Federal University of Juiz de Fora
  • Juiz de Fora, Minas Gerais, Brazil
Recent publications
Resumen Objetivo: evaluar el uso de la aplicación Renal Health por parte de los receptores de trasplante renal. Método: estudio observacional retrospectivo con una muestra compuesta por usuarios que se registraron en la sección de trasplantados renales dentro de la aplicación desde julio de 2018 hasta abril de 2021. Se recolectaron las siguientes variables: datos demográficos, ingreso de datos, tiempo de uso, registros de peso, presión arterial, glucosa en sangre, creatinina, esquemas de medicación, consultas y exámenes. Se realizó un análisis descriptivo de los datos. Resultados: Ocurrieron 1.823 descargas de la aplicación y 12,3% se registró en la sección de trasplantados, la mayoría del sudeste de Brasil (44,9%), con edad de 36±11 años y del sexo femenino (59,1%). De la muestra, 35,1% ingresó información como: creatinina (62%), peso (58,2%) y presión arterial (51,8%). La mayoría utilizó la aplicación durante un día (63,3%) y el 13,9% más de cien días. Quienes lo usaron por más de un día (36,7%), agregaron peso (69%), programación de consultas (69%), medicación (65,5%) y creatinina (62%). Conclusión: la sección para trasplantados renales de la aplicación Renal Health despertó interés en la población joven, pero mostró baja adherencia en los meses evaluados. Estos resultados ofrecen una perspectiva relevante en la implementación de tecnologías mHealth en el trasplante renal.
Resumo Objetivo: avaliar o uso do aplicativo Renal Health por transplantados renais. Método: estudo observacional retrospectivo com amostra composta por usuários que realizaram cadastro na seção para transplantados renais do aplicativo de julho de 2018 a abril de 2021. Foram coletadas as seguintes variáveis: dados demográficos, inserção de dados, tempo de uso, registros de peso, pressão arterial, glicemia, creatinina, horários das medicações, consultas e exames. Realizou-se análise descritiva dos dados. Resultados: houve 1.823 downloads do aplicativo e 12,3% cadastraram-se na seção para transplantados renais, a maioria do Sudeste do Brasil (44,9%), com 36±11 anos e do sexo feminino (59,1%). Da amostra, 35,1% inseriram informações como creatinina (62%), peso (58,2%) e pressão arterial (51,8%). A maioria utilizou o aplicativo por um dia (63,3%) e 13,9% por mais de cem dias. Os que utilizaram por mais de um dia (36,7%), inseriram peso (69%), agendaram consultas (69%), medicações (65,5%) e creatinina (62%). Conclusão: a seção para transplantados renais do aplicativo Renal Health despertou interesse na população jovem, mas apresentou baixa adesão ao longo dos meses avaliados. Esses resultados oferecem perspectiva relevante na implementação de tecnologias mHealth no transplante renal.
Objective: This study aimed to translate, and perform a cross-cultural adaptation, and validation of the Vancouver Symptom Score (VSS) for bladder and bowel dysfunction (BBD) for Brazilian children and adolescents Materials and Methods: Six steps were performed for the translation and cross-cultural adaptation: (1) translation, (2) synthesis of translations, (3) back-translation, (4) pre-final version of the translated instrument, (5) pilot test and degree of comprehensibility and (6) elaboration of the Brazilian version of the VSS. For validation, the Brazilian Dysfunctional Voiding Score (DVSS) questionnaire was used. Results: Validation was performed on a sample of 107 children and adolescents with a mean age of 9.2 ± 2.84 years, presenting BBD and 107 without BBD (control group-CG). There was a positive correlation (r = 0.91, 95% CI 0.88 to 0.93, p < 0.0001) between total VSS score and total DVSS score. VSS was higher in patients with BBD (p < 0.0001). The internal consistency estimated by Cronbach's alpha was 0.87 for patients with BBD. The VSS showed excellent diagnostic accuracy in detecting cases, with an area under the ROC curve of 98% (95% CI 0.96 to 0.99, p < 0.001). A cut-off value of >11 points produced a sensitivity of 100% (95% CI 96.4% to 100%) and a specificity of 91.8% (95% CI 85.1% to 95.6%). Conclusion: The translated, cross-culturally adapted, and validated VSS for the Brazilian population is a reliable and valid tool to identify symptoms of BBD in children and adolescents aged five to 16 years, whose first language is Brazilian Portuguese.
