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Article ; Online: How to Do It: Transbrachial Impella Placement to Facilitate Percutaneous Coronary Intervention.

Waterford, Stephen D / Schwartz, Bryan G / Ferdinand, Francis D / Kaczorowski, David J / Rizzoni, Walter E

Innovations (Philadelphia, Pa.)

2023 Volume 18, Issue 4, Page(s) 372–375

Abstract: A 64-year-old man with diffusely diseased iliofemoral vessels and an ejection fraction of 20% to 25% presented with a non-ST elevation myocardial infarction and proximal left anterior descending (LAD) and left circumflex (LCx) coronary artery disease, ... ...

Abstract	A 64-year-old man with diffusely diseased iliofemoral vessels and an ejection fraction of 20% to 25% presented with a non-ST elevation myocardial infarction and proximal left anterior descending (LAD) and left circumflex (LCx) coronary artery disease, with a chronically occluded right coronary artery. The iliofemoral system was not suitable for Impella placement, and bilateral axillary arteries were heavily calcified. The proximal left brachial artery was chosen for placement of both an Impella CP (Abiomed, Danvers, MA, USA) and percutaneous coronary intervention (PCI) sheath through a graft sewn to the brachial artery in this single-access technique. A 6 mm graft was sewn to the brachial artery, through which the Impella CP was placed. The Impella CP sheath was then used to introduce a 7F sheath for PCI. Successful PCI with drug-eluting stents was carried out to the LAD and LCx arteries, the Impella was weaned and removed, and the graft was stapled. The patient was discharged without any access or PCI complications. This report demonstrates the feasibility of the single-access Impella technique through a brachial artery cutdown approach.
MeSH term(s)	Male ; Humans ; Middle Aged ; Percutaneous Coronary Intervention/methods ; Treatment Outcome ; Coronary Artery Disease/surgery ; Axillary Artery
Language	English
Publishing date	2023-08-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	1559-0879
ISSN (online)	1559-0879
DOI	10.1177/15569845231190870
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Article ; Online: Artificial Intelligence-enabled, Real-time Intraoperative Ultrasound Imaging of Neural Structures Within the Psoas: Validation in a Porcine Spine Model.

Carson, Tyler / Ghoshal, Goutam / Cornwall, George Bryan / Tobias, Richard / Schwartz, David G / Foley, Kevin T

Spine

2021 Volume 46, Issue 3, Page(s) E146–E152

Abstract: Study design: Experimental in-vivo animal study.: Objective: The aim of this study was to evaluate an Artificial Intelligence (AI)-enabled ultrasound imaging system's ability to detect, segment, classify, and display neural and other structures ... ...

Abstract	Study design: Experimental in-vivo animal study. Objective: The aim of this study was to evaluate an Artificial Intelligence (AI)-enabled ultrasound imaging system's ability to detect, segment, classify, and display neural and other structures during trans-psoas spine surgery. Summary of background data: Current methodologies for intraoperatively localizing and visualizing neural structures within the psoas are limited and can impact the safety of lateral lumbar interbody fusion (LLIF). Ultrasound technology, enhanced with AI-derived neural detection algorithms, could prove useful for this task. Methods: The study was conducted using an in vivo porcine model (50 subjects). Image processing and machine learning algorithms were developed to detect neural and other anatomic structures within and adjacent to the psoas muscle while using an ultrasound imaging system during lateral lumbar spine surgery (SonoVision,™ Tissue Differentiation Intelligence, USA). The imaging system's ability to detect and classify the anatomic structures was assessed with subsequent tissue dissection. Dice coefficients were calculated to quantify the performance of the image segmentation. Results: The AI-trained ultrasound system detected, segmented, classified, and displayed nerve, psoas muscle, and vertebral body surface with high sensitivity and specificity. The mean Dice coefficient score for each tissue type was >80%, indicating that the detected region and ground truth were >80% similar to each other. The mean specificity of nerve detection was 92%; for bone and muscle, it was >95%. The accuracy of nerve detection was >95%. Conclusion: This study demonstrates that a combination of AI-derived image processing and machine learning algorithms can be developed to enable real-time ultrasonic detection, segmentation, classification, and display of critical anatomic structures, including neural tissue, during spine surgery. AI-enhanced ultrasound imaging can provide a visual map of important anatomy in and adjacent to the psoas, thereby providing the surgeon with critical information intended to increase the safety of LLIF surgery.Level of Evidence: N/A.
MeSH term(s)	Algorithms ; Animals ; Artificial Intelligence/standards ; Female ; Humans ; Image Processing, Computer-Assisted/methods ; Image Processing, Computer-Assisted/standards ; Intraoperative Neurophysiological Monitoring/methods ; Intraoperative Neurophysiological Monitoring/standards ; Lumbar Vertebrae/diagnostic imaging ; Lumbar Vertebrae/surgery ; Machine Learning/standards ; Models, Animal ; Psoas Muscles/diagnostic imaging ; Psoas Muscles/surgery ; Reproducibility of Results ; Spinal Fusion/methods ; Spinal Fusion/standards ; Swine ; Ultrasonography/methods ; Ultrasonography/standards
Language	English
Publishing date	2021-01-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000003704
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Zs.A 1305: Show issues

