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Article ; Online: Incorporation of the Transverse Thoracic Plane Block Into a Multimodal Early Extubation Protocol for Cardiac Surgical Patients.

Cardinale, Jeffrey P / Latimer, Ryan / Curtis, Candace / Bukovskaya, Yana / Kosarek, Logan / Falterman, Jason / Tatum, Danielle M / Trusheim, Jay

Seminars in cardiothoracic and vascular anesthesia

2020 Volume 25, Issue 4, Page(s) 301–309

Abstract: Background: The aim for early extubation remains an important goal in cardiac surgical patients. Therefore, employment of a multimodal approach to pain management that includes a transverse thoracic plane block was retrospectively examined at a single- ... ...

Abstract	Background: The aim for early extubation remains an important goal in cardiac surgical patients. Therefore, employment of a multimodal approach to pain management that includes a transverse thoracic plane block was retrospectively examined at a single-center tertiary care hospital on the effects of time to extubation, opioid consumption, and length of stay in patients undergoing cardiac surgery via median sternotomy. Methods: Blocks were performed on all cardiac surgical patients except for those undergoing left ventricular assist device placement, thoracic transplant, emergent surgery, or redo sternotomy. Following additional exclusions for intra- and postoperative complications unrelated to anesthesia, final analysis was conducted on 75 patients per group. Multimodal pain management included intravenous analgesics and transverse thoracic plane block where patients received 15 mL 0.5% bupivacaine + epinephrine bilaterally under ultrasound guidance prior to incision. Results: Following transverse thoracic plane block and multimodal analgesics, 50.6% of patients were extubated in the operation room versus 8.6% in the control group. Intraoperative opioids were decreased, and intensive care unit and total length of stay were reduced by 5 hours and 1 day, respectively, in block patients as compared with controls. Postoperative opioids were not significantly different. There were no reported complications directly attributed to the block. Conclusions: The transverse thoracic plane block and multimodal regimen for patients undergoing median sternotomy resulted in a significant number of patients extubated in the operation room without an increase in postoperative re-intubations. Moreover, the block appears to be a quick and safe procedure to utilize on cardiac surgery patients.
MeSH term(s)	Airway Extubation ; Analgesics, Opioid ; Anesthetics, Local ; Cardiac Surgical Procedures ; Humans ; Nerve Block ; Pain, Postoperative/prevention & control ; Retrospective Studies
Chemical Substances	Analgesics, Opioid ; Anesthetics, Local
Language	English
Publishing date	2020-09-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012371-1
ISSN	1940-5596 ; 1089-2532
ISSN (online)	1940-5596
ISSN	1089-2532
DOI	10.1177/1089253220957484
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Article ; Online: Ontogenetic Patterns of Elemental Tracers in the Vertebrae Cartilage of Coastal and Oceanic Sharks

Mariah C. Livernois / John A. Mohan / Thomas C. TinHan / Travis M. Richards / Brett J. Falterman / Nathan R. Miller / R. J. David Wells

Frontiers in Marine Science, Vol

2021 Volume 8

Abstract: ... by known life history traits: C. leucas exhibited clear ontogenetic changes in elemental composition ... of elemental composition were strikingly similar between C. brevipinna and C. limbatus, suggesting they co ...

