Minimum Competence in Medical English 9782759811328

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MINIMUM COMPETENCE IN MEDICAL ENGLISH

Grenoble Sciences Grenoble Sciences poursuit un triple objectif : • réaliser des ouvrages correspondant à un projet clairement défini, sans contrainte de mode ou de programme, • garantir les qualités scientifique et pédagogique des ouvrages retenus, • proposer des ouvrages à un prix accessible au public le plus large possible. Chaque projet est sélectionné au niveau de Grenoble Sciences avec le concours de referees anonymes. (Contact : Tél. : (33)4 76 51 46 95 - E-mail : [email protected]) Deux collections existent chez EDP Sciences : • la Collection Grenoble Sciences, connue pour son originalité de projets et sa qualité • Grenoble Sciences - Rencontres Scientifiques, collection présentant des thèmes de recherche d’actualité, traités par des scientifiques de premier plan issus de disciplines différentes.

Directeur scientifique de Grenoble Sciences Jean BORNAREL, Professeur à l'Université Joseph Fourier, Grenoble 1

Grenoble Sciences bénéficie du soutien du Ministère de l'Éducation nationale, de l'Enseignement supérieur et de la Recherche et de la Région Rhône-Alpes. Grenoble Sciences est rattaché à l'Université Joseph Fourier de Grenoble.

Réalisation et mise en pages : Centre technique Grenoble Sciences avec la collaboration de 45°Nord - Grenoble ([email protected]) Illustration de couverture : Alice Giraud composée à partir de photos fournies par Dr O. CHAVANON [réimprimé de Images in cardiothoracic surgery Vol. 19, Amine HADJKACEM & Olivier CHAVANON, “Traumatic pericardial rupture with a right dislocation of the heart“, p. 215, Copyright (2001), avec la permission d'Elsevier], Dr P. BICHARD, Dr J.-M. PHELIP, Dr J.-P. BRION, Dr C. STAHL et Pr P. MORAND.

ISBN 2-86883-935-5 © EDP Sciences, 2006

MINIMUM COMPETENCE IN MEDICAL ENGLISH Jonathan UPJOHN Josiane HAY Pierre-Emmanuel COLLE Joëlle HIBBERT Amélie DEPIERRE

17, avenue du Hoggar Parc d’Activité de Courtabœuf, BP 112 91944 Les Ulis Cedex A, France

Ouvrages Grenoble Sciences édités par EDP Sciences Collection Grenoble Sciences Chimie. Le minimum à savoir (J. Le Coarer) • Electrochimie des solides (C. Déportes et al.) • Thermodynamique chimique (M. Oturan & M. Robert) • CD de Thermodynamique chimique (J.P. Damon & M. Vincens) • Chimie organométallique (D. Astruc) • De l'atome à la réaction chimique (sous la direction de R. Barlet) Introduction à la mécanique statistique (E. Belorizky & W. Gorecki) • Mécanique statistique. Exercices et problèmes corrigés (E. Belorizky & W. Gorecki) • La cavitation. Mécanismes physiques et aspects industriels (J.P. Franc et al.) • La turbulence (M. Lesieur) • Magnétisme : I Fondements, II Matériaux et applications (sous la direction d’E. du Trémolet de Lacheisserie) • Du Soleil à la Terre. Aéronomie et météorologie de l’espace (J. Lilensten & P.L. Blelly) • Sous les feux du Soleil. Vers une météorologie de l’espace (J. Lilensten & J. Bornarel) • Mécanique. De la formulation lagrangienne au chaos hamiltonien (C. Gignoux & B. Silvestre-Brac) • Problèmes corrigés de mécanique et résumés de cours. De Lagrange à Hamilton (C. Gignoux & B. Silvestre-Brac) • La mécanique quantique. Problèmes résolus, T. 1 et 2 (V.M. Galitsky, B.M. Karnakov & V.I. Kogan) • Description de la symétrie. Des groupes de symétrie aux structures fractales (J. Sivardière) • Symétrie et propriétés physiques. Du principe de Curie aux brisures de symétrie (J. Sivardière) • Physique des plasmas collisionnels. Application aux décharges haute fréquence (M. Moisan & J. Pelletier) Exercices corrigés d'analyse, T. 1 et 2 (D. Alibert) • Introduction aux variétés différentielles (J. Lafontaine) • Analyse numérique et équations différentielles (J.P. Demailly) • Mathématiques pour les sciences de la vie, de la nature et de la santé (F. & J.P. Bertrandias) • Approximation hilbertienne. Splines, ondelettes, fractales (M. Attéia & J. Gaches) • Mathématiques pour l’étudiant scientifique, T. 1 et 2 (Ph.J. Haug) • Analyse statistique des données expérimentales (K. Protassov) • Nombres et algèbre (J.Y. Mérindol) • Analyse numérique et équations différentielles (J.P. Demailly) Bactéries et environnement. Adaptations physiologiques (J. Pelmont) • Enzymes. Catalyseurs du monde vivant (J. Pelmont) • Endocrinologie et communications cellulaires (S. Idelman & J. Verdetti) • Eléments de biologie à l'usage d'autres disciplines (P. Tracqui & J. Demongeot) • Bioénergétique (B. Guérin) • Cinétique enzymatique (A. Cornish-Bowden, M. Jamin & V. Saks) • Biodégradations et métabolismes. Les bactéries pour les technologies de l'environnement (J. Pelmont) • Enzymologie moléculaire et cellulaire, T. 1 et 2 (J. Yon-Kahn & G. Hervé) La plongée sous-marine à l'air. L'adaptation de l'organisme et ses limites (Ph. Foster) • L'Asie, source de sciences et de techniques (M. Soutif) • La biologie, des origines à nos jours (P. Vignais) • Naissance de la physique. De la Sicile à la Chine (M. Soutif) • Le régime oméga 3. Le programme alimentaire pour sauver notre santé (A. Simopoulos, J. Robinson, M. de Lorgeril & P. Salen) • Gestes et mouvements justes. Guide de l'ergomotricité pour tous (M. Gendrier) • Science expérimentale et connaissance du vivant. La méthode et les concepts (P. Vignais, avec la collaboration de P. Vignais) • Histoire de la science des protéines (J. Yon-Kahn) Listening Comprehension for Scientific English (J. Upjohn) • Speaking Skills in Scientific English (J. Upjohn, M.H. Fries & D. Amadis) • Minimum Competence in Scientific English (S. Blattes, V. Jans & J. Upjohn)

Grenoble Sciences - Rencontres Scientifiques Radiopharmaceutiques. Chimie des radiotraceurs et applications biologiques (sous la direction de M. Comet & M. Vidal) • Turbulence et déterminisme (sous la direction de M. Lesieur) • Méthodes et techniques de la chimie organique (sous la direction de D. Astruc) • L’énergie de demain. Techniques, environnement, économie (sous la direction de J.L. Bobin, E. Huffer & H. Nifenecker) • Physique et biologie. Une interdisciplinarité complexe (sous la direction de B. Jacrot)

ACKNOWLEDGEMENTS

Les auteurs remercient Julie Ridard qui a mené à bien la mise en forme du manuscrit avec une patience illimitée et une gaieté imperturbable. Les auteurs tiennent aussi à remercier chaleureusement Elena Elizondo qui, avec talent et bonne humeur, a donné au lexique sa forme actuelle. Les auteurs souhaitent également témoigner leur reconnaissance à tous ceux qui, par leurs précieuses observations, leurs conseils ou l’envoi de documents, ont permis d’améliorer l’ouvrage, et notamment : Dr J.-P. Bachy (Grenoble), Dr José Manoel Bertolote (OMS), Pr Malcolm Macmillan (Deakin University, Australie), Nicole Décuré (LAIRDIL, Toulouse), Rosa Antonia Seminario (OMS), Dr Sukumar Sen (Fort William, Ecosse), Dr Gillian Upjohn (Cambridge) et Anne Yamada-Vetsch (OMS). Les auteurs expriment leur gratitude à l’Organisation mondiale de la Santé et l’Encyclopédie Wikipedia pour l’ensemble des textes reproduits avec leur accord. Crédits photos Stethoscope (1.1)

© KameleonMedia - Image de BigStockPhoto.com

Syringe (1.3)

Apian

Mouse (1.7)

© kiankhoon - Image de BigStockPhoto.com

Microscope (1.9)

© mmedia - Image de BigStockPhoto.com

Female chromosome (1.9)

Pr P. Morand, Virologie, CHU Grenoble

Occipital bone (1.9)

Dr P.-E. Colle

Blood cells (1.9)

Dr J.-P. Brion, Maladies infectieuses, CHU Grenoble

IUD (T) (1.9)

Apian

Borrelia burgdorferi (1.10)

Russell C. Johnson

Bull’s eye rash (1.10)

www.canlyme.com

Domestic violence (1.11)

© Savol_67 - Image de BigStockPhoto.com

Quizzimage (1.13)

Dr C. Stahl, Médecine légale, CHU Grenoble

Acupuncture needles (2.4)

Christiane Guiraudie

Stop watch (2.4)

© Pete Bax - Image de BigStockPhoto.com

Chernobyl liquidators (2.4)

Wladimir Tchertkoff et Emanuela Andreoli - Feldat Film

Alexander Fleming (2.4)

Postverk Føroya

Hip implant (2.4)

commons.wikipedia.org (GNU Free Documentation License, version 1.2)

6

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COMPETENCE IN MEDICAL ENGLISH

Suture - before and after (2.4)

en.wikipedia.org (GNU Free Documentation License, version 1.2)

Pyramid & Sphinx (2.4) General hospital view (2.8) Staphylococcus Aureus (2.8) US Hospital car (2.10)

© hamdan - Image de BigStockPhoto.com © Elena Ray - Image de BigStockPhoto.com Dr J.-P. Brion, Maladies infectieuses, CHU Grenoble Henry Rose Carter, ca. 1910 - University of Virginia Online Visual History Collection

Mosquito Aëdes aegypti (2.10)

United States Department of Agriculture - Agricultural Research Service

Quizzimage (2.11)

Pr M. Mouillon, Ophtalmologie - Dr Ph. Bichard, Gastro-entérologie, CHU Grenoble

Glass of wine (3.1) Contact lens (3.2) Alarm clock (3.2) Tin opener (3.2) Air conditioner (3.2) Rocket (3.8) Buruli ulcer (3.10) Quizzimage (3.11) HIV virus (3.15) Child abuse (4.1) Wounded soldier (4.6) Hospital ward for rape victims (4.6) Hospital check up (4.6) Postpartum baby (4.6)

Apian

Finger damage (4.6) Disabled children (4.6) Gage - skull (4.11) Quizzimage (4.12) Labrador (5.8) GPS (5.10) Quizzimage (5.11) Depression (5.15) Typhoid Mary (6.1) Syndrome X (6.8) Taj Mahal (6.10) Breast operation (6.10) Quizzimage (6.11)

Pr M. Mouillon, Ophtalmologie, CHU Grenoble © Scott - Image de BigStockPhoto.com Apian © mpemberton - Image de BigStockPhoto.com NASA Pr P. Johnson,

cc

Public Library of Science

Dr C. Stahl, Médecine légale, CHU Grenoble Dr J.-P. Brion, Maladies infectieuses, CHU Grenoble © Scott - Image de BigStockPhoto.com The British Army (www.army.mod.uk) © Amnesty International © Millan - Image de BigStockPhoto.com commons.wikipedia.org (Creative Commons License, version 2.0) Mate Airman Dexter Roberts, U.S. Navy (www.navy.mil) © World Health Organization / P. Virot P. Ratiu, I.-F. Talos, Brigham and Women's Hospital, Boston, MA 02115 Dr C. Stahl, Médecine légale, CHU Grenoble © cpaquin - Image de BigStockPhoto.com © cristimatei - Image de BigStockPhoto.com Dr C. Stahl, Médecine légale, CHU Grenoble © novelist999 - Image de BigStockPhoto.com The New York American, 20 juin 1909 © matka_Wariatka - Image de BigStockPhoto.com © dalan - Image de BigStockPhoto.com © Image Point Photo - Image de BigStockPhoto.com Réimprimé de Images in cardio-thoracic surgery Vol. 19, Amine HADJKACEM & Olivier CHAVANON, “Traumatic pericardial rupture with a right dislocation of the heart“, p. 215, Copyright (2001), avec la permission d'Elsevier

ACKNOWLEDGEMENTS

Ignaz Semmelweis (7.1) Pulmonary oedema (7.9) Ayurveda (7.11) Ear candling (7.11) Blueberry (7.11) Quizzimage (7.12) Tinea pedis (7.14)

7 Image de Ignaz Semmelweis (en.wikipedia.org) Dr C. Stahl, Médecine légale, CHU Grenoble Christiane Guiraudie Christiane Guiraudie United States Department of Agriculture - Agricultural Research Service Dr C. Stahl, Médecine légale, CHU Grenoble pt.wikipedia (GNU Free Documentation License, version 1.2)

Aspirin (7.16)

© Scott - Image de BigStockPhoto.com

Youri Bandajevsky (8.1)

Wladimir Tchertkoff et Emanuela Andreoli - Feldat Film

Arthritis x-ray (8.4)

© Captured Nuance - Image de BigStockPhoto.com

Obesity (8.4)

© Arlene Gee - Image de BigStockPhoto.com

Varicose veins (8.4)

Jace

Asthma (8.4)

© Frith\'s Photography - Image de BigStockPhoto.com

Allergy flower (8.4)

© EuToch - Image de BigStockPhoto.com

Diabetes injection (8.4)

© Frostie - Image de BigStockPhoto.com

Cataract (8.4)

Pr M. Mouillon, Ophtalmologie, CHU Grenoble

Disabled tennis (8.4)

© NickR - Image de BigStockPhoto.com

Clubbing fingers (8.7)

Ann McGrath

Bedside manners (8.10)

Gravure de J. Ch. Thiemen (Nürnberg, 1682)

Quizzimage (8.11)

Pr P. Zaoui, Néphrologie, CHU A. Michallon, Grenoble

Acupuncture chart (8.15)

© BiltOn Graphics - Image de BigStockPhoto.com

Rural health center (9.1)

Dr A. Vignais

Video monitor (9.3)

© briank - Image de BigStockPhoto.com

cc

en.wikipedia (License v. 2.5)

19th cent. medical instruments (9.3) commons.wikipedia.org (Creative Commons License, version 2.0) Operating theatre (9.3)

commons.wikipedia.org (GNU Free Documentation License, version 1.2)

Premature baby (9.3)

© slovegrove - Image de BigStockPhoto.com

Morphine drip (9.3)

© M.Beauregard - Image de BigStockPhoto.com

Schizo Child's drawing (9.8)

Through children's eyes - A collection of drawings and stories from the WHO Global School Contest on Mental Health, WHO/NMH/MSD/WHD/01.2, World Health Organization 2001

Breastfeeding (9.10)

F. Trouvé

Quizzimage (9.11)

Dr J.-M. Phelip, Gastro-entérologie, CHU Grenoble

Doping - Tour de France (10.1)

commons.wikipedia.org (GNU Free Documentation License, version 1.2)

Counterfeit Drugs Lipitor (10.2)

© phodopus - Image de BigStockPhoto.com

Polio Rural health centre (10.3)

The Hunger Project (www.thp.org)

Childbirth (10.7)

F. Colle, A. Fomina

Family planning - Morocco (10.7)

UN/DPI Photo

8

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COMPETENCE IN MEDICAL ENGLISH

Red Cross - Drought. Ethiopia (10.7) UN/DPI Photo Polio vaccination Congo (10.7)

UN/DPI Photo

Greenfly (10.8)

© Ronen - Image de BigStockPhoto.com

Maggot therapy (10.8)

Dr J.-P. Brion, Maladies infectieuses, CHU Grenoble

Quizzimage (10.12)

Dr Ph. Bichard, Gastro-entérologie, CHU Grenoble

Hunger strike (11.1)

www.wafin.be - Site de la Communauté BelgoMarocaine

Rising health costs (11.2)

Dr P.-E. Colle

Fracture (11.2)

© CarolinaSmith - Image de BigStockPhoto.com

Evacuation by helicopter (11.2)

SAMU (www.samu06.org)

Resuscitation BVM (11.2)

© LSmirnov - Image de BigStockPhoto.com

Depression (11.2)

© Alon-o - Image de BigStockPhoto.com

Chernobyl victim (11.2)

Wladimir Tchertkoff et Emanuela Andreoli - Feldat Film

Antenatal scan (11.8)

Joëlle Hibbert

Shingles (11.9)

Deutsches Grünes Kreuz e.V.

MMP vaccine (11.10)

© assynt_bob - Image de BigStockPhoto.com

Quizzimage (11.11)

Dr C. Stahl, Médecine légale, CHU Grenoble

Third world starvation (12.3)

UN/DPI Photo

Access to safe drinking water (12.3) © World Health Organization / G. Diez Leprosy (12.3)

Reidab © Wikimedia Foundation, Inc.

Pasteur’s portrait (12.3)

Photographie du tableau d'Albert Edelfelt (1854 -1905) représentant Louis Pasteur (1822-1895)

Mountaineers (12.8)

© Mtain - Image de BigStockPhoto.com

Grapefruit (12.11)

© Rinderart - Image de BigStockPhoto.com

St John’s Wort (12.11)

© Franck Le Driant (www.florealpes.com)

Quizzimage (12.12)

Dr J.-P. Brion, Maladies infectieuses, CHU Grenoble

Peanuts (12.16)

Apian

Crédits dessins Les illustrations Eye (1.3), Implantable Defibrillator (1.4), Shaped objects (1.9), Lyme disease (1.10), Glue ear and Grommet (1.12), Fatigue graph (2.1), Map of Oceania (2.4), Buruli distribution (3.10), Adenotonsillectomy (4.9), A tamping iron (4.11), Infectious diseases (5.1), Urinary tract infection (5.9), Typhoid (6.1), Patterns of fever (6.7), Autism (6.9), SIDS (7.10), Biofeedback, Qi and Siegesbeckia orientalis (7.11), CVA and Cirrhosis (8.8), Enlarged cancerous prostate (8.9), Pancreas (9.3), Influenza (9.15), Graphs (10.9 et 12.1) ont été réalisées par Anne-Claire Lecomte, Grenoble.

ACKNOWLEDGEMENTS

9

Crédits texte Domestic violence (Unit 1)

Royal Borough's Domestic Violence Forum (www.rbwmdvf.org.uk)

Glue ear (Unit 1)

NHS Direct Online Health Encyclopaedia, 14/03/2006

Yellow fever (Unit 2)

© World Health Organization

Bedwetting (Unit 3)

National Library of Medecine

Buruli ulcer (Unit 3)

© World Health Organization

Traumatic brain injury (Unit 4)

© M. Macmillan http://www.deakin.edu.au/hbs/psychology/gagepage/ Pgstory.php

Urinary Tract Infection (Unit 5)

© World Health Organization

Urinary tract infection (Unit 5)

PRODIGY Knowledge (2006) - Urinary tract infection. Background information. Sowerby Centre for Health Informatics at Newcastle Ltd. (SCHIN).http://www.prodigy.nhs.uk/pk.uk/urinary_tract_ infection_children/extended_information/background_in formation [Accessed: April 2006]

GIS (Unit 5)

© World Health Organization

Medical tourism (Unit 6)

© Financial Times (2 July 2003)

Breastfeeding (Unit 9)

© National Institute of Child Health & Human Development

Diabetes (Unit 10)

© World Health Organization

Osteoporosis (Unit 10)

© Jean Hailes Foundation for Womens's Health

Triple vaccine (Unit 11)

Royal College of Paediatrics and Child Health

Migraine (Unit 12)

Cephalalgia Volume 12 Page 99 - April 1992 Couturier EG, Hering R, Steiner TJ., National Library of Medecine

Abstracts (Unit 12)

© Health Canada International Symposium on Drug, Food and Natural Health Product Interactions, Health Canada, 9 -10 février 2006 ; Reproduit avec la permission du Minister of Public Works and Government Services Canada, 2006

FUNCTION

EXERCISES

UNIT 1 P. 19

What / Who Definitions & descriptions

1.1. Describing a stethoscope Checklist – Definitions & descriptions Exercises 2- 9 1.10. Lyme disease 1.11. Domestic violence 1.12. Glue ear 1.13. Quizzimage N° 1

UNIT 2 P. 35

What / Who Qualification

2.1. A guide for flight surgeons Checklist – Qualification Exercises 2- 7 2.8. Superbug 2.9. Angina 2.10. Yellow fever 2.11. Quizzimage N° 2

UNIT 3 P. 51

What / Who Compound forms

3.1. Wine, beer, and whisky Checklist – Compound forms Exercises 2- 7 3.8. Rocket fuel found in breast milk 3.9. Bedwetting 3.10. Buruli ulcer 3.11. Quizzimage N° 3

UNIT 4 P. 67

What / Who Information focus

4.1. Child maltreatment Checklist – Information focus Exercises 2- 8 4.9. Adenotonsillectomy 4.10. Peritonitis 4.11. Traumatic brain injury 4.12. Quizzimage N° 4

UNIT 5 P. 85

How much / Many Measurement & quantification

5.1. Infectious diseases mortality Checklist – Measurement & quantification Exercises 2- 7 5.8. Could dogs be used for cancer screening? 5.9. Urinary Tract Infection 5.10. Geographical information systems 5.11. Quizzimage N° 5

TABLE OF CONTENTS BACK TO

BASICS

FOLLOW

UP

1.14. Fossilization – Questions 1.15. Lexis – Negative prefixes: anti  dis  im  in  ir  un 1.16. Roots – Medical terminology 1.17. Phonology – Preserving Brain Health: Terminal

1.18. Function search – Interrogative form 1.19. Data search – OHP presentation: Object description 1.20. Phonology – Remedial exercise 1.21. Self-test

2.12. 2.13. 2.14. 2.15.

Fossilization – According to Lexis – Adjectives + prepositions Roots – Common denominator Phonology – HDL Cholesterol : Schwa

2.16. 2.17. 2.18. 2.19.

3.12. 3.13. 3.14. 3.15.

Fossilization – Important Lexis – Suffixes: -ion  -ize Roots – Names of diseases Phonology – Case study: Refusal of treatment : Terminal

3.16. Function search – Compound nouns 3.17. Data search – Buruli ulcer, neglected diseases 3.18. Phonology – Remedial exercise 3.19. Self-test

Function search – Qualifiers Data search – Disease control Phonology – Remedial exercise Self-test

4.13. Fossilization – Raise / rise - lay / lie 4.14. Lexis – Link words: besides  yet  namely  whereas … 4.15. Roots – Word building 4.16. Phonology – A Case Study :

4.17 Function search – Generalizations 4.18. Data search – Damage, surgery and lobotomy 4.19. Phonology – Remedial exercise 4.20. Self-test

5.12. Fossilization – Hard / hardly 5.13. Lexis – Suffixes: -ment  -th  -en  -ness … 5.14. Roots – Synonyms 5.15. Phonology – Clinical Depression :

5.16. Web search – Graph presentation 5.17. Data search – HealthMapper 5.18. Phonology – Remedial exercise 5.19. Self-test

12

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COMPETENCE IN MEDICAL ENGLISH

FUNCTION

EXERCISES

UNIT 6 P. 101

How much / Many Frequency

6.1. Typhoid Mary Checklist – Frequency Exercises 2- 6 6.7. Patterns of fever 6.8. Syndrome X 6.9. Autism 6.10. Medical tourism 6.11. Quizzimage N° 6

UNIT 7 P. 117

How much / Many Comparison

7.1. Semmelweis Checklist – Comparison Exercises 2- 8 7.9. Oedema and oncotic pressure 7.10. SIDS 7.11. Alternative therapies 7.12. Quizzimage N° 7

UNIT 8 P. 133

Why / How Cause & consequence

8.1. Chernobyl, contaminated food and Caesium cardiomyopathy Checklist – Cause & consequence Exercises 2- 6 8.7. Cystic fibrosis 8.8. Cerebro Vascular Accident 8.9. Prostate cancer 8.10. Bedside manners 8.11. Quizzimage N° 8

UNIT 9 P. 151

Why / How Purpose & process

9.1. Ghana – A community-based rural health project Checklist – Purpose & process Exercises 2- 7 9.8. Evaluation of schizophrenia 9.9. Peptic ulcer 9.10. Research on breastfeeding 9.11. Quizzimage N° 9

UNIT 10 P. 167

When / If Present & past

10.1. Doping in sport Checklist – Present & past Exercises 2- 7 10.8. Maggot therapy 10.9. Evolution of tuberculosis 10.10. Diabetes mellitus 10.11. Osteoporosis 10.12. Quizzimage N° 10

TABLE

13

OF CONTENTS

BACK TO

BASICS

FOLLOW

UP

6.12. Fossilization – Actually 6.13. Lexis – Multi-word verbs: rely on  carry out  consist in … 6.14. Roots – Combining forms 6.15. Phonology – Trafficking kidneys : Revision Units 2-5

6.16. 6.17. 6.18. 6.19.

Function search – Actually Data search – Medical tourism Phonology – Remedial exercise Self-test

7.13. Fossilization – Agree 7.14. Lexis – Adjective suffixes: -able  - al  -ful … 7.15. Roots – Suffix -oid 7.16. Phonology – Aspirin – the wonder drug : Weak syllables

7.17. Function search – Comparative 7.18. Data search – OHP presentation: Founding fathers of medicine 7.19. Phonology – Remedial exercise 7.20. Self-test

8.12. Fossilization – The article 8.13. Lexis – More multi-word verbs: ahead  on  through  out … 8.14. Roots – Allomorphs 8.15. Phonology – Acupuncture : / q / - / i: /

8.16. Function search – Cause & consequence: 5 diseases 8.17. Data search – Medical schools curriculum 8.18. Phonology – Remedial exercise 8.19. Self-test

9.16. Function search – Purpose & 9.12. Fossilization – Uncountable nouns process: Key words 9.13. Lexis – Verbs meaning perform: do  make  9.17. Data search – OHP presentation: take … Schizophrenia, breastfeeding 9.14. Roots – Common sense 9.18. Phonology – Remedial exercise 9.15. Phonology – Influenza: Stress in compound 9.19. Self-test nouns

10.13. Fossilization – Word pairs: grow / grow up  experience / experiment  last / latest 10.14. Lexis – Prepositions: around  behind  on the top of … 10.15. Roots – Synonyms 10.16. Phonology – Antimicrobial resistance: Contrasting / q / - / aq /

10.17. Function search – Present perfect & time markers 10.18. Data search – OHP presentation: Osteoporosis 10.19. Phonology – Remedial exercise 10.20. Self-test

14

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COMPETENCE IN MEDICAL ENGLISH

FUNCTION

EXERCISES

UNIT 11 P. 187

Modality

11.1. When life is not worth living Checklist – Modality Exercises 2- 7 11.8. Antenatal screening 11.9. Shingles 11.10. MMR Triple Vaccine 11.11. Quizzimage N° 11

UNIT 12 P. 207

Hypothesis

12.1. “To help, or at least to do no harm.“ Checklist – The conditional Exercises 2- 7 12.8. Acute mountain sickness 12.9. Apocalypse tomorrow 12.10. Migraine 12.11. Abstracts 12.12. Quizzimage N° 12

ANNEXES

Answers

P.

225

Combining forms from Greek and Latin

P.

259

Grammar notes

P.

265

TABLE

15

OF CONTENTS

BACK TO

BASICS

FOLLOW

UP

11.12. Fossilization – Numeracy 11.13. Lexis – Multi-word verbs & compound nouns 11.14. Roots – Awkward singular and plurals forms 11.15. Phonology – Tonic accent and pausing

11.16. Function search – Past modals 11.17. Data search – Seminar: Immunization 11.18. Phonology – Remedial exercise 11.19. Self-test

12.13. Fossilization – To transform / to turn 12.14. Lexis – Multi-word verbs: find out  take off  look up … 12.15. Roots – Prefixes, roots and suffixes 12.16. Phonology – Anaphylactic allergy : Intonation and rhythm

12.17. Function search – Hypothesis 12.18. Data search – Abstracts 12.19. Phonology – Remedial exercise 12.20. Self-test

The phonetic alphabet

P.

281

Phonology notes

P.

283

Lexis

P.

305

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INTRODUCTION La collection Minimum Competence a été très bien accueillie, et en particulier l’ouvrage Minimum Competence in Scientific English qui s’est vendu à près de 60 000 exemplaires. Ce succès nous a incités à poursuivre la série, qui s’enrichit maintenant d’un nouveau titre : Minimum Competence in Medical English, destiné aux étudiants de médecine, pharmacie ou du secteur paramédical. L’objectif de Minimum Competence in Medical English reste celui des autres manuels de la série : mettre au service de l’apprenant un outil conçu pour faciliter une acquisition aussi rapide et agréable que possible des compétences linguistiques indispensables dans le domaine de spécialité concerné et, par là même, rendre l’apprenant autonome. Comme les autres manuels, Minimum Competence in Medical English ne fonde pas l’apprentissage sur une approche grammaticale systématique de la langue, mais sur l’acquisition des fonctions et d’un lexique qu’une analyse de corpus a fait apparaître comme essentiels à la compréhension de textes spécialisés. Le manuel ne cherche pas non plus à suivre pas à pas un programme d’études médicales. Nous sommes convaincus qu’il est plus efficace de faire appel à l’imagination et aux nombreux centres d’intérêts des étudiants. Il ne tente pas d’établir une liste exhaustive des diverses spécialités médicales. Dans notre optique, l’étudiant qui a assimilé et maîtrisé les éléments essentiels présentés dans l’ouvrage est prêt à aborder l’étape de la spécialisation de manière autonome.

Minimum Competence in Medical English conserve la structure déjà utilisée dans les précédents ouvrages. Le manuel comporte 12 unités, chacune consacrée à une fonction linguistique précise. Chaque unité comprend :





Un test d’entrée, appelé “Self-test“. Il s’agit d’un exercice d’auto-évaluation qui a pour but de donner à l’apprenant une idée réaliste de ce qu’il sait afin de lui donner les moyens de se fixer des objectifs d’apprentissage. Nous sommes profondément convaincus que le “Connais-toi toi-même“ de Socrate est la condition première d’un progrès vers la maîtrise de la langue. Une liste de points à vérifier, appelée “Checklist“. Cette liste présente les éléments essentiels de chacune des fonctions. Elle a pour but d’aider les apprenants à structurer en un tout cohérent les connaissances souvent fragmentaires accumulées au cours des années, à l’école ou ailleurs. Ainsi réorganisées, celles-ci seront plus faciles à assimiler. Cette liste permet par ailleurs à l’apprenant de définir son “objectif d’apprentissage personnel“.

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Une série d’exercices sur des thèmes concernant la médecine. Ces exercices offrent des activités variées et motivantes permettant aux apprenants de “manipuler“ le lexique essentiel afin de l’assimiler.



Des textes : une série de textes plus longs et de “mystères médicaux“ appelés “Quizzimage“ sur des thèmes stimulants favorisant l’interaction et les débats au sein du groupe d’apprenants.







Une section d’exercices divers intitulée “Back to basics“ (retour à l’essentiel). Cette partie offre un choix d’activités : repérage et travail sur les erreurs “fossilisées“, enrichissement lexical, révision de la phonologie avec les exercices intitulés “Sounds & Rhythm“, et étude des racines gréco-latines, domaines trop souvent négligés, mais qui n’en sont pas moins essentiels. Une section d’exercices complémentaires intitulée “Follow up“, comportant souvent des recherches sur Internet. Ces exercices ont été conçus pour permettre la réutilisation de ce qui vient d’être appris. Il est en effet essentiel de reprendre les nouvelles acquisitions pour les fixer en mémoire. Sans cette consolidation, l’oubli s’installe – et le travail fourni l’aura été en vain. Un test de sortie intitulé “Self-test“, qui fait pendant au test d’entrée de l’unité. Cet exercice d’auto-évaluation s’inscrit dans la logique de l’ouvrage : il permet à l’apprenant de vérifier qu’il a bien atteint des objectifs qu’il s’était fixés, et d’en tirer les conclusions qui s’imposent.

Pour finir, le manuel regroupe plusieurs annexes en fin d’ouvrage : les réponses aux exercices, des notes grammaticales et d’usage, un échantillon représentatif de racines grecques et latines et une table des symboles phonétiques. Un glossaire anglais - français des termes utilisés complète le manuel. Ce glossaire, qui constitue une nouveauté par rapport aux précédents ouvrages, a été conçu dans un esprit pédagogique. L’apprenant y trouvera à la fois une aide à la compréhension et un outil d’enrichissement du lexique de spécialité grâce aux exemples fournis. L’orthographe respecte l’origine britannique ou américaine des textes, ce qui explique les variations de norme, peu importantes au demeurant. Dans les exercices de phonologie, ainsi que dans le glossaire nous avons recours à la transcription phonétique standard. Nous sommes conscients que les apprenants ne maîtrisent pas tous l’écriture phonétique, mais il nous a semblé que la transcription phonétique, même imparfaitement maîtrisée, pouvait constituer un précieux outil d’aide à la prononciation. Elle permet en effet de se détacher de l’orthographe pour se concentrer sur une représentation visuelle des sons différente, et ainsi de repérer certains problèmes tels que la prononciation des voyelles et donc de les corriger. Nous espérons avoir atteint le but que nous nous étions fixé : offrir un manuel essentiellement pratique qui réponde aux besoins et attentes de toutes celles et tous ceux qui, par nécessité ou par choix, sont amenés à utiliser l’anglais dans un contexte médical. Si vous souhaitez nous faire part d’observations ou de suggestions, c’est avec plaisir que nous les recevrons.

Les auteurs

1. DEFINITIONS & DESCRIPTIONS

It goes without saying that one of the essential skills in language is being able to explain and to clarify what you mean. Inevitably, it is even more important for non-native speakers to be able to do this clearly and concisely. In this first unit, which is linguistically speaking quite simple, we look at a few of the main ways of doing this in the section “Definitions & Descriptions – Checklist”, and then, throughout the rest of the unit (and the book), we help you develop an automatic fluency in this function.

What do you know? – Self-test 1.1. Pair work  Describe the object to your partner.

Stethoscope

 Discussion You probably had some difficulty describing the stethoscope. Why? What were the problems? Working with your partner, try to identify the specific difficulties you had. If you can find answers to questions like these, it will make you a faster and more efficient learner.

Definitions & descriptions – Checklist In the following section you will find a checklist of the essential structures and lexis for describing objects.  Read it through, underlining any words that are not familiar. This should be your learning target – the language that must be known in order to be an efficient speaker of English.

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A. Categorization One of the simplest ways of defining a word is by using the word “to be” and assigning it to a general category. • The definition answers the implicit question: “What (sort of thing ) is X?” It is an object  component  instrument  tool  device  apparatus  machine  system  technology  symptom  examination  test POTENTIAL MODIFIERS

It's a kind of / sort of / type of (tool)  Lethargy is a sort of symptom that is often linked to emotional trauma.  A colonoscopy is a kind of examination used to diagnose intestinal disorders.

B. Constituent elements A word can be defined by enumerating and describing its parts or components. • Implicit question: “What are the basic elements of X?” It is made of  It consists of / inG. Notes 1  It is composed of  It comprises  It includes POTENTIAL MODIFIERS

typically  basically  mostly  mainly  The Department consists basically of three divisions: gynecological oncology, endocrinology, and urogynecology.  Typically, research teams are multidisciplinary, comprising clinical, scientific, and computer specialists.

C. Location Definitions can be refined by indicating position or direction. • Implicit question: “Where is X?” It is situated / found / located / placed  It moves / proceeds / progresses (+ preposition)

UNIT 1 – DEFINITIONS &

DESCRIPTIONS

21

FREQUENTLY USED PREPOSITIONS

above  along  at the bottom / top  behind  beneath  below  beside  between  in front of  inside  near  next to  in the middle  on the right / left-hand side  opposite  through  towards  underneath  within  A stent is a tubular device placed inside the artery.  The microscope has an adjustable diaphragm located beneath the specimen.

D. Use Definitions may explain the use of an object. • Implicit question: “What is X for?” It is to / for (+ -ing)  It is used to / for (+ -ing) POTENTIAL MODIFIERS

above all  commonly  essentially  frequently  mainly  typically  widely  The money is intended essentially for financing the ambulance service.  Heparin is widely used to prevent blood clotting.

E. Shape We often make definitions by indicating the shape of an object. • Implicit question: “What does X look like?” It is circular / round / oval / curved  It is square / oblong / triangular / rectangular  It is hollow / solid / rigid / flexible  It is narrow / wide / thin / thick / fat / flat POTENTIAL MODIFIERS

relatively  quite  fairly  about  roughly  approximately  The pancreas is a fairly narrow, flat organ located deep in the abdominal cavity.  In ultrasonic liposuction, fat is extracted by a thin, hollow canula.

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N.B. – One simple way of defining a word is by using the structure: NOUN + “-SHAPED”. cube-shaped  cone-shaped  disc-shaped  diamond-shaped  Y-shaped  tree-shaped  An otoscope is a cone-shaped instrument used for examining the ear.

F. Relative pronouns In order to gain in precision, definitions often resort to the use of relative pronouns: who  whose  (of) which  that … For people: who  whose

 It is a team consisting of 4 doctors whose expertise is internationally recognized.

For objects: which  that

 The nasal septum is made of cartilage and bone which / that is covered with a lining (mucosa).

Exercises 1.2. Group work  Using as many phrases as possible from the checklist, make an improved description of the stethoscope (question 1.1). When you have finished, compare your answer with the model (see answer section).

1.3. Pair work  Working in turns, and with the help of the checklist, describe the objects below to your partner: retina cornea lens pupil

macula vitreous chamber

iris optic nerve

Syringe

Eye

UNIT 1 – DEFINITIONS &

23

DESCRIPTIONS

1.4. ICDs (Implantable Converter Defibrillators)

tarter

Strong magnetic fields may interfere with ICDs and pacemakers; hair removal by electrolysis and magnetic resonance imaging (MRI), for example, must be completely avoided. As a result, manufacturers recommend certain precautions when using their products. • What precautions do you think they might suggest for cell phones?

The text below contains numerous examples of phrases and structures used in the “Checklist”.  Read it, and then underline at least 20 words that are used. When you have finished, check in the answer section. Cardiac arrhythmia, which is a fairly common complaint, refers to any abnormality in the myocardial rate of rhythm. ICD therapy however, is usually only prescribed for patients whose condition is serious and who have undergone episodes of ventricular tachycardia or ventricular fibrillation. Although there is a wide variety of different ICD systems, the sophistication of modern technology means that today the majority are multimode; they can be used either as simple cardiac monitors without delivering any electric stimulation, as pacemakers to regulate the heart rate in cases of bradycardia, or for defibrillation in cases of tachycardia. ICDs consist basically of three main parts. Firstly, there is the electronic component, including a sensor, a timing circuit, a pulse generator and a lithium battery with an expected life of roughly 6 years. This circuitry is located inside a hollow, oblongshaped case made of titanium, about 4 cm long and 1 cm thick. Finally, the device is connected to the heart via thin, flexible, insulated wires with electrodes at the tips which conduct the electrical impulses between the system and the heart. As can be seen in the figure on the right hand side of the page, the lithium case is implanted subcutaneously, typically just beneath the clavicle. The endocardial electrodes are passed into the venous system, generally through the subclavian, axillary, or cephalic vein, and advanced to the right ventricle and / or atrium, thereby avoiding the need for openchest surgery.

electrode

wires right ventricle

Implantable defibrillator

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1.5.  Match the two halves of the sentence. 1. Emphysema can be caused by work-related damage to the respiratory …

•

•

a. adequate unless the animal is very fat.

2. Capillary hemangiomas are composed of …

•

•

b. system, as in the case of musicians playing wind instruments.

3. For canine bone marrow biopsy, an insertion of about 1 cm is usually quite …

•

• c. due to structural scoliosis.

4. The spine is abnormally curved …

•

•

d. a lack of coordination and failure to arrange words in their proper order.

5. The x-ray clearly showed a banana-shaped …

•

•

e. beneath the lining of the anal canal.

6. Hemorrhoids are dilated veins located …

•

•

f. right hand corner of the page for more detailed information.

7. Click the button at the bottom …

•

• g. transverse fracture of the femur.

8. Dysphasia is a speech disorder consisting of …

•

•

h. therapeutic intervention will vary.

9. Depending on the nature of the tumor, the kind of …

•

•

i. masses of blood vessels that are atypical in arrangement and size.

1.6.  Complete these definitions from a medical glossary. 1. CARDIOMYOPATHY: A group of disorders in which … 2. AORTA: The largest artery in the body carrying blood from the left … 3. CHRONIC

ILLNESS:

An illness whose symptoms …

4. ANTIARRYTHMIC AGENT: A drug used for … 5. ENDOSCOPY: A diagnostic procedure involving the introduction of a thin, hollow, flexible fibreoptic scope into …

UNIT 1 – DEFINITIONS &

25

DESCRIPTIONS

6. ARRHYTHMIA: Any abnormal or absent heart rhythm, including … 7. KIDNEYS: Two oblong, curved, bean-shaped glands situated … 8. VENTRICULAR TACHYCARDIA (VT): A rapid heartbeat producing symptoms of … 9. ANXIETY: An unpleasant emotional state comprising physiological symptoms including …

1.7. Defining a mouse  Study the example below.  A mouse is a device which consists basically of an electronic roller-ball mechanism in a plastic case and / that is used to control a cursor.  Construct sentences with the same pattern, selecting phrases from each box. N.B. – Box N° 4 is not complete – supply the function yourself.



thermometer  cervical smear  forensic anthropologist  magnetic resonance imager  clinical social worker  scalpel  glasses

 IS ARE

WHICH





AND THAT



is (mainly used) to / for  is located / employed …

/ THAT / WHOSE





a sort of screening test  an electronic scanning apparatus  a device  a measuring instrument  person  an electronic apparatus  a kind of surgical tool  a type of optical device  a medical doctor

rehabilitation of patients with severe physical and emotional disorders  can be found in operating theatres  consists of collecting sample cells from the vaginal mucosa  is usually made of glass  is found in large hospitals  job includes facilitating the psychosocial rehabilitation of patients  expertise comprises criminology, statistics, and sociology  consists of two transparent lenses and a frame

1.8. Pair work  Now, produce similar examples of your own. Your partner must guess the answer. Start with “It is … (something) ... which”, then indicate the sort of object (cf. box N°2), next some defining characteristics (cf. box N°3) and finally the function (cf. box N°4).

Example: It is an organ composed of numerous small lobules, located just below the diaphragm which transforms sugars into glycogen.

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1.9.  Look at the example below:  An L-shaped incision is made over the subcutaneous border of the thumb metacarpal.  In pairs, complete the description of the images using a similar construction ending in … ”shaped” (different answers are possible). Here are a few suggestions: BRAIN TREE





X

EGG



HEART





CRESCENT

HORSESHOE





MOON



T



LEAF



STAR



BOX



TRAPEZOID



DOME

………… ? …………… shaped astrocytes provide neurons with mechanical support and supply them with nutrients.



In females, the 23rd pair of chromosomes are …………………...… .



The microscope stands on a



The occipital bone is a …………………...… bone situated at the posterior part of the cranium.



…………………...…

base.

UNIT 1 – DEFINITIONS &

27

DESCRIPTIONS

An IUD is a small, …………………...… device that is placed inside a woman’s uterus.



The …………………...… blood cells signal the presence of a genetic form of anemia.



1.10. Lyme disease – A ticky situation  Below is a text on Lyme disease. Read it and fill in the blanks with the words and phrases below so that the text makes sense and explains the disease: TYPICALLY EMPLOYED CORKSCREW-SHAPED





RELATIVELY NARROW AND LONG

INFECTION IS TRANSMITTED

LIVING IN WOODLANDS AND GRASSY AREAS CIRCULAR RASH









WHICH WAS FIRST

CONSISTING OF

WHICH IS A KIND OF







OR

A TYPE OF



A CHARACTERISTIC

COMMONLY USED FOR

Lyme disease is (1) ………………………………………… ………………… infectious disease (2) ………………… …………………………………………… identified in 1975, in the town of Lyme, Connecticut. In most cases, it is ticks (ixodes dammini) from deer and other wild animals (3) ……………………………………………… Reservoir: the white-footed ……………………………………… that are responsible mouse and white-tailed deer for the spread of the disease. Lyme disease, which is also endemic in Europe and Asia, has been reported in nearly every state in the US but is particularly prevalent on the East Coast.

Borrelia burgdorferi

The causative agent is Borrelia burgdorferi, (4) ……………………..………………………… spirochete, (5) ……..……………………………… ………………… bacteria. It is gram-negative and can be stained with ordinary dyes such as crystal violet and carbofuchsin. The bacteria is (6) ………...……………………… ………………… – only 0.2- 0.3 micrometers in width but 15 -20 micrometers or more

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in length and can only be viewed using dark-field microscopy. The most common reservoir is the white-footed mouse and the white-tailed deer, and the (7) …..………… …………………………………… by tick bites. In about 50% of the cases, patients develop erythema migrans. This is (8) …………………………..……………………… ……………………….. that continues to grow in diameter and appears between a few days and a few weeks after the tick bite. The rash generally has the appearance of an expanding red ring and is often referred to as “a bull’s eye rash” (9) ………………………………………… ………………………………… alternating light and dark rings. Not all patients get the rash and the first sign of bacterial infection may be symptoms of second or thirdstage Lyme disease, such as meningitis or arthritis. Bull’s eye rash

ELISA (enzyme-linked immunosorbent assay), a fundamental of clinical immunology and (10) …………………… ……………………………… the detection of non-specific infections, is the most common blood test ordered to confirm the diagnosis. Once diagnosed, Lyme disease is usually treated by antibiotics such as doxycycline, a tetracycline which is (11) ………………………………………………………. to treat infections by spirochetes, or amoxycillin, a broad-spectrum antibiotic. The disease is often recognized as debilitating in the later stages. Not all ticks are infected; the percentage ranges from 2 to 90% according to the tick species and the geographic regions.

1.11. Domestic violence  Fill in the gaps with the missing word: MENTAL



ATTEMPT



LOSS



LEAD



COPE



FORMER



INJURY



LIKELY



DUE



MEDICATION

PHYSICAL EFFECTS Physical effects of domestic violence can involve broken bones, bruising, hair ……………. and burns, some of which may be long-term resulting in permanent ……………. such as missing teeth, scars, and brain damage due to persistent blows to the head. At its extreme, domestic violence can result in death with two women every week being killed by a current or ……………. partner.

Domestic violence

PSYCHOLOGICAL EFFECTS Psychological effects of domestic violence, both in childhood and adulthood, is a common factor in depression and anxiety and may ……………. to sleep disorders, self-harming and eating disorders for example. Women already diagnosed with

UNIT 1 – DEFINITIONS &

29

DESCRIPTIONS

mental health disorders may find it harder to report domestic violence ……………… to the stigma attached to having mental health disorders, fearful that they may not be believed. Perpetrators may use a victim’s …………….. health to abuse them further, suggesting that the victim would not be able to ……………. without them, threatening to take the children away, or withholding ……………. for example. Women suffering domestic violence are three times more ……………. to be diagnosed with depression, and five times more likely to ……………. suicide.

1.12. Glue ear

tarter

With your partner, describe how a human ear works. Here is some vocabulary: – outer ear, middle ear, inner ear; – ear canal, eardrum (tympanic membrane), Eustachian tube, cochlea, auditory nerve, semicircular canals; – stirrup (also called stapes, U-shaped, smallest bone in the human body), anvil (also called incus) and hammer (also called malleus).

 Work with a partner and answer the questions below. Glue ear is a condition in which fluid builds up in the middle ear. It is a common cause of impaired hearing in young children. It is also known as secretory otitis media, otitis media with effusion, or serous otitis media. The middle ear is the part of the ear on the inner side of the eardrum. In the middle ear there are three tiny leverlike bones that carry sound vibrations from the eardrum to the inner ear. The middle ear has a mucus-producing lining and a drainage tube, called the Eustachian tube, running forward to a point high up on the back of the throat. Close to the front opening of the Eustachian tubes are masses of tissue called adenoids.

stirrup anvil hammer

semicircular canals vestibular nerve

ear drum

external auditory canal

auditory nerve Eustachian tube

outer ear

middle ear

cochlea

inner ear

If the front opening of the drainage tube gets blocked by enlarged adeHow the middle ear works noids or swelling from frequent colds, mucus will gather in the middle ear and will soon become thickened and sticky. This prevents movement of the three tiny bones, so that they can’t move freely. Sounds coming into the child’s ear then appear indistinct.

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People of any age can develop glue ear. However it is most common in children under the age of eight. This may be because the passages in the ear grow as a child ages and consequently become less easy to block.  Questions 1. What is otitis? 2. How is glue ear defined in this text? 3. What is the name of the three lever-like bones that carry sound vibrations from the eardrum to the inner ear? (not in text) 4. Why do the sounds coming into the ear appear indistinct in glue ear? TREATMENT There are three options for surgical treatment of glue ear: • Inserting a grommet – The specialist will provide a new drainage exit from the middle ear by inserting a tiny plastic drainage tube called a grommet into the eardrum. This treatment is performed under general anaesthetic. Grommets normally fall out after 6 to 12 months by which time glue ear has usually gone away, and if not, a new grommet may be fitted. I.5 mm Grommets cause no discomfort while in place. They leave the drum intact when falling out. Children with grommets may go swimming but should never be allowed to dive. When washing the child’s hair, use earplugs to stop soapy A grommet water getting into the child’s ears. • Adenoidectomy – If the adenoids are unusually enlarged, and blocking the Eustachian tubes, they may also have to be removed. • Combining the above – This has been shown to have more effective long-term results than either of the treatments individually.  Questions 5. What is a grommet? 6. What do grommets do? 7. Why do grommets fall out? (not in text, give a good hypothesis) 8. Can you explain what “combining the above” means? 9. What two precautions should be taken? PREVENTION Because the cause of glue ear is not clear, it is not easy to take measures to prevent it. However, breastfeeding and making sure your child is not exposed to tobacco smoke will both reduce the risk of developing glue ear. If you have any concerns about your child’s hearing, or if your child is complaining of earache, visit your GP. Never attempt to insert drops as this could cause further damage.

UNIT 1 – DEFINITIONS &

DESCRIPTIONS

31

 Question 10. The word earache is made of two words. Which ones? Explain the meaning of the word earache? Do you know other similar words?  Going further With your partner, write a list of possible symptoms for glue ear. When you have finished, pool all the answers and make a class list.

1.13. Quizzimage N° 1  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 1.14. Fossilization Certain errors can become fossilized. That is to say, although students have been corrected many, many times they continue making the same old mistakes. An important part of MCME is to help you eradicate the worst of these. ASKING

QUESTIONS

A surprising number of students are still not sure of the interrogative form. Are you?  Write questions referring to the words in bold. • • • •

The overall MRI examination lasted 25 minutes. A bone marrow transplant in the U.S. costs more than $ 120,000. In all cases of head injury, pathologists examine the brain histologically. The risk of developing chronic glaucoma increases with age.

 Now check in the answer section. Are all your answers correct? If not, what action can you take to eradicate these fossilized mistakesG. Notes 14?

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1.15. Flexing the lexis NEGATIVE

PREFIXES

One useful way of extending the lexis is by the use of negative prefixes.  The sentences below are self-contradictory or absurd. First locate the nouns and adjectives that can take a negative form and then insert the appropriate prefixes: ANTI

1.



DIS



IM



IN



IR



UN

The National Health Service has published a list of errors and accidents indicating medical competence.

2. Endometriosis spreads throughout the pelvis causing measurable suffering to patients. 3. Coagulants help prevent blood clots from forming. 4. After the operation, there will be significant functional ability for 10 days. 5. In cases of back injury, the most important thing is to keep the person mobile until medical help arrives. 6. A patient has the right to continue medical treatment even if it will cause death. 7.

Spinal cord compression can lead to reversible damage.

8. The insulin levels are altered despite the treatment. 9. Consumption of alcohol can cause accurate test results. 10. Joseph Lister was the first to carry out the operation under septic conditions. 11. A few of these harmful bacteria will survive if they are affected by the treatment. 12. For a practicing physician, a purely conceptual approach is clinically relevant.

1.16. Roots MEDICAL

TERMINOLOGY

Elements from Greek and Latin are widely present in specialist medical vocabulary (see annexe). For example stethoscope is made from steth, meaning “breast” or “chest”, and scop, meaning “look at”, and the “o” in the middle is a linking vowel.  Make as many words as you can using elements from the table below.

UNIT 1 – DEFINITIONS &

33

DESCRIPTIONS

First element from Greek arthr  brady  bronch  card(i)  col  end  graph  hist  lapar  lob  nephr  ot  path  phleb  sthet  tachy  tom  trach(e)

Linking vowel

Second element from Greek

Suffixe

-o-i-

card(i)  graph  log  path  scop(e)  tom

-ia -ist -y

1.17. Phonology – Sounds & Rhythm  Pair work Student A reads the text below to student B who monitors with the help of the text in the Annexe “Phonology notes”.  Student A Your task is to read this text as fluently as you can to your partner. Before starting, check through to yourself to make sure you understand all the vocabulary. PRESERVING BRAIN HEALTH

IN AN

AGEING POPULATION

The BBC reports that a group of London hospitals are working on plans to intensify the search for strategies to preserve brain health as the population grows older. Several promising methods have been proposed which could help maintain both cognitive and emotional functions. According to the researchers, it appears that brain health is closely related not just to genetics, but also to education, cardiovascular health, physical activity and psychosocial factors.

Follow up 1.18. Web search: Functions – The interrogative form  Using the medical register of the web as a corpus (see “Answers 1.18 – Web search techniques”) write a 5-sentence test on the interrogative form based on the examples in 1.14G. Notes 14.

1.19. Data search a): OHP / Videoprojector presentation  For the next lesson: in pairs, find an illustration of an object and prepare a 3-minute OHP description using the structures in the Checklist.

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1.20. Phonology – Remedial work (see Annexe “Phonology notes”) 1.21. Self-test – Exit proficiency  Complete the sentences by filling in the blanks with an appropriate word. 1.

The regulations for handling radioactive material are fa…………………… complex and you will need expert advice. (relatively, quite)

2. The inhaler is a plastic de…………………… which delivers the correct dose of drug automatically to asthma patients. (construction, apparatus) 3. A laparoscope is a ki…………………… of telescope that is inserted through a small incision beneath the navel. (sort) 4. Excellent collaboration with the nursing staff, who co…………………… the majority of the hospital workforce, is crucial. (make up, constitute) 5. In the past, parents had to sleep on the floor be…………………… the child’s bed in the hospital. (next to) 6. A recent study suggests that Ibuprofen and other co…………………… used painkillers for treating inflammation increase the risk of heart attack. (frequently, widely) 7.

For suturing skin, it is best to use a cu…………………… needle. (not straight, crescent-shaped)

8. The technology is ideal for visualising ho…………………… organs, such as sinuses. (not solid, empty inside) 9. From the point of view of health, it is quite clear that a 100 years of social policy have failed to na…………………… the gap between the rich and the poor. (make smaller, reduce) 10. 10 g of nitrogen ro………………… equals 60 g of protein which in turn equals 300 g of red meat. (approximately)

2. QUALIFICATION

In this Unit, we look at a selection of high frequency adjectives and adverbs that are used for qualifying the meaning of other words, i.e. for making what we say more precise. The world we live in is complex and simplistic descriptions are not enough. It is not sufficient to learn that the patient has symptoms – what we want to know is whether the symptoms are: mild, severe, common, chronic, acute… and so on. This may seem obvious. However, what is less well understood is that the lack of defining vocabulary is one of the greatest weaknesses of many language learners. Fluency is helped immensely once you have an easy control of a wide range of adjectives and adverbs to facilitate a more accurate formulation of your ideas.

What do you know? – Self-test 2.1. Performance maintenance during continuous flight operations – A guide for flight surgeons

tarter

As the text below shows, modern warfare is not just a question of enhanced technology. Retired Admiral Stephen Baker, from the “Center for Defence Information” in Washington calls for a radical approach. What he calls, “better soldiers through chemistry”, is being looked at very closely. • With your partner, draw up a list of 5 priority areas for medicine in modern warfare.

 Working with your partner, replace the words in the text written in bold by synonyms from the list: (1-9) ALMOST  DEPENDABLE  ESSENTIALLY  IMPORTANT  MAJOR  QUITE  SEVERE  DECISIVE  UTTERLY (10-17) APPROPRIATE  BASICALLY  COMMON  EXCEEDINGLY  PROPERLY  TYPICALLY  CORRECT  USEFUL (1) One of the most significant new trends in modern military thinking is the use of pharmacology for optimizing performance in an attempt to produce “ironbodied and iron-willed personnel”. According to a document from the Pentagon’s

36

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COMPETENCE IN MEDICAL ENGLISH

“Advanced Research Projects Agency”, it would be possible to entirely change current military concepts of operational tempo if elite troops could be produced, “capable of resisting the mental and physiological effects of sleep deprivation and acute stress”. One of the foremost problems of virtually all aircrews is fatigue. B-52 crews are sometimes required to fly non-stop for 44 hours. Clearly, this can have serious consequences on performance involving a crucial decrease in cognition and central nervous system activation. Just 18 to 21 continuous hours without sleep leads to performance impairments similar to those seen with blood alcohol concentrations of 0.05 to 0.08%. At the moment, basically two sorts of treatment are available. Pilots call them “go pills” and “no-go pills.” The first enhance the capability to resist the mental and physiological effects of sleep deprivation. The use of amphetamines to make troops more reliable by maintaining alertness is now fairly (10) widespread. USAF pilots during Desert Storm reported that suitable doses (on average 5 mgs) of dextro-amphetamine (Dexedrine) proved to be extremely helpful in maintaining alertness. “No-go pills” on the other hand, are sedatives used as counter-measures for the disruption of the circadian rhythm. Benzodiazepines are most frequently used as they have the desired hypnotic action and, at the same time, induce short-term anterograde amnesia. However, John Pike of “Global Security.org” points to the dangers of this approach; “the side-effects of such treatment have not been thoroughly studied”. He suggests, for example, that medication could be responsible for “errant bombing”. In 2002, an American F-16 pilot in Afghanistan was accused of failing to exercise proper flight discipline after refusing to obey air control and dropping fully alert take off approach a 500-pound laser-guided bomb landing less vigilant on allied troops, killing 4 Canadian soldiers. There are also three cases refuelling refuelling low performance of special unit forces based at Fort Bragg N.C. who murdered asleep their wives. “On the whole”, says Pike, “this sort of paranoid, hyperPERFORMANCE EFFECTS OF FATIGUE aggressive behavior is just what An already tired aviator flying an uneventful one would associate with excesseven hour Combat Air Patrol (CAP) sive use of such drugs”.

Qualification – Checklist Adjectives and adverbs qualify the words with which they are associated. Their number is extremely large. This selection contains words that are of particular interest as they are both frequently used and particularly useful in scientific discourse (N.B. – In most cases, adjectives can be transformed into adverbs and vice versa).

UNIT 2 – QUALIFICATION

37

A. Adjectives IMPORTANCE

important  significant  relevant  crucial  meaningful  alarming  worrying  disturbing  There have been several worrying reports on the increasing use of psychotropic drugs in children. DIMENSION

enormous  tremendous  huge  widespread

small-scale  tiny  minute

≠

 Depression is widespread among heart attack patients. HIERARCHY

major  main  chief  leading  primary  foremost  oustanding

• secondary  minor  common • average  mean  typical  standard  common

≠

 The Nobel prize is awarded for outstanding contributions to science. INTENSITY

dramatic  striking  acute  steep  sharp

mild  chronic  dull  slight  gradual

≠

 A slight increase in blood pressure levels can lead to a high risk of a second cardiac event. APTITUDE

appropriate  suitable

UTILITY

useful  helpful  reliable  efficient

 Local anaesthetics are not suitable for young children with mouth ulcers.

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B. Adverbs ESSENCE

essentially  fundamentally  basically  on the whole  Basically, homeopathy is a system that attempts to stimulate the body to heal itself. MANNER

carefully  steadily  thoroughly  accurately  properly  The drug was thoroughly field-tested in clinical studies on patients with cancer. NEGATION

hardly (any)

(G-notes 4)

 scarcely (any)  barely (any)

 After 4 days’ treatment, there was scarcely any improvement. DEGREE

• a little  a bit  slightly • relatively  quite  rather  fairly • very  extremely  exceedingly  Many people think that it is nicotine that causes cancer rather than the smoke. APPROXIMATION

• nearly  almost • roughly  more or less  virtually • to a certain extent  partly

≠

totally  quiteG. Notes 27  entirely  utterly  thoroughly

 Severe sepsis causes almost 10% of cancer deaths.

Exercises 2.2. Qualifiers are often found in collocations (commonly associated word groups). These are indicated in bold.

UNIT 2 – QUALIFICATION

39

 Match the two parts of the sentences correctly. 1. In order to gather meaningful data, …

•

•

a. that osteoporosis is a disease that only affects women.

2. Botox is injected into the muscles …

•

•

b. before a suitable treatment is found.

3. Alcohol is the second leading cause …

•

• c. in tiny amounts.

4. Because patients react differently, several medications may be tried …

•

•

d. the brain is utterly dependent on immediate availability of oxygen. e. some sort of system is needed to assess the real outcome of surgery.

5. The patient has no diabetic complications, drinks hardly any alcohol, …

•

•

6. The web site provides links to other …

•

• f. of acute pancreatis.

7. There is a widespread belief …

•

•

g. and takes Mixtard insulin twice daily.

8. Because of its high metabolic rate, …

•

•

h. relevant resources concerning malaria.

2.3.  Insert the missing word from the list below: SCARCELY ANYONE COMMON





ACCURATELY

FOREMOST





SLIGHTLY



ROUGHLY



TO A CERTAIN EXTENT



ON THE WHOLE

1. Magnetic resonance imaging can help radiologists …………………………. determine the spread of malignant tumours. 2.

………………………….,

students prefer clinical work.

3. Peripheral vascular disease (PVD) affects …………………………. 8.4 million Americans. 4. Surgery to remove the gallbladder is the most symptomatic gallstones.

………………………….

way to treat

5. The National Research Council is Canada’s …………………………………. research and development agency. 6. The pancreas was normal, there was no evidence of peritoneal fluid and the uterus was …………………………. enlarged. 7.

………………………….

8. Today there is

our response to stress is within our control.

………………………….

who does not use electronic equipment.

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2.4. Pair work  Work in turns making sentences about the pictures below using qualifiers from the checklist. A different qualifier should be used each time and each student must provide 2 examples (there are more words than necessary):  For example in the picture Oceania: “The Solomon islands are tiny islands in the South Pacific”. RELIABLE



ACCURATE SHARP SLIGHT

 



SHARP



HUGE

WIDESPREAD

THOROUGHLY CRUCIAL









PROPERLY TINY

ROUGHLY

SUITABLE









FOREMOST

SECONDARY FAIRLY





HARDLY



OUTSTANDING

 …) 

MINOR

LEADING

(ANY



SUITABLE



USEFUL

ON THE WHOLE

  

BASICALLY

Alexander Fleming Acupuncture needles

Hip implant

Chernobyl liquidators

Suture – before and after

Stop watch Papua New Guinea

Solomon islands

New Caledonia Australia

Pyramid & Sphinx Oceania

New Zealand

French Polynesia

UNIT 2 – QUALIFICATION

41

2.5.  Match the qualifiers on the left with the dictionary definitions on the right. 1. minute

•

• a. completely, carefully, and conscientiously

2. key

•

• b. of limited size, extent

3. virtually

•

• c. very important or necessary, chief

4. appropriate

•

• d. abrupt, rising sharply

5. small-scale

•

• e. extremely small

6. rather

•

• f. to some degree, fairly

7. thoroughly

•

• g. correct or suitable for a particular time or purpose

8. steep

•

• h. almost, practically

2.6.  Insert the qualifiers from Exercise 2.5. into the following sentences. 1. The medical staff, numbering nearly 1100, represents …………………… every medical specialty. 2. A …………………… pilot study of hospital inpatients was carried out to evaluate side effects of the drug. 3. Hands must be performed.

……………………

4. The PSA level was 5.

……………………

washed and dried before an aseptic technique is

……………………

high, so a prostate biopsy was performed.

medical evaluation is essential for the treatment of anthrax.

6. Even when present in …………………… quantities, some compounds produced by tumours can be detected by dogs. 7. There has been a the last 20 years.

……………………

increase in sexually transmitted diseases over

8. General Practitioners (GPs) play a vascular disease.

……………………

role in the detection of cardio-

2.7.  Complete the sentences below with a qualifier (the first two letters and a synonym are given). 1. One of the ma………………. (main) concerns in obstetrics is the rising number of interventions, es…………… (particularly) caesarian sections.

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2. CSF (Cerebro Spinal Fluid) samples should be ca…………………… (with precaution) protected from light before being sent for spectrophotometry. 3. Single gene disorders are ra…………….. (comparatively) uncommon. 4. Renal failure is the cause of death in al…………………… (nearly) 50 % of insulin dependent diabetics. 5. With good treatment, the av…………………… (mean) survival of a patient with cystic fibrosis is now more than 30 years. 6. For reasons which are not qu…………………… (completely) clear, N. meningitidis can sometimes overwhelm the body’s defences and cause meningitis. 7. Asthma is the ch………………… (principal) reason why children miss school, and UK children are fa……………………. (quite, rather) hard hit. 8. In the past decade, there has been a dr……………………. (spectacular, great) improvement in the way spinal fusion operations are performed.

2.8. “Superbug”  The qualifiers listed below have been omitted in the following text. Insert them in their appropriate blank. There might be more than one possibility: (1-7) ALMOST  MINOR  TYPICALLY  STANDARD  COMMONLY  QUITE  GRADUALLY (8-15) HUGE  EFFECTIVE  WIDESPREAD  FUNDAMENTALLY  RELIABLE  SHARP  FOREMOST  WORRYING (1) Staphylococcus aureus, ……........................... referred to as “staph”, are bacteria which are .......................... carried on the skin, in the nose or in the throat of healthy people called carriers. They can therefore be easily transmitted by physical contact or by droplet spread. Occasionally staph can cause infections, most of which are .......................... and can be treated with .......................... antibiotics. However, they can also cause a broad range of …………….…… serious infections, such as septicaemia, pneumonia, boils, urinary tract infections (UTI), etc., depending on the infected body part. For many years since the advent of antibiotics, these infections had been successfully treated with penicillinrelated antibiotics. Over the past 50 years, however, specific bacteria have .........................……. developed resistance to ........................…….. all antibiotics, thus methicillin-resistant Staphylococcus aureus (MRSA) has become widespread in hospitals throughout Europe and the USA.

UNIT 2 – QUALIFICATION

43

There are a certain number of factors which are likely to put patients at higher risk for MRS; (8) .......................... amongst these are: prolonged hospitalization in an intensive care unit (ICU) or a burn unit, having an open wound, being catheterized, operated on, etc., and overall physical weakness of the elderly or very sick. Recently, there have been .......................... reports suggesting that MRSA may also be responsible for serious disease outside hospitals, infecting younger, previously healthy people. .......................………... statistics point to a sudden, .......................... increase in reported cases. Even Staphylococcus aureus more .......................... are reports from the USA of a bug resistant to all existing antibiotics: VRSA (Vancomycin Resistant Staphylococcus aureus). If vancomycin is no longer .........................., then the only alternative left to healthcare workers will be contact isolation which is both extremely difficult to organise and involves .................……......... costs. It is to be hoped that current research will yield some sort of treatment in the near future. However, we should not be surprised at the situation. After all, aren’t large scale epidemics of this sort ..............……............ all about “the survival of the fittest” – bacteria as well as humans?

2.9. Angina  Before you read the text, make a list with your partner of 5 things you know about Angina. Then check to see if they correspond to the text. Angina is not a disease, but is a symptom indicating myocardial oxygen deficiency. It is usually characterised by pain or discomfort in the area of the chest or other parts of the body including arms, shoulders, mouth, jaws and neck. Angina affects about 2% of the population and prevalence rises with increasing age and is higher for males than females. Its incidence is closely related to lifestyle, with higher rates among smokers, those who are obese and who take little exercise. Stable angina is the most common form and is typically brought on by physical effort, which increases the oxygen demand for the myocardium, for example, when running or walking upstairs. It can also be caused by emotional stress and overeating. The onset is fairly predictable and the pain disappears as soon as the physical effort stops. Unstable angina, on the other hand, is not predictable, and follows no regular pattern. It can be triggered by the slightest physical effort and may even occur when lying in bed. Unstable angina should be considered as a medical emergency. CAUSES – The principal cause of angina is a gradual narrowing of the coronary arteries due to atherosclerosis consecutive to the deposit of plaque. In unstable angina, however, a clot may be formed abruptly if a plaque is dislodged. This can occur at any moment, which explains its unpredictability.

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TREATMENT – Temporary relief of pain can be provided by administering glyceryl trinitrate (GTN), a fast-acting drug which dilates the coronary arteries, thereby increasing the blood flow. Mild or moderate angina can be treated with long-acting drugs to dilate the blood vessels, reduce the workload of the heart, dissolve clots or act as anticoagulants. Daily low-dose aspirin reduces risks of thrombosis by inhibiting platelet aggregation. If drug therapy is not effective surgery may be required: • Angioplasty – this involves inserting a catheter into the artery to increase the blood flow by removing a clot, widening the artery and inserting a stent. • Coronary artery bypass – consists in grafting a segment of vein to shunt blood around an obstruction.

2.10. Yellow fever

tarter

• Have you ever travelled outside Europe? If you have, did you need specific vaccination or medical treatment before you left? If you didn’t need any, do you know of any specific vaccination requirements for foreign travel?

 First read the text and then, in pairs, answer the comprehension questions below. Yellow fever is a viral disease of variable severity belonging to the group of haemorrhagic fever-causing viruses that includes Ebola, Marburg, and Crimean-Congo fevers. While most patients recover after an initial febrile stage, accompanied by headache, muscle pains, chills, nausea and vomiting, 15% after a brief period of remission enter a severely toxic phase, characterized by damage to Hospital car used for conveying patients to multiple organs, including the liver the base hospitals – folding beds made of gas pipe, chains and canvas and kidneys, generalized haemorrhage often accompanied by black “coffee-ground1” vomiting. Half of the patients who enter the “toxic phase” die within 10-14 days; the remainder recover without significant organ damage. It is the jaundice resulting from liver failure which yellows the eyes and skin that gave the disease its name. The old alternative name, “black vomit”, was a further testament to the terrifying symptoms.

1. “Coffee-grounds”: the particles remaining at the bottom of a cup of Turkish coffee.

UNIT 2 – QUALIFICATION

45

At the start of the 20th century, the Caribbean had been the heartland of yellow fever since at least 1650, with a case-fatality rate approaching 85% in some epidemics. During the regional disputes in 1898, armies lost five times as many soldiers to yellow fever and other diseases as to combat, while French efforts to construct a canal across the isthmus of Panama failed in large part because more than half of the workforce succumbed to yellow fever. Quarantine policies in North America and elsewhere resulted in huge commercial losses which explains why the eradication campaign that was initiated was better supported than most. Until the end of the nineteenth century, the aetiology of yellow fever had remained a puzzle because the massive outbreaks appeared to be similar to epidemics, yet the disease was not directly contagious. In 1900, in an effort to find ways to control the disease, the U.S. sent Dr Walter Reed and a team of researchers to Cuba to investigate how the disease spread. Fifty years earlier, Dr Carlos Finlay, a renowned Cuban physician, had suggested that the disease might be spread by insects and it had also been noticed that epidemics were brought to a halt when cold winds stopped mosquitoes breeding. Dr Reed designed an experiment to prove that yellow fever was spread by the bite of the mosquito Aëdes aegypti. He had two 14 x 20 foot buildings erected. In the first one, called the “Infected Clothing and Bedding Building”, the windows and doors were fitted with mosquito screens to prevent insects entering, but the volunteer soldiers who were confined inside the building were issued with clothes and bedding stained with blood and vomit from infected patients. After three weeks, all emerged healthy. In the second building, the “Infected Mosquito Building”, all clothing had been sterilized, but infected mosquitoes were introMosquito duced. Within four days the volunteer had contracted Aëdes aegypti (a non fatal case of) yellow fever. Dr Reed’s experiment proved that the secret to overcoming yellow fever was the elimination of the virus-carrying mosquitoes. The discovery had an immediate and powerful effect; mosquito screens were introduced and nearby wet breeding grounds of the insect were destroyed. Within three months, for the first time in over 150 years, yellow fever was virtually eliminated from Havana. The same techniques were used a few years later in Panama. The efforts to construct the Panama Canal were resumed in 1904, this time accompanied by a campaign to eliminate the mosquito breeding sites. Swamps were drained, stagnant water sealed with oil, houses were fumigated and windows screened. In less than nine months, yellow fever was banished from the isthmus.  Questions Now, without consulting the text, test your partner’s comprehension. Student A asks questions A1-A5 and student B questions B1-B5. When you have finished check your answers together in the text.

46

MINIMUM

A.1. Where does the name of the disease, Yellow fever, come from? A.2. What is puzzling about the way the disease spreads? A.3. What had Dr Finlay suggested? A.4. What did Dr Reed prove? A.5. What was the effect of the discovery?

COMPETENCE IN MEDICAL ENGLISH

B.1. Why was the vomiting called “coffee ground” or black vomiting? B.2. How long has the cause of the disease been known for? B.3. When had Dr Finlay suggested it? B.4. How did Dr Reed prove it? B.5. What happened in 1904?

2.11. Quizzimage N° 2  Describe and comment: settings, pathology.

Back to basics 2.12.Fossilization “ACCORDING

TO“

 Which, if any, of the following sentences are correct? • According to a study published in the BMJ, dogs can detect cancer by smell. • According to Lucy, it will rain tomorrow. • After the age of 55 there is, according to the BBC, a considerable increase in the error-rate of surgeons. • According to me, public health facilities need improving.  Check in the answer section and then give personal opinions about the following: The National Health system in Britain  Placebos  Stress  Medical research

UNIT 2 – QUALIFICATION

47

2.13.Flexing the lexis ADJECTIVES +

PREPOSITIONS

Certain adjectives are followed by specific prepositions.  Insert the correct preposition: AT

1.



IN





FOR

TO



OF



WITH

The general public is often not aware

the health risk.

………

2. General gynaecologists are very good

………

initial infertility evaluation.

3. The difficulty is identifying the types of HPV (Human Paplloma Virus) responsible ……… these infections. 4. If the mother’s blood type is Rh negative, it will be incompatible a fetus’s Rh positive blood type.

………

5. Aristotle believed that the deaf were incapable ……… learning or thinking. 6. Premature babies are more liable 7.

………

get anaemia due to lack of iron.

A recent study suggests that individuals from higher socio-economic classes have a slightly increased risk of falling ill ……… schizophrenia.

8. A total of roughly 50 students are involved 9. A post is vacant for a doctor qualified

………

………

holistic medicine.

10. I am sending you a list of web sites relevant 11. Students are often surprised diseases. 12. This project is suitable

………

………

this project.

………

epidemiology.

the difficulty of diagnosing simple

students interested in bio-interactions.

2.14. Roots COMMON

DENOMINATOR

 What do the following terms have in common? CHLORINE



CIRRHOSIS

ERYTHROCYTE





CYANOSIS

LEUCOCYTE



MELANOMA

2.15.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Read this short text on cholesterol levels to your partner. Before starting, read it to yourself and make sure you understand all the vocabulary.

48

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HDL

COMPETENCE IN MEDICAL ENGLISH

CHOLESTEROL LEVELS

An HDL level of 30 is not considered to be a healthy level. The level should be at least 40 for men, and some experts recommend more than 45 for women. High levels of HDL cholesterol can actually help your heart as they carry potentially harmful LDL away from the arteries.

Follow up 2.16.Web search: Functions – Qualifiers  Select 6 qualifiers with which you are not familiar from the Checklist and find 2 examples of each from a web search in the medical field. Present these in class next week.

2.17. Data search: Disease control  Group work Each group prepares a short presentation on one of the following topics (see Exercise 2.10): • • • • • •

Carlos Finlay and his work Dr Walter Reed and his work yellow fever and the Panama canal yellow fever vaccination present day situation: resurgence, control, surveillance… any other yellow fever related topic based on information found in one of the sites.

You can consult one of the following sites: • Centers for Disease Control and Prevention, Government of the U.S.A. • World Health Organization • University of Virginia Health Science Library (historical aspects)

2.18. Phonology – Remedial work (see Annexe “Phonology notes”) 2.19. Self-test – Exit proficiency  Complete the sentences by filling in the blanks with an appropriate word. 1.

The “Student B.M.J” contains a great deal of re………………………… information for medical students. (pertinent, meaningful for the person concerned)

UNIT 2 – QUALIFICATION

49

2. Mi………………………… amounts of mustard gas can have long-term carcinogenic effects. (tiny, extremely small) 3. He was an ou………………………… student and was offered a one-year scholarship at Cambridge University. (exceptional, excellent) 4. Alcohol drinking in middle age involves a subsequent risk of mi…………………… cognitive impairment and dementia in old age. (not severe) 5. There are many types of antibiotics and each works in a sl………………………… different way. (rather, moderately) 6. The treatment is not su………………………… for elderly patients. (appropriate, right) 7.

Transvaginal ultrasound is an extremely re………………………… method for screening for endometrial carcinoma. (dependable, it works consistently)

8. The medical council withdrew the drug as it had ha………………………… any effect at all. (almost none, scarcely any) 9. Aids workers in Gambia are instructed to make sure that all food is th………………………… cooked. (completely) 10. The patient’s me………………………… temperature over a seven-day period was 39.2 °C. (average, median)

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

3. COMPOUND FORMS

This unit is concerned with compound forms. A single noun may not be sufficient to express a complex concept. By juxtaposing two, three, or more nouns and adjectives to form one unit, simple notions can be qualified so that they express more elaborated ideas. Such forms are particularly useful for rendering the complexity of much scientific, technical and medical jargon. A large number of established compound nouns exist in the language: “a heart attack”, “The World Health Organization”, “an intravenous glucose tolerance test”. However, in a changing world, new ones are continually being created.

What do you know? – Self-test 3.1. Wine, beer, and whisky The good news is that some hospitals are now prescribing red wine to patients to combat cholesterol. The bad news is that Italian scientists at the Pavese Pharma Biochemical Institute are trying to transform wine into a pill by freeze-drying the ingredients.

tarter

Before reading the text, answer the following questions: • Give 3 negative and 3 positive effects of alcohol. • Can you explain why alcohol reduces cholesterol?

 Read the text below and then answer the questions at the end of the exercise.

(Line 1) There is now overwhelming evidence that moderate alcohol intake (commonly defined as up to 21 standard-size drink units per week for men and 14 for women) can lead to a significant lowering of coronary heart disease incidence. According to Arthur L. Klatcky in the “Scientific American”, moderate alcohol consumption lowers the risk of CHD death by as much as 32% and some doctors are now beginning to prescribe extensive life-style intervention programmes which include alcohol in the daily diet. This of course is not to deny the overall harmful health effects of heavy drinking which may lead to blood pressure elevation hazards, increased triglycerides, prevalence towards obesity, and overall increases in both cardiac and total mortality rates.

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(Line 12) Pathologists in the 1900s had already noted findings of surprisingly atherosclerosis-free circulation systems during post-mortems on patients suffering from cirrhosis. Why was it necessary to wait more than half a century before the beneficial nature of alcohol could be established? It was above all due to the fact, that as there is a tendency for drinkers also to be smokers, the negative effect of nicotine hid the statistical correlation pointing to the beneficial nature of alcohol. It was only in the 1960s, with the advent of computer enhanced research techniques, that it at last became possible to disambiguate the different heart health risk factors that were involved. (Line 26) At first, it was believed that it was only wine that had this beneficial nature but a large number of diet-controlled crossover study data from different countries now suggest that it applies Standard drink unit to all types of alcohol. The principal explanation (12.7 mL of alcohol) for this protective role is that it triggers an increase in serum high density lipoprotein cholesterol levels. The HDL cholesterol has the ability of stimulating LDL cholesterol elimination capacity via the liver and thereby reducing blood vessel cholesterol build-up.  Using one word only, give exact answers to the questions below according to the text. 1. What does moderate alcohol intake lower? (line 1)

…………………………..

2. What does 21 refer to? (line 2)

…………………………..

3. What are doctors prescribing? (line 6)

…………………………..

4. What does heavy drinking lead to? (line 8)

…………………………..

5. What surprised the pathologists? (line 12)

…………………………..

6. What made it possible to discover the benefits? (line 16)

…………………………..

7. What was disambiguated? (line 23)

…………………………..

8. What shows that all forms of alcohol are beneficial? (line 26)………………………….. 9. What is increased by alcohol? (line 30)

…………………………..

10. What does the HDL stimulate? (line 33)

…………………………..

11. What does this reduce? (line 33)

…………………………..

UNIT 3 – COMPOUND

53

FORMS

Compound forms – Checklist A. Compound nouns As you know, nouns can be qualified in several different ways: 1. ADJECTIVES

a big / a general / a private / a mental …

hospital

2. POSSESSIVE FORMS

hospital

St Mary’s / a children’s … 3. “-ING” PARTICIPLES

a teaching / a smoothly running …

hospital

4. PAST PARTICIPLES

a well-built / a modernly equipped …

hospital

However, it is very important to understand that nouns can also be qualified by other nouns, i.e. the qualifying nouns function as if they were adjectives. These constructions are called compound nouns. 5. NOUN MODIFIERS

hospital

a research / community / prison

• Compound nouns are used to refer to specific, identifiable objects or concepts. They are extremely common in scientific and technical English because they make it possible for complex notions to be expressed in a condensed, elegant way. Notice the efficiency and concision of:  pain management clinics Compared to:  clinics whose role is to cope with the management of pain • Compound nouns are frequently difficult to understand. Why? It is because the order is the inverse of that which is found in many languages. This is particularly clearly illustrated by acronymsG. Notes 26. English United Nations Organization Human immunodeficiency virus

French

UNO



ONU

HIV



VIH

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The reason that the order is inverted is because the principal meaning of a compound noun is in the final word.

Example: What is “an emergency treatment center”? It is a center.  It is a center designed to provide treatment.  It is a center designed to provide treatment in cases of emergency.



an emergency



a center



treatment



center



designed to provide treatment



in cases of emergency

• There is no definitive list of compound nouns. As new ideas develop, new compound nouns are created to correspond to specific purposes. Supposing that the medical establishment requires a new tool to detect:  “ions in forensic examination without human intervention” a perfectly acceptable, new English word (which, doubtless, has never been used before in the history of the language) can be invented to describe this tool:  a remote controlled forensic ion detector

B. Compound adjectives There are three different forms. • The “ -ing” form. The present participle of the verb can be used as a modifier.  a hard-working student (s/he works hard)  a highly-interesting report  a disturbing epidemic  a warning signal … Meaning – This form refers to a typical defining characteristic, i.e. what someone or something is. • The past participle can also be used.  a well-written report (the report was written well by someone)  an ill-equipped laboratory  a well-made set of dentures  evidence based medicine … Meaning – This form has essentially a passive meaning, (i.e. you can add “by”) and refers to something already done, something in the past. • A small number of compound adjectives are formed by adding “-ed” to a noun (the nouns act as if they were verbs):  a cold-blooded animal  a one-armed woman  a blue-eyed boy  a left-handed man …

UNIT 3 – COMPOUND

55

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Exercises 3.2. Compound nouns are often collocations (a group of frequently juxtaposed words)  Form compound noun collocations by matching the words in the left hand and the right hand column. Start by making compound nouns for the 4 illustrations. acid

clock

air

conditioner

blood

opener

ozone

lens

data

layer

alarm

disease

heart

pollution

can

pressure

water

processing

contact

rain

3.3. Acronyms – Pair work As we said above, the change in order of compound nouns becomes particularly visible in the acronyms used by bilingual international organisms.  Find the English translations of the following and then check in the answer section. French ONG SIDA OIT OMS AIEA OMC

English Organisation non gouvernementale Syndrome d’immuno-déficience acquise Organisation internationale du travail Organisation mondiale de la santé Agence internationale de l’énergie atomique Organisation mondiale du commerce

NGO

……………………………………………...

AIDS

………………………………….…………..

ILO

……………………………….……………..

WHO

…………………………….………………..

IAEA

…………………………….………………..

WTO

………………………….…………………..

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3.4. More acronyms Acronyms are, of course, particularly widespread in scientific and medical terminology.  In this exercise, try to find the equivalent French acronym with its complete formulation. English

French

CVA

Cerebrovascular accident

……

………………………………………...

NMR

Nuclear magnetic resonance

……

………………………………………...

CVP

Central venous pressure

……

…………………………………….…..

ENT

Ear, nose, throat

……

…………………………………….…..

STD

Sexually transmitted disease

……

…………………………………….…..

LVF

Left ventricular failure

……

……………………………….………..

TOP

Termination of pregnancy

……

……………………………….………..

NAD

Nothing abnormal detected

……

……………………………….………..

FBC

Full blood count

……

…………………………….…………..

……

…………………………….…………..

NSAID Non-steroidal anti-inflammatory drug

3.5. Technical jargon  Fill in the column on the right with compound nouns formed from words taken from boxes A and B. 1.

…………………………….…………………………...…..

2.

…………………………….…………………………...…..

3.

…………………………….…………………………...…..

4.

…………………………….…………………………...…..

5.

…………………………….…………………………...…..

6. B. care  failure  hazard  membrane  protein  ray  7. records  structure  surgery 8.

…………………………….…………………………...…..

9.

………………………………………………...….………..

A. cell  health  cancer  x  heart  auscultation  eye  cell  body

…………………………….…………………………...….. …………………………….…………………………...…..

3.6. 3-word compound nouns  Now add a third modifier of your own to your answers in 3.5 (notice, the modifier can be placed either in first, second, or third place). Example: “brain monitor”

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FORMS

This compound could be modified with any of the following words: “remote”, “temperature”, “sensor”:  “remote brain monitor”  “brain temperature monitor”  “brain monitor sensor” N.B.

Modifying nouns have the same function as adjectives. This explains why they do not take an "-s" (with some exceptions) – even after numerals.  a four-inch incision in the abdomen  five-year review of surgical management  a three-drug regimen …

3.7. Pair work  Look at the table below containing 2-term compound nouns. Fill in the spaces with appropriate nouns to build up 4-term compound nouns. Start with the right hand column. 6-month  real-time  university  leg  long-term  laboratory …………………………….…… …………………………….…… …………………………….…… …………………………….…… …………………………….…… …………………………….……

research computer muscle hospital cancer blood

treatment  design  program  director  therapy  experiments laboratory software coordination training tumor cell

…………………………….…… …………………………….…… …………………………….…… …………………………….…… …………………………….…… …………………………….……

SPELLING

The rules for spelling compounds are not strictly codifiedG. Notes 20. They can be: • written as 1 word

 a stomachache

• linked with a hyphen

 an x-ray

• written as 2 words

 a wheel chair

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3.8. Rocket fuel found in breast milk

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As the months go by, new examples of hazardous environmental pollution are brought to light. • Discuss recent examples that you have heard of. To what extent do you find them worrying, what action could / should be undertaken to minimize the risks.

 Complete the text with the missing compound forms. The prompts are at the bottom of the text. The first study of perchlorate contamination in breast milk has been published by a team from Texas Tech University reinforcing disturbing rumors concerning levels of perchlorate exposure. Two studies were carried out: one analyzed breast milk of 36 women coming from 17 different states in the US and, in parallel, 47 samples of (1) ……………………………… ………………….…………………………….. were tested. (2) …………………………………………… ………………………………..………. were found in all samples but one, with an average of 10.5 micrograms per litre for the former and 2.0 micrograms per litre for dairy milk. The highest levels recorded were 92 parts per billion (ppb), more than 20 times the (3) ……………………………………..………..…………………………… by a National Academy of Sciences committee. Particularly worrying was the fact that there appeared to be a correlation between high concentrations of perchlorate and low levels of iodide. It is believed that this may be a (4) ………………………………………..………..………......……………………. . According to David Copper of Johns Hopkins University, ”Perchlorate can competitively inhibit (5) ……………………………………………………………………………………………..………..…………. . Breast tissue concentrates iodide in the same way, so perchlorate may also lead to the same outcome”. Iodide is essential for the thyroid in order to produce (6) ………...………………………………..…………………………… . If this function is impaired, the deficiencies may lead to neurodevelopmental problems such as learning disabilities and mental retardation in children.

Launch of the Mercury Atlas Rocket

This (7) ………………………………..…..……………………………. is one of the primary ingredients used in solid rocket fuels. Although found naturally in some areas, industrial production for the military and aerospace industry accounts for 90 percent of its use. It dissolves easily and there is high risk of (8) …………………………………… ………………………………… . Preliminary reports suggest that perchlorate contamination is most common in the vicinity of Air Force installations and weapon sites belonging to the military.

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Some nutritionists have suggested that infants, pregnant and nursing mothers should be given (9) ……………………………..…………………………………………………………… . But Sandra Steingraber, biology professor at Ithaca College in New York, believes “the answer is not to put babies back on formula milk which is nutritionally inferior for newborns. It is to get the contaminants out of the environment in the first place and out of women’s breasts”. 1. 2. 3. 4. 5. 6. 7. 8. 9.

milk which is from a dairy and was bought in a store levels of perchlorate which can be measured recommendations for a dose that is safe which were issued recently an effect “on the side”, coming from the ingestion of perchlorate the uptake of iodide to the category of glands which are called thyroid hormones for the development of the brain a chemical which disrupts the thyroid contamination of the supply of water which is increasing diets which are rich in iodine and which are compensatory

3.9. Bedwetting (alternative name: Enuresis)  Before starting to read, try and answer these questions. Then check in the text. 1. 2. 3. 4. 5.

Do genetic factors contribute to bedwetting? Is it more common in boys, in girls or is there no difference? What do you think is the best way of dealing with the problem? Electric alarm systems exist. Do you think they help or have an adverse effect? Is there any effective medication for the ailment?

Bedwetting is involuntary urination in children over 5 to 6 years old. It usually occurs at night, at least twice a month. Bedwetting runs strongly in families. More than 5 million children in the U.S. wet the bed. At age 5, the figures are more than 7% for boys and 3% for girls. At age 10, 3% and 2% still do it. TREATMENT Doing nothing or punishing the child are both common responses to bedwetting. Neither helps. Waking the child once each night may yield dry sheets and improve self-esteem, but won’t speed the end of bedwetting. Unless steps are taken to solve the problem, about 85 percent of children wetting this year will still be wetting next year. With the proper help, most children can be dry within 12 weeks. Some children just need to drink less than 2 ounces in the 2 hours before going to bed to decrease the amount of urine. If the wetting doesn’t improve within 2 weeks, however, continuing this won’t help. Some children respond to “star charts”. Getting a star for dry nights can help the sleeping brain be alert for the bladder’s signal. Again, if the wetting doesn’t improve within 2 weeks, continuing won’t help. Gently telling the child as he is falling asleep to be ready later for his bladder’s signal may be useful.

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Most will be dry within 12 weeks with a bedwetting alarm that wakes the parents (and then they wake the child) when the bladder is full. Here, you will often NOT see a response within the first two weeks. The alarms are small, unobtrusive and readily available without prescription at pharmacies, medical supply stores, and even department stores. Prescription medications such as DDAVP are available to treat bedwetting by forcing the body to make less urine at night. They are easy to use and have quick results. They can be used short-term for an important sleep-over. To help outgrow bedwetting, however, they must be continued for at least 6 months beyond achieving dryness, and they are expensive.

3.10. Buruli ulcer: neglected diseases that disable millions

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• Can you name some diseases that have recently emerged or have recently been identified? • Have you heard of “neglected diseases”? Can you explain what they are?

 Read the text below and then answer the questions. A

DRAMATICALLY EMERGING DISEASE REMAINS SHROUDED IN MYSTERY

Buruli ulcer is a severely disfiguring and disabling bacterial disease in the same family as leprosy and tuberculosis that has emerged dramatically over the last decade. Although cases have been reported from over 30 countries throughout the tropical world, West Africa is by far the most severely affected geographic area, with thousands of cases now being reported each year. Prevalence rates have been estimated at 16% in some communities in the Ivory Coast and at over 20% in Ghana, where the disease occurs throughout the country, and is now the second most prevalent mycobacterial disease after tuberculosis.

endemic regions

Buruli ulcer – distribution

In addition to a dramatic surge in the number of cases, the disease is also showing increased geographical spread. In worldwide numbers of cases, Buruli ulcer ranks just beneath tuberculosis and leprosy as the third most common mycobacterial disease in immunocompetent humans.

Mortality is low, but morbidity is high and horrendous. Caused by Mycobacterium ulcerans, Buruli ulcer begins as a painless small swelling in the skin – no more alarming than hundreds of other skin ailments in the tropical world. Beneath this nodule, concealed destruction spreads. M. ulcerans is unique in that the bacteria

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61

secrete a necrotizing toxin, called mycolactone, as they proliferate. The toxin attacks the subcutaneous layer of fat, destroying so much tissue that the skin above dies, leaving crater-like ulcers. Untreated, the ulcers can spread over a whole limb or the entire back or chest. Occasionally, the infection attacks the bone. THE BURULI

MYSTERIES

The causative agent is poorly understood and the mode of transmission is unknown. It is suspected, though not proven, that aquatic insects may play a role. It is also suspected that wounds as slight as the cut from a blade of grass – common in farmers and children – might give the bacteria their route into the human body. The environmental home of the bacteria is likewise unknown, though some evidence suggests that the bacteria may reside in stagnant or slow-running water. In many cases, the disease erupts following significant environmental disturbances, and some believe that the recent explosive increases in Africa are linked to deforestation and subsequent flooding, or to construction of dams and irrigation systems. The epidemiology of Buruli ulcer is also a mystery. Why does a largely African disease occasionally surface in distant countries such as Australia? Why have cases completely vanished from Buruli county in Uganda where outbreaks in the 1960s gave the disease its name?  Questions Work with your partner and answer the following questions. Check your answers: • What is the most common mycobacterial disease in Ghana? • What are the first and second most common mycobacterial diseases in immunocompetent humans worldwide? • Find the phrase “as they proliferate” (paragraph 3): what does “they” refer to?  Information exchange Student A Explain in your own words how the disease spreads. Student B Tell your partner in your own words why infected people do not seek care immediately.  Together, make a list of: • what is not known about the disease • what is considered possible but is not proven

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3.11. Quizzimage N° 3  Describe and comment: size, settings, consequences (prognosis)

Back to basics 3.12.Fossilization “IMPORTANT“

Are you sure you know what the word “important” means? In which of the following sentences can it be used? 1. A small but ……………………… minority of Alzheimer patients show a modest response to these agents. 2. For the second year consecutively, the syphilis rate is becoming more …………………… . 3. Our research shows that there is an extremely ……………………… population of Americans who suffer from hidden thyroid disorders. 4. There is a very nerves.

