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By Fr. Francis Pizzarelli

Once again the holiday season is upon us. It is a time to reflect and slow down; a time to give thanks for the blessings we’ve received. It is a time to celebrate the great gifts of family and relationships. It’s a time for contemplation and renewed social action. For Christians around the world, it is a time to give thanks for the birth of the child Jesus, a birth that has changed the course of human history forever.

Father Francis Pizzarelli
Father Francis Pizzarelli

During this time of year, every newspaper ad and every TV commercial attempts to convince us to spend money we don’t have, on things we don’t need, for people we can stand — and we call this Christmas?! Think about this for a moment: How many cards will you send and gifts will you give because you feel compelled to do so for all the wrong reasons, rather than just giving from your heart to the people you genuinely care about?

The “reason for this season” is to celebrate the hope that lives within each of us and the belief that we have the power to make a difference in our world. We can change the world one person at a time if we draw on faith. Kindness and compassion seem contagious this time of year. There is a spirit in the air that touches people’s hearts to engage in random acts of kindness.

What has been so powerful to witness this season is so many young people reaching out to those less fortunate than themselves. Thousands of volunteers have been helping our own local Santa Claus — Charlie Russo with his Christmas Magic program — a program that touches thousands of children across Long Island who will be spending this Christmas season in our homeless shelters.

Last year around this time Hope House Ministries opened Hope Academy on the grounds of Little Portion Friary in Mount Sinai. More than 35 years ago that program of compassion and love opened its doors on the grounds of this Anglican monastery. On those grounds, Christmas miracles happen every day. Broken lives are transformed — young people who were thought to be dead have come back to life. All of this and so much more happens because ordinary people choose to do extraordinary things for others and not just at Christmas time.

Unfortunately, this holiday season there will be countless people everywhere that will not embrace the hope and joy of this extraordinary time of year. Some of them are the victims of war, some are the casualties of people’s hate and discrimination and still others will be shackled in prisons they create. We do not have enough opportunities to meet the epidemic need of those afflicted with addictions and mental health disorders. You don’t have to go to the streets of New York City to find them. They are walking and bleeding among us. Even though we are the richest county in New York State, we don’t have enough detox beds and long-term residential treatment beds to take care of our own.

The gift we could give this Christmas is to challenge the bureaucrats who lead us in Albany and Washington to celebrate this season of hope not as a season of death, to make a difference in this national health crisis we call the heroin epidemic that is infecting countless families everywhere. I pray that no one buries a son or daughter during this Christmas season due to the social indifference and benign neglect of those who lead us.

Fr. Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

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By Barbara Beltrami

The winter holidays are a time of rewards. Toys for good little children. Electronic devices for good big children. Baubles and bangles and bicycles. Sweaters and scarves and sleds. (I don’t know…these days does Santa still leave coal for bad children?)

And of course, sweet indulgences for having endured the holiday hassle, the spartan salads and remarkable restraint of the past year’s daily fare, the life of lattes instead of lunch and denial instead of dessert.

From January to November with a few hops off the wagon in between, we all feel guilty about satisfying our sweet teeth (tooths?) But come December, it’s Wahoo! Bring on those cookies and candy canes and chocolate Santas. And hey! What’s for dessert?

Here are three of my favorite desserts for the holidays. They’re all festive enough for a holiday table and easy enough for a special family treat.

Apple Tartapple-tart

INGREDIENTS:

2 cups flour

1/2 teaspoon salt

2/3 cup solid vegetable shortening

2 teaspoons sugar

4 tablespoons ice water

3-4 Granny Smith apples, peeled, cored, and cut into thin crescent-shaped slices

1/4 – 1/3 cup granulated sugar

2 tablespoons butter, cut into small pieces

1/4 cup confectioners sugar (optional)

DIRECTIONS:

Preheat oven to 425 F. In an electric food processor, blend the flour, salt, vegetable shortening and sugar; pulse until the mixture resembles coarse meal. Add ice water and process again until mixture forms ball.

Remove, place between two sheets of waxed paper and roll out into large circle that will fit bottom and sides of a well-greased 8- or 9-inch spring form tart pan. Gently lift top paper away and invert crust over pan. Peel away bottom sheet. Spread and pat dough against bottom and sides of pan. With rolling pin, remove any irregular pieces from top edge of pan. (Don’t worry if you have to patch crust as the apple slices will cover it.)

Arrange apple slices in attractive circles to fill crust. Sprinkle with granulated sugar; dot with butter. Bake 30 to 40 minutes, until crust is golden and apples are tender. Set aside on rack to cool: Gently remove tart from pan by pushing bottom of pan up. It is best to avoid trying to remove tart from bottom, but go ahead if you are brave. Before serving, sift confectioners sugar over top, if desired.

