READING

COMPREHENSION

1
 Pre-Reading INSTRUCTIONS

In order to understand and grasp a thorough comprehension of the four reading texts
presented in this Supplementary Material, it is essential you need to revise (or refer
back to) the following English grammar points:
1. Tenses including
a. the Present Simple
b. the Past Simple
c. the Present Perfect
2. Passive Voice of
a. the Present Simple tense
b. the Past Simple tense
c. Modal Verbs, including can, could, may, might, should, would, …
3. Relative Clauses and Relative Pronouns including
a. who, whom
b. which
c. that
4. Reduction of Relative Pronouns

2
3
 EXERCISES on Reading Text CARDIAC SURGERY: A BRIEF HISTORY

(From English for Medicine, Garnet Education Publishing Ltd., 2011)

Read the text carefully and answer the questions as requested. (It is recommended that you
NOT refer to any dictionary while doing the exercise. Try to GUESS the new words.):

First, number the paragraphs. There are nine paragraphs altogether.

I. VOCABULARY CHECK: Choose the best answer to each question on the words/ phrases
taken from the text:
1. date from (paragraph 1)
a. write a date for some activity c. have existed for a long time
b. made at a time in the past d. started and finished in the past
2. bypass operation (paragraph 1) a medical operation to
a. make blood flow past a blocked part of c. cut open the heart
the heart
d. make stitches on the heart
b. make blood flow through the heart
3. lodge (paragraph 2) (bullet: a piece of metal that is shot from a gun and causes serious
damage to a person or thing it hits)
a. go past
c. firmly hit
b. move around
d. firmly fix
4. accomplish (paragraph 3)
a. complete
c. remove
b. start
d. do sth. and succeed
5. critical (paragraph 4)
a. time-consuming
c. difficult to deal with
b. long-lasting
d. simple to understand
6. deprivation (paragraph 4)
a. limitation
c. lack of
b. in large quantity
d. flow
7. immerse (paragraph 5)
a. put in a liquid
c. carry
b. cut open
d. boil in a liquid
8. make the headlines (paragraph 6)
a. talk to the newspaper reporters
c. become well-known
b. become Head of a hospital
d. be successful
4
9. subsequently (paragraph 6)
a. at the same time
c. after a short time
b. later
d. after a long time
10. recipient (paragraph 8)
a. a person who receives a heart from
c. a specialist in heart transplant
someone else
d. a scientist who makes success in heart
b. a doctor who performs a heart
operations
operation
11. donation (paragraph 8)
a. offering money for a heart operation
c. giving an organ of the body for money
b. offering a heart to an accident patient
d. giving a part of the body to someone
12. defying statistical probabilities by a huge margin (paragraph 8)
a. similar to what the modern medicine has proved
b. within his expectations of the heart transplant
c. different from what the normal statistics say
d. beyond his expectations of the heart transplant
13. breakthrough (paragraph 9)
a. operation c. finding
b. achievement d. scientific study
14. desperate (paragraph 9)
a. needing heart transplant very much c. saying “No” to heart transplant
b. going to die soon d. going to take a new heart soon
15. alternative (paragraph 9)
a. a development in medicine c. a person who donates his/her heart
b. an achievement in heart transplant d. a donor heart

II. WORD REFERENT: Which word from the text does each of the following words refer to?
(The words in italics in the brackets are to help you find out the words easily.) Try to be as
specific as you can.

1. (… have been) those (paragraph 1):

2. (… two-thirds of) those (paragraph 1):

5
3. (… bullets lodged in) their hearts (paragraph 2):

4. (Dislodging) them (paragraph 2):

5. (… successfully remove) it (paragraph 2):

6. (… began using) the technique (paragraph 3):

7. This (was known as …) (paragraph 4):

8. Her (heart functioned …) (paragraph 5):

9. the patient (subsequently died) (paragraph 6):

10. Such (breakthroughs …) (paragraph 9):

11. thousands (are left desperate …) (paragraph 9):

III. COMPREHENSION QUESTIONS: Compete the table: (Write KEY WORDS only)
There is NO INFORMATION where a cross (X) exists:

No Time Doctor’s name Achievement

1 1896 (1) ……………………. repaired stab wound to R ventricle

2 during WWII Dwight Harken (2) ………………………………………..

