Congratulations are in Order
If you would like to feature the recent accomplishment of someone in your department, please send an email to firstname.lastname@example.org.
Congratulations to Samantha Parker (Slone Epidemiology Center, BUSPH) and colleagues on their publication, “Menarche, Menopause, Years of Menstruation, and the Incidence of Osteoporosis: The Influence of Prenatal Exposure to Diethylstilbestrol,” in The Journal of Clinical Endocrinology and Metabolism. Estrogen is critical for bone formation and growth in women. The objective of this study was to investigate the association between age at menarche, age at menopause, and years of menstruation with incidence of osteoporosis and assess the impact of prenatal exposure to diethylstilbestrol (DES), a synthetic estrogen, on such associations. Participants were 5,573 women in the National Cancer Institute Combined Cohort Study of DES (1994-2006). Data on reproductive history and medical conditions were collected through questionnaires at baseline in 1994 and subsequently in 1997, 2001, and 2006. Age-stratified Cox regression models were used to calculate multivariable incidence rate ratios (IRR) and 95% confidence intervals (CI). Effect measure modification by prenatal DES exposure was assessed using cubic restricted spline regression models. Study findings were that the IRRs for osteoporosis incidence with age at menarche <11 years and age at menopause ≥50 years were 0.82 (CI: 0.59, 1.14) and 0.61 (CI: 0.40, 0.92), respectively. Fewer than 25 years of menstruation was associated with an increased incidence of osteoporosis (IRR: 1.80; CI: 1.14, 2.86) compared with ≥ 35 years of menstruation. Associations were stronger among women who had not been prenatally exposed to DES. The study data support the hypothesis that lifetime cumulative exposure to estrogens is protective against osteoporosis. Furthermore, prenatal exposure to estrogen appears to modify these associations, although the mechanism by which this occurs is unknown.
Congratulations to Dr. Emily Feinberg (Department of Pediatrics, BUSM/BMC) and colleagues on their publication, “Improving Maternal Mental Health After a Child's Diagnosis of Autism Spectrum Disorder: Results From a Randomized Clinical Trial,” in the JAMA Pediatrics. The prevalence of psychological distress among mothers of children with autism spectrum disorder (ASD) suggests a need for interventions that address parental mental health during the critical period after the child's autism diagnosis when parents are learning to navigate the complex system of autism services. The objective of this study was to investigate whether a brief cognitive behavioral intervention, problem-solving education (PSE), decreases parenting stress and maternal depressive symptoms during the period immediately following a child's diagnosis of ASD. A randomized clinical trial compared 6 sessions of PSE with usual care. Settings included an autism clinic and 6 community-based early intervention programs that primarily serve low-income families. Participants were mothers of 122 young children (mean age, 34 months) who recently received a diagnosis of ASD. Among mothers assessed for eligibility, 17.0% declined participation. Outcomes were reported after 3 months of follow-up (immediate postdiagnosis period). During the study, problem-solving education, which is a brief, cognitive intervention, was delivered in six 30-minute individualized sessions by existing staff (early intervention programs) or research staff without formal mental health training (autism clinic). Primary outcomes were parental stress and maternal depressive symptoms. Fifty-nine mothers were randomized to receive PSE and 63 to receive usual care. The follow-up rate was 91.0%. Most intervention mothers (78.0%) received the full PSE course. At the 3-month follow-up assessment, PSE mothers were significantly less likely than those serving as controls to have clinically significant parental stress (3.8% vs 29.3%; adjusted relative risk [aRR], 0.17; 95% CI, 0.04 to 0.65). For depressive symptoms, the risk reduction in clinically significant symptoms did not reach statistical significance (5.7% vs 22.4%; aRR, 0.33; 95% CI, 0.10 to 1.08); however, the reduction in mean depressive symptoms was statistically significant (Quick Inventory of Depressive Symptomatology score, 4.6 with PSE vs 6.9 with usual care; adjusted mean difference, -1.67; 95% CI, -3.17 to -0.18). The study concluded that the positive effects of PSE in reducing parenting stress and depressive symptoms during the critical postdiagnosis period, when parents are asked to navigate a complex service delivery system, suggest that it may have a place in clinical practice. Further work will monitor these families for a total of 9 months to determine the trajectory of outcomes.
