Posted on 07/24/2009 3:37:21 AM PDT by nw_arizona_granny
http://www.mccormick.com/SpicesForHealth/Tips.aspx?dfaid=McCormickCampaigns
* Boost flavor and more with Cinnamon
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Cinnamon tips
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Perk up your morning coffee with Ground Cinnamon. Sprinkle 1/2 teaspoon over ground coffee before brewing.
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Cinnamon Coffee
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For lightly sweetened, cinnamon-spiced yogurt, mix 1/2 teaspoon Ground Cinnamon and 1 teaspoon maple syrup or honey into 1 cup plain yogurt.
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Cinnamon Yogurt
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Keep a shaker of Ground Cinnamon handy to sprinkle over everything from hot cocoa to oatmeal and fruit salad.
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Cinnamon Oatmeal
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Spice up cake mixes with Ground Cinnamon. Add 1 teaspoon Ground Cinnamon to angel food or white cake mix. Add 1 to 2 teaspoons to chocolate or yellow cake mix.
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Cinnamon Streusel Cake
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Next time you make French toast, pancakes, waffles or muffins, try adding ½ to 1 teaspoon Ground Cinnamon to the batter.
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Cinnamon Pancakes
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Cinnamon and apple is a natural flavor combination. A sliced apple tossed with 1/2 teaspoon Ground Cinnamon in a resealable plastic bag makes a great snack. Plus the cinnamon coating helps keep the apple slices from turning brown.
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Keep Cinnamon Sugar on hand to use as a topping for quick breads, cobblers, muffins or cookies just before they go into the oven. Mix 1/2 cup granulated sugar and 1 tablespoon Ground Cinnamon.
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Give lunchbox sandwiches an unexpected flavor boost. Add a sprinkle of Ground Cinnamon to peanut butter and jelly sandwiches. Also tastes great on peanut butter and banana sandwiches!
* Boost flavor and more with Cinnamon
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Cinnamon tips
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Perk up your morning coffee with Ground Cinnamon. Sprinkle 1/2 teaspoon over ground coffee before brewing.
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Cinnamon Coffee
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For lightly sweetened, cinnamon-spiced yogurt, mix 1/2 teaspoon Ground Cinnamon and 1 teaspoon maple syrup or honey into 1 cup plain yogurt.
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Cinnamon Yogurt
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Keep a shaker of Ground Cinnamon handy to sprinkle over everything from hot cocoa to oatmeal and fruit salad.
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Cinnamon Oatmeal
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Spice up cake mixes with Ground Cinnamon. Add 1 teaspoon Ground Cinnamon to angel food or white cake mix. Add 1 to 2 teaspoons to chocolate or yellow cake mix.
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Cinnamon Streusel Cake
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Next time you make French toast, pancakes, waffles or muffins, try adding ½ to 1 teaspoon Ground Cinnamon to the batter.
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Cinnamon Pancakes
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Cinnamon and apple is a natural flavor combination. A sliced apple tossed with 1/2 teaspoon Ground Cinnamon in a resealable plastic bag makes a great snack. Plus the cinnamon coating helps keep the apple slices from turning brown.
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Keep Cinnamon Sugar on hand to use as a topping for quick breads, cobblers, muffins or cookies just before they go into the oven. Mix 1/2 cup granulated sugar and 1 tablespoon Ground Cinnamon.
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Give lunchbox sandwiches an unexpected flavor boost. Add a sprinkle of Ground Cinnamon to peanut butter and jelly sandwiches. Also tastes great on peanut butter and banana sandwiches!
* Call on Ginger for added potency
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Ginger tips
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Quench your thirst with Ginger Lemonade. Add 1/2 teaspoon Ground Ginger to 1 quart freshly squeezed lemonade or lemonade from a mix.
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Ginger Lemonade
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Add a hint of ginger to hot or iced tea. Sweeten 1 cup tea with 3/4 teaspoon sugar mixed with 1/4 teaspoon Ground Ginger.
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Ginger Hot Tea
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Add a dash of warm sweet flavor to winter vegetables. Sprinkle Ground Ginger onto cooked carrots, acorn or butternut squash, or sweet potatoes.
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Ginger Spiced Mashed Sweet Potatoes
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The softly spiced flavor of Ground Ginger perfectly complements green tea.
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Ginger Hot Tea
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Add Asian flair to salmon. Stir 1/2 teaspoon Ground Ginger into 1/2 cup hoisin sauce. Brush over salmon fillets during the last few minutes of grilling or broiling.
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Salmon Oriental
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For an easy Peach Ginger Glaze, stir 1 tablespoon Worcestershire sauce and 1 to 1 1/2 teaspoons Ground Ginger into 1 cup peach or apricot preserves. Spoon over chicken or pork during the last 10 minutes of roasting.
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Herb Pork Roast with Ginger Peach Glaze
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Drinks lots of hot liquids when you have a cold. Prepare this brew of 1 cup hot water, 2 wedges squeezed lemon, 1 teaspoon honey and 1/4 teaspoon Ground Ginger.
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Versatile Lemon Ginger Topping makes a number of delicious desserts. Mix 1/2 cup lemon curd, 1/2 cup sour cream and 1/4 to 1/2 teaspoon Ground Ginger until well blended. Use as a topping for fresh berries or pound cake. Or layer with cake cubes and fruit in a trifle.
http://www.mccormick.com/SpicesForHealth/Tips.aspx?dfaid=McCormickCampaigns
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Oregano tips
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For a twist on the typical grilled cheese, prepare sandwich with sliced mozzarella cheese, sliced tomato and 1/4 teaspoon Oregano Leaves.
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Oregano Grilled Cheese
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Forego the butter and sour cream on baked potato. Drizzle with 1 teaspoon of olive oil mixed with a sprinkle of Oregano Leaves.
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Oregano Olive Oil Potato
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Perk up homemade or frozen pizza by sprinkling Oregano Leaves over pizza right from the oven.
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Easy Pizza Margherita
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Add a flavor boost to jarred tomato sauce. Stir 1 teaspoon Oregano Leaves into 2 cups low sodium jarred tomato sauce.
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For Greek Vinaigrette Dressing, stir 1/2 teaspoon Oregano Leaves and 1 to 2 tablespoons reduced fat feta cheese into 1/2 cup bottled vinaigrette dressing.
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Enhance canned soup with Oregano Leaves. Add Oregano Leaves to canned chicken noodle or lentil soup.
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Add zing to jarred chunky salsa. Stir 1/2 teaspoon Oregano Leaves into 1 jar (16 oz.) chunky salsa. Serve with tortilla or pita chips.
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Sprinkle sautéed cherry or grape tomatoes with Oregano Leaves, Garlic Powder, salt and pepper to taste.
* Heat up your favorites with Red Pepper
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Red Pepper tips
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Sprinkle store-bought or homemade hummus or guacamole with Paprika. Or, add a kick by stirring in 1/4 teaspoon Ground Red Pepper or Crushed Red Pepper.
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Classic Hummus
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For an attractive garnish, lightly sprinkle Paprika over deviled eggs, tuna or chicken salad, cottage cheese or dips.
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Delicious Deviled Eggs
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Serve bread with olive oil like it’s done in an Italian restaurant. Mix ¼ cup olive oil, 1 teaspoon grated Parmesan cheese, ½ teaspoon Garlic Powder, 1/8 teaspoon Crushed Red Pepper and sea salt to taste in small shallow dish.
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Italian Bread Dipping Oil
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Ground Red Pepper’s heat is a nice addition to basic Italian dressing or even raspberry vinaigrette, where it balances the sweetness of the fruit flavor.
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Keep a jar of Crushed Red Pepper at the table. Use to add a touch of heat from everything to pizza to salad, soup, eggs and meat.
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Mix up your own spiced salt by mixing 2 tablespoons Sea Salt, 2 teaspoons Paprika, ½ teaspoon Ground Cumin and a pinch of Ground Red Pepper. Sprinkle over grilled or roasted meat, fish and poultry.
* Make Rosemary tops in your kitchen
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Rosemary tips
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Dress up ready-to-bake rolls. Just before baking frozen dinner rolls or ready-to-bake rolls, brush tops with olive oil then sprinkle with crushed Rosemary Leaves and Sea Salt before baking.
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Rosemary Baked Rolls
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Make great tasting Roasted Chicken. Before roasting, brush chicken with olive oil. Sprinkle all over with 2 teaspoons crushed Rosemary Leaves, 1/2 teaspoon Thyme Leaves, Sea Salt and Ground Black Pepper.
