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70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Glioblastoma Hypoxia Adult (>18 year old) patients with newly diagnosed GBM presenting to our centre for surgical management and post-operative chemoradiation 2. Creatinine clearance > 60 ml/minute 3. Able to tolerate an MR scan 4. Capable of providing informed consent Prior brain surgery or radiation 2. History of liver disease requiring liver MRI (due to accumulation of ferumoxytol in Kupffer cells which can affect liver MRI for up to 3 months) 3. On more than two antihypertensive medications 4. History of allergy or adverse reaction to iron supplements 5. Prior treatment with ferumoxytol 6. Large (>50%) hemorrhagic component in the solid enhancing part of the tumor 7. Need for emergency craniotomy. 8. Pregnant patients 9. Breast feeding 10. Serum ferritin of >800 ng/mL | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Congestive Heart Failure ≥ 18 years of age Presenting to clinic with worsening heart failure due congestion (fluid overload) Patient reported worsening fluid overload based on perception of edema and/or weight gain With at least one of the following symptoms Worsening dyspnea on exertion or fatigue Worsening orthopnea or paroxysmal nocturnal dyspnea (PND) Perception of abdominal and/or lower extremity edema Early satiety and/or decreased appetite And at least one of the following signs Lower extremity edema Ascites Elevated jugular venous distension (JVD) Pulmonary rales Patients with symptomatic hyponatremia will be excluded from the study Patients with severe hyponatremia, defined as serum sodium < 125 milliequivalents per Liter (mEq/L) at the time of screening, will be excluded regardless of whether they are symptomatic or not Patients with the following predisposing factors for osmotic demyelinating syndrome (ODS), assessed by the study investigator judgment, will be excluded: chronic alcoholism at the time of study, severe liver disease, marked malnutrition, and risk for chronic hypoxia Patients currently undergoing renal replacement therapy Planned hospitalization for acute heart failure History of primary significant liver disease or acute hepatic failure, as defined by the investigator Hemodynamically significant arrhythmias Acute coronary syndrome (ACS) or acute myocardial infarction within 4 weeks prior to study entry Active myocarditis Hypertrophic obstructive, restrictive, or constrictive cardiomyopathy | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-75.0, Obesity Premature Recovery From Anesthesia Patient presented for surgery under general anesthesia Documented OSA Patients with BMI above 35 Coronary Artery Disease or Myocardial infarcts Mitral valve prolapse Cyclosporine, contraceptive drugs Known allergic reaction to Modafinil or any of its products | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obesity Hypoventilation Syndrome Aged 18+ Diagnosed with OHS by a practicing physician Existing full face mask user or a nasal mask user Prescribed PAP therapy (Bi-Level or CPAP) Inability to give informed consent Pregnant or think they may be pregnant Anatomical or physiological conditions making PAP therapy inappropriate Patients requiring supplemental oxygen with their PAP device Patients who are in a coma or decreased level of consciousness Existing Simplus and Eson users No arterial PCO2 value from their medical records | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 20.0-75.0, Sleep Apnea, Obstructive Objectively confirmed OSA (at the time of original diagnosis) with an oxygen desaturation index (ODI) and apnoea-hypopnoea-index (AHI) of ≥20/h Currently an oxygen desaturation index (≥4% dips) of ≥15/h during an ambulatory nocturnal pulse oximetry performed on the last night of a four-night period off CPAP Treated with CPAP for more than 12 months Device usage >4h per night, >80% of the last 365 days, and AHI<10 with treatment (according to CPAP machine download data) Age between 20 and 75 years Written informed consent as documented by signature Previous ischemic or haemorrhagic stroke; known cerebral aneurysm or arterio-venous malformation Carotid artery stenosis > 70% Use of alpha and beta-adrenergic blocking medication, antianginal medications, triptans, selective COX-inhibitors Unstable, untreated coronary or peripheral artery disease, severe arterial hypertension or hypotension (>180/110 or <90/60mmHg) Implanted pacemaker or internal cardiac defibrillator Changes in medication during the trial Previous ventilatory failure (awake SpO2 <93% andPaCO2>6kPa) Obesity hypoventilation syndrome, COPD Previously diagnosed with Cheyne-Stokes breathing | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 55.0-999.0, Atrial Fibrillation Participants: The study population will be derived from the Aetna and Medicare populations Male or females age > 75 or Male age > 55, or females age > 65, and Prior CVA, or Heart failure, or Diagnosis of both diabetes and hypertension, or Mitral valve disease, or Left ventricular hypertrophy, or COPD requiring home O2, or Sleep apnea, or Current or prior diagnosis of atrial fibrillation, atrial flutter or atrial tachycardia Receiving chronic anticoagulation therapy Hospice care End stage renal disease Diagnosis of moderate or greater dementia Implantable pacemaker and/or defibrillator History of skin allergies to adhesive patches Known metastatic cancer Aetna Compassionate Care Program (ACCP) participants individuals with advanced illness and limited life expectancy | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Colorectal Cancer Patient with metachronous or synchronous metastases of a colorectal cancer progression under standard therapy no proven brain metastases no curative option no standard therapy available Age > 18 years At least one metastases measurable according to Response Evaluation In Solid Tumors V 1.1 in CT or MRI scan not older than 2 weeks before into the trial Lab values within the usual borders for these patient group e.g Neutrophil ≥ 1.5x109/ •Platelets ≥ 100x109/L Leukocytes ≥ 1.0x109/L Hemoglobin ≥ 9.0 g/dL or 5.59 mmol/l Life expectancy < 3 months Participation in another interventional study within the last 30 days Known hypersensitivity against a part of the study drug Pregnancy or breastfeeding HIV infection oder active hepatitis B/C | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obstructive Sleep Apnea Syndrome Clinical presentation of ischemic stroke confirmed by imaging (CT or MRI brain scan) less than 24 hours from onset of symptoms admitted to the Neurovascular unit of the Emergency Hospitalisation Department of 'Hôpital Nord' of the university hospital of Saint-Étienne presenting obstructive sleep apnea syndrome (defined as an apnea-hypopnea index (AHI) of ≥ 10 and > 50% of obstructive events) written consent of patient Concussion (Coma Glasgow Score <12) Comprehension aphasia Uncontrollable confusion and agitation History of dementia History of ischemic stroke with neurological damage History of hemorrhagic stroke History of epilepsy Cerebrospinal fluid leak, recent cranial surgery or head injury Serious bullous lung disease Hypoxic pulmonary disease | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-70.0, Hypoxemia Trauma Acute Myocardial Infarction to 70 years of age Male and female volunteers ASA physical status I, II and III Capable and willing to provide written informed consent in English Acute cardiopulmonary disease, as defined by blood pressure greater than 150/90, HR greater than 120 and room air oxygen saturation less than 92 Allergy to lidocaine or adhesive tape History or physical exam finding of nasal polyps Currently taking oral or parenteral anticoagulant medications (other than aspirin) History of frequent nose bleeds Current symptoms of nasal congestion Physical examination findings of rales or wheezing Facial hair that prevents forming a seal with an anesthesia mask | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Hypothyroidism Neoplasms Postoperative Complications Biopsy proven head and neck cancer, as defined by AJCC staging system Treated with surgery in Edmonton, Alberta Treated with curative intent Diagnosis of sub-clinical hypothyroidism after head and neck surgery (TSH 4-10mIU/L, and free T4 10-24pmol/L) Head and neck cancer of the thyroid gland, or other subsite involving the thyroid gland Underwent previous treatment for a different head and neck cancer History of radiation therapy and or chemotherapy to the head and neck History of thyroid disease as follows Hypothyroidism Hyperthyroidism Autoimmune thyroid disease including Grave's disease and Hashimoto's thyroiditis History of thyroiditis History of diabetes mellitus History of long term steroid usage | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-70.0, Obstructive Sleep Apnea for COPD Subjects Age range 40-70 years Demonstrated moderate to severe COPD as determined by spirometry (post-bronchodilator spirometry FEV1/FVC < 0.70 for diagnosing CODP and FEV1<80% predicted for staging) Smoking history of ≥ 10 pack-years for Control Subjects Age range 40-70 years Demonstrated no COPD as determined by normal spirometry (post-bronchodilator spirometry FEV1/FVC > 0.70 for diagnosing CODP and FEV1<80% predicted for staging) No smoking history as defined by less than 100 cigarettes smoked in a lifetime for both COPD and Control Subjects Metal objects that may interfere with chest CT quantification including presence of a cardiac pacemaker, defibrillator, metal prosthetic heart valve, metal projectile or metal weapon fragment (bullet, shrapnel, shotgun shot) or metal shoulder prosthesis Subjects unable to perform spirometry due to chest or abdominal surgery in the past three months a heart attack in the last three months detached retina or eye surgery in the past three months hospitalization for any other heart problem in the past month History of hypersensitivity to Afrin, Lidocaine or albuterol A psychiatric disorder, other than mild depression; e.g. schizophrenia, bipolar disorder, major depression, panic or anxiety disorders More than 10 cups of beverages with caffeine (coffee, tea, soda/pop) per day | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, COPD Home Care Oxygen Therapy informed consent acute on chronic respiratory distress | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 20.0-50.0, Hypoxia Diabetes Mellitus, Type 1 Patients with typ1 diabetes with a duration of the disease between 10-20 years (HbA1c ≥ 65 mmol /l) 2. Healthy controls matched for age, BMI and gender on group bases Smoking 2. Infections during the last month 3. Major cardiovascular complications such as coronary heart disease, unstable or stable angina, myocardial infarction, ventricular arrhythmias, and atrial fibrillation in the last 3 months 4. Decompensated congestive heart failure or functional class 3-4. 5. Therapy with b-blockers 6. Severe hypertension (180 mmHg systolic or 110 mmHg diastolic blood pressure 7. Proliferative retinopathy. 8. Obvious sign for diabetic neuropathy (decreased/absent sensitivity to 10 g monofilament, vibration, plantar reflex) 9. Definite autonomic dysfunction 10. HbA1c ≥ 108 mmol/l 11. Any concomitant disease or condition that may interfere with the possibility for the patient to comply with or complete the study protocol 12. Malignancy 13. History of alcohol or drug abuse 14. Participant in another ongoing pharmacological study 15. Unwillingness to participate following oral and written information 16. Subjects with any other severe acute or chronic medical or psychiatric condition that make the subject inappropriate for the study in the judgment of the investigator | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Obesity, COPD, OHS age ≥ 18 years patients with COPD (GOLD I-IV Group A-D) with obesity (BMI> 30kg/m2), obese healthy adults with BMI> 30kg /m2, patients with Obesity hypoventilation syndrome informed consent provided patients less than BMI <30 kg/m2 with or without COPD, OHS Age < 18 years pregnancy, lactation any medical, psychological or other condition restricting the patient's ability to provide informed consent participation in another clinical trial | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-80.0, Chronic Obstructive Pulmonary Disease Patients with Chronic Obstructive Pulmonary Disease (COPD) in Global Initiative on Obstructive Lung Disease (GOLD) stages II to IV COPD patients with mild to moderate cognitive impairment (MCI-group: n=100) and without cognitive impairment (Control-group: n=60) Normotensive (Blood Pressure range: 101-143/62-91 millimeters of mercury [mmHg]) Resting partial pressure of oxygen in arterial blood (paO2) <55 millimeters of mercury [mmHg] Resting partial pressure of carbon dioxide in arterial blood (paCO2) >45 millimeters of mercury [mmHg] last exacerbation ≤4weeks severe cognitive impairment/dementia other neuropsychiatric symptoms | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Ventricular Tachycardia Patients undergoing radiofrequency catheter ablation for scar VT which includes VT secondary to ischemic cardiomyopathy and non-ischemic cardiomyopathy Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test within 24 hours prior to the start of study drug Women must not be breastfeeding WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with Apixaban plus 33 days post-treatment completion Males who are sexually active with WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment and for a total of 93 days post-treatment completion Participants must agree to the use of one approved method of contraception History of cerebral vascular accident/transient ischemic attack (CVA/TIA) in last 3 months