World Cancer Day 2013 2 страница

Madonna’s always been a fearless femme fatale in our eyes. But even kickboxing, leather corset-wearing megastars are afraid of thunderstorms: Madonna is apparently a sufferer of brontophobia, the fear of thunder.

b) Make up sentences using the words in the right order

1) Jennifer Aniston, all, a fear, Michael Jackson, and, Whoopi Goldberg, have, of flying.

2) The, excessive, 34^th, of, had, an, president, fear of hospitals, the United States, Richard Nixon.

3) the, Orlando Bloom, a, phobia, strange, actor, has, British, pigs, fear, of, the.

4) feared, Sigmund Freud, who, the, neurologist, founded, the, school, psychoanalyst, ferns (папоротники),of, psychiatry.

PART II

TREATMENT FOR NEUROSES

Exercise 1. Topic vocabulary

Multifaceted approach - комплексний підхід

To establish trust - установити довіру

Cognitive-behavioral therapy – когнітивно-поведінкова терапія

Faulty thinking patterns - неправильні (помилкові) шаблони мислення

Behavior patterns - моделі поведінки

Anxiety-provoking - такі, що викликають тривогу, страх

Beta-blockers - адреноблокатори

Exercise 2. Translate into Ukrainian

To be treatable to various degrees of success; to include a multifaceted approach; to identify, understand, and change faulty thinking and behaviour patterns; to learn how to control smb’s worry; to react to anxiety-provoking situations; to learn relaxation techniques; keep the symptoms of neuroses under control; to establish trust and help the neurotic persons

Exercise 3. Explain the difference in the meanings of the following words. Use them in the sentences.

a) Treat - treating – treated – untreated – treatable – untreatable

b) Change - changing – changed – unchanged – changeable – unchangeable

Exercise 4. Read the text

TREATMENT FOR NEUROSES

Disorders that are considered a neurosis or neurotic disorder are treatable to various degrees of success. In general, the sooner that the symptoms of neuroses are recognized and treated, the more effective treatment will be. The most effective treatment plans generally include a multifaceted approach and may include medications and psychotherapy.

Disorders that are considered a neurosis are treated with an individualized combination that may include medications, cognitive therapy and anxiety management. Psychotherapy, sometimes known as "talk therapy", may also be prescribed. In psychotherapy, a psychotherapist builds a relationship with a client, establishing trust and helping the client to address the neurosis through such techniques as communication and behaviour therapy.

Cognitive-behavioral therapy, or CBT, is the standard psychotherapy for treating neurotic disorders. It helps sufferers to identify, understand, and change faulty thinking and behaviour patterns, thus allowing neurotic people to learn how to control their worry. The cognitive part of CBT helps by changing the thinking patterns that create and support fears; the behavioral part helps with changing the way sufferers react to anxiety-provoking situations.

A part of cognitive-behavioral therapy can include learning relaxation techniques. In addition to medication and psychotherapy, your doctor or therapist might suggest activities such as meditation, yoga or other types of physical exercise.

Medication can keep the symptoms of neuroses under control while the patient receives psychotherapy. Medications used for treating neurotic disorders include antidepressants, anti-anxiety drugs, and beta-blockers.

Warnings

· Never try any medication without prescription from a doctor. Seek the advice of a neurological specialist before starting a new medication since most clinical doctors are not experts in the field of neurology.

· Only you can recognize if a medication is right for you after it has been prescribed. Many doctors are quick to prescribe anti-depressants to the neurotic patients. Keep in mind, however, that many of anti-depressant companies have a lot of money for promotion. As a result, never feel guilty for telling a doctor to take you off of a medication that you don't think is working (especially if it is for a child).

Exercise 5. Complete the questions and answer them

1) …. will the treatment for neuroses be effective?

2) What approaches may ….. include?

3) …. known as "talk therapy"?

4) How does psychotherapy influence….?

5) What parts does cognitive-behavioral therapy…?

6) What additive techniques …?

7) Why are the drugs administered….?

8) ….. antidepressants, anti-anxiety drugs, and beta-blockers prescribed?

