Employee Retention at Target Health

 

 

The following staff and consultants have been at Target Health at least 10 years. As a company, we recognize that it is a well-oiled team that makes it all happen and that experience and knowledge of employees and staff is what drives the engine.

 

We are very proud of the best team in the industry. The date indicates the year started at THI.

 

1.  Joyce Hays – 1993
2.  Jules Mitchel – 1993
3.  Mui Ying Kwan – 1995
4.  Daisy Sun – 1996
5.  Ralph D’Agostino, Jr. – 1997 (consultant; biostatistics)
6.  Yong Joong Kim – 1999
7.  Otto Mills – 1999 (consultant, dermatology)
8.  Laura Suciu – 2000
9.  Kevin Kim – 2000
10. Mimi Yu – 2000
11. Violet Arlequin – 2000
12. Joonhyuk Choi – 2001
13. Timothy Cho – 2002
14. Leigh Ren – 2002

 

For more information about Target Health contact Warren Pearlson (212-681-2100 ext. 104). For additional information about software tools for paperless clinical trials, please also feel free to contact Dr. Jules T. Mitchel or Ms. Joyce Hays. The Target Health software tools are designed to partner with both CROs and Sponsors. Please visit the Target Health Website at www.targethealth.com

Urinary Tract Infection (UTI)

 

 

The urinary tract is comprised of the kidneys, ureters, bladder, and 1) ___. A urinary tract infection (UTI) is an infection caused by pathogenic organisms (for example, bacteria, fungi, or parasites) in any of the structures that comprise the urinary tract. UTIs are common, leading to between seven and ten 2) ___ doctor visits per year. Although some infections go unnoticed, UTIs can cause problems that range from dysuria (pain and/or burning when urinating) to organ damage and even death.

 

The 3) ___ are the active organs that produce about 1.5 quarts of urine per day. They help keep electrolytes and fluids (for example, potassium, sodium and water) in balance, assist in the removal of waste products (urea), and produce a hormone that aids in the formation of red blood cells. If kidneys are injured or destroyed by infection, these vital functions can be damaged or lost.

 

While most doctors state that UTIs are not transmitted from person to person, other investigators dispute this and say UTIs may be contagious and recommend that 4) ___ partners avoid relations until the UTI has cleared. There is general agreement that intercourse can cause a UTI. This is mostly thought to be a mechanical process whereby bacteria are introduced into the urinary tracts during the sexual act. There is no dispute about the transmission of UTIs caused by 5) ___ ___ ___ (STD) organisms; these infections (for example, gonorrhea and chlamydia) are easily transmitted between consenting partners and are very contagious. Some of the symptoms of UTIs and STDs can be similar (pain and foul smell).

 

Some studies suggest that cranberries can help to prevent UTI, but not treat a UTI infection, and is more effective in young and middle-aged women. Cranberries contain a substance that prevents E. coli bacteria from sticking to the walls of the bladder. If you don’t like the taste of 6) ___ juice, capsules or tablets may work, too. People with a history of kidney stones should check with a doctor, first.

 

 

The most common causes of UTI infections (about 80%) are E. coli bacterial strains that usually inhabit the 7) ___. However, many other bacteria can occasionally cause an infection (for example, Klebsiella, Pseudomonas, Enterobacter, Proteus, Staphylococcus, Mycoplasma, Chlamydia, Serratia and Neisseria spp.), but are far less frequent causes than E. coli. In addition, fungi (Candida and Cryptococcus spp.) and some parasites (Trichomonas and Schistosoma) also may cause UTIs; Schistosoma causes other problems, with bladder infections as only a part of its complicated infectious process. In the U.S., most infections are due to Gram-negative bacteria with E. coli causing the majority of 8) ___.

