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• Laura B. Kaufman DMD, et al
• Azadeh Ahmadian, MD, et al
• Devyani Misra, MD, MS, et al
• Elaine Hylek, MD, MPH, et al


Laura B. Kaufman DMDCongratulations to Dr. Laura B. Kaufman (General Dentistry, BUSDM and Geriatrics, BMC) and colleagues on their publication, “An oral health study of centenarians and children of centenarians,” in the Journal of the American Geriatrics Society. The objective of this study is to determine whether oral health is better in centenarians than in a published birth cohort-matched sample and to compare oral health in centenarian offspring with a case-controlled reference sample. Seventy-three centenarians, 467 offspring, and 251 offspring generation-reference cohort subjects from the New England Centenarian Study (NECS) participated in this observational cross-sectional study. A self-report questionnaire was administered to measure oral health in all three groups, with edentulous rate as the primary outcome measure. The NECS made information on sociodemographic characteristics and medical history available. Centenarian results were compared with published birth cohort-matched results. Data from offspring and reference cohorts were analyzed to determine differences in oral health and associations between oral health measures and specific medical conditions. The edentulous rate of centenarians (36.5%) was lower than that of their birth cohort (46%) when they were aged 65 to 74 in 1971 to 1974 (according to National Center of Health Statistics). Adjusting for confounding factors, the reference cohort was more likely to be edentulous (adjusted odds ratio (AOR) = 2.78, 95% confidence interval CI = 1.17-6.56), less likely to have all or more than half of their own teeth (AOR = 0.48, 95% CI = 0.3-0.76), and less likely to report excellent or very good oral health (AOR = 0.65, 95% CI = 0.45-0.94) than the centenarian offspring. The study concluded that Centenarians and their offspring have better oral health than their respective birth cohorts. Oral health may prove to be a helpful marker for systemic health and healthy aging.
Kaufman LB, Setiono TK, Doros G, Andersen S, Silliman RA, Friedman PK, Perls TT. An oral health study of centenarians and children of centenarians. J Am Geriatr Soc. 2014 Jun.

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Congratulations to Dr. Azadeh Ahmadian (Cardiovascular Medicine, Department of Medicine, BUSM/BMC) and colleagues on their publication, “Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis,” in the Journal of Nuclear Cardiology.  FDG PET/CT with myocardial perfusion imaging is a useful method for evaluating cardiac sarcoidosis (CS), but interpretation is not standardized. A method for quantification of cardiac FDG PET/CT was developed and its relationship to conventional interpretation, perfusion defects, clinical events, and immunosuppressive treatment was evaluated in this study. FDG PET/CT with MPI studies performed for CS (n = 38) were retrospectively compared to negative control studies acquired for oncologic indications (n = 10). Quantitative measures of FDG volume-intensity (Cardiac Metabolic Activity, CMA) was performed using standardized uptake values (SUVs). CMA (477.7 ± 909 vs 0.55 ± 2.1 vs 0.3 ± 0.3 g glucose, P = .02) was significantly greater in visually FDG-positive studies compared to visually negative and oncologic negative studies. Among patients with CS, CMA was greater in studies with an EF < 50% (760.3 ± 1,148 vs 87.4 ± 161 g glucose, P = .03) and preceding an adverse clinical event (1,095 ± 1,253 vs 73 ± 144 g glucose, P = .006). CMA was the only independent predictor of events by multivariate analysis. In patients with repeat examinations (n = 7), CMA decreased with prednisone treatment in 5 of 6 patients. The study concluded that quantification of FDG uptake in CS correlates with lower EFs, clinical events, and immunosuppression treatment.
Ahmadian A, Brogan A, Berman J, Sverdlov AL, Mercier G, Mazzini M, Govender P, Ruberg FL, Miller EJ. Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis. J Nucl Cardiol. 2014 May 31.

