It has potential use as a new fast-acting analog of insulin We c

It has potential use as a new fast-acting analog of insulin. We cloned the monomeric insulin B27 DTrI precursor (MIP) into the pTWIN1 vector, and prepared by intein mediated

expression in E. coli. After tryptic digestion, the MIP was converted to B27K-DTrI insulin. The product was purified by HPLC. The mass spectrometry showed that the molecular mass of purified B27K-DTrI was consistent with the theoretical value. (C) 2011 Elsevier Inc. All rights reserved.”
“Background Rituximab plus chemotherapy, most often CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone), is the first-line standard of care for patients with advanced indolent lymphoma, and for elderly patients with mantle-cell lymphoma. Bendamustine

plus rituximab is effective for relapsed or refractory disease. We compared bendamustine plus rituximab ARN-509 nmr with CHOP plus rituximab (R-CHOP) as first-line treatment for patients with indolent and mantle-cell lymphomas.

Methods We did a prospective, multicentre, randomised, open-label, non-inferiority trial at 81 centres in Germany between Sept Cell Cycle inhibitor 1, 2003, and Aug 31, 2008. Patients aged 18 years or older with a WHO performance status of 2 or less were eligible if they had newly diagnosed stage III or IV indolent or mantle-cell lymphoma. Patients were stratified by histological lymphoma subtype, then randomly assigned according to a prespecified randomisation list to receive either intravenous bendamustine (90 mg/m(2)

on days 1 and 2 of however a 4-week cycle) or CHOP (cycles every 3 weeks of cyclophosphamide 750 mg/m(2), doxorubicin 50 mg/m(2), and vincristine 1.4 mg/m(2) on day 1, and prednisone 100 mg/day for 5 days) for a maximum of six cycles. Patients in both groups received rituximab 375 mg/m(2) on day 1 of each cycle. Patients and treating physicians were not masked to treatment allocation. The primary endpoint was progression-free survival, with a non-inferiority margin of 10%. Analysis was per protocol. This study is registered with, number NCT00991211, and the Federal Institute for Drugs and Medical Devices of Germany, BfArM 4021335.

Findings 274 patients were assigned to bendamustine plus rituximab (261 assessed) and 275 to R-CHOP (253 assessed). At median follow-up of 45 months (IQR 25-57), median progression-free survival was significantly longer in the bendamustine plus rituximab group than in the R-CHOP group (69.5 months [26.1 to not yet reached] vs 31.2 months [15.2-65.7]; hazard ratio 0.58, 95% CI 0.44-0.74; p<0.0001). Bendamustine plus rituximab was better tolerated than R-CHOP, with lower rates of alopecia (0 patients vs 245 (100%) of 245 patients who recieved >= 3 cycles; p<0.0001), haematological toxicity (77 [30%] vs 173 [68%]; p<0.0001), infections (96 [37%] vs 127 [50%]); p=0.0025), peripheral neuropathy (18 [7%] vs 73 [29%]; p<0.0001), and stomatitis (16 [6%] vs 47 [19%]; p<0.0001).

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As adults, rats were tested in paradigms known to elicit ADHD-lik

As adults, rats were tested in paradigms known to elicit ADHD-like behaviors from Fast rats and then kindled from the amygdala to assess relative seizure disposition. While omega-3 supplementation did not significantly alter the relative hyperactivity, learning deficits or heightened seizure sensitivity naturally exhibited by Fast rats, it dramatically reduced their impulsivity to Slow-like levels. In contrast, typical behavioral patterns in Slow rats were largely unaffected by omega-3 supplementation yet their proclivity for seizure was greatly increased. This

heightened vulnerability to seizure in Slow rats was paralleled by VS-4718 clinical trial a drop in circulating plasma non-esterified fatty acids (NEFA) to match levels normally observed in Fast rats. These findings suggest a delicate balance between seizure predisposition and ADHD-like behaviors that can be influenced by omega-3 treatment. Further, a relationship between circulating NEFA levels and seizure susceptibility has surfaced that advocates caution when treating different genetic backgrounds with omega-3 fatty acids. (c) 2009 IBRO. Published by Elsevier Ltd. All

