RESUMO A cultura do milho é altamente responsiva à adubação nitrogenada, no entanto, a aplicação de doses elevadas, geralmente, provoca redução do aproveitamento do fertilizante. Neste sentido, objetivou-se com este estudo determinar a produtividade e o balanço do nitrogênio no milho cultivado em sistema de plantio direto. O experimento consistiu na aplicação de quatro doses de nitrogênio (0, 30; 70 e 95 kg ha-1). Foi aplicado em todas as parcelas do milho híbrido AG 1051, 80 e 56 kg ha-1 de P2O5 e K2O, respectivamente. O experimento foi disposto em delineamento em blocos ao acaso, com cinco repetições. A produtividade teve comportamento linear crescente em função das doses de nitrogênio, a qual atingiu 5.684,79 kg ha-1 de grão. A eficiência da adubação e a extração do N aumentaram linearmente com as doses de nitrogênio, obtendo-se com a maior dose a extração de 114,93 kg ha-1 de N e uma eficiência de adubação de 65%. O estoque de N do solo de 4.489 kg ha-1 disponibiliza às plantas de milho 52,81 kg ha-1 desse nutriente. O milho ajusta a produção de biomassa de acordo com a disponibilidade do nitrogênio, não havendo efeito das doses de N no teor do nutriente nos tecidos da planta.

ABSTRACT The corn crop is highly responsive to nitrogen fertilization; however, the application of high doses generally causes a reduction in the use efficiency of fertilizer. In this sense, this study aimed to determine the yield and nitrogen balance in corn grown under the no-tillage system. The experiment consisted of the application of four nitrogen doses (0, 30; 70 and 95 kg ha-1). In all plots with the AG 1051 hybrid corn, 80 and 56 kg ha-1 of P2O5 and K2O were applied, respectively. The experiment was arranged in a randomized block design with five replications. The grain yield had a linear increasing behavior according to the nitrogen doses, which reached 5,684.79 kg ha-1. The fertilization efficiency and the N extraction increased linearly with the increase of the nitrogen doses, obtaining with the highest dose the extraction of 114.93 kg ha-1 of N and a fertilization efficiency of 65%. The soil N stock of 4,489 kg ha-1 provides corn plants with 52.81 kg ha-1 of this nutrient. Corn adjusts the biomass production according to the availability of nitrogen, with no effect of N doses on the nutrient content in plant tissues.

ABSTRACT Schinus terebinthifolius Raddi, Anacardiaceae, native to Brazil, is referred to as "pimento-rosa" and is used to treat inflammatory disease in folk medicine. Studies have reported important pharmacological properties, but these effects have still not been fully exploited. This study reports that the crude extract and isolated compounds of S. terebinthifolius (leaves) have in vitro antioxidant, antiproliferative, and in vivo anti-inflammatory activities. The samples were evaluated for antioxidant activity using 2, 2-diphenyl-1-picrylhydrazyl, β-carotene/linoleic acid and 2,2′-azino-bis-(3-ethylbenzothiazoline)-6-sulphonic acid reagents. The anti-inflammatory effects were assayed against a carrageenan-induced paw oedema model in mice to test doses of 10, 100 and 300 mg/kg at different time points in addition to myeloperoxidase activity analysis. The antiproliferative activity was evaluated using ten human tumour cell lines. Two derivatives of gallic acid and four flavonoids were isolated and exhibited considerable antioxidant activity. The extract and its compounds showed selectivity towards ovarian cancer cells, with growth inhibitory activity values ranging from 1.9 to 6.5 µg/ml. Sample extracts and methyl gallate significantly inhibited carrageenan-induced oedema in the mice paw oedema experimental model. The calculated topological polar surface area for methyl gallate (86.98 Å2) showed good intestinal absorption. The effects reported herein are be related to the presence of flavonoids and the galloyl phenolic derivative content.

