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Health Capsules: May 15

By: Lisa Russell


Common drug holds promise for treating cystic fibrosis

A recent large, long-term study compared the two primary treatments for atrial fibrillation, a common heart rhythm disorder.

About 30,000 people in the U.S. are currently living with cystic fibrosis, a progressive genetic disease with no known cure and limited treatment options. As the U.S. marks its annual Cystic Fibrosis Awareness Month in May, researchers have announced their recent discovery of a new potential treatment – an older antifungal drug called amphotericin – which may help many who suffer from this ultimately fatal disease. 

In healthy people, a protein secreted in the lungs controls the movement of salt and water in and out of cells. In people with cystic fibrosis, though, the defective gene responsible produces a defective protein which causes thick, sticky mucus to accumulate in the lungs, making breathing difficult and leading to frequent bacterial infections.

In studies using human cells and animal models, amphotericin helped lung cells function in a way that could make it easier for patients to fight these infections, by performing the work of the defective or missing protein.

 “The really exciting news is that amphotericin is a medicine that’s already approved and available on the market,” said Martin D. Burke, M.D., Ph.D., the study’s leader and a professor of chemistry at the University of Illinois in Champaign.  “We think it’s a good candidate.”

While some other drug treatments are currently available for cystic fibrosis, their value is limited because different people have different types of mutated proteins, and about 10% of those with the disease make no protein at all. But amphotericin, Burke said, has shown the potential to work regardless of the kind of mutation, and even when the protein is missing.

The next step is to conduct human studies to validate these findings, which were published in the journal Nature.

Measles outbreak expands to Missouri

Missouri has officially recorded its first case of measles in a rapidly expanding 2019 outbreak which is now the largest since the disease was declared eradicated in 2000. Several potential cases also have been reported in Illinois. 
Nationally, the 764 measles cases across 23 states confirmed as of May 3 is already the highest number for any full year since 1994. 
In addition to stressing the extreme importance of childhood vaccinations – an initial dose of the MMR vaccine between 12 and 15 months with a second dose between 4 and 6 years of age – the Centers for Disease Control and Prevention recently recommended that adults born before 1968 “should be revaccinated” with at least one dose of the current live attenuated measles vaccine. 
The outbreak also has sparked a travel warning from St. Louis area health authorities. “With the summer travel season approaching and as residents begin making travel plans and plans to receive summer guests, it’s important that they take precautions to reduce the risk of contracting, and possibly spreading, this highly contagious illness,” Health Department Director Fredrick Echols recently said in a statement. “Travelers should make sure they have a measles vaccination and add vaccinations on their travel planning check-off list.”

New research compares AFib treatments

Atrial fibrillation [AFib], an irregular heart rhythm that occurs when the heart’s two upper chambers experience chaotic electrical signals, is the most common cardiac arrhythmia among Americans, affecting at least 2.7 million adults. AFib’s most significant long-term health consequences are stroke and heart failure. 

While some patients have no symptoms, others’ quality of life is greatly impaired by symptoms of AFib – which include rapid heart palpitations, fatigue, shortness of breath, and difficulty with physical exertion, among others. Some people become extremely distressed or even disabled by these uncomfortable symptoms and their unpredictable nature.

The two primary treatments for AFib are blood-thinning medications, which help to prevent dangerous blood clots from forming; and catheter ablation, a common cardiovascular procedure in which the heart tissue that triggers its abnormal rhythm is scarred or destroyed.

These two treatments were compared in a group of more than 2,200 patients in an international seven-year trial called CABANA: Catheter Ablation vs. Antiarrhythmic Drug Therapy for Atrial Fibrillation. Researchers wanted to learn which one produced better outcomes for patients, both in terms of reducing rates of death or disability from AFib and improving their overall quality of life.  

Recently reported results from the much-anticipated trial are mixed. They showed that catheter ablation, although a far more invasive treatment option, is no more effective than drug treatment in preventing strokes and other complications in people with AFib, including deaths. 

However, patients who had the ablation procedure experienced both greater symptom relief and more long-term quality of life improvements, compared to those who had drug treatments alone. Those who had the most severe symptoms before undergoing the procedure showed the most significant improvements.

“CABANA, because of its size and duration, provides extraordinary new data regarding the patient’s perspective,” said Yves Rosenberg, M.D., the program officer for the study.

At the start of the study, 86% of patients in the ablation group and 84% on drug therapy reported having AFib symptoms during the previous month. By its end, only 25% of patients in the ablation group reported symptoms, compared to 35% of those treated with drug therapy alone.

Two new studies based on the CABANA results were recently published in the Journal of the American Medical Association.

On the calendar

St. Luke’s Hospital offers a free information session, You Can Manage It – Prevent Diabetes from Controlling Your Life, on Tuesday, May 21 from 1-2:30 p.m. at the Desloge Outpatient Center, 121 St. Luke’s Center Drive in Chesterfield. Take charge of your health by providing the information and resources needed for a successful diabetes self-management plan. Register online at stlukes-stl.com. 

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The Missouri Botanical Garden presents a free class, Detox Your Domicile, on Thursday, May 23 from 7-8 p.m. at the Daniel Boone Library, 300 Clarkson Road in Ellisville. Discover methods to evaluate product safety and create low-cost, healthier DIY alternatives to home cleaning and personal care products. Online registration is available at slcl.org/Events.

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An American Red Cross Blood Drive is on Thursday, May 23 from 11 a.m.-3 p.m. at the Daniel Boone Library, 300 Clarkson Road in Ellisville, in Meeting Rooms 2 and 3. To schedule an appointment, visit redcrossblood.org or call the Red Cross at 1-800-733-2767.

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St. Luke’s Hospital and Dierbergs Markets co-sponsor Learn to Shop for a Healthier You on Thursday, May 23 from 10-11:30 a.m. at Dierbergs Des Peres, 1080 Lindemann Road. Join a St. Luke’s dietitian for a store tour that will focus on how to make better choices, read labels and plan meals. Tour will meet at the store’s School of Cooking. The cost is $5, but all participants will receive a $5 Dierbergs gift card at the end of the tour. To register, visit Dierbergs.com or call (314) 238-0440.

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BJC St. Louis Children’s Hospital sponsors a Staying Home Alone course on Saturday, June 1 from 9-10:30 a.m. at Children’s Specialty Care Center, 13001 N. Outer Forty Road in Town & Country. This parent/child class will help to determine a child’s physical, mental, social and emotional readiness to stay home alone and prepare them for the experience. The fee is $25 per family. To register, call (314) 454-5437.

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St. Luke’s Hospital’s annual Tour de Wellness – Ride for Heart Health is on Sunday, June 2 beginning at 7:30 a.m. at the hospital’s Desloge Outpatient Center, 121 St. Luke’s Center Drive in Chesterfield. The event welcomes cyclists of all levels; choose from one of three routes ranging from 17 to 60 miles. Registration, sponsorship details and general information are available online at stlukestourdewellness.com.

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