 

There are many risk factors for UTIs. In general, any interruption or impedance of the usual flow of 9) ___ (about 50 cc per hour in normal adults) is a risk factor for a UTI. For example, kidney stones, urethral strictures, an enlarged prostate, or any anatomical abnormalities in the urinary tract increases infection risk. This is due in part to the flushing or washout effect of flowing urine; in effect, the pathogens have to “ go against flow” because the majority of 10) ___ enter through the urethra and have to go retrograde (against a barrier of urine flow in the urinary tract) to reach the bladder, ureters, and eventually the kidneys.

 

ANSWERS: 1) urethra; 2) million; 3) kidneys; 4) sex; 5) sexually transmitted disease; 6) cranberry; 7) colon; 8) infections; 9) urine; 10) pathogens

Joseph E. Murray MD (1919 – )

 

I was just a member of the team, and I was delighted to be there at the right time. I am very pleased to be recognized, but it’s not the be all and end all. I am right in the middle of reading Alexander Pope’s Essay on Man. It’s about how everyone shares happiness, the beauty of the flowers and the sky. I think really we live in Eden, if we’re only smart enough to know it.”

 

 

Joseph E. Murray MD was awarded the 1990 Nobel Prize for Physiology or Medicine for performing the first kidney transplant in 1954. This work opened the entire field of organ transplantation and stimulated scientific investigation that led to the understanding of the biological phenomenon whereby the human body rejects ‘foreign’ tissue. The work of Murray and his colleagues at The Peter Bent Brigham Hospital in Boston was some of the most important work ever done in clinical medicine. Murray is among an elite group of surgeons to ever win the Nobel Prize. Others were Frederick Banting and Alexis Carrel. Carrel’s work on suturing blood vessels in a sense made Murray’s advances possible so Murray and Carrel are linked forever in history

 

Joseph Murray, MD, was one of the surgeons who headed the first successful human kidney transplant without the problem of immune rejection in the 1940s at the Peter Bent Brigham Hospital in Boston meeting the challenges of human organ transplantation. Brigham-based Ronald Herrick was the one who donated his kidney to his identical twin brother, Richard Herrick, who was having renal failure.

 

Dr. Joseph Murray and the medical team at Boston’s Peter Bent Brigham Hospital perform the first successful long-term organ transplant, Dec. 23, 1954.

 

In 1954, Before this historic transplant surgery took place, Dr. John P. Merrill (left) explains the workings of a then-new machine called an artificial kidney to Richard Herrick (middle) and his brother Ronald (right). The Herrick twin brothers were the subjects of the world’s first successful kidney transplant, Ronald being the donor.

 

Ten months after the transplant, Ronald Herrick (left) and his identical twin Richard toast their good health.

 

Photo: Joseph Shapiro, NPR
In July 2004, transplant pioneer Dr. Joseph Murray (left), 85, was reunited with his first organ donor, Ronald Herrick, 73, at the U.S. Transplant Games in Minneapolis. Richard Herrick died eight years after his kidney transplant.

                                  

 

 

Murray’s first patient and donor were identical twins. They had to be or the recipient’s immune system would reject the donated organ. It would be years before doctors figured out ways to trick the immune system. Ronald Herrick was a healthy 23-year-old who had just been discharged from the Army. His twin brother Richard had just gotten out of the Coast Guard – and was in a hospital, dying of kidney disease. Ronald Herrick says going through with the then-untried medical procedure was a difficult decision, but when Richard tried to call off the operation the night before surgery, Ronald stood firm. On December 23, 1954, Richard Herrick became the first human to receive a successful organ transplant when he was given a kidney from his identical twin brother, Ronald. Today, over 50,000 organ transplants are done yearly in the United States, with 75% of them involving kidneys.

 

After receiving his medical degree from Harvard in 1943, Murray took a surgical internship at a Harvard-affiliated hospital, Peter Bent Brigham Hospital (now Brigham and Women’s Hospital) in Boston. In 1944, he was given a commission in the U.S. Army Medical Corps and served at Valley Forge General Hospital in Pennsylvania as a plastic surgeon under James Barrett Brown and Bradford Cannon. Murray performed over 1,800 surgeries during this period, specializing in the reconstruction of hands and eyes of burn victims. In the 1940s, allografting was not a permanent solution because the patient’s body would soon reject the foreign skin and it would fall off. Murray’s mentor, Brown, had studied this problem in the 1930s and discovered that the only allografts that were successful were those between identical twins. At that time, the common theory of organ rejection, proposed by French surgeon Alexis Carrel, suggested that the body attacked foreign tissue or skin as if it were fighting off, or resisting, a disease.

