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Breast Cancer (BC) is one of the most common cancers diagnosed in population femmale and it has several subtypes, one of them being theexpressing human epidermal growth factor receptor 2 positive (HER2 +), one of the treatments for HER2+ breast cancer consists of chemotherapy plus trastuzumab deruxtecan. Several clinical trials have shown the effectiveness and safety of trastuzumabe deruxtecano in cancer patients, however, several Adverse Events (AEs) have been described and the decrease in left ventricular ejection has been singled out for more prominent analysis. Objective: We conducted a systematic review and meta-analysis to investigate the cardiovascular effects of Trastuzumab Deruxtecano and whether it can influence the appearance of reduced left ventricular ejection fraction.. METHODS: We performed a systematic search in Embase, PubMed and Cochrane databases for randomized controlled trials (RCTs) showed a decrease in left ventricular ejection fraction in patients using trastuzumab deruxtecan against Her-2-positive breast cancer compared to patients to used another's treatments against this disease. Mean difference (MD) with 95% confidence intervals (CI) were calculated using a random effects model. The heterogeneity was examined in the I2 statistic. P-values > 0.05 were considered statistically significant. The statistical analysis was carried out using R software version 4.2.3. RESULTS: A total of 3 RCTs were included, with a total of 1656 patients evaluated, 928 patients randomized to the use of Trastuzumab Deruxtecan and 728 patients to the use of other treatments according to medical choice, follow-up ranged from 10 to 38 months. There was a visible in the decrease in left ventricular ejection fraction, with a higher incidence in the group that used trastuzumab compared to the placebo group (RR: 5.73%; 95% CI 1.51 - 21.78; I2 33% ; P= 0.010466). Another important point is the discontinuation of treatment due to grade 2 adverse events, classified as reduced LVEF, where a higher incidence is seen in the group that used Trastuzumab Deruxtecan compared to the placebo group (RR 2.11%; 95% CI 1.54 - 2.89; P = 0.000003),7. CONCLUSION: In this meta-analysis, Trastuzumab Deruxtecan showed a relationship with a decrease in left ventricular ejection fraction, displaying the need for more studies to evaluate the cardiotoxicity of trastuzumab and its effects as a whole on the cardiovascular system.

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BACKGROUND: Contemporary understanding characterizes cardiotoxicity as a reduction in left ventricular ejection fraction (LVEF) by at least 10%, resulting in a final value below 53% in successive assessments. Nevertheless, breast cancer therapy can impact the cardiovascular system through various avenues. Cardiotoxicity is a known side effect of anthracycline chemotherapy, and the effectiveness of concomitant statin use in mitigating this risk is still unclear. PURPOSE: We aimed to evaluate the potential cardioprotective effects of statin exposure during anthracycline treatment. Our hypothesis posited that patients receiving statins during their treatment would experience a lesser decline in left ventricular ejection fraction (LVEF), lower levels of cholesterol and a reduced occurrence of cardiotoxicity compared to those not exposed to statins. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing statin versus placebo in patients undergoing anthracycline therapy. We searched PubMed, Embase and Cochrane for eligible trials. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Heterogeneity was examined with I2 statistics. P values of < 0.05 were considered statistically significant. Statistical analysis were performed using R software version 4.2.3. RESULTS: A total of 4 RCTs comprising 580 patients were included, of whom 281 were randomized to statins and 299 to placebo. The follow up period ranged from 2.5 to 24 months, with participant ages varying between 36 to 68.9 in the intervention group and 37.9 to 72 in the control group. Compared with placebo, statins were significantly associated with a higher left ventricular ejection fraction (MD 2.57%; 95% CI 1.05-4.08; p<0.001; I2=0%), reduction in left ventricular systolic end-volume (MD -4.5 mL; 95% CI -7.57 to -1.44; p<0.004; I2=0%) and diastolic end-volume (MD -6.08 mL; 95% CI -11.27 to -0.9; p<0.021; I2=0%), with a low heterogeneity value. Statins also showed important reduction of total cholesterol (MD -46.28 mg/dL; 95% CI -71.3 to -21.25; p<0.001; I2=89%) and LDL-C (MD -39.45 mg/dL; 95% CI -52.27 to -26.64; p<0.001; I2=84%). CONCLUSIONS: In this metaanalysis of RCTs, the use of statins showed a correlation with improved cardiovascular parameters, indicating their effectiveness in minimizing cardiotoxicity in breast cancer patients undergoing anthracycline chemotherapy

