Clinical examination of the breast

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Management of primary breast cancer

The current management of primary breast cancer is based on a selective combination approach using surgery of lesser extent, radiotherapy and systemic therapy. It aims at achieving excellent locoregional control and improved survival with minimal morbidity. This article describes a rational approach to the management of primary operable breast cancer < 5 cm in size. Its success is measured by the rates of locoregional recurrence and long-term survival, which would be separately addressed. A brief discussion would also be made on the management of ductal carcinoma in situ and the follow-up policy for women after treatment of the primary cancer.published_or_final_versio

Common breast conditions: when to refer and what will the specialist do?

When a woman presents with a breast symptom, the family physician has to decide whether there is a risk of cancer or whether the symptoms can be managed without referral to the breast surgeon. This article describes common breast conditions encountered in family medicine, with emphasis on guidelines for referral and principles of management.published_or_final_versio

Performance of turbo codes with fading compensation in multipath channels

This paper studies the performance of turbo-coded system in the frequency non-selective correlated Rayleigh fading channels. The turbo-coded system employs a pilot-symbol-aided (PSA) technique for fading compensation and interleaving for spreading the error bursts to reduce the error rate. The PSA technique is also used to provide the decoder with channel side information (CSI) for better performance in fading channel. Two PSA techniques, three normalized Doppler spreads and different interleaving sizes have been investigated. Results of computer simulations have shown that, an improved first-order fading prediction technique can improve the BER performance by a factor of about 62, relative to those obtained using the pilot symbols only. Results have also shown that an interleaving depth equal to one-quarter the reciprocal of normalized Doppler spread can achieve a good BER performance.published_or_final_versionThe IEEE 49th Vehicular Technology Conference (IEEE-VTS 1999), Houston, TX., 16-20 May 1999. In IEEE-VTS Vehicular Technology Conference Proceedings, 1999, v. 3, p. 2413-241

Utilization of glucose, blood pressure, and lipid lowering medications among people with type II diabetes in the United States, 1999-2010

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Review of trigeminal neuralgia in a regional neurology clinic

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Urotensin II: Its function in health and its role in disease

Urotensin II (U-II) is the most potent vasoconstrictor known, even more potent than endothelin-1. It was first isolated from the fish spinal cord and has been recognized as a hormone in the neurosecretory system of teleost fish for over 30 years. After the identification of U-II in humans and the orphan human G-protein-coupled receptor 14 as the urotensin II receptor, UT, many studies have shown that U-II may play an important role in cardiovascular regulation. Human urotensin II (hU-II) is an 11 amino acid cyclic peptide, generated by proteolytic cleavage from a precursor prohormone. It is expressed in the central nervous system as well as other tissues, such as kidney, spleen, small intestine, thymus, prostate, pituitary, and adrenal gland and circulates in human plasma. The plasma U-II level is elevated in renal failure, congestive heart failure, diabetes mellitus, systemic hypertension and portal hypertension caused by liver cirrhosis. The effect of U-II on the vascular system is variable, depending on species, vascular bed and calibre of the vessel. The net effect on vascular tone is a balance between endothelium-independent vasoconstriction and endothelium-dependent vasodilatation. U-II is also a neuropeptide and may play a role in tumour development. The development of UT receptor antagonists may provide a useful research tool as well as a novel treatment for cardiorenal diseases. © 2005 Springer Science + Business Media, Inc.postprin

Group versus individual professional antenatal breastfeeding education for extending breastfeeding duration and exclusivity

Although breastfeeding initiation rates have increased substantially in many developed countries over the past several decades, breastfeeding duration and exclusivity remain suboptimal. In the antenatal period, both group and individual education interventions have been implemented to improve breastfeeding. The purpose of this review was to compare the effectiveness of group and individual antenatal professional education on breastfeeding exclusivity and duration. A systematic search of the literature was conducted using Medline (1946-June 2014), PubMed (1883-June 2014), the Cumulative Index to Nursing and Allied Health Literature (1947-June 2014), EMBASE (1947-June 2014), British Nursing Index (1994-June 2014), Google Scholar, and the Cochrane Library. Included studies were limited to health care professional-conducted education delivered to pregnant women only. Only studies reporting breastfeeding duration or exclusivity were included. Nineteen studies were included, of which 13 evaluated antenatal group education, 5 evaluated individual antenatal education, and 1 evaluated both a group and an individual antenatal education. When compared with standard care, 4 out of 12 studies supported the effectiveness of antenatal group education on breastfeeding duration or exclusivity, whereas 4 out of 6 studies supported the effectiveness of antenatal individual education. Two studies compared antenatal group education with peer-led education and neither study showed a significant difference in breastfeeding outcomes. The methodological heterogeneity and the small number of high quality studies limited our ability to draw firm conclusions about the effectiveness of either mode of antenatal education.postprin

The association between glycated haemoglobin and waist circumference in the US population

INTRODUCTION: Glycated haemoglobin (A1C) is now used for the diagnosis of diabetes and pre-diabetes. As these are related to obesity, we studied their relationship with waist circumference. METHODS: We analysed data on 960 men and 1001 women who participated in the United States National Health and Nutrition Examination Survey 2007-08. Participants who were older than 20 years, had …published_or_final_versionThe 17th Medical Research Conference, The University of Hong Kong, Hong Kong, 14 January 2012. In Hong Kong Medical Journal, 2012, v. 18 suppl. 1, p. 43, abstract no. 6