Objectives To investigate the perceptions and attitudes of health professionals working in emergency services and critical care units in Spain about spiritual care provided during the COVID-19 pandemic. Methods A qualitative investigation was carried out using in-depth interviews with 48 emergency and emergency and ICU health professionals from different regions of Spain concerning their perceptions and opinions of spiritual needs and spiritual care during COVID-19 pandemic were done and thematic analysis were used. Findings The sample consisted of 48 health professionals. The qualitative analysis yielded four main themes that reflect the following categories: “the experience with spirituality in clinical practice”; “resources and barriers to provide spiritual care”; “the COVID pandemic and spiritual care” and “training in spiritual care”. In addition, two subdeliveries were also obtained: “ethical dilemma” and “rituals of death”. Conclusions The most emergency and critical care nurses believe spiritual care is important to their clinical practice, but there are still several barriers to address patients’ spiritual needs. During the COVID-19 pandemic in Spain, nurses felt that spiritual beliefs have emerged as important needs of patients and the restrictions imposed by the pandemic made health professionals more exposed to ethical dilemmas and end-of-life religious issues. The general impression of nurses is that more training and resources are needed on this topic.
This paper advances the investigation of the adequacy of inductive coupling-based narrowband power line communication (PLC) systems in overhead medium voltage power distribution networks (MV-PDNs). Relying on raw data obtained from a measurement campaign which was carried out in urban and rural feeders in the south region of Brazil, it shows that overhead MV-PDNs may be a challenging data communication media when considering inductive coupling devices since the level of insertion losses associated with the coupling process is relevant. Also, the presence of significant loads between the source and destination nodes can severely degrade loops of currents, which are necessary to perform data communication in an inductive coupling-base PLC system, resulting in an erasure data communication media. For the reliable links (i.e., without erasure), the performance analysis shows that PLC channel impulse responses and additive noises can be respectively modeled as time-invariant systems with a quasi-flat channel frequency magnitude and white Gaussian random processes in urban and rural areas. Last but not least, an attenuation model and achievable data rates are discussed for the reliable links.
Objectives This study aimed to measure the hospitalization costs for suspect or confirmation cases of COVID-19 and aggregate knowledge in the costing process for future research on related topics. Methods A cost calculation model was applied using absorption costing technique. Cost was allocated into 2 main groups: hospitalization and personnel. The cost analysis considers the hospital perspective. This is a retrospective study whose data were collected between April and September 2020, equivalent to the first wave of the disease in Brazil. This research uses data from Hospital Information System, Brazilian Unified Health System (SUS) Cost Calculation and Management System, and SUS Hospital Information System. Results The average total cost per hospitalization was US$11 260 (R$63 504) for patients suspect or confirmed by COVID-19, and considering only detectable cases, the value was US$17 178 (R$96 886). The profile of hospitalized patients was male (51%), with a mean age of 59 years, white ethnicity (64%), and average length of stay of 9 days. Conclusions The amount approved by SUS for remuneration of hospitalizations by COVID-19 proved to be insufficient to cover the calculated costs. The results of this study collaborate to measure the expenditure of hospital institutions with COVID-19 hospitalizations, contribute as a parameter for health managers to identify whether the values attributed to hospitalization by COVID-19 by the SUS are adequate to cover all costs involved, and provide lessons learned on costs to the public health system in the event of new pandemics.