……………….....………

number of syndromes involving cranial

3.13.Flexing the lexis SUFFIXES

Suffixes can be used to form nouns or verbs: -(AT)ION  -(S)ION  -IZE/ISEG. Notes 3  to vary  variation  to divide  division  Complete the table below with the missing nouns or verbs.

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63

FORMS

Verbs

Nouns

1. The Ministry of Health has issued New ………………… have been published guidelines to regulate disposal of by the Ministry to deal with medical hospital waste. detritus. 2. There is a growing need to palliative care service.

……………

The expansion of palliative care services has become top priority.

3. The EC is attempting to standardize There is an EC project for the …………… the surveillance of "hospital-acquired of monitoring techniques of HAI. infection". 4. When landmines ……………………… According to UNO, the explosion of they cause injury mainly to the legs landmines injures 450,000 a year. and feet. 5. Hospitals are making active efforts to The aim is to reduce pain to a minimize pain.

…………

.

6. The U.S. government should ……..…… Public health in the US depends on the ………………… health insurance to the extension of medical insurance for the unemployed. poor. 7. Nearly all charitable organizations try The use of the media for the …………… to generate funds through publicity ………… of funds for charities is becoming widespread. campaigns. 8. A growing number of children are The pressure being exerted by parents being ……………………………… by their on school children is alarming. parents to achieve at school. 9. If enough fluid accumulates it is Abnormal ……………………………… of fluid beneath the skin is known as edema. called edema.

3.14.Roots NAMES

OF DISEASES

The following suffixes are used to form names of diseases and conditions: -IA: phobia -IASIS: elephantiasis -ITIS: glomerulonephritis -OMA: carcinoma -OSIS: multiple sclerosis  Find more examples in English and translate them into French.

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3.15.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Your task is to read this text fluently to your partner. Before starting, read it to yourself and make sure you understand all the vocabulary. CASE

STUDY

9: HIV – REFUSAL

OF TREATMENT

On July 5th, Mr Y, a 35 year old man, phoned to ask for a consultation at the university medical center. He had been tested positive for HIV and he requested a second opinion. He informed the doctor that he had never engaged in any high risk behavior and believed that the positive result of the HIV antibody test was an error. Physical examination revealed a loss of weight, and low-grade fever accompanied by fatigue and pain in his lower abdomen. A further HIV test was carried out and an appointment made for the following week in order to explain the results. It was, however, the sister who came to the appointment. The doctor informed her that he was not able to reveal the results. When Dr H telephoned, Mr Y explained that he had been afraid to return and had in fact anticipated the bad news. Mr Y, who was a worker in a Korean electronics firm, feared that if his employer learned of the results, he would lose his job, and thought that no matter what he did he was going to die. Mr Y never returned to the hospital. HIV virus

Follow up 3.16.Web search: Functions – Compound nouns  Using head words such as: device  system  process  drug, or words of your own, find four 3-word compound nouns in the medical register (for search instructions, see the answer section).

3.17. Data search  Find more information about Buruli ulcer (clinical management or research for example) and prepare a short presentation.

UNIT 3 – COMPOUND

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65

 Prepare a short presentation on neglected diseases in general or on another neglected disease: African trypanosomiasis (sleeping sickness), Chagas disease, Guinea worm disease, leishmaniasis, leprosy, lymphatic filariasis (elephantiasis), onchocerciasis (river blindness), shistosomiasis and soiltransmitted helminthiases (parasitic worms)…

3.18. Phonology – Remedial work (see Annexe “Phonology notes”) 3.19. Self-test – Exit proficiency  Form compound nouns corresponding to the definitions. 1.

Staff whose job it is to care for the health of prisoners.  …………………………………………………………………………………………………………… .

2.

The deprivation of androgen for a period (term) which is short.  …………………………………………………………………………………………………………… .

3.

A programme for the evaluation of cancer on a scale which is large.  …………………………………………………………………………………………………………… .

4.

Tools for learning which will last as long as one’s life.  …………………………………………………………………………………………………………… .

5.

A programme for training which lasts six months.  …………………………………………………………………………………………………………… .

6.

A system for classification which is used very widely.  …………………………………………………………………………………………………………… .

7.

A manufacturer of equipment which produces rays which are in the category X.  …………………………………………………………………………………………………………… .

8.

A tube made out of Plexiglas which has a diameter of 4 inches.  …………………………………………………………………………………………………………… .

9.

A trend which is nationwide and grows.  …………………………………………………………………………………………………………… .

10. A monster from space with one eye.  …………………………………………………………………………………………………………… .

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

4. INFORMATION FOCUS

Not everything that is said is of equal importance. This means that all languages require strategies so that they can highlight what is new and relevant and eclipse what is of secondary importance. At one level, this can be done by using focusing adverbs, e.g. words like “specially, particularly”, or, in spoken English, by the use of stress and tonic accent (see 11.15), but there are also numerous other grammatical resources which make it possible to reorganize the place and prominence of information in the sentence. This unit is concerned with 3 grammatical strategies used to organize information which are particularly frequent in scientific English, namely the passive voice, existential sentences, and impersonal it.

What do you know? – Self-test 4.1. Child maltreatment Child abuse and neglect is a major pediatric public health challenge. Unfortunately, however, there is a tendency for research to be focused on better known childhood pathologies – especially those that lend themselves to drug treatment.

tarter

With your partner draw up a short list of what you know about the different aspects of child abuse mentioned below: – Main responsibility: mothers, fathers, relatives, neighbours, strangers? – Victims: age, sex? – Types of abuse? • Check your conclusions in the answer section.

 Provide the most suitable agent (by whom / by what) for the phrases in bold from the list below: BY ADULTS



BY ABUSE

BY PEDIATRICIANS WORLD







BY OUTSIDE OBSERVERS

BY THE GENERAL PUBLIC

BY TEACHERS





BY THE VICTIMS



BY MALTREATMENT

BY MEDICAL AUTHORITIES

/ SOCIAL WORKERS / RELATIVES 

BY ALL OF US





BY THE REAL

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The incidence of maltreatment among children is much higher than is commonly realized. It has been estimated that, in the US, there were approximately 906,000 cases in 2003, 60% involving neglect, 19% physical abuse 10% sexual abuse and 5% emotional abuse. Diagnosis is made difficult by the fact that children who have been mistreated have psychological blocks which may prevent them communicating their experience to adults. This is partly due to the fact that they think that they will not be believed or that they will be held responsible. Among older children, it is not uncommon for them to remain silent out of a desire to protect the offender. It would appear that, to a certain extent, this mistrust of adults is justified as there are a considerable number of cases where the children’s stories have been dismissed, minimized and no action taken; many adults, including parents, have the greatest psychological difficulty facing unwanted truths. It should be remembered that children with disabilities, including partial deafness, have a higher likelihood of being maltreated than normal children. Children who have been abused or neglected are liable to show a pattern of multiple symptoms, both physical and behavioral. SYMPTOMS Physical symptoms, such as bruises, burns, fractures and other abdominal or head injuries which cannot be explained, are the easiest to detect. Physical development may be affected resulting in lower than expected weight and head circumference. Among the most common behavioral symptoms one finds that life skills such as talking and socializing may be retarded and develop more slowly than would normally be expected. Alternatively, skills which were once mastered may be lost so the child regresses to an earlier stage. Similarly, there may also be an abrupt decline in cognitive and academic performance. The interaction between parent and child may be affected in a number of ways. Parents may show little interest in their children, neither touching, looking at them nor speaking to them. Alternatively, there may be signs of excessive parental protection, coupled with the refusal to let their children play and contact others. Neglected children frequently show low self-esteem. When self-confidence has been undermined this may lead to depression and fear, accompanied by withdrawal and self-destructive tendencies. One indicator of vulnerability that is occasionally reported is that children become exceptionally sensitive to the moods of adults, trying their utmost to avoid potential areas of conflict. Sometimes, children show total lack of interest in the outside world, or an obsessive concern over minor details and irrational fear. Children may act out behaviors that they have learned, such as violence, or explicit and inappropriate sexual behavior.

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FOCUS

Information focus – Checklist A. The passive  Meaning What is the function of the passive voice? Essentially, the passive allows information to be organized differently. The normal word order for an active transitive verb is: subject + verb + object. The passive allows this order to be reversed so that unimportant information can be eclipsed and important information highlighted. Look at the example:  The nurse sterilized the needles.  The needles were sterilized. (by the nurse) What is important in this phrase is the sterilization of the needles and not the person who did it. It is typical of scientific texts that it is the not the agent that is important but the process. This explains the high percentage of passives in scientific tests (≈ 35%) and the frequent suppression of the agent (≈ 80%). Note that there may be other reasons for wishing to suppress the agent. S/he may be unknown, the information may be too obvious to mention or the reference may be to “people in general”.  He was injured in a road accident. (by someone unknown)  The operation was carried out at 5 o’clock. (obviously by a surgeon)  It is well-known that these cancers may spread to the liver. (by everyone)  Formation and usage • The passive is formed as follows: CONTINUOUS FORM SIMPLE FORM

TO BE TO BE

+ -ED

+

BEING

+ -ED

For a complete table see G. Notes 15.

 The drug is prescribed. (simple present passive)  The samples were being analyzed. (past continuous passive) • The passive frequently combines with modals:  By the age of 12, children should be vaccinated.  The risk may have been underestimated.

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• Sometimes, the agent (not necessarily a person) is mentioned, giving the phrase particular prominence:  Much better results were obtained by the hormonal treatment. • Multi-word verbs may be used with the passiveG. Notes 17:  The temperature chart is filled in twice daily.  Emergencies must de dealt with immediately.

B. Impersonal it • This form allows you to make a comment on a fact or an action. You can thus highlight 2 elements: IT WAS

+

THAT

/ WHO / WHICH …

 I saw Dr Smith.

 It was Dr Smith that I saw.

 The drug surprisingly had no effect.

 It was surprising that the drug had no effect.

• This structure makes it possible for complex subjects to be relegated to the end of a sentence.  It was hard to believe that infant mortality figures for the Glasgow area were so high. • The form is widely used with reporting verbsG. Notes 16 (passive form).  It was agreed that the patient should undergo laser surgery.  It is acknowledged that there is a lack of anesthetists.  It has been reported that 10% of surgical acts are unnecessary. • The form is also commonly found with adjectives like : appropriate  clear  doubtful  essential  important  inevitable  likely  interesting  obvious  possible  probable  strange  surprising  unlikely  It is clear that with an aging population medical costs will rise.

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C. Existential sentences • This form makes it possible to focus on the noun group following “there is”. Formation: THERE

+

TO BE

 There are 3 reasons why certain patients may not receive prophylaxis. (Three reasons exist.) • Existential sentences also combine with: – modals – adjectives such as: likely, certain, sure + to be … – verbs such as: seems, appears to be … – reporting verbsG. Notes 16 such as: say, believe, acknowledge …  There must be some explanation for the relapse.  There is likely to be a loss of sensation on the tongue.  There seems to be a growing fear of infection.  There is believed to be some sort of genetic link.

Exercises 4.2.  Transform these active sentences into passives without agent.  We classify muscle tissues according to the striations of their cells.  Muscle tissues are classified according to the striations of their cells. 1. The doctor has diagnosed the patient with eczema.  The patient ………………………………………………………………………….…….…………… . 2. They should have carried out a cystoscopy at an earlier stage.  A cystoscopy ………………………………………………………………………….……………… . 3. The obstetrician referred her for ultrasound examination.  She ………………………………………………………………………….…….…….…….………….. . 4. Blood vessel grafts can bypass coronary arteries.  Coronary arteries ……………………………………………………………………………………. .

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5. Tomorrow, if all goes well, they will transplant the bone marrow.  If all goes well, …………………………………………………………………………………….… . 6. We are observing an increase in the number of duodenal ulcers among the black population of South Africa.  An increase in the number ……………………………………………………………………… .

4.3.  Reformulate the sentences below using “Impersonal It” (1-4) and “Existential there” phrases (5-8) from the list below: IT SHOULD BE REMEMBERED THAT  IT IS ACKNOWLEDGED  IT HAS BEEN SUGGESTED  IT WAS ASSUMED THAT

THERE IS CERTAIN TO BE  THERE IS SAID TO HAVE BEEN  THERE APPEARS TO BE  THERE CAN’T BE 1. That clinical trials last too long is an opinion put forward by some.  ………………………………………………………………………………………………………………. . 2. The conclusion of the specialists was that fetal distress must have been due to infection.  ………………………………………………………………………………………………………………. . 3. You ought not to forget that the colon is a flexible, irregular tube.  ………………………………………………………………………………………………………………. . 4. The medical profession admits that some individuals will not respond to the drug.  ………………………………………………………………………………………………………………. . 5. I do not believe that there is a great number of general practitioners who are under-worked.  ………………………………………………………………………………………………………………. . 6. After the operation, a drop in the blood pressure will necessarily occur.  ………………………………………………………………………………………………………………. . 7. Signs of acute hepatocellular necrosis seem to be present.  ………………………………………………………………………………………………………………. . 8. According to many people, there were more then 40 million victims in the 1919 ‘flu epidemic.  ………………………………………………………………………………………………………………. .

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4.4.  Select one phrase from each of the boxes A, B, C to make complete passive sentences using the present continuous, the simple past, the present perfect and modal forms. B

A

By the age of 40  Currently  Many years ago  Today  Over the past 30 years  It is now clear  In modern times  In the 19th century

the recovery rate has been improved  that HIV patients may be infected  surgery is being transformed  syphilis was treated  opium was widely used  huge profits are being made  the overall incidence of gonorrhea  all women should have been screened

C

by oral mercury  with more than one type of infection  by modern technology  for breast cancer  by pharmaceutical companies  has been reduced  as an everyday remedy for common ailments  thanks to new antibiotics

1.

…………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………….. .

2.

…………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………….. .

3.

…………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………….. .

4.

…………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………….. .

5.

…………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………….. .

6.

…………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………….. .

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4.5.  Make generalizations by matching the phrases in the 2 columns. 1. It is often forgotten that …

•

•

a. nuclear war could exterminate mankind by totally destroying the ozone layer.

2. It is well known that …

•

•

b. the provision of a more abundant supply of water will necessarily improve health.

3. It is widely thought that …

•

•

c. psychoanalysis can have harmful effects.

4. It is sometimes claimed that …

•

•

d. nails and hair continue to grow for several days after death.

5. It is commonly believed that …

•

rd • e. in the 3 world, calories save

•

f. several celebrities, including Henry Kissinger, have received shiatsu treatment to promote good health.

6. It is seldom admitted that …

more lives than medication.

•

4.6. Pair work  In turns, make comments on each – the present continuous passive, – the present perfect passive, – and the future passive.

of the 6 photos, using:  “X is being (done) …”  “X has (recently) been (done) …”  “X will be (done) …”

Disabled Japanese children

Military ambulance Hospital ward for rape victims – Congo

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75

Check up Finger damage

Postpartum baby

4.7. Imagine you’re introducing a new member of staff to the organisation of your hospital. S/he needs to know who does what. You’re likely to use the passive form with an agent introduced with “by”, so that the important information is precisely the person rather than the action.  Make sentences from the list below using an action, a verb and add the corresponding hospital job (the same word can be used more than once).

Example: Delivering mothers are cared for and assisted by a midwife.

Actions

samples  hip replacements  treatments  wards  diets  patients’ problems  bedbath  patients  wound dressings

Verbs

work out  do  perform  organize  collect and test  move from one ward to another  assist  run  prescribe  deal with  help to mobilize

Jobs

the auxiliary nurses  ward sisters  the porters  the house officers  laboratory officers  the social worker  the staff nurses  orthopedic surgeons  the physiotherapists  dieticians

4.8. Medicine has greatly improved over the centuries, and when we refer to discoveries or improvements, it’s not so much the person who discovered something as the discovery itself which is important, hence the massive use of the passive.

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 Make sentences using an item from each column. • The first antiseptic (carbolic • are being treated acid)

• by Florence Nightingale.

• The discovery (in the 17th • is often considered • the “greatest medical to be achievement of all time”. century) that blood flows in a closed circuit • Many heart defects

• will have made

to

• Standards of hospital hygiene • was discovered

be • before birth. • for more than ten years in laminectomies.

• Once discovered, the vaccine • were greatly improv- • available to everyone. against AIDS ed • The gestational sac

• has been common- • by Joseph Lister. ly practiced

• Penicillin

• can be visualized

• at 41/ 2 weeks.

• Since the advent of prostate- • have been used specific antigen (PSA) test, many prostate cancers

• in open-heart surgery for some years now.

• Endoscopes and lasers

• by chance.

• can be detected

• The addition of hypothermia • was pioneered to CPB (cardiopulmonary bypass)

• before they are even palpable.

4.9. Adenotonsillectomy Patients are by definition patient and passive, especially when they undergo surgery, which involves a period of unconsciousness and total dependence on medical and nursing staff.

tarter

Before reading the text, draw up a list of the main indications of tonsillectomy, the care involved and the possible complications.

 Part a – Read the text below and fill in the blanks with the verbs, using the correct tense and form (passive or active – you may need to refer to Unit 10 checklist on tenses): (1-8) CAUSE  REMOVE  PERFORM  SHOULD CARRY OUT  SURROUND  REMAIN  KEEP  MAY PERFORM (9-18) MUST MONITOR  ADMINISTER  OCCUR  WILL EXAMINE  REMOVE  NOT ALLOW  SHOULD POSITION  MUST REPORT  ENCOURAGE  RECOMMEND

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 Part b – Now find the questions you would need to ask to find the underlined piece of information. Tonsillectomy is a surgical procedure in which the tonsils, and sometimes the adenoids, (1) ……………………………… . Despite a significant reduction in the number of tonsillectomies in the USA, several millions (2) ……………………………………… in the 1970s against approximately 600,000 in the late 1990s), it is the most common surgery performed on children. This procedure (3) ……………………………………………. (still) by controversy especially regarding indications for surgery and details of surgiear drum cal technique. middle ear

There are three absolute indications, the Eustachian tube first one being enlarged tonsils that adenoids (4) ………..……………………….. upper airway tonsil tongue obstruction, severe dysphasia, sleep disorsoft palate ders, or cardiopulmonary complications. A second indication is peritonsillar abscess that (5) …………………….………. unresponsive to medical management and drainage. Lastly, a tonsillectomy (6) …………………………………………. (also) in case of tonsillitis either resulting in febrile convulsions or requiring biopsy to define tissue pathology. Contraindications include acute infection, bleeding diathesis, anesthetic risk or anemia. In the past children (7) ………………..……… overnight as an inpatient but now surgery is commonly performed on an outpatient basis. Coagulation tests (prothrombin time and platelets) as well as other tests (8) …………………………………………………… to avoid potential bleeding problems. There are several different surgical techniques for removing the tonsils, all have their own advantages and disadvantages. So far tonsils (9) ………………………………… using a knife, electrocautery, laser, harmonic scalpel and coblation tonsillectomy. As for any other surgical procedure, the patient (10) ………………………………. to eat or drink six hours prior to surgery, and a bath or shower with iodine is taken. Premedication (11) ……………………….……………. and correct identity checked before transport to the operating theatre. Postoperatively, the patient (12) ………………………………………….. on the side with the head down so as not to inhale blood or a tonsil fragment. Respiration, color, pulse and blood pressure (13) ……………………………………….. and excessive bleeding (14) ……………………………………….. to the surgeon who (15) …………………………………. the patient again. If bleeding occurs, the patient is returned to the theatre for ligation of the bleeding point. The following day, the patient (16) ……………..……………….. to eat and drink and analgesia is given if required. Post-operative recovery may take 10-20 days, during which analgesics are typically prescribed. A diet of soft food (17) ………………………………. to minimize pain and the risk of bleeding. Hemorrhage is the most common complication and it is reported that almost 3% of the children had to return to the operating room for control of

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bleeding, and in 76% of these cases the hemorrhage (18) ……………………………….. in the first 24 hours. Later bleeding may also occur, most commonly 7-11 days after surgery, when scabs begin sloughing off from the surgical sites.  Follow-up work Choose another type of surgery, describe its indications, contraindications, specific care and complications. Use as many passive forms as possible. Make a short presentation to your partner.

4.10. Peritonitis  The word order of some of the sentences has been mixed up. Rewrite them so that they make sense and insert them in the text. 1. 2. 3. 4. 5.

condition more the men in is than in common and the ovarian ruptured tubes cysts fallopian occur can perforation also peritonitis without abdomen the abdominal and tender is position the wall is surgery perforation emergency has performed if occurred

Peritonitis is an inflammation of the peritoneum, a thin, transparent membrane which lines the abdominal cavity and surrounds the intestinal tract and the viscera. (1) ……………………………………………………………………………………………………… women. The major cause of peritonitis is the perforation of the gastro intestinal tract bringing the peritoneum into contact with bacteria, intestinal juices, blood and foreign matter as they leak into the abdomen. Such perforation is typically due to the rupture of the appendix or peptic ulcer. Other causes include abdominal wounds, complications after surgery, and in women, infections of (2) ……………………………..… ………………………….…………………………………………… . Infection from catheters used during peritoneal dialysis in the treatment of kidney failure is not uncommon. (3) ………………………………………………..………………………………………………………………… Irritation of the abdominal organs (acute pancreatitis) can lead to inflammation and accumulated fluid in the abdominal cavity as a result of alcohol-related liver disease. This creates a favourable environment for the development of micro organisms. Symptoms depend on the type of inflammation or infection. Frequently, the patient presents in the fetal (4) …………………………………………………………………………………… rigid. Other symptoms may include abdominal swelling and severe pain, vomiting, loss of appetite, low urine output, dehydration, chills and fever (38.0°C) an increased heartbeat and a fall in blood pressure. Peritonitis is life-threatening and prompt treatment is required. (5)……………………… ……..……………………………………………………………… . In other cases it can be treated with antibiotics, by draining intestinal fluids and the intravenous administration of fluids to compensate for fluids that have been lost.

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4.11. Traumatic brain injury The computer generated graphic below shows how, in 1848, a 3-foot long, pointed rod penetrated the skull of Phineas Gage, a railway construction foreman1. The rod entered at the top of his head, passed through his brain, and exited his skull by his temple. Gage survived the accident but suffered lasting personality and behavioural problems.

tarter

Traumatic brain injury (TBI) is a major public health problem, especially among male adolescents and young adults ages 15 to 24, and among elderly people of both sexes 75 years and older. Children aged 5 and younger are also at high risk for TBI. • Can you explain what traumatic brain injury is and give examples? • What explanation can be given for the 3 different age groups at high risk?

 Read the text and then do the exercises at the end of the text. PHINEAS GAGE’S STORY Phineas Gage is probably the most famous patient to have survived severe damage to the brain. He is also the first patient from whom we learned something about the relation between personality and the function of the front parts of the brain. As the first newspaper account of the accident reported, Phineas Gage was the foreman of a railway construction gang working on the Rutland and Burlington Rail Road, Vermont. On 13th September 1848, an accidental explosion of a charge he had set blew his tamping iron2 through his head.

A tamping iron

The tamping iron was 3 feet 7 inches long and weighed 13 1/2 pounds. It was 1 1/4 inches in diameter at one end, and tapered3 over a distance of about 1-foot to a diameter of 1/4 inch at the other. The tamping iron went in point first under his left cheek bone and came out through the top of his head, landing about 25 to 30 yards behind him. Phineas was knocked over but may not have lost consciousness even though most of the front part of the left side of his brain was destroyed. Dr John Martyn Harlow, the young physician of Cavendish, treated him with such success that he returned home to Lebanon, New Hampshire 10 weeks later.

1. “Foreman”: supervisor, in charge of a group of workers. 2. “(a) tampon iron”: a metal bar or rod used to pack sand or earth into a hole over an explosive. 3. “taper”: grow narrower – thick one end and thin at the other.

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Some months after the accident, probably in about the middle of 1849, Phineas felt strong enough to resume work. But because his personality had changed so much, the contractors who had employed him would not give him his position back again. Before the accident he had been their most capable and efficient foreman, one with a well-balanced mind, and who was looked on as a shrewd, smart businessman. He was now fitful, irreverent, and grossly profane, showing little deference for his fellows. He was also impatient, obstinate and capricious, unable to settle on any of the plans he devised for future action. His friends said he was “no longer Gage.” As far as we know, Phineas never worked at the level of foreman again. He appears to have been employed in a number of different jobs, caring for horses and working on farms. In February 1860 he began to have epileptic seizures and died on 21st May 1860.

No studies of Phineas Gage’s brain were made post-mortem. Late in 1867, his body was exhumed, and his skull and the tamping iron sent to Dr Harlow, then in Woburn (MA). Harlow reported his findings, including his estimate of the brain damage. He then, in 1868, gave the skull and tamping iron to what became the Warren Museum of the Medical School of Harvard University where they were much studied. They are now on display at Harvard’s Countway Library of Medicine.  Read paragraph 3. a. Student A Shut your book and explain to your partner what happened. Use your own words. b. Student B Describe the tamping iron to your partner using metric approximations. c. The text below is a summary of the story you have just read. Read it and find the missing words. First try to guess the words, then look at the list at the end of the text and fill in the remaining gaps with the words you didn’t guess. When you have finished, look at the text in the answer section and compare it with your own. Perhaps the most famous …………..….. patient in the history of medicine was Phineas Gage. In 1848, Gage was a 25-year-old railway construction foreman working on the Rutland and Burlington ………..…….. in Vermont. In the 19th century, little was understood about the brain and even less was known about how to treat ………..…….. to it. Most serious injuries to the brain resulted in death due to ……….. or infection. Gage was working with explosive powder and a packing rod, called a tamping iron, when a spark caused an explosion that propelled the 3-foot long, pointed rod through his head. It penetrated his ………..…….. at the top of his head, passed through his ………..…….. and exited the skull by his temple. Amazingly, he ……….. the accident with the help of physician John Harlow who …………..….. Gage for 73 days. Before the accident, Gage was a quiet, mild-mannered man; after his injuries he became obscene, obstinate and self-absorbed. He continued to …………..….. personality and …………..….. problems until his death in 1861. Word list: BEHAVIOURAL  BLEEDING  SURVIVED  TBI  TREATED

BRAIN



SUFFER



INJURY



RAILROAD



SKULL



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4.12.Quizzimage N° 4  Describe and comment: case (diagnosis), causes, settings.

Back to basics 4.13.Fossilization “TO

RAISE

/

RISE

–

TO LAY

/

LIE“

These pairs of words are frequently mixed up.  Complete the sentences with the appropriate word. After you have done this, try and find an explanation for the difference. Then checkG. Notes 19. 1. To avoid sunburn, you should never

……………..

in the sun after swimming.

2. If cardiac output is reduced this will

……………..

atrial pressure.

3. Why did the suicide rate …………….. in the UK in 1997? It was essentially because of the death of Princess Diana. 4. It was Arab physicians and scholars who helped …………….. the foundations for medical practice in Europe. 5. A computer game has been designed in order to of prostate cancer. 6. The systolic blood pressure may 7. The patient was asked to the scan.

……………..

……………..

……………..

awareness

to above 100 mm Hg.

on the hospital bed until ready for

8. Then, the Guru usually …………….. his hands on the patient’s head and begins to chant mantras.

4.14.Flexing the lexis LINK

WORDS

 Insert the most suitable link words in the sentences below: EVEN THOUGH WHEREAS



HENCE



IN FACT



YET



AS A RULE



BESIDES



NAMELY



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1. All these drugs can cause menopausal symptoms, flushes, sweats, and vaginal dryness.

………………………

hot

2. War and violent conflict are 2 factors posing serious threats to health, …………………… they are neglected in most medical curricula. 3. As a doctor, I had to face many other problems in Bihar …………………… the simple operations like hernias, appendicitis, and emergency surgeries. 4. In both surgery and emergency medicine, outcomes tend to be immediate and tangible, …………………… in psychiatry the timespan is longer. 5. There is reduced cardiac output, …………………… blood pressure is lowered. 6. A person weighing 70 kg should, ……………………, be expected to pass urine at 35-70 ml/hr. 7. Most people in Britain today die in hospital, would prefer to die at home.

……………………

they say they

8. Medical marriages are increasingly popular, ……………………, in a few years half of all doctors will be married to doctors.

4.15.Roots WORD

BUILDING

 Using combining forms of Greek origin (see annexe), build up words to match the following definitions: • • • • • • • •

a deficiency of red blood cells inflammation of the skin excessive acidity in the body a disease caused by parasitic worms a collection of blood in the brain under the dura mater a medical doctor who treats children and infants taking diagnostic x-ray pictures of breasts removal of the womb

4.16.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Read the text through to yourself and make sure you understand all the vocabulary. Then read it to your partner as fluently as possible.

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83

A CASE STUDY Mrs Chang is a 59-year old obese female. She is of Chinese origin and employed as an unqualified worker in the textile industry. She was admitted at a quarter past ten on Wednesday morning to the Emergency room of the Chester Infirmary. She has a prolonged history of severe chest pain. When questioned she admitted that although she had been suffering for the last 9 months, she had not yet seen a doctor. She smokes 10 cigarettes a day and is often short of breath. On Monday night she felt ‘sick’, but just asked her children to get some “heartburn” pills from the chemist’s. Further questioning revealed that this morning she felt an unrelenting pressure over her chest and severe “heartburn” which seemed to paralyze her left arm. She was obliged to quit work and came directly by taxi to Chester Infirmary.

Follow up 4.17. Web search: Generalizations  Make a web search for 6 interesting generalizations using impersonal passives. Use the following structures: IT IS BELIEVED



IT IS ACKNOWLEDGED



IT IS ADMITTED



IT IS THOUGHT



IT IS ASSUMED



IT IS CONSIDERED

N.B. – Put your phrase between inverted commas and add a specialist term to ensure that you get words in a medical register. If you use a search string with a “wild card” inserted before the verb, you will also recuperate useful adverbs.  < “it is * believed” thrombosis > (widely, etc.)

4.18. Data search Follow up from 4.11. Traumatic brain injury.  Go to http://www.deakin.edu.au/hbs/GAGEPAGE/  The class is split into three groups. Each group studies one of the three sections: Damage, Surgery and Lobotomy, and prepares a short OHP summary of the contents of the section.

4.19. Phonology – Remedial work (see Annexe “Phonology notes”)

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4.20.Self-test – Exit proficiency  Reformulate the sentences using the appropriate passive, impersonal forms and modals. 1.

If it is necessary to move the child, it is advisable to immobilize his neck and back first.  If your child ……………………...…… the neck and back ………………………………… .

2. The doctor had unsuccessfully treated the ulcer for 18 months.  The ulcer ……………………………………………..…………………………………………….… . 3. When male doctors are examining female patients, the U.K. General Medical Council recommends offering chaperones.  When female patients ………………………………………………………………………..… . 4. Apparently, there is a hereditary component in Asperger Syndrome.  There seems ……………………………………………………………..………………………… . 5. The University set up a new medical school in order to cope with an increased need for doctors after the baby boom.  The new medical school …………………………………..…………………………………… . 6. Most people acknowledge that the decline in tooth decay is due to fluoridation of the water supply.  It …………………………………………………………………………..……………………………… . 7.

Better nutrition will considerably improve her resistance to disease.  Her resistance to disease ……………………………………………………………..…….… .

8. With regard to allergens, the government has introduced legislation to make food labeling obligatory.  With regard to allergens, legislation ……………………………………………………… . 9. It is possible to enhance the effects of medication if one improves blood pressure and cholesterol levels.  By ……………………………………………………………..……………….………………………… . 10. It is rare for babies to sustain severe injury which leads to bleeding. Consequently, doctors diagnose few cases of hemophilia within the first 6 months.  Babies are ……………………………………………………………..……………………………… .

5. MEASUREMENT & QUANTIFICATION

Medicine may be an art, but without the help of science and technology – of measurement and instrumentation – it is a weak and fragile enterprise. The deathblow to ancient medicine came in the 17th century with the replacement of Galen’s “qualitative humours” by the introduction of quantitative experimental procedure, notably in the work of Santorio Santorio (De Statica Medicina, 1614; “On Medical Measurement”). This was the age when thermometers, microscopes and devices for measuring the pulse were being developed, when the groundwork for an objective description of health and illness in terms of norms, standards and statistics were slowly being elaborated.

What do you know? – Self-test 5.1. Infectious disease mortality in the United States

tarter

Great progress has been made over the last century, however, it would be wrong to consider that infectious diseases are no longer a public health threat. They still remain the leading cause of death worldwide. New diseases are now emerging and old diseases, frequently in drug-resistant forms, are coming back. • What do you think are leading causes of death from infectious diseases in: – the developing countries? – Europe?

 After reading the text, choose the words in bold which you find difficult and ask your partner to explain them. Check in the answer section.  Certain bits of information have been deleted from the text. What do you think the answers are for the missing details in (a), (b), (c), (d), (e), (f)? Check in the answer section. Between 1900 and the year 2000 there was a dramatic improvement in health in the developed countries. This was due basically to three factors: (a) ……………………… …………………………., (b) ………………………………. and (c) ……………………………………. This can be clearly seen from the graph below where between the early stages of the century and the end there was an approximate 15-fold drop in mortality rates.

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Starting at a level of roughly 800 0/0000 at the beginning of the century, mortality rates declined to just over 50 0/0000 at the end. It is important to remember that, at the same time, the range of diseases fell steadily. In developed countries, diseases such as diphtheria, polio and tuberculosis have virtually disappeared thanks to the introduction of new drugs, widespread screening and increases in medical knowledge. It is difficult to assess exactly what the position was prior to 1900; the figures are not reliable as accurate monitoring was not carried out. However, the curves in the graph show two noteworthy exceptions to this general trend. The relatively sharp decrease from 800 0/0000 in 1900 to 500 0/0000 in 1918 is interrupted by a sudden, huge peak, reaching almost 1000 0/0000 in 1920. This was caused by the (d) ………………………………………… which had devastating effects, not only in the USA, but throughout the world. It has been estimated that it was responsible for more than 40-50 million deaths.

mortality rate per 100,000

The second exception is for the period from 1980 onwards. As can be seen in the box on the right hand side of the graph, after a slow but steady drop the curve began to rise. This unexpected growth in morbidity can be explained by two main factors. In the first place, it was partly due to the (e) …………………… 80 1000 secondly, it was an inevitable out60 come of the devastating increase 800 40 in (f) ……………..……….. . 20

600

0 1970

1980

1990

2000

400 200 0 1900

1920

1960

1940

1980

year

2000

It should also be remembered that these global statistics apply to a broad cross-section of the community but there can be significant variations with localised clusters of high mortality due to social, financial, or genetic factors.

Infectious disease mortality 1900 - 2000 – United States

Measurement & quantification – Checklist N.B. – Many of the words in this section have multiple grammatical forms, e.g. NOUN :  a blood sample VERB :  the bacteria was randomly sampled

UNIT 5 – MEASUREMENT &

87

QUANTIFICATION

PRECISION (ADJECTIVES)

• accurate  reliable

≠

inaccurate  unreliable  faulty  defective • average  mean  standard  common

 Many web sites carry inaccurate medical information.  The mean height of the population is increasing. QUANTITY AND AMPLITUDE (NOUNS)

• amount  measurement  size  extent  area  range  span  scope • limit  threshold  stage  step • height  length  depth  width  thickness • weight  heaviness  load  pressure • cross-section  sample  A wide range of tests is needed to diagnose the ailment.  If the pain threshold level is attained morphine is prescribed.  A reduction in the glycemic load may help. DATA (NOUNS)

• a fact  figure  feature • result  outcome  finding  reading  The findings of the tuberculosis survey were published last year.  First you must check the ECG readings and blood pressure. EVALUATION (VERBS)

• to study  survey  assess  appraise • check  monitor  scan  sample  screen • record  compute  process  work out  PSA tests are used to assess the risk of prostate cancer.  All newborns must be screened for genetic and metabolic disorders.

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GRAPH (NOUNS)

• a graph  chart  grid  table • curve  display  cluster  cohort • level  degree  scale  pattern  Fetal alcohol syndrome is a cluster or pattern of inter-related problems.  The results of the audiometry test may be recorded on a grid or graph. VARIATION (VERBS)

• to increase  grow  gain  rise  spread • decrease  decline  fall  drop • scatter  Unless treated, the cancerous cells will spread to other parts of the body.  There were 12 isolated cases of meningitis at locations scattered across the country. NUMBERS (MIXED)

• single  a third  sixth • to halve  double  triple • twice  three times  fourfold • five out of ten  one in twenty • proportion  ratio  rate • even  odd  Head trauma results in a fourfold increase of Parkinson’s disease.  After a first autistic child, there is a one-in-twenty risk for the second.  Normal results show an even distribution of radioactive material.

Exercises 5.2.  Look at the words in their context and match them with the definitions.

UNIT 5 – MEASUREMENT &

89

QUANTIFICATION

1. We are on the threshold of curing cancer.

•

• a. correct, error-free

2. The range of drugs available in China is small.

•

• b. that can be divided by two

3. The next stage of the treatment requires hospitalization.

•

• c. assess the value, judge

4. They examined a cross-section of the population.

•

•

5. Accurate diagnosis depends on the results of the tests and clinical judgment.

•

• e. compact group, concentration

6. Tests were carried out in order to appraise the effect of palliative care.

•

• f. point, step, moment

7. A cluster of cases of severe acute respiratory syndrome have been reported in Hong Kong.

•

• g. selection, choice

8. Normal organisms always have an even number of chromosomes.

•

•

SPREAD



d. frontier – the dividing point separating two different states

h. a typical or representative sample

5.3.  Supply the missing words: FINDINGS



COHORT



SCREENING



HALVE



SMALL- SCALE



HEIGHT



AVERAGE

1. Full adult

…………………………..

is attained at about the age of 17.

2. Calcium and vitamin D supplements can ………………………….. bone fracture risks. 3. One study reports that marijuana may block the forms of cancer. 4. The first

…………………………..

…………………………..

of several

human clinical trial will be carried out in June.

5. An increase in the incidence of infant leukemia was observed in a …………………… of children born after Chernobyl. 6. Preventive ……………………………….. tests are recommended for infants so that metabolic and genetic conditions can be diagnosed and treated. 7. Recent ………………………….. suggest soy’s estrogenic properties may decrease the symptoms. 8. Nationally, obstetricians and gynecologists earn an $240,000 per year.

…………………………..

of about

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5.4.  Match the two parts of the sentence to complete the collocations (commonly associated word strings). 1. The less you weigh the more you will be affected by a given ……….............……………

•

• a. type of skin cancer

•

•

b. survey of infectious diseases

•

•

c. records of the missing woman had been lost

•

•

d. of three patients died in the postoperative period

•

• e. check once a year

•

•

•

• g. chart twice a day

•

• h. amount of alcohol

……………………………......……………………….. .

2. Unfortunately for the police, the dental ……………...................………………………............. ...............................................………………………. .

3. The government carried out a national ……………...................………………………............. ...............................................………………………. .

4. The thermometer readings are recorded on the temperature …………………………… …………………………………………………………. .

5. Instruments with digital ……………………… ……………...................………………………........... .

6. Dermatologists recommend doing a skin ……………...................………………………............. …………………………………………………………. .

7. Squamous cell carcinoma (SCC) is a common ……………………………………………

f. displays are often easier to read

…………………………………………………………. .

8. The risk factor is high, as two out …………………………………………………………. .

5.5.  These sentences were taken from medical contexts. The beginning or the end has been deleted. Propose a replacement and then compare your answer with the original phrase in the answer section. 1.

………………………………………………………………………………………………………………….

that the thymic carcinoma was about the size of an orange. 2. To what extent is modern medical theory and practice influenced by ………………..………………………………………………………………………………………………. ? 3.

…………………………………………………………………………………………………………………

was based on a random sample of children with respiratory disease. 4.

………………………………………………………………………………………………………………

trying to work out why placebos are so effective.

UNIT 5 – MEASUREMENT &

5.

91

QUANTIFICATION

…………………………………………………………………………………………………………………

organ whose function is to process substances that are “foreign” to our body. 6.

…………………………………………………………………………………………………………………

average thickness of 2 µm and extend across the breadth of the cornea. 7. For a long time, many scientists believed that the human life-span was ……………………… ………………………………………………………………………………………… .

8.

……………………………………………………………………………………………………………..…… ; the next step is to make sure that all foreign bodies and secretions are removed from the back of the throat.

5.6.  The information in the following sentences is incorrect. Replace the words in bold with a more appropriate word or phrase, and then compare your answers with the original phrase in the answer section. 1. Liposuction is widely used for people who are underweight. 2. The importance of the viral load remains stable throughout the illness. 3. The average age of the onset of Alzheimer’s is 47.5 years. 4. Clinical features of mumps include prodromal fever, a severe cough, conjunctivitis, coryza on the buccal mucosa. 5. One of the main preoccupations of nuclear medicine is how to increase x-ray scatter. 6. At birth, the female / male ratio is 106 : 100. 7. Adolescent suicides have more than halved over the last decade. 8. Pediatric dermatology is an area of clinical practice where the more you see, the less you know.

5.7.  Fill in the gaps: IN



ONCE

1.

LEVELS





CHECKED

PATTERN





SPAN

PRESSURE





DEFICIENT

DATA





SURVEYS

DEGREE





FAULTY



MEASUREMENT



TWICE

More than 4,500 patients in the United States get bone marrow transplants to replace ………………………… immune cells.

2. Everyone age 20 or older should have their cholesterol ………..….. every five years.

……………..…..

at least

3. According to ……………….., as many as 93% of arthritis sufferers believe that atmospheric …………………… and weather affects their pain ……………………... . 4. Canadian …………… suggest that most multiple sclerosis patients experience some ……….. of progression of the disease.

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The …………………………. of erythrocyte sedimentation rate (ESR) is a commonly performed laboratory test.

6. In the treatment of transient ischemic attacks (TIAs), the recommended dose of ticlopidine is 250 mg ……………. a day. 7.

Cystic fibrosis affects 1 …………… 2500 babies and it is estimated that almost 20% of the population carry the abnormal recessive gene.

8. Tumors in this stage of development show a characteristic growth.

……………………..

of

9. This comprehensive course will ……………. a variety of critical topics in obstetrics, gynecology, and pelvic reconstructive surgery. 10. Hemophilia B is characterized by defective or

………………………

factor IX.

5.8. Could dogs be used for cancer screening?  Read the text. The words in bold have been wrongly placed. Rearrange them so that the text makes sense again. In September 2004, the British Medical Journal published the samples of a study carried out with dogs at Amersham hospital, Buckinghamshire. Dogs were trained over seven months to detect bladder cancer by sniffing human urine. The participants were 36 male and female patients (age study 48-90 years) presenting with new or recurrent transitional cell carcinoma of the bladder (27 results used for training; 9 used for formal testing); 108 male and female controls (diseased and healthy, age range 18-85 years – 54 samples used in training, 54 used for carrying out). Taken as a group, the dogs correctly selected urine from patients with bladder cancer on 22 ten-thousandth occasions, (i.e. nearly 41% compared with 14% expected by chance alone). These results are well below what is considered acceptable on most medical tests, but the idea is in its infancy and several experts even suggested that, considering a dog can detect a chemical at one out of 54 to one hundred-thousandth the concentrations that humans can (a dog’s sense of smell is 10,000 to 100,000 times better than a human’s), the dogs had not been trained enough. This range was only small but was the first to be published in a medical journal and to provide scientific backing for the idea that dogs were capable of detecting cancer. Meanwhile, other research teams world-tall are testing further tests on dogs’ ability to detect other diseases, such as: lung, breast and liver cancer in breath; prostate cancer in urine and melanoma on skin. Considering the fact that many anecdotes have been reported about dogs sniffing malignant moles on their owners, or that they can even warn their masters of an impending epileptic fit, can we remain skeptical?

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Of course, dogs will not replace x-rays, CT scans, fiber-optic scopes, mammograms, pap smears…, but they may complement them. How would you feel, if next time you go to your doctor’s, he tells his 3 foot wide Labrador to sniff you all over and to smell your urine?

5.9. Urinary Tract Infection (UTI)  Complete the text with the words in the list below: ACCOUNTING FOR PATHOGENIC





BACTERIAL

REVERSE





SAMPLES

BLADDER





BOWEL





COMPRISES

NEWBORN



STONE

Urinary tract infection (UTI) …………. symptoms of infection together with the presence of …………………. microorganisms in the urine, urethra, …..... …………………………., or kidney. UTI is usually caused by bacteria from the gastrointestinal tract.

ureter

bladder

Urinary tract infections (UTIs) are opening of the ureter among the most common ……………. childhood infections. It has been urethra estimated that UTIs are diagnosed in 1% of boys and 3-8% of girls. UTIs are much more common in girls than boys. This is true for all age groups Female urinary system except the ……………. where the higher incidence of congenital abnormalities of urinary tract in the male makes the ……………. true: in the first year of life, UTI prevalence rates are 2.7% in boys compared with 0.7% in girls. By school age, the rate has decreased in boys and increased in girls. Most UTIs are due to normal ……………. flora. Gram negative organisms are those most commonly isolated from urine ……………. of children with uncomplicated UTI, with Escherichia coli (E. coli) ……………. 70 to 90% of infections. Other common causative organisms are Staphylococcus saprophyticus and Proteus mirabilis (its motility and adherence to uroepithelium facilitate movement up the urinary tract and invasive infection; urease production promotes ……………. formation).

5.10. Geographical information systems and HealthMapper

tarter

• Do you know what a “Global Positioning System” is? • How is the “Global Positioning System” usually named? • What are the various uses of this technology?

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 Read the text and then do the exercises below. Space age epidemiological tools mean a quantum leap ahead for disease surveillance and control. Geographical information systems and remote sensing from earth-observing satellites are sophisticated and powerful technologies that are finding applications far beyond those originally intended. Both are products of the Cold War developed by departments of defence for military purposes. Together, they allow near real-time access to data on temperature, soil, elevation, patterns of land use and phases of vegetation, in addition to the precise geographical location of water bodies, population centres and buildings, roads, and other infrastructure. Their utility for purposes ranging from the search for natural resources to transportation engineering, urban design and agricultural planning was quickly recognized and exploited with impressive results. Geographical information systems and remote sensing have capabilities that might have been expressly designed for use in infectious disease surveillance and control, particularly for the many vector-borne neglected diseases that are often found in poor populations in remote rural areas. They are also ideally suited to the demands of outbreak investigation and response when prompt location of cases, rapid communication of information and quick mapping of the epidemic’s dynamics are vital. However, the use of these tools in public health – where scarce resources are the norm – was hindered by the prohibitive cost of hardware and the great sophistication of computer models that made it extremely time-consuming as well as costly to extract information relevant to the practical demands of disease prevention and control. FAVOURABLE CONDITIONS The situation has changed dramatically over just the past few years, and geographical information systems and remote sensing are now poised to take disease surveillance and control forward in a quantum leap. Hardware prices have plummeted, simple new devices are now on the market and a new generation of civilian satellites is in orbit, covering virtually every country on earth. WHO has developed a simplified user-friendly tool, the HealthMapper, with a range of practical applications for both single-disease initiatives and the integrated surveillance and control of several diseases interrelated in geographical space and time. Yet another spaceage technology, Global Positioning Systems – utilized via a simple and surprisingly affordable hand-held device – is making it possible to apply these powerful technologies at the level of field work in the developing world. The device, which provides the exact position of the user through signals transmitted by satellites, is likewise revolutionizing the management of outbreaks and epidemics and will also contribute greatly to compliance with the new reporting requirements in the revised International Health Regulations. Just as satellites and the Internet led to an exponential explosion of information, these technologies are making it possible to acquire high-quality epidemiological data with a precision and speed that could not have been imagined just a decade ago.

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The endemicity of infectious diseases, especially those transmitted by vectors, is strongly influenced by environmental factors, including temperature, elevation, soil conditions, rainfall and other meteorological conditions. Vegetation can be sensed remotely, and vegetation is influenced by elevation, temperature, precipitation and humidity – factors that likewise influence spatial and temporal patterns of vector populations. Different phases of vegetation remotely sensed as different shades of green, can be predictive for the presence of insects, snails and other vectors, or their sudden proliferation, thus signalling conditions conducive to an epidemic.  Work with your partner. 1.Discuss the meaning of the following words (in order of appearance in the text). If you don’t know, try and make an intelligent guess using the context. When you are finished, read the explanations given in the answer section. • • • • • • • •

quantum leap remote sensing vector-borne (find the infinitive of the verb in the word, give examples of vectors) outbreak user-friendly affordable compliance shade (of green)

2. a. With your partner, draw up a list of the general and specific uses of geographical information systems mentioned in the text. Make sure you understand all the uses on your list. b. Read the question, prepare your answer and tell your partner: • Student A What are the factors that affect the endemicity of vector-borne infectious diseases and why? • Student B What is the connexion between the different shades of green and epidemics?

5.11. Quizzimage N° 5  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

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Back to basics 5.12.Fossilization “HARD /

HARDLY”

Are you sure that you can distinguish clearly between the meanings of these two words?  Write two sentences giving an example of how each word is used.  Explain to your partner the differences between the two words.  Check in theG. Notes 4 section.  Insert hardly any / hard in the appropriate places in the following sentences: 1. A uterine myoma is a benign growth that forms on the muscle layer. 2. The liver becomes enlarged and, at first, there are symptoms. 3. Bone is a highly vascularized tissue with both a mineral component and a connective tissue component. 4. It is the basic molecular biology that makes brain tumors to treat. 5. Some people with Crohn’s disease have only minor symptoms and discomfort. 6. Pharmaceutical companies are working to improve the comfort of transplant patients.

5.13.Flexing the lexis SUFFIXES

Suffixes can be used to transform adjective into nouns or verbs.  Supply, where appropriate, the following suffixes: -MENT  -TH  -EN  -NESS  -Ø  a wide road  the width of the road  to widen the road

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Adjectives

Nouns

Verbs

1. These drugs may The drugs could pro- Besides prolonging preprolong pregnancy, long pregnancy and gnancy, the drugs …....… make labor time increase the ………..…… ………… labor time. longer and affect the ………….. of labor time. blood flow of the fetus. 2. The skin was more The actual ……………….. After exposure to sunthan 2 cm thick. of the skin depends on light, the outer layer of thyroid function. the skin ……………….. . 3. Blood sugar levels fall The insulin helps to The duration of activity in the range of 80 to lower blood glucose lev- of this sort of insulin 120 mg/dL. els to the normal …....… …………………..... from 10………….. . 24 hours or longer. 4. Osteoporosis is a The first symptoms of Osteoporosis ………… disease characteriz- this disorder include ……………..….. the bone, ed by weak and fra- varying degrees of ….… leading to an increase gile bones. ……………………… in the in the risk of fracture. legs. 5. In some sorts of Herpes infections of the herpes, the eyes eye can lead to …......… become red and sub- …………...., inflammation cutaneous blisters and sensitivity to light. appear.

Herpes will cause the skin to ………..…………….. and then erupt with multiple small blisters.

6. In fact, achieving wo- This week, Toronto celemen are less likely to brates the outstanding be childless. …………………………….. of Canadian women in medicine.

In the next 50 years, women will certainly ……………………….. much more academic prominence in medicine.

7. The artery must be Angioplasty means the A stent was inserted to opened wide enough use of balloon-type ………………. the artery. to allow adequate devices to expand the blood flow. …………………….. of the coronary arteries. 8. Easily assessable pro- The article deals with cedures are required childhood and adolesto evaluate health risk cent tobacco risk ….....… to adolescents. ……………………… .

The survey was carried out to ……………………….. tobacco risk factors for adolescent smokers.

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5.14.Roots SYNONYMS

 Find synonyms of Greek or Latin origin for the following words: • • • • • • •

heart muscle farsightedness weakness of sight speech impairment taste disorder appendix removal tongue tie

5.15.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Your task is to read this text fluently to your partner. Before starting, read it to yourself and make sure you understand all the vocabulary. CLINICAL DEPRESSION Depression is the fastest-growing diagnosis at doctors’ offices in North America. It is an ailment that can strike anyone, however, recent research has shown that people with cardiac problems are more likely to suffer from depression than healthy patients and conversely, that people with depression have a higher risk of developing heart disease. Unfortunately, as many as half those suffering from depression remain untreated. This is unacceptable as treatment helps patients manage both diseases, thus enhancing survival and quality of life. According to a recent publication from the Harvard School of Public Health, about 1 in 20 American adults experiences major depression in a given year, with an even higher number – about one in three – for people who have survived a heart attack.

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Follow up 5.16.Web search: Graph presentation  Find a medically orientated graph on the web and make a 4-minute OHP presentation, using as many words as possible form the checklist.

5.17. Data search (cf. Exercise 5.9)  Prepare a short presentation of WHO HealthMapper and /or Global Atlas of Infectious Diseases or of other public health maps and atlases:

Key words: Geospatial resources, Maps and Atlases, Public Health Maps For example, many resources are listed on the Humboldt library site, geospatial pages.

5.18. Phonology – Remedial work (see Annexe “Phonology notes”) 5.19. Self-test – Exit proficiency  Complete the sentences by filling in the blanks with an appropriate word. 1.

Researchers in San Francisco have established a relation between family si……...… ……………., breastfeeding and the incidence of childhood asthma. (magnitude)

2. According to the World Health Organization, ou……………………. of schizophrenia are better in developing countries than in industrialised ones. (final results, consequences) 3. Very low dose, anti-inflammatory compounds such as aspirin increase mean life sp…………………….. . (length, range) 4. After the solar eclipse the department of health has asked for a report to as……………………. eye damage in the UK. (evaluate) 5. The study suggested that those who did not drink coffee had a fi……………………. greater risk of developing Parkinson’s disease than drinkers. (multiplied by five) 6. The sc…………………............…. for clinical benefit from gene-therapy is enormous. (extent, range, opportunity) 7.

Ten years later, graduates from the medical faculty can be found sc…..............… ………………. all over France. (spread, disseminated)

8. The th………………….......…. of the carotid artery wall is a good predictor of heart attack. (transversal dimension) 9. Indonesia aims to ha……………….....……. the tuberculosis rate before 2015. (divide by 2) 10. Secondary clinical fe…………….....………. of migraine include nausea, phonophobia and photophobia. (characteristics)

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6. FREQUENCY

Beyond the world of objects which we can describe and measure, there is also a dynamic world of actions, movements, patterns and repetition. Grammar must also be able to account for these. Frequency is the linguistic function that is concerned with all those phenomena that occur more than once and less than always. Frequency is expressed not only by adverbs, but also by adjectives, nouns and verbs.The grammar contains specific structures for word formation and there are also a certain number of adverbial phrases dedicated to this function. Frequency is a type of measurement, consequently you will encounter certain expressions for a second time.

What do you know? – Self-test 6.1. The sad story of “Typhoid Mary” The problem of disease and personal liberty is a real one, well exemplified by the case of “Typhoid Mary”, an Irish immigrant who, in the 1900s, worked in New York as a cook. Mary Mallon had the misfortune of being a typhoid carrier, infecting approximately 50 people. As a result, she was arrested, “kicking and screaming”, and spent 26 years of her life in isolation, incarcerated at Riverside Hospital on North Brother Island. Illiterate, poor and single she was victimised by the Hearst press and was unable to understand how, with no symptoms herself, she could be spreading disease to others. As she tragically said, “I lived a decent, upright life under the name of Mary Mallon until the press rechristened me Typhoid Mary”.

tarter

• Before reading the text, discuss some examples of conflict between the requirements of public health and the rights of the individual.

 Target vocabulary is in bold. In turns, explain to your partner the meaning of the words which are both in bold and underlined.

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Typhoid fever is an acute, life-threatening, infectious disease, caused by the Eberth bacillus (Salmonella typhi). In the past, it has been responsible for recurrent devastating epidemics causing, amongst others, the death of Franz Schubert and Wilbur Wright. The disease is unevenly distributed throughout the world, and since the improvement in sanitation and sewage, is hardly ever encountered in industrialised countries. The intermittent outbreaks that do occur are unpredictable and almost always caused by travellers returning from abroad. The public health authorities are able to trace the cause by following the occurrence of localised clusters of infection. The disease is contracted by the ingestion of contaminated food or water carrying S. typhi which infects the intestines. Within a period of 24-72 hours the bacterium spreads via the bloodstream, to the lymph nodes, spleen and liver. The incubation period ranges from 12 to 15 days. The set of early symptoms may include headaches, fever, tiredness, slow dicrotic pulse, nosebleed, abdominal pain, rash on the abdomen and chest, constipation followed by diarrhoea with blood present in stools. As the disease develops, there is a steady rise in temperature which finally oscillates around 39-40°C. If the fever continues the symptoms will increase in intensity leading to delirium. PROGNOSIS – The illness usually resolves within a period of 2-4 weeks and with appropriate treatment the outcome is likely to be good. COMPLICATIONS – On the whole, complications seldom occur when medical care is at hand, although a few cases are reported of intestinal haemorrhage, peritonitis and kidney failure. Untreated however, death rates can be as high as one in four. Long-term carriers constitute up to 3-5% of cases. Effective treatment of typhoid has only been available since 1948 and, with the introduction, first of chloramphenicol, followed more recently by a wide array of new antibiotics, mortality rates have phase 1 (week 1) phase 2 (week 2-4) fallen to 1-2%. VACCINATIONS – Protection can be obtained by periodic vaccinations: injectable Typhim V1, containing polysaccharide antigen with renewed booster injections every other year, or oral Vivotif capsules taken every other day over a period of one week with 2-yearly boosters. Typhoid – symptoms

headache cough

delirium slow heartbeat

sore throat joint pain

abdominal pain fever loss of appetite

spots on chest and abdomen intestinal bleeding or perforation (5% of cases) persistant fever constipation/diarrhea

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Frequency – Checklist A. Adverbs (always)

(never)

I

I

I

I

constantly steadily non-stop

often frequently usually commonly

sometimes occasionally periodically from time to time now and then

rarely seldom hardly ever scarcely ever

 Osteopaths scarcely ever apply pressure that exceeds five grams.  Now and then, cases of tubercular brain abscess have been reported.

B. Adjectives regular  steady  even  constan  non-stop

periodic  intermittent  recurrent  repeated  cyclic

irregular  random  unpredictable

oscillating  cyclic  alternate  fluctuating

 Resistance to bacteria is very unevenly distributed around the world.  According to an opinion poll, 87.3% of the population support random steroid testing among high school athletes.

C. Nouns an oscillation  wave  wave-length  pulse  beat

a series  string  cluster  set  range  array  pattern  ratio

 Asthma has been linked to a cluster of 291 genes.  In 1997, there was a severe wave of meningitis epidemics in Central Africa.

D. Verbs to recur  repeat  reduplicate  echo

to oscillate  fluctuate  vibrate  alternate  beat  swing

 If the symptoms recur, the dose should be doubled.  The patient’s heart rate was more than 100 beats per minute.

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E. Word formation NOUN (TIME UNIT) + -LY

hourly  daily  weekly  yearly  The average yearly mortality decreased significantly. RE-

+ VERB

to rebuild  replace  rearrange  reproduce  refill  reorganise  repay  reinforce  re-examine  It is now possible to replace bone marrow biopsies for leukaemia by blood tests.

E. Fixed expressions  Recurrence month two weeks / three weeks other / second / third day

EVERY

once twice three times

A

/

PER

minute day week

 Low-dose aspirin (100 mg) taken every other day failed to protect women from developing cancer.  Ratio  Three out of four patients do not read the medication leaflet.  Untreated, anthrax kills about one in five people.  The ratio of orthopaedic surgeons in San Francisco is 1 per 4,000 patients.

Exercises 6.2. Adverbs  Answer the questions and give a reason why. Example: What do you do periodically?

Periodically, I go to see the doctor – in order to have a checkup. 1. What sort of trauma is steadily increasing? ….………………………………………………… ………………………………………………………………………………..……………………………....… .

2. In alternative medicine, give an example of an event that happens from time to time. ……………………………………………………………..………………………………………….. .

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3. In what sort of situation do people work non-stop? …….………………………………….. ………………………………………….……….………………………………………………………......…. .

4. In surgery, what sort of accident seldom occurs?…………………………………………… ………………………………………………..………………………………………………………………… .

5. What sort of illnesses are hardly ever cured?………………………………………………… ……………………………………………………………………………………………………………......… .

6.3. Adjectives  Supply the missing words. 1. The test was carried out on a …..……………. sample of patients. 2. Breast cancer can be linked to the ……….....……………. hormone levels during a woman’s monthly cycle. 3. Psoriasis is a …………………… skin condition that affects around 2% of the population in the UK. 4. There is a fairly malignancies.

…………………….

distribution of hematologic

a. b. c. d. e.

recurrent fluctuating periodic random even

f. g. h. i. j.

pattern series cluster array ratio

5. It is recommended that ECGs should be included in the …….… ………………. medical check-up.

6.4. Nouns 1. The anatomy course consists of a …...……………. of 23 lectures. 2. In the faculty of medicine the student staff ………..……. is 1 : 5. 3. The Department of Pathology provides a comprehensive …..… ………………. of clinical and anatomic tests. 4. An MRI scan may show a suggests Pick’s disease.

…………………..…….

of atrophy that

5. A major …………………………. of thyroid cases is located in the vicinity of the nuclear power plant.

6.5. Verbs 1. The aim is to ………………. surgery by non-invasive techniques. 2. These findings …………...……. other studies suggesting that the epidemic was not under control. 3. There has been a considerable concerning euthanasia. 4. Symptoms are more likely to tropical country.

……………….

……………….

in public opinion

if you return to a

5. The government announced plans to ……....…. hospital services.

k. reorganise l. swing m. recur n. echoed o. replace

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6.6.  Match the beginning with the end of each sentence. 1. During anticoagulant therapy, the prothrombin time (PT) should be …

•

•

a. carried out every three to four months.

2. Periodic measurement of glycosylated hemoglobin (Hb A1c) to monitor blood sugar in diabetics is …

•

•

b. recur in up to 20% of cases.

3. Treating hepatitis B patients who have cancer with both an antiviral drug and chemotherapy helps prevent …

•

• c. by about 90 percent.

4. After antibiotic therapy is discontinued in antibiotic-associated diarrhea, symptoms …

•

•

5. Women who have three-yearly cervical smear tests reduce their risk of developing cervical cancer …

•

• e. relapse of the disease.

6. The skin is organized into layers that …

•

•

f. as it is worn away by the body’s normal activities.

7. In healthy individuals, chondrocytes continuously rebuild the collagen in cartilage …

•

•

g. constantly renew themselves.

8. The most serious arrhythmia is ventricular fibrillation which is an …

•

• h. occasional extra beat.

d. monitored at least every four weeks.

9. An ectopic heartbeat or an extrasystole is an …

•

•

i. common cyclic disorder which may involve, fatigue, irritability and depression.

10. Premenstrual syndrome (PMS) is a …

•

•

j. uncontrolled, irregular beat.

6.7. Patterns of fever The pattern of fever varies from disease to disease but the clinical validity of fever curves remains intact, especially in difficult-to-diagnose infections.  Match the different columns of the grid below: number of picture, pattern of fever, definition and finally, possible disease.

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40°C

40°C

39°C

39°C

38°C

38°C

37°C

37°C

am pm am pm am pm am pm am pm N° 1 day 1 day 2 day 3 day 4 day 5

N° 2

am pm am pm am pm am pm am pm day 1 day 2 day 3 day 4 day 5

41°C 40°C 39°C 38°C 37°C 36°C

N° 3

1 3 5 7 9 11 13 15 17 19 21 22 23 25 27 31 33 35 37 39 41

days

40°C

40°C

39°C

39°C

38°C

38°C

37°C

37°C

am pm am pm am pm am pm am pm N° 4 day 1 day 2 day 3 day 4 day 5

N° 5

am pm am pm am pm am pm am pm day 2 day 3 day 4 day 5 day 1

Temperature chart N°

Fever pattern

1

undulant

Temperature varies during each Borreliosis 24 hour period, but never reaches normal.

2

intermittent

Febrile episodes are separated Brucellosis by apyretic intervals (of several days).

3

sustained

The temperature curve displays Tuberculosis, viral a wavy appearance. fever, many bacterial infections

4

recurrent / relapsing

The circadian rhythm is exagger- Typhoid fever ated, with wide variations.

5

remittent

There is a persistent elevation Malaria in temperature with minimal diurnal variation (less than 1°C).

Definition

Typical infection

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6.8. Syndrome X It is easy to forget now, but the isolation of insulin as a pancreatic extract in 1921, by the Canadian scientists Banting and Best was one of the great breakthroughs in medicine. Suddenly the diabetic patient, instead of facing almost certain death, could expect not just to survive, but to live a full healthy life.

tarter

• What is “insulin resistance”? • With your partner make a list of 5 pieces of advice to increase insulin sensitivity. When you have finished compare with the list in the answer section.

 Fill in the gaps with words from the list below: STEADILY

1

OUT OF

 RANDOM  COMMONLY  REORGANISATION  4 PEOPLE  RANGE  CLUSTER

FLUCTUATE



ARRAY



PATTERN



Syndrome X is a term used to describe a (1) ………………….....…. of abnormalities including high triglycerides, decreased HDL, obesity, and high blood pressure. They (2) …………………...…. occur together which suggests that they are interrelated. Any one of these symptoms increases the predisposition to heart disease and diabetes, but the presence of the whole (3) ……………….……. of conditions associated with syndrome X increases the risk factor considerably. The “PROCAM” study, involving a (4) ……………….....… sample of 2,754 males aged 40-65 clearly demonstrated this (5) ……………………. . The study showed that high blood pressure alone increased the risk of heart attack only by a factor of 2.5. However, when high blood pressure and diabetes were associated the risk factor rose to 8 and when abnormal lipid levels, high blood pressure and diabetes were all present the risk attained 20.

“An apple a day keeps the doctor away”

The factor which appears to link these different features is what is termed “insulin resistance”, that is to say the failure of the body tissues to react appropriately to insulin. In normal health, thanks to the insulin secreted from the pancreas, blood glucose is maintained at a fairly constant level, although it does (6) …………………..........…. slightly. However, with insulin resistance, the blood glucose level begins to increase (7) ……………...……………. and so, in order to compensate, the pancreas secretes more insulin.

This leads to hyperinsulinemia which is a marker for the syndrome. However, this only delays the onset of diabetes, for, in the long-term, the pancreas is unable to maintain non-stop high levels of insulin production, and so in due course, blood glucose levels rise and a type II diabetes is diagnosed. TREATING INSULIN RESISTANCE – At the moment, there are no drugs that specifically treat the insulin resistance that is the cause of syndrome X. The most effective treatment is a complete (8) ………………..…………. in lifestyle. Patients should reduce

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body weight so that it corresponds to the normal (9) ………...….……………. . A diet should be adopted which is low in calories and contains fruit, vegetables and fibre. Patients should do at least 20 minutes’ aerobic exercise daily. These measures will ensure that most of the metabolic abnormalities seen in syndrome X substantially improve. It is estimated that (10) resistance.

………………........…….

has a genetic predisposition for insulin

6.9 Autism  Before you start looking at the text, list 5 “Key points” about autism. Then read the text and compare your answers.

It may be present at birth, but is usually only diagnosed between the age of 12 and 30 months. Evaluations of incidence vary. According the National Health Service, it is in the range of 5 in 10,000 and increasing and is four times more prevalent in boys than girls.

160,000 140,000

number of children

Autism is one of the most common developmental disabilities and is characterised by the way it affects children’s ability to relate to the outside world.

120,000 100,000 80,000 60,000 40,000 20,000 0 92

93

94

95

96

97

98

99

00

01

02

03

year

Increasing incidence of autism 1982 - 2003 (age 6-22) – United States

SYMPTOMS Autism is characterised by a number of deviant behaviour patterns in the following areas: • Social relationships – Autistic children appear indifferent to others, incapable of sharing emotions and unwilling to engage in social relations. Even with their own parents, they do not seek warm physical contact and embraces, they avoid eye contact and have difficulty understanding and interpreting the feelings and expressions of others. • Linguistic skills – More than 50% never learn to speak and those who do are retarded and use language in bizarre ways. They may, for example, repeat phrases they hear again and again, often they speak in a fragmented mechanical way or they may show a misunderstanding of the pronoun system by referring to themselves as “you”. • Behavioural patterns – Autistic children frequently show strong resistance to any form of change, whether it is in their immediate environment, (furniture arrangement, new food, clothes, etc.) or in the ritualistic habits that they have developed. They adopt inappropriate play patterns becoming compulsively attached to mechanical objects and there is a tendency towards stereotyped repetitive actions, for example rocking backwards and forwards.

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It should be noted autistic children can vary widely in abilities, intelligence, and behaviours. While over 70% are severely retarded, others may have exceptional, idiosyncratic abilities in one specific field such as music, graphic art or arithmetic. CAUSES Up until 20 years ago, there was heated controversy as to the origin of autism; many maintained that it was essentially a psychological ailment, the outcome of a malfunctioning family unit. It is now considered to be a biological and neurological disorder with strong genetic factors, as can be shown by the statistical probability of siblings (50% likelihood) and identical twins (90% likelihood) suffering from the same disability. It is believed that a fragile X syndrome may contribute to the disease as may chromosomal abnormalities or prenatal viral infections. No known drug therapy changes the underlying disorder, although it may alleviate certain behaviour manifestations.

6.10. Medical tourism

tarter

• Try and find historical or literary examples of medical and health tourism (names, places, dates).

 Read the following two paragraphs. Health tourism is travel to improve one’s health, such as a visit to a health resort or weight-loss camp. It also includes the practice of travelling to another state in order to benefit from free or less expensive health care, be it surgery, non invasive procedures, or treatments that are not covered under insurance. The first Health Tourism trip occurred thousands of years ago when Greek pilgrims travelled from all over the Mediterranean to the small territory in the Saronic Gulf called Epidauria. This territory was the sanctuary of the healing god Asklepios. Epidauria became the original travel destination for health and medical tourism. Medical tourism is the act of travelling to other countries to obtain medical, dental and surgical care. A combination of many factors has led to the recent increase in popularity of medical tourism: exorbitant costs of healthcare in industrialized nations, ease and affordability of international travel, favourable currency exchange rates in the global economy, rapidly improving technology and expertise in many countries of the world.  Discussion What is the difference between health tourism and medical tourism? Can you name some destinations for medical tourism? In your opinion, what type of medical treatments do these countries provide?

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INDIA FOSTERS GROWING “MEDICAL TOURISM“ SECTOR India is promoting the “high-tech healing” of its private healthcare sector as a tourist attraction. The government hopes to encourage medical tourism, selling foreigners the idea of travelling to India for low-cost but world-class medical treatment. Naresh Trehan, executive director of Escorts Heart Institute and Research Centre, a leading private healthcare provider, says India has established world-class expertise in practices such as cardiac care, cosmetic surgery, joint replacements and dentistry. Merging medical expertise and tourism became government policy when finance minister Jaswant Singh, in this year’s budget, called for India to become a “global health destination”. If foreigners respond, a new medical tourism industry could be generating revenues of €1.9bn by 2012, according to a report by McKinsey Consultants and the Confederation of Indian Industry, a business group. There is no doubt that the Indian medical industry’s main appeal is low-cost treatment. Most estimates claim treatment costs in India start at around a tenth of the price of comparable treatment in America or Britain. For example, in April the Madras Medical Mission, a Chennai-based hospital, successfully conducted a complex heart operation on an 87-year-old American patient at a reported cost of €7,000 including the cost of his airfare and a month’s stay in hospital. The patient claimed that a less complex operation in America had earlier cost him €34,800. Other procedures such as diagnostic services offer significant cost-savings. Take the rising popularity of “preventive health screening”. At one private clinic in London, a thorough men’s health check-up that includes blood tests, electro-cardiogram tests, chest x-rays, lung tests and abdominal ultrasound costs €500. By comparison, a comparable check-up at a clinic operated by Delhi-based healthcare company Max Healthcare costs €73. Yet cost-savings may not be enough to foster a trade in medical tourism. Unfairly or not, most foreigners would not think of India as a land of good health. The sight of the country’s overcrowded public hospitals, open sewers and garbage-littered streets would unsettle most visitors’ confidence about public sanitation standards in India. Private healthcare providers argue that foreigners can be sheltered from such nastiness, and that the quality of India’s corporate hospitals are world-class. “In a corporate hospital, once the door is closed you could be in a hospital in America,” says P.V.R.K. Prasad, director-general of the Dr Marri Channa Reddy Human Resource Development Institute.

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 Read the text below and fill in the gaps with the 10 words below (one word may be suitable for several gaps): CONDITIONS PROCEDURES



GLOBAL





HEALTH CARE



INDUSTRY



LIKELY



LOW



MEDICAL



POTENTIAL



UNDENIABLY

India is hoping to expand its tourist (1) …………...………… to include visitors with heart (2) …………...…..……… and cataracts. Indeed, (3) …………......………… tourism, where foreigners travel abroad in search of (4) …………………… cost, world-class medical treatment is gaining popularity in countries like India. The field has such lucrative (5) ………………......… that Indian finance minister Jaswant Singh called for India to become a “(6) …….........………… health destination.” And, with prices at a fraction of those in the US or Britain, it is (7) …………………… that the concept will have broad consumer appeal – if people can overcome their prejudices about (8) …………………… in developing countries. Though the quality of health care for the poor in countries like India is (9) …………………… low, private facilities offer advanced technology and (10) …………………… on par with hospitals in developed nations. One Indian hospital director maintains, “In a corporate hospital, once the door is closed you could be in a hospital in America.”

6.11. Quizzimage N° 6  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 6.12. Fossilization “ACTUALLY”

Do you use this word correctly?

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 Is the sentence below correct or incorrect? Decide, then check in the answer section.  The problem is that actually, only about one third of women who intend to take estrogen replacement do so.

6.13.Flexing the lexis MULTI-WORD

VERBS

The meaning of many verbs depends on the adverbial or prepositional particle that follows. These are called multi-word verbsG. Notes 17.  Supply the correct particle for each verb and match it with the definition: OF



UP



OUT



FOR



ON

1. Clinical trials rely …………… the participation of patients to test the new therapies.

•

•

a. to do / to perform

2. Auscultation includes carrying …………… ……….......... includes assessment by visualisation, palpation and percussion.

•

•

b. to be made of / formed from

3. An artificial pancreas would consist ……………… two parts, a device to administer insulin and an implantable sensor.

•

•

c. to be determined by

4. The web site was set …………… to help isolated patients in remote areas.

•

•

d. to calculate / find the solution

5. The problem is how to work …………… exactly why the treatment failed.

•

•

e. to create / establish

6. Vaginal birth increases the risk of passing …………… genital herpes.

•

•

f. need / cannot do without

7. Sports injuries in fact account substantial morbidity.

•

•

g. to be linked / associated

•

•

h. to provide an explanation

……………

8. Which test you are offered will depend …………… the hospital where you plan to give birth.

6.14.Roots COMBINING

FORMS

 Medical terms often use combining forms of Greek or Latin origin, many of which refer to body parts. Match the words in the two lists.

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• • • • • • • • • • •

cardiac cerebrovascular chiroplasty dermatologist hepatitis lymphadenopathy myalgia nephropathy osteoporosis pneumonia ventricular

• • • • • • • • • • •

COMPETENCE IN MEDICAL ENGLISH

belly bone brain gland hand heart kidney liver lung muscle skin

6.15.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Read the text as fluently as you can to your partner. Before starting, read it through to yourself and make sure you understand all the vocabulary. TRAFFICKING

KIDNEYS

– LETTER TO THE

EDITOR

Dear Sir, With reference to your article on kidney donors, I have had some direct experience of the question while working in a private hospital in India. India has become an “international centre” for the transplantation of kidneys. Donors are all from the lower impoverished classes with an urgent need for cash, either to pay back a debt for a daughter’s marriage, buy medication for their own children or to escape from bonded labour. However, the hazards of the operation are considerable and heightened by the fact that the donors are hardly ever in good health. Hence the quality of the kidneys is often very poor. As to the question of payment, more than 80% of the money goes to the middleman. There are no postoperative check-ups, consequently complications are relatively frequent. In my case the trafficking was organised by the chief administrator of the hospital with the help of a surgeon in charge of the outpatient department. Needless to say, I quit the job as soon as possible and found work elsewhere. Yours faithfully, Dr Quentin Chatterton

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Follow up 6.16.Web search: Fossilization – actually / at the moment / currently  To show the contrast in meaning: Group 1 makes a Web search in the medical register and presents on OHP / videoprojector six sentences exemplifying the use of “actually”, 2 in which the word could be replaced by “in practice”, 2 in which it could be replaced by “really” and 2 in which it could be replaced by “it is surprising, but true”. The other group presents on OHP 3 examples each of “at the moment” and “currently”.

6.17. Data search: Medical tourism A surprisingly wide range of procedures are offered in medical tourism including: blepharoplasty  bone marrow transplant  breast augmentation / lift / reduction / surgery  bridge  buttocks lift  cataract surgery  chemical peel  chin augmentation  crown  dental implant  dermabrasion  double eyelid surgery / eyelid reconstruction  face lift  hair transplant  heart surgery  LASIK  liver transplant  mammoplasty  reduction surgery  rhinoplasty  root canal  tooth fillings  implant  total hip / knee replacement  Make sure you understand what these procedures mean.  Group them according to type: cosmetic, dental, eye, surgery, etc.  Go to Google, type “Medical Tourism” and choose a site (including dental and eye treatments). Alternatively, run a search using key words such as procedure, country, cost, etc. Present the site to the other learners.  Answer the following questions: • • • • • • • • •

name of site name of sponsors purpose of site organization of the information (main parts of the site) medical offer (procedures) location offered (countries) costs quoted (if any) interesting features or site personal opinion

6.18. Phonology – Remedial work (see Annexe “Phonology notes”)

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6.19. Self-test – Exit proficiency  Complete the sentences by filling in the blanks with an appropriate word. 1.

The number of medical students choosing family medicine as a career has declined slowly but st……………………… during the past decade. (constantly, regularly)

2. In fact, diminished consciousness is the most co……………………… error in diagnosis in trauma patients. (widespread, frequent) 3. In terminal obstructive pulmonary disease patients se………………………… receive holistic care appropriate to their needs. (rarely, not often) 4. Giles doesn’t think it is his baby because they ha………………………… ever have sex. (almost never, barely) 5. The problem is to ensure that the distribution of GPs is ev………………………… spread geographically. (equally, fairly) 6. 5.4 percent of a ra………………………… sample of 335 Swedish women was reported to have an incidence of fibroid tumours. (arbitrary, non systematic) 7.

Steroid injections may be better than shock wa………………………… therapy for tennis elbow. (oscillation)

8. A cl………………………… of cases of severe acute respiratory syndrome has been reported from Hong Kong. (a group, collection) 9. Obesity is one of the factors indicating that prostate cancer may re……...…… ……………… . (happen again, repeat itself) 10. The newsletter is distributed online ev………………… week. (once in fifteen days, each fortnight)

7. COMPARISON

As we saw in Units 2 and 3, we can increase clarity and refine what we say by qualifying nouns with adjectives, adverbs or other nouns. Another way of gaining in precision is by indicating the relationship between different objects or actions. Are they similar, different? If so, in what way? All languages have grammatical tools for doing this (i.e. the comparative form) but it is important to remember that there is also an extremely rich lexical store which enables this to be done with great facility. Instead of saying “the blood temperature gets hotter” it is simpler to say the “temperature rises“; “the most important pharmaceutical company” is similar in meaning to “the leading company” and so on. It is these different ways of expressing comparative relationships that will be explored in Unit 7.

What do you know? – Self-test 7.1. Semmelweis and the medical establishment

tarter

One of the “laws” of science seems to be that new, avant-garde ideas are bitterly resisted by the “old guard”. The examples of Copernicus, Galileo, and Darwin show that, all too frequently, great innovations are rejected by the weight of conservative authority that cannot or will not reconsider their opinions. A less widely known example of this is the case of Ignaz Semmelweis, the Hungarian obstetrician who was the first to realise the necessity of asepsis. • What is puerperal fever? With your partner, make a list of things you know about it.

 Read the text below and provide synonyms, antonyms or explanations for the words in bold. It was in 1848 that Ignaz Semmelweis made one of the most significant breakthroughs in the history of medicine, leading to the beginning of an understanding of antiseptic prophylaxis. As assistant in the obstetrics department in Vienna General Hospital, he was confronted by the horrifying death-rate from puerperal fever so common in hospitals in the early 19th century. At that time, the only explanation for this death rate was that it came from “an imbalance of the humours, miasma, the onset of lactation, over-crowding or lack of fresh air in the wards”. However, what puzzled Semmelweis was the huge variation in the mortality rate. In one maternity

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ward the rate was nearly 19%, in the other there were only half as many deaths. There was no apparent difference between the two wards apart from the fact that, unlike in the ward with high mortality where gynaecological interventions during labour and delivery were carried out by medical students, the low mortality ward was staffed by midwives. A further detail that aroused Semmelweis’s attention was that the death rates peaked with students that had come directly from the dissecting room and been in contact with corpses. From this, Semmelweis concluded that it was the “cadaveric material” on their hands that was the cause of death. The solution he proposed Ignaz Semmelweis was simple; he merely required students to wash their hands with chlorinated lime before carrying out examinations. There was immediately a dramatic improvement, with death rates decreasing from 18.27% to 1.27%. Unfortunately, the significance of this finding was rejected by his professors and superiors who took no notice of the results as they were convinced that washing hands was both irrelevant and “a waste of time”. From then on, the medical establishment in Vienna obstructed his career and one of the foremost medical journals, the “Wiener Medizinische Wochenschrift” talked of that “nonsense about washing your hands in chlorine”. Semmelweis was obliged to move to Pest, Hungary, where he successfully put his theories into practice obtaining mortality rates of as low as 0.85%. However, the stress of the years of controversy and polemic gradually weakened his mental health. Semmelweis finally had a nervous breakdown and was admitted to an asylum. He died insane.

Comparison – Checklist A. Irregular forms

• much / more / the most

≠ ≠ ≠

• far / farther / the farthest



• good / better / the best • many / more / the most

bad / worse / the worst few / fewer / the fewest little / less / the least far / further / the furthest

 Note – Farther is used to indicate greater distance.  Rural patients have to travel farther. – Further often means “supplementary, additional”.  For further details regarding the outpatient centre, please call (907) 851-7520.

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B. Difference  Comparative (superiority) TO BECOME / MAKE SOMETHING (+) BIG

to increase  grow  expand  lengthen  widen  enlarge  extend  spread  further TO BECOME / MAKE SOMETHING (+) HIGH

to raise  lift  heighten

TO BECOME / MAKE SOMETHING (+) GOOD

to improve  boost  enhance

 Hospital safety can be improved if nursing staff ratios are increased.  Comparative (inferiority) TO BECOME / MAKE SOMETHING (–) BIG

TO BECOME / MAKE SOMETHING (–) GOOD

to decrease  reduce  lessen  shorten  lower

to worsen  weaken  deteriorate

 Studies suggest that stress for newborns may weaken the immune system later in life.  Superlative meaning (++) IMPORTANT

(++) HIGH

the chief  main  leading  foremost

the top  peak  tip

 Worldwide, the leading causes for female deaths are maternal mortality and AIDS.

C. Similar or equal things can be contrasted SIMILARITY / DISSIMILARITY

it is like / unlike  similar to  the same as  equal to  in comparison  by contrast DUALITY

both  either / or  neither / nor

COMPATIBILITY

to match  fit  suit  correspond

 Before transfusion, blood is matched with the recipient’s.

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D. as + as twice 3 times half nearly almost

+

as

+

large fast expensive much / many likely

 Low birth weight babies are 20 times as likely to die.

+

as  The placebos were almost as effective as the antidepressants.

E. Other comparative patterns  As the years go by, the nursing shortage is becoming worse and worse. (comp. + and + comp.)  The poorer people are, the less medical care they get. (comp. + S + V) + (comp. + S + V)

F. Word formation In Unit 1, we saw a structure using “… -shaped”. A similar comparative structure can be formed with “… -like”. noun

+ -shaped

 a cone-shaped segment (with the shape of)

noun

+

 an AIDS-like syndrome (similar to AIDS)

-like

G. Prefixes Comparison can also be expressed by prefixes. Over to overeat food  to oversleep in the morning  (more than required) to oversimplify a problem  to overheat the incubator … Under undernourished children  an underdeveloped country  (less than required) underpaid nurses  an understaffed hospital …

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Exercises 7.2. Pair work – Grammatical forms of the comparative and superlative  The following sentences contain either a comparative or superlative. Work in pairs and provide: a. the form which is missing (i.e. in question 1, the superlative form), b. an antonym, c. the rules for formation. 1. 2. 3. 4. 5.

Generic medicines are cheaper than brand-names. Gastrointestinal infections are common in hotter climates. The Internet has become much easier to use. IUDs are not the most suitable form of contraception for teenagers. It is the worst flu epidemic since 1989.

7.3. Comparison – Lexical forms  Join the two parts of the sentence. 1. Successful revaccination will …

•

•

a. improves diagnosis of acute coronary syndromes.

2. To be effective the strains of the virus must …

•

•

b. extend immunity for 10 to 20 years.

3. The US government has repeatedly attempted to …

•

•

c. lengthen the time required for treatment.

4. If left untreated, depression can …

•

•

d. lessen lung inflammation in cases of acute berylliosis.

5. Pre-hospital ECG …

•

•

e. match those causing the illness.

6. Various circumstances such as age and blood pressure may …

•

•

f. raise haemoglobin levels in the body.

7. EPO (erythropoietin) is now widely used to …

•

•

g. weaken World Health Organization legislation to control the sale of tobacco.

8. Prompt corticosteroid therapy is required to …

•

•

h. worsen the symptoms of other illnesses.

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7.4. Adjectives, nouns and adverbs expressing comparison  Match the two parts of the sentence.

1. To prevent …

•

•

a. an increasing number of people are resistant to insulin treatment.

2. A major problem is that …

•

•

b. improvement in medical care for the poor over the last 30 years.

3. Prostate cancer …

•

•

c. a leading manufacturer of medical equipment.

4. There has been little …

•

•

d. much less likely to survive in hospitals without neonatal intensive care units.

5. He was employed by …

•

•

e. the spread of cholera, smallpox, diphtheria and yellow fever the patient must be isolated.

6. According to paediatricians whole milk is not …

•

•

f. suitable for infants before the age of 9 months.

7. Babies with low birth weights are …

•

•

g. twice as frequently as for females.

8. Kidney cancer in males is diagnosed …

•

•

h. unlike other sorts, often progresses very slowly.

7.5. “as … as …“ The comparative form can also express equality. Look at this example:  Cardiovascular diseases claim almost twice as many deaths as cancer.  In pairs: – Student A chooses a phrase from list 1. – Student B supplies the first part of the sentence from list 2. – Student A finishes with a phrase from list 3.

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123

1

2

3

• twice as many biopsies • lost about three times as much fat • about half as much caffeine • almost as effective • just as important • almost as dangerous • not as common

• Electronic blood pressure devices are • Methadone is • Oolong is semifermented and has • People who participated in the study group • Taking time to discuss a patient’s problem is • The study shows sleepy • Women in the US have

• • • •

as aneroid ones as black tea as intoxicated drivers as providing the right medication • as those in the control group • for breast cancer as women in the UK • when administrated orally as it is by injection

7.6. Compound adjectives Look at this example:  Peliosis is a tumour-like condition affecting the liver.  Match the two parts of the sentence. 1. The pharyngeal muscles move in a …

•

• a. and other flu-like symptoms.

2. In myalgic encephalitis (or Chronic Fatigue Syndrome), affected people may initially develop fatigue, headaches …

•

• b. bone-like tissue formation.

3. It has been suggested that Parkinson’s disease and schizophrenia could be treated with …

•

•

4. The cure rate was 41 percent for those just treated with …

•

• d. marijuana-like chemicals.

5. A considerable number of patients suffering from breast cancer have opted for treatment by …

•

• e. penicillin-like antibiotics.

6. Chim Wei Ming won the top prize in the Medical Research Award for his study of …

•

• f. wave-like motion.

c. cult-like churches such as scientology.

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7.7. Expressing the concept “more than necessary”  Group work – Discuss the following: 1. 2. 3. 4. 5.

over-prescribing antibiotics overworked doctors over-emphasising the importance of bio-terrorism the risk? / importance? of oversimplifying the results over-cooking food

7.8. Expressing the concept “less than is required”  Group work – What are the medical hazards involved in the following? 1. 2. 3. 4. 5.

undercharging for medical care understaffed hospitals under-estimating climate change under-financing the health system underused medical facilities

 Produce examples of your own.

7.9. Oedema and oncotic pressure  Fill in the gaps with the missing words: (1-8) LESSEN  LOWER  FOREMOST  THE GREATER THE ONCOTIC PRESSURE IS  WEAKEN  NET-LIKE  SPREAD  INCREASES (9-16) HOMOGENEOUS  MAIN  BOOSTED  ENHANCED  EXPANDS  HEIGHTENED  UNLIKE  WIDENED

Pulmonary oedema

Oedema is an abnormal accumulation of watery fluid in the intercellular spaces of the body. The (1) ……….………………………… cause for the accumulation of oedema in body tissues is oncotic pressure. The red cells and large molecules in the blood retain fluid in the vascular bed and, as the biological membranes are semi-permeable, ..........………..................… the more fluid will be ....................………....… through the intercellular spaces of the body. A certain number of diseases such as liver disease and malnutrition ………..............……..… serum proteins

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and so ......………..............… the oncotic pressure. This ......……….............. the amount of fluid which leaks into the tissues and must be drained away by the lymphatics. Some diseases will ............………........… the vessel walls making them permeable. In other words, the ............………........… interstices in the biological membrane may be (9) .......……….............… as a result of the disease. ..........………..........… liver diseases, during heart failure, serum proteins remain normal and it is the .....………...............… venous pressure that is responsible for the accumu-

lation of interstitial fluid. The clinical manifestation of oedema in the lungs reflects the underlying structure and haemodynamics. As a result of the force of gravity, the visibility of accumulating oedema will be .......………............. at the bases as the fluid pressure ................ ...……….................… the interstitium and vessels. Pulmonary lymphatic drainage is not ...........……….........… . There are two ........……...……….........… groups that drain centrally, accompanying the pulmonary arteries and veins. Subsidiary lymphatics drain into the pleural space and back to the heart via systemic lymphatic drainage. Pulmonary interstitial fluid clearance is (16) .............………...………....… significantly by peripheral lymph channels.

7.10. SIDS (Sudden Infant Death Syndrome)  The following text discusses SIDS. Before looking at the text, with your partner, make a list of 5 questions you would like to ask about the subject. Then read the text to find out if the answers are provided. Sudden infant death syndrome (SIDS) refers to the unexpected death of an apparently healthy infant (0-2 years) which can be accounted for, neither by the medical history, nor by the post-mortem examination. With a rate of 50 per 100,000 live births, it is the most frequent cause of infant death in the post neonatal period (1 month - 1 year). No definitive cause for SIDS has been found, however there are a number of risk factors associated with the event. It is no longer believed that SIDS is connected to sleep apnoea; the present hypothesis is that it is a multi-factor phenomenon. Over the past 20 years, thanks to maternal counselling, there has been a significant decrease in the number of cases. 90 70 50

year

SIDS : an overall decrease 1988 - 2002 – Alberta (Canada)

2002

2000

1998

1996

1994

1992

10 0

1990

30

1988

number of SIDS

RISK FACTORS: INFANTS SIDS occurs most frequently between the ages of 2 and 4 months, and 90% of all cases occur before the age of 6 months. There is a higher prevalence among boys than among girls. Reports suggest that it is associated with less than average birth weight (< 2000 g), with premature babies and with multiple births.

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RISK FACTORS: MATERNAL Recent research indicates that the incidence is higher in lower socio-economic groups and particularly among young, single mothers who smoke or use illegal drugs. However, the single most important factor appears to be the sleeping position as there is a 70% improvement in the figures if infants sleep on their back. IMPLICATIONS FOR THE PRACTIONER This is a situation of major psychological trauma for the parents and should be handled with the utmost care. Because of the totally incomprehensible nature of the event, parents feel guilty and tend to blame themselves for what has happened. In many cases, these feelings are aggravated by the inevitable medical and police investigations to determine the cause of death. On arrival, the doctor has no alternative but to consider such a case as a suspect death which must be reported to the coroner. The standard examinations have to be carried out to assess the time of death, rigidity, rectal temperature, signs of dehydration, and maltreatment. The coroner must be contacted and the family informed that a post-mortem will be carried out and that a routine call by a police officer will be made. N.B. – In approximately 15% of cases, a post-mortem identifies a cause of death other than SIDS (disease, genetic disorder, accidental injury, non-accidental injury).

7.11. Alternative therapies

tarter

Look at this A to Z of alternative therapies. • Which ones would you consider as alternative therapies for yourself? Which ones do you consider dangerous? Which ones have you never met / never heard off? Which ones are missing in you opinion?

• • • • •

Aromatherapy Ayurveda Biofeedback Colour therapy Dolphins (swimming with)

• • • • • •

Ear candling Flotation Green Tea Massage Needles (acupuncture) Osteopathy

• • • • •

Placebo Effect Qi Rebirthing Sauna Urine (drinking)

 Pair work There are 4 texts below. Choose 2 texts each, read them and give a short summary to your partner using your own words. Then answer the questions at the end of the text.

