Hi gang: The folks at Specimatch reached out to me, hoping that our readers would find this of interest. I'm intrigued. After looking at this program, I decided to give them some coverage. They've provided readers of this blog a code to receive ONE MONTH Free: SMATCH11 (expires March 1, 2017) Merry Christmas to all of you. Nan and Dom
Web-based software service connects patients, oncologists to a comprehensive database of more than 250,000 clinical trials and targeted therapies
****Some quick details: Powered by Thomson Reuters and healthcare start-up Specimatch, Specimatch.com’s interface was created to let both doctors and patients take part in the management of their cancer care. The program is an oncologist-created cloud- and web-based software, taking the clinical and genetic data from the patient and continuously scouring more than 250K trials for precision-matched treatment opportunities. With both a clinician and a patient interface, it allows oncologists better partner with patients in ensuring the best possible outcomes from their treatment plan. It's the first service to easily put hard-to-find trial information in the hands of patients and their caregivers, empowering them to take an active role in their care.
ATLANTA, (December 1, 2016) –– Specimatch, the first continual clinical trial monitoring service, announced today the availability of its web-based software service for cancer patients and oncologists. On Specimatch.com, users can easily and intuitively connect to clinical trials personally matched to the patient’s genetic and clinical profiles.
Reducing the impact of cancer continues to grow as a priority across not only the healthcare sector, but also influential institutions ranging from global advocacy groups to the White House. Clinical trials are a key driver in bringing cancer breakthroughs to market, yet 75 percent of investigators fail to enroll the targeted amount of patients per trial despite hundreds of millions of dollars in spending per trial. Although trials offer first access to cutting-edge precision treatments, approximately 85 percent of U.S. cancer patients lack access to these opportunities and only 3 percent are successfully placed into trials.
“Accessibility to cancer trials is not only critical to improving the quality of precision medicine, but it is also an invaluable option for the cancer patient whose survival is at stake,” said Dr. Ken Dixon, founder of Specimatch, and founder/surgical oncologist of Surgical Oncologists of Northeast Georgia. “We created Specimatch as a solution for patients and oncologists to tap into a complex landscape of breakthrough treatments with both accuracy and simplicity. Specimatch alleviates the gaps in care by putting the power of precision medicine in the hands of patients and the doctors with whom they partner in the fight against cancer.”
Specimatch is a monthly subscription-based software service offering:
· Continual 24/7 Monitoring – Combs database (powered by Thomson Reuters) of more than 250,000 trials to identify matching trials in real time, based on a user-completed clinical and genetic profile
· Email Notifications – Alerts users to latest clinical trials matching their specific molecular diagnosis
· Patient Interface – Allows patients to manage their information and matching trials anywhere through the intuitive, web- and mobile-friendly Care Timeline
· Care Provider Interface – Allows clinicians to review and manage information for each of their patients in one place
· HIPAA-Compliant Cloud Infrastructure – Protects patient information with best-in-class measures exceeding HIPAA requirements
“Specimatch restores the power that a cancer diagnosis can often steal from a patient,” Dr. Dixon said. “We are proud to provide this timely information and access because we believe it’s how cancer will meet its match and survival rates will improve.”
For more information on Specimatch, visit www.specimatch.com. ***Readers of this blog may use the following code to get 1 month free of this innovative new program: SMATCH11 (expires March 1, 2017)
Specimatch is a first-of-its-kind web-based software service enabling patients and their doctors to intelligently share an expanded knowledge base to better determine the right individual cancer care. Headquartered in Atlanta, Ga., Specimatch was founded in 2016 by Dr. Ken Dixon, founder/surgical oncologist of Surgical Oncologists of Northeast Georgia, and is designed, operated and managed by a team of experienced clinical oncologists and proprietary software developers. For more information, visit www.specimatch.com and follow updates from Specimatch on Facebook and Twitter.
A three-drug combination showed both tolerability and favorable overall response rates (ORR) for patients with smoldering multiple myeloma in a phase 2 trial.
The triplet of Empliciti (elotuzumab), Revlimid (lenalidomide) and dexamethasone showed an overall response rate (ORR) of more than 80 percent, while also proving to be well-tolerated in a phase 2 trial of patients with high-risk smoldering multiple myeloma (SMM), said Irene Ghobrial, M.D., who presented the data at the 2016 American Society of Hematology (ASH) Annual Meeting.