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BACKGROUND Atherosclerotic cardiovascular disease (ASCVD), affects approximately 18.6 million individuals worldwide and poses a significant healthcare related challenge. Despite the established efficacy of both high-intensity statin monotherapy (HIS) and moderate-intensity statin plus ezetimibe (MIS+EZT) in ASCVD management, the optimal treatment strategy remains unclear. METHODS A thorough literature study was conducted across PubMed, Embase, and the Cochrane databases, focusing on studies that compared the effects of moderate-intensity statins plus ezetimibe with high-intensity statin monotherapy in ASCVD patients. RESULTS In the 13 included studies, involving 8,592 patients, 4,525 (52.67%) of which received moderate-intensity statin plus ezetimibe treatment. The follow-up period ranged from 4 to 156 weeks, with participant ages varying LDL-C from 55.2 to 71 years old. Analysis revealed significant MIS+EZT-associated with greater percentages of patients achieved the goal in Low-Density Lipoprotein (LDL-C) < 70 (Odds Ratio (OR) 1.76; 95% CI [1.26; 2.45]; p=0.001; I²=73%), LDL-C reduction (Mean Difference (MD) -5.05 mg/dL; 95% CI [-9.02;-1.07]; p<0.013; I²=56%;); Total Cholesterol reduction (MD -7.91 mg/ dL; 95% CI [-14.90; -0.91]; p<0.027; I²=60%); Triglycerides reduction (MD -8.20 mg/ dL; 95% CI [-13.05; -3.35]; p<0.001; I²=2%;); There was no statistical difference between groups in Drug Adverse reaction (Risk Ratio (RR) 1.19; 95% CI [0.79; 1.78]; p=0.404; I²=0%); and Drug intolerance (RR 0.78; 95% CI [0.32; 1.92]; p=0.584; I²=35%). CONCLUSIONS This meta-analysis highlights the effectiveness of MIS+EZT in improving significant lipid profile components for ASCVD patients, as can been seen through the greater percentage of patients achieving the LDL-C <70 mg/dL target and lower LDL-C, total cholesterol and triglycerides levels. Importantly, there were no significant differences in the occurrence of overall adverse events and adverse drug reactions between the two groups.

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A trademark's image is usually the first type of indirect contact between a consumer and a product or a service. Companies rely on graphical trademarks as a symbol of quality and instant recognition, seeking to protect them from copyright infringements. A popular defense mechanism is graphical searching, where an image is compared to a large database to find potential conflicts with similar trademarks. Despite not being a new subject, image retrieval state-of-the-art lacks reliable solutions in the Industrial Property (IP) sector, where datasets are practically unrestricted in content, with abstract images for which modeling human perception is a challenging task. Existing Content-based Image Retrieval (CBIR) systems still present several problems, particularly in terms of efficiency and reliability. In this paper, we propose a new CBIR system that overcomes these major limitations. It follows a modular methodology, composed of a set of individual components tasked with the retrieval, maintenance and gradual optimization of trademark image searching, working on large-scale, unlabeled datasets. Its generalization capacity is achieved using multiple feature descriptions, weighted separately, and combined to represent a single similarity score. Images are evaluated for general features, edge maps, and regions of interest, using a method based on Watershedding K-Means segments. We propose an image recovery process that relies on a new similarity measure between all feature descriptions. New trademark images are added every day to ensure up-to-date results. The proposed system showcases a timely retrieval speed, with 95% of searches having a 10 second presentation speed and a mean average precision of 93.7%, supporting its applicability to real-word IP protection scenarios.