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Rosemary Roasted Chicken
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For a delicious accompaniment to roasted meats, try Rosemary Roasted Potatoes. Toss 4 medium baking potatoes, cut into wedges, 2 tablespoons olive oil, 2 teaspoons crushed Rosemary Leaves and 1/2 teaspoon Sea Salt in large bowl until well coated. Spread potatoes in single layer on foil-lined shallow baking pan. Bake in preheated 425°F oven 35 to 40 minutes or until potatoes are tender.
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Easy Roasted Potatoes
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Add ¼ teaspoon each crushed Rosemary Leaves and Garlic Salt to hot cooked peas or green beans.
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Herbed Summer Green Beans
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Stir 1/2 teaspoon each crushed Rosemary Leaves and Garlic Powder and ¼ teaspoon Black Pepper into 4 cups hot cooked mashed potatoes.
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Garlic Rosemary Mashed Potatoes
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A hearty vegetable omelet is an easy dish to make for breakfast, lunch or dinner. Sprinkle vegetables such as asparagus, spinach or tomatoes with crushed Rosemary Leaves. Use as a filling for omelet.
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Perk up store-bought chicken salad with crushed Rosemary Leaves. Serve as a sandwich filling or on a bed of greens.
http://www.mccormick.com/SpicesForHealth/Tips.aspx?dfaid=McCormickCampaigns
* Take meals to a new lever with Thyme
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Thyme tips
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Wake up your taste buds with Herbed Scrambled Eggs. Beat 1/8 teaspoon Thyme Leaves into 2 eggs before scrambling.
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Thyme Herbed Scrambled Egg
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Sprinkle Thyme Leaves on steamed or sautéed asparagus along with a twist of freshly Ground Black Pepper and a dash of Sea Salt.
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Herbed Asparagus
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Herbed Butter is a quick way to add flavor to vegetables, potatoes and pasta. Mix 1 stick softened butter, 1/2 teaspoon Parsley Flakes, 1/4 teaspoon Tarragon Leaves and 1/8 teaspoon Thyme Leaves until well blended. Also tastes great on freshly baked rolls.
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Savory Herb Butter
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Dress up seafood or tuna salad by adding Thyme Leaves. Serve as a sandwich filling or on a bed of greens.
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Spring Thyme Salmon
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Thyme brings out the flavor of mushrooms. Sauté 1 pound sliced mushrooms in 1 tablespoon olive oil. Sprinkle with 1/2 to 1 teaspoon Thyme Leaves.
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Dress up your favorite vinaigrette with 1/4 to 1/2 teaspoon Thyme Leaves. Try using raspberry or other berry-flavored vinegar instead of your usual vinegar.
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Add hearty flavor to soup. Stir ¼ teaspoon Thyme Leaves into chicken, beef or vegetable soups.
* Add vibrancy with Yellow Curry
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Yellow Curry tips
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For a new twist to chicken salad, add a dash of Curry Powder along with nuts, fruit, or chopped apples.
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Chicken Salad
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For an out of the ordinary side dish that is lightly spiced and sweet, try Curried Pilaf.
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Curry Rice Pilaf
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Mix 1/2 teaspoon Curry Powder into 8 ounces plain yogurt to use as great spread in a turkey and vegetable pita sandwich.
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For a deliciously different dip, try Curried Chutney Dip. Mix 1 cup reduced fat sour cream, 1/4 cup fruit chutney, 1 tablespoon honey, 1 teaspoon Curry Powder and 1/2 teaspoon lemon juice until well blended. Serve as a dip with pita wedges.
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Turn tomato soup from dull to delicious. Add ½ teaspoon Curry Powder to 2 cups tomato soup. Sprinkle with chopped cashews.
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Add flavor and color to steamed rice or couscous with a sprinkle of Curry Powder. For extra flavor and texture, try adding toasted sliced almonds, shredded carrots, peas and/or raisins.
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Lightly dust hot popcorn or snack mixes with Curry Powder for a new taste sensation.
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Macaroni and cheese is humdrum no more. Stir 1/2 teaspoon Curry Powder into 2 cups prepared macaroni and cheese.
[This Doctor is seeking the help of the world’s Doctors, and it does not look good, to me....
granny]
INFLUENZA PANDEMIC (H1N1) 2009 (43): PEDIATRIC QUESTIONS
***********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Wed 9 Sep 2009
From: Amar HSS amarhss@gmail.com
[The following comments have been received from Dr Amar-Singh HSS,
Consultant Community Paediatrician & Head Paediatric Department, Ipoh
General Hospital, Malaysia, relating to the content of the above
ProMED-mail post. Readers able to respond to Dr. Amar-Singh should
communicate with him directly and not ProMED-mail. - Mod.CP]
Re: Influenza pandemic (H1N1) 2009 (39): pediatric deaths 20090904.3118
The argument:
1. Data from MMWR on the 36 deaths: Only 8 out of 36 deaths were aged
5 years or below. If we compare co-morbids in those aged 5 years or
below and those above 5 years, 4/8 (50 percent) were in those aged 5
years or below, and 22/28 (78.6 percent) in those aged above 5 years.
Hence, these data do not support one of the conclusions that
“children aged less than 5 years or with certain chronic medical
conditions are at increased risk for complications and death from
H1N1;” certain chronic medical conditions yes, but not under 5 years of age.
2. The data suggest the limited value of treatment in well children
with ILI. See Neuraminidase inhibitors for treatment and prophylaxis
of influenza in children: Systematic review and meta-analysis of
randomised controlled trials. Matthew Shun-Shin, et al. BMJ 2009;339:b3172.
3. There is concern about toxicity of oseltamivir (See: Oseltamivir
adherence and side effects among children in three London schools
affected by influenza A(H1N1)v, May 2009, and in an internet-based
cross-sectional survey. A Kitching, et al. Eurosurveillance, Volume
14, Issue 30, 30 July 2009 and other studies in rats.
4. Finally, lots of children under 5 yrs will get an URTI (upper
respiratory tract infection) — defined as ILI under current
circumstances — so we will definitely be treating many children.
Comments would be appreciated.
[Separately, Dr. Amar-Singh has sent the following request. Again,
ProMED-mail suggests that readers able to respond should communicate
directly with Dr. Amar-Singh. - Mod.CP]:
I [would like to post the following problem] on ProMED-mail for
discussion: We are in the phase of the epidemic in which we are
seeing children come back with a 2nd ILI, and we are not sure how to
manage them.
Possible presentations of child with 2nd ILI, previously:
1. Child admitted with ILI treated with oseltamivir. PCR positive for H1N1
2. Child admitted with ILI treated with oseltamivir. PCR negative for H1N1
3. Child seen with ILI in OPD/A&E (Out patients/Accidents &
Emergency) treated with oseltamivir. No PCR but Rapid Kit Inf A positive.
4. Child seen with ILI in OPD/A&E not treated with oseltamivir. No
PCR but Rapid Kit Inf A negative.
5. Child seen with ILI in OPD/A&E treated with oseltamivir. No
PCR/Rapid kit test.
6. Child seen with ILI in OPD/A&E not treated with oseltamivir. No
PCR/Rapid kit test.
Possibilities interpretations:
1. Nosocomial infection (bacterial) from hospital stay
2. Another viral agent
3. Re-infected with same H1N1 strain (unlikely)
4. Infected with variant H1N1 strain
I know we will have to use clinical judgment, but it can be tough. We
have had children coming back with viral pneumonias (2nd episode
within 4 weeks).
If they were positive for H1N1 before, it is easier as there is no
need to give oseltamivir, but for the other, how many courses of
oseltamivir are we going to give?
—
Dr Amar-Singh HSS
Consultant Community Paediatrician & Head
Paediatric Department
Ipoh General Hospital
Malaysia
amarhss@gmail.com
[see also:
Influenza pandemic (H1N1) 2009 (39): pediatric deaths 20090904.3118]
.................................................cp/msp/dk
Our first new vehicle was a Nash Rambler wagon. The front seats dropped down making a bed. Us two adults slept in front. Our four tykes slept in sleeping bags in back-two facing the front and two facing the back. What good times we had!! Cooking over a campfire, catching frogs and tadpoles, counting stars, watching for shooting stars, counting the calls of a whip-poor-will before he stopped to catch his breath. As I look at my great-grand children today, I feel so sad for what they are missing as they carry around their I-Pods, play computer games and text on their cell phones. Their parents, my grand children, are frantically trying to keep up with the Jones, hiring landscapers and never taking a minute to smell the roses. Of my five children and five grand children, hubby and I are the only ones who still have a vegetable garden. So very, very sad.
How to Avoid a Soggy Crust!