……………………………………………

……………………………………………

3 (3) ………… Dwight Harken closed-heart surgery

4 X Bill Bigelow (4) ………………………………………

5 (5)…………… Walton Lillehei & John open-heart surgery

Lewis

6
6 1967 (6) …………………….. (7) ……………………………………….

7 (8) ………….. Norman Shumway (9) ……………………………………….

8 past 20 years X (10) ………………………………………

9 Today X (11) ………………………………………

7
 Smallpox vaccinations
One of the greatest achievements of 20'°-century
medicine was the global eradication of smallpox.
The disease is one of the most devastating known to
mankind. In 1967, it was estimated by the World
Health Organization (WHO) that two million people
died of smallpox that year.
Smallpox is caused by the variola virus and is most
often transmitted by inhaling the virus. It has an
incubation period of between 7 and 17 days, after
which symptoms begin to appear. The initial
symptoms are flu-like. A significant feature of the
disease is the development of blisters on the upper
part of the body, which eventually scab over and leave
scars when the scabs fall off. Around 30 per cent of’
those infected with smallpox die, usually within two
weeks of symptoms appearing.
The first attempts to control the disease used a
technique known as variolation. Dried scab tissue
from victims of smallpox was used to deliberately
infect young people. Of those infected by variolation,
one per cent died, far fewer than the 30 per cent killed
by infection in the normal way. Despite the risks,
variolation was still used in some remote
communities until relatively recently.
However, it was the discovery of vaccination by
Edward Jenner in 1 796 which marked a major step
forward in controlling the disease. Vaccination
involves the administration of a preparation that
allows the body to develop resistance to a disease
without having to be exposed to it. By infecting
children with cowpox, a relatively minor disease,
Jenner found they developed immunity to smallpox.
By 1853, infants in the UK were required by law to bc
vaccinated against smallpox, though the vaccines used
were not always effective. .
Further advances were made in the 1920s with the
development of dried vaccines in France and the
Netherlands. These were more effective but were
difficult to store in hot climates. An outbreak of
smallpox in New York City in 1947 led to the
development of a freeze-drying technique which
meant the vaccine could be stored for months without
refrigeration, even in tropical climates.
In 1966, the WHO set a ten-year goal for the
eradication of smallpox worldwide. Considerable
resources were devoted to the development of
mechanisms for reporting and monitoring the disease.
Improved technology and better vaccines also helped.
By 1960, the WHO could formally declarc smallpox
eradicated worldwide. The last naturally occurring
case was reported in 1977, in Somalia. The last
fatality was in the UK in 197S, following the escape
of the virus from a research lab. It was the first time
a hurrian infectious disease had been completely
eradicated. Smallpox was no longer a killer of
humanity.
Smallpox has a number of unique characteristics
which made its eradication possible. Its symptoms
develop quickly, making those infected aware of the
disease at an early stage and reducing the possibility
of them unknowingly transmitting the disease to
others. Because it is almost completely specific to
humans, there is a very low possibility of smallpox
being kept alive in animals to reinfcct humans. The
availability of effective vaccines was also a necessary
factor. Finally, the high level of mortality from the
disease made it easier to achieve global agreement
on its eradication.
Although smallpox has ceased to kill, it remains a
potential danger to humanity. Though the possibility
of the virus surviving in animals is very low, it is still
a possibility. So, too, is the accidental release of
material traditionally used for variolation in remote
communities. Howcver, the most pressing fear is that
stocks of the variola virus set aside for research
purposes could some day be used as a biological
warfare agcnt. The proposal, in 2003, to inoculate
health care staff in some countries against such a
possibility shows that the potential of smallpox to
kill remains as strong as ever.
8
 EXERCISE on Reading Text SMALLPOX VACCINATIONS
(from English for Medicine, Garnet Education Publishing Ltd., 2011)

Read the text carefully and answer the questions as requested. (It is recommended that you NOT
refer to any dictionary while doing the exercise. Try to GUESS the new words.):

1. What is the word “eradication” in Introduction paragraph closest in meaning to?

a. spread
b. infection
c. stop
d. application
(Which words in the sentence have helped you guess its meaning?) → ………………………