Cardiac surgery or neurosurgery within 3 months of the intended procedure date Any active bleeding Severe hypersensitivity reaction to (including drug hypersensitivity, such as skin rash and allergic reactions) Participants cannot have prosthetic heart valves History or bleeding and clotting disorders Contraindications to Aspirin therapy Contraindication to oral anticoagulation Patient on an anticoagulant prior to the ablation for other primary indications like atrial fibrillation (AF), deep vein thrombosis (DVT) or a mechanical valve Evidence of intracardiac thrombus | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 21.0-85.0, Chronic Obstructive Pulmonary Disease Age > 21 years of age; < 85 years of age Participants that have been physician diagnosed (primary diagnosis) with Obstructive Airway Disease (to include:Chronic Obstructive Pulmonary Disease (COPD); Bronchiectasis; Severe Asthma); forced expiratory volume in 1 second (FEV1) < 60% FEV1/ forced vital capacity (FVC) <60% Arterial CO2 > 45 mmHg as determined by blood gas (PaCO2) or transcutaneous (tcCO2) >50 within the past month Ability to provide consent Participant has not used Non-Invasive Ventilation (BiPAP/CPAP) therapy in the past 8 hours Participant has no child bearing potential OR a negative pregnancy test in a woman of childbearing potential Participants that have not returned to their baseline health status from an exacerbation of COPD or other pulmonary problems or have not established at least two weeks of stability at a new baseline Use of antibiotics or prednisone for a COPD exacerbation within the previous 4 weeks Uncontrolled Hypertension Participants that require greater than 3 liters of oxygen at rest History of cardiovascular instability, including uncontrolled ventricular arrhythmias, angina, diastolic BP > 100 mmHg and all Participants with pacemakers Any major non-COPD uncontrolled disease or condition, such as congestive heart failure, malignancy, end-stage heart disease, liver or renal insufficiency (that requires current evaluation for liver or renal transplantation or dialysis), amyotrophic lateral sclerosis, or severe stroke, or other condition as deemed appropriate by investigator as determined by review of medical history and / or participant reported medical history History of pneumothorax Apnea Hypopnea Index (AHI) > 15 via in-home sleep study Excessive alcohol intake (> 6oz hard liquor, 48 oz. beer or 20 oz. wine daily), or illicit drug use by review of medical history and / or participant reported medical history Daily use of prescribed narcotics (greater than 30 mg morphine equivalent) | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Congestive Heart Failure FOCUS 1. Remotely monitored with CRT-CIED focus groups 1 & 2: implant ≤ 12 months focus groups 3 & 4: implant ≥ 12 months 2. Current patient of PPG-Cardiology 3. History of HFrEF (heart failure in the setting of reduced ejection fraction) 4. Access to computer and internet 5. *Ability to provide informed consent 6. *Age ≥ 18 years and 6 must apply to caregivers, partners, and/or support persons Not remotely monitored with CRT-CIED 2. Not current patient of PPG-Cardiology 3. No history of HFrEF 4. Pacemaker dependent 5. Does not have access to computer and internet 6. *Inability to provide informed consent 7. *Age < 18 years 8. *Does not meet Only 6, 7, and 8 apply to caregivers, partners, and/or support persons TRIAL 1. Remotely monitored with Biotronik CRT-CIED for more than 60 days 2. Ability to provide informed consent 3. Age ≥ 18 years 4. Willing to have MyChart or proxy to MyChart 5. Current patient of PPG-Cardiology 6. History of HFrEF Do not have a Biotronik CRT 2. Have a Biotronik CRT-CIED for less than 60 days 3. Not being remotely monitored with a Biotronik CRT-CIED 4. No history of HFrEF 5. Inability to provide informed consent 6. Age < 18 years 7. Lack of internet access or otherwise unable to access MyChart 8. Pacemaker dependency 9. Does not meet | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Upper Airway Obstruction Respiratory Insufficiency Respiratory Failure for the study are: 1. Participant has ability to provide written informed consent 2. Participants aged ≥18 years old 3. Participant has documented respiratory failure (e.g. sleep hypoventilation with historical PtCO2 increase ≥ 10mmHg) and/or daytime hypercapnia (>45 mmHg) 4. Participant is currently using non-invasive positive pressure ventilation in ST or VAPS mode for ≥ 3 months 5. Participants with a previously documented AHI ≥ 5/hr 6. Participants with a recently (≤ 12 months ago) reviewed EPAP setting for the study are: 1. Participants are not compliant on NIPPV (e.g. < 4 hr/night) 2. Participants who are pregnant 3. Participants on oxygen therapy ≥5 L/min 4. Participants with an invasive interface (e.g. tracheostomy) 5. Participants who have had an acute exacerbation within the last 3 months that resulted in a hospitalisation 6. Participants who are acutely ill, medically complicated or who are medically unstable 7. Participants in whom NIPPV therapy is otherwise medically contraindicated 8. Participants who have had surgery of the upper airway, nose, sinus, or middle ear within the previous 90 days 9. Participants with untreated, non-OSA sleep disorders, including but not limited to; insomnia, periodic limb movement syndrome, or restless legs syndrome. 10. Participants who have the following pre-existing conditions: severe bullous lung disease, recurrent pneumothorax or pneumomediastinum, cerebrospinal fluid leak, recent cranial surgery or trauma. 11. Participant does not comprehend English 12. Participant is unable or unwilling to provide written informed consent 13. Participant is physically and/or mentally unable to comply with the protocol 14. Participant is not suitable to participate in the trial for any other reason in the opinion of the investigator | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 4.0-99.0, Methicillin-Resistant Staphylococcus Aureus Cystic Fibrosis Male or female with a confirmed diagnosis of CF (clinical features and positive sweat test and/or identification of 2 CF disease causing mutations). 2. At least 4 years of age or older. 3. Chronic infection with MRSA defined as having had MRSA positive respiratory cultures for > 1 year with ≥ 50% of cultures being MRSA positive e.g. 2/4 of the most recent cultures grew MRSA. 4. Being able to expectorate sputum on a consistent basis, i.e. also at the end of IV therapy. 5. Having a pulmonary exacerbation defined for this protocol as the decision of the treating physician to start IV therapy in hospital or at home. Typically this occurs when there has been a >5% drop in FEV1 % predicted compared to the patient's baseline and increased respiratory symptoms. NOTE: Patients who had oral or inhaled antibiotics with or without MRSA activity but failed this outpatient therapy i.e. are changed to IV anti-MRSA antibiotics are allowed to participate.(Example: was on oral doxycycline and on admission changed to ceftaroline = eligible. On oral doxycycline that is continued on admission = not eligible) Patient enrollment should be prioritized to those receiving IV vancomycin or ceftaroline, with secondary consideration of patients who receive oral anti-MRSA therapy (TMP-SMX or a tetracycline derivative) that was initiated on hospital admission Patients on linezolid will not be included as this medication is given orally and IV and may confound analyses Presence / infection with B. cepacia genomovar III (=B. cenocepacia). Subjects who have undergone lung or liver transplant in the past (NOTE: patients listed for transplant are eligible) 2. Concomitant participation and/or use of an investigational drug within 30 days of this study. 3. Concomitant observational studies are allowed with TRI-STAR, if approved by the other study investigator or their proxy | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 30.0-64.0, Myalgia Apnea, Obstructive Sleep Any race or ethnicity Meet Research Diagnostic for TMD to confirm Group II: Masticatory Muscle Disorders, 1A: Myalgia Rate their TMD pain severity as ≥4 on a 0-10 numeric rating scale Have no history of treatment for OSA. If taking a prescription medication (with the exception of prescription formulations of NSAIDs, acetaminophen, and aspirin) episodically for the management of pain, the subject must agree to discontinue its use prior to or at the baseline visit. If taking a prescription medication daily for the management of pain, must agree to continue the daily use of the medication throughout the 16-week observation period. If taking an over-the-counter pain medication daily, the subject must agree to continue the daily use throughout the study <8 retained teeth per arch Tooth mobility Unmanaged periodontal disease Skeletal Class III occlusion Central sleep apnea Hypoventilation syndromes Congestive heart failure Chronic obstructive pulmonary disease | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-70.0, Sleep Apnea, Obstructive; Post-Traumatic Stress Disorders Normal sleep study aside from elevated AHI Prior home sleep test (HST) or polysomnogram with results consistent with mild, moderate, or severe sleep apnea. If a sleep study has not been performed in the past, the participant will be offered an HST and included if OSA is confirmed on HST PTSD as diagnosed by psychiatrist, psychologist, or other licensed mental health professional Any known cardiac (apart from treated hypertension), symptomatic pulmonary (including asthma), renal, neurologic (including epilepsy), neuromuscular, or hepatic disease Pregnant women History of hypersensitivity to Afrin, Lidocaine, or Trazodone History of bleeding diathesis and/or gastrointestinal bleeding Daily use of any sedative medications that may affect sleep or breathing, including benzodiazepines, opioids, or hypnotics A psychiatric disorder, other than mild depression or PTSD; e.g. schizophrenia, bipolar disorder, major depression, panic or anxiety disorders Substantial cigarette (>5/day), alcohol (>3oz/day) or use of illicit drugs More than 10 cups of beverages with caffeine (coffee, tea, soda/pop) per day Subjects with oxyhemoglobin desaturations to <70% on the initial PSG (Aim 1) will be excluded from participation in Aim 2 Current, everyday use of continuous positive airway pressure therapy | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Obstructive Sleep Apnea Study Aged ≥ 18 and ≤ 80 Ability and willingness to provide written informed consent AHI ≤ 15 as per AASM 2007 scoring Ability to tolerate a CPAP one hour long run in test The presence of unstable cardiac disease Inability to give fully informed consent Supplemental oxygen Secondary sleep pathology e.g. Periodic Limb Movement Syndrome, Narcolepsy, Circadian Disorder, obesity hypoventilation syndrome ESS ≥ 15, or concerns about sleepy driving from physician/ sleep lab staff BMI ≥ 40 | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 60.0-89.0, Obstructive Sleep Apnea OSA COPD Overlap Syndrome OSA defined by the International classification of Sleep Disorders-322 diagnostic with moderate-to-severe disease, i.e. apnea hypopnea index (AHI) 15* per hour by polysomnography Moderate-to-severe COPD defined by GOLD 2 and 3 (Global Obstructive Lung Disease) 23 with FEV1/FVC ratio <70% and FEV1 >30% and <80% of predicted based on PFT done within the past 1 year and a past significant history (10 pack-years) of smoking Age 60 years Male or female gender Mild COPD Mild OSA Overlap Syndrome with mild OSA plus mild COPD Central sleep apnea defined as central apnea index >5 per hour Already on daytime oxygen or nighttime CPAP, NIPPV, oral appliance Current smokers Pregnant women Disorders of hypoventilation due to known neuromuscular or chest wall diseases** Patients with significant restrictive lung disease on pulmonary function testing Recent admission for any acute illness within the prior 4 months | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Pain Male or female, at least 18 years of age at screening. 2. Scheduled to undergo primary unilateral TKA under general or spinal anesthesia. 3. American Society of Anesthesiologists (ASA) physical status 1, 2, or 3. 4. Female subject must be surgically sterile; or at least 2 years postmenopausal; or have a monogamous partner who is surgically sterile; or practicing double-barrier contraception; or practicing abstinence (must agree to use double-barrier contraception in the event of sexual activity); or using an insertable, injectable, transdermal, or combination oral contraceptive approved by the FDA for greater than 2 months prior to screening and commit to the use of an acceptable form of birth control for the duration of the study and for 30 days after completion of the study. 5. Able to demonstrate sensory function by exhibiting sensitivity to cold, pinprick, and light touch. 6. Able to provide informed consent, adhere to the study visit schedule, and complete all study assessments Currently pregnant, nursing, or planning to become pregnant during the study or within 1 month after study drug administration. 2. Planned concurrent surgical procedure (e.g., bilateral TKA). 3. Concurrent painful physical condition that may require analgesic treatment (such as an NSAID or opioid) in the postsurgical period for pain that is not strictly related to the knee surgery and which may confound the postsurgical assessments (e.g., significant pain from other joints including the non-index knee joint, chronic neuropathic pain, concurrent or prior contralateral TKA, concurrent foot surgery). 4. Previous open knee surgery on the knee being considered for TKA. Prior arthroscopy is permitted. 