BackgroundAnaphylaxis is a life-threatening event, but it is frequently undertreated in pediatric patients with food allergies. Previous studies showed that auto-injectable adrenaline (AAI) is underused by patients and parents. This is especially troubling since fatal anaphylaxis has been associated with delayed adrenaline administration.ObjectivesThis study aimed to investigate parental practice and knowledge in anaphylaxis management, and perceived barriers and facilitators in using AAI.ResultsA retrospective survey was completed by 75 parents (41 mothers, 34 fathers) of children with food allergy and AAI prescription attending the Food Allergy Referral Center of Veneto, Italy. Results showed poor parental preparedness and reluctance to use AAI despite a high/moderate self-rated knowledge (median total score of 23–min. 3, max. 30). Most parents (77%) declared they were carrying AAI but only 20% used it in case of a severe reaction. Most reported Fear/Fear of making mistakes (46 parents) and Concern about possible side effects as barriers (35), while Poor knowledge of the correct AAI use (1) and Lack of knowledge/ incorrect assessment of symptoms (2) were reported less frequently. Theoretical-practical courses for parents on AAI use (65), Psycho-education/Psychological support (3) for better dealing with the emotional aspects of anaphylaxis and Written instructions (1) have been suggested as main facilitators.ConclusionUnderstanding parents' experience and perspective on managing anaphylaxis is crucial to implement effective educational programs. A multidisciplinary approach should be considered.

Objectives Preterm premature rupture of membranes (pPROM) causes preterm delivery, and increases maternal T-cell response against the fetus. Fetal inflammatory response prompts maturation of the newborn’s immunocompetent cells, and could be associated with unfavorable neonatal outcome. The aims were to examine the effects of pPROM (Mercer BM. Preterm premature rupture of the membranes: current approaches to evaluation and management. Obstet Gynecol Clin N Am 2005;32:411) on the newborn’s and mother’s immune system and (Test G, Levy A, Wiznitzer A, Mazor M, Holcberg G, Zlotnik A, et al. Factors affecting the latency period in patients with preterm premature rupture of membranes (pPROM). Arch Gynecol Obstet 2011;283:707–10) to assess the predictive value of immune system changes in neonatal morbidity. Methods Mother-newborn pairs (18 mothers and 23 newborns) who experienced pPROM and controls (11 mothers and 14 newborns), were enrolled. Maternal and neonatal whole blood samples underwent flow cytometry to measure lymphocyte subpopulations. Results pPROM-newborns had fewer naïve CD4 T-cells, and more memory CD4 T-cells than control newborns. The effect was the same for increasing pPROM latency times before delivery. Gestational age and birth weight influenced maturation of the newborns’ lymphocyte subpopulations and white blood cells, notably cytotoxic T-cells, regulatory T-cells, T-helper cells (absolute count), and CD4/CD8 ratio. Among morbidities, fewer naïve CD8 T-cells were found in bronchopulmonary dysplasia (BPD) (p=0.0009), and more T-helper cells in early onset sepsis (p=0.04). Conclusions pPROM prompts maturation of the newborn’s T-cell immune system secondary to antigenic stimulation, which correlates with pPROM latency. Maternal immunity to inflammatory conditions is associated with a decrease in non-major histocompatibility complex (MHC)-restricted cytotoxic cells.

Aim: Placental location affects the outcome of pregnancy. The influence of certain maternal factors on placental location is unknown. This study aimed at investigating the relationship between placenta location, maternal blood group, maternal genotype and parity among Port Harcourt women. Methodology: The study was a retrospective study which investigated the Relationship Between Placental Location, Blood Group and Genotype in Port Harcourt Women in Port Harcourt, Nigeria. A survey of pregnant women from October 1, 2013, to September 30, 2017, as well as delivery of the pregnancy, was undertaken using medical records. 250 antenatal/post-natal medical records of parous women were randomly selected at the University of Port Harcourt Teaching Hospital. Placental locations were recorded. Each placenta was categorized as anterior, posterior and fundal. Lateral placentas located on the left or right portion of the anterior and posterior uterine walls were classified as anterior and posterior respectively. Data were also collected for other variables such as maternal blood group, genotype and parity.   Results: Anterior placenta was predominant (47%) followed by the posterior placenta (45%) while Fundal was the least (8%). Majority of the women were of the O blood group (67.6%), blood group A (18%) was next, blood group B (13%) while AB (1.2%) was the least. Genotype AA was predominant (83.6%), followed by AS (15.6%) whereas genotype SS (0.8%) was the least. The distribution of parity showed that women who had given birth twice designated as Two were predominant (33.2%), followed by those who had given birth once designated as One, (30.8%), Three  (19.2%) while Four and above, (10.8%) were the least. The association between placenta location and blood group was not significant (p>0.05). Similarly, there was no significant association between placenta location and genotype (ρ>0.05). However, there was a significant association (p<0.05) between placenta location and parity. Conclusion: Placental location had no association with blood group and genotype but was associated with parity.  There was an absence of a relationship between placental location and these factors.