PROBLEMS_OF_GROWTH_amp_amp_DEVELOPMENT

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 wellfounded, 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 highcalorie 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)

1.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:

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”:

1.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:

1.Anemia may be caused by…

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

2.The most important method for early diagnosis of anemia is …

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

3.Treatment of anemia requires …

a)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 crossmatch 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:

1.hemophilia –кровоточивость

2.sodium citrate –лимоннокислый натрий – цитрат натрия

3.cross-match test –проба на перекрестную совместимость

4.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