Alternativas aos antibióticos na profilaxia das infecções urinárias recorrentes não complicadas na mulher / Alternatives to antibiotics in the prophylaxis of recurrent uncomplicated infections in women

A infecção do trato urinário (ITU) é a doença bacteriana mais comum no sexo feminino, e cerca de 25% a 30% das mulheres apresentam ITUs recorrentes ao longo da vida. Os antibióticos são muito utilizados para o tratamento e prevenção dessas infecções. Entretanto, o uso excessivo e indevido desses medicamentos, além dos efeitos adversos, está relacionado ao surgimento de uropatógenos multirresistentes. Há um interesse crescente na comunidade científica para encontrar alternativas ao uso de antibióticos para tratamento e/ou prevenção das infecções bacterianas. Esta revisão tem por objetivo discutir algumas dessas alternativas.(AU)

Urinary tract infection (UTI) is the most common bacterial disease in females, and about 25% to 30% of women experience recurrent UTIs throughout their lives. Antibiotics are widely used standard for treating and preventing these infections. However, the excessive and improper use of these drugs, in addition to the adverse effects, is related to the emergence of multidrug-resistant uropathogens. There is a growing interest in the scientific community to find alternatives to the use of antibiotics for the treatment and/or prevention of bacterial infections. This review aims to discuss some of these alternatives.(AU)

Cranberries (Vaccinium macrocarpon Aiton) in dog nutrition: influence on diet digestibility and palatability and in the course of urinary tract infections / [Cranberrys (Vaccinium macrocarpon Aiton) na nutrição de cães: influência na digestibilidade e palatabilidade da dieta e no curso de infecções do trato urinário

The objective was to evaluate the effects of cranberry on blood and urinary parameters of dogs (experiment I), digestibility of nutrients (experiment II), palatability of diet (experiment III) and the influence of cranberry on E. coli UPEC-MRHA fimbriae in vitro (experiment IV). For experiment I and II, ten dogs were fed with diets containing 0% or 0.4% cranberry for 30 days. Experiment III compared the diets containing 0% and 0.4% cranberry using 16 adult dogs. There were no statistical differences (P>0.05) in the blood parameters evaluated. Dogs consuming cranberry presented lighter color and appearance of urine, compared to the control group (P<0.05). The diet containing cranberry showed higher digestibility of dry matter, organic matter, ether extract, higher metabolizable energy (P<0.05) and reduced fecal sialic acid concentration (P<0.05) compared to the control diet. There was no influence of cranberry on the formation of fimbriae of E. coli UPEC-MRHA. There was a lower intake ratio of the diet containing cranberry (P<0.05). The inclusion of 0.4% cranberry increases the digestibility of nutrients and influences the color and appearance of urine of dogs. However, it reduces diet palatability and does not alter the adhesion of E. coli UPEC-MRHA in vitro.(AU)

O objetivo foi avaliar os efeitos do cranberry nos parâmetros sanguíneos e urinários de cães (experimento I), na digestibilidade dos nutrientes (experimento II), na palatabilidade da dieta (experimento III) e a influência do cranberry sobre E. coli UPEC-MRHA fimbriae in vitro (experimento IV). Para os experimentos I e II, 10 cães foram alimentados com dietas contendo 0% ou 0,4% de cranberry por 30 dias. O experimento III comparou as dietas contendo 0% e 0,4% de cranberry usando 16 cães adultos. Não houve diferenças estatísticas (P>0,05) nos parâmetros sanguíneos avaliados. Cães que consumiram cranberry apresentaram cor e aparência mais claras da urina, em comparação com o grupo controle (P<0,05). A dieta contendo cranberry apresentou maior digestibilidade da matéria seca, extrato etéreo, matéria orgânica, maior energia metabolizável (P<0,05) e menor concentração de ácido siálico fecal (P<0,05) comparada à dieta controle. Não houve influência do cranberry na formação de fímbrias de E. coli UPEC-MRHA. Houve uma menor taxa de ingestão da dieta contendo cranberry (P<0,05). A inclusão de 0,4% de cranberry aumenta a digestibilidade dos nutrientes, influencia a cor e a aparência da urina dos cães. No entanto, reduz a palatabilidade da dieta e não altera a adesão de E. coli UPEC-MRHA in vitro.(AU)

Avaliação in vitro da atividade antibacteriana de sucos de cranberry (Vaccinium macrocarpon) sobre cepas de Escherichia coli responsáveis por infecção urinária / Evaluation of the antibacterial activity of cranberry juices (Vaccinium macrocarpon) on Escherichia coli strains responsible for urinary infection