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INTRODUCTION: Gantenerumab is a monoclonal antibody targeting amyloid ß protein (Aß) in early Alzheimer's disease (AD). The authors sought to evaluate gantenerumab safety and efficacy in early AD patients. METHODS: MEDLINE, Embase, and Cochrane databases were systematically searched until 2 December 2023. Data were examined using the Mantel-Haenszel method and 95% confidence intervals (CIs). Meta-regression analysis was conducted to evaluate a possible link between baseline Clinical Dementia Rating Scale - Sum of Boxes (CDR-SB) and amyloid-related imaging abnormalities (ARIA) at follow-up. R, version 4.2.3, was used for statistical analysis. RESULTS: A total of 4 RCTs and 2848 patients were included, of whom 1580 (55%) received subcutaneous gantenerumab. Concerning clinical scores, the placebo group achieved better rates of change in the Disease Assessment Scale (ADAS-Cog13) (SMD -0.11; 95% CI -0.19- -0.03; p = 0.008569; I2 = 0%). Gantenerumab was strongly associated with the occurrence of ARIA-E and ARIA-H: (19.67% vs. 2.31%; RR 9.46; 95% CI 5.55-16.11; p = <0.000001; I2 = 10%) and (21.95% vs. 12.38%; RR 1.79; 95% CI 1.50-2.13; p = <0.000001; I2 = 0%), respectively. DISCUSSION: In this meta-analysis, consistent results suggest that gantenerumab is not safe and efficient for early AD, showing no improvement in clinical scores for AD and being associated with the occurrence of ARIA-E and ARIA-H.

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The efficacy and safety of dual antiplatelet therapy (DAPT) relative to intravenous (IV) alteplase in patients with acute minor ischemic stroke are insufficiently established. Therefore, we aimed to perform a meta-analysis to compare DAPT with IV alteplase in patients with acute minor stroke. MEDLINE, Embase, and Cochrane were searched for studies comparing DAPT with IV alteplase in patients with minor stroke. Functional and safety outcomes in 90 days were analyzed. Statistical analysis was performed using Rstudio 4.3.1. Subanalyses were performed restricted to non-disabling minor strokes and NIHSS score ≤ 3. PROSPERO (CRD42023440986). We included five studies with a total of 6,340 patients, of whom 4,050 (63.9%) received DAPT. The follow-up period for all included studies was 90 days. There was no significant difference for individual outcomes of mRS 0-1 (OR 1.26; 95% CI 0.85-1.89; p = 0.25), mRS 0-2 (OR 0.99; 95% CI 0.69-1.43; p = 0.97), or all-cause mortality (OR 0.80; 95% CI 0.20-3.13; p = 0.75) between groups. Symptomatic intracranial hemorrhage (sICH) was significantly lower (OR 0.11; 95% CI 0.003-0.36; p < 0.001) in patients treated with DAPT compared with IV alteplase. In terms of mRS 0-1 and mRS 0-2, we found no significant difference in both subgroup analyses. We found no statistically significant difference between DAPT and IV alteplase regarding functional outcome (mRS scores of 0-1 and 0-2) or all-cause mortality at 90 days in patients with minor ischemic stroke. Additionally, DAPT was associated with a significantly lower rate of sICH.

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Recent randomized controlled trials (RCTs) have shown a benefit of brexpiprazole in managing agitation in patients with Alzheimer's disease (AD). However, its efficacy and safety remain unclear. We systematically searched PubMed, Embase, and Cochrane Library for RCTs comparing brexpiprazole with placebo in patients with agitation and AD. Three studies comprising 1,048 patients were included. In patients with agitation and AD, brexpiprazole significantly improved the Cohen-Mansfield Agitation Inventory total score (CMAI) at any dose (MD -3.05; 95% CI -5.12, -0.98; p < 0.01; I2 = 19%) and at 2 mg (MD -4.36; 95% CI -7.02, -1.70; p < 0.01; I2 = 0%) over 12 weeks. Brexpiprazole at any dose and 2 mg also showed benefit in the Clinical Global Impression - Severity of illness (CGI-S) score as related to agitation over 12 weeks (MD -0.20; 95% CI -0.36, -0.05; p < 0.01; I2 = 35%). There is no significant difference between the groups in the incidence of at least one treatment-emergent adverse events (TEAEs; RR 1.14; 95% CI 0.95, 1.37; p = 0.16; I2 = 45%) and all-cause mortality (RR 1.99; 95% CI 0.37, 10.84; p = 0.42; I2 = 0%). Brexpiprazole at any dose significantly increased the Simpson-Angus Scale (SAS; MD 0.47; 95% CI 0.28, 0.66; p < 0.01). Our results suggest that brexpiprazole is more efficacious than placebo in the treatment of agitation in AD patients. Further studies are still necessary to confirm long-term effects of brexpiprazole.Prospero registry: CRD42023486694.

