Mushroom Tapenade

By : Karen
Mushroom Tapenade
Makes about 1½ cups

1½ lbs. mixed, fresh mushrooms, button, portabello, shiitake, oyster, etc.

3 Tbsp. extra-virgin olive oil
¼ tsp. salt
3 cloves garlic, minced
6 anchovy filets
1 Tbsp. drained capers
2 tsp. minced fresh rosemary or thyme
½ - ¾ cup extra-virgin olive oil
salt and pepper to taste

Preheat the oven to 425 F. Remove any tough stems from the mushrooms. Toss with the 3 Tbsp.
olive oil and salt. Spread out in a single layer onto a baking sheet and roast for 20 minutes. Some
will be shriveled and this is fine. Let cool.

Place in a food processor with the garlic, anchovies and capers, rosemary or thyme. With the
motor running, slowly add the olive oil to form a juicy paste. Taste and season with salt and
pepper.

Calories: 2148
Fat: 221 grams
Carbs: 30 grams
Fiber: 8 grams
Protein: 28

Easy Tuna Spread

By : liz (lizzy38)
1 cup ricotta cheese
2 tbs. fresh chopped basil or 2 tsp. of dried.
2 tbs. lemon juice
2 tbs. sour cream
1 can (12 oz.) tuna in water, drained
Place all ingredients in blender or food processor. Blend on medium speed until smooth.
Place this in a mold lined with plastic wrap or in several sm. molds and refrigerate about 2 hrs. or
until set. Carefully remove from mold and set on serving plate.

Calories 20 carb. 1 gr. protein 4 gr.

You can put this on a wheat thin or by itself on a plate and top it with a sliced tomatoe and alfalfa
sprout.

Ingredients:
 • 1 lb very firm tofu (I use one labeled "high protein extra firm")
• oil
• salt and/or other seasonings

Preparation:
1. Heat about 1/4 inch of oil in a large skillet (I like to use a non-stick pan) .

2. Slice the tofu into rectangles about 1/4 - 1/3 inch thick. They will shrink slightly during
cooking.

3. Place tofu pieces in the pan (if the oil doesn't sizzle, it isn't hot enough yet). Leave
some space between the pieces.

4. Fry each piece until golden brown in the bottom, about 3-4 minutes. You will start to
see the edges turning color. Turn and brown on the other side, about 2 minutes or so.

5. Remove from pan to a cooling rack or absorbant toweling. If using salt or other
seasoning, do it while the chips are still hot.

Serving Suggestions

There are lots of ways to use tofu chips. Here are but a few:

1. Use instead of chips for nachos, by melting cheese over the top and serving with
guacamole, salsa, and sour cream.

2. Sprinkle with cinnamon and granulated sugar substitute, then use butter and sugar-free
syrup or jam, similar to French toast.

3. Use similar to crackers as a vehicle for spreads and dips, or as the foundation for
appetizers that might ordinarily go on bread, such as pesto or eggplant spread.

4. Same as above, only sweet - cover with peanut butter and/or sugar-free jam.

5. Sprinkle with hot pepper, or any other spice that strikes your fancy, when hot.
DEVILED EGG
Ingredients:

• 12 eggs, hard boiled

• 1/3 cup regular mayonnaise
• 2 T prepared mustard (yellow or brown)
• 1/4 cup sugar-free sweet pickle relish, or see note above
• A few drops of hot sauce
• Salt (about 1/4 teaspoon, or to taste)
• Pepper to taste
• 2 T chopped chives (not totally necessary, but good)
 • Paprika, sweet, hot, or smoked, depending on your taste

Preparation:
1) Split hard-boiled eggs, and remove the yolks.

2) Mash the yolks with a fork, and mix with the other ingredients.

3) Fill the cavities in the egg white, smoothing the mixture over the top (or pipe it in, or
however you want to do it).

4) Sprinkle paprika over the top.

Nutritional Information: Each serving (1/2 an egg) has less than half a gram of
carbohydrate plus 3 grams of protein, and 59 calories
FRENCH TOAST
Ingredients:

• 2 eggs
• 4 T ricotta (or cream cheese)
• dash cinnamon and nutmeg

• 2 pkt Splenda

Directions:

• Heat frying pan. Mix all ingredients together.