9) What warnings …?

Exercise 6. Read, open the brackets, and discuss the case history

CASE

Mr. T. K (Patient Reference Number-4285) (to bring) to the clinic with anxiety disorder. He (to suffer) from severe anxiety for last 4-6 months. He (to be) a software engineer with increased work related stress.

He (not can) express his anger. When he (to be) alone he (to get) thoughts of quitting from the job but (not to have) the courage to do so. He (to have) a nervous temperament with lack of confidence. Frequently he (to experience) sensation of itching on his palms and feet, along with repetitive movement of his legs. Due to all of these complaints his sex life (to affect), along with it his relations with other family members also (to affect). His appetite (to increase) when he (to depress). His sleep (to disturb). He often (to suffer) from neck and lower back pains. All of these (to identify) as stress related concerns. Dr. Shah (to study) his case in detail and (to prescribe) him research based medicine for anxiety neurosis.

In 8 weeks Mr. T.K. (to report) to the clinic, he (to feel) better. His body pains (to reduce) and his sleep (to improve). His medication (to continue) . In next 8 weeks he (to report) the anxiety to have reduced by 50 %. He said he (not to experience) such relief since quite long time. He (to feel) calmer and relaxed. The itching on his palms and soles (to reduce) considerably.

Exercise 7. Translate into English using:

a) Complex Subject (Nominative Infinitive Construction)

1) Відомо, що люди із слабким типом нервової діяльності більш схильні до нервових розладів.

2) Вважають,що когнітивно-поведінкова терапія є одним із основних методів лікування неврозів.

3) Ліки при неврозах, без сумніву, призначаються лише спеціалістом у неврології.

4) Повідомили, що болі у спині та шиї у цього хворого мають невротичне походження.

5) Відомо, що люди, які страждають на істерію, відчувають постійний страх і втрачають самоконтроль.

b) Complex Object (Objective Infinitive Construction)

1) Пацієнт помітив, що свербіж з’являється в ситуації стресу, розумової чи фізичної напруги.

2) Лікар побачив, що зіниці хворого розширені.

3) Численні фобії змушують Вуді Аллена боятися висоти, замкненого простору та комах.

4) Лікар дозволив хворому припинити прийом антидепресантів .

5) Гіппократ вважав, що істерія спричинена порушенням кровообігу.

Exercise 8. Describe the terms

Neurosis

Phobia

Obsessive-compulsive disorder

Cognitive-behavioral therapy

TEST

1. Neuroses are caused by … .

a) organic diseases; b) disrupted brain activity; c) radical loss of touch with reality

2. Physical symptoms of anxiety include … .

a) nausea, palpitations, chest pains, and breathlessness;

b) shortness of breath, cough, fever, elevated blood pressure;

c) sweating and radical loss of touch with reality

3. The most characteristic symptom of phobias is … .

a) high places, fire, and bacteria; b) fixation on fire;

c) unreasonable fears of smth. or smb.

4. In … a person suffers from intrusive, repetitive, and disturbing thoughts.

a) common neuroses; b) obsessive-compulsive disorder; c) anxiety

5. Conversion neuroses are also called … .

a) obsessive-compulsive disorders; b) hysterical neuroses; c) phobias

6. Somatoform disorders manifest themselves in physical symptoms, such as … that are not caused by organic disease.

a) blindness, paralysis, or deafness; b) pale skin, dilated pupils, and trembling;

c) behaviour including rituals such as repetitive hand washing or door locking

7. The cognitive part of CBT helps by … .

a) supporting faulty thinking patterns; b) creating faulty thinking patterns;

c) changing faulty thinking patterns

8. Medications used for treating neurotic disorders include antidepressants, anti-anxiety drugs, and beta-blockers.

a) antidepressants, anti-anxiety drugs, and beta-blockers;

b) sedatives, statins, and anticonvulsants;

c) anti-anxiety drugs, tonics, and beta-blockers

9. Seek the advice of … before starting a new anti-depression therapy.

a) you family doctor; b) a neurological specialist; c) any practicing physician

10. Meditation, yoga, and special physical exercises are considered to be … for neuroses.

a) a first-line treatment; b) a part of “talk therapy”; c) an additional treatment

