Shadowing Practice: A pediatric cerebrovascular approach: techniques and challenges - Learn English Speaking with Video
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Music My
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practice is unique in the fact that I do about 90 percent,
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85 percent of what I do is all children.
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children with vascular malformations, both of the brain and the neck, maxillofacial areas.
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We receive them from newborn actually to 19, 18 years of age.
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We do of course also adults with vascular malformations,
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but as things are evolving and you can see how fantastic this course is and the tremendous progress that has exist.
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So children are not small adults and that has happened throughout medicine.
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There was the general doctor first,
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then became pediatricians, which was obviously that required different things.
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So within the vascular lesions of the human body,
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there's a certain amount of diseases that occur in children primarily,
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and that affect children sometimes exclusively.
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So, based on my practice,
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I have dedicated myself to improve the treatment in those children,
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decrease the radiation, decrease the time of the procedure,
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being very meticulous with the technique, very meticulous with fluids.
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For small children that are in severe heart problems with brain problems,
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if you use the same techniques in adults,
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you actually could have a lot of harm.
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So there are dedicated, specific problems that occur in children.
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There are specific, dedicated challenges,
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technical, medical, physiological, that are specific for children.
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And there's even difference between children and newborns.
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We have newborns that are born in severe heart failure with a disease called vein of gallant malformation
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that even treated is lethal within the first year of life.
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So those children require techniques,
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for example, we develop techniques to go through the umbilical artery.
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So we can actually place a cathode from the umbilical artery to enter the body,
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to then navigate into the brain.
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In this pediatric population, the diseases are rare,
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so it's very hard to do really trials.
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We're more involved in developing devices,
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actually because coming from children,
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they can be translated towards adults.
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We also have a lot of patients,
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or practices, patients of rare diseases,
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such as vascular malformation of the maxillofacial area.
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very difficult to treat.
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So we have developed techniques like direct percutaneous puncture.
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Instead of going from the femoral artery and trying to catheterize them,
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it's to actually use 3D angiography or the eye guide
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or the different types of technologies that have been developed for adults
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and try to use them to place catheters or needles directly into the malformation.
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And that has changed the whole ballgame.
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We also involve trying to develop things which are called sclerotherapy.
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Sclerotherapy is a technique in which you inject something that will damage the endothelium.
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And then the healing of that scarring,
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that will produce scarring, will actually sclerose or thrombose or close and scar those vascular malformations that they cannot feel.
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And that includes venous malformation.
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That includes lymphatic malformations.
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That includes arteriovenous malformation.
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And we're using biological substances such as chemotherapeutic agents, bleomycin for example.
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And they've made a tremendous change in the outcome of this patient.
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Actually, we're trying to use more and more ultrasound to guide ourselves to do these procedures.
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Also, within the medical industry of x-rays,
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we're forcing the manufacturers to create things like last image hold.
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And then with that last image hold,
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will, for example, collimate, try to center memories so that we don't have to radiate these children.
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Mothers come to me and ask me that,
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will my child have a stroke while you're doing this horrible malformation?
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They ask me how much radiation are they gonna get?
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Or the anesthesia?
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Well, there is a potential role for endovascular radiosurgery.
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I worked like 15, 20 years ago to try to treat vascular malformations that way.
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But radiation is a difficult thing to control.
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It's a difficult thing to prove,
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a difficult thing to get approved through a regulatory pathway like the Food and Drug Administration and so on.
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And dangerous for everyone, including you as an operator.
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Everything is dangerous if it's improperly used.
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You know, if you have a genie and you let the genie out of the box and there's no control,
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it can be very, very dangerous.
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So I would say that radiation has a potential,
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but it is not something that is around the corner.
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The tools that we have today are pretty much adaptation of adults to children.
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So we're still at the beginning.
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We're very much interested in developing tools that are designed for newborns and for children,
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which today do not exist.
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So we take a catheter that is a meter and a half,
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because it's the only catheter that we have.
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The technology exists, but the market is so small
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that industry is not very interested in developing high technology for a very small market.
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And this is not simply the question of smaller arteries.
