Target Health Software Suite and the Paperless Clinical Trial

 

Properly designed software can make our lives more efficient and improve workflows and processes. Starting in 1999, Target Health has been committed to being the best and most productive CRO by combining the talents of our clinical development teams and software. Target Studio™ is our flagship product that allows users to configure EDC applications using a graphic user interface (GUI) and when needed, advanced programming. Once a trial is up and running, there is only one website to go to in order to manage the clinical trial. Target e*Informed Consent™ (coming very soon) and Target e*PRO (released) allow the clinical site to manage study subject accounts and for subjects to enter data and yes, sign electronically.

 

What makes us different is that not only do we have the software, we have the know-how and skills to get products to the market. In other words, we have to put our money where our mouth is.

 

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Can You Find the Buzzing Bee in Central Park (NYC)?

 

Hidden in the flower is the miraculous Bee doing it’s thing. Can you find it?

 

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Buzzing Bee in Central Park©Target Health Inc. 2015

 

ON TARGET is the newsletter of Target Health Inc., a NYC-based, full-service, contract research organization (eCRO), providing strategic planning, regulatory affairs, clinical research, data management, biostatistics, medical writing and software services to the pharmaceutical and device industries, including the paperless clinical trial.

 

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.

 

Joyce Hays, Founder and Editor in Chief of On Target

Jules Mitchel, Editor

QUIZ

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Red Blood Cell Diseases

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Effect of Osmotic Pressure on Red Blood Cells

 

Affected by Sickle-cell disease, red blood cells alter shape and threaten to damage internal organs. Blood diseases involving the red blood cells include the following:

 

Anemias which are diseases characterized by low 1) ___ transport capacity of the blood, because of low red cell count or some abnormality of the red blood cells or the hemoglobin. Iron deficiency anemia is the most common anemia; it occurs when the dietary intake or absorption of 2) ___ is insufficient, and hemoglobin, which contains iron, cannot be formed

Sickle-cell disease is a 3) ___ disease that results in abnormal hemoglobin molecules. When these release their oxygen load in the tissues, they become insoluble, leading to misshaped red blood cells. These sickle shaped red cells are less deformable and viscoelastic meaning that they have become rigid and can cause blood vessel blockage, pain, strokes, and other tissue damage.

Thalassemia is a genetic disease that results in the production of an abnormal ratio of hemoglobin subunits.

Hereditary spherocytosis syndromes are a group of inherited disorders characterized by defects in the red blood cell’s cell membrane, causing the cells to be small, sphere-shaped, and fragile instead of donut-shaped and flexible. These abnormal red blood cells are destroyed by the spleen. Several other hereditary disorders of the red blood cell membrane are known.

Pernicious anemia is an autoimmune disease wherein the body lacks intrinsic factor, required to absorb vitamin B12 from 4) ___. Vitamin B12 is needed for the production of hemoglobin.

Aplastic anemia is caused by the inability of the bone marrow to produce blood cells.

Pure red cell aplasia is caused by the inability of the bone 5) ___ to produce only red blood cells.

 

Hemolysis is the general term for excessive breakdown of red blood 6) ___. It can have several causes and can result in hemolytic anemia. The malaria parasite spends part of its life-cycle in red blood cells, feeds on their hemoglobin and then breaks them apart, causing fever. Both sickle-cell disease and thalassemia are more common in malaria areas, because these mutations convey some protection against the parasite. Polycythemias (or erythrocytoses) are diseases characterized by a surplus of red blood cells. The increased 7) ___ of the blood can cause a number of symptoms. In polycythemia vera the increased number of red blood cells results from an abnormality in the bone marrow. Hemolytic transfusion reaction is the destruction of donated red blood cells after a transfusion, mediated by host antibodies, often as a result of a blood type mismatch.