5. History of hypersensitivity or idiosyncratic reaction to amide-type local anesthetics. 6. Contraindication to any one of the following: bupivacaine, oxycodone, morphine, or hydromorphone. 7. Use of any of the following medications within the times specified before surgery: long-acting opioid medication or NSAIDs (except for low-dose aspirin used for cardioprotection) within 3 days, or any opioid medication within 24 hours. 8. Initiation of treatment with any of the following medications within 1 month of study drug administration or if the medication(s) are being given to control pain: selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), gabapentin, pregabalin (Lyrica®), or duloxetine (Cymbalta®). If a subject is taking one of these medications for a reason other than pain control, he or she must be on a stable dose for at least 1 month prior to study drug administration. 9. Current use of systemic glucocorticosteroids within 1 month of enrollment in this study. 10. Use of dexmedetomidine HCl (Precedex®) within 3 days of study drug administration. 11. History of impaired kidney function, poorly controlled chronic respiratory disease, rheumatoid arthritis, coagulopathy, or loss of sensation in extremities. 12. Impaired kidney function (e.g., serum creatinine level >2 mg/dL [176.8 µmol/L] or blood urea nitrogen level >50 mg/dL [17.9 mmol/L]) or impaired liver function (e.g., serum aspartate aminotransferase [AST] level >3 times the upper limit of normal [ULN] or serum alanine aminotransferase [ALT] level >3 times the ULN.) 13. Uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments. 14. Any chronic neuromuscular deficit effecting the peripheral nerves or muscles of the surgical extremity. 15. Any chronic condition or disease that would compromise neurological or vascular assessments. 16. Malignancy in the last 2 years, with the exception of non-metastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix. 17. Suspected or known history of drug or alcohol abuse within the previous year. 18. Body weight <50 kg (110 pounds) or a body mass index >44 kg/m2. 19. Previous participation in an study. 20. Administration of an investigational drug within 30 days or 5 elimination half-lives of such investigational drug, whichever is longer, prior to study drug administration, or planned administration of another investigational product or procedure during the subject's participation in this study | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obstructive Sleep Apnea years and older Ability to speak, read, and write Dutch Ability to follow-up Ability to use a computer with internet connection for online questionnaires Diagnosis with symptomatic mild or moderate OSA (5 < AHI < 30) Expected to maintain current lifestyle (sports, medicine, diet, etc.) Untreated periodontal problems, dental pain, and a lack of retention possibilities for an MAD Medication used/related to sleeping disorders Evidence of respiratory/sleep disorders other than OSA (eg. central sleep apnea syndrome) Systemic disorders (based on medical history and examination; e.g. rheumatoid arthritis) Temporomandibular disorders (based on the function examination of the masticatory system) Medical history of known causes of tiredness by day, or severe sleep disruption (insomnia, Periodic Limb Movement Disorder, Narcolepsy) Known medical history of mental retardation, memory disorders, or psychiatric disorders Reversible morphological upper airway abnormalities (e.g. enlarged tonsils). - Inability to provide informed consent simultaneous use of other modalities to treat OSA Previous treatment with a MAD | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Sleep Apnea Syndromes OSA 1. Age greater than 18 years 2. Able to provide informed consent 3. New diagnosis of OSA by polysomnogram 4. Agree with CPAP treatment Control 1. Age greater than 18 years 2. Without OSA 3. Able to provide informed consent Not able to give informed consent due to psychological incapacity 2. Chronic use of hypnotics for more than 6 weeks 3. Current drug or alcohol addiction 4. Rhythm other than sinus at enrollment 5. Mandatory and biventricular pacing 6. History of heart transplant or left ventricular assist device (LVAD) 7. Active use of intravenous vasodilators, vasopressors or inotropes 8. Hemodialysis or peritoneal dialysis 9. Active infection including bacteremia 10. Acute coronary syndrome (ACS) within 6 weeks 11. Major trauma or surgery within 6 weeks 12. Malignant neoplastic disease on active treatment including chemotherapy and radiation therapy, or life expectancy less than 1 year 13. Collagen vascular disease on active treatment including steroids and other immunomodulating drugs 14. Systemic steroid use within 6 weeks 15. Concomitant use of investigational drug within 6 weeks | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obesity Hypoventilation Syndrome Obstructive Sleep Apnea Chronic Obstructive Pulmonary Disease Neuromuscular Disease Aged 18+ Existing full face mask user or a nasal mask user Prescribed NIV therapy for at least 3 months Inability to give informed consent Pregnant or think they may be pregnant Anatomical or physiological conditions making NIVtherapy inappropriate Patients who are in a coma or decreased level of consciousness Existing Simplus and Eson users | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-45.0, Invasive Aspergillosis Subjects will be males and females of any ethnic origin aged between 18 and 45 years of age and weighing 50-100 kg inclusive. 2. Subjects must be in good health, as determined by a medical history, physical examination, 12-lead electrocardiogram (ECG) and clinical laboratory evaluations (congenital non haemolytic hyperbilirubinaemia is acceptable). 3. Subjects will have given their written informed consent to participate in the study and to abide by the study restrictions Male and female subjects who are not willing to use appropriate contraception during the study and for three months thereafter. 2. Subjects who have received any prescribed systemic or topical medication within 14 days of the dose administration unless in the opinion of the Investigator and the Medical Monitor the medication will not interfere with the study procedures or compromise safety. 3. Subjects who have used any non-prescribed systemic or topical medication (including herbal remedies) within 7 days of the dose administration (with the exception of vitamin/mineral supplements and paracetamol) unless in the opinion of the Investigator and the Medical Monitor the medication will not interfere with the study procedures or compromise safety. 4. Subjects who have received any medications, including St John's Wort, known to chronically alter drug absorption or elimination processes within 30 days of the dose administration unless in the opinion of the Investigator and the Medical Monitor the medication will not interfere with the study procedures or compromise safety. For at least 2 weeks prior to dosing and until all blood samples and observations are completed on Day 18 +/ (Part 1) or Day 15 +/ (Part 2), subjects will not be allowed to eat any food or drink any beverage containing alcohol, grapefruit or grapefruit juice, apple or orange juice, vegetables from the mustard green family e.g. kale, broccoli, watercress, spring greens, kohlrabi, Brussels sprouts, mustard and charbroiled meats | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 5.0-12.0, Pediatric Sleep Apnea Obesity Morphine Metabolism Child presenting for surgery that will require opioids Age between 5 -12 years of age OSAS group Pre-operative polysomnography study conducted prior to day of surgery Obese Body weight >95th percentile for age Emergency procedures involving AT, including tonsillar bleeding Patients allergic to morphine Patients with comorbidities altering opioid metabolism (i.e. liver disease) Patients with chronic inflammatory, rheumatologic, or other confounding co-morbid diseases (i.e. Crohns disease, ulcerative colitis, sickle cell, Sjogren's, etc.) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-55.0, Dizziness Adult patients who were experiencing sudden onset dizziness of unknown etiology for the first time were included in the study Patients with a history of chronic diseases such as any liver disease,diabetes mellitus, hypertension,congestive heart failure, hepatitis B or C infection 2. Patients with any central dizziness attacks 3. Patients with hemodynamically unstable and emesis; 4. Patients receiving drugs that could affect liver function tests, such as, acetaminophen, antibiotics, oral contraceptives, antihypertensive drugs (e.g., angiotensinconverting enzyme inhibitors), or hormones (e.g.,estrogen) 5. Patients who was experienced dizziness with systemic diseases 6. Patients with any neurological disorders 7. Patient who do not want to participate in the study | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Asthma for Phase I For the WTC population with Irritant-Induced Asthma (IA) > 18 years of age* Current nonsmoker* < 5 pack year (p-y) history of tobacco use* Spirometry in the past 6 months or on day of evaluation with a bronchodilator* response of ≥ 12% and 200 ml improvement in FEV* Positive methacholine challenge test (decrease in FEV1* ≥ 20% (PC20) after inhalation of < 16 mg/ml of methacholine) Inhaled corticosteroid use in previous 1 month or more will be allowed* Patients will be recruited from the WTC EHC and will have WTC dust cloud exposure New symptoms after 9/11 Symptoms of wheeze and shortness of breath (> 2x / week) in the 4 weeks before (persistent symptoms). for Allergic Asthma Population (AA) Current Smoker Pulmonary diseases such as Chronic Pulmonary Disease (COPD) or Interstitial Lung Disease Cardiac Disease Inability to perform lung function or other maneuvers Upper respiratory tract infection within the last 4 weeks FEV1 <60% predicted normal pre-bronchodilator Oral corticosteroid treatment within the last 4 weeks No vulnerable subjects will be part of this study | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obstructive Sleep Apnea Consecutive adult patients with newly diagnosed obstructive sleep apnea (apnea-hypopnea index ≥5 events/h), who were offered PAP treatment Must be able to give informed consent Disabled to come to follow-ups | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 0.167-4.917, Pneumonia History of cough <14 days or difficult breathing with fast breathing (for children 2 to <12 months of age, >50 breaths/minute and for children >12 months of age, > 40 breaths/minute) Ability and willingness of children's caregiver to provide informed consent and to be available for follow-up for the planned duration of the study, including accepting a home visit if he/she fails to return to Kamuzu Central Hospital (KCH) with the child for a scheduled study follow-up visit If fast breathing observed at screening resolves after bronchodilator challenge Chest-indrawing Severe respiratory distress, classified by World Health Organization (WHO) pocketbook guidelines (e.g., grunting, nasal flaring, head nodding, crackles on auscultation, or very severe chest-indrawing) Presence of WHO Intergrated Management of Childhood Illness (IMCI) danger signs including: lethargy or unconsciousness, convulsions, vomiting everything, or inability to drink or breastfeed Hypoxia (SaO2 < 90% on room air, as assessed by a Lifebox pulse oximeter) Stridor when calm HIV-1 seropositivity or HIV-1 exposure, assessed as follows An HIV-positive result upon rapid antibody test will any child from this study. If a child is less than 12 months or age or breastfeeding with a positive rapid test result, the child will be referred to receive additional confirmatory HIV testing (e.g., dried blood spot filter paper test) and follow-up from KCH staff, as per standard of care. Even if the confirmatory HIV testing subsequently shows that child is HIV-negative, he or she will remain excluded from the study If a child is less than 12 months of age or breastfeeding and has an HIV-negative result upon rapid antibody test, the child's biological mother's HIV status will need to be assessed. If the mother is HIV-positive, the child will be excluded. If the mother has a documented HIV-negative test result from within the past 3 months, the child will be included. If the mother does not have documentation of an HIV-negative test result, she will be tested via rapid antibody testing to determine the child's for this study If a child is over 12 months of age and not breastfeeding, an HIV-negative rapid antibody test is required for in the study | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 0.0-999.0, Heart Failure Myocardial Infarction Ventricular Tachycardia Post-MI patients eligible for ICD implantation in the setting of primary prevention NYHA IV or ambulatory NYHA IV 2. Acute coronary syndrome in the last 40 days 3. Stable angina not eligible to revascularization 4. Revascularization in the last 3 months (except MI) 5. Antiarrhythmic therapy other than b-blockers 6. LVEF<20% 7. GFR<30ml/min/1.73m2 8. Systematic illnesses | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 50.0-70.0, Chronic Disease Obstructive Pulmonary individuals who have been diagnosed with COPD , stage II and III disease are undergoing treatment at the hospital João de Barros Barreto in the period January and February 2016 both sexes to 70 years of age hemodynamically stable were not diagnosed with COPD present associated diseases that may interfere with cardiac autonomic control had less than 50 years or over 70 years old are in stage I of the COPD in intensive care unit present muscle skeletal deformities hemodynamic instability make use of pacemakers in need of supplemental O2 who do not tolerate the practice of exercises | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obstructive Sleep Apnea All adult surgical patients (>18 yr) with a diagnosis of OSA with or without a CPAP prescription. 