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Congratulations to Dr. Devyani Misra (Clinical Epidemiology Unit, BUSM/BMC) and colleagues on their publication,Incident long-term warfarin use and risk of osteoporotic fractures: propensity-score matched cohort of elders with new onset atrial fibrillation,” in Osteoporosis International. Prior studies examining the association of warfarin use and osteoporotic fractures have been conflicting, potentially related to methodological limitations. Thus, the study examined the association of long-term warfarin use with risk of hip, spine, and wrist fractures among older adults with atrial fibrillation, attempting to address prior methodologic challenge. Men and women ≥65 years of age with incident atrial fibrillation and without prior history of fractures were included from The Health Improvement Network followed between 2000 and 2010. Long-term warfarin use was defined in two ways: (1) warfarin use ≥1 year; (2) warfarin use ≥3 years. Propensity-score matched cohorts of warfarin users and nonusers were created to evaluate the association between long-term warfarin use and risk of hip, spine, and wrist fractures separately as well as combined, using Cox-proportional hazards regression models. Among >20,000 participants with incident atrial fibrillation, the hazard ratios (HR) for hip fracture with warfarin use ≥1 and ≥3 years, respectively, were 1.08 (95%CI 0.87, 1.35) and 1.13 (95 % CI 0.84, 1.50). Similarly, no significant associations were observed between long-term warfarin use and risk of spine or wrist fracture. When risk of any fracture was assessed with warfarin use, no association was found [HR for warfarin use ≥1 year 0.92 (95%CI 0.77, 1.10); HR for warfarin use ≥3 years 1.12 (95%CI 0.88, 1.43)]. The study concluded that long-term warfarin use among elders with atrial fibrillation was not associated with increased risk of osteoporotic fractures and therefore does not appear to necessitate additional surveillance or prophylaxis.
Misra D, Zhang Y, Peloquin C, Choi HK, Kiel DP, Neogi T. Incident long-term warfarin use and risk of osteoporotic fractures: propensity-score matched cohort of elders with new onset atrial fibrillation. Osteoporos Int. 2014 Jun.

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Elaine Hylek, MD, MPHCongratulations to Dr. Elaine Hylek (General Internal Medicine BUSM/BMC) and colleagues on their publication, “Major Bleeding in Patients With Atrial Fibrillation Receiving Apixaban or Warfarin: The ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation): Predictors, Characteristics, and Clinical Outcomes,” in the Journal of the American College of Cardiology.This study sought to characterize major bleeding on the basis of the components of the major bleeding definition, to explore major bleeding by location, to define 30-day mortality after a major bleeding event, and to identify factors associated with major bleeding. Apixaban was shown to reduce the risk of major hemorrhage among patients with atrial fibrillation in the ARISTOTLE (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation) trial. Factors associated with major hemorrhage were identified using a multivariable Cox model. The on-treatment safety population included 18,140 patients. The rate of major hemorrhage among patients in the apixaban group was 2.13% per year compared with 3.09% per year in the warfarin group (hazard ratio [HR] 0.69, 95% confidence interval [CI]: 0.60 to 0.80; p < 0.001). Compared with warfarin, major extracranial hemorrhage associated with apixaban led to reduced hospitalization, medical or surgical intervention, transfusion, or change in antithrombotic therapy. Major hemorrhage followed by mortality within 30 days occurred half as often in apixaban-treated patients than in those receiving warfarin (HR 0.50, 95% CI: 0.33 to 0.74; p < 0.001). Older age, prior hemorrhage, prior stroke or transient ischemic attack, diabetes, lower creatinine clearance, decreased hematocrit, aspirin therapy, and nonsteroidal anti-inflammatory drugs were independently associated with an increased risk.  The study concluded that apixaban, compared with warfarin, was associated with fewer intracranial hemorrhages, less adverse consequences following extracranial hemorrhage, and a 50% reduction in fatal consequences at 30 days in cases of major hemorrhage.
Hylek EM, Held C, Alexander JH, Lopes RD, De Caterina R, Wojdyla DM, Huber K, Jansky P, Steg PG, Hanna M, Thomas L, Wallentin L, Granger CB. Major Bleeding in Patients With Atrial Fibrillation Receiving Apixaban or Warfarin: The ARISTOTLE Trial (Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation): Predictors, Characteristics, and Clinical Outcomes. J Am Coll Cardiol. 2014 May 27.

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Congratulations to each of you for your accomplishments!

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