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About This Term Requirements: 1. Full class attendance and active involvement 2. Continued attention on word-formation 3. More careful study of texts 4. Persistence in after-class reading and writing 5. A notebook for medical English learning
Unit 2 Osteoporosis
Word Formation oste/o -osis -orexia -ia neur/o meno- (bone) e. g. osteoporosis (diseased condition) (appetite) e. g. anorexia (diseased condition) e. g. bulimia (nerve) e. g. neuromuscular (menses; menstruation; period) 月经 e. g. menopause hyster/o (uterus ) e. g. hysterectomy
andr/o (male) e. g. androgen estr/o (female) e. g. estrogen hypo(deficiency) e. g. hypogonadism gonad/o (gonad) e. g. gonadotropin dys(with difficulty) e. g. dysfunction -ectomy ( excision) -tomy (incision) gastr/o ( stomach)
Questions to consider: 1. What is osteoporosis ? 2. What are the possible causes and general symptoms ? 3. How to prevent osteoporosis ?
Osteoporosis Overview The word osteoporosis literally means porous bones. It occurs when bones lose an excessive amount of their protein and mineral content, particularly calcium. Over time, bone mass, and therefore bone strength, is decreased. As a result, the bones become fragile and break easily. Even a sneeze or a sudden movement may be enough to break a bone in someone with severe osteoporosis.
• Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.
• Osteoporosis is caused by decreased bone mass resulting in fragile bones. Progressive osteoporosis may cause loss of height, stooped posture, a humpback, and severe pain. It commonly affects the thoracic and thoracolumbar regions of the spine and may cause debilitating pain. The structural deterioration of bone increases the risk for fracture in the hip, spine, and wrist.
There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include: • Joint pain and tenderness • Swelling • Warmth over the affected joint
A number of factors increase the risk of developing osteoporosis. They include: • Age. Osteoporosis is more likely as people grow older and their bones lose strength. • Sex. Women are more likely to have osteoporosis because they start out with less bone. They also lose bone tissue more rapidly as they age. While women commonly lose 30%– 50% of their bone mass over their lifetimes, men lose only 20%– 33% of theirs. • Body type. Women with small bones or thin frames are more liable to develop osteoporosis.
• Early menopause. Women who begin menopause early • • • because of heredity, surgery, or lots of physical exercise may lose large amounts of bone tissue early in life. Such conditions as anorexia and bulimia may also lead to early menopause and osteoporosis. Lifestyle. People who smoke or drink too much, or do not get enough exercise, have an increased chance of getting osteoporosis. Medications. Certain prescription medications may speed up the loss of bone. Diet. Adults who do not get enough calcium or protein may be more likely to have osteoporosis.
• Osteoporosis is a serious public health problem. Some 28 million people in the United States are affected by this potentially debilitating disease, which is responsible for 1. 5 million fractures (broken bones) annually. These fractures, which are often the first sign of the disease, can affect any bone, but the most common locations are the hip, spine, and wrist. Breaks in the hip and spine are of special concern because they almost always require hospitalization and major surgery; and may lead to other serious consequences, including permanent disability and even death.
• To understand osteoporosis, it is helpful to understand the basics of bone formation. Bone is living tissue that's constantly being renewed in a two-stage process (resorption and formation) that occurs throughout life. In the resorption stage, old bone is broken down and removed by cells called osteoclasts. In the formation stage, cells called osteoblasts build new bone to replace the old. During childhood and early adulthood, more bone is produced than removed, reaching its maximum mass and strength by the mid-30 s.
• After that, bone is lost at a faster pace than it's formed, so the amount of bone in the skeleton begins to slowly decline. Most cases of osteoporosis occur as an acceleration of this normal aging process. That is referred to as primary osteoporosis. The condition can also be caused by other disease processes or prolonged use of certain medications that result in bone loss; if so, it is called secondary osteoporosis.
• Osteoporosis occurs most often in older people, especially in women after menopause. It affects nearly half of all adults, men and women, over the age of 75. Women, however, are five times more likely than men to develop the disease. They have smaller, thinner bones than men to begin with, and they lose bone mass more rapidly after menopause (usually around age 50), when they stop producing a boneprotecting hormone called estrogen.
In the five to seven years following menopause, women can lose about 20% of their bone mass. By age 65 or 70, though, men and women lose bone mass at the same rate. osteoporosis
• Physical exercise reduces the risk of osteoporosis. Moderate weight-bearing exercises, such as leisurely cycling, dancing, walking, and tennis, stimulate the deposition of calcium, strengthen bones, and reduce the risk of osteoporosis. However, young people benefit most from exercise; strong and healthy bones are more easily established in adolescents and young adults. A modest amount of jumping (as little as 50 jumps a day) can increase the density of hips in premenopausal women by as much as 3 per cent.