2. Scheduled for a non-cardiac surgery (general surgery, orthopedics, urology, plastic surgery and spine) that is expected to require a postoperative hospital stay of more than one night They are unwilling or unable to give informed consent to the study. 2. They are on supplemental oxygen preoperatively (daytime or nocturnal). 3. They are pregnant. 4. Surgery included tonsillectomy, septoplasty, uvuloplasty, pharyngoplasty, tracheostomy, or prolonged (> 48 hrs) postoperative mechanical ventilation of the lungs is anticipated. These procedures/interventions are likely to cure or at least modify the severity of OSA | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 45.0-75.0, Work of Breathing • COPD Diagnosis: mild-to-moderate, with FEV1 30-80% and requiring no long-term oxygenotherapy Refuse to participate in the study for one of the following reasons: i. wearing a oesophageal catheter; ii. wearing the gas mask; iii. giving blood sample; iv. claustrophobia Oesophageal background wounds Facial anthropometrical issues | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 22.0-999.0, Obstructive Sleep Apnea Aged 22 and over Diagnosed with Obstructive Sleep Apnea (OSA) and prescribed Positive Airway Pressure (either Continuous positive airway pressure (CPAP) or AutoCPAP) For experienced users of PAP (CPAP or AutoCPAP) you must be using PAP of more than 4 hours/night for 70% during the last 30 days Contraindicated for PAP (CPAP or AutoCPAP) therapy Has other significant sleep disorders (e.g periodic leg movements, insomnia, central sleep apnea) Has obesity hypoventilation syndrome or congestive heart failure Requires supplemental oxygen with their PAP (CPAP or AutoCPAP) device Has implanted electronic medical devices (e.g cardiac pacemakers) Pregnant or think they may be pregnant Not fluent in spoken and written English | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 50.0-90.0, Alzheimer's Disease Obstructive Sleep Apnea Patients diagnosed of mild probable AD according to NIA-AA (MMSE>20). 2. Informed Consent Form signed by the patient (and/or if applicable the legal representative if different from the responsible caregiver) and the responsible caregiver. 3. The patient has a knowledgeable and reliable caregiver who will accompany the patient to all clinic visits during the study. 4. Absence of visual and hearing problems that, in the investigator's judgement, difficult for compliance with the study procedures Previous diagnosis of OSA. 2. Severe Alzheimer's disease, other types of dementia or patients with mild Alzheimer's disease with current acetylcholinesterase inhibitors or memantine treatment. 3. Presence of any previously diagnosed sleep disorder: narcolepsy, insomnia, chronic lack of sleep. 4. Having serious comorbidities: cancer, excessive intake of alcohol (>280 gr/week), severe depression, severe renal or hepatic insufficiency, severe cardiac or respiratory failure. 5. Currently receiving an investigational drug or device. 6. Patient or family declining to take part. 7. Disabling drowsiness not justifiable by any other cause. 8. The patient has MRI evidence of hydrocephalus, stroke, a space-occupying lesion, cerebral infection or any clinically significant central nervous system disease other than AD. 9. The patient suffers from mental retardation, organic mental disorders, or mental disorders due to a general medical condition (DSM-IV-TR™ criteria). 10. The patient has an untreated vitamin B12 or folate deficiency that is considered clinically significant, or has clinical and laboratory evidence of untreated thyroid disease. Patients with vitamin B12 or folate deficiency may be enrolled in the study provided they have been on a supplement therapy for >3 months prior to the Screening Visit and are stable. Patients with thyroid disease may be enrolled in the study provided they are stable and euthyroid. 11. Patient on betablockers, antidepressants, neuroleptics, hypnotics, or they have been removed 15 days before conducting polysomnography (PSG) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 35.0-80.0, Chronic Obstructive Pulmonary Disease One previous chronic obstructive pulmonary disease exacerbation in last year Can not be oxygen dependant PaCO2 < 60 | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Ventricular Tachycardia (VT) Prior Myocardial Infarction and One of the following VT events while not being treated with amiodarone, sotalol, or another class I or class III antiarrhythmic drug) within the last 6 months Sustained monomorphic VT documented on 12-lead ECG or rhythm strip terminated by pharmacologic means or DC cardioversion ≥3 episodes of VT treated with antitachycardia pacing (ATP), at least one of which was symptomatic ≥ 5 episodes of VT treated with antitachycardia pacing (ATP) regardless of symptoms ≥1 appropriate ICD shocks ≥3 VT episodes within 24 hours Unable or unwilling to provide informed consent Active ischemia (acute thrombus diagnosed by coronary angiography, or dynamic ST segment changes demonstrated on ECG) or another reversible cause of VT (e.g. drug-induced arrhythmia), had recent acute coronary syndrome within 30 days, coronary revascularization (<90 days bypass surgery, <30 days percutaneous coronary intervention), or have CCS functional class IV angina. Note that biomarker level elevation alone after ventricular arrhythmias does not denote acute coronary syndrome or active ischemia Are ineligible to take the antiarrhythmic drug to which they would be assigned due to allergy, intolerance or contraindication Are known to have protruding left ventricular thrombus or mechanical aortic and mitral valves Have had a prior catheter ablation procedure for VT Are in renal failure (Creatinine clearance <15 mL/min), have NYHA Functional class IV heart failure, or a systemic illness likely to limit survival to <1 year Have had recent ST elevation myocardial infarction or non-ST elevation MI (< 30 days); note that biomarker elevation alone after ventricular arrhythmias does not denote MI Are pregnant | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 25.0-60.0, Sleep Apnea, Obstructive Obesity Patients who have been diagnosed with severe obstructive sleep apnea syndrome (AHI > 30) and are already receiving CPAP treatment (since at least 6 months), who have class I and class II obesity (body mass index (BMI) >= 30 kg /m2 y <= 40 kg/m2) diseases that limit exercising or diet cognitive impairment that prevents understanding the program psychiatric disorders severe diseases, major cardiovascular disease clinical instability within the previous month prior bariatric surgery refusal to participate in the study participation in another clinical trial | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 65.0-999.0, Thyroid Dysfunction Atherosclerosis Heart Failure Community-dwelling patients aged >= 65 years with subclinical hypothyroidism Written informed consent Subjects currently under levothyroxine or antithyroid drugs (amiodarone, lithium) Recent thyroid surgery or radio-iodine (within 12 months) Grade IV NYHA heart failure Prior clinical diagnosis of dementia Recent hospitalization for major illness or elective surgery (within 4 weeks) Terminal illness Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption Subjects who are participating in ongoing RCTs of therapeutic interventions (including CTIMPs) Plan to move out of the region in which the trial is being conducted within the next 2 years (proposed minimum follow-up period) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 45.0-99.0, Obstructive Sleep Apnea Arrhythmia orthopaedic, urologic, vascular, digestive surgery under general anaesthesia or sedation age > 45 years old STOP-BANG score>3 Head and neck surgery, planned prolonged mechanical ventilation after surgery (>24h) Severe COPD Post-operative ICU planned Diagnosed OSA or other sleep disorder breathing | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Postoperative Pain ASA I-III subjects Ages 18-80 years Weight between 60 and 110 Kg At least 60in (152cm) tall Scheduled for elective open colonic surgery at UPMC Presbyterian Shadyside Hospital in Pittsburgh, Pennsylvania Age younger than 18 years or older than 80 years Any contraindication to the placement of bilateral thoracic paravertebral catheters American Society of Anesthesiologists physical status IV or greater Chronic painful conditions Preoperative opioid use Coagulation abnormalities or patients who are expected to be on therapeutic anticoagulants postoperatively Allergy to any of the drugs/agents used study protocol Personal or family history of malignant hyperthermia Serum creatinine greater than 1.3 g/dl Pregnancy | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 15.0-999.0, Pulmonary Disease, Chronic Obstructive Patients who have been diagnosed with chronic obstructive pulmonary disease (chronic bronchitis, emphysema) by physician and need relief of various symptoms associated with Long Acting Beta2 Agonist (LABA) or Long Acting Muscarinic Antagonist (LAMA) Patients who are prescribed Tio+Olo FDC 5µg/5µg for the first time Patients who have been registered once in this study (i.e., re-entry of patients is not allowed) Patients who are participating in a registry or clinical trial Patients who have a contraindication to Tio+Olo FDC 5µg/5µg defined in the package insert for Tio+Olo FDC 5µg/5µg | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Chronic Obstructive Pulmonary Disease (COPD) Sleep Apnea Obstructive (OSA) Healthy Volunteers COPD patients stages GOLD III IV, FEV1/FVC ratio < 0,7 and maximum voluntary ventilation (MVV) < 50% of predicted values BMI < 30 kg/m² Age between 18 and 80 years Non-smoking or ex-smoker (stop since more than 3 months) Stable condition since more than 3 months PaCO2 < 45 mmHg resting with ambiant air No OSA diagnostic OSA patients Severe OSA recently dignosed (apnoea-Hypopnoea Index (AHI) > 30) OSA and COPD patients Pathologies cardiovascular, neuromuscular, métabolic, renal Alcoholism BMI > 30 kg/m² Psychiatric disorders or history of behavioural disorders, vision disorders, vestibular disorders, neurologic disease sensitive to disrupt the postural control and the walking, cognitive disorders Instability since less than 3 months Counter argument to the application of an external magnetic field Control subjects Respiratory pathologies, cardiovascular, neuromuscular, metabolic, renal Alcoholism BMI > 30 kg/m² | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-65.0, Influenza, Human Subjects with acute uncomplicated influenza with oral temperature ≥ 37.8 ℃ (100.04 °F); plus at least one respiratory symptom (nasal congestion, sore throat, cough); and at least one constitutional symptom (aches or pains, fatigue, headache, chills or sweats). If antipyretics were taken, may wait at least 4 hours after dosing to determine if a qualifying temperature is observed. 2. Subjects with RIDT confirmed influenza infection. 3. Onset of symptoms less than 48 hours before Visit 1 (Screening; study drug administration visit). The onset of symptoms is defined as either Time of the first increase in body temperature to ≥ 37.8 ℃ (100.04 °F); or Time when the subject experiences at least one general or respiratory symptom. 4. Age 18 to 65 years old. 5. Subjects who are able to understand and willing to sign the informed consent form (ICF). 6. All female subjects of child-bearing potential must have a negative urine pregnancy test result. All female subjects of child-bearing potential and male subjects and their spouse/partner must agree to use a medically acceptable method of contraception (e.g., abstinence, an intrauterine device, a double barrier method such as condom + spermicide or condom + diaphragm with spermicide, a contraceptive implant, an oral contraceptive or have a vasectomized partner with confirmed azoospermia) throughout the entire study period, and for 30 days for females and 90 days for males after study drug discontinuation Subjects with severe influenza virus infection requiring inpatient treatment. 2. Subjects with concurrent infections requiring systemic antimicrobial and/or antiviral therapy at the time of screening. 3. Subjects who have any of the following documented conditions: uncontrolled hypertension (systolic blood pressure > 140 mm Hg or diastolic blood pressure > 90 mm Hg), diabetes, asthma (any current or recent, not childhood if resolved), COPD (any), cardiac, hepatic, renal (including eGFR<60) and hematopoietic disorders, bleeding tendency or hemorrhagic disease, neurological system disease, compromised immune system (including patients receiving immunosuppressant therapy, or those with cancer within the past 5 years or human immunodeficiency virus [HIV] infection), endocrine disorders (including thyroid disorders). 4. Subjects with anatomical nasal obstruction or gross anatomical abnormalities. For example, nasal polyps or significant nasal septal deviation. 5. Clinically obese subjects with BMI≥40. 6. Subjects with recent history (within 1 year) of alcoholism or substance abuse. 7. Received influenza vaccine within 21 days. 8. Participation in other clinical trial within 1 month, or during the study. 9. Pregnant or breast-feeding female subjects 10. Allergy or known allergy to components of study medication. 11. Subjects who took a monoamine oxidase inhibitor (MAOI) within 2 weeks prior to enrollment. 12. Previous history of difficulty swallowing capsules. 