Congratulations to Dr. Joanne Murabito (Department of Medicine, BUSM/BMC) and colleagues on their publication, “Parental longevity is associated with cognition and brain ageing in middle-aged offspring,” in Age and Ageing. Offspring of long-lived individuals have lower risk for dementia. The study examined the relation between parental longevity and cognition and subclinical markers of brain ageing in community-dwelling adult offspring. Offspring participants with both parents in the Framingham Heart Study, aged ≥55 years and dementia-free underwent baseline and repeat neuropsychological (NP) testing and brain magnetic resonance imaging (MRI). Parental longevity was defined as having at least one parent survive to age ≥85 years. To test the association between parental longevity and measures of cognition and brain volumes, the study used multivariable linear and logistic regression adjusting for age, sex, education and time to NP testing or brain MRI. Of 728 offspring (mean age 66 years, 54% women), 407 (56%) had ≥1 parent achieve longevity. In cross-sectional analysis, parental longevity was associated with better scores on attention (beta 0.21 ± 0.08, P = 0.006) and a lower odds of extensive white matter hyperintensity on brain MRI (odds ratio 0.59, 95% CI: 0.38, 0.92, P = 0.019). The association with white matter hyperintensity was no longer significant in models adjusted for cardiovascular risk factors and disease. In longitudinal analysis (6.7 ± 1.7 years later), offspring with parental longevity had slower decline in attention (0.18 ± 0.08, P = 0.038), executive function (beta 0.19 ± 0.09, P = 0.031) and visual memory (beta -0.18 ± 0.08, P = 0.023), and less increase in temporal horn volume (beta -0.25 ± 0.09, P = 0.005). The associations persisted in fully adjusted models. The study concluded that parental longevity is associated with better brain ageing in middle-aged offspring.
Congratulations to Dr. Xinning Li (Orthopaedic Surgery, BUSM/BMC) and colleagues on their publication, “Functional outcomes after total shoulder arthroplasty in obese patients,” in The Journal of Bone and Joint Surgery.Obesity is increasingly prevalent in the United States. There are several reports of outcomes in obese patients after total knee or hip replacement. The purpose of this study was to compare the functional outcomes and complications of obese patients undergoing shoulder arthroplasty with those of overweight or normal-weight patients. Seventy-six patients who underwent primary total shoulder arthroplasty were grouped according to body mass index. The groups were classified as: normal, which was denoted by a body mass index of <25 kg/m2 (twenty-six patients); overweight, which was denoted by a body mass index of 25 to 29.9 kg/m2 (twenty-five patients); and obese, which was denoted by a body mass index of ≥30 kg/m2 (twenty-five patients). Preoperative demographics and perioperative and postoperative complications were recorded. The American Shoulder and Elbow Surgeons score, Short Form-36, and visual analog scale pain and fatigue scores were evaluated at baseline and at the two-year follow-up visit. In the normal group, the mean scores (and standard deviation) improved for the American Shoulder and Elbow Surgeons score from 38.4 ± 15.5 points preoperatively to 80.2 ± 19.4 points at two years postoperatively (p < 0.001) and for the Short Form-36 Physical Component Summary score from 38.3 ± 6.5 points preoperatively to 53.7 ± 11.3 points at two years postoperatively (p < 0.001); the visual analog scale pain scores decreased from a mean score of 62 points preoperatively to 12 points at two years postoperatively (p < 0.001). In the overweight group, the mean scores (and standard deviation) improved for the American Shoulder and Elbow Surgeons score from 37.4 ± 18.1 points preoperatively to 75.2 ± 24.9 points at two years postoperatively (p < 0.001) and for the Short Form-36 Physical Component Summary score from 36.1 ± 8.0 points preoperatively to 39.8 ± 12.2 points at two years postoperatively (p = 0.21); the visual analog scale pain scores decreased from 68 points to 18 points (p < 0.001). In the obese group, the mean scores (and standard deviation) improved for the American Shoulder and Elbow Surgeons score from 35.8 ± 12.5 points preoperatively to 80.0 ± 20.6 points at two years postoperatively (p < 0.001) and for the Short Form-36 Physical Component Summary score from 36.3 ± 8.4 points preoperatively to 40.7 ± 12.4 points at two years postoperatively (p = 0.15); the visual analog scale pain scores decreased from 66 points preoperatively to 11 points at two years postoperatively (p < 0.001). There was one deep infection in the overweight group that required surgical irrigation and debridement. Two revisions of the components were required in the normal group. The study concluded that obesity did not have a detrimental effect on the improvement of short-term shoulder function. However, the overall physical function of obese and overweight patients does not significantly improve after total shoulder arthroplasty. In the normal body mass index group, patients did improve overall physical function after total shoulder arthroplasty.
Congratulations to each of you for your accomplishments!