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BACKGROUND: Dual antiplatelet therapy (DAPT) with clopidogrel plus aspirin is a well-established practice after a minor stroke or transient ischemic attack (TIA). However, ticagrelor plus aspirin may be an alternative. AIMS: We systematically searched PubMed, Embase, and Cochrane Central from inception to January 2024. We included randomized controlled trials (RCTs) enrolling adults with acute minor stroke or TIA within 72 hours of the onset of the symptoms. RESULTS: A total of 8 RCTs were included in our meta-analysis. Ticagrelor plus aspirin (RR, 0.70; 95% CrI 0.52, 0.91) and clopidogrel plus aspirin (RR, 0.79; 95% CrI 0.64, 0.98) were superior to aspirin in preventing stroke recurrence in overall analysis. Excluding studies with dual antiplatelet up to 90 days, ticagrelor plus aspirin was the only strategy that maintained superiority compared with aspirin regarding stroke recurrence (RR, 0.70; 95% CrI 0.51, 0.95) and ischemic stroke (RR, 0.68; 95% CrI 0.47, 0.94). There was no significant difference between treatment groups regarding hemorrhagic stroke, functional disability, and mortality. CONCLUSIONS: DAPTs were superior to aspirin in preventing recurrence or ischemic stroke. Although no significant difference was observed between DAPTs, ticagrelor plus aspirin may be related to worse major bleeding results, including intracranial bleeding. Ticagrelor plus aspirin is a considerable option for patients after a minor stroke or TIA.

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BACKGROUND: Within the context of uncontrolled blood pressure telemonitoring, the remote tracking of blood pressure and patient data, offers a transformative avenue. We aimed to perform a meta-analysis of the strategic redesign of healthcare services, harnessing information and communication technology (ICT) to enhance hypertension management and blood pressure control in primary care, providing timely interventions, and improving patient outcomes. METHODS: PubMed, Embase, and Cochrane databases were searched for RCTs comparing ICT with usual care in patients with uncontrolled hypertension. A random-effects model was used to calculate the risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: A total of twenty-eight studies and 13,111 patients were included, of whom 7,312 were randomized to ICT and 5,799 to usual care. Compared with standard care, ICT significantly reduced systolic blood pressure (MD -4.44 mmHg; 95% CI -5.55,-3.33; p<0.01) and diastolic blood pressure (MD -1.08 mmHg; 95% CI -1.71,-0.45; p<0.01). There was no significant difference between groups for adherence (RR 1.16; 95%CI 0.89-1.50; p=0.27). CONCLUSION: In this meta-analysis of RCTs of patients with uncontrolled hypertension, ICT was associated with a reduction in systolic and diastolic blood pressures, compared with usual care.

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BACKGROUND AND OBJECTIVES: The preferred osmotic agent used for brain relaxation during craniotomies remains unclear, either mannitol (MAN) or hypertonic saline (HTS). Hence, we sought to compare these solutions in this population. METHODS: MEDLINE, Embase, and Cochrane databases were systematically searched until August 02, 2023. Data were examined using the Mantel-Haenszel method and 95% CIs. Heterogeneity was assessed using I2 statistics. Meta-regression analysis was conducted to evaluate a possible link between Brain Relaxation Score and tumor volume. R, version 4.2.3, was used for statistical analysis. RESULTS: A total of 16 randomized controlled trials and 1031 patients were included, of whom 631 (61%) underwent surgery for supratentorial tumor resection. Compared with MAN, HTS achieved better rates of brain relaxation (80% vs 71%; odds ratio [OR] 1.68; 95% CI 1.22-2.33; P = .001; I2 = 0%), which was also demonstrated in the subgroup analysis of patients with supratentorial brain tumor (78% vs 65%; OR 2.02; 95% CI 1.36-2.99; P = .0005; I2 = 0%); a minor number of patients requiring a second dose of osmotic agent (14% vs 28%; OR 0.43; 95% CI 0.27-0.69; P = .0003; I2 = 0%); a lower fluid intake (mean difference -475.9341 mL; 95% CI -818.8952 to -132.9730; P = .007; I2 = 88%); and lower urine output (mean difference -462.0941 mL; 95% CI -585.3020 to -338.8862; P = <.001; I2 = 96%). Hospital length of stay and focal neurological deficits did not reach a statistically significant difference between groups. CONCLUSION: In this updated meta-analysis, consistent results suggest that HTS is associated with more beneficial outcomes than MAN in patients undergoing craniotomy.

