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How a Toothpick Nearly Killed Teen

The Free Press WV

He suffered from nausea, diarrhea, abdominal pain, bloody stool, and fever for almost three weeks before doctors finally figured out what was wrong. The answer may seem almost funny—but by the time the mystery was solved, it had caused an infection that nearly killed him. What was the problem? The 18-year-old, a professional athlete who was on the road for training with his team at the time, had swallowed a 3-inch toothpick from a sandwich he ate. His case was recently reported in the New England Journal of Medicine. As the New York Times reports, toothpicks are often swallowed without incident, but a 2014 analysis of 136 serious cases found almost 10% were fatal. The wood picks aren’t affected by stomach acid or digestive enzymes, and they’re hard to see on medical scans.

In the athlete’s case, he visited doctors and hospitals multiple times over the course of his illness, but everyone was stumped; blood tests, a CT scan, and an MRI offered no clues. Finally, as his symptoms became even more severe and his temperature jumped to 105 degrees, doctors performed a colonoscopy and found the toothpick. It had poked through the man’s intestinal wall and pierced an artery, letting bacteria into his bloodstream and causing severe bleeding. Blood started spurting from the artery once the toothpick was removed, and the patient was rushed into surgery to repair his intestine and artery; ultimately, a 1.2-inch segment of the artery had to be removed due to damage and replaced with a vein from the patient’s thigh.

FALLEN CHOCOLATE CAKES

The Free Press WV

Fallen chocolate cake, or molten chocolate cake, is an undercooked-in-the-center mound of intense, buttery chocolate cake. We wanted to turn this restaurant-menu standard into a practical recipe for home cooks.

Beating the egg whites and yolks separately and then folding them together as some recipes instruct resulted in a cottony cake; we found that beating the eggs with sugar to a foam and then folding them into melted chocolate delivered cakes with the rich, moist texture we wanted. A mere 2 tablespoons of flour did an able job of holding the souffle-like cakes together_any more and the cakes were dry, with no fluid center.

Finally, we wanted to ensure that these decadent desserts would arrive at the table hot and still molten; happily, we found that we could prepare the batter ahead of time, refrigerating the filled ramekins until ready to use and then placing them in the oven to bake during dinner. You can substitute bittersweet chocolate for the semisweet; the flavor will be slightly more intense.


FALLEN CHOCOLATE CAKES

Servings: 8

Start to finish: 1 hour

Unsweetened cocoa powder, for dusting

8 ounces semisweet chocolate, chopped coarse

8 tablespoons unsalted butter, cut into 8 pieces

4 large eggs plus 1 large yolk, room temperature

1/2 cup (3 1/2 ounces) granulated sugar

1 teaspoon vanilla extract

1/4 teaspoon salt

2 tablespoons all-purpose flour

Confectioners’ sugar

Adjust oven rack to middle position and heat oven to 400 F. Grease eight 6-ounce ramekins and dust with cocoa. Arrange ramekins on rimmed baking sheet. Microwave chocolate in large bowl at 50 percent power for 2 minutes. Stir chocolate, add butter, and microwave at 50 percent power for 2 minutes longer, stopping to stir after 1 minute. If chocolate is not yet entirely melted, microwave for an additional 30 seconds; set aside.

Using stand mixer fitted with whisk attachment, whip eggs, yolk, granulated sugar, vanilla, and salt on high speed until eggs are pale yellow and have nearly tripled in volume. (Egg foam will form ribbon that sits on top of mixture for 5 seconds when dribbled from whisk.) Scrape egg mixture over chocolate mixture, then sprinkle flour on top. Using rubber spatula, gently fold egg mixture and flour into chocolate until mixture is uniformly colored.

Divide batter evenly among prepared ramekins. (Unbaked cakes can be refrigerated for up to 8 hours. Return to room temperature for 30 minutes before baking.) Bake until cakes have puffed about 1/2 inch above rims of ramekins, have thin crust on top, and jiggle slightly at center when ramekins are shaken very gently, 12 to 13 minutes. Run thin knife around edges of ramekins to loosen cakes. Invert each ramekin onto plate and let sit until cakes release themselves from ramekins, about 1 minute. Lift off ramekins, dust with confectioners’ sugar, and serve.

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Nutrition information per serving: 318 calories; 153 calories from fat; 17 g fat (8 g saturated; 0 g trans fats); 161 mg cholesterol; 108 mg sodium; 33 g carbohydrate; 6 g fiber; 14 g sugar; 9 g protein.

TIRAMISU

The Free Press WV

With its boozy, coffee-soaked ladyfingers and sweet, creamy filling, it’s no wonder tiramisu is Italian for “pick me up.”

Instead of making a custard filling, we simply whipped egg yolks, sugar, salt, rum and mascarpone together and lightened it with whipped cream. We briefly moistened the ladyfingers in a mixture of coffee, espresso powder, and more rum.

We prefer a tiramisu with a pronounced rum flavor; for a less potent rum flavor, reduce the amount of rum in the coffee mixture. Brandy or whiskey can be substituted for the rum.

Don’t let the mascarpone warm to room temperature before whipping. Dried ladyfingers are also called savoiardi; you will need between 42 and 60, depending on their size and the brand.


TIRAMISU

Servings: 10-12

Start to finish: 1 hour, plus cooling time

2 1/2 cups strong brewed coffee, room temperature

1 1/2 tablespoons instant espresso powder

9 tablespoons dark rum

6 large egg yolks

2/3 cup (4 2/3 ounces) sugar

1/4 teaspoon salt

1 1/2 pounds (3 cups) mascarpone cheese, chilled

3/4 cup heavy cream, chilled

14 ounces dried ladyfingers

3 1/2 tablespoons unsweetened cocoa powder

1/4 cup grated semisweet or bittersweet chocolate (optional)

Combine coffee, espresso powder, and 5 tablespoons rum in wide bowl or baking dish until espresso dissolves.

