Posted by Stefanie Gans, Dining Editor / Tuesday, December 3rd, 2013
“Am I an optimist or a pessimist?” I asked Warren Rojas, the former Northern Virginia Magazine dining editor, at dinner last night. Over fried calamari (with a wasabi aioli at a Chinese restaurant; I’ll get to that in the February issue), we were talking about hope. I want every restaurant meal to be wonderful. Glorious. To flush me with enough fodder to create taste memories forever. But sometimes they don’t. And then I’m heartbroken.
“You have to manage your expectations,” Warren tells me, as I’m about to finish my second year as a restaurant critic.
“So, if I always want the best, but then am disappointed, does this make me a deluded optimist? Or a perpetual pessimist?” We didn’t figure it out.
Eating for the 50 Best Restaurants issue is a balance in presumptions and, after the swallow, reality. Will my favorite restaurants from last year continue producing thoughtful food? Will a new restaurant fail to fulfill its promise? Will an established restaurant suddenly feel more vibrant than ever?
It takes a lot of meals, money and miles to put together a list of upstanding restaurants from Arlington to The Plains, from Lovettsville to Fredericksburg. It also requires some intuition. When the Loudoun County chef shuffle placed some of the area’s top chefs in new restaurants—just before our deadline to close the list—we had to decide how to handle the switches. The magazine’s policy would normally allow the chefs to gain comfort in their new kitchens before formally reviewing the food. But we didn’t have the editorial time in bizarre magazine world where we work on Christmas stories when it’s still jacket-less weather. My editor and I decided to judge them immediately because they were established chefs at established restaurants. It was a time I hoped for the best and a time when these newly rearranged talents rewarded me with lovely dishes. Maybe I am an optimist.
The 2013 Best Restaurants list was compiled differently than last year: Only the top 10 restaurants are ranked and the remainder of the restaurants are compared to other restaurants in that same county, which should help you find a great place to eat, much closer to home.
After the jump: Updates on the list, as the chef shuffles continue.
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WUSA examines a push for young blue voters in 2013.
Prince George crime continues to fall.
Homeless man killed by police near Ft. Belvoir.
McLean schools are getting mobile.
Posted by Anthony Baracat / Thursday, October 24th, 2013
Roger Ebert is quoted as saying that “The Cabinet of Dr. Caligari” might be the first true horror film, “a subjective psychological fantasy.” The silent German expressionist film, directed by Robert Wiene in 1920, first shocked audiences with a very present danger—that of a somnambulist, or a sleep walker with the ability to use his or her motor skills. You know where this is going.
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Posted by Carten Cordell / Wednesday, October 16th, 2013
It’s time to ditch the treadmills and hit the trails. Embrace the cool, fall air and take your workout routine outdoors. Whether you’re a beginner or a seasoned runner, we’ve got all your running needs covered. Take your position, and brace yourself for that first place finish.
By Lexi Gray Steacy
Thanks in part to government projects such as the Women’s Health Initiative and outreach by celebrities like Angelina Jolie, the risks associated with breast cancer are commonly discussed in the national media. Still, many women may wonder where to begin after determining the need to assess their own risk of developing breast cancer.
Lisa Lilienfield, M.D., of the Kaplan Center for Integrative Medicine in McLean, says that many good things have resulted from the increased focus on breast cancer over the past few decades, yet there is still a need for more discussion regarding individual symptoms and preventive lifestyle changes for those battling breast cancer.
A great starting point for those investigating their own risk for breast cancer is to first take stock of the family medical history. “Talk to a primary care physician or nurse practitioner about your concerns. It’s important to choose a healthcare provider who will block off a significant amount of time to listen to their patients—30 minutes or more is ideal. The patient should not feel rushed,” Lilienfield says.
Several tests are used to determine a person’s risk of developing breast cancer, provide an assessment of estrogen levels and how the hormones are being metabolized. Lifestyle changes may help to metabolize hormones in a way that minimizes the risk of developing breast cancer.
“Various dietary and lifestyle habits may affect the way your body is metabolizing the estrogen, so people who are overweight, do not exercise, or are diagnosed with endocrine disorders like hypothyroidism may have an increased risk.” Lilienfield suggests eating a number of foods that may improve the way estrogen is metabolized in a person’s body: broccoli, cauliflower and flax seed.
Women living in Northern Virginia are at an advantage when it comes to seeking advice and treatment for breast cancer and other health concerns, Lilienfield says. “I do believe that women in this area have access to quality screening facilities and health education. This area is known for having a fairly well education population, which means many people are aware of many risk factors associated with breast cancer.”
