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Healthcare online Keeping you up-to-date
VOL.  7     ISSUE:  3    March 31, 2009 Medical Services Department

SQUARE Pharmaceuticals Ltd.

EDITORIAL

Dear Doctor:

Welcome to this edition of "e- SQUARE" healthcare bulletin !

This issue features a variety of articles including "Stress & E. Coli !", "Schizophrenia Alert !", "Aspirin Guideline !", "Traffic Alert !", "Eye Cancer Risk !", "Biomarkers For RA !".

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.

 Stress & E. Coli !

 Stress Might Encourage E. Coli Illness

Researchers say they have found a possible link between stress-induced sickness and a diarrhea-causing strain of the E. coli bacterium. Researchers at the University of Texas Southwestern Medical Center say the newly discovered QseE receptor, found on the enterohemorrhagic Escherichia coli (EHEC) strain, picks up signals when stress hormones are released in the body. Once activated, this pathogen -- which usually enters the body through contaminated food such as raw meat -- sets off a series of reactions that release toxins into the body. This process changes the makeup of other cells and robs the body of nutrients. QseE, which is found only in intestinal bacteria, works with the known previously found QseC sensor kinase (enzyme) on the EHEC bacterium. QseC provides the timing for the bacterium's actions, including the regulation of the genes necessary for EHEC to cause diarrhea. It appears to have a key role in other disease development because its senses stress cues, mostly from body chemicals generally linked to blood poisoning, also known as sepsis. The human body usually hosts millions of potentially harmful bacteria that stay dormant until they receive a signal that it's to release their toxins. If those signals never arrive, the bacteria pass through the body without harm.

SOURCE: HealthDay News, March 2009.

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 Schizophrenia Alert !

Parasite May Trigger Schizophrenia

The parasite that causes toxoplasmosis has been linked to schizophrenia, and biologists in the UK may have discovered why. It seems the organism produces an enzyme that increases the production of the brain chemical dopamine. Toxoplasma is a parasite, typically carried by cats but which can infect any mammal. People who catch it may develop toxoplasmosis; this is usually a minor illness, although it can be serious when it is passed on by pregnant women to their unborn baby, and it can cause problems in people with impaired immune systems when it infects the brain. "Several studies have found a statistical correlation of toxoplasmosis with schizophrenia," one of the study author said. "Hence, someone with schizophrenia is more likely to have toxoplasmosis than the general population”, he added. On the other hand, other evidence suggests a link between dopamine and schizophrenia, because treatments for schizophrenia, such as haloperidol, block dopamine. The team found the parasite's genetic make-up included an enzyme that aids in the production of dopamine.

SOURCE: Reuters Health, March 2009.

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 Aspirin Guideline !

Revised Guidelines On Daily Aspirin For Heart

U.S. experts have revised guidelines stating that lower doses appear to be at least as effective as higher doses and safer at preventing heart attack and stroke. The issue of dosage has long been discussed because aspirin carries with it an increased risk for gastrointestinal bleeding, especially when taken in combination with the clopidogrel. The new U.S. Preventive Services Task Force guidelines are tailored to match age and gender. Among the recommendations: Men aged 45 to 79 should take aspirin if the chances of preventing a heart attack outweigh the chances of gastrointestinal bleeding. Women aged 55 to 79 should take the drug if the chances of reducing ischemic stroke outweigh the risks of GI bleeding. Aspirin seems to be more effective in men for preventing heart attack but, in women, better at preventing stroke, the scientist added. The researcher, medical director of cardiac rehabilitation at the Ochsner Heart and Vascular Institute in New Orleans, added: "The benefits of aspirin use always have to be balanced against the risks. If a patient has low risk of events in the near future, aspirin should not be prescribed. If the risk is very high, clearly aspirin is needed." The recommendations state:

  • Men aged 45 to 79 with heart risk factors should take aspirin if the preventive benefits outweigh the risk of bleeding.

  • At-risk women aged 55 to 79 should take aspirin if the odds of reducing a first ischemic stroke outweigh the chance of bleeding.

  • Men under the age of 45 and women under 55 who have never had a heart attack or stroke should not take aspirin for prevention.

  • At this time, it isn't clear whether patients aged 80 and older should take aspirin.

The task force emphasized that the recommendations only apply to people who have never had a heart attack or stroke. The last task force recommendations came out in 2002. At the time, the panel acknowledged that the evidence for the use of aspirin in preventing heart problems was still evolving. The task force reaffirms that lower doses of daily aspirin (75 milligrams to 81 milligrams) are equally, if not more effective, than higher doses (100 mg or more) in preventing heart attack and stroke in at-risk individuals. The paper also found that high doses may actually do more harm, especially in people taking clopidogrel. According to background information in the study, aspirin is the most used drug worldwide to prevent heart attack and stroke. More than one-third of U.S. adults are believed to take aspirin each day.

SOURCE: HealthDay News, March 2009.

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 Traffic Alert !