 

In 1947, Murray left military life and returned to Boston’s Brigham and Women’s Hospital. He became a member of the hospital’s team of doctors studying end-stage renal (kidney) disease. One of the processes this team was studying was the practice of kidney transplantation. He soon won a reputation among his colleagues for his neck and head surgical reconstructions on cancer patients as well as gaining recognition for the field of plastic surgery. His assignment within the Brigham group, however, was to find a competent surgical procedure for kidney transplants. After working on dogs for many years, he gradually developed a technique that is still used today of placing the transplanted organ in the lower abdomen. Before then, no one knew how long a kidney would be able to survive outside the body or the complicated surgical techniques of attaching a donated kidney to the recipient’s blood vessels and extremely precise urinary system.

 

Murray and the Brigham team had their first chance at a successful kidney transplant in 1954. A patient who was suffering with kidney failure had an identical twin brother who was willing to donate one of his kidneys. Even after fifteen previous failures in which the transplanted organ was rejected within hours or days, Murray felt that the transplant was the only way to save the man’s life. The doctors in the team consulted the clergy and were even granted a special decree from the Massachusetts Supreme Court that allowed the operation to proceed. The operation was a success and the patient lived eight additional years before dying from congestive heart failure brought on by the same kidney disease that had necessitated the transplant.

 

Over time, Murray shifted the focus of his research to study the body’s immune system, which would attack a foreign transplanted organ as an invader. He eventually developed drugs and techniques to reduce the body’s own fight against transplanted organs and thus curb the rejection of those organs. He began studying transplants in fraternal twins, often using low doses of X-rays to help suppress the patient’s immune system. It was also during this period that Murray had one of his greatest successes in transplantation with the longest-living kidney transplant recipient, Edith Helm. Helm received a kidney from her sister in May of 1956 and continued to correspond with Murray into the 1990s. During the 1950s, significant advances were being made in pharmaceutical research, especially in the area of manipulating the immune system. In 1951 two scientists out of the Burroughs Wellcome Research Laboratories developed a drug called 6-MP (6-mercaptopurine). Initially used to treat leukemia, a form of cancer, 6-MP was found to inhibit the immune system from reacting to a foreign substance in the body. Later tests by British researcher Roy Calne and Boston hematologists Robert Schwartz and William Dameshek of kidney transplants in dogs using 6-MP found that the drug reduces the body’s rejection of transplanted organs. The two scientists from Burroughs, Gertrude B. Elion and George H. Hitchings Jr., were awarded the Nobel Prize in 1988 for their work.

 

In 1961, Murray and other researchers at Brigham (including Elion, Hitchings and Calne, who had moved to Boston to collaborate with Murray) developed Imuran (azathioprine), an immunosuppressive drug still in use today. The next year, they used the drug successfully for the first time in a kidney transplant from an unrelated donor. This was the first time an operation of this type had worked. By 1965, the survival rates after receiving a kidney transplant from an unrelated donor were exceeding 65%. Later drugs, including cyclosporine and FK-506, pushed the survival rate even farther using the basic principles developed by Murray and his team at Brigham. As Murray’s successes rapidly became known worldwide, other physicians began experimenting with organ transplantation.