Objetivo: Analisar o efeito antimicrobiano de sucos de cranberry concentrados, sobre cepas de Escherichia coli. Métodos: Difusão em disco, difusão em poços e microplaca, utilizando a cepa ATCC 25922 da bactéria E. coli. Resultados: Os resultados foram comparados com o controle positivo e negativo e dados encontrados na literatura para melhor compreensão da sua possível atividade antibacteriana. O resultado final encontrado foi que o suco de cranberry não tem nenhuma atividade contra o crescimento da cepa de Escherichia coli diante dos métodos realizados. Conclusão: Não houve atividade antimicrobiana do suco de cranberry sobre cepas de Escherichia coli.

Objective: Within this context the aim of this study was to analyze the antimicrobial effect of concentrated cranberry juice, on Escherichia coli. Methods: Testing as disk diffusion, diffusion in microplate wells and using the ATCC 25922 strain of E. coli bacteria. Results: The results were compared with the positive and negative control, and data in the literature, for better understanding of their potential antibacterial activity. The end result was found that cranberry juice has no activity against the growth of Escherichia coli strain before realized methods. Conclusion: There was not antimicrobial activity of cranberry juice on strains of Escherichia coli.

Tratamiento no farmacológico de la infección urinaria / Non-pharmacological treatment of urinary infection

En varios estudios in vitro se observó que el jugo y cóctel de cranberries tenían efectos inhibitorios sobre la adherencia bacteriana pero sin poder bactericida, por lo tanto se propuso su uso para prevención de la infección urinaria (IU). Estudios clínicos sobre la eficacia del jugo de cranberries han sido limitados y no han demostrado disminución en la aparición de la infección del tracto urinario (ITU), desaconsejando su uso prolongado y aparición de efectos adversos gastrointestinales. Los probióticos reducirían el riesgo de ITU recurrente porque mantiene un pH bajo, producen citoquinas antiinflamatorias y peróxido de hidrógeno como microbicida. Aún así no puede demostrarse un beneficio significativo con el uso de probióticos dado que los estudios que existen no demuestran evidencia suficiente

In several in vitro studies it was observed that the cranberries juice and cocktail had inhibitory effects on bacterial adhesion but with no bactericidal power; therefore, its use was proposed for urinary infection (UI) prevention. Clinical studies on the efficacy of cranberries juice have been limited and have not shown a decrease in the onset of urinary tract infection (UTI), discouraging prolonged use and occurrene of gastrointestinal adverse effects. Probiotics would reduce the risk of recurrent UTI because they maintain a low pH, produce anti-inflammatory cytokines and hydrogen peroxide as a microbicide. Still, no significant benefit can be demonstrated with the use of probiotics since the existing studies show no enough evidence

The impact of cranberry (Vaccinium macrocarpon) and cranberry products on each component of the metabolic syndrome: a review

BACKGROUND: Some studies have shown that cranberry (Vaccinium macrocarpon) has beneficial effects on the components of the metabolic syndrome (MetS), a condition characterized by a cluster of cardiovascular risk factors suchas central obesity, hypertension, impaired glucose homeostasis, elevated triglycerides, and decreased HDL cholesterol levels. Cranberry is very rich in polyphenols, which may significantly reduce cardiovascular disease (CVD) risk. Main body of the ABSTRACT: Nutritional intervention studies have indicated that the intake of cranberries and cranberry products may have the following impact on metabolic health: (1) attenuate markers of obesity such as body weight, body mass index, and waist circumference; (2) reduce systolic and diastolic pressures; (3) decrease plasma concentrations of triglycerides and oxidized LDL-cholesterol, as well as increase HDL cholesterol; and (4) promote glucose homeostasis. In addition, nutritional intervention with cranberries could confer antioxidant and anti-inflammatory properties and the ability to reduce biomarkers of atherosclerosis associated with the MetS, such as homocysteine. Short CONCLUSION: Although there has been promising results, particularly related to lipid profile and blood pressure, further research is needed to support the recommendation of cranberry intake as a nutritional intervention for the treatment of MetS

Infección del Tracto Urinario por Escherichia Coli Resistente a Antibióticos Tratada con Vaccinium Macrocarpon (Arándano Rojo): Reporte de Caso / Urinary tract infection caused by antibioticresistant Escherichia coli treated with Vaccinium macrocarpon (cranberry): a case report

