Perioperative management of face transplantation: a survey.

BACKGROUND: Since the first facial allograft transplantation was reported in France in 2005, 18 cases have been performed in 4 countries and the rate is increasing. METHODS: We have devised a survey to assess anesthesia-related management and rationale of facial allograft transplantation. It was sent to the lead anesthesiologists of the first 14 face transplants performed worldwide. RESULTS: Responses were received corresponding to 13 face transplants. The median duration of surgery and anesthesia was 19 hours (95% confidence interval 15-23 hours). The surgical preparation and dissection of multiple small anatomical structures of the recipient was time-consuming for 11 cases. Blood loss was considerable. All patients received packed red blood cells (median 20 U, 95% confidence interval 5-28 U). A median of 13 L of crystalloid was administered (95% confidence interval 10-18 L). CONCLUSIONS: During facial allograft transplantation, the anesthesiologist must be prepared for a long anesthetic with rapid blood loss after reperfusion of the graft.

Efficacy of Mindfulness-Based Cognitive Therapy on Quality of Life of Mothers of Children with Cerebral Palsy.

OBJECTIVE: The findings demonstrated that parents of children with cerebral palsy experience elevated levels of distress, depression, anxiety, posttraumatic stress symptom and subjective symptom of stress and low quality of life. Effective interventions targeting relapse have the potential to dramatically reduce the point prevalence of this condition. Many studies have shown that Mindfulness Based Cognitive Therapy (MBCT) is an intervention that has shown efficacy in improving quality of life. In this study, the effect of Mindfulness -Based Cognitive Therapy (MBCT) on increasing quality of life in mothers of children with cerebral palsy has been examined. METHOD: Three mothers of CP children with low scores on quality of life in WHOQOL-BREF inventory participated in this single- case study. RESULTS: Findings revealed that the MBCT program elevated quality of life of the participants. The improvement quotient for quality of life of each participant was good . CONCLUSION: The results have implication for efficacy of mindfulness for improvement of psychosocial life of families of children with cerebral palsy.