• Melt some butter in small frying pan and pour batter in, spreading a little.
• Brown on one side, and flip, and brown other side

How the medical system manages patients with

suspected or confirmed heart failure in Hungary
In Hungary, left ventricular dysfunction not causing complaints is generally not
diagnosed. Systematic screening examinations (like echocardiography or brain natriuretic
peptide) are not currently ongoing, however, diagnostic tests (ECG, chest X-ray) for
abnormalities are carried out because other indications or evaluation of left ventricular
failure causing disease (hypertension, coronary heart disease, valvular heart disease,
inflammatory states) may reveal subclinical (asymptomatic) left ventricular dysfunction.

Heart failure patients generally turn to primary care physicians to seek help with their
complaints. This means that the first level of medical care, which most of the time,
besides recording medical history and physical examination, the first ECG, blood count,
routine chemical tests and urinalysis are performed. In the case of patients presenting
with mild, non-typical symptoms the primary care physician may frequently not consider
heart failure. Only typical complaints and severe symptoms warrant suspicion of left
ventricular dysfunction at this level. In the case of acutely presenting heart failure, the
patient is often evaluated and treated first by the emergency service. Family practitioners
when suspecting heart failure refer patients to higher levels of medical care. The possible
secondary care institutions are the following:

• internal medicine or outpatient clinics specialized in cardiology, organized by

territorial assignment;
• hospitals with cardiology departments;
• cardiology center outpatient clinics;
• regional internal medicine hospital or intensive care units in the case of severe or
acute clinical presentation; and
• a small percentage of patients reach tertiary care cardiology centers directly at this
level since those centers have territorially assigned secondary care obligations.

At secondary level institutions of care there is the possibility to obtain clear-cut diagnosis
of heart failure, assess left ventricular function and evaluate haemodynamic background.
In these facilities cardiology consultants, echocardiography and in some cases isotope
diagnostics are available. To evaluate the exact stage of heart failure treadmill tests are
often used as well as outpatient Holter monitoring for recognition of electrophysiological
consequences. In general, mild or medium clinical stage, heart failure patients and those
who do not need invasive studies or treatment (cardiac catheterization, electrophysiology
procedures and cardiothoracic surgery) receive care and start treatment at this level.
Follow-up is done by the family practitioner in co-operation with secondary care
specialists.

Recently, drug therapy for cardiac failure tends to follow the up to date standards in most
of the secondary care institutions. Not only digitalis and diuretics but also ACE inhibitors
are given to patients with heart failure, however — it is worth to point out — in doses
lower than in the large survival studies. Treatment is usually targeted only to alleviate
symptoms; haemodynamic variables are not taken into consideration. Patients — with the
exception of nitrates that are widely used ischaemic heart disease — are not taking direct
vasodilators or β-blockers. Newer agents in clinical phase studies are rarely used.
Recently the use of calcium antagonists is pushed to the background at even the
secondary level institutions.

In the case of severe heart failure, inadequate response to therapy, the need of diagnostic
or therapeutical devices not available at secondary level institutions and for the above
mentioned invasive procedures, patients are transferred to tertiary centers as in- or out-
patients, currently, there are six tertiary centers serving Hungary’s population, three of
them in the capital, Budapest, and the rest in the major regional cities. In these centers
cardiac catheterization, coronarography, PTCA, PTA and stenting are routine practices as
well as cardiac-surgery. In addition some of them are equipped with electrophysiology
and molecular biology laboratories. Transesophageal echocardiography is available in all
six centers of Hungary. Only one of the centers is running a heart transplantation program
and the number of operations are very limited (10–12/year) primarily due to financial
reasons. Implantation of mechanical devices assisting the left or both ventricles is
currently unavailable in Hungary.
At tertiary level, the drug therapy of heart failure is following the 1997 European
guidelines, but it is far from homogenous. There are marked differences in the frequency
of β-blocker use, the dosage of ACE inhibitors, the usage of adjunctive direct
vasodilators, the prevalence of hemodynamics oriented steering of drug therapy and the
spectrum of new methods currently in the phase of clinical studies.

Tertiary centers reroute patients to the primary care physician after fine-tuning their
treatment regime, however by virtue of regular outpatient control visits these patients
continue to be followed by tertiary care specialists. Often the regional secondary level
institution also takes part in the regular checkouts. In cases of worsening clinical
condition or need of additional studies patients are usually referred back to the regional
center.

In Hungary, gerontology care network in its current, inadequately built state, compared to
family care physicians does not play a significant role in heart failure management.