El Vaccinium macrocarpon (arándano rojo) tiene alguna evidencia que puede ayudar a prevenir las infecciones del tracto urinario (ITU); sin embargo, la información es limitada si se trata del uso de este producto en el tratamiento de las ITU. Se presenta el caso de una mujer de 42 años de edad con antecedentes de ITU a repetición y con episodio activo, que presenta urocultivo positivo a E. coli resistente a fluoroquinolonas, aminoglucósidos y cefalosporinas de segunda generación. La paciente acepta tomar tratamiento con polvo estandarizado de Vaccinium macrocarpon durante 20 días. Se evidenció resolución del cuadro clínico y adecuada respuesta bacteriológica a dicho suplemento, según controles a los 6, 16, 65 y 93 días postratamiento. Este reporte podría ser el primer paso para ampliar los estudios sobre el uso de productos derivados de Vaccinium macrocarpon para tratamiento de episodios de ITU resistente a antibióticos.

Cranberry extract supplementation exerts preventive effects through alleviating Aβ toxicity in Caenorhabditis elegans model of Alzheimer's disease / 中国天然药物

Cranberry extract (CBE) rich in polyphenols are potent to delay paralysis induced by alleviating β-amyloid (Aβ) toxicity in C. elegans model of Alzheimer's disease (AD). In order to better apply CBE as an anti-AD agent efficiently, we sought to deterrmine whether preventive or therapeutic effect contributes more prominently toward CBE's anti-AD activity. As the level of Aβ toxicity and memory health are two major pathological parameters in AD, in the present study, we compared the effects of CBE on Aβ toxicity and memory health in the C. elegans AD model treated with preventive and therapeutic protocols. Our results revealed that CBE prominently showed the preventive efficacy, providing a basis for further investigation of these effects in mammals.

Atividade antibacteriana e efeito interativo in vitro de um produto a base de cranberry sobre Escherichia coli / Antibacterial activity and interactive effect in vitro of a cranberry product on Escherichia coli

Produtos derivados de plantas estão sendo bastante estudados devido à possibilidade de apresentarem substâncias com atividades antimicrobianas, principalmente, em decorrência do aumento da resistência bacteriana aos antimicrobianos, Vaccinium macrocarpon Aiton, conhecido como cranberry, é uma planta nativa, bastante difundida na América do Norte por suas propriedades terapêuticas, particularmente, na prevenção e tratamento de infecções urinárias, Este estudo objetivou avaliar in vitro a atividade antibacteriana, a concentração inibitória mínima (CIM) de um produto comercial a base de cranberry bem como as possíveis interações deste produto quando em associação com antimicrobianos, frente a cepas de Escherichia coli, As avaliações da atividade antibacteriana e da CIM foram realizadas utilizando-se discos de papel filtro estéreis (Cefar®), embebidos em 30µL da solução contendo frutos de cranberry em diferentes concentrações, O estudo da interferência do produto sobre a efetividade dos antimicrobianos foi realizado embebendo-se os discos de antibióticos, com 30µL da solução de cranberry [20mg/mL] equivalente a ½ CIM, Os resultados mostraram que a solução de cranberry apresentou atividade para todas as cepas de E, coli testadas independentemente do perfil de resistência e foi capaz de provocar diferentes efeitos interativos quando associado aos antimicrobianos, Estes dados comprovam o potencial antibacteriano deste fruto, promissor, para estudos de desenvolvimento de novos fármacos, entretanto, também mostram que em algumas situações, pode interferir sobre a efetividade de antimicrobianos de uso clínico...

Products derived from plants are being studied because often have substances with antimicrobial activity, mainly due to the increase in bacterial resistance to antimicrobial compounds. Vaccinium macrocarpon Aiton, known as cranberry, is a plant native to, quite widespread in North America for its therapeutic properties, particularly in the prevention and treatment of urinary infections. This study aimed to evaluate the antibacterial activity, the minimum inhibitory concentration (MIC) and the possible interactions between a cranberry product when in association with antimicrobial agents against strains of Escherichia coli. The sensitivity profile was performed by disk diffusion using discs (Multifar ®), and the assessments of antibacterial activity and the MIC were performed using sterile filter paper discs (Cefar ®), soaked in 30 µl of the solution of cranberry, tested in different concentrations. The study of interference of cranberry solution about the effectiveness of antimicrobials was accomplished by soaking the antibiotic discs in their respective concentrations, with cranberry solution 30µL [20 mg/mL] equivalent to 0.5 MIC. The results showed that cranberry solution presented activity for all strains regardless of resistance profile of these lineages and was able to provoke different interactive effects when associated to antimicrobials. These results prove the antibacterial potential of this fruit promising possible, for studies of development of new products, however, also show that in some situations, it may interfere on the effectiveness of antimicrobials for clinical use...