Reversible cerebral vasoconstriction syndrome (RCVS) is a clinical condition characterized by arterial involvement of the intracranial vessels, manifesting with vasospasm. The most common clinical manifestation related to the syndrome is the thunderclap headache, which consists of a severe headache that reaches the peak of pain within minutes. The imaging study assumes a leading role in the complementary investigation. Laboratory tests and cerebrospinal fluid analysis are often nonspecific and without significant diagnostic importance. Non-contrast studies of the brain parenchyma reveal variable results that can often be normal. Angiographic findings, which initially may not reveal any changes, allow the visualization of diffuse narrowing of the vessels, with the posterior cerebral circulation being preferentially affected. The present study reports the case of a 19-year-old woman with no relevant medical history, except that she was a regular user of marijuana and a drug based on chloroform and ether. The patient showed clinical and imaging signs compatible with RCVS, and the narcotics used by her were considered precipitating factors.
On the ground of multi-reference configuration interaction (MRCI) calculations with an account of spin-obit coupling (SOC) we have predicted the probability of two unknown spin-forbidden transitions in the spectrum of the N 2 molecule; the electric dipole A′ ⁵ Σ g ⁺ → A ³ Σ u ⁺ emission system and the magnetic dipole a′ ¹ Σ u ⎯ ← A ³ Σ u ⁺ transition. The radiative lifetime of the lowest A′ ⁵ Σ g ⁺ sublevel is less than a microsecond; the magnetic transition induced by the spin current in the triplet state is predicted with relatively low oscillator strength (f = 10 ⁻¹⁰ ) which still could be detectable.
Introduction: Voiding diary (VD) is an important tool in the evaluation of children with voiding symptoms. Voiding frequency, maximal voided volume (MVV), average voided volume (AVV) and nocturnal volume (NV) can be extracted and are valuable in diagnosing and monitoring these disorders. Recently, ICCS has reduced the period of data recording on VD from 3 to 2 days.We hypothesized that one day voiding diary would be enough for guiding treatment. Materials and methods: Children with overactive bladder (OAB) and primary monosymptomatic enuresis (PMNE) were oriented to fulfill a 3-day VD. Data obtained from VD were evaluated for the first day (1dVD), the first two days (2dVD), and all 3 days (3dVD) and compared according to the MVV, AVV, frequency, NV and expected bladder capacity (EBC). The Friedman, Student's t test and the Fisher's exact was used. ANOVA was used for multiple comparisons. We also used Pearson correlation test. Results: Ninety-eight children were included, 59 had PMNE and 30 OAB. Frequency, AVV and VN were similar regardless how many days the voiding episodes were recorded. Only MVV was higher by a mean of only 32 mL on 3dVD compared to 1dVD. A 1dVD has a sensitivity of 93,9% and a positive likelihood ratio of 2.2. As for the correlation of MVV and EBC it was observed that in 83% of children, MVV was lower than EBC. MVV corresponds to 67% and 69% of EBC in children with PMNE and OAB, respectively. Conclusion: We believe that 1dVD is sufficient to assess these children. It has a high sensitivity and good correlation to 3dVD in evaluating these children. Bladder capacity in this population, evaluated by maximum voided volume, was close to 68% of that obtained by the EBC.