13. Any other associated disease or condition which, in the opinion of the investigator, might restrict or impede participation in the study or affect the study results | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 16.0-86.0, Refractory Epilepsy Patients with refractory focal epilepsy Initiation of perampanel between 05/2014 and 04/2015 Exact date of initiation of Perampanel not defined Patients without follow-up data | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Chronic Obstructive Pulmonary Disease Already on primary care COPD register and DOSE score <4 (low risk) No capacity to consent or unable to travel to primary care practice (local GP surgery) | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 1.0-31.0, B Acute Lymphoblastic Leukemia Central Nervous System Leukemia Ph-Like Acute Lymphoblastic Leukemia Testicular Leukemia Patients must be enrolled on APEC14B1 and consented to Screening on the Part A consent form prior to enrollment on AALL1131 White Blood Cell Count (WBC) Age 1-9.99 years: WBC >= 50 000/uL Age 10-30.99 years: Any WBC Age 1-30.99 years: Any WBC with Testicular leukemia CNS leukemia (CNS3) Steroid pretreatment Patients must have newly diagnosed B lymphoblastic leukemia (2008 World Health Organization [WHO] classification) (also termed B-precursor acute lymphoblastic leukemia); patients with Down syndrome are also eligible Organ function requirements for patients with Ph-like ALL and a predicted TKI-sensitive mutation: patients identified as Ph-like with a TKI-sensitive kinase mutation must have assessment of organ function performed within 3 days of study entry onto the dasatinib arm of AALL1131 With the exception of steroid pretreatment or the administration of intrathecal cytarabine, patients must not have received any prior cytotoxic chemotherapy for either the current diagnosis of B-ALL or any cancer diagnosed prior to the initiation of protocol therapy on AALL1131; patients cannot have secondary B-ALL that developed after treatment of a prior malignancy with cytotoxic chemotherapy; patients receiving prior steroid therapy may be eligible for AALL1131 Patients with BCR-ABL1 fusion are not eligible for post-induction therapy on this study but may be eligible to enroll in a successor Children's Oncology Group (COG) Philadelphia positive (Ph+) ALL trial by day 15 Induction DS HR B-ALL patients with Induction failure or BCR-ABL1 Female patients who are pregnant are ineligible since fetal toxicities and teratogenic effects have been noted for several of the study drugs Lactating females are not eligible unless they have agreed not to breastfeed their infant Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained Sexually active patients of reproductive potential are not eligible unless they have agreed to use an effective contraceptive method for the duration of their study participation | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 20.0-75.0, Hypothyroidism TSH > 10 mU/liter Serious competing illness Pregnancy or planning to become pregnant Thyroidectomized patients Unable to speak and understand danish | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 19.0-70.0, Lipedema Ambulatory females of any race able to understand the consent process. 2. 19-70 years of age. 3. Diagnosis of lipedema Stage 1 or Stage 2 although early Stage 3 will be considered. 4. Weight stable for past three months per personal report of the subject. 5. Must be able to attend all 12 treatments and pre and post procedures Use of medications that might cause weight gain and prevent fat loss (e.g., second generation anti-psychotics, corticosteroids). 2. Current use of weight loss medications. 3. Tobacco or marijuana use which may alter inflammation in the body. 4. Pregnancy due to the risks associated with deep tissue treatment. 5. Two or more alcoholic beverages per day, chronically | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 65.0-999.0, Frail Elderly Exercise Therapy Physical Therapy Techniques volunteers above the age of 65 who are community residents and classified as frail according to the established by Fried et al. will be selected for in the study previous lower extremities orthopedic surgery, a history of fractures within the past year, an inability to walk unaided, carriers of neurological diseases, diagnosed acute inflammatory disease that could interfere in the assessments and the program, tumor growth in the last five years and cognitive impairment based on the mini-mental state examination [4]. Moreover, will be excluded volunteers who are absent more than three consecutive training and / or more than 25% of the sessions, and / or present the course of the physical program changes or decompensation and / or disease injury | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obstructive Sleep Apnea Adult patient Obstructive Sleep Apnea Patient previously treated by Continuous positive airway pressure non-compliant to therapy Patient naive of bilevel Positive Airway Pressure therapy Bilevel positive airway pressure Contraindication Severe respiratory disease diagnostic | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-55.0, Healthy Volunteers Premenopausal women and men <55 years of age Body weight <204 kg (<450 pounds) and >= 36 kg (>= 80 pounds) Stable weight (+/-5% within past 6 months) as determined by volunteer report Healthy, as determined by medical history, physical examination, and laboratory tests Age <18 years Weight greater than or equal to 204 kg (greater than or equal to 450 pounds, maximum weight of the iDXA machine as per manufacturer s manual), or weight <36 kg (<80 pounds, minimum weight allowed based on the NIH guidelines of blood drawing for research purposes) Use of medications affecting metabolism and appetite in the last three months Expresses unwillingness to consume all food given during the weight maintaining diet portions of the study (e.g., due to strict dietary restrictions including allergies or vegetarian or kosher diet) Current use of tobacco products, marijuana, amphetamines, cocaine, or intravenous drug use Current pregnancy, pregnancy within the past 6 months or lactation History or clinical manifestation of Type 1 and Type 2 diabetes mellitus History of surgery for the treatment of obesity Endocrine disorders, such as Cushing s disease, pituitary disorders, and hypo and hyperthyroidism | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Acute Respiratory Failure Patients over 18 years of age Competent or with legal representative able to sign inform consent Reversible ARF secondary to heart failure, COPD exacerbation, pneumonia, or at risk of pot-extubation failure* who meet the for starting NIV Signs and symptoms of respiratory distress or Moderate to severe dyspnoea, grater than usual and/or Respiratory rate greater than 25 in COPD or greater than 30 in hypoxemic ARF and/or Use of accessory muscles and/or paradoxical breathing and/or Hypercapnic encephalopathy And changes in gas exchange PaCO2>45 mmHg, pH<7.35 and/or Respiratory arrest, direct indication of OTI and IMV Severe unstable comorbidity (myocardial ischemia with ejection fraction <30%, arrythmia, uncontrolled hypotension defined as systolic blood pressure less than 90 mmHg with doses of norepinephrine>0.5 mcg/kg/min and/or dobutamine>10 mcg/kg/min) Inability to protect the airway: bronchial aspiration Fixed upper airway obstruction Tracheostomy Undrained pneumothorax Severe agitation or lack of collaboration of the patient despite medication administered Facial burns or trauma Facial surgery or anatomical changes which prevent mask fitting Hypersensitivity to the active substance or to any of the excipients listed in section 6.1 | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 60.0-999.0, Mild Cognitive Impairment Major Depressive Disorder Alzheimer's Dementia Transcranial Direct Current Stimulation tDCS MCI Group 1. Age > 60 (on day of randomization) 2. DSM-IV for Mild Neurocognitive Disorder ("MCI") 3. Willingness to provide informed consent 4. MADRS score of 10 or below 5. Availability of a study partner who has regular contact with the participant 6. Ability to read and communicate in English (with corrected vision and hearing, if needed) 1. Met DSM-IV for Major Depressive Episode in past 10 years 2. Lifetime DSM-IV diagnosis of schizophrenia, bipolar disorder, or OCD 3. DSM-IV diagnosis of alcohol or other substances use disorder within the past 12 months 4. High risk for suicide 5. Significant neurological condition (e.g., stroke, seizure disorder, MS) 6. Unstable medical illness, (e.g., uncontrolled diabetes mellitus or hypertension) 7. Having taken a cognitive enhancer (acetylcholinesterase inhibitor or memantine) within the past 6 weeks 8. Participants taking anticonvulsants, and other psychotropic medication (see exception below) that cannot be safely tapered and discontinued. The following psychotropic medications are allowed if they have been taken at a stable dose for at least 4 weeks prior to study entry: zopiclone, trazadone, or a benzodiazepine; gabapentin, pregabalin, duloxetine, venlafaxine, or low-dose tricyclic antidepressants if prescribed for chronic pain. 9. A pace-maker or other metal implants that would preclude safe use of tDCS. MDD Group 1. Age ≥ 60 (on day of randomization) 2. Meets DSM-IV for one or more MDE(s)with: 1. an offset of 2 months to 5 years from the screening visit date. It is not necessary for this (these) episode(s) to have received medical attention OR 2. an offset of 5 years or more from the screening visit date. It is necessary that at least one MDE received medical attention (e.g., previously been on one or more antidepressant(s), saw a psychiatrist, primary care physician, or had a previous hospitalization). Also, the MDE must have occurred during the participant's adult life (i.e., at 18 years of age or older). 3. MADRS score of 10 or below 4. Willingness to provide informed consent 5. Availability of a study partner who has regular contact with the participant 6. Ability to read and communicate in English (with corrected vision and hearing, if needed) 1. Meets DSM-IV for Major Neurocognitive Disorder ("dementia") 2. Lifetime DSM-IV diagnosis of schizophrenia, bipolar disorder, or OCD 3. DSM-IV diagnosis of alcohol or other substances use disorder within the past 12 months. 4. High risk for suicide. 5. Significant neurological condition (e.g., stroke, seizure disorder, MS) 6. Unstable medical illness (e.g., uncontrolled diabetes mellitus or hypertension) 7. Participants taking anticonvulsants, and other psychotropic medication (see exception below) that cannot be safely tapered and discontinued. In addition to any antidepressant, the following psychotropic medications are allowed if they have been taken at a stable dose for at least 4 weeks prior to study entry: zopiclone, trazodone, or a benzodiazepine; and gabapentin or pregabalin if prescribed for chronic pain. 8. Having taken a cognitive enhancer (acetylcholinesterase inhibitor or memantine) within the past 6 weeks. 9. A pace-maker or other metal implants that would preclude safe use of tDCS. Facilitator Group 1. Willingness to provide informed consent 2. Ability to read and communicate in English (with corrected vision and hearing, if needed) 3. Physical or medical illness that prevents participant from learning or administering CR + tDCS, as determined by the research team | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obstructive Sleep Apnea Aged 18 and over Diagnosed with OSA by a practicing physician and prescribed Positive Airway Pressure (PAP) (Continuous Positive Airway Pressure (CPAP) or AutoCPAP). Participants can be naïve to CPAP or experienced users of CPAP For experienced users of PAP (CPAP or AutoCPAP): Using the PAP of more than 4 hours/night for 70% during the last 30 days (justification allowed by the investigator) Contraindicated for PAP (CPAP or AutoCPAP) therapy Persons with other significant sleep disorder(s) (e.g periodic leg movements, insomnia, central sleep apnea) Persons with obesity hypoventilation syndrome or congestive heart failure Persons that require supplemental oxygen with their PAP (CPAP or AutoCPAP) device Persons with implanted electronic medical device (e.g cardiac pacemakers) Persons who are pregnant or think they might be pregnant | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, GERD for Healthy Persons: -Patients 18 years of age or older with no symptoms of GERD for Patients Patients 18 years of age or older with symptoms of GERD Upper gastrointestinal endoscopy within the past 6 months and a prior diagnostic pH impedance study showing predominantly upright reflux for Patients; Items indicated with an asterisk (*) are also for healthy persons Patient who fulfil ROME IV for rumination disorder20 Clinical evidence of significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological (e.g., spinal cord injuries, dementia, multiple sclerosis, Parkinson's disease), psychiatric or other disease that may interfere with the objectives of the study and/or pose safety concerns.* Any prior gastric or esophageal surgery and significant intestinal or colonic resection* Hiatal hernia measuring 3 cm or larger as assessed by endoscopic or radiological studies Prior history of Los Angeles Grade C or D esophagitis, or esophageal stricture Current use opioid analgesics or anticholinergic drugs.