Some professional bakers add a layer of bread crumbs to the bottom of their pies before adding the apples. The bread crumbs absorb part of the juice a protect the bottom crust from getting soggy. Panko crumbs are perfect. But frankly, we’ve never found them necessary Just use a dark pie pan. A dark pan absorbs heat and assures that your crust bakes. Just add a pie crust shield to avoid burning the crust edges.
Fully Loaded Apple Pie
The first of the fall storms rolled in the other night. At sunset, the sky was thick with dark, billowy clouds. The wind was strong from the northwest pressing and bending the aspen trees in the corner of the yard, their leaves chattering in rapid staccato.
The temperature dropped twenty degrees that night. In the morning, a steady, drumming rain pelted the windowpanes. It felt like the season to bake, a time to take the damp chill off the kitchen with a hot oven and a time to permeate the house with the smell of cinnamon and nutmeg.
The first apple pie of the season would be memorable, full loaded. We would gather the best baking apples we could find and make a mound of pie. We would use plenty of butter and cinnamon plus sour cream and a generous handful of walnuts. We would need some ruby red cranberries. There wouldn’t be fresh ones in the stores yet but that was okay; we would use dried ones and the steam in the pie would make them plump and tender. We would share our pie with friends, served steaming hot with a scoop of vanilla ice cream melting alongside and drizzled with a cream syrup. It would be a special pie.
And here is the recipe:
This recipe calls for sour cream, walnuts, and cranberries—hence it is fully loaded. But the secret of a great apple pie is the apples. Use the best you can find. We prefer tart apples for the recipe.
Since you are baking a high-mounded, deep dish pie, you will need about 1 1/2 to two times a normal double crust recipe. You will also need a nine-inch, deep-dish pie pan for this recipe. A dark colored pie pan will absorb heat and help bake the crust so that it does not become soggy.
Ingredients
For the crust:
9-inch double crust
For the filling:
1 cup brown sugar
1/4 cup all-purpose flour
2/3 cup sour cream
1 tablespoon lemon juice
1/2 tablespoon ground cinnamon
1/2 teaspoon ground nutmeg
1/4 teaspoon ginger
9 to 10 cups apples, peeled, cored, and sliced
1/2 cup dried or 1 cup frozen, or fresh cranberries
2/3 cup walnut pieces
4 tablespoons butter
For the topping:
1 large egg white
1 tablespoon water
1/4 teaspoon ground cinnamon
3 tablespoons granulated sugar
Directions
Preheat the oven to 375 degrees.
1. Prepare and press the pie crust into a deep-dish pie pan setting aside the dough for the top crust. Trim the crust. Do not bake the crust.
2. In a large bowl, mix the sugar, flour, sour cream, lemon juice, and spices together into a smooth paste. Add the apples, walnuts, and cranberries and mix until coated with the sour cream mixture. Scrape the apple mixture into the unbaked pie shell. Cut the butter into chunks and spread on top of the filling.
3. Roll out the top crust. Brush the top edge of the bottom crust around the rim with water to help the two crusts seal. Place the top crust over the pie. Trim the crust and seal the two crusts with the tines of a fork.
4. Mix the egg white, water and 1/4 teaspoon cinnamon together. Brush the mixture over the top of the pie. Mix the cinnamon with the granulated sugar and sprinkle over the top of the pie.
5. Cover the edges of the pie with aluminum foil to keep it from burning or use a pie crust shield. Bake for 25 minutes and then remove the foil. Bake for another 35 to 45 minutes or until the pie is bubbly and the crust is golden.
I looked up Cedar City and remembered we had seen a sign for it while we were driving around the St. George ara and Bryce Canyon and Zion Natl park. It must be a thriving city with 20,000 population. We must go there next time we are out that way. Probably sooner rather than later as we are due for a trip somewhere. We hate to leave our collie at the kennel for too long but we need at least two weeks for exploring. We have a great place in the country, over in Okla, that boards her and she is well taken care of but still we would take her with us if we could. This reminds me that we need to store dog food and I am thinking about four or six months should get us past any crisis. Hopefully!
http://www.flu.gov/vaccine/antiviralguidance.html
Updated Interim Recommendations for the Use of Antiviral Medications in the Treatment and Prevention of Influenza for the 2009-2010 Season
Objective
To provide updated guidance on the use of antiviral agents for treatment and chemoprophylaxis of influenza including 2009 H1N1 influenza infection and seasonal influenza, and assist clinicians in prioritizing use of antiviral medications for treatment or chemoprophylaxis for patients at higher risk for influenza-related complications. Additional revisions to these recommendations should be expected as the epidemiology and clinical presentation of 2009 H1N1 influenza is better understood. This guidance can be adapted according to local epidemiologic data, antiviral susceptibility patterns, and antiviral supply considerations. Clinical judgment is always an important part of treatment decisions.
Summary
* Treatment with oseltamivir or zanamivir is recommended for all persons with suspected or confirmed influenza requiring hospitalization.
* Treatment with oseltamivir or zanamivir generally is recommended for persons with suspected or confirmed influenza who are at higher risk for complications (children younger than 5 years old, adults 65 years and older, pregnant women, persons with certain chronic medical or immunosuppressive conditions, and persons younger than 19 years of age who are receiving long-term aspirin therapy.
* Persons who are not at higher risk for complications or do not have severe influenza requiring hospitalization generally do not require antiviral medications for treatment or prophylaxis. However, any suspected influenza patient presenting with warning symptoms (e.g., dyspnea) or signs (e.g., tachypnea, unexplained oxygen desaturation) for lower respiratory tract illness should promptly receive empiric antiviral therapy.
* Clinical judgment is an important factor in antiviral treatment decisions for all patients presenting for medical care who have illnesses consistent with influenza.
* Treatment should be initiated as early as possible because studies show that treatment initiated early (i.e., within 48 hours of illness onset) is more likely to provide benefit.
* Treatment should not wait for laboratory confirmation of influenza because laboratory testing can delay treatment and because a negative rapid test for influenza does not rule out influenza. The sensitivity of rapid tests can range from 10 % to 70%. Information on the use of rapid influenza diagnostic tests (RIDTs) can be found at http://www.cdc.gov/h1n1flu/guidance/rapid_testing.htm.
* Testing for 2009 H1N1 influenza infection with real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) should be prioritized for persons with suspected or confirmed influenza requiring hospitalization and based on guidelines from local and state health departments.
* Groups at higher risk for 2009 H1N1 influenza complications are similar to those at higher risk for seasonal influenza complications.
* Actions that should be taken to reduce delays in treatment initiation include:
o Informing persons at higher risk for influenza complications of signs and symptoms of influenza and need for early treatment after onset of symptoms of influenza (i.e., fever, respiratory symptoms);
o Ensuring rapid access to telephone consultation and clinical evaluation for these patients as well as patients who report severe illness;
o Considering empiric treatment of patients at higher risk for influenza complications based on telephone contact if hospitalization is not indicated and if this will substantially reduce delay before treatment is initiated.
* In selected circumstances, providers might also choose to provide selected patients at higher risk for influenza-related complications (e.g., patients with neuromuscular disease) with prescriptions that can be filled at the onset of symptoms after telephone consultation with the provider.
* Antiviral chemoprophylaxis generally should be reserved for persons at higher risk for influenza-related complications who have had contact with someone likely to have been infected with influenza.
* Based on global experience to date, 2009 H1N1 influenza viruses likely will be the most common influenza viruses among those circulating in the coming season, particularly those causing influenza among younger age groups.
* Persons with suspected 2009 H1N1 influenza or seasonal influenza who present with an uncomplicated febrile illness typically do not require treatment. However, some groups appear to be at higher risk for influenza-related complications.
* Currently circulating 2009 H1N1 viruses are susceptible to oseltamivir and zanamivir, but resistant to amantadine and rimantadine; however, antiviral treatment regimens might change according to new antiviral resistance or viral surveillance information.
* Information on the dose and dosing schedule for oseltamivir and zanamivir is provided in this document. An April 2009 Emergency Use Authorization authorizes the emergency use of oseltamivir in children younger than 1 year old (http://www.cdc.gov/h1n1flu/eua/), subject to the terms and conditions of the EUA
Background
As of August, 2009, more than 98% of circulating influenza viruses in the United States were 2009 H1N1 influenza (previously referred to as novel influenza A (H1N1). Among people who become infected with 2009 H1N1, certain groups appear to be at increased risk of complications and may benefit most from early treatment with antiviral medications. Approximately 70% of persons hospitalized from 2009 H1N1 influenza have had a recognized high risk condition (approximately 60% of children and approximately 80% among adults). These high risk conditions are the same conditions that increase the risk of complications from seasonal influenza infection.