The use of traditional faecal indicator bacteria as surrogate organisms for pathogenic viruses in domestic wastewater has been noted as a problematic as concentrations and removal rates of bacteria and viruses do not seem to correlate. In this sense, bacteriophages (phages) emerge as potential viral indicators, as they are commonly found in wastewater in high levels, and can be quantified using simple, fast, low-cost methods. Somatic and F-specific coliphages comprise groups of phages commonly used as indicators of water quality. There are two internationally recognised methods to detect and enumerate coliphages in water samples, the International Standardization Organization (ISO) and the US Environmental Protection Agency (USEPA) methods. Both methods are based on the lysis of specific bacterial host strains infected by phages. Within this context, this systematic literature review aimed at gathering concentrations in raw and treated domestic wastewater (secondary, biological treatment systems and post-treatment systems), and removal efficiencies of somatic and F-specific coliphages obtained by ISO and USEPA methods, and then compare both methods. A total of 33 research papers were considered in this study. Results showed that the ISO method is more commonly applied than the USEPA method. Some discrepancies in terms of concentrations and removal efficiencies were observed between both methods. Higher removal rates were observed for both somatic and F-specific coliphages in activated sludge systems when using the USEPA method compared to the ISO method; in other secondary (biological) treatment systems, this was observed only for F-specific coliphages. The use of different standardised methods available might lead to difficulties in obtaining and comparing phage data in different conditions and locations. Future research comparing both ISO and USEPA methods as well as viral and bacterial pathogens and indicators in WWTP is recommended.
The reversibility of asymptotic classes of geodesics in the universal covering of a Riemannian visibility manifold is a consequence of the reversibility of geodesics. The purpose of this article is to study reversibility at infinity for Finsler visibility manifolds and its relationship with geodesic reversibility. We show that a compact Finsler metric without conjugate points and visibility universal covering is p-reversible at infinity for every p in a fundamental domain if and only if the Finsler metric is geodesically reversible, namely, geodesics with reversed parametrization remain geodesics of the Finsler metric. We get as well some rigidity results for magnetic flows in compact surfaces. Let (M, g) be a compact Riemannian surface without focal points and with genus greater than one. We show that if the g-geodesic curvature of the magnetic geodesics has constant sign and the magnetic flow has no conjugate points, then p-reversibility at infinity for p in an open set in the universal covering of the surface implies that the magnetic flow is trivial. Under the same assumption on the g-geodesic curvature of magnetic geodesics, assuming that the magnetic flow is expansive we show that p-reversibility at just one point in the universal covering implies that the magnetic flow is trivial.
This study aims to evaluate the association between Total Dietary Antioxidant Capacity (dTAC) and Total Antioxidant Capacity of food groups (fgTAC) with the incidence of depression in Brazilian graduates participating in the Cohort of Universities of Minas Gerais (CUME Study). The sample consisted of 2,572 participants without a medical diagnosis of depression at baseline who responded to at least one follow-up questionnaire from the CUME project. The Ferric Reducing Antioxidant Power (FRAP) assay was used to determine dTAC. Incidence of depression was estimated by self-reported medical diagnosis of depression during the years of cohort follow-up. Cox regression models were used to relate dTAC and fgTAC to the incidence of depression. The mean follow-up time was 2.96 (1.00) years and 246 cases of depression were observed (32.3/1,000 person years). The mean dTAC was 11.03 (4.84) mmol/d. We found no associations between higher dTAC and lower risk of developing depression after adjusting for possible confounders. The incidence of depression was inversely associated with fgTAC of the beans and lentils group (HR: 0.61; IC0.41 - 0.90). The fgTAC of the Junk food group was positively associated with higher incidence of depression after all adjustments (HR:1.57; IC:1.08-2.26). Our findings do not support an association between dTAC and the incidence of depression in a highly educated Brazilian population. However, associations of fgTAC show the importance of analyzing the food matrix in which these antioxidants are inserted. We highlight the need for more prospective studies with different nationalities to confirm these results.
Objective: to evaluate the use of a renal health application by kidney transplant recipients. Method: a retrospective, observational study with a sample composed of individuals registered in the kidney transplant section of the application from July of 2018 to April of 2021. Demographic data, data entry, time of use, weight, blood pressure, blood glucose, creatinine, medication schedules, appointments, and tests were the variables collected. Descriptive analysis of the data was performed. Results: eight hundred and twenty-three downloads of the application were identified, and 12.3% of those were registered as kidney transplant recipients, the majority from southeastern Brazil (44.9%), 36±11 years old, and female (59.1%). Of the sample, 35.1% entered information such as creatinine (62%), weight (58.2%), and blood pressure (51.8%). Most used the application for one day (63.3%) and 13.9% for more than one hundred days. Those who used it for more than one day (36.7%) recorded weight (69%), medication intake (65.5%) and creatinine (62%), and scheduled appointments (69%). Conclusion: the kidney transplant recipient section of the Renal Health application generated interest in the young population, but showed low adherence throughout the assessed months. These results offer a relevant perspective on the implementation of mHealth technologies in kidney transplantation.