rights reserved.”
“After penetrating the host cell, the herpesvirus capsid is transported to the nucleus along the microtubule network and docks to the nuclear pore complex before releasing the viral DNA into the nucleus. The viral and cellular interactions involved in the docking

process are CP673451 datasheet poorly characterized. However, the minor capsid protein pUL25 has recently been reported Loperamide to be involved in viral DNA uncoating. Here we show that herpes simplex virus type 1 (HSV-1) capsids interact with the nucleoporin CAN/Nup214 in infected cells and that RNA silencing of CAN/Nup214 delays the onset of viral DNA replication in the nucleus. We also show that pUL25 interacts with CAN/Nup214 and another nucleoporin, hCG1, and binds to the pUL36 and p0UL6 proteins, two other components of the herpesvirus particle that are known to be important for the initiation of infection and viral DNA release. These results identify CAN/Nup214 as being a nuclear receptor for the herpesvirus capsid and pUL25 as being an interface between incoming capsids and the nuclear pore complex and as being a triggering element for viral DNA release into the nucleus.”
“Rehabilitation therapy is known to drive motor improvement in stroke patients. However, the interplay of functional recovery and compensation in postischemic motor behavior is poorly understood. This study focused on the time course of functional recovery versus motor compensation in skilled forelimb movements after cerebral ischemia in rats.

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Neglect is at least as damaging as physical or sexual abuse in th

Neglect is at least as damaging as physical or sexual abuse in the long term but has received the least scientific and public attention. The high burden and serious and long-term consequences of child maltreatment warrant increased investment in preventive and therapeutic strategies from early childhood.”
“Spontaneous neural hyperactivity

in the central auditory pathway is Selleck Gemcitabine often associated with deafness, the most common form of which is partial hearing loss. We quantified both peripheral hearing loss and spontaneous activity in single neurons of the contralateral inferior colliculus in a guinea-pig model 1 week after a unilateral partial deafness induced by cochlear mechanical lesion. We also measured mRNA levels of candidate genes in the same animals using quantitative real-time PCR. Spontaneous hyperactivity was most marked in the frequency region of the peripheral hearing loss. Expression of glutamate decarboxylase 1 (GAD1), GABA-A receptor subunit alpha-1 (GABRA1), and potassium channel subfamily K member 15 (KCNK15) was decreased ipsilaterally in the cochlear nucleus and bilaterally in the inferior colliculus. A member

of RAB family of small GTPase (RAB3A) was decreased in both ipsilateral cochlear nucleus and contralateral inferior colliculus. RAB3 GTPase activating protein subunit 1 (RAB3GAP1) and glycine receptor subunit alpha-1 (GLRA1) were reduced ipsilaterally in the cochlear Methisazone nucleus only. These results suggest that a decrease Gefitinib price in inhibitory neurotransmission and an increase in membrane excitability may contribute to elevated neuronal spontaneous activity in the auditory brainstem following unilateral partial hearing loss. (C) 2009 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Obstructive sleep apnoea (OSA) is a common disorder in which repetitive apnoeas expose the cardiovascular system to cycles of hypoxia, exaggerated negative intrathoracic pressure, and arousals.

These noxious stimuli can, in turn, depress myocardial contractility activate the sympathetic nervous system, raise blood pressure, heart rate, and myocardial wall stress, depress parasympathetic activity, provoke oxidative stress and systemic inflammation, activate platelets, and impair vascular endothelial function. Epidemiological studies have shown significant independent associations between OSA and hypertension, coronary artery disease, arrhythmias, heart failure, and stroke. In randomised trials, treating OSA with continuous positive airway pressure lowered blood pressure, attenuated signs of early atherosclerosis, and, in patients with heart failure, improved cardiac function. Current data therefore suggest that OSA increases the risk of developing cardiovascular diseases, and that its treatment has the potential to diminish such risk.

