<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg1.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls0">D<span class="ls1c ws0 v0">O<span class="ls1 v0">E<span class="ls2 v0">N</span></span><span class="v0">Ç<span class="v0">A<span class="ls3 v0">S</span><span class="ws2 v0"> </span></span></span></span></div><div class="t m0 x2 h3 y2 ff1 fs0 fc0 sc0 ls4">N<span class="ls1 v0">E<span class="ls1c ws0 v0">U<span class="ls5 v0">R</span><span class="v0">O<span class="v0">M<span class="ls6 v0">U</span><span class="v0">S<span class="v0">C<span class="ls6 v0">U<span class="ls7 v0">L<span class="ls8 v0">A<span class="ls9 v0">R</span></span></span></span><span class="v0">E<span class="v0">S</span></span></span></span></span></span></span></span></div><div class="t m0 x3 h4 y3 ff1 fs1 fc0 sc0 ls1c ws1">D<span class="lsa v0">U<span class="lsb v0">C<span class="lsc v0">H<span class="lsd v0">E<span class="lse v0">N</span><span class="v0">E</span></span></span></span></span><span class="v0">,<span class="lsf v0">B<span class="lsd v0">E<span class="ls10 v0">C<span class="ls11 v0">K</span></span><span class="v0">E</span></span></span><span class="v0">R<span class="ls12 v0">,</span><span class="v0">F</span></span></span></div><div class="t m0 x4 h5 y4 ff1 fs1 fc0 sc0 ls1c ws1">A<span class="v0">S<span class="lsb v0">C<span class="ls13 v0">I</span></span><span class="v0">O<span class="ls14 ws2 v0"> </span><span class="v0">E<span class="ls15 v0">S<span class="ls16 v0">C<span class="ls17 v0">A<span class="ls18 v0">P<span class="ls19 v0">U</span></span></span></span></span><span class="v0">L</span></span></span></span></div><div class="t m0 x5 h6 y5 ff1 fs1 fc0 sc0 ls1a">O<span class="ls12 ws2 v0"> </span><span class="ls1c ws1 v0">U<span class="ls1b v0">M<span class="lsd v0">E</span></span><span class="v0">R</span></span></div><div class="t m0 x6 h7 y6 ff1 fs1 fc0 sc0 ls17">A<span class="ls1c v0">L</span></div><div class="t m1 x7 h8 y7 ff1 fs2 fc0 sc0 ls1c ws2">Ione de F<span class="blank _0"></span>. Zurawski </div><div class="t m1 x7 h8 y8 ff1 fs2 fc0 sc0 ls1c ws2">L<span class="blank _1"></span>opes R<span class="blank _2"></span>A<span class="blank _1"></span>:D653JG3</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg2.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">DOEN<span class="blank _1"></span>ÇA NEUROM<span class="blank _1"></span>USCUL<span class="blank _3"> </span>AR</div><div class="t m1 x8 ha ya ff2 fs4 fc0 sc0 ls1c ws2">Doença<span class="blank _4"> </span> neuromusc<span class="blank _4"> </span>ular (DNM) é<span class="blank _4"> </span> um termo amplo que abra<span class="blank _4"> </span>nge </div><div class="t m1 x9 ha yb ff2 fs4 fc0 sc0 ls1c ws2">muitas doenç<span class="blank _4"> </span>as e males que pr<span class="blank _4"> </span>ejudicam a funç<span class="blank _4"> </span>ão muscular<span class="blank _2"></span>.</div><div class="t m1 x8 ha yc ff2 fs4 fc0 sc0 ls1c ws2">Podem acome<span class="blank _4"> </span>ter qualquer um dos<span class="blank _4"> </span> nossos mú<span class="blank _4"> </span>sculos, os<span class="blank _4"> </span> nervos </div><div class="t m1 x9 ha yd ff2 fs4 fc0 sc0 ls1c ws2">periféricos<span class="blank _4"> </span>, as células n<span class="blank _4"> </span>ervosas<span class="blank _4"> </span> e as junções<span class="blank _4"> </span> </div><div class="t m1 x9 ha ye ff2 fs4 fc0 sc0 ls1c ws2">neuromus<span class="blank _4"> </span>culares (e<span class="blank _4"> </span>struturas qu<span class="blank _4"> </span>e conectam os<span class="blank _4"> </span> nervos aos<span class="blank _4"> </span> </div><div class="t m1 x9 ha yf ff2 fs4 fc0 sc0 ls1c ws3">músculos<span class="blank _4"> </span>).