In this paper, we obtain the Bartlett-type correction factor for the gradient test statistic in heteroskedastic generalized linear models (HGLMs). We present an extensive Monte Carlo study to evaluate the performance of the corrected gradient test in small sample sizes. We also compare its performance with the usual gradient, likelihood ratio (LR), score, Wald, improved LR and improved score statistics along with bootstrap tests.
Unlabelled: The genomic characterization of phages with biocontrol potential against food-related bacteria is essential to future commercial applications. Here, we report the genome sequence of P. fluorescens phage UFJF_PfSW6 and a taxonomy proposal framing it as a novel phage species with great potential for biocontrol in the dairy industry. It showed a short linear double-stranded DNA genome (~ 39 kb) with a GC content of 21.2% and short DTR sequences of 215 bp. The genome of the UFJF_PfSW6 phage contains 48 genes with a unidirectional organization into three functional modules: DNA replication and metabolism, structural proteins, and DNA packing and host lysis. Thirteen promoters from phage and nine from host regulate these genes, and six Rho-independent terminators control their transcription. Twenty-seven genes of the UFJF_PfSW6 encode proteins with predicted functions. Comparative genome analysis revealed that the UFJF_PfSW6 genome shares 84% of genomic similarity with the genome sequence of the Pijolavirus PspYZU08, the only representative of the genus recognized so far. Therefore, our findings indicate that both phages are of the same genus, but UFJF_PfSW6 a is a novel Pijolavirus specie belonging to the Studiervirinae subfamily. Supplementary information: The online version contains supplementary material available at 10.1007/s13205-023-03485-3.
Background This preliminary study describes the Brazilian experience on dual biologic therapy or small molecule combined with a biologic therapy in patients with inflammatory bowel disease (IBD) refractory to multiple biologics. Methods We identified patients from 6 IBD centers in Brazil between April 2020 and November 2022 who received treatment with a combination of two biologics or a biologic and a small molecule drug due to refractory disease or concomitant immunomediated condition. The primary endpoint was clinical remission at week 16, defined as a total Mayo score of ≤2 for UC and Harvey-Bradshaw Index (HBI) <4 for CD. Secondary endpoints were improvement in disease activity scores and biomarkers. Adverse events were monitored and summarized descriptively. Results Twenty-nine patients were identified (69% CD, n=20), 51.8% female, mean age 38.8 years old [SD= ± 14.8 years]). Seventy per cent (n=14) had penetrating behavior among CD patients. Twenty-seven had failed to, at least, one anti-TNF; 79.9% had failed to ustekinumab (UST), and 34.5% to vedolizumab (VEDO). Twenty-six patients were treated with combination advanced therapy due to loss of response to biologics and three patients had concomitant ankylosing spondylitis. The most common combination used was UST+ADA (n=12, 41.4%), followed by UST+VEDO (n=6, 21.7%). Mean treatment time was 53.8 weeks (SD= 40.4 weeks, CI 95% [37.5 – 70]). At week 16, clinical remission rates were 80% and 66% for CD and UC, respectively. All patients under VEDO + UST combination achieved clinical remission at 16w, in both diseases. Baseline HBI mean was 10.8 (SD= ± 3.6 points; CI 95% [9.1- 12.5]), decreasing to a mean of 5.5 at week 16 (SD= ± 3.5 points; CI 95% [3.8 - 7.2]) and plateauing at 7 by week 24 (SD= ±5.4 CI 95% [3.4- 10.6]). There was a notable decrease in HBI at week 16 (p< 0.001) and a significant decrease at week 24 (p= 0.02) compared to baseline. Mean CRP at week 16 was significantly lower than baseline in CD (17.4mg/dL vs 5.5 mg/dL, p=0.001) and numerically lower in UC (from 14.3mg/dL to 9.9mg/dL, p= 0.5). Fecal calprotectin decreased from 2509mcg/g to 1472mcg/g in both groups (p=0,2). In addition, all patients with ankylosing spondylitis showed symptomatic remission. No new safety signals were identified during follow-up Conclusion Despite combination of advanced therapies in IBD is not yet recommended by treatment guidelines, this strategy seems to be a promising option for patients with refractory IBD or concomitant autoimmune disease. Our data indicate that further investigation in this direction is worthwhile.