* Children younger than 5 years old. However, the risk for severe complications from seasonal influenza is highest among children younger than 2 years old.
* Adults 65 years of age or older
* Pregnant women
* Persons with the following conditions:
o Chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, hematological (including sickle cell disease), neurologic, neuromuscular, or metabolic disorders (including diabetes mellitus);
o Immunosuppression, including that caused by medications or by HIV;
o Persons younger than 19 years of age who are receiving long-term aspirin therapy, because of an increased risk for Reye syndrome.
Among children, rates of influenza hospitalization from 2009 H1N1 have varied by age group with the highest rates of hospitalization in children younger than 2 years of age. Updated information on hospitalization rates by age group can be found at www.cdc.gov/flu/weekly.
People 65 and older are at lower risk of infection from 2009 H1N1 compared to younger age groups. However, as with seasonal influenza, people 65 or older who develop 2009 H1N1 influenza infection are at increased risk of influenza-related complications compared to younger adults.
Preliminary studies suggest that people who are morbidly obese (body mass index equal to or greater than 40) and perhaps people who are obese (body mass index 30 to 39) may be at increased risk of hospitalization and death due to 2009 H1N1 influenza infection. Additional studies to determine the risk of morbid obesity and /or obesity for these complications of 2009 H1N1 virus infection are underway. Patients with morbid obesity, and perhaps obesity, often have underlying conditions that put them at increased risk for complications due to 2009 H1N1 influenza infection, such as diabetes, asthma, chronic respiratory illness or liver disease. Patients with obesity or morbid obesity should be carefully evaluated for the presence of underlying medical conditions that are known to increase the risk for influenza complications, and receive empiric treatment when these conditions are present, or if signs of lower respiratory tract infection are present.
Transmission of 2009 H1N1 influenza is being studied as part of the ongoing epidemiologic investigation, but data available indicate that this virus appears to be transmitted in ways similar to other influenza viruses. All respiratory secretions and bodily fluids (including diarrheal stool) of 2009 H1N1 cases should be considered potentially infectious.
Close contact, for the purposes of this document, is defined as having cared for or lived with a person who is a confirmed, probable, or suspected case of influenza, or having been in a setting where there was a high likelihood of contact with respiratory droplets and/or body fluids of such a person. Examples of close contact include sharing eating or drinking utensils, physical examination, or any other contact between persons likely to result in exposure to respiratory droplets. Close contact typically does not include activities such as walking by an infected person or sitting across from a symptomatic patient in a waiting room or office.
Special Considerations for Children
Aspirin or aspirin-containing products (e.g. bismuth subsalicylate – Pepto Bismol) should not be administered to any confirmed or suspected ill case of influenza aged 18 years old and younger due to the risk of Reye syndrome. For relief of fever, other anti-pyretic medications such as acetaminophen or non-steroidal anti-inflammatory drugs are recommended.
Children younger than 4 years of age should not be given over-the-counter cold medications without first speaking with a healthcare provider.
Antiviral Treatment
Recommendations for use of antiviral medications may change as data on antiviral effectiveness, clinical spectrum of illness, adverse events from antiviral use, or resistance among circulating viruses become available. As of August 2009, more than 98% of circulating influenza viruses were 2009 H1N1 viruses susceptible to both oseltamivir and zanamivir. These treatment guidelines therefore focus on use of antiviral medications effective against 2009 H1N1 viruses. For antiviral treatment of 2009 H1N1 virus infection, either oseltamivir or zanamivir are recommended (Table 1).
Clinical judgment is an important factor in treatment decisions. Most patients who have had 2009 H1N1 virus infection have had a self-limited respiratory illness similar to typical seasonal influenza. Persons with suspected 2009 H1N1 influenza or seasonal influenza who present with an uncomplicated febrile illness generally do not require treatment. However, some groups appear to be at increased risk of influenza-related complications. Local public health authorities might provide additional guidance about prioritizing treatment within groups at higher risk for severe infection.
1. Treatment is recommended for all hospitalized patients with confirmed, probable or suspected 2009 H1N1 or seasonal influenza.
2. Treatment generally is recommended for patients who are at higher risk for influenza-related complications (see above).
3. Treatment should be initiated empirically when the decision is made to treat patients who have illnesses that are clinically compatible with influenza. Treatment should not await laboratory confirmation because laboratory testing can sometimes delay treatment and because a negative rapid test does not rule out influenza.
These recommendations should be used together with clinical judgment in making treatment decisions for both patients who are at higher risk for influenza-related complications and patients who are not at higher risk. When evaluating previously healthy children with possible influenza, clinicians should be aware that, similar to seasonal influenza, the risk for severe disease is likely to be highest among infants and younger children. Once the decision to administer antiviral treatment is made by the health care provider, treatment with zanamivir or oseltamivir should be initiated as soon as possible after the onset of symptoms.
Evidence for benefits from antiviral treatment in studies of uncomplicated seasonal influenza is strongest when treatment is started within 48 hours of illness onset. Initiating treatment as soon as possible after illness onset is also thought likely to reduce the risk of severe outcomes including severe illness or death. However, some studies of hospitalized patients with seasonal influenza treated with oseltamivir have suggested benefit, including reductions in mortality or duration of hospitalization, even for patients whose treatment was started more than 48 hours after illness onset. The recommended duration of treatment is five days. Hospitalized patients with severe infections (such as those with prolonged infection or who require intensive unit care admission) might require longer treatment courses. Antiviral doses recommended for treatment of 2009 H1N1 influenza virus infection in adults or children 1 year of age or older are the same as those recommended for seasonal influenza (Table 1). Some experts have advocated use of increased (doubled) doses of oseltamivir for some severely ill patients, although there are no published data demonstrating that higher doses are more effective. Oseltamivir use for children younger than 1 year old was recently authorized by the U.S. Food and Drug Administration (FDA) under an Emergency Use Authorization (EUA). These EUA provisions apply only when the product is provided in accordance with the local public health authority’s response plans. Dosing for children younger than 1 year old is age-based in the EUA guidance. However, some experts who are currently conducting studies on oseltamivir use in this age group prefer weight based dosing for this age group, particularly for premature or underweight infants. (Table 2) (See Emergency Use Authorization of Tamiflu (oseltamivir) available at http://www.cdc.gov/h1n1flu/eua/).
Persons at higher risk for complications from influenza or who have already developed severe illness should be treated as quickly as possible after signs or symptoms develop. To reduce delays in starting treatment, health care providers should:
1. Provide information for patients at higher risk for influenza complications about signs and symptoms of influenza and need for early treatment after symptom onset when ill with influenza;
2. Ensure rapid access to telephone consultation and clinical evaluation for these patients as well as patients who report severe illness;
3. Consider empiric treatment of patients at higher risk for influenza complications based on telephone contact if hospitalization is not indicated and if this will substantially reduce delay before treatment is initiated;
4. Request that patients at higher risk for influenza complications contact the provider if signs or symptoms of influenza develop, obtain the medication as quickly as possible and initiate treatment. In selected circumstances, providers may consider giving a prescription for an influenza antiviral to selected patients who are higher risk for influenza complications. When considering providing a prescription to patients for future use, providers might take into account patient reliability, ability to understand the information about symptoms of influenza, and access to a pharmacy. Providers might prefer to provide a prescription that requires a telephone consultation with the provider before it can be filled.
5. Counsel patients about influenza antiviral benefits and adverse effects, the potential for continued susceptibility to influenza virus infection after treatment is completed (because of other circulating influenza viruses or if illness was due to another cause), and the need to again seek early access to health care consultation if symptoms recur.
State prescribing and dispensing laws and requirements might differ. Clinicians should take applicable state prescribing and dispensing laws and requirements into account in considering these recommendations.
Patients receiving treatment should be advised that they remain potentially infectious to others while on treatment. Despite treatment with antiviral agents, including treatment with the neuraminidase inhibitors, patients may continue to shed influenza virus for up to four or more days after beginning therapy. Therefore, patients should continue good hand washing and respiratory hygiene practices during the entire period on therapy to prevent the transmission of virus to close contacts. Information about homecare of ill persons for providers and patients is available at http://www.cdc.gov/h1n1flu/guidance_homecare.htm and http://www.cdc.gov/h1n1flu/guidance_homecare_directions.htm
Treatment of influenza when oseltamivir-resistant viruses are circulating
Oseltamivir resistance is common among seasonal influenza A (H1N1) viruses. These viruses typically remain susceptible to rimantadine and amantadine. However, since April 2009, very few seasonal H1N1 viruses have circulated in the United States. Therefore, treatment, when indicated, with either oseltamivir or zanamivir is appropriate. However, if viral surveillance data indicate that oseltamivir-resistant seasonal H1N1 viruses have become more common or are associated with identified community outbreaks, zanamivir or a combination of oseltamivir and rimantadine or amantadine should be considered for use as empiric treatment for patients who might have oseltamivir-resistant seasonal human influenza A (H1N1) virus infection. National surveillance data on influenza viruses circulating in the United States is available at www.cdc.gov/flu and is updated weekly. State and local health departments are also a source of viral surveillance data in some areas. Guidance on empiric treatment recommendations when multiple influenza strains are circulating is available at http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00279.