A series of β-carboline derivatives with amino or guanidinium were synthesized and evaluated in vitro against anti-Mycobacterium tuberculosis and for antiproliferative activities against nine human cancer cell lines. The compounds 1-(4-hydroxyphenyl)-3-carboxamide(ethylamine) β-carboline (24.9 µg mL-1) and 1-(4-methoxyphenyl)-3-carboxamide(ethylamine) β-carboline (26.9 µg mL-1) were the most active against M. Tuberculosis (MTB). Compounds 1-(4-hydroxyphenyl)-3-carboxamide(ethylamine) β-carboline and 1-(4-methoxyphenyl)-3-carboxamide(propylamine) β-carboline, which had the same substituted groups, inhibited the growth of all human tumor cell lines with growth inhibitory activity (GI50) values from 1.37 to 9.20 mmol L-1. Also in this series, compounds 1-(4-hydroxyphenyl)-3-carboxamide(propylamine) β-carboline and 1-(3-nitrophenyl)-3-carboxamide(propylamine) β-carboline demonstrated significant activity against NCI/ADR cells. Among compounds with a terminal guanidine group, compounds 1-(4-hydroxyphenyl)-3-carboxamide(ethyl)guanidine β-carboline (27.8 µg mL-1) and 1-(3-nitrophenyl)-3-carboxamide(ethyl)guanidine β-carboline (37.4 µg mL-1) demonstrated the greatest activity against MTB. Additionally, compounds 1-(4-methoxyphenyl)-3-carboxamide(ethyl)guanidine β-carboline (GI50 = 0.45 mmol L-1) effectively inhibited growth and was highly selective against NCI/ADR. The in silico study revealed that 1-(4-hydroxyphenyl)-3-carboxamide(ethylamine) β-carboline, 1-(4-methoxyphenyl)-3-carboxamide(ethylamine) β-carboline, 1-(4-hydroxyphenyl)-3-carboxamide(propylamine) β-carboline, 1-(4-methoxyphenyl)-3-carboxamide(propylamine) β-carboline and 1-(3-nitrophenyl)-3-carboxamide(propylamine) β-carboline compounds follow the rules established by Lipinski, suggesting that this compound has no problems with oral bioavailability.

The cytotoxicity of a hexanic fraction produced from the ethanolic crude extract, obtained from Jatropha ribifolia (Pohl) Baill, Euphorbiaceae, roots was evaluated against ten human cancer cell lines (MCF-7, NCI-ADR/RES, OVCAR-3, PC-3, HT-29, NCI-H460,786-O, UACC-62, K-562, U251) compared with doxorrubicine as positive control. Compounds jatrophone and cyperenoic acid were isolated from the hexanic extract and characterized by spectroscopic techniques (NMR of ¹H, 13C and IR). The in vitro antiproliferative activity of jatrophone showed selectivity in a concentration dependent way with Total Inhibition growth of: glioma 0.57 µg mL-1 (U251), breast cancer 9.2 µg mL-1 (MCF-7), adriamycin-resistant ovarian cancer 0.96 µg mL-1 (NCI-ADR/RES), kidney 4.2 µg mL-1 (786-0), prostate cancer 8.4 µg mL-1 (PC-3), colon cancer 16.1 µg mL-1 (HT29) and leukemia 0.21 µg mL-1 (K-562).

OBJETIVO: Avaliar duas modalidades de tratamento da alveolite em ratos e discutir os primeiros achados de uma análise molecular neste modelo experimental. MÉTODOS: 84 ratos foram submetidos a uma extração dentária e foram divididos em quatro grupos: I- alvéolo não infectado (controle), II- alvéolo infectado sem tratamento, III- alvéolo infectado tratado com irrigação de iodeto de sódio a 2% e solução de peróxido de hidrogênio a 3%, IV- alvéolo infectado submetido à curetagem, irrigação com solução salina fisiológica e preenchimento com pasta a base de metronidazol. Os grupos foram subdivididos em períodos de sacrifício pós-operatório: 6/15/28 dias. Uma análise quantitativa e qualitativa microscópica foi realizada. Além disso, uma análise quantitativa foi realizada utilizando RealTimePCR para avaliar a expressão de genes no reparo alveolar: o colágeno tipo I / COL-I, o fator de crescimento endotelial vascular / VEGF, osteocalcina / OCN, fosfatase alcalina / ALP, fator de transcrição runt relacionados 2 / RUNX2 e fator de necrose tumoral alfa / TNF-α. RESULTADOS: O grupo I mostrou maior formação óssea, seguido pelos grupos IV, III, II, respectivamente. O grupo II apresentou maior infiltrado inflamatório e a cicatrização foi atrasada em comparação com outros grupos. Foi obtida uma correlação positiva entre a neoformação óssea e a expressão de OCN e RUNX2, infiltrado inflamatório com TNF-α e uma correlação negativa entre a neoformação óssea e TNF-α. CONCLUSÃO: Nenhuma diferença significativa foi encontrada entre os tratamentos.

