be inclined, avoidance, to persist, to respond, to achieve, to justify, to predispose, perspiration, to experience, adjustment, restriction, to retard, to arrest, caution, starvation, withdrawal.

EXERCISES

1. Translate sentences paying attention to the Objective with the Infinitive Construction:

1. Some specialists consider complete starvation to be effective in the treatment of obesity. 2. We know obesity to be defined as a degree of overweight which interferes with health or well-being. 3. The doctors believe obesity to develop only in those children whose physiological regulatory and metabolic mechanisms predispose them to this type of reaction. 4. The parents often let their children eat persistently more than they need. 5. It is difficult to make parents pay proper attention to overweight children and consult the doctor in due time. 6. We see the view on obesity have changed greatly during the last two decades. 7. The doctors believe overeating to help obese children in combating anxiety and achieving a sense of comfort. 8. We know restriction in food to help obese patients in losing superfluous weight. 9. The students heard the professor speak about successful use of controlled hunger for the treatment of stomach ulcers. 10. We know the best possible food for the infant to be its mother’s milk particularly during the earlier months of life.

II. Translate sentences, define the types of the subordinate clauses.

1. To what extent obesity is the result of genetic factors and to what extent it depends on environmental conditions is not yet clear. 2. Quite often children who have been only moderately obese in infancy show a rapid gain in weight later on. 3. Life histories of obese children sometimes reveal that the tendency toward isolation and withdrawal has often preceded the development of obesity. 4. If weight reduction is to be attempted its success will depend greatly on the patient’s desire and cooperation. 6. Medicine should never be given to a child unless it is ordered by a physician. 7. The child’s food should contain a good amount of carbohydrates for these are a source of energy. 8. In some individuals obesity corrects itself at the time of puberty as the desire to appear pleasing to the opposite sex develops. 9. It is an often debated question whether a child is in a state of blooming health with excellent nutrition or whether he suffers from obesity. 10. When the winter months come the food becomes rather poor in vitamins.

III. Translate sentences, point out the forms of the Subjunctive Mood.

1.There would be no life on the earth without sunlight. 2. The doctor advised that the baby should be weighed before and after feeding so that he could see how much milk he gets. 3. If young mothers knew how important it is to feed the child properly they would give much more attention to it. 4. It is necessary that the nursing child should be fed at regular intervals. 5. If the doctor recommended the mother to wean her child she would start it without delay. 6. It is desirable that the nursing mother should keep in good physical condition, eat properly and have enough rest. 7. The child was given cod-liver oil containing vitamin A and D lest he should develop rickets. 8. If my child were as strong as yours! 9. The doctors insist that obese children should come to regular check-ups. 10. The lecturer stepped aside so that the students could see the diagram drawn on the blackboard.

IV. Translate into Russian paying attention to the Subjective Infinitive Construction.

1. Cough is likely to be one of the symptoms most frequently complained of in childhood. 2. Cough appears to be mostly observed in many conditions associated with the respiratory infection, though there seem to be some cases having no connection with a respiratory infection. 3. In some cases cough is apt to be worse at night especially during the first few hours. 4. Surgery is likely to yield the required outcome. 5. A combination of many infection producing agents is apt to give very serious complications. 6. Early diagnosis seems not to be the only way to improve survival rate after operations. 7. Increased coagulability of the blood id most likely to be an etiological factor in ischemic heart disease. 8. In some cases cough appears to depend on irritation of the nerve centers solely. 9. Many conditions are likely to be mentioned in which cough occurs, these being most likely to be bronchitis, tracheitis, laryngitis, pneumonia, pleurisy and so on. 10. I have estimated that at least 75per cent of children seem to suffer one or more colds each year.11. Congenital cardiac disease appears to be less frequent than acquired heart disease. 12. Headache, although but a symptom, is likely to be dependent upon many and diverse conditions. 13. The acidity of the gastric contents appears to vary widely, depending upon the amount, concentration, time after ingestion and the character of the food. 14. Season is most likely to have an influence on morbidity. 15. Measles as a disease is dangerous chiefly because of certain complications which are apt to arise during its course, more especially inflammatory infections of lungs.

