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asthmatic: asthmatic children; asthmatic condition; asthmatic breathing; asthmatic
1) diverse conditions
a) разнообразные состояния
2) hypersensitivity to some harmless
b) повышенная чувствительность к
3) exaggerated susceptibility to some-
c) повышенная восприимчивость к
4) substances innocuous to normal
d) вещества, безвредные для здоро-
5) minute doses
e) минимальные дозы
6) inheritance of a predisposition to
f) наследование предрасположенно-
7) to manifest specific hypersensitive-
g) проявлять специфическую повы-
8) climatological factors
h) климатические факторы
9) to fall into allergic category
i) относиться к категории аллерги-
10) locality , altitu de or env ir onment
j) местность, высота (над уровнем
11) dusty occupa ti on s
k) пыльные занятия
12) exposure to col d s
l) подвергание простуде
attacks; an asthmatic
sensitivity: increased sensitivity; lowered sensitivity; abnormal sensitivity; unusual
sensitivity; specific sensitivity; fo od se nsit iv ity
3. Match Russian and English equivalents:
articles
thing
persons
something
ness to somethin g
некоторым безвредным веществам
чему-либо
вых людей
сти к чему-либо
шенную чувствительность к чемулибо
4. Translate into Russian the following word-combinations:
1) numerous apparently diverse conditions; 2) a similar etiological basis; 3) an exaggerated susceptibility to substances innocuous to normal persons; 4) origin of al-
ческих
моря) или окружающая среда
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lergic responses; 5) allergic diseases are periodic in nature; 6) urticaria including
the popular and giant types; 7) to try new food one at a time; 8) sympto ms occur;
9) at least a week apart; 10) exposure to colds.
5. Translate into English the follo wing word-combinations:
1) дети-астматики; 2) и другие несерьезные болезненные состояния; 3) по-
вышенная чувствительность со стороны больного к безвредным веществам;
4) применяется термин «аллергический»; 5) приобретенный в результате по-
вреждения ткани; 6) за исключением сенной лихорадки; 7) хронический
бронхит и астма; 8) предотвращать развитие аллергических симптомов; 9)
убирать детей от пыльных занятий; 10) учитывать психосоматические факто-
ры.
6. Read and translate t he given words:
1) allergy – allergic, allergen;
2) inherit – inheritable, inheritance, inherited, inheritor;
3) manifest – manifesting, manife sted, manifestation;
4) sense – senseless, sensibility, sensible, hypersensitiveness, hyposensitiveness,
sensitivity, sensitize, sens or.
7. Translate the following sentenc es:
1. Millions of allergic people receive inoculations that are supposed to desensitize them to the irritating substances to which they showed positive reactions
in allergy tests. 2. The age of the patients transferred to pediatric allergy clinic
ranged between 5 months to 12 years. 3. Food intolerance is an allergic reaction to
an ingested food. 4. All 63 pediatric patients were examined for allergy by means
of standard allergy history form and a complete physical examination. 5. Allergic
response followed the increase in the dosage of the drug. 6. Children with allergic
tendency were excluded from the study. 7. The allergic tendency is genetically
passed on from parent to child and is characterized by the presence of large quanti-
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ties of IgE antibodies. 8. Asthmatic children should be given both specific and
symptomatic treatment. 9. Simple removed of the child from dusty occupation or
from home has in many instances reduced the incidence of asthmatic attacks. 10.
The data revealed that significantly more asthmatics have a history of complications in the perinatal period. 11. History of skin allergy, food sensitivities, drug
reactions, and neonatal dif ficulties were noted in each case. 12. Urticaria is an allergic manifestation of hypersensitivity to some substances.
8. Read and translate t ext I. Make the plan of th e text using key-words.
Text I. ALLERGIC MANIFESTATIONS IN CHILDREN
Within recent years numerous apparently diverse conditions such as asthma,
hayfever, eczema, urticaria, migraine and other minor affections have been shown
to have a similar etiologic basis, a hypersensitivity on the part of the sufferer to
many usually har mless articles commonly encountered in his diet or environment.