11. He said he … such restlessness since quite long time.

a) hasn’t experienced; b) hadn’t experienced; c) didn’t experience

12. The anti-anxiety medications … by the end of the next month.

a) will take; b) will be taken c) will have been taken

13. These disturbances … as stress related concerns.

a) were identified; b) identified; c) had identified

14. Some of common phobias are fear of heights, … spaces and insects.

a) enclosed; b) enclosing; c) enclose

15. The patient noted headache … after mental exertion.

a) occur; b) to occur; c) occurs

16. People with a weak type of the nervous system … predisposed to neuroses.

a) are seemed to be; b) seem to be; c) seem to

17. Cognitive-behavioral therapy … one of the most effective methods for treating neurotic disorders.

a) is believed to be; b) believed to be; c) believes to be

18. … some anxiety is normal in certain situations, such as when sad, angry, or afraid of a specific situation, people with neurosis may experience anxiety for no known reason.

a) until; b) while; c) unless

19. Only you can recognize … a medication is right for you after it has been prescribed.

a) when; b) until; c) if

20. Never feel guilty … telling a doctor to take you off of a medication that you don't think is working.

a) for; b) of; c) from

STROKE - Інсульт

Exercise 1. Learn the active vocabulary:

Aphasia [æˈfeɪzɪə], cholesterol [kəˈlɛstərɔl] , modifiable [‘məʊdɪfaɪəbl], neurosurgery [ˌnjʊərəʊˈs3ːdʒərɪ], consciousness [ˈkɒnʃəsnɪs],

Exercise 2. Topic vocabulary

Stroke - інсульт

Cerebrovasculer accident - порушення мозкового кровообігу

Aphasia - афазія, порушення мовлення

Visual field - поле зору

Altered - змінений

Transient ischemic attack - швидкоминуче порушення мозкового кровообігу, «міні-інсульт»

Atrial fibrillation - миготлива аритмія

Modifiable - такий, що можна змінити

Anti-platelet drugs - антитромбоцитарні препарати

Leak - протікати, просочуватися

To suffer a disease - перенести захворювання

Hemiparesis - геміпарез (парез м’язів однієї половини тіла)

Exercise 3. Translate into Ukrainian

Rapid loss of brain function, disturbance in the blood supply to the brain, inability to move one or more limbs, altered taste, inability to understand or formulate speech, an inability to see one side of the visual field, the most important modifiable risk factor of stroke, interruption of the blood supply, to result from rupture of a blood vessel, the increased intracranial pressure, the leaking blood compressing the brain, an embolic stroke.

Exercise 4. Do you know that:

a) Statins are a class of drugs used to lower cholesterol levels.

b) Anti-platelet drugs are intended to prevent and/or reverse platelet aggregation in arterial thrombosis, most prominently in myocardial infarction and ischemic stroke.

c) Clot busting medications break up blood clots. During a heart attack or stroke, clot busters, also called thrombolytics, dissolve the blood clot that is blocking the artery and help to restore blood flow. These medications are injected into the arm through an intravenous (IV) line.

d) Carotid endarterectomy (CEA) is a surgical procedure used to prevent stroke, by correcting stenosis (narrowing) in the common carotid artery. Endarterectomy is the removal of material on the inside (end-) of an artery.

Exercise 5. Read the text. Define the key concepts of the theme.

STROKE

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a hemorrhage. As a result, the affected area of the brain cannot function, which might result in an inability to move one or more limbs on one side of the body (paralysis), inability to understand or formulate speech (aphasia), an inability to see one side of the visual field, or altered taste, smell, hearing.

A stroke is a medical emergency and can cause permanent neurological damage and death. Risk factors for stroke include old age, high blood pressure, previous stroke or transient ischemic attack (TIA), diabetes, high cholesterol, tobacco smoking and atrial fibrillation. High blood pressure is the most important modifiable risk factor of stroke. It is the second leading cause of death worldwide.