 

Beginning with his days working on burned soldiers at Valley Forge General Hospital, Murray continued to develop his interest and skills in plastic surgery. After working primarily in the field of organ transplantation for years, he switched back to plastic surgery. One of his most notable efforts in this field involved children, specifically devising new ways to correct inborn facial defects. From 1951 to 1986 he worked in the plastic surgery division of Brigham and Women’s Hospital, retiring as chief of plastic surgery. During that same period, from 1972 to 1985, he also served as a plastic surgeon at Children’s Hospital Medical Center in Boston. Murray retired from active surgery at Brigham in 1986 but remained on staff as chief emeritus of plastic surgery at Brigham. He has also been on the staff at Harvard University since 1970 as a professor of surgery.

 

An Interview with Dr. Joseph Murray, Organ Transplant Pioneer

 

Q: This is the 50th anniversary of the first successful organ transplant, which you performed. How do you feel about this personal achievement?

Dr. Murray: John Wooden, the UCLA coach said the secret of stardom is the rest of the team. It was teamwork. We had a wonderful group at the Brigham. It started with Dr. George Thorn, who was the chief of medicine. Dr. Frank Moore came on as chief of surgery. Thorn and Moore were really the leaders of the group. John Merrill was the nephrologist and Dr. J. Hartwell Harrison was the urologist. Dr. Gus Dammin was the pathologist. The dean of the medical school and the administration were behind us. So the whole hospital was geared for the project. We had good leadership. I was the surgeon.

Q: But you were the leader in terms of the actual transplant.

Dr. Murray: Oh, yes. As far as actually taking responsibility for the patient and getting things all ready. I did all lab work for two years, perfecting the operation, because before that time there had been sporadic attempts at kidney transplants in Europe and in this country. Because of my [World War Two] experience, I had seen skin grafts from other people disappear and wondered why. So when I got back to Brigham, I got into the lab and worked with the group, because I realized a kidney after transplant had to survive on its own. So I swapped kidneys in dogs until I got the technique down.

Q: What made you go ahead with the transplant? Was it because you had found identical twins?

Dr. Murray: We had a laboratory model of a transplanted kidney without any immunological barrier. That is, we took a kidney out of a dog, put it on the operating table, and then transferred it to different parts of the same dog. And we found out a good place for it to fit. So therefore we had this solid laboratory evidence that a transplanted kidney, in the absence of immune problems, could function. And then on our doorstep, we happened to have had identical twins. One was dying of kidney disease, the other one was healthy. It was the perfect human setup for our laboratory model.

Q: You spoke earlier about the need for suppressing the immune system as being one of the biggest challenges you faced, starting with skin grafting. So how do you think the commercial approval of cyclosporine in 1983 affected the progress of transplantation?

Dr. Murray: It was a tremendous boost. Imuran [the immunosuppressive drug azathioprine] and steroids were the two keys before that. But Cyclosporine notched it up. It was sort of like putting extra juice in the gas tank, I guess. It led the way to other organ transplants. So it was big boost.

Q: As a surgeon, you were world-renowned for both transplantation and reconstruction. But after your success with transplantation, why didn’t you stick with it?

Dr. Murray: I did not want to be a transplant surgeon, per se. I loved surgery; I loved reconstruction, taking care of children with congenital anomalies. I loved cancer work; I worked at Sloan-Kettering, at Memorial Hospital, for six months. I said to my boss that I was delighted with what I had done but that I was anxious to spend most of my time on reconstructive surgery, mostly with children and cancer patients. So we spent two years training a couple of surgeons to take up after me. So after ten years, I gave up transplantation.

Q: So do you think there is a link between your surgery in transplantation and reconstruction?

Dr. Murray: Oh sure. It’s just repair. The link is taking care of patients. I went to medical school to be a doctor purely to take care of patients. I’ve operated on six continents, and each person is the same. The liver’s in the same place, the kidney, the heart. So, as a fellow human, I feel very much part of humanity, I guess.

Q: My final question: How do you feel about being called the “father” of organ transplantation?

Dr. Murray: Well, people have said that. I was just a member of the team, and I was delighted to be there at the right time. I am very pleased to be recognized, but it’s not the be all and end all. I am right in the middle of reading Alexander Pope’s Essay on Man. It’s about how everyone shares happiness, the beauty of the flowers and the sky. I think really we live in Eden, if we’re only smart enough to know it.”