Abstract	As predators, coastal and oceanic sharks play critical roles in shaping ecosystem structure and function, but most shark species are highly susceptible to population declines. Effective management of vulnerable shark populations requires knowledge of species-specific movement and habitat use patterns. Since sharks are often highly mobile and long-lived, tracking their habitat use patterns over large spatiotemporal scales is challenging. However, the analysis of elemental tracers in vertebral cartilage can describe a continuous record of the life history of an individual from birth to death. This study examined trace elements (Li, Mg, Mn, Zn, Sr, and Ba) along vertebral transects of five shark species with unique life histories. From most freshwater-associated to most oceanic, these species include Bull Sharks (Carcharhinus leucas), Bonnethead Sharks (Sphyrna tiburo), Blacktip Sharks (Carcharhinus limbatus), Spinner Sharks (Carcharhinus brevipinna), and Shortfin Mako Sharks (Isurus oxyrinchus). Element concentrations were compared across life stages (young-of-the-year, early juvenile, late juvenile, and adult) to infer species-specific ontogenetic patterns of habitat use and movement. Many of the observed elemental patterns could be explained by known life history traits: C. leucas exhibited clear ontogenetic changes in elemental composition matching expected changes in their use of freshwater habitats over time. S. tiburo elemental composition did not differ across ontogeny, suggesting residence in estuarine/coastal regions. The patterns of elemental composition were strikingly similar between C. brevipinna and C. limbatus, suggesting they co-occur in similar habitats across ontogeny. I. oxyrinchus elemental composition was stable over time, but some ontogenetic shifts occurred that may be due to changes in migration patterns with maturation. The results presented in this study enhance our understanding of the habitat use and movement patterns of coastal and oceanic sharks, and highlights the applicability of ...
Keywords	trace elements ; vertebrae ; ontogeny ; sharks ; habitat use ; movement ; Science ; Q ; General. Including nature conservation ; geographical distribution ; QH1-199.5
Subject code	590
Language	English
Publishing date	2021-08-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Movement patterns and habitat use of tiger sharks (Galeocerdo cuvier) across ontogeny in the Gulf of Mexico.

Ajemian, Matthew J / Drymon, J Marcus / Hammerschlag, Neil / Wells, R J David / Street, Garrett / Falterman, Brett / McKinney, Jennifer A / Driggers, William B / Hoffmayer, Eric R / Fischer, Christopher / Stunz, Gregory W

PloS one

2020 Volume 15, Issue 7, Page(s) e0234868

Abstract: The tiger shark (Galeocerdo cuvier) is globally distributed with established coastal and open-ocean movement patterns in many portions of its range. While all life stages of tiger sharks are known to occur in the Gulf of Mexico (GoM), variability in ... ...

Abstract	The tiger shark (Galeocerdo cuvier) is globally distributed with established coastal and open-ocean movement patterns in many portions of its range. While all life stages of tiger sharks are known to occur in the Gulf of Mexico (GoM), variability in habitat use and movement patterns over ontogeny have never been quantified in this large marine ecosystem. To address this data gap we fitted 56 tiger sharks with Smart Position and Temperature transmitting tags between 2010 and 2018 and examined seasonal and spatial distribution patterns across the GoM. Additionally, we analyzed overlap of core habitats (i.e., 50% kernel density estimates) among individuals relative to large benthic features (oil and gas platforms, natural banks, bathymetric breaks). Our analyses revealed significant ontogenetic and seasonal differences in distribution patterns as well as across-shelf (i.e., regional) and sex-linked variability in movement rates. Presumably sub-adult and adult sharks achieved significantly higher movement rates and used off-shelf deeper habitats at greater proportions than juvenile sharks, particularly during the fall and winter seasons. Further, female maximum rate of movement was higher than males when accounting for size. Additionally, we found evidence of core regions encompassing the National Oceanographic and Atmospheric Administration designated Habitat Areas of Particular Concern (i.e., shelf-edge banks) during cooler months, particularly by females, as well as 2,504 oil and gas platforms. These data provide a baseline for future assessments of environmental impacts, such as climate variability or oil spills, on tiger shark movements and distribution in the region. Future research may benefit from combining alternative tracking tools, such as acoustic telemetry and genetic approaches, which can facilitate long-term assessment of the species' movement dynamics and better elucidate the ecological significance of the core habitats identified here.
MeSH term(s)	Animal Migration/physiology ; Animals ; Demography/methods ; Ecosystem ; Female ; Gulf of Mexico ; Life Cycle Stages/physiology ; Male ; Sharks/growth & development ; Sharks/metabolism ; Sharks/physiology
Language	English
Publishing date	2020-07-15
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0234868
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Article ; Online: Movement, Behavior, and Habitat Use of a Marine Apex Predator, the Scalloped Hammerhead

R. J. David Wells / Thomas C. TinHan / Michael A. Dance / J. Marcus Drymon / Brett Falterman / Matthew J. Ajemian / Gregory W. Stunz / John A. Mohan / Eric R. Hoffmayer / William B. Driggers / Jennifer A. McKinney

Frontiers in Marine Science, Vol

2018 Volume 5

Abstract: Conservation and management efforts of marine apex predators are more reliable when information on movement and habitat use patterns are known. The scalloped hammerhead (Sphyrna lewini) was the first shark species to be protected under the U.S. ... ...