2. What is the word “devastating” closest in meaning to?

a. dangerous
b. widely spread
c. earliest
d. recurrent
3. According to paragraph 1, what is main way of transmission of the variola virus? (Write
ONE word in the blank): Through............................system of the human body.
4. The smallpox symptoms are NOT present
a. after the first 7 days.
b. after the first 17 days
c. after flu-like symptoms
d. None is correct.
5. What does the word “those” in paragraph 1 refer to? - (Write ONE word in the blank): ………

6. Approximately one-third of those infected with smallpox die within two weeks, at the
maximum, after they contract the variola virus. (TRUE/ FALSE?)

7. Write the KEY words in the blanks to describe the development of smallpox manifestation:

…………………………….. → …………………… → …………………………………….. →

………………………→………………………………….→…………………………………

8. How many methods of controlling small pox have been used as mentioned in the passage?
a. one
b. two
c. three
d. more than three
9
→ List the method(s). …………………………………………………………………………..
9. What is variolation?
a. surgical technique
b. smallpox vaccine
c. dried scab tissue
d. None is correct.
10. What was the benefit of the first method?
a. It completely prevented small pox.
b. It limited the number of fatalities to the minimum.
c. It only killed 30 per cent of patients.
d. None is correct.
11. What is the word “far” closest in meaning to?
a. many
b. much
c. long
d. very much
12. Was variolation an effective method? Why? Why not?
→
………………………………………………………………………………………………………
………………………………..
13. What is NOT true about the discovery of vaccination by Edward Jenner?
a. It made a development for future control of the disease.
b. With this vaccination, there was body resistance to the disease.
c. Kids were infected with cowpox so that they had the abilities to resist smallpox.
d. Cowpox is as serious as smallpox.
14. Further advances of smallpox control
a. were used all over the world effectively.
b. consisted of dried vaccines and freeze-drying technique.
c. presented both dried vaccines and freeze-drying technique at the same time.
d. All are correct.

1
15. What happened in 1966? (Write the details in notes. The answer a has been done for you as
an example.)
a. the WHO’s ten-year goal for eradication of small pox worldwide
b. ……………………………………………………………………
c. ……………………………………………………………………
16. Why did the WHO formally declare smallpox eradication worldwide in 1980?
a. The last case was reported in 1977.
b. The last patient who died of the disease was reported in 1978.
c. Both a and b are correct.
d. Neither a nor b is correct.
17. What is the difference between the case of smallpox in 1977 and that in 1978?
a. They differed in the source which caused the disease.
b. The former was from a well-developed country.
c. The latter caused more deaths than the former.
d. None is correct.
18. What is NOT true about smallpox?
a. It was almost possible for the transmission of the disease.
b. It was easy for people to contract the disease by infected animals.
c. The effective vaccines were available.
d. Health services worldwide agreed on the eradication of smallpox.
19. What does the word “those” in “…, making those infected aware of the disease at an early
stage …” refer to? → ………………………………………………
20. Rewrite the sentence “Its symptoms develop quickly, … the disease to others”, using
THEREFORE, WHO, and replace “others” with other words. (Remember to use a punctuation
mark correctly.) - Complete this sentence:
→ Its symptoms ……………………………………; ……………………………………….
…………………………………….. infected aware of the disease at an early stage and ……….
the possibility of them unknowingly transmitting the disease to ………………………………… .
21. What is the main idea of the last paragraph?
a. The possibility of the smallpox virus in animals
b. The suggestion that health care staff should be inoculated against smallpox
c. The prevention of stocks of the variola virus from war purposes
d. The reasons why smallpox is still dangerous to the world