Cheesecake with Raspberry Topping

INGREDIENTS:

For the crust:

2 cups graham cracker crumbs

1/2 cup granulated sugar

1/2 cup melted butter

For the filling: 

Two 8-ounce packages cream cheese, softened at room temperature

5 large eggs, at room temperature, separated

1 teaspoon vanilla extract

2 tablespoons freshly squeezed lemon juice

1 cup granulated sugar

1 pint sour cream

For the topping:

1 pint fresh raspberries, gently rinsed and thoroughly dried

1/2 cup currant jelly, melted

Fresh mint sprigs for garnish

DIRECTIONS:

In a medium bowl, thoroughly mix graham cracker crumbs with sugar, then with melted butter. Line sides and bottom of 9-inch spring form pan (with flat bottom insert in place) with crumb mixture.  Refrigerate for at least one hour.

Preheat oven to 350 F.  In large electric mixer bowl, with mixer at medium speed or “cream,” beat cream cheese, egg yolks, vanilla, lemon juice and sugar until smooth. Add sour cream and continue beating until well blended.

In clean mixer bowl, beat egg whites until stiff.  Fold into cheese mixture. Turn cheese mixture into crumb-lined pan.  Bake 1 hour, then turn off oven and let sit in oven 1 hour longer. (When cake comes out of oven and cools, it may sink.  Do not be alarmed! The berries will cover that.)

When cooled to room temperature, run knife blade around edge of pan to loosen crust. Be sure to keep blade pressed hard against inner rim. Unclasp side of pan and lift gently from bottom. Refrigerate until ready to serve or glaze.

Spread berries evenly around top of cake. With pastry brush, coat berries with melted jelly; let set. Refrigerate. When ready to serve, garnish with mint sprigs.

Profiteroles with Pistachio-Rum Ice Cream and Chocolate  Sauce

YIELD: Serves 8

INGREDIENTS:

1 cup water

1 stick butter

1 cup flour

4 eggs

1 pint pistachio ice cream, softened but not melted

1 cup chopped red and green candied fruit or fruit peel

3 tablespoons rum

8 ounces semi-sweet chocolate pieces

8 ounces heavy cream

DIRECTIONS:

For the profiteroles: Preheat oven to 400 F. Grease a baking sheet. In medium saucepan, heat water and butter to rolling boil. Over low heat, vigorously stir in flour until mixture forms a ball. Remove from heat and vigorously beat in eggs, one at a time until mixture is smooth. Drop the dough into 8 equidistant mounds onto baking sheet. With finger tips, pat mounds into symmetrical domes.  Bake 35 to 40 minutes, until puffed and golden brown.  Allow to cool. With a sharp knife, slice about 1 inch off  tops; reserve. Carefully and gently scoop out soft dough from center; discard.  Five or 10 minutes before serving, let ice cream mixture soften a little;  fill the puffs with it and top with reserved sliced-off tops.  Stack into a pyramid and drizzle with chocolate sauce.

For the filling: Fold one cup of the candied fruit and the rum into the ice cream.  Return to freezer.

For the sauce: In a small saucepan, heat cream and chocolate pieces together.  Mix with wire whisk over medium-low heat until it reaches the consistency of chocolate pudding. Remove from heat. Let stand till just warm or room temperature. Refrigerate.  Reheat in double boiler. Add more chocolate if sauce seems too thin. Let cool a little after reheating so it’s a little less runny.

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By Linda Toga

screen-shot-2016-12-08-at-3-41-23-pmTHE FACTS: With the holidays fast approaching, I’ve been thinking about making gifts of cash to my grown children. I’ve heard that I can give each child $14,000 without any negative tax consequences. I am not wealthy but, at this point, I believe I can afford to give each of my children $14,000. I know they could really use the money.

THE QUESTION: Is there any reason I should think twice before making the gifts?

THE ANSWER: The quick answer is that when you’re talking about giving away thousands of dollars, you should always think twice. That being said, there are many factors that you should consider before deciding whether making significant cash gifts to your children is in your best interest.

Since you did not mention your age, your health status or the number of children you have, it is difficult to say which factors may prove the most important in your decision-making process.

Under current federal gift tax laws, a person can give any number of people up to $14,000 a year without incurring any gift tax liability. The recipients of the gifts need not report them on their tax returns and can simply enjoy the grantor’s generosity.

The need for the grantor to report gifts to the IRS only arises if the value of the gifts made to any one person in a single calendar year exceeds the $14,000 gift exclusion.  In that case, in April following the year in which gifts valued at over $14,000 were given to a single recipient, the grantor is required to file a gift tax return with the IRS. The return reports the amount of the gift in excess of $14,000.

For example, if the grantor made a gift of $20,000, he would have to report $6,000 of the gift on the gift tax return. Under current federal law, no gift tax will be due unless and until the cumulative value of the gifts reported by the grantor exceeds the estate tax exclusion amount in effect when the gift tax return is filed.