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Article ; Online: Metoclopramide and digoxin cause 22 episodes of bradyarrhythmias.

Schwartz, Bryan G

The American journal of medicine

2010 Volume 123, Issue 6, Page(s) e5–6

MeSH term(s)	Atrial Fibrillation/drug therapy ; Atrial Fibrillation/etiology ; Atrial Fibrillation/physiopathology ; Bradycardia/chemically induced ; Bradycardia/physiopathology ; Burns/complications ; Digoxin/administration & dosage ; Digoxin/adverse effects ; Electrocardiography ; Follow-Up Studies ; Heart Rate/drug effects ; Humans ; Injections, Intravenous ; Male ; Metoclopramide/administration & dosage ; Metoclopramide/adverse effects ; Middle Aged ; Tachycardia, Paroxysmal/chemically induced ; Tachycardia, Paroxysmal/physiopathology
Chemical Substances	Digoxin (73K4184T59) ; Metoclopramide (L4YEB44I46)
Language	English
Publishing date	2010-06
Publishing country	United States
Document type	Case Reports ; Letter
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2009.10.016
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Ua VI Zs.289: Show issues

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Article ; Online: Acute and Subacute Triggers of Cardiovascular Events.

Schwartz, Bryan G / Kloner, Robert A / Naghavi, Morteza

The American journal of cardiology

2018 Volume 122, Issue 12, Page(s) 2157–2165

Abstract: ... patients (e.g., in secondary prevention clinics or those with coronary artery Calcium >75th percentile ...

Abstract	Inability to predict short-term cardiovascular (CV) events and take immediate preemptive actions has long been the Achilles heel of cardiology. However, certain triggers of these events have come to light. Although these triggers are nonspecific and are part of normal life, studying their temporal relationship with the onset of CV events provides an opportunity to alert high-risk atherosclerotic patients who may be most vulnerable to such triggers, the "vulnerable patient". Herein, we review the literature and shed light on the epidemiology and underlying pathophysiology of different triggers. We describe that certain adrenergic triggers can precipitate a CV event within minutes or hours; whereas triggers that elicit an immune or inflammatory response such as infections may tip an asymptomatic "vulnerable patient" to become symptomatic days and weeks later. In conclusion, healthcare providers should counsel high-risk CV patients (e.g., in secondary prevention clinics or those with coronary artery Calcium >75th percentile) on the topic, advise them to avoid such triggers, take protective measures once exposed, and seek emergency care immediately after becoming symptomatic after such triggers. Furthermore, clinical trials targeting triggers (prevention or intervention) are needed.
MeSH term(s)	Acute Disease ; Cardiovascular Diseases/etiology ; Humans ; Physical Exertion ; Precipitating Factors ; Risk Factors ; Stress, Psychological/complications
Language	English
Publishing date	2018-09-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2018.08.049
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Article ; Online: Buccal caffeine strips for reversal of adverse symptoms of vasodilator stress.

