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February 5, 2016

Palestinian killed as Israel hands out West Bank demolition notices

A Palestinian youth was killed by Israeli troops following the handing out of demolition notices to seven West Bank households that belonged to terrorists.

The fatality, a male teenager, was shot Friday during riots near Hebron, according to the Ma’an news agency.

The orders of demolition — a controversial measure whose application against terrorists’ families is under frequent judicial review in Israel — were handed out Thursday to the family of Ihab Maswada from Hebron, who murdered Genadi Kaufman in a stabbing attack near the Tomb of the Patriarchs in December.

Additionally, troops gave notices to the Qalandiya family of Issa Assaf and Anan Abu Habsah, who killed Rabbi Reuben Birmajer in a stabbing attack at Jaffa Gate in Jerusalem that month; the Beit Amra home of Abdullah Dais, who murdered Dafna Meir on Jan. 17 and the Nablus homes of Bassam Saih, Ragheb Ahmad Muhammad Aliwi and Zir Ziad Jamal Amar — all members of a cell responsible for the murders of Eitam and Naama Henkin in October.

Also Thursday, Israel Defense Forces troops and border police arrested eight Palestinians suspected of terrorism in overnight raids in the West Bank, the spokespersons unit of the IDF said Friday.

Separately, the High Court of Justice on Thursday suspended demolition orders for the West Bank homes of two Palestinians who allegedly killed five Israelis in twin attacks on Nov. 19 of last year.

The court issued the temporary injunctions in response to petitions by the families of the suspected terrorists, Israel Radio reported Friday.

One of the homes belonged to Raed Masalmeh, 36, from Hebron, who admitted stabbing to death Reuven Aviram, 51, and 32-year-old Aharon Yesiav, and wounding a third person in an attack on Jewish worshipers at the Panorama building in south Tel Aviv. He has been indicted for murder at Tel Aviv District Court.

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Should you get antibiotics for that upper respiratory infection?

“The waiting is the hardest part.”
— Tom Petty

Over 100 million doctor visits in the US each year result in a prescription for antibiotics. Over a third of those visits are for respiratory infections. A large fraction of the antibiotics prescribed yield absolutely no benefit to the patient. The issue is much more severe than just unnecessary spending on ineffective medication. As I’ve written before, antibiotic overuse is a major cause of ” target=”_blank”>dangerous infections like Clostridium difficile. Antibiotics also can cause unpleasant side effects and (albeit rarely) ” target=”_blank”>an article reviewing the current evidence on the role of antibiotics in the most common respiratory infections. The recommendations are summarized below.

* * *

ACUTE BRONCHITIS
Symptoms: Cough that lasts up to 6 weeks with mild fever and aches.
Causes: Most cases are caused by viruses.
Role for antibiotics: None, unless pneumonia is present.

A generation ago we thought that colored phlegm was a sign of a bacterial infection. Now we know that the yellow or green phlegm is due to airway inflammation that can be caused by viruses or bacteria. Studies have shown that antibiotics for bronchitis don’t decrease the duration of cough and increase the rates of adverse events. If a doctor’s examination rules out pneumonia, antibiotics should be avoided.

PHARYNGITIS (THROAT INFECTION)
Symptoms: Sore throat, pain swallowing, sometimes with fever.
Causes: Usually caused by viruses. Some bacteria can also cause sore throats, most importantly Streptococcus.
Role for antibiotics: Should only be prescribed if a Strep test is positive (with rare but important exceptions in adolescents and young adults).

The presence of cough, nasal congestion, pink eye, hoarseness, diarrhea, or cold sores make a viral cause much more likely. Even in cases in which the physical examination is consistent with Strep, many patient have a viral infection. So Strep should always be confirmed by culture or rapid testing before antibiotics are prescribed.

SINUSITIS (SINUS INFECTION)
Symptoms: Nasal congestion with thick drainage, upper tooth pain, facial pain or pressure, fever, fatigue, ear pressure or fullness. Symptoms can last from a few days to a month.
Causes: Most cases are caused by viruses, allergies, or irritants. Fewer than 2% of cases are bacterial.
Role for antibiotics: Antibiotics should be prescribed if symptoms last more than 10 days, or severe or worsening symptoms last for 3 days.

Even in bacterial sinus infections, drainage of the sinuses frequently results in resolution of the illness. So decongestants like pseudoephedrine (Sudafed) or ipratropium (Atrovent) nasal spray are essential and usually curative. Antibiotics are a second line treatment if the decongestants alone don’t work.

COMMON COLD
Symptoms: Sneezing, runny nose, sore throat, cough, low grade fever, headache, and malaise lasting up to 14 days.
Causes: All colds are caused by viruses.
Role for antibiotics: None.

Antibiotics don’t help colds. Zinc supplements have been shown to modestly reduce the duration of cold symptoms if taken less than 24 hours after symptom onset, but it can cause nausea and a bad taste. There is no evidence that vitamins (like C) and herbal remedies (like Echinacea) have any effect.