PURPOSE: To evaluate two treatment modalities of dry socket in rats and to discuss the first findings of the molecular analysis in this experimental model. METHODS: 84 rats underwent a tooth extraction were divided in 4 groups: I-uninfected socket (control), II-infected socket without any treatment, III-infected socket treated with irrigation of 2% sodium iodide and 3% hydrogen peroxide solution, IV-infected socket submitted to curettage, irrigation with physiological saline solution and fulfilled with metronidazole paste as base. The groups were subdivided in postoperative sacrifice periods: 6/15/28 days. A quantitative and a qualitative microscopic analysis was performed. Also, a quantitative analysis was performed using a RealTimePCR to evaluate the genes expression in the wound healing: Collagen Type I/COL-I, vascular endothelial growth factor/VEGF, osteocalcin/OCN, alkaline phosphatase/ALP, runt-related transcription factor 2/RUNX2 and tumor necrosis factor alpha/TNF-α. RESULTS: The group I showed higher bone formation, followed by groups IV, III, II respectively. The group II presented higher inflammatory infiltrate and the wound healing was delayed compared with other groups. It was obtained a significant positive correlation between bone neoformation and the expression of OCN and RUNX2, inflammatory infiltrate with TNF-α and a negative correlation between bone neoformation and TNF-α. CONCLUSION: No significant difference was found between the treatments.

O objetivo foi avaliar a facticidade do telefone como um método de obtenção de informações sobre saúde reprodutiva no Brasil (CATI). Um total de 998 mulheres elegíveis a um estudo foi selecionado para responder um questionário por telefone com o auxílio de computador e aplicado por entrevistadoras treinadas. Os resultados de cada tentativa de contato estão descritos. A diferença entre os grupos foi avaliada pelo teste qui-quadrado. O contato telefônico foi feito em 60,3% e 57,5% completaram a entrevista. A taxa de sucesso melhorou com a diminuição do tempo entre a hospitalização e a entrevista e com a quantidade de números de telefone disponível. Um total de 2.170 chamadas foi feito, de 1 a 16 tentativas por mulher. A maioria das chamadas adicionais foi em razão de a linha estar ocupada ou de a mulher não ter disponibilidade naquele momento. O CATI pode ser um procedimento útil para obtenção de informações em saúde reprodutiva entre mulheres brasileiras, especialmente se dirigido a eventos relativamente recentes e quando mais de um número alternativo de telefone está disponível.

The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer- assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ2 test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. CATI can prove be a valuable procedure for obtaining information on reproductive health among Brazilian women, particularly for relatively recent events and when more than one alternative telephone number is available.

O objetivo foi avaliar a facticidade do telefone como um método de obtenção de informações sobre saúde reprodutiva no Brasil (CATI). Um total de 998 mulheres elegíveis a um estudo foi selecionado para responder um questionário por telefone com o auxílio de computador e aplicado por entrevistadoras treinadas. Os resultados de cada tentativa de contato estão descritos. A diferença entre os grupos foi avaliada pelo teste qui-quadrado. O contato telefônico foi feito em 60,3% e 57,5% completaram a entrevista. A taxa de sucesso melhorou com a diminuição do tempo entre a hospitalização e a entrevista e com a quantidade de números de telefone disponível. Um total de 2.170 chamadas foi feito, de 1 a 16 tentativas por mulher. A maioria das chamadas adicionais foi em razão de a linha estar ocupada ou de a mulher não ter disponibilidade naquele momento. O CATI pode ser um procedimento útil para obtenção de informações em saúde reprodutiva entre mulheres brasileiras, especialmente se dirigido a eventos relativamente recentes e quando mais de um número alternativo de telefone está disponível.

