Browsing by Author "Ammarin Thakkinstian"
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Publication Metadata only Activation of mononuclear phagocytes and its relationship to asplenia and phosphatidylserine exposing red blood cells in hemoglobin E/β-thalassemia patients(2011-01-01) Wansa Banyatsuppasin; Punnee Butthep; Vichai Atichartakarn; Ammarin Thakkinstian; Napaporn Archararit; Kovit Pattanapanyasat; Suporn Chuncharunee; Mahidol UniversityPublication Metadata only Adjuvant trastuzumab regimen for HER2-positive early-stage breast cancer: a systematic review and meta-analysis(2019-08-03) Anne Julienne Genuino; Usa Chaikledkaew; Due Ong The; Thanyanan Reungwetwattana; Ammarin Thakkinstian; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol University© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Objective: Breast cancer remains to be the globally leading female cancer. About 15% to 20% of breast cancers have human epidermal growth factor receptor 2 (HER2)-positive tumors–a more aggressive breast cancer subtype with shortened survival. In the light of new and updated trial data on trastuzumab therapy for HER2-positive early-stage breast cancer (EBC), we conducted a systematic review and meta-analysis to update the pooling of its relative treatment effects. Methods: Systematic search was performed through Pubmed and Scopus to identify studies comparing survival outcomes and risks of heart toxicity effects of adjuvant trastuzumab with chemotherapy versus chemotherapy alone for HER2-positive EBC patients. Results: Based on the eight included studies in the review, combining trastuzumab with chemotherapy continues to show lowered death and relapse risks by one-third. The decision to initiate trastuzumab, however, needs to be prudently deliberated as two to three times more cardiotoxicity risk was shown to be associated with its use. Conclusion: Administering adjuvant trastuzumab in a weekly cycle concurrently with anthracycline-taxane chemotherapy regimen appears to be a preferable option to optimize its favorable effect in improving DFS and to prevent significantly higher risk for cardiotoxic effects.Publication Metadata only Advanced epithelial ovarian carcinoma in Thai women: Should we continue to offer second-look laparotomy?(2001-07-01) Vasant Linasmita; Ammarin Thakkinstian; Somsak Tangtrakul; Sunchai Bullangpoti; Sarikapan Wilailak; Somkeart Srisupundit; Nathpong Israngura; Mahidol UniversityObjective : To determine survival among patients with epithelial ovarian carcinoma (EOC) who underwent a second-look laparotomy (SLL) and those refusing the procedure. Also to analyze factor(s) influencing the survival of the patients. Method and Material : Medical records were reviewed of patients with advanced EOC who were clinically free of disease after primary surgery and platinum-based chemotherapy between January 1, 1992, and December 31, 1998. All of them were offered SLL. Measurement outcomes include patient survival and disease-free survival. Results : There were 50 patients with clinically complete remission after chemotherapy. Sixteen patients underwent SLL, and thirty-four patients refused the procedure (NSLL). Seven patients (43.8%) were reported to have positive SLL. After the median follow-up time of 35 months, 12 patients had died, and 5 patients were lost to follow-up. The median survival time for patients with SLL was about 60 months. Five-year survival rates of patients in the SLL, and NSLL groups were 37 per cent (95%CI = 7%-69%), and 88 per cent (95%CI = 65%-96%) respectively (P<0.001). The median time to relapse was about 25 months for patients with negative SLL. Five-year disease-free survival rates of patients in the negative SLL, and NSLL groups were 28 per cent (95%CI = 4%-59%), and 54 per cent (95%CI = 34%-70%) respectively (P=0.251). By Cox regression analysis, tumor grade was the only significant prognostic factor influencing patients' survival (HR = 6, 95%CI of HR = 1.2-34.2). Conclusion : The second-look laparotomy doesn't have a favorable impact on overall and disease-free survival. Tumor grade is the only independent prognostic variable for survival of the patients.Publication Metadata only Age-Adjusted Dual X-ray Absorptiometry–Derived Trabecular Bone Score Curve for the Lumbar Spine in Thai Females and Males(2016-10-01) Chanika Sritara; Ammarin Thakkinstian; Boonsong Ongphiphadhanakul; Sasithorn Amnuaywattakorn; Chirawat Utamakul; Tawatchai Akrawichien; Prin Vathesatogkit; Piyamitr Sritara; Mahidol University; Electricity Generating Authority of Thailand© 2016 The International Society for Clinical Densitometry Trabecular bone score (TBS), which has been shown to discriminate patients with fractures from healthy individuals, decreases with age. This study was conducted to derive an age-adjusted normative TBS curve for each gender aged 30–80 + years to serve as reference data for Thai males and females. A cross-sectional study was conducted among employees from the Electricity Generating Authority of Thailand cohorts, after excluding those with conditions potentially affecting bone metabolism and analysis. The