• Although exercise may offer some protection against acquiring the disease, those already suffering from osteoporosis should avoid contact sports and exercise that put undue stress on bones and joints. In particular, flexion exercises of the spine (e. g. sit ups) should be avoided because of the risk of vertebral fractures. Swimming is an especially good exercise for those with the disease.
• Slightly overweight post-menopausal women are less likely to suffer from brittle bones than slim women. Possible reasons are that fat acts as a protective cushion; bones of plump women may be heavier and stronger; and the extra fat of plumper women enables them to produce more oestrogen which offers some protection against demineralization of bones.
Understanding the Text Para. 1 1. present---- a. / v. e. g. 1) All the symptoms of the disease are present. 2) The condition may also present in a baby. 3) Chlamydia in the male commonly presents a urethritis characterized by dysuria. 4) A 24 year-old woman presents with an influenzalike illness of five days’ duration.
5) The patient presented with severe chest pains. 6) The presenting symptoms of the disease may be extremely variable. 7) The doctors’ first task is to relieve the presenting symptoms.
2. fracture----v. to break a bone; (of bone) to break e. g. 他腕骨骨折。 He fractured his wrist. 胫骨有两处骨折。The tibia fractured in two places. ----n. break in a bone e. g. comminuted fracture 粉碎性骨折 compound / open fracture 开放性骨折
3. Some osteoporosis fractures may escape detection until years later. (Para. 1) e. g. the detection of a cyst using an endoscope 用内镜检测囊肿 Para. 2 1. “band-like” pain----带状疼痛 2. hunch---- vt. 使(背部等)弯成弓状; 使隆起 e. g. hunch up one’s shoulders 耸起双肩 ( hunchback / humpback n. 驼背 hunchbacked / humpbacked a. 驼背的 )
3. dowager hump----罗锅 An abnormal outward curvature of the vertebrae of upper back. Compression of the front (anterior) portion of the involved vertebrae leads to forward bending of the spine and creates a hump at the upper back. • Dowager's hump is due to osteoporosis changes in the thoracic spine. It may affect men or women. Like most osteoporotic changes, it is often preventable. dowager n. ----王(公等)的未亡人; 继承亡夫爵位[遗产]的寡妇; [口]年长的贵妇人 e. g. a queen dowager 王太后
Para. 3 minimal trauma/stress fracture----压迫性骨折 curb: n. 1) edge of the pavement next to the road 路边 2) 人行道台阶或阶梯等等的(缘石)。 e. g. 1) He parked his car at the curb. 他把车停在路边。 2) stepping off a curb---下台阶 Para. 4 trivial accidents----light knock or bump非常轻微的磕碰 e. g. With osteoporosis, hip fractures can … 如果患有骨质疏松,非常轻微的磕碰都能造成髋部骨折。
Para. 5 two units of alcohol----两杯酒 set up---cause; create 引起; 产生 e. g. The cold set up the inflammation of the lungs. set oneself up for----cause someone to suffer from (an illness ) on the occasion of----at a particular time Para. 6 Dubai----迪拜, 阿拉伯联合酋长国港市( The port city of United Arab Emirates )
Para. 7 “Beat the Break”----战胜骨折 • In 2007 World Osteoporosis Day (October 20 th) marked the beginning of a year dedicated to bone health awareness, whereby individuals are being urged to identify their personal risk for osteoporosis and to take appropriate action to reduce their modifiable risks.
• The year-long campaign that was launched on World Osteoporosis Day, October 20, 2007 focusd on bone health awareness at all ages under theme 'Beat the Break'.
• Officially launched on October 20, 2007 by IOF and its member societies around the world, the year's campaign theme is ‘Beat the Break: Know and reduce your osteoporosis risks’. The highlight of the campaign was the launch of a new IOF One Minute Osteoporosis Risk Test as well as the publication of a new thematic report and brochure. IOF also produced a special section on its website dedicated to osteoporosis risk factors, and issued awareness-raising posters and public service announcements.
board member----国际骨质疏松基金会成员 at epidemic proportions----以流行病的发病速度 e. g. 1) A high proportion of cancers can be treated by surgery. (大部分) 2) The proportion of outpatients to inpatients is increasing. ( 比例) 3) The disease rapidly reached epidemic proportions. ( 疾病迅速达到流行程度。)
Para. 8 A bone-friendly (healthy) lifestyle ----对骨骼有益的生活方式 Para. 9 fall into …main categories----分为…大类 Para. 10 eating disorders----饮食失调 BMI / BMD
• Bone mass (bone density) is the amount of bone present in the skeletal structure. Generally, the higher the bone density is, the stronger are the bones. Bone density is greatly influenced by genetic factors, which in turn are sometimes modified by environmental factors and medications. For example, men have a higher bone density than women. African Americans have a higher bone density than Caucasian or Asian Americans.