The objective of this study was to evaluate the feasibility of using computer assisted telephone interviewing (CATI) as a method for obtaining information on reproductive health in Brazil. A total of 998 eligible women for the study were selected to answer a questionnaire through computer- assisted telephone interviewing undertaken by trained interviewers. The outcomes of each telephone contact attempt were described. Differences between groups were assessed using the χ2 test. Phone contact was made in 60.3% of the attempts and 57.5% of the interviews were completed. The success rate improved with the decrease in time from hospitalization to interview and with the higher numbers of telephones available. A total of 2,170 calls were made, comprising of one to sixteen attempts per woman. The majority of situations where extra calls were necessary were due to the number being busy or to the fact that the woman was not available at the time of the call. CATI can prove be a valuable procedure for obtaining information on reproductive health among Brazilian women, particularly for relatively recent events and when more than one alternative telephone number is available.

In an ongoing project to evaluate natural compounds isolated from by-products or wastes from vegetables and fruits (edible plants) as modulators of antibiotic resistance, ethanol extract from mango peel was investigated using Staphylococcus aureus strains possessing efflux mechanisms of resistance to norfloxacin, erythromycin and tetracycline. The minimum inhibitory concentrations (MIC) of the antibiotics were determined by the micro dilution assay in the absence and in the presence of sub-inhibitory mango peel extract concentration. Although the extract did not display relevant antibacterial activity (MIC>2048 µg/mL), it modulated the activity of antibiotics, i.e. in combination with antibiotics (at 512 µg/mL), a four-fold reduction in the MIC values for tetracycline and erythromycin was observed. The results presented here indicates that mango peel could serve as a source of potential adjuvant of antibiotics which add value to this mango by-product.

INTRODUCTION: Limb-girdle muscular dystrophy presents with heterogeneous clinical and molecular features. The primary characteristic of this disorder is proximal muscular weakness with variable age of onset, speed of progression, and intensity of symptoms. Sarcoglycanopathies, which are a subgroup of the limb-girdle muscular dystrophies, are caused by mutations in sarcoglycan genes. Mutations in these genes cause secondary deficiencies in other proteins, due to the instability of the dystrophin-glycoprotein complex. Therefore, determining the etiology of a given sarcoglycanopathy requires costly and occasionally inaccessible molecular methods. OBJECTIVE: The aim of this study was to identify phenotypic differences among limb-girdle muscular dystrophy patients who were grouped according to the immunohistochemical phenotypes for the four sarcoglycans. METHODS: To identify phenotypic differences among patients with different types of sarcoglycanopathies, a questionnaire was used and the muscle strength and range of motion of nine joints in 45 patients recruited from the Department of Neurology - HC-FMUSP (Clinics Hospital of the Faculty of Medicine of the University of São Paulo) were evaluated. The findings obtained from these analyses were compared with the results of the immunohistochemical findings. RESULTS: The patients were divided into the following groups based on the immunohistochemical findings: a-sarcoglycanopathies (16 patients), b-sarcoglycanopathies (1 patient), y-sarcoglycanopathies (5 patients), and nonsarcoglycanopathies (23 patients). The muscle strength analysis revealed significant differences for both upper and lower limb muscles, particularly the shoulder and hip muscles, as expected. No pattern of joint contractures was found among the four groups analyzed, even within the same family. However, a high frequency of tiptoe gait was observed in patients with a-sarcoglycanopathies, while calf pseudo-hypertrophy was most common in patients with non-sarcoglycanopathies. The a-sarcoglycanopathy patients presented with more severe muscle weakness than did y-sarcoglycanopathy patients. CONCLUSION: The clinical differences observed in this study, which were associated with the immunohistochemical findings, may help to prioritize the mutational investigation of sarcoglycan genes.