Patients with SMM are a heterogeneous group who have a risk of progression to MM of about 10 percent per year, “yet we know that some of those patients who are high-risk smoldering myeloma patients are the ones who have a high chance of progression of 50 percent over two years,” said Ghobrial, attending physician, Medical Oncology, Dana-Farber Cancer Institute. In this latter group, the possibility to prevent progression through early therapeutic intervention is intriguing.
The appeal to early therapy is inhibition of clonal evolution, possibly enabling cure. “These patients also have a very good immune system, and therefore immunotherapy…could be very appealing because it could potentially cure those patient in the early stages,” she said.
A significant improvement in progression-free survival (PFS) was realized with the combination of Revlimid and dexamethasone in high-risk SMM compared with observation, and the response rate in the first induction phase (before maintenance) was 79 percent.
She and colleagues therefore sought to determine whether early therapeutic intervention with Empliciti, Revlimid and dexamethasone in patients with high-risk SMM could prevent or delay time to progression to overt MM, given the activity of Revlimid/dexamethasone in patients with high-risk MM and the proven safety and activity profile of the combination of Empliciti and Revlimid in patients with relapsed MM.
The primary objective was to determine the proportion of high-risk SMM patients who are progression-free at two years after receiving the triplet. “The two-year time point was picked because we know that high-risk SMM patients in general have a 50 percent chance of progression at two years,” she said. The trial was originally designed with two arms, with one using high-dose dexamethasone and the other using low-dose dexamethasone. The latter arm was closed after enrolling just 10 patients due to similar activity and toxicity to high-dose dexamethasone based on published data demonstrating that high-dose dexamethasone, given once weekly, does not have a detrimental effect on the immune system in patients with SMM.
A technique called extracorporeal blood purification (EBP) could be used to remove certain molecules from the blood and potentially treat different conditions, including multiple myeloma and kidney complications associated with the cancer.
During EBP, blood is passed through a membrane situated in a circuit outside the body, which filters it from harmful molecules, and returns it to the body.
The researchers explored two areas where EBP may play a therapeutic role for multiple myeloma and other conditions.
In the first study they assessed the ability of different membranes to remove cytokines, including IL-6, from the blood. IL-6 is a growth factor that stimulates inflammatory and autoimmune response during trauma or illness. Previous research has shown that IL-6 also acts as a survival factor in multiple myeloma, and is involved in the pathogenesis of the disease. Consequently, removing it from the blood could result in a regression of tumor progression.
The results have shown that the membranes tested in this study are able to remove IL-6 and certain cell-activating molecules from blood. They also showed that more porous mid-cut-off and high-cut-off membranes are able to remove these molecules an increased rate.
In the second study, researchers assessed the ability of two types of membranes to clear four mid-sized molecules that are of potential interest for the treatment of myeloma kidney disease, as well as other conditions such as sepsis and rhabdomyolysis, a condition where damaged skeletal muscle breaks down rapidly and is released into the blood.
They simulated treatment with both membranes and found that one of the membranes called the high-cut-off dialyzer was more efficient in removing the molecules that were being studied.
Multiple myeloma is characterized by antibody-producing white blood cells being transformed into malignant myeloma cells. These cells then start producing abnormal antibodies called M proteins, which build up in the body and can cause damage to organs, including kidneys.
Family Caregivers to Receive Free Meals Monthly Throughout 2017
Contest Goal is to Spotlight the Value and Selfless Commitment of Caregivers
Seniorlink, Inc., a leading caregiver solutions company, announced a call for entries for "Thank You Caregiver Nation" - a new contest focused on raising awareness of family caregivers - the many silent heroes who provide care and comfort to a loved one.
The contest will feature twelve winners, with one winner selected for each month of 2017. Each winner will receive a credit to purchase meal options from PeachDish, a nutritious meal kit delivery company. The winners can use their PeachDish credit to order fresh, farm-to-table ingredients to cook meals for their families, and reduce the stress of food shopping and meal planning.
There are an estimated 44 million caregivers in the United States today.i They are the partners, spouses, sons, daughters, friends and loved ones who carry out a daily mission of compassion, hope and assistance. Through their commitment they provide dignity and comfort to a family member or loved one in need of care.
"Seniorlink stands alongside family caregivers as they fulfill their vital role in their loved ones lives," said Thomas P. Riley, CEO of Seniorlink, Inc. "Caregiving can take a physical, financial and emotional toll. This contest is our way of saying thank you – and showing our unwavering commitment to provide the highest quality resources, advocacy and insights for caregivers and their families."