An ischemic stroke is occasionally treated in a hospital with thrombolysis (also known as a "clot buster"), and some hemorrhagic strokes benefit from neurosurgery. Prevention of recurrence may involve the administration of anti-platelet drugs such as aspirin and dipyridamole, control and reduction of high blood pressure, and the use of statins. Selected patients may benefit from carotid endarterectomy and the use of anticoagulants.

Strokes can be classified into two major categories: ischemic and hemorrhagic. Ischemic strokes are those that are caused by interruption of the blood supply, while hemorrhagic strokes are the ones which result from rupture of a blood vessel or an abnormal vascular structure. About 87% of strokes are caused by ischemia, and the remainder by hemorrhage. Some hemorrhages develop inside areas of ischemia ("hemorrhagic transformation"). It is unknown how many hemorrhages actually start as ischemic stroke.

Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive the area of brain affected, the more functions that are likely to be lost.

Loss of consciousness, headache, and vomiting usually occurs more often in hemorrhagic stroke than in thrombosis because of the increased intracranial pressure from the leaking blood compressing the brain.

If symptoms are maximal at onset, the cause is more likely to be a subarachnoid hemorrhage or an embolic stroke.

Exercise 6. Answer the questions

1) What is the cause of a stroke?

2) What does the abbreviation CVA mean?

3) What is ischemia?

4) What are the manifestations of CVA?

5) How can the the blood supply to the brain be damaged?

6) What are the risk factors for stroke?

7) What medication can be administered in stroke?

8) What kind of surgery may some CVA patients undergo?

9) What is “hemorrhagic transformation”?

10) How do stroke symptoms start?

11) How does the onset of hemorrhagic stroke differ from that of the ischemic one?

Exercise 7. Find out in the text the words with the similar meaning to the given ones:

arterial embolism, insult, lack, limbs, clot busters, bleeding, anti-thrombotics, stoppage (of blood supply), emesis, relapse, squeeze, beginning

Exercise 8. Put questions to the underlined words

1) Clot busting medications dissolve the blood clot that is blocking the artery.

2) Symptoms of a small stroke may be confused with those of other conditions that cause similar symptoms.

3) The anterior circulation of the brain that controls most motor activity, sensation, thought, speech, and emotion is supplied by the carotid arteries.

4) The patient’s condition improved gradually within 2 weeks of treatment.

5) When blood flow stops, brain cells do not receive the oxygen and glucose they require to function.

6) Two weeks after antibiotic treatment was discontinued, the patient experienced a frontal headache.

7) A 77-year-old woman was cooking in the kitchen when she collapsed onto the floor.

8) He had developed hypertension over the last 10 years.

9) Because there was occasional low-grade fever, intravenous penicillin was given for 2 weeks.

10) On day 4 of hospitalization, she developed fever (38°C), chills, and dysuria.

Exercise 9. Open the brackets

1) She (to lose) consciousness and (to transfer) to our hospital on the same day.

2) Quick action by a doctor sometimes (to reduce) the damage or (to prevent) more damages.

3) In both patients, brain abscess (to develop) at the stroke lesion site after they (to have) an infectious complication.

4) Most strokes (to happen) suddenly and (to damage) the brain within minutes.

5) If the stroke already (to happen) blood clotting drugs are not effective.

6) The ischemic infarction (to demonstrate) by computer assisted tomography and angiography.

7) After the patient (to develop) the left hemiparesis, he (to admit) to our hospital.

8) Because of the progressive multifocal cerebral manifestations in the patient, we (to decide) to perform a brain biopsy of the right parietal lobe ten days after admission.

9) As soon as a doctor (to gather) all information he (to make) a diagnosis of a suspected ischemic stroke.

10) Occlusion of small brain arteries very rarely (to cause) by the malignant intravascular lymphoma, which first (to describe) in 1959.

Exercise 10. Change the sentences with direct speech by those with reported speech

1) ‘You’ll have to consider changing your job,’ said the doctor.

2) ‘Do I need to be off of work?’ asked the patient.

3) ‘How long have these headaches been bothering you?’ he asked.