1
foring for Our Heolth
the rate of primary are in disease prevention
At the heart of primary care is the concept c›f
preventative medicine, the belief that diseases or
disability should be avoided rather than treated.
How to put this into practice is something which
hau to £re corisi‹1ered by all general practitioners
(GPs). On a purely ecc›uomic basis, the b›enefits
associated. with preventative medicine are
considerable. Firstly, resources for treatment are not
required. In addition. the individual can continue
working and contributing to the economy.
Unfortunately, not all conditioris can be prevented.
Exmnp‹ssindudeinfeedouedisessessuchas
sabnoneBa,whkhcanbeacquñedhcm
contaminated food. However, conditions such as
type 2 diabetes can be largely prevented. With a
rapidly ageing population in many ‹developing
countries, it is important that prevention should
have a high priority in primary care.
Three different aspects of prevention need to be
tnken into account by GPs when coneicteririg the
services they deliver. Firstly, primary prevention
is the promotion of health and the prevention of
8SS WSG iRVOlV8S V&C£flft&t1On TO ROI 'fe8
andefforts to ensure that a safe environment is
pzovi‹:led for individuals. Lifestyle modification
(providing advice and encouragement to patients
on how to change to healthier behaviours) ie a tool
to change this at an individual level. Smoking
cessation cronies are a good example of this.
At a community level, awareness campaigns can
be used to heighten awareness, for example
putting up healthy eating porters. Secondary
preventic›n is concerned with the early
identification of disease and the provision of
prompt treatment to minimize ita damage. This
can include running screening programmes, where
tests for specific conditions are carried out on a
regular basis.
Tertiary pmvention is about reducing the eBecta
of dieeaee and ‹disability on the patient, which
can involve minimizing the patients suffering
using appcapriate analgesia {pain z'elief) or
pmoioting salt-mariagezrierit, dte management of
a coriditic›n by the patients themselves. A good
example of this is with patients who have
diabetes.
1
Screening can deliver conei‹terable
benefits in minimizing the effects of disease. When
used with profiling, that ie, identifying patients
likely to develop specific conditions using data
from patient records, it can be very coat effective.
Early diagnosis, when conditions or diseases are
identified at an early stage, can mean that diseases
are easier to treat arid can be completely cured in
some cases. Diseases screened for include cervical
cancer, breast cancer and heart conditions.
However, ecreenixig is not suitable for all diseases.
Solzie tests can have high levels of falee positives —
results indicatin the zesence at disease.
. Tests can also
b'e expensive and may return few results if
incidence rates for a disease are low, Care needs to
be taken in deciding whether to set up a screening
programme for a specific disease.
In the developed worlcl, targeting three
disease- linked behaviours could provide huge
benefits in human and financial terrfts. The first
of theee ia tobacco smoking, causing death
through lung cancer and vasmilar ‹lieease as well as
chxpnic obstructive pulmonary diseases. It is
estimated that around 100million deaths were
directly attributable to tobacco smoking in the 20a
century and that by 2O3O this will increase by
another billion. Eating too many fatty ancf sugary
foods and not exercising is one of the main causea of
diabetes. According to tlte WHO, diabetes is likely to
be one of the most substantial threats to human
health in the 21a century, with a projected financial
cost of $192 billion by 2020 for the Uzzited
States atone. If diagnosed early, it can be
managed relatively eaeily. T'he flzuzl behaviour is a
zeductiort Tn alcohol abuse. Studies show that ttie
zrñsuse of alcohol can be
:£O6]DOtt61bte TOY' IX IO /@ OC@tt@ B@ SB O¥tB O¥t€t
can impact sigrdfi n hie te
an‹I hver
 EXERCISES on Reading Text CARING FOR OUR HEALTH
the role of primary care in disease prevention
(from English for Medicine, Garnet Education Publishing Ltd., 2011)

Number the paragraphs from 1 to 6:

Part 1: Vocabulary check: Study following words/ phrases, find where they are in the text,
then tell their meaning:

Word/ phrase Meaning

1. screening

2. profiling

3. lifestyle modification

4. self - management

5. false positives

Part 2: Read the text carefully and answer the questions as requested. (It is recommended that
you NOT refer to any dictionary while doing the exercise. Try to GUESS the new words.):

1. Rewrite this sentence, using the Active voice:

“How to put this into practice is something which has to be considered by all general
practitioners.”

You have to clarify the word “this” by one phrase from the previous sentence - the first
sentence in the paragraph

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

2. How many benefits associated with preventative medicine are mentioned in the text? Name
them.
→
………………………………………………………………………………………………………
………………………………………………………………………………………………………

3. What does the write mean by the last sentence in the first paragraph?
a. Developing countries are facing the problem of an increase in old people.