Efeitos comparativos de diferentes géis à base de cranberry e proantocianidina sobre a dentina submetida à erosão: estudo in vitro / In vitro effect of Cranberry and proanthocyanidin on dentin erosion

Considerando que a Proantocianidina e outros componentes do Cranberry possam inibir as metaloproteinases da dentina quando esta é exposta a ação de agentes erosivos e tal fato pode minimizar o desgaste dentinário, o presente trabalho tem como objetivo avaliar o efeito protetor in vitro de géis à base de extrato de Cranberry e Proantocianidina em diferentes concentrações, aplicados sobre a dentina posteriormente submetida à erosão. Para tal, 150 espécimes de dentina bovina (4 x 4 mm) foram confeccionados e igualmente divididos em 10 grupos: G1- gel de clorexidina a 0,012%; G2- gel placebo; G3- gel a base de extrato de Cranberry a 0,05%; G4- gel a base de extrato de Cranberry a 1%; G5- gel a base de extrato de Cranberry a 5%; G6- gel a base de extrato de Cranberry a 10%; G7- gel a base de Proantocianidina 0,05%; G8- gel a base de Proantocianidina 1%, G9- gel a base de Proantocianidina 5%; G10- gel a base de Proantocianidina 10%. Os diferentes géis foram aplicados uma única vez sobre os espécimes antes do primeiro desafio erosivo durante 5 minutos. Em seguida, os espécimes foram submetidos a 3 ciclagens erosivas seguidas (imersão em bebida à base de Cola por 5 minutos seguido de imersão em saliva artificial por 3 horas) por dia, durante 5 dias. Após as 3 cilclagens erosivas diárias, os espécimes foram mantidos em saliva artificial por 15 horas. A perfilometria foi utilizada para quantificar o desgaste dentinário (μm). Os dados foram analisados pelo teste ANOVA seguido do teste de Fisher (p<0,05). Os resultados (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) mostraram que o gel de Cranberry a 0,05% (G3) e gel de Proantocianidina 10% (G10) apresentaram eficácia estatisticamente significante na redução da erosão dentinária em comparação aos outros grupos analisados...

Considering that Proanthocyanidin and other Cranberrys components might inhibit dentin metalloproteinases exposed to erosive agents and it can prevent dental wear, the aim of this in vitro study was to evaluate the effect of Cranberry and Proanthocyanidin gels used in different concentrations on dentin before an erosive challenge. For this purpose, 150 bovine root dentin blocks (4x4mm) were treated by different gels and randomly divided into 10 groups: G1- 0.012% Chlorhexidine Gel (positive control), G2- Placebo gel with no active principle (negative control), G3- 0.05% Cranberry gel, G4- 1% Cranberry gel, G5- 5% Cranberry gel, G6- 10% Cranberry gel, G7- 0.05% Proanthocyanidin gel, G8- 1% Proanthocyanidin gel, G9- 5% Proanthocyanidin gel and G10- 10% Proanthocyanidin gel. The gels were applied over specimens once before the first erosive challenge for 5 minutes. After that, the blocks were subjected to 3 sequential erosive cycles (cola drink for 5 minutes and artificial saliva for 3 hours, each) per day, during 5 days. After 3 daily erosive cycles, the blocks were maintained in artificial saliva for 15 h. Profilometry was used to quantify the dentin wear (μm). Data were analyzed by ANOVA and Fisher's test (p<0.05). Results (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) showed that 0.05% Cranberry gel (G3) and 10% Proanthocyanidin gel (G10) presented similar results when compared to positive control group (G1), and these three groups showed statistically lowest wear when compared to all other evaluated groups. The results of this study suggest a significant efficacy of Cranberry and Proanthocyanidin gels in preventing wear of dentin subjected to dental erosion in vitro...

Efeito do cranberry e seus componentes sobre a dentina submetida à erosão / Effect of cranberry on dentin erosion challenge