 

Several blood tests involve red blood cells, including the RBC count (the number of red blood cells per volume of blood), the hematocrit (percentage of blood volume occupied by red blood cells), and the erythrocyte sedimentation rate. Many diseases involving red blood cells are diagnosed with a blood film (or peripheral blood smear), where a thin layer of blood is smeared on a microscope 8) ___. The blood type needs to be determined to prepare for a blood transfusion or an organ transplantation. The spleen acts as a reservoir of red blood cells, but this effect is somewhat limited in humans. In some other mammals such as dogs and horses, the spleen sequesters large numbers of red blood cells which are dumped into the blood during times of exertion stress, yielding a higher oxygen transport capacity.

 

Human erythrocytes are produced through a process named erythropoiesis, developing from committed stem cells to mature erythrocytes in about 7 days. When matured, in a healthy individual these cells live in blood circulation for about 100 to 120 days (and 80 to 90 days in a full term infant). At the end of their lifespan, they become senescent, and are removed from circulation. In many chronic diseases, the lifespan of the erythrocytes is markedly reduced. Erythropoiesis is the development process by which new erythrocytes are produced; it lasts about 7 days. Through this process erythrocytes are continuously produced in the red bone marrow of large 9) ___, at a rate of about 2 million per second in a healthy adult. The functional lifetime of an erythrocyte is about 100-120 days, during which time the erythrocytes are continually moved by the blood flow push (in arteries), pull (in veins) and a combination of the two as they squeeze through microvessels such as capillaries.

 

The aging erythrocyte undergoes changes in its plasma membrane, making it susceptible to selective recognition by macrophages and subsequent phagocytosis in the mononuclear phagocyte system (spleen, liver and lymph nodes), thus removing old and defective cells and continually purging the 10) ___. This process is termed eryptosis, erythrocyte programmed cell death. This process normally occurs at the same rate of production by erythropoiesis, balancing the total circulating red blood cell count. Eryptosis is increased in a wide variety of diseases including sepsis, haemolytic uremic syndrome, malaria, sickle cell anemia. Eryptosis can be elicited by osmotic shock, oxidative stress, energy depletion as well as a wide variety of endogenous mediators and xenobiotics.

Sources; WebMD; Wikipedia; ScienceDaily

 

ANSWERS: 1) oxygen; 2) iron; 3) genetic; 4) food; 5) marrow; 6) cells; 7) viscosity; 8) slide; 9) bones; 10) blood

 

Jan Swammerdam MD (1637-1680)

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This is a portrait, of what the artist imagined Jan Swammerdam, might have looked like. This painting is based on the face of Hartman Hartmanzoon (1591-1659) from Rembrandt’s The Anatomy Lesson of Dr. Nicolaes Tulp. No genuine portrait of Jan Swammerdam is known.

 

The first person to describe red blood cells was the young Dutch biologist Jan Swammerdam, who had used an early microscope in 1658 to study the blood of a frog. Unaware of this work, Anton van Leeuwenhoek provided another microscopic description in 1674, this time providing a more precise description of red blood cells, even approximating their size, “25,000 times smaller than a fine grain of sand“.

 