values of TBS at L1–L4 vertebrae were analyzed using a commercial software. Age-adjusted TBS curves were constructed using segmental linear regression analysis for each gender. Additional analysis was also performed on TBS with age, body mass index, and body mineral density (BMD) at L1–L4 vertebrae as covariates. A database of 848 healthy subjects (341 females and 507 males) aged 30–80+ years was created. The BMDs of both male and female subjects in the youngest decade were not statistically different from previous reports (p = 0.31 and 0.22 for females and males, respectively). In this age group, the mean TBS was higher in females, albeit not statistically significant (p = 0.12). Between the ages of 30–80+ years, female and male TBS dropped by 19.8% (0.40% per year) and 10.1% (0.20% per year), respectively. The association with TBS was weak for body mass index and moderate for BMD (coefficients of about −0.01 and 0.4–0.5, respectively). The age-adjusted reference curves for healthy Thai females and males aged 30–80+ years have been established.Publication Metadata only Alcohol relapse and its predictors after liver transplantation for alcoholic liver disease: A systematic review and meta-analysis(2019-08-22) Lancharat Chuncharunee; Noriyo Yamashiki; Ammarin Thakkinstian; Abhasnee Sobhonslidsuk; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Kyoto University© 2019 The Author(s). Background: Alcoholic liver disease (ALD) is the leading cause of liver transplantation (LT). The magnitude and risk factors of post-LT alcohol relapse are not well described. We conducted a meta-analysis to evaluate alcohol relapse rate and its predictors after LT. Methods: Searches of MEDLINE and SCOPUS identified eligible published studies of alcohol relapse after LT published up to 31 March 2018. Alcohol relapse was defined as any alcohol consumption post-LT, and heavy alcohol relapse was defined as a relapse of alcohol consumption that was associated with a significant harm. Data for the proportion of alcohol relapse was pooled using a meta-analysis for pooling proportion. An odds ratio (OR) of the predictor of alcohol relapse was extracted and pooled using meta-analysis for the pooling risk factor. Data were analyzed using a random effect model if heterogeneity was presented; otherwise, a fixed effect model was applied. The study was registered at PROSPERO (CRD42017052659). Results: Ninety-two studies with over 8000 cases were recruited for pooling proportion of alcohol relapse. The alcohol relapse rate and heavy alcohol relapse rate after LT during the mean follow-up time of 48.4 ± 24.7 months were 22% (95% confidence interval (CI): 19-25%) and 14% (95%CI: 12-16%). Psychiatric comorbidities (odds ratio (OR) 3.46, 95%CI: 1.87-6.39), pre-transplant abstinence of less than 6 months (OR 2.76, 95%CI: 2.10-3.61), unmarried status (OR 1.84, 95%CI: 1.39-2.43), and smoking (OR 1.72, 95%CI: 1.21-2.46) were associated with alcohol relapse after LT. However, we noticed publication bias of unpublished negative studies and high heterogeneity of results. Conclusions: Post-transplant alcohol relapse occurred in about one-fifth of patients who underwent alcohol-related LT. Psychiatric comorbidities represented the strongest predictor of alcohol relapse. Psychiatric comorbidities monitoring and pre-LT alcohol abstinence for at least 6 months may decrease alcohol relapse after LT.Publication Metadata only Aloe vera and health outcomes: An umbrella review of systematic reviews and meta-analyses(2021-02-01) Saranrat Sadoyu; Chidchanok Rungruang; Thitima Wattanavijitkul; Ratree Sawangjit; Ammarin Thakkinstian; Nathorn Chaiyakunapruk; Ramathibodi Hospital; Chulalongkorn University; University of Utah Health; Mahasarakham UniversityThis umbrella review aims to summarize the effects of Aloe vera on health outcomes and assess the strength of evidence. PubMed, Scopus, Embase, Cochrane database of systematic reviews, CINAHL, and AMED were searched from inception to October, 2019 for systematic reviews and meta-analyses of clinical trials that investigated the effects of Aloe vera on health outcomes. Two independent reviewers extracted data, assessed the methodological quality, and rated the credibility of evidence according to established criteria. Ten articles reporting 71 unique outcomes of Aloe vera were included. Of these, 47 (67%) were nominally statistically significant based on random-effects model (p ≤.05). Only 3 outcomes were supported by highly suggestive evidence, whereas 42 outcomes were supported by weak evidence. The highly suggestive evidence supported benefits of Aloe vera in the prevention of second-degree infusion phlebitis (RR: 0.18, 95% CI: 0.10–0.32, p-value: 1.75 × 10−9) and chemotherapy-induced phlebitis based on overall incidence (OR: 0.13, 95% CI: 0.08–0.20, p-value: 9.68 × 10−20) and incidence of the second degree of severity (OR: 0.10, 95% CI: 0.07–0.14, p-value: 3.41 × 10−35). However, the majority of the evidence were limited by small sample size and poor methodological quality. Therefore, despite the overall favorable effect of Aloe vera, more robust studies