V. Fill in the blanks with suitable words from the list in brackets.

( in spite of; either … or; not only … but also; both … and; that; after; and; before; if; for;)

1.Eating … … serves to appease bodily hunger … … is charged with emotional significance. 2. … the mother’s diet is insufficient, the milk will be poor in quality. 3. Parents should know … obesity may develop at any age. 4. The typical obese patient tends to be … broader … taller than his age peers. 5. This child is … in a state of blooming health with excellent nutrition … suffers from obesity.6. The child’s health was poor … … … the fact that he was carefully nursed. 7. Avoidance of fats is not necessary … in most individuals they inhibit gastric emptying and delay the onset of hunger. 8. In some instances there is colic … some food is ingested to which the patient is allergic. 9. Parents’ questions concerning hygienic … general care of infants engage an increasing proportion of the time of the pediatrician. 10. A baby must learn to creep … he begins to walk.

VI. Translate sentences. Pay attention to the Construction there is / are.

1.There is a great range in the weight of the newborn even within physiologic limits. 2. There are no special elements of any kind which are peculiar only to living matter and are not found in inorganic nature. 3. There are more that three scores of diseases that are caused by viruses. 4. There are three main medical fields in Russia: adult medicine, child medicine, hygiene and sanitation. 5. There is no apparent indication that the children in whom rheumatic fever occurred early in childhood have shorter span of life than those in whom the onset of the disease came later. 6. Bacteria appear in the mouth soon after birth, and increase decidedly in number of forms. 7. There are many diseases which are almost or entirely peculiar to early life. 8. There is a predisposition to certain diseases during infancy and childhood as contrasted with adult life. There is a difference, too, in the susceptibility to particular diseases at the various periods of early life. 9. There is a high mortality in elderly patients especially those with arteriosclerotic heart disease.

VII. Translate sentences into Russian.

1.Excessive eating and avoidance of activity influence the child’s personality development and life experiences. 2. An evaluation of the emotional problems of an obese child and an appraisal of the difficulties inherent in his family interrelationships constitute a necessary part of the diagnostic study. 3. Mere weight reduction without attention to underlying problems will almost invariably be followed by another increase in weight. 4. Vitamin deficiency is to be prevented. 5. Although opinion as to how often to feed the baby varies, most doctors seem to favour a three or four hour schedule. 6. Obesity is the result of positive energy balance. 7. Caloric intake is regulated in accordance with energy expenditure. 8. Food requirements of individuals are affected by several factors: muscular activity, age, weight, pathologic conditions, climate etc. 9. The most rapid growth period in a child’s life is the first months.

CRACK COMES TO NURSERY

More and more cocaine using mothers are bearing afflicted infants. Numerous reports that appeared in 1980s showed that cocaine use by pregnant women could cause serious physical and mental impairment to their newborns. It was another warning that the snowy white drug was not as harmless as some believed. Since then the situation has only changed for the worse. Despite wide-spread publicity many pregnant women underestimate the extent of the problem. There are women who would not smoke and would not drink but they can’t stay away from cocaine.

Cocaine is a powerful stimulant drug that has become increasingly popular and available in the United States. Smoking cocaine results in short periods of intense euphoric feelings, during which energy and self-esteem are enhanced and anxiety is decreased. However, within hours of use cocaine rebound effects result in anxiety, exhaustion and depressive feelings. The dependent person has to take cocaine repeatedly to avoid these “crash” rebound effects. Because of cocaine’s low molecular weight and its water and lipid solubility it readily crosses the placenta and the fetal blood brain barrier.

The growing number of women are using crack, the cheap purified form of cocaine that plagues American’s inner cities and has spread into middle class suburbs. More than 100.000 babies born in the US annually are believed to have been exposed to cocaine or other drugs during the critical period of fetal development. Doctors found that cocaine like heroin and alcohol could be passed from the user-mother to the fetus with disastrous results.

As doctors see more and more crack-damaged infants – many of them premature – a clear picture of the effects of the drug is emerging. It is not a pretty one. Because a mother’s crack binge triggers spasms in the baby’s blood vessels the vital flow of oxygen and nutrients can be severely restricted for long periods. Fetal growth including head and brain size may be impaired, strokes and seizures may occur and malformations of the kidneys, genitals, intestines and spinal cord may develop. If cocaine dose is large enough, the blood supply can be cut so sharply that the placenta may tear loose from uterus, putting mother in danger and killing the fetus. In this way even one “fit” of crack can irreparably damage the fetus. At birth the babies display obvious signs of crack exposure – tremors, irritability and lethargy that may belie the seriousness of the harm done. These symptoms may disappear in a week or more but the underlying damage remains.