</div><div class="t m1 x8 ha y10 ff2 fs4 fc0 sc0 ls1c ws2">Provoc<span class="blank _4"> </span>a fraqueza e inca<span class="blank _4"> </span>pacidades<span class="blank _4"> </span>, como as de movi<span class="blank _4"> </span>mento, de </div><div class="t m1 x9 ha y11 ff2 fs4 fc0 sc0 ls1c ws2">falar<span class="blank _5"></span>, mastigar e até res<span class="blank _4"> </span>pirar<span class="blank _5"></span>. Mas, na grande<span class="blank _4"> </span> maioria dos </div><div class="t m1 x9 ha y12 ff2 fs4 fc0 sc0 ls1c ws2">casos<span class="blank _4"> </span>, essas doen<span class="blank _4"> </span>ças não interfer<span class="blank _4"> </span>em a consciên<span class="blank _4"> </span>cia, </div><div class="t m1 x9 ha y13 ff2 fs4 fc0 sc0 ls1c ws2">memória, racioc<span class="blank _4"> </span>ínio e linguagem.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg3.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">MIOP<span class="blank _6"></span>A<span class="blank _7"></span>TIAS </div><div class="t m1 x8 hb y14 ff2 fs2 fc0 sc0 ls1c ws2">Estados patoló<span class="blank _1"></span>gicos que vão atua<span class="blank _1"></span>r na fibra muscular estriada<span class="blank _1"></span>.</div><div class="t m1 x8 hb y15 ff2 fs2 fc0 sc0 ls1d">\u2022<span class="ls1c ws2 v1"> T<span class="blank _6"></span>em como pri<span class="blank _1"></span>ncipal sintoma a fraqueza mu<span class="blank _1"></span>scular<span class="blank _5"></span>.</span></div><div class="t m1 x8 hb y16 ff2 fs2 fc0 sc0 ls1d">\u2022<span class="ff1 ls1c ws2 v1">Os pacientes podem apr<span class="blank _2"></span>esentar dore<span class="blank _1"></span>s muscular<span class="blank _1"></span>es e </span></div><div class="t m1 x9 h8 y17 ff1 fs2 fc0 sc0 ls1c ws2">hipotonia, a<span class="blank _4"> </span>ssim como sensação constante de cansaço e </div><div class="t m1 x9 h8 y18 ff1 fs2 fc0 sc0 ls1c ws4">fadiga.</div><div class="t m1 x8 hb y19 ff2 fs2 fc0 sc0 ls1d">\u2022<span class="ff1 ls1c ws2 v1">P<span class="blank _2"></span>ode ser her<span class="blank _1"></span>editária ou adquiri<span class="blank _4"> </span>da.</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg4.png"><div class="t m1 xa h9 y1a ff1 fs3 fc0 sc0 ls1c ws2">DISTROF<span class="blank _1"></span>IA MUSCUL<span class="blank _3"> </span>AR</div><div class="t m1 xb hc y1b ff1 fs5 fc0 sc0 ls1c ws2">Um grupo de doenç<span class="blank _4"> </span>as genéticas q<span class="blank _4"> </span>ue causam fraqueza <span class="blank _4"> </span>pr<span class="blank _1"></span>ogr<span class="blank _1"></span>essiva </div><div class="t m1 xc hc y1c ff1 fs5 fc0 sc0 ls1c ws2">e perda de massa muscular<span class="blank _5"></span>.</div><div class="t m1 xb hd y1d ff2 fs5 fc0 sc0 ls1c ws2">É a miop<span class="blank _4"> </span>atia na q<span class="blank _4"> </span>ual uma ano<span class="blank _4"> </span>rmalida<span class="blank _4"> </span>de genéti<span class="blank _4"> </span>ca pod<span class="blank _4"> </span>e levar a<span class="blank _4"> </span> morte </div><div class="t m1 xc hd y1e ff2 fs5 fc0 sc0 ls1c ws2">prematura<span class="blank _4"> </span> e ao des<span class="blank _4"> </span>apareci<span class="blank _4"> </span>mento da <span class="blank _4"> </span>fibra mus<span class="blank _4"> </span>cular e<span class="blank _4"> </span>striada.