Antiviral Chemoprophylaxis
The infectious period for persons infected with the 2009 H1N1 virus appears to be similar to that observed in studies of seasonal influenza. Infected persons may shed influenza virus, and potentially be infectious to others, beginning one day before they develop symptoms to up to 7 days after they become ill. Children, especially younger children, can shed influenza virus for longer periods. However, for this guidance, the infectious period for influenza is defined as one day before until 24 hours after fever ends.
* Post exposure antiviral chemoprophylaxis with either oseltamivir or zanamivir can be considered for the following:
o Persons who are at higher risk for complications of influenza and are a close contact of a person with confirmed, probable, or suspected 2009 H1N1 or seasonal influenza during that person’s infectious period.
o Health care personnel, public health workers, or first responders who have had a recognized, unprotected close contact exposure to a person with confirmed, probable, or suspected 2009 H1N1 or seasonal influenza during that person’s infectious period. Information on appropriate personal protective equipment is available at: Infection Control for Patients in a Healthcare Setting and might be updated frequently as additional information on transmission becomes available.
* Antiviral agents should not be used for post exposure chemoprophylaxis in healthy children or adults based on potential exposures in the community, school, camp or other settings.
* Chemoprophylaxis generally is not recommended if more than 48 hours have elapsed since the last contact with an infectious person.
* Chemoprophylaxis is not indicated when contact occurred before or after, but not during, the ill person’s infectious period as defined above.
Patients given post-exposure chemoprophylaxis should be informed that the chemoprophylaxis lowers but does not eliminate the risk of influenza and that protection stops when the medication course is stopped. Patients receiving chemoprophylaxis should be encouraged to seek medical evaluation as soon as they develop a febrile respiratory illness that might indicate influenza. For antiviral chemoprophylaxis of 2009 H1N1 influenza virus infection, either oseltamivir or zanamivir is recommended (Table 1). Duration of post-exposure chemoprophylaxis is 10 days after the last known exposure to 2009 H1N1 influenza.
Oseltamivir was authorized for use for chemoprophylaxis under the EUA for children less than 1 year of age, subject to the terms and conditions of the EUA. (See Treatment and Chemoprophylaxis for Children Younger than 1 Year of Age, below.) Age-based dosing recommendations are provided in the fact sheets included with the EUA letter of authorization, however weight-based dosing is an alternative preferred by some experts who are currently conducting studies of oseltamivir use in this age group...
An emphasis on early treatment is an alternative to chemoprophylaxis after a suspected exposure for some persons. Persons with risk factors for influenza complications who are household or close contacts of confirmed or suspected cases, and health care personnel who have occupational exposures, can be counseled about the early signs and symptoms of influenza, and advised to immediately contact their health care provider for evaluation and possible early treatment if clinical signs or symptoms develop. Health care providers should use clinical judgment regarding situations where early recognition of illness and treatment might be an appropriate alternative. In some exposure circumstances (e.g., person exposed is at higher risk for complications), health care providers might choose to give the exposed patient a prescription for an influenza antiviral. Providers can request that the patient contact the provider if signs or symptoms of influenza develop, obtain antiviral medications as quickly as possible, and initiate treatment. These patients should also be counseled about influenza antiviral medication side effects, and informed that they remain susceptible to influenza after treatment is completed.
Persons at ongoing occupational risk for exposure (e.g., health care personnel, public health workers, or first responders who are working in communities with influenza outbreaks) should carefully follow guidelines for appropriate personal protective equipment. Appropriate administrative controls (e.g. having health care personnel stay home from work when ill, and triaging for identification of potentially infectious patients) and personal protective equipment should be used to reduce the need for post-exposure chemoprophylaxis among health care workers.
Antiviral Resistance
2009 H1N1 influenza viruses are susceptible to the neuraminidase inhibitor antiviral medications, oseltamivir and zanamivir, but are resistant to the adamantane antiviral medications, amantadine and rimantadine. This susceptibility pattern is the same as that observed among seasonal influenza A (H3N2) and B viruses in recent years. Oseltamivir resistance appears to be rare at this time. However, oseltamivir-resistant 2009 H1N1 viruses have been identified, typically among persons who develop illness while receiving oseltamivir for chemoprophylaxis or immunocompromised patients with influenza who are being treated. These findings underscore the importance of careful and limited use of antiviral medications for chemoprophylaxis and the need for persons taking antiviral medications to continue to follow recommendations for hand and respiratory hygiene to prevent the spread of antiviral resistant viruses. Additional information on oseltamivir resistance among 2009 H1N1 viruses is available at http://www.cdc.gov/h1n1flu/HAN/070909.htm. Monitoring for antiviral resistance is ongoing and clinicians and state health departments should continue to follow state and national guidance for submission and testing of clinical specimens from persons with suspected 2009 H1N1 virus infection, particularly from those who develop influenza while taking chemoprophylaxis or who have prolonged viral shedding while on treatment.
Antiviral Use for Control of 2009 H1N1 Influenza Outbreaks
Use of antiviral drugs for treatment and chemoprophylaxis of influenza has been a cornerstone for the control of seasonal influenza outbreaks in nursing homes and other long-term care facilities that house large numbers of patients at higher risk for influenza complications. (See MMWR: Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008). At this time, no outbreaks of 2009 H1N1 have been reported in such settings. This may be the result of some level of immunity among persons 65 years and older and/or possibly fewer exposures of such persons to 2009 H1N1 thus far. However, if such outbreaks were to occur, it is recommended that ill patients be treated with oseltamivir or zanamivir and that chemoprophylaxis with either oseltamivir or zanamivir be started as early as possible to reduce the spread of the virus as is recommended for seasonal influenza outbreaks in such settings. Additional guidance for infection control measures in long-term care facilities can be found at: Using Antiviral Medications to Control Influenza Outbreaks in Institutions.
In addition to use in nursing homes, antiviral chemoprophylaxis also can be considered for controlling influenza outbreaks in other closed or semi-closed settings (e.g., correctional facilities, or other settings in which persons live in close proximity) where persons at higher risk for influenza complications are housed. For more information about influenza outbreaks in facilities see:
1. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009 (Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5808a1.htm)
2. Seasonal Influenza in Adults and Children—Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management: Clinical Practice Guidelines of the Infectious Diseases Society of America (available at: http://www.journals.uchicago.edu/doi/pdf/10.1086/598513).
3. Interim Guidance for Correctional and Detention Facilities on Novel Influenza A (H1N1) Virus (Available at: http://www.cdc.gov/h1n1flu/guidance/correctional_facilities.htm)
4. Interim Guidance for Homeless and Emergency Shelters on the Novel Influenza A (H1N1) Virus (Available at: http://www.cdc.gov/h1n1flu/guidance/homeless.htm)
Outbreaks in schools, camps, workplaces and other group settings should not be managed by providing chemoprophylaxis to all persons potentially exposed to influenza viruses. The healthy populations typically present in these settings should be educated about the signs and symptoms of influenza, and urged to consult their health care provider if severe illness develops. Post-exposure chemoprophylaxis can be considered for those who meet the above criteria for exposure and who have a medical condition that confers a higher risk for influenza complications. An emphasis on early evaluation and treatment, as described above, is an alternative. Persons in these settings also should be educated about hygiene and infection control measures that can reduce transmission of influenza viruses.
Table 1. Antiviral medication dosing recommendations for treatment or chemoprophylaxis of 2009 H1N1 infection.