For gifts made in 2015 and reported in 2016, the grantor would not have to pay any gift tax unless the value of his cumulative lifetime gifts exceeded $5.45 million. Under New York State law, there is no gift tax, but the value of gifts made in the last three (3) years of the grantor’s life may be added to the value of his estate for purposes of calculating estate tax.

Since most people are not in a position to give away millions of dollars during their lifetime, whether or not a gift triggers a gift tax liability is usually not a deciding factor in making gifts. A more important factor for many grantors is whether they will need the money as they age. The cost of long-term care and the possibility that the grantor may need to apply for Medicaid are factors that frequently dictate whether gifting is a good option.

While the gift tax laws allow people to make gifts of up to $14,000 to countless people each year without adverse tax consequences, Medicaid eligibility is not governed by the tax code. As a result, many people who make gifts in accordance with the IRS guidelines are later surprised to find they are penalized for making those gifts when applying for Medicaid.

Under the Medicaid guidelines, gifts made within five (5) years of applying for benefits may trigger a penalty period based upon the value of those gifts. For younger, healthier grantors, the risk of having to apply for benefits within five (5) years of making a gift and then facing a penalty period may be minimal. However, the risk increases for the elderly or those with serious health conditions.

If you feel that you have adequate assets to cover the cost of your care, or if you have a generous long-term care insurance policy, you may not be concerned about the cost of care down the line, in which case making significant gifts to your children should be fine.

However, before you actually write those $14,000 checks to your children, I encourage you to carefully look at both your financial and physical health and assess your risk tolerance. After all, you don’t want to make the gifts this year and then have to ask your children to return the money or pay for your care next year.

Linda M. Toga, Esq. provides legal services in the areas of estate planning, probate and estate administration, real estate, small business service and litigation from her East Setauket office.

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Botanical soaps, like these found at a recent holiday fair, make great stocking stuffers.

By Ellen Barcel

It will soon be time to select holiday presents for the gardener on your list. Of course, a gift certificate to a local nursery or gardening catalog or an amaryllis bulb (some even coated with wax for minimum care) are great gifts, but consider some more unique ones. If you’re looking for a number of small gifts, such as for stocking stuffers, here are a few suggestions.

One of my favorite periodicals is the Old Farmer’s Almanac. Published annually since 1792 this (2017) is the 225th issue. It’s funny, it’s serious, it’s filled with great information and unique advertising. Expect weather forecasts for the coming year (they claim 80 percent historical accuracy), recipes, calendar information and, yes, gardening information. In other words, everything that the farmer (yesteryear’s and today’s) could find useful. The reader will pick it up again and again throughout the year to uncover added info.

At just $6.99 it’s very affordable and perfect for that gardener’s holiday stocking. Note that the company also publishes several cookbooks, an almanac for kids and a History of the Old Farmer’s Almanac. Check out the magazine section of your local store or go to www.almanac.com for details.

A Farmer's Almanac would make a great gift for a gardener.
A Farmer’s Almanac would make a great gift for a gardener.

In general, house plants are much smaller than “outdoor” plants (shrubs and trees). As a result, typical tools for the indoor gardener need to be much smaller to fit into the small houseplant containers. A set of these tiny tools makes a lovely stocking stuffer for the indoor gardener on your list. A package of plant food for indoor plants is also nice.

Scented candles remind the gardener of the past growing season. They come in a wide variety of scents including mint (frequently Christmas candles), apple cinnamon, floral and even thyme. Botanical soaps (lavender, rose, gardenia, etc.) are another option.

Varietal honey is another lovely gift. I particularly like buckwheat with its stronger flavor, but clover, wildflower, orange blossom, blueberry and sage are just a few of the many available. Bees that gather pollen from fields of these flowers then impart the subtle taste to their honey production.

We all know that gardeners should wear gardening gloves, but we also know that many times we forget. So the hands take a beating. Consider super strength hand repair creams (O’Keefe’s Working Hands, Miracle Hand Repair, Burt’s Bees Hand Repair with Shea Butter, etc. are all possibilities). A nail brush to remove the soil from under the fingernails is also a possibility.

Field guides also make great gifts for gardeners and nature enthusiasts.
Field guides also make great gifts for gardeners and nature enthusiasts.

Membership in a horticultural society isn’t expensive, supports the good work they do, and usually comes with a newsletter or magazine. Suggestions include the Arbor Day Foundation, the American Chestnut Foundation, the American Horticultural Society, African Violet Society, American Rhododendron Society, American Fern Society, Holly Society of America, Long Island Botanical Society, etc.

If your gardener has a rock garden, consider tiny statuary, including fairy doors and other fairy pieces. Kids are not the only ones who enjoy these cute little pieces.

Another option is any of the National Audubon Society’s field guides (Trees, Mushrooms, Wildflowers, etc.). They are compact (easy to carry in a small backpack), detailed and filled with color photos making them extremely useful. Go to www.audubon.org for a complete list and details.