Background Vedolizumab, a human monoclonal antibody that blocks integrin α4-β7, was approved for the management of Inflammatory Bowel Diseases. In real-world experience the number of patients using vedolizumab as first-line biological therapy was low, mainly in Crohn′s Disease (CD). This study aimed to evaluate the efficacy of vedolizumab exclusively in CD patients who were naïve to previous biologics, with mild to moderate disease. Additionally, we aimed to analyze the safety profile of vedolizumab, rates of mucosal healing, need for abdominal surgery and drug discontinuation over time in this specific population. Methods We performed a retrospective multicentric cohort study with patients with mild to moderate CD treated with VDZ who were naïve to previous biologics agents. These patients had clinical activity scores (Harvey-Bradshaw Index [HBI]) measured at baseline and weeks 12, 26, 52 as well as at the last follow-up. Clinical response was defined as a reduction ≥3 in HBI whereas clinical remission as HBI ≤4. Mucosal healing was defined as the complete absence of ulcers in control colonoscopies. Kaplan-Meier survival analysis was used to assess the persistence with vedolizumab over time. Results From a total of 72 patients (6 excluded) 53% (35/66) reached clinical remission at week 12. This percentage increased to 71.9% (46/64) at week 26, 88.1% (52/59) at week 52 and 81.8% (54/66) at the last follow-up visit. Clinical response was achieved in 72.7% (48/66), 92.2% (59/64), 95,1% (58/61) and 83.3% (55/66) in the same periods, respectively. Mucosal healing was achieved in 62.3% (33/57) of patients. Vedolizumab was well-tolerated and most adverse events were minor; 89.3% remained on vedolizumab after 52 weeks. During vedolizumab treatment, 3/66 patients underwent surgery. Conclusion Vedolizumab was effective in the management of patients with mild to moderate CD as first biological agent, with a remission rate of 88.1% after one year. Mucosal healing was observed in 62.3% of patients and major abdominal surgery was needed in only 4.5% of patients. This is one of the first international studies focused on the use of vedolizumab as a first-line biological treatment option in clinical practice in mild to moderate CD.
The increased demand for energy results in an increase in fossil fuel consumption. However, the planet’s oil deposits will soon reach unsustainable levels, presenting an opportunity for biofuels. In this study, cattle wastewater (CWW) was used to cultivate a microalgae consortium in photobioreactors. Seven rounds of experiments were carried out with the addition of CO2 (ControlCO2), ozone application for 10, 20, and 30 min (O3T10, O3T20, and O3T30), and a combination of CO2 and ozone (O3T10CO2 and O3T20CO2). Maximum dry biomass (18.63 g/L) and CO2 biofixation (8047.79 mg/L/d) were obtained in O3T20CO2. A total of 48% of lipid was registered in O3T30 and O3T20, indicating that microalgae were stressed when exposed to ozonized wastewater. C16:0 was detected in higher concentrations in all experiments. O3T30, O3T10CO2, and O3T20CO2 had values for C18:3 in accordance with the requirements of EN 14,214. Projections show that a farm with 2000 animals could produce 430 g of biofuels per kg of biomass and fixed 2.67 tCO2/y. Removals of up to 100% for NH3–N, 99.6% for P, and 91.7% for COD were recorded. The data indicates a possibility for CWW bioremediation and biofuel production in significant quantity and quality in comparison to the current scenario of microalgae cultivation.