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Background: The benefit of adding programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors to the treatment of early-stage non-small cell lung cancer (NSCLC), both neoadjuvant therapy (NAT) and adjuvant therapy (AT), is not yet fully elucidated. Methods: We searched PubMed, Embase, and Cochrane databases for randomized controlled trials (RCT) that investigated PD-1/PD-L1 inhibitors plus chemotherapy for resectable stage NSCLC. We computed hazard ratios (HRs) or odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs). Results: A total of seven RCTs comprising 3915 patients with resectable stage NSCLC were randomized to chemotherapy with or without PD-1/PD-L1 inhibitors as NAT or AT. As NAT, the PD-1/PD-L1 inhibitors plus chemotherapy group demonstrated significantly improved overall survival (HR 0.66; 95% CI 0.51-0.86) and event-free survival (HR 0.53; 95% CI 0.43-0.67) compared with the chemotherapy alone group. There was a significant increase in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group for major pathological response (OR 6.40; 95% CI 3.86-10.61) and pathological complete response (OR 8.82; 95% CI 4.51-17.26). Meanwhile, as AT, disease-free survival was significant in favor of the PD-1/PD-L1 inhibitors plus chemotherapy group (HR 0.78; 95% CI 0.69-0.90). Conclusions: In this comprehensive systematic review and meta-analysis of RCTs, the incorporation of PD-1/PD-L1 inhibitors alongside chemotherapy offers a promising prospect for reshaping the established treatment paradigms for patients diagnosed with resectable stages of NSCLC. Moreover, our analyses support that neoadjuvant administration with these agents should be encouraged, in light of the fact that it was associated with an increased survival and pathological response, at the expense of a manageable safety profile.

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BACKGROUND: Paclitaxel and carboplatin is the standard chemotherapy for the treatment of advanced or recurrent endometrial cancer. However, the benefit of adding programmed cell death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors to chemotherapy is still unclear. METHOD: We searched PubMed, Scopus, Cochrane, and Web of Science databases for randomized controlled trials that investigated PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel compared with carboplatin and paclitaxel in primary advanced or recurrent endometrial cancer. We computed hazard ratios (HRs) or risk ratios (RRs) for binary endpoints, with 95% confidence intervals (CIs). We used DerSimonian and Laird random-effect models for all endpoints. Heterogeneity was assessed using I2 statistics. R, version 4.2.3, was used for statistical analyses. RESULTS: A total of three studies and 1,431 patients were included. Compared with carboplatin plus paclitaxel-based chemotherapy, progression-free survival (PFS) rate (HR 0.32; 95% CI 0.23-0.44; p < 0.001) and overall survival (OS) at 30 months (RR 3.13; 95% CI 1.26-7.78; p = 0.01) were significant in favor of the PD-1/PD-L1 inhibitors plus carboplatin and paclitaxel group in the mismatch repair-deficient subgroup. However, there were no significant differences in the mismatch repair-proficient subgroup for PFS (HR 0.74; 95% CI 0.50-1.08; p = 0.117) or OS at 30 months (RR 2.24; 95% CI 0.79-6.39; p = 0.13). CONCLUSION: Immunotherapy plus carboplatin-paclitaxel increased significantly PFS and OS among patients with advanced or recurrent endometrial cancer, with a significant benefit in the mismatch repair-deficient and high microsatellite instability population.

