The role of metformin on lung cancer survival: the first systematic review and meta-analysis of observational studies and randomized clinical trials.

PURPOSE: To assess the effects of metformin use on lung cancer (LC) survival according to summarized results from observational studies (OBs) and randomized clinical trials (RCTs). METHODS: We systematically searched electronic databases and, to our knowledge, for the first time, RCTs were included in a systematic review and meta-analysis about the role of metformin on LC survival. We carried out meta-analyses separately for OBs and RCTs. Analyses for overall survival (OS) concerning OBs were stratified by studies with and without time-dependent approach. Subgroup analyses were adopted for OBs to identify the sources of heterogeneity. Included studies were assessed for quality. RESULTS: We identified ten OBs and four RCTs. For OBs, metformin use was associated with improved OS for LC patients. Only two studies used time-dependent approach in which a higher ratio was found when compared to the non-use of the time-dependent analysis in eight studies. OBs were classified as high quality but the risk of bias was "unclear" in eight OBs due to absence of the time-dependent analysis. For RCTs, metformin use was not beneficial for OS and neither for progression-free survival. Heterogeneous quality was found among RCTs. Sources of bias that could alter significantly the results or raise doubts were identified in RCTs. CONCLUSION: Time-dependent analysis should be considered an appropriate strategy for OBs focused on the metformin use for LC patients' survival, and further studies applying this approach are required. More well-designed RCTs are needed to provide consistent results for the association between metformin use and LC survival.

Metformin use and lung cancer survival: a population-based study in Norway.

BACKGROUND: We assessed associations between metformin use and survival in a nationwide Norwegian cohort of lung cancer (LC) patients. METHODS: The study linked 22,324 LC patients from the Cancer Registry of Norway diagnosed 2005-2014 with the Norwegian Prescription Database. We estimated associations of pre- and post-diagnostic metformin use with overall survival (OS) and LC-specific survival (LCSS) using multivariable time-fixed and time-dependent Cox regression. RESULTS: Pre-diagnostic metformin use was not associated with improved survival in all patients. Nevertheless, pre-diagnostic metformin use was associated with better LCSS in squamous cell carcinoma (SCC) patients (hazard ratio (HR) = 0.79; 95% confidence interval (CI) 0.62-0.99) and in patients with regional stage SCC (HR = 0.67; 95%CI 0.47-0.95). Post-diagnostic metformin use was associated with improved LCSS in all patients (HR = 0.83; 95%CI 0.73-0.95), in patients with SCC (HR = 0.75; 95%CI 0.57-0.98), regional stage LC (HR = 0.74; 95%CI 0.59-0.94), and regional stage SCC (HR = 0.57; 95%CI 0.38-0.86). OS showed similar results. Analyses of cumulative use showed a dose-response relationship in all patients, patients with adenocarcinoma and SCC, and with regional and metastatic LC. CONCLUSIONS: Metformin use was associated with improved survival, especially LCSS in patients with regional stage SCC. Further prospective studies are required to clarify the role of metformin in LC treatment.

Tratamento da mordida aberta anterior: revisão de literatura / Treatment of previous open bite: literary review

Objetivo: realizar uma revisão de literatura sobre os tipos de tratamento empregados na correção da mordida aberta anterior. Materiais e métodos: foi realizada uma busca nas bases de dados PubMed, SciELO e Google Acadêmico. Os termos inseridos na pesquisa foram: Mordida Aberta; Ortodontia Corretiva; Ortodontia; Ortodontia Interceptora; Open Bite; Orthodontics, Corrective; Orthodontics; Orthodontics, Interceptive. Revisão da Literatura: a mordida aberta anterior (MAA) é uma má oclusão dentária que pode promover alteração do perfil e da fisionomia do indivíduo, dificultando também a apreensão e o corte dos alimentos. A MAA é uma das más oclusões de maior comprometimento estético-funcional, podendo ser dentária ou esquelética. A etiologia da mordida aberta anterior é multifatorial, sendo que as principais causas são hereditariedade e causas ambientais. Esses fatores interferem no crescimento e desenvolvimento normais das estruturas faciais, modificando não somente a morfologia, mas, também, a função do sistema estomatognático. Considerações finais: conclui-se que o diagnóstico precoce e a remoção do fator etiológico são fundamentais para a evolução adequada do tratamento ortodôntico.(AU)

Objective: to perform a literature review on the types of treatment used in anterior open bite correction. Materials and methods: a search was performed in the PubMed, SciELO, and Google Scholar databases. The terms entered in the search were Mordida Aberta; Ortodontia Corretiva; Ortodontia; Ortodontia Interceptora; Open Bite; Orthodontics, Corrective; Orthodontics; Orthodontics, Interceptive. Literature Review: anterior open bite (AOB) is a dental malocclusion that may change the profile and physiognomy of individuals, making it difficult to grasp and cut food. The AOB is one of the malocclusions with the most aesthetic and functional impairments, and it may be dental or skeletal. The etiology of anterior open bite is multifactorial and the main causes are heredity and environmental causes. These factors interfere with the normal growth and development of facial structures, modifying not only the morphology but also the function of the stomatognathic system. Final considerations: it is concluded that the early diagnosis and removal of the etiological factor are essential for the proper evolution of the orthodontic treatment.(AU)