Elsadany, Mohammed / Stringer, Bryan / Bote, Josiah / Abdulla, Khaled H / Doran, Jesse A / Schwartz, Ronald G / Duvall, W Lane

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology

2022 Volume 30, Issue 2, Page(s) 574–580

Abstract: Background: Due to recurrent shortages of aminophylline, intravenous caffeine has emerged as a commonly used, safe and reliable method to treat adverse effects of vasodilator stress agents. We sought to evaluate the safety and effectiveness of buccal ... ...

Abstract	Background: Due to recurrent shortages of aminophylline, intravenous caffeine has emerged as a commonly used, safe and reliable method to treat adverse effects of vasodilator stress agents. We sought to evaluate the safety and effectiveness of buccal caffeine strips which are rapidly absorbed, inexpensive, readily available, and simplify caffeine administration. Methods: Consecutive patients undergoing regadenoson stress SPECT MPI were assessed for the occurrence of symptoms during testing over an 11-week period at a single metropolitan hospital. Adverse symptoms, including their severity and duration, were recorded at the time of testing. Patient satisfaction was rated on a scale of 1 to 5 (5 being the most satisfied). Patients received reversal with caffeine if symptoms were felt to be significant enough by the patient and physician performing the test. The treatment received alternated week to week between IV caffeine (60 mg) or 100 mg buccal caffeine strips. Caffeine was given at least 3 minutes after tracer injection. A rescue dose of IV caffeine was offered 10 minutes later if indicated. Results: Of the 122 patients enrolled in the study, 70 (57%) were included during buccal caffeine weeks and 52 (43%) during IV caffeine weeks, and only 28 (24%) received reversal with a caffeine agent. Seven (6%) received IV caffeine and 21 (17%) received buccal caffeine. There was no significant difference in symptom duration between IV and buccal caffeine after treatment (152.8 vs 163.4 seconds, P = 0.87). There was no significant difference in initial and final symptom severity between groups. Only 2 patients in the buccal group required rescue IV caffeine for ongoing symptoms and emesis. None of the IV group required a rescue dose. There was no significant difference in patient satisfaction between the groups (2.8 vs 3.2, P = 0.38). Conclusion: Buccal caffeine strips are a safe, well tolerated, and effective initial strategy to reverse adverse effects of vasodilator stress in the minority of patients who request it. Buccal caffeine alone or with IV rescue caffeine was highly effective in reversing adverse effects and was free of major adverse clinical events.
MeSH term(s)	Humans ; Vasodilator Agents/adverse effects ; Caffeine ; Aminophylline ; Tomography, Emission-Computed, Single-Photon/methods ; Drug-Related Side Effects and Adverse Reactions/etiology ; Myocardial Perfusion Imaging/methods ; Exercise Test/methods
Chemical Substances	Vasodilator Agents ; Caffeine (3G6A5W338E) ; Aminophylline (27Y3KJK423)
Language	English
Publishing date	2022-07-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1212505-2
ISSN	1532-6551 ; 1071-3581
ISSN (online)	1532-6551
ISSN	1071-3581
DOI	10.1007/s12350-022-03039-9
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Zs.A 4121: Show issues

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Article ; Online: Personal journeys to and in human genetics and dysmorphology.