Jan Swammerdam’s work on insects demonstrated that the various phases during the life of an insect – egg, larva, pupa, and adult – are different forms of the same animal. As part of his anatomical research, he carried out experiments on muscle contraction. In 1658, he was the first to observe and describe red blood cells. He was one of the first people to use the microscope in dissections, and his techniques remained useful for hundreds of years. Swammerdam was baptized on 15 February 1637 in the Oude Kerk Amsterdam. His father was an apothecary, and an amateur collector of minerals, coins, fossils, and insects from around the world. His mother, Baertje Jans Corvers, died in 1661; and that same year, when he turned 24, Swammerdam entered the University of Leiden to study medicine. After qualifying as a candidate in medicine in 1663, he left for France, spending time in Issy, Saumur and Paris with Melchisedech Thevenot. He returned to Leiden in September 1665, and earned his M.D. on February 22, 1667. Once he left university, he spent much of his time pursuing his interest in insects. This choice caused a rift between Swammerdam and his father, who thought his son should practice medicine. The relationship between the two deteriorated. Swammerdam’s father cut off his financial support for Swammerdam’s entomological studies. As a result, Swammerdam was forced, at least occasionally, to practice medicine in order to finance his own research. He obtained leave at Amsterdam to dissect the bodies of those who died in the hospital. From 1667 through 1674, Swammerdam continued his research and published three books. In 1675, he came under the influence of the Flemish mystic, Antoinette Bourignon, renounced his work, and decided to devote the remainder of his life to spiritual matters. Niels Stensen, a gifted anatomist, and once his co-student, invited him to work for the Duke of Tuscany, but Swammerdam refused. The grand duke of Tuscany offered 12,000 florins for Swammerdam’s collection, on condition of Swammerdam coming to Florence to continue it. There is evidence, however, that Swammerdam did not completely give up his scientific studies. The papers, which he wished to be published posthumously, appear to have been revised during the last two years of his life. Swammerdam died at age 43 of malaria and was buried in the Eglise Wallonne.

 

A half century after his death, Herman Boerhaave translated Swammerdam’s papers into Latin and published them under the title Biblia naturae (Book of Nature). An English translation of his entomological works by T. Floyd was published in 1758. His entomological collection was divided at his death and sold in small portions. As a naturalist of his time, he has been compared with Anton Leeuwenhoek, whose life story has appeared in this newsletter, recently. No authentic portrait of Jan Swammerdam is extant nowadays. The portrait shown in the header is derived from the painting The Anatomy Lesson of Dr Tulp by Rembrandt and represents the leading Amsterdam physician Hartman Hartmanzoon (1591-1659).

 

 

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Illustration of a Mosquito from Historia, by Jan Swammerdam.

 

Knowledge of insects in the 17th century was to a great extent inherited from Aristotle. According to this classical paradigm, insects were so insignificant they weren’t worthy of the types of investigations done on fish, reptiles, and mammals. Much of Swammerdam’s entomological work was done to show that the difference between insects and the “higher“ animals was one of degree, not kind. Swammerdam is credited with the enhancement of the study of biology due to his work dissecting insects and studying them under microscopes. Swammerdam’s principal interest in this area was demonstrating that insects develop in the same gradual manner as other animals. He wanted to dispel the seventeenth-century notion of metamorphosis – the idea that different life stages of an insect (e.g. caterpillar and butterfly) represent different individuals or a sudden change from one type of animal to another. He garnered evidence against this claim from his dissections. By examining larvae, he identified underdeveloped adult features in pre-adult animals. For example, he noticed that the wings of Dragonflies and Mayflies exist prior to their final molt. Swammerdam used these observations to bolster his case for epigenesis in his 1669 publication, Historia Insectorum Generalis (The Natural History of Insects). This work also included many descriptions of insect anatomy. It was here that Swammerdam revealed that the “king“ bee has ovaries. Biblia natura published posthumously in 1737, carried the first confirmation that the queen bee is the sole mother of the colony. Despite five intense years of beekeeping, the mode of honey bee reproduction escaped him as he wrote, “I do not believe the male bees actually copulate with the females.“ In addition to his research on metamorphosis, Swammerdam’s entomological work stands out because he was among the first people to study insects in a systematized fashion (i.e., careful dissection, comparison of different species, and use of the microscope). His anatomical and behavioral descriptions of bees, wasps, ants, dragonflies, snails, worms, and butterflies were major contributions to the nascent field o fentomology in the late seventeenth century.

 

Besides Historia, he published Miraculum naturae sive uteri muliebris fabrica in 1672 and Ephemeri vita, in 1674. The latter was a study of the Mayfly, written at a time when he was becoming increasingly involved in spiritual matters. The work contains long passages on the glory of the creator. His Bybel der Natuure was a collection of his papers and drawings.

