1.Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis
Hendra ZUFRY ; Timotius Ivan HARIYANTO
Korean Journal of Radiology 2024;25(3):301-313
Objective:
The current body of evidence lacks clarity regarding the comparative efficacy and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) as minimally invasive treatments for benign thyroid nodules. The primary objective of this study is to clarify these concerns.
Materials and Methods:
A comprehensive search was conducted using the Cochrane Library, Scopus, Europe PMC, and Medline databases until October 10th, 2023, using a combination of relevant keywords. This study incorporated literature that compared RFA and MWA for benign thyroid nodules. The primary outcome was the volume reduction ratio (VRR) from baseline to follow-up. Secondary outcomes were symptom score, cosmetic score, ablation time, major complications rate, hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury. We used Risk of Bias in Non-randomized Studies - of Interventions (ROBINS-I) tool to assess the risk of bias in the included studies. We employed random effects models to analyze the standardized mean difference (SMD) and odds ratio for the presentation of outcomes.
Results:
Nine studies with 2707 nodules were included. The results of our meta-analysis indicated similar efficacy between RFA and MWA in terms of VRR during the 1 (SMD 0.06; 95% confidence interval [CI]: -0.13 to 0.26; P = 0.52) and 3 (SMD 0.11; 95% CI: -0.03 to 0.25; P = 0.12) months of follow-up. VRR was significantly higher in RFA than in MWA at the 6 (SMD 0.25; 95% CI: 0.06–0.43; P = 0.008) and 12 month of follow-up (SMD 0.38; 95% CI: 0.17 to 0.59; P < 0.001). There were no significant differences between RFA and MWA in symptom scores, cosmetic scores, or the incidence of complications, including hemorrhage, hoarseness, skin burn, cough, and sympathetic nerve injury.
Conclusion
RFA showed a higher VRR than MWA at 6 and 12-month follow-ups, with a comparable safety profile.
2.Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis
Akhil Deepak VATVANI ; Pratik PATEL ; Timotius Ivan HARIYANTO ; Theo Audi YANTO
The Korean Journal of Pain 2024;37(4):367-378
Background:
Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient’s quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia.
Methods:
A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes.
Results:
A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: –0.86, 95% confidence interval [CI]: –1.20, –0.51, P < 0.001, I 2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P< 0.001, I 2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness.
Conclusions
This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.
3.Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis
Akhil Deepak VATVANI ; Pratik PATEL ; Timotius Ivan HARIYANTO ; Theo Audi YANTO
The Korean Journal of Pain 2024;37(4):367-378
Background:
Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient’s quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia.
Methods:
A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes.
Results:
A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: –0.86, 95% confidence interval [CI]: –1.20, –0.51, P < 0.001, I 2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P< 0.001, I 2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness.
Conclusions
This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.
4.Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis
Akhil Deepak VATVANI ; Pratik PATEL ; Timotius Ivan HARIYANTO ; Theo Audi YANTO
The Korean Journal of Pain 2024;37(4):367-378
Background:
Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient’s quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia.
Methods:
A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes.
Results:
A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: –0.86, 95% confidence interval [CI]: –1.20, –0.51, P < 0.001, I 2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P< 0.001, I 2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness.
Conclusions
This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.
5.Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis
Akhil Deepak VATVANI ; Pratik PATEL ; Timotius Ivan HARIYANTO ; Theo Audi YANTO
The Korean Journal of Pain 2024;37(4):367-378
Background:
Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient’s quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia.
Methods:
A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes.
Results:
A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: –0.86, 95% confidence interval [CI]: –1.20, –0.51, P < 0.001, I 2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P< 0.001, I 2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness.
Conclusions
This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.
6.Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis
Akhil Deepak VATVANI ; Pratik PATEL ; Timotius Ivan HARIYANTO ; Theo Audi YANTO
The Korean Journal of Pain 2024;37(4):367-378
Background:
Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient’s quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia.
Methods:
A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes.
Results:
A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: –0.86, 95% confidence interval [CI]: –1.20, –0.51, P < 0.001, I 2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P< 0.001, I 2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness.
Conclusions
This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.