are needed.Publication Metadata only Antithrombotic regimens in patients with percutaneous coronary intervention whom an anticoagulant is indicated: A systematic review and network meta -analysis(2018-11-19) Wipharak Bunmark; Peerawat Jinatongthai; Prin Vathesatogkit; Ammarin Thakkinstian; Christopher M. Reid; Wanwarang Wongcharoen; Nathorn Chaiyakunapruk; Surakit Nathisuwan; University of Wisconsin-Madison; Curtin University; Ubon Rajathanee University; Naresuan University; Monash University; Monash University Malaysia; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol University; Chiang Mai University© 2007 - 2018 Frontiers Media S.A. All Rights Reserved. Background: Patients undergoing percutaneous coronary intervention (PCI) who require anticoagulant therapy are at increased risk of bleeding. The optimal regimen for these patients is uncertain. This study aimed to compare safety and efficacy of antithrombotic regimens used in patients undergoing PCI with concomitant anticoagulant therapy. Methods: A systematic review and network meta-analysis was performed among studies comparing antithrombotic regimens for anticoagulated patients undergoing PCI. The primary outcome of interest was major bleeding. The secondary outcomes were coronary events. The reference intervention was classic triple therapy (aspirin plus clopidogrel plus VKA). Cluster rank incorporating risk (major bleeding) and benefit (all-cause death) was performed to identify the most appropriate regimen(s). Results: There were 3 RCTs (6 interventions) and 29 non-RCTs (8 interventions) that met the inclusion criteria with 22,179 patients. Network meta-analysis of RCTs indicated that dual therapy (DT), either with vitamin K antagonist (VKA) or direct anticoagulant (DOAC) plus an antiplatelet, significantly reduced the risk of major bleeding compared to triple therapy (TT) [pooled RR of 0.51 (0.30-0.87) and 0.68 (0.49-0.94), respectively]. In addition, VKA-DT significantly reduced the risk of all-cause death compared to TT [pooled RR of 0.40 (0.17-0.93)]. Results from network meta-analysis of non-RCT paralleled that of RCTs. No significant differences of coronary events were found. Conclusions: In conclusion, for anticoagulated patients undergoing PCI, dual therapy, either with warfarin or DOAC plus an antiplatelet, should be considered due to its optimal balance on efficacy and safety.Publication Metadata only Association between apolipoprotein E polymorphisms and age-related macular degeneration: A HuGE review and meta-analysis(2006-11-01) Ammarin Thakkinstian; Steve Bowe; Mark McEvoy; Wayne Smith; John Attia; Mahidol University; University of Newcastle, AustraliaA possible association between apolipoprotein E polymorphisms and age-related macular degeneration has been investigated numerous times, with conflicting results. A previous analysis pooling results from four studies (Schmidt et al., Ophthalmic Genet 2002;23:209-23) suggested an association, but those investigators did not document allele frequencies, the magnitude of the association, or the possible genetic mode of action. Thus, the authors searched MEDLINE from 1966 to December 2005 for any English-language studies reporting genetic associations. Data and study quality were assessed in duplicate. Pooling was performed while checking for heterogeneity and publication bias. Frequencies of the E2and E4alleles in Caucasians were approximately 8% and 15%, respectively. Allele- and genotype-based tests of association indicated a risk effect of up to 20% for E2and a protective effect of up to 40% for E4. E2appeared to act in a recessive mode and E4in a dominant mode. There appears to be a differential effect of the E2and E4alleles on the risk of age-related macular degeneration, although the possibility of survivor bias needs to be ruled out more definitively. Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health. All rights reserved.Publication Metadata only The association between complement component 2/complement factor B polymorphisms and age-related macular degeneration: A HuGE review and meta-analysis(2012-09-01) Ammarin Thakkinstian; Mark McEvoy; Usha Chakravarthy; Subhabrata Chakrabarti; Gareth J. McKay; Euijung Ryu; Giuliana Silvestri; Inderjeet Kaur; Peter Francis; Takeshi Iwata; Masakazu Akahori; Astrid Arning; Albert O. Edwards; Johanna M. Seddon; John Attia; Mahidol University; University of Newcastle, Australia; Queen's University Belfast; L.V. Prasad Eye Institute India; Mayo Clinic; OHSU School of Medicine; National Hospital Organization, Japan; Leibniz Institute of Arteriosclerosis Research; University of Oregon; Tufts University School of Medicine; John Hunter HospitalThe authors performed a systematic review of the association of complement component 2(C2)/complement factor B (CFB) gene polymorphisms with age-related macular degeneration (AMD). In total, data from 19 studies published between 2006 and 2011 were pooled for 4 polymorphisms: rs9332739 and rs547154 in the C2 gene and rs4151667 and rs641153 in the CFB gene. Data extraction and assessments for risk of bias were independently performed by 2 