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What kind of pills are these?

Worried about those capsules you found in your teenager’s room? Not sure about some of those leftover pills still in the bathroom cabinet? There’s a good chance that our Pill Identification Wizard (Pill Finder) can help you match size, shape, colour… then lead you to find the detailed description in our drugs database.

NOTE: As a general rule, we should all periodically check our medicine cabinets for any expired, re-bottled, or unidentified pills. The safest bet is to keep all medications in their original bottles or packets, with pertinent labeling and instructions attached, to avoid confusion and mistakes.

Most pills can usually be identified by color, size, shape and a combination of letters and numbers.

Click here for a Pill Identification Wizard

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By Ryan Jaslow

(Credit: Joe Raedle/Getty Images)

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(CBS/AP) The Listeria outbreak from cantaloupes is now the deadliest foodborne illness outbreak in the U.S. in more than 25 years.

Pictures: 10 dangerous but common food safety mistakes

The CDC announced Wednesday that 23 people have died from listeriosis, while another 116 have been sickened. Not since 1985, when Listeria from Mexican-style soft cheeses killed 52 people, has a foodborne illness outbreak been this deadly in America. The current death toll also surpassed a 1998 Listeria outbreak linked to processed meats that killed 21 people.

Officials say the tainted cantaloupes from Jensen Farms in Holly, Colo., should be off store shelves by now, as they were recalled mid-September and their shelf life is about two weeks. But the number of deaths may continue to grow. Symptoms of listeriosis can take up to two months to appear.

The CDC on Wednesday confirmed two more deaths in Louisiana. Other deaths have been reported in Colorado, Indiana, Kansas, Maryland, Missouri, Nebraska, New Mexico, New York, Oklahoma, Texas and Wyoming.

Listeria illnesses have been reported in Alabama, Arkansas, California, Colorado, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Missouri, Montana, Nebraska, New Mexico, New York, North Dakota, Oklahoma, Oregon, South Dakota, Texas, Virginia, West Virginia, Wisconsin and Wyoming.

FDA investigators said that Colorado health officials found Listeria in cantaloupes taken from grocery stores and from a victim’s home that were grown at Jensen Farms. Matching disease strains were found on equipment and cantaloupe samples at Jensen Farms’ packing facility in Granada, Colo. FDA officials have said they were looking at the farm’s water supply and possible animal intrusions among other things to figure out the source of the problem. Listeria grows in moist and muddy conditions, and the bacteria are often are carried by animals.

Jensen shipped the cantaloupes to about half the states, but added that it wasn’t sure where the cantaloupes went because they have been sold and resold. Some companies may be unaware that they bought or distributed the tainted fruit.

Listeria is more deadly than other well-known pathogens such as salmonella and E. coli. While most healthy adults can consume Listeria with no ill effects, it can kill the elderly, those with compromised immune systems, and unborn children of pregnant women. The CDC said the median age of those sickened is 78, and most people who are ill are over 60. The CDC said it is also aware of one miscarriage linked to the outbreak.

Colorado has the most illnesses with 34, while Texas has reported 17.

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The Mayo Clinic Diet is a different approach to weight loss. It’s a lifestyle that can help you maintain a healthy weight for a lifetime.

By Mayo Clinic staff

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If you’re overweight, you’ve probably tried many diet and weight-loss plans, yet the weight keeps coming back. You might have even tried what you thought was a Mayo Clinic diet — but it was probably bogus.

If the diets you’ve tried haven’t worked, don’t be surprised or call it quits. Most people who diet find that weight loss is a never-ending roller coaster ride. You may lose some weight at first, but then the weight loss stops or you regain the weight.

The problem may be that you just haven’t found the right approach yet. The Mayo Clinic Diet — the real one, that is — can help. The Mayo Clinic Diet isn’t like most diets. The Mayo Clinic Diet is a lifestyle approach that can improve your health and help you maintain a healthy weight for a lifetime.