Existem indícios de que o Cranberry e a Proantocianidina (polifenol desta fruta) tenham potencial para inibir as metaloproteinases da matriz (MMPs) que degradam o colágeno dentinário, porém estes agentes não foram adequadamente avaliados em estudos sobre erosão dentária. Assim, o objetivo desta tese será avaliar o papel do extrato de Cranberry e do seu principal agente ativo isolado (proantocianidina) aplicados na forma de gel tópico na inibição da degradação da matriz orgânica da dentina desmineralizada e consequentemente na minimização do desgaste da dentina submetida à erosão. Para isso, foram realizados 3 trabalhos buscando avaliar os seguintes objetivos específicos: Artigo 1- Verificar se diferentes concentrações de géis a base de extrato de Cranberry e de Proantocianidina apresentam papel inibitório do desgaste de espécimes dentinários submetidos à erosão in vitro, tendo como controles um grupo placebo e a clorexidina; Artigo 2- Avaliar o possível efeito protetor in situ de um gel de Cranberry aplicado à dentina submetida a ciclagem erosiva, quando comparados a grupos placebo e clorexidina; Artigo 3- Avaliar o efeito de diferentes concentrações de géis de Proantocianidina, aplicados por diferentes tempos de aplicação na minimização do desgaste da dentina exposta a desafios erosivos in vitro. Os resultados desta tese mostraram que os géis experimentais testados tiveram efeitos superiores aos grupos placebos e semelhantes ao controle positivo (clorexidina) na minimização do desgaste da dentina submetida à erosão. Além disso, nas concentrações avaliadas, não foi possível encontrar uma relação dose e tempo de aplicação/ resposta na prevenção da erosão. Assim, considerando os resultados apresentados na presente tese pôde- se concluir de forma geral que os géis de Cranberry e Proantocianidina foram efetivos na diminuição do desgaste dentário quando a dentina é exposta a desafio erosivo.(AU)

There are indications that the Cranberry and Proanthocyanidin (this fruit's polyphenol) have the potential to inhibit matrix metalloproteinases (MMPs) that degrade collagen from dentin, however these agents have not been adequately evaluated in studies of dental erosion. Thus, the aim of this thesis was to evaluate the role of Cranberry extract and its isolated main active agent (proanthocyanidin) applied as topical gel in the inhibition of organic matrix degradation and thus minimizing wear of dentin subjected to erosion. For that, three studies were conducted to assess the following specific objectives: Paper 1- Evaluate different gel concentrations of Cranberry extract and Proanthocyanidin on diminishing dentin erosion progression in vitro, having as control a placebo group and chlorhexidine; Paper 2- Evaluate the possible protective in situ effect of a Cranberry gel applied to dentin subjected to erosive cycling, when compared to placebo groups and chlorhexidine, Paper 3- Evaluate the effect of different concentrations of proanthocyanidin gels, applied by different application times in minimizing the wear of dentin exposed to erosive challenge in vitro. The results of this thesis showed that the tested experimental gels had greater effect than placebos groups and similar to the positive control (chlorhexidine) in minimizing the wear of dentin subjected to erosion. Furthermore, in the concentrations evaluated, it was not possible to find a dose and time of application / response in the prevention of erosion. Thus, considering the results presented in this thesis, it could be concluded that in general the gels of Cranberry and Proanthocyanidin were effective in decreasing the tooth wear when the dentin was exposed to erosive challenge.(AU)

Efeitos comparativos de diferentes géis à base de cranberry e proantocianidina sobre a dentina submetida à erosão: estudo in vitro / In vitro effect of Cranberry and proanthocyanidin on dentin erosion

Considerando que a Proantocianidina e outros componentes do Cranberry possam inibir as metaloproteinases da dentina quando esta é exposta a ação de agentes erosivos e tal fato pode minimizar o desgaste dentinário, o presente trabalho tem como objetivo avaliar o efeito protetor in vitro de géis à base de extrato de Cranberry e Proantocianidina em diferentes concentrações, aplicados sobre a dentina posteriormente submetida à erosão. Para tal, 150 espécimes de dentina bovina (4 x 4 mm) foram confeccionados e igualmente divididos em 10 grupos: G1- gel de clorexidina a 0,012%; G2- gel placebo; G3- gel a base de extrato de Cranberry a 0,05%; G4- gel a base de extrato de Cranberry a 1%; G5- gel a base de extrato de Cranberry a 5%; G6- gel a base de extrato de Cranberry a 10%; G7- gel a base de Proantocianidina 0,05%; G8- gel a base de Proantocianidina 1%, G9- gel a base de Proantocianidina 5%; G10- gel a base de Proantocianidina 10%. Os diferentes géis foram aplicados uma única vez sobre os espécimes antes do primeiro desafio erosivo durante 5 minutos. Em seguida, os espécimes foram submetidos a 3 ciclagens erosivas seguidas (imersão em bebida à base de Cola por 5 minutos seguido de imersão em saliva artificial por 3 horas) por dia, durante 5 dias. Após as 3 cilclagens erosivas diárias, os espécimes foram mantidos em saliva artificial por 15 horas. A perfilometria foi utilizada para quantificar o desgaste dentinário (μm). Os dados foram analisados pelo teste ANOVA seguido do teste de Fisher (p<0,05). Os resultados (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) mostraram que o gel de Cranberry a 0,05% (G3) e gel de Proantocianidina 10% (G10) apresentaram eficácia estatisticamente significante na redução da erosão dentinária em comparação aos outros grupos analisados.