Individuals wishing to nominate a caregiver, or themselves if they are a caregiver, have until midnight on December 31, 2016 to register at www.tycaregivers.com. All that is required is an email address and a short written entry outlining why the nominated caregiver should be recognized. Winners will be randomly selected from a pool of applicants and notified via email.
For more than 16 years, Seniorlink has pioneered solutions for caregivers across the nation, helping them provide their loved ones with the highest quality care. Seniorlink's unique in-home care solution, Caregiver Homes, dedicates experienced care teams to work alongside caregivers and their families, offering coaching and support at every step. This model, known as Structured Family Caregiving, was the first home and community-based service in the nation to receive the National Committee for Quality Assurance's (NCQA) highest level of Accreditation for Case Management.
To move from supporting thousands to millions of caregivers, Seniorlink has developed Vela, a caregiving platform that brings compassion to technology and assists caregivers as they navigate the complex and sometimes overwhelming world of caregiving. Vela transforms the caregiving experience by connecting care partners directly with caregivers to provide them with the coaching and insights they need along their journey, ultimately improving outcomes and lowering costs for their most complex, vulnerable members. To learn more, go to www.seniorlink.com and follow on Twitter @SeniorlinkInc.
NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.
Celebrating the freshest ingredients with Southern-inspired food full of innovative flavor, PeachDish delivers a refrigerated box to your doorstep with ingredients and recipes to cook dinner at home. Customers choose from at least eight different menu options each week, including at least three vegetarian dishes. While purchasing produce at the season's peak to achieve the most flavor and nutrition, the company works directly with farmers and purveyors to source ingredients local to the Southeast, which has an especially long growing season. Boxes are priced depending on number of servings ordered, and shipping location around the U.S. Order as often as you like, with free shipping for regular subscribers.
Newly diagnosed patients treated with drugs alone more likely to progress
SAN DIEGO -- Despite the success of novel targeted agents in newly diagnosed multiple myeloma, an upfront stem cell transplant remains the best treatment choice, a researcher said here.
In a large randomized clinical trial, European investigators compared two forms of intensification therapy: high-dose melphalan (HMD) plus an autologous stem cell transplant or standard-dose bortezomib-melphalan-prednisone (VMP), according to Michele Cavo, MD, PhD, of the Bologna University School of Medicine in Italy.
After a median follow-up of nearly 32 months, the median progression-free survival (PFS) had not been reached for those getting a transplant but was 42.5 months for those getting the VMP regimen, Cavo reported at the American Society of Hematology (ASH) annual meeting.
COEUR d’ALENE — The effects of war are far and wide. For veterans, that includes PTSD, depression, unemployment, and homelessness to name a few.
But one lasting effect is not so well-known, because, according to Richard Phenneger, the government doesn’t want it to be known.
Agent Orange, a dioxin chemical used in the Vietnam War, has been linked to the deformation of the children and grandchildren of those exposed to it.
“Our government has refused to acknowledge studies by independent scientists that say this is a problem,” Phenneger said. “Once someone is exposed to Agent Orange, there’s a very good chance it attaches to the DNA, which is then passed on to future generations.”
During North Idaho College’s recent Veterans Appreciation Week, Phenneger gave a presentation about his nonprofit, Orange Heart, and how Agent Orange affects Vietnam veterans and their families.
Phenneger, the founder and president of Veteran Services Transparency, told how he stumbled upon a study about the adverse effects of Agent Orange while he was doing another study about veterans coming back from the Gulf War.
The study he found struck a nerve in him, so he decided to do more digging. He said he found evidence the U.S. government knew that Agent Orange was harmful to humans and decided to spray it in Vietnam anyway.
To get an idea of how many veterans and veteran families Agent Orange affected, he conducted a survey with the help of some researchers who found his cause worthwhile.
Of the 119 Vietnam War veterans in Kootenai County that took Phenneger’s survey, 20 percent had deformed children.
“You’d be surprised at the emotion that came out of that,” Phenneger said. “It took me a while to absorb it.”
During the presentation, Veteran Services Transparency board member Amina Fields spoke about her experiences regarding the issue.
The Vietnam refugee and American veteran echoed the idea that more studies need to be done regarding the effects of Agent Orange. She said the U.S. Department of Veteran Affairs does give out compensation for certain disabilities and health issues suffered by veterans and their families because of Agent Orange, but only for certain types of disabilities.