4) ‘Try to take the tablets after meals,’ said the doctor.

5) ‘The chances of recovery are very good and I’m confident you’ll feel a lot more comfortable after the operation,’ said the doctor.

6) ‘Your baby has a heart condition which developed when she was growing in the womb,’ said the doctor.

7) ‘Do you get any pain when you’re passing water?’ asked the doctor.

8) The doctor asked the girl, ‘Can you put your head back to help me?’

Exercise 11. Read the case and its study based upon the patient’s symptoms. answer the questions below.

A 77-year-old woman was cooking in the kitchen when she collapsed onto the floor. Her daughter called an ambulance and the woman was taken to the emergency room. She had suffered a stroke, and slowly regained consciousness over the next two days. However, when she woke up, she had the following signs and symptoms:

- paralysis of the right face and arm
- loss of sensation to touch on the skin of the right face and arm
- inability to answer questions but ability to understand what was said to her
- ability to write down her thoughts more easily than to speak them

Solving the clinical problem

Based upon the patient's symptoms, which cerebral artery was blocked?

The loss of all sensation on the right face and arm, coupled with the paralysis of muscles in these regions suggests that this woman suffered damage to the lateral portions of her left frontal and parietal lobes. Specifically, damage to the face and arm regions of the left somatosensory and primary motor cortices would cause these deficits. Damage on the left side of her brain causes right-sided symptoms since the motor and sensory tracts cross the mid-line as they travel between the cerebrum and the spinal cord. The language disorder that this patient has is called Broca's (expressive) aphasia, and it may result from damage to the dominant Broca's motor speech area, a control center that sits just anterior to the face portion of the primary motor cortex in the left frontal lobe. The artery that supplies blood to these regions is the superior division of the left middle cerebral artery. Blockage of this artery by a thrombus or embolism could cause all of this patient's signs and symptoms.

1) Which lobe of the brain, the right or the left one, was damaged? What symptoms indicate that?

2) Damage to what portion of the left lobe caused the language disorder? How is the area responsible for the language function called?

3) What artery was blocked?

Exercise 12. Explain the terms

Stroke, Ischemia, Thrombosis, Paralysis, Aphasia

TEST

1. Stroke can be due to … .

a) cerebral ischemia b) paralysis c) inability to see one side of the visual field

2. A stroke is … .

a) a chronic brain disease; b) a medical emergency; c) paralysis of limbs

3. Strokes can be divided into two types: … .

a) acute and chronic; b) acute and hemorrhagic; c) ischemic and hemorrhagic

4. The most common predisposed factors for stroke are … .

a) hypertension, diabetes, smoking; b) atrial fibrillation, hypotension, vomiting;

c) hemiparesis, old age, aphasia

5. Loss of consciousness, headache, and vomiting usually occurs more often in … because of the increased intracranial pressure from the leaking blood compressing the brain.

a) cerebral thrombosis; b) cerebral ischemia; c) cerebral hemorrhage

6. A 75-year-old woman (to wash up) in the kitchen when she (to fall down) onto the floor.

a) washes up …. falls down; b) was washing up …. fell down;

c) was washing up …. was falling down

7. The doctor asked the patient … .

a) whether she had taken all prescribed remedies;

b) she took all prescribed remedies; c) if she was taken all prescribed remedies

8. He asked … .

a) how is the affected area of the brain called;

b) how was the affected area of the brain called;

c) how the affected area of the brain was called

9. The language disorder may result … damage to the dominant Broca's motor speech area.

a) of; b) to; c) from

10. Damage … Broca's motor speech area leads to aphasia.

a) on; b) of; c) to

EPILEPSY - Епілепсія

Exercise 1. Practice the pronunciation:

Epilepsy [ ̍epilepsi]

Seizure [ ̍si: ȝə]

Partial [ ̍pɑ: ʃ(ə)l]

Unconscious [ʌn ̍kᴐnʃəs]

Cease [si:s]

Bisynchronous [bai ̍siƞkrənəs]

Posture [ ̍pᴐsʧə]

Awareness [ə ̍weənes]