 

 

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Swammerdam’s illustration of a nerve-muscle preparation.

 

Swammerdam was among the first to experimentally study muscle contraction. He used frog leg muscle along with its adherent nerve as a model for his experiments and observed muscle thickening (contraction) on nerve irritation (stimulation). He later on improved upon his technique by putting two needles at the muscle ends which showed movement on nerve stimulation. He even put the muscle into a glass pipe to avoid direct touching of its belly and used brass wire to fix the nerve and silver wire to stimulate it. Though he was very close in understanding the true nature of bioelectricity in neurophysiology; his experiments have greatly inspired many budding neurophysiologists. Swammerdam use of, and experiments with, frog muscle preparations played a key role in the development of our current understanding of nerve-muscle function. The experiments introduced a new method of studying nerves, the frog nerve-muscle preparation, which was still used centuries later. For the experiment illustrated above, Swammerdam placed a frog thigh muscle in a glass syringe with a nerve protruding from a hole in the side of the container. Irritating the nerve caused the muscle to contract, but the level of the water, and thus the volume of the muscle, did not increase. Swammerdam did not believe the results of his own experiment, suggesting that they were the result of artifact. However, he concluded in his book The Book of Nature II that “motion or irritation of the nerve alone is necessary to produce muscular motion“. This idea that nerve stimulation led to movement had important implications for neuroscience by putting forward the idea that behavior is based on stimuli. In another experiment, Swammerdam removed the heart of a frog and observed that touching certain areas of the brain caused certain muscles to contract. For Swammerdam, this was evidence that the brain, not the circulatory system, was responsible for muscle contraction. Swammerdam also played a key role in the debunking of the balloonist theory, the idea that ?moving spirits’ are responsible for muscle contractions. The idea, supported by the Greek physician Galen, held that nerves were hollow and the movement of spirits through them propelled muscle motion. Rene Descartes furthered the idea by basing it on a model of hydraulics, suggesting that the spirits were analogous to fluids or gasses and calling them ?animal spirits’. In the model, which Descartes used to explain reflexes, the spirits would flow from the ventricles of the brain, through the nerves, and to the muscles to animate the latter. Swammerdam also discovered valves in the lymphatic system, which were later dubbed Swammerdam valves.

 

Though Swammerdam’s work on insects and anatomy was significant, many current histories remember him as much for his methods and skill with microscopes as for his discoveries. He developed new techniques for examining, preserving, and dissecting specimens, including wax injection to make viewing blood vessels easier. A method he invented for the preparation of hollow human organs was later much employed in anatomy. Swammerdam’s scientific work was deeply influenced by his religious views. For him, studying the Earth’s creatures revealed the greatness of God; scientific pursuits were pious activities. His spiritual views not only motivated his work, but also affected his ideas about the natural world. For example, he rejected metamorphosis and spontaneous generation because they represented randomness and haphazardness that was not possible in a world regulated by God. His ultimate departure from the scientific scene in 1675 can also be attributed to his religiosity. Perhaps due to the influence of Antoinette Bourignon, Swammerdam came to believe that his scientific work was no longer in the service of God. He thought he was conducting investigations into the natural world merely to satisfy his own curiosity. As a result, he subjected himself to the tutelage of Bourignon and, for the most part, renounced scientific study. Centuries went by, before further investigation of red blood cells was attempted. In 1901, Karl Landsteiner published his discovery of the three main blood groups – A, B, and C (which he later renamed to O). Landsteiner described the regular patterns in which reactions occurred when serum was mixed with red blood cells, thus identifying compatible and conflicting combinations between these blood groups. A year later Alfred von Decastello and Adriano Sturli, two colleagues of Landsteiner, identified a fourth blood group – AB. In 1959, by use of X-ray crystallography, Dr. Max Perutz was able to unravel the structure of hemoglobin, the red blood cell protein that carries oxygen. The oldest intact red blood cells ever discovered were found in Otzi the Iceman, a natural mummy of a man who died around 3255 BCE. These cells were discovered in May 2012.

