2_kurs_english

Indications

In surgery:

Prevention and treatment of pre-, per-, or postsurgical capillary haemorrhages in all delicate operations and in those affecting highly vascularised tissues : E.N.T., gynaecology, obstetrics, urology, odontostomatology, ophthalmology, plastic and reconstructive surgery.

In internal medicine:

Prevention and treatment of capillary haemorrhages of whatever origin or localisation: haematuria, haematemesis, melaena, epistaxis, gingivorrhagia

In gynaecology:

Metrorrhagia, primary or ILJD-related menorrhagia in the absence of organic pathology.

In pediatrics

Prevention of periventricular haemorrhages in premature babies.

Dosage and administration Adults

Presurgical: 1 or 2 tablets (250-500 mg) or 1-2 ampoules i.v. or i.m. 1 hour before surgery.

Presurgical: 1-2 ampoules i.v. Repeat the dosage if necessary. Postsurgical: 1 or 2 tablets (250-500 mg) or 1-2 ampoules i.v. or i.m. every 4 - 6 hours as long as the risk of bleeding persists.

Internal medicine: generally 1 or 2 tablets 2 - 3 times a day (1000 - 1500 mg) to be taken with meals with a little water; treatment duration depends on the results obtained.

Gynaecology, meno-metrorrhagia: lor 2 tablets 3 times a day (1500 mg) to be taken with meals with a little water. Treatment lasts 10 days and starts 5 days before the expected onset of menses.

Emergency cases: according to the severity of the case: 1-2 ampoules i.v. or i.m. every 4 - 6 hours as long as the bleeding risks persists.

Children

Half the adult dose of 250 mg ampoule or tablet. For further information, please contact OM PHARMA.

Limitations for use Contraindications

Acute porphyria. Dicynone 250 ampoules: bronchial asthma, proven hypersensibility to sulphites.

Precautions

As parenteral administration of Dicynone may induce a drop in blood pressure it is advised to carefully monitor patients suffering from blood pressure instability or hypotension (see Adverse reactions), but no data have been reported on such a risk during oral administration. If Dicynone is administered for a reduction of excessive and/or prolonged menstrual haemorrhages, and no improvement is observed, possible pathological causes should be looked for and excluded. Pregnancy and lactation

Pregnancy category C: studies in pregnant women or animals are not available. As a precaution, Dicynone should not be administered during the first trimester of pregnancy, whereas during the second and third trimesters, it

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should be administered only if the expected therapeutic benefit is judged as superior to the potential risk for the foetus.

Adverse reaction

In certain cases, parenteral administration can produce a drop in blood pressure. Pressure returns to normal values within the next hours. Dicynone 250 ampoule contains sodium ersulphite as antioxidant that may cause allergic reactions, nausea and diarrhea in susceptible patients. The allergic reactions may leadd to anaphylactic shock and cause life-Jihireatening asthma attacks. Rare: gastralgia, nausea, headache, skin rash. In most cases, these symptoms disappear spontaneously. If they persist, the dosage should be reduced or the treatment withdrawn.

Interactions

For the oral form of Dicynone, no interaction is known up to now. Thiamine (vitamin Bl) is inactived by the sulphite contained in Dicynone 250 for injection. If a perfusion with Dextran is necessary, Dicynone 250 must be injected first.

Overdosage

Signs of overdosage are unknown.

In case of overdosage, a symptomatic treatment should be initiated.

Presentation

Tablets:

packs of 20 tablets of 250 mg

packs of 20 and 60 tablets of 500 mg Ampoules:

packs of 4 and 100 ampoules of 2 ml.

UNDERSTANDING DETAILS AND DISCUSSION …

Task 2 Pick up and underline new words and phrases. Compose sentences of your own to show you understand the unfamiliar words and phrases of the summary.

Task 3 Scan the summary of this medication to discuss each point with your partner. Use the plan suggested: properties, composition, indications, dosage and administration (adults/children), presentation.

Task 4 Scan this summary again to say about limitations for use according to:

-contraindication;

-precautions.

Present your case, if there have been any …

Task 5 Comment on the adverse reactions noted in patients to dicynone therapy.

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GOING BEYOND THE SUMMARY. DISCUSSION …

Task 6 Keep talking … Use the summary clues to discuss the overdose symptoms and treatment.

UNIT 8

ANTIBIOTICS. PENICILIN

Task 1 Read the following text. Work out the meaning of new words checking them in a dictionary, if necessary.

TEXT A.

ANTIBIOTICS. PENICILIN

The discovery of penicillin opened the era of antibiotics and is recognized as one of the great. The recognition of penicillin therapeutic potential occurred in England, while discovering how to mass-produce the drug

occurred in the US -- at the Peoria lab.

