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Healthcare online Keeping you up-to-date
VOL.  12     ISSUE:  6  June  2014 Medical Services Department

SQUARE Pharmaceuticals Ltd.

EDITORIAL

Dear Doctor:

Welcome to "e- SQUARE" healthcare online !

Hope you are enjoying this bulletin !

This issue features a variety of articles including "Asperger Syndrome Alert !", "Indoor Tanning Risk !", "Inhaled Anti-Diabetics !", "Laptop & Kids !", "Low Dose Aspirin !", "Migraine Alert !".

In our regular feature, we have some new products information of SQUARE Pharmaceuticals Ltd. as well.

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Editorial Team

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The views expressed in this publication do not necessarily reflect those of its editor or SQUARE PHARMACEUTICALS LTD.
 Asperger Syndrome Alert !

 Adults With Asperger Syndrome May Have Higher Suicide Risk

Adults with the milder form of autism known as Asperger syndrome are much more likely to think about and attempt suicide than those in the general population, a new British study suggests. The survey of 374 British adults with Asperger syndrome found that 66 percent reported having suicidal thoughts and 35 percent had planned or attempted suicide. Suicidal thoughts were much more common among those with a history of depression, the authors noted. In comparison, rates of suicidal thoughts were 17 percent in the general population of U.K. adults and 59 percent of patients with psychosis, according to the study. Among adults with Asperger syndrome, those with depression were four times more likely to have suicidal thoughts and twice as likely to plan or attempt suicide, compared to those without depression, the investigators found. The study also found that adults with more severe autism symptoms were more likely to plan or attempt suicide. "Our findings confirm anecdotal reports that adults with Asperger syndrome have a significantly higher risk of suicide in comparison to other clinical groups, and that depression is a key risk factor in this," study co-leader said. And, another study co-leader added, "Adults with Asperger syndrome often suffer with secondary depression due to social isolation, loneliness, social exclusion, lack of community services, under-achievement and unemployment." However, he believes that "their depression and risk of suicide are preventable with the appropriate support. This study should be a wake-up call for the urgent need for high-quality services, to prevent the tragic waste of even a single life," he said. Two experts in the United States weren't surprised by the findings. One expert said the new study supports "something we have known clinically for quite some time: bright, verbal individuals with autism spectrum disorder (ASD), commonly described as Asperger syndrome, have a much higher rate of depression, suicidal ideation and suicide attempts than peers who are not on the autism spectrum." She agreed with study co-leader that the finding "underscores the unmet need for increased support and resources for people with ASD at each developmental stage from childhood through adulthood." Another expert said the study "will likely have an impact on patient care by raising clinical suspicion for suicidality [in patients with Asperger syndrome] and highlighting the need for treatment and close monitoring."


SOURCE: HealthDay News, June 2014

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 Indoor Tanning Risk !

Indoor Tanning Leads To Early Skin Cancer, Study Says

Teens and young adults who engage in indoor tanning risk developing skin cancer at an early age, a new study finds. Once thought safer than outdoor sunbathing, indoor tanning can produce 10 to 15 times as much ultraviolet (UV) radiation as the midday sun, the study authors noted. "Our findings suggest that children and young adults who seek indoor tanning may be especially vulnerable to developing basal cell carcinoma, the most common form of skin cancer, at a young age," lead researcher said. The study looked at people aged 50 and younger who were diagnosed with basal cell skin cancer. While usually treatable, this type of skin cancer can be highly disfiguring if not caught early, and basal cell tumors have a high rate of recurrence. Until recently, basal cell skin cancer was considered a cancer of later life, the researchers said. The investigators found that indoor tanning was associated with developing skin cancer at an early age. Moreover, the strongest link was seen among those whose first exposure to indoor tanning occurred when they were teens or young adults. These results support the recommendation of the American Academy of Pediatrics to minimize ultraviolet exposure, the researchers said. Teens often have easy access to tanning facilities, and only a few states ban indoor tanning for minors, she said. "In the absence of laws protecting children from these exposures, our findings suggest counseling on the risks of indoor tanning and discouraging parents from consenting to this behavior," lead researcher added. In May, the U.S. Food and Drug Administration announced that tanning beds and tanning booths must carry a visible warning stating that the devices should not be used by anyone under age 18. For the study, lead researcher and colleagues collected data on indoor tanning among 657 people with basal cell skin cancer and 452 without skin cancer, who took part in the New Hampshire Skin Cancer Study. Data was also collected on indoor tanning and the type of device used -- sunlamps, tanning beds or tanning booths -- and on time spent outdoors in childhood. In about 40 percent of cases, basal cell skin cancer was found on the back or chest rather than the head and neck. Tumors on the back and chest are associated with indoor tanning, rather than with natural sunlight, the study authors pointed out. The link between indoor tanning and cancer was seen for all types of indoor tanning devices, including sunlamps, tanning beds and tanning booths, the study found.