 

A Patient’s Budding Cortex – Networking Neurons Thrive in 3-D Human “Organoid“

 

Sergiu Pasca, M.D. of Stanford University, Palo Alto, CA, and colleagues, debuted what they call “human cortical spheroids“ in the journal Nature Methods (May 25, 2015).

 

Imagine a “patient tormented by suicidal thoughts gives his psychiatrist a few strands of his hair. She derives stem cells from them to grow budding brain tissue harboring the secrets of his unique illness in a petri dish. She uses the information to genetically engineer a personalized treatment to correct his brain circuit functioning. Just Sci-fi? Yes, but?“ (from the NIH release).

 

An evolving “disease-in-a-dish“ technology, funded by the National Institutes of Health (NIH), is bringing closer the day when such a seemingly futuristic personalized medicine scenario might not seem so far-fetched. Scientists have perfected mini cultured 3-D structures that grow and function much like the outer mantle — the key working tissue, or cortex — of the brain of the person from whom they were derived. Strikingly, these “organoids“ buzz with neuronal network activity. Cells talk with each other in circuits, much as they do in our brains.

 

Prior to the new study, scientists had developed a way to study neurons differentiated from stem cells derived from patients’ skin cells — using a technology calledinduced pluripotent stem cells (iPSCs). They had even produced primitive organoids by coaxing neurons and support cells to organize themselves, mimicking the brain’s own architecture. But these lacked the complex circuitry required to even begin to mimic the workings of our brains. Based on an improved, streamlined method for producing iPSCs, Pasca’s team’s cortex-like spheroids harbor healthier neurons supported by a more naturalistic network of supporting glial cells, resulting in more functional neural connections and circuitry. Like the developing brain, the neurons form layers and talk with each other via neural networks. The spheroid technology is more consistent than earlier organoids in generating the same kinds of cortex-like structures in repeated experiments.

 

The budding cortex also lends itself to analysis using conventional brain slice methods. So, in a sci-fi future, it might potentially reveal what circuits went awry in the developing cortex of a particular individual with a brain disorder. According to David Panchision, PhD, NIMH program director for stem cell research, while the technology is still maturing, there is great potential for using these assays to more accurately develop, test safety and effectiveness of new treatments before they are used in individuals with a mental illness.“

 

What’s next? Perhaps development of multiple neuron subtypes that normally populate the cortex, as well as long-distance connections between this cortex-like structure and other — yet to be developed – organoid structures.

 

The online version of this news release contains two images: Image of budding brain-like structures and Image of cross section of spheroids

 

Mouse Model Created With a Major Genetic Cause of ALS and FTD

 

More than 30,000 Americans live with amyotrophic lateral sclerosis (ALS, Lou Gehrig’s disease), which destroys nerves that control essential movements, including speaking, walking, breathing and swallowing. After Alzheimer’s disease, frontotemporal dementia (FTD) is the most common form of early onset dementia. It is characterized by changes in personality, behavior and language due to loss of neurons in the brain’s frontal and temporal lobes. Patients with mutations in the chromosome 9 open reading frame 72 (C9ORF72) gene have all or some symptoms associated with both disorders.

 

The C9ORF72 gene is encoded by repeating strings of six DNA molecules. Disease-causing C9ORF72 mutations make the strings excessively long which leads to the accumulation of RNA that either cluster into structures, called foci, or cause the production of abnormal c9RAN proteins in the brain and spinal cord of patients.

 

According to an article published online in the journal Science (14 May 2015) a novel mouse has been “created“ that exhibits the symptoms and neurodegeneration associated with the most common genetic forms of FTD and ALS. According to the authors, the mouse model exhibits the pathologies and symptoms of ALS and FTD seen in patients with the C9ORF72 mutation, and these mice could greatly improve the understanding of ALS and FTD and hasten the development of effective treatments.”