Using stand mixer fitted with whisk attachment, mix egg yolks at low speed until just combined. Add sugar and salt and mix at medium-high speed until pale yellow, 1 1/2 to 2 minutes, scraping down sides of bowl as needed. Reduce speed to medium, add remaining 1/4 cup rum, and mix at medium speed until just combined, 20 to 30 seconds; scrape bowl. Add mascarpone and mix until no lumps remain, 30 to 45 seconds, scraping down bowl as needed. Transfer mixture to large bowl.

In now-empty mixer bowl (no need to clean mixer bowl), whip cream on medium-low speed until foamy, about 1 minute. Increase speed to high and whip until stiff peaks form, 1 to 3 minutes. Using rubber spatula, fold 1/3 whipped cream into mascarpone mixture to lighten, then gently fold in remaining whipped cream until no white streaks remain.

Working with one ladyfinger at a time, drop half of ladyfingers into coffee mixture, roll, remove, and transfer to 13 by 9-inch baking dish. (Do not submerge ladyfingers in coffee mixture; entire process should take no longer than 2 to 3 seconds for each cookie.) Arrange soaked cookies in single layer in baking dish, breaking or trimming ladyfingers as needed to fit neatly into dish.

Spread half of mascarpone mixture over ladyfingers, spreading it to sides and into corners of dish, and smooth top. Place 2 tablespoons cocoa in fine-mesh strainer and dust cocoa over mascarpone. Repeat with remaining ladyfingers, mascarpone, and 1 1/2 tablespoons cocoa to make second layer. Clean edges of dish, cover with plastic wrap, and refrigerate until set, at least 6 hours or up to 24 hours. Before serving, sprinkle with grated chocolate, if using.

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Nutrition information per serving: 641 calories; 420 calories from fat; 47 g fat ( 24 g saturated; 0 g trans fats); 308 mg cholesterol; 166 mg sodium; 41 g carbohydrate; 1 g fiber; 15 g sugar; 12 g protein.

PROVENCAL VEGETABLE SOUP

The Free Press WV

This undated photo provided by America’s Test Kitchen in January 2019 shows Provencal Vegetable Soup in Brookline, Mass. This recipe appears in the cookbook “Complete Mediterranean.“ (Carl Tremblay/America’s Test Kitchen via AP)

Highlighting the fresh flavors of Provencal cuisine, soupe au pistou is a classic French soup composed of seasonal vegetables, creamy white beans and fragrant herbs.

Celebrating colorful, early-summer produce, this soup needed to be chock-full of vegetables and simple to prepare. Leeks, green beans, and zucchini all made the cut; we liked their summery flavors and varying shades of green.

Traditional recipes use water for the base, but supplementing the water with vegetable broth promised a more rounded, flavorful base; we cooked orecchiette directly in the broth so that the starch from the pasta would give it more body.

Canned white beans tasted great and were far more convenient than long-soaking dried beans. This soup is always served with a dollop of pistou, France’s answer to pesto, and to make ours we simply whirled basil, Parmesan, olive oil, and garlic in a food processor.

If you cannot find haricots verts (thin green beans), substitute regular green beans and cook them for an extra minute or two. You can substitute small shells or ditalini for the orecchiette (the cooking times may vary slightly). Serve with crusty bread.


PROVENCAL VEGETABLE SOUP

Servings: 6

Start to finish: 45 minutes

Pistou:

1/2 cup fresh basil leaves

1 ounce Parmesan cheese, grated (½ cup)

1/3 cup extra-virgin olive oil

1 garlic clove, minced

Soup:

1 tablespoon extra-virgin olive oil

1 leek, white and light green parts only, halved lengthwise, sliced ½ inch thick, and washed thoroughly

1 celery rib, cut into 1/2-inch pieces

1 carrot, peeled and sliced 1/4 inch thick

Salt and pepper

2 garlic cloves, minced

3 cups vegetable broth

3 cups water

1/2 cup orecchiette

8 ounces haricots verts, trimmed and cut into 1/2-inch lengths

1 (15-ounce) can cannellini or navy beans, rinsed

1 small zucchini, halved lengthwise, seeded, and cut into 1/4-inch pieces

1 large tomato, cored, seeded, and chopped

For the pistou: Process all ingredients in food processor until smooth, about 15 seconds, scraping down sides of bowl as needed. (Pistou can be refrigerated for up to 4 hours.)

For the soup: Heat oil in Dutch oven over medium heat until shimmering. Add leek, celery, carrot, and 1/2 teaspoon salt and cook until vegetables are softened, 8 to 10 minutes. Stir in garlic and cook until fragrant, about 30 seconds. Stir in broth and water and bring to simmer.

Stir in pasta and simmer until slightly softened, about 5 minutes. Stir in haricots verts and simmer until bright green but still crunchy, about 3 minutes. Stir in cannellini beans, zucchini, and tomato and simmer until pasta and vegetables are tender, about 3 minutes. Season with salt and pepper to taste. Serve, topping individual portions with pistou.

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Nutrition information per serving: 288 calories; 153 calories from fat; 17 g fat (3 g saturated; 0 g trans fats); 4 mg cholesterol; 396 mg sodium; 27 g carbohydrate; 6 g fiber; 6 g sugar; 8 g protein.

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