reviewers. Allele frequencies and allele and genotypic effects were pooled. Heterogeneity and publication bias were explored. Pooled minor allele frequencies for all 4 SNPs were between 4.7 and 9.6 for all polymorphisms, except for an Indian population in which the C allele at rs9332739 was the major allele. For the C2 polymorphisms, the minor C allele at rs9332739 and the minor T allele at rs547154 carried estimated relative risks (odds ratios) of 0.55 (95 confidence interval (CI): 0.46, 0.65) and 0.47 (95 CI: 0.39, 0.57), respectively. For the CFB polymorphisms, the minor A alleles at rs4151667 and rs614153 carried estimated risks of 0.54 (95 CI: 0.45, 0.64) and 0.41 (95 CI: 0.34, 0.51), respectively. These allele effects contributed to an absolute lowering of the risk of all AMD in Caucasian populations by 2.06.0. This meta-analysis provides a robust estimate of the protective association of C2/CFB with AMD. © 2012 The Author.Publication Metadata only The association between cytokine gene polymorphisms and graft rejection in liver transplantation: A systematic review and meta-analysis(2013-01-01) Sasivimol Rattanasiri; D. Olga McDaniel; Mark McEvoy; Thunyarat Anothaisintawee; Abhasnee Sobhonslidsuk; John Attia; Ammarin Thakkinstian; Mahidol University; University of Mississippi Medical Center; University of Newcastle, AustraliaWe investigated the contribution of polymorphisms in cytokine genes (TNFa-308, IL10-1082 and -592, TGFb1-c10 and c25, and IFNg. +. 874) on the risk of graft rejection in liver transplantation. We performed a systematic review by identifying relevant studies and applied meta-analysis to pool gene effects. In total, 12 studies were eligible and included in the study. Data extraction and assessments for risk of bias were independently performed by two reviewers. Data for allele frequencies, allelic, and genotypic effects were pooled. Heterogeneity and publication bias were assessed. Pooled minor allele frequencies for TNFa-308, IL10-1082, TGFb1-c10, TGFb1-c25, IFNg. +. 874, and IL10-592 were 0.140 (95% CI: 0.083, 0.198), 0.432 (95% CI: 0.392, 0.472), 0.387 (95% CI: 0.307, 0.467), 0.090 (95% CI: 0.056, 0.123), 0.460 (95% CI: 0.392, 0.528), and 0.224 (95% CI: 0.178, 0.269), respectively. OnlyTNFa-308 and IL10-1082 polymorphisms were significantly associated with graft rejection. Patients who carried minor homozygous genotypes for these two polymorphisms were at 3.5 and 1.69 times higher risk of graft rejections than patients who carried major homozygous genotypes. The estimated lambdas were 0.41 and 0.47, suggesting an additive mode of effect was most likely. However, we could not detect the associations of TGFb1at c10 and c25, INFg. +. 874, and IL10-592 polymorphisms and graft rejection. In summary, our systematic review has demonstrated that TNFa-308 and IL10-1082 are potential risk factors of poor outcomes in liver transplantation. Future updated meta-analysis studies to confirm the power of these genotypes in association with allograft rejection are needed. © 2012 Elsevier B.V.Publication Metadata only Association between cytokine gene polymorphisms and outcomes in renal transplantation: A meta-analysis of individual patient data(2008-09-01) Ammarin Thakkinstian; Svetlana Dmitrienko; Maria Gerbase-DeLima; D. Olga McDaniel; Pablo Inigo; Kai Ming Chow; Mark McEvoy; Atiporn Ingsathit; Paul Trevillian; William Henry Barber; John Attia; Mahidol University; University of Newcastle, Australia; The University of British Columbia; Universidade Federal de Sao Paulo; University of Mississippi; Hospital Clinic Barcelona; Prince of Wales Hospital Hong Kong; John Hunter Hospital; Clinical Epidemiology UnitBackground. Cytokine gene polymorphisms have been associated with poor outcomes after renal transplantation such as chronic allograft nephropathy (CAN), graft rejection (GR) and graft failure (GF), but the effects of these polymorphisms are still controversial. We therefore conducted a systematic review, with individual patient data (IPD) where possible, to determine the association between cytokine polymorphisms (TGF-β1, TNF-α and IL-10) and outcomes after renal transplantation. Methods. Five investigators were willing to participate and provided IPD. The outcomes of interest were GF, GR and CAN. Subjects with at least one of these were classified as having poor outcomes. Heterogeneity of gene effects was assessed. Multiple logistic regression was applied to assess gene effects, adjusting for clinical variables such as HLA matching and age. Results. One-thousand and eighty-seven subjects were included in the IPD meta-analysis. Pooled results showed no evidence of heterogeneity and indicated that the strongest variables determining poor outcomes are HLA mismatching (OR = 1.6-1.8 for ≥3 HLA-A, -B, -DR mismatches compared with those with <3 mismatches) and age (OR = 1.2-1.4 for age 45 years or more). Incremental information on risk of a poor outcome is provided by the TGF-β1c10 polymorphism (OR = 1.5, P = 0.034, 95% CI: 1.0-2.2 for TC genotype compared to TT genotype). Haplotypes of TGF-β1 at c10 and c25 were inferred and the C-C haplotype was