Remember that during December there are many craft fairs that have all sorts of gardening-related gifts including some of the above suggestions. Happy Holidays!

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension and its Master Gardener program, call 631-727-7850.

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There are several boarding options for pets during the holidays.

By Matthew Kearns, DVM

No matter which holiday you celebrate this time of year there is one thing common to us all: travel. Whether we travel for a day or for over a week, this means figuring out what to do with the four-legged family members.

Bringing your pet with you

This can be as easy as loading Fluffy or Fido in the car or as complicated as figuring out how to travel by air. If traveling by air, make sure to contact the airline you plan to use first. Certain requirements include: cost of travel (do you have to pay for a full seat or just a small additional fee), health certificate (usually within two weeks of travel), vaccines and whether the airline allows you to sedate your pet for travel.

Getting a pet sitter

This can be a touchy subject as I’ve heard stories of dream pet sitters, stories of nightmare pet sitters and everything in between. Most times using a family member, friend or neighbor is the best choice. If you decide to look for a pet sitter online, make sure to set up an interview beforehand to check if the pet sitter is associated with any pet sitter associations or any state or local trade associations. An interview also gives you a chance to ask for references.

Boarding facilities

There are many boarding choices nowadays, and it can be difficult to choose which is best for you and your pet. One hopes that nothing bad will happen to our pets, but it is good to know how the facility will handle an emergency if it happens. It is best to visit the boarding facility ahead of time to check for cleanliness and orderliness, as well as find out what kind of relationship the boarding facility has with a veterinarian. 

Our boarding facility is literally attached to the animal hospital, so we have a veterinarian on premises every day (including Sundays). Other boarding facilities have a veterinarian that visits every day, and some only have a relationship with a veterinarian if your pet is injured or showing symptoms of illness. 

Additionally, when boarding at any facility, there are certain vaccines that are required by law including distemper, Bordatella (kennel cough) and rabies for dogs and distemper and rabies for cats. This may mean making an appointment with your veterinarian before dropping your pet off at the boarding facility.

Dr. Kearns and his son Matthew and his dog Jasmine.
Dr. Kearns and his son Matthew and his dog Jasmine.

I hope that this information is helpful and remember to start early in making arrangements for either a pet sitter or boarding.  The end of year holidays are the busiest time for pet boarding.

I want to wish all of the readers of this column both a safe and joyous holiday season and happy 2017. I also want to thank both Heidi Sutton and the staff of the Arts and Lifestyles section, as well as all the staff of the Times Beacon Record and affiliates for another great year.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.

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Above, Shyamalika Gopalan. The image on the screen shows methylation levels with age. Photo by Casey Youngflesh

By Daniel Dunaief

The Museum of Natural History in New York City features a slice of a 1,400-year-old sequoia tree that was cut down in California in 1891. The cross section of the tree offers a testament to history on its inside. That’s where the tree rings that grow every year mark the passing of another year. As it turns out, humans have something in common with trees. While people may not have rings in bones that an observer can see, they do have age-related changes in their genetic material, or DNA.

Human genes go through a process called methylation in which a methyl group comprised of a carbon and three hydrogens attaches to DNA. Methylation upstream of a gene generally reduces transcription, or the copying of that gene into messenger RNA that can then begin the process of building proteins.

gopalanlab2
Shyamalika Gopalan demonstrates how she prepares to extract DNA. Photo by Casey Youngflesh

Using broad time-based methylation changes, Shyamalika Gopalan, who is earning her doctorate at Stony Brook University in the Department of Ecology and Evolution, recently received a three-year grant from the Department of Justice to refine an understanding of methylation and aging. The DOJ would like to use this kind of analysis to gather more information from a scene at which the remaining clues include DNA that isn’t in one of its databases.

Gopalan isn’t the first scientist to study genetic methylation and aging. Other scientists have used blood, saliva and other tissues. She is starting with one type of tissue in the bone. “I’m trying to make” the analysis “more specific to bones,” she said. She doesn’t know how much variation she will find in the age-related methylation patterns depending on ethnicity and lifestyle. “It does appear that some sites are remarkably ‘clock-like,’” she said. “It is these types of sites I’m hoping to find and use in my research.”

Gopalan explained that millions of sites can be methylated. She’s hoping to hone in on those that act more like a clock and that change in a linear manner with time. She’s not sure how many sites she’ll use and said some changes in methylation involve removing methyl groups. “Some methylation increases and some decreases,” she said. “If you know the pattern with age at any site, you can start to build an estimate from those.”

Methylation occurs with age for several possible reasons. “A major theory for these changes in methylation level with age is that the epigenetic patterns are drifting from the optimum,” she said. “This may explain some, or even most, of the changes we observe, but I don’t think it is universally true for all sites in the genome.” Still, there probably is a biologically relevant reason why some of these sites are changing, she suggested.

Gopalan said we know that these methylation patterns are crucial in early development, from conception to birth and she suggested it probably doesn’t completely stop changing there. Some sites are probably regulated throughout life.

