INTRODUCTION: Pregnancy-associated breast cancer (PABC) is described as breast cancer diagnosed within pregnancy or within 1 year postpartum. PABC is becoming more common due to delayed childbearing, with older maternal age increasing the likelihood of tumorigenesis coinciding with pregnancy. Our review aims to outline the important principles of managing PABC, and discusses future fertility implications, genetic testing and postnatal considera-tions that are not often considered in other existing reviews. METHOD: A literature search was conducted using PubMed, Cochrane and Google Scholar databases. RESULTS: A persistent breast mass in pregnant women should be evaluated with a breast ultrasound. Total mastectomy is the standard treatment in the first trimester. Chemotherapy is contraindicated in the first trimesters, but can be given in the second and third trimester, and stopped before 35 weeks. Radiotherapy should be delayed until delivery, and hormone receptor therapy is contraindicated in pregnancy. A multidisciplinary team involving an obstetrician, medical oncologist and other allied health professionals is crucial. Delivery should be planned as close to 37 weeks as possible, and at least 3 weeks after the last chemotherapy cycle. Vaginal delivery is preferred, and breastfeeding can resume 14 days after the last chemotherapy regime. CONCLUSION A breast mass in a pregnant woman should not be dismissed. PABC must be managed by multidisciplinary teams at tertiary medical centres with access to surgery and chemoradiation therapies. Management strategies must include safe manage-ment and delivery of the fetus, contraception and future fertility planning.
Humans ; Female ; Pregnancy ; Breast Neoplasms/diagnosis* ; Pregnancy Complications, Neoplastic/diagnosis* ; Mastectomy ; Delivery, Obstetric

Cancer cells reprogram their gene expression to promote growth, survival, proliferation, and invasiveness. The unique expression of certain uptake transporters in cancers and their innate function to concentrate small molecular substrates in cells make them ideal targets for selective delivering imaging and therapeutic agents into cancer cells. In this review, we focus on several solute carrier (SLC) transporters known to be involved in transporting clinically used radiopharmaceutical agents into cancer cells, including the sodium/iodine symporter (NIS), norepinephrine transporter (NET), glucose transporter 1 (GLUT1), and monocarboxylate transporters (MCTs). The molecular and functional characteristics of these transporters are reviewed with special emphasis on their specific expressions in cancers and interaction with imaging or theranostic agents [., I-123, I-131, I-iobenguane (mIBG), F-fluorodeoxyglucose (F-FDG) and C pyruvate]. Current clinical applications and research areas of these transporters in cancer diagnosis and treatment are discussed. Finally, we offer our views on emerging opportunities and challenges in targeting transporters for cancer imaging and treatment. By analyzing the few clinically successful examples, we hope much interest can be garnered in cancer research towards uptake transporters and their potential applications in cancer diagnosis and treatment.

The kidney is a vital organ for the elimination of therapeutic drugs and their metabolites. Renal drug transporters, which are primarily located in the renal proximal tubules, play an important role in tubular secretion and reabsorption of drug molecules in the kidney. Tubular secretion is characterized by high clearance capacities, broad substrate specificities, and distinct charge selectivity for organic cations and anions. In the past two decades, substantial progress has been made in understanding the roles of transporters in drug disposition, efficacy, toxicity and drug-drug interactions (DDIs). In the kidney, several transporters are involved in renal handling of organic cation (OC) and organic anion (OA) drugs. These transporters are increasingly recognized as the target for clinically significant DDIs. This review focuses on the functional characteristics of major human renal drug transporters and their involvement in clinically significant DDIs.

With the significant reformation of the health care system in China, medical edu-cation has also been adjusted rapidly in order to meet the needs of health services and development of medical and health undertakings. However, as a result of the adjustment of medical education system and the different schooling system in different regions around the country, medical education system and academic degree in China can hardly be comparedaround the world, and the education institutions such as universities in foreign countries can't understand clearly our country's medical education system and degree very well. Based on the medical education theory and practice of Australia, this paper de-scribes and analyses the difference of medical education system between the two countries, so as to provide some idea on perfecting the medical educationtralning model in China as well as lay a founda-tion for the comparison between Chinese medical education system and mature systems of foreign countriessuch as Australia.

Introduction: Poor adherence to anti-hypertensive agents may be a major contributor for suboptimal blood pressure control among patients with hypertension. This study was conducted to assess the adherence to antihypertensive agents using Morisky Medication Adherence Scale (MMAS-8) among primary care patients, and to determine whether the blood pressure control is associated with the level of adherence. Methodolgy: This cross-sectional study was conducted between June 2011 and August 2011. Adults with hypertension older or equal to aged 30 with or without diabetes were recruited from two public primary care clinics in Negeri Sembilan, Malaysia. Medication adherence was assessed using MMAS-8. Results: Data from 231 patients were analysed, whereby 68% of them had good medication adherence but only 38.1% of the patients had their blood pressure under control. Statistical analysis failed to find correlation between adherence and blood pressure control. Twenty per cent of hypertensive subjects were on beta-blocker alone, and 37.1% of patients with either diabetes or proteinuria were not prescribed either angiotensinconverting enzyme inhibitors (ACEI) or angiotensin receptor blocker (ARB). Above half the patients (51.5%) were on monotherapy. Conclusion: Discordance between adherence to antihypertensive agents and hypertension control is clearly shown in this study, and the likely explanation for the discordance is therapeutic inertia. Keywords: primary care; hypertension; therapeutic inertia; medication adherence
Hypertension ; Blood Pressure