Patients with congenital craniofacial malformations present with complex challenges for reconstruction. Successful management requires individualized treatment often involving rebuilding the facial skeleton de novo, as well as correcting the overlying soft-tissue deficiencies in the final stages. At the University of California, Los Angeles (UCLA) Craniofacial Clinic, serial autologous fat transplantation performed during staged reconstruction is the preferred method.A total of ... إقراء المزيد

Objectives: Tostudyesophagealhighresolutionmanometry(HRM)insystemicsclerosis(SSc)patients and thecorrelationof findings toTheUniversityofCalifornia,LosAngelesSclerodermaClinicalTrials Consortiumgastrointestinaltract2.0(UCLASCTC_GIT2.0). Methods: FortySScpatientswereadministeredtotheUCLASCTCGIT2.0.PatientsunderwentHRMstudy (Solar GIMMS).HRMdatawerecomparedwith15healthyvolunteers. Results: Forty patientswithmeanage46 7 7 yearsanddiseaseduration9.3 7 7 yearsreportedupper (85.7%),lowerGIsymptoms(75%),while5%reportednosymptoms.Mean 7 SD scoresofUCLA SCTC_GIT2.0itemswereasfollows:reflux 1.2 7 0.8, distention1.6 7 1.2,fecalsoiling0.3 7 0.9, diarrhea 0.8 7 1,social1 7 1,emotional1 7 1.1,constipation0.5 7 0.9, andtotalGITscore0.9 7 0.6. Lower esophagealsphincter(LES)pressureanddistalesophagealamplitudeweresignificantly lowerin SSc patientsthancontrols.Mainmanometric findings weredecreasedLESrestingpressure(40%)and aperistalsis(40%).RegressionanalysesshoweddistalesophagealamplitudeandLESrestingpressure negativelycorrelatedwithreflux score(r ¼ −0.64; p ¼ ... إقراء المزيد