Cocaine-exposed neonates have been found to have lower birth weight, smaller head circumference, inferior visual and auditory orienting skills, poorer motor abilities, decreased consolability and more abnormal reflexes.

Because there is no specific treatment for cocaine babies doctors must work with mothers. Parenting programs are teaching women how to handle the baby’s long bouts of inconsolable crying and unresponsiveness. But such programs are usually designed for motivated women with some financial resources.

Note: an inner city –

Active words and expressions:

To afflict, to bear, to warn, to believe, to underestimate, to stay away, to enhance, to purify, to tear loose, to display, to impair, to plague, to avoid, to underlie, to emerge, to handle, to trigger, euphoria, self-esteem, exhaustion, placenta, fetus, uterus, malformation, behavior, bout, hit, irritability, lethargy, cheap, disastrous, inferior, inconsolable, despite.

EXERCISES

1.Translate into Russian paying attention to the infinitive constructions:

1. Cocaine use over long periods is known to lead to severe forms of psychosis. 2. The stimulant properties of cocaine are believed to have been recognized for over 1000 years. 3. There seem to be several reasons for the phenomenal increase in cocaine abuse, the stimulant effects, euphoria and increased energy level having contributed to its popularity. 4. Available studies uniformly indicate that cocaine-using women are likely also to be heavy users of other drugs, particularly, alcohol, marijuana and cigarettes. 5. Some pregnant women are likely to underestimate the disastrous results of having passion for cocaine. 6. Cocaine has been shown to be the largest producer of illicit income in the United States. 7. Huge amounts of money are believed to be spent on cocaine. 8. Despite widespread propaganda about the dramatic results of cocaine abuse the situation does not appear to have changed for the better.

II. Translate into Russian paying attention to different meanings of the verb would.

1. She would do anything in the world to make her child happy. 2. Your doctor warned you but you would not follow his advice. 3. Parents would be happy if their children are well-brought up, educated and well-settled in life. 4. Even if the mother’s diet does not contain all the essential nutrients, the milk would contain practically all the ingredients which the milk of a well-fed mother would have. 5. The doctor tried to persuade the patient to give up smoking but he would not listen. 6. She would develop acute attacks of asthma in June. 7. Severe hypertension, even if temporary would be likely to increase the risk of infarction in any part of the brain with reduced blood supply and reduce the chances of recovery of a damaged area.

III. Translate into Russian.

Cocaine using pregnant women, cocaine-exposed neonates, cocaine-related admissions to drug clinics, intense euphoric feelings, stimulating drugs, parents teaching programs, serious impairments, laboratory obtained findings.

AIDS and CHILDREN: COPING WITH A CALAMITY

AIDS will have a severe impact on both adult and child death rates, especially in sub-Saharan Africa, during the 1990s. The virus casts a dark shadow over prospects for major gains in children survival and development.

Babies born to women infected with HIV, the virus which causes AIDS, have a 20-40% chance of contracting the virus from their mothers. Almost all of these children will die before the age of five. By the end of the 1980s, according to the World Health Organization (WHO), an estimated 3 million women world-wide, including 2.5 million in sub-Saharan Africa, were infected with HIV, and an estimated 500,000 babies had contracted the virus from their mothers. By 1992 the total number of infants born with HIV infection, in Africa alone, is expected to reach 1 million, of whom 600,000 are likely to have developed AIDS and many will already have died.

Millions of children who are not infected with HIV are already suffering emotional and economic deprivation because their parents have died or are chronically ill. WHO estimates that during the 1990s more than 10 million children uninfected with HIV will be orphaned by AIDS. In many parts of sub-Saharan Africa, the extended family system, which has traditionally absorbed orphans, will come under severe strain as parents die of AIDS, leaving aged grandparents to cope with large numbers of young children.

An international effort continues to be urgently needed in order to:

PREVENT HIV INFECTION. The key strategy here is AIDS education through all possible channels - religious and community organisations, women’s groups, the mass media, the health services, schools and colleges, artists and entertainers. Women must also be given more say in decisions about their own health and sexual behaviour, especially by improving their incomes and education.