(Table extracted from IDSA guidelines for seasonal influenza. )
[table did not print correctly]
Agent, group
Treatment (5 days)
Chemoprophylaxis (10 days)
Oseltamivir
Adults
75-mg capsule twice per day
75-mg capsule once per day
Children 12 months
15 kg or less
60 mg per day divided into 2 doses
30 mg once per day
16-23 kg
90 mg per day divided into 2 doses
45 mg once per day
24-40 kg
120 mg per day divided into 2 doses
60 mg once per day
more than 40 kg
150 mg per day divided into 2 doses
75 mg once per day
Zanamivir
Adults
Two 5-mg inhalations (10 mg total) twice per day
Two 5-mg inhalations (10 mg total) once per day
Children
Two 5-mg inhalations (10 mg total) twice per day (age, 7 years or older)
Two 5-mg inhalations (10 mg total) once per day (age, 5 years or older)
Treatment and Chemoprophylaxis for Children younger than 1 Year of Age
Children younger than 1 year of age are at higher risk for influenza-related complications and have a higher rate of hospitalization compared to older children. Oseltamivir is not approved for use in children younger than 1 year of age. However, limited safety data on oseltamivir treatment of seasonal influenza in children younger than 1 year of age suggest that severe adverse events are rare. Oseltamivir is authorized for emergency use in children younger than 1 year of age under an EUA issued by FDA, subject to the terms and conditions of the EUA.
Because infants experience high rates of morbidity and mortality from influenza, infants with 2009 H1N1 influenza virus infections may benefit from treatment using oseltamivir. (Table 2 and Emergency Use Authorization of Tamiflu (oseltamivir)).
Table 2. Dosing recommendations for antiviral treatment or chemoprophylaxis of children younger than 1 year using oseltamivir.
Age
Recommended treatment dose for 5 days
Recommended prophylaxis dose for 10 days
Younger than 3 months
12 mg twice daily
Not recommended unless situation judged critical due to limited data on use in this age group
3-5 months
20 mg twice daily
20 mg once daily
6-11 months
25 mg twice daily
25 mg once daily
Some experts prefer weight-based dosing for children aged younger than 1 year, particularly for very young or premature infants based on preliminary data from a National Institutes of Health- funded Collaborative Antiviral Study Group (CASG). When using weight-based dosing for infants aged younger than 1 year for treatment, those 9 months or older should receive 3.5 mg/kg/dose BID, and those aged younger than 9 months should receive 3.0 mg/kg/dose BID. When using weight-based dosing for infants aged younger than 1 year for chemoprophylaxis, those 9 months or older should receive 3.5 mg/kg/dose QD, and those aged younger than 9 months should receive 3.0 mg/kg/dose QD (Source: D Kimberlin et al. Oseltamivir (OST) and OST Carboxylate (CBX) Pharmacokinetics (PK) in Infants: Interim Results from a Multicenter Trial. Abstract accepted to Infectious Diseases Society of America meeting, October 2009). Health care providers should be aware of the lack of data on safety and dosing when considering oseltamivir use in a seriously ill young infant with confirmed 2009 H1N1 influenza virus infection or who has been exposed to a confirmed 2009 H1N1 influenza case, and carefully monitor infants for adverse events when oseltamivir is used. Additional information on oseltamivir for this age group can be found at: http://www.fda.gov/downloads/Drugs/DrugSafety/InformationbyDrugClass/UCM153547.pdf
Pregnant Women
Pregnant women are known to be at higher risk for complications from infection with seasonal influenza viruses, and severe disease among pregnant women was reported during past pandemics. Hospitalizations and deaths have been reported among pregnant women with 2009 H1N1 influenza virus infection, and one study estimated that the risk for hospitalization for 2009 H1N1 influenza was four times higher for pregnant women than for the general population. While oseltamivir and zanamivir are “Pregnancy Category C” medications, indicating that no clinical studies have been conducted to assess the safety of these medications for pregnant women, the available risk-benefit data indicate pregnant women with suspected or confirmed influenza should receive prompt antiviral therapy. Pregnancy should not be considered a contraindication to oseltamivir or zanamivir use. Because of its systemic activity, oseltamivir is preferred for treatment of pregnant women. The drug of choice for chemoprophylaxis is less clear. Zanamivir may be preferable because of its limited systemic absorption; however, respiratory complications that may be associated with zanamivir because of its inhaled route of administration need to be considered, especially in women at risk for respiratory problems.
Adverse Events and Contraindications
For further information about influenza and antiviral medications, including contraindications and adverse effects, please see the following:
* Antiviral Agents for Seasonal Influenza: Side Effects and Adverse Reactions.
* Harper SA, Bradley JS, Englund JA, et al. Infectious Diseases Society of America Guidelines. Seasonal Influenza in Adults and Children—Diagnosis, Treatment, Chemoprophylaxis, and Institutional Outbreak Management: Clinical Practice Guidelines of the Infectious Diseases Society of America.
* Jamieson DJ, et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet 2009;374:451-8.
* CDC. Intensive-Care Patients With Severe Novel Influenza A (H1N1) Virus Infection -— Michigan, June 2009. 2009:58:749-52. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5827a4.htm
* Rasmussen SA. Pandemic Influenza and Pregnant Women: Summary of a Meeting of Experts. Am J Public Health 2009 (epub ahead of print).
Adverse events from influenza antiviral medications should be reported through the U.S. FDA Medwatch website.
Links to non-federal organizations are provided solely as a service to our users. These links do not constitute an endorsement of these organizations or their programs by CDC or the federal government, and none should be inferred. CDC is not responsible for the content of the individual organization Web pages found at these links.
other emails:
Questions and Answers about the Updated Antiviral Recommendations
Tue, 08 Sep 2009 15:30:00 -0500
On September 8, 2009 CDC updated its recommendations for the use of influenza antiviral medicines to provide additional guidance for clinicians in prescribing antiviral medicines for treatment and prevention (chemoprophylaxis) of influenza during the upcoming 2009-2010 flu season. These recommendations are intended to help clinicians prioritize use of antiviral drugs for treatment and prevention of influenza. In general, the priority for the use of antiviral medications this season continues to be in persons at increased risk of influenza-related complications as outlined in the antiviral recommendations posted on May 6, 2009.
http://www.flu.gov/vaccine/antiviralfaq.html
Interim Guidance for State and Local Health Departments for Reporting Influenza-Associated Hospitalizations and Deaths for the 2009-2010 Season
Tue, 08 Sep 2009 16:30:00 -0500
This interim guidance provides information for state and local health departments on how to report influenza-associated deaths and hospitalizations during the 2009-2010 season.
http://www.cdc.gov/H1N1flu/hospitalreporting.htm
She also said that it *does* freeze well. She got the recipe
from a person who worked at the restaurant.
CALICO COUNTY YELLOW SQUASH CASSEROLE
1 lb yellow squash
1 small-medium white onion, chopped
1 (6 ounce) box Stove Top Cornbread Stuffing Mix
1 (10 ounce) can cream of chicken soup
8 ounces sour cream
1 1/2 cups grated cheddar cheese (I’ve also used cheddar-jack cheese)
*Cook squash in salted water until tender.
*Drain and mash.
*Add onion, Stove Top Stuffing mix, soup, sour cream and 1 cup of cheese.
*Add pepper to taste.
*Mix well.
*Put in a buttered casserole dish.
*Top with remaining 1/2 cup shredded cheese.
*Bake for 25-30 minutes at 350° or until cheese has totally melted.
Note: You may also use cream of mushroom or cream of celery soup in place
of the cream of chicken. You can adjust the amount of cheese, more or less,
to your taste as well.
In a pinch, you can use Jiffy cornbread mix in this. Prepare the cornbread
as per directions, let it cool and crumble it up well. When you do this,
you have to add some of the spices yourself, such as thyme, basil & a little
garlic. You can also add a little poultry seasoning if you so desire.
If you use the cornbread stuffing mix, it already has the seasonings. If
the squash isn’t too sweet, you can add a touch of sugar too.
Here is a muffin recipe that I created, they are healthy and freeze well. There are a lot of options to switch them around to suit your taste. Hope you like.
Connie
Healthy Tasty Muffins
Serves 24 muffins
3 c. total any combination: All bran, oats, oat bran, crushed
oatmeal squares, etc.
2 c. milk, juice or water
1-1/4 c. whole wheat or white flour
¾ c. flaxseed, ground
2 t. baking soda
2 eggs, beaten
1 c. brown sugar
¼ c. oil
Stir together dry ingredients. Add remaining ingredients; stir only enough to barely blend. Bake in muffin cups or greased muffin tin at 375 degrees for 15-20 minutes.
Substitution
Can substitute 1 cup of milk, juice, or water for 1-1/2 c. apple sauce, crushed bananas, fruit puree or any combination of your choice.
Options
-Mix in 1-2 cups of chocolate chips.