To this group of diseases the term “allergic” has been applied; the individuals manifesting such an exaggerated susceptibility to substance innocuous to normal persons in the amount commonly encountered are said to be “allergic” to those articles; and the agents giving rise to those reactions in such apparently minute doses
are termed “allergens”. As for the origin of these allergic responses they arise in
one of two ways: either as a definite inheritance of a predisposition to manifest
specific hypersensitiveness, or acquired as the result of tissue damage or excessive
irritation.
Though the allergic tendency is prenatal in origin the actual manifestations and
causative allergens generally depend upon postnatal factors. The site and type of
reaction are frequently consequent upon some local strain or injury, and selectivity
of the allergen generally follows repeated or continuous contact with some factor
of diet or en vironment.
Allergic diseases have several characteristics in common the determination of
which proves of the utmost importance in diagnosis. They are essentially periodic
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in nature with apparent intervals of freedom. The symptoms frequently have their
onset at night or are most distressing during those hours. With the exception of
hayfever the different manifestations have their maximum onset during childhood
or adolescence, and each manifestation appears to have definite sex and seasonal
variations. In addition, allergic conditions are definitely affected by varied states of
health of the sufferer, by intercurrent diseases, such as fever, exanthemata or climatological factors, l ocality, a ltitude or environment.
Varied manifestations of disease in childhood have been shown to fall into the
allergic category. The commoner of these include such respiratory symptoms as
recurrent bronchitis and asthma; such cutaneous eruption as eczema, flexural pruritis, urticaria including the popular and giant types, and purpura; such abdominal
conditions as food -upsets, colic and recurrent vomiting, hayfever, migraine, enuresis and reactions to therapeutic serums and physic a l age nt s.
Much can be done to prevent the development of allergic symptoms in children.
The homes should be as free from dust and allergens as possible. New foods
should be tried one at a time, at least a week apart, to see if symptoms occur.
Asthmatic children should be guided away from dusty occupations. Exposure to
colds should be minimized. Psychosomatic factors, if present, should be given
proper attent io n.
9. Answer the questions using the text:
1. Why may we say that allergic diseases have a similar etiologic basis?
2. What individuals are said to be allergic to different ar ticles?
3. What term is applied to the agents giving ri se to allergic reactions?
4. What are the two ways in which allergic manifestations occur?
5. When do allergic symptoms occur most often?
6. What factors may influence the frequency and severity of allergic attacks?
7. What diseases have been shown to fall into the allergic c ategory?
8. What measures should be taken to prevent or minimize the onset of allergic symptom s?
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10. Give the English equivalents to the word combinations in brackets. Translate the sentences:
1. (Чувствительность к определенным видам) of pollen, food, stings, latex
products and drugs can produce an allergic response. 2. (После сильного присту-
па бронхиальной астмы) the child falls asleep unless a similar attack. 3. On condition the child is susceptible to respiratory symptoms (аллергического происхо-
ждения), the clinical picture may become a constant feature of the child’s health.
4. (Благоприятный исход) to mother can be easily expected provided each individual case is carefully studied. 5. Supposing some inhalant materials or foods
have periodically caused (раздражение слизистой бронхов), this may lead to the
fixation of a constant pathological condition. 6. Ephedrine and adrenaline will produce satisfactory results (при бронхиальной астме), if given in adequate dose. 7.
Local (повышенная чувствительность) activated by injury to tissues, blood vessels and nerves may be followed by necrosis. 8. Non-allergic (крапивница) may
be caused by drugs, parasites, physical allergies, and the psychogenic agents. 9.
Atopic dermatitis is often associated with asthma and (сенная лихорадка). 10.
One of the most complex questions in the study of allergy is why some individuals
show (повышенную восприимчивость) to definite substance.
11. Choose the definiti ons corresponding to the following terms:
Allergy, hayfever, urticaria, migraine, exanthema, susceptibility, adolescence,
pruritis, enur es is, pur pur a
Capability of being affected by a disease; periodic headache, often one-sided;
an abnormal reaction to union of a specific antigen and the cellular antibody; intense itching; rash on the skin; incontinence of urine during sleep; annually recurring acute allergic con junctivitis and rhi nitis followed by bronchitis, and asthma; a
disease characterized by formation of purple (багровый) patches on the skin and
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mucous membranes; a skin disease marked by transient appearance of wheals; the
age period b etween childhood and adulthood.