</div><div class="t m1 xb hc y1f ff1 fs5 fc0 sc0 ls1c ws2">O enfraquecimento <span class="blank _4"> </span>pr<span class="blank _1"></span>ogr<span class="blank _1"></span>essivo da mu<span class="blank _4"> </span>sculatura esquelét<span class="blank _4"> </span>ica, vai </div><div class="t m1 xc hc y20 ff1 fs5 fc0 sc0 ls1c ws2">pr<span class="blank _2"></span>ej<span class="blank _4"> </span>udicar os mo<span class="blank _4"> </span>vimentos.</div><div class="t m1 xb he y21 ff3 fs5 fc0 sc0 ls1c ws5">Distro\ue607na</div><div class="t m1 xb hd y22 ff2 fs5 fc0 sc0 ls1c ws2">Proteína<span class="blank _4"> </span> de membra<span class="blank _4"> </span>na da fib<span class="blank _4"> </span>ra muscu<span class="blank _4"> </span>lar<span class="blank _5"></span>,<span class="blank _4"> </span> respons<span class="blank _4"> </span>ável p<span class="blank _4"> </span>ela sua<span class="blank _4"> </span> estrut<span class="blank _4"> </span>ura e </div><div class="t m1 xc hd y23 ff2 fs5 fc0 sc0 ls1c ws6">permeab<span class="blank _4"> </span>ilidad<span class="blank _4"> </span>e.</div><div class="t m1 xb hd y24 ff2 fs5 fc0 sc0 ls1c ws2">A<span class="blank _5"></span> <span class="blank _4"> </span>ausênc<span class="blank _4"> </span>ia des<span class="blank _4"> </span>sa prot<span class="blank _4"> </span>eína des<span class="blank _4"> </span>regula a <span class="blank _4"> </span>entrada <span class="blank _4"> </span>de c<span class="blank _4"> </span>álcio na f<span class="blank _4"> </span>ibra, </div><div class="t m1 xc hd y25 ff2 fs5 fc0 sc0 ls1c ws2">desen<span class="blank _4"> </span>cadean<span class="blank _4"> </span>do o quad<span class="blank _4"> </span>ro de d<span class="blank _4"> </span>egenera<span class="blank _4"> </span>ção mus<span class="blank _4"> </span>cular a<span class="blank _4"> </span>través d<span class="blank _4"> </span>a ativa<span class="blank _4"> </span>ção </div><div class="t m1 xc hd y26 ff2 fs5 fc0 sc0 ls1c ws2">de pro<span class="blank _4"> </span>teases<span class="blank _4"> </span> e fosfo<span class="blank _4"> </span>lipas<span class="blank _4"> </span>es.</div><div class="t m1 xb hf y27 ff4 fs5 fc0 sc0 ls1c ws2">Substâ<span class="blank _4"> </span>ncia CPK</div><div class="t m1 xb hc y28 ff1 fs5 fc0 sc0 ls1c ws2">A cr<span class="blank _1"></span>eatinofos<span class="blank _4"> </span>foquinase,<span class="blank _4"> </span> conhecida pela s<span class="blank _4"> </span>igla CP<span class="blank _4"> </span>K ou CK, é uma </div><div class="t m1 xc hc y29 ff1 fs5 fc0 sc0 ls1c ws2">enzima que at<span class="blank _4"> </span>ua principalmente nos<span class="blank _4"> </span> tecidos m<span class="blank _4"> </span>uscular<span class="blank _1"></span>es, no </div><div class="t m1 xc hc y2a ff1 fs5 fc0 sc0 ls1c ws2">cér<span class="blank _1"></span>ebr<span class="blank _2"></span>o<span class="blank _4"> </span> e no coração<span class="blank _4"> </span>, sendo s<span class="blank _4"> </span>olicitada <span class="blank _4"> </span>a sua <span class="blank _4"> </span>dosagem para </div><div class="t m1 xc hc y2b ff1 fs5 fc0 sc0 ls1c ws2">invest<span class="blank _4"> </span>igar possí<span class="blank _4"> </span>veis danos <span class="blank _4"> </span>a esses<span class="blank _4"> </span> ór<span class="blank _1"></span>gãos.