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It's a whole question of a different anatomy that you're dealing with.
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It's a different anatomy.
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It's a different technology necessary for the stiffness, for example.
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You know, the blood vessels in children are more fragile in a sense.
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But on the other hand, they're more elastic.
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So they have their own specific problems,
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both technically as well as physiological.
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One of the biggest questions that we have is if we take a device,
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for example a stent, that is developed for adults which have stopped growing and we put them in small children,
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what would happen to those vessels as we increase in size?
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And therefore, personally, we have a lot of skepticism of using stents unless we are really forced.
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And the other side of the coin is we're going to press
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and push industry to develop bioactive or biodegradable devices so that
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if I put a stent in a little child and that stent will then be reabsorbed,
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it will permit then the normal physiologic growth.
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Biodegradable, bioabsorbable, biocompatible.
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It's one of the great, great, great potential expansion.
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If we can develop it for children,
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it can then be transferred to adults.
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What is interesting is that we've done very small devices based on trying to do it for pediatrics,
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and those have translated to go to the adult,
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which permits you to go to more distal circulation.
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I think that's very valuable for the training of physicians.
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You know, when I started,
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it was see one, do one,
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teach one, that no longer applies.
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We're not, it's just so much better to train,
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and I'm very involved in the training of physicians,
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training physicians in a in vitro model.
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You know, get all, I mean,
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you actually today, the reproduction is, Dr. Moret, so fantastic.
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You know, it's literally like the real thing.
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But then you get the physician to learn.
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You get the physician to train,
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you get the physician to try,
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you get the physician to make the mistake in a model.
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By the time you transfer that to the real patient,
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you have a much better trained physician.
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And I think industry is now more and more turning to these models.
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And the regulatory agencies are saying,
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wait a second, you not only have to go and train in a model first.
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You know, it used to be sometimes an animal.
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Then, you know, as you know,
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there's a lot of movement against training in animals.
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So these things have replaced a lot of the training.
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The regulatory agencies will force us to train physicians in this type of models that are now readily available.
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3D printing can make exactly the same aneurysm immediately, right away.
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And not only that, I can make 20 of those,
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or 50, or 100 to train physicians.
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So that I do believe that following that comes the proctoring.
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In other words, now you're going to go,
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this individual who's trained in the model is going to go do humans.
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So when you go humans,
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you go with somebody experience,
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the fracture you, I think that is absolutely the way to go.
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Vocabulario y notas de pronunciación para esta lección
Esta lección de conversación de nivel C2 se basa en el vídeo “A pediatric cerebrovascular approach: techniques and challenges”. Las palabras que más se repiten: malformation, physician, adult, vascular, technique. Este vídeo tiene 138 frases y 1322 palabras para practicar shadowing. La parte hablada dura 9:26. El hablante mantiene un ritmo constante de unas 140 palabras por minuto, cómodo para el shadowing. El 84 % de las palabras está entre las 3.000 más comunes del inglés; conviene repasar el resto antes de empezar.
Vocabulario clave de este vídeo
Las 15 palabras más avanzadas del vídeo, con su pronunciación y significado:
| Palabra | Pronunciación | Significado |
|---|---|---|
| malformation sustantivo | malformación | |
| vascular adjetivo | /ˈvæskjələ/ | vascular |
| stent sustantivo | /stɛnt/ | estent |
| artery sustantivo | /ˈɑɹ.təɹ.i/ | arteria |
| newborn sustantivo | recién nacido, neonato | |
| catheter sustantivo | /ˈkæθɪtɚ/ | catéter |
| dedicate verbo | /ˈdɛdɪˌkeɪt/ | dedicar |
| scar sustantivo | /skɑɹ/ | alforza, facial chirlo |
| biodegradable adjetivo | /(ˌ)baɪoʊdəˈɡɹeɪdəbl̩/ | biodegradable |
| genie sustantivo | /ˈd͡ʒiː.ni/ | genio |
| maxillofacial adjetivo | maxilofacial | |
| meticulous adjetivo | /mɪˈtɪkjɪlɪs/ | meticuloso, minucioso |
| umbilical adjetivo | /ʌmˈbɪ.lɪ.kəl/ | umbílico, umbílica |
| physiological adjetivo | /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/ | fisiológico |
| translate verbo | /tɹænzˈleɪt/ | traducir, trasladar |
Phrasal verbs que vas a escuchar
| Palabra | Significado |
|---|---|
| go through verbo | atravesar |
Gramática en este vídeo
Las estructuras que más usa el hablante, con las palabras exactas del vídeo:
| Estructura | En el vídeo |
|---|---|
| Present perfect have/has + participio pasado — una acción pasada que sigue importando ahora | has happened · have dedicated · have developed |
| Voz pasiva be + participio pasado — importa lo que ocurre, no quién lo hace | are born · can be translated · have been developed |
| Oraciones de relativo who / which + oración — información extra sobre una persona o cosa | pediatricians, which was · things which are · adults which have |
Pronunciación a tener en cuenta
El hablante usa 17 contracciones y formas reducidas, como we're, you're, don't. Dilas en su forma corta, tal como las oyes.
