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Prophylactic effect of UVA-E in women with recurrent cystitis: A preliminary report

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Abstract

The prophylactic effect of UVA-E on recurrent cystitis was evaluated in a double-blind, prospective, randomized study. A total of 57 women who had suffered at least three episodes of cystitis during the year preceding the study were treated with either UVA-E (n = 30) or placebo (n = 27) for 1 month. At the end of the 1-year follow-up period, a statistically significant difference between groups in the number of recurrences was seen. No side effects were reported. We conclude that UVA-E exerts a prophylactic effect on recurrent cystitis.
... В клиническом исследовании проанализировано влияние листьев толокнянки и корней одуванчика в течение 30 дней по сравнению с плацебо у 57 пациентов с рецидивирующими ИМП. Через 12 мес ни у одного из пациентов в исследуемой группе не отмечено рецидивов, тогда как в группе плацебо данный показатель составил 23% [24]. Эффективность другого препарата на растительной основе, состоящего из трав настурции (Tropaeoli majoris herba) и корней хрена (Armoraciae rusticanae radix), исследовалась при участии 174 пациенток. ...
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Background. Urinary tract infections remain one of the urgent problems in the aspect of qualified medical care. The causative agents of nosocomial infections are becoming more and more resistant to the drugs used, while the rate of new drugs synthesis is lower than the rate of development of antibiotic resistance. Routine and empirical prevention of recurrent urinary tract infections is often ineffective. Aim. To study the efficacy and safety of intravesical application of the drug based on bacteriophages in therapy in patients with chronic recurrent cystitis. Materials and methods. A clinical study was carried out to study the efficacy and safety of the drug for intravesical administration based on bacteriophages in therapy in patients with chronic recurrent cystitis. The study included 75 patients who were divided into 3 groups in a 1: 1: 1 ratio. In the main group, the drug for intravesical administration based on bacteriophages, as well as rectal suppositories with bacteriophages were used; in the control group only a drug for intravesical administration based on bacteriophages or rectal suppositories with bacteriophages. On visits 1-4, all patients underwent a clinical blood test, general urine analysis, bacteriological urine analysis, as well as urine analysis by the polymerase chain reaction method. The analysis of the patients condition in groups was carried out according to the dynamics of main clinical symptoms changes, data from validated scales for assessing pelvic pain and urgency/frequency of urination and assessment of symptoms of acute cystitis (Acute Cystitis Symptom Score ACSS), as well as the dynamics of changes in objective parameters of laboratory studies and possible changes in sensitivity uropathogens to antibacterial drugs. Results. The average age of the patients included in the study was 50.6 years. In all 3 groups, bacteriological examination of urine showed a predominant growth of Escherichia coli (3104 CFU/ml). In the course of the study, there was a good tolerance to therapy, a decrease in clinical symptoms, as well as a significant decrease in the total score according to the pelvic pain scale and urgency/frequency of urination and the ACSS scale in all patients. Conclusion. The emergence of a large number of microorganisms resistant to various antibiotics and their rapid spread in the environment has led to an increase in scientific interest in bacteriophage therapy as an alternative method of treatment. The overall subjective effectiveness of the therapy in our study was more than 80%, safety - 100%. Further research will allow for a personalized approach to the treatment of infectious diseases of the urinary system.
... At the same time, it is important to understand that the bearberry extracts do not for practical purposes affect the excretion of electrolytes in the urine (there was a slight increase in the elimination of ionized sodium) (36). It is also and statistically significant differences were found versus the placebo group (23%) (38). In this study, a month-long course of treatment was prescribed, which presented difficulties, since it was known that the bearberry contains hydroquinone, which in high concentrations has a carcinogenic effect. ...
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Although many plants have been known to man for centuries scientifically obtained data about their chemical content and pharmacological activity are often still lacking. Through the ages errors about plants used in different countries officially as medicinal plants have been introduced and when included in complex pharmaceutical formulations may become unsafe. One of these medicinal plants is the bearberry (Arctostaphylos uva-ursi Spreng. from the family Ericaceae). The leaves of this plant and in rare cases the stems are used for the treatment of urinary tract diseases. The aim of this review was to examine available data about main medicinal usage of the bearberry leaves as a source of biological active substances from different groups. Another important task is connected with unification of methods for quality control of bearberry leaves. The botanical classification of Arctostaphylos uva-ursi Spreng. and its subspecies also require further study. At present, all subspecies of Arctostaphylos uva-ursi Spreng. refer only to this species. Therefore analyzing the plant material quantitatively and qualitatively has been difficult.