• Normally, bone density accumulates during childhood and reaches a peak by around age 25. Bone density is then maintained for about ten years. After age 35, both men and women will normally lose 0. 3% to 0. 5% of their bone density per year as part of the aging process.
Para. 12 increase…by up to 1. 5 fold PBM (peak bone mass) 峰值骨量 Para. 14 intake----n. amount of a substance taken in; taking in (of a substance) 摄入 e. g. a high intake of alcohol suggested daily intake
Para. 15 exposure/expose e. g. The operation exposed a generalized cancer. (手术发现癌已扩散。) She was exposed to a lethal dose of radiation. (她接受了致死剂量的辐射。)
Para. 16 compound----vt. 1) to form by combining two or more things 组合; 综合; 混合 2) to make sth. ( a problem, etc. ) worse 使恶化/复杂化 dramatically----greatly; substantially • Drinking Binge/Eating Binge 豪饮/暴食 • Binge refers to excessive or uncontrolled indulgence in drink, food, etc. ( binge是一个很地道的用法,表示无节 制地做某事。drinking binge和eating binge表示无节制 地大吃大喝,是节日里很容易用到的一个词。)
• Examples: 1) Binge drinking is widespread among British men and women throughout their 20 s, 30 s, and into their 40 s. 嗜酒在英国男女 20岁,30岁直至 40岁都非常普遍。 2) It's tempting for them to go on a drinking binge in the festival. 在节日里,他们总有想去豪饮一次的冲动。
• Binge eating is a pattern of disordered eating which consists of episodes of uncontrollable overeating. It is sometimes as a symptom of binge eating disorder. During such binges, a person rapidly consumes an excessive amount of food. Most people who have eating binges try to hide this behaviour from others, and often feel ashamed or depressed about their overeating. Eating binges can be followed by so-called compensatory behaviour, acts by which the person tries to compensate for the effects of overeating. Examples of such acts are purging (induced vomiting or laxative abuse), fasting, and heavy exercising.
• Anorexia nervosa is a psychiatric illness that describes an eating disorder, characterized by extreme low body weight and body image distortion, with an obsessive fear of gaining weight. Individuals with anorexia are known to control body weight commonly through the means of voluntary starvation, purging, excessive exercise or other weight control measures, such as diet pills or diuretic drugs. While the condition primarily affects adolescent females, approximately 10% of people with the diagnosis are male. Anorexia nervosa, involving neurobiological, psychological, and sociological components, is a complex condition that can lead to death in severe cases.
• Bulimia nervosa is an eating disorder characterized by recurrent binge eating, followed by compensatory behaviors referred to as "purging". The most common form—practiced by more than 75% of people with bulimia nervosa—is self-induced vomiting; fasting, the use of laxatives, enemas, diuretics, and over exercising are also common.
Para. 17 sedentary lifestyle----久坐的生活方式 e. g. Changes in lifestyle factors have been related to the decline in mortality from ischaemic heart disease. In many studies a sedentary lifestyle has been reported as a risk factor for ischaemic heart disease. Para. 18 visual impairments----视力障碍 neuromuscular dysfunction----肌肉神经紊乱 dementia----痴呆
immobilization----固定, 制动; 卧床 ----1) immobility ( being kept still, not moving ), such as after a stroke, or from any condition that interferes with walking; 2) fixation (as by a plaster cast) of a body part in order to promote proper healing e. g. 1)Immobilization of the injured knee was necessary. 固定损伤的关节是必要的。 2)The procedure does not need long immobilization and has less complication. 术后不需长期卧床, 较少并发症。
Para. 19 onset----n. beginning 发作; 发病 e. g. 1) 这种病的发作以突起高热为标志。 The onset of the illness is marked by sudden high temperature. 2) 3) Late-onset asthma in the elderly 晚发老年哮喘 Early-onset asthma in the elderly 早发老年哮喘
menopause----绝经 post-menopausal women---premenopausal---perimenopausal---meno- 月经 ( menses; menstruation; period ) climacteric/climacterium 更年期/ 绝经期
• If a postmenopausal woman has other menopausal symptoms such as hot flashes and vaginal dryness, menopausal hormone therapy will be the proper choice for these menopausal symptoms as well as for the prevention of osteoporosis. After the menopause symptoms have passed, some other non-estrogen prescription osteoporosis medication will be considered for the long-term. hot flashes / flushes----潮热(症) e. g. non-hormonal treatment for perimenopausal hot flushes 围绝经期潮热的非激素治疗
Para. 20 -21 vast majority of---susceptible to---estrogen---Estrogen is important in maintaining bone density in women. When estrogen levels drop after menopause, bone loss accelerates. During the first five to ten years after menopause, women can suffer up to two to four percent loss of bone density per year! This can result in the loss of up to 25 to 30% of their bone density during that time period. Accelerated bone loss after menopause is a major cause of osteoporosis in women.