Gopalan is hoping to have the bone data prepared by this summer and then believes she’ll be able to get methylation types and start working on a computer algorithm to build a predictor for the next year. After her initial work, she will also shift to saliva and blood.

Like a scene from “Law & Order” or other crime shows, the DNA methylation test may be another clue for police officers or prosecutors to use to rule in or out potential suspects from a crime scene where DNA, but not a driver’s license, is left behind. If the genetic material is not in a database, “you could build a profile and it could be useful for narrowing down suspects,” Gopalan said. At this point, she is taking data for people of age classes but with different ethnicities and lifestyles and comparing them to people of a different age with a similar range of backgrounds and lifestyles.

Gopalan is using samples from medical schools around the New York area, borrowing from anatomy departments where people have donated their bodies to research or teaching. More broadly, she is interested in studying diverse populations, especially in Africa. She has worked with her thesis advisor Brenna Henn, exploring methylation from two different populations. These are the ‡Khomani San of South Africa and the Baka of Cameroon.

Gopalan was interested in working with methylation as a biomarker for aging when she came across this funding opportunity from the DOJ. “It was a good fit for what I had already been studying,” she said, adding that she hopes this method will be used in the future in forensics to assist in criminal investigations.

Krishna Veeramah, an assistant professor of primate genomics at Stony Brook and the chair of her thesis committee, described Gopalan as an “intellectually engaged student who is always eager to absorb information.” Veeramah explained in an email that he thinks “there is scope for this work to transition from basic research” to an application “in criminal forensics and related areas. It will certainly require more work and testing.”

Gopalan has been at SBU for over three years. She lives in Crown Heights, Brooklyn, and commutes about 90 minutes each way most days. She enjoys the beaches, farms, apple picking and the natural beauty of the area. Gopalan would like to continue to perform research after she earns her doctorate, whether that’s with a company, a research institution or with a university. She is excited about extracting and working with DNA, particularly from archeological sites. These samples “come from a field and, once you dust them off, it makes it personal. This is a part of a story.”

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Consuming white fleshy fruits such as pears may decrease ischemic stroke risk by as much as 52 percent.

By David Dunaief, M.D.

Stroke remains one of the top five causes of mortality and morbidity in the United States (1). As a result, we have a wealth of studies that inform us on issues ranging from identifying chronic diseases that increase stroke risk to examining the roles of medications and lifestyle in managing risk.

Impact of chronic diseases

There are several studies that show chronic diseases — such as age-related macular degeneration, rheumatoid arthritis and migraine with aura — increase the risk for stroke. Therefore, patients with these diseases must be monitored.

In the ARIC study, stroke risk was approximately 50 percent greater in patients who had AMD compared to those who did not — 7.6 percent versus 4.9 percent, respectively (2). This increase was seen in both types of stroke: ischemic (complete blockage of blood flow in the brain) and hemorrhagic (bleeding in the brain). The risk was greater for hemorrhagic stroke than for ischemic, 2.64 vs. 1.42 times increased risk.

However, there was a smaller overall number of hemorrhagic strokes, which may have skewed the results. This was a 13-year observational study involving 591 patients, ages 45 to 64, who were diagnosed with AMD. Most patients had early AMD. If you have AMD, you should be followed closely by both an ophthalmologist and a primary care physician.

Rheumatoid arthritis (RA)

In an observational study, patients with RA had a 30 percent increased risk of stroke, and those under 50 years old with RA had a threefold elevated risk (3). This study involved 18,247 patients followed for a 13-year period. There was also a 40 percent increased risk of atrial fibrillation (AF), a type of arrhythmia or irregular heartbeat. Generally, AF causes increased stroke risk; however, the authors were not sure if AF contributed to the increased risk of stroke seen here. They suggested checking regularly for AF in RA patients, and they surmised that inflammation may be an underlying cause for the higher number of stroke events.

Migraine with aura

In the Women’s Health Study, an observational study, the risk of stroke increased twofold in women who had migraine with aura (4). Only about 20 percent of migraines include an aura, and the incidence of stroke in this population is still rather rare, so put this in context (5).

Medications with beneficial effects

Two medications have shown positive impacts on reducing stroke risk: statins and valsartan. Statins are used to lower cholesterol and inflammation, and valsartan is used to treat high blood pressure. Statins do have side effects, such as increased risks of diabetes, cognitive impairment and myopathy (muscle pain). However, used in the right setting, statins are very effective. In one study, there was reduced mortality from stroke in patients who were on statins at the time of the event (6). Patients who were on a statin to treat high cholesterol had an almost sixfold reduction in mortality, compared to those with high cholesterol who were not on therapy.

There was also significant mortality reduction in those on a statin without high cholesterol, but with diabetes or heart disease. The authors surmise that this result might be from an anti-inflammatory effect of the statins. Of course, if you have side effects, you should contact your physician immediately.