Hallucination [həlu:si ̍neiʃn]

Idiopathic [idiə ̍pᴂθik]

Exercise 2. Topic vocabulary:

Seizure- епілептичний припадок

Tonic-clonic – тонічно-клонічний

Unconscious - непритомний

Confusion – часткове потьмарення свідомості

Bisynchronous spike discharges – бісинхронічний імпульсні викиди

Throughout – усюди, скрізь

Scarring – той, що має рубець

Focal – фокусний, фокальний

Exercise 3. Match the medical terms with their definitions:

Epilepsy - a perception in the absence of stimuli

Unconsciousness - a sudden involuntary contraction of a muscle, a group of muscles, or a hollow organ

Cyanosis - a transient symptom of abnormal excessive or neuronal activity in the brain

Seizure - complete or partial lack of responsiveness to people or other environmental stimuli

Spasm -a common and diverse set of chronic neurological seizures

Hallucination - the appearance of blue or purple coloration of the skin due to the lack of oxygen

Exercise 4. Translate the following word combinations:

Recurrent seizure, sudden onset, structural damage, partial and generalized seizures, to fall to the ground, result in cyanosis, urinary incontinence, to cease movements, state of confusion, brief spells of unconsciousness, bisynchronous spike and wave discharges, intermittent photic stimulation, clouded awareness, temporal lobe, focal lesions.

Exercise 5. Complete the words in the following sentences by adding a prefix. Choose from the following: un-, in-, im-, ir-, dis-.

1. An epileptic seizure is ___controlled, chaotic electrical activity in the brain. It alters consciousness and may bring on ___ involuntary movements. Epilepsy may be the result of chemical ___balance but more often the cause is ___known.

2. In a grand mal epileptic seizure, the victim falls to the ground___conscious and makes twitching movements which may last for several minutes. In a petit mal seizure, the victim may be__aware of things around him for up to thirty seconds but seldom loses consciousness.

3. In temporal lobe epilepsy, a seizure may result in the victim having ___rational feelings of anger or fear.

4. Following a stroke, many patients are left with some sort of ____ability.

5. Brain cells starved of blood are _____able to communicate with the parts of the body they are responsible for.

Exercise 6. Read and translate the text:

Epilepsy

Epilepsy is a disorder of brain function characterized by recurrent seizures that give a sudden onset. Epilepsy may be the result of disturbed chemical balance but more often the cause is unknown.

The term idiopathic is used to describe epilepsy that is not associated with structural damage of the brain. Seizures may be generalized or partial. Generalized epilepsy may take the form of tonic-clonic or absence seizures. In tonic-clonic seizures the patient falls to the ground unconscious with the muscle in a state of spasm. The lack of any respiratory movement may result in cyanosis. The tonic phase is replaced by convulsive movements when the tongue may be bitten and urinary incontinence may occur.

Movements gradually cease and the patient may rouse on a state of confusion, complaining of headache, or may fall asleep. Absence seizures consist of brief spells of unconsciousness lasting for a few seconds. During which posture and balance are maintained. The electroencephalogram characteristically shows bisynchronous spike and wave discharges during the seizures and at other times. Attacks are sometimes provoked by overbreathing or intermittent photic stimulation.

In partial seizures, the nature of the seizure depends upon the location of the damage in the brain. Symptoms may include hallucinations of smell, taste, sight, and hearing, and paroxysmal disorders of memory. Throughout an attack the patient is in a state of clouded awareness and afterwards may have no recollection of the event. A number of these symptoms are due to scarring and atrophy affecting the temporal lobe.

The different forms of epilepsy can be controlled by the use of antiepileptic drugs (anticonvulsants). Surgical resection of focal lesions in the brain is appropriate in a strictly limited number of cases.

Exercise 7. Answer the following questions:

1. What is epilepsy characterized by?

2. What is the term idiopathic used for?

3. What types of seizures are there?

4. What may be observed in the tonic phase?

5. What does the ECG usually show?

6. How can seizures be provoked?

7. What are the symptoms in partial seizures?

8. How can epilepsy be controlled?