 

 

 

MOLECULAR BIOLOGY – Dark Matter DNA Active in the Brain During Day-Night Cycle

Dark Matter DNA Active in the Brain During Day-Night Cycle

 

According online in the Proceedings of the National Academy of Sciences (22 September 2012), long stretches of DNA once considered inert dark matter appear to be uniquely active in a part of the brain known to control the body’s 24-hour cycle. Working with material from rat brains, the authors found some expanses of DNA contained the information that generate biologically active molecules. The levels of these molecules rose and fell, in synchrony with 24-hour cycles of light and darkness. Activity of some of the molecules peaked at night and diminished during the day, while the remainder peaked during the day and diminished during the night. The material came from the brain structure known as the pineal gland. Located in the center of the human brain, the pineal gland helps regulate the body’s responses to day and night cycles. In the evenings and at night, the pineal gland increases production of melatonin, a hormone that synchronizes the body’s rhythms with the cycle of light and dark. In many species, the pineal gland also plays a role in seasonally associated behaviors, such as hibernation and mating, as well as in sexual maturation.

 

The biologically active material arising from the pineal gland DNA is called long noncoding RNA (lncRNA). The lncRNA is distinct from the better-known messenger RNA (mRNA), which serves as a kind of template to translate the information contained in DNA for the manufacturing of proteins. The lncRNAs appear instead to be involved in activating, blocking or altering the activity of genes or influencing the function of the proteins, or acting as scaffolds for the organization of complexes of proteins. The authors’ use of next-generation sequencing methods detected the lncRNA activity in addition to the mRNA they originally targeted, which helped them in making their discovery.

 

To conduct the study, the authors examined RNA from the pineal glands of rats exposed to cycles of 14 hours of light and 10 hours of darkness. The authors identified 112 lncRNAs with 24 hour cycles. For nearly 60% of these lncRNAs, the rats’ DNA produced twice as many lncRNA molecules at night as during the day. In addition, nearly 90% of the lncRNAs were produced in significantly greater quantities in the pineal gland than in other tissues of the body, most of which did not have detectable levels of these lncRNAs. The authors also disrupted the rats’ regular day-night light cycle by turning on a light during a typical dark period. Within 30 minutes of the light going on, most of the lncRNAs decreased by half.

 

The role of the pineal gland lncRNAs is unclear; however, they have circadian patterns of activity. The authors previously documented hundreds of genes in the pineal gland with consistent day-night cycles of activity.

 

According to the authors, the lncRNAs show such strong activity, they obviously have something to tell us about the biology of daily body rhythms, but we are only beginning to understand how the pineal gland helps maintain the body’s 24 hour rhythms.

 

 

 

PEDIATRICS – Perioperative Dexamethasone and Bleeding Risk Following Tonsillectomy

Perioperative Dexamethasone Administration and Risk of Bleeding Following Tonsillectomy in Children

 

Corticosteroids are commonly given to children undergoing tonsillectomy to reduce postoperative nausea and vomiting; however, they might increase the risk of perioperative and postoperative hemorrhage. As a result, a study published in the Journal of the American Medical Association (2012;308:1221-1226), was performed to determine the effect of dexamethasone on bleeding following tonsillectomy in children.

 

The investigation was a multicenter, prospective, randomized, double-blind, placebo-controlled study at 2 tertiary medical centers of 314 children aged 3 to 18 years undergoing tonsillectomy. Study subjects had no history of a bleeding disorder or recent corticosteroid medication use. The study was conducted between July 15, 2010, and December 20, 2011, with 14-day follow-up. The hypothesis to be tested was that dexamethasone (0.5 mg/kg; maximum dose, 20 mg) would not result in 5% more bleeding events than placebo (0.9% saline) using a non-inferiority statistical design.

