Search

Growing competition has turned cost-cutting by means of skillful inventory management into a factor that makes a difference. Managing few large shipments holds the advantage of lowering fixed annual costs of dealing with a supplier, as interchange is infrequent; but it raises annual costs with increased average inventory. The alternative of managing job lots requires greater coordination among supply networks, but savings derived from reduced handling of large shipments will lower the product's retail price. In Venezuela, the practice of maintaining large inventories owes to relatively distant suppliers combined with foreign exchange regulation and complex import procedures. [ABSTRACT FROM AUTHOR]

Platelet dysfunction was detected in six children with purpura and eosinophilia. We conducted clinical evaluations, hematologic and platelet function tests, clotting studies (bleeding time, prothrombin time, partial thromboplastin time, thrombin time, factor XIII, factor VIII, and von Willebrand factor), assays for IgG and IgM antibodies to platelets, and a search for stool parasites. Mild bleeding phenomena (ecchymoses, petechiae, epistaxis, and gingival) were transient. All children showed intestinal parasites and marked eosinophilia (mean count = 2,615.2 cells/muL, 95% confidence interval = 1,259.6-5,429.8). Main abnormalities included prolonged bleeding times (50%) and defective aggregation with collagen (100%) adrenaline (66%), or ADP (66%). Antibodies to platelets were not detected. Anti-parasite therapy reversed the hemorrhagic manifestations and normalized eosinophil counts and platelet alterations. No relationship could be established between excess eosinophils, intensity of bleeding, or type and degree of platelet abnormalities. Thrombocytopathic features mimicked the intrinsic defect of storage pool disease. The possible pathogenic roles of eosinophilia and parasitism are reviewed. This is the first report of this pathologic combination in Latin American children.