The Mayo Clinic Diet: A new approach to healthy weight

The Mayo Clinic Diet is a program that helps you make simple, healthy, pleasurable changes in your lifestyle that result in a weight you can maintain for the rest of your life. Why the emphasis on lifestyle? It turns out that a healthy lifestyle is also a great way to lose weight and keep it off. You get better health and better weight. Not a bad deal.

Perhaps best of all, this program is enjoyable. Eating is one of the great joys in life. What you eat on this diet has to taste good, or you won’t do it. The Mayo Clinic Diet emphasizes foods that not only are healthy but also taste great.

The Mayo Clinic Diet: How does it work?

The Mayo Clinic Diet involves changing habits. With the Mayo Clinic Diet, you work to reshape your lifestyle by breaking unhealthy old habits that sabotage your weight and adopting healthy new habits that will lead you down a path toward better health.

The Mayo Clinic Diet has two phases:

• Lose It! This two-week phase is designed to help you begin seeing results right away, with weight loss of 6 to 10 pounds (2.7 to 4.5 kilograms, or kg). Unlike fad diets that promise rapid weight loss, the Mayo Clinic Diet approach is safe and healthy while building momentum and enthusiasm. It’s based on changing habits for a lifetime so that the weight you lose doesn’t come back, as it probably has in the past on fad diets.
• Live It! This second phase builds on Lose It! and is designed to help you continue to lose weight at a rate of 1 to 2 pounds (0.5 to 1 kg) a week until you reach your weight goal. This phase also helps you maintain your weight goal permanently by continuing and tweaking lifelong healthy habits.

Within each phase, the diet helps you uncover your inner motivation — what really matters to you — that will help keep you on track in your effort to lose weight.

Click here to go to Page 2 > Mayo Clinic Diet for Life

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Take note of important signs and symptoms — from unexplained weight loss to sudden flashes of light — and know when to seek medical care.

by Mayo Clinic staff
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Chest pain, sudden loss of vision or speech, and severe abdominal pain require immediate medical attention — but what about more subtle red flags? It can be tough to know what to do. Here’s a list of seven signs and symptoms that merit attention.

No. 1: Unexplained weight loss

Losing weight without trying might sound like a dream come true, but in reality it can signal a health problem. If you’ve lost up to 10 percent of your weight during the past six months — for instance, 15 pounds (7 kilograms) if you weigh 150 pounds (68 kilograms) — consult your doctor.

An unexplained drop in weight could be caused by various conditions — including overactive thyroid (hyperthyroidism), diabetes, depression, liver disease, cancer or disorders that interfere with how your body absorbs nutrients (malabsorption disorders).

No. 2: Persistent or high fever

A fever isn’t necessarily a cause for alarm. Fever seems to play a key role in fighting infection. If you’ve had a fever for more than three days, however, get checked by your doctor. Persistent fever can signal a hidden infection, which could be anything from a urinary tract infection to tuberculosis. In some cases, cancerous (malignant) conditions — such as lymphomas — cause prolonged or persistent fevers, as can some medications.

If you have a high fever — 103 F (39.4 C) or higher — consult your doctor as soon as possible.

No. 3: Shortness of breath

Shortness of breath that feels more severe than what’s caused by a stuffy nose or vigorous physical activity could signal an underlying health problem. If you’re unable to get your breath, or you’re gasping for air or wheezing, seek emergency medical care. Feeling breathless when lying down also is a symptom that needs to be evaluated promptly.

Causes for breathlessness may include chronic obstructive pulmonary disease, chronic bronchitis, asthma, pneumonia, a blood clot in the lung (pulmonary embolism), as well as other heart and lung problems. Difficulty breathing can also occur with panic attacks — episodes of intense anxiety that can cause rapid heart rate, sweating, shortness of breath and other physical symptoms.

No. 4: Unexplained changes in bowel habits

What’s considered normal for bowel movements varies widely. Consult your doctor if you notice unusual or unexplained changes in what’s normal for you, such as:

• Bloody, black or tarry-colored stools
• Persistent diarrhea or constipation
• Unexplained urges to have a bowel movement

Changes in bowel habits could signal a bacterial infection — such as campylobacter or salmonella — or a viral or parasitic infection. Other possible causes include irritable bowel syndrome and colon cancer.

