Drink Containing Antioxidants & Lactobacillus

Influence of a drink containing different antioxidants and Lactobacillus plantarum 299v on plasma total antioxidant capacity, selenium status and faecal microbial flora.

Onning G, Berggren A, Drevelius M, Jeppsson B, Lindberg AM, Johansson Hagslatt ML.

Biomedical Nutrition, Center of Chemistry and Chemical Engineering Lund University SE-221 00 P.O. Box 124 Lund, Sweden.

The aim of the study was to investigate whether a supplement of antioxidants to subjects with a high working pace can influence the antioxidant capacity. The study was parallel and double blind with 98 subjects randomised into two groups.

One of the groups was given a test drink with antioxidants for 4 weeks (450 ml/day) while the other group took a corresponding amount of placebo drink.

The test drink contained: 2 mg beta-carotene/100 ml, 40 mg alpha-tocopherol/100 ml, 80 mg ascorbic acid/100 ml, 2 mg pyridoxine/100 ml, 15 mg magnesium/100 ml, 0.2 mg manganese/100 ml, 1 mg zinc/100 ml, 0.1 mg copper/100 ml and 10 microg selenium/100 ml.

Consumption of the test drink for 4 weeks increased the total plasma antioxidant capacity by 7% (ferric reducing ability of plasma method, P
No significant changes were found in the placebo group. The test drink also contained Lactobacillus plantarum 299v (5 x 10(7) cfu/ml) and 4 weeks’ consumption led to a significant increase of Lb. plantarum 299v in the faeces.

In conclusion, consumption of a drink rich in different antioxidants can increase the antioxidant capacity in subjects with a high working pace. This can be valuable since it may increase the protection against reactive oxygen radicals.

Int J Food Sci Nutr. 2003 Jul;54(4):281-9.

Canada: Clinical Practice Guidelines

CANADA: Clinical practice guidelines for the care and treatment
of breast cancer: The management of ductal carcinoma in situ
[10/03/2001; Canadian Medical Association Journal]

This article provides a summary of changes made by Health Canada’s
Steering Committee on Clinical Practice Guidelines for the Care
and Treatment of Breast Cancer to the article “Clinical practice
guidelines for the care and treatment of breast cancer: 5.

The
management of ductal carcinoma in situ (DCIS),” originally published
in 19981 (the 2001 update can be found online). Although there
are not many changes to the guideline, new studies have provided
more evidence to support the original recommendations.

DCIS of the breast is a proliferation of malignant-appearing cells
of the ducts and terminal lobular units of the breast that have
not breached the ductal basement membrane. Since more women are
having screening mammography, DCIS is being diagnosed more frequently.
In 1996, over 200000 Canadian women aged 50-69 participated
in 7 provincial screening programs. Of the 991 cancers detected,
171 were DCIS (17%, or 0.8 cases per 1000 women screened).

DCIS
can be considered a precursor of invasive breast cancer and,
if left untreated, can develop into invasive disease in up to
35% of cases within 10 years.

Again the steering committee emphasizes the importance of careful
surgical removal of the area of DCIS and attention to meticulous
pathological processing and reporting. The most clinically useful
factors in terms of predicting local recurrence of the DCIS and
progression to invasive cancer are nuclear grade, presence of
necrosis, involvement of surgical margins and lesion size.

The original guideline recommended mastectomy, breast-conserving
surgery (BCS) plus radiotherapy or BCS alone as treatment options
for DCIS, and this recommendation has not changed substantially.

The use of breast irradiation after BCS was supported by the
results of 1 randomized trial in the 1998 guideline. A report
has since been published of a second randomized trial, in which
the European Organisation for Research and Treatment of Cancer
randomly assigned 1010 women with DCIS to either BCS or BCS plus
breast irradiation.

At a median follow-up of 4 years, the rate
of local recurrence was significantly lower in the group treated
by BCS plus radiotherapy than in the group treated by BCS alone
(9% v. 16%, p = 0.005). The survival rate was 99% in both groups.

A large retrospective study has emphasized the importance of
ensuring that there is a wide rim of normal tissue around the
excised tumour if there is consideration that a woman treated
with BCS might not have radiotherapy. The steering committee
feels that it is difficult to identify patients at such a low
risk of breast cancer recurrence that radiotherapy could be omitted
after BCS even though in such women the risk reduction in absolute
terms associated with radiotherapy may be small.

The 1998 guideline
stated that “omission of radiotherapy may be considered when
lesions are small and low grade, and when pathological assessment
shows clear margins.” The updated recommendation states
that “BCS should usually be followed by radiotherapy. Patients
with a sufficiently low risk of local recurrence with BCS alone
are difficult to identify.