“We believe there are more disabilities and health issues than identified by the VA,” she said. “UNICEF did a study in 2008 that found that out of the 30.5 million children under 18 in Vietnam, 1.2 million have disabilities, and that is considered a disproportionately large amount.”
Lori Adler, a student at the Lewis Clark State College satellite campus and volunteer with the NIC Veterans Resource Center, attended the presentation and was surprised at how big of an issue Agent Orange still is.
“I came to get more education and I have a friend who served in Vietnam who is affected by Agent Orange,” she said. “I’ve been planning on talking with a senator, and now that I have found this horrific information, I’m going to bring this to him and hopefully get a change.”
Moving forward, Orange Heart and Veteran Services Transparency’s goals are to continue to bring awareness to what has been happening and continue researching.
The group wants to raise money to conduct surveys in Vietnam to show the effects of Agent Orange there, where more people were exposed to it. Phenneger guesses the organization will need to raise about $10 million to do this.
“I am confident we will be able to fix the problem,” he said.
Multiple myeloma is a B-cell cancer caused by malignant plasma cells. It's a tough-to-treat cancer, with many patients undergoing multiple treatments over time. Eventually, patients whose disease returns despite receiving multiple prior treatments are left with few treatment options. Eventually, that could change if early-stage trial results reported by bluebird bio(NASDAQ: BLUE)are confirmed in future trials.
First, some background
B-cells are immune system cells that fight infection and disease. When B cells attack infection, they mature into plasma cells that make antibodies and that are mostly found in the bone marrow, or the soft tissue that's found inside some hollow bones.
When B-cells are cancerous, they can produce tumors in the bone, as well as other places. If a patient has more than one tumor, then that patient is diagnosed with multiple myeloma. Eventually, cancerous cells in the bone marrow crowd out normal blood cells, and proteins released by them can build up and organ damage.
According to the National Cancer Institute, over 30,000 new cases of myeloma are diagnosed in the U.S. every year. Currently, theses patients are treated with various approaches, including biologics, such as Celgene's (NASDAQ: CELG) Revlimid, corticosteroids, chemotherapy, and stem cell transplants. If a patient's disease returns, or it fails to respond to a treatment, then a different treatment option is tried. Unfortunately, this approach falls short for many multiple myeloma patients, and as a result, the five-year survival rate for the disease is only about 50%.
New research shows that excess weight increases the risk that a benign blood disorder will progress into multiple myeloma, a cancer of the blood.
The study, by a team at Washington University School of Medicine in St. Louis, is published Nov. 18 in the Journal of the National Cancer Institute.
Being overweight or obese has been known to increase the risk of multiple myeloma, a cancer of the plasma cells in the blood and bone marrow that develops more often after age 60.
Multiple myeloma is preceded by a blood disorder called monoclonal gammopathy of undetermined significance (MGUS) in which abnormal plasma cells produce many copies of an antibody protein. This precancerous condition does not cause symptoms and often goes undiagnosed.
“But our findings show that obesity can now be defined as a risk factor for developing multiple myeloma through this condition,” said the study’s first author, Su-Hsin Chang, PhD, an assistant professor of surgery in the Division of Public Health Sciences at Washington University.
“For patients diagnosed with MGUS, maintaining a healthy weight may be a way to prevent the progression to multiple myeloma, if further confirmed by clinical trials.”
The researchers analyzed data from a U.S. Department of Veterans Affairs database, identifying 7,878 patients, predominately men, diagnosed with MGUS from October 1999 through December 2009.
Among these patients, 39.8 percent were overweight and 33.8 percent were obese. The researchers then tracked whether the patients developed multiple myeloma. They found that 4.6 percent of overweight patients (followed for a median of 5.75 years) and 4.3 percent of obese patients (followed for a median of 5.9 years) developed multiple myeloma, compared with 3.5 percent of people at normal weight (followed for a median of 5.2 years) – a difference that is statistically significant.
Overweight and obese MGUS patients had a 55 percent and 98 percent higher risk of progression to multiple myeloma, respectively, than normal-weight MGUS patients.
African-American men also were more likely than their Caucasian counterparts to experience a progression from MGUS to multiple myeloma.
MGUS is caused by elevated levels of an antibody protein, known as M protein, that is found in 3 percent of people over age 50. By itself, MGUS is difficult to diagnose and often does not warrant treatment.