1
 b.There are more and more old people in developing countries; therefore, preventive
medicine should be highly taken care for.
c. Modern medicine can deal with many largely-prevented diseases such as type 2 diabetes.
d. Treatment in medicine is not as important as prevention.

4. What does it mean by “lifestyle modification”, paragraph 2?

→
………………………………………………………………………………………………………
………………………………………………………………………………………………………

Who makes lifestyle modification? GPs or patients?

→
………………………………………………………………………………………………………

5. The word “cessation” in paragraph 2 can be best replaced by

a. examining c. preventing
b. practicing d. stopping

6. Read the paragraphs 2, 3, and 4. Then complete the table: (Write KEY words only)
THREE ASPECTS OF PREVENTION

Aspect Objectives Examples

primary (1) …………………………..

(3) …………………………….
prevention
(2) ………………………….. - safe environment

secondary - early identification of disease (4) …………………………….

prevention ………………………………..
- provision of prompt treatment

(5) …………… (6) …………………………….. - appropriate analgesia

………………. ………………………………… (7) ……………………………..

(in diabetics)

7. What is the difference between “primary prevention” and “secondary prevention”?

1
→ ………………………………………………………………………………………………….
………………………………………………………………………………………………….
8. What does “cost effective” in paragraph 5 probably mean?
a. costing a lot of money c. profitable in exchange for the money
b. good but expensive d. beneficial economically
9. What does “it” in “… it can be very cost effective” refer to?
→ ………………………………………………………………………………………………….
10. Early diagnosis should be done because it helps diseases become easier to treat and then they are
completely cured. (TRUE? or FALSE?)
11. Rewrite the sentence “Diseases screened for include cervical cancer, breast cancer and
heart conditions.”, using a proper Relative Pronoun.
→ ………………………………………………………………………………………………….
………………………………………………………………………………………………….
12. List the disadvantages of screening for which it cannot be used for all cases.

-
-
-
-
13. What is the writer’s idea about a screening programme?
a. GPs have to be careful in suggesting it.
b. A screening programme needs to be taken for a specific disease.
c. Deciding to set up screening is necessary.
d. None is correct.
14. Three disease-linked behaviours consist of
a. control of lung cancer; stop of fatty and sugary foods; a reduction in alcohol misuse
b. cigarette smoking; fatty foods; wine abuse
c. too much tobacco; too much foods; too much alcohol
d. cigarette use; unhealthy diet and lifestyle; alcohol abuse
15. What are the negative results of the behaviours mentioned in question 14?

i. …………………………………………………………………………….
ii. ……………………………………………………………………………
iii. …………………………………………………………………………...

1
 THE FUTURE OF MEDICINE

A Cloning and regenerative medicine

Currently, organs and tissues from living donors are
transplanted in order to replace tho8e, which are
failing or destroyed. However, in many cases the
demand for replacement organs far outstrips supply,
to the point where they are for sale, offered by
poverty-stricken donors in third-world countries. A
new inethcid of organ replacement, using deceasecl
donors, has now been develciped. It has been used
successfully irL an operation to provide a patient with
a new trachea. Thls p replaces the DNA in the
donated organ, using stern cells.genera.ted frorri the
recipient’s tissue. In the case of the trachea transplant
it took alrriost six weeks to complete. Because of the
DNA tran5fer, the recipient’s body recognized the
transplanted trachea as her own and did not reject it.
This is a major development, which holds out the
potential of using the technique for other hollow
organs, such as lungs, in the near future.
Anderton R, Ahmad S, Cloning and regenerative medicine. American
Journal of Medical Ethics. 2007 May 3l;53(11): 132-9