Schwartz, Charles E / Aylsworth, Arthur S / Allanson, Judith / Battaglia, Agatino / Carey, John C / Curry, Cynthia J / Davies, Kay E / Eichler, Evan E / Graham, John M / Hall, Bryan / Hall, Judith G / Holmes, Lewis B / Hoyme, H Eugene / Hunter, Alasdair / Innis, Jeffrey / Johnson, John / Keppler-Noreuil, Kim M / Leroy, Jules G / Moore, Cynthia /

Nelson, David L / Neri, Giovanni / Opitz, John M / Picketts, David / Raymond, F Lucy / Shalev, Stavit Allon / Stevenson, Roger E / Stumpel, Connie T R M / Sutherland, Grant / Viskochil, David H / Weaver, David D / Zackai, Elaine H

American journal of medical genetics. Part A

2024 Volume 194, Issue 6, Page(s) e63514

Abstract: Genetics has become a critical component of medicine over the past five to six decades. Alongside genetics, a relatively new discipline, dysmorphology, has also begun to play an important role in providing critically important diagnoses to individuals ... ...

Abstract	Genetics has become a critical component of medicine over the past five to six decades. Alongside genetics, a relatively new discipline, dysmorphology, has also begun to play an important role in providing critically important diagnoses to individuals and families. Both have become indispensable to unraveling rare diseases. Almost every medical specialty relies on individuals experienced in these specialties to provide diagnoses for patients who present themselves to other doctors. Additionally, both specialties have become reliant on molecular geneticists to identify genes associated with human disorders. Many of the medical geneticists, dysmorphologists, and molecular geneticists traveled a circuitous route before arriving at the position they occupied. The purpose of collecting the memoirs contained in this article was to convey to the reader that many of the individuals who contributed to the advancement of genetics and dysmorphology since the late 1960s/early 1970s traveled along a journey based on many chances taken, replying to the necessities they faced along the way before finding full enjoyment in the practice of medical and human genetics or dysmorphology. Additionally, and of equal importance, all exhibited an ability to evolve with their field of expertise as human genetics became human genomics with the development of novel technologies.
MeSH term(s)	Humans ; Genetics, Medical ; History, 20th Century ; History, 21st Century ; Human Genetics
Language	English
Publishing date	2024-02-08
Publishing country	United States
Document type	Journal Article ; Historical Article
ZDB-ID	2108614-X
ISSN	1552-4833 ; 0148-7299 ; 1552-4825
ISSN (online)	1552-4833
ISSN	0148-7299 ; 1552-4825
DOI	10.1002/ajmg.a.63514
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Zs.A 1376/A: Show issues

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Article ; Online: Cryo-EM structure of anchorless RML prion reveals variations in shared motifs between distinct strains.

Hoyt, Forrest / Standke, Heidi G / Artikis, Efrosini / Schwartz, Cindi L / Hansen, Bryan / Li, Kunpeng / Hughson, Andrew G / Manca, Matteo / Thomas, Olivia R / Raymond, Gregory J / Race, Brent / Baron, Gerald S / Caughey, Byron / Kraus, Allison

Nature communications

2022 Volume 13, Issue 1, Page(s) 4005

Abstract: Little is known about the structural basis of prion strains. Here we provide a high (3.0 Å) resolution cryo-electron microscopy-based structure of infectious brain-derived fibrils of the mouse anchorless RML scrapie strain which, like the recently ... ...

Abstract	Little is known about the structural basis of prion strains. Here we provide a high (3.0 Å) resolution cryo-electron microscopy-based structure of infectious brain-derived fibrils of the mouse anchorless RML scrapie strain which, like the recently determined hamster 263K strain, has a parallel in-register β-sheet-based core. Several structural motifs are shared between these ex vivo prion strains, including an amino-proximal steric zipper and three β-arches. However, detailed comparisons reveal variations in these shared structural topologies and other features. Unlike 263K and wildtype RML prions, the anchorless RML prions lack glycophosphatidylinositol anchors and are severely deficient in N-linked glycans. Nonetheless, the similarity of our anchorless RML structure to one reported for wildtype RML prion fibrils in an accompanying paper indicates that these post-translational modifications do not substantially alter the amyloid core conformation. This work demonstrates both common and divergent structural features of prion strains at the near-atomic level.
MeSH term(s)	Amyloid ; Animals ; Brain/metabolism ; Cryoelectron Microscopy ; Mice ; Prions/metabolism ; Scrapie ; Sheep
Chemical Substances	Amyloid ; Prions
Language	English
Publishing date	2022-07-13
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Intramural
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-022-30458-6
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Article: Long Term Survivals in Aggressive Primary Brain Malignancies Treated With an Adjuvant Ketogenic Diet.