Valsartan is an angiotensin II receptor blocker that works on the kidney to reduce blood pressure. However, in the post-hoc analysis (looking back at a completed trial) of the Kyoto Heart Study data, valsartan used as an add-on to other blood pressure medications showed a significant reduction, 41 percent, in the risk of stroke and other cardiovascular events for patients who have coronary artery disease (7).

It is important to recognize that chronic disease increases stroke risk. High blood pressure and high cholesterol are two of the most significant risk factors. Fortunately, statins can reduce cholesterol, and valsartan may be a valuable add-on to prevent stroke in those patients with coronary artery disease.

Medication combination: negative impact

There are two anti-platelet medications that are sometimes given together in the hopes of reducing stroke recurrence — aspirin and Plavix (clopidogrel). The assumption is that these medications together will work better than either alone. However, in a randomized controlled trial, the gold standard of studies, this combination not only didn’t demonstrate efficacy improvement but significantly increased the risk of major bleed and death (8, 9).

Major bleeding risk was 2.1 percent with the combination versus 1.1 percent with aspirin alone, an almost twofold increase. In addition, there was a 50 percent increased risk of all-cause death with the combination, compared to aspirin alone. Patients were given 325 mg of aspirin and either a placebo or 75 mg of Plavix. The study was halted due to these deleterious effects. The American Heart Association recommends monotherapy for the prevention of recurrent stroke. If you are on this combination of drugs, please consult your physician.

Aspirin: low dose vs. high dose

Greater hemorrhagic (bleed) risk is also a concern with daily aspirin regimens greater than 81 mg, which is the equivalent of a single baby aspirin. Aspirin’s effects are cumulative; therefore, a lower dose is better over the long term. Even 100 mg taken every other day was shown to be effective in trials. There are about 50 million patients who take aspirin chronically in the United States. If these patients all took 325 mg of aspirin per day — an adult dose — it would result in 900,000 major bleeding events per year (10).

Lifestyle modifications

A prospective study of 20,000 participants showed that consuming white fleshy fruits — apples, pears, bananas, etc. — and vegetables — cauliflower, mushrooms, etc. — decreased ischemic stroke risk by 52 percent (11). Additionally, the Nurses’ Health Study showed that foods with flavanones, found mainly in citrus fruits, decreased the risk of ischemic stroke by 19 percent (12). The authors suggest that the reasons for the reduction may have to do with the ability of flavanones to reduce inflammation and/or improve blood vessel function. I mention both of these trials together because of the importance of fruits in prevention of ischemic (clot-based) stroke.

Fiber’s important role

Fiber also plays a key role in reducing the risk of a hemorrhagic stroke. In a study involving over 78,000 women, those who consumed the most fiber had a total stroke risk reduction of 34 percent and a 49 percent risk reduction in hemorrhagic stroke. The type of fiber used in this study was cereal fiber, or fiber from whole grains.

Refined grains, however, increased the risk of hemorrhagic stroke twofold (13). When eating grains, it is important to have whole grains. Read labels carefully, since some products that claim to have whole grains contain unbleached or bleached wheat flour, which is refined.

Fortunately, there are many options to help reduce the risk or the recurrence of a stroke. Ideally, the best option would involve lifestyle modifications. Some patients may need to take statins, even with lifestyle modifications. However, statins’ side effect profile is dose related. Therefore, if you need to take a statin, lifestyle changes may help lower your dose and avoid harsh side effects. Once you have had a stroke, it is likely that you will remain on at least one medication — low-dose aspirin — since the risk of a second stroke is high.

References: (1) cdc.gov. (2) Stroke online April 2012. (3) BMJ 2012; Mar 8;344:e1257. (4) Neurology 2008 Aug 12; 71:505. (5) Neurology. 2009;73(8):576. (6) AAN conference: April 2012. (7) Am J Cardiol 2012; 109(9):1308-1314. (8) ISC 2012; Abstract LB 9-4504; (9) www.clinicaltrials.gov NCT00059306. (10) JAMA 2007;297:2018-2024. (11) Stroke. 2011; 42: 3190-3195. (12) J. Nutr. 2011;141(8):1552-1558. (13) Am J Epidemiol. 2005 Jan 15;161(2):161-169.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.

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By Ellen Barcel

It’s getting to be that time — the time of year when the stores are filled with irresistible holiday plants. Before you make that purchase or purchases, there are some things to remember.

First, little kids and pets have a very bad habit of putting everything they see in their mouths. While some plants are safe, others are toxic. Make sure that your children and grandchildren as well as your dogs and cats can’t get at your holiday plants. A trip to the ER should not be part of your holiday experience.

Second, if you are treating that plant as you would a bouquet of flowers, that is, a decoration for a brief time, then of course put those plants where they do the best for the décor. If, on the other hand, you wish to keep your holiday plants growing year round, then you must treat them kindly. Put them where they will get enough light. Remember to water them accordingly. Don’t overwater any cactus plant, for example, but don’t let your poinsettias dry out.