... The detailed investigation did not reflect any toxicity related to the ingestion of uva-ursi. Limited clinical data from small studies suggest that uva-ursi effectively prevents UTIs in high-risk patients [174,175]. Using uva-ursi as a first-line treatment option is effective in resolving UTI symptoms and reducing antibiotic use. It also leads to favorable effects on resistance rates. ...
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The extensive usage of antibiotics and the rapid emergence of antimicrobial-resistant microbes (AMR) are becoming important global public health issues. Many solutions to these problems have been proposed, including developing alternative compounds with antimicrobial activities, managing existing antimicrobials, and rapidly detecting AMR pathogens. Among all of them, employing alternative compounds such as phytochemicals alone or in combination with other antibacterial agents appears to be both an effective and safe strategy for battling against these pathogens. The present review summarizes the scientific evidence on the biochemical, pharmacological, and clinical aspects of phytochemicals used to treat microbial pathogenesis. A wide range of commercial products are currently available on the market. Their well-documented clinical efficacy suggests that phytomedicines are valuable sources of new types of antimicrobial agents for future use. Innovative approaches and methodologies for identifying plant-derived products effective against AMR are also proposed in this review.
... Çünkü üriner sistem tedavisi için kullanılan aromatik bitkilerden olan ayı üzümü (Uva ursi), ardıç (Juniperus), ısırgan otu kökü (Urtica dioica L.) gebelikte kontrendikedir. [44][45][46] Gebelik döneminde üriner sistem enfeksiyonları için kullanılan bitkisel yön temlerin, etkinliğini ve potansiyel zararlarını belirlemek için daha fazla çalışmaya gereksinim vardır. 43 Üriner sistem enfeksiyonlarını önlemek için kullanılabilen probiyotikler ise bağırsak sisteminin, mikrobiyal popülasyonunun faydalı bir dengesini destekleyen canlı mikroorganizmalarını ifade ederler. ...
... Çünkü üriner sistem tedavisi için kullanılan aromatik bitkilerden olan ayı üzümü (Uva ursi), ardıç (Juniperus), ısırgan otu kökü (Urtica dioica L.) gebelikte kontrendikedir. [44][45][46] Gebelik döneminde üriner sistem enfeksiyonları için kullanılan bitkisel yön temlerin, etkinliğini ve potansiyel zararlarını belirlemek için daha fazla çalışmaya gereksinim vardır. 43 Üriner sistem enfeksiyonlarını önlemek için kullanılabilen probiyotikler ise bağırsak sisteminin, mikrobiyal popülasyonunun faydalı bir dengesini destekleyen canlı mikroorganizmalarını ifade ederler. ...
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T Gebelik birçok açıdan değişimlerin yaşandığı ve bu değişimlerle baş etmeyi gerektiren önemli bir dönemdir. Bu dönemde kadın, sağlık problemi yaşamasa da yaşam kalitesini olumsuz etkileyebilecek fizyolojik problemler yaşayabilmektedir. Günümüzde yaygın kullanılan tamamlayıcı tıp uygulamaları gebelikte yaşanan fizyolojik problemlerin tedavisinde de kullanılmaktadır. Gebeliğin erken döneminde görülen bulantı kusma için en sık kullanılan yöntemler akupunktur, zencefil, hipnozdur. Bu dönemdeki bir diğer sorun olan üriner sistem enfeksiyonlarında aromaterapi, kızılcık ekstresi, yaban mersini ve probiyotik kullanılmaktadır. Hipnoz, meditasyon, akupunktur, masaj ve gevşeme uygulamaları bu dönemde görülen baş ağrısını azaltmada etkilidir. Gebeliğin geç dönem sorunları arasında yer alan ödem için masaj terapisi ve ayak refleksolojisi kullanılabilmektedir. Aynı dönemde oluşan bel, sırt ve pelvik ağrıyı azaltmak için refleksoloji ve aromaterapiler kullanılmakta, uyku problemini gidermek amacıyla ayurveda tıbbı, papatya çayı, müzik terapisi ve gevşeme egzersizleri kullanılabilmektedir. Oluşan sıcak basmaları ayurveda tıbbıyla giderilebilmektedir. Gebelikte hissedilen yorgunluk yoga, egzersiz ve ginseng ile, stres ve anksiyete ise müzik terapisi ve lavantayla giderilebilmektedir. Sonuç olarak; gebeliğin kadının yaşamında yeri önemlidir. Gebe, fiziksel ve ruhsal olarak sürekli değişim içindedir. Yaşanan değişimler birtakım rahatsızlıklara yol açmaktadır. Bu rahatsızlıkların giderilmesinde çeşitli tamamlayıcı tıp uygulamaları etkilidir. Sağlık profesyonellerinin tamamlayıcı tıp uygulamalarının gebelikte kullanımıyla ilgili bilgilendirilmeleri, gebelere gerektiğinde önerilerde bulunmaları fiziksel ve psikolojik olarak sağlıklı bir gebelik dönemi açısından oldukça önemlidir
... The botanical drug mixture commonly used to treat UTIs depends on many factors, such as the portion of the plant used, as well as the method of phytoextract preparation. The main mechanisms of action include the antioxidant effect, the interference with UPEC's ability to adhere and invade the urothelium and the antimicrobial action [40][41][42][43][44][45]. ...