“The diagnosis is usually by accident, often driven by tests performed for the diagnosis or management of other conditions,” Chang said. “Although our study does not directly suggest screening for MGUS, regular check-ups can help physicians monitor whether MGUS is progressing to other disorders, including multiple myeloma.”
Multiple myeloma is the third most common type of blood cancer. An estimated 30,330 new cases of the cancer will be diagnosed in 2016, and 12,650 deaths will be attributed to the disease, according to the American Cancer Society.
“Based on our finding that being overweight or obese is a risk factor for multiple myeloma in MGUS patients, and since extra weight is a modifiable risk factor, we hope that our results will encourage intervention strategies to prevent the progression of this condition to multiple myeloma as soon as MGUS is diagnosed,” Chang said.
“Also, for black people diagnosed with MGUS, close monitoring of the disease progression, in addition to maintaining a healthy weight, should be prioritized.”
Future studies are planned by Chang and other School of Medicine researchers – including senior author Kenneth R. Carson, MD, PhD, an assistant professor of oncology, and Graham Colditz, MD, DrPH, a cancer expert who also is associate director of prevention and control at Siteman Cancer Center at Washington University School of Medicine and Barnes-Jewish Hospital.
“In the future, we will look at whether healthy weight loss is inversely associated with the progression of multiple myeloma in MGUS patients or how weight change plays a role in the progression of MGUS to multiple myeloma,” Chang said.
Back pain occurring along with abnormal lab results, weight loss or fatigue should alert clinicians to the possibility of multiple myeloma, according to research published in the Journal of the American Board of Family Medicine.
“Presenting symptoms of [multiple myeloma] are vague and nonspecific. Early detection poses a diagnostic challenge in primary care,” Neta Goldschmidt, MD, of the department of hematology, Hadassah-Hebrew University Medical Center in Jerusalem, Israel, and colleagues wrote. “We sought to identify ‘red flags’ that should alarm physicians that [multiple myeloma] is the cause of the symptoms and signs.”
Researchers wrote that although back pain is the second most common reason patients consult their primary care physician, fewer than 1% of these cases are related to malignancy, and the average primary care physician may see fewer than 10 cases of multiple myeloma in their professional career.
Goldschmidt and colleagues conducted a retrospective population-based study of 110 patients with multiple myeloma between 2002 and 2011, and matched cancer-free controls with low back pain. Laboratory and clinical data were extracted from medical records for the 2-year period prior to diagnosis of multiple myeloma, or of back pain in the controls. During that time window, 37 patients with multiple myeloma experienced weight loss or fatigue and 64 experienced back pain. There was no significant difference in pain complaints among the case-controls.
In a multivariate analysis, fatigue, weight loss, anemia, elevated erythrocyte sedimentation rate and creatinine were more frequent in patients with multiple myeloma compared with controls (P < 0.001 for all). “Given the changing clinical course of [multiple myeloma], recommendations for early treatment of smoldering myeloma, and calls for screening using free light chain levels, it is important to repeat this study in larger populations and in other clinical settings to determine whether there is justification for a policy recommending early detection of [multiple myeloma],” Goldschmidt and colleagues wrote. – by Janel Miller
A new study has found a close relationship between Agent Orange exposure during the Vietnam War and high blood pressure, a conclusion that could lead the Department of Veterans Affairs to dramatically expand the number of veterans eligible for compensation.
The study, published last week by VA researchers in the Journal of Occupational and Environmental Medicine, found a higher rate of hypertension among members of the Army Chemical Corps who handled Agent Orange during the war compared to those who didn’t. Corps members who served in Vietnam but did not spray the chemicals also had a higher rate of hypertension than their peers who served outside Vietnam.
Both results were statistically significant and add to a body of evidence linking Agent Orange exposure and hypertension.
The findings come 41 years after the close of the Vietnam War and decades since the last supplies of Agent Orange were incinerated. Since then, veterans have become increasingly distrustful of the VA. They maintain that their exposure to Agent Orange, which contained the toxic chemical dioxin, has harmed their health and has been passed on to their children.
A VA working group has been studying the latest scientific literature since March to determine whether any illnesses should be added to the agency’s list of diseases for which vets are automatically entitled to compensation if they served in Vietnam. Specifically, the group has been looking at new evidence linking bladder cancer, underactive thyroid, Parkinson’s-like symptoms and hypertension to Agent Orange exposure.