Norfork Island pines decorated for Christmas. Photo by Ellen Barcel
Norfork Island pines decorated for Christmas. Photo by Ellen Barcel

Some plants need enough humidity, like the Norfolk Island pine, which is so popular this time of year. Frequently decorated with sparkles and red bows, it makes a nice alternative to a full-sized Christmas tree. I’ve seen them in the supermarket, moderately priced, for about three feet tall. Add a few of your own decorations and you have a really nice holiday tree. I kept one growing for a number of years before the dry house air in winter finally did it in.

If you are planning to have amaryllis blooming for the holidays, you need to have that bulb planted approximately four to six weeks before the desired bloom date. While most are a bright red, there are white, pink and variegated varieties. To keep them blooming for the next year, remove the spent flower but keep the green leaves growing. You need to fertilize the plant as it is growing, since this year’s bloom is based on what the grower did the year before you bought it. The bulb will then go dormant for a number of months. If you’ve treated the bulb right, it should start to grow and bloom again in November of next year.

Look for poinsettias with the yellow center flowers still closed. They will last longer. Photo by Ellen Barcel
Look for poinsettias with the yellow center flowers still closed. They will last longer. Photo by Ellen Barcel

If you choose a poinsettia, make sure that the yellow flowers (the tiny part in the center of the “bloom”) are tightly closed, with no pollen on the red petals (actually bracts, modified leaves). This means that the flower has not really bloomed yet and will last longer in your house. If you see that the yellow flowers are open and that the pollen is out, it means the plant is an older one and will not last as long in your house.

Yes, you can try to keep a poinsettia year to year, but my experiences have not been positive ones. I treat them as I would a bouquet of flowers, nice for a decoration but to be discarded when the bloom fades. If you get one of those “doctored up” varieties, sprayed a different color or sprinkled with glitter, and are able to keep it growing year after year, you will, of course, just get the plain red bracts in future years.

Christmas cactus need dark and cool night temperatures to form buds. Photo by Ellen Barcel
Christmas cactus need dark and cool night temperatures to form buds. Photo by Ellen Barcel

Christmas cacti are much easier to keep growing year after year. They don’t mind the dry air so common in most winter houses. To get the cacti to rebloom year after year, put them in a totally dark room (or closet) each night for about two months before Christmas. The dark, the experts say, will trigger the formation of flowers. It has been my experience that as long as I keep my cacti in a very cool room (for me, my dining room) during the autumn months, the buds form. Of course, my dining room tends to be a fairly dark (but not totally dark) room in the fall.

Ellen Barcel is a freelance writer and master gardener. To reach Cornell Cooperative Extension and its Master Gardener program, call 631-727-7850.

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By Barbara Beltrami

Hello, all you cooks and bakers! I’m back after a 25-year vacation and will once again be bringing you my favorite recipes; usually easy, original, healthful, calling for quality ingredients and sometimes modified from other recipes and tested.

For a good beginning to this column and to any company or holiday meal, what else but hors d’oeuvres? In the tradition of the season, what else but cookies? While the kids are wolfing down sugar cookies and gingerbread people (we must be politically correct and not call them gingerbread men anymore) from Grandmas’s treasured recipes, the grown-ups will be sitting around calmly sipping their cocktails and wine and nibbling (or binging) on these savory cookies.

Think thin biscotti with black olives, sun-dried tomatoes and walnuts. Imagine Parmesan wafers with pungent rosemary, or olive oil-black pepper cookies. So pour yourself a drink, preheat that oven and start baking!

Parmesan-Rosemary Wafers

YIELD: 2 1/2 dozen wafers

INGREDIENTS:

1 ½ cups freshly and coarsely grated Parmesan cheese (not the kind in the package!)

1 tablespoon flour

1 ½ tablespoons minced fresh rosemary or 1 ½ teaspoons dried

½ teaspoon coarse or sea salt

½ teaspoon freshly ground black pepper

DIRECTIONS: Preheat oven to 350 F. Line two baking sheets with parchment paper. Combine all ingredients and mix well. Using a measuring teaspoon, not a regular teaspoon, and mixing well before each spoonful (the flour tends to drop to the bottom), drop mixture into little mounds onto prepared baking sheet. Bake midoven until golden, about 9 minutes. Cool on baking sheet about 5 minutes; with spatula gently remove and place on wire rack to cool.

Best if served immediately; otherwise reheat to crisp.