* We will permit low doses of tricyclic antidepressants, nortriptyline (up to 50 mg/day) or amitriptyline (up to 25 mg/day) provided they were commenced 3 months prior to the screening period, calcium channel or adrenergic1 antagonists Current use of proton pump inhibitors Known significant esophageal motor disorder (ie achalasia, aperistalsis, functional obstruction, jackhammer, distal esophageal spasm)* Inability to read due to: blindness, cognitive dysfunction, or English language illiteracy * | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 0.0-999.0, Chronic Disease Arms 1 & 2 Candidates to major elective surgical procedures in the following specialties: abdominal, gynecology, cardiovascular, urology and thoracic Patients presenting high surgical risk because they are they are aged > 70 years and/or show an American Society of Anesthesiologist (ASA) score of III/IV A tentative surgical schedule allowing for at least 4 weeks for the pre-habilitation intervention. Arms 3 & 4 Patients suffering one or more targeted chronic conditions (cardiovascular diseases, chronic obstructive pulmonary disease and type 2 diabetes mellitus) Moderate-to-severe disease (main disorder) High user of healthcare resources assessed by history of past hospital-related events (admissions and/or emergency room visits). Arms 5 & 6 Citizens at risk for chronic conditions and patients showing mild target disease(s) recruited through advertisements, primary care centers or pharmacy offices Arms 1 & 2 Emergency surgery Unstable cardiac or respiratory disease Locomotor limitations precluding the practice of exercise Cognitive deterioration impeding the adherence to the program. Arms 3-6 Unstable cardiovascular or respiratory disorders Locomotor limitations precluding the practice of exercise Cognitive deterioration impeding the adherence to the program | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-75.0, Obstructive Sleep Apnea Obesity Hypoventilation Syndrome Hypercapnia Post-Op Complication Acid-Base Imbalance Patients undergoing elective abdominal surgery Body-Mass-Index >=30 kg/m2 Ability to read and speak Signed informed consent Use of diuretics Use of theophylline Use of respiratory depressing drugs Severe lung disease (FEV1/FVC<%50) Severe hearth failure (EF<%35) Central nervous system or muscle disease Untreated hypothyroidism Renal failure (GFR<50) Total parenteral nutrition more than 72 hours Hypokalemia | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-999.0, Chronic Obstructive Pulmonary Disease (COPD) Adult patients with frequent exacerbations of COPD (clinically dominant COPD in the case of multiple co-morbidities eg. bronchiectasis, interstitial lung disease, congestive heart failure) Confirmed diagnosis of COPD (bronchodilator FEV1/FVC ratio <0.7 on spirometry within previous 12 months) Age >40 years >10 pack year smoking history Frequent COPD exacerbations in the previous 12 months before enrollment, defined by one or both of the following Treatment as an outpatient with antibiotics or prednisone (physician diagnosed COPD exacerbation) on 2 previous occasions OR One hospitalization for COPD exacerbation (as defined by 2/3 of increased dyspnea, sputum volume, or sputum purulence in patients with known airflow limitation) Expected to live > 12 months Known severe hypersensitivity to immunoglobulin or its components (anaphylaxis) Active or metastatic malignancy (including chronic lymphocytic leukemia) excluding local skin cancers History of hematopoietic stem cell transplant or solid organ transplant Current treatment with a biological therapy for other conditions Concomitant significant immunodeficiency or use of immunosuppressive treatment (other than for COPD) Alpha-1 antitrypsin deficiency (based on enzyme level from bloodwork) Significant proteinuria (dipstick proteinuria ≥ 3+ AND known urinary protein loss ≥ 2 g/day or nephrotic syndrome) and/or has a history of acute renal failure and/or severe renal impairment (creatinine more than 2.5 times the upper limit of normal and/or on dialysis) IgA deficiency (IgA <0.1 g/L) Immunoglobulin therapy in the last 12 months or on current Ig therapy or have a clinical indication for Ig replacement therapy (www.nacblood.ca/resources/guidelines/IVIG.html) Pregnancy | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Sleep Apnea, Obstructive All patients scheduled to have a PSG in the sleep laboratory center Patients < 18 years | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Observation Subjects are participants in a previously described dietician-based weight loss study in obese Chinese with obstructive sleep apnea (OSA). Specific study entry included an age range between 30 and 80 years, body mass index (BMI) >25 kg/m2, and moderate to severe OSA (apnea-hypopnea index (AHI) >15 events/hour) before the weight loss program performed in the year of 2010-2013 Subjects refused to participate the trial or unable to consent | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 21.0-90.0, Rehabilitation Recovery of Function Stroke experienced unilateral hemispheric ischemic or hemorrhagic stroke at least 3 months but no more than 7 years prior exhibit voluntarily shoulder flexion of the affected arm ≥30° with simultaneous elbow extension ≥20°. The investigators reason that persons at this motor ability level have residual arm activation and enough ability to engage in treatment-related reaching movements elicited by the computer games baseline FMA-UE score of at least 19 points but no more than 52 points (out of 60 points) based on previously published research by this study's investigators in which categories were defined based on post-stroke UE motor impairment passive range of motion in affected shoulder, elbow and wrist within 20 degrees of normal values 90 years of age a caregiver or friend who is willing to assist with the set up and operation of the computer game throughout the 6 week intervention lesion in brainstem or cerebellum because lesions in these locations my interfere with the visual-perceptual and cognitive skills needed for motor re-learning as is expected to occur as a result of the intervention presence of other neurological disease that may impair motor skills (e.g., Parkinson's Disease) pain in the affected arm that interferes with reaching movements significant cognitive impairment, defined as Montreal Cognitive Assessment score < 22 orthopedic condition or impaired corrected vision that alters the kinematics of reaching unable to travel to the UE Motor Function Laboratory in Charleston, South Carolina 4 times (pre-, mid post and retention testing) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 70.0-100.0, Unrecognized Condition Age equal or greater than 70 years of both sexes Patients with sleep study results with AHI ≥ 15 and < 30 Alternative diagnoses of other non-respiratory sleep disorders that are also cause of pathological somnolence (eg, sdr restless legs, narcolepsy, etc.) Don't sign informed consent Acute or chronic respiratory insufficiency requiring home oxygen therapy Patients with Obesity Hypoventilation Syndrome Diagnosis of neuro-psychiatric diseases with the exception of anxiety depression or diagnosis of dementia Diseases of any origin in the acute phase Heart failure or recent stroke (less than 3 months) Central SAHS (more than 50% of the registry with central apneas or Cheyne-Stokes breathing) Pre-treatment with CPAP | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-85.0, Neuromuscular Diseases Obesity Hypoventilation Syndrome Lung Disease, Restrictive Home non-invasive mechanical ventilation and clinical stability at least of 6 months ( no acute episode with admission on 2 months before) Mean Ventilator compliance > 4 h/ per night on screening visit Signed informed consent form previously Ventilation with oxygen join system | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Chronic Obstructive Pulmonary Disease Admitted with COPD exacerbation as a primary diagnosis Subjectively produces more than 1 tablespoon (15 ml) / day of sputum Has the subjective feeling that he/she cannot cough up or clear her secretions Physical respiratory system exam by the physician with evidence of course ronchi suggestive of impacted secretions > 10 pack-year smoking history Cannot use the flutter device or unable to follow commands Altered mental status Known active malignancy Known systolic congestive heart failure (CHF) with ejection fraction (EF) < 40% or clinically in acute CHF exacerbation as documented by cardiologist or primary diagnosis other than COPD Pregnancy Patients in severe exacerbation (Intubated, Continuous use of NIPPV, Unable to speak full sentences) Intracranial pressure (ICP) >20 mmHg Hemodynamic instability (requiring vasopressor support) Recent facial, oral, or skull surgery or trauma Acute sinusitis | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Elevated Blood Pressure Hypertension Mental Stress Sleep Disorders User of a (1) Withings blood pressure cuff (2) Withings activity tracker and (3) Withings Body Cardio scale User has measured their blood pressure at least once per week for the majority of weeks over the last three months Aortic artery disease Peripheral vascular disease Atrial fibrillation Weight > 396 lbs Pregnant women | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 20.0-40.0, Constipation - Functional Patients whose BMI exceeded 30 kg/m2 were included. In addition, they fulfilled the ROM of constipation, as follows: 1. Suffered from any 2 or more of the following symptoms in the past 12 weeks (not necessarily consecutive), with the onset of symptoms at least 6 months prior to diagnosis: 1. straining during at least 25% of defecations, 2. lumpy or hard stools in at least 25% of defecations, 3. sensation of incomplete evacuation for at least 25% of defecations, 4. sensation of anorectal obstruction/blockage for at least 25% of defecations, 5. requirement of manual maneuvers to facilitate at least 25% of defecations (e.g., digital evacuation, support of the pelvic floor muscles), and 6. fewer than 3 defecations per week; 2. Loose stools rarely occurred without the use of laxatives; 3. Insufficient for irritable bowel syndrome; and 4. Women were sedentary (less than 1 hour/week of physical activity), with no evidence of participation in diet control/weight reduction programs within the last 6 months Patients with metabolic, endocrine, and neurologic constipation current or past smokers those with any orthopedic limitation; and those with congenital megacolon, pseudo-obstruction, and anorectal disorders were excluded from the study. Patients suffering from constipation due to drugs, disabled patients, and those who had undergone any abdominal surgery during the intervention or those who failed to complete the study protocol were also excluded | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-85.0, Traumas, Brain Alzheimer Disease Dementia Head Injury Concussion, Brain TBI individuals aged 18 2. distress associated with being the primary caregiver of a person with TBI or dementia 3. endorsement of at least two of the following items: felt overwhelmed, felt like needed to cry, angry or frustrated, distant or cut of from family or friends, moderate to high levels of stress, felt their health had declined 4. provide at least one hour of care (supervision or direct assistance) per week over the past three months 5. approval by Primary Care Provider to participate in physical exercise 6. be proficient in spoken and written English current or lifetime history of any psychiatric disorder with psychotic features 2. prominent suicidal or homicidal ideation 3. current alcohol or substance abuse 4. diagnosis of probable or possible dementia 5. a Short Portable Mental Status score of ≥ 8 6. participation in another caregiver intervention within the past year 7. lack of regular access to the internet 8. planned transfer of care recipient to another caregiver or nursing home within 12 months; 8) current severe cardiac disease (e.g., uncontrolled atrial fibrillation, defined as mean 24 hour heart rate >85 beats/min, or 24 hour maximal ventricular rate >150 beats/min; uncontrolled ventricular arrhythmias, defined as recurrent ventricular tachycardia >3 beats in succession, or 24 hour PVC count >20%; active pericarditis or myocarditis; Class III/IV heart failure and / or ejection fraction < 20%; thrombophlebitis; pulmonary disease with a drop in O2 Sat with exercise to 90% without oxygen; embolism within past 6 months) 9. inability to participate in an exercise stress test 10. morbid obesity (BMI > 39) 11. inability to read, verbalize understanding and voluntarily sign the Informed Consent. Caregivers meeting any of these will be excluded from all aspects of this project | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-70.0, Graves Ophthalmopathy Thyroid Associated Ophthalmopathy Thyroid Associated Orbitopathy Age 18-70 years 2. Active mild to moderate with at least one sign of mild GO (NO SPECS class 2a and b) with reference to Colour Atlas at website (www.eugogo.eu). Exophthalmos up to 24 mm with a disease duration of <18 months (as recorded by the patient) 3. Graves´ disease with clinical and laboratory euthyroidism after stopping treatment with anti thyroid drugs (ATD), or 2 months treatment with ATD, or euthyroid 6 months after treatment with radioiodine, or euthyroid after total thyroidectomy. Clinical and laboratory euthyroidism is defined as normal fT4, fT3 and TSH below the upper limit of the local reference interval and no clinical symptoms or signs of hyperthyroidism. L-thyroxine is used to achieve euthyroidism during the study period Pregnancy or breast-feeding 2. Previous treatment of Graves´ ophthalmopathy 3. Severe Graves ophthalmopathy requiring corticosteroid treatment, retrobulbar irradiation, orbital decompression surgery 4. Current or previous treatment with simvastatin or other statins (within 3 months) 5. Allergy (skin rash or systemic reactions) to statins 6. Congestive heart failure 7. Renal insufficiency (glomerular