<</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg5.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">DISTROF<span class="blank _1"></span>IA MUSCUL<span class="blank _3"> </span>AR</div><div class="t m1 x8 h10 y2c ff4 fs6 fc0 sc0 ls1c ws2">Existem <span class="blank _1"></span>mais de<span class="blank _1"></span> 30 tipos <span class="blank _1"></span>de distrof<span class="blank _1"></span>ia muscul<span class="blank _1"></span>ar<span class="blank _5"></span>, porém, os <span class="blank _1"></span>mais </div><div class="t m1 xd h10 y2d ff4 fs6 fc0 sc0 ls1c ws2">comuns <span class="blank _1"></span>são:</div><div class="t m1 x8 h11 y2e ff2 fs6 fc0 sc0 ls1c ws2"> <span class="blank _1"></span> \u2013 Distrofia <span class="blank _1"></span>Muscular de<span class="blank _1"></span> Duchenne;</div><div class="t m1 xd h11 y2f ff2 fs6 fc0 sc0 ls1c ws2">\u2013 Distro<span class="blank _1"></span>fia Muscular<span class="blank _1"></span> de Becker<span class="blank _1"></span>;</div><div class="t m1 xd h11 y30 ff2 fs6 fc0 sc0 ls1c ws2">\u2013 Distro<span class="blank _1"></span>fia Muscular<span class="blank _1"></span> do tipo <span class="blank _1"></span>Cinturas;</div><div class="t m1 xd h11 y31 ff2 fs6 fc0 sc0 ls1c ws2">\u2013 Distro<span class="blank _1"></span>fia Muscular<span class="blank _1"></span> Facio-Esc<span class="blank _1"></span>ápulo-Umeral;</div><div class="t m1 xd h11 y32 ff2 fs6 fc0 sc0 ls1c ws2">\u2013 Distro<span class="blank _1"></span>fia Muscular<span class="blank _1"></span> Miotônica o<span class="blank _1"></span>u de Steiner<span class="blank _1"></span>t;</div><div class="t m1 xd h11 y33 ff2 fs6 fc0 sc0 ls1c ws2">\u2013 Distro<span class="blank _1"></span>fia Muscular<span class="blank _1"></span> Congênita.</div><div class="t m1 x8 h12 y34 ff3 fs7 fc0 sc0 ls1c ws2">Distro\ue607<span class="blank _1"></span>a Muscula<span class="blank _1"></span>r Prog<span class="blank _1"></span>ressiv<span class="blank _1"></span>a</div><div class="t m1 x8 h11 y35 ff2 fs6 fc0 sc0 ls1c ws2">Caracter<span class="blank _1"></span>ística dege<span class="blank _1"></span>nerativa e h<span class="blank _1"></span>ereditár<span class="blank _1"></span>ia, irrevers<span class="blank _1"></span>ível.</div><div class="t m1 x8 h11 y36 ff2 fs6 fc0 sc0 ls1c ws2">Classificada de ac<span class="blank _1"></span>ordo co<span class="blank _1"></span>m as alter<span class="blank _1"></span>ações clinicas, <span class="blank _1"></span>alteraçõ<span class="blank _1"></span>es genéticas </div><div class="t m1 xd h11 y37 ff2 fs6 fc0 sc0 ls1c ws7">aprese<span class="blank _1"></span>ntadas.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg6.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">DOEN<span class="blank _1"></span>ÇA DO N<span class="blank _1"></span>EURÔNIO <span class="blank _1"></span>MOTOR</div><div class="t m1 xe hb y38 ff1 fs8 fc0 sc0 ls1e"><<span class="ff2 fs2 ls1c ws2">É um grupo de deso<span class="blank _1"></span>rdens caracterizad<span class="blank _1"></span>as pela gradua<span class="blank _1"></span>l deterioração<span class="blank _1"></span> dos </span></div><div class="t m1 xf hb y39 ff2 fs2 fc0 sc0 ls1c ws2">neurônio<span class="blank _1"></span>s que compõe<span class="blank _1"></span>m o SNC com a função de controla<span class="blank _1"></span>r as atividades </div><div class="t m1 xf hb y3a ff2 fs2 fc0 sc0 ls1c ws2">do músculo.