* * *

On this issue, societal interest and the welfare of individual patients are aligned. No one is asking patients to forego helpful medications for the sake of preserving the benefit of antibiotics for the future. On the contrary, patients are exposing themselves to harm and harming society when they take antibiotics for illnesses for which they have no benefit. So why are so many inappropriate antibiotic prescriptions written, and why do so many patients take them?

First, lots of patients grew up in an era when antibiotics were routinely prescribed for bronchitis and for sinus infections. We just didn’t know better then. The patients improved after taking these antibiotics (as they would have had they taken carrot soup or Tylenol or nothing) and are understandably convinced that antibiotics are required in these cases. Doctors have to educate these patients despite their entrenched expectations. Many doctors find that writing a prescription is faster than taking the time to teach.

Second, antibiotics give patients the (false) impression that they are doing something to hasten their recovery. The alternative – treating symptoms and waiting – can be very difficult when one is miserable. Doctors who are fully aware that antibiotics will be ineffective sometimes relent and prescribe them because it buys us ten days during which the patient accepts he’s on the road to recovery.

So patients owe it to themselves to be educated about when antibiotics work and when they don’t. And doctors owe patients an explanation about why antibiotics won’t help and how long it will take to recover. And then patients have to do the hard part and wait. That’s why we call you patients.

Learn more:
” target=”_blank”>Appropriate Antibiotic Use for Acute Respiratory Tract Infection in Adults (Annals of Internal Medicine summary for patients)
” target=”_blank”>CDC Sounds the Alarm about Antibiotic Resistance
” target=”_blank”>Clostridium difficile Infections on the Increase
” target=”_blank”>Untreatable Gonorrhea – The Next Infectious Threat

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Sanders, Clinton in sharp exchange over his Iran policy

Hillary Rodham Clinton and Bernie Sanders snapped at one another over Sanders’ Iran policy in their final debate before the New Hampshire primary contest, with Clinton twice suggesting it would endanger Israel.

The NBC moderators of the debate in Durham, New Hampshire on Thursday night pressed Sanders on what they said were gaps in his foreign policy; Sanders has not named a foreign policy team of advisers and generally focuses on the economy in his campaigning.

Clinton stepped in with her own broadside, naming Israel as facing increased dangers under Sander’s policies.

“A group of national security experts, military intelligence experts, issued a very concerning statement about Sen. Sanders’s views on foreign policy and national security, pointing out some of the comments he has made on these issues, such as inviting Iranian troops into Syria to try to resolve the conflict there; putting them right at the doorstep of Israel,” she said.

Sanders has not quite advocated inviting Iran to add troops to its contingent already in Syria, where it is allied with the Assad regime and is combating rebel forces, including the Islamic State terrorist group. Instead, in a November debate, he lumped Iran in with other Muslim states he said would be more appropriate than the United States to directly battle the Islamic State.

“The Muslim nations in the region — Saudi Arabia, Iran, Turkey, Jordan, all of these nations — they’re going to just have to get their hands dirty, their boots on the ground,” he said in the November debate.

Sanders, an independent senator from neighboring Vermont, is leading Clinton substantially in New Hampshire, the first primary state, which votes on Tuesday. He tied with Clinton in Iowa, the first caucus state, on Monday, and a win in new Hampshire could lend him momentum as he challenges Clinton nationally, where she is ahead in polling.

He has pushed back against Clinton’s resume, which includes a stint as President Barack Obama’s first secretary of state, by noting that he opposed the Iraq War in 2002, while Clinton, then a senator from New York, supported it. She now says she regrets voting for the war.

He returned to that theme on Thursday night. “Once again, back in 2002, when we both looked at the same evidence about the wisdom of the war in Iraq, one of us voted the right way and one of us didn’t,” he said.

Sanders and Clinton also tussled over whether he said he would “normalize” ties with Iran in the wake of last year’s nuclear deal with the country, which both candidates support. In a debate last month, Sanders said, “What we’ve got to do is move as aggressively as we can to normalize relations with Iran,” although he quickly added that he was not advocating for full ties, and noted Iran’s backing for terrorism.

“They are destabilizing governments in the region, they continue to support Hezbollah and Hamas in Lebanon against Israel,” Clinton said at Thursday’s debate. “If we were to normalize relations right now, we would remove one of the biggest pieces of leverage we have to try to influence and change Iranian behavior.”

Sanders said he never advocated immediately normalizing relations. “Who said that I think we should normalize relations with Iran tomorrow?” he said. “I never said that. I think we should move forward as quickly as we can.”

Unusually for Sanders, who has been reticent about his Jewish upbringing, he closed Thursday’s debate by relating a memory of his father.

“My dad came to this country at the age of 17 from Poland,” he said.

“Didn’t have any money, couldn’t speak English, he died pretty young, and I think it would have been beyond his wildest dreams to see his son up here on this stage today running for president,” Sanders said. “I love this country, and my dad loved this country, and he was the most proud American because of what it gave him in terms of raising his family, even though we never had much money.”

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5 Top Dishes from Albuquerque’s StreetFood Asia

Chef Tai Tok, owner of StreetFood Asia and StreetFood Market, is making quite a culinary splash these days by bringing an Asian concept never seen before in my taste trek wanderings. A native of Malaysia, he introduces a medley of Asian cuisines into one inclusive though extensive menu.