No. 5: Confusion or personality changes

Seek medical attention if you have:

• Sudden confused thinking
• Confusion about time or place (disorientation)
• Sudden problems with concentration or memory
• Sudden personality or behavior changes, such as becoming aggressive

Changes in behavior or thinking could be caused by many problems, including infection, anemia, low blood sugar, dehydration or mental health conditions. Sometimes medications contribute to confusion or personality changes.

No. 6: Feeling full after eating very little

If you consistently feel full sooner than normal or after eating less than usual, get checked by your doctor. This feeling, known as early satiety, also may be accompanied by nausea, vomiting, bloating, fever, and weight loss or gain. If so, be sure to tell your doctor about these signs and symptoms as well.

Possible causes of early satiety include gastroesophageal reflux disease, commonly known as GERD, and irritable bowel syndrome. In some cases, a more serious problem — such as pancreatic cancer — could be a factor.

No. 7: Flashes of light

Bright spots or flashes of light and other visual disturbances sometimes indicate a migraine. In other cases, sudden flashing lights could signal retinal detachment. Immediate medical care can help prevent permanent vision loss.

Technorati Tags: Chest Pain, Confusion, Dangerous Symptoms, Flashes of Light, Loss of Speech, Loss of Vision, Persistent High Fever, Severe Abdominal Pain, Shortness of Breath, Unexplained Changes in Bowel Habits, Unexplained Weight Loss

Question? I’ve been diagnosed with carpal tunnel syndrome.

Would regular hand and wrist exercises help me avoid surgery?
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Answer from Peter C. Amadio, M.D. - Probably not.

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When used alone, carpal tunnel exercises aren’t likely to relieve symptoms such as pain and numbness. And they don’t replace other carpal tunnel treatments, such as surgery, behavior modification or wrist splints.

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Carpal tunnel syndrome is caused by compression of the median nerve as it passes through the carpal tunnel and under the transverse carpal ligament at the wrist. A number of factors can contribute to carpal tunnel syndrome, including the anatomy of your wrist, certain underlying health problems and possibly patterns of hand use.

Nerve-gliding exercises — one type of carpal tunnel exercise — are meant to help the median nerve move normally, but they can sometimes worsen symptoms. If a median nerve remains trapped, nerve-gliding exercises can stretch, irritate or injure the nerve.

Despite their limits, carpal tunnel exercises may be helpful in some situations:

• To complement another treatment option. Carpal tunnel exercises may be helpful for mild to moderate symptoms when combined with other treatments, such as activity modification, wrist splinting or corticosteroid injections.
• After surgery to prevent the nerve from becoming scarred in the incision area. Range-of-motion exercises — which may include nerve-gliding exercises — can be helpful when there has been significant trauma to the area, such as a fracture that requires wrist surgery or repair near the carpal tunnel.

If your doctor recommends carpal tunnel exercises, start them gradually to ensure they don’t cause more harm than good.

Go to the Mayo Clinic web site for more information about carpal tunnel and other problems you may want to research.

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by Chris Lillis, MD

The tragic irony of pharmaceutical coupons

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As a primary care physician in private practice, I have my own little taste of celebrity.

Every day attractive people come to my office seeking time to speak with me and collect my autograph.  They fawn over my partners and I, and bring us food for lunch, and will invite us to the nicest restaurants in town for dinner.   These people also used to bring gifts, until they were barred from doing so a couple of years ago.  I must admit, they are not doctor-groupies.  They are pharmaceutical marketing representatives. Rather than stalking me, they are just performing the job they are paid to do.

Each year, the pharmaceutical industry and its army of salespeople spend billions of dollars marketing brand name patented drugs.  Annual estimates range from $20-60 Billion every year.    Sadly, this represents almost 30% of their sales revenue, while they invest about 11% on research and development of new pharmaceuticals.