12. Give the summary of text I according to you r plan.
13. Read text II and write out key-terms of each of the paragraphs. Give the
summary of the text.
Text II. Management of B ronchial Asthma
True bronchial asthma is an allergic condition which is usually preceded or associated with seasonal or perennial rhinitis and with partial obstruction of the lower air passages. Bronchial asthma is characterized by wheezing, dyspnea, orthopnea, bronchial congestion, and cough. Demonstration of the causative allergens,
especially in patients in whom asthma has begun after the age of 40 years, is not
always possible; in children, however, the discovery of the allergen is almost always a com paratively simple matter.
A good case history must con cern itself not only with possible allerg ic factors
but also with past illness, emotional problems and details relating to previous immunizations. The physical examination must be thorough, with special attention to
the lungs and heart as well as to the nasal passages. A complete blood count should
be made in each case, as well as a skin test, nasal smear, urinalysis, and determination of the erythrocyte sedimentation rate. Skin tests are indicated in almost all allergic conditions, but they are usually useless in urticaria and migraine. Skin tests
should be made by scratch method, but intradermal tests must follow unless the
scratch method yields adequate information.
Therapy may be specific, symptomatic, or preventive. The specific management
of asthmatic children consists in avoidance of causative allergens, with or without
hyposensitization, usually the results are good. Symptomatic therapy of bronchial
asthma is nonspecific, and nothing more than temporary relief of symptoms can be
expected. Reassurance is the most important single measure especially if the child
is having his first severe attack. For mild to moderate symptoms bronchodilators
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and substances that alleviate or arrest the paroxysm are used. Such substances are
adrenaline (subcutaneous) and ephedrine (orally). Hormonotherapy, cortisone,
prednisolo ne are useful in the control of the most severe cases (status asthmaticus).
Proper hygienic measures, mental influence, fresh air, and if possible keeping
the child outdoors all the time are most reliable agents for checking asthma. The
administration of such a regimen for a prolonged period causes the attacks to subside.
14. Read text III and speak about measures ensuring prevention of asthmatic
attacks in children.
Text III. Prevention of Asthmatic Attacks in Children
There are many instances when children suffer from acute asthmatic attacks.
However, an acute asthmatic attack should not be regarded as an isolated clinical
entity, but as one manifestation of a complex constitutional defect. Therefore successful treatment depends not on the management of the attack itself, but it should
be aimed at elimination of chronic physiologic defect, at minimizing its impact on
a child’s physical and emotional development. Prevention should be regarded as
the best strategy in case of “statu s asthmaticus”.
The earliest possible recognition and treatment of developing asthma attack
should be considered as the first step in prevention of “status asthmaticus”.
The medical history of an asthmatic child must contain all the findings concerning the onset and progression of symptoms as they have a great significance in the
evaluation of this condition.
Acute attacks of dyspnea or wheezing may be preceded by a prodromal period,
it being characterized by upper respiratory congestion, cough or nonrespiratory
symptoms, among which loss of appetite, headache, irritability and listlessness
should be mentioned. The overt attack may follow the prodromal period in a few
hours or in several da ys.
In order to follow the management of choice in overt attacks two types of such
episodes should be differ entiated. Rapidl y evolving attacks of acute onset may fo l-
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low stimuli such as antigen contact or exercise. Prophylactic treatment should be
considered best in this case. After the onset of symptoms the child should be instructed to sit down, slowly sip a cup of tepid water, this being followed by slow
deep diaphragmatic breathing. Though such maneuvers may have no physiologic
effect on the asthmatic process, they may have a calming effect, and allow time for
medication to be prepared. The attack may be relieved with rest alone. However, if
it does not subside the child should be administered an aerosol sympathomimetic
drug, it being given by a pressurized hand-held nebulizer, or with an air compressor unit.
A more gradual onset evolving over hours or days is characteristic of the other
type of attack. On the one hand weather change or upper respiratory infection may
result in such an attack; on the other hand, it may represent an exacerbation of
poorly controlled chronic asthma. In this kind of attack “status asthmaticus” is
most likely to develop therefore such a situation presents the more important
treatment problem. If a child suffers only a mild asthma, which does not require
maintenance therapy, the administration of a rapidly absorbed theophylline preparation every four to six hours for a few days may suffice. However if the child has
already been receiving oral theophylline therapy it may be necessary to add an inhaled sympa thomimetic bron ch o dilator several times a day.