Chironomus sancticaroli is a tropical species, easy to grow and to maintain in laboratory cultures. It has a fast reproduction cycle, under adequate conditions, around 30 days, allowing it to have many generations per year, an important criterion for selecting a test organism in ecotoxicology. Its life stages include: eggs, four larval instars (one planktonic and three benthic), pupa and adult (midges) This study aimed to: (1) review the methods for C. sancticaroli cultivation and its use in ecotoxicological tests, (2) establish a laboratory culture of C. sancticaroli, presenting the difficulties and discussing the ways to overcome them. Early 4th instar larvae was the most used in acute studies, while the 1st instar larvae (early 1st instar) was the most used in chronic studies; 96 h and 28 days were the most frequent durations in acute and chronic studies, respectively. The most common endpoints evaluated were organisms’ survival and development, and most of the ecotoxicological studies using C. sancticaroli were performed in laboratory. Most of the tested contaminants were pesticides and these had the most adverse effects on organisms. Most mesocosms with environmental contaminated samples did not show adverse effects on C. sancticaroli. Chronic and field studies as well as those testing the effects of the mixture contaminants on C. sancticaroli were still deficient. Keeping the laboratory environment and equipment effectively sanitized was important as well as maintaining stabilized conditions of temperature, photoperiod, physical, chemical and biological water quality in cultures.
Purpose: To evaluate bone loss, prosthodontics and biological complications, and implant survival rates of internal conical connections (ICC) compared with internal non-conical connection (INCC) implants. Methods: The systematic review was registered on PROSPERO (CRD42021237170). Meta-analysis was performed using standardized mean difference (SMD) for bone loss and risk ratio (RR) for implant survival and complication rates. Risk of bias analysis was evaluated using RoB 2.0, while the GRADE tool was used to evaluate the certainty of evidence. A systematic search of the PubMed, Web of Science, Embase, Cochrane, and ProQuest databases was performed independently by two reviewers for articles published up to March 2022. The search criteria had no language or publication date restrictions. Handsearching analysis was performed in the reference list of potential articles. Results: Twelve randomized clinical trials (RCT), including 678 patients and 1006 implants (ICC [n = 476]; INCC [n = 530]) were included. Meta-analysis revealed that ICC demonstrated a lower risk for marginal bone loss (SMD: -0.80 mm; P = 0.004) and prosthodontics complications (RR: 0.16; P = 0.01) than INCC. However, both internal connections demonstrated no significant difference in implant survival rates (RR: 0.54; P = 0.10) and biological complications (RR: 0.90; P = 0.82). The overall risk of bias revealed some concerns and low risk of bias for most of included studies. However, the certainty of evidence of outcomes was considered low to moderate. Conclusion: ICC may be considered a more favorable treatment option than INCC owing to greater preservation of peri-implant bone tissue and a lower probability of prosthodontics complications. However, well-conducted studies with long-term follow-up are warranted. This article is protected by copyright. All rights reserved.
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4,578 members
Bruno Salles Sotto Maior
  • Departamento de Odontologia Restauradora (ORE)
Ana Emília Farias Pontes
  • Dentistry Department
Leonardo Fernandes Martins
  • Departamento de Psicologia (PSI)
Maria Silvana Alves
  • Departamento de Ciências Farmacêuticas (DCF)
Mateus Laterza
  • Faculdade de Educação Física
University Campus, 36036900, Juiz de Fora, Minas Gerais, Brazil
Head of institution
Prof. Marcus Vinicius David