As with any medical condition, being able to identify common misconceptions is also important. When it comes to breast cancer, a common misconception is that hormone replacement therapy should always be avoided in menopause, due to an associated risk of developing breast cancer. Lilienfield says that while certain hormone replacement therapies do in fact carry an increased risk for breast cancer, there are others on the market that have a much lower risk, as they closely mimic the body’s own estrogen. It is important for patients to explore these concerns with health care providers, in order to find safe solutions that will also improve quality of life.
By Carten Cordell
While Congress can’t end the government shutdown, a McLean youth sports league has whipped the gridlock in federal court.
A federal judge ruled that because the park sits on federal land, but is managed by the Fairfax County Park Authority, that the federal government could not restrict McLean Youth Lacrosse’s access to the park. According to McLean Youth Lacrosse’s lawsuit, the group paid Fairfax County Park Authority $5,000 to use the fields this fall, not the federal government.
The ruling by U.S. District Judge Liam O’Grady is temporary though, as both parties will head back to court in Alexandria Oct. 18 to negotiate a permanent resolution. Until then, play on children.
By Lexi Gray Steacy
Discussions about breast cancer risks in the media and through various outreach groups have led to a higher public interest in accessing screening methods and technologies that identify and treat the illness. Health care providers in Northern Virginia are meeting the needs of their patients by continuing to add new and effective technologies that target the prevention and treatment of breast cancer.
3D Mammography Provides Increased Accuracy of Breast Cancer Screenings
For many women, breast cancer screening is an important part of their overall healthcare maintenance—and options for early detection continue to improve throughout the years. 3D mammography is a relatively new technology that visualizes each layer of the breast tissue, providing radiologists the ability to review certain details that are not captured by older mammography tools.
“3D mammography does three important things, including: decreasing the mammogram recall rate; increasing the positive predictive value for whether a lesion is cancerous; and decreasing the benign biopsy rate,” says Deborah Blair, M.D., chair of the Department of Radiology at Invoa Mt. Vernon and a member of the medical staff of Ultrasound Associates in Alexandria.
The improved visibility that comes with 3D mammography may be of special interest to women with dense breast tissue, according to Stephanie Akbari, M.D., medical director of the Reinsch Pierce Family Center for Breast Health at Virginia Hospital Center in Arlington, where the technology has been offered since late 2012. Traditional mammography may be unable to detect cancerous cells if a woman has dense breasts—which is what happened to Nancy Cappello, Ph.D., founder of the breast cancer awareness organization Are You Dense. Cappello was diagnosed with advanced stage breast cancer in 2004, after a decade of annual mammograms that failed to detect the illness, due in part to the density of her breasts.
Since Cappello’s story became public, Virginia and several other states have adopted laws that require radiologists to send notification to women about the density levels of their breasts. The technology is a viable add-on even for those women who do not have dense breasts, says Akbari, who adds that 3D mammography can be performed at the same time as traditional digital mammography.
While there is a slightly higher amount of radiation emitted with 3D mammography, there is a lower chance of being called back for a repeat test, which may occur more frequently with traditional digital mammography. “A decrease in recall rates with mammograms also means a decrease in the patient’s anxiety level related to their health,” says Blair. “The benefit of identifying cancer earlier and more accurately outweighs the risk of being exposed to a slightly higher amount of radiation.”
New Technology Improves Outcomes of Lumpectomies
Members of the radiation oncology team at Virginia Hospital Center (VHC) in Arlington, express an awareness of the opinion that most people would define a positive healthcare experience as one that leaves them feeling informed and aware of all available options.
When patients have access to clear and complete information about treatments, it creates a more positive and trusting healthcare environment.
VHC recently expanded its list of tools available to breast cancer patients with the addition of the Margin Probe System, which is designed to lower the need for additional surgery following a lumpectomy. Lumpectomy surgery seeks to remove only the malignant tissue from a patient’s breast, and is one of several surgical options available to breast cancer patients. After a lumpectomy is performed, samples of the excised breast tissue are examined under a microscope to determine if the edges—or margins—contain malignant cells. When malignancy is discovered, the patient must undergo additional surgery, when possible, in an attempt to remove the rest of the cancer. Despite careful planning and attention from the surgical team, a chance exists that malignant tissue will remain in the breast following the procedure. And, the prospect of additional surgery can cause considerable stress for the patient, both mentally and physically, says VHC’s Akbari.
Surgeons at VHC have recognized the benefits of the Margin Probe System for several years, since receiving an opportunity to use this tool during its clinical trial phases. When this technology received FDA approval earlier this year, VHC was able to officially integrate the Margin Probe System into its lumpectomy procedures. “We planned for a year so that we could permanently bring this technology to VHC as soon as possible. It’s important for us to have access to the most effective tools for improving patient outcomes,” Akbari says.