B A model for ending global inequalities in health

. A child firm in Sweden is almost 3D times mñre
likely to each theagepf five diari a child born in
Swazila d. While the national rates conceal
variations in mortality between rich and poor, urban
and rural, it is possible to suggest that national
wealth. is the key factor in determining mortality.
Ploweveo the evident clearly indicates that
mortality is affected by factor other than national
wealth.. The most striking example is the
comparison between the United States and Cuba.
Though life expectancy in both is virtually
identical, the former spends less than $200 per person
on healthcare while the latter spends almost $4,400
per person. Cooper R et al. (2006) state that much of
this is due to relatively small amounts invested in
e ra rtcture cA ned wR h a well-developed hublic
‘ie : „ex :ce of.C: :, copay ex dem"othee"
would be transfoiarict:1'. 1-ioivever; since the 1980s
Cuba has also been involved in technolo8y
deveopmentr e. ,dév#1opmentand
marketing of adyâneeñ drug on a, w.cirldwfdñ sfiale
illustrates how.zrtfi1.can be acbteved by,a
1ow- in«.ooie. couzttry.
Find less M. A miuiel for ending global inequalities in health. Intematic•nat
Journal of Epidemitilogy. 2036 Jan 3J ; 2 (4):S17—824

C The meclical potential of nanotechnology

very impressive. Delivering anti-cancer drugs to the
Developrrierlts in nanotechnology have enorrrious
brain has been a major problem due to the blood-
potential to revolutionize ctrtig delivery systems. The
brain barrier. However, anti-cancer drugs bound to
overall aim is to allow drugs to be deliverecl to the
nanorriaterials have successfully crossed the blood-
areas within the body which they are targeting. The
brainbarrier and released the drugs at therapdiitic
active ingredients of drugs are placed inside a
concentrations in the brain.
wrapper that is genetically deGigned to locate a
particular part of the body. The wrapper i8 attracted to Ratchet C, Brown G, Rail M, VVeng F. The medical pc›tential c›f
the cell receptors of the releva nt area and attaches to nanotechnology. Nature Mancitechnolo . 2008 h‹rv 31; 3(11): 63a
it, discharging its active ingrediertts. Early results are

O Dealing with futuze pandemics

weapon in this fight. I-However, the delay in providing
It is not clear where the HIV viriis emerged from. What is
victims of AlDS with the anti-retroviral drugs to fight the
clear is that since tire recogni.tion of the pan‹:1emic in 1981,
disea‘se, because nf the desire of the drugs companies to
arounct 25 million people worldwide have lost their lives to
make money, suggests that this knowledge may not be
it. The anti-retroviial clrugs which have helped fight
equally applied to all countries and individuals.
I- HV / AIDS owe little to the advances in genetic research
which have taken place over the last l5 years. It is to this
research that we must look when we face up to new threats Braines G, Kahn M. Dealing with future paridemics. Virology
of paridemics. The example of 1-l5N1 (also known as bird Journal. 2008 Sept 31; 5(l):133-142.
flu), which appeared to jump from birds to humans, is
perhaps. the most widely known. The. great understanding of
human biology and viral reproduction which has emerged
from recent research into the human genome gives us a vital
 EXERCISES on Reading Text THE FUTURE OF MEDICINE

(From English for Medicine, Garnet Education Publishing Ltd., 2011)

I. Find the words from the text closest to the meanings of these definitions

1. People who give blood or a part of their bodies to be used by doctors in medical
treatment.
2. Refuse to accept something.
3. The number of deaths.
4. the number of years that a person is likely to live.
5. a disease that spreads over a whole country or the whole world.
6. to become known.

II. These statements are incorrect; find the suitable details to correct them.

1. The trachea transplant needed 3 months to be completed.

2. A child born in Swaziland has more possibility to live than that in Sweden.

3. Mortality is determined by only one factor, that is the national wealth.

4. A person in the US spends almost 22 times more on healthcare than that in Cuba.

5. The aim of nanotechnology in medicine is to deliver drugs to third-world countries.

6. H5N1 originated from humans, infecting others quickly.

III.Match the statements with suitable sections A, B, C, or D

1. The genetic research, in some way, has not helped much in the fight of HIV/AIDS.
2. National wealth is not the key factor to determining mortality.
3. The research was carried out in two American countries.
4. Advances in organ replacement have proved their effect via a new method
named “deceased donors”.
5. Thanks to the advanced technology, active ingredients of drugs can be delivered to
the targeting body organs.
6. In order to fight against diseases, the deep understanding of human biology and
viral reproduction is a need.