 

The main outcome measure were the rate and severity of post-tonsillectomy hemorrhage in the 14-day postoperative period using a bleeding severity scale (level I, self-reported or parent-reported postoperative bleeding; level II, required inpatient admission for postoperative bleeding; or level III, required reoperation to control postoperative bleeding).

 

One hundred fifty-seven children (median, 6 years) were randomized into each study group. Results showed that 17 patients (10.8%) in the dexamethasone group and 13 patients (8.2%) in the placebo group reporting bleeding events. In an intention-to-treat analysis, the rates of:

 

  1. level I bleeding were 7.0% (n = 11) in the dexamethasone group and 4.5% (n = 7) in the placebo group; (P for non-inferiority < 0.17)
  2. level II bleeding were 1.9% (n = 3) and 3.2% (n = 5); (P for non-inferiority < 0.001)
  3. level III bleeding were 1.9% (n = 3) and 0.6% (n = 1); (P for non-inferiority = 0.002)

 

According to the authors, perioperative dexamethasone administered during pediatric tonsillectomy was not associated with excessive, clinically significant level II or III bleeding events based on not having crossed the non-inferior threshold of 5%. Increased subjective (level I) bleeding events caused by dexamethasone could not be excluded because the non-inferiority threshold was crossed.

Indirect Effects of Elevated Body Mass Index on Memory Performance Through Altered Cerebral Metabolite Concentrations

 

Elevated body mass index (BMI) at midlife is associated with increased risk of cognitive decline in later life. As a result, a study published in Psychosomatic Medicine September (2012;74:691-698), was performed to assess mechanisms of early brain vulnerability by examining if higher BMI at midlife affects current cognitive performance through alterations in cerebral neurochemistry.

 

For the study, 55 participants, aged 40 to 60 years, underwent neuropsychological testing, health screen, and proton magnetic resonance spectroscopy examining N-acetylaspartate, creatine (Cr), myo-inositol (mI), choline, and glutamate concentrations in occipitoparietal gray matter. Concentrations of N-acetylaspartate, choline, mI, and glutamate were calculated as a ratio over Cr and examined in relation to BMI using multivariate regression analyses. Structural equation modeling was used to determine if BMI had an indirect effect on cognition through cerebral metabolite levels.

 

Results showed that higher BMI was associated with elevations in mI/Cr (p = .006), independent of age, gender, fasting glucose levels, and systolic blood pressure. Moreover, BMI had an indirect effect on global cognitive performance (p < 0.001). Subsequent follow-up analyses revealed that this effect was specific to memory (p < 0.001).

 

According to the authors, a higher BMI was associated with elevations in mI/Cr concentrations in the occipitoparietal gray matter and indirectly related to poorer memory performance through mI/Cr levels, potentially implicating plasma hypertonicity and neuroinflammation as mechanisms underlying obesity-related brain vulnerability.

TARGET HEALTH excels in Regulatory Affairs. Each week we highlight new information in this challenging area

 

 

New FDA Task Force Will Support Innovation in Antibacterial Drug Development

 

 

More than 70% of the bacteria that cause hospital-associated infections (HAIs) are resistant to at least one type of antibacterial drug most commonly used to treat these infections. In the United States, nearly 2 million Americans developed HAIs in 2002, resulting in about 99,000 deaths.

 

Research and development for new antibacterial drugs has been in decline in recent decades, and the number of new FDA-approved antibacterial drugs has been falling steadily since the 1980s. During this time, the persistent and sometimes indiscriminate use of existing antibacterial drugs worldwide has resulted in a decrease in the effectiveness of these drugs. This phenomenon, known as antibacterial drug resistance or antibiotic resistance, has become a serious issue of global concern.

 

The FDA has announced the formation of an internal task force that will support the development of new antibacterial drugs, a critical public health care goal and a priority for the agency. As part of its work, the Antibacterial Drug Development Task Force will assist in developing and revising guidance related to antibacterial drug development, as required by the Generating Antibiotic Incentives Now (GAIN) Title of the Food and Drug Administration Safety and Innovation Act (FDASIA), signed into law on July 9, 2012.

