Rapid death from thrombotic thrombocytopaenic purpura following caesarean section.

We report a case of rapid death from thrombotic thrombocytopaenic purpura (TTP) in a young pregnant lady who developed full blown symptoms soon after caesarean section. Extensive intramyocardial confluent haemorrhages and widespread microthrombi in heart, brain, adrenals and kidney were found at autopsy. Thrombotic thrombocytopaenic purpura is an uncommon condition, which carries a high fatality rate if untreated. Awareness of this syndrome together with its high risk of sudden death underlines the importance of rapid diagnosis and treatment.     

Determination of cocaine and benzoylecgonine in human amniotic fluid using high flow solid-phase extraction columns and HPLC.

A new solid-phase extraction procedure for the determination of cocaine and benzoylecgonine in amniotic fluid, using high flow co-polymeric sorbents is reported. The recoveries of cocaine and benzoylecgonine within the range 0.1-1 mg/l were 95.7% and 50.3%, respectively. The use of high-flow sorbents allowed the easy extraction of amniotic fluid regardless of sample viscosity or physical nature. The use of these solid-phase columns provided many advantages over the more commonly used solvent extraction, including an increase in extraction speed and efficiency, reduced operator time, reduced solvent use and disposal volumes and exceptional extract quality. Further, the determination of amniotic fluid obtained from pregnant cocaine users may provide important information about handling of cocaine by the fetus at various gestational ages. The procedure was successfully applied to amniotic fluid from suspected cocaine abusers.     

Bargaining for justice: A means to resolve competing justice claims

In many types of social situations, individuals defend their claims to a portion of the rewards by arguing that they are just. Although a great deal of research demonstrates that individuals differ in their distribution preferences and thus their beliefs about what is fair, the literature curiously omits consideration of the consequences of these differences, especially the conflict they may engender. This paper first reviews the few attempts to address such justice conflict. The limitations of these approaches suggest concerns to be addressed in an alternative framework. The paper presents a theoretical discussion of this alternative that integrates assumptions about distribution preferences, justice beliefs, conditions fostering the emergence of justice conflict, and elements of negotiation processes as a basic framework for predictions about the bargaining strategies individuals may employ to resolve competing justice claims.     

Parent-adolescent congruence on decision-making and its relation to adolescent adjustment

Much attention has been paid to the nature of parent-adolescent relationships, with a frequent conclusion being that it is a time of marked disagreement between parents and their adolescents. However, other literature suggests that this time is not inherently conflictual. The purpose of this study was to examine agreement and disagreement between mothers, fathers, and adolescents on specific issues. Then, adolescent adjustment was assessed, and the degree to which it was a function of congruence with parents was examined. A modified version of the Issues Checklist was used to measure intrafamily agreement; the Revised Behavior Problem Checklist and the Harter Scale of Child's Actual Competence were completed by adolescents' social studies teachers to assess adolescent functioning. Relative to their parents, adolescents reported that they should make more decisions alone, while both mothers and fathers reported that decisions should be made jointly among all family members. Only father-adolescent congruence was found consistently to be related to adolescent functioning. Possible explanations for the present results and relevant issues pertaining to family agreement are discussed.     

Is technology transfer to subsistence farmers doubling nothing?

Editors Note: This commentary touches on an aspect of technology transfer to the Third World that often is neglected: Can the technology recipients afford to use it? Although the authors focus on the economics of shrimp production by subsistence farmers, affordability is one of the major concomitant issues of transfer from developed to developing countries.     

Chronic disease and disadvantage: the new politics of HIV infection

HIV infection is now perceived as the end stage of a chronic disease that is spreading most rapidly among blacks and Hispanics. The politics of the HIV epidemic in the 1980s were dominated by four interacting factors: fear and fascination; who had the disease and to whom it seemed to be spreading; the endemic problems of United States social policy; and the impact on policy of advances in scientific knowledge. This paper analyzes the political history of each of these factors and describes the dominant policies of the federal government and the states regarding HIV in the areas of surveillance, prevention, research, and financing. Four uncertainties will have a profound influence on the future politics of the HIV epidemic: how the states and the federal government will address the general problems of paying for the care of people with chronic diseases and providing access to care for the uninsured and the underinsured; the number and distribution of the sexual behaviors that transmit infection with HIV and the effectiveness of policies to persuade people to modify these behaviors; precisely who uses addictive drugs and the effectiveness of measures to change their behavior; and the natural history of the virus.