Com o propósito de aumentar a atividade anticâncer demonstrada anteriormente pelas 1-fenilssubstituído-3-(2-tioxo-1,3,4-oxadiazol-5-il) β-carbolinas 1a-c, neste trabalho foram realizadas a síntese e a avaliação in vitro da atividade antitumoral de novas bases de Mannich 2-7(a-c), derivadas da introdução de diferentes grupos alquilamino(metil) na unidade 1,3,4-oxadiazol de 1a-c. Os derivados 1a-c e 2-7(a-c) foram também avaliados quanto às atividades antibacteriana e antifúngica. Adicionalmente, um estudo in silico das propriedades de ADME dos novos compostos sintetizados 2-7(a-c) foi realizado pela avaliação de seus parâmetros de Lipinski e de dados de área de superfície topológica polar (TPSA) e de porcentagem de absorção (% ABS).

With the purpose of activity enhancement of 1-substituted phenyl-3-(2-thioxo-1,3,4-oxadiazol-5-yl) β-carbolines 1a-c, reported as potential antitumor agents in our previous study, herein we report the synthesis and antitumor activity evaluation of several novel Mannich bases 2-7(a-c), by the introduction of different alkylamino(methyl) groups in the 1,3,4-oxadiazole unity of 1a-c. The antimicrobial activities of 1a-c and of 2-7(a-c) were also evaluated. Additionally, an in silico study of the ADME properties of novel synthesized β-carboline derivatives 2-7(a-c) was performed by evaluation of their Lipinski's parameters and topological polar surface area (TPSA) and percentage of absorption (% ABS) data.

Plantas consumidas como remédio nem sempre são identificadas taxonomicamente de maneira correta. Se estas plantas forem utilizadas para obtenção de uma droga vegetal ou um fitoterápico, tal erro pode afetar a qualidade do produto final. Neste trabalho são descritos marcadores para a identificação de Solanum cernuum Vell. (Solanaceae), esteja a planta íntegra, triturada ou como extrato bruto. Indivíduos de quatro localidades de Minas Gerais foram coletados, analisados e comparados. Os caracteres morfológicos foram utilizados para a planta íntegra. Para a planta triturada, o conjunto dos tricomas foi utilizado como marcador anatômico. Um marcador macromolecular também foi determinado. Para tal a região ITS1, 5.8S e ITS2 do DNAr foi clonada e seqüenciada. A seqüência, com cerca de 600 pares de bases dos quais 48,1% são AT, foi depositada no GenBank sob o número de acesso DQ837371. Por ser uma seqüência específica para S. cernuum, ela pode ser usada como marcador desta espécie. Para o extrato bruto foram determinados perfis cromatográficos de extratos das folhas por cromatografia em camada delgada e por cromatografia líquida de alta eficiência. Dois flavonóides foram isolados e identificados como quercitrina e afzelina. Assim, neste trabalho foram determinados marcadores morfológicos, anatômicos, macro e micromoleculares para identificar S. cernuum.

The plants consumed as remedy by the population may have imprecise taxonomical identification. If these plants are used for the production of phytomedicines such misidentification may affect the quality of the product. Hereby, we describe markers for identification of the entire plant or grounded plant material or the crude extract of Solanum cernuum Vell. (Solanaceae). Specimens from four localities were collected, analyzed and compared. Morphological characters were used to identify the plant when it is not grounded or extracted. However, when the plant material is grounded, the set of trichomes may be used as anatomical marker. The region ITS1, 5.8S and ITS2 of the nuclear ribosomal DNA was cloned and sequenced. The sequence, with length of about 600 base pairs, being 48.1% AT , was deposited in GenBank under the accession number DQ837371. Once this sequence is specific to S. cernuum, it was used as marker for this species. For the crude extract, chromatographic profiles of the leaves extracts were obtained by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). Two flavonoids were isolated and identified as quercitrin and afzelin. So, this study presents morphological, anatomical, macro and micromolecular markers to identify S. cernuum.

Apresentamos o caso de um menino de 8 anos com quadro de síndrome de Kearns-Sayre (SKS), caracterizada por oftlamoparesia, ptose palpebral, miopatia mitocondrial, retinite pigmentosa, associada a baixa estatura, quadro cerebelar, distúrbio de condução cardíaca, diabetes mellitus, hiperproteinorraquia e distonia focal em mãos e pés. A biópsia muscular demonstrou a presença de fibras tipo "ragged-red", citocromo C oxidase negativas e succinato deidrogenase positivas. A ressonância magnética de cabeça mostrou alterações de sinal simétricas no tegmento das estruturas do tronco cerebral, globo pálido e tálamo. A análise do DNA mitocondrial do músculo esquelético mostrou a presença de deleção em condição heteroplásmica. A associação com distonia, descrita pela primeira vez neste caso de SKS com confirmação molecular, é ressaltada, sendo discutida a importância dos defeitos da fosforilação oxidativa na fisiopatogênese desta desordem de movimento.