Provide health care and social and economic support for families in which a child or a parent has HIV/AIDS and to families and communities caring for children orphaned by AIDS. The guardians of these children must be helped to provide them with a basic level of food, shelter, health care and education. Without such support, AIDS orphans will be condemned to poverty. Many will die prematurely; others will resort to crime and prostitution and will themselves be at high risk for AIDS.

Although AIDS cannot be cured, many of its symptoms can be treated with low-cost, basic drugs. Sensitive counselling can help people with HIV/AIDS to live longer and enhance their quality of life through “living positively”. In countries such as Ghana, Uganda and Zambia, non-governmental organisations now provide ‘home-based care’ programmes, which are also an entry point for educating the wider community.

The AIDS pandemic comes at a time when many developing nations are having to freeze or even reduce their expenditure on primary health care and social services. In most sub-Saharan countries, the health services lack the essential drugs, supplies and transport needed to provide minimum care to people with HIV/AIDS. Increased international assistance to meet these needs is urgently required. Health workers also need special training, particularly in counselling skills and in the diagnosis and treatment of infants and young children with HIV/AIDS, who may be slow to respond to standard treatments for common illnesses.

The eventual scale and impact of the AIDS disaster depends on how quickly policy makers, professionals and the general public become aware of the full scale of the threat and begin taking the obvious steps to contain it.

Active words and expressions:

AIDS = Acquired Immunodeficiency Syndrome; HIV = Human Immunodeficiency Virus; WHO = World Health Organisation; to have an impact on something; major gains; deprivation; extended family system; an orphan; to cope with something; urgently; to condemn; premature; to resort to something; expenditure; a policy maker; to be aware of; to take steps; calamity; disaster; expenditure; pandemic.

EXERCISES

1.Translate into Russian. Pay attention into participle 1, participle 11, gerund.

1.Babies born to women infected with AIDS have a 20-40% chance of contracting the virus from their mothers. 2. WHO estimates that during the 1990s more than 10 million children uninfected with HIV will be orphaned by AIDS. 3. By the end of the 1980s an estimated 3 million women world-wide, including 2.5million in sub-Saharan Africa, were infected with HIV. 4. Women must also be given more say in decisions about their own health and sexual behaviour, especially by improving their incomes and education. 5. Sensitive counselling can help people with HIV/AIDS to live longer and enhance their quality of life through ‘living positively’. 6. The AIDS pandemic comes at a time when many developing nations are having to freeze or even reduce their expenditure on primary health care. 7. Increased international assistance to meet these needs is urgently required.8. Health workers also need special training, particularly in counselling skills and in the diagnosis and treatment of infants and young children with HIV/AIDS. 9. Vaccinated, HIV-infected patients had a lower mortality rate than those not previously vaccinated. 10. Measles is a severe illness in immunocompromised patients. 11. The number of immunocompromised children has increased as a result of the use of cytotoxic chemotherapy for the treatment of malignancies and the increasing prevalence of human immunodeficincy virus (HIV) infection. 12. All patients included in this study were hospitalized at Children’s Hospital of the University of Chicago. 13. After washing, the cells were incubated for 30 minutes. Then the cells were washed and examined by fluorescence microscopy. 14. Severe complications occurred in eight patients, including seven cases of pneumonitis. 15. Pneumonitis uniformly occurred within 2 weeks following the onset of measles, as determined by the onset of the febrile illness or rash. 16. Ribavirin was administered within 48 hours following the onset of dyspnea.

II. Define English equivalents to A from B:

Главная стратегия; повысить доходы; справляться с бедствием; детская выживаемость; система расширенной семьи; средства массовой информации; службы здравоохранения; повысить качество жизни; заморозить расходы; удовлетворить потребности; осознавать; вести положительный образ жизни; неправительственные организации; работники здравоохранения.

To live positively, extended family system, health services, to meet the needs, key strategy, nongovernmental organisations, to freeze the expenditure, to increase the incomes, child survival, mass media, to enhance the quality of life, to become aware of, health workers, to cope with a calamity.