Schwartz, Kenneth A / Noel, Mary / Nikolai, Michele / Olson, Lawrence K / Hord, Norman G / Zakem, Micheal / Clark, Justin / Elnabtity, Mohamed / Figueroa, Bryan / Chang, Howard T

Frontiers in nutrition

2022 Volume 9, Page(s) 770796

Abstract: Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation ... ...

Abstract	Aggressive primary brain tumors (APBT) glioblastoma multiforme and grade IV astrocytoma are treated with multimodality treatments that include surgery to remove as much tumor as possible without sacrificing neurological function followed by radiation therapy and chemotherapy usually temozolomide. Survivals in adults are in the range of 8-16 months. The addition of a ketogenic diet (KD) to rodents with transplanted brain tumors increased survival in nine of 11 animals to over 299 days compared to survival in untreated controls of 33 days and radiation only controls of 38 days. We treated humans with APBT with standard of care neurosurgery immediately followed by 6 weeks of an adjuvant ketogenic diet concurrent with radiation therapy and temozolomide. Twice daily measurements of blood ketones and glucose were recorded and the patients' diet was modified toward the goal of maintaining blood ketone levels approaching 3 mM. Of the nine patients who completed the protocol three younger patients age 32, 28, and 22 at enrollment are alive and employed with clinically stable disease and brain images 74, 58, and 52 months since diagnosis. All the six older patients mean age 55 have died with disease progression detected on average 8 months after Dx. In conclusion: 1. It is possible to implement and maintain dietary induced ketosis in patients with APBT; 2. The longer survivals observed in younger patients treated with KD need to be confirmed in larger studies that should be focused on younger patients possibly under age 40.
Language	English
Publishing date	2022-05-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2022.770796
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Article ; Online: Correction: HIV Viremia and T-cell Activation Differentially Affect the Performance of Glomerular Filtration Rate Equations Based on Creatinine and Cystatin C.

Bhasin, Bhavna / Lau, Bryan / Atta, Mohamed G / Fine, Derek M / Estrella, Michelle M / Schwartz, George J / Lucas, Gregory M

PloS one

2019 Volume 14, Issue 4, Page(s) e0215630

Abstract: This corrects the article DOI: 10.1371/journal.pone.0082028.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0082028.].
Language	English
Publishing date	2019-04-16
Publishing country	United States
Document type	Published Erratum
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0215630
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Article ; Online: High-resolution structure and strain comparison of infectious mammalian prions.

Kraus, Allison / Hoyt, Forrest / Schwartz, Cindi L / Hansen, Bryan / Artikis, Efrosini / Hughson, Andrew G / Raymond, Gregory J / Race, Brent / Baron, Gerald S / Caughey, Byron

Molecular cell

2021 Volume 81, Issue 21, Page(s) 4540–4551.e6

Abstract: ... the most clearly infectious (e.g., ∼10 ...

Abstract	Within the extensive range of self-propagating pathologic protein aggregates of mammals, prions are the most clearly infectious (e.g., ∼10
MeSH term(s)	Amyloid/chemistry ; Animals ; Brain/metabolism ; Cryoelectron Microscopy/methods ; Glycolipids/chemistry ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; Mice ; Phenotype ; Polysaccharides/chemistry ; Prion Proteins/chemistry ; Prions/chemistry ; Prions/ultrastructure ; Protein Binding ; Protein Structure, Secondary ; Thermodynamics
Chemical Substances	Amyloid ; Glycolipids ; Polysaccharides ; Prion Proteins ; Prions
Language	English
Publishing date	2021-08-25
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1415236-8
ISSN	1097-4164 ; 1097-2765
ISSN (online)	1097-4164
ISSN	1097-2765
DOI	10.1016/j.molcel.2021.08.011
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