Pratique du Shadowing: A pediatric cerebrovascular approach: techniques and challenges - Apprendre l'anglais à l'oral avec la vidéo
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138 phrases
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Music My
Ma Musique
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practice is unique in the fact that I do about 90 percent,
Ma pratique est unique du fait que j'en réalise environ 90 %,
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85 percent of what I do is all children.
Quatre-vingt-cinq pour cent de ce que je fais concerne entièrement les enfants.
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children with vascular malformations, both of the brain and the neck, maxillofacial areas.
enfants présentant des malformations vasculaires, à la fois au niveau du cerveau et du cou, ainsi que des régions maxillofaciales.
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We receive them from newborn actually to 19, 18 years of age.
En réalité, nous les accueillons depuis la période néonatale jusqu'à l'âge de 18 ou 19 ans.
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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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Vocabulaire et conseils d’expression pour cette leçon
Cette leçon d’expression orale de niveau C2 s’appuie sur la vidéo « A pediatric cerebrovascular approach: techniques and challenges ». Les mots qui reviennent le plus souvent : malformation, physician, adult, vascular, technique. Cette vidéo contient 138 phrases et 1322 mots à répéter en shadowing. La partie parlée dure 9:26. Le locuteur parle à un rythme régulier d’environ 140 mots par minute, confortable pour le shadowing. 84 % des mots font partie des 3 000 mots les plus courants en anglais ; le reste mérite d’être vu avant de commencer.
Vocabulaire clé de cette vidéo
Les 15 mots les plus avancés de la vidéo, avec leur prononciation et leur sens :
| Mot | Prononciation | Sens |
|---|---|---|
| malformation nom | malformation | |
| vascular adjectif | /ˈvæskjələ/ | vasculaire |
| artery nom | /ˈɑɹ.təɹ.i/ | artère |
| newborn nom | nouveau-né, nouveau-née | |
| catheter nom | /ˈkæθɪtɚ/ | cathéter |
| dedicate verbe | /ˈdɛdɪˌkeɪt/ | consacrer, vouer |
| scar nom | /skɑɹ/ | cicatrice, balafre |
| biodegradable adjectif | /(ˌ)baɪoʊdəˈɡɹeɪdəbl̩/ | biodégradable |
| genie nom | /ˈd͡ʒiː.ni/ | jinn, djinn |
| meticulous adjectif | /mɪˈtɪkjɪlɪs/ | méticuleux, soigneux |
| umbilical adjectif | /ʌmˈbɪ.lɪ.kəl/ | ombilical |
| physiological adjectif | /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/ | physiologique |
| translate verbe | /tɹænzˈleɪt/ | traduire |
| anatomy nom | /əˈnætəmi/ | anatomie |
| tremendous adjectif | /tɹɪˈmɛndəs/ | formidable |
Les verbes à particule que vous entendrez
| Mot | Sens |
|---|---|
| go through verbe | traverser |
La grammaire de cette vidéo
Les structures que le locuteur utilise le plus, avec les mots exacts de la vidéo :
| Structure | Dans la vidéo |
|---|---|
| Present perfect have/has + participe passé — une action passée qui compte encore maintenant | has happened · have dedicated · have developed |
| Voix passive be + participe passé — l’accent est mis sur ce qui arrive, pas sur qui le fait | are born · can be translated · have been developed |
| Propositions relatives who / which + proposition — une précision sur une personne ou une chose | pediatricians, which was · children that are · things which are |
Prononciation à surveiller
Le locuteur utilise 17 contractions et formes réduites, comme we're, you're, don't. Prononcez-les sous leur forme courte, telles que vous les entendez.
- Les sons « th »: catheter /ˈkæθɪtɚ/, anesthesia /ˌæn.əsˈθi.ʒə/, catheterize /ˈkæθətəɹaɪz/, cathode /ˈkæθ.oʊd/, pathway /ˈpæθˌweɪ/
- Les sons « sh » et « zh »: anesthesia /ˌæn.əsˈθi.ʒə/, lesion /ˈliːʒən/, pediatrician /ˌpidi.əˈtɹɪʃ(ə)n/, reproduction /ˌɹiːpɹəˈdʌkʃən/, circulation /ˌsɝkjʊˈleɪʃən/
- Mots longs — placez bien l’accent: biodegradable /(ˌ)baɪoʊdəˈɡɹeɪdəbl̩/, meticulous /mɪˈtɪkjɪlɪs/, umbilical /ʌmˈbɪ.lɪ.kəl/, physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, anatomy /əˈnætəmi/
Les sons difficiles pour les francophones :
- /tʃ/ et /dʒ/ — à ne pas adoucir en « ch » et « j »: genie /ˈd͡ʒiː.ni/, physiological /ˌfɪz.i.əˈlɑ.d͡ʒɪ.kəl/, angiography /ˌæn.d͡ʒiˈɑ.ɡɹə.fi/, inject /ɪnˈd͡ʒɛkt/, puncture /ˈpʌŋkt͡ʃɚ/
- /r/ anglais — langue recourbée, sans frotter la gorge: artery /ˈɑɹ.təɹ.i/, scar /skɑɹ/, biodegradable /(ˌ)baɪoʊdəˈɡɹeɪdəbl̩/, translate /tɹænzˈleɪt/, tremendous /tɹɪˈmɛndəs/
Comment s’entraîner avec cette vidéo
- Écoutez la vidéo en entier une fois sans parler et notez les mots que vous ne connaissez pas.
- Répétez phrase par phrase à vitesse normale, en reprenant chacune jusqu’à ce que votre rythme corresponde à celui du locuteur.
- Enregistrez-vous et comparez avec l’original, en faisant attention à des mots comme malformation, vascular, artery.
Qu'est-ce que la technique du Shadowing ?
Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.