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AYURVEDA Ayurveda: in Sanskrit, “Ayu” means life and “veda” means knowledge of. Ayurveda or ayurvedic medicine is a comprehensive medical system that has been practiced in India for over 5,000 years. It is based on a holistic approach rooted in Vedic culture. Ayurveda also has a tradition of surgery but the vast majority of Ayurvedic therapies are herbal compounds. Featuring a mix of diet, exercise and meditation, its focus is on healthy living and prevention, and on treating mind and spirit as well as body. Today, Ayurveda is gaining a lot of interest in Western countries. Due to the severe regulations surrounding medical practice in Europe and America, Ayurvedic treatments in the West are primarily massage and dietary and herbal advice. EAR

CANDLING

Ear candling, also known as auricular candling or coning, refers to various procedures that involve placing a cone-shaped device such as a hollow candle in the ear canal in order to extract earwax and other impurities with the help of smoke or a burning wick. In ear candling, the patient lies down and the candle is lit. This is claimed to create a low-level vacuum that draws wax and other debris out of the ear canal. Proponents claim that the procedure removes impurities from the inner ear, the facial sinuses, or even the brain itself, all of which are said to be connected to the canal. The benefits of candling, it is claimed, range from relieving sinus pressure and pain, to purifying the mind, purifying the blood or opening and aligning the chakras. The origins of candling are obscure. The technique is related to cupping and moxibustion, widely found folk healing methods. BIOFEEDBACK Biofeedback is a treatment technique in which people are trained to improve their health by using signals from their own bodies. Patients learn how to relax by machine-monitoring their heart rate, temperature, muscle tension and gradually train themselves to control them. Biofeedback is used to treat conditions such as migraines and other types of pain, digestive problems, high and low blood pressure, asthma, stress, Raynaud’s disease, epilepsy, paralysis and other movement disorders. QI Also commonly spelled “ch’I”, “chi” or “ki”, is a fundamental concept of Chinese culture, most often defined as “air” or “breath” and, by extension, “life force” or “spiritual energy” that is part of everything that exists. Theories of traditional

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Chinese medicine assert that the body’s vital energy, “qi”, circulates along specific interconnected channels called meridians. Deficiencies or imbalances of qi, or of qi movement through these channels (including blockages) are seen as the cause of symptoms of various ill-nesses. Traditional Chinese Medicine seeks to relieve these imbalances by adjusting the flow of qi in the body using a variety of therapeutic techniques. Some of these techniques include herbal medicines, special diets, physical training, massages to clear blockages, and acupuncture.  Questions (after explaining the texts to your partner answer the questions below) 1. What do Ayurveda and Qi have in common? 2. What is the difference between Biofeedback and allopathic medicine or the other types of medicine presented here? 3. The approach used in Ear candling differs from that used in the other texts. What is different in the presentation of Ear candling? What information do you derive from this approach?  Description Read the description of xi xian cao or Siegesbeckia orientalis. Then, fill the gaps in the text on blueberries with the words listed. XI

XIAN CAO OR

SIEGESBECKIA

ORIENTALIS

Xi xian cao or Siegesbeckia orientalis is a small shrub native to eastern Asia with green, oval- or triangular-shaped leaves and small, yellow flowers covered with sticky hairs. Both the aerial parts and the sap are used in herbal preparations. In traditional Chinese medicine, Siegesbeckia orientalis is considered to have bitter and cold properties, and affects the liver and kidney meridians. Its main functions are to clear heat and release toxins. The sap is used externally to treat rheumatic pains and skin conditions such as boils and eczema. Internally, Siegesbeckia orientalis is used as a sedative and (with other herbs) to treat hypertension.

Siegesbeckia orientalis

BLUEBERRIES BERRIES



NEAR

GENERATIONS TREAT

Blueberry





SHRUB



DISORDERS

POOR









EATEN

JAM

EAT

NIGHT

HEIGHT





 

TIMES

Blueberry (or bilberry) (Vaccinum myrtillus) is a perennial (1) ……………...……….. growing to about 16 inches in (2) ………………..…….. and bearing purple black (3) ………...……………... . Blueberries have been (4) …………………….. as fruit since prehistoric (5) …………………….. and

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they have been used for (6) ……………........……….. to make (7) …….....……………….. . Blueberries are used to (8) …………………….. eye strain, (9) ……………….. sightedness, (10) …………………….. blindness, (11) …………………….. circulation, bruising, diarrhoea and other intestinal (12) …………………….. .  Writing In pairs or groups write short paragraphs (6 to 10 lines) presenting one or more of the following techniques or tools. Use the internet. Note the type of site you are using as a reference (academic, public service, advertising, private, etc.). Check what is said on sites such as Bandolier http://www.jr2.ox.ac.uk/bandolier/aboutus.html, a serious independent journal about evidence-based healthcare, written by Oxford scientists. When you have finished, share your work. • • • • • • • • • •

Acupressure Acupuncture Fasting Cupping glasses / fire cupping Flotation Gigong Herbal teas Homeopathy Iridology Kinesiology

7.12. Quizzimage N° 7  Describe and comment: case (diagnosis), causes, settings consequences (prognosis).

• • • • • • • • • •

Luo points Manipulative therapy Moxibustion Pushing hands Rebirthing Reflexology Shiatsu Urine (drinking) Vegetarianism / vegetalianism Yoga

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Back to basics 7.13. Fossilization “TO

AGREE“

This is a classic francophone zone of error.  Group work – Discuss: What is the error? What is the correct formulation? Check in the answer section.  Following the models in the answer section, give an example and a justification of: a. something with which you are in agreement. b. an opinion of a public figure of which you are critical.

7.14. Flexing the lexis SUFFIXES

 Use the suffixes to form appropriate adjectives to complete the text: - ABLE  - AL / - IAL  - FUL  - IC  - ISH  - IVE  - LESS  - ENT ATHLETE’S

FOOT

Tinea pedis, otherwise known as athlete’s foot, is a chronic (fungus) …......… …………..…. infection and is estimated to be the second most common skin disease in the United States, with 15% of the population affected. In most cases, tinea pedis can be identified by a (vision) ………………........…. examination, but a laboratory test revealing the presence of (microscope) ………………..…. yeast cells provide a more (rely) ……………….....…. diagnosis.

Tinea pedis can be associated with other (clinic) …………….....…..…. syndromes, such as (recur) …………….......…........…. cellulitis, asthma and immune / (allergy) ………………............…. responses. A large number of (without colour) and (without odour) ……......………..… creams, sprays, and liquids, (obtain) ……........………… from pharmacists without a prescription, provide (effect) ……......…..……… treatment in most cases. ……......………..…

More (power) ……………….................... drugs, containing hydrocortisone, e.g. Daktacort HC, may be (use) ………………..…. if the skin is (irritate) ………………..…., (slightly red) ………………..…. and inflamed. These drugs are not (suit) ……………….. for children under 10 or during pregnancy and breastfeeding.

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7.15. Roots SUFFIX “-OID“

Did you know that allantoid means “shaped like a sausage”?  Find what the terms in the following list are “shaped like” or “similar to”: AMYGDALOID



CARDIOID



CORTICOID



MASTOID



OVOID



THYROID



TRAPEZOID

7.16. Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Your task is to read this text fluently to your partner. Make sure you understand all the vocabulary before starting to read. ASPIRIN – THE WONDER

DRUG

Aspirin is the most widely used drug by the general public, and more than fifty billion tablets are taken worldwide each year. It is effective for such different ailments as headache, temperature, arthritis, blood clots, cancer and Alzheimer’s disease. It was one of the drugs selected for inclusion in the self-medication kits taken to the moon by the Apollo astronauts in 1969. In 1948, a general practitioner noticed that aspirin dramatically reduces the incidence of heart attacks and it is now widely used for the prevention of cardiovascular events, saving millions of lives. Nevertheless, like all drugs, it can have dangerous secondary effects and, on average, is responsible for about 2000 deaths per year for the UK.

Follow up 7.17. Web search: Functions – Comparative  Look through the checklist – Select 5 important words you are not familiar with and find 2 examples of each in the medical register.

7.18. Data search  Two groups – Each makes an 8-minute presentation of two founding fathers of medicine.

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7.19. Phonology – Remedial work (see Annexe “Phonology notes”) 7.20. Self-test – Exit proficiency  Complete the sentences by filling in the blanks with an appropriate word. 1.

Health inequalities continue to wi…………………… despite government rhetoric. (to grow bigger, the gap increases)

2. The we…………………… of the patients’ immunological responses dramatically increases morbidity and mortality rates. (losing force, ≠ strengthening) 3. The rapid sp…………………… of HIV in sub-Saharan Africa is one of the greatest failures in the history of public health. (extension, advance) 4. Publication is an important step in fu…………………… one’s career. (advancing, developing) 5. Trachoma is the world’s le…………………… cause of blindness. (foremost, principal) 6. It was a fifteen-year old adolescent who approached the doctor asking to be prescribed drugs to en…………………… sporting performance. (improve, boost) 7.

It has been claimed that hypnosis can help reduce your stress, relieve phobias, le…………………… anxiety, break addictions and ease asthma symptoms. (decrease, reduce)

8. The use of antidepressant drugs may he…………………… the risk of suicidal behaviour. (raise, make higher) 9. In other parts of the world, cases of cholera typically pe…………………… during the rainy season. (attain their highest point, reach the zenith) 10. Un…………………… x-rays, withdrawing blood and cerebrospinal fluid are invasive procedures. (as opposed to, ≠ similar to)

8. CAUSE & CONSEQUENCE When, in the 4th century B.C., Hippocrates doubted that the origin of disease was to be found in “the visitation of the Gods”, he opened wide the door to etiology – the search for cause (and its twin brother consequence), cornerstones of a scientific approach to medicine. This unit is devoted to exploring these 2 functions, cause and consequence which, inevitably, are at the heart of all medical discourse.

What do you know? – Self-test 8.1. Chernobyl, contaminated food, and Caesium cardiomyopathy Y.I. BANDAZHEVSKY – PRISONER

OF CONSCIENCE

Professor Youri Bandajevsky, pathologist and former rector of Gomel Medical Institute in Belarus was arrested in June 1999 and sentenced to 8 years’ prison1. He was accused initially of terrorism and later of corruption. However, no proof was ever brought against him. What was his crime? Denouncing government waste of research funds and revealing the disastrous effect of post-Chernobyl, low level radiation.

tarter

• Give other examples of doctors or scientists who suffered because of their professional convictions.

 Replace the words in bold in the text by synonyms taken from the list: COMING FROM BECAUSE OF





CAUSED

OWING TO

 

GIVE RISE TO HENCE





AS A RESULT OF



SPARKING OFF



RESULTS



SINCE

Populations living in southern Belarus and elsewhere have been subject to high levels of radio contamination brought about by post-Chernobyl fallout, a situation which, due to the simultaneous ingestion of contaminated food, is a serious threat to the health of the inhabitants. The International Atomic Energy Agency (IAEA) has estimated that the Chernobyl disaster released as much as 400 times the radioactive contamination of the Hiroshima bomb. About 60% of this contamination fell in Belarus and, as the domestic economy is extremely weak, a large proportion of the population is dependent both on home-produced food, such as milk and 1. Professor Bandazhevsky obtained a conditional release in January 2006.

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vegetables originating from contaminated agricultural land, and on products gathered from the surrounding forests: mushrooms, berries, fish and wild birds. This means that the intake of long-lived radio isotopes, such as Caesium 137 (137 Cs) may lead to high levels of corporeal contamination. According to Bandazhevsky, during pregnancy 137 Cs in the maternal blood is, to a certain extent, taken up by the placenta, thus the foetus is partially protected. Youri Bandajevsky – arrested in 1999 However, from birth onwards, starting with maternal milk, there is a constant risk of contamination, particularly for young populations who, on account of their high metabolic activity, are more vulnerable. Bandazhevsky has been able to establish a statistical correlation between high 137 Cs loads and a number of diseases rarely found in children. These included cardiac arrhythmia, unstable blood pressure, gastrointestinal infections, endocrine disorders and cataract. Post-mortem examinations indicate a relationship between high levels of 137 Cs in the myocardium and heart disease. Similar outcomes have been found in animal experiments, when rats were exposed to 137 Cs. These findings support the hypothesis that there may in fact be serious radiationinduced health effects as a result of the Chernobyl explosion and that the accumulation of radio caesium in the human organism via the food chain may be a determining factor in triggering hitherto unexplained pathological processes.

Cause & consequence – Checklist Cause and consequence describe the chain of events associated with the question “why”. When it is causality which is the focus of the sentence, the cause – a person or thing – is normally the subject of the sentence, while the consequence is the complement. CAUSE

CONSEQUENCE

 Infection by strep bacteria causes

scarlet fever.

N.B. This order can be inversed by using the passive form: see Unit 4. When it is the consequence which is the focus, this becomes the subject followed by a different set of introductory verbs. CONSEQUENCE

 Infection  Scarlet fever

CAUSE

results is caused

from inhalation of contaminated aerosols. by infection from the strep bacteria.

Cause and consequence are not only expressed by verbs; there are nouns, adverbs and conjunctions which have a similar function.

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A. Cause 1. VERBS

to cause  be responsible for  bring about  induce  lead to  produce  provoke  result in  spark (off)G. Notes 6  trigger (off)G. Notes 6

 Notice the different particles that follow certain verbs.

 High levels of lipids in the blood may trigger a thrombosis.  Regular physical exercise can bring about cardiovascular improvement. 2. NOUNS

a cause  (on the) grounds  origin  reason  root (cause)  source  stimulus  Hormonal imbalance is the root cause of type 2 diabetes.  The patient asked for a hysterectomy on the grounds of unacceptable cyclical pain. 3. ADVERBS AND CONJUNCTIONS

because of  owing to (the fact that)  due to  on account of  as a result of  thanks to  since  as  so (+ adj) that  such (a + noun) that  Distended liver, whether due to a tumour or to an infection, is generally fatal.  Since drugs administered to nursing mothers can pass into breast milk, caution should be exercised.

B. Consequence 4. VERBS

to arise from  come from  derive from  originate from  result from  stem from  Most trauma injuries stem from car accidents. 5. NOUNS

consequence  complication  by-product  (side) effect  (final) outcome  result  spin-off  Early intervention makes the greatest difference to the final outcome for cancer patients.

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6. ADVERBS AND CONJUNCTIONS

consequently  as a result  hence  therebyG. Notes 13  therefore  thus  Pseudoephedrine is applied to induce vasoconstriction, thereby minimizing bleeding from inadvertent trauma.

Exercises 8.2.  Find suitable combinations for the phrases in the left and right hand columns. 1. Anemia may result in …

•

• a. is generated by the sinus node.

2. Demand for medical services is largely due to …

•

• b. drugs or alcohol.

3. Violent behavior in schizophrenics is usually sparked off by …

•

•

c. are requested to inform the administration.

4. The spread of diseases such as malaria, tuberculosis, measles, etc. is a major problem in Vietnam since …

•

•

d. activation of “latent” metastases in early breast cancer.

5. Students absent on account of illness …

•

• e. tiredness and fatigue.

6. A mild sedative may be given to induce …

•

•

7. An electrical stimulus …

•

• g. relaxation.

8. Surgery can provoke …

•

•

f. neither adequate preventive nor therapeutic health measures have been fully developed.

h. underlying problems of mental health.

8.3.  In pairs, reformulate the sentences using the following phrases: MAY BE DUE TO OUTCOMES





COMES FROM

ARISES FROM





THANKS TO

ON ACCOUNT OF





THE ORIGIN

AS



ONE OF THE POSSIBLE

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137

CONSEQUENCE

1. In the third world, epilepsy at child birth is often owing to the lack of peri-natal care. 2. The negligence of treatment for Parkinson’s disease stems from the widespread lack of public awareness.

Infant epilepsy in the 3rd world often ………………………………………………………… ..…………………………………………………...... .

Parkinson’s disease is often neglected ………………………………………………………… …………………………………………………….… .

3. Mumps can lead to deafness, meningitis, painful swelling of the testicles or ovaries and, rarely, death.

Meningitis is

4. Computer programs that monitor drug usage have been developed, thereby decreasing drug prescription errors.

……………………….. computer monitoring, ................…...……………………………………… …………………………………………………….… .

5. Hypoglycemia can spark off migraine.

Migraine

6. Unfortunately, decrease of patient and doctor responsibility is one of the sideeffects of free medical treatment.

………………………………………………………… ………………………………………………………… …… there is a decrease in responsibility.

7. The brain damage was brought about by rubella (German measles).

………………………………………………………… …………… of the brain damage ………..… .

8. Heavy drinkers often experience a lack of appetite, hence their reduced food consumption.

Their reduced food consumption ……...… …………..…………………………………………… ……………………………………………….....…… .

……..……………………….…….. ………………………………………………………… ..……………………………………………………... .

………………………...………….…… .

8.4. Pair work  Look at the pictures below and discuss causes and consequences of the different ailments using words from the list: 

CAN BE DUE TO ABOUT CAUSE FOR



BY





SINCE

IS USUALLY BROUGHT

ORIGINATES

FROM

ROOT

ARISES FROM

IS OFTEN RESPONSIBLE

PRODUCT OF

 

LEADS



IS PROVOKED BY

TO





THE

MAY LEAD TO



COMES



THUS







ONE

AS A RESULT

HENCE





IS A BY-

AN OUTCOME OF

OF THE SPIN OFFS FROM THEREFORE

FROM



STEMS FROM

THEREBY



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Handicap

Varicose veins

Arthritis

Obesity

Allergy Asthma

Diabetes

Cataract

8.5.  Find plausible endings to the phrases and then compare with the original sentences in the answer section. 1. Significant side-effects of chemotherapy are

………………………………………………… ………………………………………………………………………………………………………………..... .

2. Alternative medicine militants have criticized vaccination programs on the grounds that …………………………………………………………………………………………… .

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CONSEQUENCE

3. The recent statistics on obesity have provided a stimulus for

…………………… …….………………………………………………………………………………………………………....… .

4. Women over 50 who weigh less than 55 kg are at greater risk of a fracture as ………………………………………………………………………………………………………………..… .

5. Urinary infections in pregnancy can spark off

………………………………………… ………………………..…………………………………………………………………………………….…... .

6. Thanks to the PET (positron emission tomography) scanning capability …………… …………………………………….……………………………………………………......……………….….. .

7. Doctors have been accused of inducing labour ……………………………………………… ………………………………………………………………………………………………………………...... .

8. According to the study, the new anti-convulsion drug for pregnant women can lead to ………………………………………………..…………………………………………………….. .

8.6.  Fill in the blanks with an appropriate word. There may be more than one possibility: COMPLICATION  REASON  STIMULI  SPIN-OFFS  ROOT  SIDE-EFFECTS  UNWANTED EFFECTS  GROUNDS 1. The reaction of the brain to control group.

………………………….

2. Laser research has had important

was considerably slower in the

………………………….

3. Digoxine toxicity often presents with gastrointestinal as anorexia, nausea or vomiting.

for eye surgery. …………………………….

such

4. Deep vein thrombosis (DVT) results from bed rest and its most common serious ……………………………. is pulmonary embolism. 5. Beta-blockers and thiazide diuretic combinations should be prescribed with care since ……………………………. are numerous. 6. Pregnancies may be terminated before the end of the 24th week on the ………………………. of foetal abnormality.

…………

7. The most common …………………………………. for undergoing sinus surgery is a chronic infection that does not resolve with medication. 8. Some researchers suggest that vaccinations might be at the of the asthma epidemic.

………………………….

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8.7. Cystic fibrosis

tarter

Before reading the text, try and answer the following questions: • What is the other name (less common) for cystic fibrosis? • What causes this disease? • What are the many consequences on body physiology?

Cause and consequence are closely interrelated, and sentences expressing cause can be rewritten, expressing consequence, and vice-versa.  In the following text certain expressions of cause and consequence have been written in bold. Using the prompts given at the bottom of the text, reformulate the sentences. Cystic fibrosis (CF), or mucoviscidosis is the most common, life-threatening inherited disease brought about by a recessive gene. Its incidence among Caucasian populations is 1 in 2,500 live births, therefore the carrier rate is 1 in 25. A health authority with a population of 250,000 has approximately 35 resident patients with CF (some having died at an early age), of whom 15 are adults. Medical staff, and especially pediatric staff regularly come across patients with Cystic fibrosis since the complications are very severe, and often require hospitalization. Cystic fibrosis is the result of mutations affecting a gene which is essential for the regulation of sodium, chloride, and water movements across cell membranes. Improper or faulty regulation results in dehydration, and as a result, in higher viscosity of all exocrine gland secretions. The most severely affected are the pancreas, and the glands of the intestines, biliary tract, lungs and the reproductive system. When the lungs are affected, excessively thick mucus causes obstruction of airways, giving rise to recurrent bronchitis and pneumonia, bronchiectasis, emphysema and clubbing of the fingers, and eventually death from respiratory failure. Thick secretions in the pancreatic duct prevent the normal flow of enzymes. This can result in malabsorption, in particular of fats and fat-soluble vitamins. This in turn will cause malnutrition, poor weight gain, steatorrhea. There may be obstruction of the bile ducts, leading to cirrhosis and some infants even present at birth with meconium ileus, which can have a fatal outcome when it leads to perforation. Other consequences are the malfunctioning of sweat glands, which causes excessive salt, and infertility especially in men. Clubbing of the fingers – one of the symptoms of CF

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In addition to a complete medical history and physical examination, diagnostic procedures may include a sweat test (chloride), blood tests, chest x-rays, pulmonary function tests, stools evaluation, sputum cultures and pancreatic function tests. Therapy includes treatment of respiratory problems (physiotherapy, antibiotics, bronchodilators, oxygen therapy, and mucolytics), of malnutrition (enzyme and vitamin supplements, diet low in fat and high in protein and carbohydrates) and involves many different health professionals. Thanks to improved treatments and care, there has been a dramatic increase in the survival of people with cystic fibrosis into their 30’s and beyond. However, the symptoms can be so severe that death in childhood and early adulthood are still not uncommon.  Reformulate the phrases in the text. 1. A recessive gene (the cystic fibrosis conductance regulator) is responsible for ………….……………………………………………………………………………………………………...… .

2. 4% of the Caucasian population are carriers since

……………………………………..…. ………………………………………………………………………………………………………………..… .

3. The complications are so severe that

…………………………………………………………… ……………………………………………………………….…….………………………………………....… .

4. Excessive viscosity of exocrine secretions is due to

……………………………………… ……………………………………………………………..………………………………………………....… .

5. Bronchitis and pneumonia can result from…………………………………………………… …………………………………………………………………..…………………………………………....… .

6. Malnutrition, failure to thrive and fatty stools are consequences of ………………… ………………………………..……………………………………………………………………………....… .

7. Perforation can arise from

……………………………………………………..…..………………… ……………………………………………………………………………………………………………......… .

8. More and more patients live into adulthood as

……………………………………………… ………………………………………………………….……………………………………………….....…… .

8.8. Cerebro Vascular Accident  The two drawings summarize the causes and consequences of CVA (Cerebro Vascular Accident) and cirrhosis of the liver. Using your knowledge and the information from 8.7. write a paragraph on these two diseases.

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Cystic Fibrosis affects many organs lungs: thick mucus pneumonia, bronchiectasis

COMPETENCE IN MEDICAL ENGLISH

Hepatic insufficiency

Portal hypertension

coma

esophageal varices

jaundice ascites

liver: bile duct obstruction

liver damage

Causes of cirrhosis

pancreas: duct occluded malnutrition

ileum: obstruction

skin: excess salt in sweat

alcohol abuse

drugs

hemorrhagic tendency

reproductive system

heredity

ankle edema viruses

unknown

8.9. Prostate cancer  The word order of some of the sentences has been mixed up. Rearrange the words so that they make sense and replace them in the text. 1. 2. 3. 4. 5. 6. 7.

has its increased over incidence the considerably the father cancer likelihood or with prostate a doubles obstructs of tumor urethra swelling which the the cannot whole early and detected cancers the be is spread to cancer neighboring likely have to already parts has of not the to illness other spread used testerone thereby be to can levels decrease

THE PROSTATE The prostate is a small cone-shaped gland situated in front of the rectum, below the bladder and surrounding the urethra. It secretes the thin, milky fluid that liquefies the coagulated semen. Prostate cancer is the most common cancer in men and (1)

……………………………… …………………………………………………………………………………………………… last 30 years

due to improved screening techniques. The disease is uncommon before the age of 45, however, by the age of 95, almost all males are affected by it. The causes are still not fully understood. The disease is fairly rare among Asians, more frequent in European populations and highest among Afro-American populations. Genetic proximity is a risk factor, as having a brother (2) ……………………………… …………………………..………………………………….…………………………………… of contracting the disease.

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SYMPTOMS Often the first symptom is a tendency to urinate more frequently, accompanied by a weak jet and difficulty with starting and stopping. This can be caused by a (3) …… ………………………………………………………..……………………………………………………………… …………………… . However, non-cancerous swellings – for example, benign prostatic

hyperplasia, produce the same effect. Other symptoms include painful ejaculation, blood in the urine and frequent back pains. DIAGNOSIS High PSA (prostate specific antigen) levels indicate an enlarged prostate though not necessarily a cancerous one. A digital rectal examination may detect hard cancerous nodules, but the examination is not infallible as (4) …………………………………………… ……………………………..………………………………………………………………………………………

prostate cannot be explored. Complete confirmation can only be obtained by biopsy. TREATMENT If the cancer is diagnosed early, the prognosis is good. In other cases the (5) ……… ……………………………………..…………………………………………………………………………………

organs, or bone marrow metastases may have developed. For elderly men, with slow developing, non-aggressive cancer, and for those whose life expectancy is not endangered, the most reasonable course of action is not to intervene and merely monitor the situation. In other cases radical prostatectomy can be performed. This consists in the removal of the organ and is technically effective, provided that the (6) …………………… ……………………………………..………………………………………………………………………………

the body. However, this treatment has serious drawbacks, as it can lead to impotence and incontinence. External or internal radiotherapy is an alternative solution. The risks of incontinence and impotence are lessened, but potentially dangerous, radiation side-effects remain.

bladder

prostate

pubic bone

Hormone therapy – Drugs (7) …..……… …………………………………………………..… …………………………………………… causing

urethra

the cancerous cells to shrink in size. The negative effects of this treatment include: lowering of the libido, potential impotence, sweating and swelling of the breasts.

enlarged prostate

Enlarged cancerous prostate

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8.10. Bedside manners

tarter

Group work: • What do you think the title means? • What do you expect the text to say?

 Read the text and then prepare for the debate as is explained below. HORSE WHISPERER MEETS BRAIN SURGEON: UA NEUROSURGEON USES HORSES TO TEACH COURSE ON BEDSIDE MANNERS An equine equation: what do you get when you put together a horse, some medical students, and a world-renowned neurosurgeon? A medical school class called “Medicine & Horsemanship: An Introduction to Human Nonverbal Interaction at the Bedside.” For two hours on Friday afternoons, medical students from the University of Arizona College of Medicine meet at a ranch just outside of Tucson, Arizona, to learn horsemanship exercises. Through these exercises, the students also learn something even more valuable – more effective bedside manners. “Think of it as ‘horse whisperer meets brain surgeon’”, explained Allan J. Hamilton, M.D., F.A.C.S.2, head of the UA Department of Surgery, when describing his unique way of teaching medical students how to communicate with their patients. Dr Hamilton, a Harvard-trained neurosurgeon specializing in brain and spinal cord tumors, created this course to help young physicians learn how to handle difficult moments such as when a parent needs to be told their child has died, or when a patient has to be told of a bad outcome on a test.“ I am not equating patients with horses,” Dr Hamilton stressed. “However, horses can teach us a great deal about nonverbal communication that is applicable to our interactions with patients.” “Communication has become an essential component to patient care“, Dr Hamilton said. How health care professionals relate to their patients is as important as the medications they prescribe and the treatments they give. “Horsemanship requires the understanding of body language and sensitivity,” he said. “There is no behaviour that will more quickly and effectively teach you awareness of your own body language and energy level than learning the principles of working with horses. You learn patience, gentleness and a method of physically relating to patients that is nonverbal, effective and powerful.” The class is an elective offered this spring by the UA College of Medicine at the Arizona Health Sciences Center, a world-renowned research center with expertise in cancer, 2. FACS: Fellow American College of Surgeons.

UNIT 8 – CAUSE &

CONSEQUENCE

145

cardiovascular disease, imaging and rheumatic diseases. The Department of Surgery is nationally recognized for its research, patient care and academic achievement.  Debate Read the questions, make sure you understand them and think of a few answers before you start the group discussion. You can note down a few ideas, but don’t write complete answers. 1.

What are the two examples of difficult moments in a physician’s life mentioned in the text?

2. In what way does Dr Hamilton think horsemanship can help handle these difficult moments? 3. What does horsemanship teach you, according to Dr Hamilton? 4. Do you think you can be taught “soft skills” like respect, courtesy, listening and anticipating patients’ needs? 5. Do French medical students receive some formal training in bedside manners? Does your medical school give you (and other health workers and employees) skill-building opportunities in this field, such as learning ways to say things, to keep families informed of the patient’s condition and to approach difficult topics? If yes, can you describe them? 6. At some medical schools, during the first years, students conduct practice physicals with volunteer patients or actors. The sessions are videotaped or audiotaped, and students receive feedback on their approach to patients. Medical students are also encouraged to observe practicing clinicians in action. What do you think of this way of learning? Have you experienced it? 7.

How would you like to be taught bedside manners? How would you teach this subject?

8. In the United States, lawsuits against physicians are common. Evidence seems to suggest that physicians who have strong relationships with their patients are less likely to get sued for malpractice. It also seems that health professionals with good bedside manners are happier in their jobs. Can you explain the association between rapport with patients and the incidence of lawsuits? Can you suggest an explanation why health professionals with good bedside manners are happier in their jobs? 9. In English-speaking countries, physicians are reminded to eliminate medical jargon (i.e. medical English) when talking to their patients, in order to make sure they understand what they’re being told. Do you think this also applies in Frenchspeaking countries? 10. Bedside manners are cultural. Can you think of examples of cultural differences between French bedside manners and those of another culture?  Dictation (pair work) A dictates text 1 to B, B dictates text 2 to A (if your partner doesn’t understand a word, spell it to him).

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TEXT 1 Mahoney, who has been at Children’s Memorial Hospital since 1984, says her most memorable experiences occurred during her days as a bedside nurse. “You really have an ability to impact patients’ and families’ experiences with your organization,” she says. “You can help them heal. Sometimes you feel you don’t have the time to sit and have conversations, but you can do little things. You can touch a child’s hand, make eye contact or acknowledge their emotions in 30 seconds.” TEXT 2 With healthcare employers increasingly measuring patient satisfaction levels and rewarding their employees for providing high-quality customer service, health professionals are realizing a good bedside manner is more important than ever. Good bedside manners not only improve interactions with patients, but also advance health professionals’ careers. Evidence suggests those who have strong relationships with their patients are less likely to get sued, and may be more likely to move up the professional ranks.

8.11. Quizzimage N° 8  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 8.12.Fossilization “THE /

A”

Do you know how to use the article?  Fill in the gaps with “THE 

A

/ AN  Ø”.

OBSESSIVE-COMPULSIVE

DISORDER

• Obsessive-compulsive disorder is ….…. anxiety disorder characterized by ……. repeated occurrence of obsessive ideas or behaviour.

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CONSEQUENCE

• It was previously believed to be ….…. rare condition. However, ….…. recent data show that ….…. likelihood of developing OCD in …….. general population is between 2% and 3%. •

….…. disorder can occur in people of all …….. ages. One third to one half of adults with OCD report that it started during …….. childhood. ….…. recent study has found that it takes ….…. average of 17 years for people to obtain ….…. adequate treatment.

•

…….. probable biologic explanations of obsessive-compulsive disorder include ….…. heredity, ….…. brain lesions, and ….…. serotonergic dysfunction.

• Thanks to advances in ….…. psychopharmacologic treatment of OCD prognosis is improving.

….….

• In ….…. United States and ….…. Europe, Fluvoxamine is among commonly used drugs used to treat it.

most

….….

8.13.Flexing the lexis MORE

MULTI-WORD VERBSG. Notes 17

 First match the sentence with the definitions in the right hand column. Then insert the appropriate particle from the list below: AHEAD



ON



THROUGH



DOWN



OUT



INTO



UP



OFF

1. Thousands of prisoners were killed by the typhus epidemic that broke …..…. in Buchenwald in 1942.

•

• a. continue

2. Migraine may be so severe that it interferes with your ability to work and carry …..…. normal activities.

•

• b. created

3. Bar code technology can help cut the incidence of medical error.

•

•

4. Twenty AIDS counseling centers will be set ……... over the next 6 months.

•

• d. investigate

5. A committee has been created to look …..…. the causes of medical error.

•

• e. proceed

6. Patients often ignore symptoms and put …..…. seeking medical attention.

•

• f. reduce

7. Could you please check …..…. the list of items before arriving at the hospital?

•

•

8. So far the results have been satisfactory, consequently the decision has been made to go …..…. with clinical trials.

•

• h. verify

…..….

c. delay, postpone

g. started suddenly

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8.14.Roots ALLOMORPHS

Elements from Greek or Latin are present in modern languages like English or French under different forms. Each of the following sets of words contains the same Greek or Latin element.  Underline the relevant parts of the words and find the meaning. • • • • •

duct, abduction, introduce tendency, tense, tension analysis, dialysis, analytical, electrolyte antibiotics, biology, biopsy, aerobic, microbial, microbe haeme, haemoglobin, haematoma, anaemia, uraemia

8.15.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Read the text to your partner as fluently as you can. Make sure you understand the vocabulary before starting. ACUPUNCTURE Although acupuncture has been practised in China for more than 2000 years, it is only since the late nineteen sixties that it has been adopted in the West. The reason is partly due to the publicity generated by an American journalist who had his appendix removed under acupuncture during the visit of Dr Henry Kissinger to China in 1971. The technique requires hair-thin needles, usually made of stainless steel, and with a thickness of no more than 0.5 millimeters, which are inserted in the skin at specific points of the body so as to “stimulate the energy flow, restore body balance and thus reduce disease”. Acupuncture points

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CONSEQUENCE

149

Follow up 8.16.Web search: Cause & consequence  Using expressions from the checklist, search the web to find out the causes and consequences of: • • • • •

vitamin E deficiency legionnaire’s disease depression anorexia multiple sclerosis

8.17. Data search: Bedside manners  Look at the curricula of a few English language Medical Schools / Schools of medicine. Are bedside manners taught as such? If yes, is it compulsory or elective? How much time is devoted to the subject? Help – Type “Medical School Curriculum” or “School of Medicine Curriculum” in your search engine. Select schools with a Site Search feature. You can also use Google Directory of Medical Schools, or try Nursing Schools. If you are working in a group try to find English Language Medical schools / Schools of Medicine in various parts of the world: Europe, America (North and South), Asia, Africa, the Caribbeans, etc. What conclusions (if any) can you draw from your Internet search?

8.18. Phonology – Remedial work (see Annexe “Phonology notes”) 8.19. Self-test – Exit proficiency  Complete the following phrases with the missing words (sometimes 2 words are required). 1.

Gastroesophageal reflux in infants usually disappears before the age of 2, but occasionally le……………..……. complications. (results in)

2. Carbon monoxide is a by………………..……. of incomplete combustion. (spin off, secondary effect) 3. A needle is inserted to withdraw a small amount of fluid, th………..……………. lowering the pressure in the eye. (by doing this) 4. The tendency for doctors to over-prescribe st……..…………..……. a fear that a relapse may take place. (derives from) 5. The patient was unable to stand on ac……………..……. the pain. (due)

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6. Anterior uveitis can give ri………………..…. pain, photophobia, and decreased vision. (bring about, be responsible for) 7.

Studies indicate that estrogens appear to tr…………..……… migraine which explains why three times as many women suffer from it. (cause, spark off)

8. Although it is not widely known, depression is a serious psychological ou…......… …………... of osteoporosis. (consequence) 9. Anxiety can be in…………..…………. by a medical disorder or the discontinuation of a drug. (provoked, caused) 10. Biotin functions as a coenzyme for carbon dioxide transfer and he…………..…………. is essential to fat and carbohydrate metabolism. (therefore)

9. PURPOSE & PROCESS

In this unit we look at 2 separate functions. The first, Purpose, answers the question, “why/for what reason”. It is concerned with objectives, aims and intentions. In its simplest form, Purpose can be expressed by the infinitive: “To lower the fever, take paracetamol”. But, there are a considerable number of verbal and lexical tools which cover the same domain. The second function is Process, concerned with the question “how”. The way in which something is achieved is most obviously expressed by adverbs of manner and the passive agent introduced by the preposition “by” (see Unit 4). However, there are also alternative prepositional and adverbial phrases which have the same function.

What do you know? – Self-test 9.1. Ghana – Implementation of a community-based rural health project Developing countries as a whole, and rural Africa in particular, suffer from an inadequate health care infrastructure, resulting in a correspondingly high death and morbidity rate. The text below gives a brief outline of a pragmatic approach to improving the situation.

tarter

• What are the principle reasons that account for the inadequate health care infrastructure in third world countries?

 Read the text and then ask your partner questions on the information introduced by the words in bold. Prevention of common, curable illnesses is not only better than cure, but it is also much cheaper if information can be provided proactively on basic nutritional practices, good hygiene and primary health-care practices. To accomplish this long-term objective, a training program for paramedical staff will be implemented in prenatal and postnatal care, nutrition, hygiene, first aid, immunization and vaccination. Next, a series of video documents in local dialects, specifically aimed

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at school children will be prepared. Thirdly, health-care personnel will be trained so that they can present the materials to the local population during village meetings. These presentations are designed to cover areas such as hygiene, nutrition, immunization and vaccination, pre- and post-natal care for women of child-bearing age and mothers, and first aid practices. After the initial presentation phase, there will be an assessment phase to make it possible to determine the effectiveness of the material. This will be done by means of a communitywide survey in the coverage area. The main targets of this project are children and young adults. In order to ensure success, it is therefore essential that we obtain the collaboration of the village dignitaries and teachers to function as intermediaries with the local community. The overall goal of the project is to increase attendance in schools, reduce infant mortality and morbidity, thereby enhancing the socioeconomic well-being of the rural population. Weighing a baby in a traditional health centre

Purpose & process – Checklist A. Purpose Sentences expressing purpose answer questions of “why / what for”. NOUNS

the purpose  function  role  use  The amount of blood drawn depends on the purpose of the phlebotomy.

the aim  goal  target  objective  The aim of the treatment is to increase the patient’s tolerance to allergens.

UNIT 9 – PURPOSE &

PROCESS

153

VERBS

it is designed to / forG. Notes 25  is devised to / for  is planned to / for  is aimed to / for  is targeted to / at  is indicated to / for  The drug is designed to slow down the progress of dementia.  An open access information system has been devised for 1st and 2nd year medical students.

it provides  supplies  it functions (as)  operates (as)  Last year, the NGO supplied Namibia with 5000 HIV test kits.

it prevents  avoids  inhibits  impedes  obstructs  forbids  There is evidence that live yoghurt bacteria can inhibit the formation and breakdown of carcinogens.  Poor venous drainage will impede wound healing. OTHER EXPRESSIONS

in order to / so as to  so that  so as not to  in an attempt / effort to  A small vacuum drain is inserted behind the ear to remove any blood.  A small vacuum drain is inserted behind the ear in order to remove any blood.  A small vacuum drain is inserted behind the ear so that any blood can be removed. N.B. – “In order to / so as to” have basically the same meaning as “to”. They are merely stronger, more formal ways of expressing the idea of purpose. “So that” is followed by a clause composed of subject + verb.

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B. Process Process is concerned with questions of “how” or “in what way” something is done. ADVERBIAL AND PREPOSITIONAL PHRASES

by means of  through  thanks to  via  Insomnia and similar disorders can be cured by means of psychotherapy. therefore  thus  thereby  The blood supply is reduced, thus increasing the risk of heart disease. VERBS

to enable  make (it) possible (for)  allow  permit  Rehabilitation enables brain-injured patients to return to social life.  After surgery, children are not allowed to eat or drink until the intestine has healed. N.B. – Meaning • “To enable / to make possible” have the primary meaning of making something feasible or physically possible. • “To allow / to permit” have the primary meaning of making something possible by giving authorization or permission. In modern English, however, the meaning of to allow / to permit is often extended to physical possibility.

Generic drugs

have have have have

enabled made it possible for allowed permitted

third world countries to treat millions of patients.

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Exercises 9.2.  Match the two parts of the sentences. 1. A significant correlation has been established between birth weight and cognitive …

•

•

2. The colonoscope is equipped with fiberoptic cables that …

•

• b. function at age 8 years.

3. At the moment, the prime …

•

• c. target funding to poorer areas.

4. The Department of Obstetrics and Gynecology …

•

•

d. is planning to organize a series of workshops starting in February.

5. Today, it is easier to treat schizophrenia and other mental illnesses …

•

•

e. were operating as paramedics in America.

6. The ministry of health has decided to …

•

• f. prevents jetlag.

7. In many cases nurse practitioners can …

•

•

g. thanks to improved public awareness.

8. By the year 1978, approximately 9,500 persons had been trained and …

•

•

h. goal is to decrease infantile death rate.

9. There is fairly good evidence that melatonin …

•

•

i. enable a physician to visually inspect the lining of the intestine.

10. Most medical faculties only allow students to study bones within the department and it is …

•

• j. provide equivalent care to GPs.

a. forbidden to take them out of the college building.

9.3.  In pairs, comment on the images using phrases such as: AIMS TO VIA





PURPOSE

THEREBY





GOAL

ENABLE





DESIGNED FOR

BY MEANS OF





PROVIDE



IN ORDER TO

MAKE IT POSSIBLE



AVOID



OBSTRUCT



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esophagus

stomach

gallbladder liver cystic duct common duct duodenum

pancreas

Operating theatre

Pancreas Morphine drip Premature baby

19th century medical instruments

Video monitor

9.4.  Insert the appropriate word or phrase: THEREBY



THEREFORE

1.

AVOID





BY MEANS OF



SUPPLIES



VIA



FUNCTIONS AS



USE



ALLOW



OBSTRUCTS

The right coronary artery (RCA) usually …………………………………. nutrients and oxygen to the inferior or underside of the heart.

2. A connection is made with a catheter, and the vein then ……………………………. an artery, supplying blood to the heart. 3. Reliable diagnosis can be achieved ………………………. magnetic resonance imaging. 4. In anemia there is a decrease in hemoglobin and ……………………………. the blood carries less oxygen. 5. In cases of subglottic stenosis, a tracheostomy tube may be introduced to ……………………………. the child to breathe. 6. Diagnosis of vitreoretinal disease involves the ……………………………………. and interpretation of ultrasound, angiography and electrophysiology. 7.

The EMR (electronic medical record) automatically warns physicians of a patient’s allergies, ……………………………. reducing the chance of a medical error occurring.

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8. Digital photographs and case histories can be sent ……………………………. intranet for a second opinion. 9. Patients are advised that they should ………………………. foods that are rich in salt. 10. If a stone ……………………………. the cystic duct, it will lead to distension of the bladder, accompanied by nausea, vomiting and pain.

9.5. Nursing and medical procedures are numerous and complex, but all have a specific purpose.  Match the procedures with their purpose, then make sentences, selecting one of the phrases suggested in the middle column. 1. Intravenous infusion

is a method of

assess the pressure of blood returning to the right atrium.

2. Two-hourly changes of position are carried out

so that

relieve symptoms associated with ascites.

3. A Redivac drain is left in situ

in order to

the sampling of cerebrospinal fluid (CSF).

4. A lumbar puncture is performed

is indicated to

preventing chemotherapy-induced alopecia.

5. Analgesics are administered

is a method used to

prevent the formation of pressure sores.

6. CVP (Central Veinous Pressure) readings are done

aims at

force a blockage out of the trachea.

7. Barrier nursing

so as to

enteral nutrition.

8. Intrapleural drainage

to allow

blood and fluid doesn’t collect in a surgical wound.

9. A nasogastric tube is inserted

to

restore normal lung expansion after a pneumothorax.

10.The Heimlich manœuvre can be performed

in an attempt to

controlling the spread of pathogenic organisms.

11. Abdominal paracentesis

is often used to

prevent dehydration.

12.Scalp cooling

to enable

promote the patient’s comfort after surgery.

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9.6. Purpose can be negative – the objective is to stop something happening. This is expressed by negative sentences or verbs with a negative meaning.  Answer the questions. 1. What are antibiotics used for?  They are used to prevent

….....................................................................................…… ………………………………………………………………….……........................................................... .

2. Why do they give insulin injections?  So as to avoid …….....................................................................................…………………… …………………………………………………………..................................................................………. .

3. What is the reason for anesthetizing patients?  So that they do not ……..................................................…………………………………… …………………………………………………………..................................................................………. .

4. What can be done to inhibit coagulation?  It can be inhibited by ……………........................……………………………………………… …………………………………………………………..................................................................………. .

5. What is a tourniquet designed to do?  It is designed to impede …….................................................……………………………… …………………………………………………………..................................................................………. .

 Complete the sentences. 6.

……………………………………………………………………………….…

in an attempt to stop

ventricular fibrillation. 7.

………………………………………………………………………….………..….

so as to forbid the

illegal use of drugs. 8.

………………………………………………… so ……………………… .

that the epidemic doesn’t ……………………

9.7. When explaining physiology, a specific role is often assigned to each organ.  Find the gland, hormone etc. whose function(s) is / are indicated.

Example: "Hormone" The ………… hormones increase the metabolic rate. (thyroid)

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PROCESS

1. Gland

The ……………. gland’s role is to regulate the activity of most other endocrine glands.

2. Hormone

The function of

3. Hormone

…………….

4. Blood cells

……………. are produced in the bone marrow and help inhibit the spread of infectious disease.

5. Fluid

One of the functions of nutrients.

6. Fluid

……………. makes it possible for the body to break down fats into fatty acids.

7. Vitamin

Vitamin blood.

8. Vitamin

Vitamin ……………. allows calcium to enter the bloodstream and is required for bone formation.

…………….

is to reduce urine output.

prevents blood sugar getting too high.

…………….

…………….

is to supply the brain with

plays an essential role in the clotting of

 Find other examples and test your partner’s knowledge.

Example: This vitamin plays an important role in the formation of rhodopsin (visual purple).

9.8. Evaluation of inpatients suffering from schizophrenia  Replace the words in bold by synonyms. Although WHO considers schizophrenia to be one of the ten most debilitating diseases in the world, the nature of schizophrenia remains far from clear. Agreement in diagnosis is notoriously unreliable, and no single symptom can be identified. Many specialists believe that it is better to consider it as a group of disorders rather than a single disease. The purpose of this study is to try and come to an understanding of the biologic basis of schizophrenia. More specifically, the study is designed to prevent a confusion being made between the symptoms which are related to the illness itself and those which are merely related to medications used for treatment. Schizophrenia is a chronic brain disorder whose prognosis is poor and whose pathophysiology is unclear. Neuroimaging technologies such as PET (positron emission tomography), fMRI (functional magnetic resonance imaging), MRSI (magnetic resonance spectroscopic imaging), and SPECT (single photon emission computerized tomography) provide tools for understanding the pathophysiology by studying how the brain functions in living patients. The use of these techniques to study psychotic disorders is to a certain extent impeded however, by the influence of neuroleptics on patients’ behavior. In order to overcome this problem the following protocol has been devised.

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Patients suffering from schizophrenia are admitted to the Clinical Center. After an evaluation of their neuropsychiatric status, psychotropic medications are discontinued for a brief period thereby making it possible for patients to be studied free from any interference from neuroleptic treatment. The different phases of the protocol can then be implemented. The first phase is the evaluation phase and includes gathering historical data, structured diagnostic interviews, general physical and laboratory assessments, basic physiological monitoring and neuropsychological testing. In the second, randomized, double-blind phase, the patients are supplied with either an inactive placebo or an active neuroleptic. Each stage lasts 4 to 6 weeks. During the neuroleptic period, patients are enrolled in a series of neuroimaging and other approved protocols whose goal is to elucidate the neurobiology of these disorders. The neuroleptic free period is essential to distinguish the effects of illness versus medication. Thanks to the combined use of different neuroimaging modalities the functional relationship between a variety of brain abnormalities can be studied. This will allow a better understanding of hippocampal, neurochemical abnormalities, deficits in prefrontal cortical activation, and dysregulation of subcortical dopamine in a single patient. Drawing by a 9-year old schizophrenic child

9.9. Peptic ulcer  Use the following words to complete the text: ASSUMED DISH





AWARDED

RESOLVED





EFFECTIVE

STATING





FURTHER

SUCCESSFULLY





GROWN



RECURRENT



REGIMEN



THEREBY

INTRODUCTION Helicobacter pylori is a bacterium that infects the mucus lining of the human stomach. Many peptic ulcers and some types of gastritis are caused by H. pylori infection, This bacterium lives in the human stomach exclusively and is the only known organism that can thrive in that highly acidic environment. It is helix-shaped (hence the name helicobacter) and can literally screw itself into the stomach lining to colonize. HISTORY Helicobacter pylori had been studied in the 19th century by German, Italian and Polish scientists in 1875, 1982 and 1899 respectively. But the bacteria couldn’t be ………….…….……. in culture, and their work, including a book written in Polish, didn’t have much impact. The results were forgotten. The bacterium was rediscovered in 1982 by two Australian scientists Robin Warren and Barry Marshall: they isolated the organisms from mucosal specimens from human stomachs and were the first to ………….……….…. culture them. In their original paper, Warren and Marshall contended that most stomach ulcers and gastritis

UNIT 9 – PURPOSE &

PROCESS

161

were caused by colonization with this bacterium, not by stress or spicy food as had been …….……….……. before. The medical community was slow to recognize the role of this bacterium in stomach ulcers and gastritis, believing that no bacterium could survive for long in the acidic environment of the stomach. The community began to come around after …………….….……. studies were done, including one in which Marshall drank a Petri …………….…….…. of H. pylori, developed gastritis, and the bacteria were recovered from his stomach lining, …………….….………. satisfying three out of the four Koch’s postulates. Marshall’s gastritis later ……….………….……. without treatment. Marshall and Warren went on to show that antibiotics are …………….…….. in the treatment of gastritis. In 1994, the National Institutes of Health published a paper …………….…….…. that most ………….……….… gastric ulcers were caused by H. pylori, and recommended that antibiotics be included in the treatment …………….……………. . In 2005, Warren and Marshall were …………….…….…. the Nobel Prize in Medicine for their work on H. pylori.

9.10. Research on breastfeeding The text in Unit 1.12 mentions that breastfeeding reduces the risk of developing glue ear. The following text discusses other benefits of breastfeeding.  Read the text and then answer the questions below. Breastfeeding, sometimes called “nursing,” can be a convenient and inexpensive way for a mother to feed her child. According to the American Academy of Pediatrics (AAP) Policy Statement on Breastfeeding, women who don’t have health problems, like HIV, should exclusively breastfeed their infants for at least the first six months of life. AAP suggests that women try to breastfeed for the first 12 months of life because of the benefits to both mother and baby. If a mother stops breastfeeding before the child is a year old, then she should feed her infant iron-fortified, commercially available formula1. Health care providers advise women not to give their infants cow’s milk until the child is at least a year old. Breastfeeding offers many benefits to the baby. For instance, breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler. Some of the nutrients in breast milk also help protect an infant against some common childhood illnesses and infections, Breastfeeding such as diarrhea and certain lung infections. Some recent research supported by the National Institute of Child Health & Human Development (NICHD) also suggests that breast milk contains important amino acids, protein building blocks, that help an infant’s brain develop. Specifically, researchers discovered that two amino acids present in breast milk, which are currently not added to infant formula commercially available in the United States, may 1. Formula (also formula milk): replacement food for babies, given instead of breast milk.

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help infants to increase their cognitive skills. Infants who were fed formula with the two amino acids added scored higher on intelligence tests than infants whose formula lacked the nutrients. Further research is now underway to see whether adding these amino acids to infant formula is safe in the long-term. For more information on these and other findings, read the Institute’s news releases about breastfeeding. Breastfeeding also benefits the mother. In response to the baby’s sucking, the mother’s body releases a hormone that makes the uterus contract. Many mothers also reap emotional benefits from breastfeeding because of the closeness of this interaction with the baby. Many societies and cultures also encourage mothers to breastfeed, which can offer support to a new mother. Even though breastfeeding is a natural process, it’s not always easy. Many health care providers suggest that women work with a lactation counselor or lactation specialist to learn how to breastfeed and to learn what is involved in breastfeeding. Many health centers, clinics, and hospitals have lactation counselors on staff. Ask your health care provider for more information about getting help with breastfeeding. Even with help, though, some women still have trouble breastfeeding.  Questions Answer the questions either alone or with your partner. 1. Breastfeed: the word is made of a noun and a verb. Can you identify the two parts? 2. What is the noun related to the verb? What is the past of the verb? 3. Breastfeeding is sometimes called nursing. What are the other meanings of the verb to nurse? 4. There are many words for young human beings in the text: baby, infant, child, toddler. Find the definition of these words. 5. Re-read the text and find in it: • advice to mothers/to women • benefits of breastfeeding to babies • benefits of breastfeeding to mothers • general advantages • recent findings of research in the field • why further research is under way  Discussion BREASTFEEDING

RATES

Breastfeeding rates vary enormously in Europe. In Norway, 98% women breastfeed, in Switzerland, 92%, in Great Britain, 63% and in Ireland 42%. French women do not breastfeed very much: on average 52% breastfeed while in the maternity hospital, 25% cease as soon as they return home, and only 10 to 15% are still breastfeeding 3 weeks after returning home.  Discuss these rates. Can you suggest reasons why they vary so much?

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9.11. Quizzimage N° 9  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 9.12.Fossilization INFORMATION 

ADVICE



KNOWLEDGE



RESEARCH



EQUIPMENT

 Complete these sentences using the words in brackets. 1. Please send me details of all the

……………

2. The consultant gave the patient 2 3. He has considerable

……………

available. (information)

…………… .

(advice)

of tropical medicine. (knowledge)

4. None of the …………… so far …………. produced significant results. (research + have) 5. On the following day, 5 more (equipment)

……………

were delivered by helicopter.

 Check your answers in the answer section.

9.13.Flexing the lexis VERBS

MEANING

“PERFORM”

 The verbs DO  MAKE  TAKE  CARRY OUT can all have the meaning of perform. But which word should be used when? It depends on the context.

Example: She ………… a fatal mistake in her diagnosis. (made)

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1.

It is time the Ministry of Health shortage of geriatricians.

2. An incision must be the bone.

………………...

………………...

4. First of all, the doctor should

………………...

5. Immunization programs have tality rates.

………………...

7.

………………...

something about the

through the skin to expose an area of

3. The first living kidney donor operation was brothers in Boston, USA in 1954.

6. Measures must be

COMPETENCE IN MEDICAL ENGLISH

………………...

between twin

a detailed family history. a spectacular impact on mor-

to reduce nosocomial infections.

An angiogenic agent is liable to ………………... a lot of harm, because it will actually promote stenosis.

8. The course provides guidelines for ………………... a diagnosis of asthma in infants and children. 9. A great deal of research has already been ………………... linking cancer and diet. 10. Students are required to December.

………………...

the dermatology examination in

9.14.Roots COMMON

SENSE

 What do the terms in each of following lists have in common? • • • • •

antibiotic, vitality euthanasia, lethal, mortality nosocomial, morbidity hygiene, sanatorium mycobacterial, fungicide

9.15.Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Read the text through to yourself, making sure you understand all the vocabulary. Then read it to your partner as fluently as possible.

UNIT 9 – PURPOSE &

165

PROCESS

INFLUENZA Influenza (‘flu) is an infection of the respiratory tract. The virus that causes it mutates and new strains arise each year which means that there is, at present, no effective flu treatment. In most cases people can be treated at home and await recovery. SYMPTOMS • high body temperature (usually above 38°C) • intermittent sweating and shivering • muscle and back pains • headaches • appetite loss • throat irritation • chest pains INCUBATION

PERIOD

– 1- 4 days

TREATMENT – Antibiotics are not effective and antiviral medication must be administered within 2 days of onset. BED

REST

PAIN

RELIEF

BODY

– This is highly important as it allows the body to heal itself. – Aspirin, paracetamol or ibuprofen can be used.

FLUIDS

– Drink plenty of liquid to replace what is lost from fever.

COUGH MEDICINE – Decongestants and antihistamines can be taken to reduce coughing.

Follow up 9.16.Web search: Functions – Purpose & process  Search the Web in the medical register and find 2 examples each of the 5 most interesting / difficult words in the checklist.

9.17. Data search  For the next lesson, two pairs of students will give a short 4 minute OHP presentation of schizophrenia: • Group 1 will discuss definitions and symptoms. • Group 2 will talk of past and present theories of causes in treatment.  Look for breastfeeding on the Internet and check what makes Norway different from France in this respect, or find out more about breastfeeding in the other listed countries.

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9.18. Phonology – Remedial work (see Annexe “Phonology notes”) 9.19. Self-test – Exit proficiency  Find the missing word. Sometimes more than one word may be required. 1.

The action of the sex hormones can be in……………………… by various drugs. (restricted, checked)

2. The data en…………………………… clinicians to make rational choices about the prescription of expensive drugs. (permits) 3. Travelers are advised to av………………………… eating raw fruits and vegetables. (to take action not to do it) 4. Drug dependence will im………………………… the adolescent’s ability to make friends. (obstruct, hinder) 5. Tirapazamine is the first drug to ta………………………… so-called hypoxic cancer cells. (be aimed at, focused on) 6. Scientists have de………………………… a way of diagnosing the bone disease at an earlier stage. (worked out, designed) 7.

Hepatitis B is a viral infection that is spread th………………………… contact with infected blood and other bodily fluids. (by means of, as a result of)

8. Cytology and histology of biopsy specimens ma………………………… to evaluate the precise condition of the liver. (permit the evaluation) 9. The go………………………… of treating osteoporosis is to prevent fractures from minor injuries. (the reason for, purpose) 10. There are a number of hospitals in the area which pr………………………… psychiatric and mental health care services. (offer, supply)

10. TIME – PRESENT & PAST

Language is used to express spatial variations, variations in frequency, difference and similarity and so on, but it must also be able to account for variations in the dimension of time. Often, this is not as simple as one might think, since “time” is not an objective fact, and languages vary in the way they interpret it. In the French expression, “J’arrive demain”, a present tense, is used to express future action, while the English expression, “The patient has been hospitalized”, may, according to the context, be translated into French by a present or a “passé composé”. A great help for learners is the fact that the tenses are frequently accompanied by time markers – that is to say, adverbs and other expressions which give contextual information concerning the choice of tense. One of the best ways of mastering the tenses is by focusing on the collocations of tense + time-marker.

What do you know? – Self-test 10.1. Doping in sport

tarter

Doping in sport: • Who? Why? Where? and How?

 Read the following text and, with the help of the time markers (in bold), put the verbs in the brackets in the appropriate tense. In 1998, the Tour de France ……………………… (make) headlines more for the scandal surrounding the widespread and organized practice of doping than for the cycling itself, as tests ………………………. (reveal) that many cyclists ………………………… (resort) to this practice during the competition. The common use of performance-enhancing drugs ………………………… (now / become) such a serious health concern that a researcher in Australia ………………………… (even / write) of an “epidemic of drug usage” in sport. The use of anabolic steroids and other performance-enhancing drugs ……………………......… (start) in the 60’s and since then many remedies to the problem …………………………… (be sought).

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The main anti-doping policy so far …………………… (be) of the punitive, “law and order” kind: the first compulsory controls ……......………………….…. (take place) in the Winter Olympic Games in Grenoble in 1968, and since then both the number of doping tests and their sophistication …………………....… (increase). However, it is generally accepted that doping in sport is still widespread and, in fact, ………………………………….. (increase) with regard to the amounts of drugs taken and the number of sports involved. In the UK, a major study carried out in 1995, …………………………… (find) that 23% of athletes ……………………………. (feel) that the problem of doping …………………………….. (get) worse over the previous months, compared to just 6% who …………………. (feel) it …………………………… (improve). A more recent policy has been to move towards what might be described as a “harm reduction” or an “occupational health” framework. One of the most widely used drugs in cycling is EPO (erythropoietin), a peptide hormone which ………… …………… (occur) naturally in the human body. It is produced in the kidneys and ………....………………. (act) on the bone marrow to stimulate red blood Tour de France cell production thereby increasing the amount of oxygen carried to the muscles. While artificially produced EPO has a legitimate use in the treatment of anaemia in patients with ailments such as kidney disease, HIV, or cancers, its prescription for healthy people can produce a dangerous thickening of the blood, which increases the risk of heart failure, stroke and clots in the lung. No test exists to identify the use of EPO but in 1997, a series of health-checks …………………………………. (be introduced), with the agreement of cyclists, in order to reduce the risk of further fatalities from EPO use. Blood tests would be carried out to determine the level of hematocrit and, if it was above 50%, participation in the race was forbidden until a further test ………………………… (indicate) that the rider’s level of red blood cells ………………………… (drop) to within safe limits. The blood test is therefore no more a drugs test but a health test. Obviously, there is no simple and quick solution to the problem, but the “harm reduction” policy ……………………………………… (currently / raise) some hopes. However, for a few months now, some scientists have begun to fear that gene therapy technology, now only at a very basic level, might become in the future a new form of undetectable and irreversible doping: gene doping.  Group discussion Imagine you are a doctor and a patient comes to consult at your surgery. S/he practices sport and asks for a prescription for a doping agent. How would you react? What would you say and do? Discuss with the group.

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Organizing time: The present & the past – Checklist An important characteristic of English is that it has both a simple and a continuous form. This doubles the number of forms available for expressing time. Consequently, one way of describing the language would be to say that there are four present tenses and four past tensesG. Notes 21.

A. Present Time  Present simple Example

Meaning

 The report indicates ...

The “general” present

 She likes music. He doesn’t eat meat.

Opinions and habits

 Dr Skelton lives in Cambridge.

The “status quo”

 The nurse starts work at 7 o’clock.

Habitual actions

 Water boils at 100°C.

Scientific facts

TYPICAL TIME MARKERS

always  every day  usually  often  sometimes  it is a fact (N.B. – Time markers may be implicit.)

 Present continuous Example

Meaning

 World population is increasing.

On-going present time

 Be quick! The child is bleeding.

Actions happening now

 At the moment, she is working in San Temporary actions in the present Francisco. TIME MARKERS

(just) now  at the moment  currently  at present  temporarily

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 Present perfect simple Example

Meaning

 The doctor has already examined the It is important now / a surprise patient.  He has broken his leg.

The result is important – (He can’t walk now)

 The anesthetist has just arrived.

The finishing is part of the present

 She has never worked in Canada.

In her lifetime – up to now

 He has worked in the hospital since From then till now – It is not history 2005.  She has consulted a gynecologist twice The time span is the present – this month – this month. not last month TIME MARKERS

• justG. Notes 10  recently  already  not yet • ever  neverG Notes 11  so far  up to now • since 1999  for 3 years • this week  this month  Present perfect continuous Example

Meaning

 He has been working in geriatrics for An on-going situation – not yet completed several months.  Researchers have been studying the Non-stop – up to the present disease for years.  She has been working in Bordeaux.

Temporary present – up to now

TIME MARKERS

for 10 years  for a long time  since 1999  recently

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B. Past time  Past simple Example

Meaning

 Last week, the doctor prescribed anti- Past, finished actions biotics.  In 1865, Pasteur discovered the theory Dates – “History” of microbes.  I took the pill 2 hours ago.

Past action considered as no longer important

 When she was a student…

Memories

TIME MARKERS

yesterday  two days ago  last week  in 1970  in the 18th century  during the war  Past continuous Example

Meaning

 The research team was making no Past duration progress.  While she was giving an injection, the Two past actions – one interrupted by another telephone rang.  Last summer, she was expecting a baby. Temporary past TIME MARKERS

while  when

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 Past Perfect simple Example

Meaning

 As soon as he had finished examining The first of two past the x-ray plates, he phoned for an ambu- events lance. TIME MARKERS

after  as soon as  when  previously  Past Perfect continuous Example

Meaning

 The intern had been working non-stop 1st of 2 actions – past for 15 hours when the accident occurred. action with duration  Doctors had been trying to find a cure for Stress on the duration of the action diphtheria for years and years when … TIME MARKERS

when  after  for a long time  during this period

Exercises 10.2. Counterfeit drugs  Read the text. 1. Draw an arrow connecting the verbs (in bold) and the verb form. 2.Look at the Checklist and select the most appropriate meaning for each verb (example: opinion and habits…). Indicate the 2 verbs that are in the passive.

UNIT 10 – TIME – PRESENT &

(1) PRESENT SIMPLE

PRESENT CONTINUOUS

PRESENT PERFECT SIMPLE

PRESENT PERFECT CONTINUOUS

PAST

SIMPLE

PAST CONTINUOUS

PAST

PERFECT

SIMPLE

PAST

PERFECT

CONTINUOUS

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(2)

The BBC reports a disturbing case of imported counterfeit drugs which have been circulating in Britain for the last 4 months. Last week, the “Medicines and Healthcare Regulatory Agency” issued an alarm after copies of the Pfizer anti-cholesterol drug Lipitor had been found in East London. Lipitor, a relatively expensive drug costing £24 per pack of 28 pills, is prescribed to 11 million Briton’s each year and used to treat patients suffering from cardiovascular diseases, diabetes, angina, and high blood pressure.

………….…………... …………………....... …………………….... .…............................

………………….......

So far, several hundred packets of the fake drug have been discovered as a result of information received from customs officers in Rotterdam, Holland. Lipitor is not the only case of counterfeit drugs; amongst others, counterfeit batches of Cialis, used to treat impotence, and Reductil, used to facilitate weight loss were intercepted last May while they were being transported from Luton airport to Birmingham. Today, the market in counterfeit drugs is attracting a growing number of criminals and is regarded as one of the greatest threats to public health. It is not just sales via the Internet which pose a problem; in recent years, thousands of patients in the developing world have been victims of fake anti-malaria and insulin treatments.

……………..……..... ……………..…….....

………………….......

………………...…….

10.3. Foundation – Africa now  Fill in the gaps with the most suitable tenses. ADVERTISEMENT – JOB VACANCY We are an international NGO and ……………………..…...…………………… (currently to recruit) doctors to work in our rural Health Centre in Senegal. The Health Centre ……………………………..…… (to be created) 5 years ago and …………………….........…………. (to serve) a population of around 7,000 people, with full services, accommodation,

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clinical support and ambulance for patient transfer. Candidates must be single and ………….…… ….………………………… (to have) at least 3 years’ previous experience. Preference will be given to candidates with relevant skills, especially those who ………………… ……………………… (to work) in tropical medicine and / or have experience in emergencies. Please contact Dr Ed Silver, [email protected], for more details.

10.4. The wealthier, the healthier?  Supply the correct tense. It ……………………………….………… (commonly to be believed) that the richer people are, the better their health. However, researchers who ………………………..………… (to investigate) health data in 3 different European countries …………………….…………… (to show) that the question is more complicated than that. In a two-year study, epidemiologists ………………..………………… (to examine) children from 3 different countries according to various health criteria. As expected, insulin resistance in Denmark was higher in families which ………………………………………… (to receive) fewer years’ education and with correspondingly lower incomes. In Portugal and Estonia, however, on the contrary, the wealthier the families, the higher the insulin resistance was. The explanation ………….………………… (to come) from the fact that the economies of Portugal and Estonia ………………………………… (develop) rapidly, but so far only the richer classes ……………..……………… (to profit) from the increase in the standard of living and adopted the sedentary life style with poor diet which so often accompanies it.

10.5.  Insert the time marker which corresponds best to the verb form (some can be used in more than one place): NEVER



AS SOON AS

TEMPORARY

1.



WHILE





SO FAR



…………………….……………….

 10 YEARS

PREVIOUSLY

OVER THE LAST

CURRENTLY



IT IS A FACT



THIS YEAR



the Lancet has published several major articles on

clinical depression. 2. She contracted typhus

…………………….……………….

3. Her health record showed that she had hormone replacement therapy regime.

she was living aboard.

……………………….…………….

followed a

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4.

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PAST

…………………….…………..…. the overall suicide rate among Alaska natives has been steadily increasing.

5. At the time, she was doing a …………………………… job in the Multiple Sclerosis Clinic in Manchester. 6.

…………………….…………

that asthma affects 10%-12% of American children under

18 years of age. 7.

…………………….…………….

11 cases of malaria have been reported.

8. Two new therapies are …………………….……… being investigated by the Medical Research Council. 9. Although she has a high blood pressure and leg swelling, she has …………….....…… taken diuretics. 10.

it had been established that the illness was mosquitoborne, the Ministry of Health took the required measures.

…………………….…………

10.6. Multiple Choice Questions  Choose the most suitable answer. 1. The dermis is a layer of tissue beneath the epidermis which ………………………… ……………………. blood vessels, lymphatic vessels, hair follicles, and glands. a. contained

b. is containing

c. has contained

d. contains

2. I saw her earlier in the week. She …………………………………. psychiatric treatment for a period of three months. a. had been undergoing

b. has been undergoing

c. was undergoing

d. is undergoing

3. Before being admitted to hospital, she …………………………………. from chronic psoriasis with inflamed swollen skin lesions. a. had suffered

b. suffers

c. had been suffering

d. suffered

4. They

………………………………….

a liver biopsy to quantify iron accumulation.

a. have already requested

b. had already been requesting

c. have already been requesting

d. are already requesting

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5. At present, the Medical Association …………………………………. formulating guidelines for doctors on migraine treatment. a. has been considering

b. is considering

c. has considered

d. considers

6. By the end of the war, penicillin

………………………………….

a. was becoming

b. became

c. had become

d. has become

widely available.

7. The doctors observed that as time went by, the metabolic rate of the kidney …………………………. . a. has gradually decreased

b. was gradually decreasing

c. has been gradually decreasing

d. gradually decreased

8. He ……………………………………. a nosocomial infection as a result of his stay in hospital last year. a. was developing

b. has been developing

c. developed

d. has developed

10.7.  With your partner, comment on the following photos in turn. As each of the verb forms in the list below is used, cross it out; the new speaker must proceed with a different tense. When you have finished picture one, compare what you have said with the model answer at the end of the unit, then go on to describe the other pictures: PRESENT

SIMPLE

 PRESENT  PAST

PERFECT CONTINUOUS

PAST

PERFECT CONTINUOUS

 PRESENT PERFECT SIMPLE  PRESENT  PAST CONTINUOUS  PAST PERFECT SIMPLE 

CONTINUOUS SIMPLE

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Small pox eradicated – Congo (1965)

Red Cross worker assists drought victims – Ethiopia

Family planning clinic – Morocco

Childbirth

10.8. Maggot therapy The wound-cleansing properties of maggots were first used in Western medicine by surgeons during the American Civil War, although their effectiveness in preventing infection in battle injuries had been recognised for centuries.  Find suitable time markers to, either fill in the blanks, or replace those in bold type. From the end of the 1914-1918 war until (1) the dawn of the antibiotic era, maggots were widely used in clinical practice to treat osteomyelitis and chronic or acutely infected soft tissue injuries, including abscesses, carbuncles, leg ulcers, pressure ulcers, mastoiditis and compound fractures. Indeed many surgeons report that “maggots (2) ………..….. produce rapid and thorough debridement and stimulate granulation tissue formation, the application of maggots can prevent the development of infection and (3) …………..………. accelerates healing and reduces offensive smells”. Despite advances in sterilizing the eggs, the main problem encountered (4) at the time was that no method had (5) yet been perfected to kill all spore forming bacteria, and therefore during the treatment patients were sometimes developing infections brought by the larvae themselves (tetanus, gas gangrene).

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The use of maggots in clinical practice for wound management was revived in the UK (6) in 1995, and (7) since then the BRU (British Research Unit) has supplied over 20,000 treatments under the brand name LarvE to more than a thousand centres. Maggots secrete a powerful mixture of proteolytic enzymes that break down slough and necrotic tissue into a semi-liquid form that they can ingest. During this process, the maggots are actively feeding and destroying bacteria, thus helping to combat wound infections, including those caused by antibiotic-resistant organisms such as methicillin-resistant Staphylococcus aureus (MRSA).

Greenbottle fly

Sterile maggots are (8) now being produced by chemically sterilising the eggs of the greenbottle fly, Lucilia sericata, which are collected on the liver of pigs from adult flies kept in cages in the laboratory. Before distribution, the maggots are (9) …………..…….. tested for the presence of endotoxins.

From a survey carried on over 300 cases (10) …………..………., 72% of clinicians rated the treatment as good or very good and only 33% rated it as poor or very poor. Reasons for discontent were: the maggots failing to survive (it is now thought that this could be due to the acidity of the medium, an ideal pH being 8.5), the maggots escaping, or pain associated with the treatment (particularly in ischaemic leg ulcer, an already very painful condition) and, more rarely, bleeding of the wound. (11) Currently, maggot therapy is being used for pressure sores, leg ulcers, diabetic ulcers, traumatic injuries, burns, surgical wounds, and even malignant wounds. (12) Since February 2004, GPs in the UK have been prescribing sterile maggots, which can now be dispensed by chemists in the normal way.

1. Severe infection of leg stump – wet grangrene

2. Wound after one treatment with larvae

3. Wound after two treatments with larvae

10.9. Evolution of tuberculosis in the USA: 1892-2003  The graph shows the evolution of tuberculosis in the USA since the end of the nineteenth century. Describe it, making sure you use as many different tenses as you can and you relate the different trends to the various medical advances. • Sanatorium system (Europe 1850s, USA 1882) (rest, pure air, good food…) • Discovery of Mycobacterium Tuberculosis by Robert Koch (1882) • Discovery of x-rays (1895)

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PAST

0.3 0.2

2003

1997

2000

1990

1980

1970

10

1952

1947

1942

1937

1932

1927

0

1922

Reported cases of TB – United States

20

1917

• Screening for TB

30

1912

• DOTS (Directly Observed Therapy Short Course)

40

1907

• Deterioration of the public health infrastructure

rate per 100,000 population

• HIV / AIDS epidemic

1960

0.1

1902

• Multi-drug resistance T.B.

0.5

1953

• Immigration from countries where TB is common

0.7

1897

• Effective use of antibiotics (streptomycin 1944; isoniazid 1965; ethambutol 1962; rifampicin 1963…)

1.0

1892

• BCG (bacille Calmette-Guérin) first administered to humans 1921

rate per 100,000 population

UNIT 10 – TIME – PRESENT &

10.10. Diabetes mellitus  Before you read the text, make a list with your partner of 5 key issues concerning diabetes. Then check to see if they are the same as those mentioned. Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas or by the ineffectiveness of the insulin produced. Such a deficiency results in increased concentrations of glucose in the blood which in turn damage many of the body’s systems, in particular the blood vessels and nerves. There are two principle forms of diabetes: • Type 1 diabetes (formerly known as insulin-dependent) in which the pancreas fails to produce the insulin which is essential for survival. This form develops most frequently in children and adolescents, but is being increasingly noted later in life. • Type 2 diabetes (formerly named non-insulin-dependent) which results from the body’s inability to respond properly to the action of insulin produced by the pancreas. Type 2 diabetes is much more common and accounts for around 90% of all diabetes cases worldwide. It occurs most frequently in adults, although a growing number of cases is now being found among adolescents. Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) refer to levels of blood glucose concentration above the normal range, but below those which are diagnostic for diabetes. Patients with IGT and/or IFG are at substantially higher risk of developing diabetes and cardiovascular disease than those with normal glucose tolerance. The benefits of clinical intervention in patients with moderate glucose intolerance is a topic of much current interest.

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10.11. Osteoporosis

tarter

• The word Osteoporosis is made of two parts “osteo” and “porosis”. Can you explain the meaning of these two parts? • Can you explain simply what osteoporosis is? Check in the answer section.

 Read the text and then act out the role play suggested at the bottom. Read the advice below given to women who wish to have an investigation for osteoporosis. Arrange a longer consultation with your doctor so your doctor has sufficient time with you to take a detailed medical history and so that you do not feel rushed. When your doctor assesses your bone health s/he will need to establish whether you have particular risk factors for osteoporosis. Your doctor will take a medical history about your general health including: • calcium intake1, • level of exercise, • whether there is a family history of osteoporosis, • use of drugs such as prednisolone and thyroxine2, • history of thyroid disease, • smoking status, • alcohol intake, • caffeine intake, • menstrual history3, • menopausal status3, and • whether you have ever had a fracture, noticed a change in your posture or noted loss of height.

If your doctor establishes that you have significant risk factors for osteoporosis, then s/he may arrange the following tests.

1. The best sources of calcium are milk, cheese and yogurt, and certain types of fish which are eaten with the bones. A pint of milk a day, together with a reasonable amount of other foods which contain calcium, should be sufficient Vitamin D for the body to absorb calcium. 2. Corticosteroid therapy. 3. Women who have had an early menopause (before the age of 45), or a hysterectomy where one or both ovaries have been removed, are at greater risk (oestrogen deficiency).

UNIT 10 – TIME – PRESENT &

PAST

181

DEXA A Dual Energy x-ray Absorptiometry scan (DEXA scan) is a specialised x-ray technique, which specifically measures bone mineral density (bone mineral content) and provides the most accurate way to assess this. This is just like a normal x-ray with no pain involved. It is used to: • confirm the diagnosis of osteoporosis; • estimate severity of bone loss; • determine whether the patient is responding to treatment; • it is a fast scan, has high resolution, is easily reproducible and has a lower radiation dose compared to other methods. Usually only the lumbar spine (lower back) and proximal femur (hip region) are measured. PLAIN X-RAY A plain x-ray of your upper and lower spinal column (thoraco-lumbar spine) may be ordered to determine whether there are already features of osteoporosis affecting the spinal column (vertebral bodies). BLOOD TESTS It may also be necessary for you to have blood tests to look for any contributing causes for osteoporosis. This may involve assessment of vitamin D levels, calcium levels, thyroid function and other tests. OTHER TEST – ULTRASOUND

MEASUREMENT

Currently ultrasound tests are available at many pharmacies. This test involves an ultrasound measurement of the heel. Ultrasound tests are not as accurate in assessing for osteoporosis as a DEXA study and are not recommended by doctors.  Role play The aim of the exercise is to practice asking questions (see Unit 1). Work in pairs: one doctor and one patient. Using the information above, the “doctor” will take the “patient’s” medical history and suggest some tests. To make it dynamic the doctor should try and expand the questions and ask for details. The patient should improvise coherent answers (you could take a family member as a model). The “patient” should not just answer but also ask as many questions as possible.

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10.12. Quizzimage N° 10  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 10.13. Fossilization CONFUSING

WORD PAIRS

to grow to realize last experience

   

to grow up to carry out latest experiment

 Explain to your partner the difference in meaning. Check answers atG. Notes 9.  Associate each of the words below with one of the words above: YEAR



CLINICAL TESTS



SCIENTIFIC



EMBRYO



SUDDENLY





PERSONAL

CHILD



ALONG



NEWS

10.14. Flexing the lexis PREPOSITIONS

OF MOVEMENT AND SPACE

 Fill in the gaps with the most suitable prepositions: AROUND BESIDE





BEHIND



ON THE TOP OF



TOWARDS



BENEATH



ACROSS



THROUGH

1. Insert the needle of the hypodermic syringe the intercostal nerve is located.

…………………….

the rib where

2. Click on the button in the right hand corner …………………………….. the page. 3. If calcification occurs ………………………. the urinary tract, an intravenous urogram may be necessary for a decisive diagnosis.

UNIT 10 – TIME – PRESENT &

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PAST

4. A plasma drip was placed

…………………….

the patient’s bed.

5. If you hear a murmur, move the stethoscope cordium, noting where the sound is loudest. 6. The x-rays pass

…………………….

9. Chest pain located heart attack.

the pre-

the patient’s chest.

7. Blood in the main arteries flows 8. New blood vessels develop

………………………….

…………………….

…………………….

…………………….

the smallest arteries.

tumors.

the sternum is a major symptom of

10.15. Roots SYNONYMS

 Find a synonym of Greek origin for the following: • kidney disease • red blood cell • inflammation of the urinary bladder • nosebleed • falling sickness

• • • • •

pain-killer blood in the urine liver-toxic chemical absence of sweat agent that promotes the excretion of urine

10.16. Phonology – Sounds & Rhythm Student A (the text for student B is in the Annexe “Phonology notes”)  Read the text to your partner. ANTIMICROBIAL

RESISTANCE AND THE THIRD WORLD

The great upsurge in the spread of drug-resistant microbes over the past decade is undermining today’s efforts to control infectious diseases, as those once thought to be under control become increasingly resistant to available drugs. Although antimicrobial resistance affects industrialised and developing countries alike, the impact is far greater in developing countries. The switch from less expensive, first-line drugs to second or third-line drugs involves a dramatic escalation in the price, making some diseases too expensive to treat.

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Follow up 10.17. Web search: Functions – Present perfect simple / present perfect continuous  Search the web for 5 examples of the present perfect simple and the present perfect continuous forms. Note the contexts in which they are used and the associated time markers. Report back to the class explaining the difference in use. N.B. – To make search strings, choose a field of interest, then select a verb and put it between brackets.  < obstetrics “have been improving” >

10.18. Data search: Osteoporosis  Group work Share out the topics below (you don’t have to use them all) and consult a few websites to gather the information you are looking for and summarize it. Make a 3 minute OHP presentation to the rest of the group. • • • • • • •

epidemiology and pathogenesis causes factors associated with an increased risk of developing osteoporosis risk groups preventive strategies: diet, lifestyle, hormones therapies: recognized therapies, new therapies (such as strontium) osteoporosis in men

10.19. Phonology – Remedial work (see Annexe “Phonology notes”) 10.20. Self-test – Exit proficiency  Put the verbs in brackets into the correct verb form. 1.

The rate of surgical births (C-sections) is high in America. One of the reasons is that more and more women …………………………… (seek) to avoid vaginal delivery.

2. Workers …………………………………….. (be exposed) to asbestos throughout the 1950’s, 60’s and 70’s, long after doctors ……………………………………. (realize) it ………………………….. (cause) a new form of malignancy. 3. By using cowpox, which ………………………………….. (cause) a mild disease in human beings, to protect a person from the deadlier smallpox, Edward Jenner ……………………………….. (discover) vaccination in 1796. His method of injecting dead bacteria or their toxins ……………………………. (help) eradicate smallpox at the time. It ………………………………… (still be used) to protect against diphtheria, mumps, tetanus and other diseases.

UNIT 10 – TIME – PRESENT &

4. Lyme disease 1970’s.

PAST

……………………………………………..

185

(first be identified) in the late

5. Numerous studies ……………………………………… (so far / show) that exposure to passive smoking is a public health hazard, since it …………………………………… ………………… (increase) the risk of CHD (coronary heart disease). 6. Although management of diabetes in pregnancy …………………………… (steadily improve) over the years, women and their infants …………………………… (remain) at higher risk for a number of complications. 7.

Within the last ten years, researchers …………………………………………….. (develop) new medication to limit some of the effects of multiple sclerosis.

8. Only one HIV candidate vaccine ……………………………………… (complete) the full testing process (phases I, II and III) in more than 20 years of the epidemic. 9. H. K. Beecher ……………………………………. (study) as a medical student at Harvard when he …………………………….. (write) a paper on the pulmonary complications of anesthesia. 10. Adrenaline …………………………………………. (be used) in cardiac pulmonary resuscitation for more than 100 years, but it …………………………………… (become) controversial because it is associated with increased myocardial oxygen consumption.

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11. MODALITY

In unit 10, we studied the tenses and how meaning is expressed in relation to time. That is to say, we were basically concerned with describing the real world. However, things cannot be reduced to a simplistic black-and-white world of facts which are either true or untrue. Much of what we think and say, and particularly in science, is of necessity speculative, hypothetical. Modal verbs can be confusing as they are used in many different ways. They are a special linguistic category of auxiliaries which allow the speaker to express attitudes and opinions concerning notions of permission, possibility, probability and desirability. In medicine they have a particular role to play when dealing with areas of factual uncertainty and ethical controversy.

What do you know? – Self-test 11.1. When life is not worth living – Hunger strikes What have certain members of the following groups got in common with Mahatma Ghandi: women suffragettes, al Qaeda prisoners in Guantanamo, British animal rights activists, underpaid Indian doctors, American pastors protesting the embargo against Cuba? Like Ghandi, certain members of these groups have all resorted to hunger strikes in an attempt to bring “an intolerable injustice” to public awareness.

tarter

• Give examples of famous people who have gone on hunger strike. • What is the approximate limit for the duration of a hunger strike? • Sometimes prisoners are forcibly fed. Can that be justified?

 Read the text and replace the words in bold with synonymous expressions: PROBABILITY



TECHNICALLY POSSIBLE

A MORAL OBLIGATION PROBABLE







CERTAINLY

HAS THE CAPACITY TO





IS PLAUSIBLE



SUPPOSED

HAS NO OPTION BUT TO





HAVE

WE THINK IT IS

IS IT RIGHT FOR

Hunger strikes have existed since at least Roman times and although doubtless, few doctors have to deal with such cases, they occur more frequently than is commonly realized and, it can be assumed, they will continue to exist. In French prisons alone, more than 1,500 cases are reported each year.

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Despite the 1991 Malta declaration of the World Medical Association, which states that doctors should not “participate in any form of torture or cruel, degrading treatment, including forced feeding”, for many doctors it is not easy to remain neutral when confronted with self-destructive activity. The situation raises a whole series of questions including: whether it is ethical or not to artificially feed a ‘competent’ adult striker? When, in the last stages of a strike, a patient has lost consciousness, to what extent is it meaningful to call a patient “competent”? Ought the doctor to take into consideration the wishes of the family? There is a further problem. It is now becoming apparent that starvation is not a purely physiological phenomenon. Lack of food can trigger psychological transformations leading to personality change. In such cases it might be said that strikers are no longer reacting to “an objective injustice in the outside world”, but are trapped within a vicious circle of pathological depression. What occurs at a physiological level is fairly straightforward. In the absence of energy input, the organism must draw on the reserves within the body: triglycerides (85.3%) proteins (14.4% and glycogene (0.3%) reserves. During the first few days, the glycogen in the liver and muscles are used, resulting in glucagon-induced naturesis and substantial loss of weight (up to 600 gm / day). During the next phase, when these reserves have been exhausted, amino acids are used for glucogenesis leading to muscle loss.

Hunger strike by Kurdish refugees seeking asylum – Belgium

In the final stage, the only source of energy that remains comes from the breakdown of the fatty acids into ketones. Once these reserves have been exhausted, catabolism sets in, and from then, on avoiding long-term complications is sometimes no longer feasible.

The physiological deterioration is accompanied by behavioural transformations with increases in impulsivity and aggressiveness. Similar tendencies can be observed when examining other sorts of food deprivation such as studies of “therapeutic” starvation of clinically obese patients. Investigators report manifestations of psychiatric disorder including megalomania, auditory hallucinations, dissociation and suicidal tendencies. So the question is, if it is to be expected that manifestations enhance the likelihood of self-destruction, do they impair competence? Where does the patient’s integrity begin and where does it end?

Modality – Checklist A. The meaning of modals • Modals are a special category of words. They include: can / could, may / might, must, will / would, should / ought to.

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• Most modals have at least 2 meanings – a simplified presentation is given below. For a more detailed account seeG. Notes 18. • Modals give a different sort of information from other verbs. They allow a speaker to express the range of nuances of probability that lie between certainty on the one hand, and impossibility on the other. In an ordinary verb phrase when you say: “The patient has been cured”, you are giving information about the patient. With modals, the information is not about the action, it tells us whether the speaker thinks that the action is probable, possible, or desirable.  They may remove the tumor. (I think, there is a 50% chance of this happening)  They can't remove the tumor. (it is not possible)  They shouldn't remove the tumor. (in my opinion, it would be wrong) 1. WILL

 The metastases will spread. (this is a fact – there is no possible doubt) Meaning – Total certitude about a future event – probability “100%”. cf. – It is certain …

2. MUST

 There must be a cause for the disease. (I am convinced, but I have no proof)  She’s got a high temperature – she must be ill. (it is the only logical explanation) Meaning – Almost total certitude – probability “90%”. cf. – I am almost sure …

3. MAY

 She may have been contaminated by the Chernobyl cloud. (perhaps she was, perhaps she wasn’t) Meaning – There is a reasonable chance – probability “50%”. cf. – Perhaps  maybe …

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4. MIGHT

 The microbe might be resistant. (it is possible, but I would be rather surprised) Meaning – The difference between might and may is slight in modern English. However, might frequently expresses the notion of “reduced probability”. That is why it is often followed by “but…” – probability “30%”. cf. – Perhaps, but …  it is just possible …

5. SHOULD / OUGHT TO

 Doctors should / ought to report cases of child abuse. (it is a moral obligation)  You should eat less saturated fat. (if not, you will put on weight)  You should go and see the film. (it is a good film, it would be a mistake not to see it)  The blood test should be ready this evening. (if nothing abnormal happens) Meaning – The primary meaning of should / ought to is “what is right, good, normal”. cf. – It would be a good idea  it is advisable / desirable  it is to be expected / if nothing goes wrong  normally / theoretically / in principle …

6. CAN

 Hearts can be transplanted. (it is feasible, technically possible…)  He can play the piano. (he has the capacity, the skill…) Meaning – Unlike the previous examples, can and could do not express probability, but feasibility – what is intellectually, physically or technically possible. The feasibility is 100%. cf. – To be able to  to succeed in …

7. COULD

 It could be a nosocomial infection. (there are several possibilities – this is one of them) Meaning – Could expresses the idea that something is technically possible, but that it will not necessarily happen. It is just one hypothesis. cf. – It is a possibility  perhaps  maybe …

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N.B. – The distinctions in meaning between “could”, “may” and “might” are very small. In practice, when speaking of probability and possibility, they are used almost interchangeably.

B. Future and past time THE FUTURE

As modals give the speaker's assessment of the situation at the time of speaking, they can be used to talk about the future.  He might get a job with WHO next year. (my present opinion is that there is a slight chance of this for next year)

THE PAST

SUBJECT

+

Past modality is expressed by using the past infinitive. MODAL + HAVE + PAST PARTICIPLE

must  The surgeon should may

have

operated

two hours ago. last week. already.

C. Alternative expressions to suppose  to assume  to presume  to expect

it is probable  possible  feasible  likely / unlikely  doubtless / doubtful  It is doubtful whether they will find a cure for the disease within the next 10 years.  It is expected that animal models will speed up the search for effective therapies.

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Exercises 11.2.  Pair work Mini dialogues – Comment on the photos using past and present modals: MUST  MAY  MIGHT  SHOULD / OUGHT TO  CAN  COULD

Example: A - Why is she in hospital? B - She may have AIDS. (present) / She may have had a heart attack. (past) A - Why do you say that? B - She looks pale.

Oletchka: 14-year old Chernobyl victim

Rising health costs Femur fracture Evacuation by helicopter

Resuscitation

Depression

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11.3. Present and future time  Rewrite the sentences using the most appropriate modals: SHOULD / OUGHT TO  COULD  MIGHT  MUST  CAN  MAY

Example: The doctor is out. It is almost certain that he is at the hospital.  He must be at the hospital. 1. It is possible for intestinal bacteria to be the cause of cystitis.  Cystitis ………………………….………………………………………………………………...….... . 2. There is a chance that the ultrasound will not detect every ectopic pregnancy.  The ultrasound ………………………….…………………………………………………………... . 3. In theory, antibiotic therapy will reduce maternal or fetal infectious morbidity.  Antibiotic therapy ………………………….……………………………………………………….. . 4. It is essential to increase availability of palliative care in rural districts.  Availability of palliative care ………………….………………………………………………… . 5. When ill, women doctors are more likely than men to continue to work. It is perhaps possible that this reflects a sex difference.  When ill, women doctors are more likely than men to continue to work. This ……………………….…………………………………………………………………………………….. .

6. None of the victims was able to afford open heart surgery.  None of the victims ………………………….………………………………………………….… .

11.4. Past time (Modal + have + PP)  Complete the sentences with the appropriate modal (N.B. – Some examples are in the passive form, i.e. + been). 1. If it had remained undiagnosed, the allergic reaction ……………………………… led to serious medical consequences. (a strong possibility) 2. The operation …………………………………… caused trauma in the intestinal tissue resulting in blood in the stool. (this is scientifically inevitable) 3. The investigation indicated that there ……………………………… been gross medical negligence. (this seems to be the only explanation) 4. The immunological response ………………………………… triggered by unidentified exotoxins. (this is just possible, but I am not really convinced) 5. The symptoms …………………………………… treated much earlier before they had become acute. (this is a case of medical negligence) 6. The post-mortem indicated that the injection death. (it is technically excluded)

………………………………

caused his

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11.5.  Match the phrases in the left and the right hand columns. 1. Biopsies were performed on the patients 6 weeks later and cure was assumed …

•

• a. in the contaminated areas. b. capable of self-repair, otherwise they would not have survived.

2. After the injection it is highly unlikely …

•

•

3. Clearly, the first living organisms must have been …

•

• c. a peptic ulcer.

4. The decline in the death rate in the 1900s was doubtless due …

•

•

d. be screened every two years for bowel cancer.

5. People over 55 ought to …

•

•

e. above all to better nutrition and better housing.

6. If the symptoms include melena, vomiting and nausea, then you might have …

•

• f. for about one in three patients.

7. The incidence of cataract in children was much higher than expected …

•

• g. if all tests were negative.

8. Bone marrow transplant is only feasible …

•

•

h. that you can pass on rubella to anyone else.

11.6.  Modals are a way of expressing the speaker’s opinion about a particular event. Transform the following sentences, replacing the verb of opinion by a modal.

Example: I’m sure she has contracted AIDS.  She must have contracted AIDS. 1.

It is a possibility, but I am not quite certain, that triple therapy is more effective.

2. I know left ventricular failure (LVF) leads to pulmonary edema and orthopnea. 3. I advise you to have regular medical checkups. 4. It seems plausible that cross-infection has been caused by symptomless carriers.

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5. We know myocardial infarction is going to cause ST elevation on the ECG. 6. We didn’t transfer the patient to the intensive care unit (ICU). I wish we had. 7.

I advise diabetic patients not to take any hypnotic drugs.

8. It seems to me quite possible that the E. Coli infection was perhaps caused by urinary catheterization. 9. We oblige all theatre staff to maintain strict aseptic technique near the operating field. 10. I suppose autoimmune thrombocytopenic purpura is perhaps triggered by a viral infection such as measles.

11.7.  You’ll probably have understood by now that modals are often only a matter of degree. In all the following sentences, the wrong modal has been used. Replace each modal by a more appropriate one. When you have finished, compare your results with your partner, discuss the different answers proposed in the answer section, and try and explain the difference in meanings. 1. Hands can be thoroughly washed before changing a dressing. 2. Many structural chromosome abnormalities might be detected thanks to amniocentesis. 3. A nurse may have a sound knowledge of the use, action and side-effects of the drugs administered. 4. A biopsy of the swelling may be performed after surgery since it should be cancerous. 5. Hydrocortisone should also be administered intrathecally, but great care can be taken. 6. Epidural anesthesia is contraindicated in patients with coagulation defects, since it would cause an epidural hematoma. 7. A patient with hypertension may stop smoking. 8. Coagulation tests would be prescribed so that the patient must have an epidural anesthesia if needed. 9. You will choose to terminate your pregnancy if the ultrasound shows fetal abnormality.

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11.8. Antenatal screening

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If there is one topic in medicine that is controversial, it is the issue of the unborn child – a controversy that is considerably amplified by the technical know-how of modern medicine. Procedures like antenatal screening have opened up a Pandora’s box of hitherto non-existent choices and dilemmas. • Give examples of 3 important ethical issues related to antenatal screening.

