Browse Health
Internist, Cardiologist (heart)
10 years of experience
Video profile
Accepting new patients

Education ?

Medical School Score
Wayne State University (2000)
  • Currently 1 of 4 apples

Awards & Distinctions ?

Associations
American Board of Internal Medicine

Affiliations ?

Dr. Maynard is affiliated with 17 hospitals.

Hospital Affilations

Score

Rankings

  • St John Detroit Riverview Hospital
    Cardiology
    7733 E Jefferson Ave, Detroit, MI 48214
    • Currently 5 of 4 crosses
  • St. Mary Mercy Hospital
    Cardiology
    36475 5 Mile Rd, Livonia, MI 48154
    • Currently 4 of 4 crosses
    Top 25%
  • Providence Hospital and Medical Center
    Cardiology
    16001 W 9 Mile Rd, Southfield, MI 48075
    • Currently 4 of 4 crosses
    Top 25%
  • Botsford Hospital
    Cardiology
    28050 Grand River Ave, Farmington Hills, MI 48336
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital,Troy
    Cardiology
    44201 Dequindre Rd, Troy, MI 48085
    • Currently 4 of 4 crosses
    Top 25%
  • Saint Joseph Mercy Hospital
    Cardiology
    505 E Huron St, Ann Arbor, MI 48104
    • Currently 4 of 4 crosses
    Top 25%
  • Saint Joseph Mercy Livingston Hospital
    Cardiology
    620 Byron Rd, Howell, MI 48843
    • Currently 4 of 4 crosses
    Top 25%
  • Hurley Medical Center
    Cardiology
    1 Hurley Plz, Flint, MI 48503
    • Currently 4 of 4 crosses
    Top 25%
  • McLaren Regional Medical Center
    Cardiology
    401 S Ballenger Hwy, Flint, MI 48532
    • Currently 4 of 4 crosses
    Top 25%
  • Henry Ford Hospital
    Cardiology
    2799 W Grand Blvd, Detroit, MI 48202
    • Currently 4 of 4 crosses
    Top 25%
  • St. Joseph Mercy Oakland
    Cardiology
    44405 Woodward Ave, Pontiac, MI 48341
    • Currently 4 of 4 crosses
    Top 25%
  • Beaumont Hospital, Grosse Pointe
    Cardiology
    468 Cadieux Rd, Grosse Pointe, MI 48230
    • Currently 3 of 4 crosses
    Top 50%
  • Beaumont Hospital, Royal Oak
    Cardiology
    3601 W 13 Mile Rd, Royal Oak, MI 48073
    • Currently 3 of 4 crosses
    Top 50%
  • Providence Park Hospital
    47601 Grand River Ave, Novi, MI 48374
  • Royal Oak
  • St. Mary Mercy Livonia
  • Royal Oak (4 Years
  • Publications & Research

    Dr. Maynard has contributed to 6 publications.
    Title Antirestenotic Effects of a Locally Delivered Caspase Inhibitor in a Balloon Injury Model.
    Date November 2004
    Journal Circulation
    Excerpt

    BACKGROUND: The precise role of arterial barotrauma-mediated apoptosis in causing restenosis is unclear. The purpose of this study was to determine if a link exists between angioplasty-mediated medial smooth muscle cell apoptosis and subsequent neointimal hyperplasia. METHODS AND RESULTS: Bilateral iliac artery angioplasty was performed in 25 male New Zealand White rabbits. Simultaneous with balloon injury, each artery was treated locally with either the caspase inhibitor N-benzyloxycarbonyl-Val-Ala-Asp(Ome)-fluoromethylketone (ZVAD-fmk) or control. In the acute cohort that was survived to 4 hours (n=10, 7 high dose and 3 low dose), an apoptotic index was calculated using the terminal deoxynucleotidyl TUNEL method. In the intermediate cohort that was survived to 2 weeks (n=5), luminal reendothelialization was measured via CD-31 staining. In the chronic cohort that was survived to 4 weeks (n=10), neointimal area was measured. In the acute cohort, there was a 40% reduction in the apoptotic index with high-dose ZVAD-fmk (P=0.008) and a 33% reduction with low-dose ZVAD-fmk (P=0.08). At 2 weeks, there was no significant difference in the degree of luminal reendothelialization. However, at 4 weeks, there was a 33% (0.33+/-0.23 versus 0.22+/-0.20 mm2) (P<0.005) reduction in neointimal area in ZVAD-fmk-treated arteries. CONCLUSIONS: The local delivery of ZVAD-fmk during balloon injury inhibits smooth muscle cell apoptosis. This corresponds to a significant reduction in neointimal proliferation seen at 4 weeks without a significant change in the degree of reendothelialization at 2 weeks.

