Alexandra Taggart Feb 17, 2010:

Sorry, Rachel - vice versa My translation from e-mail:"The biochemical results are obvious, but symptoms are weak or null".

Alexandra Taggart Feb 17, 2010:

Forgive me everyone before the Day of Forgiveness. I've translated some of this discussion to the neuropathologist (I have to visit him regularly due to my head trauma), who said by e-mailing to me, that such diagnosis results came from a lab - they are clinical results, something is not enough there and the word "невыраженная" expresses DEFICIENCY in a biochemical analysis, that contradicts the obvious symptoms detected during the observation.

Natalie Feb 17, 2010:

May I suggest that we stop discussing whose degree and in which field is better or worse as this discussion becomes personal, does not help the asker at all, and, moreover, violates rules http://www.proz.com/siterules/general/2#2, http://www.proz.com/siterules/kudoz_answ/3.5#3.5 and http://www.proz.com/siterules/kudoz_answ/3.7#3.7 . Michael, please post an argumented answer if you wish, otherwise please kindly stop abusing the discussion field. Thank you.

Michael Korovkin Feb 17, 2010:

You continue talking around the argument As for the un-known degree of expertise, I have an MD and a biology degree in neurophysiology(both - from Russia, so, I would know what I am talking about without resorting to Google, wouldn't I?), I'm a full professor of Medical Anthropology (a new book on stress coming out in April, in which anaemia is dealt with as well), because I also have a Masters Degree and a doctorate in Anthropology. Enough rank throwing for you? But I think I've lost enough time on this evidently fruitless exercise already. Say hello to your specialists for me and, of course, to Google

Rachel Douglas (asker) Feb 17, 2010:

Thank you, Michael... for your opinion, expressed with a high dose of Sturm und Drang and an unknown degree of expertise. Happily, I'll have the opportunity to consult with two physician/translators - one a native speaker of English, the other of Russian - before the deed is done. I was hoping to clarify as many difficult points as possible, before bothering them, but in this case there has been too much flapping and expostulating to arrive at a clear determination. As far as I know, "(не)выраженный" sometimes means "not-/pronounced" and, in those cases, has nothing to do with being manifested or not; possibly that's not the case here, but you haven't proven that to me. I really don't care who's right; I'd rather know what's right.

Michael Korovkin Feb 17, 2010:

OK, then, basically, Natalie argues that, cutting the frills, невыраженная=легкая. You can google and overgoogle, and quote whatever scales and gradients (incidentally, beside the point) but it is my well-considered opinion that the argument completely breaks down over a simple and absolutely undeniable clinical fact that ЛЕГКАЯ АНЕМИЯ МОЖЕТ БЫТЬ ВЫРАЖЕННОЙ И НЕВЫРАЖЕННОЙ exactly like in your (wrongly) chosen anwer, mild anaemia may be and often is observable or asymptomatic. And that's the difference: heavy anaemia is ALWAYS vyrazhennaia, whilst the mild one may be either or. You see now why it is said that synonyms don't really exist? You are not translating here but trespassing into editing the medical text, substituting – through your "mild" and tons of clever argument – "nevyrazhennaia" with "legkaia", which ain't right and, tons of clever argument notwithstanding, an unsafe practice. To err is human; to insist on the error is diabolic. Cheers, I think I've nothing else to say.

Rachel Douglas (asker) Feb 16, 2010:

Thank you, Natalie! I do appreciate your rigorous commentary. From the outset, I was trying to understand whether "(не)выраженный" corresponded to "expressed/not expressed" (i.e., "asymptomatic") in English, or to the other, quite widespread, sense of "выраженный", namely "pronounced/not pronounced." Your documentation that it is the latter is quite convincing. Also, there are English-language sources in accord:
"Clinically relevant levels of anaemia (mild to moderate, pronounced, and severe) were graded..."
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC500425/
(In other words, the "mild to moderate" would be "not pronounced.")
This reading is bolstered by the existence of the several English-language sources I found which refer to "mild asymptomatic anemia," indicating that the type and level of anemia can be both these things; i.e., that mild/asymptomatic is irrelevant as a categorical distinction in English.

Also pushing me in favor of your interpretation is the fact that my 60 thousand-word text has zillions of instances of conditions being described as "asymptomatic" using the word "асимптоматический", not "невыраженный".