 Ask questions about the underlined words and phrases using the associated modal in bold. While certain doctors and midwives feel morally justified in doing their utmost to save the lives of babies born on the margins of viability, there are others who perform terminations of pregnancy and feel they’re doing as they should. It is estimated that about two thirds of the women in the world may have access to legal abortion, whereas about one twelfth live in countries where it is strictly prohibited. In the UK, even though terminations of pregnancy are seldom performed after 12 weeks, abortion remains legal up to 24 weeks providing certain criteria are met (the act must be performed in a hospital or licensed clinic; two doctors must certify that the requirements for abortion have been met). A study carried out in Britain in 1995 showed that out of a total of 4,004 premature babies (20 - 25 weeks), 314 survived. It also reported that two and a half years later, half of that number were suffering from some form of disability. These statistics raise two conflicting questions. In the first place, it can be asked whether abortions should be performed at a stage when the baby can survive, and conversely, one may also wonder whether it is advisable to save babies who are at high risk of being disabled. Currently, abortions are being carried out on the grounds of minor disabilities, while major disabilities are being incurred by resuscitating extremely preterm infants. In the USA, it is estimated that about 30% of all pregnancies end in abortion. Bearing all these facts in mind, it is not surprising that the debate should be so vehement. When a woman becomes pregnant, she will routinely be offered a full array of blood tests and screening procedures, such as full blood count (FBC), blood group and antibody screen, hepatitis B and C serology, HIV serology, urinalysis, ultrasound screening, and in some cases amniocentesis and chorionic villus sampling (CVS), etc. High resolution scanning during the first trimester is now possible and is routinely done in many units. This means that not only chromosomal abnormalities but also

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structural anomalies can be diagnosed. Most women being offered these scans are at low risk of fetal abnormality and the scan constitutes their first visual encounter with their baby. Many believe that screening only provides information about gestational age and they are totally unaware both of the range of abnormalities that can be detected, and that, when scanning does detect an abnormality, there could be pressure for a quick decision to terminate so as to facilitate a suction termination. Under these circumstances, it seems reasonable to suggest that before having an early high resolution scan, pregnant women ought to be given a clear explanation as to the nature of the information that might be revealed, the degree of certainty about the information and the possibility of false positive and false negative diagnoses. Only then would she be in a position to choose not to have an investigation that could lead to the discovery of abnormality.  Follow up work Choose and discuss one of the ethical issues below. • Epidural anesthesia: How safe is it? What are the risks? Should it be performed as often as it is? • Minor abnormalities may be detected by scanning. How can one decide whether they are to be considered as grounds for possible termination of pregnancy? • HIV-positive mothers.

11.9. Shingles (herpes zoster)  Discuss the questions with your partner, answer them if you can, and then read the text to check. 1. Is shingles infectious or contagious? 2. Why are those undergoing chemotherapy at a higher risk? 3. What is the probability of developing shingles? 4. What accounts for the characteristic shape or pattern that the shingles rash has? 5. What do antiviral drugs do? 6. What is “postherpetic neuralgia”? What are the chances of getting it? 7. Why is it so important to treat eyes at an early stage?

Characteristic shingles rash

Shingles is neither a skin disease nor is it infectious. It is caused by the varicellazoster virus, the same that causes chickenpox. After contracting chicken pox, usually in childhood, the virus travels via the nerve pathways to the ganglia of the spinal or cranial nerves where is remains latent. If the virus is reactivated, it is usually in people over the age of 50, and it is often associated with a period of a weakening of the immune system, as is found typically with immunosuppressed patients,

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those suffering from AIDS, undergoing chemotherapy, organ transplants, stress or aging. More than 25% of adults will develop shingles during their lifetime. SYMPTOMS The initial symptoms of the disease may include a tingling sensation followed by pain in skin areas in the region of the chest, the neck, the lower back and legs. There may be fever, chill, headache and stomach upsets. About 5 days later, the skin reddens, a rash appears, and small fluid-filled blisters, similar to chicken pox blisters appear. Characteristically, the rash is often restricted to one side of the body and takes the shape of a semi-circular belt or band following the pathways of the infected nerve fibres. After a period of about 3 days, the blisters dry out, become yellowish in colour and a crust forms. At this stage, there is no further risk of contagion1 (of chicken pox). The total duration of a shingles episode is typically 2-4 weeks. TREATMENT There is no cure for the disease but treatment with antiviral drugs, particularly if they are prescribed within the first 3 days, can have a significant effect in reducing the duration and the severity of the symptoms. In most cases the pain can be treated with standard analgesics such as acetaminophen or ibuprofen. PROGNOSIS For young and otherwise healthy patients, the prognosis is excellent. However, for elderly people there is a risk of complications. Postherpetic neuralgia occurs in about 1 in 5 cases. This is characterized by chronic pain, extreme skin sensitivity which in certain cases may last a year and even more. The blisters occasionally cause permanent depigmentation. If eye infections are not treated at an early stage, the cornea may be scarred and vision permanently impaired.

11.10. Joint Statement from the Faculty of Public Health Medicine Royal College of Paediatrics & Child Health

tarter

In France, children are routinely immunized against a number of diseases. • Can you name some of these diseases? Do you know if immunization against these diseases is compulsory or only recommended?

 Read the questions, and then, working with your partner try and find answers in the text below.

1. “Contagion”: unlike chicken pox, shingles is not infectious and cannot be transmitted by coughing, sneezing, etc. It is, however, contagious and direct contact with blisters can cause chicken pox.

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 Questions 1.

What is MMR?

2. Who published the press release (in general terms) and why? 3. Why did these professionals feel it necessary to publish this statement? 4. What do these professionals refute? 5. What are their arguments in favour of the triple or combined vaccine? 6. What are the arguments against single vaccines? 7.

Are measles, mumps and rubella dangerous?

8. The last paragraph but one mentions “recent publicity”. What does this expression refer to? 9. What was MMR coverage before this “recent publicity”? 10. What are the consequences of this “publicity”? 11. What is the risk for the UK mentioned in the last paragraph and why is there such a risk? 12. What happened in Ireland?

PRESS

RELEASE

Joint Statement from the: Faculty of Public Health Medicine Royal College of Paediatrics & Child Health

PUBLIC HEALTH MEDICINE ENVIRONMENTAL GROUP Community Practitioners and Health Visitors Association

ENDORSING THE CONTINUED USE

OF THE

MMR TRIPLE VACCINE

Our professional bodies represent the doctors and nurses who are responsible for the health care of children in the UK and for advising parents on how they can best protect their children from infection. In January 2001 we issued a joint statement supporting the use of the triple vaccine MMR by parents. We, and in particular our specialists on childhood infection, have been continuing to monitor carefully all the relevant scientific data, and the uptake2 of vaccination. We have seen no new evidence that would make us change our advice to parents. Indeed, two new authoritative and independent scientific reviews of all the available data by the UK’s Medical Research Council and the American Academy of Pediatrics have found against there being an association between the MMR vaccine and autism, 2. Act of accepting, adopting, absorbing something.

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associated disorders or inflammatory bowel disease. The American review was asked its opinion on vaccine type and specifically advised against use of single vaccines. Our organisations therefore continue to support the policy of the Department of Health and the World Health Organisation that parents should continue to immunise their children with the combined triple vaccine for measles, mumps and rubella (MMR). There is a huge body of evidence that shows that the combined vaccine, which has been given to 500 million children worldwide in 90 countries, remains safe and effective. We note that no country in the world recommends use of single vaccines when MMR is available. Some parents are requesting single vaccines, which are unproven in both safety and effectiveness. In contrast MMR is now probably the best researched vaccine worldwide and its few, very rare side effects are well known. There has been little research conducted to ascertain whether single vaccines for measles, mumps and rubella could have significant side effects. We do not believe that it is sensible to subject children to six injections without good reason – whilst prolonging the risk of exposure in the interim to those diseases which they are still waiting to be vaccinated against. Hence we cannot support use of single vaccines by parents when there is a safer, effective, well-researched alternative, the MMR vaccine. Professor David Hall, President of the Royal College of Paediatrics and Child Health, said: “The MMR vaccine was introduced because these diseases can be serious – the supposed link between MMR and autism is completely unsubstantiated whereas there is absolutely no doubt that the diseases themselves can cause brain damage – as I know from my own experience over the past 30 years”. The latest data from the Communicable Disease Surveillance Centre, published in January, indicated that there had been a small recovery in uptake of MMR and that before the recent publicity, over three quarters of parents were choosing MMR for their children by age 16 months with over four fifths having the vaccine by two years of age.

Chicken pox

This recovery will now be prejudiced by the current publicity. Even so, levels are too low and, as we have seen in recent days, the UK is at a much higher risk of outbreaks of measles, mumps and rubella if children remain unprotected – which will lead to unnecessary suffering among both parents and children. Three children died in the recent Dublin measles outbreak and inevitably there will be some deaths and handicapped children if the levels of uptake of the MMR vaccine do not improve.

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 Debate The widespread use of vaccines has reduced the spread of many different diseases saving millions of lives every year. In the United States, for instance, according to official figures, before the polio vaccine, 13,000 to 20,000 children each year were stricken with the disease. Pertussis (whooping cough) can lead to pneumonia, seizures, and death in infants: prior to immunization, 260,000 cases of pertussis were reported each year, resulting in 9,000 deaths. Before vaccination for chicken pox began in 1995, chicken pox was responsible for four million cases, 11,000 hospitalizations, and 100 deaths each year. However, in spite of the benefits of immunization many parents choose not to immunize their children. Discuss some of the arguments presented by parents who decide against immunization (religious reasons, philosophical reasons, desire to remain free, disbelief in the effects of immunization, preference for alternative therapies, etc.). If necessary, look for arguments on the Internet.

11.11. Quizzimage N° 11  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 11.12. Fossilization CHECK

YOUR NUMERACY

 How do you say the following? (write down your answers and check in the answer section) FRACTIONS:

43  123  15,765  7–5 2 23  6 38

DECIMALS:

0.706

DATES:

04.03.2007

NUMBERS:

TELEPHONE

NUMBERS:

462201

PRICE:

$ 153

TIME:

9.05  14.45  16.30  17.55

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11.13. Flexing the lexis MULTI-WORD

VERBS

&

COMPOUND NOUNS

Certain compound nouns derive from multi-word verbsG. Notes 17. Example: “a medical checkup“ Sometimes the meaning may not be immediately obvious.  Supply the missing particle in the sentences below: AHEAD

1.



DOWN



OUT



THROUGH



BACK



UP

After an initial success during the first few months, the research program suffered a serious set …….. . (problem, reversal)

2. The laboratory has announced a major break (development, success)

……..

in anticancer therapy.

3. The maternity ward will have to be closed due to a cut ……. in government funding. (reduction) 4. As a result of the successful clinical trial, the gomarketing the drug. (permission to proceed) 5. The chief administrator asked for a print (paper copy) 6. He suffered from a serious nervous break and domestic friction. (collapse, failure) 7.

…….

…….

…….

has been given for

of the e-mail message.

as a result of work stress

The lay ……. and format of a research article is strictly defined. (organization, design)

8. The set system)

…….

for recruiting staff must be totally reorganized. (structure,

9. If the pill is taken more than 3 hours late, a back ……. method of contraception should be employed. (support, secondary) 10. Any improvement in the organization of the department depends on a more efficient feed ……. system. (system for taking into account and reacting to new information, criticism, suggestions…)

11.14. Roots AWKWARD

SINGULAR AND PLURAL FORMS

 Which of the following words are singular and which are plural? Give the other form(s): APPARATUS OVERDOSES



BACTERIA





PANCREAS

DIABETES





FEMORAVFUNGUS

PHENOMENA



TIBIA





METASTASIS

VERTEBRA



MYOCARDIA



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11.15. Phonology – Sounds & Rhythm TONIC

ACCENT AND PAUSING

This exercise is concerned with 2 things – tonic accent and pausing. To speak clearly and intelligibly, stress must be put on words of importance (usually nouns, verbs and contrasting words), and pauses must be made to separate the meaning units. Remember, pausing is the punctuation of the spoken language.  Read the sentences below to your partner trying to respect the rhythm, stress and pauses between the units. Pauses are indicated by ….. Stressed syllables are marked in red. • Clearly ….. the kidney damage was due to antibiotics. IklqFlq Ikqdnq dju : ,A AntqbaqIotqks • Was there an increase ….. or a decrease in the blood pressure? IqCkri : s Idi : kri : s blyd • In fact ….. when she finally left hospital ….. her cough was worse. fAkt IfaqnFlq Ihospqtl kof wE : s • The doctor found a swelling in the left ….. but not in the right knee. IdoktF(rr) IswelqC left not raqt • On the whole ….. colds are more serious in infants ….. than in adults. hFxl kFxldz mc : (rr) IqnfFnts IAdylts • The most important factor ….. is the nature of the damage. mFxst IfAktF(rr) IneqtHF(rr) IdAmqdG • The patient couldn’t move his leg ….. but the doctor told his wife IpeqHnt Ikxdnt leg IdoktF(rr) waqf to take him to hospital. teqk Ihospqtl

Follow up 11.16. Web search: Functions – Past modals  Make a web search for past modals in the field of health hazards. Use the following search strings: “might have caused”  “should have taken”  “must have been”.

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11.17. Data search  Class work – Organization of a seminar on subject A or B All students prepare a short presentation. Share out the subjects. On the day of the presentation, choose a moderator who will check that the time allocated to each presentation is respected. A. IMMUNIZATION AGAINST • • • • • • • • • •

DISEASES OF PUBLIC HEALTH IMPORTANCE

The benefits of immunization History of immunization Commonly used vaccines (Global) immunization coverage (choose a few vaccines) Vaccines under development How vaccines work Types of vaccines Effectiveness and safety The cost-effectiveness of immunization & the cost of immunizing a child The European Immunization week

B. PRESENTATION OF SOME VACCINE PREVENTABLE DISEASES Choose an individual vaccine preventable disease. Prepare a short presentation of the disease: description of illness (signs, symptoms), complications, transmission, epidemiology, treatment, recent outbreaks, prevention… (use Fact sheets under Health Topics on the WHO site for example).

11.18. Phonology – Remedial work (see Annexe “Phonology notes”) 11.19. Self-test – Exit proficiency  Fill in the gaps with modals (1-5) or lexical forms (6-10). 1.

The standard PSA test ……………………. diagnose prostate cancer but only assess the risk. (is incapable)

2. The dramatic fall in appendicectomy rates ……………………. been due to more accurate diagnosis and increased use of ultrasound examination. (was almost certainly) 3. Whooping cough ……………………. also lead to complications, such as bronchiectasis, pneumonia and ear infections. (it is perhaps the case) 4. The Royal College of Obstetricians recommends that all women with IUDs ……………………………. be routinely screened for chlamydia, and other anaerobes. (it would be a good idea) 5. The National Cancer Institute suggests that thousands of cases of thyroid cancer ……………………. been caused by fallout exposure. (this is one of the possibilities)

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6. When prescribing for the elderly, it is wise to as……………………. at least a mild degree of renal impairment. (adopt as a hypothesis) 7.

It is ex…………………………. that 5 -7% of students will fail the test. (it is thought probable / normal)

8. According to the ophthalmologist, earlier treatment would do……...………………. have improved the prognosis. (unquestionably, clearly) 9. Heart transplantation is not considered a fe…………………………. treatment for patients with chronic refractory angina pectoris. (technically possible) 10. In Dr Winter’s opinion, it is highly li……………………. that the cancer was induced by exposure to post-Chernobyl ionising radiation. (probable)

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

12. HYPOTHESIS

Hypothesis has a privileged place in scientific and medical research, and although it may be true that a great many medical breakthroughs in the past have been the result of “trial and error” (the discovery of penicillin, small pox vaccination…), researchers (and the rest of us) more often turn to conscious elaboration of exploratory hypotheses. It is the conditional form which offers a platform for this “fictional” world of the potential, the contingent and the speculative as can be seen in the following example:  When the child was sedated, it had difficulty breathing.  If the child was sedated, it would have difficulty breathing.

The first case deals with the real world, and the child in fact suffered. In the second, it did not; it was not sedated.

What do you know? – Self-test 12.1. “To help, or at least to do no harm.”

tarter

“To help, or at least to do no harm", this rather plaintive appeal by Hippocrates (it is not part of the Hippocratic oath as is widely believed) is a reminder that one of perennial problems of the doctor is that it is the practice of medicine itself that can be the cause of ill health and death. We should not forget that our chances of dying at the hands of a physician are considerably higher than of dying on the motorway. • Give examples of medical errors that you have heard of. • What would you say are the main causes of medical error?

 Locate the 6 conditional sentences in the text and explain: – how they are formed, – their meaning.  Replace the four words in bold by synonymous phrases. “Do American hospitals get away with murder”? (Business & Health, 2000) Headlines of this sort are generally considered as little more than a hysterical reflection of media

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sensationalism: a reflection of the old journalistic adage, “If it bleeds, it leads1”. Consequently, the profession has systematically ignored and brushed aside such comments. However, the BMJ in a recent article argues that, if progress has been made in the field of medical errors (otherwise called “preventable adverse events”), it is almost entirely thanks to the intervention of the media. The traditional public image that the medical profession has fostered has been one of the infallible provider, a safe, magnanimous benefactor, wholly dedicated to the population’s needs. But, according to the BMJ, denunciation by the media has been a prerequisite of reforms that, alas, could have been carried out many years earlier, if the profession had wanted to. Particularly important, in this respect, was the media outrage following the publication of the 1999 “Institute of Medicine” report admitting the possibility of up to 98,000 preventable US deaths a year: more than road accidents and breast cancer combined. In Australia, a similar report attributed 17% of hospital admissions to adverse events.

100,000 90,000 80,000 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 hospital errors

auto accidents

workplace accidents

air crashes

Errors range from wrong site surgery in mastectomy and arthComparison of causes of death roscopy with intervention on the wrong organ, to mistaking a dialysis catheter for a feeding tube and pumping food into the abdomen, child deaths resulting from unnecessary tonsillectomies and various medication errors including fatal overdoses of cisplatin in breast cancer chemotherapy. Those responsible for the mistakes include physicians, nurses, and administrative staff. The number and gravity of errors stems from a variety of factors. First and foremost, perhaps, is the breakthrough in drugs and surgical techniques since World War II. Clearly, if the power of technology increases, error risks will be correspondingly greater.

urinary tract 13%

surgical wounds 50%

16%

respiratory 21% septicemia

Most frequent types of adverse events

Other well-documented causes include: emotional stress, overwork and fatigue, the unwillingness and structural difficulty for nurses to question doctors’ actions, and the complexity of medical procedures. The general consensus now is that, fundamentally, these alarming figures are not due to inexperienced clinicians or substandard medical care, but rather to communi1. That is to say, if the news refers to murder or death, it goes on the front page.

UNIT 12 – HYPOTHESIS

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cation breakdown. To deal with the problem successfully, it is essential to understand that errors result, above all, from faulty systems, not from faulty people. Unless an atmosphere of openness can be instilled, and the culture of silence overcome, nothing will be attained. If practitioners were given greater encouragement to report errors voluntarily, so that we could learn to face the nature of the problem more openly, then, at least, it would be possible to make a start on improving these alarming statistics.

The conditional – Checklist A. Verb forms There are four different forms of the conditional. 1. THE TIMELESS CONDITIONAL IF

+

PRESENT

/ PRESENT

PERFECT

+

PRESENT

 If water boils, it is safe to drink.  If water has boiled for ten minutes, it is sterilized. Meaning: Conditions which are invariably true – therefore timeless. Typically used to express scientific facts and logical links. 2. THE FIRST CONDITIONAL IF

+

PRESENT

/ PRESENT

PERFECT

+

FUTURE (WILL)

 If you boil the water, it will be safe to drink.  If the virus continues to spread, there will be an epidemic. Meaning: Potential future events and situations. Used for predictions, possible consequences and warnings. 3. THE SECOND CONDITIONAL IF

+

PAST

+

CONDITIONAL (WOULD)

 If you boiled the water, it would be sterile.  If he specialized in tropical medicine, he would find a job in Africa. Meaning: Speculation, unreal or imaginary situations which will not necessarily happen. N.B. – The difference between 2 and 3 is not a difference in time – it is a difference in the probability of the condition.

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4. THE THIRD CONDITIONAL IF

+

PAST PERFECT

+

PAST CONDITIONAL (WOULD HAVE

+ P.P.)

 If Fleming had not discovered penicillin, millions would have died.  If the population had been vaccinated (passive form), the epidemic would not have spread. Meaning: Reference to events and results in the past that did not occur because the conditions were not fulfilledG. Notes 7.

B. Conjunctions “If” is not the only conjunction used to introduce conditions. POSITIVE CONDITIONS

if  provided / - ing  on condition that NEGATIVE CONDITIONS

unless  except if  otherwise

C. Lexical expressions There is a restricted number of lexical expressions which implicitly have a conditional meaning. • a requirement  a prerequisite • to depend on  to require  to entail  to imply • it is necessary  essential  The age of menopause depends on hereditary factors. (If the mother…)  Agreement between patient and surgeon is a prerequisite for successful plastic surgery. (If not…)

Exercises 12.2.Pair work  Each person thinks of 2 conditional phrases to exemplify timeless conditionals. Give your partner two key words from your phrase and ask him to make a sentence.

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Compare the answer to your original phrase. Example: A - If the patient is ill, his temperature rises. (temperature / rises) B - “If the temperature rises, icebergs melt.” Do the same thing for the 3 other forms of the conditional.

12.3.Pair work  Look at the pictures and in turns, ask and answer two or three hypothetical questions. A. Timeless conditions – scientific statements and logical propositions Example: What happens to children if …?

Third world starvation

B. First conditional – predictions and warnings (will + provided)

Access to safe drinking water

C. Second conditional – speculation, imaginary hypotheses (would + on condition)

Leper with warning bell – 14th century manuscript

D. Third conditional – past events that did not occur (would have + unless)

Louis Pasteur in his laboratory

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12.4.  Match the sentences in the two columns below. a. providing that the drugs are administered three times a day.

1. It would not have been necessary to remove the prostate …

•

•

2. Most nuclear medicine examinations …

•

• b. unless specifically requested.

3. Hardly anyone with a disc condition would choose surgery …

•

• c. if it is non-coercive.

4. Szasz is not opposed to the practice of psychiatry …

•

• d. if there was any alternative.

5. To be moderately overweight constitutes only a slight risk …

•

•

e. if the biopsy had been negative.

6. After a period of intensive therapy exercise should be continued …

•

•

f. on condition that they are at least 23 years of age.

7. The results are excellent …

•

•

g. otherwise there is a risk of relapse.

8. A thorough knowledge of normal function is …

•

•

h. require approximately 45-60 minutes of imaging time.

9. Please note that the publishers will not return electronic material submitted for publishing …

•

•

i. except if you have diabetes, or high blood pressure.

10. Candidates for the postgraduate course may be allowed to enroll …

•

•

j. a prerequisite to understanding disease.

12.5.  Transform these sentences into conditionals using the appropriate tense.

Example: The production of insulin requires an intake of carbohydrates.  Provided carbohydrates are assimilated, insulin is produced. 1. The physician said that to avoid a miscarriage it was essential that the patient should rest.  He said that unless the patient ………………………………………………………………… ………… …………………………….…………………………………………………………….........… .

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2. He said that the child’s life depended on organ donation.  Provided an organ ………………………………………………………………………………… ……………………………………………………….…………………................……………………… .

3. To be successful, the treatment for obesity entails a rigorous 3-month diet.  If you want …………………………….……………………………………………………………… …………………………………………….………………………………………………….............…… .

4. The majority did not survive. This was due to the fact that they had no access to medical treatment.  If they …………………………….……………………………………………………………………… …………………………………….………………………………………………………………......…… .

5. Basically, good health implies that a person has access to safe water, adequate food, and a decent standard of living.  Unless ………………………….…………………………………………………………...…………… …...……………………………………………………………………………………………….......…… .

6. It is imperative that a common set of guidelines should be formulated.  …………………….……………………… otherwise …………………………………………… ……………………………………………………………………………………………………………... .

7. One of the conditions of entering the medical school was that candidates had been vaccinated.  They would be admitted to …………………………….……………………………………… ……………………………………………………………………………………………………………… .

8. Hypnosis requires the patient to relax and free the subconscious mind.  Unless the patient …………………………….……………………………..……………………… …………………………………………………………………………………………………………...… .

12.6.  Make conditional chains (the consequence of sentence 1 becomes the condition of sentence 2).

Example: If she ate fewer carbohydrates ……….…… a) If she ate fewer carbohydrates, the pancreas would produce less insulin.  b) If the pancreas produced less insulin, fewer fatty acids would be absorbed.  c) If fewer fatty acids were absorbed, she would lose weight.  Choose the hypothesis that you find most interesting (only one) and write a chain of consequences. Then invent a chain of your own and propose it to your partner.

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1. Timeless conditionals (pres. + pres.) LOGIC AND SCIENTIFIC PROPOSITIONS

If a blood clot forms  If you use a stethoscope  If the pulse rate increases a) If

........................................................................................................................………………………....

b) If

.......................................................................................................................………………….......

c) If .............................................................................................................………………................ 2. First conditional (pres. + will) FUTURE EVENTS, PREDICTIONS, WARNINGS

If the virus becomes resistant  If the number of nurses decreases  If there is a lack of vitamins a) If

........................................................................................................................………………………....

b) If

.......................................................................................................................………………….......

c) If .............................................................................................................………………................ 3. Second conditional (past + would) SPECULATION, IMAGINARY SITUATIONS

If government funding for research decreased  If a cure for Aids was discovered  If the needle was infected a) If

........................................................................................................................………………………....

b) If

.......................................................................................................................………………….......

c) If .............................................................................................................………………................ 4. Third conditional (past perf. + would have) PAST EVENTS WHICH DID NOT OCCUR

If anesthetics had not been discovered  If the blood test had been positive  If I had studied at Harvard a) If

........................................................................................................................………………………....

b) If

.......................................................................................................................………………….......

c) If .............................................................................................................………………................

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12.7.  Make three sentences with each set of phrases, then discuss with a partner in which specific situation (time and place) each would be appropriate.  MAINTAIN  PATIENT  SURVIVE 1. If cardiopulmonary resuscitation is maintained, the patient will survive. (resuscitation is being performed)

Example:

CARDIOPULMONARY RESUSCITATION

2. If cardiopulmonary resuscitation was maintained, the patient would survive. (the medical team is about to abandon resuscitation) 3. If cardiopulmonary resuscitation had been maintained, the patient would have survived. (resuscitation has been stopped, the patient is dead) 1.

NURSE

2.

PATIENT



KNOW





PATIENT ALLERGIC

BE TOLD



FETUS





NOT ADMINISTER ASPIRIN

DOWN SYNDROME



CHOOSE TO HAVE A TERMINATION OF

PREGNANCY

3.

PREVENTIVE ANTICOAGULANT THERAPY

(DEEP VEIN THROMBOSIS) AND 4.

NURSE



FIND OUT





START



EARLY



PATIENT



NOT DEVELOP DVT

PE (PULMONARY EMBOLISM)

BLOOD DONOR AND RECIPIENT GROUPS NOT COMPATIBLE



NOT START

TRANSFUSION

5.

CHILDREN NOT PROVIDED WITH A BALANCED DIET



SUFFER FROM MALNUTRITION

12.8. Acute mountain sickness  Read the text below, insert the correct phrases in the right blanks, putting the verb into the correct tense each time: IF HE (COMPLAIN) OF SEVERE HEADACHE  PROVIDING IT (BE) RECOGNIZED AND MANAGED PROPERLY  THERE (BE) AN INCREASING DEMAND ON DOCTORS TO GIVE ADVICE  IF CLIMBERS (ALWAYS TAKE) THIS BASIC PRECAUTION  IF A SENSIBLE ALTITUDE GAIN (BE) OBSERVED  IF NO TREATMENT (BE) UNDERTAKEN  UNLESS THERE (BE) GOOD REASONS FOR THINKING OTHERWISE  THEY (GREATLY REDUCE) THEIR CHANCES OF BEING ILL If more and more people are to travel to high altitudes, ……………………………………………………………………………… ………….. to those planning mountain excursions above

2,000 meters, or to provide help for patients when travelling. Acute mountain sickness (AMS) is common but preventable ……………………………………………………… ………………………………. . When it does occur, it usually remains mild and self-limiting ………………………………… ……………………………………………… . For most travellers, altitude related illness is an unpleasant but benign syndrome, consisting of headache, anorexia, nausea, weakness, dizziness, breathlessness on exertion and

High altitude climbing

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insomnia. These non-specific symptoms may be attributed to other conditions, but when they occur six to twelve hours after arrival at a new altitude, they should be interpreted as possible AMS …………………………………………...………………………………. . Symptoms will normally resolve quickly if appropriate action is taken such as: resting, stopping the ascent, taking analgesics (acetaminophen, ibuprofen) and antiemetics (metaclopramide). ………………………………………………………………………………… or if the symptoms do not resolve, signs of HACE (High Altitude Cerebral Edema) may appear, and emergency treatment is immediately required. Typical symptoms of HACE are breathlessness at rest, cyanosis, a dry cough which soon becomes productive, and crackles on auscultation. A patient should be suspected of suffering from HACE ……………………………………………………………………………………..………… or if he becomes confused, ataxic, irrational, lethargic or sleepy. However, the most effective prophylaxis is to allow time for the body to acclimatize. If, at heights above 3,000 meters, mountaineers never climbed more than 300 to 600 meters per day …………………………………………………………………………………………… ……………………… and, in the past, a considerable number of lives would have been saved ……………………………………………………………………………………………………......…… .

12.9.Apocalypse tomorrow

tarter

There have always been prophets of doom2, warning that we should fear the future and that the end is near. However, it is unexpected that the origin of such ominous predictions should be the highly respected “Council of Foreign Affairs”.

 Read this short text and then, working in groups, develop the implications of the conditional phrases taken from the web that are in the box below. PANDEMICS Since antiquity, the greatest threat to mankind has been disease, not war, and when disease comes in the form of pandemics, it can totally disrupt society. A large number of people are now convinced that some sort of pandemic is, in the short or mid-term future, inevitable. Recent estimations report that the 1918-19 Spanish flu pandemic killed between 50 and 100 million people, the majority of whom were 18 to 40 years old and largely healthy. According to the “Council of Foreign Affairs”, when these figures are extrapolated to the modern population, they yield mortality figures of up to 360 million. If such is the case, it is clear that a major outbreak in the near future would bring panic, chaos, and at least temporarily, change society as we know it.

2. The end of the world – the last judgement.

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217

the Government would require … 25% of businesses would be … would trigger greater devastation than a tsunami …

broadcasters and journalist would …

the long-term effects would include … it would be a disaster for …

the most immediate personal impact would be a …

doctors would be expected … priority would be given …

older members of the population would …

the impact on the developing countries would … quarantine control strategies would …

12.10. Migraine  The order of the words in the sentences below has been mixed up. Reorganize them and insert them into the text. 1. attacks are be likely migraine of to social 2. by collected 151 data from questionnaire 3. claimed group have the to weekend whole 21.9% 4. from of tension-type the suffered but women 23% 5. support attacks are idea that the results weekend Migraine it is the most common neurological condition in the developed world. It affects over 15% of the UK population and is more prevalent than diabetes, epilepsy and asthma combined.

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The principal reasons for a predominantly weekend incidence……………………………… or psychological in origin. There may be another factor. This study examines the use of caffeine containing substances. We ………………………………………………………………………………… migraine clinic patients with the diagnosis of migraine or tension type headache. Of ………...…………………… …………..………………………………………………………………… attacks, with relatively more male than female patients. The males amongst these were all migraine patients, ……………………………………………………………………………………………………… headache. Patients with both a high daily caffeine intake and excessively delayed wakening at weekends (each defined as greater than the mean for the whole group) had a 69% risk of weekend headache. This compared with 4% in patients exceeding the mean in one only, and zero in those with moderate habits in both. These ……........…………… .....…………………………………………………………………………………………… linked to caffeine withdrawal. Sleeping in is not on its own a significant cause. We suggest that this possibility should be considered in clinical management of affected patients. ……………………………………………………………………

12.11. Abstracts

tarter

• Explain to your partner what an abstract is. Together, try and make a good definition.

 • • •

Read abstract N° 1 below: Describe the outline. What are the characteristics of this type of scientific writing? What is the subject of the abstract (in your own words)? International Symposium on Drug, Food and Natural Health Product Interactions

ABSTRACT N° 1 David G. Bailey, Research Scientist Department of Medicine, Lawson Health Research Institute, London Health Sciences Centre and University of Western Ontario, London, Ontario, Canada

CURRENT UNDERSTANDING OF MECHANISMS AND CLINICAL RELEVANCE OF FOOD – DRUG INTERACTIONS: FROM INACTIVATION OF DRUG METABOLISM TO INHIBITION OF DRUG TRANSPORT The public generally considers natural products, like foods and herbal medications, to be safe and advantageous for human health. That these substances are not formally regulated contributes to the popular opinion that they are entirely innocuous, which may not be always true. In some cases, there is the potential for drug interactions, sometimes with adverse clinical outcomes. The focus of this presentation will be grapefruit, which will include the discovery of the original interaction and the multiple possible mechanisms of modulation of biological processes that regulate the disposition of numerous drugs. There will be a discussion of inactivation of drug

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219

metabolism mediated by intestinal, compared to hepatic, cytochrome P450 3A4 (CYP3A4), a crucial enzyme estimated to be involved in the elimination of 50% of all drugs. It will address our current understanding of the effect on the intestinal and hepatic efflux transporter, P-glycoprotein. Moreover, recent research findings will be presented on the action on intestinal active uptake of drugs mediated by organic anion transporting polypeptides Grapefruit (OATPs). Where possible, issues addressed for each mechanism will include inter-individual variability and reproducibility in the extent of the pharmacokinetic interaction, influence of age of individual, class of affected drugs (known and predicted), active ingredients in grapefruit and clinical implications (importantly affected medications, potential alternative non-interacting drug, volume and duration-effect relationships) and other similarly acting foods. Finally, consideration will be given to the accuracy of current labelling and cautionary statements based on known scientific information.  Now read Abstract N°2 and compare the outline and characteristics of Abstract N°2 with those of Abstract N°1. What is the subject of abstract N°2 (in your own words)? ABSTRACT N° 2 Richard B. Kim, Professor of Medicine and Parmacology. Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA

MOLECULAR BASIS

OF

HERBAL-DRUG INTERACTIONS

Herbals products have been widely utilized for centuries to treat a variety of illnesses. For example, extracts of the resin of guggulu tree have been used to treat ailments ranging from obesity to lipid disorders, while the Chinese herbal mixture Yin Zhi Huang has been used to treat neonatal jaundice. However, like drugs, herbal products are increasingly recognized to have unexpected adverse interactions, particularly when combined with drugs. Indeed, ingestion of St John’s wort has been shown to cause induction of drug metabolism and loss of therapeutic efficacy for a number of concomitantly administered drugs. Recent studies clearly suggest many herbal remedies contain constituents that interact with proteins that regulated the expression of drug metabolizing enzymes and transporters called nuclear receptors. Specifically, activation of xenobiotic responsive nuclear receptors such as Pregnane X Receptor (PXR), ConstiSt John’s wort 3 tutive Androstane Receptor (CAR), and Farnesoid 3. French translation: millepertuis.

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X Receptor (FXR) appear to account for both the therapeutic as well as adverse effects of many herbal remedies. Accordingly, a better understanding of nuclear receptor biology may help in identifying herbals likely to cause clinically relevant herbal-drug interactions prior to their widespread use.

12.12. Quizzimage N° 12  Describe and comment: case (diagnosis), causes, settings, consequences (prognosis).

Back to basics 12.13. Fossilization “TO

TRANSFORM

/

TO TURN“

 Answer the questions. • What happens to glucose if it is not used? (is turned / fat) ……………………………………………………………………………………………………………

• What happens to the cells? (are transformed / malignant tumor) ……………………………………………………………………………………………………………

Check your answers.  Give 4 examples of transformations using the passive form: is / was / were  transformed / changed / turned (e.g. Nutrients  Mass …).

12.14. Flexing the lexis MULTI-WORD

VERBSG. Notes 17

 Put the part of the sentence in brackets in the correct order. The meaning of the verb is indicated in the column on the right.

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221

1. In cases of photophobia, it is important

………………… …………………………………………………………………………

(out / find / to / light / if) makes the eye feel painful or just uncomfortable.

discover

2. Obviously, when I go into the operating theatre ….…… …………………………………………………………………………… ………………… (and / hijab / I / off / on / take / my / put)

remove

green theatre scrubs. 3. When in doubt, ………………..…………………………………… ………………………………… (drug / you / dosages / look / should / up) side effects, and interactions.

check in a medical manual

4. Palliative caregivers

……………………………………………… …………………………………… (impact / cope / the / help /

confront

psychological / patients / with) of approaching death. 5. The German government will supply ……………………… …………………………………………………………………………

(into / long / look / to / effect / the / term / funds) of doping in athletes.

investigate

6. More patients are using the internet ……………………… …………………………………………………………………………

verify

(physicians’ / on / to / up / prescriptions / check). 7. Every effort should be made to encourage women to ………………………………………………………………………

reduce

(their / during / down / smoking / on / cut) pregnancy. 8. Students particularly …………..………………………………… (clinical / forward / starting / look / medicine / to).

are impatient for

9. The waiting list is long so don’t ……………………………… …………………………………………………………………………

delay

(an / asking / off / put / appointment / for).

12.15. Roots PREFIXES,

ROOTS AND SUFFIXES

 Build up as many words as you can using elements from the table below. For example, dialysis consists of a prefix (dia-), a root (lys) and a suffix (-is); more than one element of each category may be used.

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Prefix

COMPETENCE IN MEDICAL ENGLISH

Root

d i a -  e p i -  i n -  arthr  carb  ced  post-  pro-  re-  e c  fe c t  g n o s  unhydr  hygien  lept  malign  mast  neur  oper  pulmon  scop  spir  stat  stol  tom  tonsil(l)

Suffix -al  -at(e) -ious -ory 

-ant  -ic  -is -ure 

 -ary   -ion   - i ve  -y

12.16. Phonology – Sounds & Rhythm Students A & B (the text for student C is in the Annexe “Phonology notes”)  In this exercise, students A & B read the dialogue, while student C monitors. THE

CASE OF

NANCY BAXTER

A. The case concerns a schoolgirl. B. How old was she? A. 14. One day, she was having lunch at home with her father, when suddenly she began to have difficulty in breathing. B. Were there any other symptoms? A. Her lips and mouth turned blue. B. And what did the father do? A. He called the ambulance and they came at once. B. They examined her I suppose? A. Yes. She had tachycardia, a blood pressure of 90/65, and her skin was flushed. B. What happened then? A. She collapsed, went into shock and was rushed to hospital. B. Was she given any treatment? A. Yes – intramuscular adrenalin – but she wasn’t responsive. She was dead on arrival. B. What about her history? A. Well, basically – she was in good health. A year ago, she had mild asthma and she always carried an inhaler. B. Anything else? A. Yes – She suffered from eczema and took cortisone. She was also allergic to penicillin and nuts. Peanuts

UNIT 12 – HYPOTHESIS

223

Follow up 12.17. Web search: Functions – Hypothesis  Find 5 interesting medical examples on the web of passive 3rd conditionals (events which did not occur because the condition was not fulfilled). Use “would have been” as a search string.

12.18. Data search: Abstracts  Work in pairs or small groups. Each group chooses a phrase: “Abstract writing”, or “Scientific abstract” or “Abstract” + the name of a medical or scientific field. Type your phrase into a search engine. Look at the results, take notes and report to the class.

12.19. Phonology – Remedial work (see Annexe “Phonology notes”) 12.20. Self-test – Exit proficiency  Supply the missing synonyms (1-6) and the appropriate verb forms (7-10). 1.

A doctor should never withhold relevant information from a patient un……………………… he thinks there is a risk factor. (except if)

2. Emergency endoscopic sclerotherapy en……………………… injection of sclerosant into the variceal columns. (involves) 3. The mumps vaccine is effective pr……………………… a booster is administered within 10 months. (on condition that) 4. At the first signs of allergy, the treatment must be interrupted, ot…………………… it might prove fatal. (if not) 5. The Ottawa Charter for Health Promotion recognises peace as the first pr……………………… for health. (condition) 6. It is unfortunate that the term “patient” im……………………… passivity at best, and “sufferer” at worst. (suggests) 7.

If there was a pandemic, there hospital beds. (to be)

…………….…………………….

an acute shortage of

8. The TB infection would have been detected weeks ago if a blood test ………………….………………. available. (to be) 9. If the drug is well tolerated, the pharmaceutical company .………………. to carry out clinical tests. (proceed) 10. Doubtless Freud (to explain)

………………….……………

………………………

this behavior by the Oedipus complex.

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

ANSWERS

UNIT 1

Exercises  1.1. Describing (N.B. – Don’t read this answer until you have done Exercise 1.2) Model answer: A stethoscope is a kind of listening device, widely used by doctors for auscultation. The instrument is basically Y-shaped with a long curved tail. The head consists of a flat, hollow cylinder covered underneath by a thin diaphragm made of aluminum or plastic which is placed on the patient’s skin to listen to sounds inside the body. The sound is conveyed along a narrow, flexible tube which divides into two rigid, metallic or plastic tubes through which the sound is conveyed to the rubber earplugs located at the end of the tubes.

 1.3. A syringe is a device that consists of a hollow tube and piston made of glass or plastic for injecting drugs. The eye is a soft, globe-shaped, hollow organ which is basically composed of three elements: the lens, the retina and the optic nerve. It is located in its orbit in the front of the skull.

 1.4. ICDs STARTER Cell phones – Manufacturer’s Warning In certain cases, a cellular phone could affect an ICD or pacemaker’s operation if it

is closer than 6 inches (15 cm) to the implanted device. This interaction is temporary, and moving the phone away from the implanted device will return it to proper function. To reduce the chance of any interaction, follow these precautions: • maintain a distance of at least 6 inches (15 cm) between the cellular phone and the implanted device. If the phone transmits more than 3 watts, increase the distance to a minimum of 12 inches (30 cm); • hold the cellular phone on the opposite side of the body from the implanted device; • don’t carry a cellular phone in a breast pocket or on a belt if it places the phone within 6 inches (15 cm) of the implanted device. These precautions apply only to cellular phones, not to household cordless phones. EXERCISE – VOCABULARY Cardiac arrhythmia which is a fairly common complaint comprises any abnormality in the rate or rhythm of myocardium. ICD therapy, however, is usually only prescribed for patients whose condition is serious and who have undergone episodes of ventricular tachycardia or ventricular fibrillation. Although there is a wide variety of different ICD systems, the sophistication of modern technology means that today, the majority are multimode; they can be used either as simple cardiac monitors without delivering any electric stimulation, as pacemakers to regulate the heart rate in cases of bradycardia, or for defibrillation in cases of tachycardia.

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ICDs consist basically of three main parts. Firstly, there is the electronic component, including a sensor, a timing circuit, a pulse generator, and a lithium battery with an expected life of roughly 6 years. This circuitry is located inside a hollow, oblongshaped case made of titanium, about 4 cm long and 1 cm thick. Finally, the device is connected to the heart via thin, flexible, insulated wires with electrodes at the tips which conduct the electrical impulses between the system and the heart. As can be seen in the figure on the righthand side of the page, the lithium case is implanted subcutaneously, typically just beneath the clavicle. The endocardial electrodes are passed into the venous system, generally through the subclavian, axillary, or cephalic vein, and advanced to the right ventricle and/or atrium, thereby avoiding the need for open-chest surgery.

 1.5. 1./b  2./i  3./a  4./c  5./g  6./e  7./f  8./d  9./h

 1.6. Possible answers (as found in the glossary): 1. CARDIOMYOPATHY: a group of disorders in which … the heart muscle is weakened and cannot pump blood efficiently. 2. AORTA: the largest artery in the body carrying blood from the left … side of the heart to every part of the body. 3. CHRONIC ILLNESS: an illness whose symptoms … persist for longer than six weeks. 4. ANTIARRYTHMIC AGENT: a drug used for ... regulating and stabilizing the heartbeat. 5. ENDOSCOPY: a diagnostic procedure which involves the introduction of a thin, hollow, flexible fibreoptic scope into … an organ such as the lower or upper gastrointestinal tract for diagnostic or therapeutic purposes.

COMPETENCE IN MEDICAL ENGLISH

6. ARRHYTHMIA: any abnormal or absent heart rhythm, including … tachycardia (fast heart rhythms) and bradycardia (slow heart rhythms). 7. KIDNEYS: two oblong, curved, beanshaped glands situated … in the upper posterior abdominal cavity, one on either side of the vertebral column. 8. VENTRICULAR TACHYCARDIA (VT): a rapid heartbeat producing symptoms of … fainting, dizziness, weakness, blind spots, and potentially, unconsciousness and cardiac arrest. 9. ANXIETY: an unpleasant emotional state comprising physiological symptoms including … increased heart rate [tachycardia], altered breathing rate, sweating, weakness and fatigue.

 1.7. Defining Possible answers: • A thermometer is a measuring instrument that is usually made of glass and is used for taking temperatures. • A cervical smear is a sort of screening test that consists of collecting sample cells from the cervical mucosa and is used to diagnose venereal diseases, cancer and other ailments. • A forensic anthropologist is a medical doctor whose expertise comprises criminology, statistics and sociology and is employed to help the police. • A Magnetic Resonance Imager is an electronic scanning apparatus that can be found in large hospitals and is employed for non-invasive detection of cancer. • A clinical social worker is a person whose job includes facilitating the psychosocial adjustment of patients, and is employed by the social services. • A scalpel is a kind of surgical tool that is found in operating theatres and is used for making incisions. • Glasses are a type of optical device that consists of two transparent lenses and a frame and are mainly used to improve vision.

ANSWERS

 1.9. Suggestions: • star-shaped astrocytes • x-shaped chromosomes • a horseshoe-shaped base • a trapezoid-shaped bone • a T-shaped device • crescent-shaped cells

 1.10. Lyme disease (1) a type of (2) which was first (3) living in woodlands and grassy areas (4) which is a kind of (5) or corkscrew-shaped (6) relatively narrow and long (7) infection is transmitted (8) a characteristic circular rash (9) consisting of (10) commonly used for (11) typically employed

 1.11. Domestic violence • • • • • • • • • •

loss injury former lead due mental cope medication likely attempt

 1.12. Glue ear SIMPLIFIED EXPLANATION The ear has three main parts: the outer, middle and inner ear. The outer ear (the part you can see) opens into the ear canal. The eardrum separates the ear canal from the middle ear. Small bones in the middle ear help transfer sound to the inner ear. The inner ear contains the auditory (hearing) nerve, which leads to the brain. Any source of sound sends vibrations or sound waves into the air. These funnel through the ear opening, down the ear canal, and strike your eardrum, causing it

227 to vibrate. The vibrations are passed to the small bones of the middle ear, which transmit them to the hearing nerve in the inner ear. Here, the vibrations become nerve impulses and go directly to the brain, which interprets the impulses as sound (music, voice, wind, etc.). QUESTIONS 1. Inflammation of the ear. 2. A condition in which fluid builds up in the middle ear. 3. Stirrup, anvil and hammer. The three bones are called the ossicles. 4. The three tiny bones can’t move freely so the sounds coming in to the child’s ear appear indistinct. 5. A grommet is a tiny plastic drainage tube that is inserted into the eardrum. 6. Grommets allow air to enter the middle ear. They give the middle ear a chance to recover. 7. Because the eardrum heals and pushes the tube out. 8. Inserting a grommet and removing the adenoids. 9. You should not dive or allow soapy water to get into your ear. 10. Earache is composed of ear + -ache. When you have an earache you have a painful or sore ear. There are many similar words: headache, backache, toothache, etc. Possible symptoms of glue ear • deafness • indistinct hearing • complaining of a (slight) earache • problems with speech • language problems • social interaction problems • clumsiness • balance problems • appearing to have selective hearing (disobeying verbal instructions) • turning up the volume on the television or radio • often saying ‘Pardon’? or ‘What’?

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• being less responsive to sounds (especially babies), etc.

 1.13. Quizzimage N° 1 Car crash and open fracture of the left tibia with dislocation of the fibula. Young male, 35 years of age, dead on arrival.

COMPETENCE IN MEDICAL ENGLISH

(N.B. – More than two combining forms can be found in many terms: endocrinology, neuropsychlogical, thrombocytopenia, etc.)

Follow up  1.18. Web searching techniques

Back to basics  1.14. Fossilization • How long did the examination last? (other answers are less common e.g. “For how many minutes“ / “What was the length“…) • How much does it cost? What does it cost? • What do they examine? • What increases with age?

 1.15. Flexing the lexis 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

incompetence immeasurable anticoagulants disability immobile discontinue irreversible unaltered inaccurate antiseptic unaffected irrelevant

To obtain more interesting examples during a Web search, use complex search strings including words linked to your medical fields of interest. For example, if you are looking for examples of a word like “basic”, you will find more interesting results if you include a word like “biopsy” in your search e.g. < biopsy basic >.

 1.21. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

fairly device kind comprise beside commonly curved hollow narrow roughly

 1.16. Roots Suggested answers: • arthroscopy, bronchoscopy, coloscopy, endoscopy; • bradycardia, tachycardia; • bronchopathy, cardiopathy, colopathy, nephropathy, phlebopathy; • cardiology, graphology, histology, nephrology, pathology; • cardiologist, graphologist, histologist, nephrologist, pathologist; • laparoscope, otoscope, stethoscope; • lobotomy, phlebotomy, tracheotomy; • tomography.

UNIT 2

Self-test  2.1. Performance maintenance • • • • • • • •

significant – important entirely – utterly acute – severe foremost – major virtually – almost crucial – decisive basically – essentially reliable – dependable

ANSWERS • • • • • • • • •

fairly – quite widespread – common suitable – appropriate on average – typically extremely – exceedingly helpful – useful thoroughly – properly proper – correct On the whole – basically

Exercises  2.2. 1./e  2./c  3./f  4./b  5./g  6./h  7./a  8./d

 2.3. 1. 2. 3. 4. 5. 6. 7. 8.

accurately on the whole roughly common foremost slightly to a certain extent scarcely anyone

 2.5. 1./e  2./c  3./h  4./g  5./b  6./f  7./a  8./d

 2.6. 1. 2. 3. 4. 5. 6. 7. 8.

virtually small-scale thoroughly rather appropriate minute steep key

 2.7. 1. 2. 3. 4. 5. 6. 7. 8.

major – especially carefully rather almost average quite chief – fairly dramatic

229

 2.8. Superbug (1) commonly typically minor standard quite gradually almost (8) foremost widespread reliable sharp worrying effective huge fundamentally

 2.10. Yellow fever STARTER Mandatory vaccination, as authorized by the International Health Regulations, nowadays (2006) concerns only yellow fever. Endemic countries are situated in tropical areas of Africa and Central and South America; over 40 countries are endemic. Numerous countries require vaccination from travellers coming from endemic countries – for up to date information check WHO site. However, other vaccines are often advised on the basis of a travel risk assessment for the individual traveller. Vaccine for travellers (International travel and health, WHO 2005): • routine vaccination: diphtheria/pertussis/tetanus (DPT), hepatitis B (HVB), haemophilus influenzae type b (Hib), measles (MMR), poliomyelitis (OPV or IPV); • selective use for travellers: cholera, influenza, hepatitis A (HAV), Japanese encephalitis, lyme disease, meningococcal meningitis, pneumococcal disease, rabies, tick-borne encephalitis, tuberculosis (BCG), typhoid fever, yellow fever for individual protection; • mandatory vaccination: yellow fever (for protection of vulnerable countries),

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meningococcal disease (required by Saudi Arabia for pilgrims visiting Mecca annually [Hajj] or at anytime [Umrah]); • malaria: there is no vaccination against malaria, but anti-malarial drugs may be advised.

(N.B. – OPV = oral poliomyelitis vaccine; IPV = inactivated poliomyelitis vaccine) QUESTIONS A.1. It comes from the colour of the eyes and skin of the patients who suffer from liver failure / jaundice. B.1. Because it contains blood as the patients suffer from generalized haemorrhagia. A.2. It behaves like an epidemic (it strikes many people at once) and yet it isn’t directly contagious. B.2. It has been known for 125 years. A.3. He suggested that yellow fever might be spread by insects. B.3. He first suggested it in the middle of the 19th century / 50 years before it was proved. A.4. Dr Reed proved that the vector was the mosquito Aëdes aegypti. B.4. He placed two groups of volunteers in two different buildings. One was screened but infected material had been spread in it, the other was disinfected, but infected mosquitoes were placed in it. No one was sick in the first building, the volunteer in the second building developed yellow fever. A.5. It became possible to eliminate yellow fever by getting rid of the mosquitoes that carry it. B.5. The digging / building of the Panama canal was resumed (this time as a US government project).

 2.11. Quizzimage N° 2 The first (eye fundoscopy) was made by an ophthalmologist. No remarkable sign. The second (colonoscopy) by a gastroenterologist. Flat tumor. Chemotherapy.

COMPETENCE IN MEDICAL ENGLISH

Back to basics  2.12. Fossilization According to – All the sentences are correct except sentence 4. “According to” is rarely used to express one’s own opinion.

 Look at G. Notes 2 for more detail on how to express personal opinion.

 2.13. Flexing the lexis 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

aware of good at responsible for incompatible with incapable of liable to ill with (also “fall ill from”) involved in qualified in relevant to surprised at suitable for

 2.14. Roots They are of Greek origin and contain the name of a colour: chlorine (green), cirrhosis (reddish), cyanosis (blue), erythrocyte (red), leucocyte (white), melanoma (black).

Follow up  2.19. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

relevant minute outstanding mild slightly suitable reliable hardly thoroughly mean

ANSWERS

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UNIT 3

Self-test  3.1. Wine, beer, and whisky 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.

the incidence (of disease) units (of drink) programmes (of intervention) hazards (caused by blood pressure) the system (of blood circulation) techniques (developed on computers) the factors (of risk) the data (from studies) levels (of cholesterol) the capacity (of elimination) the build-up (of cholesterol)

Exercises  3.2. • • • •

contact lens alarm clock can-opener air-conditioner, etc.

 3.3. Acronyms – Pair work NGO AIDS ILO WHO IAEA WTO

Non-Governmental Organization Acquired Immune Deficiency Syndrome International Labor Organization World Health Organization International Atomic Energy Agency World Trade Organization

 3.4. ENGLISH CVA NMR CVP ENT STD

FRENCH AVC Accident vasculaire cérébral RMN Résonance magnétique nucléaire PVC Pression veineuse centrale ORL Oto-rhino-laryngologie MST Maladie sexuellement transmissible

LVF

IVG

TOP

IVG

NAD FBC

RAS NFS

NSAID

AINS

Insuffisance ventriculaire gauche Interruption volontaire de grossesse Rien à signaler Numération formule sanguine Anti-inflammatoire non-stéroïdien

 3.5. Technical jargon Possible answers: 1. cell structure 2. health care 3. cancer hazard 4. x-ray 5. heart failure 6. auscultation records 7. eye surgery 8. cell membrane 9. body protein

 3.7. Possible answers: • university research laboratory director • real-time computer software design • leg muscle coordination therapy • 6-month hospital training program • long-term cancer tumor treatment • laboratory blood cell experiments

 3.8. Rocket fuel found in breast milk (1) store-bought dairy milk (2) measurable perchlorate levels (3) recently issued safe dose recommendations (4) perchlorate ingestion side effect (5) thyroid gland iodide uptake (6) brain development hormones (7) thyroid disrupting chemical (8) increasing water supply contamination (9) compensatory iodine rich diets

 3.10. Buruli ulcer STARTER Diseases that have recently emerged or have recently been identified include:

232 – Avian influenza, SARS (Severe Acute Respiratory Syndrome), Nipah virus infection… – Ebola, AIDS (Acquired ImmunoDeficiency Syndrome), HIV (Human Immunodeficiency Virus) infection… Neglected diseases (WHO text) The so-called “neglected” diseases form a group because they affect almost exclusively poor and powerless people living in rural parts of low-income countries. While they cause immense suffering and often life-long disabilities, these diseases rarely kill and therefore do not receive the attention and funding of high-mortality diseases like AIDS, tuberculosis, and malaria. They are neglected in a second sense as well. Confined as they are to poor populations, all have traditionally suffered from a lack of incentives to develop drugs and vaccines for markets that cannot pay. Where inexpensive and effective drugs exist, demand fails because of inability to pay. QUESTIONS • The most common mycobacterial disease in Ghana is tuberculosis. • Worldwide, the first and second most common mycobacterial diseases in immunocompetent humans are tuberculosis and leprosy. • “They“ refers to “bacteria”. INFORMATION EXCHANGE Student A (example) Under the nodule, the bacteria secrete a toxin that destroys subcutaneous tissues. Eventually, the skin above the nodule dies and an ulcer appears. These ulcers spread. Sometime the toxin attacks the bone. Student B (example) At the beginning, nodules do not hurt. They seem to be unimportant small swellings. They do not look different from other small skin problems people have in tropical areas. 3 LISTS The following is not known: – the mode of transmission of the disease, – the environmental home of the bacteria,

MINIMUM

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– the epidemiology of the disease (why the disease sometimes appears in distant countries, why it has disappeared from Buruli county). It is considered possible, but not proven or not definitely proven: – that aquatic insects could play a role; – that very small wounds could allow bacteria to enter the body; – that the bacteria could live in stagnant or slow running water; – that there is a link between the disease and deforestation, flooding, construction of dams, and irrigation systems.

 3.11. Quizzimage N° 3 Pancreas, post-mortem. The size is given by the letters of the towel. The pancreas is an organ that serves two functions: • exocrine – it produces pancreatic juice containing digestive enzymes; • endocrine – it produces several important hormones, including insulin. The pancreas is located posterior to the stomach and in close association with the duodenum. Diseases of the pancreas: • benign tumours • carcinoma of pancreas (pancreatic cancer) • cystic fibrosis • diabetes • exocrine pancreatic insufficiency • pancreatitis – acute pancreatitis – chronic pancreatitis • pancreatic pseudocyst

Back to basics  3.12. Fossilization “Important” can only be used in sentence 1.

 See G. Notes 23.  3.13. Flexing the lexis 1. regulations 2. expand

ANSWERS 3. 4. 5. 6. 7. 8. 9.

standardization explode minimum extend generation pressurized accumulation

 3.14. Roots Suggested answers: -ia: phobia (phobie), megalomania (mégalomanie), pneumonia (pneumonie), schizophrenia (schizophrénie), ankyloglossia (ankyloglossie), aphasia (aphasie), alexia (alexie), anomia (anomie), agraphia (agraphie), apraxia (apraxie), hypercholesterolemia (hypercholesterolémie), oliguria (oligurie), uraemia (urémie) -iasis: elephantiasis (éléphantiase), amoebiasis (amibiase), helmithiasis, (helminthiase), lithiasis (lithiase), schistosomiasis (schistosomiase) -itis: glomerulonephritis (glomerulonéphrite), endocarditis (endocardite), hepatitis (hépatite), meningitis (méningite), otitis (otite) -oma: carcinoma (carcinome), schwannoma (schwannome ou neurinome), lymphoma (lymphome), melanoma (mélanome) -osis: multiple sclerosis (sclérose en plaques), amyloidosis (amylose), osteoporosis (ostéoporose), stenosis (sténose), tuberculosis (tuberculose)

Follow up  3.16. Function search Search Instructions: the simplest way to search for examples like this is to: 1. Enter the following string into Google < a * * device >. (N.B. – The inverted commas ensure that you search for a string, i.e. a series of consecutive words. The * * represents wild cards which replaces any 2 words.) 2. Add a defining word to ensure that you search in a medical register. For example: “a * * device” artery…

233 3.

Make sure that you choose an example which is a real compound noun (i.e. noun + noun + noun) and not an example with just 2 modifying adjectives. e.g. a new medical device .

 3.19. Self-test 1. 2. 3.

prisoner health care staff short-term androgen deprivation a large-scale cancer evaluation programme 4. lifelong learning tools 5. a six-month training programme 6. a widely used classification system 7. an x-ray equipment manufacturer 8. a 4-inch (diameter) Plexiglas tube 9. a growing nationwide trend 10. a one-eyed space monster

UNIT 4

Self-test  4.1. Child maltreatment STARTER (Figures for the US) • Responsibility – Mothers (58%) were responsible in most cases and were statistically younger than men. • Victims – Highest numbers of victims in the range: birth - 3 years (16.4 0/000). Slightly more girl victims than boys. • Types of abuse – Fatalities: main cause of fatalities was neglect (34%), followed by physical abuse. 79% deaths were under 4 years old. Highest rate: infant boys under 1 year. Sexual abuse: friends, neighbours 75%, parents 3%. (Source: National Clearinghouse on Child Abuse and Neglect Information 2005)

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EXERCISE Other answers are possible. • realized by the general public • estimated by medical authorities • mistreated by adults • believed by teachers / social workers / relatives • justified by the real world • dismissed by teachers / social workers / relatives • remembered by all of us • abused by adults • explained by outside observers • developed by abuse • retarded by maltreatment • expected by pediatricians • mastered by the victims • undermined by abuse • reported by specialists

Exercises  4.2. 1. 2. 3. 4. 5. 6.

… has been diagnosed … should have been carried out … was referred … can be bypassed … the bone marrow will be transplanted … of duodenal ulcers is being observed

1. 2. 3. 4. 5. 6. 7. 8.

It has been suggested that clinical trials … It was assumed that … It should be remembered that … It is acknowledged that … There can’t be a great number … There is certain to be a drop … There appears to be signs … There is said to have been more than …

 4.3.

 4.4. Possible answers: 1. By the age of 40, all women should have been screened for breast cancer. 2. Currently, huge profits are being made by pharmaceutical companies. 3. Many years ago, syphilis was treated by oral mercury.

COMPETENCE IN MEDICAL ENGLISH

4. Today, surgery is being transformed by modern technology. 5. Over the past 30 years, the overall incidence of gonorrhea has been reduced. 6. It is now clear that HIV patients may be infected with more than one type of infection. 7. In modern times, the recovery rate has been improved thanks to new antibiotics. 8. In the 19th century, opium was widely used as an everyday remedy for common ailments.

 4.5. Possible answers: 1./e  2./f  3./b  4./a  5./d  6./c

 4.7. • Samples are collected and tested by laboratory officers. • Hip replacements are performed by orthopedic surgeons. • Treatments are prescribed by the house officers. • Wards are organized and run by ward sisters. • Diets are worked out by dieticians. • Patients’ problems are dealt with by the social worker. • Bedbaths are done by the auxiliary nurses. • Patients are moved from one ward to another by the porters. • Patients are helped to mobilize by the physiotherapists. • Wound dressings are performed by the staff nurses.

 4.8. • The first antiseptic (carbolic acid) was pioneered by John Lister. • The discovery (in the 17th century) that blood flowed in a closed circuit is often considered “greatest medical achievement of all time.” • Many heart defects can be detected before birth. • Standards in hospital hygiene were greatly improved by Florence Nightingale.

ANSWERS • Once discovered, the vaccine against AIDS will have to be made available to everyone. • The gestational sac can be visualized at 4 weeks. • Penicillin was discovered by chance. • Since the advent of the prostate-specific antigen (PSA) test, many prostate cancers are being treated before they are even palpable. • Endoscopes and lasers have been used for more than ten years in laminectomies. • The addition of hypothermia to CPB has been commonly practiced in open-heart surgery for some years now. 1 2

 4.9. Adenotonsillectomy PART A (1) are removed (2) were performed (3) is still surrounded (4) cause (5) remains (6) may also be performed (7) were kept (8) should be carried out (9) have been removed (10) is not allowed (11) is administered (12) should be positioned (13) must be monitored (14) must be reported (15) will examine (16) is encouraged (17) is recommended (18) occurred PART B • How many tonsillectomies were performed in the USA in the late 1990s? • In what cases of tonsillitis may a tonsillectomy be performed? • On what basis is surgery now commonly performed? • What tests should be carried out before surgery? • What (treatment) is administered before transport to the operating theatre?

235 • In what position should the patient be nursed postoperatively? • When is the patient encouraged to drink and eat after surgery? • Why is a diet of soft food recommended?

 4.10. Peritonitis 1. The condition is more common in men than in … 2. the fallopian tubes, and ruptured ovarian cysts. 3. Peritonitis can also occur without perforation. 4. position, the abdomen is tender and the abdominal wall … 5. If perforation has occurred emergency surgery is performed.

 4.11. Traumatic brain injury Summary Perhaps the most famous TBI patient in the history of medicine was Phineas Gage. In 1848, Gage was a 25-year-old railway construction foreman, working on the Rutland and Burlington Railroad in Vermont. In the 19th century, little was understood about the brain and even less was known about how to treat injury to it. Most serious injuries to the brain resulted in death due to bleeding or infection. Gage was working with explosive powder and a packing rod, called a tamping iron, when a spark caused an explosion that propelled the 3-foot long, pointed rod through his head. It penetrated his skull at the top of his head, passed through his brain, and exited the skull by his temple. Amazingly, he survived the accident with the help of physician John Harlow who treated Gage for 73 days. Before the accident Gage was a quiet, mildmannered man; after his injuries he became obscene, obstinate and self-absorbed. He continued to suffer personality and behavioural problems until his death in 1861.

 4.12. Quizzimage N° 4 Bone fragments after a probable mass murder.

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The charred bodies of 16 Solar Temple members – including three children – were found in Saint-Pierre-de-Cherennes, a remote region of the French Alps. After an exhaustive search through the forests near Grenoble, a police helicopter spotted the bodies. Most of the victims were drugged and were found with plastic bags tied around their heads, others had bullet wounds in them, suggesting they had been murdered. All the bodies had been doused with flammable liquid before being burned.

Back to basics  4.13. Fossilization 1. 2. 3. 4. 5. 6. 7. 8.

lie raise rise lay raise rise lie lays

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• taking diagnostic x-ray pictures of breasts: mastography (the more commonly used term mammography is of mixed, Latin + Greek, origin) • removal of the womb: hysterectomy

Follow up  4.20. Self-test 1.

… must be moved … should be immobilized. 2. … had been unsuccessfully treated … 3. … are being examined … 4. … to be … 5. … was set up … 6. It is generally/widely acknowledged … 7. … will be improved … 8. … has been introduced … 9. by improving blood pressure … effects of medication can be enhanced. 10. are unlikely to sustain … few cases of hemophilia are diagnosed …

 4.14. Flexing the lexis Possible answers: 1. namely 2. yet 3. besides 4. whereas 5. hence 6. as a rule 7. even though 8. in fact

 4.15. Roots • • • •

a deficiency of red blood cells: anaemia inflammation of the skin: dermatitis excessive acidity in the body: acidosis a disease caused by parasitic worms: helminthiasis • a collection of blood in the brain under the dura mater: a cephaloh(a)ematoma • a medical doctor who treats children and infants: a paediatrician

UNIT 5

Self-test  5.1. Infectious diseases STARTER – Malaria, HIV / AIDS, measles, diarrheal diseases, tuberculosis. – Lower respiratory infections (pneumonia, etc.), tuberculosis. EXERCISE • improvement – to get better • graph – chart, diagram showing the relation between variables • stages – periods • 15-fold – 15 times, by a factor of 15 • rates – levels, figures, statistics • level – point, figure • declined – decreased

ANSWERS • range – number, variety • fell – decreased, declined • screening – preventative examination to detect disease • assess – evaluate • figures – numbers, statistics • reliable – dependable, valid • accurate – precise, exact • monitoring – medical follow-up, evaluation • curves – lines on a graph showing increase / decrease • decrease – fall, decline • drop – decline, fall • rise – move upwards, increase • growth – increase, expansion • cross-section – representative sample, selection • clusters – groups, concentrations (a) (b) (c) (d) (e) (f)

the introduction of new drugs rising standards of living gains in medical knowledge the Spanish flu pandemic, 1919 abrupt rise in HIV related deaths resistance to antibiotics

Exercises  5.2. 1./d  2./g  3./f  4./h  5./a  6./c  7./e  8./b

 5.3. 1. 2. 3. 4. 5. 6. 7. 8.

height halve spread small-scale cohort screening findings average

 5.4. 1./h  2./c  3./b  4./g  5./f  6./e  7./a  8./d

237

 5.5. 1. The x-ray revealed that the thymic carcinoma was about the size of an orange. 2. To what extent is modern medical theory and practice influenced by its more primitive forms? 3. The 15-month study was based on a random sample of children with respiratory disease. 4. They have spent years trying to work out why placebos are so effective. 5. The liver is an organ whose function is to process substances that are foreign to our body. 6. The lamellæ have an average thickness of 2 µm and extend across the breadth of the cornea. 7. For a long time, many scientists believed that the human life-span was infinitely extendible. 8. In cases of multiple trauma, the first step is to maintain the patient in a supine posture; the next step is to make sure that all foreign bodies and secretions are removed from the back of the throat.

 5.6. 1. 2. 3. 4. 5. 6. 7. 8.

overweight varies usually above 60 measles decrease 100 : 106 doubled more you know

 5.7. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

faulty checked, once surveys, pressure, levels data, degree measurement twice in pattern span deficient

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MINIMUM

 5.8. • • • • • • • • • •

samples – results study – range results – samples carrying out – testing ten-thousandth – out of 54 out of 54 – ten-thousandth range – study tall – wide testing – carrying out wide – tall

 5.9. Urinary Tract Infection • • • • • • • • • •

comprises pathogenic bladder bacterial newborn reverse bowel samples accounting for stone

 5.10. GIS STARTER Global Positioning System is a satellite navigation system. It is a system of earth-orbiting satellites, transmitting signals continuously towards the earth, that enables the positioning of a receiving device on or near the earth’s surface to be accurately estimated from the difference in arrival times of the signals (Collins 2000). Its usual abbreviation or acronym is GPS. This technology is commonly used on land, in mountains, at sea and in the air. GPS has a variety of applications on land, at sea and in the air. The most common applications are for aviation. At sea, GPS is also used for navigation by fishermen and professional or recreational sailors. On land, applications are more diverse. The scientific community, for example, uses GPS for its precision timing capability and position information. Recreational uses of GPS are almost as varied as the number of sports

COMPETENCE IN MEDICAL ENGLISH

available. GPS is popular among hikers, hunters, mountain bikers, and cross-country skiers, just to name a few. GPS is now commonplace in automobiles as well. Some sophisticated systems show your position on a street map and allow the driver to keep track of where he or she is and suggest the best route to follow to reach a designated location. (This is not a complete list. There are other uses of GPS not mentioned here, such as in the work of surveyors.) EXERCISES 1. Discuss the meaning of the following words. • quantum leap: a big change (a leap is to jump) • remote sensing: scanning the earth from space to collect data • vector-borne (find the infinitive of the verb in the word): carried by vectors; the verb is to bear (to carry); (example of vectors) : mosquitoes, snails. Malaria is a mosquito-borne disease. • outbreak: sudden start of disease • user-friendly: easy to use • affordable: not too expensive (you can afford it) • compliance: the practice of obeying a law, a rule • shade (of green): different greens, some lighter, some darker 2.a. With your partner, draw up a list of the general and specific uses of geographical information systems mentioned in the text. • General uses: near real-time access to data on temperature, soil, elevation, patterns of land use, phases of vegetation; precise location of water bodies, population centres, buildings, roads, other infrastructure; wide range of uses: search for natural resources, transportation, urban design, engineering, agricultural planning. • Specific uses: in infectious disease surveillance and control, particularly for vector-borne neglected diseases in poor populations in remote rural areas: quick very precise high-quality epidemiological data.

ANSWERS In outbreak investigation and response: locate cases, communicate information and map quickly. • More specifically: data on environmental factors influencing endemicity of vector borne infectious diseases, (temperature, elevation, soil conditions, rainfall, other meteorological conditions). 2.b. Read the question, prepare your answer and tell your partner. Student A Vector-borne diseases are affected by environmental factors such as temperature, elevation, soil conditions rainfall and meteorological conditions, because these factors have a direct influence on vectors, for example: • temperature: reproduction of vectors is affected by temperature; • elevation: some vectors live at certain heights only; • soil conditions: some vectors live / reproduce only when the soil conditions are right for them; • rainfall and meteorological conditions: some vectors are affected by rain, drought… Student B Vegetation goes through phases according to meteorological conditions and time of the year. Shades of green indicate these different phases. Some insects, snails, etc are present or proliferate during some phases. The shades of green therefore indicate conditions in which epidemics can occur. Shades of green can also indicate infestations.

 5.11. Quizzimage N° 5 Post-mortem. Skull cap of a man killed by a bullet (still in place) which went through the brain but stayed lodged in the bone causing lines of fracture.

239

Back to basics  5.12. Fossilization 1. 2. 3. 4. 5. 6.

a hard benign growth hardly any symptoms a hard, highly vascularized tissue hard to treat hardly any discomfort working hard to improve

 5.13. Flexing the lexis longer  length  lengthen thick  thickness  thickens range  range  ranges weak  weakness  weakens red  redness / reddening  redden achieving  achievement  achieve wide  width  widen assessable  assessment  assess

1. 2. 3. 4. 5. 6. 7. 8.

 5.14. Roots • • • • • • •

heart muscle: myocardium farsightedness : hyperopia weakness of sight: amblyopy speech impairment: aphasia taste disorder: ageusia / dysgeusia appendix removal: appendectomy tongue tie: ankyloglossia

Follow up  5.19. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

size outcomes span assess fivefold scope scattered thickness halve features

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UNIT 6

Self-test  6.1. Typhoid Mary • • • • • • • • • • • • •

recurrent – repeated unevenly – not equally, irregularly hardly ever – very rarely unpredictable – random, arbitrary almost always – usually clusters – concentrated groups ranges – varies set – group, collection steady – regular seldom – rarely array – display, selection every other year – every second year yearly – every year

Exercises  6.3. 1./d  2./b  3./a  4./e  5./c

 6.4. 1./g  2./j  3./i  4./f  5./h

 6.5. 1./o  2./n  3./l  4./m  5./k

 6.6. 1./d  2./a  3./e  4./b  5./c  6./g  7./f  8./j  9./h  10./i

 6.7. Patterns of fever Temperature chart N° 1 FEVER PATTERN: remittent  DEFINITION: temperature varies during each 24 hour period, but never reaches normal  TYPICAL INFECTION: tuberculosis, viral fever, many bacterial infections. Temperature chart N° 2 FEVER PATTERN: recurrent relapsing  DEFINITION: febrile episodes are separated by apyretic intervals (of several days)  TYPICAL INFECTION: borreliosis.

COMPETENCE IN MEDICAL ENGLISH

Temperature chart N° 3 FEVER PATTERN: undulant  DEFINITION: the temperature curve displays a wavy appearance  TYPICAL INFECTION: brucellosis. Temperature chart N° 4 FEVER PATTERN: intermittent  DEFINITION: the circadian rhythm is exaggerated, with wide variations  TYPICAL INFECTION: malaria. Temperature chart N° 5 FEVER PATTERN: sustained  DEFINITION: there is a persistent elevation in temperature with minimal diurnal variation (less than 1°C)  TYPICAL INFECTION: typhoid fever.

 6.8. Syndrome X STARTER • Enjoy exercise – regular physical activity (both aerobics and strength training). • Lose weight, if necessary – even as little as a 10% reduction in weight can help improve your cells’ insulin sensitivity. • Eat a moderate carbohydrate diet (about 45% of total calories). • Replace excess carbohydrates with more heart healthy monounsaturated fats. • Consume adequate protein with meals. • Manage stress, and get enough sleep. QUESTIONS (1) cluster (2) commonly (3) array / cluster (4) random (5) pattern (6) fluctuate (7) steadily (8) reorganisation (9) range (10) 1 out of 4 people

 6.10. Medical Tourism (1) (2) (3) (4) (5) (6) (7)

industry conditions medical low potential global likely

ANSWERS (8) health care (9) undeniably (10) procedures

 6.11. Quizzimage N° 6 Pericardial rupture with an extrapericardial dislocation of the heart is a rare but serious lesion resulting from a violent blunt trauma of the chest. In this case, the 35 year old man was admitted for multiple trauma following a violent skiing accident: the patient had fallen over 100 meters on a steep slope. Thoracic CT scan: right dislocation of the heart, bilateral hemopneumothorax predominant on the left side. Chest x-ray: fracture of the left clavicle, multiple rib fracture, left pneumothorax, right hemothorax, dextro positioned heart.

Back to basics  6.12. Fossilization Actually – Whether the sentence is right or wrong depends on what you mean. If you mean “In fact only 33% have replacements” the sentence is correct. If you mean “Today the number is 33%” the sentence is incorrect. This is a serious mistake and must be corrected.

241 • myalgia – muscle • nephropathy – kidney • osteoporosis – bone • pneumonia – lung • ventricular – belly (N.B. – ‘Ventricule’ means litteraly ‘little belly’ and comes from the Latin word VENTER: ‘belly, abdomen’, i.e. today ‘the little belly of the heart’.)

Follow up  6.19. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

steadily common seldom hardly evenly random wave cluster recur every other

UNIT 7

 See G. Notes 24.  6.13. Flexing the lexis 1. 2. 3. 4. 5. 6. 7. 8.

rely on  f carrying out  a consist of  b set up  e work out  d / h involved in  g account for  h depend on  c

 6.14. Roots • • • • • •

cardiac – heart cerebrovascular – brain chiroplasty – hand dermatologist – skin hepatitis – liver lymphadenopathy – gland

Self-test  7.1. Semmelweis STARTER Puerperal fever A uterine infection after childbirth. Onset within 10 days to 2 weeks after child birth. Potential causes include: placental remnants, bacterial infection of uterus. If the infection involves the bloodstream, it constitutes puerperal sepsis. Can lead to infertility or septicaemia. Now rare, due to improved hygiene and antibiotics.

242

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EXERCISE • most significant ≠ least important • overcrowding ≈ too many people present • half as many ≠ twice as many • unlike ≈ as opposed to • further ≈ supplementary • peaked ≈ reached its highest point • improvement ≠ worsening • decreasing ≠ rising • both ≈ not only… but • leading ≈ most prominent • weakened ≠ strengthened

Exercices  7.2. 1. cheaper a. (cheaper + than) – the cheapest b. ≠ more expensive (less / not so cheap) c. RULES – Short adjectives: adj. + -er (+ than) – the + adj. + -est 2. hotter a. (hotter + than) – the hottest b. ≠ colder c. RULES – Monosyllabic words: Idem above. N.B. – If preceded by one consonant and one vowel, double the consonant. 3. easier a. (easier + than) – the easiest b. ≠ more difficult c. RULES – Adjectives ending in “-y”: Idem above. “-y” changes to “-i”. 4. most reliable a. more reliable + (than) – the most reliable) b. ≠ less reliable c. RULES – Long adjectives: more + adj. + than – the + most + adj. 5. worst a. worse + than – (the worst) b. ≠ better c. RULES – Irregular adjectives

COMPETENCE IN MEDICAL ENGLISH

 7.3. 1./b  2./e  3./g  4./h,c  5./a  6./c,h  7./f  8./d

 7.4. 1./e  2./a  3./h  4./b  5./c  6./f  7./d  8./g

 7.5. Other combinations are possible. • Women in the US have twice as many biopsies for breast cancer as women in the UK. • People who participated in the study group lost about three times as much fat as those in the control group. • Oolong is semi-fermented and has about half as much caffeine as black tea. • Methadone is almost as effective when administered orally as it is by injection. • Taking time to discuss a patient’s problem is just as important as providing the right medication. • The study shows sleepy drivers are almost as dangerous as intoxicated drivers. • Electronic blood pressure devices are not as common as aneroid ones.

 7.6. 1./f  2./a  3./d  4./e  5./c  6./b

 7.9. Oedema and oncotic pressure (1) foremost (2) the greater the oncotic pressure is (3) spread (4) lower / lessen (5) lessen / lower (6) increases (7) weaken (8) net-like (9) widened (10) unlike (11) heightened (12) enhanced (13) expands (14) homogeneous

ANSWERS (15) main (16) boosted

 7. 11. Alternative therapies QUESTIONS 1. They relate to traditional medicines of two of the world’s oldest and most complex civilizations. 2. Biofeedback trains patients to control their bodies in order to improve their health without outside intervention, medicine or human intermediary as in other medicines. 3. In Ear candling, the writer uses the word “claim” three times (which is claimed to, proponents claim, it is claimed). “Claim“ means that what is said has not been proved. The writer also says “which are said to be”, and not “which are”. This is a way of expressing doubt. The author also uses the words “proponents” i.e. those who support this technique (not the writer) and “folk healing methods” i.e. based on the beliefs of ordinary people and not on scientific facts. The writer is telling the reader: this is a technique that exists, however there is doubt about its benefits. This approach differs from that of the other texts where the writers describe a technique or a plant in a neutral fashion. Blueberries (1) shrub (2) height (3) berries (4) eaten (5) times (6) generations (7) jam (8) treat (9) near (10) night (11) poor (12) disorders

 7.12. Quizzimage N° 7 Post-mortem. Young man killed by stab wounds. These

243 are wounds where the depth of injury is greater than the length. They penetrate more deeply than slash wounds and tend to come into contact with vital organs in the chest and abdomen. Stabbing is the most common mode of homicide in the UK, due to the strict control of guns. Stab wounds are caused most obviously by knives, but are also caused by bayonets and swords, as well as scissors and even blunter instruments such as screwdrivers. These type of wounds have the following features, they are usually slit-like, but when the object is removed the skin contracts slightly, leaving a wound that is slightly shorter than the blade width. The centre of the wound often widens.

Back to basics  7.13. Fossilization To agree Example: I agree (with you) that… I disagree with the project… N.B. – The verb “to be” is never used before agree. Example: “I am agreed that…“

 7.14. Flexing the lexis • • • • • • • • • • • • • • • •

fungal visual microscopic reliable clinical recurrent allergic colourless odourless obtainable effective powerful useful irritable reddish suitable

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 7.15. Roots amygdaloid – almond-shaped cardioid – heart-shaped corticoid – cortex (having an action similar to that of a hormone of adrenal cortex) mastoid – breast-shaped ovoid – egg-shaped thyroid – butterfly-shaped (but THYREOS in Greek means ‘oblong shield’) trapezoid – trapezoid is a plane foursided figure (geometry); the adjective trapezoidal means ‘shaped like a trapezoid’; trapezium is the name of a bone of the thumb; from Greek TRAPEZA, meaning ‘table’.

 7.20. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

widen weakening spread furthering leading enhance lessen heighten peak unlike

• • • • • • •

COMPETENCE IN MEDICAL ENGLISH

originating – coming from lead to – give rise to thus – hence on account of – owing to outcomes – results induced – caused triggering – sparking off

Exercises  8.2. 1./e  2./h  3./b  4./f  5./c  6./g  7./a  8./d

 8.3. 1. … comes from a lack of peri-natal care. 2. … on account of the lack of public awareness. 3. … one of the possible outcomes of mumps. 4. Thanks to … drug prescription errors are being decreased. 5. … may be due to hypoglycemia. 6. As medical treatment is free … 7. The origin … was rubella. 8. … arises from a lack of appetite

 8.5.

UNIT 8

Self-test  8.1. Chernobyl, contaminated food, and Caesium cardiomyopathy

Alternative answers are possible. • brought about by – as a result of • due to – because of • as – since

1. Significant side effects of chemotherapy are… nausea and vomiting. 2. Alternative medicine militants have criticized vaccination programs on the grounds that… they are linked to the “sudden infant death syndrome”. 3. The recent statistics on obesity have provided a stimulus for… improving school children’s diet. 4. Women over 50 who weigh less than 55 kg are at greater risk of a fracture as… they are more liable to suffer from osteoporosis. 5. Urinary infections in pregnancy can spark off… premature labor. 6. Thanks to the PET scanning capability… diagnosis of cancerous lesions has vastly improved.

ANSWERS 7. Doctors have been accused of inducing labour… for financial reasons. 8. According to the study, the new anticonvulsion drug for pregnant women can lead to… birth defects.

 8.6. 1. 2. 3. 4. 5. 6. 7. 8.

stimuli spin-offs side-effects complication unwanted effects grounds reason root

 8.7. Cystic fibrosis 1. A recessive gene (the cystic fibrosis conductance regulator) is responsible for cystic fibrosis. 2. 4% of the Caucasian population are carriers, since the incidence is of one per 2,500 live births (1/25 of the population are carriers, each carrier has a 1/25 chance of having a partner who is a carrier, and if this is the case, they have a 1/4 chance of having an affected child, the gene being recessive). 3. The complications are so severe that hospitalization is often necessary. 4. Excessive viscosity of exocrine secretions is due to gene mutations. 5. Bronchitis and pneumonia can result from excessively thick mucus, obstruction of the airways and emphysema. 6. Malnutrition, failure to thrive and fatty stools are consequences of secretions in the pancreatic duct and defective enzyme flow. 7. Perforation can arise from mecunium ileus. 8. More and more patients live into adulthood as treatments have improved.

 8.9. Prostate cancer (1) … its incidence has increased considerably over the … (2) … or a father with prostate cancer doubles the likelihood …

245 (3) … swelling of the tumor which obstructs the urethra … (4) … early cancers cannot be detected and the whole … (5) … cancer is likely to have spread to neighboring … (6) … illness has not already spread to other parts of the … (7) … can be used to decrease testerone levels, thereby …

 8.11. Quizzimage N° 8 Abdominal tomodensitometry, 45 year old man. Polycystic kidney disease is a disorder in which clusters of cysts develop primarily within your kidneys. Cysts are noncancerous (benign) round sacs of water-like fluid. Polycystic kidney disease isn’t limited to only your kidneys, although the kidneys usually are the most severely affected organs. The disease can cause cysts to develop in your liver, pancreas, membranes that surround your brain and central nervous system, and seminal vesicles. The greatest risk for people with polycystic kidney disease is developing high blood pressure. Kidney failure also is common with polycystic kidney disease.

Back to basics  8.12. Fossilization • … an anxiety … the repeated … • … a rare … Ø recent … the likelihood … the general … • The disorder … Ø ages … Ø childhood. A recent … an average … Ø adequate … • The probable … Ø heredity, Ø brain … Ø serotonergic … • … the/Ø psychopharmacologic … the/Ø prognosis … • … the United … Ø Europe … the most …

 8.13. Flexing the lexis 1. broke out  g 2. carry on / out  a

246 3. 4. 5. 6. 7. 8.

MINIMUM

cut down  f set up  b look into  d put off  c check through  h go ahead  e

 8.14. Roots EXAMPLES IN ENGLISH: duct, abduction, introduce GREEK OR LATIN ELEMENT: Latin DUCERE MEANING: lead EXAMPLES IN ENGLISH: tendency, tense, tension GREEK OR LATIN ELEMENT: Latin TENDERE MEANING: stretch EXAMPLES IN ENGLISH: analysis, dialysis, analytical, electrolyte GREEK OR LATIN ELEMENT: Greek LYO MEANING: set free EXAMPLES IN ENGLISH: antibiotics, biology, biopsy, aerobic, microbial, microbe GREEK OR LATIN ELEMENT: Greek BIOS MEANING: life EXAMPLES IN ENGLISH: haeme, haemoglobin, haematoma, anaemia, uraemia (spelt heme, hemoglobin, hematoma, anemia, uremia in American English) GREEK OR LATIN ELEMENT: Greek HAIMA MEANING: blood

 8.19. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

leads to by-product thereby / thus stems from account of rise to trigger (off) outcome induced hence

COMPETENCE IN MEDICAL ENGLISH

UNIT 9

Self-test  9.1. Ghana Potential questions: 1. What are the objectives? 2. Who are the video documents aimed at? 3. For what reason will the health-care personnel be trained? 4. What are they designed to do? 5. What will the assessment phase make possible? 6. How will the assessment be done? 7. What are the main targets? 8. Why is it essential to assure the collaboration of local dignitaries? 9. What is the goal of the project? 10. What will the consequence of reducing infant mortality be?

Exercises  9.2. 1./b  2./i  3./h  4./d  5./g  6./c  7./j  8./e  9./f  10./a

 9.4. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

supplies functions as by means of therefore allow use thereby via avoid obstructs

 9.5. Possible answers: 1. Intravenous infusion (is often used) to prevent dehydration. 2. Two-hourly changes of position are carried out (in an attempt to) prevent the formation of pressure sores.

ANSWERS 3.

A Redivac drain is left in situ (so that) blood or fluid doesn’t collect in a surgical wound. 4. A lumbar puncture is performed (to enable) the sampling of cerebrospinal fluid (CSF). 5. Analgesics are administered (in order to) promote the patient’s comfort after surgery. 6. CVP (central veinous pressure) readings are done (so as to) assess the pressure of blood returning to the right atrium. 7. Barrier nursing (aims at) controlling the spread of pathogenic organisms. 8. Intrapleural drainage (is a method used to) restore normal lung expansion after a pneumothorax. 9. A nasogastric tube is inserted (to allow) enteral nutrition. 10. The Heimlich manœuvre can be performed (to) force a blockage out of the trachea. 11. Abdominal paracentesis (is indicated to) relieve symptoms associated with ascites. 12. Scalp cooling (is a method of) preventing chemotherapy-induced alopecia.

 9.7. 1. pituary (hypophysis) 2. ADH (antidiuretic hormone or vasopressin) 3. insulin 4. leucocytes 5. CSF (cerebrospinal fluid) 6. bile 7. K (phylloquinone) 8. D (calciferol)

 9.8. • • • • • • • • •

purpose – aim designed – devised prevent – avoid provide – supply functions – operates impeded – obstructed, inhibited in order to – so as to devised – elaborated, designed thereby – thus

247 • • • • •

making it possible – allowing supplied – given / provided goal – objective thanks to – by means of allow – enable

 9.9. Peptic ulcer • • • • • • • • • • • •

grown successfully assumed further dish thereby resolved effective stating recurrent regimen awarded

 9.10. Research on breastfeeding 1. “Breast“ (noun, mammary gland) and “to feed“ (verb). 2. Food – To give food is “to feed“. The past of “to feed“ is “fed“, the past participle is also “fed“. 3. “To nurse“ also means (this is not an exhaustive list): to care for or look after a person who is ill; to spend time taking care of something as it grows, like a young tree; to look after an injury, such as nursing a sore knee; to hold a small child in your arms to comfort it. 4. Child – A boy or a girl between birth and puberty. Baby – Many meanings: newborn, recently born, youngest of a family or group, smallest of a family or group and other meanings. Infant – A child in the earliest stage of its life (in French infant and child is infanto-juvénile). Toddler – A child who has only recently learnt to walk (no French equivalent in one word). 5. Advice to mothers / women Mothers – should exclusively breastfeed their infants for at least the first six months of life;

248 – should feed their infant iron-fortified, commercially available formula (if they are not nursing). Health care providers – advise women not to give their infants cow’s milk until the child is at least a year old. APP – suggests that women try to breastfeed for the first 12 months of life because of the benefits to both mother and baby; – suggest that women work with a lactation counselor or lactation specialist to learn how to breastfeed and to learn what is involved with breastfeeding. Direct advice: Ask your health care provider for more information about getting help with breastfeeding. Benefits of breastfeeding to babies – Breast milk provides the right balance of nutrients to help an infant grow into a strong and healthy toddler; – some of the nutrients in breast milk also help protect an infant against some common childhood illnesses and infections, such as diarrhea and certain lung infections. Benefits of breastfeeding to mothers – The mother’s body releases a hormone that makes the uterus contract; – emotional benefits. General advantages – It is convenient and inexpensive. Recent findings of research in the field – Recent research also suggests that breast milk contains important amino acids, protein building blocks, that help an infant’s brain develop specifically, that two amino acids present in breast milk may help infants to increase their cognitive skills. Why further research is under way – These two amino acids are not currently added to infant formula commercially available in the United States. As infants who were fed formula with the two amino acids added scored higher on intelligence tests than infants whose formula lacked the nutrients, further research is now

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

underway to see whether adding these amino acids to infant formula is safe in the long-term.

 9.11. Quizzimage N° 9 Middle-aged man, death. Liver osteosarcoma with non-injected computed tomography. The white spots in the liver are not injected contrast medium but “bone” structure in the liver. Notice the same echogenicity as ribs. Calcified tumour on the left liver. Osteosarcoma is the most common type of bone cancer, and the sixth most common type of cancer in children. Although other types of cancer can eventually spread to parts of the skeleton, osteosarcoma is one of the few that actually begins in bones and sometimes spreads (or metastasizes) elsewhere.

Back to basics  9.12. Fossilization These words are uncountable nouns in English and are always singular. Note how the problem of expressing number is solved in question 2 and 5. 1. information (no S) 2. bits / pieces of advice 3. knowledge (no S) 4. research (no ES) + has 5. items / bits / pieces of equipment  See “Uncountable nouns“ (G. Notes 12).

 9.13. Flexing the lexis 1. 2. 3. 4. 5. 6. 7. 8. 9.

did something about incision must be made operation was carried out take a detailed family history made a spectacular impact measures must be taken do a lot of harm making a diagnosis research has already been carried out / done 10. take the dermatology examination

ANSWERS

249

 9.14. Roots They contain combining forms from Greek or Latin having the same meaning. • antibiotic, vitality G. BIOS / L. VITA (life) • euthanasia, lethal, mortality G. THANATOS / L. MORS / L. LETUM (death) • nosocomial, morbidity G. NOSOS / L. MORBUS (disease) • hygiene, sanatorium G. HYGIEINE / L. SANTIAS (health) • mycobacterial, fungicide G. MYKES / L. FUNGUS (mushroom)

• • • • • • • • • • • •

Exercises

 9.19. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

inhibited enables avoid impede target devised through make it possible goal provide

is increasing / has increased found felt had got felt had improved occurs acts was introduced indicated / had indicated had dropped is currently raising

 10.2. Counterfeit drugs – Answers: see Checklist. – Passive verbs: “were intercepted“, “were being transported“.

 10.3 Foundation – Africa now • • • • •

are currently recruiting was created serves have had / have have worked / have been working / are working

 10.4. The wealthier, the healthier?

UNIT 10

Self-test  10.1. Doping in sport • • • • • • • • • •

made revealed were resorting / had resorted is now becoming / has now become has even written started have been sought has been took place has increased / has been increasing

• • • • • • • •

is commonly believed have been investigating / have investigated have shown examined had received comes are developing / have been developing have profited

 10.5. Other answers are possible. 1. This year 2. while 3. previously 4. Over the last 10 years 5. temporary 6. It is a fact 7. So far

250

MINIMUM

9. currently 9. never 10. As soon as

 10.6. Multiple choice 1. / d  2 . / b  3 . / c  4 . / a  5 . / b  6./c,a (depending on the speaker’s intention)  7./b,d (depending on the speaker’s intention)  8./c

 10.7. Example: • The male nurse is vaccinating the boy. (at the moment) • Small pox kills thousands of people. (it is a scientific fact) • The mother has brought her child to be vaccinated. (today) • The villagers have been waiting for hours. • WHO started a vaccination campaign last year. • This was because the death rate was growing year by year. • After the nurse had finished his training in Paris, he returned to the Congo. • Before that, he had been working in a hospital in Kinshasa.

