JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study
Effect of a soy isoflavone supplement on lung function and clinical outcomes in patients with poorly controlled asthma: a randomized clinical trial.
Soy isoflavone supplements are used to treat several chronic diseases, although the data supporting their use are limited. Some data suggest that supplementation with soy isoflavone may be an effective treatment for patients with poor asthma control. ⋯ Among adults and children aged 12 years or older with poorly controlled asthma while taking a controller medication, use of a soy isoflavone supplement, compared with placebo, did not result in improved lung function or clinical outcomes. These findings suggest that this supplement should not be used for patients with poorly controlled asthma.
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Associations between subclinical thyroid dysfunction and fractures are unclear and clinical trials are lacking. ⋯ Subclinical hyperthyroidism was associated with an increased risk of hip and other fractures, particularly among those with TSH levels of less than 0.10 mIU/L and those with endogenous subclinical hyperthyroidism. Further study is needed to determine whether treating subclinical hyperthyroidism can prevent fractures.
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Are β-blockers associated with lower rates of mortality and morbidity after cardiac or noncardiac surgery? ⋯ In cardiac surgery, β-blockers are associated with a lower incidence of supraventricular tachycardias (SVTs) and ventricular arrhythmias. In noncardiac surgery, β-blockers are associated with a possible increase in mortality and strokes, a lower incidence of acute myocardial infarctions (AMIs) and SVTs, and an increase in bradycardia and hypotension. If tolerated, long-term β-blocker treatment should be continued perioperatively, whereas the decision to start a β-blocker should be individualized, weighing risks and benefits.
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The association of copy number variations (CNVs), differing numbers of copies of genetic sequence at locations in the genome, with phenotypes such as intellectual disability has been almost exclusively evaluated using clinically ascertained cohorts. The contribution of these genetic variants to cognitive phenotypes in the general population remains unclear. ⋯ Known pathogenic CNVs in unselected, but assumed to be healthy, adult populations may be associated with unrecognized clinical sequelae. Additionally, individually rare but collectively common intermediate-size CNVs may be negatively associated with educational attainment. Replication of these findings in additional population groups is warranted given the potential implications of this observation for genomics research, clinical care, and public health.