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An oblique shock impinging on a shear layer that separates two uniform supersonic streams, of Mach numbers
, at an incident angle
can produce regular and irregular interactions with the interface. The region of existence of regular shock refractions with stable flow structures is delineated in the parametric space
considering oblique-shock impingement on a supersonic vortex sheet of infinitesimal thickness. It is found that under supercritical conditions, the oblique shock fails to deflect both streams consistently and to provide balanced flow properties downstream. In this circumstance, the flow renders irregular configurations which, in the absence of characteristic length scales, exhibit self-similar pseudosteady behaviours. These cases involve shocks moving upstream at constant speed and increasing their intensity to comply with equilibrium requirements. Differences in the variation of propagation speed among the flows yield pseudosteady configurations that grow linearly with time. Supercritical conditions are described theoretically and reproduced numerically using highly resolved inviscid simulation.
No information is available about the financial impact of central venous catheter (CVC)-associated bloodstream infection (BSI) in Mexico.
To calculate the costs associated with BSI in intensive care units (ICUs) in Mexico City.
An 18-month (June 2002 through November 2003), prospective, nested case-control study of patients with and patients without BSI.
Adult ICUs in 3 hospitals in Mexico City.
Patients and Methods.
A total of 55 patients with BSI (case patients) and 55 patients without BSI (control patients) were compared with respect to hospital, type of ICU, year of hospital admission, length of ICU stay, sex, age, and mean severity of illness score. Information about the length of ICU stay was obtained prospectively during daily rounds. The daily cost of ICU stay was provided by the finance department of each hospital. The cost of antibiotics prescribed for BSI was provided by the hospitals' pharmacy departments.
For case patients, the mean extra length of stay was 6.1 days, the mean extra cost of antibiotics was $598, the mean extra hospital cost was $11,591, and the attributable extra mortality was 20%.
In this study, the duration of ICU stay for patients with central venous catheter-associated BSI was significantly longer than that for control patients, resulting in increased healthcare costs and a higher attributable mortality. These conclusions support the need to implement preventive measures for hospitalized patients with central venous catheters in Mexico.
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