filtration rate <60 ml/min) 8. ASAT or ALAT > 2.5 times the upper limit of the local laboratory 9. Alcoholism as judged by local 10. Coagulopathy including treatment with warfarin or new oral anti-coagulation drugs 11. Previous or current gastric ulcer 12. Inflammatory bowel disease diabetic retinopathy or nephropathy 13. Trauma within 10 days | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 19.0-999.0, Stroke Rehabilitation Motor Function Acute first-ever stroke Upper limb score of Fugl-Meyer assessment at 7 days after onset : 25~84 Transient ischemic stroke Joint contracture of affected upper extremity | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-75.0, Sleep Apnea, Obstructive Hypertension Age between 18 and 75 years Apnea-Hypopnea Index (AHI) ≥ 15 events/hr on diagnostic polysomnography(PSG) No previous history of surgical treatment of OSA, and no medical treatment of OSA within the past 6 months Adherence to prescribed anti-hypertensive medications as assessed by an average adherence between Visits 1-2 of at least 0.85 Arm circumference less than 50 cm Unable or unwilling to provide informed consent No telephone access or inability to return for follow-up Diagnosis of another sleep disorder in addition to OSA (e.g., periodic limb movement disorder [greater than 5 limb movements associated with arousal/hr of sleep], central sleep apnea [greater than 50% of apneas are central apneas], obesity hypoventilation syndrome, narcolepsy) Positive urine drug screen for any of the following: amphetamines, cocaine, opiates, barbiturates, benzodiazepines, phencyclidine (PCP), alcohol (ETOH), methadone (Visit 1) Requiring oxygen, bi-level positive airway pressure, or adaptive servo-ventilation for treatment of OSA Oxygen saturation < 87% for a period of 2 minutes during resting wakefulness during home sleep testing (HST) or PSG (Visit 2) Severe and inadequately controlled arterial hypertension (SBP greater than 180 mm Hg; diastolic BP greater than 110 mm Hg on 2 of 3 spot measurements on Visit 1) Participants with 24-hr SBP ≥ 140 mm Hg who are not on BP medications and participants on 4 or more BP medications with a 24-hr SBP < 135 mm Hg (Visit 2) A clinically unstable medical condition as defined by a change in medications in the previous month, including anti-hypertensive medications, or a new medical diagnosis in the previous 2 months (e.g., myocardial infarction, chronic heart failure, unstable angina, active infection, thyroid disease, depression or psychosis, cirrhosis, surgery, or cancer) Shift workers, individuals who regularly experience jet lag, or have irregular work schedules by history over the last 3 months | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Hypothyroidism examined for thyroid stimulating hormone, free thyroxine, thyroid peroxidase antibody (TPO Ab), and urine iodine concentration (UIC) already have a thyroid disease(benign thyroid diseases or thyroid cancer) | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-999.0, COPD Sleep Apnea Syndromes COPD patients with informed consent pregnant patients, patients with serious respiratory diseases other than COPD, patients with limited life expectancy, patients that can't coordinate well | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, Pain The subject is scheduled for elective unilateral TKA; 2. The subject is ≥ 18 years and ≤ 80 years; 3. The subject's weight is between 65-130 kg; 4. The subject's primary anesthesia care team has planned for a neuraxial anesthetic (i.e. spinal, epidural or combined-spinal epidural); 5. The patient agrees to receive an adductor canal block; 6. American Society of Anesthesiologists class 1-3 Subject is < 18 years of age or >80 years of age; 2. Subject is non-English speaking; 3. Subject is known or believed to be pregnant; 4. Subject is a prisoner; 5. Subject has impaired decision-making capacity per discretion of the Investigator; 6. Symptomatic untreated gastroesophageal reflux or otherwise at risk for perioperative aspiration; 7. Any condition for which the primary anesthesia care team deems neuraxial anesthesia inappropriate; 8. Significant pre-existing neuropathy on the operative limb; 9. Significant renal, cardiac or hepatic disease per discretion of the investigator; 10. American Society of Anesthesiologists class 4-5; 11. Known hypersensitivity and/or allergies to local anesthetics; 12. Chronic Opioid Use (daily or almost daily use of opioids for > 3 months) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-75.0, COPD Sleep Apnea Syndromes Non-invasive Positive Pressure Ventilation patients with COPD and sleep apnea dyspnea syndrome patients with non-stable hemodynamics patients with limited life expectancy patients with other severe respiratory diseases patients with motor neuron diseases patients with contraindications for NIPPV | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-999.0, COPD Pulmonary Vascular Disorder Right Ventricular Dysfunction stable COPD patients patents with other respiratory diseases and pulmonary hypertension other than group 3 PH psychopath, addict or patients not able to coordinate patients in pregnancy or breastfeeding patients with limited life expectancy patients with contraindiction for MRI or PET patients having cerebrovascular events in 3 months unstable COPD patients | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 0.0-80.0, COPD Anxiety Depression Stable chronic obstructive pulmonary disease (COPD) patients Patients with bronchial asthma or other severe pulmonary diseases or having received pulmonary surgery in 6 months Patients with tumor history during past 5 years Patients with COPD exacerbations during past 4 weeks Participants in clinical trials Patients in pregnancy or breastfeeding Patients unable to complete questionaire independently Patients older than 80 years old Patients receiving long-term domiciliary oxygen therapy | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Agitation,Psychomotor Emergency Department patients (18+) with acute undifferentiated agitation requiring chemical sedation at the discretion of the attending emergency physician Known pregnancy Allergy to the medication during the block Prisoner/under arrest | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-999.0, Pulmonary Disease, Chronic Obstructive Hypercapnia Hypoxia admitted to the hospital for an acute exacerbation of COPD within the past 12 weeks have COPD as the primary diagnosis have smoked > 10 pack years receiving supplemental oxygen as part of their usual clinical care willing to give informed consent upper airway or nasal problems that prohibit the use of high flow oxygen current use (≤ 4 weeks of study entry) of any PAP-therapy (e.g., CPAP or NPPV) sleep apnea as follows: STOPBang scores ≥ 5 or STOPBang score ≥ 2 plus BMI > 35 kg/m2; or Berlin questionnaire scores suggesting high likelihood of sleep apnea with increased risk of sleep-related accident (e.g., occupation as a commercial driver or pilot) excessive daytime sleepiness (i.e., either of High (>15) score on the Epworth Sleepiness Scale or "fall asleep" accident or "near miss" accident in prior 12 months) | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 20.0-70.0, Obesity Obstructive Sleep Apnea Bariatric Surgery Candidate BMI above 30 kg/m2 Age between 20 and 70 years Willingness to understand the protocol and willingness to participate in the study is severe co-morbidities that would prevent the patients to undergo bariatric surgery. Such as severe anemia, severe heart failure, active or previous malignancies the last 5 years. Myocardial infarction or unstable angina pectoris the last 6 months. Pregnancy. Suspected poor compliance. Drug or alcohol abuse. Major gastrointestinal disease Inability to undergo polysomnography | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Pulmonary Disease, Chronic Obstructive, Severe Early-Onset Episodes of patients with exacerbation of chronic obstructive pulmonary disease (COPD). Those patients can be admitted with 2 presentations: A) known case of COPD: episodes of patients with a previous diagnosis of COPD (FEV1/FVC<70%) who have an exacerbation of COPD. The exacerbation of COPD is defined as an acute worsening of symptoms in relation to the baseline situation and beyond the patient's daily variability. In addition, the exacerbation makes necessary to make changes in the patient's usual medication. The most frequently reported symptoms are dyspnea, cough, increased the sputum's production, and changes in the sputum's color. B) New case of COPD: episodes in which COPD is suspected because of the medical history and anamnesis (smokers or ex-smorkers of more than 15 pack/year, with basal dyspnea, cough, and expectoration for more than three months per year) and it is compatible with an exacerbation. The diagnosis will be confirmed at respiratory outpatient clinic within two months after discharge, by performing a spirometry when the patient is stable. If COPD is not confirmed in this consultation, the patient would be excluded from the study Patients who sign informed consent Patients admitted with obstructive or restrictive ventilatory failure due to another disease (asthma, consequences of tuberculosis, pachypleuritis, restrictive diseases) All COPD patients finally admitted for any other cause, other than exacerbation or complicated COPD Patients with severe physical or psychopathological disease, cognitive deterioration, any neurologic disease, that prevented them from properly completing the questionnaires Patients who do not understand the Spanish language to complete properly the questionnaires Patients that do not want to participate or do not sign the inform consent. For re-admissions Those who are programmed admissions or those for another cause not in relation with CMS algorithms | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Acute Respiratory Failure With Hypercapnia Hypoxemic and no hypercapnic acute respiratory failure severe dyspnea at rest with a respiratory rate >25 breaths/min PaO2/FiO2 <300 PaCO2 <45 mmHg age <18 years NPPV contraindications past history of respiratory chronic disease (COPD, cystic fibrosis…) cardiac pulmonary edema Pre-defined intubation other than respiratory organ failure : systolic pressure <90 mmHg,current treatment with epinephrine or norepinephrine, decreased level of consciousness ( Glasgow score ≤ 12) profound aplasia (white cells count <1000/mm 3) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 55.0-90.0, Chronic Obstructive Pulmonary Disease Age > 55 years COPD patients with confirmed pulmonary function test results of FEV1<70% Regular follow-up at the pulmonary medicine clinic Stable condition without acute exacerbation No pulmonary rehabilitation training within a year None oxygen usage at home No smoking history or quit smoking Inform consent signed Fever (Body Temperature >37.5°C) Acute infection symptoms Unstable cardiovascular status (Eg: Blood pressure >150/100 mmHg after medication usage, angina pectoris, or abnormal ECG) Activity restrictions due to orthopedic or neuromuscular disease | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-80.0, COPD Hypercapnic Respiratory Failure Clinically stable with chronic hypercapnic COPD (baseline arterial carbon dioxide pressure (PaCO2) of 50 mmHg or higher, measured resting in a sitting position and breathing room air without having used NPPV for at least 1 hour) other lung/pleural diseases or thoracic deformity severe heart failure (New York Heart Association class IV), severe dysrhythmia unstable angina, or malignant comorbidity obesity (BMI ≥ 35 kg/m²) severe obstructive sleep apnea syndrome | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Chronic Obstructive Pulmonary Disease Age > 18years Chronic obstructive pulmonary disease stade III to IV Referred for pulmonary rehabilitation. Non Pregnancy or likely to be History of psychiatric, neuro-vascular, cognitive disease or cranial trauma Active alcoholism Guardianship Hospitalisation for acute exacerbation of chronic obstructive pulmonary disease in the previous 4 weeks Interruption of the pulmonary rehabilitation program > 15 days Disruption of the training before the 18th session Less than 18 sessions in four month | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 21.0-999.0, Chronic Heart Failure Central Sleep Apnea patients with heart failure and reduced ejection fraction (LVEF < 45%) due to ischemic or hypertensive heart disease moderate to severe central sleep apnea/cheyne stokes respiration treatment should be stable for the last 30 days preceding entry into the study O2 /CPAP therapy active smoking primary valvular heart disease nasal obstruction BMI ≥ 32 Kg/m2 cardiac surgery/transient ischemic attack/stroke/resynchronization therapy within 3 months nocturnal hypoventilation receiving opiates or methadone medication | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 40.0-999.0, Acute Exacerbation of COPD Age ≥ 40 years 2. Confirmed diagnosis of underlying COPD or ACOS (Asthma-COPD Overlap Syndrome) 3. Experiencing acute hypercapnic respiratory failure 4. Informed consent from patient or legally authorized representative 5. Meets one of the three following 1. Is at high risk of requiring intubation and invasive mechanical ventilation (MV) after at least one hour on NIV due to one or more of the following Respiratory acidosis (arterial pH <= 7.25) despite NIV Worsening hypercapnia or respiratory acidosis relative to baseline blood gases No improvement in PaCO2 relative to baseline blood gases and presence of moderate or severe dyspnea Presence of tachypnea > 30 breaths per minute Intolerance of NIV with failure to improve or worsening acidosis, dyspnea or work of breathing *OR* 2. After starting NIV with a baseline arterial pH ≤ 7.25, shows signs of progressive clinical decompensation manifested by decreased mental capacity, inability to tolerate NIV, or increased or decreased respiratory rate in setting of worsened or unchanged acidosis. *OR* 3. Currently intubated and receiving Invasive MV, meeting both of the following Intubated for ≤ 5 days (from intubation to time of consent), AND Has failed a spontaneous breathing trial OR is deemed not suitable for a spontaneous breathing trial (SBT) OR is deemed not suitable for extubation DNR/DNI order 2. Hemodynamic instability (mean arterial pressure < 60 mmHg) despite infusion of vasoactive drugs 3. Acute coronary syndrome 4. Current presence of severe pulmonary edema due to Congestive Heart Failure 5. PaO2/FiO2 < 120 mmHg on PEEP >/= 5 cmH2O 6. Presence of bleeding diathesis or other contraindication to anticoagulation therapy 7. Platelet count >= 100,000/mm3 not requiring daily transfusions to maintain platelet count above 100,000/mm3 at time of screening 8. Hemoglobin >= 7.0 gm% not requiring daily transfusions to maintain hemoglobin count above 7.0 gm% at time of screening, and no active major bleeding 9. Unable to protect airway (e.g. unable to generate cough or clear secretions) or significant weakness or paralysis of respiratory muscles due to causes unrelated to acute exacerbation of COPD 10. Cerebrovascular accident, intracranial bleed, head injury or other neurological disorder likely to adversely affect ventilation or airway protection. 