Whether Malaysian, Chinese, Japanese, Korean, Thai or Vietnamese, he keeps the cuisines distinctive, tasty, and authentic to this region of the world. How does he do it? By offering 7 different wok Asian broths, 3 different Asian curries, and 6 different wok Asian flavors. And when it comes to lobster – a house specialty – you can have it steamed and served with butter or coconut-battered in addition to 16 other flavorings. That’s a lot of food flavors, seasonings and choices.

StreetFood Asia is located in the trendy neighborhood of Nob Hill, the cultural and voguish hub of Albuquerque. With large picture windows overlooking Old Route 66, the Asian bistro serves up sumptuous and generous portions that easily make for another take-home meal. If this is your first visit, the best way to try the different ethnic dishes is by ordering the appetizers or samplers.

The diverse menu almost guarantees that there’s something for everyone – so it makes for a great venue for large group celebrations. The menu can also be customized for vegetarians and gluten-free eaters. Just let your waiter know before you order. Plus, if you have an aversion to an ingredient like I do with green bell peppers, just let them know. Likewise for substitutions.

Also, after browsing the menu it will be obvious that the different city streets indicate the different Asian foods. From Beijing Street (Chinese), Kuala Lumpur Street (Malay), Tokyo Street (Japanese) Seoul Street (Korean), Bangkok Street (Thai), to Saigon Street (Vietnamese), they are easily labeled on the menus and identified with the specific ingredients and cooking style. That translates into great Asian street food dishes such as Vietnamese pho, Korean BBQ, Malay satay, Japanese udon, and Chinese stir-fry. And you can have any of them conveniently in one place.

Don’t be alarmed by the voluminous menu offerings. Focus instead on whether you want to order a seafood specialty, small plates, dumpling bar, wok fried noodles, noodle soup, curries, Kuala Lumpur Street satay bar, or salads.

Though I didn’t have room to try any of the salads, each of the four menu items were equally inviting: Saigon street vermicelli salad, Bangkok street papaya salad, Kuala Lumpur street tofu salad, and Tokyo street salad. As if that isn’t enough, the four different salads can have different protein choices cooked in the street style of preference. Four different reasons why I need to come back.

StreetFood Asia also has daily features such as orange sesame chicken, sriracha chicken, Mongolian beef, grilled chile tofu and Portobello, grilled spare or short ribs, and fried coconut chicken.

1.  Dumpling Sampler – From the streets of Seoul and Beijing come vegetable and chicken dumplings that can be steamed, pan seared or crispy along with grilled beef bulgogi bao, shrimp cilantro, BBQ pork, and chicken bao. 

2.  Char Kway Teow (Kuala Lumpur Street) – This is a wok-seared fresh wide rice noodle dish with a mixture of eggs, garlic, and rice wine. Vegetables are yellow onions, bell peppers, bean sprouts, green onions, spinach, and tofu with seasonings that include Malay sambal tamarind, spicy chili paste, Thai chilis, kecap manis, basil, and lemon grass. The House, otherwise known as the special edition, includes shrimp and Chinese Lap Cheong sausage. The dish presented with a textured yet layered profiled. I absolutely loved the dish but wasn’t as wild about the Chinese sausage.  

3.  Malay Curry Laksa (Kuala Lumpur Street) – This award-winning soup is a tantalizing mixture of Chinese vermicelli rice noodles, spicy Malay coconut curry chicken broth, basil, spinach, bean sprouts and cilantro. The house version comes with the addition of shrimp, calamari, and stuffed shrimp tofu. The flavor profile is complex, sensuous, with a distinctive depth to each ingredient.

4.  Grill Sampler – Inspired by streets in Bangkok, Beijing, and Seoul, the sampler is a meat-eater’s delight with chicken wings, pork spare ribs, and beef short rib kalbi – all grilled to perfection. (The chef let me in on a secret that a mutual celebrity chef we both know from Santa Fe loves to dine on the specialty ribs!)  

5.  Seafood Lobster Combo – A house specialty and fan favorite, the seafood medley includes lobster tail (or whole if preferred), salmon, jumbo shrimp, calamari steak strips, clams, and mussels. My combo was fresh, succulent and bursting with a sapid profile. The dish can be made with 16 different flavors and prepared steamed and served with butter or coconut-battered. The choices are yours to make.

As might be expected, specialty drinks are available from a separate menu, including their house famous lemonade. (They also have a delicious freshly-made limeade, my favorite.) Also, an extensive selection of green, black, herbal, white, and oolong teas make sure you don’t leave thirsty.

Save room for dessert, as the hot sesame balls with red bean paste are absolutely divine – the best I’ve ever had, and believe me, I’ve had a few. (Sesame balls should always be eaten while they are warm as they do not reheat well).

If in Albuquerque, do yourself a favor by trying the six Asian flavors at StreetFood Asia. As Chef Tai Tok says, “Nobody does what we do anywhere in the country, so you need to come here.” Your taste buds will thank you.

StreetFood Asia

3422 Central Avenue, SE

Albuquerque, New Mexico 87106

(505) 260-0088

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