SOURCE: HealthDay News, June 2014

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 Inhaled Anti-Diabetics !

FDA Approves Inhaled Diabetes Medication

People with type 1 or 2 diabetes now have a new means of getting their medication, with the U.S. Food and Drug Administration's approval of the first inhaled medicine for the blood sugar disease. The drug, Afrezza, "is a new treatment option for patients with diabetes requiring mealtime insulin, said the director of the Division of Metabolism and Endocrinology Products in the FDA's Center for Drug Evaluation and Research. He said that Afrezza's approval "broadens the options available for delivering mealtime insulin in the overall management of patients with diabetes who require it to control blood sugar levels." The FDA estimates that almost 26 million Americans -- about 8.3 percent of the population -- now live with diabetes, which can lead to dangerous complications such as heart disease, vision loss and nerve and kidney problems. Many patients must take injected insulin daily to maintain healthy blood sugar levels. Afrezza's approval came after a study involving more than 3,000 people -- approximately 1,000 with type 1 diabetes and nearly 2,000 with the type 2 form of the illness. For people with type 1 disease, researchers compared the effectiveness of Afrezza in adult patients against that of fast-acting insulin, used in both cases alongside basal insulin (long-acting insulin). Over 6 months, the combo of long-acting insulin and Afrezza met required treatment effectiveness in terms of blood sugar control, the FDA said. For patients with type 2 diabetes, researchers combined Afrezza with standard diabetes pills and compared the use of the inhaled drug at mealtimes against the use of standard medications plus a placebo. At six months, the Afrezza-plus-standard medications combination produced better results overall, the FDA said. The agency stressed that Afrezza should never substitute for long-acting insulin, and patients with type 1 diabetes must use the drug in combination with long-acting insulin. Smokers should avoid Afrezza, as well, the agency said, and the drug is not to be used in the treatment of a condition called diabetic ketoacidosis. People with certain lung conditions should also not use Afrezza, due to a dangerous complication called acute bronchospasm. For this reason, the FDA has ordered a warning be placed on the product's labeling to caution people with chronic obstructive pulmonary disease (COPD) from using the drug. The FDA is also advising that people with asthma avoid Afrezza for the same reason. According to the agency, the most common side effects from Afrezza were hypoglycemia (low blood sugar), cough, and throat pain or irritation. The FDA is also ordering that "post-marketing studies" be conducted to track the safety and effectiveness of Afrezza in children, and to see if there is any connection between the use of Afrezza and any lung cancers.  
SOURCE: HealthDay News, June 2014

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 Laptop & Kids !

A Laptop May Boost A Hospitalized Child's Recovery

A hospital can be a lonely and stressful place for a sick child recuperating from a serious illness, but researchers say relief from boredom and isolation is just a mouse click away. Kids who regularly videoconference with family and friends exhibit significantly reduced stress by the end of their hospital stay. "This social connection is important to their state of mind, health and well-being," said senior author. "The kids love it, and the parents love it. They are happier and more likely to participate in rehab." Hospital provides loaner laptops to children expected to have an extended stay in the hospital. It will even ship a loaner webcam to parents located far away who don't have one, he added. The laptops are loaded with many videoconferencing options -- Skype, Yahoo and such -- so the kids and parents can use a program they might already have at home. Doctors have seen much anecdotal evidence that videoconferencing can help keep up a kid's spirits. And earlier studies have shown that in-person family visits can decrease stress and improve recovery times, researchers said. This new study aimed to see if virtual visits could provide those same health benefits, he said. The study included 367 patients at UC Davis Children's Hospital. The average child in the study was nearly 10 years old, stayed about 12 days in the hospital, and lived about 73 miles away. About two-thirds of the patients took advantage of the hospital's videoconferencing program, while the other third did not. Researchers assessed the patients' stress levels upon their admission and discharge, and compared one group to the other. Children who kept in touch with people using videoconferencing had 37 percent more reduction in stress by the time they left the hospital, compared with children who didn't videochat, researchers found. UC Davis has provided videoconferencing for kids for about a decade, its technology evolving from clunky old videophones to sleek new laptops, he said. He recalled a girl who had been hit by a car and lost her leg in the mid-2000s. Her long struggle in the hospital led her to become very surly, a nurse's nightmare. "The thing she said she missed the most was her school classmates," he said. The hospital set up a videophone in a room at her school, and at lunchtime her friends could visit with her. "It was a game-changer in terms of her affect and her participation in rehab," senior author said. "She became a complete joy to care for." The proliferation of Wi-Fi and high-speed Internet makes it relatively easy for a hospital to offer such videoconferencing to child patients, Hilfer said. "I hope it catches on," he said. But Marcin noted that times are tight in health care, and "if you can't bill for it, it's tough to get personnel to do it." Also, kids may be slightly ahead of the curve than the doctors caring for them, he added. "They're very engaged in their social media world," he said. "I think health care has to catch up with that."
SOURCE: HealthDay News, June 2014

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 Low Dose Aspirin !