Traffic Jams Hurt The Heart

A new study out of Germany has uncovered evidence that getting stuck in traffic prompts an even more serious and immediate consequence -- a much higher risk for suffering a heart attack. The finding does not isolate which particular virtue of road congestion -- stress, pollution, car exhaust or noise -- might be the driving force behind the apparent cardiovascular threat. However, after a four-year analysis of nearly 1,500 heart attack cases, the authors came to the conclusion that making one's way through traffic -- whether as a driver, a rider of public transport, or even a bicyclist -- seems to more than triple the chances for experiencing a heart attack in the first hour immediately following exposure. "We found that when people are participating in traffic, they have a threefold increased risk to experience a heart a attack one hour later," said study author, head of the research unit at the Institute of Epidemiology in Helmholtz Zentrum Munchen, Germany, and an adjunct associate professor in Harvard's School of Public Health. "For someone with a very low risk for a heart attack, this doesn't mean much," the scientist noted. "But for someone already at a higher risk for a heart attack -- because of lifestyle issues such as smoking or being overweight, or perhaps because of genetic makeup -- then traffic might be an additional stressor that could cause a heart attack to occur at this time." One-quarter of the patients were women, and the average age was 60. All had suffered a heart attack between 1999 and 2003, and all were subsequently interviewed to recall experiences in the four days leading up to the event that might have triggered the first symptoms. The researchers found that 8 percent of the heart attacks were specifically attributable to having been in traffic. In addition to identifying a 3.2 times higher risk for suffering a heart attack within the first hour after traffic exposure, the research team found that even six hours after exposure, there remained a significant -- though small -- increase in risk. Being the driver of a car was the most common form of traffic exposure, followed by being a rider of public transportation and/or bicycling. Patients who had a prior history of angina -- as well as women, elderly men and the unemployed -- appeared to be particularly sensitive to the observed increase in risk. Women, in fact, were found to have a five times greater risk for a heart attack following such exposure -- a gender bump the researchers suggested might be rooted in physiological differences or simply a reflection of the smaller number of women included in the study. Going forward, the researchers have embarked on further studies to try to determine exactly what aspects of traffic could account for the connection.

SOURCE: HealthDay News, March 2009.

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 Eye Cancer Risk !

Freckles, Moles May Indicate Risk For Eye Cancer

 People with moles and other features that put them at higher risk of skin cancer may also have an increased chance of developing melanoma of the eye, a new study says. Canadian researchers found links between skin moles, freckles, moles on the iris and risk of uveal melanoma. Among the findings were that people with atypical moles had almost three times the risk of having uveal melanoma as did those without such moles. "The study points to an interaction of genetic susceptibility and an environmental insult in the form of UV exposure," according to the scientist of the University of Alberta's ophthalmology department and leader of the study. Each year, about six people in a million develop uveal melanoma, the most common non-skin melanoma in the United States. People age 70 or older with light skin and eye color and who are prone to sunburn most often develop the condition, according to earlier research, but the mortality rate remains high.

SOURCE: HealthDay News, March 2009.

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 Biomarkers for RA !

Scientists Identified Biomarkers For Rheumatoid Arthritis

Biomarkers that can be detected before women develop rheumatoid arthritis (RA) have been identified by U.S. researchers. The researchers of the  Women's Hospital and Harvard Medical School, examined blood samples taken from 170 participants in the Women's Health Study and the Nurses' Health Study. The women had no symptoms of RA when the blood samples were taken but later developed the disease. The researchers found that levels of two cytokines called tumor necrosis factor (TNF) and interleukin-6 (IL-6) were elevated before the women developed RA symptoms. Levels of both cytokines are elevated in people with active RA. Because TNF degrades rapidly in stored blood samples, the researchers used soluble tumor necrosis factor receptor II (sTNFRII) as a surrogate. Levels of sTNFRII were elevated up to 12 years before development of RA symptoms and were associated with a twofold increased risk of RA. Levels of IL-6 were elevated about four years before the onset of RA symptoms. "The findings suggest that during the preclinical phase of autoantibody production, there is immune reactivity, with production of proinflammatory cytokines that are typically seen in symptomatic RA, namely IL-6 and TNF," the researchers wrote. Screening for biomarkers could be used for RA risk counseling and for targeted therapies to prevent the disease, they suggested.

SOURCE: HealthDay News, March 2009

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New Products of SQUARE Pharmaceuticals Ltd.

  Product De-rash®
  Generic Name Zinc Oxide
  Strength 40%
  Dosage form Ointment
  Therapeutic Category Emollient & Protectant
  Product Apsol®
Generic Name

Amlexanox

Strength

5%

Dosage form Oral Paste
Therapeutic Category Anti-apthous Ulcer
  Product Virux® Suspension
  Generic Name Aciclovir
  Strength

200 mg/5 ml

  Dosage form Suspension
  Therapeutic Category Systemic Anti-virals (Excluding Anti-HIV)

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