 10.8. Maggot therapy (1) the 1950s (2) often (3) frequently (4) then (5) so far (6) some years ago (7) so far (8) currently (9) always (10) some time ago (11) at the moment (12) for the last few years

 10.11. Osteoporosis Medical definition of osteoporosis The World Health Organisation (WHO) Working Group defines osteoporosis according to measurements of bone mineral density

COMPETENCE IN MEDICAL ENGLISH

(BMD) using dual-energy x-ray absorptiometry (DEXA): • osteoporosis is defined as a bone density T score at or below 2.5 standard deviations (T score) below normal peak values for young adults. A clinical definition of osteoporosis was developed in 2001 by the National Institutes of Health (NIH) Consensus Development Panel on Osteoporosis: • osteoporosis is defined as a skeletal disorder characterised by compromised bone strength predisposing a person to an increased risk of fracture.

 10.12. Quizzimage N° 10 52 year old man, in this case cure was obtained after removing the polyp. Colonoscopy  adenomatous polyps. Adenomatous polyps (adenomas) of the colon and rectum are benign (non-cancerous) growths that may be precursor lesions to colorectal cancer. Polyps greater than one centimeter in diameter are associated with a greater risk of cancer. If polyps are not removed, they continue to grow and can become cancerous.

Back to basics  10.13. Fossilization Other answers are possible. • An embryo grows • A child grows up • To suddenly realize • To carry out clinical tests • Last year • The latest news • A personal experience • A scientific experiment

 See G. Notes 9.  10.14. Flexing the lexis Suggested answers: 1. beneath 2. on the top of 3. along

ANSWERS 4. 5. 6. 7. 8. 9.

beside across through towards around behind

251

UNIT 11

Self-test  11.1. When life is not worth

 10.15. Roots • kidney disease – nephropathy • red blood cell – erythrocyte • inflammation of the urinary bladder – cystitis • nosebleed – epistaxis • falling sickness – epilepsy • pain-killer – analgesic • blood in the urine – h(a)ematuria • liver-toxic chemical – hepato(to)xin • absence of sweat – anhidrosis (sometimes spelt wrongly: anhydrosis) • agent that promotes the excretion of urine – diuretic

 10.20. Self-test Other answers are possible. 1. are seeking 2. were exposed  had realized  caused / was causing 3. causes  discovered  helped  is still being used / is still used 4. was first identified 5. have so far shown  increases 6. has been steadily improving / has steadily improved  remain 7. have developed 8. has completed 9. was studying  wrote 10. has been  has become

living • • • • • • • • • •

doubtless – certainly assumed – supposed should – have a moral obligation ought to – is it right for can – has the capacity to might – is plausible must – has no option but to feasible – technically possible expected – we think it is probable likelihood – probability

Exercises  11.3. Present and future time 1. Cystitis can be caused by … 2. The ultrasound may not detect … 3 Antibiotic therapy should / ought to reduce … 4. Availability of palliative care must be increased … 5. This might / may reflect … 6. None of the victims could afford …

 11.4. 1. 2. 3. 4. 5. 6.

could have led will have caused must have might have been should have been treated cannot have caused

 11.5. 1./g  2./h  3./b  4./e  5./d  6./c  7./a  8./f

 11.6. Other answers are possible. 1. Triple therapy could / might be more effective.

252

MINIMUM

2.

Left ventricular failure will lead to pulmonary edema and orthopnea. 3. You should have regular medical checkups. 4. Cross-infection may have been caused by symptomless carriers. 5. Myocardial infarction will cause ST elevation on the ECG. 6. The patient should have been transferred to the intensive care unit. 7. Diabetic patients shouldn’t take any hypnotic drugs. 8. The E. Coli infection may / could have been caused by urinary catheterisation. 9. All theatre staff must maintain strict aseptic technique near the operating field. 10. Autoimmune thrombocytopenic purpura may be triggered by a viral infection such as measles.

• When would she be in a position to choose?

 11.10. Joint Statement 1. 2.

3.

4.

5.

 11.7. 1. 2. 3. 4. 5. 6. 7. 8. 9.

must / should can / will must / should will / must / should … may / might / could can / could … must / should can / could / may should / must will / may / can / should … can / may may / might / can / could

 11.8. Antenatal screening Potential questions: • Who feel that they are doing as they should? • What proportion of women may have legal access? • Where must the act be performed? • How many doctors must certify? • When should abortions be performed? • Why should the debate be so vehement? • What will she be offered? • What can be diagnosed? • Why could there be pressure? • What ought to be given to the women? • What sort of information might be revealed?

COMPETENCE IN MEDICAL ENGLISH

6.

MMR is a triple vaccine against measles, mumps and rubella. Professional bodies representing doctors and nurses published it in support of the continued use of the triple vaccine MMR. It seems that many parents consider the MMR triple vaccine dangerous for their children and prefer single vaccines. These professsionals refute any association between MMR and autism, associated disorders or inflammatory bowel disorders. Arguments in favour of the triple or conbined vaccine: • two new authoritative and independent scientific reviews and all the available data refute this association; • WHO also advises the triple vaccine; • it has been given to 500 million children in 90 countries; • a huge body of evidence shows that it remains safe and effective; • it is probably the best researched vaccine worldwide and its few very rare side-effects are well known. Arguments against single vaccines: • asked for its opinion on vaccine type, the American review specifically advised against use of single vaccines; • single vaccines are unproven in both safety and effectiveness; • no country in the world recommends use of single vaccines when MMR is available; • there has been little research conducted to ascertain whether single vaccines for measles, mumps and rubella could have significant sideeffects; • it is not sensible to subject children to six injections without good reasons;

ANSWERS • vaccinating children against one disease at a time means that, while waiting for their next immunization, the children remain at risk of exposure to the other diseases against which they are not yet vaccinated. 7. Measles, mumps and rubella can cause brain damage, leave children handicapped, and can even kill. 8. This expression refers to the alleged association between autism and MMR. 9. 3/4 of the parents were choosing MMR for their children by age 16 months, and over 4/5 vaccinated their children before they were 2 years of age. 10. The small improvement in use of the triple MMR vaccine is now prejudiced. 11. The UK is at much higher risk of outbreak of measles, mumps and rubella because levels of immunization are too low. If the levels of MMR vaccine do not improve and children remain unprotected outbreaks will result in some deaths and handicapped children. 12. Three children have died in a recent measles outbreak.

 11.11. Quizzimage N° 11 Man, 45 years of age, post-mortem. Hepatomegaly or enlargement of the liver beyond its normal size, here almost 2 times. Common causes: • alcoholism • poisoning • drugs • bacterial infections • viral infections • infection from endoparasites • hypoglycemia • hepatitis • haemochromatosis • Gaucher’s disease • Hunter syndrome • Zellweger’s syndrome • Crimean-Congo hemorrhagic fever • carnitine palmitoyltransferase I deficiency • carnitine palmitoyltransferase II deficiency

253 • carnitine-acylcarnitine translocase deficiency

Back to basics  11.12. Fossilization forty-three  a hundred and twenty three  fifteen thousand, seven hundred and sixty five  seven to the power minus five (seven to the minus five) two and two thirds  six and three eighths nought point seven oh / nought six the fourth of March, two thousand and seven / March the fourth / US: March fourth

 See G. Notes 5. four six double two oh one a hundred and fifty three dollars five past nine  a quarter to three (two forty five)  half past four / four thirty  five to six

 See G. Notes 5.

 11.13. Flexing the lexis 1. 2. 3. 4. 5. 6. 7. 8.

setback breakthrough cutback go-ahead printout layout set-up feedback

 11.14. Roots SINGULAR

PLURAL

apparatus

apparatuses, apparata (rare) bacteria no plural femora, femurs (rare) fungi, funguses (rare) metastases myocardia, myocardiums (rare) overdoses no plural phenomena tibiae, tibias (rare) vertebrae, vertebras (rare)

bacterium (rare) diabetes femur fungus metastasis myocardium overdose pancreas phenomenon tibia vertebra

254

MINIMUM

 11.19. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

cannot must have may ought to / should could have / may assume expected doubtless feasible likely

UNIT 12

Self-test  12.1. "To help, or at least to do no harm." • “If it bleeds, it leads.” (if + present + present) • “… if progress has been made … it is almost entirely …“ (if + present perfect + present) • “… could have been carried out … if the profession had wanted …” (past conditional modal + if + past perfect) • “… if the power of technology increases … risks will be …” (if + present + future) • “Unless an atmosphere can be instilled … nothing will be attained.“ (unless + present modal + will) • “If practitioners were given … it would be possible …” (if + past + conditional) For the meanings, consult the Checklist. otherwise – alternatively, also prerequisite – condition essential – necessary (if not … then) unless – only if

COMPETENCE IN MEDICAL ENGLISH

Exercises  12.4. 1./e  2./h  3./d  4./c  5./i  6./g  7./a  8./j  9./b  10/f

 12.5. Possible answers: in some cases the 1st conditional (will) can be replaced by the timeless conditional (present). 1. … rested, there would be a miscarriage. 2. … was donated, the child could be saved. 3. … to lose weight, you will have to / must follow a three-month diet. 4. … had had access to medical treatment, they would have survived. 5. … people have access to safe water, they have little chance of being in good health. 6. A common set of guidelines must be formulated, … there will be a problem. 7. … the medical school only if they were / had been vaccinated. 8. … relaxes, s/he cannot be hypnotized.

 12.7. 1. • If the nurse knows a patient is allergic to aspirin, she won’t administer it. • If the nurse knew a patient was allergic to aspirin, she wouldn’t administer it. • If the nurse had known the patient was allergic to aspirin, she wouldn’t have administered it. 2. • If the patient is told her fetus presents with Down syndrome, she will choose to have a termination of pregnancy. • If the patient was told her fetus presented with Down syndrome, she would choose to have a termination of pregnancy. • If the patient had been told her fetus presented with Down syndrome, she would have chosen to have a termination of pregnancy. 3. • If warfarin therapy is started early, the patient won’t develop DVT and PE.

ANSWERS

255

• If warfarin therapy was started early, the patient wouldn’t develop DVT and PE. • If warfarin therapy had been started early, the patient wouldn’t have developed DVT and PE. 4. • If a nurse finds out that donor and recipient blood groups are not compatible, she doesn’t start / she won’t start the transfusion. • If the nurse found out that donor and recipient blood groups were not compatible, she wouldn’t start the transfusion. • If the nurse had found out that donor and recipient blood groups were not compatible, she wouldn’t have started the transfusion. 5. • If children aren’t provided with a balanced diet, they will suffer from malnutrition. • If children weren’t provided with a balanced diet, they would suffer from malnutrition. • If children hadn’t been provided with a balanced diet, they would have suffered from malnutrition.

 12.8. Acute mountain sickness • … there will be an increasing demand on doctors to give advice … • … if a sensible altitude gain is observed … • … providing it is recognized and managed properly … • … unless there are good reasons for thinking otherwise … • … If no treatment is undertaken … • … if he complains of severe headache … • … they would greatly reduce their chances of being ill … • … if climbers had always taken this basic precaution …

 12.10. Migraine 1. … of migraine attacks are likely to be social … 2. … collected data by questionnaire from 151 …

3. … the whole group, 21.9% claimed to have weekend … 4. … but 23% of the women suffered from tension-type … 5. … results support the idea that weekend attacks are …

 12.11. Abstracts STARTER Definition – An abstract is a shortened version of the paper or article. It contains all the information necessary for the reader to determine: – what the objectives of the study were, – how the study was done, – what results were obtained, – and the significance of the results. ABSTRACT N° 1 Outline • Name of symposium • Name of author • Place of work / Research laboratory of author • Title of abstract • Introductory statement, statement of the problem to be addressed • Research methodology • Results • Concluding statement Characteristics • It is short. • It is written as a single paragraph. • There is no bibliography. • It is well structured (the focus will be; there will be; moreover; finally). • It is written for a specialized audience, the language is technical. • There is a long enumeration: issues (…) will include inter-individual variability and reproducibility (…), influence of age of individual, class of affected drugs (…), active ingredients in grapefruit and clinical implications (importantly affected medications, potential alternative non-interacting drug, volume and duration-effect relationships) and other similarly acting foods.

256 • The future is used: will be; will include; will address; will be presented; will include; will be given. • There are many passives: the focus will be (not: the presentation will focus on); there will be a discussion (not: we will discuss); findings will be presented (not: I shall present findings); consideration will be given (not: I will consider). • The tone is impersonal: not: I, not: We in the text, but passives and many there (is, will be). • Caution (hedging) is used in statements: the public generally considers (not: considers) (…) to be safe; which may not be always true (not: which is not always true); In some cases, there is (not: There is); sometimes with clinical outcomes, estimated to be involved (not: involved in). Subject The possible interaction between grapefruit juice and medicine. ABSTRACT N° 2 Outline Idem Characteristics • No future tense in this abstract, numerous passives, interesting hedging (taking precautions, talking with moderation): a better understanding (…) may help in identifying herbals likely to cause… • More abbreviations are used: Pregnane X Receptor (PXR), Constitutive Androstane Receptor (CAR), and Farnesoid X Receptor (FXR). Only one abbreviation was used in Abstract N° 1: organic anion transporting polypeptides (OATPs). These abbreviations are characteristic of scientific literature. Subject Adverse interaction between herbal products such as St John’s wort and concomitantly administered drugs. Notes on Abstracts An abstract is a normal part of a research article published in a journal (only a small percentage of them do not require them).

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

Most scientists write the abstract last, after the paper. For presentations at scientific meetings the “published abstract” is often the only written record. Abstracts are also used in library reference tools or databases such as Biological Abstracts, Medline, etc. Frequently, scientists will only read the abstracts on their computers. Styles may vary according to the scientific “culture community”, i.e. according to the area of specialization.

 12.12. Quizzimage N° 12 Acromegaly is a hormonal disorder that results when the pituitary gland (gland just below the brain) produces excess growth hormone (GH). The term acromegaly comes from the Greek words for “extremities” and “enlargement” and reflects one of its most common symptoms, the abnormal growth of the hands and feet. The patient can suffer from any of the following symptom: increasing hand and feet size, extra growth of skin, coarseness and thickening of skin, enlarged jaw and tongue, enlarged facial bones, hoarseness, headache, diminished vision, easy fatigue, excessive sweating, weakness, joint pains, widely spaced teeth, or weight gain. It most commonly affects middle-aged adults and can result in serious illness and premature death. Once recognized, acromegaly is treatable in most patients, but because of its slow and often insidious onset, it frequently is not diagnosed correctly.

Back to basics  12.13. Fossilization • Glucose is turned into fat. • They are transformed into a malignant tumor.

 Check the grammatical explanation in G. Notes 8.

ANSWERS

257

 12.14. Flexing the lexis 1. 2. 3. 4. 5. 6. 7. 8. 9.

to find out if light I take off my hijab and put on you should look up drug dosages help patients cope with the psychological impact funds to look into the long-term effect to check up on physicians’ prescriptions cut down on their smoking during look forward to starting clinical medicine put off asking for an appointment

 12.15. Roots Suggested answers: arthroscopy, carbohydrate, diagnosis, diastolic, epileptic, hydrate, infection, infectious, inoperational, inspiration, malignant, mastectomy, neuroleptic, operation, postinfectious, postoperational (rare), postoperative, procedure, prognosis, prostate, pulmonary, respiration, respiratory, tonsillectomy, unhygienic

 12.20. Self-test 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

unless entails provided / ing that otherwise prerequisite implies would be had been will proceed / proceeds would have explained

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COMBINING

FORMS FROM

GREEK AND LATIN

In most European languages elements from Greek and Latin are widely present in medical vocabulary. They make international communication between specialists easier, in spite of occasional slight differences. However, specialist vocabulary may be difficult to understand for the lay person and even for the medical student. The following notes give an outline of the basic principles.

1. Mind the spelling!
British or American? Some combining forms are spelt differently in British English and in American English. British spelling is closer to Greek. American spelling is simpler (-aebecomes -e-). Compare: Greek

British English

American English

French

AISTESIA

anaesthetic anaesthesia

anesthetic anesthesia

anesthésique anesthésie

AITIA

aetiology

etiology

étiologie

GYNE

gynaecological gynaecologist urogynaecology

gynecological gynecologist urogynecology

gynécologique gynécologue urogynécologie

HAIMA

haeme
haemoglobin
heme
hemoglobin
haematoma
hematoma
anaemia
uraemia anemia
uremia

hème
hémoglobine
hématome
anémie
urémie

PAIS

paediatrician paediatrics orthopaedic

pédiatre pédiatrie orthopédique

pediatrician pediatrics orthopedic


Greek or Latin? Sometimes, two elements, one from Latin and the other from Greek, look misleadingly similar. Note that they combine in different ways and cannot be used indiscriminately in word formation. The meaning is sometimes the same, as is the case with bi- from Latin and di- from Greek, both meaning “two“, but there can be differences. Compare dis- from Latin, meaning the “direct opposite“ of a word, the “reversal“ of

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an action or the “removal“ of something, and dys- from Greek, meaning “bad“ or “difficult“:

bi-

bicarbonate biceps bifid bisexual bilateral

dis-

discomfort disease disinfectant dislocation displacement dissociation dissolution

di-

dioxide dioptre dielectric

dys-

dysentery dysfunction dyslexia dyspepsia dysphasia dysregulation dystrophy


English vs French, false friends? The French equivalents of most of the terms from Greek and Latin are easy to find. However, there can be slight differences. In the following examples the differences are emphasised in bold type: English

French

abnormal amyloidosis an(a)esthetic hepato(to)xic hyperopia nat(ri)uresis pancrea(ti)tis prosthesis seroton(in)ergic thrombocytopenia

anormal amylose anesthésique hépatotoxique hypermétropie natriurèse pancréatite prothèse sérotoninergique thrombopénie

2. What’s in a word? Appearances, i.e. the form of words, can be misleading, but even more so is the meaning. Some words or combining forms are polysemous, i.e. have more than one meaning, as is the case with metr- meaning “womb“ in endometrial, endometriosis, endometrium, metrometer, but having various other meanings due to different etymology inmetrocyte (mother cell), metrology (a system of weights and measures), chronomet r y (measurement of intervals of time), metromania (a mania for writing verses), etc. Synonymy, which is the opposite of polysemy, occurs when several forms (terms, words or even parts of words) have the same meaning.

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COMBINING FORMS FROM GREEK AND LATIN

261

It often happens in English that elements from Greek and Latin combine and give rise to unrelated synonyms, i.e. terms of different etymology, used to name the same idea or concept. They are usually present alongside vernacular terms, for example:  nephrolith (from Greek) / renal calculus (from Latin) / kidney stone (English term) The French language being more directly derived from Latin, it often has fewer different forms (“néphrolithe“ / “calcul rénal“), but we note with interest that in Canadian French the term ‘pierre aux reins’ is also in use. Purists reject terms of mixed origin, like renal stone or kidney calculus and recommend that they should be replaced. However it is difficult to change usage by law, for example the “pure“ term mastography (mast- + graph-, both from Greek) is not as frequently used as mammography (mamm- from Latin + graph- from Greek). Prefixes usually stem from Greek or Latin prepositions. Here are a few examples: Meaning

Elements from Latin

Elements from Greek

ABOVE,

sursurvival
surface

epiepidemic
epidermis
epiglottis
epilepsy
epistaxis

AGAINST

contracontraceptive
contraception
contrafissura
contraindication
contralateral
contrastimulant

antiantiarrythmic
antibacterial
antibiotic
antibody
anti-cholesterol
anticoagulants
anti-convulsion
anti-inflammatory
antimalarial
antiretroviral
antiseptic

INSIDE

intraintranasal
intratracheal
intravenous
intravascular

OUTSIDE

exexotoxin
export
extract

endtendemic
endemicity
endocardial
endocrine
endocrinology
endometrial
endometriosis
endoscopy
endotoxin ecectomy
ectopic

OVER

supersuperficial
superinfection

hyperhyper-aggressive
hyperinsulinemia
hypertrophy

THROUGH

transtransmission
transplant
trans-vaginal

diadialysis
diaphragm
diarrhea
diuretics

UNDER

subsubclavian
subcortical
subcutaneous(ly)
subglottic

hypohypoallergenic
hypodermic

ON

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The list of roots is virtually unlimited. Some roots, mainly those of Greek origin, e.g. ankyl- in ankylosis, are almost exclusively restricted to the medical field and conspicuously different from what can be found in ordinary vocabulary. Others, from Latin, have been present in English for hundreds of years, and still combine to form present day specialist vocabulary, e.g. stit- in both institution and interstitial. There are numerous examples and a few of them are given in the following table: Combining form

From Latin

Meaning

Examples from non specialist English

Examples from the medical field

duc(t)-

DUCERE

lead

introduction
product duct
reproduction

production
reduce reproductive

oper-

OPUS. OPERA

work

opera
operation(al)

operation

stit-

STATUERE

place
set up

institution
destitute

interstitia

tract-

TRAHERE

draw

extract
tractor

tract

treat-

TRACTARE

handle

treaty

treat
treatment

It is not uncommon that Greek and Latin elements have the same meaning originally, but the resulting combining forms in English are used differently. Compare: Meaning

Elements from Latin

Elements from Greek

HEAR

audi(t) auditory nerve
audiologist

acoustacoustic tubercle

LIFE

vit-/viv survival
vital
vitamin
vivisection

bi(o)(t)antibiotics
bio-interaction
biopsy

MAN

virilvirilism
virilescence

andrandrogen
andriatrics

PAIN

dolordolorific
dolorigenic
dolorimetry

algalgesiogenic
analgesic
myalgia

Derivational suffixes used to form adjectives or nouns are common in medical English, as well as in other fields of science, for example:

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263

-al

abdominal
abnormal
emotional
endocardial
intestinal
nasal
oval
renal

-ic

a n t i a rry t h m i c
a n t i b i o t i c
c e p h a l i c
c h r o n i c
d i a g n o s t i c
endemic
fiberoptic
orthop(a)edic
plastic
scientific
traumatic
ultrasonic

-ical

biological
cer vical
etical
gyn(a)ecological
medical
physical
physiological
therapeutical

-ive

aggressive
invasive
radioactive

-oid allantoid
cardioid
ch o r o i d
corticoid
fibroid
mastoid
(shaped like ovoid
paranoid
steroid
thyroid
typhoid
trapezoid or similar to) Some adjectives take the suffix -ic only; others add -al to it. In a few cases both adjectives exist, usually with a slight difference in meaning or usage: anatomic pathology / anatomical science, electric stimulation / electrical impulse, optic nerve / optical device. The French equivalents of such suffixes are often predictable and systematic (“a b d o minal“, “antibiotique“, “cervical“, “invasif“, “thyphoïde“), but not always. Compare: emotional / “émotionnel“, autosomal / “autosomique“, physical / “physique“, paranoid / “paranoïaque“. Some of the words in -ic or -oid are nouns. Related adjectives can be formed by adding -al: antibiotical, medical, allantoidal, choroidal; plastic can be either a noun or an adjective.

3. Names of diseases and conditions Various terms and suffixes are used to form the names of diseases and conditions. They are rarely interchangeable. Some are more common than others: disease

altitude disease
chronic active liver disease
cerebrovascular disease
Lyme disease
Parkinson('s) disease

illness

acute febrile illness
bipolar illness
environmental illness
heat illness
manic-depressive illness
mental illness

sickness

altitude sickness
sea-sickness
sleeping sickness

syndrome

AIDS
SARS
SIDS (Sudden Infant Death Syndrome)

nos-

nosocomial
nosogenesis
nosography

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GRAMMAR NOTES

Grammar notes Index

N°

Grammar notes Index

N°

According to Actually Compound forms and hyphens Compound nouns Confusing word pairs Countable / uncountable nouns Dates Hard / hardly Important Interrogative form Just Modals Multi-word verbs Never Numbers, dates and time

2 24 20 26 9 12 5 4 23 14 10 18 17 11 5

Past conditions Phonology Quite Reporting verbs Spelling Tenses and aspect Tenses: active and passive forms Thereby / therefore Time To consist of / in To design / devise + to / for To lay / lie To raise / rise To transform / change / turn into To trigger / spark (off)

7 22 27 16 3 21 15 13 5 1 25 19 19 8 6

1. To consist of / in There is a slight difference in meaning in the 2 verbs. Compare:  The leg consists of 5 major segments: pelvis, femur, tibia-fibula, tarsalsmetatarsals and phalanges.  The therapy consists in teaching patients to relax.  “To consist of“ means “to be composed of, include“.The verb refers to the different elements of an object or a process. It is often followed by a list.  “To consist in“ on the other hand, refers to the essential features, the defining characteristics of something. It is often followed by an “-ing form“.

2. According to – expressing personal opinion There is a tendency for learners to misuse the expression “according to me“ when expressing personal opinion. The phrase “according to“ is similar in meaning to the verb “to claim“. It is used typically when reporting the opinion of other people, accepted authorities or experts; the speaker is indicating that the claim may not necessarily be true:

266

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 According to the post-mortem, death was due to a massive lung hemorrhage.  According to the Minister of health, the epidemic peaked in China in late February.  According to hospital records, she was admitted to the emergency service at 3.15 a.m. To express personal opinion, the following expressions are commonly used:

Formal

“In my view, a long-term solution requires … Acupuncture, in my opinion, should be used only in cases of … To my mind, the main argument against private medicine is …

Less formal

I would say that home birth was the best option for me. It seems to me that hospital services are much better nowadays. Personally, I feel there is small chance of a full recovery.

3. Spelling  DOUBLING

LETTERS

When a consonant in a monosyllabic word is preceded by a single vowel, the consonant is doubled:  fat / fatter  stop / stopped  drop / dropping If the consonant is preceded by two vowels the letter is not doubled:  meet / meeting In polysyllabic words the same rule applies (with some exceptions) if the syllable is stressed:  be'gin / beginning  oc'cur / occurring  per'mit / permitted But not if it is unstressed:  de'velop / de'veloping  BRITISH AND AMERICAN

SPELLING

There are a certain number of spelling differences between British English and American English. From a learner's point of view these are not crucial as they have little effect on comprehension. British English tends to be more conservative, retaining historical and etymological traces whereas the American system has moved in the direction of simplification.

GRAMMAR

267

NOTES

British English

American English

-OUR  -OR

colour  behaviour  neighbour  honour  labour

color  behavior  neighbor  honor  labor

-RE  -ER

centre  metre  fibre  theatre center  meter  fiber  theater

-ENCE  -ENSE

defence  offence  licence

-ISE  -IZE

organise  recognise  realise  organize  recognize  realize  criticise  analyse  paralyse criticize  analyze  paralyze programme  levelling 

DOUBLE LETTERS: travelling  equalling REDUCTION

DIPHTHONGS: SIMPLIFICATION AE/OE



E

-OGUE  -OG

(In British English, "program" is used when referring to a computer program)

program  leveling  traveling  equaling

anaemia  anaesthesia  diarrhoea  gynaecology  haemophilia  leukaemia  orthopaedic  paediatric

anemia  anesthesia  diarrhea  gynecology  hemophilia  leukemia  orthopedic  pediatric

dialogue  analogue  catalogue  pedagogue

dialog  analog  catalog  pedagog

OTHER EXAMPLES enquire  aluminium  OF SIMPLIFICATION

defense  offense  license

sceptic  cheque  moustache

inquire  aluminum  skeptic  check  mustache

4. Hard / hardly These words, which have almost diametrically opposed meanings, are often confused:  A hard disk drive. (adj.)  She worked hard for her exam. (adv.)  Last year, she hardly worked at all. (adv.)  “Hard” can be either an adjective or adverb. It has several meanings including “rigid / resistant, with effort / assiduously, difficult“. The adverb is placed after the verb.  “Hardly” on the other hand, can only be an adverb. It is placed before the word it qualifies. It is a synonym of “scarcely“ and “barely“ with the meaning of “very little, almost none“. It has a negative connotation which explains why it is very frequently followed by the negative particle “any“:  Hardly any money / hardly anything / hardly anyone

268

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5. Numbers, dates and time  LARGE NUMBERS • GB – Large numbers are said as follows:  179  A hundred and seventy nine.  42,392  Forty two thousand, three hundred and ninety two. Note that:

A / One:

in large numbers “and“ is inserted between the hundreds and the tens. hundreds and thousands do not take “- s“ when preceded by a numeral. When talking of hundreds, thousands, etc., “a“ is normally used except when a contrast is being made with a different number, or when precision is important:

 Not 100 - 200!  Not one hundred, two hundred!  He had exactly one hundred and twenty five pounds in the bank.  9,136  Nine thousand, one hundred and thirty six. • US – In US English “and“ is often left out in large numbers.  623  Six hundred twenty three.  FRACTIONS The most common fractions are 1/2 (a half)  1/4 (a quarter)  3/4 (three quarters)  1/3 (a third)  1/8 (an eighth)  3/10 (three tenths).  ZERO • GB – The figure “0“ can be expressed in three different ways: zero (science, medicine, temperatures)  nought (decimals)  oh (telephone numbers). • US – In US English, nought is usually replaced by zero.  DECIMALS  0.563  Nought / zero point five six three.  TELEPHONE NUMBERS Usually each figure is said separately:  01622 87812  Oh one six two two (or double two ) eight seven eight one two.  DATES They can be written in a variety of ways: • GB – 5 June 2007  31st January 1999  9.1.2001

GRAMMAR

269

NOTES

When reading dates note the use of “the“ and “of“:  (10.3.2006)  The tenth of March, two thousand and six / March the tenth, two thousand and six. • US – In US English, the order or month and date is reversed. Consequently, 10.03.2006 refers to the third day of October:  October tenth, two thousand and six.  TELLING THE TIME  12.00 

It is twelve o'clock / midday.

 1.05



It is five past one.

 1.15



It is a quarter past one / one fifteen.

 1.30



It is half past one / one thirty.

 1.45



It is a quarter to two / one forty five.

 1.55



It is five to two / one fifty five.

Normally, the day is divided into two periods of 12 hours (except for timetables, the military, etc.). If it is necessary to specify, a.m. (ante meridiem) and p.m. (post meridiem) are used:  Two a.m. (02.00)  Two p.m. (14.00)

6. To trigger / spark (off) These two verbs are used in very similar circumstances with the meaning of “causing or providing the stimulus for an event (often important or dramatic)“. Both words can be used with or without “off“. The particle brings no fundamental change in meaning, just reinforcing the notion of initiating a new action. Compare:  This discovery could spark a revolution in the treatment of prostate cancer.  Sometimes, a single genetic mutation is enough to trigger a tumour.

and  Sexual stimulation sparks off the release of neurotransmitters in the brain.  Migraine can be triggered off by stress, certain foods, bright lights, loud noises, etc.

7. Past conditions (3rd conditional) The third conditional typically refers to past events that did not occur. Consequently, a past perfect conditional is normally used:  If the patient had been given nitro-glycerine, he would probably have survived. (he did not survive)

270

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However, in certain circumstances the past condition may refer to present time:  If the patient had been given nitro-glycerine, he would probably be alive today.

8. To transform / change / turn into The preposition “into“ is used to indicate movement and change in position. Similarly, “into“ is used with verbs like “translate, change, transform, turn, make, develop …“, when, as a result of an action, there is a transformation of state:  Stem cells taken from human fat can be transformed into muscle cells.  A drug called L- DOPA, is absorbed in the brain and changed into dopamine.  The body turns carbohydrates into blood sugar.  The office was made into a reception room.

9. Confusing word pairs The following pairs of words are often confused:  TO

CARRY OUT

/

REALISE

 The operation was carried out in the middle of the night. (do, perform, complete successfully)  She realized that she had forgotten her cell phone. (become suddenly aware, understand clearly)  AN

EXPERIENCE

/

EXPERIMENT

• “Experiment“ is a term associated with science, referring to testing procedures under controlled conditions in order to verify a hypothesis. It can also mean “an attempt when the final outcome is not sure“:  The patient had not been informed that it was part of a medical experiment.  The experiment in computer- assisted diagnosis was disappointing. • “Experience“ on the other hand is associated with personal or everyday life. It is essentially the practical knowledge and skills attained by participation in, and observation of events. It can mean “an event in one's life which leaves an impression“:  He is young, knows a lot, but needs more experience.  His experience as a doctor in the 3 rd world marked him for life.  LAST /

LATEST

• “Last“ is the opposite of first; it means “following all the rest, ultimate, a terminal element in a series“:

GRAMMAR

NOTES

271

 The last train leaves just before midnight.  The last Dodo became extinct in the 1680s. • “Latest“ on the other hand, is the superlative of late, and means “the last one so far, the most recent, the most modern“:  The site publishes the latest medical news.  The latest and most modern equipment.  TO

GROW

/

GROW UP

• The primary meaning of “to grow“ is “to increase in size, to develop“. It can also mean “to become“:  The tumour is growing very fast.  He is growing old. • “To grow up“ on the other hand, is used when referring to the process of attaining physical, emotional and intellectual maturity, developing into an adult:  He grew up in Berlin during the war years.  Don't be such a baby – grow up!

10. Just Words like “just  already  yet“ are used differently in British and US English. • GB – In British English these words are associated with present time, and usually found with the present perfect tense:  The Secretary for Health has just returned from a visit to China. • US – In US English on the other hand, these words are commonly associated with the past, and used in conjunction with past tenses:  The state of Montana just legalized medical marijuana last year.

11. Never When talking about personal experience, “never“ is frequently found with the present perfect tense. This is because the word means “up to now, so far“:  He has never been vaccinated. (so far in his life) Obviously, when talking about historical or dead people the past tense is required:  Louis Pasteur never visited Australia.

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Similarly, if a living person is talking about a past period of his life, then a past tense is required:  When she was working in Africa, she never visited Johannesburg. (during that period of her life)

12. Countable / uncountable nouns Most nouns in English have plural forms and can be counted:  3 nurses  5 blood tests  many doctors However, there are certain nouns that, in normal circumstances, cannot be itemized or counted; they are not normally preceded by words like “a, every, many, several …“, and they have no plural form. Amongst these words you find words like: advice  beauty  bread  coffee  equipment  fruit  furniture  glass  hair  happiness  heat  information  intelligence  knowledge  measles  money  news  obstetrics  progress  research  traffic  tuberculosis  water … Sometimes however, it is necessary to itemize uncountable words. This can often be done by adding words like “bit, piece, item …“:  Each student must also accomplish a piece of research.  Several items of equipment have not yet been delivered.  I would like to give one bit of advice to all nursing students.  There report contained several important items of information. Itemizing can also be done by using words like “bottle, a cup, a slice, a case …“:  a bottle of water  2 cups of coffee  3 slices of bread  4 cases of measles Some uncountable nouns also have a countable form, but usually the meaning changes:  glass  glasses (optical instruments)  fruit  fruits (different varieties of fruit) N.B. – Words ending in “-s“ like “news, measles …“ are singular.

13. Thereby / therefore These two words both have the meaning of “consequently“. However, there is a fundamental difference. “Thereby“ refers essentially to a practical consequence: the result of an action. “Therefore“ has a more logical connotation: it refers to the consequence of certain facts.

GRAMMAR

273

NOTES

 THEREBY  Certain surgeons ask to be paid in cash, thereby avoiding tax claims.  Saturated fat diets block up the arteries, thereby reducing the blood flow to the heart.  THEREFORE  “I think therefore I am.“ (Descartes)  Most patients have little understanding of disease, it is therefore necessary to … N.B. – “Thereby“ is usually followed by an “-ing“ form.

14. Interrogative form The interrogative is normally formed as follows: AUXILLIARY

+

SUBJECT

+

VERB

/ COMPLEMENT

Auxiliaries are verbs like “to be, to have“, or modals “can, may, will …“:  Is she better?  Have you finished?  Can I go home? In other cases, the replacement auxiliaries “do, does, did“ are used:  Do you work with Susie?  Does he speak Russian?  Did he see the film? N.B. – The verb following the auxiliary is in the infinitive. When question words are used (who, what, which, when, why, how, where …) they are placed in initial position:  Who do you work with? (I work with Susie)  Why does she smoke so much? (She smokes because … )  Where did they go last week? (They went to Venice) When the Q word refers to the subject, no auxiliary is used:  Who works with Susie? (Peter works with Susie)  What caused the accident? (Rain caused the accident)

15. The tenses: active and passive forms Below is a comparative table of the active and passive forms (certain forms are extremely rare and have been omitted).

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Passive

PRESENT She examines him – SIMPLE – CONTINUOUS She is examining him

He is examined (by the nurse) He is being examined (by …)

PRESENT PERFECT She has examined him – SIMPLE – CONTINUOUS She has been examining him

He has been examined (by …) –

FUTURE

She will examine him She will be examining him

He will be examined (by …) –

PAST

She examined him – SIMPLE – CONTINUOUS She was examining him

He was examined (by …) He was being examined (by …)

PAST PERFECT She had examined him – SIMPLE – CONTINUOUS She had been examining him

He had been examined (by …) –

16. A list of common “reporting“ verbs used with the passive To accept  acknowledge  admit  announce  assume  claim  consider  decide  estimate  feel  fear  forget  imply  know  note  notice  propose  realize  reckon  remember  report  request  say  suggest  suppose  think  understand  It is estimated that 1 million children die from measles annually.

17. Multi-word verbs Multi-word verbs (also called phrasal verbs) consist of verbs followed by 1 or 2 particles (adverbs, prepositions). The group functions as a single verb. However, the combination of verb + particle is not always transparent in meaning:  (take + after) She takes after her mother. (has similar inherited features)  (put + up + with) I can’t put up with the noise. (endure, tolerate) Multi-word verbs have frequently a more colloquial connotation than corresponding synonyms. Compare:  He put off the appointment / He postponed the appointment  She put out the fire / She extinguished the fire. Multi-word verbs can be transitive, or intransitive (not requiring an object):  The nurse turned down the heating.  The patient sat down.

GRAMMAR

275

NOTES

If the particle is a preposition, verb and particle are separable. One can say either:  She gave back the book. (returned)  She gave the book back. N.B. – If a pronoun is used, it must be placed between the verb and the particule:  She gave it back. If the particle is an adverb, it is inseparable from the verb:  She got off the bus. (She got the bus off) N.B. – Many compound nouns are derived from multi-word verbs, with a particle either in initial or terminal position:  an outbreak of measles (epidemic)  intake of calcium (consumption)  a mental breakdown (failure, collapse)  a cutback in government funding (reduction) Particles may have different meanings; the following frequently-used particles can be confusing:  to switch off the electricity  to call off a meeting (interrupt / postpone)



OFF



ON



OUT



OVER



THROUGH



UP

 to carry on working  to put on the heating (continue / connect the electricity)  to try out a drug  to work out the answer (test completely / find a solution)  to think over a problem  to get over an illness (reflect / recover)  to read through a report  to get through an exam (from one end to the other / succeed)  to eat up the food  to give up smoking (finish / stop)

The rules governing multi-word verbs are complex. Probably, the fastest way of learning is to start by familiarising yourself with a number of basic forms so that you can recognize them and use them fluently. Below, you will find a selection of verbs commonly found in medical English.  BRING ABOUT 

BRING BACK



BRING UP

 Steroid infusions failed to bring about the desired effect. (cause)  The treatment helps bring back the libido in post-menopausal women. (restore)  The child was brought up by unemployed and alcoholic parents. (raised, looked after as a child)

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 CALL

BACK





CALL FOR

COMPETENCE IN MEDICAL ENGLISH

CALL OFF

 The secretary called back to confirm the appointment. (telephoned a second time)  The strike by ambulance drivers was called off on Friday evening. (cancelled, abandoned)  The minister is calling for greater efforts to reduce medical costs. (demanding)  CHECK

IN



CHECK OVER



CHECK UP

 New patients should check in at the registration office. (register)  You should check over the details of her medical history. (examine closely)  Could you check up on his previous operations? (investigate)  CUT

DOWN



CUT OFF



CUT UP

 You should cut down your intake of salt, sugar and fat. (reduce)  Cutting off the blood supply to tumors impedes growth. (interrupting)  The pathologist cut up the specimen. (cut into small pieces)  GET ABOUT 

GET OVER



GET THROUGH

 After the operation, she was soon able to get about by herself. (move, walk)  She never got over the death of her newborn child. (recovered from)  The article was in German and it took some time to get through. (read to the end)  KEEP AWAY 

KEEP ON



KEEP UP WITH

 Children with eczema should be kept away from cats and dogs. (isolated)  Life expectancy keeps on increasing from year to year. (continues)  It is difficult to keep up with progress in science (remain in contact)  SET ABOUT 

SET OUT



SET UP

 As soon as he arrived, he set about reorganising the department. (started)  The ministry has set out guidelines for treating terminal cancer. (specified in detail)  The research department was set up only 2 years ago. (established)

GRAMMAR

NOTES

277

18. Modals The presentation of modals in Unit 11 was concerned above all with expressing the functions of probability, certainty and desirability. The examples below show how modals are used to express other functions:  Permission – may, can (might)  Visitors may not smoke anywhere in the Hospital. (it is not allowed)  Can I visit the patient tomorrow? (more common, but less polite than “may“)  Might I ask a question? (extremely formal and polite – rare)  Requests – will, would, can, could  Will you post the letter for me?  Would you post this letter for me? (more polite)  Can you give me a hand?  Could you give me a hand please? (more polite)  Obligation / prohibition  You must bring your insurance card with you. (it is required by the administration)  You must not make a noise after 8 p.m. (it is forbidden)  Decisions / refusal  The patient won't take the medicine. (he refuses, he is not willing)  The car won't start.

19. To raise / rise – to lay / lie These word pairs can be confused. Study the examples:  First, you should lay the patient on his side. Next, you should raise the patient's legs.  The patient was lying on the examination table. Her temperature was rising.  “To raise / lay” are transitive verbs; they are followed by objects. Their basic meaning is “to put“. • “To raise“ means “to put in a higher position“. • “To lay“ means “to put in a horizontal position, to put down carefully“. The two words express the idea of an action imposed on an object.

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 “To rise / to lie“ on the other hand, are intransitive verbs. They do not take objects. • “To rise“ means “to move from a low position to a higher one“. “Rise“ doesn't refer to an action imposed by s/o but to the movement upwards. • “To lie“ means “to be in a low position, to be horizontal”. N.B. – A further confusing factor is the irregular forms of these verbs: To raise  raised / raised To lay  laid / laid

To rise  rose / risen To lie  lay / lain

20. Compound forms and hyphens There is considerable variation in the use of hyphens. The hyphen is used in British English more frequently than in American English. It is better to hyphenate:  Compound adjectives where the first element is: • an adjective: • a number: • a letter:

 a short-term treatment  full-time employment  a 3-minute presentation  a 50-year-old patient  an x-ray  a T-shirt

 Compound nouns where one of the elements is: • a past participle:  a home-made cake  a severely-injured patient • a noun + “-ed”:  a four-legged animal  a one-eyed man • an “-ing” form:  freeze-drying  a waiting-room • a grammatical word (like non-, anti-, self-, etc):  non-steroidal drugs  anti-inflammatory analgesics

21. Tenses and aspect There are different sorts of grammatical descriptions of the tenses. In MCME we adopt a similar model to certain major “pedagogical grammars“ (cf. Collins Cobuild English, 2005, and Longman's Advanced Learners' Grammar, 2005) which present the progressive or continuous forms and the present perfect forms as tenses. Certain other academic grammars prefer to refer to these forms as “Aspects“.

22. Phonology The phonological transcription used is that of the International Phonetic Alphabet (see Annexe “Phonetic Alphabet“), describing standard British English. In the transcriptions of the texts we have not used the customary slashes ( / / ) to separate phonological units in order to make the text easier to read.

GRAMMAR

NOTES

279

23. Important “Important“ is a false friend. The reason is that the word is polysemic in French, that is to say that it has two separate meanings: “big” and “significant”:  un nombre important / un livre important In English it only has the meaning: “significant, of value, influential, having authority“:  Cambridge has a small but important medical faculty.  It was a very important decision.  It is important to follow basic rules of medical deontology. N.B. – When the French word “important“ refers to dimension it can be translated by “big, large, considerable …“:  a large increase in the population  a big town

24. Actually The word “actually” is another false friend, and is a consistent problem for French learners as it is confused with the French word “actuellement“. However, it's meaning is very different. The word has no connection with time, it is concerned with reality, fact, the truth. Look at the examples:  A very small percentage of those who do go on to college actually go into medicine.  Increasing numbers of studies that get published are actually written by pharmaceutical firms.  The police report showed that the physician never actually examined the patient. “Actually” can also be used to express surprise:  For once, she actually came on time!

25. Designed / devised + to / for There is a small but important difference between these two verbs.  To design The basic meaning of “design“ is “to plan and organize the structural elements of an object or project (often on paper)“. By extension, it also means “to aim, to intend“:  The hospital was designed by Sir George Scott in 1839.  He is an orthopaedic surgeon and has designed several prosthetic joints.  The software is designed to eliminate basic prescription errors.

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 To devise “Devise“, on the other hand, means “to elaborate, invent a system or a solution, involving careful thought and innovation“:  to devise a way of reducing medical malpractice.  Strategies were devised for overcoming the shortage of staff. N.B. – “To“ is used to introduce the infinitive, and “for“ when using a noun (including verbal nouns: “verb + -ing“):  The software was designed for students and workers in the health care sciences.  A low-cost teaching aid specifically designed for training paramedics.

26. Compound nouns In languages like Latin and French, the principal meaning of a compound noun is in the first word and the link between the elements is often made clear with a preposition:  équipe de recherche On the other hand, in Greek and in Germanic languages like English, the principal meaning of a compound noun is in the final word which is qualified by the preceding nouns. This explains why the word order is inversed. The link between the elements is implicit:  research team

27. Quite “Quite“ is another polysemic word with two completely different meanings.  “Quite“ = to a certain extent, fairly, relatively  The weather is quite hot  He is quite good at maths  The film was quite interesting  We had to wait quite a long time  She is quite tall In this sense “quite“ is used with gradable words, that is to say words which have degree, which can be used with the comparative form: “the weather can be more or less hot, you can be good at maths or very good …“.  “Quite“ = totally, completely, to the utmost degree  It is quite impossible  It is quite extraordinary  You are quite right  I quite agree with you  He hasn't quite recovered from the illness In the second meaning, “quite“ is used with words that express an absolute quality, words which are binary and cannot be divided into degrees: “something is either right or wrong, something cannot be “very impossible“ …“. In US English “quite“ is less commonly used with the meaning of “relatively“.

THE PHONETIC ALPHABET The transcriptions correspond to the most common usage in standard British English. Consonant symbols which are identical are not shown in the table below.

CONSONANTS

VOWELS

D

the, other

B

think, path

A: hard, car

aq my, eye

G

vision, usual

c:

call, door

cq boy, noise

dG joke, urgent

E:

her, bird

ax house, cow

H

Long vowels

shop, machine

tH cheese, nature C angry, wrong

Short vowels

i:

DIPHTHONGS

sheep, police

eq they, day

u: who, you

Fx go, nose

q

ship, win

eF where, their

e

pen, get

qF ear, here

A man, hat y

sun, must

o

hot, not

x

book, foot

F the, above, teacher

 Main stress is marked by the sign / I /. Example: a medical assistant  / F Imedqkl FIsqstFnt /

7KLVSDJHLQWHQWLRQDOO\OHIWEODQN

PHONOLOGY NOTES

Unit 1 Phonology – Sounds & Rhythm (Exercise 1.17) Terminal “-s“  Student B: Your partner will read you the text, “Preserving Brain Health in an Ageing Population“. Your job is to monitor his/her pronunciation. Listen carefully and check (underline with a pencil) whether s/he pronounces the terminal “-s“, marked in red in the text. When you have finished, explain the nature of the exercise to your partner and then change roles.

PRONUNCIATION NOTES Because of interference from the French phonological system, French speakers often omit to pronounce the terminal “-s“.

PRESERVING BRAIN HEALTH

IN AN

AGEING POPULATION

The BBC reports that a group of London hospitals are working on plans to intensify the search for strategies to preserve brain health as the population grows older. Several promising methods have been proposed which could help maintain both cognitive and emotional functions. According to the researchers it appears that brain health is closely related not just to genetics, but also to education, cardiovascular health, physical activity and psychosocial factors.

Remedial work (Exercise 1.20)  Never forget, problems of rhythm and pronunciation will do more to prevent you being understood than poor grammar. If you had problems pronouncing the “s“ in Exercise 1.17, learn the following sentence by heart. You must be able to say it quickly, fluently and automatically. There are many causes of back pains, including working on computers in uncomfortable chairs.

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Unit 2 Phonology – Sounds & Rhythm (Exercise 2.15) The weak form – schwa / F /  Student B: Your partner will read you the text below, “HDL cholesterol levels“. Your job is to monitor his/her pronunciation. Listen carefully and check (underline with a pencil) whether s/he uses the weak form satisfactorily. Weak forms are transcribed in a phonological transcriptionG. Notes 22. When you have finished, explain the nature of the exercise to your partner and then change roles.

PRONUNCIATION NOTES Weak forms An extremely important feature of English is the existence of the weak vowel, the schwa / F /. One of the major pronunciation problems for many learners is their failure to master this vowel. The schwa is found particularly in prepositions, grammatical words and auxiliaries: for example words like:  from  to  a  as  and  can  was. It is also found in the unstressed syllables of multi-syllable words:  ago  possible  particular. Remember: • The schwa is pronounced with a completely relaxed mouth; lips, tongue and jaw are in a neutral position. • You will obtain a good approximation if you try to pronounce nothing. Consequently, “from“ is not normally pronounced like “John“, but like “fr'm“, “to“ is not pronounced like “you“ but like “t'“, the first syllable of “considered“ is not pronounced “kon“ but “k'n“, etc. • Sometimes the vowel is so weak between two consonants that it disappears completely: level  / Ilevl /

N.B. – In U.S. English, the “r“ following a vowel would be pronounced:  < considered > / kFnIsqdFrd / In the transcriptions below, in order to facilitate reading we have not used the customary slashes ( / / ) to separate phonological units.

PHONOLOGY

285

NOTES

HDL

CHOLESTEROL LEVELS

An HDL level of 30 is not considered to be a healthy level. Fn Ilevl Fv kFnIsqdFd tF F Ilevl The level should be at least 40 for men, and some experts recommend DF Ilevl Ft fF Fnd ,rrekFImend more than 45 for women. DFn fF High levels of HDL can actually help your heart as they carry potentially Ilevlz Fv kFn Fz pFItenHFlq harmful LDL away IhA : mfl FIweq

from frFm

the arteries. DF IA: tFrqz

Remedial work (Exercise 2.18)  Did you have problems with the schwa? If you did, how can you deal with it? Clearly the problem will not disappear by itself. The schwa is by far the most common vowel in the English language, so it is important that you should master it. Learn the model phrase below by heart. Repeat it five times a day for a week until it becomes automatic. You can overcome some of the problems by repeating the model kFn FxvFIkym Fv DF IproblFmz DF Imodl from time to time. frFm tF

Unit 3 Phonology – Sounds & Rhythm (Exercise 3.15) The ending “- er“  Student B: Your partner will read the text to you. Listen carefully – your job is to assess his/her pronunciation of “- er  - or  - ior“. Do not tell this to your partner until s/he has finished. The “- er“ words are underlined. Mark any word that is mispronounced and show your partner afterwards.

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PRONUNCIATION NOTES The ending “- er“ is a classic francophone pronunciation problem. You must make every effort to avoid saying: teach eur . There are 3 very important things to remember: 1. The syllable is always weak. It is not stressed. 2. In British English the “- r“ is not usually pronounced. It is almost as if you say nothing: teach'. 3. In US English there is an “- r coloration“ but no stress: teach(r).

N.B. – In the transcription below, the “- r“ in brackets at the end of certain words, e.g. / ImqstF(r) /, indicates the possibility of American “- r coloration“.

CASE

STUDY

9: HIV – REFUSAL

OF TREATMENT

On July 5th, Mr Y, a 35-year-old man, phoned to ask for a consultation at the ImqstF(rr) university medical center. He had been tested positive for HIV and he IsentF(rr) requested a second opinion. He informed the doctor that he had never engaged in any high risk behavior IdoktF(rr) InevF(rr) bqIheqvjF(rr) and believed that the positive result of the HIV antibody test was an error. IerF(rr) Physical examination revealed a loss of weight, and low-grade fever accompanied Ifi : vF(rr) by chronic fatigue and pain in his lower abdomen. IlFxF(rr) A further HIV test was carried out and an appointment made for the following IfE : DF(rr) week in order to explain the results. It was, however, the sister who came to the Ic : dF(rr) haxIevF(rr) IsqstF(rr) appointment. The doctor informed her that he was not able to reveal the results. IdoktF(rr)

PHONOLOGY

NOTES

287

When Dr H telephoned, Mr Y explained that he had been afraid to return and IdoktF(rr) ImqstF(rr) had in fact anticipated the bad news. Mr Y, who was a worker in a Korean electronics firm, feared that if his ImqstF(rr) IwE : kF(rr) employer learned of the results, he would lose his job, and thought that no qmIplcqF(rr) matter what he did, he was going to die. ImAtF(rr) Mr Y ImqstF(rr)

never returned to the hospital. InevF(rr)

Remedial work (Exercise 3.18) Weak terminal “- er“. The syllable is completely unstressed.  Learn the model by heart paying attention to the rhythm. After the dinner she talked to the doctor who said to the mother she'd died F(rr) F(rr) F(rr) F(rr) DA di di DA di di DA di di DA di di DA di di DA di di DA of a fever. F(rr) di di DA di

Unit 4 Phonology – Sounds & Rhythm (Exercise 4.16) The sounds “qu - ch“  Student B: Your partner will read the following text to you. Listen carefully – your job is to assess his/her pronunciation of “qu“ and “ch“. Do not tell this to your partner until s/he has finished. The target words are underlined. Mark any word that is mispronounced and discuss this with your partner afterwards. Read the text first to make sure you understand all the words.

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PRONUNCIATION NOTES “qu - ch“ • In French “qu“ is pronounced “k“. In English “qu“ is pronounced “kw“. • In French “ch“ is pronounced “sh“. In English “ch“ is pronounced “tch“. (phonetic symbol / tH /)

N.B. – Words of Greek origin beginning with “ch“ are exceptions. They are pronounced / k / (cf. chaos, character, chemist).

A CASE STUDY Mrs Chang is a 59-year-old obese female. She is of Chinese origin and employed tHAC tHaqIni : z as an unqualified worker in the textile industry. She was admitted at a quarter Ikwolqfaqd Ikwc : tF(rr) past ten on Wednesday morning to the Emergency room of the Chester Infirmary. ItHestF(rr) She has a prolonged history of severe chest pain. When questioned she admitted tHest IkwestHFnd that although she had been suffering for the last 9 months, she had not yet seen a doctor. She smokes 10 cigarettes a day and is often short of breath. On Monday night she felt 'sick', but just asked her children to get some “heartburn“ pills from ItHqldrFn the chemist's. Further questioning reveals that this morning she felt an unrelenting IkwestHFnqC pressure over her chest and severe “heartburn“ which seemed to paralyze tHest her left arm. She was obliged to quit work and came directly by taxi to Chester Infirmary. kwqt ItHestF(rr)

PHONOLOGY

NOTES

289

Remedial work (Exercise 4.19) The sounds “kw - ch“  To eliminate problems with “qu - ch“ practice the following sentences until you are satisfied. • The chairperson is in charge of the meeting. ItHeFpE : sn ItHA : dG • You must check that their qualifications are in order. tHek kwolqfqIkeqHnz ,k • The Chinese quota has been reduced by a quarter. tHaqIni : z IkwFxtF Ikwc : tF(rr) • He chose the cheapest flight to Quebec. ItHFxz ItHi : pqst kwqIbek

Unit 5 Phonology – Sounds & Rhythm (Exercise 5.15) The sound “h“  Student B: The mispronunciation of “h“ is one of the classic francophone mistakes. By the end of the year all students should have mastered it. Listen to your partner as s/he reads the text – your job is to assess the pronunciation of “h“. Underline only the words with “h“ that are mispronounced. (indicated in red) When s/he has finished, explain the nature of the exercise, discuss and change roles.

PRONUNCIATION NOTES “h“: The sound is not difficult. It is made by the friction of outgoing air on the vocal tract: for example, when you try warming your hands by blowing on them on a cold winter's day.

N.B. – In careful slow reading, the “h“ is pronounced in “has“. In fast spoken English it would normally not be pronounced, e.g.

research has shown  research uz shown

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CLINICAL DEPRESSION Depression is the fastest growing diagnosis at doctors' offices in North America. It is an ailment that can strike anyone, however, recent research has shown that people with cardiac problems are more likely to suffer from depression than healthy patients and conversely, that people with depression have a higher risk of developing heart disease. Unfortunately, as many as half those suffering from depression remain untreated. This is unacceptable as treatment helps patients manage both diseases, thus enhancing survival and quality of life. According to a recent publication from the Harvard School of Public Health, about 1 in 20 American adults experiences major depression in a given year, with an even higher number – about one in three – for people who have survived a heart attack.

Remedial work (Exercise 5.18)  Practice the following contrasting pairs of sentences until you are perfect. Notice the sentences have the same rhythm. Try to reproduce it. • She's really quite ill. di DA di di DA

He lives on the hill.

• It's bacon she's eating. di DA di di DA di

It’s water she's heating.

• She studies fine art. di DA di di DA

She's got a bad heart.

• Jane said she ate it. DA di di DA di

Why do you hate it?

Unit 6 Phonology – Sounds & Rhythm (Exercise 6.15) Revision (Units 2-5)  Student B: This exercise revises the phonological points seen in Units 2- 5, namely the schwa, “- er“, “h“, “ch“ and “kw“. Each section highlights one of the problem areas. Listen and correct your partner. When you have finished change roles.

PHONOLOGY

291

NOTES

PRONUNCIATION NOTES • The schwa / F / : Remember that the schwa is a weak, neutral vowel, pronounced with a completely relaxed mouth. A very close approximation is to pronounce no sound at all. Instead of saying: to, say: t'. • “- er“: Idem. For “Doctor“ instead of saying: dokteure, say: dokt'. • “h“: The sound vibrates in the vocal cavity. • “qu“ is pronounced “kw“ and “ch“ is pronounced “tch“. (phonetic transcription / tH /)

Sounds & Rhythm – Student B TRAFFICKING

KIDNEYS

– LETTER TO THE

EDITOR

Dear Sir, With reference to your article on kidney donors I have had some IrefrFns tF IdFxnF(rr)zz hFv direct experience of the problem while working in a private Fv DF IproblFm F

schwa =/ F /

hospital in India. Ihospqtl IqndqF India has become an international center for the transplantation sentF(rr) of kidneys. Donors are all from the lower impoverished classes with IdFxnF(rr)zz IlFxF(rr) an urgent need for cash, either to pay back a debt for a daughter's IaqDF(rr) Idc : tF(rr)zz

- er =/ F /

marriage, buy medication for their own children or to escape from bonded labour. IleqbF(rr) However, the dangers of the operation are considerable and haxIevF(rr) heightened by the fact that the donors are hardly ever in good health, Ihaqtnd IhA : dlq helB hence the quality of the kidneys is often very poor. hens

h

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As to the question of payment, more than 80% of the money goes IkwestHFn to the middleman. There are no post operational checkups, consequently complications ItHekyps Ikonsqkwentlq are relatively frequent. In my case the trafficking was organised by the Ifri : kwFnt chief administrator of the hospital with the help of a surgeon in charge tHi : f tHA : dG of the outpatient department. Needless to say, I quit the job as soon kwqt as possible and found work elsewhere. Yours faithfully, Dr Quentin Chatterton Ikwentqn ItHAtFtFn

Remedial work (Exercise 6.18) Revision: Weak terminal “- er“, schwa, the sounds “h“, “qu“ and “ch“  Learn the model by heart, paying attention to the rhythm. • Of course the doctor was

qualified.

Fv

DF

IdoktF wFz Ikwolqfaqd

di DA

di

DA di

• Check the heart tHek

DA

DF

di

and

di

DA di di

change the dose if required.

hA : t

Fnd tHeqndG DF

DA

di

DA

rqIkwaqFd

di DA

di di DA di

• If the headache doesn't get better take an aspirin. DF

di di

Ihedeqk

DA di

IbetF

DA di

Fn IAsprqn

di DA di DA di

DA di

qu = kw ch = tH

PHONOLOGY

293

NOTES

Unit 7 Phonology – Sounds & Rhythm (Exercise 7.16) Weak syllables  Student B: Listen to your partner without stopping him. Underline any mistake. When you have finished, change roles.

PRONUNCIATION NOTES • In French there is a tendency to pronounce every syllable. In English, however, in multi-syllabic words, certain syllables are very weak (see Unit 2) or disappear altogether. • The words “aspirin“, “different“ and “general“ are usually pronounced with 2 syllables not 3. e.g. IAsprqn (2) IdqfrFnt (2) IdGenrFl (2) • In the correction sheet the number of syllables is indicated after the phonetic transcription.

ASPIRIN – THE WONDER

DRUG

Aspirin is the most widely used drug by the general public and IAsprqn (2) IdGenrFl (2) more than fifty billion tablets are taken worldwide each year. It is effective for IbqljFn (2) such different ailments as headache, temperature, arthritis, blood clots, cancer IdqfrFnt (2) ItemprFtHF (3) and Alzheimer's disease. It was one of the drugs selected for inclusion in the qnIklu : Gn (3) self-medication kits taken to the moon by the Apollo astronauts in 1969. medqIkeqHn (4) In 1948, a general practitioner noticed that aspirin dramatically reduces the IdGenrFl (2) IAsprqn (2) drFImAtqklq (4) incidence of heart attacks and it is now widely used for the prevention of cardioprqIvenHn (3) vascular events, saving millions of lives.

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Nevertheless, like all drugs, it can have dangerous secondary effects and, IdeqndGrFs (2) sekFndrq (3) on average, is responsible for about 2,000 deaths per year in the UK. IAvrqdG (2)

Remedial work (Exercise 7.19)  If you had problems with the above exercise, learn the following model by heart. • The average cost per patient is IAvrqdG (2) IpeqHnt (2) • Generally the IdGenrFlq (3)

different from one country to another. IdqfrFnt (2)

temperature increases considerably during the day. ItemprFtHF (3) kFnIsqdrFblq (4)

• Naturally in certain circumstances medicines can be dangerous. InAtHrFlq (3) Imedsqnz (2) IdeqndGrFs (2)

Unit 8 Phonology – Sounds & Rhythm (Exercise 8.15) The sounds / q / and / i: /  Student B:Your partner will read the text on acupuncture below. Listen carefully – your job is to assess whether s/he uses the sound / q / instead of the sound / i : /. Do nots interrupt your partner until s/he has finished. The critical areas where mistakes are likely to be made have been marked in bold – blue for the sound / q / and red for the sound / i : /. Underline any word that is mispronounced and discuss the results with your partner. Then change roles.

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NOTES

PRONUNCIATION NOTES The sounds / q / and / i : / The distinction between these 2 sounds found in the words: it  eat fit  feet still  steel is a common and a serious francophone pronunciation problem, as these two sounds differentiate the meanings between words. The problem is not easy to eradicate. The distinction does not exist in French and consequently French speakers do not easily hear it. • The / i: / sound is easier for French speakers. It is a long vowel, made with the lips spread and the tongue pushing upwards towards the roof of the mouth. It is similar to the French sound in the word “oui“. • The / q / sound on the other hand, is a problem. It is one of the most common vowels, but French speakers tend to replace it by / i: /. It is made with a more relaxed mouth, with no tongue pressure. It is a short vowel.

N.B. – Before your partner reads, practice the difference between the two sounds. Start with your lips spread and the tongue pushing up and then quickly relax your mouth sliding from: eat leave feel least

   

it live fill list

ACUPUNCTURE Although acupuncture has been practised in China for more than 2000 years, bi : n IprAktqst qn it is qt qz

only since the late nineteen sixties that it has been adopted IFxnlq sqns naqnIti : n Isqkstqz qt bi : n FIdoptqd ,n

in the West. qn

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The reason is partly due to the publicity Iri : zn qz IpA : tlq pybIlqsFtq

COMPETENCE IN MEDICAL ENGLISH

generated by an American IdGenFreqtqd FImerqkFn

journalist who had his appendix removed under acupuncture during dGE : nFlqst hqz FIpendqks rqImu : vFd IdjxFrqC the visit of Dr Henry Kissinger to China in nineteen vqzqt Ihenrq IkqsqndGE : qn ,n naqnIti : n

seventy one. sevntqwyn

The technique requires hair-thin needles usually made of stainless tekIni : k rqIkwaqFz Bqn Ini : dlz Iju : GFlq steel and with a thickness of no more than 0.5 millimeters which are sti : l wqD IBqknqs Imqlqmi : tFz inserted in the skin at specific points of the body so as to stimulate qnIsE : tqd qn skqn spFIsqfqk Ibodq Istqmjxleqt the energy flow, restore body balance and thus reduce disease. IenFdGq rqIstc : Ibodq rqIdju : s dqIzi : z

Remedial work (Exercise 8.18) Distinction between / q / and / i : /  Learn the model by heart so that you can say it quickly and fluently. Pay particular attention to the rhythm. • Do the shoes fit your feet?

di • Be

di

DA

fqt

fi : t

di di

DA

quick. The train leaves at three thirty.

bi :

kwqk

di

DA

li : vz

di

DA

DA

Bri :

di di

IBE : tq

DA di

• Will you sit down please? There's a seat over there. wql

DA

sqt

di

di DA

pli : z

di

si : t

di

di DA di di DA

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297

NOTES

Unit 9 Phonology – Sounds & Rhythm (Exercise 9.15) Tonic stress in compound forms  Student B: Read the text before your partner starts reading. Underline any of her/his errors. Then explain the nature of the exercise and change roles.

PRONUNCIATION NOTES • Compound nouns are frequently misunderstood because the tonic stress is badly placed. • Usually (but not always) the tonic stress moves forward to the first element of the compound. • In the passage below, the compound nouns are underlined and the stressed syllable is indicated in capitals and bold.

INFLUENZA Influenza is an infection of the reSPIratory tract. The virus that causes it mutates rqIspqrFtrq and new strains arise each year which means that there is, at present, no effective FLU treatment. In most cases people can be treated at home and await recovery. Iflu: SYMPTOMS • high BOdy temperature (usually above 38°C) Ibodq • intermittent sweating and shivering • muscle and BACK pains IbAk • HEADaches Ihedeqks • APpetite loss IApqtaqt • THROAT irritation IBrFxt • CHEST pains ItHest INCUBATATION qCkjxIbeqHn

PERIOD

– 1- 4 days

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TREATMENT – Antibiotics are not effective and antiviral medication must be administered within 2 days of onset. BED REST – This is highly important as it allows the body to heal itself. Ibed PAIN RELIEF – Aspirin, paracetamol or ibuprofen can be used. Ipeqn BODY FLUIDS – Drink plenty of liquid to replace what is lost from fever. Ibodq COUGH MEDICINE – Decongestants and antihistamines can be taken to reduce Ikof coughing.

Remedial work (Exercise 9.18) Compound forms: These phrases consist of a 2-term adjective compound + a 2-term noun compound.  Learn to repeat them as 2 units, with a stress / fall pattern on each unit.

• a well-documented case study

• a fast-increasing data base

• a widely-used cancer drug.

• a four-month pilot test

• a long-term research project

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NOTES

Unit 10 Phonology – Sounds & Rhythm (Exercise 10.16) Distinction between the sounds found in “tip“ / tqp / and “type“ / taqp /  Student B: Your partner will read the text “Antimicrobial resistance and the third world“. Monitor his/her pronunciation, underline any errors and then change roles.

PRONUNCIATION NOTES Two vowel sounds are frequently confused by French speakers of English: • The short / q / as found in words like “sit  it  hit  bit“.

N.B. – Remember this vowel is short and relaxed and must not be confused with the long vowel / i: / found in: “eat  feet  keep“ (see Unit 8). • The second sound is the diphthong / aq / as found in: “like  bike  Mike“. The / q / sound is marked in red, and the / aq / sound is marked in blue.

ANTIMICROBIAL IAntqmaqIkrFxbqFl

RESISTANCE AND THE THIRD WORLD

rqIzqstFns

The great upsurge in the spread of drug-resistant microbes over the qn rqIzqstFnt ImaqkrFxbz past decade is undermining today’s efforts to control infectious qz yndFImaqnqC qnIfekHFs diseases as those once thought to be under control become increasingly dqIzi : zqz bqIkym qCIkri : sqClq resistant to the available drugs. rqIzqstFnt Although antimicrobial resistance affects industrialised and developing IAntqmaqIkrFxbqFl rqIzqstFns qnIdystrqFlaqzd dqIvelFpqC countries alike, the impact is far greater in Ikyntrqz FIlaqk IqmpAkt qz qn

developing dqIvelFpqC

countries. Ikyntrqz

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The switch from less expensive first-line drugs to second or third-line drugs swqtH qkIspensqv laqn laqn involves a dramatic escalation in qnIvolvz drFImAtqk qn

price, praqs

making some ImeqkqC

diseases too expensive to treat. dqIzi : zqz qkIspensqv

Remedial work (Exercise 10.19) Distinction between / aq / marked in red and / q / marked in blue  Learn the model by heart. Pay attention to the rhythm. • Light-sensitive cells in the retina Ilaqt IsensFtqv

DA

di di di

qn

DA di di DA di di

• A high-powered Nikon haq

di DA DA • Five c.c. faqv

DA

IretqnF

surgical

microscope

InaqkFn IsE : dGqkl ImaqkrFskFxp

DA di

DA di di

of hydrogen IhaqdrFdGFn

DA DA di DA di di

DA di di

peroxide pFIroksaqd

di DA di

Unit 11 Phonology – Sounds & Rhythm Tonic accent and pausing

Remedial work (Exercise 11.18)  Learn the phrases so you can say them quickly and fluently. Pay attention that you respect the rhythm (tonic accent in red, weak schwa in blue) and mark the pauses.

PHONOLOGY

301

NOTES

FIRST AID

INSTRUCTIONS

–A

LEG WOUND

• The first thing to do … is to stop the bleeding. DF

di

tF

DA di

tF

di DA

DF

di di DA di DA di

• To do that … you can press on the wound. tF

kFn

di DA DA

di

di

DF

DA

di di

DA

• When that's been done … you should raise the leg. HFd

di

DA

di

DA

di

di

DF

DA

di DA

• If the bleeding has stopped … put on a bandage. DF

di di DA di

hFz

di

F

DA

DA di di DA di

Unit 12 Phonology – Sounds & Rhythm (Exercise 12.16) Weak and stressed syllables – Intonation in questions  Student C: Your job is to monitor the dialogue between students A and B as they read the dialogue about Nancy Baxter.

PRONUNCIATION NOTES This is not an easy exercise to monitor. You have to listen to two different things. • Monitoring student A. Listen to make sure that s/he respects the rhythmic alternation between stressed and weak syllables. Stressed words are in red. The rhythm for the first sentence should be:  The case concerns a schoolgirl. di DA di DA di DA di • Monitoring student B. What interests us here is the intonation of questions. To simplify, one can say that in questions which ask for information there tends to be a fall, but in questions asking for confirmation (Yes/No) there is a rise. Consequently, in B's first question, there is a fall: “How old was she?“. In the 2nd question, there is a rise: “Were there any other symptoms?“.

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THE A. The case keqs di DA

concerns a kFnIsE:nz di DA di

CASE OF

COMPETENCE IN MEDICAL ENGLISH

NANCY BAXTER

schoolgirl. Isku:lgE:l DA di

B. How old was she? Fxld A. Fourteen. She was having lunch at home with her father when fc:Iti:n hAvqC lyntH hFxm IfA:DF(rr) suddenly she began to have difficulty in breathing. Isydnlq bqIgAn IdqfqkFltq Ibri:DqC

B. Were there any wF(rr) Ienq

other IyDF

symptoms? IsqmptFmz

A. Her lips and mouth turned blue. lqps maxB blu:

B. And what did the father do? wot IfA:DF(rr) du: A. He called the ambulance and they came at once. Ikc:ld IAmbjxlFns keqm wyns

B. They examined her I suppose? qgIzAmqnd sFIpFxz A. Yes. She had tachycardia, a blood jes tAkqIkA:dqF blyd and her skin was flushed. skqn flyHt

B. What wot

happened IhApFnd

then? Den

pressure of 90/65, IpreHF(rr) InaqntqsqkstqIfaqv

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NOTES

A. She collapsed and was rushed to hospital. kFIlApst ryst Ihospqtl

B. Was she given any treatment? Igqvn Itri:tmFnt A. Yes – intramuscular adrenalin – but she wasn't jes qntrFImyskxlF(rr) FIdrenFlqn woznt

responsive. rqIsponsqv

She was dead on arrival. ded FIraqvl

B. What wot

about her history? FIbaxt Ihqstrq

A. Well, basically – she was in good health. A year ago, she had mild Ibeqsqklq gxd helB jqF(rr) FIgFx maqld asthma and she always AsmF Ic:lweqz

B. Anything IenqBqC

carried an inhaler. IkArqd qnIheqlF(rr)

else? els

A. Yes – She suffered from eczema and took cortisone. She was also jes IsyfFd IeksqmF Ikc:tqzFxn Ic:lsFx allergic to penicillin and nuts. FIlE: dGqk penqIsqlqn nyts

(In fact, Nancy Baxter died of an anaphylactic reaction to a nut allergy. She was unaware that the sausage she was eating contained traces of nut.)

Remedial work (Exercise 12.19)  Learn the phrases by heart. Pay particular attention to: – the rhythm and stress (stress is marked in red), – rising intonation on yes / no questions.

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• Have you brought the results of the test? brc:t rqIzylts test Yes – I gave them to the secretary. jes geqv IsekrFtrq

• Have you been short of breath recently? Hc:t breB Iri:sntlq Well, in fact I have – for a couple of months. wel fAkt hAv Ikypl mynBs

• Are your ankles ACklz

swollen? IswFxln

Yes they are – and I've got a pain in my chest. jes A: peqn tHest

COMPETENCE IN MEDICAL ENGLISH

LEXIS

Le présent lexique a été conçu pour servir à la fois d’aide à la compréhension et d’outil d’apprentissage du vocabulaire. Il est conseillé de lire les explications ci-dessous pour en tirer le meilleur parti.

Aide à la compréhension : contenu du lexique Choix des mots-entrées Le présent lexique a été établi à partir de la liste des termes utilisés dans Minimum Competence in Medical English. Cette liste contient plus de 11 000 mots : il a donc fallu faire des choix. N’ont donc pas été retenus : les articles, les pronoms, les auxiliaires des verbes, les modaux (shall, will, etc.) qui sont traités ailleurs dans le manuel, certaines prépositions fondamentales, les verbes conjugués (was, has gone, imagined…), les noms très semblables dans les deux langues ou transparents, ainsi que quelques autres termes dont l’usage a semblé trop marginal. Le lexique ne remplace pas un dictionnaire puisque les termes non employés dans le manuel n’y figurent pas.

Verbes Les verbes figurent à l’infinitif. Sans précisions, ils sont réguliers. Les formes irrégulières sont indiquées pour les autres verbes. La taille du lexique ne permet pas de fournir des explications sur la transitivité, qui, pour un même verbe, peut varier selon le sens. Pour résoudre en partie ce problème, des exemples sont fournis lorsqu’il existe des différences notables entre le français et l’anglais. Exemple : le verbe enter est illustré par air enters the chest cavity : “l’air pénètre dans la cavité pulmonaire“. De même, il n’est pas possible de présenter la complexité des verbes dits à particule (phrasal verbs) : en anglais, la plupart des verbes peuvent se combiner avec un certain nombre de prépositions et prendre chaque fois un sens particulier. Exemple : look at signifie “regarder“, look for “chercher“, look forward to “se réjouir à la perspective de“. Pour les verbes les plus courants, run ou get, par exemple, le nombre de combinaisons est très élevé. La sélection fournie se limite donc aux verbes à particule utilisés dans le manuel, à laquelle peut s’ajouter, selon le cas, quelques autres combinaisons importantes pour ce verbe.

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Noms La taille réduite du lexique ne permet pas de donner toutes les précisions sur les emplois des noms “comptables“ (que l’on peut compter et qui peuvent se mettre au pluriel, tels que book/s, bed/s) et “non comptables“ (qui ont un sens collectif, ou de masse, de quantité, et ne se mettent pas au pluriel, tels que furniture : “le mobilier“). En anglais, certains noms ne sont jamais comptables, comme information, intelligence, equipment, d’autres sont parfois comptables, parfois non comptables, suivant le sens. Ainsi paper dans le sens de “papier“ (matière) est non comptable et ne peut pas se mettre au pluriel, mais dans le sens d’“article“ ou “communication“ il est comptable et peut se mettre au pluriel. Dans le lexique, les termes toujours non comptables dans les sens habituels sont indiqués comme non comptables. Lorsqu’il est possible de le faire, quelques emplois précis sont présentés. Lorsque la situation est trop complexe, des exemples sont donnés uniquement pour les emplois les plus fréquents.

Adjectifs Tous les termes en position adjectivale (vrais adjectifs, participes, noms) sont étiquetés adjectifs.

Sens et exemples Les sens illustrés dans le lexique sont ceux qui apparaissent dans le manuel, auxquels ont été ajoutés des exemples de sens soit très courants soit utiles dans le domaine étudié. Les sens rares, littéraires, archaïques ou relevant d’autres domaines ne sont pas traduits. Là encore, le dictionnaire fournira l’ensemble des sens.

Transcription phonétique : choix et position La transcription phonétique correspond à l’anglais britannique, comme dans le reste de l’ouvrage. Seule la prononciation la plus courante est fournie. Lorsque la prononciation est identique pour toutes les parties du discours (nom, verbe, adjectif…), la transcription est placée au début, après le mot-entrée. Lorsque la prononciation varie selon la partie du discours, la transcription est placée après l’indication de celle-ci.

Abréviations abrév. acron. adj. adv. conj. habit. inv. n.c. pl. prép.

abréviation acronyme adjectif adverbe conjonction habituellement invariable non comptable pluriel préposition

Anat. Biol. Bot. Dent. Ens. Inf. Ing. Math. Méd. Nucl.

Anatomie Biologie Botanique Dentisterie Enseignement Informatique Ingénierie Mathématique Médecine Nucléaire

LEXIS

pron. qqch. qqn prp ptp sb. sing. sth. vb.

307

pronom quelque chose quelqu'un participe présent participe passé somebody, someone singulier something verbe

Opt. Pharm. Phys. Psych. Tech. Typ.

Optique Pharmacie Physique Psychologie Technologie Typographie

Variantes orthographiques américaines Les variantes orthographiques américaines sont données entre parenthèses :  Exemple : labour (US labor)

Apprentissage du vocabulaire Ce lexique a également été conçu pour permettre à l’apprenant/e d’enrichir son vocabulaire. Consulter un dictionnaire est une démarche active de recherche du sens d’un terme, d’exigence de compréhension face à un texte. Le lexique tente de tirer parti de cette démarche dans son traitement du sens, des exemples et des catégories grammaticales et par la transcription phonétique. Il propose à l’apprenant qui interrompt un exercice du manuel pour interroger le lexique, de profiter de cette pause pour compléter ses connaissances lexicales. Il a été conçu pour favoriser un travail indépendant d’enrichissement du vocabulaire et pour aider l’utilisateur à trouver les équivalents français qui lui permettront d’exprimer sa pensée avec précision.

Traitement du sens À l’exception de certains termes techniques sans emplois métaphoriques, il n’existe pas de correspondance parfaite pour tous les sens du terme entre un mot d’une langue et son équivalent dans une autre langue. C’est pourquoi il est indispensable d’apprendre le lexique d’une langue dans cette langue et en contexte, et non en partant du sens d’un équivalent partiel dans une autre langue, même proche. Ceci signifie qu’il est peu efficace d’apprendre des listes de vocabulaire courant où deux mots en deux langues se font face. Il est plus utile de commencer à construire “l’aire sémantique“ du terme que l’on souhaite apprendre, ce qui permettra, par déduction, de deviner d’autres sens dans d’autres contextes. Pour cette raison, chaque entrée du lexique est d’ordinaire suivie de plusieurs traductions. Cette liste inclut toujours les sens que prend le terme dans les contextes illustrés par le manuel. Lorsque l’on cherche la signification d’un terme, un premier exercice consiste à lire la liste et à “essayer“ les traductions pour trouver celle qui convient le mieux pour le mot recherché. Le deuxième exercice consiste à relire la liste et à essayer de s’imprégner des différentes traductions pour commencer à bâtir le sens du terme anglais. La lecture attentive de la liste doit permettre, à partir d’un noyau central, d’élargir le sens du terme afin de faciliter par déduction la compréhension des autres sens non répertoriés.

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Ordre des mots dans les listes de traduction De manière générale, le vocabulaire s’est développé du concret à l’abstrait, c’est-àdire que, par analogie, les termes concrets ont servi à exprimer des notions abstraites. Lorsque le sens concret présente un intérêt, le terme a été fourni et placé au début de la liste. Les autres sens sont séparés par des puces (•). Les termes relevant du domaine médical au sens large sont placés à la fin de l’entrée.

Catégories grammaticales Tout francophone classe son lexique dans des catégories grammaticales précises. Sauf pour certains couples nom/adjectif au singulier, un changement de catégorie entraîne normalement des modifications morphologiques (“rond/arrondir“ ; “rapide/rapidité“). Il est utile de s’habituer à ne pas penser le lexique en fonction de catégories grammaticales fixes lorsque qu’aucun élément morphologique ne vous y contraint. Pour apprendre à jeter un autre regard sur les catégories grammaticales, les mots du lexique ont été regroupés selon leur forme. Ainsi, abuse, nom, et abuse (to) verbe, se trouvent sous la même entrée. De même, il suffit que le terme apparaisse dans une catégorie grammaticale au sein des exercices de la première partie pour qu’il figure dans toutes les autres catégories grammaticales qui remplissent les critères de sélection énoncés plus haut. Cette sélection additionnelle permet ainsi à l’apprenant à la fois d’enrichir son lexique et d’acquérir l’agilité nécessaire pour passer d’une catégorie grammaticale à l’autre, et donc d’améliorer sa vitesse de lecture.

Les exemples Les exemples fournis relèvent tous du champ médical dans un sens large. La majeure partie des exemples est tirée du manuel. Ces extraits sont complétés par des groupes de mots apparaissant fréquemment ensemble et par des expressions courantes.

Transcription phonétique Le français écrit est un système alphabétique dans lequel il existe des liens de régularité entre les lettres ou groupes de lettres et les sons qui leur correspondent. Une fois que vous savez lire, vous pouvez reconstituer l’image phonique d’un mot et soit retrouver celui-ci dans votre dictionnaire mental oral, soit le créer et l’ajouter à celuici. Le problème est différent pour l’anglais, qui n’est que partiellement alphabétique. Les consonnes sont relativement stables, mais les voyelles varient selon qu’elles sont accentuées ou non. Or nous ne pouvons pas apprendre un nouveau mot sans lui attribuer une image phonique. Lorsqu’une personne francophone se trouve face à un terme qu’elle ne connaît pas ou à un terme qu’elle ne retrouve pas dans son dictionnaire mental oral, elle le lit selon les règles de lecture du français et l’ajoute à son sous cette forme. Si elle lit souvent ce mot, en même temps que son sens elle aura assimilé l’image phonique obtenue en appliquant les règles de lecture du français. Ainsi, la plupart des étudiant(e)s francophones prononcent biology comme le français “biologie“ et sont désespéré(e)s devant le mot ache. S’il est relativement facile d’apprendre un nouveau terme avec sa prononciation, il est beaucoup plus difficile

LEXIS

309

de modifier une image phonique, qui remonte à la surface en situation de stress. La transcription phonétique est une réponse partielle à ce problème. Elle permet en effet de vérifier assez facilement la prononciation des voyelles problématiques et la place de l’accent. Par ailleurs, tous les bons dictionnaires monolingues existent sur CD Rom et offrent des enregistrements en anglais britannique et américain. On trouve en outre sur Internet un certain nombre de dictionnaires comportant des enregistrements. Idéalement, une combinaison du recours à la transcription phonétique et aux enregistrements sur CD Rom ou sur Internet permet de fixer une image phonique suffisamment proche de la prononciation de l’anglais pour être reconnaissable par un anglophone.

Comment mémoriser de nouveaux mots Un mot prend son sens, s’actualise, dans un contexte. Tel mot a tel sens dans tel contexte, tel mot est utilisé dans un contexte précis et pas dans un autre, on utilise tel adjectif avec tel nom dans tel contexte, etc. Il est donc indispensable d’apprendre de nouveaux termes dans leur contexte d’utilisation. Par ailleurs, on retient plus facilement un mot lorsqu’il est placé en contexte. Il est de ce fait très rentable de se constituer des listes d’exemples en contexte. Internet constitue un outil irremplaçable dans ce domaine : il suffit de choisir quelques mots clés ou de faire des recherches sur un site spécialisé, puis de sélectionner quelques bons exemples parmi ceux qui ont été recueillis. Ces phrases ou membres de phrases doivent être relus plusieurs fois. Un apprentissage efficace se fait sur la durée : un travail quotidien pendant une semaine, suivi d’une révision au bout d’une semaine, puis d’un mois donne généralement de bons résultats. Il est également très fructueux d’avoir recours à un apprentissage “multimodal“, c’est-à-dire de faire appel aux quatre codages ou compétences de base : lire, écrire, écouter, parler. Il faut donc lire le mot que l’on souhaite apprendre (reconnaissance visuelle du mot), l’écrire (mémorisation manuelle), l’écouter (mémorisation phonique) afin de pouvoir le reconnaître et enfin le prononcer (mémorisation articulatoire). Ces connaissances doivent être entretenues, mais une fois appris, un terme n’est jamais totalement oublié. Il suffit de se remettre au travail pour s’en souvenir. Nous espérons que ce lexique vous sera utile et qu’il facilitera votre travail d’acquisition du lexique.