ADDITIONAL GRAMMAR EXERCISES

1.Translate the following sentences into Russian: Define the function of the word «should»

1. The doctor in charge insisted that the child whose health had been weakened by the disease should rest in bed for an hour in the daytime. 2. It is necessary that the child should always sleep alone. 3. Should crying or coughing occur during the examination of a small child the character of these must be noted. 4. One daily nap should continue until the sixth year. 5. One should be cautious in stating diagnosis. . 6. Sleeping out of doors or with the windows open should always be advisable. 7. Should the condition progress, the patient should be given another course of intensive therapy. 8. We suppose we should be allowed to assist during the operation which should be performed by our doctor. 9. I was told that I should be able to get up as soon as my condition considerably improved, the temperature fell to normal, and the inflammation subsided. 10. We should like to stress the great importance of sleep for maintaining health and labour capacity of man.

II. Translate the following sentences into Russian. Pay attention to Participles 1 and II used attributively.

1.As the child grows the amount of sleep required gradually decreases. 2. The bed clothing needed must vary with the season. 3.The growing organism must have sufficient amount of sleep. 4. Adenoma, a form of tumour occurring in the cellular tissue of a gland, is usually treated according to the organ involved. 5. Disease-causing, or pathogenic, bacteria harm the human body by the poisons or toxins produced by them. 6. The work described here was part of an investigation of a skin disease encountered in early childhood. 7. Sore throat is one of the most common conditions met with in medical practice. 8. The wounds studied differed in size, etiology and bacterial flora, but each was of the type regarded as surgically infected. 9. Lesions remaining for a long time within the stomach produce slowly developing symptoms. 10. This nervous condition improving method is similar to that employed in many clinics of our country. 11. When checked, the child showed no abnormality as to growth and development. 12. If given a sufficient amount of mother’s milk the normal child is satisfied after a ten-fifteen minute nursing. 13. If properly treated, a disease may have no sequelae in later life. 14. Acid is a substance which when combined with alkalies forms salts. 15. Infected adenoids, if untreated, usually remain enlarged and cause other disturbances, colds and other infections being common. 16. When used indiscriminately, antibiotics may lead to growth within the body of new strains of previously harmless bacteria which become drug-resistant and thus expose the patient to residual infections. 17. High concentrations of mineral acids have a corrosive effect on human tissue, and, when taken internally, cause severe burning sensation in the mouth, throat and stomach, followed by abdominal pain and vomiting. 18. Vitamins do not decompose until heated. 19. Although described in the first century AD migraine has been extensively investigated only in recent years. 20. Whether followed by complications or not nephritis requires constant supervision.

III. Translate the following sentences into Russian. Pay attention to the conjunctions and prepositions.

A. 1. Poliomyelitis occurs both in sporadic and epidemic forms. 2. In grave cases of chorea children can neither sit nor stand; they cannot dress or eat by themselves and often have speech disturbances. 3. A tendency of bleeding may depend either on changes in the blood itself (reduced coagulation due to deficiency of fibrinogen in the blood), or changes in the vascular wall. 4. As in many other illnesses the food in acute laryngitis should be reduced both in quantity and strength. 5. When small doses of the antimeasles serum are administered during the first incubation days the disease is either prevented or considerably mitigated. 6. Unlike measles, rubella either has no prodromal stage or the latter is extremely feebly pronounced. 7. Both a stridulous and a labored breathing may be present when a laryngeal diphtheria exists. 8. Chickenpox is neither transmitted through things nor through third persons. 9. When the inflammation reaches the intermediate tubes in acute bronchitis, both respiration and pulse are accelerated.

B. 1. The rate of growth of the head during the first year of life of an infant is not uniform, since it is far more rapid during the first half of the year than it is during the second half. 2. Carcinoma of the thyroid in children usually lasts many years before death occurs. 3. After operation the patient should have strict bed rest for 4-6 weeks so that all the soft and bony tissue damage may heal. 4. Since his discharge from the hospital he has continued to feel exceedingly well. 5. Additional studies as roentgen ray examinations, biopsy and sternal puncture may be necessary before the actual diagnosis of anaemia is established. 6. The hypotensive agents were given to the patients promptly after the diagnosis was established. 7. A tuberculin test should never be omitted once suspicion of tuberculous meningitis has been aroused. 8. The only illness since birth was a mild case of chicken pox at 3 months of age. 9. During the prodromal symptoms, before the appearance of the rash, measles is similar to other acute upper respiratory infections. 10. Operation was considered only after conservative measures had failed. 11. All the children with negative reactions in the untreated group were tested in a late stage of meningitis, most of them only once. 12. The paralyses of intercostal muscles and the diaphragm are very grave since they impair respiration. 13. Surgery can be started once the body temperature falls below 39⁰C (degrees). 14.After vaccination the child may be washed and bathed until the appearance of an inflammatory reaction, but, once inflammation and suppuration have begun, the vaccinated arm must not be washed. 15. Pancreas is the most inaccessible structure in the gastrointestinal system, since it cannot readily be palpated, visualized, opacified with radiopaque substances or biopsied. 16. A child with bronchitis should be kept in bed at least three days after the temperature is normal, and kept in the house until the lungs are entirely clear. 17. Since the disease is highly contagious, every case should be isolated.