... The botanical drug mixture commonly used to treat UTIs depends on many factors, such as the portion of the plant used, as well as the method of phytoextract preparation. The main mechanisms of action include the antioxidant effect, the interference with UPEC's ability to adhere and invade the urothelium and the antimicrobial action [40][41][42][43][44][45]. ...
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Berberine is an alkaloid of the protoberberine type used in traditional oriental medicine. Its biological activities include documented antibacterial properties against a wide variety of microorganisms; nonetheless, its use against Escherichia coli strains isolated from urinary infections has not yet been widely investigated in vivo. The emergence of antimicrobial resistance requires new therapeutic approaches to ensure the continued effectiveness of antibiotics for the treatment and prevention of urinary infections. Moreover, uropathogenic Escherichia coli (UPEC) has developed several virulence factors and resistance to routine antibiotic therapy. To this end, several in vitro and in vivo tests were conducted to assess the activity of berberine on uropathogenic E. coli strains. Galleria mellonella as an infection model was employed to confirm the in vivo translatability of in vitro data on berberine activity and its influence on adhesion and invasion proprieties of E. coli on human bladder cells. In vitro pre-treatment with berberine was able to decrease the adhesive and invasive UPEC ability. In vivo treatment increased the larvae survival infected with UPEC strains and reduced the number of circulating pathogens in larvae hemolymph. These preliminary findings demonstrated the efficacy and reliability of G. mellonella as in vivo model for pre-clinical studies of natural substances.
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Comparative phytochemical and pharmacological analysis of leaves and shoots of Arctostaphylos uva-ursi (L.) Spreng. and endemic of Transcaucasia and North Caucasia Arctostaphylos caucasica Lipsch. was carried out. Phenolic compounds in methanol extracts were investigated by HPLC-PDA-ESI-MS. Pharmacological investigation was carried out at the models of generation of superoxide, DPPH, hydroxyl and nitrosyl radicals. The antityrosinase properties were evaluated in the reaction of tyrosinase inhibition using L -tyrosine as a substrate. Five new compounds were identified in the shoots and leaves of A. uva-ursi: 4,6-di-О-galloylglucose; 2,3-di-О-galloylglucose; 1,4,6-tri-О-galloylglucose; 1,2,4,6-tetra-О-galloylglucose; tetra-О-galloylhexose. Thirty-five phenolic compounds and two saponins were identified for the first time in A. caucasica. Water-alcohol extract (70% ethanol) from A. caucasica had the highest antiradical activity. Water extracts from both species had antityrosinase activity and possessed comparable efficiency (IC50 = 36.4 ± 1.2 µg/ml and IC50 = 35,5 ± 2 µg/ml, respectively).
