Tele-Intensive Care and the Current Situation in Turkey, Opportunities, Restrictions

Intensive care treatment needs and costs are expected to increase with the ageing population in our country and the world. Tele-intensive care unit (Tele-ICU) applications can provide an alternative solution to treat and follow up critical patients remotely. It can help use existing resources efficiently. With the Tele-ICU program, intensive care specialists will reach all intensive care beds in the country without restrictions. They will evaluate the patients' situations with all data from electronic recording systems. However, problems with some legal regulations or terms of job descriptions, deterioration of patient-doctor, doctor-patient's relative relationships, or some infrastructure deficiencies when using the Tele-ICU system could override the potential benefit of the new solution strategy. This review was written to inform about Tele-ICU, draw attention to opportunities, shortcomings, and limitations if Tele-ICU is applied in our country, and ensure that the necessary steps are taken to resolve these deficiencies

The effect of proximal tibial corrective osteotomy on menisci, tibia and tarsal bones: a finite element model study of tibia vara

ugur, levent/0000-0003-3447-3191; OZKAN, Arif/0000-0002-1288-6166; Celik, Talip/0000-0003-0033-2454; Atmaca, Halil/0000-0001-5820-6456WOS: 000333298800010PubMed: 23983147BackgroundProximal tibial open wedge osteotomy (PTO) is a corrective operation used in the surgery of lower extremities and is applied to patients with varus deformities for sufficient correction. The aim of the study was to evaluate whether the PTO can achieve decreased stress-bearing on the tibia and tarsal bones in addition to correcting the mechanical axis of the lower limb in patients with tibia vara. MethodsThree-dimensional (3D) solid modelling of the lower extremity was carried out using computed tomography (CT) and magnetic resonance (MR)-containing images of all of the bony elements and non-bony structures. PTO was applied to the obtained deformed model in the computer environment and the correction was carried out. ResultsStress distributions in menisci, tibia and tarsal bones were calculated. With respect to loading on the tarsal bones, the maximum equivalent stresses on all bones decreased except for the navicula in the PTO-simulated model in the current study. ConclusionThese results clearly indicate that PTO can achieve decreased stresses on the tarsal bones in patients with tibia vara. Copyright (c) 2013 John Wiley & Sons, Ltd

Stress distribution comparisons of foot bones in patient with tibia vara: a finite element study

ugur, levent/0000-0003-3447-3191; OZKAN, Arif/0000-0002-1288-6166; Celik, Talip/0000-0003-0033-2454; Atmaca, Halil/0000-0001-5820-6456WOS: 000332507000009PubMed: 24479742Blount's disease, or tibia vara, is the most common cause of pathologic genu varum in children and adolescents. Changes in the loading of knee structures such as tibial articular cartilage, menisci and subcondral bone are well documented in case of genu varum. But the mechanical effects of this condition on foot bones are still questionable. In this study, the authors hypothesized that stress distributions on foot bones might increase in patients with tibia vara when compared with patients who had normal lower extremity mechanical axis. Three-dimensional (3D) finite element analyses of human lower limb were used to investigate and compare the loading on foot bones in normal population and patient with tibia vara. The segmentation software, MIMICS was used to generate the 3D images of the bony structures of normal and varus malalignment lower extremity. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones were independently developed to form foot and ankle complex. Also femur, tibia and fibula were modeled utilizing mechanical axis. ANSYS version 14 was used for mechanical tests and maximum equivalent stresses (MES) were examined. As a result of the loading conditions, in varus model MES on talus, calcaneus and cuboid were found higher than in normal model. And stress distributions changed through laterally on middle and fore foot in varus deformity model

Stress distribution comparisons of foot bones in patient with tibia vara: a finite element study

ugur, levent/0000-0003-3447-3191; OZKAN, Arif/0000-0002-1288-6166; Celik, Talip/0000-0003-0033-2454; Atmaca, Halil/0000-0001-5820-6456WOS: 000332507000009PubMed: 24479742Blount's disease, or tibia vara, is the most common cause of pathologic genu varum in children and adolescents. Changes in the loading of knee structures such as tibial articular cartilage, menisci and subcondral bone are well documented in case of genu varum. But the mechanical effects of this condition on foot bones are still questionable. In this study, the authors hypothesized that stress distributions on foot bones might increase in patients with tibia vara when compared with patients who had normal lower extremity mechanical axis. Three-dimensional (3D) finite element analyses of human lower limb were used to investigate and compare the loading on foot bones in normal population and patient with tibia vara. The segmentation software, MIMICS was used to generate the 3D images of the bony structures of normal and varus malalignment lower extremity. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones were independently developed to form foot and ankle complex. Also femur, tibia and fibula were modeled utilizing mechanical axis. ANSYS version 14 was used for mechanical tests and maximum equivalent stresses (MES) were examined. As a result of the loading conditions, in varus model MES on talus, calcaneus and cuboid were found higher than in normal model. And stress distributions changed through laterally on middle and fore foot in varus deformity model

The Impact of Mechanical Ventilation Modes on Complications of Fiberoptic Bronchoscopy in Critically Ill Patients

OBJECTIVE: The effects of fiberoptic bronchoscopy are not elucidated in different mechanical ventilation modes. The present study aimed to evaluate the effects of fiberoptic bronchoscopy on lung mechanics, ventilation parameters, and gas exchange in 2 often-used modes, volume control and pressure control, in invasively ventilated patients followed up in the intensive care unit