Marketing practices of pharmaceutical companies should not be news, but you may not be noticing the building battle between insurers and pharmaceutical companies unless you are being “detailed” every day like me.

The formularies kept by private insurance companies are a great source of pain for pharmaceutical marketing professionals.  These are lists of available drugs, categorized into tiers. Tier 1 drugs are often generics: very inexpensive, and therefore offered to patients at very low copayments.  Tier 2 drugs are brand name drugs without generic alternatives, and at the other end of the spectrum are Tier 3 drugs – typically brand name drugs that may be new to market, and have several alternatives both generic and brand name. As you advance up the tiers, the copayments rise.  In order to force more generic medication usage, insurance companies are rapidly increasing these copayments to reduce their expenditures.

So begins the battle.  Pharmaceutical companies know that high copayments are effective ways to encourage patients to ask their doctors to prescribe generic drugs.  So pharma lobbies the insurance companies to reduce the tier status of their drugs.  In some cases, this leads to drugs being switched tiers, sometimes quite often.  A tier 3 drug that gets bumped down to tier 2 becomes a marketing highlight.  And it always leaves those of us with prescription pads guessing and rather frustrated.

The latest trend I have observed: coupons.  Pharmaceutical representatives will provide physicians coupons to give to patients for their new product.  The most generous of these coupons will actually cover the entire copayment of the drug, thereby eliminating the incentive designed by the insurance industry to encourage generic drug use.

Coupons may be great for individuals with higher copayments set by their insurers, but they do nothing to lower our national health care expenditures.  In fact, coupons encourage higher costs for pharmaceuticals.

The tragic irony of the coupon scheme devised by pharmaceutical marketing is that Medicare Part D patients cannot use them. The government by regulation prohibits any inducement that would directly or indirectly cause the government to spend money. Hence these coupons are not permitted to be split billed with Medicare or Medicaid.  Those who need help to defray their prescription costs the most cannot use them, but in some way I am glad.  This forces me to choose generic prescriptions more often.

The pharmaceutical industry lobbyists have been successful thus far in avoiding regulations that would hurt their profits.  But this is leading to skyrocketing costs.  In both the inception of Medicare Part D and in the passage of the Affordable Care Act, Congress neglected to provide the authority to Medicare to negotiate the prices of prescription medicines, leaving it to the private insurers who administer Medicare Part D.  This has led to greater profits for pharma at the direct expense of the consumer and taxpayer.

A study conducted by a prominent health care economist, funded by the Robert Wood Johnson Foundation, found that if Medicare adopted the Veterans Affairs (VA) drug formulary, America would save $14 billion a year on drug costs.  The VA directly negotiates drug costs with manufacturers, and its evidence-based formulary is able to keep drug costs down.

If any politician were bold enough to advance the proposal of allowing Medicare to negotiate drug prices, I can imagine the demagogue’s argument: “Don’t allow government to restrict your choices of drugs!”  Except that the facts point to health care consumers much preferring to have lower drug costs than infinite choices of expensive brand name drugs.  Polls show 80% of Americans would choose generic medicines in order to save money.

Between pharmaceutical marketing costs and the inflated prices of brand name medicines, there are tens of billions of dollars to be saved in health care expenditures each year.  I am confident the pharmaceutical industry will fight for those billions with vigor, but will we?

Chris Lillis is an internal medicine physician who blogs at Progress Notes.

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Technorati Tags: Consumer Prices, Drug Coupons, Generic Medicine, Higher Drug Prices, Medicare Part D, Prescription Insurance

