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Biomedical subjects

R Riedo

Publications and source records attributed to R Riedo.

8 recordsLinked to original sources
PubMed1997

[Anesthesia in Apert syndrome].

The anaesthetic technique chosen for a laparohysterectomy in a woman affected by Apert's acrocephalosyndactilia is described. Difficulties in performing tracheal intubation were overcome by mean of loco-regional anesthesia (LRA). In order to minimize the anaesthetic risk, a standardised preoperative evaluation and assessment integrating the usual investigations and the possibility of employing intubation techniques as alternative to direct laryngoscopy are suggested.

Acrocephalosyndactylia↗
PubMed1992

[Immigrants in Switzerland: possibilities and difficulties of integration].

Immigrants find it hard--although not all in the same way--to adapt to the language, the social structure and the way of life of their host country. Different factors overlap: the foreigners' social and cultural background, their education and their adaptability to a foreign environment, their plans for the future, the political and legal situation in the host country as well as the local population's acceptance of and tolerance and respect for a foreign culture. The fact that 75% of all foreigners in Switzerland possess a residence permit can be considered as rather positive; however, this does not necessarily mean that these people are familiar with the local language and way of life. Isolation and a continuously postponed return to the home country are conditions well known even among resident foreigners. Seasonal workers, on the other hand, feel great uncertainty and concern. In critical life situations, for instance caused by illness, accidents or unemployment, the process of rehabilitation can strongly be influenced by earlier living conditions. The Swiss legislation on foreigners as well as the legislation on social security can often bring about fundamental fateful questions. In order to find efficient solutions to the wide range of possible difficulties, a whole-hearted interdisciplinary cooperation is extremely important.

Acculturation↗
PubMed1992

[The use of propofol in a female patient predisposed to malignant hyperthermia (central core disease)].

In this paper the Authors describe the anesthetic techniques used for abdominal surgery in a 19 year-old woman with "central-core disease". This uncommon congenital neuromuscular disorder is frequently related to malignant hyperthermia syndrome. Total intravenous anesthesia with the association propofol-fentanyl was well tolerated by the patient. There was no evidence of malignant hyperthermia during the procedure and cardiovascular stability was excellent.

Adult↗
PubMed1988

Origin of the specific H reflex facilitation preceding a voluntary movement in man.

1. In a reaction time situation, the monosynaptic spinal reflex (H reflex) is facilitated before the onset of an electromyographic (EMG) response. The aim of the present investigation was to test if the facilitation can be attributed either to a subliminal depolarization of motoneurones or to an increase of the excitatory effect of the afferent volley reaching the motoneurones. 2. At the onset of an acoustic warning signal, human subjects were required to concentrate on a reaction time task and, in addition, to initiate a steady isometric plantar flexion of medium intensity in both feet. In response to a following visual stimulus, they carried out a ballistic plantar flexion randomly with the right or left foot. At different times after the visual reaction signal, H reflexes were elicited bilaterally. 3. The facilitation of the H reflex was similar in the presence and absence of a steady activation. In addition, the facilitations were similar in absolute amplitude and duration when the stimuli evoking the H reflexes were at threshold intensities, or at an intensity which produced control H reflexes of 60% maximum amplitude. 4. In a second series of experiments, no H reflexes were elicited but the strength of the steady plantar flexion was varied. Premotor time, i.e. the interval between the onset of the visual stimulus and the EMG response, and reaction time, i.e. the interval between the onset of the visual stimulus and the mechanical response, were computed. Neither parameter depended significantly on the intensity of steady flexion and they were the same with steady flexion as without. 5. The rectified EMG records and the torque records were aligned by the end of premotor time. Three-dimensional displays of average activity as a function of time and steady activation level were computed. No activation before premotor and reaction time was detected which could have been related to the H reflex facilitation. 6. The present results suggest that all motoneurones, in particular those being activated during the voluntary contraction, can contribute to the H reflex facilitation before movement onset and that the basis of this facilitation is an enhanced excitatory effect of the afferent volley elicited by the H reflex stimulus. Mechanisms leading to the facilitation could be removal of presynaptic inhibition at I a terminals or facilitation of interneurones intercalated in polysynaptic components of the reflex pathways.

Adult↗
PubMedDate not supplied

[Protocol for preoperative chest X-rays in elective surgery].

BACKGROUND: To evaluate the effects of a protocol designed to optimize the use of preoperative chest X-rays (CXRs) in the evaluation of patients undergoing anesthesia for elective surgery. DESIGN: Observational prospective study. SETTING: General 350 bedded hospital, with main surgical branches. METHODS: a) PROTOCOL: routine CXRs can be avoided in patients aged less than 60 years, nonsmokers, without acute-chronic respiratory, cardiovascular symptoms, free from neoplastic diseases, not candidates to major vascular, abdominal or thoracic surgery, not treated with immunosuppressive therapy, nor immigrants from areas of endemic TB. b) All out patient subjects admitted to anesthesiology service for evaluation prior to elective surgery. RESULTS: Out of 5198 patients, 3795 were enrolled in the protocol; in 152 cases, preoperative CXRs were performed, 3456 patients (57.2% ASA 1; 42% ASA 2; 0.8% ASA 3) underwent surgery without CXRs. Thirty-four percent of patients had general anesthesia, 54.5% regional anesthesia, 20.6% regional-peripheral anesthesia with/without MAC. No critical events nor major complications were observed in the perioperative period in these subjects. Preoperative CXRs (performed in 152 cases) yelded useful informations with effect on the clinical management in 20 instances. CONCLUSIONS: In a context of adequate preoperative anesthesiologic evaluation, this protocol proved to be effective in reducing the number of routine preoperative CXRs in patients undergoing elective surgery. This resulted in a substantial reduction of radiation exposure both to the subject and to the general population, and costs saving, without evident negative side-effects.

Adolescent↗