</div><div class="t m1 xe hb y3b ff2 fs2 fc0 sc0 ls1d">\u2022<span class="ls1c ws2 v1"> Esclerose Lateral <span class="blank _5"></span>Amio<span class="blank _1"></span>trófica( ELA), atrofia muscular prog<span class="blank _1"></span>ressiva (AMP), </span></div><div class="t m1 xf hb y3c ff2 fs2 fc0 sc0 ls1c ws2">esclerose late<span class="blank _1"></span>ral primária (EL<span class="blank _1"></span>P) e paralisia bu<span class="blank _1"></span>lbar progressiva<span class="blank _1"></span> (PBP<span class="blank _4"> </span><span class="ff1 fs8 ws8">).</span></div><div class="t m1 xe hb y3d ff2 fs2 fc0 sc0 ls1d">\u2022<span class="ls1c ws2 v1">Costumam surgir entre<span class="blank _1"></span> a quinta e sétima déca<span class="blank _1"></span>das de vida e e<span class="blank _1"></span>nglobam </span></div><div class="t m1 xf hb y3e ff2 fs2 fc0 sc0 ls1c ws2">fraqueza muscula<span class="blank _1"></span>r progressiva<span class="blank _1"></span>, debilidad<span class="blank _1"></span>e e fasciculação dos múscu<span class="blank _1"></span>los, </div><div class="t m1 xf hb y3f ff2 fs2 fc0 sc0 ls1c ws2">espasticidad<span class="blank _1"></span>e ou rigidez no<span class="blank _1"></span>s membros superiores<span class="blank _1"></span> e inferiores e reflexo<span class="blank _1"></span> </div><div class="t m1 xf hb y40 ff2 fs2 fc0 sc0 ls1c ws2">hiperativo d<span class="blank _1"></span>os tendões.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg7.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">DISTROF<span class="blank _1"></span>IA DE DUCHENN<span class="blank _1"></span>E</div><div class="t m1 x8 h13 y41 ff2 fs8 fc0 sc0 ls1c ws2">É uma doença hereditária<span class="blank _1"></span> de transmissão recessiva ligada ao gênero, que ocorr<span class="blank _1"></span>e </div><div class="t m1 x9 h13 y42 ff2 fs8 fc0 sc0 ls1c ws2">devido a mutação do gene r<span class="blank _1"></span>esponsável pela produção da pro<span class="blank _1"></span>teína distrofina </div><div class="t m1 x9 h13 y43 ff2 fs8 fc0 sc0 ls1c ws2">localizado no braço curto do cromossomo X (re<span class="blank _1"></span>gião Xp 21). </div><div class="t m1 x8 h13 y44 ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ls1c ws2 v1">Descrita por Guillaume Du<span class="blank _1"></span>chenne na década de 60.</span></div><div class="t m1 x8 h13 y45 ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ls1c ws2 v1">Sexo masculino é mais acometido. (50%)</span></div><div class="t m1 x8 h13 y46 ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ls1c ws2 v1">Sexo feminino é portador<span class="blank _5"></span>. (50%)</span></div><div class="t m1 x8 h13 y47 ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ls1c ws2 v1">Inicio precoce ( por volta de 4 ano<span class="blank _1"></span>s).</span></div><div class="t m1 x8 h13 y48 ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ff1 ls1c ws2 v1">Enfraqueciment<span class="blank _1"></span>o simétrico <span class="blank _1"></span>e bilateral da muscu<span class="blank _1"></span>latura.