We present a boy of eight years of age with symptoms of Kearns-Sayre syndrome (KSS) characterised by ophthalmoparesis, palpebral ptosis, mitochondrial myopathy, pigmentous retinitis, associated to short stature, cerebellar signs, cardiac blockade, diabetes mellitus, elevated cerebrospinal fluid protein concentration, and focal hand and foot dystonia. The skeletal muscle biopsy demonstrated ragged red fibers, cytochrome C oxidase-negative and succinate dehydrogenase-positive fibers. The magnetic resonance imaging showed symmetrical signal alteration in tegmentum of brain stem, pallidum and thalamus. Mitochondrial DNA analysis from skeletal muscle showed a deletion in heteroplasmic condition. The association of dystonia to KSS, confirmed by molecular analysis, is first described in this case, and the importance of oxidative phosphorylation defects in the physiopathogenesis of this type of movement disorder is stressed.

OBJETIVO: Analisar o teste de esforço cardiopulmonar (TECP) no diagnóstico de miopatias. MÉTODOS: 27 pacientes com miopatia realizaram TECP (protocolo de bicicleta em rampa, máximo, interrompido por sintoma). RESULTADOS: Pacientes distróficos e pacientes com mitocondriopatias mostraram diferenças significativas em relação aos controles para as variáveis potência do trabalho desenvolvido (watt) e pico do consumo de oxigênio (VO2 máx). Pacientes com mitocondriopatias mostraram diminuição significativa do limiar anaeróbio em relação aos controles, além de elevação dos valores do quociente respiratório (QR) do pico do exercício em relação aos demais grupos. CONCLUSÕES: TECP pode ser útil na avaliação evolutiva do grau de limitação física dos pacientes com miopatia. As variáveis potência do trabalho desenvolvido, VO2 máx, limiar anaeróbio e QR do pico do exercício podem sugerir o diagnóstico de miopatia e seus subtipos, excluindo quadros psicológicos.

PURPOSE: To evaluate the cardiopulmonary exercise testing (CPX) for the diagnosis of myopathies. METHODS: 27 patients with myopathy were submitted to CPX testing (symptom limited bike protocol). RESULTS: Dystrophic patients and patients with mitochondrial disease, compared with controls, showed significant differences for the power of work perfomed (watt) and the maximum oxygen consumption (VO2 max). Patients with mitochondrial disease presented significantly lower values of anaerobic threshold when compared to controls and elevation of exercise peak respiratory exchange ratio (RER) values when compared to the others groups. CONCLUSIONS: CPX testing may be useful in evaluating degree of physical limitation of patients with myopathy at inicial stage as well on follow-up examinations. Power of work performed, VO2 max, anaerobic threshold and RER at exercise peak may suggest the diagnosis of myopathy and its sub-types and therefore exclude psychologic causes of limitation.

Miotonia é o fenômeno da diminuição da velocidade de relaxamento muscular após contração, estímulo mecânico ou elétrico. As miotonias congênitas são afecções hereditárias e não apresentam distrofia muscular. Atualmente, a tendência é agrupá-las como doenças de canais iônicos, juntamente com as paralisias periódicas. Foram acompanhados sete pacientes, seis do sexo masculino e um do sexo feminino, com idade entre 16 e 48 anos (média 27 anos) e início dos sintomas entre 1 e 10 anos (média S anos), que apresentavam fenômeno miotônico desencadeado por contração intensa e hipertrofia muscular global. Três pacientes foram diagnosticados como miotonia generalizada tipo Becker por apresentarem herança autossômica recessiva e/ou episódios transitórios de fraqueza muscular. Dois pacientes correspondiam à miotonia congênita de Thomsen, com padrão de herança autossômica dominante e/ou ausência de episódios de fraqueza ou fatores de piora. Dois pacientes apresentavam miotonia flutuante, piorando com o frio e/ou ingestão de potássio. O diagnóstico clínico foi confirmado através de exames complementares (eletroneuromiografia, biópsia muscular e estudo do DNA). Cada paciente fez uso de diferentes drogas, no sentido de procurar o máximo de melhora da miotonia. Houve cinco relatos de melhora com difenil-hidantoína, um com carbamazepina, três com acetazolamida, um com bloqueador de canal de cálcio, um com beta-adrenérgico, um com tiazídico e nenhum com quinidina/procainamida.