Para. 22 genetic predisposition----遗传倾向 (be)predisposed to----with a tendency to e. g. 1) All the members of the family are predisposed to vascular diseases. predisposition----a tendency to be affected by a particular disease or kind of disease e. g. She has a predisposition to obesity.
Para. 23 a prior fracture: a previous fracture prior adj. [用作前置定语]在前的, 更早的; 优先的 [与to连用]在. . . 之前, 比. . . 优先 e. g. 1) have a prior engagement 预先有约会 2) prior claims 优先要求权 3) This task is prior to all others. 这项任务比所有其它任务都重要。 fracture free
Para. 25 hysterectomy ----the surgical removal of the uterus, either through an incision in the abdominal wall (abdominal hysterectomy ) or through the vagina ( vaginal hysterectomy ) vigilant about----watchful; on guard against 密切关注, 当心, 提防; 对…保持警觉
Para. 26 corticosteroid 皮质类固醇 ----any steroid hormone synthesized by the adrenal cortex. There are two main groups of corticosteroids, glucocorticoids and mineralocorticoids. turnover----更新 ; 转换, 转化; 代谢; primary/secondary----原发 / 继发
Para. 27 Rheumatoid arthritis 类风湿性关节炎 Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder that most commonly causes inflammation and tissue damage in joints (arthritis) and tendon sheaths, together with anemia. It can also produce diffuse inflammation in the lungs, pericardium, pleura, and the sclera of the eye, and also nodular lesions, most common in subcutaneous tissue under the skin. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility.
It is diagnosed chiefly on symptoms and signs, but also with blood tests (especially a test called rheumatoid factor) and X-rays. Diagnosis and long-term management are typically performed by a rheumatologist, an expert in the diseases of joints and connective tissues.
• The name is based on the term "rheumatic fever", an illness which includes joint pain and is derived from the Greek word rheumatos ("flowing"). The suffix -oid ("resembling") gives the translation as joint inflammation that resembles rheumatic fever. The first recognized description of rheumatoid arthritis was made in 1800 by Dr Augustin Jacob Landré-Beauvais (1772 -1840) of Paris.
toll----(usu. sing. ) the amount of damage done or the number of people who were killed or injured 损害程度; 伤亡人数 e. g. The death-toll from the earthquake was 3500. take a heavy toll / take its toll ( on/of sth. ) ----to cause loss, damage, suffering, etc. e. g. 类风湿性关节炎对骨骼造成极大损害
Para. 28 • Hypogonadism is a medical term for a defect of the reproductive system that results in lack of function of the gonads (ovaries or testes). The gonads have two functions: to produce hormones , gametes (eggs or sperm). Deficiency of sex hormones can result in defective primary or secondary sexual development, or withdrawal effects (e. g. , premature menopause) in adults. Defective egg or sperm development results in infertility.
• The term hypogonadism is usually applied to permanent rather than transient or reversible defects, and usually implies deficiency of reproductive hormones, with or without fertility defects. The term is less commonly used for infertility without hormone deficiency.
Para. 29 The long term use of corticosteroids (such as Prednisone, Cortisone, and Prednisolone) can lead to osteoporosis. Corticosteroids cause decreased calcium absorption from the intestines, increased loss of calcium from the kidneys, and increased calcium loss from the bones.
Phrases in the Text 1. A minimal trauma fracture/stress fracture 2. Peak bone mass 3. Dietary calcium intake 4. Visual impairment 5. Neuromuscular dysfunction 6. Genetic predisposition 7. primary/secondary osteoporosis 8. Estrogen deficiency
9. Endocrine disorders 10. Bone mineral density 11. Bone mass index 12. Sedentary lifestyle 13. post-menopausal women 14. Osteoporosis fracture
15. At epidemic proportions 16. Eating disorders 17. Rheumatoid arthritis 18. long-term glucocorticoid therapy 19. Increased bone turnover 20. Anorexia nervosa
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