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noh [2016/01/31 14:43] (current)
sflitman created
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 +===== Neurogenic Orthostatic Hypotension =====
 +
 +
 +Neurogenic Orthostatic Hypotension (NOH) is a surprisingly common condition where people become lightheaded when they stand up, with high risk for falls and injury. ​ Few options exist for treatment, so there is need for new approaches.
 +
 +^ Condition(s) ^ Type of Drug ^ Phase ^ Placebo ^ Duration ^ Open Label Extension ^
 +|  NOH  |  Droxidopa (approved) ​ |  IV  |  25%  |  24 weeks  |  24 weeks  |
 +
 +====== Response Form ======
 +
 +<​html>​
 +<p align=justify> ​
 +If you or a loved one is interested in participating in one of our trials, please ​
 +contact us at (855) 829-8899 or use the form below. ​ One of our skilled Clinical Research
 +Coordinators will contact you as soon as possible. ​ Thank you for your interest in our research!
 +<div align=right>​- Stephen S. Flitman, MD, Medical Director</​div> ​
 +<​p> ​
 +<div align=center> ​
 +<form method=post action="​http://​neurozone.org/​cgi-n/​emailform.cgi"> ​
 +<input type=hidden name="​_site"​ value="​Clinical Research Inquiry"> ​
 +<input type=hidden name="​_link"​ value="​http://​neurozone.org/​wiki/​doku.php?​id=epilepsy"> ​
 +<input type=hidden name=trialtype value="​NOH">​
 +<table border=2 cellspacing=0 cellpadding=2> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=white>​Your Name</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​input type=text name=contact value=""​ maxlength=50 size=50> ​
 +  </​td> ​
 + </​tr> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=white>​Name of Patient</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​input type=text name=patient value=""​ maxlength=50 size=50> ​
 +  </​td> ​
 + </​tr> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=white>​Email Address</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​input type=text name=email value=""​ maxlength=50 size=50> ​
 +  </​td> ​
 + </​tr> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=white>​Your Telephone</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​input type=text name=phone value=""​ maxlength=50 size=50> ​
 +  </​td> ​
 + </​tr> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=white>​Best Time to Call</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​input type=text name=calltime value=""​ maxlength=50 size=50> ​
 +  </​td> ​
 + </​tr> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=white>​Comments</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​textarea name=comments cols=50 rows=4 wrap=on></​textarea> ​
 +  </​td> ​
 + </​tr> ​
 + <​tr> ​
 +  <td bgcolor=purple align=right><​font color=yellow>&​nbsp;​Ready?</​font></​td> ​
 +  <td bgcolor=purple align=center> ​
 +   <​input type=submit value="​Send your information"> ​
 +  </​td> ​
 + </​tr> ​
 +</​table> ​
 +</​form> ​
 +</​html>​
  
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