By Kristina Fiore, Staff Writer, MedPage Today . The FDA has approved a short-acting opioid painkiller with abuse-deterrent properties, the drugmaker Pfizer announced Monday. Oxecta, a new formulation of oxycodone, had previously been under development as Acurox, which included niacin to deter oral abuse. That version received a thumbs down from an FDA advisory panel in 2009. The new drug uses “Aversion” technology, licensed from Acura Pharmaceuticals — which is described as a “unique composition of commonly used pharmaceutical ingredients” — to stop potential abusers from crushing, chewing, snorting, or injecting the opioid. It does not deter oral abuse. But Pfizer noted in a statement that the potential to abuse the drug via these routes still exists and “there is no evidence that Oxecta has a reduced abuse liability compared to immediate-release oxycodone.” In an earlier interview, Gail Cawkwell, MD, vice president of medical affairs at Pfizer, told MedPage Today that the technology causes the drug to break down into crumbled chunks instead of powder if crushed, and turns it “sudsy” if it is mixed with liquid and drawn into a syringe. Oxecta is indicated for acute and chronic moderate-to-severe pain and is contraindicated in patients with respiratory depression, paralytic ileus, bronchial asthma or hypercarbia, and in those with a hypersensitivity to the opioid. Among the most common adverse reactions are nausea, constipation, vomiting, headache, itchiness, trouble sleeping, and dizziness, according to Pfizer. The new formulation joins a handful of other abuse-deterrent opioids that are on the market or in development. Purdue Pharmaceuticals, maker of long-acting oxycodone (OxyContin), had a tamper-proof version of its drug approved last year. Making drugs harder to abuse has been one key strategy for some companies in an attempt to control what the government has deemed an epidemic of prescription painkiller abuse. Pfizer acquired Oxecta when it merged with King Pharmaceuticals last year, along with an abuse-deterrent formulation of long-acting oxycodone (Remoxy) which is up for FDA approval on June 23.

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by Mayo Clinic Staff

Get the facts about these common fibromyalgia myths. Learning all you can about fibromyalgia is the first step toward gaining control of your symptoms.

Fibromyalgia is a widely misunderstood condition that causes widespread pain and fatigue. If you’ve been diagnosed with fibromyalgia and are trying to learn all you can about the condition, you may come across some myths and misconceptions about fibromyalgia.

In this interview, Connie Luedtke, R.N., the nursing supervisor of the Fibromyalgia and Chronic Fatigue Clinic at Mayo Clinic, Rochester, Minn., answers questions about some of the most common misconceptions about fibromyalgia.

What is the most common misconception about fibromyalgia?

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The top misconception is that people think fibromyalgia isn’t a real medical problem or that it is “all in your head.” It’s sometimes thought of as a “garbage-can diagnosis” — if doctors can’t find anything else wrong with you, they say you have fibromyalgia. Being diagnosed with fibromyalgia does require that you meet specific criteria, including painful tender points above and below the waist on both sides of the body.

There’s a lot that’s unknown about fibromyalgia, but researchers have learned more about it in just the past few years. In people who have fibromyalgia, the brain and spinal cord process pain signals differently; they react more strongly to touch and pressure, with a heightened sensitivity to pain. It is a real physiological and neurochemical problem.

Click here to read the rest of this article on fibromyalgia misconceptions from the Mayo Clinic.

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X-ray of Patient with Tuberculosis

This report summarizes provisional 2010 data from the National TB Surveillance System and describes trends since 1993.

Despite an average decline in TB rates of 3.8% per year during 2000–2008, a record decline of 11.4% in 2009 (2), and the 2010 decline of 3.9%, the national goal of TB elimination (defined as <0.1 case per 100,000 population) by 2010 was not met (3).

Although TB cases and rates decreased among foreign-born and U.S.-born persons, foreign-born persons and racial/ethnic minorities were affected disproportionately by TB in the United States.

In 2010, the TB rate among foreign-born persons in the United States was 11 times greater than among U.S.-born persons. TB rates among Hispanics, non-Hispanic blacks, and Asians were seven, eight, and 25 times greater, respectively, than among non-Hispanic whites. Among U.S.-born racial and ethnic groups, the greatest racial disparity in TB rates was for non-Hispanic blacks, whose rate was seven times greater than the rate for non-Hispanic whites.

Progress toward TB elimination in the United States will require ongoing surveillance and improved TB control and prevention activities to address persistent disparities between U.S.-born and foreign-born persons and between whites and minorities.

Click here to read the complete article. Trends in Tuberculosis

Technorati Tags: TB, TB Rate, Tuberculosis