IV. Translate the following sentences into Russian, paying attention to the forms of adjectives and adverbs:

1. Enlarged bronchial glands produce a most persistent cough. 2. Quinsy occurs much less frequently among children than among adults. 3. The inflammation begins in the deeper tissues, later affecting the mucosa. 4. The onset of the peritonsillar abscess is similar to that of tonsillitis, but the pain is much more severe, and nearly always on one side only, radiating into the ear. 5. The symptoms of adenoids may get worse as the child grows older. 6. Any disease of the lung or pleura will produce an increased respiratory rate; the greater the involvement, usually the more rapid will be the breathing. 7. The younger the child, the more active is the infection. 8. Bronchitis of the smallest tubes, or capillary bronchitis, is the most dangerous form. 9. The spread of infection is made easier in the colder months by closer contact with large groups of people. 10. The most valuable proteins are found in meat, milk and eggs. 11. Anemia due to increased destruction of red cells (hemolytic anemia) is less common than anemia due to decreased blood formation. 12. Substernal pain is more significant than precordial pain. 13. The most serious cases of rheumatic fever are associated with the lesions in the myocardium, the pericardium, and the valves of the heart. The more severe the acute rheumatic fever, the greater the likelihood of cardiac involvement. 14. Rheumatic fever is more widespread among older children (8-15 years of age), while in early childhood the rate of rheumatic morbidity is much lower. 15. Mortality in pneumonia depends on the form of the disease, as well as the age and condition of the child. The younger the child, the higher the mortality. 16. The sooner the antimeasles serum is administered, the more reliable the prophylactic effect.

V. Translate the following sentences into Russian. Pay attention to the Subjective and Objective Infinitive Constructions, functions of the infinitive.

1. Preventive medicine urges us to prepare and eat nutritious food, control our weight and visit our doctor periodically for check-up examinations. 2. Children, particularly, are apt to have severe abdominal pain as one of the symptoms of some transmittable diseases, including pneumonia and infectious mononucleosis. 3. Antibiotics are known to have been employed with dramatic success in the treatment of many bacterial, viral and fungus diseases. 4. Many different organisms have been suspected to be causative agents of acute infections of the upper respiratory tract. 5. Certain persons seem to be immune to acute rhinitis while others have repeated attacks. Immunity, if acquired, seems to be of very short duration as shown by repeated attacks. 6. Skin is believed to be the most active tissue. 7. Of 15 patients treated 3 were found to show sensitiveness to the local application of the drug administered. 8. In case of local application of some drugs healing seemed to have been definitely slowed. 9. Examination showed the patient to have moderate tenderness over the right abdomen. 10. The laparotomy demonstrated the patient to have sustained a perforation both of the stomach and the bladder. 11. The experiments repeatedly indicated the defence mechanism to be one of local manifestations of a general resistance. 12. Nausea and vomiting, the most common early symptoms, should cause one to reduce the dose of the drug used. 13. After eliciting briefly the chief symptoms from which the child seems to be suffering, it is often well to allow the mother to give as full an account as possible of the case. 14. Radiation appears to lower immunity, damage connective tissue and lead to premature aging. 15. The way to be sure that your child is well is to consult a district pediatrician at regular intervals. 16. The mother is usually the first to note any changes in her baby’s appearance and behaviour. 17. There are many diseases and injuries of a child to be reported to the doctor immediately. 18. To see how the child is growing, to observe his development, to give him necessary inoculations is the task of a district pediatrician. 19. To treat a child is often more difficult than an adult as children vary greatly from the latter. 20. The first step to assure survival of a premature baby is to regulate the body heat.