    Title Accidental Administration of Oxytocin to a Premature Infant.
    Date July 2002
    Journal Neonatal Network : Nn
    Excerpt

    Oxytocin has been used for several decades in close proximity to newborns, yet no published information is available regarding complications associated with its accidental administration to a newborn. We describe a case where oxytocin instead of vitamin K was accidentally administered intramuscularly to a premature infant shortly after birth. The patient described remained hemodynamically stable but developed transient hyponatremia as the sole biochemical abnormality.

    Title Randomized, Controlled Trial of Low-dose Inhaled Nitric Oxide in the Treatment of Term and Near-term Infants with Respiratory Failure and Pulmonary Hypertension.
    Date November 1999
    Journal Pediatrics
    Excerpt

    Recent reports indicate that inhaled nitric oxide (iNO) causes selective pulmonary vasodilation, increases arterial oxygen tension, and may decrease the use of extracorporeal membrane oxygenation (ECMO) in infants with persistent pulmonary hypertension of the newborn (PPHN). Despite these reports, the optimal dose and timing of iNO administration in PPHN remains unclear. OBJECTIVES: To test the hypotheses that in PPHN 1) iNO at 2 parts per million (ppm) is effective at acutely increasing oxygenation as measured by oxygenation index (OI); 2) early use of 2 ppm of iNO is more effective than control (0 ppm) in preventing clinical deterioration and need for iNO at 20 ppm; and 3) for those infants who fail the initial treatment protocol (0 or 2 ppm) iNO at 20 ppm is effective at acutely decreasing OI. STUDY DESIGN: A randomized, controlled trial of iNO in 3 nurseries in a single metropolitan area. Thirty-eight children, average gestational age of 37.3 weeks and average age <1 day were enrolled. Thirty-five of 38 infants had echocardiographic evidence of pulmonary hypertension. On enrollment, median OI in the control group, iNO at 0 ppm, (n = 23) was 33.1, compared with 36.9 in the 2-ppm iNO group (n = 15). RESULTS: Initial treatment with iNO at 2 ppm for an average of 1 hour was not associated with a significant decrease in OI. Twenty of 23 (87%) control patients and 14 of 15 (92%) of the low-dose iNO group demonstrated clinical deterioration and were treated with iNO at 20 ppm. In the control group, treatment with iNO at 20 ppm decreased the median OI from 42.6 to 23.8, whereas in the 2-ppm iNO group with a change in iNO from 2 to 20 ppm, the median OI did not change (42.6 to 42.0). Five of 15 patients in the low-dose nitric oxide group required ECMO and 2 died, compared with 7 of 23 requiring ECMO and 5 deaths in the control group. CONCLUSION: In infants with PPHN, iNO 1): at 2 ppm does not acutely improve oxygenation or prevent clinical deterioration, but does attenuate the rate of clinical deterioration; and 2) at 20 ppm acutely improves oxygenation in infants initially treated with 0 ppm, but not in infants previously treated with iNO at 2 ppm. Initial treatment with a subtherapeutic dose of iNO may diminish the clinical response to 20 ppm of iNO and have adverse clinical sequelae.

