GM-CSF is key in the efficacy of vaccine-induced reduction of Helicobacter pylori infection.

BACKGROUND: Helicobacter pylori (H. pylori) colonizes the human gastric mucosa with a high worldwide prevalence. Currently, H. pylori is eradicated by the use of antibiotics. However, elevated antibiotic resistance suggests new therapeutic strategies need to be envisioned: one approach being prophylactic vaccination. Pre-clinical and clinical data show that a urease-based vaccine is efficient in decreasing H. pylori infection through the mobilization of T helper (Th) cells, especially Th17 cells. Th17 cells produce interleukins such as IL-22 and IL-17, among others, and are key players in vaccine efficacy. Recently, granulocyte-macrophage colony-stimulating factor (GM-CSF)-producing Th17 cells have been identified. AIM: This study explores the possibility that GM-CSF plays a role in the reduction of H. pylori infection following vaccination. RESULTS: We demonstrate that GM-CSF+ IL-17+ Th17 cells accumulate in the stomach mucosa of H. pylori infected mice during the vaccine-induced reduction of H. pylori infection. Secondly, we provide evidence that vaccinated GM-CSF deficient mice only modestly reduce H. pylori infection. Conversely, we observe that an increase in GM-CSF availability reduces H. pylori burden in chronically infected mice. Thirdly, we show that GM-CSF, by acting on gastric epithelial cells, promotes the production of ßdefensin3, which exhibits H. pylori bactericidal activities. CONCLUSION: Taken together, we demonstrate a key role of GM-CSF, most probably originating from Th17 cells, in the vaccine-induced reduction of H. pylori infection.

Ultrasound-guided aspiration of adnexal cysts with a low risk of malignancy: is it a recommendable option?

OBJECTIVES: The purpose of this study was to establish the viability of ultrasound (US)-guided adnexal cyst aspiration and identify a target group in which this procedure would be advisable. METHODS: A prospective cohort of 96 women with a low risk of malignant adnexal cysts was studied between 2002 and 2009, using recurrence after the procedure as the primary outcome measure. All procedures were performed on an outpatient basis without anesthesia. Patients were followed by US imaging at 6, 12, 24, 48, and 72 months. Potential risk factors for recurrence (menopausal status, previous hysterectomy, symptoms, US pattern, cyst diameter, and aspirated fluid volume and color) were analyzed by multivariate logistic regression. The association between recurrence and cyst size was calculated by Kaplan-Meier curves. RESULTS: The median diameter of the cysts was 61 (range, 30-150) mm. Multivariate logistic regression analysis showed that an increased risk of recurrence was associated with a cyst diameter of greater than 70 mm (odds ratio, 4.2; 95% confidence interval, 1.2-14.1) and the presence of symptoms (odds ratio, 5.03; 95% confidence interval, 1.02-24.6). The median follow-up time was 24 (range, 2-78) months. Surgery was avoided in 64 patients (73.6%). Full cyst recurrence was observed in 34 patients (39.0%). CONCLUSIONS: Ultrasound-guided aspiration is a viable alternative to surgery for treatment of adnexal cysts with a low risk of malignancy, especially when the cyst diameter is less than 70 mm.

Atención de enfermería en pacientes con infarto agudo del miocardio complicado con falla de bomba / Nursing care in patients with acute yocardial infarction complicated with heart failure

Se estudiaron 10 pacientes que sufrían de infarto del miocardio (IMA) complicado con falla de bomba, de éstos se le aplicó el catéter de Swan-Ganz a 8 casos (80

), y se pudo apreciar la importancia de la obtención de datos en esos casos, lo que ofrece un mejor tratamiento de la enfermedad. Se describen los cuidados y utilización de los distintos parámetros medibles con la aplicación de esta técnica y la importancia de la labor realizada por el enfermero bien entrenado. Se expresan las experiencias obtenidas durante el tratamiento de los pacientes afectados por esta enfermedad atendidos en la Unidad de Cuidados Intensivos del Centro de Investigaciones Medicoquirúrgicas (CIMEQ). Se analizan los resultados. El inicio exitoso de este tipo de estudio pone en disposición un elemento más a considerar en el diagnóstico y pronóstico de los pacientes que sufren de IMA, y el enfermero puede tener más precisión en la atención al paciente

Atención de enfermería en pacientes con infarto agudo del miocardio complicado con falla de bomba / Nursing care in patients with acute myocardial infarction complicated with heart failure

Se estudiaron 10 pacientes que sufrían de infarto del miocardio (IMA) complicado con falla de bomba, de éstos se le aplicó el catéter de Swan-Ganz a 8 casos (80%), y se pudo apreciar la importancia de la obtención de datos en esos casos, lo que ofrece un mejor tratamiento de la enfermedad. Se describen los cuidados y utilización de los distintos parámetros medibles con la aplicación de esta técnica y la importancia de la labor realizada por el enfermero bien entrenado. Se expresan las experiencias obtenidas durante el tratamiento de los pacientes afectados por esta enfermedad atendidos en la Unidad de Cuidados Intensivos del Centro de Investigaciones Medicoquirúrgicas (CIMEQ). Se analizan los resultados. El inicio exitoso de este tipo de estudio pone en disposición un elemento más a considerar en el diagnóstico y pronóstico de los pacientes que sufren de IMA, y el enfermero puede tener más precisión en la atención al paciente