Penicillin was discovered in 1928 by bacteriologist Alexander Fleming, working at St. Mary’s Hospital in London. A group of scientists at England's Oxford University began intensive research and was able to demonstrate penicillin's

ability to kill infectious bacteria.

The acceleration of penicillin production was one of the most successful achievements of American chemists and chemical engineers, establishing the production of antibiotics and fostering today's pharmaceutical industry. While it was often called the “wonder drug” because of its effectiveness, one of penicillin’s true wonders was the short development time from recognizing its value to mass availability.

WHAT IS PENICILLIN?

An antibiotic is a chemical compound that inhibits or abolishes the growth of microorganisms, such as bacteria, fungi, or protozoans. The original meaning of antibiotic includes any agent with biological activity against living organisms; however, the term is commonly used to refer to substances with anti-bacterial, antifungal, or anti-parasitical activity. The first antibiotic compounds used in modern medicine were produced and isolated from living organisms, for example, the penicillin class produced by fungi in the genus Penicillium, or streptomycin from bacteria of the genus Streptomyces. With the advent of organic chemistry many

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antibiotics are now also obtained by chemical synthesis, such as the sulfa drugs. Many antibiotics are relatively small molecules with a molecular weight less than 2000 Da.

Some anti-bacterial antibiotics destroy bacteria (bactericidal), whereas others prevent bacteria from multiplying (bacteriostatic).

Although potent antibiotic compounds for treatment of human diseases caused by bacteria (such as tuberculosis, bubonic plague, or leprosy) were not isolated and identified until the twentieth century, the first known use of antibiotics was by the ancient Chinese over 2,500 years ago. Many other ancient cultures, including the ancient Egyptians and ancient Greeks already used molds and plants to treat infections, owing to the production of antibiotic substances by these organisms. At that time, however, the compounds having antibiotic activity and present in molds or plants were unknown.

The antibiotic properties of Penicillium sp. were first described in France by Ernest Duchesne in 1897. However, his work went by without much notice from the scientific community until Alexander Fleming's discovery of Penicillin.

Modern research on antibiotic therapy began in Germany with the development of the narrow-spectrum antibiotic Salvarsan by Paul Ehrlich in 1909, for the first time allowing an efficient treatment of the then-widespread problem of Syphilis. The drug, which was also effective against other spirochaetal infections, is no longer in use in modern medicine.

Antibiotics were further developed in Britain following the re-discovery of Penicillin in 1928 by Alexander Fleming. More than ten years later, Ernst Chain and Howard Florey became interested in his work, and came up with the purified form of penicillin. The three shared the 1945 Nobel Prize in Medicine. "Antibiotic" was originally used to refer only to substances extracted from a fungus or other microorganism, but has come to include also the many synthetic and semi-synthetic drugs that have antibacterial effects.

Classes of antibiotics

At the highest level, antibiotics can be classified as either bactericidal or bacteriostatic. Bactericidals kill bacteria directly where bacteriostatics prevent them from dividing. However, these classifications are based on laboratory behavior; in practice, both of these are capable of ending a bacterial infection.

UNDERSTANDING DETAILS AND DISCUSSION …

Task 2 Scan the text for unfamiliar medical and pharmaceutical words and terms. Look them up in a dictionary and learn to use them.

Task 3 Use the unfamiliar words and phrases in the sentences of your own to show you understand them.

Task 4 Give a definition of the pharmaceutical term ‘antibiotic’. Compare it with a dictionary defenition.

Task 5 Scan the text again to say how:

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-‘antibiotic’ was originally used to …

-‘antibiotic’ has come later to …

-antibiotics are classified.

GOING BEYOND THE TEXT …

Task 6 Keep talking … Use the data from the text to construct a 1012 line dialogue to act it out with a partner in class.

TEXT B.

WHAT IS THE POSTANTIBIOTIC ERA?

Task 1 Skim through the text and trace the ‘wonder drug’ result hurling the American chemists into the Post-Antibiotic Era.

As we enter the 21st Century, we are gradually slipping into the PostAntibiotic Era, a time when antibiotics no longer work because bacteria have become resistant to all the antibiotics. In the next 5-10 years we will start noticing the change much more dramatically. We will start to see friends, relatives and even close family members dying from simple infections that used to be cured with antibiotics - pneumonia, ear infections, and ‘strep’ throat1.

We have seen entire countries turn back the process of bacterial resistance, simply by using antibiotics wisely. In Iceland, the percentage of resistant pneumococcus (causes ear infections, pneumonia, sinusitis and meningitis) actually dropped from 25% to 15% in 5 years, after doctors stopped using penicillin to treat colds and other virus infections. (Antibiotics don’t work for virus infections anyway.) This is REALLY IMPORTANT, because it shows that bacterial resistance is NOT inevitable, and probably would stabilize at a low level if antibiotics were used only when there is a valid reason.