    Title Tracheal Epithelial Permeability to Nonelectrolytes: Species Differences.
    Date December 1993
    Journal Journal of Applied Physiology (bethesda, Md. : 1985)
    Excerpt

    We developed a new excised tracheal preparation to measure the epithelial permeability of large lipid-insoluble nonelectrolytes and macromolecules. Tracheae were suspended vertically in a Ringer solution bath, and a solution containing labeled test solutes was positioned in the center of the tracheal segment, away from damaged ends. Permeability coefficients, calculated from solute fluxes into the bath, were constant for > or = 2 h at 37 degrees C, and no histological changes were observed. Measurements after epithelial removal with detergent indicate that in the intact trachea the epithelium represents > 90% of the resistance to transport. For the rat trachea, permeability coefficients for sucrose, inulin, and Dextran 20 were 9.22, 2.20, and 0.214 x 10(-7) cm/s, respectively. Values for cat tracheae were similar, those for rabbit tracheae were lower, and those for guinea pig tracheae were markedly greater. With the assumption of transport by diffusion through thin rectangular slits between epithelial cells, the rat and guinea pig data fit a slit width of 7-8 nm, whereas the rabbit and cat data cannot be explained by a model with slits of a single size.

    Title Alterations in Feline Tracheal Permeability After Mechanical Ventilation.
    Date February 1993
    Journal Critical Care Medicine
    Excerpt

    OBJECTIVES: Previous investigations of ventilator-induced airway injury focused on histopathologic changes associated with various ventilators and strategies for their use. We hypothesized that mechanical ventilation is associated with alterations in tracheal epithelial permeability, and designed a study using an animal model to evaluate changes in tracheal epithelial permeability after administering different types of mechanical ventilation to test this hypothesis. DESIGN: Prospective, multiple-group, controlled trial. Five groups of animals were studied and compared. Eight animals were studied without intubation or mechanical ventilation. A total of 28 animals (seven in each group) were studied after conventional mechanical ventilation, high-frequency positive-pressure ventilation, high-frequency jet ventilation, or high-frequency flow interruption at respiratory rates of 20, 150, 400, and 900 breaths/min, respectively. Comparison of data for each group was done using the Kruskall-Wallis analysis of variance. Between-group comparisons were made using standard error of the mean comparisons. For airway pressures and other physiologic data, one-way analysis of variance was performed. Between-group comparisons were made using the Student-Newman-Keuls' test. SETTING: Small animal physiology laboratory. SUBJECTS: Thirty-six adult cats. INTERVENTIONS: Mechanically ventilated animals were treated for 8 hrs and then killed. Inspired oxygen concentration, BP, and mean airway pressures were comparable in mechanically ventilated animals. Spontaneously breathing control animals were killed without endotracheal intubation or exposure to mechanical ventilation. MEASUREMENTS AND MAIN RESULTS: Permeability values in isolated tracheal segments were calculated for 14C-sucrose, 3H-inulin, and fluorescein isothiocyanate-dextran-20. Tracheal epithelial permeability to all studied molecules increased after exposure to mechanical ventilators. These different mechanical ventilators increased epithelial permeability in a progressive manner that paralleled ventilatory frequency. The changes were greatest after ventilation at the highest frequency. These observed changes in tracheal permeability are consistent with previously observed alterations in tracheal histopathology after exposure to mechanical ventilation. CONCLUSIONS: Mechanical ventilation was associated with increases in tracheal permeability to large and small nonionic molecules. These changes occurred with all studied ventilators, used as they are clinically. Permeability changes paralleled ventilatory rate changes.

    Title Assessment of the Diurnal Variations in Urinary Homovanillic and Vanillylmandelic Acid Excretion for the Diagnosis and Follow-up of Patients with Neuroblastoma.
    Date July 1985
    Journal Clinical Biochemistry
    Excerpt

    The diurnal variation of urinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) was studied in neuroblastoma patients and in a control group. Urinary HVA and VMA levels in four sequential 6-hour urine collections within a 24-hour period were compared. HVA and VMA levels were expressed in microgram/mg of urinary creatinine (UCr) and in mg/6h specimens. No statistically significant variations between the four time intervals were found when expressed in microgram/mg UCr or mg/6h. The small variations that exist in the excretion of HVA and VMA during different periods of the day are due to variations in renal excretion rather than variations in production. The results from this study indicate that a random urine sample should be as good as a 24-hour collection for diagnosis and follow-up of neural crest tumors.

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