It always somewhat surprises me how some interventions never seem to die. One therapy that refuses to be put to rest, or even to be clarified, is the use of cranberry juice for urinary tract infections (UTIs). PubMed references go back to 1962, and there are over 100 references. Firm conclusions are still lacking.
There is a reasonable, but incomplete, basic science behind the use of the cranberry juice for UTIs. E. coli , the most common cause of UTIs, causes infection in the bladder by binding to the uroepithelial cells. To do this, they make fimbriae, proteinaceous fibers on the bacterial cell wall. Fimbriae are adhesins that attach to specific sugar based receptors on uroepithelial cells. Think Velcro. Being able to stick to cells is an important virulence factor for bacteria, but not a critical one — it is not the sine qua non of bladder infections.
Are all E. coli causing UTIs fimbriated? No. It is the minority of E. coli that cause UTI that have fimbria, and the presence of fimbriae may be more important for the development of pyelonephritis (kidney infection) than cystitis (bladder infection). Read more »
*This blog post was originally published at Science-Based Medicine*
I really didn’t expect to like Eat, Pray, Love. In fact, since its publication in 2006, I’d been avoiding it like the plague. “Typical new-agey, Oprah-y, girly-book,” I thought. Nothing in it to speak to me.
Then I saw the trailer for the movie, and I was hooked –- probably because I, like mostly everyone, love Julia Roberts. I immediately downloaded the book on my iPhone using the Kindle App and began to read.
First, let me say that Elizabeth Gilbert writes exceptionally well, and the book is actually a joy to read. I, of course, loved the Italy eating part. But more surprising to me, I wasn’t turned off by the whole yoga, Guru, find-yourself stuff. This is because Gilbert writes it all with a reporter’s curiosity and a skeptic’s eye, and frames it not as a belief system, but as a tool for self-discovery and peace. (Plus, I’m really good at skimming if I get bored.)
Too bad Gilbert’s curiosity and skepticism does not extend to the healthcare she receives while in Bali. She accepts the curative powers of a warm leaf placed on an oozing, infected cut without even wondering what leaf it might be or how it might have worked. Was it the heat (most likely) or something else (possibly)? I was dying to know.
She Xeroxes pages and pages of traditional medical treatments without sharing a single one with us in any meaningful way. While I’m pretty sure 99 percent of what was in there was bunk, there might be a few gems that would serve medical science. Unless Lizzie made a second copy, we’ll never know, will we?
But it was the UTI that really got to me. Read more »
*This blog post was originally published at tbtam*
A patient came into the office the other day carrying a small clipping from a reputable women’s health newsletter touting new research on an herbal remedy for urinary tract infection. Having recurrent bladder infections, my patient naturally was wondering if this was something she should try.
The article was entitled “Herbal Remedy Effective for Urinary Tract Infections” and began with this startling revelation:
The common herbal extract forskolin can greatly reduce urinary tract infections and could potentially help antibiotics kill the bacteria that cause most bladder infections.
But the article advised that the “popular” remedy was not FDA approved for this indication, so you should “ask your doctor.” Read more »
*This blog post was originally published at The Blog that Ate Manhattan*