Article
Objectives: To discuss optimal management of recurrent urinary tract infections (UTIs) in women. About every second woman experiences at least one UTI in her lifetime, of those 30% experience another UTI, and 3% further recurrences. Especially young healthy women without underlying anatomical deficiencies suffer from recurrent UTIs (rUTI), which are associated with significant morbidity and reduction in quality of life. Methods: This is a narrative review, investigating publications dealing with recurrent UTI in women. Risk factors and options for management are discussed. Results: The increased susceptibility of women to rUTI is based on the female anatomy in addition to behavioural, genetic, and urological factors. However, why some women are more likely than others to develop and maintain rUTI remains to be clarified. Invasive characteristics of certain uropathogenic Escherichia coli that are able to form extra- and intracellular biofilms and may therefore cause delayed release of bacteria into the bladder, may play a role in this setting. Treatment recommendations for an acute episode of rUTI do not differ from those for isolated episodes. Given the nature of rUTI, different prophylactic approaches also play an important role. Women with rUTI should first be counselled to use non-antibiotic strategies including behavioural changes, anti-adhesive treatments, antiseptics, and immunomodulation, before antibiotic prophylaxis is considered. In addition to the traditional treatment and prophylactic therapies, new experimental strategies are emerging and show promising effects, such as faecal microbiota transfer (FMT), a treatment option that transfers microorganisms and metabolites of a healthy donor's faecal matter to patients using oral capsules, enemas, or endoscopy. Initial findings suggest that FMT might be a promising treatment approach to interrupt the cycle of rUTI. Furthermore, bacteriophages, infecting and replicating in bacteria, have been clinically trialled for UTIs. Conclusion: Due to the limitation of available data, novel treatment options require further clinical research to objectify the potential in treating bacterial infections, particularly UTIs.
Chapter
Uva-ursi (Arctostaphylos uva-ursi) is a shrub whose leaves are used to make medicine. Clinical trials are almost non-existent for this herb and indicate that uva-ursi may be beneficial for prevention of recurrent urinary tract infections but may not be effective for acute urinary tract infections. Uva-ursi has been reported to show antibacterial efficacy in more than 70 strains of bacteria known to exist in the urinary tract. Arbutin, the chief constituent found in the leaves of the herb, has been shown to have antibacterial properties via its metabolite hydroquinone glucuronide. The presence of hydroquinone glucuronide in the bladder prevents bacteria from adhering to the uroepithelium. This chapter examines some of the scientific research conducted on uva-ursi, both alone and in combination formulas, for treating cystitis and recurrent urinary tract infection. Finally, the chapter presents a list of uva-ursi’s active constituents, different Commonly Used Preparations and Dosage, and a section on “Safety and Precaution” that examines side effects, toxicity, and disease and drug interactions.
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A variant of the interstitial cystitis (IC) syndrome, minimal or no pain or significant pain that has been lessened by another therapy, can be clinically improved by retraining of the individual's voiding pattern. Patients with greater pain but capable of completing this protocol also may be helped. While this group of patients fills the diagnostic criteria of IC and has many of the classic changes, many differ in that they have minimal or no pain while simultaneously they have a dysfunctional bladder as expected from long-term low-volume voiding. All patients were placed on a protocol which focused on progressively increasing intervals between voids. Fifteen to thirty minutes initially were added to their present voiding time. The same increase was added to the voiding pattern every three or four weeks until an interval of three to four hours between voids was achieved. Twenty-one patients fit the criteria to be entered into this study. Overall 71 percent (151 21) had successful management of their symptoms and reported a 50 percent decrease in their symptoms of urinary urgency, frequency, and nocturia. Nineteen percent (4121) reported 25 percent decrease in symptoms and 10 percent had no change. Presence of significant pain adversely affects outcome, 317 (with pain) improvements versus 12114 (without pain). For all patients there was a significant increase in bladder capacity (92 mL average before study and 179 mL after) and average daily voids (13.2/day prestudy and 7.4 post-therapy). These differences in voided profiles were statistically significant (p value < 0.01).
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The body weight of mice and rats is decreased after administration of Herba Taraxaci (8 ml fluid extract/kg). The diuretic action of the extracts was compared with Furosemidum used as reference substance.
Experimentelle Untersuchungen zur Frage der antibakteriellen Prinzipien in Begonia semperflorens und Folia Uvae-Ursi. (Dissertation) FU-Berlin
  • J Schfitz
Schfitz J. Experimentelle Untersuchungen zur Frage der antibakteriellen Prinzipien in Begonia semperflorens und Folia Uvae-Ursi. (Dissertation) FU-Berlin, 1962.
Portrait of a medicinal plant—Arctostaphylos uva-ursi (L.) spreng. The Bearberry
  • Frohne
Experimentelle Untersuchungen zur Frage der antibakteriellen Prinzipien in Begonia semperflorens und Folia Uvae-Ursi
  • Schütz