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MINIMUM

COMPETENCE IN MEDICAL ENGLISH

Traduction de “maladie“

Synonym note from the Oxford Advanced Learner's Dictionary 7 th Edition © Oxford University Press 2005

LEXIS

311

A ability nom / @"bIl@tI / capacité, aptitude, disposition, faculté, compétence, you have an ability to impact patients’ experiences : vous êtes en mesure d’influer sur le vécu du patient able (to be) vb. / "eIbl / être capable, en mesure de, apte à, à même de abnormally adv. / &b"nO:m@lI / anormalement abort (to) vb. / @"bO:t / avorter, faire avorter, échouer, faire échouer • interrompre, mettre fin à abortion nom / @"bO:Sn / avortement about / @"baUt / 1 prép. près de, autour de, concernant, au sujet de, relatif 2 adv. à peu près, environ, tout autour, dans les environs abroad adv. / @"brO:d / à l’étranger abstract 1 nom / "&bstr&kt / résumé, abrégé (article, texte : paper, text ) 2 adj. / "&bstr&kt / abstrait 3 (to) vb. / @b"str&kt / établir un résumé, résumer, + from : retirer de, soustraire abuse 1 nom n.c. / @"bju:s / mauvaise utilisation, abus • insultes, injures • brutalités, cruautés, mauvais traitements, violations, child abuse : sévices à enfant, physical abuse : violences physiques • sexual abuse : violences sexuelles 2 (to) vb. / @"bju:z / malmener, maltraiter, battre, abuser de, brutaliser, insulter, injurier, infliger des mauvais traitements/des sévices, agresser sexuellement, violer • to abuse drugs : se droguer accommodation nom n.c. / @%kQm@"deISn / hébergement, logement, chambre, locaux, installations, infrastructures d’accueil according to adv. / @"kO:dIN / conformément à, selon, suivant, d’après, en fonction de, en proportion de accordingly adv. / @"kO:dINlI / de ce fait, en conséquence, dès lors, dans ces conditions, c’est pourquoi account for (to) vb. / @"kaUnt / constituer • expliquer, justifier • tenir compte de, prendre en considération account nom / @"kaUnt / compte rendu, to take into account : tenir compte de, prendre en considération accuracy nom n.c. / "&kj@r@sI / exactitude, précision

accurate adj. / "&kj@r@t / exact, correct, juste, précis, fiable accurately adv. / "&kj@r@tlI / exactement, avec exactitude, avec précision ache / eIk / 1 nom douleur, souffrance, maux, mal à, toothache : mal aux dents 2 (to) vb. faire mal, être douloureux achieve (to) vb. / @"tSi:v / parvenir à, réaliser, accomplir, mener à bien, réussir achievement nom / @"tSi:vm@nt / obtention, réalisation, résultats, succès, réussite, progrès, conquêtes, œuvre, niveau (d’études) acknowledge (to) vb. / @k"nQlIdZ / reconnaître, admettre, tenir compte de • répondre à, réagir à • rendre hommage à • to acknowledge receipt of : accuser réception de acknowledgement nom / @k"nQlIdZm@nt / reconnaissance, indication (de la source), prise en considération • témoignage de gratitude across adv. / @"krQs / 1 prép. perpendiculairement à • de l’autre côté de • entre • dans tout, across the country : dans tout le pays • comparisons across : comparaisons entre 2 adv. across from : en face act (to) vb. / &kt / agir, intervenir, se comporter, se conduire, fastacting : à action rapide, long-acting : à action prolongée actual adj. / "&ktSU@l / effectif, réel, véritable, concret, exact, proprement dit actually adv. / "&ktSU@lI / en fait, en réalité • effectivement, réellement, vraiment, véritablement, à proprement parler acute adj. / @"kju:t / intense, vif, violent, aigu (douleur : pain ), grave, urgent, préoccupant (problème) Méd. aigu (maladie, douleurs : disease, pain ) add (to) vb. / &d / ajouter, inclure, additionner, add to : augmenter, accroître, développer, intensifier adequate adj. / "&dIkw@t / suffisant, adéquat, approprié, convenable, adapté, satisfaisant, correct adjust (to) vb. / @"dZVst / régler, adapter, ajuster, mettre au point, corriger • adjusted : bien intégrée (personne) adjustable adj. / @"dZVst@bl / réglable, modulable, ajustable, orientable adulthood nom n.c. / "&dVlthUd / âge adulte

312 advance / @d"vA:ns / 1 nom avance, progression, progrès, développement, découverte, amélioration, medical advance : progrès de la médicine 2 adj. préliminaire, préalable, anticipé 3 (to) vb. faire progresser/des progrès, (faire) avancer, favoriser, promouvoir, mettre en avant advent nom / "&dvent / venue, avènement, apparition adverse adj. / "&dv3:s / défavorable, négatif, critique, hostile • Méd. adverse drug reactions : effets indésirables (médicament, vaccin : drug, immunization ), adverse events following immunization : manifestations postvaccinales indésirables advertise (to) vb. / "&dv@taIz / faire de la publicité, faire connaître, rendre public advertisement (abrév. advert) / @d"v3:tIsm@nt / publicité, annonce advice nom n.c. / @d"vaIs / conseil, information, to give advice : donner des conseils, a piece of advice : un conseil advisable adj. / @d"vaIz@bl / souhaitable, utile, opportun, judicieux advise (to) vb. / @d"vaIz / conseiller, recommander • + that : émettre l’avis que • + on : donner des conseils • + of : mettre au courant avertir • + against : déconseiller • patients are advised that : il est conseillé aux malades de… aerial adj. / "e@rI@l / aérien affect (to) vb. / @"fekt / toucher, concerner, influer sur, influencer, avoir des incidences/des répercussions sur, avoir des effets défavorables, perturber le fonctionnement • Méd. (maladie : disease ) intéresser, toucher, atteindre, retentir (sur un organe), the interaction may be affected in a number of ways : divers facteurs peuvent influer sur l’interaction afford (to) vb. / @"fO:d / to be able to afford : avoir les moyens d’acheter, pouvoir se payer • not to be able to afford : ne pas pouvoir se permettre affordability nom n.c. / @%fO:d@"bIl@tI / accessibilité économique affordable adj. / @"fO:d@bl / d’un coût, d’un prix abordable, raisonnable • peu coûteux, économique, bon marché afterwards adv. / "A:ft@w@dz / après, ensuite, plus tard again adv. / @"geIn / de nouveau, à nouveau, encore

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

against prép. / @"geInst / contre, à l’encontre de • par rapport à ageing / "eIdZIN / 1 nom n.c. vieillissement 2 adj. vieillissant aggressiveness nom n.c. / @"gresIvnIs / agressivité ago adv. / @"g@U / 10 days ago : il y a 10 jours, 2 months ago : il y a 2 mois, a long time ago : il y a longtemps, some years ago : il y a quelques années agree (to) vb. / @"gri: / to agree : être d’accord, être du même avis, partager cet avis • se mettre/tomber d’accord, I agree : je suis d’accord, it was agreed : il a été décidé • + about/on/upon : se mettre d’accord sur • + to : accepter • + with : être d’accord avec agreed adj. / @"gri:d / convenu, défini, (bien) établi agreement nom / @"gri:m@nt / accord, consentement, assentiment, to be in agreement : être d’accord ahead adv. / @"hed / avant, devant, en tête, à l’avance, en avance, à venir AIDS acron. / eIdz / Acquired Immunodeficiency Syndrome AIDS : SIDA Syndrome d’Immunodéfience Acquise ail (to) vb. / eIl / être souffrant ailing adj. / "eIlIN / malade, en mauvaise santé, de santé fragile ailment nom / "eIlm@nt / affection, maladie aim / eIm / 1 nom but, finalité, visée, objectif 2 (to) vb. + at : pointer sur, diriger • + to : s’efforcer de, viser à, tendre à, poursuivre (un but), avoir l’intention de air-conditioner nom / "e@k@n%dIS@n@(r) / climatiseur air-conditioning nom n.c. / "e@k@n%dIS@nIN / climatisation aircrew nom / "e@kru: / équipage (voyages aériens) airfare nom / "e@fe@(r) / prix d’un billet d’avion airway nom / "e@weI / voies respiratoires, voies aériennes alarm / @"lA:m / 1 nom alarme, alerte, inquiétude, préoccupation • alarm clock : réveil, to issue an alarm : lancer une alerte 2 (to) vb. alarmer, s’alarmer alarming adj. / @"lA:mIN / inquiétant, préoccupant

LEXIS alert / @"l3:t / 1 adj. vigilant, en éveil, personne âgée : en possession de toutes ses facultés mentales • + to : attentif à, conscient de 2 (to) vb. éveiller l’attention, alerter, avertir alertness nom / @"l3:tnIs / vigilance, promptitude, activité • vivacité (d’esprit) align (to) vb. / @"laIn / + with : harmoniser avec, mettre en conformité alike / @"laIk / 1 adj. se ressembler, être semblables 2 adv. de la même façon alive adj. / @"laIv / vivant, en vie • animé alleviate (to) vb. / @"li:vIeIt / soulager, calmer allied adj. / "&laId / allié • lié, connexe, apparenté associé • comparable, similaire, analogue allow (to) vb. / @"laU / permettre, autoriser, laisser • accorder, allouer almond nom / "A:m@nd / amande almost adv. / "O:lm@Ust / presque alone adj. , adv. / @"l@Un / seul along prép. / @"lQN / le long de • along the lines : conformément alongside prép. / @"lQNsaId / le long de, à côté de, aux côtés de already adv. / O:l"redI / déjà • d’ores et déjà alter (to) vb. / "O:lt@(r) / modifier, transformer, changer alternate adj. / O:l"t3:n@t / alterné, successif • sur deux : on alternative Saturdays : un samedi sur deux • autre, de rechange, de substitution although conj. / O:l"D@U / bien que, quoique altogether adv. / %O:lt@"geD@(r) / totalement, entièrement, complètement, tout à fait • en tout • au total • dans l’ensemble, globalement amazing adj. / @"meIzIN / extraordinaire, effarant, stupéfiant amazingly adv. / @"meIzINlI / étonnamment, chose étonnante among(st) prép. / @"mVN(st) / parmi, entre, chez

313 amount / @"maUnt / 1 nom montant, somme, quantité, importance 2 (to) vb. + to : s’élever à, se chiffrer à, atteindre, représenter, se résumer à, se traduire par andriatrics nom n.c. / &ndrI"&tIks / andrologie ankle nom / "&Nkl / Anat. cheville antibody nom / "&ntIbQdI / anticorps anvil nom / "&nvIl / Anat. enclume, un des trois osselets (ossicles ) de l’oreille moyenne, PNA incus apparatus nom / %&p@"reIt@s / pl. apparatus ou apparatuses appareil, équipement, instrument appeal / @"pi:l / 1 nom demande, appel, attraction, intérêt, the concept has broad consumer appeal : l’idée plaît énormément au consommateur 2 (to) vb. + for : demander, solliciter • + to : lancer un appel à, demander à, faire appel à • plaire à, susciter l’intérêt appear (to) vb. / @"pI@(r) / paraître, sembler • apparaître, surgir • figurer, se trouver (nom, données : name, data ) • paraître, être publié (publication) appearance nom / @"pI@r@ns / apparition, arrivée, venue • parution, publication • apparence, aspect extérieur applied adj. / @"plaId / appliqué apply (to) vb. / @"plaI / appliquer, utiliser, employer • s‘appliquer, être applicable (règle : rule ) • poser sa candidature • + for : demander, solliciter, postuler appointment nom / @"pOIntm@nt / rendez-vous • poste, nomination, désignation appraise (to) vb. / @"preIz / évaluer, estimer approach / @"pr@UtS / 1 nom méthode, démarche, manière de procéder, perspective, point de vue, conception 2 (to) vb. aborder, envisager, concevoir • approcher, contacter • s’approcher, se rapprocher, être proche, the adolescent approached the doctor : l’adolescent s’est adressé au médecin appropriate adj. / @"pr@UprI@t / adapté, opportun, indiqué, souhaitable, judicieux • compétente, qualifiée (personne) approve (to) vb. / @"pru:v / approuver, adopter, agréer • + of : avoir une bonne opinion de, approuver, apprécier

314 area nom / "e@rI@ / superficie, aire, surface • zone (géographique), région, secteur, environs, quartier • domaine, matière, champ, discipline • partie, élément argue (to) vb. / "A:gju: / discuter, débattre, argumenter • préconiser, défendre (thèse) • + that : faire valoir que, soutenir que, affirmer que, prétendre que • + against : avancer des arguments contre • + for/in favour of : défendre, plaider en faveur de • + with : contredire, contester, discuter, être en désaccord arise (to) vb. / @"raIz /, arose / @"r@Uz /, arisen / @"rIzn / survenir, apparaître, se présenter, se produire • s’élever, se poser (problème, difficultés) • + from/out of : découler de, résulter de, provenir de around / @"raUnd / 1 prép. autour, autour de • environ, à peu près, around the world : dans le monde 2 adv. autour, tout autour, dans les environs arouse (to) vb. / @"raUz / éveiller, réveiller, provoquer, exciter array nom / @"reI / grande quantité, gamme, assortiment, série, panoplie, éventail, ensemble, full array of blood tests : une batterie complète d’examens du sang arrest / @"rest / 1 nom arrestation, arrêt, cardiac arrest : arrêt cardiaque, growth arrest : arrêt de croissance 2 (to) vb. arrêter, retarder, entraver • enrayer une maladie, atrophier arrow nom / "&r@U / flèche asbestos nom n.c. / @z"bestQs/ amiante ascent nom / @"sent / ascension, montée ascertain (to) vb. / %&s@"teIn / établir, vérifier aside adv. / @"saId / de côté, à l’écart de, à part • + from : à part, excepté, sauf asleep adj. / @"slI:p / endormi assay nom / @"seI / test, essai, dosage assert (to) vb. / @"s3:t / exprimer, exposer (opinion) • imposer, affirmer, soutenir, faire valoir • + that : déclarer que, affirmer que, soutenir que assess (to) vb. / @"ses / évaluer, apprécier, faire le bilan, faire le point, analyser • déterminer (la valeur), chiffrer, calculer le montant

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

assessment nom / @"sesm@nt / évaluation, bilan, état des lieux, diagnostic, détermination de la valeur assign (to) vb. / @"saIn / + to : attribuer à, mettre à la disposition de, destiner à, classer dans • confier (une tâche : a task ) • fixer (une date) associated adj. / @"s@USI@tId / lié, connexe, complémentaire, combiné, associé • + with : lié à, corrélé avec assume (to) vb. / @"sju:m / (responsabilités), prendre/revêtir assumer (aspect) • postuler (principe : principle ), se baser sur (hypothèses) • + that : supposer que, partir du principe que • assuming that : dans l’hypothèse où, en admettant que, si • it can be assumed these strikes will continue to exist : on peut supposer que ces grèves persisteront • cure was assumed : la guérison a été tenue pour acquise assumed adj. / @"sju:md / prétendu, fictif • supposé, présumé attack nom / @"t&k / attaque, agression • attentat • Méd. crise (asthme : asthma etc.) attempt / @"tempt / 1 nom tentative, efforts 2 (to) vb. essayer, tenter, entreprendre attend (to) vb. / @"tend / être présent, assister, participer, fréquenter • + to/on : soigner, prodiguer des soins, veiller sur, rester au chevet de attendance nom / @"tend@ns / présence, participation, assiduité, school attendance : fréquentation scolaire • assistance, public, auditoire, participants, spectateurs • assistance, soins, Méd. attendance on a patient : visite à un malade attitude nom / "&tItju:d / attitude • mentalité, esprit, opinion, conception, psychologie, démarche attract (to) vb. / @"tr&kt / attirer • susciter, provoquer (intérêt, critiques : interest, criticism ) attraction nom / @"tr&kSn / attrait, attirance • intérêt • tourist attraction : attraction touristique audience nom / "O:dI@ns / spectateurs, public, auditoire, assistance audiotaped adj. / "O:dI@UteIpt / audiotaped recording : enregistrement audio auditory adj. / "O:dItrI / Anat. auditory nerve : nerf auditif auricle nom / "O:rIkl / pavillon auriculaire, oreille externe • auricule (cœur)

LEXIS

315

availability nom / @%veIl@"bIl@tI / disponibilité available adj. / @"veIl@bl / disponible average nom / "&v@rIdZ / moyenne, average thickness : épaisseur moyenne avian adj. / "eIvI@n / aviaire avoid (to) vb. / @"vOId / éviter await (to) vb. / @"weIt / attendre, être dans l’attente de, they are awaiting recovery : ils attendent de se rétablir award / @"wO:d / 1 nom attribution, délivrance • diplôme, bourse • allocation, prix, récompense 2 (to) vb. accorder, octroyer, attribuer, décerner, délivrer aware adj. / @"we@(r) / + of : conscient de, au courant de, informé sur awareness nom n.c. / @"we@nIs / connaissance, (prise de) conscience, sensibilisation, to raise public awareness : sensibiliser l’opinion publique away adv. / @"weI / loin, au loin, éloigné • absent, en déplacement, parti awkward adj. / "O:kw@d / maladroit • malaisé, peu commode • embarrassant, délicat

B back / b&k / 1 nom dos • back injury : blessure dorsale, back pain : dorsalgie • fond : back of the throat : fond de la gorge 2 adv. en arrière, derrière • to pay back : rembourser • to come back : revenir • to put back to : remettre • back to basics : retour aux fondamentaux 3 (to) vb. back ou back up : appuyer, soutenir, aider, assister, seconder • confirmer (hypothèse), étayer (théorie) backache nom / "b&keIk / mal de dos • backaches : douleurs dorsales, dorsalgies backing nom n.c. / "b&kIN / appui, soutien, aval • aide financière backward adj. / "b&kw@d / en retard, sous-développé, Méd. arriéré backwards adv. / "b&kw@dz / en arrière • rocking backwards and forwards : se balançant d’avant en arrière balance / "b&l@ns / 1 nom n.c. équilibre, harmonie • right balance : bon équilibre 2 (to) vb. équilibrer, trouver/main-

tenir un (juste) équilibre, être en équilibre, s’équilibrer • être égal à un autre montant (amount ) aussi élevé • contrebalancer balanced adj. / "b&l@nst / bien équilibré band nom / b&nd / tranche (d’âge), fourchette barely adv. / "be@lI / à peine, guère, tout juste, pratiquement pas basically adv. / "beIsIklI / fondamentalement, avant tout • essentiellement en substance, dans l’ensemble, pratiquement, foncièrement basics nom pl. / "beIsIks / rudiments, notions, (grands) principes, l’essentiel, règles essentielles, éléments essentiels, fondamentaux basis nom / "beIsIs / pl. bases / "beIsi:z / base, socle, fondement, éléments essentiels, principe fondamental, grandes lignes • on the basis of : d’après, suivant, selon, sur la base de, en fonction de • on a daily basis : quotidiennement batch nom / b&tS / pl. batches lot, série bath nom / bA:T / pl. baths / bA:Dz / bain • baignoire battery nom / "b&t@rI / pile, batterie, accumulateur be (to) vb. / bi: /, was / wQz /, been / bi:n / être • as can be seen : comme on peut le voir/le constater bean nom / bi:n / haricot bear (to) vb. / be@(r) /, bore / bO:(r) /, borne / bO:n / porter, supporter, tolérer • assumer • mettre au monde, donner naissance • child bearing age : en âge de procréer • + on : concerner, avoir un lien, un rapport avec, une influence sur • + out : confirmer, corroborer (des hypothèses) • bearing these facts : compte tenu de ces données bearing nom / "be@rIN / lien, rapport, relation, corrélation • incidence(s), effet(s), to have a bearing on : avoir une influence sur beat / bi:t / 1 nom battement (pouls : pulse, cœur : heart ), 80 (heart) beats a minute : 80 pulsations (cardiaques) par minute 2 (to) vb. beat, beat, beaten / "bi:tn /, frapper, vaincre, battre (pouls : pulse, cœur : heart ) because conj. / bI"kQz / parce que, + of : en raison de bedding nom n.c. / "bedIN / literie

316 bed rest nom / "bedrest / appuie-dos • alitement bedside nom habit. sing. / "bedsaId / chevet • bedside manner : comportement du médecin envers les malades bedwetting nom n.c. / "bed%wetIN / énurésie before / bI"fO:(r) / 1 prép. avant, devant, auparavant 2 conj. avant de, avant que begin (to) vb. / bI"gIn /, began / bI"g&n /, begun / bI"gVn / commencer, débuter beginning nom / bI"gInIN / début, commencement, origine • at the beginning : au début behave (to) vb. / bI"heIv / se comporter, se conduire behavio(u)ral adj. / bI"heIvj@r@l / de comportement, comportemental • behavioriste (études : studies ) • behavioural problems : troubles du comportement behaviour (US behavior) nom n.c. / bI"heIvj@(r) / conduite, comportement • behaviour therapy : thérapie comportementale behind / bI"haInd / 1 prép. derrière, en arrière, en retard • to be behind sth. : être l’initiateur de • to be behind sb. : soutenir qqn 2 adv. derrière, en retard beings nom pl. / "bi:INz / êtres • human beings : êtres humains belief nom / bI"li:f / croyance • conviction (religieuse), foi • confiance • opinion, idée • widespread belief : croyance largement répandue believe (to) vb. / bI"li:v / croire, avoir confiance en • avoir la foi • it is believed : on croit, on pense que, on estime belly nom / "belI / ventre belong (to) vb. / bI"lQN / appartenir à, faire partie de belongings nom pl. / bI"lQNINz / affaires, possessions • personal belongings : effets personnels below / bI"l@U / 1 prép. sous, au-dessous de 2 adv. en (contre) bas, plus bas, ci-dessous, au-dessous belt nom / belt / ceinture beneath / bI"ni:T / 1 prép. sous, au-dessous, en dessous 2 adv. dessous, au-dessous

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

benefactor nom / "benIf&kt@(r) / bienfaiteur beneficial adj. / %benI"fISl / bénéfique, utile, avantageux benefit / "benIfIt / 1 nom avantage, bienfait, effet bénéfique, utilité, intérêt • prestations, allocations, indemnités, aide 2 (to) vb. benefit, benefited (US benefitted), rendre (des) service(s) à, profiter à, favoriser, être favorable/utile à/pour • this will benefit everyone : ceci profitera à tout le monde • to benefit from : (re)tirer (un) avantage de, profiter de, bénéficier de benign adj. / bI"naIn / humain, bienveillant, rassurant • inoffensif, anodin • Méd. bénin berry nom / "berI / pl. berries Bot. baie berth nom / b3:T / couchette beside prép. / bI"saId / à côté de, auprès de besides / bI"saIdz / 1 adv. en plus, en outre • d’ailleurs, du reste 2 prép. en plus de, en dehors de • sauf, sinon, à part between / bI"twi:n / 1 prép. entre • between them/us : ensemble, à eux/à nous tous 2 adv. au milieu, dans l’intervalle beyond / bI"jQnd / 1 prép. au-delà de, de l’autre côté de • au-dessus de 2 adv. au-delà, plus loin, là-bas • applications far beyond those intended : applications dépassant largement celles qui avaient été prévues bilberry nom / "bIlbrI / Bot. myrtille birth nom / b3:T / naissance • childbirth : accouchement • live birth : naissance vivante bit nom / bIt / morceau, petite quantité, bit informatique bite / baIt / 1 nom morsure, piqûre (insecte) • bouchée • tick bite : piqûre de tique 2 (to) vb. bite, bit / bIt /, bitten / "bItn /, mordre, piquer • to bite one’s nails : se ronger les ongles bitter adj. / "bIt@(r) / amer • féroce, violent, cruel bitterly adv. / "bIt@lI / amèrement, âprement bladder nom / "bl&d@(r) / vessie

LEXIS blade nom / bleId / lame • brin (d’herbe) • shoulder blade : omoplate blame / bleIm / 1 nom n.c. reproche, critique, to get the blame : être rendu responsable de 2 (to) vb. rendre responsable, to blame sb. for sth. : rejeter la responsabilité de qqch. sur qqn, to blame oneself : se faire de reproches, se sentir coupable blank / bl&Nk / 1 nom blanc, espace vide, lacune, trou 2 adj. en blanc, vierge bleed (to) vb. / bli:d /, bled / bled /, bled saigner, perdre du sang blind / blaInd / 1 nom pl. the blind : les aveugles 2 adj. aveugle • blind spot : Anat. tache aveugle • Méd. scotome 3 (to) vb. rendre aveugle, aveugler, éblouir blindness nom n.c. / "blaIndnIs / cécité • aveuglement blister nom / "blIst@(r) / ampoule, cloque, phlyctène • blister pack/package : plaquette thermoformée (pharmacie) blood nom n.c. / blVd / sang • blood count : numération sanguine • blood pressure : tension artérielle • blood culture : hémoculture, blood glucose level : glycémie bloodstream nom / "blVdstri:m / circulation sanguine blow / bl@U / 1 nom coup 2 (to) vb. blow, blew / blu: /, blown / bl@Un /, souffler • + out : éclater • + up : exploser • agrandir (photo) blueberry nom / "blu:berI / Bot. myrtille blunt adj. / blVnt / peu tranchant, blunt instrument : instrument contondant • brusque (personne) bodily adj. / "bQdIlI / matériel, physique • physiologique (fonctions), organique (fluides) • bodily injury : lésion corporelle body nom / "bQdI / corps, organisme, organe • élément principal boil / bOIl / 1 noun furoncle 2 (to) vb. bouillir, faire bouillir bold adj. / b@Uld / audacieux, intrépide • Typ. caractère gras bond (to) vb. / bQnd / lier, se lier, s’attacher • bonded labour : travail de personnes réduites en esclavage (travail non rémunéré pour le compte d’un créancier) bone nom / b@Un / os • bone marrow : moelle osseuse

317 boom nom / bu:m / expansion, augmentation rapide • baby-boom boost / bu:st / 1 nom habit. sing. impulsion, élan, stimulation 2 (to) vb. augmenter, accroître, développer, améliorer, promouvoir, encourager booster nom / "bu:st@(r) / (injection de) rappel (vaccination) booth nom / bu:D / cabine border nom / "bO:d@(r) / bord, frontière, rive, lisière born (to be) / bO:n / naître, born : né, I was born on : je suis né(e) le borne / bO:n / + borne : transporté par (air, mer : airborne, seaborne ), waterborne disease : maladie véhiculée par l’eau/à transmission hydrique (voir bear ) both / b@UT / 1 pron. tous (les) deux, l’un(e) et l’autre, non seulement… mais encore 2 adj. les deux, l’un(e) et l’autre bottom / "bQt@m / 1 nom bas, fond 2 (to) vb. atteindre son point le plus bas bowel nom généralement pl. / "baU@l / Anat. bowels : intestins, bowel cancer : cancer des intestins box nom / bQks / pl. boxes boîte, carton • encadré bracket nom / "br&kIt / tranche, fourchette, parenthèse • in brackets : entre parenthèses, Typ. square brackets : crochets brain nom / breIn / cerveau, brain damage : lésions cérébrales, brain health : santé cérébrale brand nom / br&nd / ou brand-name : marque (de fabrique) brave adj. / breIv / courageux, vaillant, brave new : idéal, Brave New World : Le meilleur des mondes (A. Huxley), titre tiré de The Tempest, Shakespeare breadth nom / bretT / largeur, ampleur break (to) vb. / breIk /, broke / br@Uk /, broken / "br@Uk@n / casser, briser, rompre, interrompre • + down : craquer, faire une dépression (personne), tomber en panne (machine), produit chimique : (se) décomposer, (se) dissoudre, + into : en • + out : se déclarer, se déclencher (épidémie) • + up : (se) fractionner

318 breakdown nom / "breIkdaUn / panne, défaillance • trouble psychique • asthénie, dégénérescence • effondrement breakthrough nom / "breIkTru: / percée, avancée, progrès décisif, importante découverte, innovation, étape décisive breast nom / brest / poitrine (homme et femme) • sein breastfeed (to) vb. / "brestfi:d /, breastfed / "brestfed /, breastfed nourrir au sein, allaiter breast-feeding nom n.c. / "brestfi:dIN / allaitement maternel breath nom / breT / haleine, souffle, respiration • Méd. take a deep breath : respirez (à fond) breathe (to) vb. / bri:D / respirer • + in : inspirer • + out : expirer breathing nom n.c. / "bri:DIN / respiration • breathing apparatus : appareil respiratoire breathlessness nom n.c. / "breTlIsnIs / difficulté/gêne respiratoire, oppression breed (to) vb. / bri:d / bred, / bred /, bred élever, faire de l’élevage (animaux), se reproduire (moustiques : mosquitoes ), se multiplier breeding nom n.c. / "bri:dIN / élevage, reproduction, prolifération (moustiques : mosquitoes ) bridge nom / brIdZ / pont • Anat. arête, dos du nez, Dent. bridge bring (to) vb. / brIN /, brought / brO:t /, brought apporter, donner, fournir • + about : causer, entraîner, provoquer broad adj. / brO:d / large, considérable, principal, général broadcast / "brO:dkA:st / 1 nom émission (de radiodiffusion, de télévision), radiodiffusion 2 (to) vb. broadcast, broadcast, broadcast, diffuser, émettre (radio, télévision) broadcaster nom / "brO:dkA:st@(r) / organisme de radiodiffusion, personne qui fait de la radio/de la télévision, personnalité de la radio, de la télévision bruise / bru:z / 1 nom ecchymose, bleu 2 (to) vb. contusionner, faire un bleu à budding adj. / "bVdIN / naissant bug nom / bVg / punaise, insecte, bestiole, microbe, virus, superbug : superbestiole, supercoque

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

build (to) vb. / bIld /, built / bIlt /, built construire, bâtir, mettre en place, développer • + on : s’appuyer sur, accomplir des progrès sur la base de, tirer parti • + up : s’accumuler • bâtir • augmenter, intensifier, se développer, renforcer (effectifs) • constituer (des stocks, une base de données) • building block : composante build(-)up nom / "bIldVp / développement, intensification • rassemblement • accumulation building nom / "bIldIN / bâtiment, édifice, immeuble • construction burn / b3:n / 1 nom brûlure • burn patient : (grand) brûlé 2 (to) vb. burn, burned or burnt / b3:nt /, brûler • graver (CD) • + out : US se surmener, épuiser ses ressources burns unit nom / "b3:nzju:nIt / service des grands brûlés burrow (to) vb. / "bVr@U / creuser (un terrier), se réfugier sous butterfly nom / "bVt@flaI / papillon buttock nom / "bVt@k / fesse buy (to) vb. / baI /, bought / bO:t /, bought acheter, to buy oneself sth. : s’acheter qqch. bypass / "baIpA:s / 1 nom rocade, bretelle de contournement • bypass surgery : pontage 2 (to) vb. courtcircuiter, contourner, éviter (d’utiliser), omettre

C calculus nom n.c. / "k&lkjUl@s / calcul, calcul infinitésimal, Méd. calcul rénal call / kO:l / 1 nom appel, demande • recours 2 (to) vb. appeler, (dé)nommer • + at/in : s’arrêter, rendre visite • + for : demander, lancer un appel en faveur de • nécessiter, exiger • + on : faire appel à • + off : annuler candle nom / "k&ndl / bougie candling nom n.c. / "k&ndlIN / cônage d’oreille, utilisation de chandelles auriculaires canvas nom / "k&nv@s / grosse toile cap nom / k&p / capuchon, bouchon, capsule • Anat. kneecap : rotule carbohydrate nom / %kA:b@"haIdreIt / glucide • hydrate de carbone

LEXIS carbuncle nom / "kA:bVNkl / furoncle care / ke@(r) / 1 nom n.c. soin, attention, sollicitude • traitement, thérapeutique, thérapie • assistance, aide • prise en charge • garde, placement (d’enfant) • to take care : faire attention • to take care of : prendre soin de, veiller sur • to take care of oneself : se prendre en charge • to take care that : veiller à ce que 2 (to) vb. + about : se préoccuper de • + for : se préoccuper de • s’occuper de, venir en aide à, prendre soin de, soigner (un malade) careful adj. / "ke@fl / soigneux, consciencieux • prudent • approfondi (examen, étude) carefully adv. / "ke@f@lI / soigneusement, prudemment caregiver nom / "ke@%gIv@(r) / aidant (non professionnel), proche soignant un malade, prestataire de soins non professionnel caring adj. / "ke@rIN / bienveillant, humain, secourable • chargé de dispenser des soins carrier nom / "k&rI@(r) / transporteur (personne, véhicule) • Méd. porteur d’un agent infectieux carry (to) vb. / "k&rI /, carried / "k&rId / porter, transporter, être porteur de (virus, maladie) • + on : poursuivre, continuer • + out : accomplir, exécuter, réaliser CAT acron. / k&t / CAT, computer axial tomography : TMD (tomodensitométrie) • CAT scanner : scanner à rayons X caution / "kO:Sn / 1 nom n.c. prudence, circonspection, mise en garde, avertissement 2 (to) vb. inciter à la prudence, mettre en garde, avertir cautionary adj. / "kO:S@n@rI / servant d’avertissement, cautionary statement : mise en garde cell nom / sel / cellule certainty nom / "s3:tntI / certitude chair (to) vb. / tSe@(r) / présider chair ou chairperson nom / "tSe@%p3:sn / présidence • président(e) • to take the chair : présider les débats, ouvrir la séance challenge / "tS&lIndZ / 1 nom remise en question, défi, difficulté, problème, obstacle, enjeu 2 (to) vb. mettre en cause, en doute, en question, critiquer, défier

319 charge / tSA:dZ / 1 nom charge (explosifs) • prix, frais (dépenses) • tâche, responsabilité, direction, surveillance • (person) in charge : responsable (qui dirige) • to be in charge of : diriger, commander, être à la tête 2 (to) vb. facturer, faire payer chart nom / tSA:t / graphique, diagramme, tableau, carte charter nom / "tSA:t@(r) / charte cheap adj. / tSi:p / bon marché check / tSek / 1 nom contrôle, vérification, examen, health check : examen médical 2 (to) vb. arrêter, bloquer, faire échec à • enrayer, endiguer • examiner, inspecter, vérifier • + in : se présenter, faire enregistrer ses bagages • + off : cocher (éléments liste) • + out : régler sa note, quitter l’hôtel • + up/over : vérifier checklist nom / "tSeklIst / liste de contrôle, de points à vérifier checkpoint nom / "tSekpOInt / contrôle, point de contrôle checkup nom / "tSekVp / contrôle, vérification • to go for/to have a checkup : se faire faire un bilan de santé cheek nom / tSi:k / Anat. joue cheese nom / tSi:z / fromage chemical adj. / "kemIkl / chimique chemist nom / "kemIst / chimiste • pharmacien chemistry nom n.c. / "kemIstrI / chimie chest nom / tSest / Anat. poitrine, cage thoracique • chest cold : inflammation des voies respiratoires chickenpox nom n.c. / "tSIkInpQks / varicelle chief adj. / tSi:f / principal child nom / tSaIld / pl. children / "tSIldr@n / enfant • child labour : travail des enfants, maind’œuvre enfantine childbirth nom / "tSaIldb3:T / accouchement childhood nom n.c. / "tSaIldhUd / enfance childless adj. / "tSaIldlIs / sans enfant

320 chill nom / tSIl / refroidissement, sensation de froid, frisson, to catch a chill : prendre froid chin nom / tSIn / menton choice nom / tSOIs / choix • to make a choice : faire un choix choose(to) vb. / tSu:z /, chose / tS@Uz /, chosen / "tS@Uzn / choisir, décider church nom / tS3:tS / église circuitry nom / "s3:kItrI / circuit (électrique) claim / kleIm / 1 nom affirmation, allégation • demande, requête, exigence 2 (to) vb. demander, exiger, réclamer • causer, provoquer, entraîner, cardio-

vascular diseases claim almost twice as many deaths as cancer : les maladies cardiovasculai-

res font presque deux fois plus de victimes que le cancer • + that : affirmer que, soutenir que, assurer que, prétendre que clavicle nom / "kl&vIkl / = collarbone / "kQl@b@Un / Anat. clavicule clean / kli:n / 1 adj. propre • non pollué (environnement, eau), pur (air), non polluant (technologie, énergie), propre (énergie, carburant : fuel ), non contaminé (sang, eau, seringue : blood, water, syringe ) • intègre (personne) 2 (to) vb. nettoyer • + out : nettoyer à fond • + up : tout nettoyer, (re)mettre de l’ordre cleansing nom n.c. / "klenzIN / nettoyage cleanup nom habit. sing. / "kli:nVp / (opérations) de nettoyage, décontamination, dépollution, assainissement • lutte contre la corruption clear / klI@(r) / 1 adj. libre, dégagé, clair • to make it clear : indiquer clairement, bien spécifier 2 (to) vb. s’éclaircir, disparaître • enlever, débarrasser • approuver, autoriser, + away : disparaître • + up : disparaître • élucider clearance nom / "klI@r@ns / déblaiement, dégagement, élimination, évacuation • espace libre • autorisation, approbation, (formalités) de contrôle • pulmonary interstitial fluid clearance : élimination du liquide interstitiel pulmonaire • medical clearance : avis favorable du médecin-conseil clearing house nom / "klI@rINhaUs / bureau, organisme de centralisation des informations

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

clearly adv. / "klI@lI / manifestement, clairement, nettement, distinctement climb / klaIm / 1 nom montée, côte, ascension 2 (to) vb. grimper, monter, augmenter, gravir, escalader climber nom / "klaIm@(r) / grimpeur close 1 nom habit. sing. / kl@Uz / fermeture, clôture 2 adj. / kl@Us / proche, intime • étroit (coopération) • attentif (examen), + to : sur le point de • (up)on close(r) inspection : après un examen approfondi 3 adv. / kl@Us / près de, contre 4 (to) vb. / kl@Uz / fermer, conclure • rapprocher • to close the gap : combler le fossé • + down : fermer ses portes closely adv. / "kl@UslI / étroitement, intimement, de près, attentivement, to work closely with : travailler en étroite collaboration avec closeness nom n.c. / "kl@UsnIs / proximité, étroitesse (des rapports) clot / klQt / 1 nom caillot (de sang, lait : blood, milk ) • clot in the lung/on the brain : embolie pulmonaire/ cérébrale, clot in the leg : thrombose à la jambe 2 (to) vb. coaguler, se coaguler clothes nom pl. / kl@UDz / vêtements, habits • bedclothes : draps et couvertures clothing nom n.c. / "kl@UDIN / vêtements cloud / klaUd / 1 nom nuage, nuée (insectes) 2 (to) vb. rendre trouble (liquide) clubbing (of fingers) nom n.c. / "klVbIN / Méd. doigts en baguette de tambour, hippocratisme digital clumsily adv. / "klVmzIlI / maladroitement clumsiness nom n.c. / "klVmzInIs / maladresse • caractère peu pratique de qqch. clumsy adj. / "klVmzI / maladroit • incommode (outil : tool ) cluster nom / "klVst@(r) / grappe, amas, ensemble, agrégat, groupe, regroupement coarse adj. / kO:s / grossier, peu raffiné, vulgaire coarseness nom n.c. / "kO:snIs / grossièreté (texture), rugosité (peau : skin ) coast nom / k@Ust / côte, littoral

LEXIS colourless (US colorless) adj. / "kVl@lIs / sans couleur, incolore, terne cold / k@Uld / 1 nom froid, rhume • head cold : rhume de cerveau 2 adj. froid, cold-blooded : à sang froid collapse (to) vb. / k@"l&ps / s’écrouler, s’effondrer, faire faillite • perdre conscience collect (to) vb. / k@"lekt / rassembler, recueillir • prélever (un échantillon) • s’accumuler come (to) vb. / kVm /, came / keIm /, come venir, arriver, parvenir à • + across : rencontrer, tomber sur • + apart : se désintégrer • + back : revenir • + down : baisser • + down with : contracter (une maladie) • + from : provenir de • + out of : résulter de • + round/to : revenir à soi, reprendre connaissance • + upon : trouver par hasard comma nom / "kQm@ / virgule • inverted commas : guillemets common adj. / "kQm@n / courant, fréquent, commun, usuel commonly adv. / "kQm@nlI / fréquemment, couramment commonplace adj. / "kQm@npleIs / banal, commun, ordinaire communicable adj. / k@"mju:nIk@bl / transmissible, Méd. communicable disease : maladie transmissible compare (to) vb. / k@m"pe@(r) / comparer, + to/with : avec • être comparable à complain (to) vb. / k@m"pleIn / se plaindre • make a complaint : formuler une réclamation complaint nom / k@m"pleInt / réclamation, protestation • plainte • maladie, affection, symptôme, douleur • to have a heart/cardiac complaint : avoir une maladie de cœur/cardiaque, souffrir du coeur compliance nom n.c. / k@m"plaI@ns / + with : respect de, observation de, en conformité avec • Méd. observance d’un traitement component nom / k@m"p@Un@nt / élément constitutif, constituant, composant(e), partie compound 1 nom / "kQmpaUnd / combinaison, composé (chimique) 2 adj. / "kQmpaUnd / Méd. compliqué (fracture) 3 (to) vb. / k@m"paUnd / composer, constituer, combiner comprise (to) vb. / k@m"praIz / comprendre, être composé de, constituer

321 compulsive adj. / k@m"pVlsIv / irrépressible, obsessionnel • compulsif, compulsionnel • to be a compulsive eater : être boulimique compulsively adv. / k@m"pVlsIvlI / compulsivement, to be compulsively attached to : avoir un attachement obsessionnel à compulsory adj. / k@m"pVls@rI / obligatoire, imposé compute (to) vb. / k@m"pju:t / calculer, évaluer • computed tomography : tomodensitométrie, scanographie computer nom / k@m"pju:t@(r) / ordinateur • computer enhanced : accentué, amélioré par ordinateur • computer monitoring (voir monitoring ) computerized adj. / k@m"pju:t@raIzd / informatisé, par ordinateur comprehensive adj. / %kQmprI"hensIv / détaillé, (très) complet, global, d’ensemble conceal (to) vb. / k@n"si:l / cacher, dissimuler conclude (to) vb. / k@n"klu:d / conclure, terminer, se terminer, s’achever concluding adj. / k@n"klu:dIN / dernier, final, de clôture, concluding statement : conclusion conducive adj. / k@n"dju:sIv / propice à, favorable à • to be conducive to : prédisposer à, it is not conducive to : cela n'incite pas à confirm (to) vb. / k@n"f3:m / confirmer • obtenir la confirmation, vérifier, s’assurer que conflict 1 nom / "kQnflIkt / conflit, contestation • contradiction, incompatibilité 2 (to) vb. / k@n"flIkt / + with : être en contradiction avec, entrer en conflit avec, s’opposer à conflicting adj. / k@n"flIktIN / contradictoire, incompatible, divergent confound / k@n"faUnd / 1 nom confounding factor : facteur parasite, facteur confusionnel • confounding variable : variable de confusion 2 (to) vb. étonner, déconcerter, surprendre • réfuter (une théorie) • mettre en échec confront (to) vb. / k@n"frVnt / affronter, faire face à • to be confronted with : se heurter à confuse (to) vb. / k@n"fju:z / déconcerter, troubler, induire en erreur, rendre perplexe • confondre • + with : confondre avec, prendre pour

322 confused adj. / k@n"fju:zd / perplexe, déconcerté, troublé • Méd. état confusionnel • to be confused : ne pas comprendre • être dans un état confusionnel confusing adj. / k@n"fju:zIN / difficile à comprendre, déconcertant, obscur, confus • to be confusing : prêter à confusion coning nom n.c. / "k@UnIN / conâge (d’oreille) conscious adj. / "kQnS@s / conscient • health-conscious : soucieux de sa santé • environmentally conscious : respectueux de l’environnement consciousness nom n.c. / "kQnS@snIs / connaissance • to lose – : perdre connaissance, to regain - : revenir à soi, reprendre connaissance • consciouness-raisIng : sensibilisation consequently adv. / "kQnsIkwentlI / c’est pourquoi, donc, par conséquent, en conséquence consistent adj. / k@n"sIst@nt / cohérent, constant, logique, + with : compatible/ en harmonie avec, dans la logique de consistently adv. / k@n"sIst@ntlI / invariablement, toujours, régulièrement, chaque fois, systématiquement consonant nom / "kQns@n@nt / consonne conspicuous adj. / k@n"spIkjU@s / bien visible, peu discret, en évidence, ostensible, remarquable, manifeste, flagrant conspicuously adv. / k@n"spIkjU@slI / visiblement, manifestement, avec ostentation consult (to) vb. / k@n"sVlt / consulter (un médecin) • consulting hours/ rooms : heures/cabinet de consultation consumer nom / k@n"sju:m@(r) / consommateur/trice consumption nom n.c. / k@n"sVmpSn / consommation contagious adj. / k@n"teIdZ@s / contagieux contain (to) vb. / k@n"teIn / contenir, inclure, englober • maîtriser (les dépenses), endiguer, juguler, empêcher la propagation de (épidémie…) contend (to) vb. / k@n"tend / + that : affirmer que, soutenir que content nom / "kQntent / contenu, contenance, teneur • table of contents : table des matières, sommaire continuously adv. / k@n"tInjU@slI / sans interruption, continuellement

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

contractor nom / k@n"tr&kt@(r) / entrepreneur, prestataire extérieur, fournisseur contradictory adj. / %kQntr@"dIkt@rI / contradictoire, opposé à contraindicated adj. / %kQntr@"IndIkeItId / contre-indiqué contrary / "kQntr@rI / 1 adj. + to : contraire à, opposé à 2 adv. + to : contrairement à contribute (to) vb. / k@n"trIbju:t / contribuer à, concourir à, participer à, apporter une contribution contributing adj. / k@n"trIbju:tIN / contributing factor/cause : un facteur/une cause parmi d’autres, l’un des facteurs/l’une des causes controversial adj. / %kQntr@"v3:Sl / controversé, discutable, qui prête à controverse controversy nom / "kQntr@v3:sI / controverse, polémique convenient adj. / k@n"vi:nI@nt / commode, pratique conversely adv. / "kQnv3:slI / inversement, à l’inverse converter nom / k@n"v3:t@(r) / implantable converter defibrillator : cardioverter défibrillateur implanté convey (to) vb. / k@n"veI / transporter (marchandises, voyageurs : goods, travellers ) • transmettre, traduire (exprimer), faire part de convince (to) vb. / k@n"vIns / convaincre, persuader cook / kUk / 1 nom cuisinier 2 (to) vb. cuire, faire la cuisine, cuisiner cool (to) vb. / ku:l / (se) refroidir, (se) rafraîchir cope (to) vb. / k@Up / se débrouiller, faire face, s’en sortir • + with : faire face/s’adapter à (la situation, le problème), surmonter (les difficultés), affronter • coping strategy : stratégie d’adaptation cordless adj. / "kO:dlIs / à piles, sans fil corkscrew nom / "kO:kskru: / tire-bouchon corner nom / "kO:n@(r) / coin, angle, virage cornerstone nom / "kO:n@st@Un / pierre angulaire, clé de voûte, fondement, élément fondamental

LEXIS corporate adj. / "kO:p@r@t / relatif à une société, une entreprise • de société, du monde des affaires • du secteur privé corpse nom / kO:ps / cadavre correct / k@"rekt / 1 adj. correct, exact, juste, convenable, bon (ordre, endroit…) 2 (to) vb. corriger, reprendre (pour corriger) correctly adv. / k@"rektlI / correctement, judicieusement correspondingly adv. / %kQrI"spQndINlI / proportionnellement, en conséquence cost / kQst/ 1 nom coût, frais, dépense • prix 2 (to) vb. cost, cost, cost, coûter, établir le prix costly adj. / "kQstlI / coûteux, onéreux cough / kQf / 1 nom toux, cough medicine : médicament contre la toux 2 (to) vb. tousser coughing nom n.c. / "kQfIN / toux, coughing fit : quinte de toux council nom / "kaUnsl / conseil (assemblée) counsel nom / "kaUnsl / conseil, avis • avocat, groupe d’avocats counselling (US counseling) nom n.c. / "kaUns@lIN / information et conseils (fourniture de), (services de) consultation(s), orientation • aide/soutien/ prise en charge/accompagnement psychologique counsellor (US counselor) nom / "kaUns@l@(r) / conseiller (d’orientation), psychologue count nom habit. sing. / kaUnt / décompte, comptage • full blood count : numération/formule sanguine complète counterfeit adj. / "kaUnt@fIt / faux (monnaie), de contrefaçon (médicaments), pirate (logiciel) counter-measure nom / "kaUnt@meZ@(r) / contre-mesure, parade country nom / "kVntrI / pays, campagne, country doctor : médecin de campagne county nom / "kaUntI / comté course nom / kO:s / cours (temps, universitaire), parcours, itinéraire, Méd. traitement, thérapeutique, série (injections) • évolution (clinical course ) • of course : bien entendu, in due course : en temps voulu/ opportun, à terme

323 courtesy nom n.c. / "k3:t@sI / courtoisie, obligeance, politesse, by courtesy of : avec l’aimable autorisation de cover (to) vb. / "kVv@(r) / couvrir, recouvrir • porter sur, concerner • englober • faire un reportage, these presentations cover areas such as : les exposés présentés traitent de sujets/portent sur des domaines tels que coverage nom n.c. / "kVv@rIdZ / champ, domaine • traitement • coverage area : région couverte/étudiée cowpox nom n.c. / "kaUpQks / (cow : vache • pox : variole, nom populaire de vaccinia) vaccine crackle / "kr&kl / 1 nom crépitement, grésillement 2 (to) vb. crépiter, grésiller crash / kr&S / 1 nom s’effondrer, s’écraser • Inf. planter 2 adj. urgent, accéléré 3 (to) vb. accident, (de la circulation, ferroviaire, d’avion : car, rail, plane ), catastrophe, collision, faillite, Inf. plantage crater nom / "kreIt@(r) / cratère cream nom / kri:m / crème create (to) vb. / kri:"eIt / créer, produire, susciter crescent nom / "kresnt / croissant crew nom / kru: / équipage • aircrew : équipage (transport aérien) cross / krQs / 1 nom croix, Red Cross : Croix-Rouge, Biol. hybride, croisement 2 (to) vb. traverser, franchir, croiser, + out : barrer, rayer cross-country adj. / %krQs"kVntrI / + skiing : de fond, de randonnée cross-infection nom / "krQsInfekSn / contagion crossover (study) n.c. / "krQs@Uv@(r) / étude croisée cross-section nom / %krQs"sekSn / coupe transversale • échantillon/groupe représentatif crowd nom / kraUd / foule, cohue crown nom / kraUn / couronne • sommet • Dent. couronne crust nom / krVst / croûte, couche, Méd. croûte, escarre CSF abrév cerebrospinal fluid : liquide cérébrospinal

324

MINIMUM

CT abrév

computerized tomography : TDM, tomodensitométrie, scanographie • CT scanning : TDM,

scanographie cupping nom n.c. / kVpIN / succion à l’aide de ventouses • cupping glass : ventouse curable adj. / "kjU@r@bl / guérissable cure / "kjU@(r) / 1 nom remède, guérison • past/beyond cure : inguérissable, incurable 2 (to) vb. guérir (de), éliminer (pauvreté…), remédier à, Méd. guérir currency nom / "kVr@nsI / monnaie, devise current adj. / "kVr@nt / actuel, présent, en cours, d’actualité, le plus récent currently adv. / "kVr@ntlI / actuellement, à présent, à l’heure actuelle curriculum nom / k@"rIkjUl@m / pl. curricula ou curriculums programme d’études/des cours, cursus • medical curriculum : programme des études de médecine curve nom / k3:v / courbe, temperature curve : courbe de température curved adj. / k3:vd / courbé, courbe, recourbé, arrondi customer nom / "kVst@m@(r) / client, clientèle customs nom pl. / "kVst@mz / douane, customs officer : douanier cut / kVt / 1 nom coupure, entaille Méd. incision 2 (to) vb. + down on : réduire (sa consommation), + back : réduire • + off : couper • + out : découper cutting needle nom / "kVtINni:dl / aiguille à sutures CVA acron. CVA cerebrovascular accident : AVC : accident vasculaire cérébral cycling nom n.c. / "saIklIN / cyclisme

D daily adv. / "deIlI / quotidiennement dairy nom / "de@rI / laiterie, dairy milk : lait frais (de vache) dam / d&m / 1 nom barrage, retenue, réservoir 2 (to) vb. endiguer, construire un barrage

COMPETENCE IN MEDICAL ENGLISH

damage / "d&mIdZ / 1 nom dommages, dégâts • préjudice, Méd. lésion, atteinte 2 (to) vb. endommager, détériorer, altérer, causer du tort à, compromettre (santé : health ) dark adj. / dA:k / sombre, foncé data nom / "deIt@ / pl. (de datum sing. / "deIt@m /) données dawn nom / dO:n / aube, aurore • naissance (civilisation…) dead adj. / ded / mort deadly adj. / "dedlI / mortel, meurtrier deaf adj. / def / sourd deafness nom n.c. / "defnIs / surdité deal / di:l / 1 nom transaction, opération, marché, affaire, a great/good deal : beaucoup (de), de nombreux, une grande quantité 2 (to) vb. deal, dealt / delt /, dealt, + with : porter sur, traiter de (texte) • examiner, aborder (question) • faire face, intervenir, affronter, s’occuper de, prendre des mesures, résoudre, surmonter • few doctors have to deal with such problems : peu de médecins ont à faire face à/à intervenir lors/de tels problèmes death nom / deT / la mort, décès deathblow nom / "deTbl@U / coup mortel, fatal debilitating adj. / dI"bIlIteItIN / débilitant, affaiblissant decade nom / "dekeId / décennie decay / dI"keI / 1 nom n.c. tooth/dental decay : carie 2 (to) vb. se gâter, se décomposer • Dent. carier decline (to) vb. / dI"klaIn / baisser, diminuer, régresser • décliner, s’altérer decongestant nom / %di:k@n"dZest@nt / décongestif decrease 1 nom / "di:kri:s / diminution, décroissance, baisse, ralentissement, réduction 2 (to) vb. / dI"kri:s / diminuer, décroître, baisser, réduire dedicated adj. / "dedIkeItId / dévoué à (personne), consacré à, spécial à, spécialisé dans, ayant pour vocation

LEXIS deep adj. / di:p / profond, vif • to deep freeze : surgeler • Deep Vein Thrombosis (DVP) : thrombose veineuse profonde (TVP) deer nom / dI@(r) / pl. deer cervidé : cerf, biche, daim, chevreuil defect nom / "di:fekt / défaut, malfaçon, anomalie, birth defect : anomalie congénitale defective adj. / dI"fektIv / défectueux, anormal, malformé, Méd. déficient deficiency nom / dI"fIS@nsI / manque, déficit, insuffisance, déficience, faiblesse, Méd. carence, déficience, deficiency disease : maladie carentielle define (to) vb. / dI"faIn / définir, déterminer, délimiter, préciser definitely adv. / "defInItlI / certainement, avec certitude, incontestablement, absolument degree nom / dI"gri: / degré, niveau, mesure, proportion, taux • ampleur, importance • Ens. diplôme • a degree of uncertainty : une part d’incertitude delay / dI"leI / 1 nom retard, ralentissement, temps perdu, délai 2 (to) vb. retarder, différer, ajourner, remettre • ralentir delete (to) vb. / dI"li:t / effacer, supprimer, rayer deliver (to) vb. / dI"lIv@(r) / distribuer, livrer, acheminer, amener, remettre, fournir (services), Méd. mettre au monde, (faire) accoucher, donner naissance delivery nom / dI"lIv@rI / livraison, distribution • diffusion, transmission • prestation de services • accouchement • health care delivery : prestation de soins de santé demonstrate (to) vb. / "dem@nstreIt / démontrer, faire la démonstration, mettre en évidence • manifester dentures nom pl. / "dentS@z / dentier denunciation nom / dI%nVnsI"eISn / dénonciation, accusation (publique), condamnation deny (to) vb. / dI"naI / démentir, rejeter, contester, nier, refuser d’admettre, ne pas reconnaître, refuser d'accorder (quelque chose) depend (to) vb. / dI"pend / + upon/on : dépendre de, être déterminé par • se reposer sur, varier selon dependable adj. / dI"pend@bl / fiable, sûr, sur qui on peut compter, fidèle

325 depending prp. / dI"pendIN / + on : selon depth nom / depT / profondeur, ampleur derive (to) vb. / dI"raIv / + from : tirer de, retirer de (satisfaction), obtenir de (avantage) • résulter de, être le résultat de • provenir de describe (to) vb. / dI"skraIb / décrire, exposer, expliquer, présenter • + as : qualifier de, désigner sous le nom de, appeler design / dI"zaIn / 1 nom projet • but, objectif, intention • plan, maquette, conception, schéma • urban design : urbanisme 2 (to) vb. concevoir, élaborer, mettre au point, créer, dessiner • well designed : bien étudié • to be designed to : viser à, être conçu pour, destiné à, avoir pour but/fonction de • servir à designated adj. / "dezIgneItId / désigné, indiqué, déterminé, designated as : appelé desirability nom n.c. / dI%zaI@r@"bIl@tI / opportunité, utilité, intérêt desperate adj. / "desp@r@t / prêt à tout (personne) • énorme (besoin : need ), extrêmement grave (situation), désespéré (tentative : attempt ), desperate shortage : extrême pénurie despite prép. / dI"spaIt / malgré, en dépit de, bien que destitute / "destItju:t / 1 nom the destitute : les indigents 2 adj. indigent, sans ressource, dans le dénuement le plus complet destitution nom n.c. / %destI"tju:Sn / indigence, misère (noire) dénuement le plus complet destroy (to) vb. / dI"strOI / détruire, anéantir, exterminer, supprimer detail / "di:teIl / 1 nom détail, details : renseignements, informations, précisions, données, coordonnées 2 (to) vb. exposer en détail, présenter/décrire de manière détaillée • énumérer, répertorier detailed adj. / "di:teIld / détaillé, approfondi, complet, more detailed information : de plus amples renseignements detect (to) vb. / dI"tekt / découvrir, déceler, détecter, dépister (maladie) determine (to) vb. / dI"t3:mIn / déterminer, établir, constater • fixer, décider

326 deterrent / dI"ter@nt / 1 nom dissuasion 2 adj. dissuasif, thromboembolic detterrent stockings : bas de prévention thrombo-embolique devastating adj. / "dev@steItIN / terrible, effroyable, très grave, désastreux, catastrophique (épidémie), foudroyant (crise cardiaque : heart attack ) device nom / dI"vaIs / appareil, dispositif, mécanisme, instrument • système, procédé, moyen devise (to) vb. / dI"vaIz / concevoir, imaginer, inventer, mettre au point devote (to) vb. / dI"v@Ut / consacrer à, affecter à diagnose (to) vb. / "daI@gn@Uz / diagnostiquer diagnosis nom / %daI@g"n@UsIs / pl. diagnoses / %daI@g"n@UsI:z / diagnostic dictation nom / dIk"teISn / dictée die (to) vb. / daI /, died / daId /, died, dying / "daIIN / mourir of/from : de, décéder de • + out : disparaître diet / "daI@t / 1 nom régime (alimentaire), alimentation, to be on a diet : faire un régime 2 (to) vb. suivre un régime dietary adj. / "daI@trI / alimentaire, de diététique differ (to) vb. / "dIf@(r) / + from : différer de, être différent de • ne pas être du même avis dig (to) vb. / dIg /, dug / dVg /, dug creuser directory nom / daI"rekt@rI / répertoire, guide, annuaire disability nom / %dIs@"bIl@tI / invalidité, infirmité, handicap, incapacité disable (to) vb. / dIs"eIbl / rendre invalide, disabling disease : maladie invalidante disabled adj. / dIs"eIbld / handicapé disadvantage nom / %dIs@d"vA:ntIdZ / inconvénient, handicap, point faible • to be at a disadvantage : être pénalisé disadvantaged adj. / %dIs@d"vA:ntIdZd / défavorisé, déshérité, the disadvantaged : les personnes économiquement faibles

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

disagree (to) vb. / %dIs@"gri: / ne pas être d’accord/du même avis (with : avec, about/on : sur), être en désaccord avec, I disagree with the project : je suis contre le projet disappear (to) vb. / %dIs@"pI@(r) / disparaître disbelief nom n.c. / %dIsbI"li:f / incrédulité disbelieve (to) vb. / %dIsbI"li:v / ne pas croire (en : in ) discomfort nom n.c. / dIs"kVmf@t / gêne, malaise, sensation désagréable/pénible discontent nom / %dIsk@n"tent / mécontentement • malaise social discontinue (to) vb. / %dIsk@n"tInju: / mettre fin à, cesser, arrêter, interrompre discourse nom / "dIskO:s / exposé, étude, débat, discours discover (to) vb. / dIs"kVv@(r) / découvrir, s’apercevoir discovery nom / dI"skVv@rI / découverte discuss (to) vb. / dI"skVs / examiner, étudier, analyser, expliquer, discuter de, débattre de, the PhD students discussed the results with the scientist : les doctorants ont examiné les résultats avec le chercheur disease nom / dI"zi:z / maladie (mentale, physique), affection diseased adj. / dI"zi:zd / malade disfigure (to) vb. / dIs"fIg@(r) / défigurer dish nom / dIS / plat (récipient, mets : container, food ), Petri dish : boîte de Pétri dislocation nom / %dIsl@"keISn / perturbation, bouleversement, Méd. dislocation, déboîtement, luxation dislodge (to) vb. / dIs"lQdZ / détacher, se détacher, déplacer dismiss (to) vb. / dIs"mIs / congédier, renvoyer • rejeter (allégations, demande), ne pas prendre au sérieux, ne pas tenir compte de disobey (to) vb. / %dIs@"beI / désobéir, enfreindre, some patients tend do disobey doctors’ orders : certains malades ont tendance à désobéir aux consignes du médécin disorder nom / dIs"O:d@(r) / désordre, Méd. troubles, affection

LEXIS dispense (to) vb. / dI"spens / distribuer, préparer, délivrer (médicament), dispensing chemist : pharmacien d’officine display / dI"spleI / 1 nom présentation, exposition, manifestation (courage), Inf. affichage, écran • on display : exposé • screen display : écran de visualisation 2 (to) vb. présenter, exposer, afficher • montrer, manifester, Méd. présenter (des symptômes) disposal nom / dI"sp@Uzl / disposition, at the disposal of : à la disposition de • élimination, évacuation, enlèvement, rejet (déchets : waste ) • disposal of hospital waste : élimination des déchets des hôpitaux disrupt (to) vb. / dIs"rVpt / perturber, troubler, déséquilibrer, déranger • interrompre disruption nom / dIs"rVpSn / perturbation disseminate (to) vb. / dI"semIneIt / répandre, disperser, disséminer • diffuser, distribuer disseminated ptp. / dI"semIneItId / + cancer : cancer généralisé, + sclerosis : sclérose en plaques dissimilarity nom / %dIsImI"l&r@tI / différence, dissemblance dissolve (to) vb. / dI"zQlv / dissoudre, faire fondre, disparaître distend (to) vb. / dI"stend / ballonner, dilater distension nom n.c. / dI"stenSn / ballonnement, dilatation distinguish (to) vb. / dI"stINgwIS / reconnaître, distinguer (from : de), apercevoir, discerner distress nom n.c. / dI"stres / souffrance, peine, désarroi, difficultés, situation difficile, Méd. souffrance, détresse distressed adj. / dI"strest / en détresse, en difficulté, désemparé, traumatisé, désespéré • sinistré distribute (to) vb. / dI"strIbju:t / distribuer, répartir district nom / "dIstrIkt / région, zone, district, secteur, quartier disturbance nom / dI"st3:b@ns / troubles, dérangement, perturbation disturbing adj. / dI"st3:bIN / préoccupant, inquiétant, alarmant, gênant dive (to) vb. / daIv /, dived (US dove / d@Uv /), dived plonger

327 diverse adj. / daI"v3:s / variable, hétérogène, différent • très divers divide (to) vb. / dI"vaId / (se) diviser, (se) répartir, partager • être divisible par • dividing line : ligne de démarcation division nom / dI"vIZn / division, service, département (administration) dizziness nom n.c. / "dIzInIs / vertiges dizzy adj. / "dIzI / to feel dizzy : avoir le vertige, être pris d’étourdissements, a dizzy spell : un vertige dome nom / d@Um / dôme, sommet arrondi, calotte (crâne) domestic adj. / d@"mestIk / domestic violence : (actes de) violence familiale donate (to) vb. / d@U"neIt / faire don de, donner, offrir donation nom / d@U"neISn / don donor nom / "d@Un@(r) / donateur, bailleur de fonds, Méd. donneur doping nom n.c. / "d@UpIN / dopage dosage nom habit. sing. / "d@UsIdZ / dosage, doses, posologie DOTS acron. / dQts / Directly Observed Therapy Short course : traitement de brève durée sous surveillance directe doubt / daUt / 1 nom doute, incertitude 2 (to) vb. douter, avoir des doutes, there is no reason to doubt the diagnosis : il n’y a aucune raison de mettre en doute le diagnostic doubtful adj. / "daUtfl / peu convaincu • douteux • to be doubtful about : avoir des doutes au sujet de • it is doubtful : il est douteux, encore incertain doubtless adv. / "daUtlIs / sans doute, certainement drain / dreIn / 1 nom canalisation, tuyau d’écoulement, Méd. drain 2 (to) vb. drainer, assécher, + away : s’écouler (liquide) drainage nom n.c. / "dreInIdZ / drainage, assèchement, écoulement dramatic adj. / dr@"m&tIk / spectaculaire, impressionnant, remarquable, extraordinaire, intense dramatically adv. / dr@"m&tIklI / spectaculairement, considérablement, énormément

328 draw (to) vb. / drO: / drew / dru: / drawn / drO:n / dessiner • tirer (conclusion), établir (comparaison), attirer (attention) • susciter, provoquer (réactions) • + on : utiliser comme source, puiser dans (réserves), faire appel à • + out : enlever, retirer, + up : rédiger, établir, dresser (liste), mettre au point drawback nom / "drO:b&k / inconvénient, désavantage, point faible drawing nom / "drO:IN / dessin dressing nom / "dresIN / Méd. pansement drink / drINk / 1 nom boisson, verre (d’alcool) 2 (to) vb. drink, drank / dr&Nk /, drunk / drVNk /, boire, prendre (boisson…) drinker nom / "drINk@(r) / buveur drinking nom n.c. / "drINkIN / (fait de) boire, boisson • drinking water : eau potable/de boisson drip nom / drIp / goutte, Méd. perfusion, to put up a drip : poser une perfusion, to be on a drip : être sous perfusion driver nom / "draIv@(r) / conducteur drop / drQp / 1 nom goutte de liquide, Méd. gouttes • baisse (in : de), chute, diminution 2 (to) vb. laisser/faire tomber, lâcher • baisser, diminuer, + down : tomber droplet nom / "drQplIt / gouttelette drought nom / draUt / sécheresse drown (to) vb. / draUn / (se) noyer, inonder, submerger, être submergé drug nom / drVg / médicament • drogue, stupéfiant • produit dopant • drug addiction : toxicomanie • drug abuse : toxicomanie, dopage, pharmacodépendance • drug resistant : pharmacorésistant dry / draI / 1 adj. sec, aride 2 (to) vb. dry, dried / draId /, dried, sécher, essuyer dryness nom n.c. / "draInIs / sécheresse, aridité duct nom / "dVkt / conduite, canalisation, tranchée, canal • Anat. pancreatic duct : canal pancréatique ou canal de Wirsung due adj. / dju: / due to : dû à, en raison de, par • due to the fact : dû au fait que, du fait de

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

dura mater nom, pl. dura maters dure-mère ( pl. dures-mères) DVT abrév TVP (voir deep ) dye / daI / 1 nom teinture, colorant 2 (to) vb. teindre dying / "daIIN / (voir die )

E each adj. , pron. / i:tS / chaque, chacun ear nom / I@(r) / Anat. oreille earache nom / "I@reIk / mal d’oreille eardrum nom / "I@drVm / Anat. tympan earn (to) vb. / 3:n / gagner (salaire) earner nom / "3:n@(r) / soutien économique (personne), personne rémunérée • source de revenus earpiece nom / "I@pi:s / écouteur earplug nom / "I@plVg / Boules Quiès“, protège-tympans earth nom / 3:T / terre, monde, planète, globe earwax nom n.c. / "I@w&ks / cérumen, cire ease / i:z / 1 nom n.c. tranquillité, bien-être, aisance, facilité 2 (to) vb. soulager, apaiser, atténuer, alléger, faciliter easily adv. / "i:zIlI / facilement, aisément eastern adj. / "i:st@n / de l’est, oriental, d’orient edema nom / I"di:m@ / pl. edemata œdème edge nom / edZ / bord, côté, abords effect nom / I"fekt / effet, conséquence, incidence, répercussion, résultat • efficacité • action sur (médicament) effective adj. / I"fektIv / efficace, performant, utile • effectif, réel effectively adv. / I"fektIvlI / efficacement, effectivement, réellement, en fait, dans la pratique

LEXIS effectiveness nom n.c. / I"fektIvnIs / efficacité, utilité efficacy nom n.c. / "efIk@sI / Méd. efficacité (théorique) d’un traitement ou

efficaciousness

efficiency nom n.c. / I"fISnsI / capacité, compétence (personne) • efficience, bon fonctionnement, utilisation rationnelle des ressources, organisation rationnelle, efficacité, rentabilité, rendement, productivité efflux nom / "eflVks / pl. effluxes Méd. hepatic efflux : flux hépatique egg nom / eg / œuf either adj. pron. / "aID@r / l’un ou l’autre, n’importe lequel (des deux) • chaque elbow nom / "elb@U / Anat. coude elderly / "eld@lI / 1 adj. âgé 2 nom pl. the elderly : les personnes âgées elective nom / I"lektIv / cours facultatif ELISA acron. / I"laIz@ / enzyme-linked immunosorbent assay : titrage immunoenzymatique utilisant un antigène adsorbé else adv. / els / d’autre, anyone else : n’importe qui d’autre elsewhere adv. / %els"we@(r) / ailleurs embrace / Im"breIs / 1 nom étreinte 2 (to) vb. étreindre, prendre dans ses bras : embrasser (religion), englober, adopter emerge (to) vb. / I"m3:dZ / émerger, apparaître emergency / I"m3:dZ@nsI / 1 nom urgence, crise, situation critique, détresse 2 adj. d’urgence, de crise, de secours, de sécurité, emergency exit : sortie de secours emerging adj. / I"m3:dZIN / nouveau, récent • émergent (maladies) emotional adj. / I"m@US@nl / affectif, psychique (troubles : disorders ), psychologique (problème), émotionnel (état : state ) • émotif, sensible, sentimental, passionné (personne) • émouvant, pathétique (discours), emotional disorders : troubles affectifs, psychiques emphasize (to) vb. / "emf@saIz / souligner, mettre l’accent sur, insister sur, attirer l’attention sur

329 enable (to) vb. / I"neIbl / permettre à qqn de faire qqch., donner la possibilité, les moyens encounter / In"kaUnt@(r) / 1 nom rencontre (inattendue) 2 (to) vb. rencontrer (à l’improviste), se heurter à (difficultés) end / end / 1 nom bout, extrémité, fin, to this end : dans ce but 2 (to) vb. finir, (se) terminer, mettre fin endanger (to) vb. / In"deIndZ@(r) / mettre en danger endeavour (US endeavor) / In"dev@(r) / 1 nom effort, tentative 2 (to) vb. s’efforcer, tenter de ending nom / "endIN / fin, conclusion • terminaison endorse (to) vb. / In"dO:s / appuyer, apporter son soutien, soutenir, approuver, se prononcer en faveur de enforce (to) vb. / In"fO:s / faire respecter, mettre en application, imposer engage (to) vb. / In"geIdZ / susciter, éveiller (l’intérêt), retenir l’attention, faire participer activement • + in : exercer (une profession), avoir des activités, travailler dans, pratiquer, entreprendre, prendre part à • + to : s’engager à • + with : nouer le dialogue avec engine nom / "endZIn / moteur, search engine : moteur de recherche engineering nom n.c. / %endZI"nI@rIN / technique, technologie, ingénierie, mécanique, conception enhance (to) vb. / In"hA:ns / renforcer, consolider, développer, accroître, augmenter • accentuer, améliorer enhanced adj. / In"hA:nst / Pharm. potentialisé • computer enhanced : amélioré, exploité par ordinateur enjoy (to) vb. / In"dZOI / to enjoy sth. : aimer qqch. • to enjoy doing sth. : aimer faire quelque chose enlarge (to) vb. / In"lA:dZ / (s’)agrandir (photo), (s’)étendre, (se) développer, augmenter, (s’)élargir, (se) dilater, Méd. (s’) hypertrophier enlarged adj. / In"lA:dZd / agrandi, augmenté, plus important, dilaté • Méd. hypertrophié enlargement nom / In"lA:dZm@nt / agrandissement, élargissement, accroissement, dilatation • Méd. hypertrophie enormously adv. / I"nO:m@slI / énormément, extrêmement

330 enough pron. , adv. / I"nVf / assez, suffisamment (de) enrol (US enroll) (to) vb. / In"r@Ul /, (UK, US enrolled) embaucher, + in : (s’) inscrire, (s’)engager ensure (to) vb. / In"SO:(r) / assurer, garantir, veiller à • + that : vérifier que, s’assurer que, veiller à ce que, faire en sorte que ENT acron. ear, nose and throat : nez, gorge, oreille ORL entail (to) vb. / In"teIl / entraîner, occasionner, nécessiter, comporter enter (to) vb. / "ent@(r) / entrer dans, pénétrer dans • s’engager dans, participer à (compétition) • inscrire, saisir (données) • air enters the chest cavity : l’air pénètre dans la cavité pulmonaire, bacteria enter the body : les bactéries pénètrent dans le corps enteric / en"terIk / ou enteral / "ent@r@l / adj relatif aux intestins, intestinal, enteric fever : autre nom de la fièvre typhoïde - typhoid fever entire adj. / In"taI@(r) / entier entirely adv. / In"taI@lI / entièrement, tout à fait, absolument equate (to) vb. / I"kweIt / assimiler à, identifier à, mettre sur le même pied, égaliser • + to/with : être équivalent à equine adj. / "ekwaIn / chevalin era nom / "I@r@ / ère, époque, temps erect / I"rekt / 1 adj. , adv. droit, dressé, debout 2 (to) vb. ériger, élever, bâtir, construire errant adj. / "er@nt / indiscipliné, indocile • anormal, défectueux, intempestif • errant bombing : bombardement mal dirigé erupt (to) vb. / I"rVpt / entrer en éruption, éclater, déclencher • Méd. sortir, apparaître, percer (dents) especially adv. / I"speS@lI / surtout, en particulier, particulièrement establish (to) vb. / I"st&blIS / créer, instituer, fonder, établir, fixer • établir, constater, montrer, démontrer, prouver established adj. / I"st&blISt / établi, existant • en place, connu, reconnu • classique, traditionnel establishment nom / I"st&blISm@nt / établissement • classe dirigeante, élites, autorités, pouvoir, hiérarchie

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

even / "i:vn / 1 adj. plat, égal, régulier, uniforme, homogène • pair (opposé à odd : impair) 2 adv. encore, même • + nég. : not even : pas même • + comp. : encore, an even higer number : un chiffre encore plus élevé • even though : bien que evenly adv. / "i:vnlI / également, de façon homogène, régulièrement, uniformément event nom / I"vent / événement, fait, phénomène, manifestation, in the event of : au cas où, dans l'éventualité où eventually adv. / I"ventSU@lI / ultérieurement, plus tard, finalement, en fin de compte ever adv. / "ev@(r) / jamais, hardly ever : presque jamais • en fin de questions : jamais, déjà • have you ever travelled outside Europe? avez-vous jamais/déjà fait des voyages en dehors de l’Europe ? • for ever : pour toujours • sans cesse everyday adj. / "evrIdeI / de tous les jours, quotidien, courant, ordinaire everyone pron. / "evrIwVn / = everybody : tout le monde, chacun, n’importe qui everything pron. / "evrITIN / tout evidence nom n.c. / "evId@ns / preuves, témoignage • données scientifiques, informations disponibles, faits • + based : fondé sur des données factuelles (scientifiques), scientifiquement fondé • evidence based medicine : médecine factuelle, médecine des preuves evolve (to) vb. / I"vQlv / élaborer, mettre au point • se développer • évoluer exceed (to) vb. / Ik"si:d / dépasser, excéder, aller au-delà exceedingly adv. / Ik"si:dINlI / extrêmement except prép. / Ik"sept / sauf, excepté, à l’exclusion de, abstraction faite de exchange nom / Iks"tSeIndZ / échange, exchange rate : taux de change excretion nom / Ik"skri:Sn / excrétion, sécrétion exemplify (to) vb. / Ig"zemplIfaI / être un bon exemple, (bien) illustrer, être représentatif de, donner l’exemple le plus caractéristique de exert (to) vb. / Ig"z3:t / exercer exertion nom n.c. / Ig"z3:Sn / effort

LEXIS exhaust (to) vb. / Ig"zO:st / (s’)épuiser(ressources) • pousser à bout, exténuer exhaustive adj. / Ig"zO:stIv / exhaustif, complet, approfondi exit (to) vb. / "eksIt / sortir expand (to) vb. / Ik"sp&nd / augmenter, (se) développer, élargir, amplifier • croître expanding adj. / Ik"sp&ndIN / extensible, en expansion expansion nom / Ik"sp&nSn / expansion, dilatation, agrandissement, développement, augmentation expect (to) vb. / Ik"spekt / s’attendre à, attendre, prévoir, anticiper, escompter • supposer expectancy nom n.c. / Ik"spekt@nsI / attente, espoir, life expectancy : espérance de vie (personne), durée de bon fonctionnement (appareil : appliance ) expected adj. / Ik"spektId / prévu, prévisible, attendu, escompté • to be expected : devoir, être censé • the consultation is expected to last one hour : la consultation devrait durer une heure expensive adj. / Ik"spensIv / cher, coûteux, onéreux experience / Ik"spI@rI@ns / 1 nom n.c. expérience (acquise, vécue), pratique, cas, situation 2 (to) vb. éprouver, ressentir (douleur : pain ) • subir, connaître, souffrir, (la faim : hunger ), être victime de • découvrir experienced adj. / Ik"spI@rI@nst / expérimenté experiment / Ik"sperIm@nt / 1 nom expérience (scientifique), essai, to carry out an experiment : faire une expérience 2 (to) vb. faire une expérience, expérimenter • + with : expérimenter qqch., faire l’expérience de qqch. expertise nom n.c. / %eksp3:"ti:z / compétences techniques, savoir-faire, expertise explain (to) vb. / Ik"spleIn / expliquer, élucider, éclaircir explore (to) vb. / Ik"splO:(r) / explorer, étudier expose (to) vb. / Ik"sp@Uz / découvrir, exposer exposed adj. / Ik"sp@Uzd / exposé (à : to ), vulnérable, précaire exposure nom n.c. / Ik"sp@UZ@(r) / + to : exposition à (amiante : asbestos…), orientation, exposition (bâtiment)

331 expressly adv. / Ik"spreslI / expressément, explicitement extend (to) vb. / Ik"stend / prolonger, se prolonger, s’étendre • augmenter, développer, agrandir, approfondir • + to : étendre à • comprendre, inclure • + from…to : s’étendre, durer de … à extended adj. / Ik"stendId / prolongé, long, approfondi, élargi, étendu extendible, extendable adj. / Ik"stend@bl / renouvelable, extensible extent nom habit. sing. / Ik"stent / étendue, longueur, largeur, dimension • champ, domaine • importance, ampleur • degré, mesure (large, grande) extract / "ekstr&kt / 1 nom extrait (to) 2 vb. extraire, tirer de eye nom / aI / Anat. œil -eyed adj. , (composé) / aId / de eye : œil • big-eyed : aux grands yeux eyelid nom / "aIlId / Anat. paupière

F face / feIs / 1 nom visage, apparence • façade, côté 2 (to) vb. être situé en face, de • (devoir) faire face à, affronter, être confronté, se trouver devant • to be faced with : être confronté à facility nom / f@"sIl@tI / sing. facilité, don • sing. ou pl. : installations, infrastructure, équipement(s), établissement, usine, complexe • pl. : locaux, moyens, ressources, possibilités, facilités fact nom / f&kt / fait, élément • donnée, information faculty nom / "f&kltI / faculté, aptitude • corps professoral, faculté (université) fail (to) vb. / feIl / faiblir, s’affaiblir • + to : omettre de, négliger de, ne pas parvenir à, ne pas ( + vb. ) • rater, ne donner aucun résultat, tomber en panne, échouer, faire échouer, to fail an exam : échouer à un examen failure nom habit. n.c. / "feIlj@(r) / omission • échec • panne • manque de • + to : manque de, absence de, refus de • Méd. insuffisance, défaillance (heart, kidney, liver : cardiaque, rénale, hépatique…) faint / feInt / 1 adj. faible, vague, léger • to feel faint : se sentir mal 2 (to) vb. s’évanouir, perdre connaissance

332 fairly adv. / "fe@lI / assez, plutôt, relativement • équitablement • honnêtement faith nom / feIT / foi, confiance, faith healer : guérisseur • faith healing : guérison par la foi faithfully adv. / "feITf@lI / fidèlement • yours faithfully : veuillez agréer etc. fake / feIk / 1 adj. faux, truqué 2 (to) vb. faire un faux, falsifier, contrefaire, simuler fall / fO:l / 1 nom diminution, baisse, réduction, décroissance • chute, déclin • en pente, descendant 2 (to) vb. fall, fell / fel /, fallen / "fO:l@n /, tomber, to fall ill, sick : tomber malade • baisser, diminuer, régresser, être en recul • + out : tomber fallout nom n.c. / "fO:l%aUt / retombées (radioactives) false adj. / fO:ls / faux, falsifié famous adj. / "feIm@s / célèbre far / fA:(r) / 1 nom comp. farther / "fA:D@(r) / ou further / "f3:D@(r) / sup. farthest / "fA:DIst / ou furthest / "f3:DIst / so far : jusqu’ici • by far : de loin, de beaucoup • as far as we know : pour autant que nous sachions • far beyond : bien au-delà • far greater : bien plus (grand, puissant, fort…) etc. 2 adv. loin 3 adj. lointain, éloigné • extrême • the Far East. : l'Extrême-Orient farm nom / fA:m / exploitation agricole, ferme, plantation farmer nom / "fA:m@(r) / agriculteur, paysan farsighted adj. / %fA:"saItId / prévoyant, sage, avisé • hypermétrope, presbyte farsightedness nom n.c. / %fA:"saItIdnIs / prévoyance • hypermétropie (US) (UK longsightedness ) • presbytie farther / "fA:D@(r) / 1 adv. plus loin (sens littéral, distance) 2 adj. plus éloigné, plus lointain fashion nom / "f&Sn / manière, façon • mode fast / fA:st / 1 adj. rapide 2 adv. vite, rapidement • fermement 3 (to) vb. jeûner fat / f&t / 1 nom graisse 2 adj. gros, gras fatty adj. / "f&tI / gras (nourriture, acide), Méd. fatty tissue : tissu adipeux • fatty degeneration : dégénérescence graisseuse

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

faulty adj. / "fO:ltI / défectueux, erroné, défaillant favour (US favor) / "feIv@(r) / 1 nom faveur, service, in favour of : en faveur de 2 (to) vb. préconiser, être favorable à, soutenir, appuyer, préférer, favoriser, avantager fear / fI@(r) / 1 nom peur, crainte 2 (to) vb. avoir peur de, craindre fearful adj. / "fI@fl / peureux, craintif (personne) • effrayant, affreux, épouvantable (accident, son) • fearful that : craignant que, fearful of : par crainte de feasibility nom n.c. / %fi:z@"bIl@tI / possibilité (de réaliser), faisabilité feasible adj. / "fi:z@bl / possible, faisable, viable • vraisemblable, plausible feature / "fi:tS@(r) / 1 nom trait/caractère/élément (distinctif), particularité, caractéristique, spécificité • fonctionnalité 2 (to) vb. comprendre, comporter • être équipé de • figurer, représenter feed (to) vb. / fi:d /, fed / fed /, fed nourrir, (s’) alimenter feedback nom n.c. / "fi:db&k / retour d’information, réaction, rétroinformation feel / fi:l / 1 nom uniquement sing. toucher • sensation • atmosphère • impression • intuition 2 (to) vb. feel, felt / felt /, felt, toucher, sentir, ressentir • être sensible à, éprouver • avoir l’impression • make the eye feel painful : rendre l’œil douloureux • to feel ill, sick : se sentir malade feeling nom / "fi:lIN / sensation, sentiment, impression, émotion, sensibilité fellow nom / "fel@U / compagnon, pair • membre (association etc.) • research fellow : chercheur fertility nom n.c. / f@"tIl@tI / fécondité, fertility clinic : centre de procréation médicalement assistée, fertility rate : taux de fécondité fever nom / "fi:v@(r) / fièvre few / fju: / 1 adj. peu (de) 2 pron. quelques-uns fictional adj. / "fIkS@nl / imaginaire, fictif, de fiction field nom / fi:ld / champ, terrain, domaine, secteur, branche • sur le/de terrain • field work : travail sur le terrain • dark field microscopy : microscopie sur fond noir

LEXIS fifth nom / fIfT / cinquième fight / faIt / 1 nom combat 2 (to) vb. fight, fought / fO:t /, fought, se battre, combattre, lutter fill (to) vb. / fIl / remplir, se remplir, combler (lacune : gap) • exécuter, (commande : order ), + in : remplir (questionnaire) • Dent. obturer (dent : tooth ) filling nom / "fIlIN / Dent. plombage, obturation finally adv. / "faIn@lI / enfin, finalement, pour finir find (to) vb. / faInd / trouver, constater, s’apercevoir de, se rendre compte finding nom / "faIndIN / découverte, findings : conclusions, résultats, constatations, données recueillies fine adj. / faIn / (the) fine art(s) : (les) beaux-arts finger nom / "fINg@(r) / Anat.doigt fire nom / "faI@(r) / feu, incendie • fire cupping : ventouses appliquées à chaud fisherman nom / "fIS@m@n / pl. fishermen pêcheur fit / fIt / 1 nom concordance, adéquation • to be fit : être en bonne santé • survival of the fittest : survie du plus apte • Méd. accès, crise • an epileptic fit : une crise d’épilepsie 2 (to) vb. correspondre à, être adapté à, (bien) aller • fixer, poser • + (out) with : équiper, aménager, installer fitful / "fItfl / troublé, agité, changeant fivefold adj. , adv. / "faIv%f@Uld / quintuple, au quintuple (voir fold ) flat adj. / fl&t / plat, stable, uniforme • flat rate : tarif forfaitaire flex (to) vb. / fleks / faire jouer ses muscles, ses articulations, pour les assouplir flight nom / flaIt / vol (oiseau, insecte, avion) float (to) vb. / fl@Ut / flotter, faire flotter flooding nom n.c. / "flVdIN / inondation flow / fl@U / 1 nom habit. sing. flux, courant, écoulement, circulation, blood flow : circulation sanguine 2 (to) vb. couler, s’écouler, circuler, affluer

333 flu / flu: / abrév. n.c influenza : grippe fluency nom n.c. / "flu:@nsI / maîtrise (langue :language ), aisance fluently adv. / "flu:@ntlI / couramment, avec aisance flush / flVS / 1 nom rougeur, afflux (de sang), Méd. hot flushes : bouffées de chaleur 2 (to) vb. rougir flushed adj. / flVSt / rouge, enflammé (de fièvre…) fly / flaI / 1 nom pl. flies mouche 2 (to) vb. fly, flew / flu: /, flown / fl@Un /, voler (oiseau, avion), aller/voyager/faire un voyage en avion • piloter, emmener/transporter en avion • passer vite focus / "f@Uk@s / 1 nom pl. focuses ou foci / "f@UkaI / foyer (de lentille) • centre des préoccupations/d’attention, élément central, centre d’intérêt, accent, enjeu, focus on : gros plan sur 2 (to) vb. + on : centrer (efforts) sur • orienter, diriger, canaliser, concentrer sur, porter (principalement, surtout) sur (travaux) • concerner • être axé/centré sur • se consacrer à, insister sur, mettre l’accent sur • to be focused on : porter principalement, surtout, sur fold ou -fold / f@Uld / 1 nom pli 2 (to) vb. plier, replier 3 adj. to increase threefold : tripler 4 adv. twentyfold : vingt fois folding adj. / "f@UldIN / pliant folk / f@Uk / 1 nom gens • tradition populaire 2 adj. folk healing : médecine populaire • folk medicine : médecine traditionnelle follow (to) vb. / "fQl@U / suivre, exécuter, se conformer à • as follows : comme suit, + up : suivre, faire/donner suite à, poursuivre, prolonger, assurer le suivi • surveiller, observer following adj. / "fQl@UwIN / suivant • the following : ce qui suit follow up / "fQl@UVp / 1 nom suite donnée, suite à donner, prolongement • contrôle, suivi, surveillance 2 adj. complémentaire, ultérieur, faisant suite food nom / fu:d / nourriture, aliment foot nom / fUt / pl. feet / fi:t / pied, patte -footed adj. (composé ) / fUtId / de foot : pied patte • four-footed : quadrupède, qui possède 4 pattes • white-footed mouse : souris aux pattes blanches

334 forbid (to) vb. / f@"bId /, forbade / fO:"b&d /, forbidden / f@"bIdn / interdire, défendre, empêcher (qqn de faire qqch. : sb. from doing sth.) forcibly adv. / "fO:s@blI / de force, par la force, énergiquement foreign adj. / "fQr@n / étranger, extérieur foreigner nom / "fQr@n@(r) / étranger foreman nom / "fO:m@n / pl. foremen / "fO:men / contremaître, chef d’équipe foremost / "fO:m@Ust / 1 adj. plus grand, plus éminent, de premier plan 2 adv. tout d’abord forensic adj. / f@"rensIk / médico-légal, de police scientifique • forensic doctor/pathologist : médecin légiste • forensic laboratory : laboratoire de police scientifique • forensic medicine : médecine légale forget (to) vb. / f@"get /, forgot / f@"gQt /, forgotten / f@"gQtn / oublier form / fO:m / 1 nom forme, sorte, genre • formulaire, imprimé 2 (to) vb. (se) former, construire, blood clots form : des caillots sanguins se forment formal adj. / "fO:ml / officiel, formel, formalisé, en règle, présenté dans les formes, conventionnel, formal training : véritable formation, formation dans le cadre des études formally adv. / "fO:m@lI / formellement, en bonne et due forme, dans les règles former / "fO:m@(r) / 1 pron. celui/celle-là, le premier (des deux) 2 adj. ancien, d’autrefois, former… latter (solution) : la première … la seconde (solution) formerly adv. / "fO:m@lI / autrefois, anciennement formula / "fO:mjUl@ / 1 nom pl. formulas ou formulae / "fO:mjUli: / infant formula : préparation pour nourrissons mathematical formulae : formules mathématiques 2 adj. formula milk : lait maternisé fortify (to) vb. / "fO:tIfaI / fortifier • iron fortified : enrichi en fer fortnight nom habit. sing. / "fO:tnaIt / une quinzaine, deux semaines, quinze jours (UK) forward / "fO:w@d / 1 adj. en avant, (dirigé) vers l’avant • en avance • précoce • avancé • moderne • prévisionnel 2 forward(s) adv. en avant, droit devant soi 3 prép. à l’avant de, put forward : proposer,

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

suggérer, avancer (opinion) • take forward : faire avancer, progresser, move forward : avancer, progresser • faire avancer/progresser • avancer (date…) • look forward to (starting) : attendre avec impatience (de commencer), se réjouir à la perspective de commencer, être heureux de commencer 4 (to) vb. faire avancer, envoyer, faire suivre fossilized adj. / "fQs@laIzd / fossilisé, figé foster (to) vb. / "fQst@(r) / favoriser, encourager • entretenir (image) found (to) vb. / faUnd / fonder, créer, constituer, établir, baser sur foundation nom / %faUn"deISn / fondation, création • fondement, base, socle founding adj. / "faUndIN / founding father : père (fondateur), auteur fourfold adj. adv. / "fO:f@Uld / quadruple, au quadruple (voir fold ) frame / freIm / 1 nom cadre, charpente, armature • ossature • structure • monture (lunettes : glasses, spectacles ) 2 (to) vb. élaborer, concevoir, exprimer, formuler (question) framework nom / "freImw3:k / cadre, structure, squelette, infrastructure • cadre de référence • schéma, grandes lignes/axes free / fri: / 1 adj. libre, libéré, exempt de, dégagé de • gratuit • + of, from : libre de, sans • free of disease : indemne de maladie 2 adv. en liberté, libéré, dégagé • gratuitement 3 (to) vb. libérer, exempter (impôts : taxes ) • se libérer/débarrasser/ dégager de freely adv. / "fri:lI / librement, en toute liberté freeze (to) vb. / fri:z /, froze / fr@Uz /, frozen / "fr@Uzn / geler, (se) congeler, surgeler freezing nom n.c. ou sing. / "fri:zIN / congélation, gel (rémunérations : pay ) fresh adj. / freS / frais, récent, nouveau friendly adj. / "frendlI / gentil, affectueux, amical, aimable • childfriendly : aménagé pour les enfants, adapté aux besoins des enfants, user-friendly : accessible, facile d’emploi, facile à utiliser, convivial front / frVnt / 1 nom habit. sing. avant, devant, partie antérieure, début • in front of : à l’avant, au début 2 adj. de devant, (en) avant 3 adv. par devant

LEXIS

335

fuel / "fju:@l / 1 nom combustible, carburant 2 (to) vb. ravitailler (en combustible) • susciter, alimenter (le débat) fulfil (to) vb. / fUl"fIl /, fulfilled / fUl"fIld /, prp. fulfilling / fUl"fIlIN / accomplir, s’acquitter de (tâches : tasks ) • atteindre, réaliser (objectifs) • tenir (engagements : obligations ) • remplir (conditions) • répondre (attente : expectations ) fund / fVnd / 1 nom fonds, moyens (financiers) • ressources (financières) • capitaux • fund-raising: collecte de fonds, appel à la générosité publique 2 (to) vb. financer, doter de funding nom n.c. / "fVndIN / financement, capitaux, fonds fungal adj. / "fVNgl / fongique fungus nom / "fVNg@s / pl. fungi / fVngaI / ou funguses champignon, moisissure, Méd. mycose funnel / "fVnl / 1 nom entonnoir 2 (to) vb. faire passer dans un entonnoir, canaliser furniture nom n.c. / "f3:nItS@(r) / mobiliser, meubles, a piece of furniture : un meuble further / "f3:D@(r) / 1 adj. nouveau, supplémentaire, complémentaire • autre, ultérieur, plus complet/détaillé/précis/approfondi 2 adv. davantage, plus • plus loin, plus longtemps, plus avant • d’ailleurs, par ailleurs 3 (to) vb. promouvoir, stimuler, faire progresser, favoriser, faciliter, servir, aider à (voir far ) furthermore adv. / %f3:D@"mO:(r) / en outre, de plus, d’autre part

G gain / geIn / 1 nom gain, profit, bénéfice, avantage • amélioration, progrès • hausse, augmentation • weight gain : prise de poids 2 (to) vb. obtenir, recueillir, susciter • gagner • + by/from : retirer un/des avantages de, bénéficier de, profiter de • + in : augmenter de, acquérir plus de gall nom n.c. / gO:l / = bile, Méd. bile gall-bladder nom / "gO:lbl&d@(r) / vésicule biliaire gallstone nom / "gO:lst@Un / calcul biliaire game nom / geIm / jeu • gibier

gap nom / g&p / écart, disparité, différence, fossé • lacune, trou, intervalle • manque, insuffisance, pénurie • gap year : année libre entre l’école et l’université • to bridge a gap (between) : combler un écart, jeter une passerelle (entre) • to narrow the gap between the rich and the poor : réduire l’écart (qui existe) entre les riches et les pauvres garbage nom n.c. / "gA:bIdZ / ordures (ménagères), détritus, déchets gather (to) vb. / "g&D@(r) / (s’) accumuler, (re)cueillir, (se) rassembler, (se) réunir • + that : déduire que, conclure que general adj. / "dZenr@l / général, d’ensemble, general public : grand public generate (to) vb. / "dZen@reIt / engendrer, produire, dégager, susciter • créer (emplois) • provoquer • charitable organizations generate funds through publicity campaigns : les campagnes de publicité permettent aux œuvres charitables d’obtenir des fonds gentleness nom n.c. / "dZentlnIs / douceur gently adv. / "dZentlI / avec douceur, doucement, gentiment German nom, adj. / "dZ3:m@n / allemand, d’Allemagne • Méd. German measles : rubéole (aussi rubella ) get (to) vb. / get /, got / gQt /, got (US gotten / "gQtn /) obtenir, recevoir, trouver, devenir, prendre, (aller) chercher, appeler (to get the doctor ), attraper (maladie), être atteint de (amnésie), + into : pénétrer dans • + out : s’en aller, s’échapper • enlever, (se) débarrasser de, to get better : aller mieux • to get rid of : se débarrasser de • to get sued : être poursuivi en justice (for : pour) • to get away with murder : se permettre de faire n’importe quoi (sans être sanctionné) girl nom / g3:l / petite fille, jeune fille, fillette, fille give (to) vb. / gIv /, gave / geIv /, given / "gIvn / (sb. sth.) : donner (qqch. à qqn), the nurse gave her tablets : l’infirmière lui a donné des comprimés glass nom / glA:s / verre (n.c. substance ) • pl. glasses : verres (récipients pour la boisson ) • Opt. lentille glasses nom pl. / glA:sIz / lunettes • cupping glasses : ventouses (en verre) global adj. / "gl@Ubl / mondial, planétaire, d’ampleur mondiale, global globally adv. / "gl@Ub@lI / mondialement, à l’échelle mondiale/planétaire, dans le monde entier, universellement

336 glue / glu: / 1 nom colle • Méd. glue ear : otite séreuse 2 (to) vb. coller goal nom / g@Ul / objectif (plus lointain, target : objectif immédiat ), but God nom / gQd / Dieu gradually adv. / "gr&dZUlI / petit à petit, peu à peu, progressivement graduate / "gr&dZU@t / 1 nom / "gr&dZU@t / diplômé de l’enseignement supérieur, étudiant poursuivant des études supérieures 2 adj. / "gr&dZU@t / diplômé, de l’enseignement supérieur • graduate courses/ studies : études universitaires supérieures, graduate school : école/faculté d’enseignement universitaire/supérieur 3 (to) vb. / "gr&djUeIt / obtenir son diplôme graft / grA:ft / 1 nom greffe, greffon 2 (to) vb. greffer (on : sur) grapefruit nom / "greIpfru:t / pl. grapefruit ou grapefruits pamplemousse graph nom / grA:f / graphique, diagramme, courbe grass nom / grA:s / herbe, gazon, pelouse • herbage, pâturage • blade of grass : brin d’herbe grassy adj. / "grA:sI / herbeux greatly adv. / "greItlI / vivement, beaucoup, considérablement, fortement, nettement green nom adj. / gri:n / vert (couleur ) greenbottle nom / "gri:n%bQtl / mouche verte de la viande - lucile soyeuse grey (US gray) nom adj. / greI / gris (couleur ) grid nom / grId / grille grommet nom / "grQmIt / aérateur transtympanique (diabolo) gross adj. / gr@Us / grossier, fruste • flagrant, manifeste • grave, lourd (erreur), gross negligence : faute grave grossly adv. / "gr@UslI / grossièrement, nettement, manifestement, considérablement, totalement, excessivement, grossly overweight : obèse ground nom / graUnd / sol, terre, terrain, domaine • breeding ground : gîte larvaire • base, fondement, raison, motif,

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

cause, on the ground(s) that : parce que, étant donné que, on the grounds of : pour des raisons de grounds nom pl. / graUndz / coffee grounds : marc de café groundwork nom n.c. / "graUndw3:k / préparatifs, travail préparatoire grow (to) vb. / gr@U /, grew / gru: /, grown / gr@Un / croître, pousser, grandir, grossir, se développer, s’accroître, augmenter • cultiver, faire pousser • + into : devenir • + up : grandir (enfant) • to grow + adj : devenir : to grow bigger, older… : grandir, vieillir… growing adj. / "gr@UIN / qui pousse, croît • croissant, en développement, de plus en plus (net, prononcé, important, marqué, abondant…) growth nom / gr@UT / n.c. croissance, essor, développement, pousse (cheveux, poils) • augmentation, growth hormone : hormone de croissance • growth rate : taux de croissance • comptable : Méd. tumeur guess / ges / 1 nom hypothèse, conjecture, supposition 2 (to) vb. deviner, conjecturer, supposer, penser que guideline nom / "gaIdlaIn / conseil, indication, ligne directrice, principe directeur, recommandation, orientation gum / gVm / 1 nom gomme, colle, caoutchouc, chewing-gum, Anat. gums ( pl. ) : gencives 2 (to) vb. gum, gummed, gummed, coller, + up : coller, encrasser (et empêcher le bon fonctionnement) gun nom / gVn / arme à feu, pistolet, fusil, canon, gun control : réglementation sur les armes à feu

H habit nom / "h&bIt / habitude, Méd. habit forming : engendrant une dépendance HACE acron. High Altitude Cerebral Edema : OCHA œdème cérébral de haute altitude hair nom / he@(r) / n.c. cheveux, chevelure (tête, êtres humains), comptable : poils (corps humain, animaux, plantes) half / hA:f / 1 nom pl. halves : moitié, -and a half : -et demi(e), in half : en deux 2 adj. demi, a half bottle : une demie bouteille 3 adv. (à) moitié, 50%, it is half as expensive in winter : c'est deux fois moins cher en hiver, he earns half as much as his wife : il gagne deux fois moins que son épouse, half as much again : une fois et demie, he has only half recovered from his operation : il n'est qu'à moitié remis de son opération

LEXIS halve (to) vb. / hA:v / couper en deux, diviser par deux, diminuer/réduire de moitié hammer nom / "h&m@(r) / Anat. marteau, un des trois osselets (ossicles ) de l’oreille moyenne, PNA malleus –handed adj. composé / h&ndId / de hand : main • one-handed : d’une main, avec une main, left-handed : gaucher handle / "h&ndl / 1 nom poignée, manche 2 (to) vb. manutentionner • s’occuper de, se charger de, faire face à • régler, traiter (problème), se charger de handling nom n.c. / "h&ndlIN / manutention, traitement, manipulation, gestion • mesures prises (pour faire face à) HAPE acron. High Altitude Pulmonary Edema : OPHA œdème pulmonaire de haute altitude happen (to) vb. / "h&p@n / se produire, se passer, arriver • se faire/se trouver que hard / hA:d / 1 adj. dur, pénible, difficile • incontestable (faits), concret, sûr, tangible, hard drugs : drogues dures 2 adv. fort, dur, to work hard : travailler dur hardly adv. / "hA:dlI / à peine, pratiquement pas, guère, presque, tout juste • hardly ever : presque jamais • hardly anyone : presque personne hardware nom n.c. / "hA:dwe@(r) / matériel, quincaillerie • Inf. matériel informatique (opposé à logiciel) harm / hA:m / 1 nom n.c. mal, dommages, dégâts, effets nocifs, tort • to do harm : faire du tort/du mal 2 (to) vb. faire du tort, nuire à, endommager harmful adj. / "hA:mfl / nocif, néfaste, nuisible, mauvais, dommageable hate (to) vb. / heIt / détester hazard nom / "h&z@d / risque, danger, péril, occupational hazards : risques professionnels hazardous adj. / "h&z@d@s / dangereux, nocif, hazardous wastes : déchets dangereux head / hed / 1 nom tête • personne, habitant • chef, responsable, directeur • haut 2 (to) vb. être à la tête, diriger • être en tête, se diriger headed writing paper : papier à lettres à en-tête

337 headache nom / "hedeIk / mal de tête • problème complexe headlamp nom / "hedl&mp / (également headlight ) phare, feu avant • Méd. lampe casque frontal headline nom / "hedlaIn / gros titre, grand titre • to make headlines : faire les gros titres, la une des journaux headword nom / "hed%w3:d / entrée, mot-entrée heal (to) vb. / hi:l / cicatriser, guérir • apaiser, guérir (qqn) healing / "hi:lIN / 1 nom n.c. guérison, cicatrisation, apaisement, réparation, reconstruction 2 adj. cicatrisant, médicinal, apaisant • faith healing : guérison par la foi • folk healing : médecine populaire health / helT / 1 nom n.c. santé, good/poor health : bonne, mauvaise santé • health foods : aliments diététiques, health hazard : risque/danger pour la santé, environmental health : hygiène publique • occupational health : hygiène/médecine du travail • health resort : station thermale/climatique, ville d’eaux 2 adj. de santé, sanitaire, médical • health authority : administration de la santé • health concern : soucis, problèmes de santé • health record : dossier médical • health tourism : tourisme médical • preventive health screening : dépistage médical préventif health care nom n.c. / "helTke@(r) / soins de santé : health care delivery : prestation de soins de santé, health care worker : agent de santé • health care provider : prestataire de soins de santé • personnel(s) de santé • primary health care : soins de santé primaires healthy adj. / "helTI / en bonne santé, bien portant (personne) • sain, salubre (chose) • salutaire (conseils… ), vigoureux, prospère hear (to) vb. / hI@(r) /, heard / h3:d /, heard entendre, apprendre (une nouvelle), to hear of : entendre parler de hearing nom n.c. / "hI@rIN / ouïe, audition, hearing impaired : sourd ou malentendant, hearing nerve : nerf auditif heart nom / hA:t / cœur, centre, heart failure : syncope/insuffisance cardiaque • by heart : par coeur heartbeat nom / "hA:tbi:t / battement de/du cœur, pouls • weak heartbeat : pouls faible heartburn nom / "hA:tb3:n / brûlure d’estomac

338 heartland nom / "hA:tl@nd / cœur, centre (d’un pays) heat / hi:t / 1 nom n.c. chaleur, heat production : production thermique 2 (to) vb. chauffer, échauffer, (se) réchauffer : + up : chauffer, se réchauffer heaviness nom n.c. / "hevInIs / poids, lourdeur, abondance Méd. heaviness of the blood loss : importance de l’hémorragie heavy adj. / "hevI / lourd, pénible (travail) • fort, élevé, important, intense, dense, lourd, violent, heavy drinker/ smoker : gros buveur/fumeur, heavy drinking : consommation excessive d’alcool • Méd. heavy cold : gros rhume, heavy periods : règles abondantes heavily adv. / "hevIlI / fortement, abondamment, lourdement, beaucoup, très fort hedge (to) vb. / hedZ / se dérober, répondre avec des détours, éviter de répondre directement, esquiver, éluder, nuancer heel nom / hi:l / Anat. talon (pied), hypothénar (main) height nom / haIt / hauteur, taille, altitude, élévation, sommet, what is your height? : combien mesurez-vous ? heighten (to) vb. / "haItn / augmenter, intensifier, monter, s’intensifier heightened adj. / "haItnd / accru, très aigu help / help / 1 nom n.c. aide, secours, help! : à l’aide !, ask the chemist/pharmacist for help : demandez conseil au pharmacien 2 (to) vb. aider, contribuer à, être utile, secourir • I can’t help it : je ne peux m’en empêcher, je n'y peux rien helpful adj. / "helpfl / coopératif, serviable (personne), utile, dextrine proved helpful in this case : la dextrine s’est révélée utile dans ce cas (précis) hence adv. / hens / en conséquence, par conséquence, donc, de ce fait, d’où, ce qui explique herb nom / h3:b / herbes pl. herbes médicinales, simples herbal adj. / "h3:bl / herbal medicine : phytothérapie, herbal tea : infusion, tisane high adj. adv. / haI / haut, élevé • fort • supérieur, high up : haut, en haut • at high risk : très vulnérable • can be as high as : peut atteindre • high in : contenant beaucoup de • high (triglyceride) : taux élevés

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

de (triglycérides) • to score higher : obtenir de meilleurs résultats highlight / "haIlaIt / 1 nom événement/fait marquant • pl. : éléments/ données/chiffres essentiel(le)s, grandes lignes 2 (to) vb. souligner, attirer l’attention, mettre en relief/en évidence/en avant • faire ressortir, surligner highly adv. / "haIlI / extrêmement, hautement, très highpowered adj. / %haI"paU@d / dynamique (personne), très puissant (machine), ardu, difficile (texte, cours) high school nom / haIsku:l / établissement d’enseignement du secondaire hiker nom / "haIk@(r) / randonneur hill nom / hIl / colline, pente (montée/descente) hinder (to) vb. / "hInd@(r) / gêner, entraver, faire obstacle, retarder hip nom / hIp / Anat. hanche, to break one’s hip : se casser le col du fémur • hip replacement : pose d’une prothèse de la hanche history nom / "hIstrI / n.c. histoire, passé • comptable antécédents • Méd. anamnèse, interrogatoire, antécédents • medical history : antécédents médicaux • a history of psychiatric disorders : des antécédents de troubles psychiatriques, family history : antécédents familiaux hit / hIt / 1 nom collision, attaque, coup • résultat (recherche sur ordinateur ) 2 (to) vb. hit, hit, hit, frapper, heurter, taper sur, attaquer, toucher, atteindre, appuyer sur une touche de clavier hitherto adv. / %hID@"tu: / jusqu’ici HIV acron. HIV human immunodeficiency virus : VIH virus de l’immunodéficience humaine hoarse adj. / hO:s / enroué, to be hoarse : être enroué, avoir la voix rauque hoarseness nom n.c. / "hO:snIs / enrouement hold / h@Uld / 1 nom n.c. ou sing. prise, étreinte, emprise 2 (to) vb. hold, held / held /, held, tenir, maintenir, supporter (le poids), détenir holiday nom / "hQl@deI / vacances, (jour de) congé, jour férié hollow adj. / "hQl@U / creux

LEXIS

339

hope / h@Up / 1 nom espoir, espérance 2 (to) vb. espérer horrendous adj. / hQ"rend@s / épouvantable horsemanship nom n.c. / "hO:sm@n%SIp/ talent de cavalier, monte household / "haUsh@Uld / 1 nom ménage 2 adj. de ménage, ménager, familial, de maison, de l’habitation, household budget : budget familial, household cordless phone : téléphone sans fil résidentiel housing nom n.c. / "haUzIN / logement, habitat, habitations, housing conditions : conditions de logement however adv. / haU"ev@(r) / cependant, néanmoins, pourtant, toutefois, en fait huge adj. / hju:dZ / énorme, immense, très grand/fort, gigantesque, de grande ampleur, extraordinaire, huge peak : pic record, pic de très grande ampleur humour (US humor) nom n.c. / "hju:m@(r) / humour • Méd. (histoire ) humeur hunger nom n.c. / "hVNg@(r) / faim, hunger strike : grève de la faim hunter nom / "hVnt@(r) / chasseur hurt (to) vb. / h3:t /, hurt, hurt (se) faire du mal, (se) blesser, causer du tort, nuire à, être mauvais pour, it hurts : cela me fait mal, my leg hurts : ma jambe me fait mal, she got hurt : elle s’est blessée, elle s’est fait mal hut nom / hVt / hutte, cabane, refuge, abri, mud hut : hutte de terre

I IAEA acron.