a marker of a poor outcome (OR = 1.3, P = 0.177, 95% CI: 1.0-2.3). Three polymorphisms of the IL-10 gene at -1082, -819, -592 are in strong linkage disequilibrium with each other (correlation coefficients: 0.6-1) and inferred haplotypes between these three loci show some association, with ACC increasing the risk of poor events com- pared to GCC (OR = 1.3, P = 0.044, 95% CI: 0.9-1.6). Conclusion. Pooled results to date suggest possible association between both the TGF-β1 c10 polymorphism and a 3-SNP-haplotype of IL-10 and poor outcomes in renal transplantation, but this needs to be confirmed in larger studies. © The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.Publication Metadata only The association between genetic polymorphisms in ABCG2 and SLC2A9 and urate: an updated systematic review and meta-analysis(2020-12-01) Thitiya Lukkunaprasit; Sasivimol Rattanasiri; Saowalak Turongkaravee; Naravut Suvannang; Atiporn Ingsathit; John Attia; Ammarin Thakkinstian; Hunter Medical Research Institute, Australia; Rangsit University; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol University© 2020, The Author(s). Background: Replication studies showed conflicting effects of ABCG2 and SLC2A9 polymorphisms on gout and serum urate. This meta-analysis therefore aimed to pool their effects across studies. Methods: Studies were located from MEDLINE and Scopus from inception to 17th June 2018. Observational studies in adults with any polymorphism in ABCG2 or SLC2A9, and outcome including gout, hyperuricemia, and serum urate were included for pooling. Data extractions were performed by two independent reviewers. Genotype effects were pooled stratified by ethnicity using a mixed-effect logistic model and a multivariate meta-analysis for dichotomous and continuous outcomes. Results: Fifty-two studies were included in the analysis. For ABCG2 polymorphisms, mainly studied in Asians, carrying 1–2 minor-allele-genotypes of rs2231142 and rs72552713 were respectively about 2.1–4.5 and 2.5–3.9 times higher odds of gout than non-minor-allele-genotypes. The two rs2231142-risk-genotypes also had higher serum urate about 11–18 μmol/l. Conversely, carrying 1–2 minor alleles of rs2231137 was about 36–57% significantly lower odds of gout. For SLC2A9 polymorphisms, mainly studied in Caucasians, carrying 1–2 minor alleles of rs1014290, rs6449213, rs6855911, and rs7442295 were about 25–43%, 31–62%, 33–64%, and 35–65% significantly lower odds of gout than non-minor-allele-genotypes. In addition, 1–2 minor-allele-genotypes of the latter three polymorphisms had significantly lower serum urate about 20–49, 21–51, and 18–54 μmol/l than non-minor-allele-genotypes. Conclusions: Our findings should be useful in identifying patients at risk for gout and high serum urate and these polymorphisms may be useful in personalized risk scores. Trial registration: PROSPERO registration number: CRD42018105275.Publication Metadata only Association between IRF6 and 8q24 polymorphisms and nonsyndromic cleft lip with or without cleft palate: Systematic review and meta-analysis(2016-09-01) Kachin Wattanawong; Sasivimol Rattanasiri; Mark McEvoy; John Attia; Ammarin Thakkinstian; Mahidol University; University of Newcastle Faculty of Medicine and Health Sciences© 2016 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc. Background: We conducted a systematic review and meta-analysis of interferon regulatory factor 6 and 8q24 polymorphisms with nonsyndromic cleft lip with/without cleft palate (NSCL/P). Methods: Data extraction was independently performed by two reviewers. Genotypic effects of four polymorphisms from 31 studies were pooled separately by ethnicity using a mixed-effect logit model with accounting for heterogeneity. Results: For rs2235371, AA and GA carried, respectively, 51% (95% confidence interval [CI], 37%–61%) and 42% (95% CI, 32%–50%) lower risks of NSCL/P than GG genotypes in Asians, but these genotypes were not significant in Caucasians. For rs2013162, only AA was significant, that is, carried 0.65 (95% CI, 0.52–0.82) times lower odds than CC in Caucasians but not for Asians. For rs642961, AA and GA genotypes, respectively, carried 2.47 (95% CI, 1.41–4.35) and 1.40 (95% CI, 1.12–1.75) times higher odds in Asian, and 2.03 (95% CI, 1.52–2.71) and 1.58 (95% CI, 1.37–1.82) times higher odds in Caucasians compare with GG genotypes. For rs987525, AA and CA genotypes carried 2.27 (95% CI, 1.43–3.60) and 1.34 (95% CI, 1.02–1.77) times higher odds in Asian, and 5.25 (95% CI, 3.98–6.91) and 2.13 (95% CI–1.82, 2.49) times higher odds in Caucasians, and 1.42 (95% CI, 1.10–1.82) and 1.28 (95% CI, 1.09–1.50) times higher odds in mixed ethnicities compared with CC genotypes. These variant effects remained significant based on applying Bonferroni corrected-thresholds, except in the mixed ethnicity. Conclusion: We show robust variant effects in NSCL/P. Considering them with other genes and risk factors might be useful to improve prediction of NSCL/P occurrence. Birth Defects Research (Part A) 106:773–788, 2016. © 2016 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc.Publication Metadata