Abstract	Conservation and management efforts of marine apex predators are more reliable when information on movement and habitat use patterns are known. The scalloped hammerhead (Sphyrna lewini) was the first shark species to be protected under the U.S. Endangered Species Act and has life history characteristics that make this species particularly at risk for local depletion. Consequently, the goal of this study was to better understand the movement dynamics of this species in the Gulf of Mexico (GOM) where discards through the longline fishery can be substantial. A total of 33 scalloped hammerheads were tagged with fin mounted satellite tags and tracked for an average of 146 days (ranging from 5 to 479 days) to examine horizontal movements and quantify space use. Scalloped hammerheads showed a wide range of movements throughout the GOM continental shelf with limited long-distance dispersal and females displayed a shelf-edge association relative to more mid-shelf use by males. A generalized additive model was developed to identify habitat suitability for scalloped hammerheads in the GOM, while state-space modeling was used to examine movement behaviors. Model results highlighted the use of continental shelf waters with high occurrence at close proximities to both artificial and hard-bottom habitat combined with low chlorophyll a concentrations (∼0–4 mg m-3) and moderate salinities (33–35.5). Habitat suitability for scalloped hammerheads was predicted to be high on the mid to outer continental shelf inside the 200 m isobath and state-space model results suggest area-restricted behavior was most common relative to transient behavior. Findings from this study provide important information on movement of this species in the GOM and highlight their restricted use of continental shelf habitat and resident behavior that will need to be incorporated in future stock assessments and extinction risk analyses.
Keywords	Sphyrna lewini ; shark ; movement ; conservation ; Gulf of Mexico ; Science ; Q ; General. Including nature conservation ; geographical distribution ; QH1-199.5
Subject code	333 ; 590
Language	English
Publishing date	2018-09-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article: Pheochromocytoma: clinical diagnosis and management.

Falterman, C J / Kreisberg, R

Southern medical journal

1982 Volume 75, Issue 3, Page(s) 321–328

Abstract: The incidence of pheochromocytoma among the hypertensive population is less than 1%. One third of the patients have intermittent hypertension, one third have remittent hypertension, and one third have persistent hypertension. The most common symptoms ... ...

Abstract	The incidence of pheochromocytoma among the hypertensive population is less than 1%. One third of the patients have intermittent hypertension, one third have remittent hypertension, and one third have persistent hypertension. The most common symptoms accompanying paroxysms include palpitation, headache, sweating, and pallor. Several familial syndromes have been described and should be searched for in every case of pheochromocytoma. Indications for screening for this tumor include severe and progressive hypertension, labile hypertension, or paroxysmal, symptomatic hypertension. In the majority of cases, diagnosis can be established by urinary assays for vanillylmandelic acid (VMA) and metanephrine. Plasma catecholamine determinations and computerized axial tomography have added other dimensions to the preoperative diagnosis and localization of this tumor. Surgery is obviously the treatment of choice. Preoperative alpha-blockade ameliorates clinical manifestations, allows volume expansion, and allows safe induction of anethesia.
MeSH term(s)	Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/surgery ; Adult ; Catecholamines/metabolism ; Child ; Diagnosis, Differential ; Humans ; Hypertension/etiology ; Middle Aged ; Pheochromocytoma/complications ; Pheochromocytoma/diagnosis ; Pheochromocytoma/surgery ; Preoperative Care
Chemical Substances	Catecholamines
Language	English
Publishing date	1982-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
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Ua VI Zs.117: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
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Article: Transfusion reaction due to unrecognized ABO hemolytic disease of the newborn infant.

Falterman, C G / Richardson, C J

The Journal of pediatrics

1980 Volume 97, Issue 5, Page(s) 812–814

MeSH term(s)	ABO Blood-Group System ; Adult ; Erythroblastosis, Fetal/complications ; Erythroblastosis, Fetal/immunology ; Female ; Histocompatibility ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Transfusion Reaction
Chemical Substances	ABO Blood-Group System
Language	English
Publishing date	1980-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/s0022-3476(80)80277-0
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Article: Small left colon syndrome associated with maternal ingestion of psychotropic drugs.

Falterman, C G / Richardson, C J

The Journal of pediatrics

1980 Volume 97, Issue 2, Page(s) 308–310

MeSH term(s)	Benztropine/adverse effects ; Biperiden/adverse effects ; Chlorpromazine/adverse effects ; Colonic Diseases, Functional/chemically induced ; Doxepin/adverse effects ; Female ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases/chemically induced ; Intestinal Obstruction/chemically induced ; Male ; Pregnancy ; Pregnancy Complications/drug therapy ; Psychotropic Drugs/adverse effects ; Schizophrenia/drug therapy ; Thiothixene/adverse effects
Chemical Substances	Psychotropic Drugs ; Biperiden (0FRP6G56LD) ; Doxepin (1668-19-5) ; Benztropine (1NHL2J4X8K) ; Thiothixene (7318FJ13YJ) ; Chlorpromazine (U42B7VYA4P)
Language	English
Publishing date	1980-08
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/s0022-3476(80)80504-x
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Article: Tracheoesophageal compression syndromes related to vascular ring.

Vallette, R C / Arensman, R M / Falterman, K W / Ochsner, J L

Southern medical journal

1989 Volume 82, Issue 3, Page(s) 338–341

Abstract: Seventeen cases of vascular ring have been encountered at Ochsner Clinic over the past 22 years. Anatomic configurations consisted of double aortic arch in 11 cases, right aortic arch with left ligamentum arteriosum in five cases, and aberrant right ... ...

Abstract	Seventeen cases of vascular ring have been encountered at Ochsner Clinic over the past 22 years. Anatomic configurations consisted of double aortic arch in 11 cases, right aortic arch with left ligamentum arteriosum in five cases, and aberrant right subclavian artery in one case. In four cases chest x-ray films revealed air block or hyperinflation and led to further diagnostic tests. The definitive diagnostic methods included esophagogram in 15 cases, aortography in 14 cases, two-dimensional echocardiography in one case, and esophagoscopy/bronchoscopy in eight cases. Presenting symptoms were respiratory in 13 cases and feeding difficulties in three; one asymptomatic case was found incidentally. Four cases of air block syndrome were observed as an early and unusual presentation of vascular ring in infants. Hyperinflation of the lung fields on chest x-ray film should spur suspicion of a possible vascular ring. Two case reports are included to demonstrate air block in relation to vascular rings in neonates.
MeSH term(s)	Adolescent ; Adult ; Aortic Arch Syndromes/complications ; Aortic Arch Syndromes/congenital ; Aortic Arch Syndromes/diagnosis ; Aortic Arch Syndromes/surgery ; Child ; Child, Preschool ; Esophageal Diseases/diagnostic imaging ; Esophageal Diseases/etiology ; Female ; Humans ; Infant ; Infant, Newborn ; Infant, Premature, Diseases/diagnostic imaging ; Male ; Methods ; Radiography ; Retrospective Studies ; Tracheal Diseases/diagnostic imaging ; Tracheal Diseases/etiology
Language	English
Publishing date	1989-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	185329-6
ISSN	1541-8243 ; 0038-4348
ISSN (online)	1541-8243
ISSN	0038-4348
DOI	10.1097/00007611-198903000-00015
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Article: Ventilatory management casebook. Congenital diaphragmatic hernia meeting criteria for extracorporeal membrane oxygenation.

Adolph, V / Arensman, R M / Falterman, K W / Goldsmith, J P

Journal of perinatology : official journal of the California Perinatal Association

1990 Volume 10, Issue 2, Page(s) 202–205

Abstract: ... to conventional management. In those patients with adequate gas exchange who fall into the C group, transfer ...

Abstract	Respiratory distress in newborns with CDH is the result of the interaction of pulmonary hypertension and pulmonary hypoplasia. Many patients will demonstrate adequate pulmonary parenchyma after repair as evidenced by adequate oxygenation and ventilation. Patients should be classified into groups of predicted mortality using Bohn's criteria. Patients in groups A, B, and D may be managed conventionally if blood gases can be kept in the normal range. These patients should be supported with ECMO if unresponsive to conventional management. In those patients with adequate gas exchange who fall into the C group, transfer to an ECMO center should be undertaken early, since mortality with continued conventional management is predictable. Some patients never demonstrate a "honeymoon" period, and mortality can be reliably predicted in this group as well by using Bohn's criteria. Because the relative significance of pulmonary hypoplasia compared with pulmonary hypertension in an individual patient cannot be reliably determined, any patient who has respiratory failure after repair of CDH should be supported with ECMO when conventional techniques fail as long as no contraindications exist. At least one institution will withhold ECMO therapy if lung parenchyma is judged inadequate as predicted by the inability to achieve a preductal PaO2 greater than 100 mm Hg and PaCO2 less than 50 mm Hg with maximal conventional therapy. In our experience, however, some patients can survive with ECMO support when all other indicators would suggest hypoplasia incompatible with life. Therefore, we do not believe any patient should be refused ECMO support when conventional measures fail.(ABSTRACT TRUNCATED AT 250 WORDS)
MeSH term(s)	Adult ; Extracorporeal Membrane Oxygenation ; Female ; Hernia, Diaphragmatic/complications ; Hernia, Diaphragmatic/therapy ; Hernias, Diaphragmatic, Congenital ; Humans ; Infant, Newborn ; Male ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
Language	English
Publishing date	1990-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	645021-0
ISSN	0743-8346
ISSN	0743-8346
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Article: A correlation of pulmonary hypoplasia, mean airway pressure, and survival in congenital diaphragmatic hernia treated with extracorporeal membrane oxygenation.

Redmond, C / Heaton, J / Calix, J / Graves, E / Farr, G / Falterman, K / Arensman, R

Journal of pediatric surgery

1987 Volume 22, Issue 12, Page(s) 1143–1149

Abstract: Thirty infants with congenital diaphragmatic hernia (CDH) who required therapy within the first day of life were treated in our institution over the past 3 years. Eighteen of these infants were not treated with extracorporeal membrane oxygenation (ECMO). ...

Abstract	Thirty infants with congenital diaphragmatic hernia (CDH) who required therapy within the first day of life were treated in our institution over the past 3 years. Eighteen of these infants were not treated with extracorporeal membrane oxygenation (ECMO). Survival in this group was 83%. Twelve infants were treated with ECMO. Seven (58%) were weaned from ECMO and ventilator support with six (50%) long-term survivors. Minimum preoperative alveolar-arterial oxygen gradient (AaDO2), maximum postoperative mean airway pressure (MAP), and pulmonary hypoplasia were evaluated. Bohn et al have prospectively shown that the relationship of PaCO2 to mechanical ventilatory requirements accurately predicted survival in a group of 58 infants with CDH in whom ECMO was not a therapeutic option. This criteria would predict nonsurvival in all 12 of our patients treated with ECMO, including the seven survivors. Differences between our ECMO and non-ECMO groups were statistically significant for all three criteria. All P values less than .05. Morphometric analysis of the lungs of all ECMO nonsurvivors revealed hypoplastic ipsilateral lungs by lung weight to body weight ratios and radial alveolar counts when compared with experimental and historical controls (P less than .05). The contralateral lung was hypoplastic in 80% of the nonsurvivors. There is a strong correlation between the maximum postoperative MAP and the degree of contralateral pulmonary hypoplasia (r = .03, P = .02). We conclude that the maximum postoperative MAP is an accurate predictor of survival in the treatment of CDH and can be correlated with the degree of pulmonary hypoplasia.(ABSTRACT TRUNCATED AT 250 WORDS)
MeSH term(s)	Adolescent ; Child ; Child, Preschool ; Congenital Abnormalities/complications ; Congenital Abnormalities/therapy ; Hernia, Diaphragmatic/complications ; Hernia, Diaphragmatic/mortality ; Hernia, Diaphragmatic/therapy ; Humans ; Hyperbaric Oxygenation/adverse effects ; Infant ; Lung Diseases/etiology ; Lung Diseases/pathology ; Lung Diseases/physiopathology
Language	English
Publishing date	1987-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80165-3
ISSN	1531-5037 ; 0022-3468
ISSN (online)	1531-5037
ISSN	0022-3468
DOI	10.1016/s0022-3468(87)80725-x
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