Myotonia is the phenomenon of decrease of muscular relaxation rate, after either a contraction or a mechanical or electrical stimulus. Congenital myotonias are hereditary affections and do not present muscular dystrophy. The current trend is to group them as ionic channels diseases, together with the periodic paralysis.The authors accompanied the cases of seven patients, six males and one female, with ages ranging from 16 to 48 years (average 27 years) and onset of symptons between 1 and 10 years (average 5 years). These patients presented a myotonic phenomenon unleashed by intensive contraction and global muscular hypertrophy. Three patients were diagnosed as cases of Becker type generalized myotonia because they presented a recessive autosomic heredity and/or transient episodes of muscular weakness. Two patients fitted the description of Thomsen congenital myotonia, with a pattern of dominating autosomic heredity and/or absence of weakness episodes or worsening factors for their condition.Two patients presented fluctuating myotonia, which became worse in cold weather or at potassium intake. The clinical diagnosis was confirmed through complementary tests (electroneuromyography, muscle biopsy and DNA study). Each of the patients made use of different drugs, in the search of optimal lessening of their myotonia. There were five reports of amelioration with the use of diphenilhydantoine; one report with the use of carbamazepine; three reports with the use of acetazolamide; one report with the use of a calcium channel blocker; one report with the use of a beta-adrenergic; one report with the use of thiazide; and none with the use of quinidine/procainamide.

Os autores relatam o caso de paciente do sexo feminino de 18 anos de idade com fraqueza lentamente progressiva nos quatro membros desde a infância, sem antecedentes relevantes. O exame neurológico mostrou déficit motor discreto proximal e distal com retração muscular leve ao nível de ombros, cotovelos, articulações coxo-femurais, joelhos e tornozelos; hipotrofia muscular nas pernas e pés: reflexos presentes e sensibilidade normal. Creatinofosfoquinase com aumento de uma vez e meia o valor normal. Eletroneuromiografia: diminuição de amplitude e duração dos potenciais de ação e traçado de interferência paradoxal, compatíveis com afecção muscular primária. Biópsia muscular em congelação (HE, Gomori, PAS, ATPases, NADH, SDH, fosfatases ácida e alcalina, citocromo-c-oxidase e Oil-red-O) revelou afecção muscular primária caracterizada pela presença de corpos nemalínicos e corpos intracitoplasmáticos esferóides. Os corpos nemalínicos podem ser encontrados com diferentes alterações das fibras musculares, porém essa associação é rara. Este é o segundo relato da associação entre corpos nemalínicos e esferóides.

The authors report the case of a female patient, 18 years of age, with slowly progressing weakness in upper and lower limbs since childhood. There were no significant antecedents. The neurologic examination showed mild proximal and distal motor deficit with a slight muscular retraction at the level of shoulders, elbows, coxofemural joints, knees and ankles; muscular hypotrophy in the legs and feet; reflexes were present and sensitivity was normal. Creatinephosphokinase showed an increase of one and a half times the normal value. Electroneuromyography: decrease in the amplitude and duration of action potentials and excessive recruitment of motor units, compatible with a primary muscular disease. A muscle biopsy with frozen sections (HE, Gomori, PAS, ATPases, NADH, SDH, acid and alcaline phosphatases, cytochrome oxidase and Oil-red-o) revealed a primary muscular disease characterized by the presence of nemalinic and intracytoplasmic spheroid bodies. Nemalinic bodies have been described with different structural abnormalities of muscle fibers; however, such association is rare. This is the second case report of concomitant occurrence of nemalinic and spheroid bodies.