Infant Patients with Adult Pain

While doctors and nurses accept that newborn babies suffer pain as much as older children and adults, they do little to help infants who have to undergo distressing procedures. Dr Jane Tohill and Dr Olive McMorrow of the National Maternity Hospital, Dublin, sent out a detailed questionnaire to the staff of 21 neonatal intensive care units in the British Isles about their pain relief policy. Of the 17 that replied, just less than three-quarters agreed that doctors tend to under-prescribe painkillers and a third that nurses do the same.

More upsetting, the survey revealed that more than a quarter of the units give babies no pain relief before a chest drain is inserted and only 40 per cent provide relief to babies suffering from fatal conditions such as spina bifida. The researchers argue in The Lancet that units should have a written policy on when pain relief should be given; otherwise it will not be provided. Most important, traumatic procedures should be performed without pain relief only in emergencies.

14. Read and translate the dialogue between the doctor working at the intensive care units and his assistant:

Assistant: And what does the Apgar Score provide?

Doctor: So, it provides a standard for describing condition of infants at birth.

Assistant: What objective signs does Apgar Scoring system evaluate?

Doctor: It evaluates heart rate, respiratory effort, muscle tone, reflex irritability and colour (blue, pink or pale) at 1 and 5 minutes after birth and each is given a score 0,1 or 2. The sum of the 5 scores is the Apgar Score.

Assistant: What does a score of 3 to 6 indicate?

Doctor: Moderate depression.

Assistant: And score of 0 to 2?

Doctor: Oh, it indicates severe depression. The one-minute Apgar Score and the five minutecorrelate best with survival, while the those at 10 and 20 minutes seem to be better prognosticators of neurological damage at 1 year of age.

15. Make up your own dialogue “At the Neonatal Intensive Care Unit”.

16. Point out ‘the preposition + gerund constructions’ in the following sentences. Translate them:

1. On examining the child they decided to apply chemotherapy. 2. On paasing through the diaphragm, the thorasic duct enters the posterior mediastinum. 3. By following the doctor’s advice carefully parents may help to prevent many infectious diseases. 4. Sometimes the child stops crying after placed on his stomach. 5. The doctor diagnoses diphtheria by examining the patient’s mouth and throat. 6. Bacterial infection maybplay a part in causing neonatal jaundice. 7. The child’s appetite and sleep depend on being out in the open air for some time every day. 8. The patient’s body reacts to infection by producing substances capable of combating the germs and their toxins. 9. We have had the experience of selecting and intensively studying a single drug suspected on clinical basis of producing malformations of the heart and have demonstrated that it is highly capable of causing congenital heart defects. 10. On comparing small series of patients, such discrepancies in results may be observed due not only to differences in the methodology employed but also to patient character.

17. Translate the sentences containing ‘without + gerund construction’:

1. The cardiac muscle has a remarkable “built-in” safety mechanism which enables the heart to sustain the increased burden without failing. 2. No doctor will ever risk diagnosing anemia without first doing blood tests. 3. The sick child was lying quietly without complaining of anything. 4. It is impossible to prevent spreading of whooping cough without isolating sick children from healthy ones. 5. The mild form of scarlet fever allowed the child to be treated at home without being hospitalized. 6. It is impossible to protect children against diseases without creating condotions for strengthening them and building up their resistance. 7. Inoculations with weakened strains of the infection-germs will make a person immune to the given disease without causing any severe form of it. 8. The doctor cannot take a case-history without describing the patient’s complaints. 9. A physician mustn’t make a diagnosis without examining a patient. 10. It appears, that HTLV-III (Human T-Lymphotropic Virus, Type III), like other viruses, may ramain latent in the body without ever causing AIDS (Acquired Immune Deficiency Syndrome) disease.

18. Point out gerundial constructions in the following sentences. Translate the sentences:

1. The child’s being infected with antitoxin in time may lead to a favourable course of diphtheria. 2. The doctor insited on the chold’s adenoids being removed as soon as possible. 3. Because of the pregnant woman’s gaining excessive weight her diet has been changed. 4. Causative agents having penetrated in the body doesn’t necessarily cause an infectious disease. 5. The onset of rheumatic fever began with the child’s sleeping poorly, loosing his appetite and running a subfebrile fever in evenings. 6. The necessity of the child’s being isolated from healthy children immediately was emphasized by the doctor. 7. After the child’s having been discharged from the hospital all steps must be taken at home to prevent a recurrence of the attack. 8. The child became infected with scarlet fever because of the mother’s having allowed him to come into contact with his sick brother. 9. The home of the sick child must be thoroughly disinfected after his having been taken to the hospital. 10. The child’s appetite being impaired made him refuse not only food, but even drink.