Considering that Proanthocyanidin and other Cranberrys components might inhibit dentin metalloproteinases exposed to erosive agents and it can prevent dental wear, the aim of this in vitro study was to evaluate the effect of Cranberry and Proanthocyanidin gels used in different concentrations on dentin before an erosive challenge. For this purpose, 150 bovine root dentin blocks (4x4mm) were treated by different gels and randomly divided into 10 groups: G1- 0.012% Chlorhexidine Gel (positive control), G2- Placebo gel with no active principle (negative control), G3- 0.05% Cranberry gel, G4- 1% Cranberry gel, G5- 5% Cranberry gel, G6- 10% Cranberry gel, G7- 0.05% Proanthocyanidin gel, G8- 1% Proanthocyanidin gel, G9- 5% Proanthocyanidin gel and G10- 10% Proanthocyanidin gel. The gels were applied over specimens once before the first erosive challenge for 5 minutes. After that, the blocks were subjected to 3 sequential erosive cycles (cola drink for 5 minutes and artificial saliva for 3 hours, each) per day, during 5 days. After 3 daily erosive cycles, the blocks were maintained in artificial saliva for 15 h. Profilometry was used to quantify the dentin wear (μm). Data were analyzed by ANOVA and Fisher's test (p<0.05). Results (G1: 15,6 ± 2,4b; G2: 23,1 ± 1,4e; G3: 15,1 ± 2,3b; G4: 20,4 ± 1,9cd; G5: 19,0 ± 2,1ac; G6: 18,7 ± 1,4a; G7: 18,2 ± 1,6a; G8: 21,1 ± 1,2d; G9: 19,2 ± 2,6ac; G10: 15,2 ± 2,5b) showed that 0.05% Cranberry gel (G3) and 10% Proanthocyanidin gel (G10) presented similar results when compared to positive control group (G1), and these three groups showed statistically lowest wear when compared to all other evaluated groups. The results of this study suggest a significant efficacy of Cranberry and Proanthocyanidin gels in preventing wear of dentin subjected to dental erosion in vitro.

Clinical Guideline for Childhood Urinary Tract Infection (Second Revision)

To revise the clinical guideline for childhood urinary tract infections (UTIs) of the Korean Society of Pediatric Nephrology (2007), the recently updated guidelines and new data were reviewed. The major revisions are as follows. In diagnosis, the criterion for a positive culture of the catheterized or suprapubic aspirated urine is reduced to 50,000 colony forming uits (CFUs)/mL from 100,000 CFU/mL. Diagnosis is more confirmatory if the urinalysis is abnormal. In treating febrile UTI and pyelonephritis, oral antibiotics is considered to be as effective as parenteral antibiotics. In urologic imaging studies, the traditional aggressive approach to find primary vesicoureteral reflux (VUR) and renal scar is shifted to the targeted restrictive approach. A voiding cystourethrography is not routinely recommended and is indicated only in atypical or complex clinical conditions, abnormal ultrasonography and recurrent UTIs. 99mTc-DMSA renal scan is valuable in diagnosing pyelonephritis in children with negative culture or normal RBUS. Although it is not routinely recommended, normal scan can safely avoid VCUG. In prevention, a more natural approach is preferred. Antimicrobial prophylaxis is not supported any more even in children with VUR. Topical steroid (2-4 weeks) to non-retractile physiologic phimosis or labial adhesion is a reasonable first-line treatment. Urogenital hygiene is important and must be adequately performed. Breast milk, probiotics and cranberries are dietary factors to prevent UTIs. Voiding dysfunction and constipation should be properly treated and prevented by initiating toilet training at an appropriate age (18-24 months). The follow-up urine test on subsequent unexplained febrile illness is strongly recommended. Changes of this revision is not exclusive and appropriate variation still may be accepted.

