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Radiofrequency ablation (RFA) is a minimally invasive outpatient procedure that has recently emerged as a treatment option for autonomous functioning thyroid nodules (AFTNs), offering a less invasive alternative to surgery. The objective of this systematic review and meta-analysis is to evaluate the efficacy of RFA for AFTNs. Global databases of PubMed, Scopus, Embase, Web of Science, and Cochrane Library were systematically searched from 1990 until January 5, 2024, for studies on AFTNs undergoing RFA that presented volume reduction ratio (VRR) for at least one of 1, 3, 6 or 12 months post-operative follow-up with the results presented as means. The primary outcomes were VRR and TSH normalization rate, and the secondary outcomes were the cosmetic score, symptom score, and post-procedure complications. Heterogeneity was assessed by Cochrane and I2 statistics, and a random-effects model was used for meta-analysis. The study protocol was registered on PROSPERO (CRD42024499932). A total of 10 eligible studies with a total sample size of 254 were included. The pooled VRR after 1, 3, 6, and 12 months of follow-up post-treatment with RFA was 46.6% (95% CI: 40.3–52.9%), 62% (95% CI: 57.6–66.4%), 67.4% (95% CI:62.3–72.6%), and 77.2% (95% CI: 79.2–81.5%), respectively. The overall rate of TSH normalization was 76.4% (95% CI: 58.1–88.4%). Based on included studies the overall rate of subclinical hypothyroidism as one of the most important side effects of this method was 4% (95% CI: 1.9%−8.1%). RFA emerges as a promising non-surgical treatment for AFTNs, showing high rates of TSH normalization, tumor size reduction, and improved cosmetic and symptom scores. However, further research is needed to compare RFA with surgical methods and assess long-term outcomes. [Display omitted] [ABSTRACT FROM AUTHOR]

We aimed to explore how probiotics, prebiotics, or synbiotics impact glycemic indices in patients with diabetes mellitus. A comprehensive search was conducted on PubMed, Scopus, and Web of Science from inception up to April 2023. The random-effects model was employed for the study analysis. Furthermore, sensitivity and subgroup analyses were conducted to investigate potential sources of heterogeneity. AMSTAR2 checklist was used to determine the quality of studies. Comprehensive meta-analysis version 3 was used for the study analysis. A total of 31 studies were included in the final analysis. Based on the results of the meta-analysis, gut microbial therapy could significantly decrease serum fasting blood glucose levels in patients with type 2 diabetes mellitus (effect size: −0.211; 95 % CI: −0.257, −0.164; P < 0.001). Additionally, significant associations were also found between gut microbial therapy and improved serum levels of fasting insulin, glycated hemoglobin, and homeostatic model assessment for insulin resistance (effect size: −0.087; 95 % confidence interval: −0.120, −0.053; P < 0.001; effect size: −0.166; 95 % confidence interval: −0.200, −0.132; P < 0.001; effect size: −0.230; 95 % confidence interval: −0.288, −0.172; P < 0.001, respectively). Our results revealed promising effects of gut microbiota modulation on glycemic profile of patients with type 2 diabetes mellitus. The use of these agents as additional treatments can be considered. • Managing blood glucose levels is crucial for controlling type 2 diabetes progression. • Significant improvements in glycemic profile were observed by gut microbiota modulation. • Probiotics can be considered as an adjuvant therapy in type 2 diabetes mellitus management. [ABSTRACT FROM AUTHOR]

Nonalcoholic fatty liver disease (NAFLD) is a global health challenge, with a rising rate in line with other metabolic diseases. We aimed to assess the global prevalence of NAFLD in adult and pediatric populations. PubMed, Scopus and Web of Science databases were systematically searched up to May 2023. Heterogeneity was assessed using Cochran's Q test and I 2 statistics, and random-effects model was used for meta-analysis. Analyses were performed using STATA version 18. A total of 479 studies with 78,001,755 participants from 38 countries were finally included. The global prevalence of NAFLD was estimated to be 30.2% (95% CI: 28.7–31.7%). Regionally, the prevalence of NAFLD was as follows: Asia 30.9% (95% CI: 29.2–32.6%), Australia 16.1% (95% CI: 9.0–24.8%), Europe 30.2% (95% CI: 25.6–35.0%), North America 29% (95% CI: 25.8–32.3%), and South America 34% (95% CI: 16.9–53.5%). Countries with a higher human development index (HDI) had significantly lower prevalence of NAFLD (coefficient = –0.523, p = 0.005). Globally, the prevalence of NAFLD in men and women was 36.6% (95% CI: 34.7–38.4%) and 25.5% (95% CI: 23.9–27.1%), respectively. The prevalence of NAFLD in adults, adults with obesity, children, and children with obesity was 30.2% (95% CI: 28.8–31.7%), 57.5% (95% CI: 43.6–70.9%), 14.3% (95% CI: 10.3–18.8%), and 38.0% (95% CI: 31.5–44.7%), respectively. The prevalence of NAFLD is remarkably high, particularly in countries with lower HDI. This substantial prevalence in both adults and children underscores the need for disease management protocols to reduce the burden. [ABSTRACT FROM AUTHOR]