7.TSHR Gene (rs179247) Polymorphism and Susceptibility to Autoimmune Thyroid Disease: A Systematic Review and Meta-Analysis
Hendra ZUFRY ; Timotius Ivan HARIYANTO
Endocrinology and Metabolism 2024;39(4):603-614
Background:
Both Graves’ disease (GD) and Hashimoto’s thyroiditis (HT) are classified as autoimmune thyroid diseases (AITDs). It has been hypothesized that changes in the thyroid-stimulating hormone receptor (TSHR) gene may contribute to the development of these conditions. This study aimed to analyze the correlation between the TSHR rs179247 gene polymorphism and susceptibility to AITD.
Methods:
We conducted a thorough search of the Google Scholar, Scopus, Medline, and Cochrane Library databases up until March 2, 2024, utilizing a combination of relevant keywords. This review examines data on the association between TSHR rs179247 and susceptibility to AITD. Random-effect models were employed to assess the odds ratio (OR), and the findings are presented along with their respective 95% confidence intervals (CIs).
Results:
The meta-analysis included 12 studies. All genetic models of the TSHR rs179247 gene polymorphism were associated with an increased risk of developing GD. Specifically, the associations were observed in the dominant model (OR, 1.65; P<0.00001), recessive model (OR, 1.65; P<0.00001), as well as for the AA genotype (OR, 2.09; P<0.00001), AG genotype (OR, 1.39; P<0.00001), and A allele (OR, 1.44; P<0.00001). Further regression analysis revealed that these associations were consistent regardless of the country of origin, sample size, age, and sex distribution. However, no association was found between TSHR rs179247 and the risk of HT across all genetic models.
Conclusion
This study suggests that the TSHR rs179247 gene polymorphism is associated with an increased risk of GD, but not with HT, and may therefore serve as a potential biomarker.
8.Factors associated with side effects of COVID-19 vaccine in Indonesia
Johan WIBOWO ; Rivaldo Steven HERIYANTO ; Felix WIJOVI ; Devina Adella HALIM ; Claudia CLAUDIA ; Elizabeth MARCELLA ; Billy SUSANTO ; Michele INDRAWAN ; Nadia Khoirunnisa HERYADI ; Michelle IMANUELLY ; Jonathan Juniard ANURANTHA ; Timotius Ivan HARIYANTO ; Chintya MARCELLIN ; Terry Devita SINAGA ; Saraswati Anindita RIZKI ; Novia SIETO ; Jeremia Immanuel SIREGAR ; Nata Pratama Hardjo LUGITO ; Andree KURNIAWAN
Clinical and Experimental Vaccine Research 2022;11(1):89-95
Purpose:
As coronavirus disease 2019 (COVID-19) continues to spread rapidly causing approximately 186 million confirmed cases around the world, the urgency to reach herd immunity through vaccination is increasing. However, vaccine safety is a top priority to limit the occurrence of adverse events. Henceforth, this study aims to recognize and perceive COVID-19 vaccine safety in Indonesia during the pandemic.
Materials and Methods:
This is a cross-sectional study and was conducted in Indonesia during the COVID-19 pandemic using an online survey of demographic information and a qualitative questionnaire. Responses were recorded and the association between demographic characteristics from survey questions was tested using chi-square with a risk estimate and 95% confidence interval.
Results:
A total of 311 participants from 33 out of 34 provinces in Indonesia participated in this study. Recorded responses showed multiple side effects of the COVID-19 vaccine both short- and long-term experienced by the participants. Significant associations were found between demographic factors and COVID-19 vaccine side effects such as female gender with short-term puncture site (odds ratio [OR], 0.463; 95% confidence interval [CI], 0.263–0.816) and short-term other reactions (OR, 0.463; 95% CI, 0.263–0.816), domicile outside Java island with long-term puncture site (OR, 4.219; 95% CI, 1.401–12.701) and immune reactions (OR, 3.375; 95% CI, 1.356–8.398), also between married marital status and long-term vagal reaction (OR, 4.655; 95% CI, 1.321–16.409).
Conclusion
Gender, domicile and marital status factors were associated with COVID-19 vaccine side effects in Indonesian people.