</span></div><div class="t m1 x8 h13 y49 ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ff1 ls1c ws2 v1">Esta fraqueza mus<span class="blank _1"></span>cular tor<span class="blank _1"></span>na -se <span class="blank _1"></span>evidente quan<span class="blank _1"></span>do a criança t<span class="blank _1"></span>em </span></div><div class="t m1 x9 h14 y4a ff1 fs8 fc0 sc0 ls1c ws2">di@culdade<span class="blank _1"></span>s para cor<span class="blank _1"></span>r<span class="blank _2"></span>er<span class="blank _4"> </span>, levantar -se<span class="blank _1"></span> do ch<span class="blank _1"></span>ã o, sub<span class="blank _1"></span>ir e descer </div><div class="t m1 x9 h14 y4b ff1 fs8 fc0 sc0 ls1c ws2">escadas , q<span class="blank _1"></span>uedas fr<span class="blank _2"></span>equentes, e<span class="blank _1"></span> pr<span class="blank _1"></span>ogride<span class="blank _1"></span> para o tr<span class="blank _2"></span>onco e múscu<span class="blank _1"></span>los </div><div class="t m1 x9 h14 y4c ff1 fs8 fc0 sc0 ls1c ws2">dos membr<span class="blank _2"></span>os supe<span class="blank _1"></span>rior<span class="blank _1"></span>es (MMSS)<span class="blank _1"></span> e membr<span class="blank _2"></span>os inferior<span class="blank _1"></span>es (MMII). </div><div class="t m1 x8 h13 y4d ff2 fs8 fc0 sc0 ls1f">\u2022<span class="ls1c ws2 v1">São características o aumento de volume da<span class="blank _1"></span>s panturrilhas, escápula alada e </span></div><div class="t m1 x9 h13 y4e ff2 fs8 fc0 sc0 ls1c ws9">hiperlordose<span class="ff3">.</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg8.png"><div class="t m1 x10 h8 y4f ff1 fs2 fc0 sc0 ls1c ws2">Herança r<span class="blank _1"></span>ecessiva ligada ao sex<span class="blank _2"></span>o<span class="blank _1"></span>.</div><div class="t m1 x10 h8 y50 ff1 fs2 fc0 sc0 ls1c ws2">Alteração no<span class="blank _4"> </span> cr<span class="blank _2"></span>omossomo <span class="blank _4"> </span>X</div><div class="t m1 x11 h15 y51 ff3 fs2 fc0 sc0 ls1c ws2">Biopsia Mus<span class="blank _1"></span>cular</div><div class="t m1 x11 h13 y52 ff2 fs8 fc0 sc0 ls1c ws2">Um <span class="blank _8"> </span>pequeno <span class="blank _8"> </span>pedaço <span class="blank _8"> </span>de <span class="blank _8"> </span>músculo </div><div class="t m1 x11 h13 y53 ff2 fs8 fc0 sc0 ls1c ws2">pode <span class="blank _9"> </span>ser <span class="blank _9"> </span>removido <span class="blank _9"> </span>por <span class="blank _9"> </span>meio <span class="blank _9"> </span>de </div><div class="t m1 x11 h13 y54 ff2 fs8 fc0 sc0 ls1c ws2">uma pequena incisão. <span class="blank _2"></span>A<span class="blank _5"></span> análise da </div><div class="t m1 x11 h13 y55 ff2 fs8 fc0 sc0 ls1c ws2">amostra <span class="blank _a"> </span>pode <span class="blank _a"> </span>distinguir <span class="blank"> </span>distrofias </div><div class="t m1 x11 h13 y56 ff2 fs8 fc0 sc0 ls1c ws2">musculares <span class="blank _b"> </span>provenientes <span class="blank _b"> </span>de </div><div class="t m1 x11 h13 y57 ff2 fs8 fc0 sc0 ls1c ws2">outras <span class="blank _c"> </span>doenças <span class="blank _c"> </span>que <span class="blank _c"> </span>atingem <span class="blank _c"> </span>os </div><div class="t m1 x11 h13 y58 ff2 fs8 fc0 sc0 ls1c ws9">músculos</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf9" class="pf w0 h0" data-page-no="9"><div class="pc pc9 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bg9.