Idle central venous catheter-days pose infection risk for patients after discharge from intensive care

This prospective observational study measured idle central venous catheter (CVC)-days (no medical indication), and ward clinicians' adherence to evidence-based practices for preventing short-term central line-associated bloodstream infections (CLABSIs). In 340 patients discharged from ICU over a 1-year period, 208 of 794 CVC-days (26.2%) were idle. Interventions to prevent CLABSIs were poorly implemented. Ward clinicians need education regarding risk management strategies to prevent CLABSIs, and clear accountability processes for prompt catheter removal are recommended.

A preliminary assessment of machinability of titanium alloy Ti 6Al 4V during thin wall machining using trochoidal milling

Titanium alloys are of great demand in the aerospace and biomedical industries. Most the titanium products are either cast or sintered to required shape and finish machined to get the appropriate surface texture to meet the design requirements. Ti-6Al-4V is often referred as work horse among the titanium alloys due to its heavy use in the aerospace industry. This paper is an attempt to investigate and improve the machining performance of Ti-6Al-4V. Thin wall machining is an advance machining technique especially used in machining turbine blades which can be done both in a conventional way and using a special technique known as trochoidal milling. The experimental design consists of conducting trials using combination of cutting parameters such as cutting speed (vc), 90 and 120 m/min; feed/tooth (fz) of 0.25 and 0.35 mm/min; step over (ae) 0.3 and 0.2; at constant depth of cut (ap) 20mm and using coolant. A preliminary assessment of machinability of Ti-6Al-4V during thin wall machining using trochoidal milling is done. A correlation established using cutting force, surface texture and dimensional accuracy.

Cost-effectiveness of dalteparin vs unfractionated heparin for the prevention of venous thromboembolism in critically ill patients

Venous thromboembolism (VTE) is a common complication of acute illness, and its prevention is a ubiquitous aspect of inpatient care. A multicenter blinded, randomized trial compared the effectiveness of the most common pharmocoprevention strategies, unfractionated heparin (UFH) and the low-molecular-weight heparin (LMWH) dalteparin, finding no difference in the primary end point of leg deep-vein thrombosis but a reduced rate of pulmonary embolus and heparin-induced thrombocytopenia among critically ill medical-surgical patients who received dalteparin.

Venous thromboembolism and underutilisation of anticoagulant thromboprophylaxis in hospitalised patients with inflammatory bowel disease

Background: Venous thromboembolism (VTE) is a well-recognised extra-intestinal manifestation of inflammatory bowel disease (IBD). Despite the widespread support for anticoagulant prophylaxis in hospitalised IBD patients, the utilisation and efficacy in clinical practice are unknown. Aims: The aim of this study was to assess the prevalence and clinical features of VTE among hospitalised IBD patients and ascertain whether appropriate thromboprophylaxis had been administered. Methods: All patients with a discharge diagnosis of Crohn disease or ulcerative colitis and VTE were retrospectively identified using International Classification of Diseases, tenth revision codes from medical records at our institution from July 1998 to December 2009. Medical records were then reviewed for clinical history and utilisation of thromboprophylaxis. Statistical analysis was performed by Mann-Whitney test and either χ2 tests or Fisher's exact tests. Results: Twenty-nine of 3758 (0.8%) IBD admissions suffered VTE, 13 preadmission and 16 during admission. Of these 29 admissions (in 25 patients), 24% required intensive care unit and 10% died. Of the 16 venous thrombotic events that occurred during an admission, eight (50%) did not receive anticoagulant thromboprophylaxis and eight (50%) occurred despite thromboprophylaxis. Most thromboembolism despite prophylaxis occurred post-intestinal resection (n = 5, 63%). Conclusion: Thromboprophylaxis is underutilised in half of IBD patients suffering VTE. Prescription of thromboprophylaxis for all hospitalised IBD patients, including dual pharmacological and mechanical prophylaxis in postoperative patients, may lead to a reduction in this preventable complication of IBD. © 2014 Royal Australasian College of Physicians.

One-hit machining of titanium alloy (Ti-6al-4v) wall component with trochoidal milling

This research will definitely give guidelines to industries associated with titanium slot machining.