Biscotti with Black Olives, Sun-dried Tomatoes and Walnuts

biscotti-with-black-olivesYIELD: 3 1/2 dozen biscotti

INGREDIENTS:

1 ¼ cups unbleached all-purpose flour

4 ounces freshly and coarsely grated Parmesan cheese (don’t use the packaged kind)

1/4 teaspoon salt

freshly ground black pepper, to taste

one stick of unsalted butter, sliced into ½-inch pieces

¼ cup Italian or Greek black olives, pitted and chopped

½ cup oil-packed and drained sun-dried tomatoes, chopped

½ cup chopped walnuts

2 ½ tablespoons milk

one large egg

DIRECTIONS: In a bowl, combine flour, cheese, salt and pepper. With a pastry blender or fork, cut in butter until mixture looks like coarse crumbs. Stir in olives, tomatoes and walnuts. In a small bowl, beat together the milk and egg; combine egg mixture with dry ingredients and stir just until blended. Shape dough into a ball. Divide dough in half; pat and roll each piece into a 6- to 8-inch log and place each on a sheet of plastic wrap. Wrap tightly and refrigerate till firm, preferably overnight, but at least 6 hours.

Preheat oven to 400 F. Butter two large baking sheets. Diagonally cut the logs into ¼-inch slices and place one inch apart on the baking sheets. Bake until the biscotti are just brown around the edges (10 to 12 minutes). With a spatula, transfer to wire racks to cool.

Best if served immediately; otherwise reheat to crisp.

Olive Oil Cookies with Black Pepper

oliv-oil-cookies-with-black-pepperYIELD: 4 to 5 dozen cookies

INGREDIENTS:

Nonstick cooking spray

2 ½ cups flour

2 teaspoons freshly ground black pepper

½ teaspoon sea or coarse salt

1/2 cup sugar

2 eggs

½ cup extra virgin olive oil (yes, it does make a difference!)

¾ cup dry red wine

DIRECTIONS: Preheat oven to 375 F. Lightly spray 2-3 baking sheets with nonstick cooking spray. Combine dry ingredients. Beat together the eggs, oil and wine. Add liquid ingredients to dry mixture, stirring with a wooden spoon until a smooth dough forms. Drop by rounded measuring teaspoonsful onto baking sheets. Bake until browned around the edges, 12 to 14 minutes. Remove with spatula and cool on wire racks.

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Most snakes ... have no sign of limb development when X-rayed or when their skeletons are studied by anatomists.

By Elof Axel Carlson

Elof Carlson
Elof Carlson

The re-discovery of Mendelism in 1900 greatly enhanced breeding for new varieties of animals and plants. Similarly, the discovery of sex chromosomes and the chromosome theory of heredity enhanced Mendelism five years later. The discovery in the 1970s of genes controlling embryonic organs and body plans enhanced both embryology and genetics.

Also in the late 20th century a molecular approach was worked out that allows detection of genes and their functions using DNA sequencing and tools for isolating and inserting genes from one species into another. A good example of this is the analysis of limb development in vertebrates.

We are vertebrates because we have a spinal column and so do fish, frogs and tetrapods (four-limbed organisms like mice, humans, deer and lizards).

But some vertebrates lack limbs. Snakes are the best example of this. Boas and pythons do have internal vestigial hind limbs but totally lack any rudiments of limbs for their forelimbs. Most snakes, like vipers, have no sign of limb development when X-rayed or when their skeletons are studied by anatomists.

How did the snakes lose their limbs? The earliest ancestors of snakes did have hind limbs. Those ancestral types are only known from the fossil record. In the 1970s Hox genes, which determine development from the head to the tail, were found in vertebrates. The Hox gene for limb development is Hox C-6. It is regulated by another gene called sonic hedgehog or Shh. In vipers the Shh gene regulating Hox C-6 is mutated for both fore and hind limb production. In pythons it is nonfunctional for forelimbs but mutated with an aborted development preventing full growth of the hind limb buds.

Just this year, molecular biologists used the new techniques of gene removal and transfer (using a tool called CRSPR) and removed the Shh gene from a mouse fertilized egg. It resulted in a limbless baby mouse. When they put a python’s Shh gene in a mouse embryo whose Shh gene was removed, the resulting baby mouse had vestigial nubbins. When a mouse fertilized egg had its own Shh gene removed and replaced by that of a fish or human Shh gene, the baby mouse had perfectly normal limb development.

This work by Axel Visel and colleagues at Lawrence Biology Laboratories in Berkeley was published in the journal Cell. What makes science so attractive to scholars is its convincing logic, tested by experiments, to explore, confirm or rule out different interpretations of a puzzle. The puzzle of nature in this case is why snakes lost their limbs.

Those who see it in human terms (because we often use the ancient Greek dictum “Man is the measure of all things”) may invoke that the snake was punished for its role in corrupting humans. The scientist, however, likes to see things in more detail. There is comparative anatomy, the fossil record, experimental embryology, gene identification for function, sequencing for recognizing the gene, molecular tools for isolating the gene and experimental means of altering fertilized eggs to follow their fate.

Elof Axel Carlson is a distinguished teaching professor emeritus in the Dept.of Biochemistry and Cell Biology at Stony Brook University.

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