In the U.S., doctors continue to use antibiotics 10 to 20 times more often than they are actually needed. There are many reasons for this. For example, sore throats are mostly caused by virus infections which are not helped in any way by using antibiotics. The only indication for using an antibiotic for a throat infection is to treat Streptococcus pyogenes (or "strep" germs). Most doctors test for strep with a throat swab, and it is positive only 5-10% of the time. Amazingly, doctors still use antibiotics, even if the strep test is negative!

Other examples, include treating virus infections such as colds, coughs, bronchitis, sinusitis, and croup with antibiotics which only work on bacteria infections. Millions of Americans are treated with antibiotics for colds every year, when not one of them has been helped by it, and the result is hurling the whole country into the Post-Antibiotic Era.

An important reason that doctors over-prescribe is that they have the perception that their patients expect and demand to be treated with antibiotics. Most doctors these days run their practices like a business, striving for "customer satisfaction". They will try to keep the customers happy, even if it is to their detriment. Patients must become involved now, and start to demand appropriate

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treatments for their virus infections, and demand that doctors stop using antibiotics inappropriately.

Unfortunately, doctors will continue to treat their other (less informed) patients with useless antibiotics. This is where the strategy gets tricky. How can we get the word out to the other patients? All information about the bad effects of the antibiotics seems to have had no effect on the public.

___________________________________

‘strep’ throat (abbr. for STREPTOCOCCI) – a throat infection with STREPTOCOCCI

INTRODUCING DETAILS AND DISCUSSION …

Task 2 Look up the new words and phrases in a dictionary and learn to use them.

Task 3 Use the new words and phrases in the sentences of your own to show you understand them.

Task 4 What does the abbreviation ‘strep’ stand for? Use it in the sentence of you own.

Task 5 Explain how you understand ‘customer satisfaction’

GOING BEYOD THE TEXT …

Task 6 Keep talking … what makes doctors to over-prescribe antibiotics to their patients. Give reasons.

READING COMPREHENSION

TEXT C.

COMMON DISEASES WIDELY – SPREAD ON THE GLOBE

Read the following text to learn more about the diseases spread widely on the Earth.

The human immunodeficiency virus (HIV) causes infection that can lead to acquired immunodeficiency syndrome (AIDS). HIV infects and gradually destroys immune system cells, reducing the body's protection against infection and cancers.

What are the symptoms?

The first symptoms of HIV infection can appear within six weeks of the virus entering the body. Some people experience a flu-like illness with sore throat, fever,

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swollen lymph nodes, muscle aches and a rash. After a few weeks, these symptoms usually disappear.

Many people with HIV do not have any symptoms for many years after initial infection. Others may have persistent swollen lymph nodes, mouth infections, persistent herpes infections, such as cold sores, extensive genital warts or weight loss.

It can take from between one year and more than ten years before AIDS develops. When this happens a person may develop severe weight loss over a short period of time, severe and persistent infections, and cancers such as Kaposi's sarcoma and lymphoma.

How's it transmitted?

Since combination therapy has become available, the number of people dying from AIDS has fallen, which means the number of people living with HIV in the UK is increasing.

HIV is often transmitted through unprotected sex. Most HIV infections in the UK occur in gay men. The number of infections in this group has remained steady.

The number of heterosexually acquired HIV infections has increased steadily and, since 1999, has been greater than the number acquired through sex between men.

Sharing contaminated needles for drug misuse can also transmit HIV. The number of people becoming infected through injecting drugs appears to be falling.

You can/t get HIV …

from hugging, kissing, sneezes, coughs, sharing baths or towels, swimming pools, toilet seats or from sharing cups, plates or cutlery, and you can’t HIV from any animal or insect, including mosquitoes.

How's it treated?

Anti-HIV drugs are available and taking a combination of these can slow down the damaging effects of HIV on the immune system.

Medication is used when needed, for example, to treat infection.

Maintaining a healthy lifestyle to keep the immune system as strong as possible is very important. Emotional support for the person with HIV and those around them is also helpful.

There's no cure for HIV, but there are drugs called antiretrovirals that can help prevent someone infected with HIV from becoming ill. These drugs can significantly increase the life expectancy of someone with HIV. The drugs must be taken every day for life, otherwise the treatment will stop being effective and the person affected may become ill.

Drug treatment is free in the UK.

Treatment consists of taking several drugs together, which is known as combination therapy. Typical combinations include two drugs from the NRTI group (nucleoside reverse transcriptase inhibitors, also known as 'nukes') plus an NNRTI ('non-nuke') or a protease inhibitor.

Newer types of antiretrovirals such as entry inhibitors are usually reserved for people who have to switch treatments because of side-effects, or because the first drug combination stops working.

Research continues around the world to develop a HIV vaccine. Progress is being made, although it's likely to be a number of years before such a treatment is widely available.

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UNDERSTANDING DETAILS AND DISCUSSION …

Be prepared to talk aboud HIV and AIDS, these much - spread diseases, that plagued our Globe now.

