Biomarker candidates of neurodegeneration in Parkinson’s disease for the evaluation of disease-modifying therapeutics

Reliable biomarkers that can be used for early diagnosis and tracking disease progression are the cornerstone of the development of disease-modifying treatments for Parkinson’s disease (PD). The German Society of Experimental and Clinical Neurotherapeutics (GESENT) has convened a Working Group to review the current status of proposed biomarkers of neurodegeneration according to the following criteria and to develop a consensus statement on biomarker candidates for evaluation of disease-modifying therapeutics in PD. The criteria proposed are that the biomarker should be linked to fundamental features of PD neuropathology and mechanisms underlying neurodegeneration in PD, should be correlated to disease progression assessed by clinical rating scales, should monitor the actual disease status, should be pre-clinically validated, and confirmed by at least two independent studies conducted by qualified investigators with the results published in peer-reviewed journals. To date, available data have not yet revealed one reliable biomarker to detect early neurodegeneration in PD and to detect and monitor effects of drug candidates on the disease process, but some promising biomarker candidates, such as antibodies against neuromelanin, pathological forms of α-synuclein, DJ-1, and patterns of gene expression, metabolomic and protein profiling exist. Almost all of the biomarker candidates were not investigated in relation to effects of treatment, validated in experimental models of PD and confirmed in independent studies

Atuação ambulatorial do profissional de educação física no atendimento a crianças e adolescentes obesos

A freqüência da obesidade na infância e adolescência aumentou nos últimos anos. Essa situação tem preocupado a área da saúde, não só pelas conseqüências promovidas pela obesidade na população em geral, mas pela imposição de prejuízos biopsicossociais, ainda na infância. O tratamento é bastante complexo, pois sua causa é multifatorial, exigindo atenção interdisciplinar. O presente trabalho teve como objetivo relatar o papel do professor de educação física na equipe de atendimento ambulatorial de crianças e adolescentes obesos. A atividade física, depois da taxa metabólica basal, é considerada o segundo maior componente do gasto energético diário. Diversos estudos demonstraram que a atividade física associada ao controle alimentar leva a melhores resultados do que essas ações isoladas. O aumento da atividade física é muito benéfico no tratamento de crianças e adolescentes obesos, pois permite maior ingestão alimentar e auxilia a preservar a massa magra. Entretanto, o exercício físico deve ser adaptado às condições de excesso de peso e de crescimento ósseo. Além desses cuidados, o profissional depara-se com a dificuldade de manter crianças e adolescentes em programa de exercício regular. Desse modo, a prescrição do aumento de movimento corporal após a anamnese da rotina diária de cada paciente foi a solução encontrada para, inicialmente, colocá-los em contato com o próprio corpo. Paralelamente, o professor de educação física auxilia a criança a encontrar um tipo de esporte que mais lhe agrade, dentro daqueles permitidos pelo seu excesso de peso e fase de crescimento. Geralmente, recomendam-se atividades que tenham baixo impacto, como nadar, caminhar e andar de bicicleta. O professor de educação física, como educador, deve fazer parte do atendimento multidisciplinar de crianças e adolescentes obesos

Rationale, design and methods of the HEALTHY study physical education intervention component

The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention integrated nutrition, physical education (PE) and behavior changes with a communications strategy of promotional and educational materials and activities. The PE intervention component was developed over a series of pilot studies to maximize student participation and the time (in minutes) spent in moderate-to-vigorous physical activity (MVPA), while meeting state-mandated PE guidelines. The goal of the PE intervention component was to achieve ≥150 min of MVPA in PE classes every 10 school days with the expectation that it would provide a direct effect on adiposity and insulin resistance, subsequently reducing the risk of type 2 diabetes in youth. The PE intervention component curriculum used standard lesson plans to provide a comprehensive approach to middle school PE. Equipment and PE teacher assistants were provided for each school. An expert in PE at each center trained the PE teachers and assistants, monitored delivery of the intervention and provided ongoing feedback and guidance

Rationale, design and methods of the HEALTHY study physical education intervention component

The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention integrated nutrition, physical education (PE) and behavior changes with a communications strategy of promotional and educational materials and activities. The PE intervention component was developed over a series of pilot studies to maximize student participation and the time (in minutes) spent in moderate-to-vigorous physical activity (MVPA), while meeting state-mandated PE guidelines. The goal of the PE intervention component was to achieve ≥150 min of MVPA in PE classes every 10 school days with the expectation that it would provide a direct effect on adiposity and insulin resistance, subsequently reducing the risk of type 2 diabetes in youth. The PE intervention component curriculum used standard lesson plans to provide a comprehensive approach to middle school PE. Equipment and PE teacher assistants were provided for each school. An expert in PE at each center trained the PE teachers and assistants, monitored delivery of the intervention and provided ongoing feedback and guidance