A5110851596- Obstructive Sleep Apnea Research
- Neuroscience of respiration and sleep
- Intensive Care Unit Cognitive Disorders
- Cardiovascular and Diving-Related Complications
- Sleep and Wakefulness Research
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Respiratory Support and Mechanisms
- Family and Patient Care in Intensive Care Units
- Sleep and related disorders
- Heart Failure Treatment and Management
- Traumatic Brain Injury Research
- Pulmonary Hypertension Research and Treatments
- Chronic Obstructive Pulmonary Disease (COPD) Research
- High Altitude and Hypoxia
- Stroke Rehabilitation and Recovery
- Pleural and Pulmonary Diseases
- Aortic Disease and Treatment Approaches
- Lung Cancer Diagnosis and Treatment
- Lung Cancer Treatments and Mutations
- Atrial Fibrillation Management and Outcomes
- Cardiac Arrest and Resuscitation
- Venous Thromboembolism Diagnosis and Management
- thermodynamics and calorimetric analyses
- Myeloproliferative Neoplasms: Diagnosis and Treatment
- Cardiovascular Issues in Pregnancy
University of South Florida
2016-2025
James A. Haley Veterans' Hospital
2014-2025
Tampa General Hospital
2019-2023
Florida College
2019-2021
University of Miami
2020
Sleep Research Society
2020
National Institutes of Health
2020
Pontificia Universidad Católica de Chile
2020
National Institute of Nursing Research
2020
University of Tampa
2013-2018
Rationale: Less invasive, nonsurgical approaches are needed to treat severe emphysema.Objectives: To evaluate the effectiveness and safety of Spiration Valve System (SVS) versus optimal medical management.Methods: In this multicenter, open-label, randomized, controlled trial, subjects aged 40 years or older with severe, heterogeneous emphysema were randomized 2:1 SVS management (treatment) alone (control).Measurements Main Results: The primary efficacy outcome was difference in mean FEV1...
Rationale: Usual interstitial pneumonia (UIP) is the defining morphology of idiopathic pulmonary fibrosis (IPF). Guidelines for IPF diagnosis conditionally recommend surgical lung biopsy histopathology UIP when radiology and clinical context are not definitive. A "molecular UIP" in transbronchial biopsy, Envisia Genomic Classifier, accurately predicted histopathologic UIP.Objectives: We evaluated combined accuracy Classifier local detection pattern.Methods: Ninety-six patients who had...
Evaluate the safety and efficacy of Janus kinase (JAK)1/JAK2 inhibitor ruxolitinib in COVID-19-associated acute respiratory distress syndrome requiring mechanical ventilation.Phase 3 randomized, double-blind, placebo-controlled trial Ruxolitinib Participants With COVID-19-Associated Acute Respiratory Distress Syndrome Who Require Mechanical Ventilation (RUXCOVID-DEVENT; NCT04377620).Hospitals community-based private or group practices United States (29 sites) Russia (4 sites).Eligible...
Objective: Obstructive sleep apnea (OSA) has been associated with structural and functional brain changes cognitive impairment in clinic samples. Persons traumatic injury (TBI) are at increased risk of OSA compared to community samples, many experience chronic disability. However, the impact on outcome after TBI is unknown. The purpose this study was examine relationship between polysomnographic parameters neuropsychological performance 2 years following TBI. We hypothesized that oxygen...
Abstract Introduction Hormones have been shown to play an important part in obstructive sleep apnea (OSA). Female hormones are thought be protective of with increased prevalence OSA postmenopausal females. In transgender medicine, exogenous testosterone is the cornerstone treatment goal virilization achieve physical attributes that match gender identity. Androgen excess females leads thickening vocal cords hypertrophy and hyperplasia thyroarytenoid muscle, laryngeal mucosa epithelium, edema...
Abstract Introduction Nocturnal tachypnea is commonly linked to central sleep apnea (CSA) with Cheyne-Stokes breathing (CSB), a pattern of nocturnal alternating apneas. Persistent in the setting CSA, however, unusual and can result from cardiogenic oscillations (COs)—cyclic intrathoracic pressure changes during cardiac cycle—which mimic inspiratory efforts trigger bilevel positive airway (PAP) devices, leading inappropriate initiation tachypnea. Report case An 83-year-old man history...
