RESUMEN
Breast cancer remains a leading cause of morbidity and mortality worldwide yet methods for early detection remain elusive. We describe the discovery and validation of biochemical signatures measured by mass spectrometry, performed upon blood samples from patients and controls that accurately identify (>95%) the presence of clinical breast cancer. Targeted quantitative MS/MS conducted upon 1225 individuals, including patients with breast and other cancers, normal controls as well as individuals with a variety of metabolic disorders provide a biochemical phenotype that accurately identifies the presence of breast cancer and predicts response and survival following the administration of neoadjuvant chemotherapy. The metabolic changes identified are consistent with inborn-like errors of metabolism and define a continuum from normal controls to elevated risk to invasive breast cancer. Similar results were observed in other adenocarcinomas but were not found in squamous cell cancers or hematologic neoplasms. The findings describe a new early detection platform for breast cancer and support a role for pre-existing, inborn-like errors of metabolism in the process of breast carcinogenesis that may also extend to other glandular malignancies. Statement of Significance: Findings provide a powerful tool for early detection and the assessment of prognosis in breast cancer and define a novel concept of breast carcinogenesis that characterizes malignant transformation as the clinical manifestation of underlying metabolic insufficiencies.
RESUMEN
Objetivo: Investigar a associação entre o desenvolvimento de linguagem, a qualidade do ambiente escolar, escolaridade parental, sexo e idade de crianças na faixa etária de quatro a seis anos, matriculadas em Unidades Municipais de Educação Infantil de Belo Horizonte. Métodos: Trata-se de estudo observacional analítico transversal com amostra probabilística. Estudou-se 169 crianças de quatro a seis anos, matriculadas em cinco Unidades Municipais de Educação Infantil. Os instrumentos utilizados foram: questionário estruturado, protocolo de Avaliação do Desenvolvimento da Linguagem e Early Childhood Environment Rating Scale-Revised. Realizou-se análise descritiva dos dados e associação entre as variáveis de exposição e os eventos. Foram consideradas associações estatisticamente significativas aquelas que apresentaram valor p≤0,05%. Resultados: 47,9% e 52,1% das crianças pertenciam ao sexo masculino e feminino, respectivamente, com predomínio da faixa etária de cinco anos (62,7%). 22,5% das crianças apresentaram algum distúrbio no desenvolvimento da linguagem. Predominaram responsáveis com ensino médio completo e superior incompleto (42,6%). A pontuação da média global da ECERS-R indicou qualidade de nível entre mínimo e bom; a maior média quanto à qualidade do ambiente escolar refere-se à sub escala Interação, que corresponde ao nível entre bom e excelente. Houve associação com significância estatística somente entre o desenvolvimento da linguagem e a sub escala interação e idade. Conclusão: O desenvolvimento da linguagem apresentou associação com significância estatística com a idade e o domínio interação da escala ECERS-R. Não houve associação com significância estatística entre o resultado da linguagem e as variáveis: ambiente escolar, domínio linguagem e raciocínio da escala ECERS-R, sexo e escolaridade parental.
Objective: To investigate the association between language development, quality of school environment, parental education, gender and age of children aged four to six years, enrolled in Municipal Units of Early Childhood Education in Belo Horizonte. Methods: Observational analytic cross-sectional study with probabilistic sample. One hundred and sixty nine children aged four to six years enrolled in five Municipal Units of Early Childhood Education were studied. The instruments used were: structured questionnaire, Language Development Assessment protocol and Early Childhood Environment Rating Scale-Revised. A descriptive analysis of the data and association between the exposure variables and the events was performed. As statistically significant associations were considered those with p value ≤0.05%. Results: 47.9% of the children were male and 52.1% were female, with the predominant age of five years (62.7%). 22.5% of the children had some language development disorder. Guardians with complete secondary education and incomplete high education (42.6%) predominated. The overall average ECERS-R score indicated a quality level between minimum and good; the highest average regarding quality of the school environment was referred to the interaction subscale, which corresponds to a level between good and excellent. There was statistically significant association only between language development and the interaction subscale and age. Conclusion: The language development was significantly associated with age and the interaction domain of the ECERS-R scale. There was no statistical association between language outcome and the variables: school environment, language and reasoning domain of the ECERS-R scale, gender and parental education.
Objetivo: Investigar la asociación entre el desarrollo del lenguaje, la calidad del entorno escolar, la educación de padres, el sexo y la edad de niños de cuatro a seis años, matriculados en Unidades Municipales de Educación Infantil de Belo Horizonte. Métodos: Estudio observacional analítico transversal con una muestra probabilística. Se estudió 169 niños de cuatro a seis años, inscritos en cinco Unidades Municipales de Educación Infantil. Los instrumentos utilizados fueron: cuestionario estructurado, protocolo de Evaluación del Desarrollo del Lenguaje y Early Childhooh Environment Rating Scale-Revised. Se realizo análisis descriptivo de los datos y asociación entre las variables de exposición y eventos. Se consideró asociación estadísticamente significativa aquella con valor p ≤ 0,05%. Resultados: 47,9% y 52,1% de los niños pertenecían al sexo masculino y femenino, respectivamente, con edad predominante de cinco años (62,7%). 22,5% de los niños tenía alguna alteración en el desarrollo del lenguaje. Fue predominante la educación secundaria completa y superior incompleta (42,6%). La puntuación media global de la ECERS-R indico calidad de nivel entre mínimo y bueno, el promedio más alto en la calidad del entorno escolar se refiere a la sub escala Interacción, que corresponde al nivel entre bueno y excelente. Hubo asociación estadísticamente significativa solamente entre el desarrollo del lenguaje y la sub escala de la interacción y edad. Conclusión: El desarrollo del lenguaje presentó asociación con significación estadística para la edad y el dominio interacción de la escala ECERS-R. No hubo asociación con significación estadística entre el resultado del lenguaje y las variables: entorno escolar, dominio lenguaje y razonamiento de la escala ECERS-R, género y educación de los padres.