IAEA International Atomic Energy Agency :

AIEA Agence internationale de l’énergie atomique ICD acron. implantable converter defibrillator : cardioverter défibrillateur implanté CDI identify (to) vb. / aI"dentIfaI / reconnaître, faire connaître son identité • déterminer, définir, désigner • mettre en évidence, déceler, repérer, trouver, détecter • recenser, répertorier, inventorier… ignore (to) vb. / Ig"nO:(r) / ne pas tenir compte de, ne tenir aucun compte de, ne pas prêter attention à • ne pas se préoccuper de • passer outre, ne pas respecter

ill / Il / 1 adj. mauvais, néfaste, pernicieux • méchant, malveillant • malade, souffrant, atteint, blessé, ill health : mauvaise santé, problème de santé, maladie • to be ill : être malade, souffrant • to fall/take/be taken ill : tomber malade, avoir un malaise, être pris d’un malaise • to feel ill : ne pas se sentir bien • to look ill : avoir l’air malade, souffrant • to make sb. ill : rendre qqn malade • to be ill with pneumonia : avoir une pneumonie 2 adv. mal illiteracy nom n.c. / I"lIt@r@sI / analphabétisme, illettrisme • ignorance, incompréhension, méconnaissance • computer illiteracy : méconnaissance de l’informatique illiterate adj. / I"lIt@r@t / analphabète, illettré • sans culture, ignorant, sans connaissances • computer illiterate : ne maîtrisant pas l’outil informatique illness nom / "IlnIs / maladie • childhood illness : maladie infantile ill-timed adj. / %Il"taImd / inopportun ill-treatment nom n.c. / %Il"tri:tm@nt / mauvais traitements, sévices imaging nom n.c. / "ImIdZIN / Méd. imagerie (médicale) imbalance nom / %Im"b&l@ns / déséquilibre immeasurable adj. / I"meZ@r@bl / incommensurable, infini, inestimable immune adj. / I"mju:n / Méd. immunisé (contre : to/from ) • immunitaire, immun • immune deficiency : immunodéficience • immune response : réaction/réponse immunitaire • immune system : système immunitaire • immune system deficiency : carence immunitaire immunization nom / %ImjUnaI"zeISn / vaccination, immunisation • immunization coverage : couverture vaccinale • booster immunization : vaccination de rappel • immunization schedule : calendrier vaccinal immunize (to) vb. / "Imju:naIz / vacciner, immuniser, (contre : against ) impact / "Imp&kt / 1 nom choc, impact • effets, conséquences, répercussions, incidences 2 (to) vb. entrer en collision avec • toucher, concerner, viser, avoir une incidence/des incidences/un effet/des répercussions/sur, influencer, influer/agir sur impacted adj. / Im"p&ktId / Dent. impacted tooth : dent incluse

340 impair (to) vb. / Im"pe@(r) / détériorer, diminuer • abîmer, porter atteinte à, nuire à, mettre en péril • réduire, affaiblir • perturber, altérer impaired adj. / Im"pe@d / abîmé, affaibli, déficient, défectueux, détérioré, diminué, impaired hearing : atteint d’une déficience auditive, malentendant, visually impaired : atteint d’une déficience visuelle, malvoyant impairment nom / Im"pe@m@nt / affaiblissement, diminution, déficience, trouble, hearing/visual impairment : déficience auditive, visuelle, speech impairment : troubles du langage impede (to) vb. / Im"pi:d / entraver, gêner, empêcher (sb. from doing sth. : qqn de faire qqch.) impediment nom / Im"pedIm@nt / obstacle, empêchement, entrave, gêne • handicap, défaut, speech impediment : défaut d’élocution impending adj. / Im"pendIN / imminent implant 1 nom / "ImplA:nt / implant • greffe • dental, breast implant : implant dentaire, mammaire… 2 (to) vb. / Im"plA:nt / implanter, s’implanter, Méd. implanter implantable adj. / Im"plA:nt@bl / implantable converter defibrillator ICD : cardioverter défibrillateur implanté CDI implantation nom n.c. / %ImplA:n"teISn / implantation (embryon) implement 1 nom / "ImplIm@nt / outil, instrument, équipement, matériel 2 (to) vb. / "ImplIment / appliquer, mettre en application, exécuter, mettre en œuvre/en place, réaliser implementation nom n.c. / %ImplImen"teISn / mise en œuvre, application, exécution, réalisation implied adj. / Im"plaId / implicite, tacite, de fait imply (to) vb. / Im"plaI / suggérer, sembler indiquer, laisser entendre • signifier, impliquer impoverish (to) vb. / Im"pQv@rIS / appauvrir, impoverished : pauvre impressive adj. / Im"presIv / remarquable, impressionnant, imposant, spectaculaire, excellent improper adj. / Im"prQp@(r) / déplacé, inconvenant • mal adapté, inadéquat, inapproprié, mauvais • contre-indiqué, incorrect • improper diagnostic : diagnostic incorrect, erroné, improper term : terme inexact

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

improve (to) vb. / Im"pru:v / améliorer, faire progresser, perfectionner • s’améliorer, se développer, faire des progrès • to improve public awareness : mieux faire connaître improved adj. / Im"pru:vd / meilleur, amélioré, perfectionné, much improved : nettement meilleur • improved public awareness : meilleure sensibilisation du public improvement nom / Im"pru:vm@nt / n.c. amélioration, développement, perfectionnement : improvement of the patient’s condition : amélioration de l’état du malade • pl. improvements : aménagements (maison etc.) impulse nom / "ImpVls / impulsion inability nom n.c. / %In@"bIl@tI / incapacité/inaptitude (à faire qqch. : to do sth.) inaccurate adj. / In"&kjUr@t / inexact, imprécis inadequate adj. / In"&dIkw@t / insuffisant, inadéquat, inadapté, mal adapté, peu satisfaisant, médiocre, mauvais inadvertent adj. / %In@d"v3:t@nt / insouciant • commis par inadvertance, non intentionnel inappropriate adj. / %In@"pr@UprI@t / inopportun, déplacé, impropre • mal choisi, mauvais inch nom / IntS / pouce (2,54 cm) incidence nom habit. sing. / "InsId@ns / fréquence, proportion, taux, nombre de cas, épidémiologie : incidence, incidence of heart attacks : incidence des crises cardiaques include (to) vb. (pas de progressif ) / In"klu:d / englober • comprendre, comporter, être composé de, consister (notamment) en • faire figurer, inscrire • to be included in : faire partie de, figurer dans including prép. / In"klu:dIN / y compris, dont, et notamment income nom / "INkVm / revenu(s), low income countries : pays à faible revenu increase 1 nom / "INkri:s / augmentation, accroissement, développement, intensification, agrandissement, hausse 2 (to) vb. / In"kri:s / augmenter, croître, (s’)accroître, se développer, grandir, agrandir, s’intensifier, due to an increased use of ultrasound examination : due au développement de/du recours à/l’échographie

LEXIS increasing adj. / "INkri:sIN / de plus en plus net/important/prononcé/abondant • grandissant, croissant increasingly adv. / "INkri:sINlI / de plus en plus incur (to) vb. / In"k3:(r) / s’attirer, s’exposer à (risques) • supporter (coûts) • contracter (dette) • subir (perte, préjudice, dommage) incus nom / "INk@s / pl. incudes / In"kju:di:z / Anat. enclume, un des trois osselets (ossicles ) de l’oreille moyenne = anvil indeed adv. / In"di:d / en effet, effectivement, bien entendu, en fait, d’ailleurs indiscriminately adv. / %IndI"skrImIn@tlI / sans discernement, sans distinction, au hasard induce (to) vb. / In"dju:s / pousser à, persuader de, inciter à • provoquer, produire induced adj. / In"dju:st / -induced : causé par, provoqué par, selfinduced : intentionnel, volontaire • Méd. induced abortion : avortement provoqué, interruption (volontaire) de grossesse, induced labour : accouchement déclenché indurate (to) vb. / "IndjU%reIt / indurer, indurated : induré ineffective adj. / %InI"fektIv / inefficace, inopérant ineffectiveness nom n.c. / %InI"fektIvnIs / inefficacité inexpensive adj. / %InIk"spensIv / bon marché infancy nom n.c. / "Inf@nsI / bas âge, de première enfance • commencement, début, to be in its infancy : n’en est qu’à ses débuts infant nom / "Inf@nt / nourrisson, infant mortality : mortalité infantile • infant and child mortality : mortalité infantojuvénile • infant death syndrome : mort subite du nourrisson • infant formula : préparation pour nourrisson infect (to) vb. / In"fekt / infecter, contaminer (air, sang), to be infected wih malaria : être atteint du paludisme • infected with HIV : séroposif infection nom / In"fekSn / infection, contamination (air, sang) • ear infection : otite, throat infection : angine, hospitalacquired infections : infections nosocomiales

341 infectious adj. / In"fekS@s / Méd. contagieux • infectieux • infectious hepatitis : hépatite infectieuse influenza nom n.c. / %InflU"enz@ / grippe ingest (to) vb. / In"dZest / Méd. ingérer inhale (to) vb. / In"heIl / inhaler • respirer • avaler la fumée (fumeur) inhaler nom / In"heIl@(r) / inhalateur inherit (to) vb. / In"herIt / hériter de : to inherit sth. inherited adj. / In"herItId / héréditaire (maladie), hérité (gène) inhibit (to) vb. / In"hIbIt / freiner, entraver, empêcher, faire obstacle • diminuer, neutraliser (l’action, la réaction) inhibited adj. / In"hIbItId / inhibé, réservé • gêné, entravé • refoulé injure (to) vb. / "IndZ@(r) / blesser, to injure oneself/one’s leg : se blesser/ se blesser à la jambe injured / "IndZ@d / 1 nom pl. the injured : les blessés, les accidentés 2 adj. blessé, accidenté injury nom / "IndZ@rI / blessure, lésion(s), traumatisme, dommages (corporels), accident • to do sb. an injury : blesser quelqu’un • brain injuries : traumatisme cérébral inner adj. / "In@(r) / intérieur, interne, profond, intime • inner ear : oreille interne innocuous adj. / I"nQkjU@s / inoffensif, anodin inpatient / "In%peIS@nt / 1 nom malade hospitalisé 2 adj. inpatient care : soins aux malades hospitalisés, soins en établissement input / "InpUt / 1 nom apport, contribution, participation, aide • ressources/moyens (mis(es) en œuvre) • entrées (par opposition. à output : sorties) • Inf. données 2 (to) vb. input, input, input ou inputted, saisir, entrer (données) insane / In"seIn / 1 nom pl. Méd. the insane : les aliénes 2 adj. Méd. aliéné, dément insanity nom n.c. / In"s&n@tI / Méd. aliénation mentale, démence

342 inside adj. / "InsaId / dedans, dans, à l’intérieur instead adv. / In"sted / plutôt, au contraire • instead of : au lieu de, plutôt que, à la place instil (US instill) (to) vb. / In"stIl / + into : inculquer (principle, knowledge : principe, connaissances), instiller (médicament, idée), faire comprendre (idée), insuffler (courage), inspirer, faire naître (crainte : fears ), susciter instruct (to) vb. / In"strVkt / instruire, enseigner/apprendre qqch. à qqn • donner des instructions, des ordres, to instruct sb. to do sth. : charger qqn de faire qqch., donner des instructions à qqn de faire qqch. • to be instructed to do : être chargé de, avoir pour mission de insulate (to) vb. / "InsjUleIt / + against : contre • isoler (électricité, froid, chaleur : electricity, cold, heat ), calorifuger, insonoriser (son : sound ) insulated adj. / "InsjUleItId / isolé • isotherme (récipient : container ) • isolant intake nom / "InteIk / prise, admission, ingestion, consommation, absorption, ration, food intake : ration alimentaire • dose, apport, recommended daily intake : apport quotidien recommandé • air intake : entrée d’air • contingent, effectif, nombre d’étudiants admis intend (to) vb. / In"tend / avoir l’intention de • + for : destiner à intended adj. / In"tendId / visé, voulu, prévu, recherché • + for : destiné (à) • to be intended to : avoir pour but/objet de interfere (to) vb. / %Int@"fI@(r) / + in/with : se mêler de • gêner, perturber • faire obstacle, empêcher interrelated adj. / %Int@rI"leItId / interdépendant, (étroitement) liés (entre eux), closely interrelated : intimement liés interview nom / "Int@vju: / entretien, entrevue, interview • diagnostic interview : entretien - diagnostic introduce (to) vb. / %Intr@"dju:s / présenter, faire connaître • mettre en place, établir, adopter, lancer invasive adj. / In"veIsIv / Méd. sanglant, effractif, vulnérant, invasif invert (to) vb. / "Inv3:t / inverser, intervertir, renverser (a process : une opération), retourner (objet) inverted adj. / "Inv3:tId / inverted commas : guillemets • in inverted commas : entre guillemets

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

involve (to) vb. / In"vQlv / mettre en jeu, présenter, comporter (un risque…) • concerner, intéresser • porter sur • consister à/en • the procedure involves… : la méthode consiste à… • to be involved : participer à, jouer un rôle dans, intervenir dans, être concerné • to get involed in : s’engager, s’investir, intervenir • involving : représentant, s’accompagnant de involved adj. / In"vQlvd / concerné, en jeu, en cause, en question • considéré, dont il s’agit, involved in : mêlé à, absorbé par, to get involved in : participer à involvement nom n.c. / In"vQlvm@nt / participation, rôle • engagement • intervention, atteinte, bone marrow involvement : atteinte de la moelle osseuse iron nom / "aI@n / fer (Fe) n.c. • comptable tamping iron : dame (outil de damage) irrelevant adj. / I"rel@vnt / hors de propos, en dehors du sujet, sans rapport (avec la question considérée), sans importance • sans intérêt irreverent adj. / I"rev@r@nt / irrévérencieux island nom / "aIl@nd / Île isolation nom n.c. / %aIs@"leISn / isolement, isolation unit/ward : service des malades contagieux issue / "ISu: / 1 nom question, sujet, thème, problème, enjeu (politique) • issue, conclusion, résultat 2 (to) vb. publier, faire paraître, sortir isthmus nom / "Ism@s / pl. isthmuses ou isthmi / "IsmaI / isthme itch / ItS / 1 nom démangeaison, Méd. prurit, the itch : la gale 2 (to) vb. éprouver des démangeaisons, my skin itches : j’ai la peau qui me gratte, me démange • itching : qui démange itchy adj. / "ItSI / qui démange, itchy skin : peau qui gratte, qui démange item nom / "aIt@m / article, objet, point, question, élément • rubrique IU(C)D acron. intrauterine (contraceptive) device : dispositif intra-utérin, DIU, stérilet ivory nom n.c. / "aIv@rI / ivoire, Ivory Coast : Côte d’Ivoire

LEXIS

343

J jaundice nom n.c. / "dZO:ndIs / Méd. jaunisse jaw nom / dZO: / Anat. mâchoire jet lag nom n.c. / "dZetl&g / décalage horaire (effets du) job nom / dZQb / emploi, travail, tâche join (to) vb. / dZOIn / attacher, assembler, joindre, rejoindre, lier, relier, unir • devenir membre de, adhérer à, entrer (en fonction) dans • + in : participer à joint / dZOInt / 1 nom articulation • out of joint : démis (poignet…), pain in the joints : douleurs articulaires, arthralgie 2 adj. commun, collectif, mixte, joint statement : déclaration commune, joint effort : effort collectif juice / dZu:s / 1 nom jus (de fruit) • sucs (intestinaux, pancréatiques : intestinal, pancreatic etc.) 2 (to) vb. fabriquer/faire du jus avec (fruits) jump / dZVmp / 1 nom saut, bond 2 (to) vb. sauter, franchir d’un bond

K keep (to) vb. / ki:p /, kept / kept /, kept garder, conserver, tenir (sa parole : one’s word ) • keep track of the vehicles : suivre les véhicules ketone ou keytone nom n.c. / "ki:t@Un / ketone bodies : corps cétoniques key nom / ki: / clé, solution • liste des abréviations • touche de clavier kick / kIk / 1 nom coup de pied 2 (to) vb. donner des coups de pied • kicking and screaming : à son corps défendant kidney nom / "kIdnI / rein • kidney failure : insuffisance rénale kill (to) vb. / kIl / tuer, faire mourir, abattre killer nom / "kIl@(r) / tueur, assassin, meurtrier (personne) • cause de décès/de mortalité (maladie, virus, drogue…) • cancer remains a major killer : la cancer reste une maladie très meurtière • killer disease : maladie mortelle/meurtrière • painkiller : analgésique, antalgique

kind nom / kaInd / genre, type, sorte, a kind of : un genre de, une sorte/espèce de • in kind : en nature kit nom / kIt / panoplie, jeu, trousse, nécessaire, matériel, first-aid kit : trousse de premiers soins/de premiers secours knee nom / ni: / Anat. genou, knee joint : articulation du genou, kneecap : rotule knife / naIf / 1 nom pl. knives couteau, surgical knife : bistouri 2 (to) vb. donner un coup de couteau knock / nQk / 1 nom coup, heurt, choc 2 (to) vb. frapper, cogner (à la porte : at the door ), knock down : renverser, faire tomber • abattre, démolir (chose) • knock over : renverser (qqn, par une voiture) know (to) vb. / n@U /, knew / nju: /, known / n@Un / connaître, savoir, as far as I know : à ma connaissance, also known as (aka) : également appelé/connu sous le nom de knowledge nom n.c. / "nQlIdZ / connaissance(s), savoir, medical knowledge : connaissances médicales

L label / "leIbl / 1 nom étiquette • dénomination, appellation 2 (to) vb. labelled (US labeled), étiqueter • intituler, appeler, dénommer labelling (US labeling) nom n.c. / "leIblIN / étiquetage, dénomination, appellation labour (US labor) / "leIb@(r) / 1 nom travail (dur), labeur • n.c. effort physique, main d’œuvre • travailleurs, personnel, Méd. travail, in labour : en travail, en train d'accoucher 2 (to) vb. travailler dur, peiner lack / l&k / 1 nom habit. sing. manque, absence, défaut, pénurie 2 (to) vb. manquer de, être dépourvu de, ne pas avoir, food has been lacking : la nourriture a fait défaut land / l&nd / 1 nom terre, terrain, terres, sol, land use : occupation des sols, utilisation du sol, pattern of land use : mode d’utilisation des terres 2 (to) vb. débarquer, descendre à terre, (se) poser (avion), atterrir, tomber (objet, personne) landmine nom / "l&ndmaIn / mine terrestre

344 last / lA:st / 1 nom le dernier, pl. the last : les derniers 2 adj. dernier, précédent, last 10 years : 10 dernières années 3 adv. en dernier (lieu), (pour) la dernière fois • enfin, finalement • at last : enfin, Here they are ! At (long) last ! : Les voici enfin ! Ce n’est pas trop tôt ! 4 (to) vb. durer lasting adj. / "lA:stIN / durable lastly adv. / "lA:stlI / enfin, finalement, en dernier lieu late / leIt / 1 adj. en retard, de dernière minute, tardif, ultérieur • to be late : être en retard • in the late 60s : à la fin des années 60 • at a later stage : ultérieurement • later in life : plus tard, ultérieurement dans sa vie • latest : dernier en date, le plus récent/plus moderne, the latest news : la dernière nouvelle/les informations les plus récentes 2 adv. tard, tardivement, avec du retard, à la fin de, later : plus loin (dans texte) • later on : plus tard, ultérieurement, late in 1998 : au cours des derniers mois de 1998 law nom / lO: / droit, législation, loi lawsuit nom (spécialement US) / "lO:su:t / procès lay (to) vb. / leI /, laid / leId /, laid poser, placer, déposer, mettre, étendre layer nom / "leI@(r) / couche, épaisseur layout nom habit. sing. / "leIaUt / plan, schéma, conception, disposition, aménagement (locaux) • mise en page, présentation (texte) lead (to) vb. / li:d /, led / led /, led diriger, mener, être à la tête/en tête, if it bleeds it leads : si ça saigne, ça fait un grand titre • + to : entraîner, provoquer, causer, déboucher sur, aboutir à, conduire à, se traduire par leading adj. / "li:dIN / principal, premier, important, majeur, de premier plan, a leading manufacturer : l’un des principaux fabricants leaf nom / li:f / pl. leaves / li:vz / feuille, feuillage, feuillet leaflet nom / "li:flIt / brochure, dépliant, prospectus leak / li:k / 1 nom fuite (liquide, gaz, information) 2 (to) vb. fuir, s’écouler, laisser s’échapper, filtrer, s’infiltrer leap nom / li:p / saut, bond, quantum leap : grand bond en avant, bond prodigieux

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

learn (to) vb. / l3:n /, learned / l3:nId / ou learnt / l3:nt / apprendre qqch./à faire qqch. : to learn a language : apprendre une langue, to learn (how) to swim : apprendre à nager • I learned a lot from my mother : j’ai appris beaucoup de choses auprès de ma mère (voir teach ) learner nom / "l3:n@(r) / apprenant learning / "l3:nIN / 1 nom n.c. apprentissage • acquisition des connaissances 2 adj. learning disabilities : difficultés d’apprentissage least / li:st / sup. de little / "lItl / 1 adj. le moins de, (le, la) moindre, (le, la) plus petit(e) • least developed countries : pays les moins avancés • at the least sign : au moindre signe 2 pron. that's the least of their problem : c'est le moindre de leur problème, at least : (tout) au moins, du moins • at least 6 inches : au moins 15 cm, at the very least : au minimum, not in the least : pas du tout 3 adv. le moins, the least suitable : le moins bien adapté, not least because : notamment leave (to) vb. / li:v /, left / left /, left laisser, quitter, partir • if depression is left untreated : lorsque/si la dépression n’est pas traitée lecture nom / "lektS@(r) / cours-conférence left nom, adj. / left / gauche • left-handed : gaucher leg nom / leg / Anat. jambe • patte (animal), pied (meuble) lend (to) vb. / lend /, lent / lent /, lent prêter, accorder à • se prêter à • pathologies that lend themselves to drug treatment : pathologies qui se prêtent à/relèvent d’un traitement médicamenteux length nom / leNT / longueur, durée (de temps) lengthen (to) vb. / "leNT@n / allonger, rallonger, prolonger lengthy adj. / "leNTI / long, de longue durée, prolongé lens nom / lenz / lentille, verre (de lunette, de contact), objectif (photo, microscope etc.), Méd. cristallin (de l’œil) less / les /

comp. de little / "lItl / adj. pron. adv prép. moins • less likely : moins probable, less likely to : moins susceptible de lessen (to) vb. / "lesn / diminuer, atténuer let (to) vb. / let /, let, let laisser, Méd. to let blood : faire une saignée

LEXIS level nom / "levl / niveau, échelon, hauteur • degré, quantité, taux, teneur, concentration (d’un polluant) : hormone/ insulin/cholesterol level : taux • level of alcohol in the blood : alcoolémie lever nom / "li:v@(r) / levier lexis nom n.c. / "leksIs / lexique liable adj. / "laI@bl / + for : responsable (devant la loi), tenu à/de faire qqch. (de par la loi) • + to : susceptible de, sujet à • to be liable to : être susceptible de, risquer de, pouvoir library nom / "laIbr@rI / bibliothèque license (US licence) / "laIsns / 1 nom permis, autorisation, agrément, medical license : autorisation d’exercer la médecine 2 (to) vb. délivrer un permis, une autorisation, un agrément, accorder une licence : physicians are licensed by the state les médecins doivent obtenir une autorisation d’exercer la médecine délivrée par l’État licensed adj. / "laIsnst / titulaire d’un permis, d’une autorisation, d’une licence, autorisé à exercer • licensed profession : soumis à autorisation d’exercice licensee nom / %laIs@n"si: / détenteur d’un permis, d’une autorisation, d’une licence licensing / "laIs@nsIN / 1 nom n.c. délivrance d’un permis, d’une autorisation, d’une licence, d’un agrément, d’une autorisation d’exercer • autorisation, agrément, Pharm. autorisation de mise sur le marché 2 adj. licensing authority : organisme de délivrance lie (to) vb. / laI /, lay / leI /, lain / leIn /, lying / "laIIN / s’allonger, s’étendre, être allongé, étendu, to be lying in bed : être au lit, être étendu/allongé dans son lit (personne) • se trouver, être, se situer (objet) lifesaving adj. / "laIfseIvIN / pouvant sauver des vies, salvateur, vital • de sauvetage nom pl. ci-après lifesavings nom pl. / "laIfseIvINz / économies accumulées au cours de toute une existence lifetime nom / "laIftaIm / vie (entière), (toute) l’existence, durée (de vie), in her lifetime : au cours de sa vie/de son existence, de son vivant

345 lift (to) vb. / lIft / lever, soulever, face-lift : lifting light / laIt / 1 nom lumière, éclairage, lueur • lampe, feu 2 adj. clair, léger, allégé 3 (to) vb. light, lit / lIt /, lit, allumer, éclairer, illuminer likelihood nom / "laIklIhUd / probabilité, chance, in all likelihood : probablement, a strong likelihood : de fortes chances likely adj. / "laIklI / probable, vraisemblable, + to : susceptible de, to be likely to : risquer de, avoir tendance à, they are more likely to : ils courent un risque plus grand, ils ont davantage de chance de likewise adv. / "laIkwaIz / aussi, de même, de plus, en outre limb nom / lIm / Anat. membre lime nom n.c. / laIm / chaux, chlorinated lime ou chloride of lime : chlorure de chaux lining nom / "laInIN / doublure, revêtement, Anat. paroi (estomac, musculaire…) link / lINk / 1 nom lien, liaison, rapport, relation 2 (to) vb. lier, relier, associer, établir un lien/un rapport linked adj. / lINkt / lié, relié, en liaison avec, associé, de liaison, enzyme-linked immunosorbent assay : titrage immunoenzymatique utilisant un antigène adsorbé linking adj. / lINkIN / linking vowel : voyelle de liaison lip nom / lIp / Anat. lèvre list / lIst / 1 nom liste, table (des illustrations) 2 (to) vb. établir/dresser une liste, énumérer, répertorier, indiquer listen (to) vb. / "lIsn / écouter, to listen to sb./sth : écouter qqn/qqch. • listening device : dispositif/appareil d’écoute lit adj. / lIt / éclairé, illuminé (voir light ) litter / "lIt@(r) / 1 nom n.c. détritus, ordures, vieux papiers 2 (to) vb. laisser des détritus, des vieux papiers, garbage-littered : jonché de détritus liver nom / "lIv@(r) / Anat. foie

346 load / l@Ud / 1 nom charge, chargement, poids, pression, fardeau 2 (to) vb. charger, accabler locate (to) vb. / l@U"keIt / localiser, déterminer l’emplacement/la position, repérer • (se) situer, se trouver • s’établir, s’implanter (entreprise : firm ) location nom / l@U"keISn / lieu, endroit, emplacement, Méd. siège (d’une lésion) longsighted adj. / %lQN"saItId / hypermétrope, presbyte • prévoyant longsightedness nom n.c. / %lQN"saItIdnIs / hypermétropie, presbytie • prévoyance look (to) vb. / lUk / look pale : avoir l’air pâle • look different from : avoir l’air différent • look like : ressembler à, avoir l’air • look after : s’occuper de, prendre soin de, soigner, surveiller • look at : regarder, examiner, considérer • look for : chercher, rechercher • look forward to : attendre avec impatience, avoir hâte de, se réjouir (à l’idée), s’attendre à, espérer • look into : examiner, étudier, s’occuper de, se pencher sur • look on as : considérer, voir (comme) • look through : regarder, examiner, parcourir, feuilleter • look up : chercher, (re)chercher dans, vérifier dans, consulter • look upon : considérer, voir, envisager loom (to) vb. / lu:m / se profiler, se dessiner (à l’horizon), surgir, être imminent, menacer (de), loom large : planer, devenir imminent, dangereusement proche lose (to) vb. / lu:z /, lost / lQst /, lost perdre loss nom / lQs / perte, weight-loss camp : centre d'amaigrissement lot nom / lQt / a lot of : beaucoup de loud adj. / laUd / fort, sonore, bruyant low adj. / l@U / peu élevé, faible, bas • low in fat : à faible teneur en matière grasse, Méd. low back pain : lombalgie • low birth weight : insuffisance pondérale à la naissance • low blood pressure : hypotension • low blood sugar level : hypoglycémie • low-grade fever : fébricule, Psych. low selfesteem : mauvaise image de soi low-cost adj. / %l@U"kQst / peu coûteux, bon marché lower / "laU@(r) / 1 comp. de low adj. inférieur, plus bas, moins élevé, lower abdomen : bas-ventre • lower back pain : lombalgie • lower leg : partie inférieure de la jambe • lower respiratory tract infection : infection respiratoire des voies aériennes

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

inférieures 2 (to) vb. (faire) baisser, abaisser, to lower sb.’s resistance : diminuer la résistance lowering nom n.c. / "l@U@rIN / abaissement, baisse (température), diminution lung nom / lVN / Anat. poumon, lung specialist : pneumologue LVF acron. left ventricular failure : insuffisance ventriculaire gauche IVG lying / "laIIN / être allongé (voir lie ) lymph nom n.c. / lImf / Anat. lymphe : lymph node : ganglion lymphatique

M maggot nom / "m&g@t / ver, asticot magnetic adj. / m&g"netIk /

magnetic resonance (imaging) scan, MRI scan :

examen IRM, remnographie • image IRM main adj. / meIn / principal, premier, essentiel, dominant, main office : siège mainly adv. / "meInlI / principalement maintain (to) vb. / meIn"teIn / maintenir, continuer à, poursuivre • préserver, conserver, tenir (à jour), entretenir, gérer maintenance nom n.c. / "meInt@n@ns / entretien, maintien, sauvegarde major adj. / "meIdZ@(r) / grand, important, principal, de premier plan, de grande ampleur, vaste, profond, intense, major disease/problem : maladie/problème grave malfunction / %m&l"fVNkSn / 1 nom mauvais fonctionnement, défaillance, anomalie (de fonctionnement) 2 (to) vb. mal fonctionner, ne pas fonctionner correctement malignancy nom / m@"lIgn@nsI / Méd. affection, tumeur maligne (sein, poumon, peau… : breast, lung, skin ) malignant adj. / m@"lIgn@nt / Méd. malin (maladie, tumeur… : disease, tumor ), cancéreux (tissu : tissue ) malleus nom / "m&lI@s / pl. mallei / "m&lI / Anat. marteau, un des trois osselets (ossicles ) de l’oreille moyenne = hammer malpractice nom / %m&l"pr&ktIs / faute professionnelle, medical malpractice : erreur/faute médicale maltreatment nom n.c. / %m&l"tri:tm@nt / mauvais traitement, sévices

LEXIS manage (to) vb. / "m&nIdZ / gérer, administrer, diriger, s’occuper de • faire face à (situation, problème) • to manage to : réussir à, parvenir à • Méd. prendre en charge (malade, maladie) managed adj. / "m&nIdZd / managed care : prise en charge globale des soins management nom n.c. / "m&nIdZm@nt / gestion, administration, direction, organisation • Méd. prise en charge (malade, maladie), thérapeutique, traitement, pain management : prise encharge de la douleur • direction, cadres mandatory adj. / "m&nd@t@rI / obligatoire, impératif manic-depressive adj. / "m&nIkdI"presIv / maniacodépressif, cyclothymique manipulative adj. / m@"nIpjUl@tIv / qui soigne par des manipulations, manipulative treatment, therapy : (traitement par) manipulations, médecine/thérapie manuelle mankind nom n.c. / %m&n"kaInd / l’humanité, le genre humain manner nom / "m&n@(r) / manière, façon • attitude, comportement, bedside manner(s) : comportement du médecin envers les malades • pl. manners : manières mannered adj. / "m&n@d / mild-mannered : doux, d’un naturel doux manufacturer nom / %m&njU"f&ktS@r@(r) / fabricant, constructeur map / m&p / 1 nom carte, plan 2 (to) vb. dresser une carte/un plan, établir la cartographie de, reporter sur une carte • to map physiological functions : établir la cartographie des fonctions physiologiques mapping nom n.c. / "m&pIN / cartographie margin nom / "mA:dZIn / marge, bord, lisière mark (to) vb. / mA:k / marquer, indiquer, représenter marker nom / "mA:k@(r) / marqueur, Méd. marqueur market nom / "mA:kIt / marché marrow nom n.c. / "m&r@U / bone marrow : moelle osseuse massive adj. / "m&sIv / massif, considérable, écrasant, énorme, gigantesque, généralisé, Méd. très grave, foudroyant, massive heart attack : crise cardiaque foudroyante

347 master / "mA:st@(r) / 1 nom maître 2 (to) vb. maîtriser, bien posséder, être (très) bon match / m&tS / 1 nom correspondance, concordance, équivalence • adéquation, compatibilité (génétique) 2 (to) vb. égaler, (équi)valoir • être identique, correspondre à, concorder avec, harmoniser/être en harmonie avec • match the two parts : rapprochez, combinez les deux parties • + with : mettre en rapport avec, assortir matching adj. / "m&tSIN / correspondant, compatible, assorti matter / "m&t@(r) / 1 nom matière • question, problème, pl. matters : choses, situations, no matter : indépendamment de, quel que soit, peu importe 2 (to) vb. importer, avoir de l’importance, être important, compter may préterit might vb. / "meI / pouvoir, risquer de • parfois, peut-être, il se peut que, il est possible que, il arrive que maybe adv. / "meIbi: / peut-être meal nom / mi:l / repas, meals on wheels : repas livrés à domicile aux personnes âgées ou handicapées mean / mi:n / 1 nom Math. moyenne 2 adj. moyen, mean deviation, mean temperature : écart moyen, température moyenne 3 (to) vb. mean, meant / ment /, meant, signifier, vouloir dire, avoir un sens/pour sens • représenter, équivaloir à meaning nom / "mi:nIN / sens, signification meaningful adj. / "mi:nINfl / significatif, important, qui a un sens, valable, utile means nom ( sing. et pl. ) / mi:nz / moyen(s), ressources • a means : un moyen, by no means : nullement • by means of : au moyen de meanwhile adv. / "mi:nwaIl / entre temps, pendant ce temps, en attendant measles nom n.c. / "mi:zlz / measles : la rougeole, German measles ou rubella : rubéole measure / "meZ@(r) / 1 nom mesure, dose • démarche, to take measures : prendre des mesures 2 (to) vb. mesurer, évaluer, doser measurement nom / "meZ@m@nt / mesure, dimension meat nom / mi:t / viande

348 medal nom / "medl / médaille median / "mi:dI@n / 1 nom médiane 2 adj. médian medium / "mi:dI@m / 1 nom pl. media ou mediums moyen d’expression/de communication • moyen, outil, instrument • milieu (environnement) • media : les médias 2 adj. moyen, medium-priced : à prix moyen meet (to) vb. / mi:t /, met / met /, met (se) rencontrer, faire la connaissance de, se réunir, se retrouver • répondre à (besoin : need ), réagir à (situation) meeting nom / "mi:tIN / réunion, séance, assemblée, rendez-vous, entrevue merely adv. / "mI@lI / simplement merge (to) vb. / m3:dZ / se mêler, se fondre, se joindre, fusionner middle / "mIdl / 1 nom milieu 2 adj. du milieu, moyen, middle ear : oreille moyenne middleman nom / "mIdlm&n / pl. middlemen / "mIdlmen / intermédiaire midwife nom / "mIdwaIf / pl. midwives / "mIdwaIvz / sage-femme mild adj. / maIld / doux, léger, tempéré, modéré, atténué, peu important, mild-mannered : doux, d’un naturel doux • Méd. modéré (symptômes), léger (maladie, douleur, retard mental : disease, pain, mental retardation ), bénin, peu prononcé mislead (to) vb. / %mIs"li:d /, misled / %mIs"led /, misled induire en erreur, tromper, fourvoyer mind nom / maInd / esprit, mind and body : esprit et corps • mind and spirit : esprit et âme, dimensions intellectuelles et spirituelles de la personne • to bear in mind : tenir compte de, bearing in mind that : étant donné que minus prép. / "maIn@s / Math. : moins, 10 minus 3 is 7 : 10 moins 3 égal 7 minute / "mInIt / 1 nom minute (60’ = 1 hour) 2 adj. minuscule, extrêmement faible • précis, détaillé • minutieux (examen, analyse), in minute/the minutest details : dans les moindres/les plus infimes détails miscarriage nom / "mIsk&rIdZ / Méd. avortement spontané, fausse couche

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

misfortune nom / %mIs"fO:tSu:n / malchance, malheur, déboires misleading adj. / %mIs"li:dIN / trompeur, ambigu, mensonger, to be misleading : prêter à confusion mispronounce (to) vb. / %mIspr@"naUns / mal prononcer mispronunciation nom / %mIspr@%nVnsI"eISn / mauvaise prononciation, prononciation incorrecte miss (to) vb. / mIs / ne pas remarquer, ne pas déceler (symptômes), manquer, rater • to miss school : manquer l’école, to miss an opportunity : laisser passer une occasion missing adj. / "mIsIN / disparu (personne), absent, manquant (chose) mistake nom / mI"steIk / erreur, faute, méprise, to make a mistake : faire une erreur mistreat (to) vb. / %mIs"tri:t / maltraiter, mistreated : maltraité mistrust / %mIs"trVst / 1 nom n.c. méfiance, manque de confiance en 2 (to) vb. to mistrust (a person) : se méfier de, ne pas avoir confiance en (une personne) misunderstand / %mIs%Vnd@"st&nd / 1 (to) vb. misunderstand, misunderstood / %mIs%Vnd@"stUd /, misunderstood, mal comprendre 2 adj. misunderstood : mal compris mix / mIks / 1 nom combinaison, mélange, diversité 2 (to) vb. mélanger, mêler, to mix up : confondre mixed adj. / mIkst / mixte, divers, hétérogène, term of mixed origin : nom hybride formé à partir de deux racines modifier nom / "mQdIfaI@(r) modificateur mole nom / m@Ul / grain de beauté monitor / "mQnIt@(r) / 1 nom contrôleur, écran, Méd. TV. : moniteur, heart rate monitor : moniteur cardiaque 2 (to) vb. surveiller, contrôler, suivre (l’évolution), superviser • écouter, enregistrer monitoring nom n.c. / "mQnIt@rIN / surveillance, veille, contrôle, suivi, supervision, Méd. monitorage, monitoring, fetal monitoring : monitorage fœtal month nom / mVnT / mois monthly / "mVnTlI / 1 adj. mensuel, Méd. monthly period : règles 2 adv. mensuellement, au mois, tous les mois

LEXIS mood nom / mu:d / humeur, état d’esprit • ambiance, Méd. mood disorder : trouble de l’humeur, mood swings : saute d’humeur moon nom / mu:n / lune moreover adv. / mO:"r@Uv@(r) / en outre, de plus, par ailleurs, d’autre part, de surcroît morning nom adj. / "mO:nIN / matin, matinée • adj. matinal, du matin, morning sickness : nausées matinales (femme enceinte), morning-after pill : pilule du lendemain mosquito nom / m@s"ki:t@U / pl. mosquitoes moustique, mosquito borne : transmis par les moustiques • mosquito screen : moustiquaire mother / "mVD@(r) / 1 nom mère 2 adj. maternel, mother tongue : langue maternelle 3 (to) vb. dorloter, Psych. materner, mothering : maternage mountaineer nom / %maUntI"nI@(r) / alpiniste mouse nom / maUs / pl. mice / maIs / souris mouth / maUT / 1 nom bouche 2 adj. buccal, mouth ulcer : aphte move / mu:v / 1 nom mouvement • déménagement • action, démarche, mesure, opération 2 (to) vb. bouger, (se) déplacer, transporter, déménager (à : to ) • move forward : avancer • move towards : progresser/évoluer vers • move up : s’élever dans la hiérarchie MRI acron. magnetic resonance imaging MRI : IRM imagerie par résonance magnétique, MRI scan : examen IRM • image IRM MRSA acron.

methicillin-resistant Staphylococcus aureus (MRSA) : staphylocoque doré résistant à la méthicilline (SDRM) ou Staphylococcus aureus

résistant à la méthicilline (SARM) MS acron. multiple sclerosis (MS) sclérose en plaques (SEP) muffle (to) vb. / "mVfl / assourdir, étouffer (son : sound ) mumps nom n.c. / mVmps / oreillons murder / "m3:d@(r) / 1 nom meurtre, assassinat, they get away with murder : il peuvent tout se permettre 2 (to) vb. assassiner

349 murmur nom / "m3:m@(r) / murmure, bourdonnement, Méd. a heart murmur : un souffle au coeur muscle / "mVsl / 1 nom Anat. muscle 2 adj. musculaire, muscle pain : douleur musculaire mushroom / "mVSrUm / 1 nom champignon 2 (to) vb. se développer rapidement, être en plein essor, se multiplier mustard nom n.c. / "mVst@d / mustard gas : gaz moutarde mutate (to) vb. / mju:"teIt / subir une mutation, faire subir une mutation à mycobacterial adj. / %maIkQb&k"tI@rI@l / mycobactérien, mycobacterial diseases : maladies mycobactériennes

N nail / neIl / 1 nom Tech. clou, Anat. ongle 2 (to) vb. clouer name / neIm / 1 nom nom, appellation, dénomination 2 (to) vb. donner un nom, nommer, appeler, dénommer, désigner namely adv. / "neImlI / à savoir, c’est-à-dire narrow / "n&r@U / 1 adj. étroit, limité 2 (to) vb. (se) réduire (écart : gap ), (se) rétrécir, limiter narrowing nom n.c. / "n&r@UIN / rétrécissement, réduction nastiness nom n.c. / "nA:stInIs / méchanceté, malveillance (personne) • caractère désagréable (objet) nasty adj. / "nA:stI / méchant, mauvais, désagréable, pénible, grave, dangereux, a nasty cold : un gros rhume nationwide adj. adv. / %neISn"waId / a l’échelle nationale, national • qui s’étend à tout le pays • dans l’ensemble du pays, dans le pays tout entier navel nom / "neIvl / Anat. nombril near / nI@(r) / 1 adj. proche, voisin, (tout) près (de) ( espace ) • prochain, imminent, près de (temps ) • proche, qui se rapproche de • to be near-sighted : être myope 2 (to) vb. (s’)approcher, être proche de nearby / nI@"baI / 1 adj. voisin 2 adv. tout près, à proximité nearly adv. / "nI@lI / presque • not nearly as (good, efficient) as : bien/beaucoup moins (bon, efficace) que

350 nearsighted adj. / %nI@"saItId / myope neck nom / nek / Anat. cou, neck-brace : minerve, collier cervical necrotize (to) vb. / "nekr@%taIz / nécroser, necrotizing : nécrosant need (to) vb. / ni:d / 1 nom besoin, nécessité • n.c. difficulté(s) • comptable besoins : to supply sb.’s needs : subvenir aux besoins de qqn 2 (to) vb. demander, nécessiter • avoir besoin, falloir • if needed : si (cela) s’avère nécessaire, trials are needed : il faut procéder à des essais needle nom / "ni:dl / aiguille, seringue needless adj. / "ni:dlIs / inutile, superflu • needless to say : il va sans dire que, évidemment neglect / nI"glekt / 1 nom manque d'intérêt, indifférence • défaut de soins (à enfant) • mauvais entretien 2 (to) vb. ne pas s'occuper de, délaisser, laisser à l'abandon • ne pas tenir compte de, négliger, ne pas se préoccuper de • omettre de neglected adj. / nI"glektId / délaissé, méconnu, ignoré, négligé • neglected child : enfant délaissé, abandonné • neglected disease : maladie orpheline neighbouring adj. / "neIb@rIN / voisin, limitrophe neighbour (US neighbor) nom / "neIb@(r) / voisin neither pron. adj. adv. conj. / "naID@(r) / aucun, ni l’un ni l’autre, ni… ni, aucun des deux • pas non plus. I can’t make it to the seminar on Tuesday. Neither can I : Je ne pourrai pas aller au séminaire mardi. Moi non plus nerve / n3:v / 1 nom Anat., Dent. nerf • remove, kill the nerve (of a tooth) : dévitaliser (une dent) 2 adj. nerveux • nerve ending : terminaison nerveuse : nerve cell : celllule nerveuse • neurone • nerve agent : produit neurotoxique, nerve gas : gaz neurotoxique • nerve specialist : neurologue neurosurgeon nom / %njU@r@U"s3:dZn / neurochirurgien neurotransmitter nom / %njU@r@Utr&nz"mIt@(r) / neurotransmetteur nevertheless adv. / %nev@D@"les / néanmoins, cependant, et pourtant newborn adj. / "nju:bO:n / nouveau-né, a newborn baby : un nouveau-né • the newborn : les nouveaux-nés

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

news nom n.c. / nju:z / nouvelle(s), information(s), actualité(s) • a piece/ an item of news : une information • the news : le journal parlé/télévisé, to watch the news : regarder les informations à la télévision, le journal télévisé • the good news : la bonne nouvelle • a news release : un communiqué de presse newsletter nom / "nju:z%lEt@(r) / bulletin d’information, lettre newspaper nom / "nju:speIp@(r) / journal • daily newspaper : quotidien next / nekst / 1 adj. prochain, suivant, à venir • voisin • next to : près de, à côté de 2 adv. ensuite, après NGO acron. Non-Governmental Organization : ONG organisation non gouvernementale night nom / naIt / nuit, soir nitrogen nom n.c. / "naItr@dZ@n / azote, nitrogen fertilizer : engrais azoté NMR acron. nuclear magnetic resonance • RMN Résonance magnétique nucléaire • NMR scan : examen RMN, remnographie, image RMN • NMR scanning : examen RMN, remnographie NMRI acron. nucler magnetic resonance imaging : imagerie par résonance magnétique nucléaire • NMRI scanner : remnographe node nom / n@Ud / nœud, Anat. nodus, nodosité • lymph node : ganglion lymphatique none pron. / nVn / aucun, pas, plus, none of : aucun de nor conj. / nO:(r) / suit neither : neither … nor : ni … ni (non plus) north nom adj. adv. / nO:T / nord, septentrional, du/au nord, vers le nord Norway nom / "nO:weI / la Norvège nose nom, adj. / n@Uz / nez • nose drops : gouttes nasales nosebleed nom / "n@Uz%bli:d / saignement de nez notably adv. / "n@Ut@blI / particulièrement, remarquablement • en particulier, notamment • notablement note / n@Ut / 1 nom note • billet de banque 2 (to) vb. noter, prendre note • constater, remarquer, signaler noted adj. / n@UtId / renommé, célèbre, très connu, réputé

LEXIS

351

noteworthy adj. / "n@Utw3:DI / remarquable, notable nothing nom sing. pron. adj. / "nVTIN / rien notice / "n@UtIs / 1 nom avis, notification 2 (to) vb. remarquer, s’apercevoir, to take no notice : ne pas faire attention, ne pas tenir compte notion nom / "n@USn / notion • idée, opinion notoriously adv. / n@U"tO:rI@slI / notoirement nought nom / nO:t / zéro • nought point one : 0.1 noun nom / naUn / nom, substantif nowadays adv. / "naU@deIz / de nos jours, aujourd’hui NSAID acron. non-steroidal anti-inflammatory drugs : antiinflammatoires non stéroïdiens - AINS number / "nVmb@(r) / 1 nom nombre, chiffre, telephone number : numéro • a number of : un certain nombre de • staff numbers : effectifs 2 (to) vb. numéroter • compter, comprendre (comporter) numbering nom n.c. / "nVmb@rIN / numérotage numeracy nom n.c. / "nju:m@r@sI / aptitude au calcul, numeracy programme : programme d’initiation au calcul numerous adj. / "nju:m@r@s / nombreux nurse / n3:s / 1 nom adj. infirmier/ère • nurses : personnel infirmier 2 (to) vb. Méd. soigner, to nurse a cold : soigner un rhume • to nurse a baby : allaiter nursing / "n3:sIN / 1 nom n.c. soins infirmiers • profession d’infirmier • allaitement, nursing mother : femme allaitante 2 adj. nursing school : institut/école de formation en soins infirmiers • nursing staff : personnel infirmier nutrition nom n.c. / nju:"trISn / nutrition, alimentation nuts nom pl. / nVts / fruits à coque

O oath nom / @UT / serment, Hippocratic oath : serment d’Hippocrate obey (to) vb. / @"beI / obéir à, se conformer à

oblong adj. / "QblQN / oblong, plus long que large, rectangulaire obsessive compulsive disorder (OCD) nom / @b"sesIvk@m"pVlsIvdIs"O:d@(r) / Psych. troubles obsessionnels compulsifs (TOC) obstruct (to) vb. / @b"strVkt / obstruer, bloquer, gêner, entraver, Méd. + with : obstruer obtain (to) vb. / @b"teIn / obtenir, recueillir, recevoir, se procurer obtainable adj. / @b"teIn@bl / qu’on peut de procurer, obtenir • disponible obvious adj. / "QbvI@s / évident, incontestable obviously adv. / "QbvI@slI / manifestement, bien entendu, évidemment occasionally adv. / @"keIZ@n@lI / parfois, de temps en temps, de temps à autre occupational adj. / %QkjU"peIS@nl / professionnel, du travail. occupational accident : accident du travail, occupational disease/hazard : maladie/risque professionnel(le), occupational health : hygiène du travail, occupational health service : service de la médecine du travail, occcupational physician : médecin du travail, occupational therapy : ergothérapie occur (to) vb. / @"k3:(r) / se produire, arriver, apparaître, se présenter, se trouver o'clock adv. / @"klQk / (indique l’heure) 5 o’clock : 5 heures odd adj. / Qd / bizarre, étrange • dépareillé, Math. : impair, odd and even : impair et pair odourless adj. / "@Ud@lIs / inodore offender nom / @"fend@(r) / délinquant offer / "Qf@(r) / 1 nom offre (de : of, pour : for ), proposition 2 (to) vb. offrir (à : to ), proposer (à : to ), to offer to do sth. : proposer de faire qqch. office nom / "QfIs / bureau, service, administration, doctor’s office : cabinet médical (US) officer nom / "QfIs@(r) / officier, fonctionnaire, agent, employé, customs officers : agents des douanes often adv. / "Qfn, "Qft@n / souvent OHP acron. pl. OHPS overhead projector : rétroprojecteur ointment nom / "OIntm@nt / onguent, pommade

352 ominous adj. / "QmIn@s / de mauvaise augure, menaçant, sinistre, inquiétant omit (to) vb. / @"mIt / omettre, oublier (de faire qqch. : to do sth.), négliger once adv. / wVns / une (seule) fois • autrefois, diseases once thought to be incurable : les maladies que l’on pensait autrefois incurables • at once : immédiatement onset nom / "Qnset / début, commencement, Méd. apparition (d’une maladie : of a disease ) onward adj. / "Qnw@d / en avant, onward journey : poursuite du voyage onwards adv. / "Qnw@dz / (to continue) onwards : avancer, poursuivre, from now/this time onwards : désormais, dorénavant, from 1980 onwards : à partir de 1980 opener nom / "@Upn@(r) / can opener = tin opener : ouvre-boîte openly adv. / "@Up@nlI / ouvertement, au grand jour openness nom n.c. / "@Up@nnIs / franchise, ouverture operate (to) vb. / "Qp@reIt / exploiter, gérer, faire fonctionner, Méd. opérer, operated by a company : exploité, géré par une entreprise • privately operated hospital : hôpital privé • operating as parademics : intervenant en tant qu’auxiliaires médicaux • to operate on sb. (chirurgien : surgeon) opérer qqn operating adj. / "Qp@reItIN / operating theatre : salle d’opération, operating field : champ opératoire operator nom / "Qp@reIt@(r) / exploitant, agent, opérateur, conducteur (machine), tour operator : voyagiste opinion poll nom / @"pInI@n p@Ul / sondage d’opinion opportunity nom / %Qp@"tju:n@tI / possibilités, occasion, chance (à saisir), perspective(s) (d’avenir), to take the opportunity : saisir l’occasion opposite / "Qp@zIt / 1 nom contraire, inverse, the opposite is true : c’est le contraire, l’inverse 2 prép. en face de, the surgery is opposite the church : le cabinet est en face de l’église 3 adj. opposé, contraire, autre • d’en face, opposite side : le côté opposé 4 adv. en face, d’en face, the graph opposite : le graphique (sur la page d’) en face opt (to) vb. / Qpt / opter (pour : for ), choisir

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

OPV acron.

Oral Poliomyelitis Vaccine : vaccin polio oral

(VPO) order / "O:d@(r) / 1 nom ordre, commande • word order : ordre des mots, in order of appearance : par ordre d’apparition • law and order : ordre public • in order : en règle (papiers, qualifications…) • in order to : pour, afin que 2 (to) vb. ordonner à, donner l’ordre à, to order sb. to do sth. : commander à qqn de faire qqch. • classer, ranger ordinary adj. / "O:d@nrI / ordinaire, normal ossicles nom pl. / "QsIklz / osselets de l’oreille (enclume : incus, anvil • étrier : stapes, stirrup • marteau : malleus, hammer ) other pron. adj. / "VD@(r) / autre otherwise adv. / "VD@waIz / autrement, sinon, otherwise known as : également connu sous le nom de ought to vb. / O:t / préterit ought devoir (obligation), doctors ought to report… : les médecins devraient signaler… ounce nom / aUns / once (28,35 gr) outbreak nom / "aUtbreIk / déclenchement, Méd. épidémie, flambée épidémique outcome nom / "aUtkVm / résultat, suites, issue, effet outer adj. / "aUt@(r) / extérieur, externe, outer ear : oreille externe outgoing adj. / "aUtg@UIN / sortant outgrow (to) vb. / aUt"gr@U /, outgrew/ aUt"gru: /, outgrown / aUt"gr@Un / se débarrasser de avec le temps, parvenir à se débarrasser de outline / "aUtlaIn / 1 nom grandes lignes, aperçu, exposé, compte rendu, plan, schéma 2 (to) vb. décrire à grands traits, donner un aperçu, exposer, présenter, définir dans les grandes lignes, donner/présenter une vue d’ensemble outpatient / "aUtpeISnt / 1 nom malade ambulatoire 2 adj. outpatient care : traitement ambulatoire, outpatient clinic/ department : service des consultations externes output nom / "aUtpUt / production, rendement, résultat, sortie (input/ output ), débit, volume, Méd. cardiac output : débit cardiaque

LEXIS outrage nom / "aUtreIdZ / (acte de) violence, atrocité • scandale, media outrage : indignation des médias outside / aUt"saId / 1 nom habit. sing. extérieur, dehors, apparence 2 prép. à l’extérieur, hors de, devant, dehors : there are taxis outside the clinic : il y a des taxis devant la clinique, ouside working hours : en dehors des heures de travail/de bureau 3 adj. extérieur, à l’extérieur, the outside world : le monde extérieur, outside help : aide extérieure 4 adv. à l’extérieur de, dehors outstanding adj. / %aUt"st&ndIN / remarquable, exceptionnel, d’exception, illustre over / "@Uv@(r) / 1 prép. sur, dessus, au-dessus, pressure over her chest : poids sur la poitrine, just over 6,000 : chiffre légèrement supérieur à 6000, survey carried over 300 cases : enquête menée sur 300 cas • pendant, durant, over the past decade : au cours de la dernière décennie, over the next 6 months : pendant les 6 mois qui viennent, over time : sur la durée, over the years : au cours du temps • plus de, people over 55 : les personnes de plus de 55 ans, over 20% : plus de 20 %, for over 5,000 years : pendant plus de 5000 ans • sur, au sujet de, concerned over details : préoccupé par des détails • all over : partout, all over the world : dans le monde entier • over the counter (drug) : médicaments délivrés sans ordonnance/en vente libre 2 adj. terminé, when it is over : lorsque ce sera terminé 3 adv. dessus, over here/there : ici, là-bas overall / "@Uv@rO:l / 1 adj. général, total, d’ensemble, global 2 adv. en général, dans l’ensemble, globalement • en tout overcome (to) vb. / %@Uv@"kVm /, overcame / %@Uv@"keIm /, overcome surmonter, vaincre, dominer, triompher de overcrowded adj. / %@Uv@"kraUdId / surpeuplé, surchargé, bondé overcrowding nom n.c. / %@Uv@"kraUdIN / surpeuplement, entassement, promiscuité overeat (to) vb. / %@Uv@r"i:t /, overate / %@Uv@r" eIt /, overeaten / %@Uv@r"i:tn / manger en trop grande quantité, se suralimenter overheat (to) vb. / %@Uv@"hi:t / surchauffer overnight / "@Uv@naIt / 1 adv. (jusqu’au) lendemain, du jour au lendemain, overnight delivery : livraison le lendemain, overnight success : succès immédiat, instantané, children remained in the hospital overnight : les enfants ont passé une nuit à l’hôpital 2 adj. d’une nuit, de nuit oversimplify (to) vb. / %@Uv@"sImplIfaI / simplifier à l’extrême/excessivement/outre mesure

353 oversleep (to) vb. / %@Uv@"sli:p /, overslept / %@Uv@"slept /, overslept se réveiller trop tard, dormir trop overweight / %@Uv@"weIt / 1 nom n.c. surpoids, Méd. surcharge pondérale 2 adj. to be overweight : avoir un excédent de poids overwhelm (to) vb. / %@Uv@"welm / submerger, déborder, accabler, écraser, to be overwhelmed : être débordé overwhelming adj. / %@Uv@"welmIN / écrasant, insurmontable, overwhelming evidence : preuves accablantes overwork / "@Uv@w3:k / 1 nom n.c. surmenage 2 (to) vb. surmener, se surmener, surcharger de travail, trop travailler owing prép. / "@UIN / + to : en raison de, à cause de own / @Un / 1 pron. à moi (lui, elle, etc…) 2 adj. propre (à soi), your own opinion : votre opinion (à vous), say it in your own words : dites-le à votre façon 3 (to) vb. être le propriétaire de, posséder, avoir owner nom / "@Un@(r) / propriétaire, possesseur, titulaire ox nom / Qks / pl. oxen / "Qksn / bœuf

P pacemaker nom / "peIsmeIk@(r) / stimulateur cardiaque pack nom / p&k / pack of pills : boîte de médicaments, Méd. cold/ wet pack : compresse froide/humide packing rod nom / "p&kIN rQd / outil de remplissage (batte coudée) pain nom / peIn / douleur, souffrance, to be in pain : souffrir, I have a pain in my knee : j’ai une douleur au genou, stomach pains : maux d’estomac, pain relief : soulagement de la douleur, pain relieving drug : analgésique painful adj. / "peInfl / douloureux, pénible, my right elbow is painful : mon coud droit me fait mal painfully adv. / "peInf@lI / douloureusement, péniblement, painfully swollen : enflé/gonflé et douloureux painkiller nom / "peIn%kIl@(r) / analgésique, antalgique, médicament contre la douleur painkilling adj. / "peIn%kIlIN / painkilling drug : analgésique, antalgique, médicament contre la douleur

354 painless adj. / "peInlIs / indolore, sans souffrance, painless childbirth : accouchement sans douleur painlessly adv. / "peInlIslI / sans douleur, sans souffrance paramedic nom / %p&r@"medIk / auxiliaire médical • ambulancier secouriste paramedical adj. / %p&r@"medIkl / paramedical staff : personnel médical auxiliaire, auxiliaires médicaux partial adj. / "pA:Sl / partial deafness : malentendant particular adj. / p@"tIkjUl@(r) / particulier, spécial, spécifique, certain, donné particularly adv. / p@"tIkjUl@lI / en particulier, notamment, surtout partly adv. / "pA:tlI / en partie, partiellement pass (to) vb. / pA:s / passer, Méd. to pass urine/water : uriner, to pass on (a disease) to : transmettre (une maladie) à • + away/on : s'éteindre, décéder • + out : s'évanouir, perdre connaissance path nom / pA:T / chemin, trajectoire, voie (voir pathway ) pathologist nom / p@"TQl@dZIst / anatomopathologiste • médecin légiste pathway nom / "pA:T%weI / voie, trajet, chaîne, filière, Méd. voie de conduction/de transmission pattern nom / "p&tn / caractéristiques, grandes lignes • mode, modalités • habitudes, évolution, tendance • système • agencement, organisation • modèle, exemple • schéma, tableau, forme, dessin… • patterns of land use : mode d’utilisation du sol/d’organisation de l’espace, spacial and temporal patterns of vector population : distribution spatiotemporelle des populations de vecteurs, Méd. respiratory infection patterns : tableau des infections respiratoires, therapeutic patterns : schémas thérapeutiques, pattern of sleep : phases du sommeil, pattern of fever : type de fièvre, profil d’une fièvre peace nom n.c. / pi:s / peace corps : organisation fédérale américaine

indépendante de coopération et d’aide aux pays en développement

peak / pi:k / 1 nom n.c. ou sing. maximum, sommet, niveau record, point culminant 2 (to) vb. atteindre son maximum, son plus haut niveau, culminer, to peak at : atteindre un sommet de per prép. , adv. / p3:(r) / par, per annum : par an, l’an • per capita : par habitant, par personne • per os : par voie orale

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

perennial adj. / p@"renI@l / perpétuel, éternel, chronique, Bot. (plante) vivace, pluriannuelle perfect (to) vb. / "p3:fIkt / parfaire, mettre au point, perfectionner perform (to) vb. / p@"fO:m / exécuter, accomplir, remplir (une fonction), jouer (un rôle), pratiquer, Méd. réaliser un acte médical, to perform an operation : pratiquer une opération, opérer performance / p@"fO:m@ns / exécution, accomplissement, réalisation, résultats, rendement, efficacité • performance enhancing drugs : produits dopants, academic performance : résultats scolaires, universitaires perhaps adv. / p@"h&ps / peut-être personnel nom n.c. / %p3:s@"nel / personnel, personnel department : service du personnel pertussis nom n.c. / p@"tVsIs / coqueluche PET acron. / pet / positron emission tomography : tomographie par émission de positons TEP • PET scanner : tomographie à émission de positons, PET scan(ning) : tomographie par émission de positons phantom adj. / "f&nt@m / phantom limb : membre fantôme, phantom pregnancy : grossesse nerveuse phase (to) vb. / feIz / échelonner, mettre en place, + in : mettre en application progressivement, + out : supprimer progressivement/par étape phenomenon nom / f@"nQmIn@n / pl. phenomena / f@"nQmIn@ / phénomène phone (to) vb. / f@Un / = telephone phrasal adj. / freIz@l / syntagmatique, phrasal verb : verbe à particule, ex. : look for : chercher, look at : regarder phrase / freIz / 1 nom expression, formule, membre de phrase • syntagme 2 (to) vb. exprimer, formuler physician nom / fI"zISn / médecin piece nom / pi:s / morceau, piece of advice : avis, piece of equipment : élément d’équipement pig nom / pIg / porc, cochon pilgrim nom / "pIlgrIm / pèlerin

LEXIS pill nom / pIl / pilule, contraceptive pill : pilule contraceptive, to be on the pill : prendre la pilule (contraceptive) pilot-test / "paIl@%test / 1 nom essai pilote 2 (to) vb. procéder à un essai pilote pint nom / paInt / pinte : UK 0,568 litre • US 0,473 litre plain adj. / pleIn / ordinaire, simple, clair plane nom / pleIn / abrév. de aeroplane ou airplane : avion, aéronef plate nom / pleIt / assiette, plaque, plateau • Dent. dental plate : dentier • Méd. broche (fracture) • X-ray plates : clichés (de radios) platelet nom / "pleItlIt / plaquette (sanguine) plenty pron. / "plentI / beaucoup, drink plenty of liquid : buvez beaucoup plummet (to) vb. / "plVmIt / baisser brusquement/fortement, chuter, plonger, s’effondrer pocket nom / "pQkIt / poche, breast pocket : poche de poitrine point / pOInt / 1 nom pointe • point, degré, stade • lieu, endroit • question • key point : élément clé, the point of a remark : le sens d’une observation, to make a point : présenter une observation • dividing point : point de démarcation, nought point seven : zéro virgule sept 2 (to) vb. être orienté (vers), + to/towards : montrer, indiquer, sembler indiquer, suggérer, + out : signaler, souligner poised adj. / pOIzd / to be poised : être prêt à, être sur le point de poisoning nom n.c. / "pOIz@nIN / empoisonnement, intoxication policy nom / "pQl@sI / pl. policies politique, orientations, stratégie, mesures, health policy : politique de santé, policy statement : déclaration de principe Polish adj. / "pQlIS / polonais, de Pologne (Poland ) pool (to) vb. / pu:l / mettre en commun, rassembler, unir poor / pO:(r) / 1 nom inv. the poor : les pauvres, les défavorisés, les personnes économiquement faibles 2 adj. pauvre, de condition modeste • médiocre, faible, insuffisant, peu satisfaisant, mauvais, poor quality : de qualité inférieure, poor health : mauvaise santé, poor diet : mauvais régime alimentaire/régime inadapté

355 poorly adj. / "pO:lI / mal, poorly understood : mal compris post-mortem / %p@Ust"mO:t@m / 1 nom pl. post-mortems, autopsie, to hold/carry out a post-mortem : faire l’autopsie, autopsier 2 adj. post-mortem examination : autopsie postoperative adj. / %p@Ust"Qp@r@tIv / postopératoire postpone (to) vb. / p@"sp@Un / remettre/renvoyer à plus tard, différer, reporter posture nom / "pQstS@(r) / position, posture pound nom / paUnd / livre (poids) : (453,6 gr) • £ livre : unité monétaire britannique power / "paU@(r) / 1 nom n.c. pouvoir, puissance, force, énergie • électricité, courant, nuclear power plant : centrale nucléaire, 7 to the power minus 5 : 7 à la puissance moins 5, power cut : panne de courant 2 (to) vb. alimenter en électricité, faire fonctionner powered adj. / "paU@d / fonctionnant à, alimenté en énergie, sun powered : fonctionnant à l’énergie solaire, wind powered : alimenté en énergie éolienne powerful adj. / "paU@fl / puissant, violent, fort, profond powerless adj. / "paU@lIs / impuissant, démuni (devant) practice nom / "pr&ktIs / pratique, exercice, expérience, usages, Méd. exercice • clientèle, cabinet (médical, dentaire), a large practice : un cabinet important, une nombreuse clientèle, general practice : médecine générale, cabinet de médecine générale, group practice : cabinet de groupe practise (US practice) (to) vb exercer (une profession), to practice medicine : exercer la médecine practised (US practiced) adj. / "pr&ktIst / expérimenté practising (US practicing) adj. / "pr&ktIsIN / en activité, en exercice practitioner nom / pr&k"tIS@n@(r) / general practitioner, GP : (médecin) généraliste predictable adj. / prI"dIkt@bl / prévisible, sans surprise predictably adv. / prI"dIkt@blI / comme il fallait s’y attendre, comme cela était à prévoir, de manière prévisible predictor nom / prI"dIkt@(r) / facteur prédictif

356 pregnancy nom / "pregn@nsI / grossesse pregnant adj. / "pregn@nt / enceinte (femme) prejudice / "predZUdIs / 1 nom préjugés, idée préconçue 2 (to) vb. nuire à, porter atteinte à • influencer qqn contre, to prejudice sb. against sb. else : faire naître chez qun des préjugés défavorables contre qqn d’autre, to be prejudiced (against) : avoir des préjugés (contre) premature adj. / "prem@tjU@(r) / prématuré, avant terme, premature baby : prématuré, né avant terme, premature confinement/ delivery/labour : accouchement avant terme prerequisite / %pri:"rekwIzIt / 1 nom condition préalable/nécessaire/indispensable (pour : for ) 2 adj. nécessaire, préalable, indispensable prescribe (to) vb. / prI"skraIb / prescrire prescription nom / prI"skrIpSn / ordonnance, on prescription : sur ordonnance, to make out/write out a prescription : faire une ordonnance, to make up (US fill) a prescription : exécuter une ordonnance, prescription drug/ medicine : médicament délivré sur ordonnance present (to) vb. / prI"zent / + with : présenter/montrer à • poser un problème à • the patient presents with carcinoma of the bladder : le malade présente un cancer de la vessie preserve (to) vb. / prI"z3:v / conserver, maintenir pressure nom / "preS@(r) / pression, tensions, pressure sores : escarre (de décubitus), blood pressure : pression artérielle, high/low blood pressure : hypertension/hypotension artérielle preterm adj. / "pri%t3:m / prématuré, avant terme prevalent adj. / "prev@l@nt / courant, répandu • actuel prevent (to) vb. / prI"vent / empêcher, prévenir, éviter preventable adj. / prI"vent@bl / évitable prevention nom n.c. / prI"venSn / prévention, prevention of disease : prévention de maladies, mesures prophylactiques preventive adj. / prI"ventIv / préventif previous adj. / "pri:vI@s / précédent, antérieur

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

previously adv. / "pri:vI@slI / auparavant, previously unknown : inconnu jusqu’ici, previously believed : que l’on pensait jusque là… price nom / praIs / prix, the price of treatment : le prix du traitement prisoner nom / "prIzn@(r) / détenu, prisonnier, prisoners health : santé carcérale primarily adv. / "praIm@r@lI / principalement, essentiellement, surtout prime adj. / praIm / principal, essentiel, capital, de premier ordre/ choix prior / "praI@(r) / 1 adj. antérieur, précédent, préalable 2 adv. antérieurement à, préalablement à, avant prize nom / praIz / prix, the Nobel Prize : le prix Nobel proactive adj. / pr@U"&ktIv / qui prend des initiatives, qui anticipe (personne) • préventive, intervenant en amont (action) proactively adv. / pr@U"&ktIvlI / préventivement, de manière anticipée, en amont procedure nom / pr@"si:dZ@(r) / méthode, technique • procédé, démarche • procédure, Méd. acte thérapeutique/diagnostique, geste thérapeutique, intervention, opération, examen proceed (to) vb. / pr@"si:d / agir • progresser, se diriger vers, poursuivre • + with : commencer qqch., mettre en œuvre process / "pr@Uses / 1 nom processus, opérations, modalités, méthodes, procédé • in process : en cours, in the process of : au cours de 2 (to) vb. traiter, transformer, analyser • examiner la cas/le dossier produce (to) vb. / pr@"dju:s / produire, fabriquer • causer, provoquer product nom / "prQdVkt / produit, résultat profane adj. / pr@"feIn / profane • blasphématoire proficiency nom n.c. / pr@"fISnsI / compétence, aptitude progress 1 nom n.c. / "pr@Ugres / progrès, évolution, avancement, to make progress : faire des progrès, in progress : en cours (de réalisation), medical progress : les progrès de la médecine 2 (to) vb. / pr@"gres / avancer, progresser, faire des progrès

LEXIS prohibit (to) vb. / pr@"hIbIt / interdire, empêcher (qqn de faire qqch. : sb. from doing sth.) prolonged adj. / pr@"lQNd / prolongé, long prominence nom n.c. / "prQmIn@ns / importance, position en vue, place importante, centre de l’attention prominent adj. / "prQmIn@nt / proéminent, frappant, important, éminent, distingué, de premier plan, notable prominently adv. / "prQmIn@ntlI / (bien) en évidence/en vue, bien visible promising adj. / "prQmIsIN / prometteur, d’avenir promote (to) vb. / pr@"m@Ut / agir en faveur de, favoriser, faire progresser, développer, appuyer, soutenir, assurer la promotion de, faire mieux connaître, encourager (le recours à), to promote safe sex : faire campagne en faveur d’une sexualité sans risque prompt / prQmpt / 1 nom message de guidage, invite 2 (to) vb. provoquer, susciter, + to : inciter à, pousser à, amener à 3 adj. rapide, prompt proof ou –proof / pru:f / 1 nom preuve, no proof was brought against him : aucune preuve n’est jamais venue étayer les accusations portées contre lui 2 adj. waterproof : imperméable, étanche (à l'eau), bulletproof : pare-balles propel (to) vb. / pr@"pel / propulser, faire avancer proper adj. / "prQp@(r) / approprié, adéquat, convenable • correct, véritable, en bonne et due forme • proprement dit properly adv. / "prQp@lI / de façon appropriée, satisfaisante • convenablement, correctement, comme il convient property nom / "prQp@tI / n.c. objets, biens, biens immobiliers, propriété (terre et bâtiment), intellectual property : propriété intellectuelle • comptable : propriétés, soy’s estrogenic properties : les propriétés estrogènes du soja, medicinal properties : propriétés médicinales proponent nom / pr@"p@Un@nt / partisan, tenant, adepte proposed adj. / pr@"p@Uzd / envisagé, proposé prove (to) vb. / pru:v /, proved, proved ou proven / "pru:vn / prouver, démontrer • se révéler, s’avérer proven adj. / "pru:vn / indubitable, qui a fait ses preuves, confirmé

357 provide (to) vb. / pr@"vaId / fournir, offrir, procurer, provide care : prodiguer/ dispenser des soins, + with : fournir à, doter de, to provide sb. with health care : dispenser des soins de santé à qqn provided conj. / pr@"vaIdId / (that ) à condition que, si tant est que, pour autant que, sous réserve que provider nom / pr@"vaId@(r) / fournisseur, prestataire de service, health care providers : prestataires de soins de santé providing conj. / pr@"vaIdIN / (that ) à condition que, pour autant que provision nom / pr@"vIZn / fourniture, approvisionnement, offre, prestation health care provision : prestation de soins de santé public adj. / "pVblIk / public service : services publics, fonction publique, public figure : personnalité (publique), raise public awareness : sensibiliser l’opinion publique, public image : image (de marque), lack of public awareness : absence de/manque de sensibilisation du public/de l’opinion publique publish (to) vb. / "pVblIS / publier • éditer publisher nom / "pVblIS@(r) / éditeur, maison d’édition puffiness nom n.c. / "pVfInIs / gonflement, bouffissure puffy adj. / "pVfI / gonflé, bouffi pulse nom / pVls / Méd. pouls, to take sb.’s pulse : prendre le pouls de qqn, pulse rate : pouls puncture / "pVNktS@(r) / 1 nom Méd. ponction, lumbar puncture : ponction lombaire, puncture wound : perforation 2 (to) vb. percer, transpercer, Méd. percer, ouvrir (abcès) punish (to) vb. / "pVnIS / punir purple nom / "p3:pl / violet bleu, pourpre (violet rouge), visual purple : pourpre rétinien purplish adj. / "p3:plIS / violacé purpose nom / "p3:p@s / but, objectif, finalité, fonction, usage put (to) vb. / pUt /, put, put mettre, placer, + forward : proposer, suggérer, avancer, présenter une idée/un projet • + off : remettre à plus tard, différer, reporter puzzling adj. / "pVzlIN / incompréhensible, déroutant, surprenant

358

MINIMUM

Q qualification nom / %kwQlIfI"keISn / pl. qualifications : compétences, aptitudes, qualifications • titres, diplômes, academic qualifications : titres universitaires qualified adj. / "kwQlIfaId / qualifié • possédant les aptitudes/compétences requises • Méd. diplômé, possédant les titres nécessaires, newly qualified doctor : médecin venant d’obtenir son diplôme qualify (to) vb. / "kwQlIfaI / + to : donner à quelqu’un les compétences professionnelles pour faire quelque chose/exercer une profession, the programme qualifies students to be a diving instructor : formation qualifiante de moniteur de plongée sous marine • + for : rendre apte à occuper un emploi • avoir les compétences requises/remplir les conditions pour (un emploi) • + as : to qualify as a nurse : obtenir un diplôme d’infirmière qualifying adj. / "kwQlIfaIIN / qui permet de se qualifier • remplissant les conditions requises quarter nom / "kwO:t@(r) / quart, a quarter past ten : dix heures et quart quick adj. / kwIk / rapide, prompt, quick recovery : prompt rétablissement quickly adv / "kwIklI / rapidement, vite, sans tarder quiet adj. / "kwaI@t / doux, tranquille, calme quit (to) vb. / kwIt /, quit ou quitted / "kwItId / s’en aller, quitter, laisser, cesser/s’arrêter de faire, abandonner quite adv. / kwaIt / bien, très quote (to) vb. / kw@Ut / citer (texte), indiquer, donner (prix)

R rabies nom n.c. / "reIbi:z / rage, rabies vaccine : vaccin antirabique, rabies virus : virus de la rage race nom / reIs / course railway / "reIlweI / (US railroad / "reIlr@Ud /) nom chemin de fer rain / reIn / 1 nom pluie 2 (to) vb. pleuvoir rainfall nom / "reInfO:l / précipitations, hauteur de pluie, pluviométrie

COMPETENCE IN MEDICAL ENGLISH

rainy adj. / "reInI / pluvieux, rainy season : saison des pluies raise (to) vb. / reIz / lever, élever, soulever (questions), dresser (qqch.), augmenter • provoquer (controverses), to raise money : recueillir des fonds raised adj. / reIzd / raised edge : bord saillant random adj. / "r&nd@m / aléatoire, random sample : échantillon aléatoire randomize (to) vb. / "r&nd@%maIz / randomiser randomized adj. / "r&nd@%maIzd / randomized trial : essai randomisé randomly adv. / "r&nd@mlI / aléatoirement, au hasard, sans ordre particulier range / reIndZ / 1 nom gamme, série, ensemble, éventail, fourchette, a range of : une gamme/série de, divers • the range of : les divers, broad range of infections : des infections très diverses, wide range of tests : toute une gamme de tests, age range : tranche d’âge, range of application : champ d’application 2 (to) vb. s’étendre, to range from… to : aller de … à, varier de … à, être compris entre, the incubation period ranges from… to : la période d’incubation varie de … à … rank / r&Nk / 1 nom rang 2 (to) vb. classer, se classer rape nom / reIp / viol rapport nom n.c. / r&"pO:(r) / bonnes relations, affinités, bon contacts rash nom / r&S / Méd. érythème, éruption rate / reIt / 1 nom taux, niveau, tarif, barème, coefficient, rythme, death rate : taux de mortalité, heart rate : fréquence cardiaque, metabolic rate : taux métabolique 2 (to) vb. évaluer, considérer comme, clinicians rated the treatment as good/as poor : les cliniciens ont jugé le traitement bon/médiocre rather adv. / "rA:D@(r) / plutôt, rather than : plutôt que, …et non, au lieu de, it is nicotine that causes cancer rather than the smoke : c’est la nicotine qui provoque le cancer et non la fumée ratio nom / "reISI@U / quotient, taux, rapport, proportion, coefficient raw adj. / rO: / cru, brut, non traité ray nom / reI / rayon

LEXIS reach (to) vb. / ri:tS / atteindre, toucher, contacter, parvenir à, tirer (conclusions), to reach a location : parvenir à un lieu react (to) vb. / rI"&kt / réagir read (to) vb. / ri:d /, read, read lire readily adv. / "redIlI / volontiers • facilement, aisément, readily available without prescription : que l’on obtient facilement sans ordonnance reading nom / "ri:dIN / lecture, interprétation (texte) • mesure, relevé ready adj. / "redI / prêt real adj. / rI@l / vrai, véritable, réel, real world : réalités, real time : temps réel realize ou realise (to) vb. / "rI@laIz / comprendre, se rendre compte de, prendre conscience de, penser, more frequently than is commonly realized : plus fréquemment qu’on le pense généralement really adv. / "rI@lI / vraiment, réellement reap (to) vb. / ri:p / moissonner, récolter, tirer (profit : benefits ) rearrange (to) vb. / %ri:@"reIndZ / réorganiser reason nom / "ri:zn / raison, motif, cause, there is reason to believe that : il y a lieu de croire que reasonable adj raisonnable, plausible, suffisant, satisfaisant, there is a reasonable chance that : il y a des chances que reasonably adv. / "ri:zn@blI / raisonnablement, relativement, assez, plutôt rebirthing nom n.c. / %ri:"b3:TIN / rebirth rebuild (to) vb. / %ri:"bIld /, rebuilt / %ri:"bIlt /, rebuilt rebâtir, reconstruire, Méd. refaire (visage, nez) receive (to) vb. / rI"si:v / recevoir, accueillir, to receive treatment : subir un traitement receiving adj. / rI"si:vIN / de réception, receiving device : appareil de réception recently adv. / ri:"sntlI / récemment, dernièrement rechristened adj. / %ri:"krIsn / rebaptisé

359 recipient nom / rI"sIpI@nt / bénéficiaire, prestataire, receveur (transfusion sanguine, greffe : blood transfusion, transplant ), destinataire (lettres, messages) recognize ou recognise (to) vb. / "rek@gnaIz / reconnaître, admettre, se rendre compte de, être conscient de, to recognize as : reconnaître comme, considérer comme, juger ( + adj. ) recognized adj. / "rek@gnaIzd / reconnu, consacré, éprouvé, classique, admis recombinant adj. / ri:"kQmbIn@nt / recombiné recommend (to) vb. / %rek@"mend / recommander, conseiller recommended adj. / %rek@"mendId / recommandé, recommended daily allowance : apport journalier recommandé reconsider (to) vb. / %ri:k@n"sId@(r) / reconsidérer, réexaminer (question), revoir (sa position), changer d’avis record 1 nom / "rekO:d / enregistrement, document, fiche, registre, dossier, fichier, documentation pl. archives, données, informations, renseignements, chiffres, compte-rendu, bilan, Méd. health record : dossier médical, previous record of : antécédents 2 (to) vb. / rI"kO:d / enregistrer, archiver, noter, recenser recover (to) vb. / rI"kVv@(r) / retrouver, récupérer (qqch.) • guérir, se rétablir, + from : se remettre de recovery nom / rI"kVv@rI / récupération • convalescence, guérison, rétablissement, recovery rate : taux de guérison, recovery room : salle de réveil recreational adj. / %rekrI"eIS@nl / de loisir(s), pour les loisirs recruit (to) vb. / rI"kru:t / recruter, embaucher recruiting nom n.c. / rI"kru:tIN / recrutement recuperate (to) vb. / rI"ku:p@reIt / Méd. se rétablir, se remettre (de : from ) recuperation nom n.c. / rI%ku:p@"reISn / Méd. rétablissement, convalescence recur (to) vb. / rI"k3:(r) / se reproduire/revenir/réapparaître (périodiquement) recurrence nom / rI"kVr@ns / répétition, réapparition, résurgence, Méd. récidive recurrent adj. / rI"kVr@nt / renouvelable, régulier, à répétition, périodique, cyclique • courant, Méd. récidivant, à répétition, récurrent, recurrent bronchitis : bronchites répétées

360 redden (to) vb. / "redn / rougir, devenir rouge/roux reddening nom / "rednIN / rougissement, roussissement reddish adj. / "redIS / rougeâtre, roussâtre redness nom n.c. / "rednIs / rougeur, rousseur reduce (to) vb. / rI"dju:s / réduire, diminuer, baisser, abaisser, Méd. résorber (gonflement : swelling ), faire baisser/ descendre (température) reduced adj. / rI"dju:st / réduit, soldé, reduced scale : échelle réduite, reduced probability : moindre probabilité reduplicate (to) vb. / rI"dju:plIkeIt / redoubler reduplication nom / rI%dju:plI"keISn / redoublement refer (to) vb. / rI"f3:(r) / + to : soumettre à, s’en rapporter à, mentionner, indiquer, faire référence à, renvoyer à • adresser un patient à un spécialiste, referred to as : appelé, dénommé, dit reference nom / "ref@r@ns / mention, référence, citation, consultation, references : références bibliographiques, reference may be to : il est possible que (l’information) porte sur…, in reference to : en ce qui concerne, en réponse à (lettre), with reference to : en particulier, notamment, surtout referral nom / rI"f3:r@l / orientation, aiguillage (d’un malade vers un spécialiste : of a patient to a specialist ), diriger vers refine (to) vb. / rI"faIn / améliorer, perfectionner, (r)affiner reflect (to) vb. / rI"flekt / indiquer, faire apparaître • traduire, correspondre à, réfléchir (qqch.) refractory adj. / rI"fr&kt@rI / réfractaire refusal nom / rI"fju:zl / refus regard / rI"gA:d / 1 nom considération, estime • with regard to : en ce qui concerne 2 (to) vb. considérer (as : comme), it is regarded as : il est considéré comme regarding prép. / rI"gA:dIN / pour/en ce qui concerne, quant à regimen nom / "redZImen / Méd. schéma thérapeutique, régime regular adj. / "regjUl@(r) / courant, ordinaire, habituel, régulier

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

regulate (to) vb. / "regjUleIt / régir, régler, réglementer, réguler rehabilitation nom n.c. / %ri:@bIlI"teISn / remise en état, rééducation, réadaptation (blessé, malade), réinsertion (délinquant), réhabilitation (justice) relapse 1 nom / "ril&ps / Méd. rechute, to have a relapse : avoir/faire une rechute 2 (to) vb / rI"l&ps / rechuter relate (to) vb. / rI"leIt / établir un rapport entre, rapprocher, rattacher, lier, to relate to sb : établir/entretenir des rapports avec qqn related adj. / rI"leItId / lié, analogue, apparenté, voisin, + to : lié à, apparenté à, relatif à, se rapportant à, health related problems : problèmes de santé/liés à la santé relating adj. / rI"leItIN / relating to : concernant, relatif à relationship nom / rI"leISnSIp / liens (de parenté), relation(s), rapport(s) relative nom / "rel@tIv / parent (membre de la famille), mothers, fathers, relatives, neighbours : mères, pères, parents, voisins relax (to) vb. / rI"l&ks / relâcher, (se) décontracter, (se) détendre, (se) délasser, se relaxer release / rI"li:s / 1 nom libération • autorisation de sortie d’hôpital • sortie, publication, news release : communiqué de presse 2 (to) vb. libérer, dégager • émettre, sécréter • autoriser un malade hospitalisé à rentrer chez lui • diffuser, publier, sortir relevance nom n.c. / "rel@v@ns / pertinence, intérêt, valeur, utilité (pratique), importance relevant adj. / "rel@v@nt / pertinent, digne d’intérêt, concerné, relevant to : adapté à, lié à, en rapport avec, concernant, relatif à reliable adj. / rI"laI@bl / fiable, digne de foi/de confiance, sérieux, solide, sûr relief nom / rI"li:f / soulagement, secours, aide, assistance, pain relief : soulagement de la douleur, relief agency : organisation humanitaire, relief worker : secouriste, relief workers : équipes de secours relieve (to) vb. / rI"li:v / soulager, atténuer, calmer, apaiser • aider, secourir, relieve these imbalances : atténuer ces déséquilibres

LEXIS reliever nom / rI"li:v@(r) / pain reliever : antalgique, analgésique, antidouleur rely (to) vb. / rI"laI / + on : compter sur, faire confiance à, se fier à, se reposer sur, tabler sur remain (to) vb. / rI"meIn / rester, demeurer remainder nom / rI"meInd@(r) / reste, restant remedial adj. / rI"mi:dI@l / correctif, Méd. curatif, remedial exercise : exercices de réadaptation/rééducation remedy nom / "rem@dI / remède, solution remember (to) vb. / rI"memb@(r) / se souvenir de, it should be remembered that : il faut se souvenir que remind (to) vb. / rI"maInd / remind sb. of sth. : rappeler qqch. à qqn, remind sb. that : rappeler à qqn que, to remind sb. to do sth. : rappeler (faire penser) à qqn de faire qqch., physicians are reminded that : il est rappelé aux médecins que remnant nom / "remn@nt / reste, débris, Méd. placental remnants : débris placentaire remote adj. / rI"m@Ut / éloigné, isolé, reculé, peu accessible, lointain (lieu) • à distance, remote control : télécommande, remote sensing : télédétection remotely adv. / rI"m@UtlI / à l’écart, à distance removal nom / rI"mu:vl / enlèvement, suppression, soulagement (douleur), Méd. ablation, hair removal : épilation remove (to) vb. / rI"mu:v / enlever, ôter, supprimer, Méd. enlever, procéder à l’ablation renew (to) vb. / rI"nju / renouveler, remplacer renowned adj. / rI"naUnd / renommé, célèbre, réputé, world-renowned : de renommée mondiale repair / rI"pe@(r) / 1 nom réparation 2 (to) vb. réparer repeat (to) vb. / rI"pi:t / répéter, renouveler, characterized by repeated occurrence of obsessive ideas : se caractérise par la fréquence des idées obsessionnelles repeatedly adv. / rI"pi:tIdlI / à de nombreuses/diverses/plusieurs reprises, souvent

361 report / rI"pO:t / 1 nom rapport, compte rendu, exposé • reportage 2 (to) vb. rendre compte de, établir un compte rendu, signaler, indiquer, notifier, at a reported cost of €7,000 : dont le coût s’élèverait à 7000 € • is reported to have an incident : aurait une incidence reportedly adv. / rI"pO:tIdlI / selon les informations disponibles reporting nom n.c. / %rI"pO:tIN / déclaration(s), notification(s), établissement d’un rapport, reporting verb : verbe déclaratif reproduce (to) vb. / %ri:pr@"dju:s / reproduire, se reproduire request / rI"kwest / 1 nom demande, requête 2 (to) vb. demander, students are requested to inform : il est demandé aux étudiants d’informer… require (to) vb. / rI"kwaI@(r) / exiger, nécessiter, demander • avoir besoin de, may require : peut avoir besoin de, peut nécessiter/exiger • + to : obliger à, imposer de required adj. / rI"kwaI@d / nécessaire, obligatoire • exigé, to be required to : devoir requirement nom / rI"kwaI@m@nt / condition (requise), norme, règle • besoin(s), nécessité, exigence research / rI"s3:tS, "ri:s3:tS / 1 nom n.c. recherche(s), travail/travaux de recherche, études, to do/conduct research : faire/effectuer des/de la recherche(s)/des travaux de recherche, research scientist/worker : chercheur 2 (to) vb. faire des recherche (on/ into : sur) • to research an article : faire des recherches/se documenter pour écrire/préparer un article • well researched alternative : une autre solution ayant fait l’objet de recherches très approfondies • best researched : ayant fait l’objet des recherches les plus complètes researcher nom / rI"s3:tS@(r), "ri:s3:tS@(r) / chercheur resistant ou –resistant adj. / rI"zIst@nt / resistant to penicillin : pénicillorésistant, insulinresistant : résistant à l’insuline, antibioticresistant : antibio-résistant resolve (to) vb. / rI"zQlv / résoudre, régler (problème), se résoudre, se décider, resolve to/that : décider de resort / rI"zO:t / 1 nom recours • health resort : station thermale/ climatique 2 (to) vb. + to : avoir recours à, recourir à

362 resource nom / rI"sO:s, -"zO:s / ressources, moyens, resources : ouvrages de référence, matériel didactique respect nom / rI"spekt / respect • in this respect : à cet égard, with respect to : pour/en ce qui concerne, quant à, without respect : sans tenir compte de respond (to) vb. / rI"spQnd / intervenir, réagir (to : à), répondre à (to : à • with : par), respond to the therapy : (bien) réagir au traitement, faire des progrès response nom / rI"spQns / réaction, réponse, riposte, intervention responsible adj. / rI"spQns@bl / responsable, consciencieux, sérieux, raisonnable, could be responsible for : pourrait être la cause de responsive adj. / rI"spQnsIv / réceptif, sensible à, coopératif, + to : attentif à, sensible à, responsive to the needs of patients : sensible aux besoins de malade, to be responsive to : réagir positivement face à, bien réagir devant, Méd. to be responsive to treatment : réagir au traitement rest / rest / 1 nom reste, the rest of us : nous autres, nous tous • repos bed rest : repos au lit 2 (to) vb. se reposer, laisser reposer • poser, appuyer restore (to) vb. / rI"stO:(r) / rendre, restituer, rétablir, restore to health : rétabli, guéri restricted adj. / rI"strIktId / limité, + to : réservé à, limité à result / rI"zVlt / 1 nom résultat(s), pl. results : conséquences, incidences, répercussions, effets, as a result : en conséquence, de ce fait, ainsi, donc, aussi, as a result of : à la suite de, en raison de, grâce à 2 (to) vb. résulter, + from : résulter de, découler de, + in : aboutir à, entraîner, provoquer, conduire à, occasionner, yellow fever always results in death : la fièvre jaune est toujours mortelle resume (to) vb. / rI"zju:m / reprendre (ce qui a été interrompu), recommencer, se remettre à, to resume work : reprendre le travail, retravailler resurgence nom / rI"s3:dZ@ns / résurgence, réapparition, reprise, recrudescence resuscitate (to) vb. / rI"sVsIteIt / Méd. réanimer resuscitation nom n.c. / rI%sVsI"teISn / Méd. réanimation retain (to) vb. / rI"teIn / garder, conserver, maintenir, retenir retardation nom n.c. / %ri:tA:"deISn / retard mental, arriération mentale

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

retarded adj. / rI"tA:dId / souffrant d’arriération, arriéré mental retinal adj. / "retIn@l / rétinien retired adj. / rI"taI@d / à la retraite return / rI"t3:n / 1 nom retour, renvoi 2 (to) vb. revenir, retourner, rentrer reveal (to) vb. / rI"vi:l / révéler, découvrir, mettre à jour revenue nom / "rev@nju: / rentrées, recettes reversal nom / rI"v3:sl / renversement, revirement, revers reverse (to) vb. / rI"v3:s / intervertir, inverser • supprimer, annuler review / rI"vju: / 1 nom examen, étude, compte rendu, analyse, critique, révision 2 (to) vb. examiner, étudier, analyser, réviser, critiquer revive (to) vb. / rI"vaIv / reprendre conscience, réanimer (malade), réactiver, relancer, rétablir reward / rI"wO:d / 1 nom récompense, avantages 2 (to) vb. récompenser, gratifier rib nom / rIb / Anat. côte, rib cage : cage thoracique rid (to) vb. / rId /, rid, rid ou ridded débarrasser, délivrer, to be rid of : être débarrassé de, to get rid of : se débarrasser de, éliminer rider nom / "raId@(r) / cavalier, cycliste right / raIt / 1 nom (le) bien, droit (de droit, avoir droit…), la droite, to have the right : avoir le droit, animal rights activists : défenseurs des droits des animaux, the rights of individuals : les droits des personnes 2 adj. bon, bien, souhaitable, juste, exact, approprié, adapté, it is right for : (c’)est bon pour 3 adv. tout droit, tout de suite, tout, bien (correctement), (à) droite ring / rIN / 1 nom anneau, rond, cercle 2 (to) vb. entourer d’un cercle, mettre un anneau rise / raIz / 1 nom hausse, augmentation, poussée, montée, progression, give rise to : entraîner, causer, provoquer occasionner 2 (to) rise, rose / r@Uz /, risen / "rIzn /, se lever, se mettre debout, s’élever, monter, croître, augmenter, être en hausse rising adj. / "raIzIN / en hausse, croissant, montant, ascendant, en augmentation

LEXIS risk / rIsk / 1 nom risque, at risk : vulnérable, menacé, en danger, exposé à 2 (to) vb. risquer (de), s’exposer aux risques de, courir le risque river nom / "rIv@(r) / rivière, fleuve, river blindness : cécité des rivières (onchocercose) road nom / r@Ud / route, chemin, road accident : accident de la route, de la circulation rock / rQk / 1 nom roche, roc, rocher 2 (to) vb. bercer, (se) balancer, chanceler, ébranler, secouer, to rock back and forth : se balancer d’avant en arrière rocket nom / "rQkIt / fusée, rocket fuel : propergol rod nom / rQd / baguette, tringle, tige rodent nom / "r@Udnt / rongeur, rodent tumor : ulcus rodens, rodent cancer : carcinome basocellulaire, cancer rongeur Roman adj. / "r@Um@n / romain, Roman times : époque romaine roof nom / ru:f / toit, plafond, thatched roof : toit de chaume room nom / ru:m / place, espace, pièce, chambre, bureau, salle, emergency room : service des urgences, salle d’urgence, dissecting room : salle de dissection root / ru:t / 1 nom racine, origine, cause 2 (to) vb. enraciner, s’enraciner, prendre racine roughly adv. / "rVflI / environ, approximativement, à peu près, essentiellement round / raUnd / 1 nom rond, cercle, tournée 2 adj. rond, arrondi… 3 adv. autour, en rond… 4 prép. autour de, environ, d'un bout à l'autre… routine adj. / ru:"ti:n / régulier, normal, ordinaire, habituel, routine screening : dépistage systématique routinely adv. / ru:"ti:nlI / régulièrement, normalement, couramment, ordinairement, habituellement, typiquement • automatiquement, she is routinely offered blood tests : des analyses de sang sont systématiquement offertes (à la femme enceinte) rubber / "rVb@(r) / 1 nom n.c. caoutchouc 2 adj. en caoutchouc, rubber boots : bottes en caoutchouc rubella nom n.c. / ru:"bel@ / rubéole

363 rule / ru:l / 1 nom autorité, pouvoir, règle(s), principe, réglementation • as a rule : en règle générale, en principe, normalement 2 (to) vb. diriger, gouverner, juger run / rVn / 1 nom course, tour, trajet, ruée, in the long/short run : à long/court terme 2 (to) vb. run, ran / r&n /, run, courir, se précipiter • couler (nez, yeux) • circuler • fonctionner, (faire) marcher • diriger, gérer, running or walking upstairs : monter les escaliers à une vitesse normale ou en courant • Inf. to run a search : effectuer une recherche • the Eustachian tube, running forward to a point… : la trompe d’Eustache, canal qui va de… à/qui relie… bedwetting runs in the family : l’énurésie est héréditaire • to run a fever/ a temperature : avoir de la fièvre rupture / "rVptS@(r) / 1 nom rupture, Méd. hernie, aneurysm rupture : rupture d’anévrisme, = hernia 2 (to) vb. Méd. to rupture oneself : se donner une hernie rush / rVS / 1 nom ruée, hâte, précipitation 2 adj. express, effectué à la hâte 3 (to) vb. se précipiter, se hâter, aller/faire à toute allure • she was rushed to hospital : elle a été transportée d’urgence à l’hôpital

S sad adj. / s&d / triste safe adj. / seIf / en sécurité, sûr, sans danger, non toxique, sans risque, safe water : eau saine, non polluée, propre à la consommation, safe drinking water : eau potable, safe motherhood : maternité sans risque, safe insecticide : insecticide non toxique safety nom n.c. / "seIftI / sécurité, innocuité (produit), Nucl. sûreté, safety regulations : règles de sécurité, safe benefactor : bienfaiteur dont on n’a rien à craindre sailor nom r / "seIl@(r) / marin, matelot sale nom / seIl / vente salt nom n.c. / sO:lt / sel, sodium chloride : chlorure de sodium same adj. pron. / seIm / même sample / "sA:mpl / 1 nom échantillon, spécimen, exemplaire • blood sample : échantillon de sang 2 adj. type, modèle 3 (to) vb. effectuer un prélèvement, faire l’expérience de, essayer

364 sampling nom n.c. / "sA:mplIN / prélèvement/collecte/prise d’échantillon(s) sandfly nom / "s&ndflaI / phlébotome SARS acron.