Before talking, answer the following questions and use them as prompts in your discussion.

-What does it stand for HIV (AIDS)?

-What are the symptoms of HIV (AIDS) infection?

-How is it transmitted?

-Is it an infectious disease?

-What is the treatment?

-Is it effective enough to totally cure or just to relieve a pain?

-Is there any cure for this disease?

Task 1 Scan the text to find the information on:

-prevention measures in fighting against flu;

-H5N1, the avian influenza virus – new studies.

TEXT.

HOW (AND HOW NOT) TO BATTLE FLU: A TALE OF 23 CITIES

When the Spanish flu reached the United States in the summer of 1918, it seemed to confine itself to military camps. But when it arrived in Philadelphia in September, it struck with a vengeance.

By the time officials there grasped the threat of the virus, it was too late. The disease was rampaging through the population, partly because the city had allowed large public gatherings, including a citywide parade in support of a World War I loan drive, to go on as planned. In four months, more than 12,000 Philadelphians died an excess death rate of 719 people for every 100,000 inhabitants.

Scientists are still studying the 1918 pandemic, the deadliest of the 2Oth century, looking for lessons for future outbreaks — including the possibility that H5N1, the avian influenza virus, could mutate into a form spread easily from human to human. This month, researcher’s published two new studies in The Proceedings of the National Academy of Sciences comparing public-' health responses in cities like St. Louis and Philadelphia.

Using mathematical models, they reported that such large differences in death rates could be explained by the ways the cities carried out prevention measures,

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especially in their timing. Cities that instituted quarantine, school closings, bans on public gatherings and other such procedures early in the epidemic had peak death rates 30 percent to 50 percent lower than those that did not.

A two-week difference in response times, according to the researchers, is long enough for the number of people infected in an influenza epidemic to double three to five times. Dr. Martin Cetron, director for global migration and quarantine at the federal Centers for Disease Control and Prevention in Atlanta, found reason for optimism in the study results.

The second study, in the same issue of The Proceedings, suggests that in one sense preventive measures can be too effective. In an influenza epidemic, a certain number of people survive the illness and are immune to reinfection. As these numbers increase, the epidemic fades.

But an effective prevention program without a vaccine can leave enough people uninfected and still susceptible to the virus to start the epidemic again as soon as the controls are lifted. This is what happened in St. Louis. On Nov. 14, 1918 — in high spirits three days after the armistice that ended the war, and with influenza cases declining — the city reopened schools and businesses. Two weeks later, the second wave of the epidemic struck, this time with children making up 30 percent to 40 percent of the infections. Controls were immediately reinstituted.

The study examined the course of the epidemic in 23 cities: San Francisco, St. Louis, Milwaukee and Kansas City, Mo., had the most effective prevention programs, and time was of the essence. If restrictions were introduced too late or lifted too early, success rates declined substantially.

This study shows that interventions even without a vaccine can be effective in blocking transmission. What's much less certain is whether society is prepared to bear the costs of implementing such intrusive and costly measures for the months that would be required to manufacture a vaccine.

UNDERSTANDING DETAILS AND DISCUSSION …

Task 2 Think about and discuss with your classmates the material according to these main points:

-A tale of 23 cities grasped the flu-virus;

-Scientists are still studying the 1918 pandemic looking for lessons for future outbreaks;

-H5N1, the avian influenza virus, could mutate into a form spread easily from human to human;

-An effective prevention programme – new studies.

Task 3 Discuss more actively the cases of the avian influenza virus in Ukraine and other countries where tragic lessons of the epidemic occurred.

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MODULE 6

HEALTH AND DIET

____________________________________________________________

PREPARING TO READ…

as you read, notice how:

-one’s body needs vitamins to grow, develop and work properly just like you should;

-careful you are about your diet;

-to be encouraged in order to be active;

-the influence of vitamins on one’s body works.

UNIT 1

VITAMINS

Task 1 Read the article on the theme studied and be prepared to comment on it.

TEXT.

VITAMINS

Vitamins and minerals are substances that are found in foods we eat. Your body needs them to work properly, so you grow and develop just like you should. When it comes to vitamins, each one has a special role to play. For example:

Vitamin D in milk helps your bones.

Vitamin A in carrots helps you see at night.

Vitamin C in oranges helps your body heal if you get a cut.

B vitamins in leafy green vegetables help your body make protein and

energy.

Vitamins Hang Out in Water and Fat

There are two types of vitamins: fat soluble and water soluble. When you eat foods that contain fat-soluble vitamins, the vitamins are stored in the fat tissues in your body and in your liver. They go and wait around in your body fat until your body needs them.

Fat-soluble vitamins are happy to stay stored in your body for awhile - some stay for a few days, some for up to 6 months! Then, when it's time for them to be

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