Natalie Feb 16, 2010:

Hi Rachel Sorry for late response. Let me explain. Невыраженная here is the opposed to выраженная. Выраженная анемия means that Hb level is much lower than the LLN (lower limit of normal), while невыраженная means that Hb is somewhat lower than LLN. The normal level of Hb is 132—173 g/L; therefore 95 g/L are defined as mild anemia while, for example, 50, or 30 g/L would be defined as severe anemia. Here is a reference for you:

По уровню снижения содержания гемоглобина выделяют легкую степень анемии (110–90 г/л), среднюю (90–70 г/л) и тяжелую (<70 г/л).
http://www.consilium-medicum.com/magazines/magazines/cm/pedi...

Michael Korovkin Feb 16, 2010:

Rachel sometimes your consciencious thoroughness gets on your own way! Asymptomatic (as you doubtless aware, meaning "with no signs" is perfect. "Subclinical" would do too but it's less safe. Silent (or, even posher, acephalic) – somebody mentioned is even more problematic for it's often used for "active" sickness (say hepatitis) rather than, as it were, for gradual wasting away.

Rachel Douglas (asker) Feb 16, 2010:

Despite the surfeit of arm-waving... I don't believe this question has (yet) been thoroughly answered to my satisfaction. As I said, I'll reopen it if somebody really sheds a brighter light on the matter. I appreciate the discussion, but haven't found decisive help in it. ... To tell you the truth, I didn't mean to close the question; I mixed it up with a question for which the system was demanding that I pick an answer, even though I was far from ready to do that and my deadline is many weeks away.

Michael Korovkin Feb 16, 2010:

Hear, hear, Gabrielle! All I could add is that one must be particularly careful not as much in asking and answering questions as in choosing the right answer: unfortunatelly, often the same lack of competence that prompts us to ask a question (as we all do) prevents us from being able to pick the most suitable, or at least the safest, of the answers proferred. The helpers may come from very disparate linguistic fields, but the asker must be extra-careful and try to pick something that at least isn't going to hurt. In the case in point she did not... sorry Rachel! :)

Rachel Douglas (asker) Feb 16, 2010:

For the follow-up discussion... About how the question was posed: one _was_ "careful" in posing the question. I asked: Is Hb > 95 г/л, described as "невыраженная" in Russian, called "mild" anemia in English, or is it "asymptomatic"? That is, I provided the specific context, namely the hemoglobin level which defines this condition (it appears in a list of possible side effects of one drug).

I appreciate the observations by Michael, and would be interested in what Natalie has to say about them, if she has time to comment further, because - in replying to Ellen - she indicated specific knowledge about how the term "невыраженный" is used.

For what it's worth, there are many English-language medical articles and sections of books which talk about "mild, asymptomatic anemia." Thus, it seems clear that mild vs. asymptomatic is not a categorical distinction in English, when talking about anemia.

I have three weeks available to decide this problem (and can reopen the question here, if appropriate).

Alexandra Taggart Feb 16, 2010:

Beautiful, Gabrielle!!! "Clinically undetectable" - correct!

Gabrielle Leyden Feb 16, 2010:

weak vs nil Agree with Michael & Ellen - silent, subclinical, and latent anemias are not the same as a clinically detectable or patent "mild anemia." One should be careful when asking questions (complete expressions and/or context!) and giving answers.

Michael Korovkin Feb 15, 2010:

It's all very nice but: "Slabo vyrazhennaia anemia" and "nevyrazhennaia anemia" are two different kettles of fish. The difference is not quantitative as your choice implies but categorical. As a matter of fact, such anaemias as, for example, the potentially lethal pernicious anaemia, during the first period of their development (sometimes years) are not "weakly expressed" but are, as is the case in point, not expressed at all, that is asymptomatic. Moreover, what is often implied by the term is that differently from SVA, NVA remains un-diagnosed and that's exactly why the distinction is so important: "no symptoms" is drastically different from "weak symptoms". If, say, you fail to diagnose something (and screw the patient over) because there were no symptoms, is the ordinary hardships of the medical art; if you neglect to diagnose something though the symptoms are observable albeit weakly expressed, it's a professional suicide. That's why expressions like the one in question require an extra careful aproach without inferences as to what the expression "should have been", which, to me, is a vyrazhennyj sign of undue interference into the original text.

Natalie Feb 13, 2010:

Эллен Здесь все дело в употреблении слов "выраженный", слабо выраженный", "сильно выраженный" и т.п. русскими врачами. Смысл, вкладываемый в слово "невыраженный" иной, нежели смысл, вкладываемый в слово "скрытый"

Ellen Kraus Feb 13, 2010:

ввнду того, что для латентной формы анемия характерна скудность явно выраженных клинических проявлений, автоматически думаешь что при невыраженной анемии речь идет о скрытой или патентной анемии. It is thus hard to believe that the Russian counterpart of mild anemia is неывраженная а. rather than something like слабо развитая форма анемия.Однако век живи, век учисьб а ........