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Background: Doxorubicin induces acute and chronic cardiotoxicity. This study is aimed to evaluate the efficacy and safety of vitamin E and levocarnitine (EL) as cardioprotective agents against acute doxorubicin cardiotoxicity in female adult breast cancer patients. Methods: A prospective, randomized controlled study was conducted in patients treated with doxorubicin and cyclophosphamide (AC). Patients were randomly assigned to EL plus AC or AC alone for the duration of 4 cycles. Cardiac enzymes (B-type natriuretic peptide, creatine kinase, troponin I (Trop)) and cardiac events were monitored during treatment to evaluate the cardioprotective efficacy of EL. Results: Seventy-four patients were recruited and received four cycles of chemotherapy. The intervention group (n = 35) showed a significant reduction in both the B-type natriuretic peptide and creatine kinase cardiac enzymes compared to the control group (n = 39). The median (IQR) change for BNP was 0.80 (0.00–4.00) for IG versus 1.80 (0.40–3.60) for CG groups (p < 0.001); creatine kinase was −0.08 (−0.25–0.05) for IG versus 0.20 (0.05–0.50) for CG (p < 0.001). The addition of EL decreased the cardiac events by 24.2% (p = 0.02). All adverse events were tolerable and manageable. Conclusion: This study supports the addition of EL as prophylaxis against acute doxorubicin cardiotoxicity and it was also very well tolerated by a majority of the patients. The co-administration of EL at higher doxorubicin (240 mg/m2) dose should be further investigated. [ABSTRACT FROM AUTHOR]

Uniting the perspective of narrative psychology with feminist and narrative criminology, we analyzed interviews with 58 formerly incarcerated women. We identified four distinct ontologies of blame that the women used to characterize the events, actors, and circumstances that resulted in their incarceration. We argue that these four ontologies of blame—personal responsibility, socioeconomic exclusion, relational caregiving associations, and compromised decision-making—each derive from the dominant U.S. cultural value of accountability that accords great social, moral, and personal weight to accepting responsibility for, and expressing willingness to endure the consequences of, wrongdoing. Our findings suggest that academics and therapeutic practitioners could assist the formerly incarcerated women with whom they work by encouraging a critique of dominant cultural values; by expanding accountability from the individual to the community; by situating accountability in past, present, and future contexts; and by facilitating ontologies of security. Online slides for instructors who want to use this article for teaching are available on PWQ’s website athttp://journals.sagepub.com/page/pwq/suppl/index [ABSTRACT FROM AUTHOR]

Globally, the participation of women and girls in sport has increased tremendously. Much of this growth has been attributed to relatively recent changes in national and international law, yet few empirical studies exist that test this assertion. In this study, the role of law, specifically gender-based sports doctrine, is examined across four nations: the USA, Australia, Canada, and Iran. Results are mixed, suggesting women have increased their participation in elite sporting events despite national legal and bureaucratic variations regarding women in sport. On this basis, liberal feminist reliance on law as the primary determining factor for promotion of increased international opportunities for women is questioned. [ABSTRACT FROM AUTHOR]

Infective endocarditis in pregnancy is associated with high maternal and fetal morbidity and mortality and is estimated to complicate approximately 1 in 100,000 pregnancies. We report the case of a 33-year-old patient who presented at 30 weeks and 3 days gestation in her third pregnancy. The patient described a 3 week history of feeling generally unwell, an episode of temporary speech disturbance, right shoulder tip pain, left subscapular pain on inspiration and chest discomfort. Investigations included an echocardiogram, which revealed a large mobile mass on the aortic coronary cusp and a small mass on the non-coronary cusp. There was significant aortic regurgitation. Blood cultures were positive for staphylococcus lugdunensis. A diagnosis of infective endocarditis was made. The patient deteriorated, with worsening cardiac function, and proceeded to have a caesarean section on day 7 of admission. Her baby had multiple limb abnormalities, subsequently diagnosed as arthrogryposis multiplex congenita. Aortic valve replacement with a mechanical valve was then performed on day 3 post partum. The patient recovered well post operatively and was discharged home with her baby on day 45 post partum. The commonest complications of IE are congestive cardiac failure, perivalvular extension and systemic embolization. The management of infective endocarditis in pregnancy is similar to that of the non-pregnant however there is high foetal mortality associated with cardiopulmonary by-pass for cardiac surgery. The patient described here developed staphylococcus lugdunensis infective endocarditis, which is a rare but aggressive causative organism in infective endocarditis. Infective endocarditis in pregnancy is a rare but serious condition with significant fetal and maternal morbidity and mortality. Early diagnosis with a multidisciplinary team approach is essential to improve outcomes. [ABSTRACT FROM AUTHOR]