Cranberries for preventing urinary tract infections

BACKGROUND: Cranberries have been used widely for several decades for the prevention and treatment of urinary tract infections (UTIs). This is the third update of our review first published in 1998 and updated in 2004 and 2008. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. METHODS: Search methods: We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL in The Cochrane Library) and the Internet. We contacted companies involved with the promotion and distribution of cranberry preparations and checked reference lists of review articles and relevant studies. Date of search: July 2012. Selection criteria: All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products for the prevention of UTIs. Data collection and analysis: Two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) were calculated where appropriate, otherwise a narrative synthesis was undertaken. Quality was assessed using the Cochrane risk of bias assessment tool. MAIN RESULTS: This updated review includes a total of 24 studies (six cross-over studies, 11 parallel group studies with two arms; five with three arms, and two studies with a factorial design) with a total of 4473 participants. Ten studies were included in the 2008 update, and 14 studies have been added to this update. Thirteen studies (2380 participants) evaluated only cranberry juice/concentrate; nine studies (1032 participants) evaluated only cranberry tablets/capsules; one study compared cranberry juice and tablets; and one study compared cranberry capsules and tablets. The comparison/control arms were placebo, no treatment, water, methenamine hippurate, antibiotics, or lactobacillus. Eleven ...

Effects of cranberry powder on biomarkers of oxidative stress and glucose control in db/db mice

Increased oxidative stress in obese diabetes may have causal effects on diabetic complications, including dyslipidemia. Lipopolysccharides (LPS) along with an atherogenic diet have been found to increase oxidative stress and insulin resistance. Cranberry has been recognized as having beneficial effects on diseases related to oxidative stress. Therefore, we employed obese diabetic animals treated with an atherogenic diet and LPS, with the aim of examining the effects of cranberry powder (CP) on diabetic related metabolic conditions, including lipid profiles, serum insulin and glucose, and biomarkers of oxidative stress. Forty C57BL/KsJ-db/db mice were divided into the following five groups: normal diet + saline, atherogenic diet + saline, atherogenic diet + LPS, atherogenic diet + 5% CP + LPS, and atherogenic diet + 10% CP + LPS. Consumption of an atherogenic diet resulted in elevation of serum total cholesterol and atherogenic index (AI) and reduction of high density lipoprotein (HDL)-cholesterol. However, with 10% CP, the increase in mean HDL-cholesterol level was close to that of the group with a normal diet, whereas AI was maintained at a higher level than that of the group with a normal diet. LPS induced elevated serum insulin level was lowered by greater than 60% with CP (P 0.05). Mean activity of liver cytosolic glutathione peroxidase was significantly increased by LPS injection, however it was reduced back to the value without LPS when the diet was fortified with 10% CP (P 0.05). Overall results suggest that fortification of the atherogenic diet with CP may have potential health benefits for obese diabetes with high oxidative stress, by modulation of physical conditions, including some biomarkers of oxidative stress.

Cranberries and lower urinary tract infection prevention

Lower urinary tract infections are very common diseases. Recurrent urinary tract infections remain challenging to treat because the main treatment option is long-term antibiotic prophylaxis; however, this poses a risk for the emergence of bacterial resistance. Some options to avoid this risk are available, including the use of cranberry products. This article reviews the key methods in using cranberries as a preventive measure for lower urinary tract infections, including in vitro studies and clinical trials.

Prevention of Recurrent Urinary Tract Infections in Women

Urinary tract infection (UTI) is one of the most common bacterial infections affecting women. One in four of these women will develop a recurrence. Recurrent UTIs are common among otherwise healthy women with anatomically and physiologically normal urinary tracts. These conditions have a significant effect on their quality of life and have a considerable economic impact due to health care costs. This article will review risk factors predisposing pre- and postmenopausal women to recurrent UTIs, and discuss antimicrobial prophylaxis and other non-antimicrobial preventive measures, including modification of behavioral factors, estrogen, and cranberry products.