1
1
1
Exercises on the Reading Text Computing from basement to bedside
(From English for Medicine, Garnet Education Publishing, Ltd, 2011)

Lead-in questions
- What does the word “basement” mean?
- What can the title of the reading tell you about its content?
Comprehension check (Number the paragraphs from1-5)
1. The word “bulk” in paragraph 1 refers to which of the following?
A. shape
B. size
C. quantity
D. quality
2. Which is closest in meaning to the word” costly” in paragraph 2?
A. cheap
B. cost-effective
C. expensive
D. inexpensive
3. What is true about the use of computers in medicine in the 1970s?
A. Computers were used as an effective diagnostic tool.
B. Computers were fully used in patient care.
C. Computers’ practical uses outweighed their theoretical applications.
D. Computers were mainly restricted to performing administrative tasks.
4. What was NOT an issue of using information in the health care process of the 1970s?
A. How the information was used in clinical practice
B. How the information was spread.
C. How the information was acquired.
D. How the information was analyzed.

2
5. The word “handling” in paragraph 3 most nearly means .
A. dealing with
B. storing
C. accessing
D. saving
6. According to the text, what is NOT an advantage of electronic patient records over paper records?
A. They can be accessed more quickly.
B. More information can be stored.
C. They can be supported quite easily.
D. They can be kept more safely.
7. Which of the following is closest in meaning to the word “conducted” in paragraph 4?
A. made
B. performed
C. carried
D. kept
8. Are the following statements True or False?
a. The use of the Internet in medical practice has fully been employed.
b. It is not always obligatory for a surgeon to perform operations in person.
9. What needs to be solved in order to enhance the electronic exchange of medical
records? (Answer in a four-word phrase)
10. According to the text, what is true of the X-ray usage in the medical practice?
A. The acquisition and storage of X-ray images remain impossible.
B. New machines are unable to comply with the technical advances.
C. It is at the cutting-edge of computer technology.
D. X-ray images cannot be exchanged electronically between heath care professionals.

Post-reading tasks
*Draw a time line and explain why the text is titled “Computing from Basement to Bedside”
*Discuss the future applications of telemedicine.

2
2
Exercises on the Reading Text Principles of Pharmacology

(From English for Medicine, Garnet Education Publishing, Ltd, 2011)

1. What is pharmacology?

2. How does a drug improve health?

3. Are these statements TRUE or FALSE?

A. Autonomic pharmacology studies the central nervous system
B. Pharmacology has developed for a long time
C. Many drugs and medicinal plants were discovered by accident
D. Biochemists can design antiviral agents thanks to the profound understanding of the
molecular structures of viruses
4. Match the terms/names of the drugs and what the passage says about them:
A. Penicillin
B. Toxicology
C. Molecular pharmacology
D. cocaine
E. curare

I. studies the adverse effects of chemicals on the body

II. was used as an anaesthetic
III. destroys bacteria
IV. studies the effect of chemicals on central nervous system
V. was used to immobilize animals
VI. studies the molecular structure of internal receptors
VII. is used to relax patients’ muscles during surgery.

5. Which paragraph (1,2,3,4 or 5) contains the following information :

A. The future of pharmacology
B. Areas of study of pharmacology
C. What students of pharmacology do
D. How many drugs and medicinal plants were discovered

6. What does “they” in the sentence in paragraph 2: “so that they can eventually give greater
benefit in the treatment of disease” refer to?
7. What does “this” in the sentence in paragraph 5 “ This is done by modifying the chemical
structure of an existing drug” refer to?
8. Find the words from the text closest to the meaning of these definitions:
A. bad or unfavorable, not good
B. to remove or get rid of (something that is not wanted or needed)
C. a substance that makes something impure
D. helpful in the process of healing illness or infection
E. to prevent something from moving or working normally
F. a substance that reduces pain

