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Health Capsules: May 22

Common drug holds promise for treating cystic fibrosis

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.

New research compares AFib treatments

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

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.

Will the dead soon outnumber the living on Facebook?

As Facebook continues to expand worldwide, the number of deceased users may overtake living ones, a new analysis found.

If the world’s largest social network continues to expand at its current rate, the number of deceased Facebook users may be greater than living ones by as early as 2070, according to a new analysis conducted at the Oxford Internet Institute [OII].

This disturbing trend has important implications for how we treat our “digital heritage” in the future, both individually and as a society, said Carl Öhman and David Watson, doctoral students at the institute and authors of the analysis.

Their analysis predicts that, based on 2018 user levels with no further expansion, at least 1.4 billion Facebook users will die before 2100. If, however, Facebook continues to grow at current rates around the world, the number of deceased users could reach as high as 4.9 billion before the end of the century. The actual number will probably fall somewhere in between, they said.

“These statistics give rise to new and difficult questions around who has the right to all this data … On a societal level, we have just begun asking these questions and we have a long way to go. The management of our digital remains will eventually affect everyone who uses social media, since all of us will one day pass away and leave our data behind,” Öhman explained.

“Never before in history has such a vast archive of human behavior and culture been assembled in one place. Controlling this archive will, in a sense, be to control our history. It is therefore important that we ensure that access to these historical data is not limited to a single for-profit firm,” Watson added.

As the largest of several social media platforms with growing membership globally, Facebook should invite historians, archivists, archaeologists and ethicists to participate in the process of managing the “vast volume” of data left behind when users pass away, they said.

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 839 measles cases across 23 states confirmed as of May 10 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.”

On the calendar

The 13th annual Baby-Kid Expo is on Saturday, June 1, 2019 from 9 a.m.-3 p.m. at the St. Charles Convention Center, 1 Convention Center Plaza in St. Charles. This free event connects St. Louis area families to products and services including healthcare and daycare providers, educational choices and recreation. It will feature a petting zoo, Safety Street, magic acts, princess shows and more. Register for admission and prize giveaways at babykidexpo.com.

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St. Louis Children’s Hospital sponsors a Staying Home Alone class on Tuesday, June 4 from 6:30-8 p.m. at Barnes-Jewish St. Peters Hospital, 10 Hospital Drive in St. Peters, in Suite 108 of Medical Office Building 1. This class, designed for parents and children to attend together, will help determine a child’s physical, mental, social and emotional readiness to stay home alone and prepare them for this experience. A family workbook, emergency cards, fire escape plan, parent checklist and first-aid kit are included. The course fee is $25 per family. To register, call (636) 344-5437.

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BJC of St. Charles County sponsors a two-part series, Diabetes Self-Management Education Services, on Tuesdays, June 4 and June 18, from 4-7 p.m. at Barnes-Jewish St. Peters Hospital, 10 Hospital Drive in St. Peters, in Suite 117 of Medical Office Building 1. This class is targeted for adults with type 2 diabetes or prediabetes. Individual consultations can also be scheduled for those with gestational, type 1 or type 2 diabetes. Sessions are led by a diabetes nurse educator and a registered dietitian. Participation is free; a physician’s order and advance registration are required. Register online at bjcstcharlescounty.org/Events or by calling (636) 928-9355.

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BJC Progress West Hospital sponsors a free Teddy Bear Clinic for children on Saturday, June 8 from 9-10:30 a.m. at the hospital, 2 Progress Point Parkway in O’Fallon, in the cafeteria. Bring your favorite teddy bear or stuffed friend for a “check-up”; the event will include a tour of the hospital, story time and coloring activity. The event is open to all ages, but recommended for ages 2-5. No advance registration is required.

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BJC offers a Family and Friends CPR class on Tuesday, June 11 from 6:30-9 p.m. at Progress West Hospital, 2 Progress Point Parkway in O’Fallon, in Conference Room B. This class is designed for parents, grandparents, babysitters [ages 10–15 if accompanied by an adult] and childcare providers. It is taught by a registered nurse who uses the American Heart Association’s curriculum, which includes hands-on skills practice and a 65-page student manual. The class does not include certification. The course fee is $25 per person. Registration is required by calling (636) 344-5437.

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BJC of St. Charles County offers free Know Your Numbers Health Screenings for adults on Friday, June 14 from 7:30-9:30 a.m. at Barnes-Jewish St. Peters, Hospital, 10 Hospital Drive in St. Peters, in Suite 117 of Medical Office Building 1. Tests include fasting glucose, lung function, blood pressure and BMI screenings. Participants should fast for at least 10 hours prior to screening if a glucose test is desired. To register, call (636) 928-9355 for an appointment.

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BJC St. Louis Children’s Hospital sponsors a Babysitting 101 class on Saturday, June 22 from 1-5 p.m. at the Kisker Road Branch Library, 1000 Kisker Road in St. Charles, in Rooms A and B. Topics covered include the business of babysitting, child development, safety and first aid, and fun and games. A workbook, backpack and light snack are provided. The course fee is $30 per child. Advance registration is available by calling (636) 344-5437.

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BJC of St. Charles County sponsors a special “Evening with the Experts” presentation, Colon Health: Screening and Treatment Options, on Wednesday, June 26 from 6:45-8 p.m. at Siteman Cancer Center, 150 Entrance Way in St. Peters. Colorectal cancer is the third most common cancer diagnosed in both men and women. Most people with early colorectal cancer have no symptoms, yet the five-year survival rate is nearly 90% if detected early. This session will feature new guidelines on when people should be screened, available screening options and the latest recommendations for prevention and treatment. The session will be followed by a Q&A session and a bonus wellness demonstration on Tai Chi. Attendance is free. Advance registration is preferred and is available online at bjcstcharlescounty.org/Events.

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A free Grow Your Reader program is on Wednesday, June 26 from 6:30-7:30 p.m. at Barnes-Jewish St. Peters Hospital, 10 Hospital Drive in St. Peters, in Suite 117 of Medical Office Building 1. This program is designed for parents and children ages 0–5. Learn simple strategies from the St. Charles City-County Library Foundation to help prepare your child to become a successful reader and learner through reading, writing, talking, singing and playing every day. Attendees will receive a bag and free books. Advance registration is required and is available online at bjcstcharlescounty.org/Events or by calling (636) 928-9355.

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