When a patient is informed that more surgery is needed following the initial lumpectomy, it can be traumatic for the patient. “The patient wonders why the surgeons were unable to remove all malignant tissue the first time around. We do everything we can to get it right the first time, but unless a patient undergoes a mastectomy, there is a risk that cancerous tissue remains in the breast,” Akbari adds.
Recognizing the importance of minimizing additional surgery, the team at VHC saw the Margin Probe System as useful tool that can be used in the operating room to help lower the incidence of re-excision following a lumpectomy. During the initial lumpectomy, this tool provides a way for surgeons to perform an immediate assessment of tissue that has been removed from the breast. Samples of the excised breast tissue are still sent for microscopic examination following the surgery, but the Margin Probe offers an additional assessment technique that occurs before the first surgery is finished.
“Margin Probe is a valuable tool in the operating room that can evaluate the breast tissue for malignancies during surgery and potentially eliminate the chance that a patient will need additional surgery. Lumpectomies walk a fine line between taking out too much breast tissue or not enough—and the Margin Probe helps to clarify the correct amount,” Akbari says.
Based on clinical trials on the efficacy of Margin Probe, Akbari expects this technology will dramatically decrease the need to re-excisions following a lumpectomy. In one particular study, the technology lowered the rate of additional surgery by 56 percent. “While the results from the microscope will still be the final determining factor for whether a patient needs an additional surgery, the Margin Probe provides another assessment that is better than the surgeon’s eye alone,” Akbari says.
Robert L. Hong, M.D., medical director of radiation oncology at VHC, says he is excited that his hospital is able to provide a confluence of technologies that rely on one another, each working in parallel to provide the most advanced care for breast cancer patients. Hong adds, “We are working daily to stay on top of possible developments and advances that may be viable additions to the hospital. This requires careful and deliberate consideration, and the search is constant for ways to improve cancer outcomes and quality of life for our patients.”
Sentara Northern Virginia Medical Center began offering a new technology to treat patients with early-stage breast cancer through its 2013 introduction of the Xoft Axxent Electronic Brachytherapy System. The Xoft system is used during intraoperative radiation therapy (IORT) to deliver a targeted dose of radiation directly to a malignant tumor, which minimizes radiation exposure to healthy surrounding tissue.
David Weintritt, M.D., of Sentara and the National Breast Center in Lorton, says the Xoft system “allows a full course of radiation treatment to be delivered in just one dose during the lumpectomy procedure.”
Sentara will also participate in a clinical study (“A Safety and Efficacy Study of Intra-Operative Radiation Therapy (IORT) Using the Xoft Axxent eBx System at the Time of Breast Conservation Surgery for Early-Stage Breast Cancer”) regarding the Xoft system, and is currently seeking participants. [clinicaltrials.gov]
Improved Options for Post-Surgical Complications
Physicians from the Inova Breast Care Institute were able to drastically improve quality of life for an Alexandria woman suffering from painful lymphedema—the result of lymph node removal during a previous mastectomy. In early 2013, Viola Karbo was the first patient in the Northern Virginia region to undergo a lymph node transplant, a procedure designed to provide relief from the daily discomfort of lymphedema. Healthy lymph nodes were transplanted to Karbo’s affected underarm during the seven-hour surgery in order to recreate the lymphatic flow that existed prior to her mastectomy.
The lymph node transplant was performed by A.N. Mesbahi, M.D. and Mark L. Venturi, M.D., both of the National Center for Plastic Surgery in McLean and the Inova Breast Care Institute in Falls Church. The planning period to perform the lymph node transplant included traveling to Barcelona, Spain for an international meeting on lymphedema, and then to New York City to observe a colleague perform the procedure, according to Mesbahi. Karbo was later referred to the doctors as an ideal candidate for this surgery.
In order to be considered a good candidate for lymph node transplant, says Mesbahi, an individual must have severe lymphedema that is not alleviated through other measures such as lymphatic drainage, massage and compression wraps. The individual must also otherwise be in good health. Prior to her surgery, Karbo had tried a number of methods to improve her lymphedema, without success.
“Lymphedema can really impact a person’s overall quality of life—there is discomfort, dependence on compression wraps, and it can be aesthetically disfiguring. Patients may not be able to wear jewelry like rings, bracelets or watches,” Mesbahi says. “Lymphedema doesn’t have a cure—unfortunately it’s a surgical complication that many people have to learn to live with and manage long-term.”
The ultimate measure of success for Karbo was a significantly increased quality of life that has provided improved hand mobility and less swelling, says Mesbahi. Since Karbo’s surgery was performed, the physicians have heard from a number other individuals throughout the country who are suffering from lymphedema and are interested in pursuing a lymph node transplant; additional lymph node transplants are currently being planned at Inova.
Posted by Anthony Baracat / Tuesday, October 1st, 2013
Now this is cute.
