Effect of bovine lactoferrin on recurrent urinary tract infections: in vitro and in vivo evidences.

Uropathogenic Escherichia coli (UPEC) strains are the primary cause of urinary tract infections (UTIs). UPEC strains are able to invade, multiply and persisting in host cells. Therefore, UPEC strains are associated to recurrent UTIs requiring long-term antibiotic therapy. However, this therapy is suboptimal due to the increase of multidrug-resistant UPEC. The use of non-antibiotic treatments for managing UTIs is required. Among these, bovine lactoferrin (bLf), a multifunctional cationic glycoprotein, could be a promising tool because inhibits the entry into the host cells of several intracellular bacteria. Here, we demonstrate that 100 µg/ml bLf hinders the invasion of 2.0 ± 0.5 × 104 CFU/ml E. coli CFT073, prototype of UPEC, infecting 2.0 ± 0.5 × 105 cells/ml urinary bladder T24 epithelial cells. The highest protection (100%) is due to the bLf binding with host surface components even if an additional binding to bacterial surface components cannot be excluded. Of note, in the absence of bLf, UPEC survives and multiplies, while bLf significantly decreases bacterial intracellular survival. After these encouraging results, an observational survey on thirty-three patients affected by recurrent cystitis was performed. The treatment consisted in the oral administration of bLf alone or in combination with antibiotics and/or probiotics. After the observation period, a marked reduction of cystitis episodes was observed (p < 0.001) in all patients compared to the episodes occurred during the 6 months preceding the bLf-treatment. Twenty-nine patients did not report cystitis episodes (87.9%) whereas the remaining four (12.1%) experienced only one episode, indicating that bLf could be a worthwhile and safe treatment in counteracting recurrent cystitis.

Palliative home care reduces time spent in hospital wards: a population-based study in the Tuscany Region, Italy.

OBJECTIVE: To estimate the reduction of time spent in hospital obtained through palliative home care. METHODS: Retrospective analysis of the hospital admissions occurred during the last year of life. Cancer patients who were resident in the province of Florence, were registered at the Tuscan Cancer Registry, and died during the year 1997 were included in the study. Three palliative home care services were operating in the study area in 1997. MAIN RESULTS: 3423 cancer patients died in the study area during 1997. 9.2% of them received palliative home care. Palliative home care was effective in reducing the utilization of hospital care during the last three months of life. A 25% reduction of the relative risk (CI: 34-14%) to have in-patient admissions and a 49% reduction of relative risk (CI: 52-47%) of spending days in the hospital during the last 3 months of life were estimated through multivariable regression models. CONCLUSIONS: Palliative home care was effective in reducing time spent in hospital during the last 3 months of life.