only The association between oral hygiene and periodontitis: a systematic review and meta-analysis(2017-12-01) Attawood Lertpimonchai; Sasivimol Rattanasiri; Sakda Arj-Ong Vallibhakara; John Attia; Ammarin Thakkinstian; Mahidol University; Chulalongkorn University; University of Newcastle Faculty of Medicine and Health Sciences; Hunter Medical Research Institute, Australia© 2017 The Authors. International Dental Journal published by John Wiley & Sons Ltd on behalf of World Dental Federation. Objective: Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta-analysis. Material and methods: The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random-effects meta-analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed. Results: A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios (ORs) of 2.04 [95% confidence interval (CI): 1.65–2.53] and 5.01 (95% CI: 3.40–7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47–0.94) and 0.68 (95% CI: 0.47–0.98) were obtained, respectively. Conclusions: Fair to poor OH increases the risk of periodontitis by two- to five-fold. This risk can be reduced by regular toothbrushing and dental visits.Publication Metadata only The association between serum squamous cell carcinoma antigen and recurrence and survival of patients with cervical squamous cell carcinoma: A systematic review and meta-analysis(2018-07-01) Chuenkamon Charakorn; Kunlawat Thadanipon; Sawarat Chaijindaratana; Sasivimol Rattanasiri; Pawin Numthavaj; Ammarin Thakkinstian; Faculty of Medicine, Ramathibodi Hospital, Mahidol University© 2018 The Authors Objective: The aim of this systematic review and meta-analysis was to pool association effects of serum squamous cell carcinoma antigen (SCC-Ag) on recurrence and mortality in mainly squamous cell cervical cancer patients. Methods: MEDLINE and Scopus databases were searched up to June 29, 2016. Studies assessing effects of SCC-Ag on recurrence and death in cervical cancer patients were included. Data extraction was independently performed by two reviewers. A meta-analysis was applied for pooling the effects (i.e., risk ratio (RR), hazard ratio (HR), and unstandardized mean difference (USMD)) of SCC-Ag measured before and after treatment on recurrence and death. Results: A total of 61 studies were included. For pretreatment SCC-Ag and recurrence, the pooled RR, HR, and USMD for high versus low serum SCC-Ag were 2.44(95% CI: 1.91, 3.13), 2.23(95% CI: 2.03, 2.45), −7.7(95% CI: -31.7, 16.4), respectively. The corresponding effects for the posttreatment period were 3.91(95% CI: 2.96, 5.16), 3.14(95% CI: 1.29, 7.65), and 3.2(95% CI: -10.6, 17.0), respectively. In addition, patients with high level of pretreatment serum SCC-Ag were also at a higher risk for death than patients with low serum SCC-Ag with a pooled RR of 3.66(95% CI: 2.24, 5.98), pooled HR of 2.50(95% CI: 1.85, 3.37), and pooled USMD of 7.10(95% CI: 4.26, 9.94). The posttreatment serum SCC-Ag effects also reflected a similar trend. Conclusions: The serum SCC-Ag was consistently associated with recurrence and mortality of newly diagnosed cervical cancer. This marker may be useful in monitoring disease progression in cervical cancer patients. Prospero registration number is: CRD42016044024.Publication Open Access Association Between Uric Acid and Arterial Stiffness in General Adults: A Systematic Review and Meta-analysis(2018) Yan Naung Win; Pawin Numthavaj; Ammarin Thakkinstian; ยาน หน่อง วิน; ปวิน นำธวัช; อัมรินทร์ ทักขิญเสถียร; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Section for Clinical Epidemiology and Biostatistics; Nay Pyi Taw. Health and Diseases Control UnitBackground: Arterial stiffness (AS) was a surrogate marker of atherosclerosis and cardiovascular disease and may associate with serum uric acid (UA) level. Objective: To systematically review the association between serum UA and AS. Methods: Observational studies that studied the effect of serum UA level and AS in adult population were searched from MEDLINE and Scopus databases since inception to June 30, 2016. Mean differences (MDs) of serum UA level between AS groups and odds ratios of high vs low UA on AS measurement were estimated and pooled. Results: A total of 61 studies met inclusion criteria, and 44 studies were pooled. Pooled MDs of serum UA between AS vs non-AS measured by carotid femoral pulse wave velocity (cfPWV) and brachial ankle pulse wave velocity (baPWV) in 7 and 5 studies were 0.76 (95% CI, 0.50 - 1.03) mg/dL and 0.58 (95% CI, 0.31 - 0.85) mg/dL, respectively. Three baPWV studies with the pooled odds ratio of high vs low serum UA on AS was 1.49 (95% CI, 1.25 - 1.78). Pooled MDs of AS among high vs low serum UA groups were 62.43 (95% CI, 46.97 - 77.88), 86.20 (95% CI, 35.40 - 136.99), and 32.69 (95% CI, 13.45 - 51.94) cm/s for cfPWV (10 studies), baPWV (4 studies), and carotid radial pulse wave velocity (crPWV) (4 studies), respectively. Pooling beta correlation coefficients of serum UA for AS for cfPWV and baPWV were 2.51 (95% CI, 2.26 - 2.76) and 3.75 (95% CI, 2.24 - 5.25), respectively. Conclusions: Serum UA was statistically associated with AS measured