Abstract Introduction Hypoglossal nerve stimulation (HNS) has become an increasingly popular option for the treatment of select patients with obstructive sleep apnea (OSA) intolerant to positive airway pressure (PAP) therapy. Eligibility HNS requires a thorough evaluation, including drug-induced endoscopy (DISE), determine pattern upper collapse. Epiglottic obstruction, especially paradoxical movement during tongue protrusion, poses unique challenge when evaluating candidacy HNS. Report case...
Abstract Introduction Drug induced sleep endoscopy (DISE) titrations have been used as a tool to further assess different treatment options for subjects with OSA, and PAP intolerance. Suboptimal hypoglossal nerve stimulator (HNS) responders may be assessed DISE guide options. Methods We reviewed the last 7 titration studies performed at local VA hospital. obtained baseline demographic characteristics, pre post implantation studies, data. The second data collected was following intervention...
To determine the diagnostic sensitivity and specificity comparative effectiveness of traditional sleep apnea screening tools in traumatic brain injury (TBI) neurorehabilitation admissions.Prospective trial relative to criterion standard, attended level 1 polysomnography including encephalography.Six TBI Model System Inpatient Rehabilitation Centers.Between May 2017 February 2019, 449 896 screened were eligible for with 345 consented (77% consented). Additional left 263 completing final...
Rationale: Follow-up of emphysema patients treated with endobronchial valves is limited to 3–12 months after treatment in prior reports. To date, no comparative data exist between and controls a longer follow-up. Objective: assess the durability Spiration® Valve System (SVS) severe heterogeneous over 24-month period. Methods: EMPROVE, multicenter, randomized controlled trial, presents rigorous comparison control groups for up 24 months. Lung function, respiratory symptoms, quality-of-life...
OSA is prevalent during a time of critical neural repair after traumatic brain injury (TBI). The diagnostic utility existing sleep studies needed to inform clinical management acute recovery from TBI.This study aimed evaluate the non-inferiority and accuracy portable level 3 relative 1 polysomnography in hospitalized neurorehabilitation patients with prospective trial conducted at six TBI Model System sites between May 2017 February 2019. Of 896 admissions, 449 were screened eligible for...
Older adults who required mechanical ventilation while in an intensive care unit (ICU) require adequate sleep throughout recovery from critical illness. Poor post-ICU quality may contribute to worsening impairments physical, cognitive, or psychological status after illness, known as syndrome. Previous research has evaluated with qualitative mixed methods (eg, interviews, questionnaires). We proposed measurement of actigraphy. hypothesized that nighttime is associated length stay (LOS).
The objective of this study was to compare obstructive sleep apnea (OSA), demographic, and traumatic brain injury (TBI) characteristics across the American Academy Sleep Medicine (AASM) Centers for Medicare (CMS) scoring rules in moderate severe TBI undergoing inpatient neurorehabilitation.This is a secondary analysis from prospective clinical trial at 6 Model System sites (n = 248). Scoring completed by centralized center using both AASM CMS criteria OSA. Hospitalization were abstracted...
Background Mechanically ventilated (MV) patients in the intensive care unit (ICU) often experience disturbed sleep and profound inactivity. Objectives The aim of this study was to report 5 consecutive days' descriptive analyses on efficiency (SE), total time (TST), daytime activity ratio (DAR), hourly counts among critically ill MV adults from 9 ICUs across 2 hospitals. Methods A secondary analysis undertaken our parent National Institutes Health–funded randomized controlled trial (NIH R01...
Sleep apnea (SA) is a sleep disorder with serious health consequences. SA more prevalent in acquired brain injury (ABI) patients than the general population. Yet, there limited research characterizing architecture ABI comorbid during acute recovery. This was retrospective analysis of admitted for neurorehabilitation and referred polysomnography (PSG). Of 197 referred, 138 received PSG, 93 had valid results >240 minutes recorded sleep. etiologies were traumatic (66.7%), stroke (23.7%), or...
Abstract Introduction Obstructive sleep apnea (OSA) is associated with structural and functional brain changes reduced cognition. Persons traumatic injury (TBI) show disproportionately higher risk of OSA compared to community samples. Moderate-to-severe TBI often results in disabling cognitive sequelae, although the impact on outcome after poorly understood. The purpose this study was examine degree which features predict performance during early recovery. We hypothesized that greater...