VI. Translate the following sentences into Russian. Pay attention to Modal Verbs.

1. When eliciting a history of a patient attention is to be paid to such symptoms as cough, dyspnea, digestive disturbances, headache, dizziness, etc. 2. Pain should be relieved at once. 3. Great importance must be given to the results of the necessary careful postoperative treatment. 4. It should be emphasized that pain in cases of recurring ulcer may have no relation to meals. 5. Further steps in treatment are to depend upon the general condition of the patient. 6. This tumour was to be excised owing to its site and size. 7. At present time, however, one can still find a great variance of opinion as to the age at which operations in early life should be performed as well as to the best type of operation to use. 8. After operation, the patient should have strict bed rest for 4-6 weeks so that all the soft and bony tissue damage may heal. 9. Order of examination depends on circumstances and the greatest flexibility in the plan is to be allowed. 10. The cause of the headache must be sought for and appropriate treatment instituted. 11. If the infant is well, it should be put in its bed at the time for sleep and left alone in the room. If it wakes in the night it must not be taken from the bed unless it is time to nurse it, or the diaper requires changing. 12. When the pulse of the child has to be examined the warm fingers may be applied very lightly over the radial artery; and the physician’s hand should readily follow, without restraining any movements of the hand of the patient. 13 In case of a child when the medicine has to be administered it is necessary to determine exactly the method of giving it – by mouth, by injections, etc. 14. A physician ought to do everything he is able to render emergency aid to a patient in any circumstances and at any time.

VII. Translate the following sentences into Russian.

1.The gastric juice begins to be secreted even before the food enters the stomach, at the sight and smell of food. 2. Diabetes has originally been considered to be an incurable disease. 3. When he was 48 years old he was diagnosed as having diabetes. 4. This physician’s having made thorough examination and having had all analyses helped him to put a correct diagnosis. 5. We know the violet rays to be the most powerful in killing bacteria. 6 The hands should be washed before eating, especially after prolonged contact with everything in which bacteria are likely to live. 7. A large number of diseases have been definitely shown to be due to specific organisms. 8. Beginning in early infancy the baby should be trained to sleep all night from 6 to 6, except for the night feeding. 9. The peristalsis of the upper intestine induced by taking food helps the peristalsis required for defecation. 10. In treating backache the doctor first endeavors to establish the specific weight condition involved and its sources. 11. Suppurative arthritis results from spreading the infection which reaches the joint either by penetrating the epiphysis or directly from the subperiosteal abscess.

VIII. Translate the following sentences. Define the function of the Gerund.

1. Ultraviolet rays increase the resistance of the organism and are an important agent for preventing and curing rickets. 2. Sunning is not recommended on an empty stomach or earlier than one hour after breakfast. 3. In any illness one of the first considerations is the maintenance of nutrition without causing gastro-intestinal disturbance. 4. To get the best results in treating children suffering with diseases of the respiratory system, especially pneumonia, the child should receive the oxygen in a chamber specially constructed for this purpose. 5. Swimming is good for hardening and strengthening the body, and for avoiding future accidents in the water. 6. The mucus which moistens the entire surface of the mucous coat of the digestive tract facilitates the movement of food and protects the mucous coat from being damaged by solid particles of food and various chemical substances. 7. The liver participates in carbohydrate metabolism by forming and storing glycogen 8. Physical training helps the child in growing up healthy, sturdy and brave. 9. When walking with children younger than 3 years it is advisable to use a harness instead of leading the child by the hand.

IX. Translate the sentences into Russian.

1. Fifty infants admitted to the hospital were determined early signs of heart failure. 2. All infants except those having tetralogy of Fallot have recovered from heart failure. 3. Examining the infant attentively the doctor detected the cause of the deformity. 4. Pediatricians trained by our Academy work in the children’s hospitals of the region. 5. The child operated on for congenital heart defect will be followed till complete recovery. 6. All measures required are to be undertaken to save the life. 7. Unless treated in due time any disease brings about complications. 8. Being seen, the children were revealed some signs of heart failure. 9. Having reviewed the infants case histories, the surgeons revealed the incidence of respiratory infection. 10. Having been examined 19 of the 40 infants were referred to pediatric surgery.