Daily Low-Dose Aspirin May Help Ward Off Pancreatic Cancer 

People who take low-dose aspirin for more than 10 years might be reducing their risk for pancreatic cancer, a new study suggests. Even taking a daily aspirin for just three years lowered the chances of the deadly cancer by 48 percent, the researchers said. "Aspirin use has potential risks of its own, thus the risks and benefits for each person have to be evaluated based on personal characteristics," lead researcher said. "For the small numbers of people with strong family histories of pancreatic cancer or who otherwise have been evaluated to be at increased risk of pancreatic cancer, aspirin use could be part of a regimen designed to reduce their risk," he said. The main risk with continued aspirin use is bleeding in the stomach. For the study, lead researcher and colleagues collected data on 362 people with pancreatic cancer and 690 who did not have the disease. Participants were recruited from 30 Connecticut hospitals between 2005 and 2009. All of the study participants were asked when they began taking aspirin, how much and for how long. The researchers also took into account other factors, such as weight, smoking history and any history of diabetes. A dose of 75 milligrams to 325 milligrams of aspirin per day was considered low-dose and was usually taken to prevent heart disease. The researchers considered a dose higher than that, usually taken every four to six hours, as regular-dose taken for pain. The investigators found that the earlier someone started taking low-dose aspirin regularly, the more the risk for pancreatic cancer seemed reduced. The reduction ranged from 48 percent among those who started three years before the study to 60 percent in those who started taking it 20 years before the study, the researchers said. However, people who stopped taking aspirin within two years before the study saw their risk for pancreatic cancer increase threefold, compared with those who continued taking aspirin, the authors said.
SOURCE: HealthDay News, June 2014

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 Migraine Alert !

Chronic Migraines Affect The Whole Family

When a spouse, partner or parent has chronic migraines, the whole family suffers, a new study found. The research discovered that most chronic migraine sufferers report that their severe headaches have a big impact on family relationships, activities and sexual intimacy. The results were not surprising to lead study author. "I hear firsthand about the tragic effect that chronic migraine has on every aspect of people's lives, including work and home life." Still, she wanted to quantify the degree to which families were affected. People who don't experience migraines or have family members with the condition don't understand how it can affect the entire family, study author said. "It's very important to bring this data to light, to show that chronic migraines are burdensome and difficult, not only for the people who live with it but also for the people they love." Chronic migraine is defined as having migraine headache 15 or more days a month, according to the researchers. A migraine is a recurrent throbbing headache that typically affects one side of the head and is often accompanied by nausea and disturbed vision. About 38 million people in the United States have migraines, and between 3 and 7 million have chronic migraine, she noted. The study included nearly 1,000 people, including 812 women, who met the criteria for chronic headache. Those people and their spouses and children answered web-based questionnaires. People with chronic migraines said they often feel worried, guilty and sad about how their condition affects those they love, she added. Almost 75 percent of chronic migraine sufferers in the study said they thought they would be better spouses if they didn't have chronic migraines. And almost 60 percent said they felt they would be better parents without the illness. What's more, most people with migraines said they feel guilty because their headaches make them more easily annoyed or angered. Chronic migraines also made people opt out of activities on a family vacation, or even cancel or miss a vacation. Overall, people with chronic migraines missed family activities and had reduced quality time with their spouse almost seven days a month, according to the study. One result raised new questions. The researchers found that women reported lower rates of absenteeism due to chronic migraine than did men. Study author said women may be less impaired by migraine attacks than are men. Or, it could be that women take on more family responsibility that can't be delegated. "Mothers and wives may simply feel that they cannot miss a family event or drop a responsibility and so they soldier on despite debilitating pain and associated symptoms," she explained. The research was scheduled for presentation Wednesday at the American Headache Society in Los Angeles. Because the study hasn't been published in a peer-reviewed journal, it should be viewed as preliminary. She hopes the study helps people better understand migraines. "I think the results may surprise some who hold the view that migraine is 'just a headache' and hopefully shed light on the far-reaching effects of this debilitating condition."

SOURCE: HealthDay News, June 2014

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New Products of SQUARE Pharmaceuticals Ltd.
  Product Ezonide® 80 HFA MDI
  Generic Name Ciclesonide
  Strength 80 mcg/puff
  Dosage form MDI
  Therapeutic Category Antiasthma
  Product Ezonide® 160 HFA MDI
Generic Name

Ciclesonide
Strength

160 mcg/puff
Dosage form MDI
Therapeutic Category Antiasthma
  Product Dormitol®
  Generic Name Midazolam
  Strength  15 mg
  Dosage form Tablet
  Therapeutic Category Anxiolytic  

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