Urinary Tract Infection in Postmenopausal Women

Urinary tract infection (UTI) is the most common bacterial infection in women in general and in postmenopausal women in particular. Two groups of elderly women with recurrent UTI should be differentiated regarding age and general status: healthy, young postmenopausal women aged 50 to 70 years who are neither institutionalized or catheterized and elderly institutionalized women with or without a catheter. Bacteriuria occurs more often in elderly functionally impaired women, but in general it is asymptomatic. However, the risk factors associated with recurrent UTI in elderly women are not widely described. In a multivariate analysis it was found that urinary incontinence, a history of UTI before menopause, and nonsecretor status were strongly associated with recurrent UTI in young postmenopausal women. Another study described the incidence and risk factors of acute cystitis among nondiabetic and diabetic postmenopausal women. Independent predictors of infection included insulin-treated patients and a lifetime history of urinary infection. Borderline associations included a history of vaginal estrogen cream use in the past month, kidney stones, and asymptomatic bacteriuria at baseline. Another important factor in postmenopausal women is the potential role that estrogen deficiency plays in the development of bacteriuria. There are at least two studies showing a beneficial effect of estrogen in the management of recurrent bacteriuria in elderly women. One of these studies showed that vaginal estrogen cream reduced vaginal pH from 5.5+/-0.7 to 3.6+/-1.0, restored lactobacillus, and decreased new episodes of UTI. Another study reported similar results using an estriol vaginal ring. However, contradictory results are found in the literature. For example, additional studies found that the use of estriol-containing vaginal pessaries was less effective than oral nitrofurantoin macrocrystals in preventing UTI in postmenopausal women. Two other studies also did not find any benefit in the reduction of UTI by oral estrogen therapy. Unfortunately, the use of estrogen in preventing UTI in postmenopausal women remains questionable. New strategies have been researched for reducing the use of antibiotics in the prevention and treatment of UTI. Two of them are probiotics and cranberry juice or capsules. Although several studies regarding probiotics and cranberry juice or capsules have reported a reduction of episodes of UTI, there is no conclusive evidence that they are useful in the prevention of UTI in postmenopausal women. As for the optimal drug, dosage, and length of treatment for UTI in the elderly, there are no studies comparing these data with the treatment for young women.

Effects of freeze-dried cranberry powder on serum lipids and inflammatory markers in lipopolysaccharide treated rats fed an atherogenic diet

This study investigated the effects of freeze-dried cranberry powder on anti-inflammation and lipid profiles of lipopolysaccharide (LPS)-treated rats fed an atherogenic diet for 6 weeks. Forty Sprague-Dawley male rats (6-weeks-old) were equally divided into the following five groups: 1) normal diet group + saline (NC); 2) atherogenic diet + saline (HFC); 3) atherogenic diet + LPS (HL); 4) atherogenic diet with 5% cranberry power + LPS (C5); 5) atherogenic diet with 10% cranberry power + LPS (C10). LPS (0.5 mg/kg) was injected into the abdominal cavities of rats 18 hours prior to sacrifice. At the end of the experimental period, we measured serum lipid profiles as well as levels of serum C-reactive protein (CRP), nitric oxide (NO), and pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-6, and IL-10 as an anti-inflammatory cytokine. The mean serum high density lipoprotein (HDL)-cholesterol level in C5 rats was significantly higher than that in NC and HL rats (P < 0.05). The mean serum levels of CRP and IL-1beta were significantly lower (P < 0.05) in the cranberry powder groups compared to those in HL rats. Additionally, mean serum IL-6 levels tended to be lower in the cranberry groups than that in the HL group, whereas serum IL-10 and NO showed 29% and 88% higher mean values in the C5 group and 49% and 24% higher in the C10 group than those in the HL group, respectively. These results suggest that freeze-dried cranberry powder may have beneficial effects on cardiovascular diseases by modifying serum lipids and the early inflammatory response.

Effects of cranberry powder on serum lipid profiles and biomarkers of oxidative stress in rats fed an atherogenic diet

This study investigated that the antioxidative effect of freeze-dried cranberry powder against protein and lipid oxidation and ameliorative effect of serum lipid profile in rat fed atherogenic diet. Six weeks old male Sprague-Dawley rats were divided into the following four groups: normal diet group with 5% corn oil (control), atherogenic diet group with 5% corn oil, 10% lard, 1% cholesterol, and 0.5% sodium cholate (HFC), atherogenic plus 2% cranberry powder diet group (HFC + C2), and atherogenic plus 5% cranberry powder diet group (HFC + C5), and respective diet and water were fed daily for 6 weeks. After the experimental period, the serum lipid profile, such as total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglyceride, ferric reducing ability of plasma (FRAP), plasma phenolics content, superoxide dismutase (SOD) activity, serum protein carbonyl and thiobarbituric acid reactive substances (TBARS) levels were examined. Total phenolic compound and total flavonoid levels in freeze-dried cranberry powder were 9.94 mg/g and 8.12 mg/g, respectively. Serum total cholesterol and LDL-cholesterol levels were not significantly different for cranberry powder treatment, but serum HDL-cholesterol level was significantly increased in HFC + C5 group compared with HFC group. Plasma FRAP value tended to be increased by cranberry powder treatment though there was no significant difference. Plasma total phenol concentrations and SOD activities were not significantly different among all groups. Serum protein carbonyl and TBARS levels were significantly decreased in HFC + C5 group compared with HFC group. Overall results suggested that freeze-dried cranberry powder might have the serum lipid improving effect, as well as antioxidative effect demonstrated by its protective effect against protein and lipid oxidation.