by cfPWV, baPWV, and crPWV but poolings had high heterogeneity.Publication Metadata only Association between Vitamin D and uric acid in adults: A systematic review and meta-analysis(2020-10-01) Ronny Isnuwardana; Sanjeev Bijukchhe; Kunlawat Thadanipon; Atiporn Ingsathit; Ammarin Thakkinstian; Faculty of Medicine, Ramathibodi Hospital, Mahidol University© 2020. The Author(s). Association between vitamin D and uric acid is complex and might be bidirectional. Our study aimed to determine the bidirectional association between vitamin D and uric acid in adults. Using MEDLINE via PubMed and Scopus, we systematically searched for observational or interventional studies in adults, which assessed the association between serum vitamin D and serum uric acid, extracted the data, and conducted analysis by direct and network meta-analysis. The present review included 32 studies, of which 21 had vitamin D as outcome and 11 had uric acid as outcome. Meta-analysis showed a significant pooled beta coefficient of serum uric acid level on serum 25(OH)D level from 3 studies of 0.512 (95 % confidence interval: 0.199, 0.825) and a significant pooled odds ratio between vitamin D deficiency and hyperuricemia of 1.496 (1.141, 1.963). The pooled mean difference of serum 25(OH)D between groups with hyperuricemia and normouricemia was non-significant at 0.138 (− 0.430, 0.707) ng/ml, and the pooled mean difference of serum uric acid between categories of 25(OH)D were also non-significant at 0.072 (− 0.153, 0.298) mg/dl between deficiency and normal, 0.038 (− 0.216, 0.292) mg/dl between insufficiency and normal, and 0.034 (− 0.216, 0.283) mg/dl between deficiency and insufficiency. In conclusion, increasing serum uric acid might be associated with increasing 25(OH)D level, while vitamin D deficiency is associated with hyperuricemia. These reverse relationships should be further evaluated in a longitudinal study.Item Metadata only Association of neck circumference with diabetes mellitus and hypertension : a systematic review and meta-analysis(Mahidol University. Mahidol University Library and Knowledge Center, 2024) Tiwari, Sagar, 1989-; Sakda Arj-Ong Vallibhakara; Ammarin Thakkinstian; Kunlawat ThadaniponSeveral studies have suggested that neck circumference (NC) can be used as screening measures for diagnosing obesity-related metabolic complications and might be associated with type 2 diabetes mellitus (T2D) and hypertension (HT) but their results are conflicting. Therefore, we conducted this systematic review and meta-analysis to assess the overall association of NC with T2D and HT in adults. Studies were identified from MEDLINE and Scopus database up to December 2019. The exposure of measurement, i.e., NC could be categorical (high vs low) and continuous data. Clinical outcomes for T2D and HT could be dichotomous data or continuous values, e.g., fasting blood sugar (FBS), glycated hemoglobin (HBA1c), systolic blood pressure (SBP), and diastolic blood pressure (DBP). We included observational studies conducted in adult reporting odds ratio (OR) along with 95% confidence interval (CI) for risk of T2D or HT and correlation coefficient of NC with FBS, HBA1c, SBP, and DBP. Meta-analysis was performed to pool the effects sizes across studies using a random-effect model if heterogeneity was present; otherwise, a fixed-effect model was used. Heterogeneity was assessed by Q test and I2. All studies were assessed with their quality and publication bias. Seventy-three studies with the mean age of 48.5 years were included. Our results indicated high NC have 1.95 (1.31, 2.89) and 2.08 (1.23, 3.52) times higher odds of T2D than low NC among females and males, respectively. For, HT the pooled ORs (95% CI) were 1.88 (1.36, 2.58) and 1.63 (1.26, 2.11) for females and males, respectively. Each 1 cm rising in NC would increase the odds of having T2D and HT in both genders by almost 1.2 and 1.1 respectively. In addition, the unstandardized mean difference of NC was about 1.3 cm higher in T2D and HT than non-T2D and non-HT. Furthermore, we found a positive correlation of NC with FBS, HBA1c, SBP, and DBP in both genders. Finding should be upraised with caution due to high heterogeneity even after subgroup analysis in some cases. More future prospective cohort studies will need to prove and simplify the association.Publication Metadata only Associations between nocturnal urinary 6-sulfatoxymelatonin, obstructive sleep apnea severity and glycemic control in type 2 diabetes(2017-03-16) Sirimon Reutrakul; Nantaporn Siwasaranond; Hataikarn Nimitphong; Sunee Saetung; Naricha Chirakalwasan; La or Chailurkit; Kriangsuk Srijaruskul; Boonsong Ongphiphadhanakul; Ammarin Thakkinstian; Mahidol University; Chulalongkorn University; King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University© 2017, Published with license by Taylor & Francis Group, LLC. © 2017 Sirimon Reutrakul, Nantaporn Siwasaranond, Hataikarn Nimitphong, Sunee Saetung, Naricha Chirakalwasan, La-or Chailurkit, Kriangsuk Srijaruskul, Boonsong Ongphiphadhanakul, Ammarin Thakkinstian. Reduced nocturnal secretion of melatonin, a pineal hormone