resulting in a variable degree
and a character-
istic physical appearance.
People with Down's syndrome have an
extra chromosome (47 instead of 46).
Affected individuals have 3 copies of
the disorder is also called trisomy
most cases, it is the result of a sperm or
egg being formed with an extra
. If one of these takes part in
fertilization, the baby will also have the
extra chromosome. This type of abnor-
mality is more likely if the mother is
aged over 35. A less common cause is
a chromosomal abnormality known as a
, in which part of
joined with another chromosome. The
parent is unaffected but has a high risk
of having Down's children.
Typical physical features of a person
with Down's syndrome include small face
and features; sloping eyes with folds of
skin that cover their inner corners; large
tongue; and short, broad hands. People
with Down's syndrome have a greater than
normal risk for certain disorders, such as
a heart defect at birth (see
in the intestines), congenital
. Down's syndrome
children are especially susceptible to
ear infections. A type of
often develops after age 40.
Down's syndrome is usually recog-
nized soon after birth. The diagnosis is
Screening tests during early pregnancy,
those fetuses likely to have the syn-
is then offered.
to reduce high blood pressure (see
). Side effects include dizzi-
ness, headache, and nausea.
by injection, often with other anticancer
drugs. It is used to treat a variety of can-
the treatment of chronic
, and chest infection
. It is also used to
prevent and treat
. Taking the drug
with food reduces possible side effects.
Also known as triple
(whooping cough), and
; The vac-
against these infections. It is
given as a course of 3 injections at 2, 3,
and 4 months, followed by a preschool
booster dose. Before leaving school, a
further diphtheria and tetanus booster
is given. The vaccine does not provide
complete immunity to diphtheria or per-
tussis but reduces risk of serious illness.
Protection against pertussis and tetanus
gradually wanes. In adults, pertussis is
mild but can be transmitted to children.
Since tetanus is serious at any age, boost-
ers are recommended at the time of any
dirty, penetrating injury if there has not
been a vaccination in the past
Reactions to the diphtheria and tetanus
parts of the vaccine are rare. The pertus-
sis vaccine often causes slight fever and
irritability for a day or so. More serious
reactions are extremely rare and include
seizures and an allergic reaction, which
may lead to sudden breathing difficulty
and shock. Permanent damage from the
vaccine is even rarer. Doctors are now
agreed that for most children, the bene-
fits of DPT outweigh the minimal risk
from the vaccine. The pertussis element
of the vaccine should not be given to
children who have reacted severely to a
preceding dose of the vaccine, or who
have a progressing brain abnormality.
An appliance inserted
into a body cavity or wound to release air
or to permit drainage. Drains range from
simple soft rubber tubes that pass from a
body cavity into a dressing to wide-bore
tubes that connect to a collection bag or
bottle. Suction drains are thin tubes with
many small holes to help collect fluid or
air, which is drawn into a vacuum bottle.
The interpretation of a
person's dreams as part of
. First developed by Sig-
mund Freud, it is based on the idea that
repressed feelings and thoughts are re-
vealed, in a disguised manner, in dreams.
Mental activity that takes
It is thought to occur