Those occasional children whose symptoms are not relieved by prompt and
regular use of adrenergic drugs and theophylline during the attacks, frequently require hospitalization. In such cases the early use of a three or four day course of
corticosteroid consisting of prednisone 1 mg/kg three times a day should be considered effective.
Cases of acute attacks and constant control of disease should be regarded separately. If the child suffers from frequent acute attacks the presence of chronic airway obstructions seems reasonably to be looked for. For this purpose a complete
pulmonary function evaluation should be performed. In the presence of a small
airway obstruction and hyperinflation aggressive pharmacologic management
should be initiated with the aim of returning pulmonary function to normal and
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maintaining it at that level. Such a program is supposed to prevent the occurrence
of acute attacks. Occasionally cases are encountered when the child has normal interim pulmonary function in spite of frequent acute episodes. Such a variety requires therapy aimed at early recognition of prodromal signs, the whole course of
treatment being more intensive an d acute.
15. Choose the right answer to each q uestion:
1) What is “asthma”? 2) Isn’t there any other definition of the disease? 3) What
definition of the disease “asthma” was adopted by the Asthma Thoracic Society in
their statement of 1962? 4) What steps must clinicians take to manage asthmatic
patients? 5) What can these factors include? 6) Can the patient’s history provide a
clue to provocation of his asthma? 7) What treatment is required for patients with
severe asthma?
A) For patients with great bronchial hyper-reactivity, continuous treatment wit h
bronchodilators is mostly advisable. B) “Asthma” is a disease characterized by an
increased responsiveness of the trachea and bronchi to various stimuli and manifested by a narrowing of the airway that changes in severity either spontaneously
or as a result of therapy. C) According to Webster’s New Dictionary “asthma” is
labored breathing, accompanied by wheezing, a sense of chest construction, and
often by attacks of coughing or gasping caused by conditions that interfere with the
normal inflow of air in the lungs. According to Oxford’s Dictionary “asthma” is a
disease of respiration characterized by difficult breathing, a cough, etc. D) Certainly. Usually the patien t’s history provides the best clue to provocation of his asthma.
E) They can include immunologic reactions, infection, aspirin intolerance, irritant
inhalation, atmospheric changes, emotional upset, associated disease or a combination of these factors. F) They need to discover those factors which contribute to
bronchospasm. They must recognize and treat the factors that initiate and aggravate the bronchospastic state. G) Asthma is recurrent paroxysmal dyspnea with
wheezing c ough and sense of chest construction. I t is a clinical syndrom e reflecting
a state of hyperactivity of the bronchial airways.
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16. Read and translate t he dialogue:
-I’ve just examined a new patient. She has been admitted to the clinic with a history of bronch ial asthma .
-What could you reveal at t he examination, please?
-Well, she is 27. She was in distress with shortness of breath. Her chest was distended and there was increased resonance to percussion. There were inspiratory
and expiratory coarse dry râles in the bronchial tubes and wheezes throughout her
chest.
-Is her past h istory available?
-Well, in a way yes. First she had episodes of wheezing at 5, soon after successive
attacks of children diseases: measles, mumps, and chicken-pox. Mild wheezing recurred during he r ea rly childhood and lasted through the year.
-Were there any records of allergic factors? Sensitiveness to any food or drugs?
Sensibility to emotional and external impressions? To changes of conditions, for
example?
-No, there was no information about it.
17. Make up your own dialogue “The doctor and the pediatric patient with
some allergy history”.
18. Point out the conjunctions introducing the adverbial clauses of condition.
Translate the sentences:
1. The difference between the asthmatic and control groups will become more
dramatic if they are compared for incidence of birth complications. 2. Supposing
the operation for ovarian cysts was done late in pregnancy, one must always consider the necessity of cesarean section. 3. In case surgical intervention for uterine
myoma becomes necessary during pregnancy, there is practically no danger to the
patient. 4. Unless there is no improvement of cardiac symptoms, the pregnancy
may have to be terminated. 5. In case you study these data carefully, you will no-