The VA had been expected to announce its decision this year, but officials now say that will be left to the administration of President-elect Donald Trump.
“For this administration, the deadline for proposing new rules for potential new presumptions [of service connection to herbicide] has passed, and this will become work for the new administration to take to completion,” VA officials said in a written statement first reported last week in Stars and Stripes.
Hypertension is the most common ailment among veterans seeking health care at the VA. It is one of the most common ailments among older adults generally.
The study released last week found the prevalence of hypertension among members of the Army Chemical Corps to be higher than among other aging veterans. Although most of the Agent Orange used in Vietnam was sprayed from Air Force planes, the Army Chemical Corps also sprayed the herbicide from hand sprayers and helicopters.
This is a great time of year to visit Panama City Beach. The weather is still warm, the water is clear (but COLD), the tourists are gone and the kids are back in school. (And the pesky beach service guys are off of the beach).
Most of the restaurants are open and there's rarely a wait for a table.
Newswise — ROCHESTER, Minn. – People diagnosed with multiple myeloma are more likely to live longer if they are treated at a medical center that sees many patients with this blood cancer. Mayo Clinic researchers published these findings today in the Journal of Clinical Oncology.
Multiple myeloma is a rare form of blood cancer that attacks plasma cells – white blood cells that normally produce antibodies to fight infection. The study measures the difference in life expectancy for patients treated by doctors with varying degrees of experience with the disease.
“Studies on cancer surgery have shown the more experience the center or practitioner has, the better the outcome,” states study author Ronald Go, M.D., a hematologist and health care delivery researcher at Mayo Clinic. “It is very difficult to be proficient when doctors are seeing only one or two new cases of multiple myeloma per year. We wanted to see if volume matters when it comes to nonsurgical treatment of rare cancers such as multiple myeloma.”
The new research shows multiple myeloma patients benefit from treatment at more experienced centers. For example, patients treated at centers seeing 10 new patients per year had a 20 percent higher risk of death than those treated at centers seeing 40 new patients per year. Most cancer treatment centers in the United States see fewer than 10 new multiple myeloma patients per year.
The researchers used the National Cancer Database, examining outcomes for 94,722 multiple myeloma patients at 1,333 centers.
These findings previously were presented at the American Society of Hematology Annual Meeting in December 2015.
This study was made possible by the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery. The center’s goal is to uses data-driven science to improve the quality, safety and value of health care, and create better patient experiences. Dr. Go is a Kern Health Care Delivery Scholar in the center. Additional support came from the Eagles Cancer Research Fund Pilot Grant, Mayo Clinic Cancer Center, and the Division of Hematology.
3 lbs. fresh Gulf shrimp with heads on, 16-20 count to the pound
1 Tbs. lemon juice
2 tsp. Worcestershire sauce
1/4 cup dry white wine
2 cloves garlic, chopped
4 Tbs. black pepper (or more!)
1/4 tsp. salt
3 sticks butter, softened
2 tsp. paprika
1 loaf French bread
1. Rinse the shrimp and shake the excess water from them. Put them in a large skillet (or two) over medium heat, and pour the lemon juice, wine, Worcestershire, and garlic over it. Bring the liquids in the pan to a light boil and cook, turning the shrimp over with a spoon every two minutes or so, until all the brown-gray color in the shrimp is gone. Don’t overcook! At the first moment when you think the shrimp might be done, they will be: lower the heat to the minimum.
2. Cover the shrimp with a thin but complete layer of black pepper. You must be bold with this. When you think you have enough pepper in there, you still need a little more. Add the paprika and salt.
3. Cut the butter into tablespoon-size pieces and distribute over the shrimp. With a big spoon, turn the shrimp over. Agitate the pan as the butter melts over the shrimp and emulsifies into the liquid at the bottom of the pan. When no more solid butter is visible. Remove the pan from the burner.
4. Serve the shrimp with lots of the sauce in bowls. Serve with hot French bread for dipping. Also plenty of napkins and perhaps bibs.
Celebrating 29 years of marriage in December '17. After over 7 years of remission, Dom's Multiple Myeloma (Cancer of the blood plasma cells- attributed to Agent Orange Exposure while Dom served in Vietnam) has returned. Much of this blog concentrates on our adventure leading up to a Stem Cell Transplant, his remission, and our new adventure.