under circadian control, and obstructive sleep apnea have been both identified as risk factors for the development of type 2 diabetes mellitus. Whether they interact to impact glycemic control in patients with existing type 2 diabetes is not known. Therefore, this study explores the relationships between obstructive sleep apnea, melatonin and glycemic control in type 2 diabetes. As diabetic retinopathy may affect melatonin secretion, we also explore the relationship between retinopathy, melatonin and glycemic control. Fifty-six non-shift workers with type 2 diabetes, who were not using beta-blockers, participated. Most recent hemoglobin A1c (HbA1c) levels and the results of ophthalmologic examinations were obtained from medical records. Obstructive sleep apnea was diagnosed using an ambulatory device. Sleep duration and fragmentation were recorded by 7-day wrist actigraphy. The urinary 6-sulfatoxymelatonin/creatinine ratio, an indicator of nocturnal melatonin secretion, was measured in an overnight urine sample. Mediation analyses were applied to explore whether low nocturnal urinary 6-sulfatoxymelatonin/creatinine ratio could be a causal link between increasing obstructive sleep apnea severity [as measured by an Apnea Hypopnea Index (AHI)] and poorer glycemic control, and between the presence of retinopathy and glycemic control. AHI and HbA1c were log-scale (ln) transformed. Obstructive sleep apnea was found in 76.8%, and 25.5% had diabetic retinopathy. The median (interquartile range) of urinary 6-sulfatoxymelatonin/creatinine ratio was 12.3 (6.0, 20.1) ng/mg. Higher lnHbA1c significantly correlated with lower 6-sulfatoxymelatonin/creatinine ratio (p = 0.04) but was not directly associated with OSA severity. More severe obstructive sleep apnea (lnAHI, p = 0.01), longer diabetes duration (p = 0.02), retinopathy (p = 0.01) and insulin use (p = 0.03) correlated with lower urinary 6-sulfatoxymelatonin/creatinine ratio, while habitual sleep duration and fragmentation did not. A mediation analysis revealed that lnAHI negatively correlated with urinary 6-sulfatoxymelatonin/creatinine ratio (coefficient = −2.413, p = 0.03), and urinary 6-sulfatoxymelatonin/creatinine negatively associated with lnHbA1c (coefficient = −0.005, p = 0.02), after adjusting for covariates. Mediation analysis indicated that the effect of lnAHI on lnHbA1c was indirectly mediated by urinary 6-sulfatoxymelatonin/creatinine ratio (B = 0.013, 95% CI: 0.0006, 0.0505). In addition, having retinopathy was significantly associated with reduced nocturnal urinary 6-sulfatoxymelatonin/creatinine ratio, and an increase in HbA1c by 1.013% of its original value (B = −0.013, 95% CI: −0.038, −0.005). In conclusion, the presence and severity of obstructive sleep apnea as well as the presence of diabetic retinopathy were associated with lower nocturnal melatonin secretion, with an indirect adverse effect on glycemic control. Intervention studies are needed to determine whether melatonin supplementation may be beneficial in type 2 diabetes patients with obstructive sleep apnea.Publication Metadata only A bedside prediction-scoring model for late-onset neonatal sepsis(2005-12-01) Chusak Okascharoen; Sayomporn Sirinavin; Ammarin Thakkinstian; Dwip Kitayaporn; Sarayut Supapanachart; Mahidol University; Faculty of Medicine, Ramathibodi Hospital, Mahidol UniversityObjective: Insufficient tools for bedside prediction of late-onset neonatal sepsis (LNS) initiated this study. The objective was to develop and validate a simple prediction-scoring model for LNS defined as culture-proven sepsis occurring 72 hours after birth. Methods: The study was performed at a university hospital in Bangkok. The derivation phase included medical records of 1870 neonates, randomly selected from 9347 records of neonates who had been hospitalized for >72 hours during 1998 to 2000, of which 1824 records were available. In all, 100 neonates were clinically suspected of sepsis and 17 had proven LNS. The validation phase included 73 neonates suspected of having sepsis during July 2002 to June 2003 and 25 who had LNS. Weighted coefficients from Cox's proportional hazards model and receiver-operating-characteristic (ROC) curve analysis were used. Results: The incidence density of LNS was 17/11355 (1.5/1000) person-days. A scoring model was developed and consisted of the following: hypotension (score 4), abnormal body temperature (score 3), respiratory insufficiency (score 2), neutrophil band form fraction >1% (score 2), platelet count <150 × 103/μl (score 2), and umbilical venous catheterization (1 to 7 or >7 days; score 2 or 4). The area under the ROC curves for prediction of LNS in a neonate suspected of sepsis in each of the two phases was 0.85 and 0.80, respectively (p=0.436). The mean probabilities of LNS were approximately 0.10 (low risk) for scores from 0 to 3; 0.50 (intermediate risk) for scores from 4 to 6; and 0.70 (high risk) for scores ≥7. Conclusion: A simple prediction-scoring model for LNS was developed. Validation of the scores suggested good diagnostic performance. © 2005 Nature Publishing Group All rights reserved.