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Graphical Search Engines are conceptually used in many development areas surrounding information retrieval systems that aim to provide a visual representation of results, typically associated with retrieving images relevant to one or more input images. Since the 1990s, efforts have been made to improve the result quality, be it through improved processing speeds or more efficient graphical processing techniques that generate accurate representations of images for comparison. While many systems achieve timely results by combining high-level features, they still struggle when dealing with large datasets and abstract images. Image datasets regarding industrial property are an example of an hurdle for typical image retrieval systems where the dimensions and characteristics of images make adequate comparison a difficult task. In this paper, we introduce an image retrieval system based on a multi-phase implementation of different deep learning and image processing techniques, designed to deliver highly accurate results regardless of dataset complexity and size. The proposed approach uses image signatures to provide a near exact representation of an image, with abstraction levels that allow the comparison with other signatures as a means to achieve a fully capable image comparison process. To overcome performance disadvantages related to multiple image searches due to the high complexity of image signatures, the proposed system incorporates a parallel processing block responsible for dealing with multi-image search scenarios. The system achieves the image retrieval through the use of a new similarity compound formula that accounts for all components of an image signature. The results shows that the developed approach performs image retrieval with high accuracy, showing that combining multiple image assets allows for more accurate comparisons across a broad spectrum of image typologies. The use of deep convolutional networks for feature extraction as a means of semantically describing more commonly encountered objects allows for the system to perform research with a degree of abstraction.

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The increase in environmental problems in recent decades has required the evolution of the tools used to mitigate environmental impacts, such as Life Cycle Assessment (LCA). The aim of the present study was to evaluate the use of LCA in Brazilian companies. Data collection involved a questionnaire administrated to companies addressing attitudes related to environmental management, enabling the following three classifications: (1) Does not use Life Cycle Thinking (LCT), (2) Uses LCT and (3) Uses LCA. The results were categorized and submitted to both descriptive and multivariate analyses. Most companies investigated do not yet use LCA. The main obstacles were difficulties involved in implementing LCA, the lack of an external demand, a lack of available background data and difficulty applying the results to the environmental improvement of products. In contrast, the main reasons that led companies to use LCA were the possibility of reducing environmental impact, achieving improvements in the production process, the creation of a differentiated product for the market and the improvement of environmental management. The findings underscore the need for greater governmental support with regard to environmental labeling (mainly type III) and greater dissemination of information on LCA within industries, since the lack of knowledge of the tool is perceived as one of the greatest obstacles. This research is pioneering in Brazil. Further studies should identify the evolution in LCA use in Brazilian companies, which should reflect an improvement in environmental management on the national level.

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PURPOSE: Elementary flows are essential components of data used for life cycle assessment. A standard list is not used across all sources, as data providers now manage these flows independently. Elementary flows must be consistent across a life cycle inventory for accurate inventory analysis and must correspond with impact methods for impact assessment. With the goal of achieving a global network of LCA databases, a critical review of elementary flow usage and management in LCA data sources was performed. METHODS: Flows were collected in a standard template from various life cycle inventory, impact method, and software sources. A typology of elementary flows was created to identify flows by types such as chemicals, minerals, land flows, etc. to facilitate differential analysis. Twelve criteria were defined to evaluate flows against principles of clarity, consistency, extensibility, translatability, and uniqueness. RESULTS AND DISCUSSION: Over 134,000 elementary flows from five LCI databases, three LCIA methods, and four LCA software tools were collected and evaluated from European, North American, and Asian Pacific LCA sources. The vast majority were typed as "Element or Compound" or "Group of Chemicals" with less than 10% coming from the other seven types Many lack important identifying information including context information (environmental compartments), directionality (LCIA methods generally do not provide this information), additional clarifiers such as CAS numbers and synonyms, unique identifiers (like UUIDs), and supporting metadata. Extensibility of flows is poor because patterns in flow naming are generally complex and inconsistent because user defined nomenclature is used. CONCLUSIONS: The current shortcomings in flow clarity, consistency, and extensibility are likely to make it more challenging for users to properly select and use elementary flows when creating LCA data and make translation/conversion between different reference lists challenging and loss of information will likely occur. RECOMMENDATIONS: We recommend the application of a typology to flow lists, use of unique identifiers and inclusion of clarifiers based on external references, setting an exclusive or inclusive nomenclature for flow context information that includes directionality and environmental compartment information, separating flowable names from context and unit information, linking inclusive taxonomies to create limited patterns for flowable names, and using an encoding schema that will prevent technical translation errors.