 

The task force is a multi-disciplinary group of 19 CDER scientists and clinicians who will use existing partnerships and collaborations to work with other experts in the field, including from academia, industry, professional societies, patient advocacy groups, and government agencies, to identify priority areas and develop and implement possible solutions to the challenges of antibacterial drug development. The task force plans to:

 

1. Explore novel scientific approaches to facilitate antibacterial drug development, like the broader use of clinical pharmacology data, statistical methods, innovative clinical trial designs, use of additional available data sources, and the advancement of alternative measures to evaluate clinical effectiveness of potential new therapies;

 

2. Identify issues related to unmet medical needs for antibacterial drugs, reasons for the lack of a robust pipeline for antibacterial drug development, and new approaches for weighing the risks, benefits, and uncertainties of potential new antibacterial drugs;

evaluate existing FDA guidances related to antibacterial drug development, determine if revision or elaboration is needed, and identify areas where future guidance would be helpful, as set forth in the GAIN Title of FDASIA; and

 

3. Use existing collaborative agreements to work with think tanks and other thought leaders to explore various approaches that could enable antibacterial drug development, including innovative study designs and statistical analytical methods.

 

“ By establishing this task force, FDA can help make real progress and change the paradigm,” said Rachel Sherman, M.D., associate director for Medical Policy in CDER, director of CDER’s Office of Medical Policy and co-chair of the task force. “ Our hope is that this effort will result in important new breakthroughs in the field of antibacterial drug development and help in the fight against antibiotic resistance.”

 

The task force is part of FDA’s efforts to promote antibacterial drug development and combat antibiotic resistance. Over several years, the agency has provided guidance to industry and hosted public workshops and meetings to address and discuss scientific challenges in the field of antibacterial drug development. The FDA also plays a key role in working with other federal agencies to implement a national plan to address antibiotic resistance.

For more information: go to the Antibacterial Drug Development Task Force Roster

Broccoli Salad with Cashews and Cranberries

 

 

Ingredients

 

2 stalks of broccoli, stalks peeled, chopped roughly, then steam for a few minutes

1/2 cup red onion, chopped very fine

1/2 cup dried cranberries

1 cup cashews, roasted and chopped

3 Tablespoons Kraft mayonnaise ( or low-cal, low-fat)

3 Tablespoons plain yogurt (we like FAGE Greek yogurt)

1 1/2 Tablespoons fresh lemon juice

1 teaspoon brown sugar substitute (optional)

1/2 teaspoon salt (optional)

1/8 teaspoon pepper

1 Level Tablespoon Dijon prepared mustard or less if powdered

 

Directions

 

* If you want to roast your own nuts, do that first and lightly coat them in 1 teaspoon of olive oil for 1 cup cashew pieces, (optional salt) and put in a 350 F oven for about 10 minutes.

 

1) In a small bowl whisk together mayonnaise, yogurt, lemon juice, brown sugar substitute (if using), salt (optional), pepper, and mustard and set aside.

2) In your large salad bowl for serving later, mix together the broccoli, onions, cranberries, and cashews.

3) Pour the dressing over the broccoli mix and stir well. Let rest on the counter for 30 minutes or in the fridge for an hour before serving. We don’t like cold salad, so we just leave it out until we’re ready to eat.

 

Eat the same day, because the nuts get soggy and don’t have the same crispy crunch the next day.  However, this salad is so good we guarantee there will be no left-overs.  We made it last night and it was truly delicious.

 

We like a warm hearty grainy bread with this salad and a smooth sexy smoky-oaky Sauvignon Blanc. A nice compliment would be a warm delicious butternut squash soup and/or your best poultry dish (think quail). Seriously, we will post a succulent quail recipe just as soon as we improve on what we now have. We had the most mouth-watering quail last August in Santa Fe, NM that was to die for. We’re still trying to duplicate it here in Manhattan, but not quite there yet.

 

Ripe Sauvignon Blanc grapes

 

 

Cheers!