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">MANO<span class="blank _1"></span>BR<span class="blank _5"></span>A DE <span class="blank _1"></span>GOWERS</div><div class="t m1 x8 hb y14 ff2 fs2 fc0 sc0 ls1c ws2">A<span class="blank _5"></span> manobra ou levantar miopá<span class="blank _1"></span>tico, consiste na estratégi<span class="blank _1"></span>a motora </div><div class="t m1 x9 hb y59 ff2 fs2 fc0 sc0 ls1c ws2">utilizada po<span class="blank _1"></span>r crianças com DM de Duch<span class="blank _1"></span>enne para ficar de pé<span class="blank _1"></span> a partir </div><div class="t m1 x9 hb y5a ff2 fs2 fc0 sc0 ls1c ws2">de uma posição<span class="blank _1"></span> sentada no chã<span class="blank _1"></span>o.</div><div class="t m1 x8 h16 y5b ff3 fs8 fc0 sc0 ls1c wsa">https://youtu.be/wNthA<span class="blank _2"></span>UjytGg</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pfa" class="pf w0 h0" data-page-no="a"><div class="pc pca w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/05881ff8-54a4-4bf5-b214-994700927767/bga.png"><div class="t m1 x8 h9 y9 ff1 fs3 fc0 sc0 ls1c ws2">EV<span class="blank _2"></span>OL<span class="blank _d"></span>UÇÃ<span class="blank _2"></span>O CLINICA DE<span class="blank _1"></span> DUCHENNE</div><div class="t m1 x8 h17 y2c ff2 fs9 fc0 sc0 ls1c ws2">A<span class="blank _2"></span> <span class="blank _1"></span>evolu<span class="blank _4"> </span>ção da doença é progressiva.</div><div class="t m1 x8 h17 y5c ff2 fs9 fc0 sc0 ls1c ws2"> Dos 3 aos 5 anos: dificulda<span class="blank _4"> </span>de para correr e quedas frequentes.</div><div class="t m1 x8 h17 y5d ff2 fs9 fc0 sc0 ls1c ws2">8 aos 9 anos: marcha com auxilio de órteses.</div><div class="t m1 x8 h17 y5e ff2 fs9 fc0 sc0 ls1c ws2">10 a 14 anos: perdem a marcha.</div><div class="t m1 x8 h17 y5f ff2 fs9 fc0 sc0 ls1c ws2"> Posteriormente surge fraqueza dos membros superiores, com incapaci<span class="blank _4"> </span>dade </div><div class="t m1 x9 h17 y60 ff2 fs9 fc0 sc0 ls1c ws2">em os levantar<span class="blank _2"></span>,<span class="blank _1"></span> depois de levar a mão à boca e fraqueza em agarrar </div><div class="t m1 x9 h17 y61 ff2 fs9 fc0 sc0 ls1c ws2">objetos com as mãos. Os músculos de sustentação do tronco vão </div><div class="t m1 x9 h17 y62 ff2 fs9 fc0 sc0 ls1c ws2">ficando fracos e surge frequentemente escoliose. Os músculos </div><div class="t m1 x9 h17 y63 ff2 fs9 fc0 sc0 ls1c ws2">cardíacos vão ficando afetados, ocasio<span class="blank _4"> </span>nando um grau maior ou menor </div><div class="t m1 x9 h17 y64 ff2 fs9 fc0 sc0 ls1c ws2">de insuficiênci<span class="blank _4"> </span>a cardíaca. Os músculos respiratórios também vão ficando </div><div class="t m1 x9 h17 y65 ff2 fs9 fc0 sc0 ls1c ws2">progressivamente mais fracos com necessid<span class="blank _4"> </span>ade de apoio ventilatório, </div><div class="t m1 x9 h17 y66 ff2 fs9 fc0 sc0 ls1c ws2">inicialme<span class="blank _4"> </span>nte noturno e posteriormente durante todo o dia<span class="blank _4"> </span><span class="ff1 fs8">.</span></div><div class="t m1 x8 h16 y67 ff3 fs8 fc0 sc0 ls1c wsa">Marcha</div><div class="t m1 x8 h13 y68 ff2 fs8 fc0 sc0 ls1c ws2">Pé equino </div><div class="t m1 x8 h13 y69 ff2 fs8 fc0 sc0 ls1c ws2">Marcha digitígrada/ Mar<span class="blank _1"></span>cha <span class="blank _2"></span>Anserina</div><div class="t m1 x8 h18 y6a ff4 fs8 fc0 sc0 ls1c ws2">Hiperlordos<span class="blank _1"></span>e lombar</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
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