 

To create the model, the authors injected the brains of newborn mice with a disease-causing version of the C9ORF72 gene. As the mice aged, they became hyperactive, anxious, and antisocial, in addition to having problems with movement that mirrored patient symptoms. Histologically, the brains of the mice were smaller than normal and had fewer neurons in areas that controlled the affected behaviors. The authors also found that the mouse brains had key hallmarks of the disorders, including toxic clusters of ribonucleic acids (RNA) and TDP-43, a protein that has long been known to go awry in the majority of ALS and FTD cases. The authors said that finding TDP-43 in these mice was unexpected and it is not yet known how foci and c9RAN proteins are linked to TDP-43 abnormalities. However, with this new animal model, there is now a way to find out.

 

The online version of this news release contains an image of gene mutation in mouse model.

 

FDA Approves Two Therapies to Treat IBS-D

 

According to the National Institutes of Health, patients with irritable bowel syndrome (IBS) experience a number of signs and symptoms, including pain or discomfort in the abdomen and changes in bowel movement patterns. Studies estimate that IBS affects 10 to 15% of adults in the United States. IBS-D is a subtype characterized mainly by loose or watery stools at least 25% of the time.

 

The FDA has approved Viberzi (eluxadoline) and Xifaxan (rifaximin), two new treatments, manufactured by two different companies, for irritable bowel syndrome with diarrhea (IBS-D) in adult men and women. Viberzi, which contains a new active ingredient, is taken orally twice daily with food. Viberzi activates receptors in the nervous system that can lessen bowel contractions. Xifaxan is taken orally three times a day for 14 days, for the treatment of abdominal pain and diarrhea. Patients who experience a recurrence of symptoms can be retreated with a 14 day treatment course, up to two times. Xifaxan, an antibiotic derived from rifampin, was previously approved as treatment for travelers’ diarrhea caused by E. coli and for reduction of the risk in adult patients of recurring overt hepatic encephalopathy, the changes in brain function that occur when the liver is unable to remove toxins from the blood. The exact mechanism of action of Xifaxan for treatment of IBS-D is not known, but is thought to be related to changes in the bacterial content in the gastrointestinal tract.

 

The safety and effectiveness of Viberzi were established in two double-blind, placebo-controlled clinical trials in which 2,425 patients were randomly assigned to receive Viberzi or placebo. Results showed Viberzi was more effective in simultaneously reducing abdominal pain and improving stool consistency than placebo over 26 weeks of treatment. The safety and effectiveness of Xifaxan were established in three double-blind, placebo-controlled trials. In the first two trials, 1,258 patients were randomly assigned to receive Xifaxan or placebo for 14 days, and then followed for a 10-week treatment-free period. Results showed that more Xifaxan-treated patients reported improvements in abdominal pain and stool consistency than those on placebo. A third trial evaluated repeat courses of Xifaxan, because patients with IBS-D can develop recurrent signs and symptoms after a single treatment course of Xifaxan. A total of 636 patients with recurrence were randomized to receive either Xifaxan or placebo for two additional 14-day courses separated by 10 weeks. Again, more patients treated with Xifaxan than placebo were responders in abdominal pain and stool consistency in this phase of the study.

 

The most common side effects in patients treated with Viberzi include constipation, nausea and abdominal pain. The most serious known risk associated with Viberzi is the risk of spasm in the sphincter of Oddi, the smooth muscle that surrounds the end portion of the common bile and pancreatic ducts, which can result in pancreatitis. Viberzi should not be used in patients with a history of bile duct obstruction, pancreatitis, severe liver impairment, or severe constipation, and in patients who drink more than three alcoholic beverages per day. The most common side effects in patients treated with Xifaxan for IBS-D include nausea and an increase in alanine aminotransferase (ALT), a liver enzyme measured in blood. If diarrhea does not improve or worsens after treatment with Xifaxan, then evaluation for development of a severe infectious diarrhea, C. difficile enterocolitis, should be performed. Caution should be used when using Xifaxan in patients with severe liver impairment or when combined with certain other drugs.