-Sprinkle tops with frozen berries, nuts or crushed banana
applesauce muffins
Ingredients
1 cup old fashion rolled oats (not instant)
1 cup non-fat milk
1 cup whole wheat flour
1/2 cup brown sugar
1/2 cup unsweetened applesauce
2 egg whites
1 tsp. baking powder
1/2 tsp. baking soda
1/2 tsp. salt
1 tsp. cinnamon
1 tsp. sugar
raisins or nuts (optional)
Directions
Soak the oats in milk for about one hour.
Preheat the oven to 400 degrees.
Spray muffin pan with cooking spray.
Combine the oat mixture with the applesauce and egg whites, and mix until combined.
In a separate bowl measure and whisk the dry ingredients together.
Add wet ingredients to dry and mix until just combined. Add nuts or raisins if desired.
Do not over mix the batter or the muffins will be tough. Spoon muffin mixture into muffin pan.
Combine the cinnamon and sugar and top each muffin with some of the mixture.
Bake for 20-25 minutes or until done.
Remove from pan, cool and enjoy.
These can be frozen and reheated in the microwave for a quick breakfast.
http://groups.yahoo.com/group/frozen-assets/
http://groups.yahoo.com/group/cheapcooking/
Gnocchi
Posted by: “Leslie
Earlier I posted that I’m not too fond of homemade pasta, or at least
think that it’s more trouble than it’s worth. The exception to this is
gnocchi, which is made with potato, flour and egg.
Incredients:
2 russet potatoes
1 cup all-purpose flour
1 egg
salt to taste
First, peel and boil two russet potatoes in plenty of salted water in
a large pot. Some say to boil them in their skins - I don’t bother.
It’s up to you. Save the pot of water for cooking the gnocchi later.
If you have a potato ricer, run the potatoes through it into a large
bowl and let them cool enough to handle. Break an egg into the
potatoes and stir together. (If you don’t have a ricer, just mash them
with a fork, masher or whatever you have.)
Add 3/4 of the flour to the potato-egg mix and mix together well. Add
flour and mix/knead together until it becomes a slightly damp but not
sticky dough. Don’t overdo it - you want it to be fairly light.
Dust a cutting board with flour and cut off a fist-sized piece of
dough, and roll it out into a “stick” about 1/2-3/4 inch in diameter,
almost like when you made “snakes” out of clay as a kid. Try to keep
the diameter consistent along the length.
With a sharp knife, cut the “snake” into evenly-sized pieces, each
about 3/4 inch long. You should wind up with pieces about the size of
a thumb tip.
Shape each piece into the traditional gnocchi-shape by pressing it
gently onto the back of a regular table fork. When you push onto the
fork, it will have a dent from your thumb on one side, and lines from
the fork on the other. Push it off the fork, and it will tend to curl
a little towards the “dent” side. Do a few, and you’ll find that it’s
really simple to get them exactly the way they look in frozen
packages, etc. It’s not at all hard to do.
When you have a couple of dozen, carefully drop them into the boiling
water you used to boil the potatoes. They will sink to the bottom of
the pot. When they are ready (a few minutes at most) they will rise to
the top. You may have to nudge one or two if they’re the last ones and
stuck to the bottom.
You can cover them with any pasta sauce you like, or just with butter,
olive oil and/or garlic. In other words, treat them like any other
pasta.
Note: If you have extra dough left over, don’t bother trying to
refrigerate it for later use - it doesn’t keep well at all. You might
be able to freeze it, but I haven’t tried. It’s easy enough just to
make more.
If you Google “homemade gnocchi” there are plenty of videos and slight
variations available. You’ll never buy expensive frozen or packaged
Gnocchi again!
- Les
Dried Strawberry Topping
1 cup boiling water
1 cup dried strawberries
1 small package strawberry gelatin
1/2 cup whipped topping
Pour boiling water over dried strawberries and soak for 3 to 4 hours or
overnight.
Drain, reserving liquid. Add water to liquid to make 2 cups. Add gelatin
and heat
until gelatin is dissolved. Add refreshed strawberries and chill until
almost set. Fold
in whipped topping and serve on squares of cake.
________________________________________________________________________
________________________________________________________________________
2. Dried Strawberry Sherbet
Posted by: “KittyHawk”
Dried Strawberry Sherbet
3/4 cup boiling water
3/4 cup dried strawberries
10 oz can sweetened condensed milk
2 Tbsp lemon juice
2 egg whites, stiffly beaten
Pour boiling water over dried strawberries and simmer, covered, over low
heat for 20 to 30 minutes. Press through sieve, discarding pulp and
seeds and
reserving liquid.
To the juice, add milk and lemon juice. Chill. Fold in stiffly beaten
egg whites.
Freeze until firm in ice cube trays.
Serves: 4
http://groups.yahoo.com/group/FoodPreservationDryingCanningAndMore/
Jack Cashill on the air:
1. Due to the huge response to the week’s Cashill column, The United States of Newark, Jack Cashill wil be taking calls from Cashill Newsletter readers while he subs for Chris Stigall on KCMO 710, 5-9 AM (Central) tomorrow. That’s this Friday, September 11. Yes, September 11th.
No matter where you are, listen online tomorrow AM to Jack Cashill at
http://www.710kcmo.com/StigallShow/tabid/413/Default.aspx
2. And for fans for Rusty Humphries, Jack Cashill will be a guest tonight at 6:30 PM (Pacific). For a list of local radio stations carrying Rusty, go to
http://radiotime.com/options/p_45426/The_Rusty_Humphries_Show.aspx
Covidien Pedi-Cap End-Tidal CO2 Detector
Audience: Anesthesiology healthcare professionals, hospital risk managers, surgical service managers
FDA notified healthcare professionals of a Class I recall of Pedi-Cap End-Tidal CO2 Detector (Pedi-Cap and Pedi-Cap 6), because the device may increase the resistance of the flow of air into the lungs, resulting in ineffective ventilation and the inability to verify the correct placement of a breathing tube when inserting it into the windpipe. This device is used in pediatric patients, weighing 2.2-33 pounds, during the process of exchanging oxygen for carbon dioxide (ventilation) in healthcare settings. There is a reasonable probability that use of the recalled PediCap will cause serious adverse health consequences or death. Covidien informed their distributors and customers to stop selling/using the affected devices and to return them to the company.
Any adverse events or quality problems that may be related to the use of this product should be reported to the FDA’s MedWatch Adverse Event Reporting program online, by phone [1-800-332-1088], or by returning the postage-paid FDA Form 3500 by mail or fax [1-800-FDA-0178].
Read the complete MedWatch 2009 Safety summary, including a link to the recll notice, at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm181878.htm
You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm
ConMed Linvatec - Universal Cables and Power Pro Handpieces
Audience: Orthopedic surgical healthcare professionals, hospital risk managers, surgical service managers
FDA notified healthcare professionals of the Class 1 recall of two ConMed Linvatec surgical service products due to reports of a switch problem resulting in unintended self-activation of these powered tools, continued running after trigger release and tool movement in unintended directions. The products are:
* Power Pro, Power ProMax, and MPower 1 Handpieces, powered surgical handpieces in which a number of surgical tools (such as drills, blades, and small cutting devices) can be attached and are used during orthopedic surgical procedures.
* Universal Cables, MC5057, the cable connects Linvatec MicroChoice Small Bone, MicroChoice, Advantage and APEX Shaver System and Power Pro Electric I and II Large Bone System electric handpieces to the power source.
The handpieces were distributed from March 29, 2002 through June 24, 2009. The cables were distributed from January 24, 2001 through February 27, 2009. ConMed has instructed users to stop using the cable immediately if the handpiece self-activates or an intermittent operation occurs and to return the handpiece and cable to the company for evaluation.
Any adverse events or quality problems that may be related to the use of this product should be reported to the FDA’s MedWatch Adverse Event Reporting program online, by phone [1-800-332-1088], or by returning the postage-paid FDA Form 3500 by mail or fax [1-800-FDA-0178].
Read the complete MedWatch 2009 Safety summary, including links to the two recall notices and the firm press release, at:
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm181833.htm
You are encouraged to report all serious adverse events and product quality problems to FDA MedWatch at www.fda.gov/medwatch/report.htm
[America, and its most important news, this is a “news alert”, real snapshot of why we are in trouble.....
Free Wings for football fans, in a town where children miss 4 out of 5 days in the new school year, because “we did not have any food in our house...” and the homeless spread out newspapers on the sidewalk and call it a bed, or worse yet simply lay down and die.........
And no one reports on the many suicides each day, for that would make us think we were in a depression.
granny]
Top Story
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Child Porn Suspect’s Wife: ‘He’s Sick’
A Las Vegas woman who turned her husband in to police after finding child porn
in her home says he’s committed the same crime before.