However, BCS alone may be considered
after a careful discussion with the patient, if detailed pathological
assessment confirms that the lesion is small and does not have
high-grade nuclei or comedo-type necrosis and the surgical margins
are clear of disease. In addition, in such circumstances the
surgical excision should be cosmetically acceptable.”

In 1998 the steering committee concluded that evidence was not
available to support the use of tamoxifen in the treatment of
women with DCIS. Since then, the results were published of the
National Surgical Adjuvant Breast Project B-24 trial, in which
1804 women with DCIS who received BCS plus radiotherapy were
randomly assigned to receive tamoxifen or placebo.

At 5 years
the incidence of invasive breast cancer was significantly lower
in the tamoxifen group than in the placebo group (4.1% v. 7.2%,
p = 0.004); the corresponding incidence rates of recurrent DCIS
were 4.2% and 6.2% (p = 0.08). Tamoxifen can be associated with
side effects.

The updated recommendation for DCIS states that “the
role of tamoxifen in the management of patients with DCIS continues
to evolve.

The potential benefits and risks should be discussed
with patients.”

Dried Garlic Powder Tablets Efficacy

Effect of dried garlic powder tablets on postprandial increase in pulse wave velocity after a fatty meal: preliminary observations

Beate Turner A1, Christian Mølgaard , Peter Marckmann A2

A1 Department of Human Nutrition and Centre for Advanced Food Studies The Royal Veterinary and Agricultural University Frederiksberg Denmark
A2 Present affiliations: Dansk Droge Ishøj Denmark
A3 Department of Internal Medicine Roskilde Hospital Roskilde Denmark

Abstract:

Background : Garlic and sulfur-containing components of garlic have been reported to stimulate nitric oxide synthesis in the endothelium. Nitric oxide production is an important determinant of arterial stiffness.

Objective : To examine the impact of dried garlic powder tablets on arterial stiffness as assessed by measurements of pulse wave velocity (PWV).

Design : Two separate randomized cross-over studies of healthy people (trial I: n=13; trial II: n=9) were conducted. On separate days, participants consumed a high-fat meal (50 g fat) supplemented with garlic powder tablets (8.4 mg alliin), and an identical, but unsupplemented meal. PWV (m s−1) was measured immediately before and 2-3 h after the test meal.

Results : The unsupplemented fatty meal resulted in a significant 5-6% postprandial increase in PWV in both trials (I: +0.19 m s−1, p=0.04; II: +0.21 m s−1, p=0.02). In contrast, the supplemented meal was not associated with any postprandial PWV changes in either trial (I: −0.02 m s−1, p=0.31; II: 0.00 m s−1, p=0.95). In pooled analysis (trials I and II), the inhibitory effect of garlic powder on the fatty meal-induced postprandial PWV increase was statistically significant (+0.20 m s−1 vs −0.01 m s−1, p=0.01).

Conclusions : The postprandial increase in PWV associated with consumption of a high-fat meal seems to be prevented by dried garlic powder supplementation. Larger, blinded and placebo-controlled trials are needed to confirm the possible antiatherogenic effect.

Scandinavian Journal of Nutrition

Issue: Volume 49, Number 1 / March 2005
Pages: 21 – 26
DOI: 10.1080/11026480510011343

Dr. Chaber Responds to Criticism

“The Patient Failed Chemotherapy” …an Expunged Phrase

Bruce Chabner, M.D.

Editor-in-Chief, The Oncologist, Clinical Director, Massachusetts General Hospital Cancer Center, Harvard University, Chief Medical Officer, Dana-Farber/Partners Cancer Care

FROM THE EDITOR:

Our reader, Karen Parles, points out an important, and unfortunate, mistaken use of the word “failure” in my recent editorial, describing a patient’s lack of response to Iressa therapy [1]. The failure of treatment is not the patient’s fault in any regard.

The fault lies with the current state of science, and our understanding of the disease. The convenient phrase “failure,” so often used in our society to describe an unhappy outcome beyond the control of the individual, has no place in the context of unsuccessful treatment of a disease such as cancer.

I apologize for myself and my colleagues, who so often confuse outcome with intent, and I thank Karen Parles for raising our consciousness to the all-important use and impact of our words.

I assure her that I have expunged “that phrase” from my vernacular … and I urge my colleagues to do likewise.

Bruce Chabner, M.D.

Editor-in-Chief, The Oncologist

Clinical Director, Massachusetts General Hospital Cancer Center

Harvard University

Chief Medical Officer, Dana-Farber/Partners Cancer Care

REFERENCE

Chabner, BA. The Miracle of Iressa. The Oncologist 2004;9:245–246.