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Introdução As perturbações músculo-esqueléticas têm aumentado na última década para níveis deveras preocupantes, exigindo por isso uma atenção cuidada por investigadores e profissionais de saúde com o intuito de identificar e controlar os factores de risco. Estudos epidemiológicos revelam que esse aumento se verifica sobretudo nos países desenvolvidos, com tendência para a cronicidade e manutenção na idade adulta, o que representa um problema de saúde pública. Objetivos O presente estudo pretende identificar a prevalência das perturbações músculo-esqueléticas nos adolescentes e analisar a sua relação com as variáveis sociodemográficas, antropométricas e circunstanciais. Método Trata-se de um estudo não experimental, transversal, descritivo-correlacional e de caráter quantitativo, que envolveu 137 adolescentes das três escolas do Agrupamento de Escolas de Mangualde. Foi realizado com recurso ao uso de um questionário que avalia as variáveis sociodemográficas, antropométricas, circunstanciais e perturbações músculo-esqueléticas. Usámos o "questionário da atividade física" para avaliar a prática de atividade física e o "Questionário Nórdico Músculo-Esquelético" para avaliar as perturbações músculo-esqueléticas. Resultados Os dados mostram que existem grupos significativos de adolescentes a referir perturbações músculo-esqueléticas nos últimos 12 meses tendo estas ocorrido sobretudo nas pernas/ joelhos (47,4%), coluna dorsal (37,2%), coluna lombar (35,8%), coluna cervical (35,0%) e ombros (34,3%). Observa-se ainda que as perturbações musculoesqueléticas são mais prevalentes nos adolescentes do género feminino, de classes socioeconómicas baixas, com altura superior a 1,59 m, que usam a mochila sobre um ombro, que despendem mais do que 5 horas semanais a ver televisão e que gastam mais do que 5 horas semanais a jogar jogos de vídeo ou a utilizar o computador. Conclusão O nosso estudo reforça a ideia que as perturbações músculo-esqueléticas estão presentes em grupos significativos de adolescentes, têm uma origem dinâmica, multifacetada e multidimensional. Mostra ainda que existem fatores que assumem particular importância por concorrerem diretamente para a ocorrência destas manifestações (como os de origem mecânica) e outros que influenciam indiretamente, sobretudo os de origem social ou organizacional. Neste contexto torna-se imperativo que se aposte na prevenção destas patologias através de intervenções de reabilitação e readaptação promotoras de um funcionamento músculo-esquelético optimizado.

Introduction The musculoskeletal disorders have increased in the last decade to truly alarming levels, therefore requires careful attention by researchers and health professionals in order to identify and control risk factors. Epidemiological studies reveal that this increase occurs mostly in developing countries, with a tendency to chronicity and maintenance in adulthood, which is a public health problem. Objectives This study aims to identify the prevalence of musculoskeletal disorders in adolescents and analyze its relationship with sociodemographic, anthropometric and circumstantial. Method It is a non-experimental, cross-sectional, descriptive-correlational and quantitative character, which involved 137 adolescents from three schools of Group of Schools Mangualde. Was conducted using the use of a questionnaire that assesses sociodemographic, anthropometric, circumstantial and musculoskeletal disorders. We used the "Physical activity questionnaire" to assess physical activity and "Nordic Musculoskeletal Questionnaire" to assess musculoskeletal disorders. Results The data show that there are significant groups of teenagers referring musculoskeletal disorders in the last 12 months and these occurred mainly in the legs/ knees (47.4 %), spine (37.2 %), lumbar spine (35.8 %), cervical spine (35.0 %) and shoulder (34.3 %). It is also observed that musculoskeletal disorders are more prevalent in adolescent females from low socio-economic classes, taller than 1.59 m, using the backpack over one shoulder, they spend more than 5 hours per week watching TV and they spend more than 5 hours a week playing video games or using the computer. Conclusion Our study reinforces the idea that the musculoskeletal disorders are present in significant groups of teenagers, have a dynamic origin, multifaceted and multidimensional. It also shows that there are factors that are of particular importance for competing directly for the occurrence of such events (such as mechanical origin) and other influencing indirectly, especially those of social or organizational. In this context it is imperative to put the emphasis on prevention of these diseases through interventions that promote rehabilitation and upgrading of a musculo - skeletal optimized.

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