SARS Severe Acute Respiratory Syndrome :

SRAS Syndrome respiratoire aigu sévère sausage nom / "sQsIdZ / saucisse save (to) vb. / seIv / sauver, économiser, sauvegarder saving nom / "seIvIN / économie, savings : économies, épargne say (to) vb. / seI /, said / sed /, said dire, that is to say : c’est-à-dire scab nom / sk&b / croûte, escarre scale / skeIl / 1 nom barème, échelle (carte, chiffres : map, figures ), grille, niveau, échelon • ampleur, dimension, importance, on a global scale : à l’échelle mondiale • pl. scales : balance, pèsepersonne 2 (to) vb. + back/down : réduire • + up : augmenter scalp nom / sk&lp / cuir chevelu scan / sk&n / 1 nom Méd. examen (radiologique, échographique etc.), MRI scan : examen IRM, image IRM, PET scan(ning) : tomographie à émission de positions, ultrasound scan : échographie, examen échographique 2 (to) vb. examiner attentivement, parcourir • numériser, scanner, balayer (image) • Méd. procéder à un examen (radiologique, échographique etc.), soumettre (une partie du corps) à un examen (radiologique, échographique etc.) scanner nom / "sk&n@(r) / appareil d’imagerie médicale : CAT scanner : scanner à rayon X, MRI scanner : scanner IRM, PET scanner : tomographe à émission de positons, ultrasound scanner : échographe scanning adj. / "sk&nIN / numérisation, CT scanning : TDM (tomodensitométrie), scanographie, ultrasound scanning : échographie scar / skA:(r) / 1 nom cicatrice 2 (to) vb. scar, scarred, scarred, marquer d’une cicatrice, scarred : portant des traces de/marqué par • scarring : cicatrisation, tissu cicatriciel scarce adj. / ske@s / limité, rare, peu abondant, peu nombreux scarcely adv. / "ske@slI / à peine, scarcely anyone : presque personne, scarcely ever : presque jamais

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

scarlet / "skA:l@t / 1 nom rouge écarlate 2 adj. scarlet fever : scarlatine scatter / "sk&t@(r) / 1 nom habit. sing. dispersion, scatter chart/diagram : diagramme de dispersion 2 (to) vb. éparpiller, répandre, disperser, diffuser (lumière) scattered adj. / "sk&t@d / disséminé, éparpillé, dispersé, épars, sporadique, diffus (lumière) scholar nom / "skQl@(r) / savant, érudit, universitaire, expert, spécialiste scholarship nom / "skQl@SIp / n.c. érudition, savoir • travaux de recherche • comptable : bourse d’étude schwa nom / SwA: / e muet scientist nom / "saI@ntIst / scientifique, chercheur, savant scope nom n.c. / sk@Up / champ, domaine, portée, limites, perspectives score (to) vb. / skO:(r) / marquer, they scored higher on intelligence tests (than) : ils ont obtenu de meilleurs résultats aux tests d’intelligence (que) scream (to) vb. / skri:m / pousser un cri perçant, hurler screen / skri:n / 1 nom écran, mosquito screen : moustiquaire • antibody screen : recherche d’anticorps 2 (to) vb. masquer, cacher, protéger (ex. : par des moustiquaires) • sélectionner, trier, filtrer • examiner, soumettre à un contrôle (de sécurité) • + for : Méd. faire subir un examen de dépistage, dépister une maladie, rechercher (anticorps) screening nom / "skri:nIN / sélection, tri, examen, Méd. dépistage, screening test : test de dépistage, drug screening : dépistage des toxicomanies, ultrasound screening : examen échographique screwdriver nom / "skru:draIv@(r) / tournevis scrub / skrVb / 1 nom nettoyage à la brosse, brossage chirurgical 2 (to) vb. nettoyer à la brosse, + up : procéder à un brossage chirurgical seal / si:l / 1 nom sceau, cachet, fermeture hermétique 2 (to) vb. sceller, cacheter, coller, fermer (hermétiquement), souder, stagnant water sealed with oil : aspersion des eaux stagnantes avec du pétrole search / s3:tS / 1 nom habit. sing. recherches, fouille(s), in search of : à la recherche de, Web search :

LEXIS recherche sur internet 2 (to) vb. fouiller, examiner (+ for : pour trouver), search for sth. : chercher qqch., search for natural resources : recherche de ressources naturelles seat / si:t / 1 nom siège, fauteuil, place, Méd. foyer (infection) 2 (to) vb. faire asseoir, seated : assis sedate (to) vb. / sI"deIt / Méd. to sedate sb. : donner des sédatifs à qqn, mettre sous sédation seek (to) vb. / si:k /, sought / sO:t /, sought chercher, rechercher, être à la recherche, vouloir, solliciter, to seek medical advice : consulter un médecin, to seek care/treatment : se faire soigner seem (to) vb. / si:m / sembler, avoir l’air • it seems : il semble, il paraît, there seems to be : il semble qu’il y ait seizure nom / "si:Z@(r) / Méd. crise, attaque seldom adv. / "seld@m / rarement, peu souvent self nom / self / pl. selves / selvz / soi, sa propre personne, yourself : vous (-même/s), itself : il/elle (-même), self assessment/test : auto évaluation, self esteem : image positive de soi, estime de soi, self confidence : confiance en soi, assurance sell (to) vb. / sel /, sold / s@Uld /, sold vendre, se vendre semen nom n.c. / "si:m@n / sperme, semence send (to) vb. / send /, sent / sent /, sent envoyer, to send for the doctor : (faire) appeler/ envoyer chercher le médecin sense / sens / 1 nom sens, sensation, sentiment, conscience • sense organs : organes des sens • to regain one’s senses : reprendre connaissance • to make sense : avoir un sens, être logique 2 (to) vb. sentir (intuitivement), ressentir, pressentir • détecter (machine), remotely sensed : télédétecté sensible adj. / "sens@bl / raisonnable, intelligent, sensé, judicieux sensing nom n.c. / "sensIN / remote sensing : télédétection sensitive adj. / "sens@tIv / sensible (à : to ), light sensitive : sensible à la lumière sensitivity nom / %sens@"tIv@tI / tact, sensibilité, sensibilisation, sensitivity to a problem : sensibilisation au problème, Méd. réaction (allergique)

365 sensor nom / "sens@(r) / détecteur, capteur, palpeur separate 1 adj. / "sep@r@t / distinct, séparé, particulier 2 (to) vb. / "sep@reIt / séparer, se séparer, trier sepsis nom n.c. / "sepsIs / Méd. septicité, état septique septic adj. / "septIk / septique, infecté, to become/go septic : s'infecter, septic poisoning : septicémie, septic shock : choc septique series nom inv. / "sI@ri:z / série, (série de) chiffres, collection (publication), a series : une série serious adj. / "sI@rI@s / sérieux, approfondi, préoccupant, grave, important serve (to) vb. / s3:v / servir, desservir (transport, hôpital), the health service serves a population of 115,000 : le service de santé dessert une population de 115 000 habitants set / set / 1 nom ensemble, jeu, groupe, série, appareil : set of dentures : dentier • set of symptoms : tableau des symptômes 2 (to) vb. set, set, set, installer, mettre en place, régler, établir, set the charge : régler la charge, set a website : créer un site web, set a centre : mette en place un centre • set free : libérer • set a fracture : réduire une fracture, set a leg in plaster : plâtrer (une jambe) • + in : s’installer, apparaître, se déclarer (infection), + up : installer, mettre en place, créer, s’installer (médecin) settle (to) vb. / "setl / s’établir, s’installer, se fixer, + on : fixer son choix, se décider pour several adj. pron. / "sevr@l / plusieurs severe adj. / sI"vI@(r) / grave, sérieux, violent, rigoureux, douloureux, pénible, difficile, dramatique, important severely adv. / sI"vI@lI / gravement, sérieusement sewage nom n.c. / "su:IdZ / eaux usées, eaux d’égout sewer nom / "su:@(r) / égout, open sewers : égouts à ciel ouvert shade / SeId / 1 nom ombre • nuance, shades of green : nuances de vert 2 (to) vb. donner de l’ombre, ombrer, nuancer shape / SeIp / 1 nom forme, figure 2 (to) vb. façonner, former, formuler, déterminer

366 -shaped adj. / SeIpt / en forme de, bean shaped : en forme de haricot share / Se@(r) / 1 nom part, participation 2 (to) vb. partager, répartir, + in : participer à sharp adj. / SA:p / tranchant, net, marqué, important, considérable • brusque, soudain • intelligent (personne) • sharp decrease : forte baisse, sharp pain : vive douleur sheet nom / Si:t / drap, feuille, work sheet : fiche d’exercices shelter / "Selt@(r) / 1 nom abri, refuge : logement, hébergement, to give shelter : loger, héberger • to take shelter : se mettre à l’abri, s’abriter 2 (to) vb. abriter, protéger, se mettre à l’abri shield / Si:ld / 1 nom Nucl. bouclier 2 (to) vb. protéger (from : de, contre) shingles nom n.c. / "SINglz / zona, to have shingles : avoir un zona shiver / "SIv@(r) / 1 nom frisson 2 (to) vb. frissonner, trembler short adj. / SO:t / court, bref, to be short of breath : être essoufflé shortage nom / "SO:tIdZ / manque, pénurie, déficit shorten (to) vb. / "SO:tn / raccourcir, écourter, abréger, réduire shoulder / "S@Uld@(r) / 1 nom Anat. épaule 2 (to) vb. charger (sur son épaule), endosser, assumer (responsabilités), prendre à sa charge/en charge (dépenses) show / S@U / 1 nom spectacle, manifestation, témoignage (affection) 2 (to) vb. show, showed / S@Ud /, shown / S@Un /, montrer, indiquer, présenter, manifester, faire apparaître shower / "SaU@(r) / 1 nom averse, douche 2 (to) vb. doucher, se doucher, prendre une douche • faire pleuvoir (cadeaux, coups, injures) shrewd adj. / Sru:d / habile, astucieux, perspicace shrink (to) vb. / SrINk /, shrank / Sr&Nk /, shrunk / SrVNk / (se) rétrécir, (se) réduire, se contracter, diminuer, rapetisser shroud / SraUd / 1 nom linceul 2 (to) vb. envelopper d’un linceul, shrouded in mystery : enveloppé de mystère shrub nom / SrVb / arbuste, arbrisseau

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

shunt (to) vb. / SVnt / aiguiller, dériver, détourner, Méd. court-circuiter sibling nom / "sIblIN / frère ou sœur, membre de la fratrie, siblings : frères et soeurs sick / sIk / 1 nom pl. the sick : les malades 2 adj. malade, to fall sick : tomber malade, to be sick : être malade, vomir, to make sick : rendre malade • sick leave : congé maladie sickness nom / "sIknIs / maladie, bouts of sickness : vomissements, sickness benefit : indemnité de maladie side / saId / 1 nom côté, aspect, bord, on the left-hand side : à gauche, side effect : effet secondaire 2 (to) vb. + with : prendre parti pour (qqn), + against : prendre parti contre (qqn) sided adj. / saIdId / four–sided : à quatre côtés sight nom / saIt / vue, vision, spectacle sighted adj. / "saItId / qui voit • farsighted : (US) presbyte • prévoyant (qui voit loin), farsightedness : (US) presbytie • prévoyance, shortsighted : myope • imprévoyant, shortsightedness : myopie • imprévoyance signal / "sIgnl / 1 nom signal, warning signal : signal d’alarme 2 (to) vb. signaler, faire signe, donner le signal • manifester, annoncer, indiquer, signalling conditions conducive to an epidemic : indiquant que les conditions d’apparition d’une épidémie (étaient réunies) significant adj. / sIg"nIfIk@nt / important, appréciable, fort, marqué, prononcé, substantiel, marquant, most significant : extrêmement important, a significant number : un bon nombre significantly adv. / sIg"nIfIk@ntlI / beaucoup, nettement similar adj. / "sImIl@(r) / analogue, similaire, semblable, du même type similarly / "sImIl@lI / de même, de manière/façon semblable since / sIns / 1 adv. depuis, she finished her medical studies

two years ago and has since been working in Edinburgh : elle a fini ses études médicales il y

a deux ans et depuis elle travaille à Edimbourg 2 prép. depuis, since then : depuis lors, since 2005 : depuis 2005, hunger strikes have existed since Roman times : les grèves de la faim existent depuis l’époque romaine • depuis que, since he’s changed diet : depuis qu’il a modifié son régime alimentaire 3 conj. puisque, étant donné que, since the bowel contains gas : étant

LEXIS donné que les intestins contiennent des gaz, since it increases the risk : puisque cela augmente le risque single / "sINgl / 1 adj. seul, unique, simple, pris isolément, à (lui) tout seul, célibataire • single-celled : unicellulaire, single blind trial : essai en simple aveugle, single figure : nombre inférieur à 10, single use : à usage unique 2 (to) vb. + out : distinguer, choisir, mentionner tout particulièrement, désigner, repérer sister nom / "sIst@(r) / sœur, nursing sister : infirmière chef site / saIt / 1 nom situation, emplacement, lieu, chantier, endroit, siège, localisation, site (Internet), on-site : surplace 2 (to) vb. implanter, établir size / saIz / 1 nom taille, grandeur, dimensions, ampleur, étendue, importance (numérique), volume 2 (to) vb. classer, trier selon la taille (la dimension etc.) • + up : juger, mesurer skill nom / skIl / qualification, aptitude, capacité, compétence, savoir-faire, habileté, adresse, technique, talent, life skills : compétences de bases, connaissances fondamentales, gestes de la vie quotidienne, skill building : développement des compétences skilled adj. / skIld / qualifié, compétent skim (to) vb. / skIm / écrémer, écumer • parcourir, survoler, lire en diagonale skin / skIn / 1 nom peau, revêtement 2 adj. de la peau, cutané, skin disease : maladie de la peau, skin patch : timbre transdermique skull nom / skVl / Anat. crâne slash / sl&S / 1 nom entaille, balafre 2 (to) vb. entailler, taillader, balafrer • tailler/sabrer/couper dans (les dépenses, le budget), amputer le budget sleep / sli:p / 1 nom n.c. ou sing. sommeil, sleep deprivation : privation de sommeil 2 (to) vb. sleep, slept / slept /, slept, dormir, coucher, put to sleep : anesthésier, euthanasier (un animal) • avoir un effet soporifique • to sleep over : passer la nuit sleepy adj. / "sli:pI / qui a sommeil, endormi, somnolent slide / slaId / 1 nom glissade, glissement, baisse, chute • diapositive, slide show : diaporama 2 (to) vb. slide, slid / slId /, slid, glisser, faire des glissades, se glisser, faire glisser

367 slight adj. / slaIt / petit, léger, mince, menu, insignifiant • the slightest : le/la moindre slightly adv. / "slaItlI / légèrement, un peu slit / slIt / 1 nom fente, incision, entaille 2 (to) vb. fendre, inciser, to slit one’s wrists : s’ouvrir les veines, slit-skin smear : frottis cutané slope / sl@Up / 1 nom pente, inclinaison, versant, to be sloped : être en pente/incliné, steep slope : pente raide 2 (to) vb. incliner, pencher slough / slaU / 1 nom Méd. escarre 2 (to) vb. when scabs slough off : lorsque les escarres tombent/se détachent slow / sl@U / 1 adj. lent, slow release (médicament) : retard, à libération lente, slow speed : petite vitesse 2 (to) vb. + up/down : ralentir small adj. / smO:l / petit, peu nombreux, réduit, mince, léger, peu important, small child : jeune enfant, small scale : petite échelle, faible envergure, small intestine : intestin grêle smallpox nom n.c. / "smO:lpQks / variole smart adj. / smA:t / intelligent, astucieux, avisé, malin, élégant, chic, smart card : carte à puce smear nom / smI@(r) / Méd. frottis, smear test : examen de frottis smell / smel / 1 nom odorat, odeur, offensive smell : odeur repoussante 2 (to) vb. smell, smelled / smeld / ou smelt / smelt /, sentir, renifler, flairer smoke / sm@Uk / 1 nom n.c. fumée, smoke-free : non-fumeurs 2 (to) vb. fumer smoker nom / "sm@Uk@(r) / fumeur smoking nom n.c. / "sm@UkIN / tabagisme smooth / smu:D / 1 adj. lisse, dont la surface est douce, patiné • sans heurts, en douceur, aisé, facile, bien organisé 2 (to) vb. lisser, défroisser, faciliter, + out : lisser, aplanir smoothly adv. / "smu:DlI / en douceur, sans difficulté, sans heurts, sans encombre, running smoothly : bien fonctionner snail nom / sneIl / escargot

368 sneeze / sni:z / 1 nom éternuement 2 (to) vb. éternuer sniff / snIf / 1 nom reniflement 2 (to) vb. renifler, flairer, sentir l’odeur de, humer sniffer dog / "snIf@dQg / nom chien renifleur, chien de détection soap / s@Up / 1 nom savon 2 (to) vb. + down : savonner soapy adj. / "s@UpI / savonneux, soapy water : eau savonneuse soft adj. / sQft / mou • doux, tendre, indulgent • laxiste • intangible • immatériel, soft skills : compétences relationnelles, Méd. soft tissues : tissus mous software nom n.c. / "sQftwe@(r) / Inf. logiciel, un logiciel : a piece of software, a

software program ou package

soil nom / sOIl / sol, terre, soil-transmitted : transmis par le sol solid adj. / "sQlId / solide, plein, ferme, massif, concret, compact • continu, interrompu • consistant, sérieux, solid evidence : preuve(s) tangible(s)/concrète(s), données probantes, solid line : ligne continue, solid rocket fuel : combustible (propergol) solide solve (to) vb. / sQlv / résoudre, élucider, trouver la solution somehow adv. / "sVmhaU / d’une manière ou d’une autre, tant bien que mal, d’une certaine manière, sans que l’on sache comment someone pron. / "sVmwVn / quelqu’un something pron. / "sVmTIN / quelque chose sometimes adv. / "sVmtaImz / quelque fois, parfois soon adv. / su:n / prochainement, bientôt, rapidement, as soon as possible (ASAP) : dès que possible, aussitôt que possible, au plus vite sore / sO:(r) / 1 nom plaie, pressure sore : escarre 2 adj. douloureux, to have a sore ear : avoir mal à l’oreille sought / sO:t / (voir seek ) sound adj. / saUnd / en bonne santé, bien portant, solide, sain • de qualité • sérieux, sensé • sound knowledge : solides connaissances soy (a) (bean) nom / "sOI%bi:n / soja

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

spa nom / spA: / station thermale, health spa : établissement de cure, centre de remise en forme/de soins et de repos (de Spa, ville thermale belge ) space / speIs / 1 nom espace, place, emplacement, space age : ère spatiale 2 (to) vb. + out : espacer, échelonner span / sp&n / 1 nom envergure (d’avion), portée, travée (de pont), espace de temps, durée, période • lifespan : durée/espérance de vie, time-span : période (de temps) 2 (to) vb. enjamber, jeter, construire un pont sur • s’étendre sur (une période), durer • englober, porter sur l’ensemble d’un domaine spark / spA:k / 1 nom étincelle 2 (to) vb. jeter des étincelles, éveiller, + off : déclencher, provoquer, susciter speaker nom / "spi:k@(r) / orateur, intervenant, conférencier • locuteur, personne s’exprimant en (anglais, français etc.) speaking adj / "spi:kIN / English speaking countries : pays anglophones, French speaking countries : pays francophones species nom inv. / "spi:Si:z / Biol. espèce, Bot. essence, a species : une espèce specific adj. / sp@"sIfIk / précis, particulier, explicite, propre, sélectif • certain specifically adv. / sp@"sIfIklI / en particulier, particulièrement, more specifically : en particulier, plus particulièrement specimen nom / "spesIm@n / spécimen, échantillon (sang) SPECT acron.

SPECT, single photon emission computerized tomography : tomographie à émission mono-

photonique, TEMP speech nom n.c. / spi:tS / parole, langage, articulation, élocution, speech disorder : trouble de la parole, speech impairment : défaut de prononciation • comptable speeches : discours speed / spi:d / 1 nom vitesse, rapidité 2 (to) vb. speed, sped / sped / ou speeded, aller à vive allure, conduire trop vite, + up : aller plus vite, faire aller plus vite, accélérer, activer spell (to) vb. / spel /, spelt / spelt / ou spelled écrire, orthographier, épeler • signifier, se traduire par • + out : détailler, donner des précisions, préciser, expliquer spelling nom / "spelIN / orthographe spend (to) vb. / spend /, spent / spent /, spent dépenser, passer/consacrer (du temps)

LEXIS spicy adj. / "spaIsI / épicé spinal adj. / "spaInl / à/de la colonne vertébrale, spinal column : colonne vertébrale, rachis, spinal cord : moelle épinière, spinal fluid : liquide rachidien spine nom / spaIn / Anat. colonne vertébrale, épine dorsale spin-off / "spInQf / 1 nom dérivé, retombées, produit, sous-produit 2 adj. indirect, dérivé spirit nom / "spIrIt / esprit, état d’esprit, humeur, mentalité, énergie, dynamisme, enthousiasme, courage spite / spaIt / 1 nom n.c. rancune, dépit, in spite of : malgré, en dépit de 2 (to) vb. vexer, contrarier spleen nom / spli:n / Anat. rate splint nom / splInt / Méd. attelle, leg splint : attelle/éclisse de jambe split / splIt / 1 nom fente, déchirure • part, répartition • scission, séparation 2 (to) vb. split, split, split, (se) couper, (se) scinder, (se) séparer, (se) diviser, (se) répartir (en), (se) partager sponsor / "spQns@(r) / 1 nom mécène, bailleur de fonds, donateur, promoteur, organisme de parrainage 2 (to) vb. parrainer, financer, subventionner, organiser (conférence), soutenir spot / spQt / 1 nom lieu, endroit, on the spot : sur place, sur le champ, Anat. blind spot : tache aveugle, Méd. scotome 2 (to) vb. repérer, déceler détecter spray / spreI / 1 nom pluie de gouttelettes, pulvérisation • aérosol, pulvérisateur, vaporisateur, nébuliseur, nasal spray : vaporisateur nasal 2 (to) vb. pulvériser, faire des pulvérisations, vaporiser spread / spred / 1 nom n.c. ou habit. sing. extension, développement, diffusion, propagation, progression, prolifération • éventail, écart, geographical spread : répartition géographique, spread of cholera : propagation du cholera 2 (to) vb. spread, spread, spread, déployer (ailes, oiseau) • diffuser, (se) répandre, (se) propager • répartir • yellow fever is spread by… : la fièvre jaune se propage par… spring nom / sprIN / printemps

369 sputum nom / "spju:t@m / pl. sputa / "spju:t@ / crachat, expectorations squamous adj. / "skweIm@s / squameux, squamous cell carcinoma : épithélioma spinocellulaire square / skwe@(r) / 1 nom carré, carreau, place (ville) 2 adj. carré, droit, square corner : angle droit, square root : racine carrée stab / st&b / 1 nom coup de poignard, de couteau etc., stabwound : (blessure provoquée par un) coup de poignard, couteau etc. 2 (to) vb. tuer d’un coup de couteau etc., blesser d’un coup/à coups de couteau, etc. stabbing / "st&bIN / 1 nom agression (à coup(s) de couteau, etc.) 2 adj. stabbing pain : douleur lancinante staff / stA:f / 1 nom habit. sing. ou n.c. personnel, membres de personnel (employés, travailleurs, salariés, ouvriers etc.), hospitals have counselors on the staff : des conseillers travaillent à l’hôpital/ l’hôpital emploie…, staff numbers : effectifs, theatre staff : le personnel de salle d’opération, health care staff : personnel soignant 2 adj. du personnel, permanent, staff nurse : infirmier/ère (permanent/e) 3 (to) vb. pourvoir/doter en personnel/main d’oeuvre, affecter/fournir du personnel/de la main d’œuvre, travailler à, être en service/en poste, the ward was staffed by midwives : le personnel de la salle/du service se composait de sages-femmes, staffed with : employant, où travaillent staffing nom n.c. / "stA:fIN / effectifs, dotation en personnel, disponibilité/ remplacement du personnel, composition du personnel, staffing rules : règles de nomination, staffing authorization : autorisation de recrutement stage / steIdZ / 1 nom scène, estrade • étape, phase, stade, échelon, at an early stage/in the early stages : au début, vers le début, tôt, at this stage : à ce stade, in stages/by stages : par étape 2 (to) vb. monter, organiser, mener, mettre sur pied, to stage a strike : faire grève stain / steIn / 1 nom tache, colorant, teinture 2 (to) vb. tacher, entacher, ternir • teinter, colorer, stained with blood/blood stained : taché de sang, stained with dyes : teinté à l’aide de colorants, stained with carbofuchsin : coloration par la fuchsine phéniquée stainless adj. / "steInlIs / sans tache, pur, stainless steel : acier inoxydable

370 stand / st&nd / 1 nom position • étalage, kiosque, tribune, support (objet) 2 (to) vb. stand, stood / stUd /, stood, être/se tenir/rester debout, se lever • reposer (sur), se situer, se trouver • supporter, tolérer, the patient was unable to stand : le malade ne pouvait plus (se) tenir debout stapes nom / "steIpi:z / pl. stapes ou stapedes / st&"pi:di:z / Anat. étrier, un des trois osselets (ossicles ) de l’oreille moyenne = stirrup bone staph nom adj. / st&f / abrév. de Staphylococcus aureus (bacteria) : (bactérie) staphylocoque doré ou de staphylococcal : à staphylocoque, staphylococcique, staph infections : infections à staphylocoque star / stA:(r) / 1 nom étoile, astérisque, vedette 2 (to) vb. star, starred, starred, étoiler, être la vedette start (to) vb. / stA:t / 1 nom commencement, début, départ, at the start : au début, to make a start : commencer 2 (to) vb. commencer, lancer, entamer, mettre en route, débuter, démarrer starvation nom n.c. / %stA:"veISn / famine, privation de nourriture, inanition state / steIt / 1 nom état (de santé), État (United-States ), state benefits : prestations sociales, state registered nurse : infirm/ier/ère diplômé(e) 2 (to) vb. déclarer, assurer, affirmer, préciser, indiquer, énoncer, declaration which states : une déclaration selon laquelle (aux termes de laquelle), the report states : le rapport indique statement nom / "steItm@nt / déclaration, discours, affirmation, assertions • observation, formulation, énoncé • relevé (bancaire), scientific statement : énoncé scientifique, policy statement : déclaration de principe, prise de position status nom / "steIt@s / pl. statuses statut, situation, position, état, prestige, rang/ statut social • neuropsychiatric status : état neuropsychiatrique stay / steI / 1 nom séjour, a stay in hospital : un séjour à l’hôpital 2 (to) vb. rester, séjourner, loger STD acron. STD, sexually transmitted diseases : MST, maladie sexuellement transmissible steadily / "stedIlI / régulièrement, sans interruption, is steadily increasing, improving : augmente/s’améliore de manière régulière, fell steadily : a régulièrement diminué

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

steady / "stedI / 1 adj. constant, continu, permanent, stable, durable 2 (to) vb. steady drop/rise : baisse/augmentation constante, stabiliser, maintenir steel nom n.c. / sti:l / acier steep adj. / sti:p / raide, escarpé, abrupt • rapide, brutal, important, considérable, fort, élevé, steep rise : forte hausse stem / stem / 1 nom Biol. tige (plante), Biol. stem cell : cellule souche 2 (to) vb. contenir, endiguer, enrayer, juguler (maladie) • to stem from : résulter de, être dû à, découler de, provenir de, most injuries stem from car accidents : la plupart des blessures sont dues à des accidents de la route stent nom / stent / Méd. endoprothèse (vasculaire) step / step / 1 nom pas, marche (escalier), échelon • démarche, mesure • étape, phase, stade, the first step is : la première mesure à prendre/chose à faire est, the next step : l’étape suivante, to take steps : prendre des mesures 2 (to) vb. + on : marcher sur, + off : descendre de, quitter, + in : entrer, intervenir, + up : augmenter sticky adj. / "stIkI / adhésif, collant, visqueux, the mucous will become sticky : le mucus devient alors visqueux stiff adj. / stIf / rigide, raide, courbaturé, to have a stiff back : avoir des courbatures, stiff neck : torticolis stiffness nom n.c. / "stIfnIs / raideur, ankylose, joint stiffness : raideur des articulations stigma nom / "stIgm@ / pl. stigmas caractère honteux, infamant (attribué à qqn), déshonneur, honte, réprobation/condamnation sociale • préjugés, stigma attached to mental disorders : le caractère de maladies honteuses attribué aux troubles mentaux, les troubles mentaux, considérés comme des maladies honteuses, Méd. stigmate still adv. / stIl / encore, toujours • quand même, tout de même, students are still not sure : les étudiants ne sont toujours pas sûrs • doping is still widespread : le dopage est toujours répandu, is still being used : est encore utilisé, it is still essential : c’est encore (toujours) essentiel stimulus nom / "stImjUl@s / pl. stimuli / "stImjUlaI / stimulus, stimulant, incitation, encouragement, motivation stirrup nom / "stIr@p / Anat. stirrup bone : étrier, un des trois osselets (ossicles ) de l’oreille moyenne , PNA Stapes

LEXIS stocking nom / "stQkIN / bas, thrombo-embolic deterrent stocking : bas ATE, anti thrombo-embolique (bas de contention) stomach nom / "stVm@k / estomac, stomach trouble : ennuis gastriques stone / st@Un / 1 nom pierre, caillou, galet, noyau (fruit), Méd. calcul, kidney stone : calcul rénal, gall stone : calcul biliaire 2 (to) vb. jeter des pierres sur • dénoyauter stool nom / stu:l / selles (matières fécales) stop (to) vb. / stQp / arrêter, s’arrêter, cesser, faire cesser, empêcher, the patient may stop smoking : le patient s’arrêtera peut être de fumer store / stO:(r) / 1 nom provision, réserve, stock, magasin, commerce, lexical store : fonds lexical, department store : grand magasin 2 (to) vb. emmagasiner, noter, mettre en mémoire story nom / "stO:rI / récit, histoire straight adj. / streIt / droit, a straight line : une ligne droite straightforward / %streIt"fO:w@d / franc, simple, classique strain / streIn / 1 nom tension, effort, fatigue, Méd. entorse, foulure, eye strain : fatigue oculaire, Biol. souche (bactérie, virus), virus strain : souche virale 2 (to) vb. soumettre à un effort, exercer une pression, peser sur, to strain one’s back : se donner un tour de rein stranger nom / "streIndZ@(r) / inconnu, étranger strength nom habit. n.c. / streNT / force, puissance, robustesse, solidité, vigueur, fermeté, point fort, poids • effectif(s), strength training : entraînement musculaire strengthen (to) vb. / "streNTn / renforcer, consolider strep abrév. / strep / streptococcus : streptocoque stress / stres / 1 nom pression, tension, fardeau, charge, difficultés, stress • accent tonique, stress management : gestion du stress 2 (to) vb. souligner, mettre en évidence, insister sur, mettre l’accent sur, accentuer stressed adj. / strest / stressed syllables : syllabes accentuées

371 stretch / stretS / 1 nom étirement, partie • portion, étendue, période • stretch marks : vergetures 2 (to) vb. étirer, s’étirer • pousser au maximum, Méd. distendre (muscle) stretcher nom / "stretS@(r) / Méd. brancard, civière strike / straIk / 1 nom attaque, coup • découverte • grève, hunger strike : grève de la faim 2 (to) vb. strike, struck / strVk /, struck ou stricken / "strIk@n /, frapper, heurter • se produire, tomber sur, découvrir • faire grève, the region was struck by : la région a été touché par • children stricken with polio : enfants atteints de polio striker nom / "straIk@(r) / gréviste striking adj. / "straIkIN / frappant, remarquable, spectaculaire string nom / strIN / ficelle • suite, série, Inf. chaîne, search string : chaîne de recherche stroke nom / str@Uk / trait, coup, idée, Méd. accident vasculaire cérébral, attaque (cérébrale) strong adj. / strQN / fort, puissant, énergique, ferme, robuste, vigoureux, solide, bien développé • prononcé, marqué, net, strong toddler : jeune enfant vigoureux, strong relationship(s) : lien(s) étroit strongly adv. / "strQNlI / fortement, fermement, énergiquement, vivement, solidement… study / "stVdI / 1 nom étude, recherches • bureau • cross over study : essai croisé, studies were carried out : des études ont été menées 2 (to) vb. étudier, faire des études • observer, examiner subclavian adj. / sVb"kleIvi@n / Anat. sous-clavier subject 1 nom / "sVbdZIkt / question, sujet, objet (lettre) • matière, domaine discipline, Méd. sujet 2 adj. / "sVbdZIkt / + to : soumis à, susceptible de, concerné par, exposé à (maladie : disease ) • subject to : sous réserve de, à condition que, sauf 3 (to) vb. / s@b"dZekt /, + to : soumettre à, exposer à, sujet à (maladie), to be subjected to : faire l’objet de submit (to) vb. / s@b"mIt / soumettre, présenter, déposer (dossier) subsequent adj. / "sVbsIkw@nt / ultérieur, à venir, qui va suivre, + to : après

372 substandard adj. / %sVb"st&nd@d / de qualité inférieure, de mauvaise qualité, médiocre, non conforme aux normes substantial adj. / s@b"st&nSl / important, grand, marqué, sérieux, considérable, substantial loss of weight : importante perte de poids substantially adv. / s@b"st&nS@lI / considérablement, beaucoup, nettement, fondamentalement, en grand partie, sensiblement, essentiellement succeed (to) vb. / s@k"si:d / réussir (à : in ), être couronné de succès, aboutir such / sVtS / 1 adj. tel, pareil, such as : tel que, comme 2 adv. si, tellement, aussi 3 pron. ceux, celles, as such : à ce titre, en tant que tel(le)(s) suck (to) vb. / sVk / sucer, téter, baby sucking its mother’s breast : enfant qui tète le sein de sa mère sudden adj. / "sVdn / subit, soudain, imprévu, Méd. sudden infant death syndrome : (syndrome de la) mort subite du nourrisson suddenly adv. / "sVdnlI / soudain, tout à coup, subitement sue (to) vb. / su: / attaquer en justice, intenter/faire un procès à suffer (to) vb. / "sVf@(r) / subir, souffrir, + from : souffrir de sufferer nom / "sVf@r@(r) / malade, victime, accidenté, arthritis/diabetes/ asthma… sufferer : arthritique, diabétique, asthmatique… suffering / "sVf@rIN / 1 nom n.c. souffrance(s) 2 adj. souffrant, qui souffre sugar / "SUg@(r) / 1 nom sucre, blood sugar : sucre dans le sang, sugar diabetes : diabète sucré 2 (to) vb. sucrer suggest (to) vb. / s@"dZest / avancer, affirmer, laisser entendre, proposer, suggérer, laisser entrevoir, permettre de penser, sembler indiquer, recent research suggest that : des recherches récentes semblent indiquer que suicidal adj. / %su:I"saIdl / suicidaire suit (to) vb. / su:t / convenir à • adapter à, suited to the demands of investigation : adapté aux exigences de l’enquête suitable adj. / "su:t@bl / approprié (à : for ), convenable, qui convient, apte, adéquat, adapté, to be suitable : convenir, suitable for human consumption : propre à la

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

consommation humaine, suitable person : personne indiquée/compétente/qualifiée summarize (to) vb. / "sVm@raIz / résumer, récapituler summary nom / "sVm@rI / résumé, abrégé, synthèse summer / "sVm@(r) / 1 nom été 2 (to) vb. passer l’été sun / sVn / 1 nom soleil 2 (to) vb. prendre le soleil sunburn nom / "sVn%b3:n / coup de soleil sunlight nom n.c. / "sVnlaIt / lumière du soleil supine adj. / "su:paIn / in a supine position : allongé sur le dos supplements nom pl. / "sVplIm@nts / suppléments alimentaires supply / s@"plaI / 1 nom provisions, réserves, stock, approvisionnement, matériel, fournitures, water supply : approvisionnement/alimentation en eau, blood supply : irrigation sanguine, apport sanguin, flux sanguin • stocks de sang, it impairs the blood supply in the testicles : (cela) réduit l’irrigation sanguine des testicules 2 (to) vb. fournir, procurer, approvisionner, ravitailler, alimenter en (électricité…), to supply sb. with sth. : fournir/ approvisionner qqn en qqch., fournir/procurer qqch. à qqn support / s@"pO:t / 1 nom n.c. soutien, appui, aide, assistance 2 adj. d’accompagnement, d’appui 3 (to) vb. subvenir aux besoins de, subventionner, financer, soutenir, appuyer, aider, assister, favoriser, faciliter, contribuer à, soutenir, apporter son soutien, être favorable à, corroborer, étayer, accompagner, NICHD supported research : recherches financées par NICHD • we issued a statement supporting the use of the vaccine : nous avons publié une déclaration dans laquelle nous avons exprimé notre soutien en faveur du vaccin supporting adj. / s@"pO:tIN / complémentaire, connexe • personnel d’exécution, supporting document : pièce justificative suppose (to) vb. / s@"p@Uz / supposer, croire, penser supposed adj. / s@"p@Uzd / censé supposing conj. / s@"p@UzIN / à supposer que, en admettant que suppress (to) vb. / s@"pres / supprimer, réprimer, interdire, faire disparaître

LEXIS surge / s3:dZ / 1 nom mouvement puissant, vague, forte augmentation, poussée, flambée, montée 2 (to) vb. (s’) enfler, déferler • augmenter considérablement, faire un bond surgeon nom / "s3:dZ@n / chirurgien, she’s a surgeon : elle est chirurgienne surgery nom / "s3:dZ@rI / chirurgie, intervention chirurgicale, opération • cabinet (médecin, dentiste), consultation (médecin, dentiste), surgery hours : heures de consultation surprise / s@"praIz / 1 nom surprise, étonnement 2 adj. inattendu, inopiné, par surprise 3 (to) vb. surprendre, étonner surprisingly adv. / s@"praIzINlI / étonnamment, étrangement surround (to) vb. / s@"raUnd / (s’)entourer, cerner, environner, (être) autour de survey 1 nom / "s3:veI / enquête, étude, sondage, bilan, examen, rapport 2 (to) vb. / s@"veI / interroger, recenser, recueillir des données, examiner, étudier surveyor nom / s@"veI@(r) / géomètre survival nom / s@"vaIvl / survie, survival of the fittest : la lutte pour la vie, la loi du plus fort, la survie du plus apte survive (to) vb. / s@"vaIv / survivre (personne), subsister (objet), to survive sb. : survivre à qqn, réchapper de/à, he survived the accident : il a réchappé à l’accident • he is survived by a daughter : il laisse derrière lui une fille suspect 1 nom / "sVspekt / suspect, Méd. suspects : cas suspects 2 (to) vb. / s@"spekt / soupçonner, se douter de, it is suspected that aquatic insects may play a role : on pense que les insectes aquatiques pourraient jouer un rôle, a suspected case of : un cas présumé sustain (to) vb. / s@"steIn / maintenir, soutenir, poursuivre, pérenniser • subir (une perte), recevoir (une blessure) swallow (to) vb. / "swQl@U / avaler swamp / swQmp / 1 nom marais, marécage, swamp fever : paludisme 2 (to) vb. inonder, remplir d’eau, submerger sweat / swet / 1 nom n.c. ou sing. sueur, transpiration, humidité (murs) 2 (to) vb. être en sueur, transpirer sweating nom n.c. / swetIN / transpiration, suintement (murs), Méd. sudation Swedish adj. / "swi:dIS / suédois, de Suède (Sweden )

373 swell (to) vb. / swel /, swelled, sewelled ou swollen / "sw@Ul@n / (se) gonfler, enfler, grossir, augmenter swelling nom / swelIN / grosseur, bosse, enflure, gonflement, to reduce the swelling : faire désenfler swim (to) vb. / swIm /, swam/ sw&m /, swum / swVm / nager, se baigner swimming nom n.c. / "swImIN / nage, natation swing / swIN / 1 nom balancement, mouvement (de va-etvient), évolution, fluctuation, balançoire, mood swings : sautes d’humeur 2 (to) vb. swing, swung / swVN /, swung, (se) balancer, pivoter, basculer, faire basculer switch / swItS / 1 nom interrupteur, commutateur • changement, passage à, adoption de 2 (to) vb. changer de, passer (de : from… à : to ) sword nom / sO:d / épée sympathetic adj. / %sImp@"TetIk / compatissant, + to : compréhensif à l’égard de, favorable à, to be sympathetic to : compatir à, accueillir avec bienveillance/favorablement • the sympathetic nervous system : le système nerveux sympathique symptomless adj. / "sImpt@mles / dépourvu de symptômes, ne présentant aucun symptôme syringe nom / sI"rIndZ / seringue

T tablet nom / "t&blIt / Pharm. comprimé, cachet, pastille tail nom / teIl / queue (animal) tailed adj. / teIld / white tailed deer : cerf à queue blanche, cerf de virginie (odocoileus virginianus ) tailor / "teIl@(r) / 1 nom tailleur 2 (to) vb. façonner, adapter, tailler sur mesure tamp (to) vb. / t&mp / damer, tasser, to damp a drill hole : bourrer un trou de mine (argile ou sable, minage ) tamping adj. / t&mpIN / tamping iron : dame (outil de compactage) taper (to) vb. / "teIp@(r) / fuseler, tailler en pointe, effiler, s’effiler, être effilé, se terminer en pointe

374 tapered adj. / "teIp@d / fuselé, effilé, en pointe target / "tA:gIt / 1 nom cible, objectif 2 (to) vb. viser, cibler, prendre pour cible, attaquer, s’attaquer à, targeted at : destiné à, ciblé task nom / tA:sk / tâche taste / teIst / 1 nom goût, saveur, (sens du) goût 2 (to) vb. sentir (le goût), goûter teach (to) vb. / ti:tS /, taught / tO:t /, taught enseigner, apprendre à, to teach sb. sth., she teaches medical anthropology : elle enseigne l’anthropologie médicale (voir learn ) team / ti:m / 1 nom equipe 2 (to) vb. ou team up : mettre en collaboration, faire équipe, unir les efforts, s’associer, + with : faire équipe avec, collaborer avec, s’associer avec tedious adj. / "ti:dI@s / fastidieux, ennuyeux teenager nom / "ti:neIdZ@(r) / adolescent temple nom / "templ / Anat. tempe tend (to) vb. / tend / tendre à, to tend to do sth. : avoir tendance à tender adj. / "tend@(r) / Méd. douloureux, sensible au toucher/à la palpation tense nom / tens / temps grammatical term (to) vb. / t3:m / appeler, nommer test / test / 1 nom essai, test, épreuve, contrôle, vérification, analyse, Méd. analyse (de laboratoire), examen, blood/urine test : analyse de sang/d’urine, eye test : examen ophtalmologique, hearing test : examen de l’ouïe, a swab specimen was sent for tests : un prélèvement a été envoyé pour analyses 2 (to) vb. essayer, vérifier, contrôler, expérimenter, analyser, examiner, tester, they were tested for chlamydia : ils ont subi un test de dépistage de (l’infection à) chlamydia testing nom n.c. / "testIN / essai, analyse, expérimentation, examen, mesure, évaluation, test thanks nom pl. / T&Nks / remerciements, thanks to : grâce à thatched adj. / T&tSt / thatched roof : toit de chaume

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

then adv. / Den / alors, en ce temps-là, à l’époque • dès lors, ensuite, (et) puis therapy nom / "Ter@pI / traitement, thérapeutique, psychothérapie thereby adv. / De@"baI / ainsi, de cette façon, de ce fait, par ce moyen therefore conj. / "De@fO:(r) / par conséquent, pour cette raison, donc, aussi thick adj. / TIk / épais, gros, 2 cm thick : 2 cm d’épaisseur thicken (to) vb. / "TIk@n / épaissir, s’épaissir, grossir thickness nom / "TIknIs / épaisseur, grosseur thin / TIn / 1 adj. mince, maigre, fin, peu épais • léger, dispersé 2 (to) vb. délayer, s’éclaircir, se réduire think (to) vb. / TINk /, thought / TO:t /, thought réfléchir, penser (à : of ), croire, avoir l’idée, (s’)imaginer, I think therefore I am : je pense donc je suis • it is widely thought : on estime généralement • diseases once thought to be under control : maladies que l’on pensait jugulées third nom / T3:d / tiers, third world : tiers monde, third-line drugs : médicaments de troisième intention, third stage Lyme disease : troisième phase de la maladie de Lyme thorough adj. / "TVr@ / méthodique • complet, approfondi, détaillé, exhaustif, thorough health checkup : examen de santé approfondi thoroughly adv. / "TVr@lI / complètement, à fond, de manière approfondie/ exhaustive, totalement, tout à fait though / D@U / 1 adv. pourtant, cependant 2 conj. bien que, quoique, malgré, mais • even though : bien que, malgré, même si • as though : comme si • it looks as though : il semble que thought nom / TO:t / pensée, réflexion, rêverie • idée, opinion, avis threat nom / Tret / menace, health threat : menace pour la santé threaten (to) vb. / "Tretn / menacer threatening adj. / "TretnIN / menaçant, life-threatening : mettant en danger la vie/les jours du patient, mettant en jeu le pronostic vital, qui peut être/potentiellement mortel

LEXIS threshold nom / "TreS@Uld / seuil, pain, threshold level : seuil de tolérance à la douleur, on the threshold of : au bord de thrive (to) vb. / TraIv /, throve / Tr@Uv / ou thrived, thriven / TrIvn / ou thrived bien se développer (nourrisson : infant ), être florissant/prospère, prospérer throat nom / Tr@Ut / gorge, to have a sore throat : avoir mal à la gorge, avoir une angine, ear, nose and throat (ENT) : oto-rhino-laryngologie (ORL) through / Tru: / 1 prép. à travers, par, par l’intermédiaire de, grâce à, au moyen de, à l’aide de 2 adv. à travers, par, jusqu’au bout (jusqu’à ce que cela soit fini), check/read through : lire jusqu’au bout, vérifier entièrement throughout / Tru:"aUt / 1 prép. partout dans, dans tout/e, pendant tout/e, throughout Europe : partout en Europe, throughout the 1950s : pendant toutes les années 50 2 adv. partout, tout le temps, de bout en bout, du début à la fin thumb nom / TVm / Anat. pouce thus adv. / DVs / ainsi, de cette manière, par conséquent, donc tick nom / tIk / tique (parasite) till abrév. / tIl / = until, from then till now : (d’)autrefois et (jusqu’à) maintenant timeless adj. / "taImlIs / intemporel, éternel timing nom n.c. / "taImIN / choix du bon moment, minutage, timing device : minuteur tingle / "tINgl / 1 nom picotement, fourmillement 2 (to) vb. picoter, fourmiller, piquer tingling adj. / "tINglIN / qui donne une impression de picotement, de fourmillement, to have tingling fingers : avoir des picotements/des fourmillements/des fourmis dans les doigts tiny adj. / "taInI / minuscule, très petit tip nom / tIp / bout, pointe, extrémité tired adj. / "taI@d / fatigué tiredness nom n.c. / "taI@dnIs / fatigue titanium nom n.c. / tI"teInI@m / titane

375 title nom / "taItl / titre toddler nom / "tQdl@(r) / enfant qui commence à marcher, tout petit together adv. / t@"geD@(r) / ensemble, simultanément, together with : avec tongue nom / tVN / Anat. langue, tongue-tie : frein de langue (trop court), ankyloglossie, tongue depressor : abaisse-langue tonsil nom / "tQnsl / Anat. amygdale, to have one’s tonsils removed : être opéré des amygdales tonsillectomy nom / %tQnsI"lekt@mI / amygdalectomie tonsillitis nom n.c. / %tQnsI"laItIs / angine, amygdalite tool nom / tu:l / outil, instrument tooth nom / tu:T / pl. teeth / ti:T / Dent. tooth decay : carie dentaire, the child is cutting her teeth : elle fait ses dents toothache nom / "tu:TeIk / mal aux dents, rage de dents, to have a toothache : avoir mal aux dents top / tQp / 1 nom tête, haut, sommet 2 adj. le plus élevé/ important, de premier plan, principal, premier, de tête, top priority : priorité absolue 3 (to) vb. être en tête, surmonter, dépasser torso nom / "tO:s@U / Anat. torse touch / tVtS / 1 nom toucher, contact • petit détail 2 (to) vb. toucher (à) towards prép. / t@"wO:dz / vers, du côté de, en direction de • envers, à l’égard de towel nom / "taU@l / serviette (de toilette) track / tr&k / 1 nom sentier, voie, piste, trace, keep track of : suivre 2 (to) vb. suivre les mouvements/déplacements, localiser, repérer trade / treId / 1 nom commerce, échanges • profession, métier 2 (to) vb. commercer, échanger, négocier, avoir des activités commerciales train (to) vb. / treIn / former, entraîner, to train sb. : instruire • to be trained : recevoir une formation • to train : s’entraîner trained adj. / treInd / qualifié, diplômé

376 training nom n.c. / "treInIN / formation, apprentissage, instruction, entraînement, études, medical training : études de médecine transplant / tr&ns"plA:nt / 1 nom Méd. greffe 2 (to) vb. Méd. greffer transplantation nom n.c. / %tr&nsplA:n"teISn / transplantation, greffe, heart/kidney/liver transplantation : greffe cardiaque, rénale, hépatique transplanted adj. / tr&ns"plA:ntId / transplanté, greffé trap / tr&p / 1 nom piège 2 (to) vb. prendre au piège, bloquer travel / "tr&vl / 1 nom n.c. voyage(s), déplacement(s), international travel : les voyages internationaux 2 nom pl. voyages, périgrinations (temps passé à voyager, généralement pour le plaisir ) 3 (to) vb. travel, travelled (US traveled), voyager, se déplacer, circuler, parcourir traveller nom / "tr&vl@(r) / voyageur, tsigane (gens du voyage) travelling adj. / "tr&vlIN / de voyage • itinérant, ambulant treat (to) vb. / tri:t / traiter, examiner, Méd. traiter, soigner (qqn pour qqch. : sb. for sth.) treatment nom / "tri:tm@nt / Méd. traitement, soins tremor nom / "trem@(r) / Méd. tremblement, trémulation trend nom / trend / tendance, direction, évolution, orientation trial nom / "traI@l / procès • essai • épreuve • clinical trial : essai clinique, (by) trial and error : par tâtonnement, de façon empirique trigger (to) vb. / "trIg@(r) / déclencher, amorcer, provoquer, susciter trip nom / trIp / voyage, excursion • health tourism trips : voyages de/pour le/tourisme médical trouble / "trVbl / 1 nom n.c. ennuis, problème, difficultés • effort, peine • troubles, désordres 2 (to) vb. inquiéter, gêner, troubler • to be troubled by pain : avoir des douleurs • to be troubled with rheumatism : souffrir de rhumatisme(s) true adj. / tru: / vrai, véritable truth nom / tru:T / pl. truths / tru:Dz / vérité

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

try / traI / 1 nom pl. tries essai, tentative 2 (to) vb. juger • essayer, tenter, s’efforcer de tube nom / tju:b / tube feeding : alimentation par sonde turn / t3:n / 1 nom in turn : l’un après l’autre, tour à tour, successivement 2 (to) vb. tourner • devenir : to turn blue, red… : devenir bleu, rouge, bleuir, rougir… • + into : se transformer en : glucose is turned into fat : le glucose se transforme en graisse • + down : réfuser (offre) • baisser le volume • + up : to turn up the volume : augmenter le volume twelve nom pron. adj. inv. / twelv / douze twice adv. / twaIs / deux fois, twice daily : deux fois par jour, twice as much/as many : deux fois plus twin nom / twIn / jumeau/elle type nom / taIp / catégorie, type, Typ. caractères, police, bold type : caractères gras typically adv. / "tIpIklI / généralement, en règle générale, ordinairement

U UK initiales United Kingdom / ju:"naItId"kINd@m / Royaume-Uni unable adj. / Vn"eIbl / to be unable to do sth. : ne pas pouvoir/savoir faire qqch., être incapable de faire qqch. • être dans l’incapacité/l’impossibilité/ne pas être en mesure/de faire qqch. unacceptable adj. / %Vn@k"sept@bl / inacceptable, inadmissible, intolérable, unacceptable pain : douleur intolérable unaffected adj. / %Vn@"fektId / naturel, simple • non affecté par • non touchés par, to remain unaffected : rester indifférent, unaffected plans : plans inchangés unaltered adj. / Vn"O:lt@d / inchangé, non modifié, to leave unaltered : laisser tel quel, ne pas modifier unaware adj. / %Vn@"we@(r) / to be unaware of : ignorer qqch., ne pas être conscient/avoir conscience de • ignorer que, ne pas savoir que unborn adj. / Vn"bO:n / unborn child : enfant à naître/à venir, fœtus uncertainty nom / Vn"s3:tntI / incertitude, doutes

LEXIS unclear adj. / Vn"klI@(r) / peu clair, incertain, mal défini, flou, obscur, it is unclear whether : il est difficile de savoir si, de prouver que • it is unclear to me whether… : je ne sais pas vraiment pourquoi… • unclear answer, words : réponse, mots indistincts uncomfortable adj. / Vn"kVmft@bl / inconfortable (chaise), to feel uncomfortable : se sentir mal à l’aise, embarrassé, Méd. (symptômes) désagréable, pénible uncommon adj. / Vn"kQm@n / rare, peu commun, singulier, not uncommon : pas rare, assez fréquent uncomplicated adj. / Vn"kQmplIkeItId / sans complications unconscious adj. / Vn"kQnS@s / to be unconscious of : ne pas être conscient de, ne pas se rendre compte de, Méd. inconscient, sans connaissance, to become unconscious : perdre connaissance, Psych. the unconscious mind : l’inconscient unconsciousness nom n.c. / Vn"kQnS@snIs / Méd. perte de connaissance, évanouissement uncountable / Vn"kaUnt@bl / 1 nom Grammaire : nom non comptable, non dénombrable 2 adj. innombrable, incalculable • non comptable (nom) undeniably adj. / %VndI"naI@blI / incontestablement, indéniablement under / "Vnd@(r) / 1 prép. sous, dessous, au-dessous de, under the microscope : sous microscope • Droit : selon, suivant, d’après, aux termes de (law : législation) 2 adv. au-dessous, (en) dessous, under anaesthetic : sous anesthésie undercharge (to) vb. / %Vnd@"tSA:dZ / ne pas faire payer suffisamment, faire payer moins cher, sous-facturer undergo (to) vb. / %Vnd@"g@U /, underwent / %Vnd@"went /, undergone / %Vnd@" gQn / subir (examen médical, chirurgie : surgery ), suivre (traitement) underlying adj. / %Vnd@"laIIN / sous-jacent, profond/de fond undermine (to) vb. / %Vnd@"maIn / saper, ébranler, miner, amoindrir, affaiblir, attaquer underneath / %Vnd@"ni:T / 1 nom sing. dessous 2 adj. d’en dessous 3 adv. (en) dessous de 4 prép sous, au-dessous de undernourish (to) vb. / %Vnd@"nVrIS / sous-alimenté undernourished adj. / %Vnd@"nVrISt / en état de malnutrition

377 undernourishment nom n.c. / %Vnd@"nVrISm@nt / sous-alimentation underside nom / "Vnd@saId / dessous, partie inférieure understaffed adj. / %Vnd@"stA:ft / manquant d’effectifs, disposant d’effectifs insuffisants to be understaffed : manquer de personnel, être en sous-effectif understaffing nom n.c. / %Vnd@"stA:fIN / insuffisance des effectifs understandably adv. / %Vnd@"st&nd@blI / bien entendu, naturellement understanding nom n.c. / %Vnd@"st&ndIN / compréhension undertake (to) vb. / %Vnd@"teIk /, undertook / %Vnd@"tUk /, undertaken / %Vnd@"teIk@n / entreprendre, se charge de underused adj. / %Vnd@"ju:zd / sous-exploité, sous-utilisé, sous employé underway adj. / %Vnd@"weI / en cours, engagé, to be underway : être en cours underweight adj. / %Vnd@"weIt / to be underweight : ne pas peser assez, être trop maigre, être en dessous de son poids normal, avoir un poids insuffisant undiagnosed adj. / Vn"daI@gn@Uzd / non diagnostiqué undulant adj. / "VndjUleIt / ondoyant, onduleux, sinueux unemployed adj. / %VnIm"plOId / au chômage, sans travail, sans emploi (personne), inutilisé (objet) uneven adj. / Vn"i:vn / inégal, irrégulier, inégalement réparti, uneven rate, breathing, pulse : rythme, respiration, pouls irrégulier unevenly adv. / Vn"i:vnlI / de manière irrégulière, inégalement uneventful adj. / %VnI"ventfl / sans histoire, sans incidents, calme, tranquille, peu mouvementé unexpected adj. / %VnIk"spektId / inattendu, imprévu, soudain, surgissant à l’improviste unexplored adj. / %VnIk"splO:d / inexploré, medical tourism has so far been relatively unexplored : (les possibilités offertes par) le tourisme médical ont jusqu’ici été relativement peu étudiées unfair adj. / Vn"fe@(r) / injuste (+ to : envers, à l’égard de), inéquitable, déloyal, abusif, injustifié, inégal

378 unfairly adv. / Vn"fe@lI / injustement, déloyalement, abusivement unfortunate adj. / Vn"fO:tS@n@t / malheureux, regrettable, fâcheux, malencontreux unfortunately adv. / Vn"fO:tS@n@tlI / malheureusement, malencontreusement unhygienic adj. / %VnhaI"dZi:nIk / non hygiénique unidentified adj. / %VnaI"dentIfaId / non identifié unimportant adj. / %VnIm"pO:tnt / insignifiant, sans importance unknown adj. / Vn"n@Un / inconnu unless conj. / @n"les / à moins que, à moins de, unless otherwise stated : sauf indication contraire unlike / Vn"laIk / 1 adv. différent 2 prép. contrairement à, à la différence de unlikely adj. / Vn"laIklI / improbable, peu probable, peu plausible, douteux, surprenant unlimited adj. / Vn"lImItId / illimité, sans limites unmatched adj. / Vn"m&tSt / sans pareil, sans égal, incomparable, inégalé, sans équivalent, exceptionnel unnecessary adj. / Vn"nes@srI / inutile, superflu, to be unnecessary : ne pas être nécessaire UNO acron. / "ju:n@U / UNO, United Nations Organization : ONU, Organisation des Nations Unies unobtrusive adj. / %Vn@b"tru:sIv / discret unpleasant adj. / Vn"pleznt / désagréable unpredictable adj. / %VnprI"dIkt@bl / imprévisible, incertain unprotected adj. / %Vnpr@"tektId / sans défense, non protégé, sans protection, unprotected intercourse/sex : rapports sexuels non protégés unproven adj. / Vn"pru:vn / sans preuves, qui n’a pas encore fait ses preuves unqualified adj. / Vn"kwQlIfaId / non qualifié, non diplômé unquestionable adj. / Vn"kwestS@n@bl / incontestable, indiscutable

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

unquestionably adv. / Vn"kwestS@n@blI / incontestablement, indiscutablement unreal adj. / Vn"rI@l / irréel unrelated adj. / %VnrI"leItId / sans rapport, qui n’a aucun rapport/qui n‘a rien à voir (avec : to ) • sans lien de parenté unrelenting adj. / %VnrI"lentIN / incessant, continuel, unrelenting pain : douleur tenace unreliable adj. / %VnrI"laI@bl / peu fiable, peu sûr, incertain, sujet à caution, à prendre avec beaucoup de réserves unresponsive adj. / %VnrI"spQnsIv / to be unresponsive(to) : ne pas réagir à, ne pas répondre unsettle (to) vb. / Vn"setl / perturber, déranger, déstabiliser unstressed adj. / Vn"strest / inaccentué, non accentué (syllabe, voyelle) unsubstantiated adj. / %Vns@b"st&nSIeItId / sans fondement, non fondé, sans preuves, non confirmé unsuccessful adj. / %Vns@k"sesfl / manqué, infructueux, malheureux, to be unsuccessful : échouer, ne pas aboutir unsuccessfully adv. / %Vns@k"sesf@lI / sans succès until / @n"tIl / 1 prép. jusqu’à, jusqu’à ce que, en attendant que, avant que, until recently : jusqu’à une date récente 2 conj. jusqu’à ce que, avant que, en attendant que untreated adj. / Vn"tri:tId / Méd. non traité, non soigné untrue adj. / Vn"tru: / faux, it is untrue to say : il est faux de dire unusual adj. / Vn"ju:Zl / peu commun, inhabituel, étrange unusually adv. / Vn"ju:Z@lI / exceptionnellement, inhabituellement unwilling adj. / Vn"wIlIN / to be unwilling : être réticent, ne pas être disposé à • refuser de • non consentant unwillingness nom n.c. / Vn"wIlINnIs / unwillingnes to to sth. : répugnance/réticence à faire qqch. upper adj. / "Vp@(r) / supérieur, (du) haut, du dessus, upper chambers of the heart : les deux cavité supérieures du cœur (atria, auricles : oreillettes)

LEXIS upright / "VpraIt / 1 adj. droit, upright position : station verticale 2 adv. to walk upright : marcher debout upset 1 nom / "Vpset / bouleversement, changement soudain • chagrin • to have a stomach upset : avoir une indigestion 2 adj. / %Vp"set / perturbé, troublé, indigné, irrité, énervé, peiné, bouleversé, contrarié, vexé, offensé 3 (to) vb. upset / %Vp"set /, upset, upset, renverser, déranger, désorganiser, ébranler, bousculer perturber, bouleverser, contrarier, vexer, offenser upstairs / %Vp"ste@z / 1 nom étage du haut 2 adj. à l’étage 3 adv. en haut, à l’étage, d’en haut, du dessus, to run upstairs : monter (l’escalier) en courant, to take sth. upstairs : monter qqch. upsurge nom habit. sing. / "Vps3:dZ / recrudescence, forte augmentation/progression, augmentation/progression considérable, flambée uptake nom n.c. / "VpteIk / absorption (nutrition) upward(s) adj. / "Vpw@dz / en haut, vers le haut, move upwards : monter, être en hausse urinary adj. / "jU@rIn@rI / urinaire, d’urine, urinary tract : appareil, voies urinaire(s) use 1 nom / ju:s / utilisation, emploi, usage, consommation (drogue, alcool) • in use : en service, utilisé 2 (to) vb. / ju:z / se servir de, utiliser, employer, servir à useful / "ju:sfl / utile user-friendly adj. / "ju:z@(r) "frendlI / accessible, facile à l’emploi/d’emploi, facile/ simple à utiliser, Inf. convivial user nom / "ju:z@(r) / utilisateur, usager, consommateur (de drogue) usual adj. / "ju:Zl / habituel, courant, traditionnel usually adv. / "ju:Z@lI / d’habitude, généralement, habituellement, d’ordinaire UTI abrév Urinary Tract Infection : infection des voies urinaires utility nom / ju:"tIl@tI / utilité • entreprise de services collectifs, electric utility, water utility : distribution d’énergie, d’eau, public utilities : services collectifs/essentiels (énergie, eau etc.) utmost / "Vtm@Ust / 1 nom sing. to do one’s utmost : mettre tout en œuvre, faire le maximum, faire tout son possible

379 2 adj. le plus grand, extrême, de la plus haute importance utter adj. / "Vt@(r) / absolu, complet, total utterly adv. / "Vt@lI / complètement, totalement, entièrement

V vacancy nom / "veIk@nsI / vacance d’emploi • poste à pourvoir, poste vacant, to fill a vacancy : pourvoir un poste vacant vacant adj. / "veIk@nt / libre, inoccupé, vacant, à pourvoir, vacant bed : lit disponible (hôpital) • vacant job : poste vacant, à pourvoir • situations vacant : offres d’emploi vaccine nom / "v&ksi:n / vaccin, polio, pertussis, influenza etc. vaccine : vaccin antipoliomyélitique, anticoquelucheux antigrippal etc. • influenza vaccine = flu shot vacuum nom / "v&kjU@m / pl. vacuums adj vide • à vide, à dépression • vacuum flask/bottle : bouteille thermos£ • Méd. vacuum aspiration : IGV par aspiration, vacuum extraction : accouchement par ventouse, vacuum extractor : ventouse obstétricale, vacuum drain : drain aspiratif valuable / "v&ljU@bl / 1 nom pl. valuables objets de valeur 2 adj. de (grande) valeur, précieux, (très/extrêmement) utile value / "v&lju: / 1 nom valeur, utilité • value added tax (VAT) : taxe à la valeur ajoutée (TVA) 2 (to) vb. évaluer, estimer la valeur, expertiser : apprécier, être attaché à (pour sa valeur) valve nom / v&lv / soupape, valve, clapet, vanne • Méd. valvule, Eustachian valve : valvule d’Eustachi (PNA valvula venae cavi inferioris : valvula venae cavae inferiore ) varicose adj. / "v&rIk@Us / variqueux (ulcère, eczéma), varicose vein : varice varied adj. / "ve@rId / varié, divers, diversifié various adj. / "ve@rI@s / divers, différent, plusieurs vary (to) vb. / "ve@rI / varier • faire varier, modifier • + with : varier selon, en fonction de varying adj. / "ve@rIIN / variable, différent • to varying degrees : à des degrés divers

380 vast adj. / vA:st / vaste, énorme, immense, grand • the vast majority : la grande majorité vastly adv. / "vA:stlI / extrêmement, largement, nettement • vastly improved : considérablement amélioré vegetable nom / "vedZt@bl / légume • végétal, plante • vegetable kingdom : règne végétal veined adj. / veInd / veiné, marbré, nervuré veinous adj. / "vi:n@s / = veined ou veiny venous adj. / "vi:n@s / veineux, venous circulation : circulation veineuse versus prép. / "v3:s@s / (abrév. vs ) par opposition à, contre • par rapport à, par comparaison avec vessel nom / "vesl / Méd. vaisseau, blood vessel : vaisseau sanguin via prép. / "vaI@ / par, au moyen de, par l’intermédiaire, the patient is fed via a nasogastric tube : le patient est nourri par sonde nasogastrique vicinity nom sing. / vI"sIn@tI / the vicinity : voisinage, environs, proximité vicious adj. / "vIS@s / brutal, méchant, virulent, vicious circle : cercle vicieux videotape (to) vb. / "vIdI@UteIp / faire une vidéo, filmer, enregistrer sur bande magnétique, magnétoscoper, videotaped recording : enregistrement vidéo view / vju: / 1 nom vue • avis, opinion, point de vue, idée • in my view : à mon avis 2 (to) vb. voir, examiner, regarder, visionner • considérer viral adj. / "vaI@r@l / Méd. viral, viral infection : infection virale virtually adv. / "v3:tSU@lI / presque, pratiquement, civilian satellites monitor virtually every country on earth : les satellites civils observent pratiquement tous les pays de la planète virus nom / "vaI@r@s / pl. viruses adj Méd. virus, rabies virus : virus de la rage, virus disease : maladie virale visible adj. / "vIz@bl / bien visible, apparent, manifeste, notable, to make more visible : faire mieux connaître, mettre mieux en évidence visit / "vIzIt / 1 nom visite, séjour, voyage 2 (to) vb. visiter, faire un séjour, se rendre à • aller voir, rendre

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

visite • visit your GP : consultez votre médecin (généraliste) • visit our website : consultez notre site web visiting adj. / "vIzItIN / (en) visite, de passage, visiting nurse : infirmière à domicile, visiting hours (hôpital) : heures de visite visual / "vIZU@l / 1 nom document visuel, pl. dessins, schémas, figures, images, photos, supports visuels 2 adj. visuel • the visual cortex : le cortex visuel • visual field : champ de vision visualize (to) vb. / "vIZU@laIz / imaginer, voir • se représenter, s’imaginer visually adv. / "vIZU@lI / visually handicapped/visually impaired : malvoyant voice / vOIs / 1 nom voix, voice box : larynx 2 (to) vb. exprimer, formuler, to voice concern : exprimer des inquiétudes volunteer / %vQl@n"tI@(r) / 1 nom bénévole 2 (to) vb. donner, offrir, to volunteer a contribution/help : offrir une contribution/de l’aide vowel nom / "vaU@l / voyelle

W wait / weIt / 1 nom habit. sing. attente 2 (to) vb. + for : attendre, to wait for sb. : attendre qqn waiting adj. / "weItIN / waiting list : liste d’attente, waiting period : délai d’attente, waiting room : salle d’attente wake (to) vb. / weIk /, woke / w@Uk /, woke(n) / "w@Uk@n / se réveiller, s’éveiller, to wake sb. : réveiller qqn, (r)éveiller (des souvenirs : memories ) wakening nom / weIk@nIN / réveil, delayed wakening : réveil (plus) tardif walk / wO:k / 1 nom promenade, randonnée, chemin • to go for a walk : aller se promener 2 (to) vb. marcher, aller à pied, (se) promener, faire à pied, parcourir • conduire à pied, faire marcher • walk-in patient : patient sans rendez-vous, walk-in health centre : centre de soins accessibles sans rendez-vous wall nom / wO:l / mur • Anat. paroi want / wQnt / 1 nom manque, for want of : en raison d’un manque de 2 (to) vb. vouloir, désirer, demander wanting adj. / "wQntIN / inadéquat, inadapté • to be wanting : faire défaut

LEXIS war nom / wO:(r) / guerre ward nom / wO:d / Méd. service, salle, pavillon (hôpital), ward round : visite (du service etc.) par le médecin hospitalier, ward sister : infirmière chef responsable d’une salle, d’un pavillon warfare nom n.c. / "wO:fe@(r) / guerre, lutte, germ warfare : guerre biologique warm / wO:m / 1 adj. (assez) chaud, agréablement chaud • chaleureux • keep the patient warm : veillez à ce que le patient ne prenne pas froid • warmblooded : à sang chaud 2 (to) vb. chauffer, réchauffer, faire (ré)chauffer warn (to) vb. / wO:n / prévenir, avertir warning nom / "wO:nIN / avertissement, mise en garde • warning device : dispositif d’alarme • warning sign : signe avantcoureur wash / wQS / 1 nom lavage, lessive, to give a wash : laver • to have a wash : se laver 2 (to) vb. laver, lessiver, to wash oneself : se laver, to get washed : se laver, faire sa toilette • to wash one’s hands/ face/hair : se laver les mains/le visage/les cheveux washing nom n.c. / "wQSIN / lavage, lessive, blanchissage (literie : bedding ), lessivage (murs : walls ) waste / weIst / 1 nom n.c. ou sing. gaspillage, perte, waste of time : perte de temps • waste material/matter : déchets, ordures, effluents • hospital waste : déchets d'hôpitaux, également pl. wastes : déchets 2 (to) vb. gaspiller, perdre water nom n.c. / "wO:t@(r) / eau, waterborne disease : maladie à transmission hydrique, water supply : approvisionnement en eau, distribution d’eau, alimentation en eau, safe drinking water : eau potable, saine, non polluée • her waters have broken : elle a perdu les eaux watery adj. / "wO:t@rI / aqueux • watery fluid : liquide, watery discharge : écoulement wave nom / weIv / vague, Phys. onde wavy adj. / "weIvI / ondulé, onduleux wax nom n.c. / w&ks / cire, ear wax : cérumen way nom / weI / chemin • progrès • façon, manière, moyen • a long way : loin • to jump a long way : faire un

381 grand bond • in what way : de quelle manière • under way : en cours weak adj. / wi:k / faible, affaibli, to have weak lungs, a weak stomach : avoir les poumons/l’estomac fragile(s), weak bones : os fragiles weaken (to) vb. / "wi:k@n / faiblir, (s’)affaiblir, diminuer, miner weakening / "wi:k@nIN / 1 nom n.c. affaiblissement, fatigue 2 adj. affaiblissant weakness nom / "wi:knIs / faiblesse, fragilité, point faible, défaut wealthy adj. / "welTI / comp. wealthier / "welTI@ / sup. wealthiest / "welTI@st / fortuné, riche • the wealthier : les plus nantis weapon nom / "wep@n / arme wear (to) vb. / we@(r) /, wore / wO:(r) /, worn / wO:n / porter (vêtement), worn away : usé weather nom n.c. / "weD@(r) / temps (qu'il fait ), weather forecast : prévisions météorologiques web nom / web / toile d’araignée • ensemble complexe • Internet : web week nom / wi:k / semaine weekly / "wi:klI / 1 nom un hebdomadaire 2 adj. hebdomadaire, par semaine, weekly meeting : réunion hebdomadaire 3 adv. chaque semaine, par semaine weigh (to) vb. / weI / peser, how much/what do you weigh? combien pesez-vous ? weight nom / weIt / poids • importance • body weight : poids corporel • weight loss : perte de poids • weight gain : prise de poids • to put on weight : prendre du poids welfare nom n.c. / "welfe@(r) / bien-être, qualité de la vie, protection, sécurité • protection sociale, action sociale, aide sociale, affaires sociales, services sociaux, welfare worker : assistant/e social/e, child welfare : protection de l’enfance western adj. / "west@n / occidental westerner nom / "west@n@(r) / occidental wet / wet / 1 adj. humide, mouillé • wetland : zone très humide • Méd. wet lung : poumon noyé 2 (to) vb. mouiller, to wet the bed : faire pipi au lit

382 wetting nom n.c. / "wetIN / incontinence d’urine, bed-wetting : énurésie nocturne whereas conj. / %we@r"&z / (= while ) alors que, tandis que • (= although ) bien que, quoique whether conj. / "weD@(r) / si : whether it is ethical or not to feed… : s’il est ou non conforme à l’éthique de nourrir… • que : distended liver, whether due to…or… : l’hépatomégalie, qu’elle soit due à … ou à … • it is doubtful whether they’ll find a cure : il est douteux que l’on découvre un remède contre… • soit : whether before or after : soit avant soit après while conj. / waIl / pendant que : do not interrupt your partner while s/he is reading : n’interrompez pas votre partenaire pendant qu’il/elle lit • tant que = as long as, while there’s life there’s hope : tant qu’il y a de la vie il y a de l’espoir • quoique, bien que = although, while the report notes…, it fails to analyse : bien que le rapport note…, il n’analyse pas • alors que, tandis que = whereas, French uses the present, while English uses the past : en français on utilise le présent, alors qu’en anglais c’est le passé whilst conj. / waIlst / = while whisper / "wIsp@(r) / 1 nom chuchotement, murmure 2 (to) vb. chuchoter, murmurer, parler/dire à voix basse (à l’oreille de quelqu’un), souffler whisperer nom / "wIsp@r@(r) / personne qui murmure WHO acron. WHO, World Health Organization : OMS, Organisation mondiale de la santé whole / h@Ul / 1 nom tout (entier), ensemble, totalité, intégralité, on the whole : dans l’ensemble, as a whole : tout entier, dans son ensemble, en bloc 2 adj. tout, entier, intact, complet • whole milk : lait entier, whole blood : sang total wholly adv. / "h@UllI / totalement, entièrement whoop / hu:p / 1 nom Méd. toux coquelucheuse, toux convulsive de la coqueluche 2 (to) vb. Méd. avoir des quintes de toux coquelucheuse whooping cough nom n.c. / "hu:pIN kQf / = pertussis : coqueluche wide ou –wide adj. / waId / large, grand, ample, vaste, Dent. "open wide" ouvrez (la bouche) tout grand, the wider world : le reste du monde, wide ranging : large, de large

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

portée, vaste, de grande ampleur • nation-wide, country-wide : à l’échelle nationale/du pays widely adv. / "waIdlI / généralement, largement, extrêmement, très, beaucoup • souvent, couramment • par beaucoup (de monde), widely available : facile à se procurer, widely misused : (très) souvent mal utilisé widen (to) vb. / "waIdn / élargir, agrandir, augmenter, accroître widespread adj. / "waIdspred / très répandu, généralisé, très important, considérable, (très) courant, très nombreux width nom / wIdT / largeur, ampleur, circle width : diamètre wife nom / waIf / pl. wives / waIvz / épouse, femme wild adj. / waIld / sauvage, violent, farouche, extravagant, fou • wild berries : fruits des bois, baies sauvages wildcard nom / "waIldkA:d / élément imprévisible, Inf. caractère générique, joker, de remplacement will nom / wIl / volonté, détermination, strong will : forte volonté, iron will : volonté de fer -willed adj. / wIld / strong/iron willed : doté d’une forte volonté, d’une volonté de fer wind / wInd / 1 nom vent, Méd. flatulence, gaz 2 (to) vb. to wind a baby : faire faire son renvoi à un bébé wine nom / waIn / vin winter / "wInt@(r) / 1 nom hiver 2 (to) vb. passer l’hiver wire nom / "waI@(r) / fil métallique/électrique, insulated wires • fils isolés wise adj. / waIz / sage, judicieux wish / wIS / 1 nom souhait, désir, vœu, the wishes of the family : les vœux de la famille 2 (to) vb. souhaiter, désirer, I wish we had : nous aurions dû le faire, si seulement nous l’avions fait withdraw (to) vb. / wID"drO: /, withdrew / wID"dru: /, withdrawn / wID"drO:n / retirer, se retirer, Méd. arrêter de pendre une drogue withdrawal nom / wID"drO:@l / retrait, suppression, Psych. repli sur soi-même Méd. (état de) manque, withdrawal symptoms : symptômes de manque

LEXIS withhold (to) vb. / wID"h@Uld /, withheld/ wID"held /, withheld retenir • remettre, différer • cacher, taire, Méd. the withholding of medical treatment : l’arrêt des soins médicaux within adv. prép. / wI"DIn / dedans, à l’intérieur de, au sein de, dans le cadre de, dans les limites de, dans l’espace de, dans ( + jours, mois, ans etc.) • if it places the phone within 6 inches of the device : si la distance entre le téléphone et l’appareil est inférieure à 15 cm • drop to within safe limits : revenir dans les limites de sécurité • within the next 10 years : au cours des 10 prochaines années, (sth. is) within our control : nous pouvons agir sur • within a period of : dans (un délai de) • within 2 days of onset : dans les premiers 48 heures, dans les 48 heures faisant suite aux premiers symptômes without prép. / wI"DaUt / sans womb nom / wu:m / utérus wonder / "wVnd@(r) / 1 nom prodige, miracle 2 (to) vb. songer, penser, se demander, one may wonder whether : on peut se demander si woodland nom / "wUdl@nd / zone(s) boisée(s) word nom / w3:d / mot, terme, parole, propos workforce nom sing. / "w3:kfO:s / population active, main d’œuvre, effectifs, personnel workload nom / "w3:kl@Ud / charge de travail worksheet nom / "w3:kSi:t / feuille de calcul, fiche d’exercices workshop nom / "w3:kSQp / atelier world nom / w3:ld / monde worldwide / %w3:ld"waId / 1 adj. mondial, d’ampleur mondiale 2 adv. dans le monde (entier), à travers le monde, partout dans le monde, au plan mondial, mondialement worm nom / w3:m / ver (de terre), asticot, Méd. to have worms : avoir des vers, Guinea worm disease : (infestation par le) ver de Guinée (dracunculose) worry / "wVrI / 1 nom souci 2 (to) vb. se faire du souci, s’inquiéter • inquiéter worrying / "wVrIIN / 1 nom n.c. souci, se faire du souci 2 adj. inquiétant

383 worsen (to) vb. / "w3:sn / empirer, se détériorer, se dégrader, s’aggraver, rendre pire wort nom / w3:t / Saint John’s wort : millepertuis worth / w3:T / 1 nom n.c. valeur 2 adj. to be worth : valoir, life isn’t worth living : la vie ne vaut pas la peine d’être vécue • it was worth the trouble : cela en valait la peine wound nom / wu:nd / blessure, Méd. plaie, a leg wound : une blessure/plaie à la jambe • the wound is healing : la plaie se cicatrise wrong adj. / rQN / faux, inexact, erroné • mauvais • anormal, inadapté, the wrong person : pas la bonne personne, to go wrong : mal tourner, mal se passer, something is wrong with my arm : j’ai quelque chose au bras • it would be wrong to : ce serait une erreur que de wrongly adv. / "rQNlI / mal, incorrectement, à tort, faussement

X x axis nom / eks "&ksIs / pl. axes / "&ksI:z / abscisse x-ray nom / "eksreI / X-rays : rayons X • X-ray : radiographie

Y yard nom / jA:d / yard = 91,44 cm yawn / jO:n / 1 nom bâillement 2 (to) vb. bâiller year nom / jI@(r), j3:(r) / an, année • for (many) years : pendant de(s) (nombreuses) années • over the (past 50) years : au cours/au fil des (50 dernières) années • during the year : au cours de l’année • within one year : en (moins d’)un an • year by year : d’année en année • x deaths a year : x décès par an/tous les ans • 74 years old : âgé de 74 ans • every other year : tous les deux ans • last 20 years : 20 dernières années • a year ago : il y a un an yearly / "jI@lI, "j3:- / 1 adj. annuel 2 adv. chaque année, tous les ans, twice yearly : deux fois par an yeast nom / ji:st / levure, Méd. yeast infection : candidose yellow / "jel@U / 1 nom jaune 2 adj. jaune, yellow flag : pavillon de quarantaine 3 (to) vb. jaunir

384 yellow fever nom n.c. / %jel@U"fi:v@(r) / Méd. fièvre jaune yellowish adj. / "jel@UwIS / jaunâtre yesterday adv. / "jest@deI, -dI / hier yet / jet / 1 adv. encore, she hasn’t yet seen a doctor : elle n’a pas encore vu de médecin 2 conj. cependant, pourtant, toutefois, néanmoins, and yet the disease isn’t contagious : et pourtant la maladie n’est pas contagieuse

MINIMUM

COMPETENCE IN MEDICAL ENGLISH

yield / ji:ld / 1 nom production, rendement (à l’hectare…), débit (puits…), rapport (finance), produit 2 (to) vb. produire, rapporter, further research yielded some interesting results : des recherches complémentaires ont donné quelques résultats intéressants young adj. / jVN / comp. younger / jVNg@ / sup. youngest / jVNgIst / jeune, young child : enfant en bas âge