To commemorate the 25th Anniversary of Tyson’s Galleria, the mall will be hosting something new every Saturday in October. This Saturday, The Washington Ballet (TWB) comes to town to make your little ballerina’s wish come true at Breakfast With a Ballerina. Along with DKNY PR guru Aliza Licht and influential fashion blogger Bryanboy, the infamous D.C. troupe will be performing for the general public in the Galleria’s center court (just outside of Saks). Fox 5 Morning News Anchor Allison Seymour will present the event, with ticket-holders enjoying a ballet-specific hair and makeup styling, photographs and breakfast with the ballerinas themselves, and treats from the Ritz-Carlton and chic French bakery Paul.
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Posted by Anthony Baracat / Thursday, September 26th, 2013
The same Amadeus that brought you “Requiem” back in April opens their orchestral season on Sunday with an artistic conglomeration at Saint Luke Church. Cellist Steven Honigberg and the D.C.-based musicians will be teaming up with Great Falls Studios for a medley of fine arts. Paintings and other pieces will be displayed in addition to the three-piece concert, a performance boasting the work of Mendelssohn, Tchaikovsky and Schubert. (See the Schubert piece, Symphony No. 2, below by the Wiener Kammer Orchestra.)
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Between fine dining and neighborhood joint, Le Mediterranean Bistro offers the comforts of French food.
Driss Zahidi turns 40 in five months. “Eh, another day of life,” he says of his pending big birthday. “As long as the health is there, we’re good.”
Zahidi—after years cooking under the rule of others—is the sole owner of his restaurant. “It was my dream to open a restaurant by myself,” he says in the next breath.
In his piece of Fairfax, the Moroccan-born chef lets duck confit cuddle into clove-marinated white beans for a dish that is both elegant and homey, and an absolute steal: $14 for three courses. The soup special that day, a potato and leek creamery, lets the oniony green pop through with bits of herby oil seeping into its density.
Le Mediterranean Bistro is a bit of a rectangle with mustardy brown walls. It refuses to play into American visions of a Parisian restaurant, which Bistro Vivant in McLean, Zahidi’s previous kitchen of employment, structured itself. Non-descript art hangs from the walls, but it is merely decoration, not a statement of identity. A nod of France appears on a huge blackboard with chalk announcing the plats du jour. Otherwise, it feels like the suburbs of America. That is what makes this place such a benefit to Fairfax City. It is French food that fits here. No gimmicks. No pretension. Solid food in your neighborhood. And neighbors are noticing.
On one Tuesday night this summer, the kitchen ran out of three dishes by 7:30. Zahidi orders ingredients conservatively for his new venture, which opened in mid-April. This is why his lunch specials exist. It brings customers; Volume, not high prices, is what Zahidi hopes will keep his restaurant going. And when neighbors see a full restaurant they pop in. Multiple times couples walked into the restaurant and requested future reservations.
Maybe through the window they noticed a crepe, tinged green and bulked up like a stuffed omelet at a Jersey diner, but instead filled with nuggets of sweet crab, garnished with more crab and microgreens. The crepe sits in a ring of firey orange oil, the hue alerting of heat.
A similar shade, this time of butter, white wine and cayenne, endear my dining companions to a bowl of shrimp. Combined with garlic and herbs, it forms not only a glorious bath for the crevettes but a pit stop for bread. Zahidi wavered between suppliers for this quintessential French ingredient, and after some disappointments, partnered with with local bread maker Panorama for a crusty rendition with a doughy, layered interior.
The house-cut beef tartare, an abundant portion of meat, silky with egg and pungent with mustard, could easily make use of the house bread. Additional sauces dot the plate, with chive oil contributing another layer of indulgence that proves our carnal tongues can devour fat upon fat upon fat.
New York strip is standard fare, with odd-shaped fries that do not lend themselves to even cooking and can therefore be either under- or over-cooked. A wild rockfish lands on the blander side, but is utterly fresh, just not sufficiently seasoned.
A better bet from the sea is a bronzino, served whole. Vegetables, sometimes ignored in the grand traditions of this historical food culture (although, not anymore says “The French Market Cookbook” by 33-year-old-Parisian Clotilde Dusoulier) create a rainbow on the plate: marigold and deep purple carrots, cooked only half-way with almost so much snap a butter knife cannot cut it, just-wilted green beans, softened yellow squash and halved cherry tomatoes. The fish is salty and lemony and plenty charred for that pleasing bitterness. A gravy boat of lemon butter accompanies the dish, as does the urge to pour it all over the plate, as if it was Aunt Jemimah heading toward your dad’s Saturday pancakes. But do show restraint, like Zahidi. This is French in the suburbs. No need to get wild. – Stefanie Gans