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White House: 1 Million Jobs Saved, Created
White House economists say the Obama administration’s recovery efforts have
saved or created more than a million jobs.
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Gaming Slump: 19 Months And Counting
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Restaurant Job Fair Continues Thursday
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Mayor To Christen Downtown ‘Firefly’
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NFL Kickoff: Free Wings For Football Fans
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Women Say They Were Duped Into Fake Reality Show
Turkish military police say they’ve stormed a villa on the outskirts of Istanbul to rescue nine women allegedly held captive after being tricked into believing they were reality show contestants. \(Sept. 10\)
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Raw Video: Open Mic Catches Calif. Lawmaker
A Republican state lawmaker in California who resigned after being caught on tape boasting about his sexual conquests says he simply was engaging in ‘inappropriate storytelling.’ \(Sept. 10\)
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‘Extreme’ Eats: Amy Faces The 6LB Burrito
“Extreme” Amy Carabba comes face to face with a massive burrito. Can she handle
it? Can you?
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Fisherman Lands 41-Pound Trout
A lifelong fisherman in northern Michigan has become a local celebrity since he
caught a record-breaking brown trout.
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Usually, I am pretty stuck on using wheat. Let’s face it, it is the most versitile grain for so many things that we usually eat. But I wanted to branch out a little more recently and add grains that had more protien, or more niacin and iron. It was just time to play a little with my food. (o:
So, we have been having a busy week experimenting with more and more ‘forgotten grains’ such as millet, popcorn, buckwheat and sprouting so many more. It’s been a fun time in our test kitchen. So there will be a few new things to share with you over the next few months.
Millet is a grain that gets ignored by most of the western culture. Traditionally used in African dishes, this grain has 6 grams of protein and a good deal of Thiamine and Iron. Pair it with some legumes (beans) and you have a complete amino acid for a protein similar to meat.
If you’ve ever cooked Couscous (it is not a grain but a wheat pasta), the Millet will be an easy transition to try. Actually, is is an easy grain to use whole.
I hope you give millet a try and enJOY playing with new foods too.
Best Blessings!
Donna
First be sure you are using millet fit for human consumption - not bird seed. (o:
To cook basic, plain millet: Rinse and drain 1 cup of millet. Set aside. In a medium saucepan, bring 2 1/2 cups water and the 1 cup millet to a boil. Cover, reduce heat to medium-low, and cook 15 minutes. Much like rice until liquid absorbs. Remove from heat and let sit covered with a towel for 20 minutes. This will be approximately 1.5 Cups in volume when done.
Once Millet is cooked and cooled, the opportunities for use are almost endless....
This one is my very favorite (so far) as a side, as a quick lunch or rolled in Nori as veggie sushi:
Millet and Veggie Salad
Ingredients:
1.5 Cups Cooked Organic Millet
1/4 Cup Cubed Cucumbers
1/4 Cup Diced Onions (red, scallions or white)
1/4 Cup Frozen Peas/Carrots
3 TBS Lowfat Italian Dressing
Optional:
1/4 Cup cooked Organic Black Beans
1/2 an Avacado Cubed*
1/4 Cup Cubed Tomato*
Mix all together in a large bowl or a container that can be coverd and refridgerated for several hours.
Serve chilled.
Lasts for almost a week in the fridge.
*Avacados added separately before serving, due to oxidation and Tomato separately due to easily spoiled.
Best Blessings and enJOY!
Donna Miller
http://www.millersgrainhouse.com
[They are having sales on pails, grains, and mills....granny]
Spelt, grain of the past, grain of the future.
Andrea Putting N.D
Spelt, grain of the past, grain of the future.
My scriptures had told me that wheat was created for the use of human kind. When I studied nutrition I had to start to question this belief, so many people have bad reactions to wheat. If God said wheat was for man, then there certainly shouldn’t be so many people reacting badly to it. Something wasn’t sitting right for me, until I discovered Spelt.
Spelt is an old grain, belonging to the Wheat family. It grew out of popularity as technology advanced and the population increased. We wanted more grain for less money. So grains were specially ‘bred’ to solve this every growing need for cheaper more profitable grain.
Some 800 years ago Hildegard von Bingen, (St.Hildegard) wrote about spelt: “The spelt is the best of grains. It is rich and nourishing and milder than other grain. It produces a strong body and healthy blood to those who eat it and it makes the spirit of man light and cheerful. If someone is ill boil some spelt, mix it with egg and this will heal him like a fine ointment.”
In many ways Spelt appears to be the perfect cereal. It makes full demands on the soil, can grow just about anywhere, is not susceptible to diseases and as it does not respond well to synthetic fertilizers, it is almost always organic.
So, why is it not commonplace?
The crop yields are less than that of the common wheat and the hulling cost as more expensive. The grain is about twice the size of wheat grains and is firmly attached to the husk. A specialised milling process is required to remove the husk. The husk has also been put to therapeutic purposes. A pillow filled with spelt husk are said to relieve pain and help with relaxation.
The Spelt grain is a highly nutritious. It is naturally high in fibre and contains more protein than other wheat. It contains 7 out of 8 essential amino acids. It contains higher than average vitamins, especially B’s, %26 minerals and high silicic acid, so it has a positive effect on the intellect, skin, hair and nails. Many who have wheat allergies and some gluten-sensitive people; find that they can safely eat Spelt based foods.
I love Spelt. It makes wonderful tasting bread. It has more taste, than regular wheat, more nutty. Spelt can be used in place of wheat in just about any recipe. I just replace it for ordinary white or wholemeal flour. Spelt is an easily digestible grain, making wonderful pasta.
One of the first things you will notice when using spelt flour is that it always seems to require less liquid than other flours. To use spelt in a recipe designed for wheat flour, you would start by using ¼ less liquid than called for or ¼ more spelt flour. It would be best to try it out on easier items, such as muffins, pancakes, coffee cake, etc., before trying to make yeast breads. I have a bread machine and I simply replace the flour in the recipes for Spelt and have great results, but you will need to keep an eye on the liquid content to start with.
For me discovering Spelt, made me release that Wheat is differently for human kinds, it just that we can’t help tampering around with things, until they aren’t what they are supposed to me. Makes you think about Genetically Modified foods, doesn’t it?
Spelt products are available on http://www.puttingitright.com.au
Andrea Putting N.D., Naturopath, Writer and creator/owner of health sites including, http://www.puttingitright.com.au, http://www.naturopathsresourcefile.info, and http://www.naturalhealth4cats.info . Explore the world of Natural Medicine; take your health into your own hands. Know how to be healthy and stay healthy.
http://www.millersgrainhouse.com/Spelt-grain-of-the-past-grain-of-the-future.html
Cooking over a campfire, catching frogs and tadpoles, counting stars, watching for shooting stars, counting the calls of a whip-poor-will before he stopped to catch his breath. As I look at my great-grand children today, I feel so sad for what they are missing as they carry around their I-Pods, play computer games and text on their cell phones.<<<
You missed, using your imagination to see real things in the way the clouds form.
Nothing like a full moon night on the desert and a few clouds to look at.
All the electronics are killing the child and adults imagination, it is easier to push a button.
I agree with you, we have come far in our inventions and have given up so much to get there.
Kids should be able to play with an empty box and make it into a house, car, spaceship, any thing they can think of.
On a blog this morning, there was a young mother that said she had not realized how many hours her children spent in front of the computer and tv, until she shut them down.
During the week, it is no electronics and after homework, the kids are expected to ‘play’, join in the family, play games with the family, etc.
She also had one night a week that the food was disaster food and not the normal foods.
Her thought was to have the kids conditioned to accept a disaster, should it come and not have to go through all the shocks at one time.
A wise Lady, I would say.
If you go to Cedar City, you will be in for a surprise, streets 100 foot and more wide, with huge shade trees.
It has a branch of the University there and there were live stage productions, almost every night of the summer, at the University.
It was a growing and pleasant town when I was there, but 1990 was and is several years ago.
6 months of dog food? I would think by then you will know what has happened and will be rationing them too.
This depression is different, for it is not only the breakdown of the banks, but pushed by those who would see the country go down and fail as we have known it.
I do not care what obama says, folks on the street are running scared and there is far more going on in any town than you will hear on the news.
I listen to the Las Vegas Police Scanner and sometimes Denver and other towns, riots, arson, suicides and folks dying on the streets, is common to the scanner.
From this link, you should be able to find your area, for it is nation wide, listen on the computer and I use the online player, it works better and uses less of my dial up internet connection:
http://www.radioreference.com/apps/audio/?ctid=1745
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