11. Hypersensitivity to heparin or history of previous heparin-induced thrombocytopenia (HIT Type II) 12. Presence of a significant pneumothorax or bronchopleural fistula 13. Current uncontrolled, major psychiatric disorder 14. Current participation in any other interventional clinical study 15. Pregnant women (women of child bearing potential require a pregnancy test) 16. Neutropenic (absolute neutrophil count < 1,00mm3, not transient) related to the presence or treatment of a malignancy; recent bone marrow transplant (within prior 8 months); current, uncontrolled AIDS. 17. Fulminant liver failure 18. Known vascular abnormality or condition which could complicate or prevent successful Hemolung Catheter insertion 19. Terminal patients not expected to survive current hospitalization 20. Requiring continuous home ventilation via a tracheostomyy 21. Any disease or condition that, in the judgment of the investigator, either places the subject at undue risk of complications from the Hemolung RAS device, or may reduce the subject's likelihood of benefitting from therapy with the Hemolung RASr | 2 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-80.0, COPD Asthma Patients with asthma or chronic obstructive pulmonary disease (COPD) Invasive mechanical ventilation Hemodynamically stable Prescribed metered dose inhaler (MDI) or intravenous bronchodilators Undrained pneumothorax Bronchopleural fistula Chest trauma Tracheoesophageal fistula Tracheal granulomas Tracheal stenosis PEEP dependence Contraindicated disconnection of the MV Endotracheal tube diameter less than 7.5 Do not make part of the protocol of daily sedation No regular ventilatory drive when with out sedation Do not reach a minimum tidal volume 6 ml/kg with a maximum peak pressure (PIP) of 35 cmH2O (centimeter of water) during MV. Do not use the same MV modes that will be tested in this study | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Obesity Obstructive Sleep Apnea Syndrome Patients over 18 years of age male or female obesity defined by a body mass index (BMI = weight in kg / height in m²) ≥ 30 free from acute or chronic painful pathology free from any chronic analgesic treatment free from any psychotropic treatment by benzodiazepine and / or tricyclic antidepressant presence of obstructive sleep apnea syndrome (with apnea-hypopnea index (IAH) 10 per hour of sleep) among 60 patients absence of obstructive sleep apnea syndrome (IAH <10 per hour of sleep) among 60 patients person who signed the information and consent form patients who have been screened for sleep apnea syndrome by Somnochek® negative (AHI <10 / h) in the last 6 months, provided that their weight is the same or lower at the time of difficulties in understanding and speaking French an alcohol abuse or dependence (DSM-IV) an abuse or dependence on illicit drugs (DSM-IV) an acute or chronic inflammatory pathology a neuro-muscular pathology clinical signs of right heart failure an analgesic treatment treatment with benzodiazepines and / or tricyclic antidepressants, a β-blocking treatment Central sleep apnea person who is absent from another study or who has received more than 4500 euros in the year following his participation in clinical studies | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 30.0-70.0, Safety and Tolerability non-diabetic subjects with asthma, or COPD. Non-smokers or smokers quit at least 6 months prior to enrollment. BMI <= 35 kg/m2. Fasting blood glucose <= 125 mg/dL pulmonary disorder other than asthma or COPD. Upper respiratory within previous 4 weeks. Significant exacerbation of asthma or COPD symptoms. Hospitalization for asthma or COPD within previous 3 months. Clinically significant medical condition. Current medications interfering with glucose metabolism | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Oxygen Inhalation Therapy Regardless of gender, at least 18 years of age and diagnosed with severe Hypoxia (PaO2/FiO2 < 300 mm Hg), dyspnea with severe rest at stake accessory muscles of respiration, respiratory rate (RR) ≥ 25 CPM, PaCO2 ≤ 45 mmHg, patient with an arterial catheter and without hemodynamic instability, Glasgow Coma Scale ≥ 12/15, written consent. Participants were also required to have a sufficient level of education to understand study procedures and be able to communicate with site personnel Patients were excluded if they Hypercapnia (> 45 mm Hg with respiratory acidosis), cardiogenic pulmonary edema, COPD, pulmonary fibrosis, hypoventilation obesity syndrom, arterial pressure < 60 mm Hg or treatment by epinephrine > to 0,1 gamma/kg/minute, deterioration of awareness (Glasgow scale < or = 12), acute confusional state. Participants were randomized in a 1:1 ratio to receive either (CHFONP) classical High Flow Oxygenation with nasal prongs (20 minutes) or with an adjunctive of a DTM. - | 1 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 0.615-0.692, Intermittent Hypoxia Male and female infants born preterm at ≤30 weeks + 6 days post menstrual age 2. Current treatment with routine caffeine 3. PMA 32 weeks + 0 days weeks + 6 days 4. Anticipated last dose of routine caffeine will be by 36 weeks + 5 days 5. At least 12 hours of breathing room air with no ventilatory support other than on room air nasal air flow therapy regardless of flow rate, or on room air and receiving nasal CPAP, and relapse not anticipated. 6. Able to tolerate enteral medications 7. It is feasible to administer the first dose of study drug no later than 36 weeks + 6 days PMA Intraventricular hemorrhage Grade III-IV or cystic periventricular leukomalacia 2. Current or prior treatment for seizures 3. Current or prior treatment for cardiac arrhythmias 4. Known renal or hepatic dysfunction that in the opinion of the investigator would have a clinically relevant impact on caffeine metabolism 5. Major malformation, inborn error of metabolism, chromosomal abnormality 6. Presence of a condition for which survival to discharge unlikely 7. Social, mental health, logistical or other issues that, in the opinion of the investigator, would impact the ability of the family to complete the study | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 18.0-999.0, Community-acquired Pneumonia for suspected CAP population Age ≥18 years Presence of at least 2 signs suggestive of CAP on presentation at general practice (one general sign of infection and one sign of pulmonary localization) at least one sign of infection fever > 38.5°C (maximum temperature measured by the patient or GP) tachycardia > 100 /min hyperpnea > 20/min global impression of severity* muscle aches, fatigue, or chills and at least one sign of pulmonary localization for suspected CAP population conditions of medical treatment not allowing for chest X-ray within 6 hours after diagnosis of CAP contraindication to chest X-ray conditions of medical management not allowing the realization of biological and bacteriological examinations within 8 hours of D0 consultation (except for patient immediately hospitalized) chest X-ray finding not compatible with CAP : chest X-ray showing another lung disease than a CAP (for example: pulmonary neoplasia, tuberculosis, pulmonary embolism) Control Patients presenting with any of the following will not be included in the study Patients who are investigational site staff members or relatives of those site staff member or subjects who are Pfizer employees directly involved in the conduct of the trial Patients with suspicion of CAP or other respiratory infectious diseases, as well as evidence of or documented concomitant infectious disease Patients residing in any long-term care facilities (for example, nursing homes, respite care facilities, etc) | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 60.0-999.0, Agitation Related to Dementia Male or female subjects > 60 years old Written informed consent from participants legally authorized representative Subjects who are residing either in an institutionalized setting (e.g. dementia unit, nursing home, assisted living facility, or other residential care facility) or in a non-institutionalized setting where the subject is not living alone and is receiving 24-hour supervision via home health care or a family member. Subjects must have been at their current location for at least 14 days before screening and plan to remain at the same location for the duration of the trial Diagnosis of Dementia (NCD) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) for at least 6 months prior to screening Mini-Mental State Examination (MMSE) < 23 Clinically relevant Behavioral and Psychological Symptoms of Dementia (BPSD) operationally defined as NPI-NH agitation/ aggression sub score of ≥3 at screening Documented history of clinically relevant BPSD Ability to participate in study evaluation and ingest oral medication Subjects will be on stable concomitant medications regimen for the treatment of BPSD for at least one month prior to the screening visit Subjects will be on stable concomitant medications regimen for the treatment of concurrent conditions for at least one month prior to the screening visit Patients receiving any of the following medications: Astemizole, Cisapride, Pimozide or Terfenadine The agitation/aggression is attributable to concomitant medications, environmental conditions or psychiatric condition Patients with severe heart disease Subjects suffering from Epilepsy Subjects suffering from anxiety disorder Subjects who had psychiatric condition in the past OR suffering from psychosis Schizophrenia OR family history of Schizophrenia OR any other mental disorder Subjects with any other condition, which in the judgment of the investigator would prevent the subject from completing the study Any condition that the Investigator believes would interfere with the intent of the study or would make participation not in the best interest of the patient Patients suffering from alcohol and/or substance abuse | 0 |
70 y/o with COPD on 2.5-3.5L O2 at baseline, OSA and obesity hypoventilation syndrome, dCHF, discharged [**2132-8-24**] now presents with agitation and altered mental status with hypoxia and O2 sats 70s on BipAp with 5L. Pt agitated then somnolent at initial presentation. Daughter reported increased agitation and altered mental status x 2-3 days with O2 sats 60s-70s at home. Daughter has also noted increased LE edema and weight gain which prompted a phone call to her PCP and increased lasix dose from 80daily to 100mg daily with some mild improvement in edema. She has had decreased appetite, PO intake, energy level at home with difficulty with ADLs. No recent history of fever, cough, chills, sputum production, CP, abd pain, or other complaints other than chronic right thigh pain last 1-2 months. Daughter also reports med compliance and compliance with BiPap at night. Past Medical History: - CAD; s/p 4 vessel CABG in [**2119**] - CHF; EF 55%, mild AS - obesity hypoventilation syndrome - obstructive sleep apnea - DM2 - ventricular tachycardia; s/p ICD in [**2127**] - hypothyroidism - schizophrenia - COPD - Pneumona treated in [**4-7**] at [**Hospital1 **] | eligible ages (years): 8.0-12.0, Pediatric Obesity Executive Function Have a BMI ≥ 85th percentile 2. Are ≥8 and ≤12 years old at the beginning of treatment 3. Can read, write, and speak English, along with their parent 4. Plan to stay living within the local area during the study period 5. Have a consenting parent who can commit to all study procedures and provide reliable travel Siblings will be eligible for study if they meet the above and will be allowed to use the same participating parent (sibling effects would then be addressed in statistical analyses) Have been diagnosed with a medical condition and/or are taking medication known to affect appetite/weight 2. Are currently participating in a formal weight management program beyond their usual medical care or have a parent participating in a formal weight management program 3. Have been diagnosed with an intellectual disability or traumatic brain injury 4. Have medical contraindications to physical activity | 0 |
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