Fetal and neonatal alloimmune thrombocytopenia: a late or missed diagnosis disease in fetal and perinatal health-care settings.

INTRODUCTION: Even though Fetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) has been recognized as the main cause of primary hemorrhagic morbidity and mortality in fetuses and newborns, screening programs to detect pregnancies at risk have not yet been implemented in any country. Moreover, in spite of increased concerns about maternal, fetal and neonatal health care in general, this potentially lethal disease is still underdiagnosed. The aim of this report is to highlight the importance of considering FNAIT in fetal and perinatal health-care settings and show the usefulness of molecular tools in early diagnosis of this clinical entity. METHODS: DNA was extracted from whole blood from parents and newborns; genotyping was performed by in house PCR using sequence-specific primers for typing Human Platelet Antigens (HPA)-1 to -6, -9, and -15, and with commercial HPA-TYPE (BAG HealthCare, Lich, Germany). Anti-HPA antibodies in the maternal serum were detected by the Monoclonal Antibody Solid Phase Platelet antibody Test (MASPAT). Chloroquine-treated platelets were used for the discrimination of platelet-specific antibodies from anti-HLA antibodies. RESULTS: Patients 1 and 2 had severe thrombocytopenia due to incompatibility in HPA-1 and HPA-15, respectively. The third case was a thrombocytopenic neonate with severe bleeding complications other than ICH and in whom differential diagnosis between FNAIT and Von Willebrand congenital disease was necessary; incompatibility in HPA-15 was also demonstrated. Case 4 represents a missed diagnostic opportunity. CONCLUSION: This is the first report of FNAIT cases confirmed by molecular evidence and anti-HPA antibodies detection in Argentina. This report reinforces the relevance of early diagnosis of this clinical entity. Since the delay in FNAIT diagnosis could lead to severe consequences in the fetus and neonates, strategies to approach maternal, fetal, and perinatal health, as well as prevention policies aimed to reduce fetal and neonatal morbidity and mortality should focus on implementing programs to identify high-risk pregnancies and thus reduce thrombocytopenia-related complications in fetuses and newborns.

Dangerous Worldview and Perceived Sociopolitical Control: Two Mechanisms to Understand Trust in Authoritarian Political Leaders in Economically Threatening Contexts.

In this research we analyzed the relationship between threatening economic contexts (i.e., undergoing the economic crisis and having low socioeconomic status) and trust in authoritarian ideologies and leaders, regardless of the left-right political axis. Based on two theoretical approaches (i.e., the dual-process model and the compensatory control model), we argue that this relationship is mediated by dangerous worldview and low perceived sociopolitical control. We conducted two correlational studies with samples of the general population. In Study 1 (N = 185), we found that perceived threat from the economic crisis and low socioeconomic status were correlated with a higher dangerous worldview, which resulted in a more authoritarian ideology (i.e., authoritarianism) and finally in greater trust in an authoritarian political leader. In Study 2 (N = 413), we replicated the findings of Study 1 and demonstrated that low perceived sociopolitical control was associated with higher authoritarianism. Moreover, low perceived sociopolitical control partially mediated the relationship between dangerous worldview and authoritarianism. Overall, our results show that two economically threatening contexts (i.e., the economic crisis and low socioeconomic status) promote authoritarianism and trust in authoritarian leaders (with unspecified political orientation) through psychological processes (i.e., perception of the social world and perceived control). These results are useful to understand and combat the rise of authoritarianism in our societies during financially difficult times such as economic crises.

Allergic reactions to peanuts, tree nuts, and seeds aboard commercial airliners.

BACKGROUND: Minimal data exist on the prevalence and characteristics of in-flight reactions to foods. OBJECTIVES: To characterize reactions to foods experienced by passengers aboard commercial airplanes and to examine information about flying with a food allergy available from airlines. METHODS: Telephone questionnaires were administered to individuals in a peanut, tree nut, and seed allergy database who self-reported reactions aboard aircraft. Airlines were contacted to obtain information on food allergy policies. RESULTS: Forty-one of 471 individuals reported allergic reactions to food while on airplanes, including 4 reporting more than 1 reaction. Peanuts accounted for most of the reactions. Twenty-one individuals (51%) treated their reactions during flight. Only 12 individuals (29%) reported the reaction to a flight attendant. Six individuals went to an emergency department after landing, including 1 after a flight diversion. Airline personnel were notified of only 3 of these severe reactions. Comparison of information given to 3 different investigators by airline customer service representatives showed that inconsistencies regarding important information occurred, such as whether the airline regularly serves peanuts. CONCLUSIONS: In this group of mainly adults with severe nut/seed allergy, approximately 9% reported experiencing an allergic reaction to food while on board an airplane. Some reactions were serious and potentially life-threatening. Individuals commonly did not inform airline personnel about their experiences. In addition, the quality of information about flying with food allergies available from customer service departments is highly variable and, in some cases, incomplete or inaccurate.