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The aim of this paper is to present a new approach to the management of uncertain lumpy demand. After providing a comprehensive review of the related literature, a new model is introduced, with the objective of improving the firm's ability to cope with lumpy orders. Its innovative principle relies on the exploitation of the information collected by the Sales Department during the negotiation process; such information helps to minimize the impact of the lumpy orders, thus reducing the need for oversized production capacity and/or working capital. An analytical model is presented to solve the trade-off between anticipating the production as soon as the order negotiation starts (thus risking production with no final order) and waiting until negotiation ends (thus risking a low service level due to the shorter time available to respond to the lumpy order): the right balance is found by keeping the right amount of stocks and of overcapacity. The model described turns out to be simple and easy to implement, since its informative needs consist of data usually available within the company, although often not exploited. [ABSTRACT FROM AUTHOR]

Clostridium difficile causes antibiotic-associated diarrhoea and pseudomembranous colitis. The main virulence factors of C. difficile are the toxins A (TcdA) and B (TcdB). A third toxin, binary toxin (CDT), which pathogenetic role had been remained largely overlooked until few years ago, nowadays have been detected in 5%-23% of strains. C. difficile has spread around world. Clostridium difficile infection (CDI) is one of the most common health-care associated infections and a significant cause of morbidity and mortality among older adult hospitalized patients. Diagnosis of CDI is often difficult and has a substantial impact on the management of patients with disease. It is usually based on a clinical history of recent antimicrobial usage and diarrhoea in combination with laboratory tests. Although the conventional methods are crucial for the diagnosis and the subsequent treatment of CDI, a timely laboratory diagnosis is essential for the detection of toxigenic strains providing either to an effective and immediately treatment or to the prevention of further disease transmission. In this review we provide general recommendations for testing of samples collected from patients with suspected CDI. [ABSTRACT FROM AUTHOR]

MG is a common event of hematologic malignancies. There are many papers regarding kidney transplantation patients with MGUS in adults, while data in pediatrics are scarce. The etiology and clinical significance of MGUS are unclear both in adults and children. Immunosuppressive drugs, graft antigenicity, and viral infection could play a possible role. The viruses most frequently implicated seem to be EBV or CMV in particular, but their role has to be defined better. However, many investigators have emphasized an impaired balance between an adequate immune response and reactivation of viral infection. [ABSTRACT FROM AUTHOR]

This paper aims at presenting a new approach to the management of uncertain lumpy demand. After providing a comprehensive review of the related literature, a new approach is introduced here in order to reduce the need for stocks when coping with uncertain lumpy demand. The basic idea of this approach is that of exploiting available information within the company or within the company's supply chain, so as to minimize the impact of lumpy orders and reduce the need for stocks. Two theoretical models are presented here to address the trade-off between the benefit of the lower inventory level and the cost of the higher risk related to the anticipatory use of uncertain information: the first model treats the lumpy order quantity as deterministic, while the arrival of the order is considered as a stochastic event; the second model deals with the opposite situation, when the arrival of a lumpy order is certain, while the order quantity is uncertain. These new models turn out to have a relevant interpretative power, and seem useful in real-life management of lumpy demand, since they can boost running capital productivity resorting to information usually available within or around the company, although often not exploited. [ABSTRACT FROM AUTHOR]

Polymerase chain reaction (PCR) amplification and colorimetric identification of amplicons were performed to detect Bartonella henselae and Afipia felis DNA in specimens from patients who were clinically and histologically suspected of having cat scratch disease. PCR products were revealed using 2% ethidium bromide agarose-gel electrophoresis and identified with specific probes in a commercial colorimetric hybridization assay (DEIA) (GEN-ETI-K; DiaSorin, Italy). Six paraffin-embedded lymph node biopsies from 18 patients as well as 18 samples of peripheral whole blood and 18 sera were investigated. Bartonella henselae DNA was recovered from the whole blood of four patients, and Bartonella henselae and Afipia felis DNA were detected in one patient's lymph node biopsy. This study suggests that PCR-DEIA is sufficiently sensitive to be considered feasible for the molecular diagnosis of cat scratch disease. [ABSTRACT FROM AUTHOR]

Unlabelled: A case of Bartonella henselae bacteraemia is reported in an immunocompetent 8-year-old boy with cat-scratch disease. Serology to B. henselae, diagnosed by polymerase chain reaction, was positive. DNA was extracted from peripheral whole blood and amplified with specific primers targeting the htrA gene of B. henselae. A non-isotopic hybridization assay with a species-specific oligonucleotide probe was used to detect the amplified product.Conclusion: The polymerase chain reaction can be used for the rapid laboratory diagnosis of bacteraemia in cat-scratch disease. [ABSTRACT FROM AUTHOR]

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Platelet-mediated antibacterial activity against gram-negative microorganisms has been investigated. Data show that human washed platelets possess the ability to partially inhibit growth of Salmonella typhi Ty-2 (a smooth strain) but not of two rough strains of Salmonella minnesota (R345-Rb and R595-Re). On the other hand, no antibacterial activity was noted in the presence of the gram-positive Staphylococcus aureus. This activity is dependent on the length of incubation of platelets with bacteria and apparently is not mediated by platelet soluble factors. Finally, lysis of platelets with Triton X-100 following their incubation with bacteria gives rise to the same degree of antibacterial activity observed in the untreated samples. This implies that the described platelet function does not rely on the possible trapping of bacteria in platelet aggregates. [ABSTRACT FROM AUTHOR]

The effects in vitro of 4 purified lipopolysaccharide (LPS) preparations from Rickettsiae on platelets and leucocytes were studied in rabbits and in man. All LPS induced aggregation in rabbit platelet-rich plasma but to differing degrees. This activity was abolished by inactivation of complement. None of the preparations induced aggregation of human platelets. Both rabbit and human leucocytes, when incubated with each of the rickettsial LPS preparations, generated a potent procoagulant activity (tissue factor). These findings add further support to the concept that rickettsial LPS behave as typical LPS from gram-negative bacteria and may be relevant to the understanding of the mechanism(s) responsible for triggering intravascular coagulation in rickettsial diseases. [ABSTRACT FROM AUTHOR]