 

Viberzi is manufactured by Patheon Pharmaceuticals, Inc. based in Cincinnati, Ohio and distributed by Forest Pharmaceuticals, Inc. a subsidiary of Forest Laboratories, LLC, based in Cincinnati, Ohio. Xifaxan is marketed by Salix Pharmaceuticals, Inc. based in Raleigh, North Carolina.

 

Fresh Vegetable Salad with Some Mysterious Ingredients

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On a warm summer evening, serve this salad, with some chilled white wine and warm sourdough bread or rolls. Sip slowly, as you enjoy whomever you’re with. This salad can be a meal in itself; however, if you crave more, serve it with pan seared rare salmon cooked quickly with olive oil, minced fresh garlic and grated fresh ginger.

 

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Delicious fresh ingredients. ©Joyce Hays, Target Health Inc.

 

 

Ingredients

 

2 carrots, boiled then peeled

6 of your favorite pickles

3 hard-boiled eggs (ten minutes)

1 head small to medium cauliflower, boiled

8 ounces of frozen sweet peas

1 fresh apple, peeled

1 small onion, chopped

1 parsnip

1 grind of black pepper

1 pinch chili flakes

2 grinds of pink Himalayan salt

4 Tablespoons mayo (or to your taste)

 

Slight Digression

 

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Himalayan Pink salt with its own grinder

 

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High in the Himalayas is a region called The Salt Range, the source of pink salt crystals. It’s located in Mianwali District, Punjab, Pakistan

 

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Pink Salt Rock from The Salt Region of the Himalayan Mountains

 

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White and Pink salt crystals from The Salt Region of the Himalaya Mountains

 

Himalayan salt is the marketing name given to halite or rock salt, from the ancient Himalayan mountains. The many hues of pink, red and white are an indication of this salt’s rich and varying mineral and energy-rich iron content. This type of salt has more than 80 minerals and elements in addition to sodium chloride. It is an unrefined, unprocessed “raw“ salt that’s hand-mined from abundant salt caves that were formed millions of years ago as ocean salt settled in certain geologic pockets around the earth. The reason why this salt is considered healthier than other types of salt is because it does not contain any additives or chemicals, and is a naturally occurring substance. It is reported by some that consuming Himalayan Salt controls the water levels within the body regulating them for proper functioning, provides essential minerals, trace elements, balances electrolytes, supports proper nutrient absorption, eliminates toxins, balances the body’s pH, normalizes blood pressure, and increases circulation and conductivity. Some say that it can also assist with relief from arthritis, skin rashes, psoriasis, herpes, and flu and fever symptoms. Himalayan Salt can also be used in bath salt recipes, body scrubs, aromatherapy, homemade soap, and for all types of culinary and spa applications.

 

 

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Pink salt caves are popping up as spa options around the country. (Photo: Alamy/Jiri Hubatka)

 

THE CLAIM: Spending time in a pink salt cave can help relieve skin conditions like psoriasis.

THE TRUTH: This could have a benefit – potentially. “Although there is very little literature on Himalayan salt, there is a great deal of research supporting that bathing and sunbathing at the salt- and mineral-rich Dead Sea is effective in treating psoriasis,“ says Joshua Zeichner, MD, Director of Cosmetic and Clinical Research in the dermatology department at NYC’s Mount Sinai Hospital. “Much of this is due to the Dead Sea’s high levels of magnesium, which has a hydrating, anti-inflammatory effect that improves skin function, strengthens the skin barrier, and increases moisture content. It is safe to assume that Himalayan salt might have the same effects.“ If you have psoriasis, extremely dry skin, or an inflammatory condition like eczema, then halotherapy (the official name for salt-based remedies) could be worth a shot. “There’s very little risk involved and it may be beneficial in some patients,“ says Zeichner tells Yahoo Health. “The question comes down to cost.“ Although treatments and prices vary, a single 45-minute-long session in a salt cave will generally run you around $30. All that being said, if you’re a healthy person, a pink salt bath probably won’t make your skin all that better. “The very sparse amount of minerals that could be dissolved into your bath water – when used in a bath – is just not going to have a meaningful impact on your skin,“ dermatologist Neal Schultz, M.D., host of DermTV, told Yahoo Health. But you could still reap other benefits from a soak. “A bath in and of itself is soothing, and means you are taking time out to take care of yourself and do something nice for yourself, and recognizing your need to slow down,“ notes integrative dermatologist Cybele Fishman, MD. “I think this, even more than the pink salt, is the key thing.“