19. Mind the meaning of the word “rate”, learn its combinations by heart:

rate n – 1. скорость, быстрота; темп, ритм; интенсивность

2. степень; процент; коэффициент; индекс; уровень; пропорция, доля

3. мощность, интенсивность

4. частота

5. доза; норма; количество; производительность

6. цена; оценка

rate v – 1. ценить, оценивать, измерять

2. считать, рассматривать, полагать

birth rate	рождаемость
death rate	уровень смертности
dose rate	мощность дозы
heart rate	частота сердечных сокращений
infant mortality rate	коэффициент детской смертности
metabolic rate	скорость, уровень метаболизма
morbidity rate	заболеваемость; распространенность болезни
sinoatrial rate	синусный ритм

20. Translate the following sentences into Russian paying attention to the word “rate”:

1. The rates of incidence vary by area. 2. The rate of HIV infection among women in the US varies from 0% to more than 50%. 3. In many populations tested it is difficult to separate rates for alcohol and for drug use. 4. The procedure is safe and leads to excellent survival rates. 5. Heart rate was monitored continuously and blood pressure (systolic and diastolic) was recorded every 5 min. 6. We also observed a high rate of remission. 7. In contrast to Liquid Chromatography the technique of Gas Chromatography developed at an amazing. 8. Advertising rates are available on request. 9. Burn patients have caloric needs exceeding those of any other injury, and their metabolic rate is related to burn size. 10. Fig. 16 shows the results of a trial in which brodicoum pellets (гранулы) achieved effect at only half the application rate.

21. Form the words given below choose the synonyms of the words and word combinations in bold type:

1. The normal babies born at term require an environmental temperature of 21-24°C. 2. Serologic techniques for demonstrating the infection in the mother and the fetus were developed. 3. It is obvious from this and other studies that hearing loss is an important symptom in congenital infection. 4. It has been suggested that the the shortened period of existence of infected cells may lead to the small size of the virus-infected newborns. 5. Because of pyelonephritis ampicilline sodium was given during the second three months of pregnancy. 6. There was initial improvement in the child’s condotion, but recurrent heart failure demanded several subsequent hospitalizations. 7. The defects resulting from inhibition of growth of specific tissues occurred only in the presence of fully infective virus. 8. The low birth weight babies may need an environmental temperature of 35°C.

(span of life, trimester, premature, consequent upon, unborn child, require, deafness, full-term babies)

22. Fill in the blanks with suitable prepositions. Translate the sentences:

1. The average duration … treatment was about 3 months and antibacterial agents were commonly given as well. 2. Congenital malformations consequent … harmful prenatal influences caused a chronic disability … this child. 3. An anesthetist must concern himself deeply … the complicated pediatric anesthesia if he wants to work … pediatric surgery. 4. The doctors of a women’s consultation centre assume full responsibility … the health of a future mother. 5. Every future mother must prepare herself for caring … her child both in health and in disease. 6. Premature infants are especially susceptible to infection … different microorganisms. 7. … examining the child they decided to apply chemotherapy. 8. Being an introduction to neonatology, the book is suitible … those who are interested … pediatrics.

23. Translate the following sentences into Russian:

1. The care of VLBW (very-low-birth-weight) infants remains a unique challenge. 2. Thanks to advances in cardiac surgery, many children born with congenital anomalies of the heart can have these disorders corrected surgically. 3. On admission to the hospital a full history had been taken, and the child was given a clinical examination. 4. They didn’t have the course of their disease changed by this therapy. 5. Cardiologists are known to treat people with diseases of the heart. 6. The neonatal survival rate has dramatically improved in recently years. 7. To understand the basic signs of every doctor. 8. The book is to be used by every member of the care unit. 9. It is now possible to examine the electrocardiogram of the fetus through most of pregnancy. 10. Increased intake of milk could have provided more calcium and phosphate for absorption.

24. Translate the following sentences into English:

1. Ученые уделяют много внимания новым методам оживления новорожденных. 2. Данная публикация рекомендуется для тех, кто работает в детских отделениях реанимации. 3. Сейчас детские реанимационные отделения оснащены современными приборами. 4. Врачи разработали несколько диагностических методов для раннего обнаружения пороков у новорожденных. 5. Достижения современной медицины помогают сегодня повысить уровень выживаемости даже для очень слабых младенцев. 6. Опубликованные данные показали, что грудное вскармливание снижает восприимчивость к заболеваниям. 7. Доктор Петров всегда утверждал, что правильный диагноз необходим для соответствующего лечения. 8. Доктор Петров добавил, что правильный диагноз сделает многие операции, которые могут быть вредны для ребенка, излишними. 9. Лечение младенца следует начинать под строгим медицинским контролем. 10. Современные больницы должны иметь все необходимое оборудование для диагностики и лечения.

25. Read text III and give the abstract of it: