A Survey-Based Study Into the Use of Peripheral Nerve Blocks for Pelvic Limb Surgery Among Veterinary Professionals With an Interest in Anesthesia.

Peripheral nerve blocks are commonly recommended as perioperative analgesia for orthopedic procedures. We aimed to determine the prevalence of use of techniques and drugs among veterinary professionals with an interest in anesthesia. Veterinary professionals were contacted via an email (ACVA-list) and newsletter (Association of Veterinary Anesthetists) containing a link to an online survey. Surveys completed in full were used for analysis. Analysis found that peripheral nerve blocks (PNBs) and epidural analgesia techniques were the preferred techniques of 46% and 38% of individuals, respectively. Of those using PNBs, nerve stimulator techniques were most common, used by 72% of individuals. Bupivacaine was used by 71% of individuals. Adjuvants were used by 37% of respondents; most commonly an alpha-2 agonist. Severe adverse effects were reported by 11 respondents, while 49% of individuals had not witnessed any adverse effects. More experienced veterinary anesthetists (>100 blocks performed) were more likely to have seen adverse effects. In conclusion, PNBs are utilized by anesthetists for pelvic limb orthopedic surgery, with nerve stimulation being the most commonly used PNB technique. Bupivacaine was the most commonly used local anesthetic however, diversity in both the techniques and drugs used was evident among respondents.

Mycoplasma fermentans and TNF-beta interact to amplify immune-modulating cytokines in human lung fibroblasts.

Mycoplasma can establish latent infections and are associated with arthritis, leukemia, and chronic lung disease. We developed an experimental model in which lung cells are deliberately infected with Mycoplasma fermentans. Human lung fibroblasts (HLF) were exposed to live M. fermentans and immune-modulating cytokine release was assessed with and without known inducers of cytokine production. M. fermentans increased IL-6, IL-8/CXCL8, MCP-1/CCL2, and Gro-alpha/CXCL1 production. M. fermentans interacted with TNF-beta to release more IL-6, CXCL8, and CXCL1 than predicted by the responses to either stimulus alone. The effects of live infection were recapitulated by exposure to M. fermentans-derived macrophage-activating lipopeptide-2 (MALP-2), a Toll-like receptor-2- and receptor-6-specific ligand. The synergistic effect of combined stimuli was more pronounced with prolonged incubations. Preexposure to TNF-beta sensitized the cells to subsequent MALP-2 challenge, but preexposure to MALP-2 did not alter the IL-6 response to TNF-beta. Exposure to M. fermentans or MALP-2 did not enhance nuclear localization, DNA binding, or transcriptional activity of NF-kappaB and did not modulate early NF-kappaB activation in response to TNF-beta. Application of specific inhibitors of various MAPKs suggested that p38 and JNK/stress-activated protein kinase were involved in early IL-6 release after exposure to TNF-beta and M. fermentans, respectively. The combined response to M. fermentans and TNF-beta, however, was uniquely sensitive to delayed application of SP-600125, suggesting that JNK/stress-activated protein kinase contributes to the amplification of IL-6 release. Thus M. fermentans interacts with stimuli such as TNF-beta to amplify lung cell production of immune-modulating cytokines. The mechanisms accounting for this interaction can now be dissected with the use of this in vitro model.