2
Evidence-based medicine in the clinical setting
(From English for Medicine, Garnet Education Publishing, Ltd, 2011)

It is generally agreed that the term evidence-based medicine (EBM) emerged in 1991 from the work of
(1) at McMaster University, Ontario (Sackett et al., 1997). It outlined three different
elements which needed to be combined in order to provide the best level of patient care possible.
Firstly, the best available evidence should be used when deciding what treatment the patient should
receive. Secondly, the experience of the doctor administering treatment should be fully used (2)
. Lastly, the choice of the patient should be taken into consideration. The clinical
benefits from using evidence-based medicine for patients are clearly evident, but there are also
economic benefits. Sackett (et al.,1996) states that evidence-based medicine is a ‘conscientious,
explicit and judicious use of current best evidence in making decisions about the care of individual
patients.’
Most practitioners seem to agree that best practice is desirable, but the literature suggests that there are
enormous barriers to introducing evidence-based medicine into clinical practice. Evidence from the
literature indicates that the most important of (3) is the difficulty of identifying the
best treatment for any given condition. The number of research articles has rocketed over the past 20
years, and doctors do not have time to identify and read all (4) for themselves. As
Greenhalgh (2006) states, ‘Only a tiny proportion of medical research breaks entirely new ground.’
Clearly, then, not all papers are relevant. It is clear that systematic reviews which gather together and
evaluate all the evidence on a clinical topic can help overcome this tremendous problem. The
consensus is that systematic reviews which use only randomized control trials are a ‘gold standard’ of
evidence in terms of (5) . Producing these can be a prolonged process however, with
only 5,000 produced by 2007. For this reason, Clinical Evidence (2009) is an outstanding additional
resource. It summarizes the significance and implication of the new research as it is published, keeping
doctors up to date with important changes.
Some writers have suggested that there are two approaches to implementing evidence-based medicine
in a hospital. The top-down approach involves management implementing detailed clinical guidelines
for (6) using the best available evidence. By then ensuring that health care staff
adheres closely to these guidelines, management can be certain that the work carried out by doctors is
in line with best practice. A bottom-up approach is where the clinical staff themselves is encouraged to
find the best available evidence for procedures and to evaluate it in relation to their own working
situations. The end result is also a set of (7) , but as these are tailored to the specific
situation, the evidence indicates they are more likely to be effective.
As a recent article indicates, getting evidence to the doctors when the decisions are being made on
treatment choices is the ultimate problem. The authors suggest (8) into IT systems
which are used for decision support. Their evidence suggests that this ‘presents an opportunity to both
reduce medical errors and improve delivery of evidence-based patient care’ (Starmer et al., 2006).
However, others have pointed out that doctors can choose to ignore this information if they wish
(Glasziou and Haynes, 2005). These writers have claimed that small teams are very efficient at
implementing guidelines when they focus on clearly defined problem areas and update their
knowledge in an organic way by regularly reviewing their procedures.

2
1/ Read the text. In pairs, complete the text using a – h.
a. these barriers
b. all procedures
c. the available evidence
d. integrating the evidence
e. clinical guidelines
f. a group of doctors
g. when making the decision
h. the effectiveness of treatments

2/ Decide which statements below are true or false.

a. Finding the best treatment for a disease is the most difficulty of evidence-based medicine.
b. All of the findings of medical research are said to have contributed to the effectiveness of
treatments.
c. The approach in which the clinical guidelines are available as the best evidence for medical staff
practice is called bottom-up approach.
d. The combination of evidence and IT system can achieve better evidence-based patient care.
e. Evidence-based medicine focuses on the experience of the doctor when making the decision.

3/ Work in group. Discuss the idea “The clinical benefits from using evidence-based medicine for
patients are clearly evident, but there are also economic benefits”

2
2
Exercises on the Reading text Implications of mapping the human genome

Read the text and mark the statements True or False or Not Mentioned

1. The US Department of Energy and the Welcome Trust are UK medical charity organizations.

2. The genome consists of 3.2 billion base pairs.

3. It was possible to achieve the stated objectives by 2005 thanks to new technologies and
techniques.
4. A rough draft of the human genome sequence was produced to create 90% of the genome

5. InterPro is a project that is similar to the Human Genome Project.

6. Watson and Crick published their paper on the structure of DNA by April 2003.
7. About half of 25,000 human genes were linked to a specific biological function.
8. Specific genes sequences are related to different diseases and disorders.
9. Drugs could be customized for the individuals based on their DNA profile.
10. There are several problems related to the knowledge created by the Human Genome Project.