 

THE CLAIM: Pink salt caves can improve allergies and asthma.

THE TRUTH: The jury’s out on this one. Proponents say inhaling Himalayan salt-infused air clears mucus, reduces sinus inflammation, and kills germs, thanks to the anti-inflammatory and antibacterial properties of pink granules. “Ultimately, we don’t have enough information to know whether halotherapy is indeed helpful,“ says NYC-based allergist Clifford Bassett, MD. “There are several Eastern European studies backing up these claims, but we don’t have many clinical U.S. trials exploring the benefits.“ A small study published in the New England Journal of Medicine did find that inhaling a concentrated salt solution improved lung function in cystic fibrosis patients. Some doctors maintain that salt can ease short-term symptoms, but the long-term side effects are unknown. “In my practice, we don’t suggest it for asthma or respiratory issues. Theoretically, in high concentrations, salt could trigger a bronchial spasm or constriction,“ Bassett told Yahoo Health. “It could potentially stimulate the nerves in your nasal system or irritate the linings of your lungs, worsening allergy symptoms. As such, it should not be recommended on a broad basis.

 

 

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©Joyce Hays, Target Health Inc.

 

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Boil the cauliflower for 3 minutes, remove and cool. ©Joyce Hays, Target Health Inc.

 

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Chop up the pickles, very well ©Joyce Hays, Target Health Inc.

 

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Thaw the green peas in a colander. ©Joyce Hays, Target Health Inc.

 

In your salad bowl, add all of the ingredients, add the spices and the mayo. Toss everything together until well combined. Taste, and add more chili flakes or mayo if needed. If you have some fresh cilantro (well chopped) and/or black sesame seeds for garnish, sprinkle on top and serve the salad.

 

 

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All ingredients, just before adding the spices and mayo ©Joyce Hays, Target Health Inc.

 

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We nibbled on two kinds of olives and roasted red peppers ©Joyce Hays, Target Health Inc.

 

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A delicious salad course ©Joyce Hays, Target Health Inc.

 

We started our basically vegetarian meal with chilled sauvignon blanc and nibbled on two kinds of olives and roasted red peppers. Then I served the veggie salad shared in this newsletter. The two mysterious ingredients in this salad are the chopped apple and the pink Himalayan salt. If you didn’t know that apple is in this salad, I don’t think you would ever guess; but it adds a soft sweetness to the recipe. Then we had my recipe for eggplant parmesan, my recipe for cheesy broccoli and my recipe for potato/kale pancakes with an avocado topping. Dessert was freshly cut up fruit – so refreshing!

 

 

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Freshly cut fruit for dessert ©Joyce Hays, Target Health Inc.

 

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Delicious, chilled, Napa Valley, Stag’s Leap Wine Cellars, Sauvignon Blanc

 

This is a busy time because our son, Alex is home with us. On Saturday we saw part one of Wolf Hall (stage version) liked it a lot, so will see part two next week. Excellent British acting and dramatic stage effects. Go see it if you like historical plays.

 

Flooding in the Big Apple, but not nearly as bad as the flooding in Texas.

 

 

From Our Table to Yours!

 

Bon Appetit!