- Los sonidos de “th”: catheter /ˈkæθɪtɚ/, anesthesia /ˌæn.əsˈθi.ʒə/, catheterize /ˈkæθətəɹaɪz/, cathode /ˈkæθ.oʊd/, pathway /ˈpæθˌweɪ/
- Los sonidos de “sh” y “zh”: anesthesia /ˌæn.əsˈθi.ʒə/, lesion /ˈliːʒən/, pediatrician /ˌpidi.əˈtɹɪʃ(ə)n/, reproduction /ˌɹiːpɹəˈdʌkʃən/, circulation /ˌsɝkjʊˈleɪʃən/
- Palabras largas — cuida el acento: biodegradable /(ˌ)baɪoʊdəˈɡɹeɪdəbl̩/, meticulous /mɪˈtɪkjɪlɪs/, umbilical /ʌmˈbɪ.lɪ.kəl/, physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, anatomy /əˈnætəmi/
Sonidos difíciles para hispanohablantes:
- s + consonante al inicio — sin añadir una “e” delante: stent /stɛnt/, scar /skɑɹ/, sclerose /skləˈɹəʊs/, skepticism /ˈskɛp.tɪˌsɪ.zəm/
- /v/ — no es /b/: los dientes tocan el labio inferior: vascular /ˈvæskjələ/, venous /ˈviː.nəs/, navigate /ˈnæv.ɪ.ɡeɪt/, vein /veɪn/, evolve /ɪˈvɑlv/
- /z/ — sonora, no /s/: physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, translate /tɹænzˈleɪt/, aneurysm /ˈæn.jəɹ.ɪz.əm/, catheterize /ˈkæθətəɹaɪz/, skepticism /ˈskɛp.tɪˌsɪ.zəm/
Cómo practicar con este vídeo
- Escucha el vídeo entero una vez sin hablar y anota las palabras que no conoces.
- Haz shadowing frase por frase a velocidad normal, repitiendo cada una hasta que tu ritmo coincida con el del hablante.
- Grábate y compara con el original, prestando atención a palabras como malformation, vascular, stent.
¿Qué es la Técnica de Shadowing?
Shadowing es una técnica de aprendizaje de idiomas respaldada por la ciencia, desarrollada originalmente para la formación de intérpretes profesionales y popularizada por el políglota Dr. Alexander Arguelles. El método es simple pero poderoso: escuchas audio en inglés nativo y lo repites en voz alta de inmediato, como una sombra que sigue al hablante con solo 1-2 segundos de retraso. A diferencia de la escucha pasiva o los ejercicios de gramática, el shadowing obliga a tu cerebro y músculos de la boca a procesar y reproducir simultáneamente patrones de habla reales. Las investigaciones muestran que mejora significativamente la precisión de la pronunciación, la entonación, el ritmo, el habla conectada, la comprensión auditiva y la fluidez al hablar, convirtiéndola en una de las metodologías más efectivas para la preparación del IELTS Speaking y la comunicación en inglés en el mundo real.