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Methods We undertook a cluster randomised trial between February,

Methods We undertook a cluster randomised trial between February, 2006, and March, 2008, in Hala and Matiari subdistricts, Pakistan. click here Catchment areas of primary care facilities and all affiliated LHWs were used to define clusters, which were allocated to intervention and control groups by restricted, stratified randomisation. The intervention package delivered by LHWs through group sessions consisted of promotion of antenatal care and maternal health education, use of clean delivery kits, facility births, immediate newborn care, identification of danger signs, and promotion of careseeking; control clusters received routine care. Independent

data collectors undertook quarterly household surveillance to capture data for births, deaths, and household practices related to maternal and newborn care. Data collectors were masked to cluster allocation; those analysing

data were not. The primary outcome was perinatal and all-cause neonatal mortality. Analysis was by intention to treat. This trial is registered, ISRCTN16247511.

Findings 16 clusters were assigned to intervention (23 353 households, 12 391 total births) and control groups (23 768 households, 11 443 total births). LHWs in the intervention clusters were able to undertake 4428 (63%) of 7084 planned group sessions, but were only able to visit 2943 neonates (24%) of a total 12 028 livebirths in their catchment villages. Stillbirths were reduced in intervention clusters (39.1 stillbirths per 1000 total births)

compared with control (48.7 per 1000; risk ratio [RR] 0.79, 95% CI 0.68-0.92; p=0.006). The neonatal mortality rate was 43.0 deaths per 1000 livebirths Vildagliptin in intervention clusters compared with 49.1 per 1000 in control groups (RR 0.85, 0.76-0.96; p=0.02).

Interpretation Our results support the scale-up of preventive and promotive maternal and newborn interventions through community health workers and emphasise the need for attention to issues of programme management and coverage for such initiatives to achieve maximum potential.”
“Peroxisome proliferator-activated receptor alpha (PPAR-alpha), which is expressed by neurons of the nigrostriatal circuit, plays a prominent role in oxidative stress and neuroinflammation. The objectives were: (i) to discern if levels of antioxidant molecules and pro-inflammatory cytokines, along with PPAR-gamma expression are modified in the nigrostriatal region of null PPAR-alpha mice, (ii) to discern whether dopaminergic neuronal features of the substantia nigra pars compacta (SNpc) and dorsal striatum are affected in null mice, and (iii) to establish if aging-induced decline of nigral neurons is different in null PPAR-alpha mice relative to wild-type littermates. A substantial decrease in antioxidant molecules was found in SNpc of null mice, by using ELISA.

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Approximately 25-40% of patients with idiopathic PD experience ha

Approximately 25-40% of patients with idiopathic PD experience hallucinations. Genetic variability within

different candidate genes has been implicated in the clinical severity of sporadic PD in many populations. Materials and Methods: We investigated 3 polymorphisms located in the 5′ flanking region of the HOMER1 gene within a sample of 131 sporadic PD patients from southern Italy, using a 3-SNP genotype and haplotype combination (rs4704559, rs10942891, rs4704560). Results: Our study implicates the effects of allele A of the rs4704559 marker in susceptibility to psychotic symptoms in PD (chi(2) = 8.092, 1 d.f., p = 0.004). Conclusion: Even though Go6983 concentration our results are preliminary, this HOMER1 gene variant may represent a biomarker for side effect evaluation in PD patients. Copyright (C) 2009 S. Karger AG, Basel”

areas of current intense interest in the neuroimaging literature are that of the visual word form area (VWFA) and of the fusiform face area (FFA) and their roles in word and face perception, respectively. These two areas are of particular relevance to laterality research because visual word identification and face identification have long been shown to be especially lateralized to the left hemisphere and the right hemisphere, respectively. This review therefore seeks to evaluate their significance for the broader understanding of lateralization Fedratinib of object recognition. A multi-level model of lateralized object recognition is proposed based on a combination of behavioral and neuroimaging findings. Rather than seek to characterize hemispheric asymmetries according to a single

principle (e.g., serial-parallel), it is suggested that current observations can be understood in terms of three asymmetric levels of processing, using the framework of the Janus model of hemispheric function. It is suggested that the left hemisphere represents features using an abstract-category code whereas the RH utilizes a specific-exemplar code. The relationships between these features are also coded asymmetrically, with the LH relying on associative co-occurrence Monoiodotyrosine values and the RH relying on spatial metrics. Finally, the LH controlled selection system focuses on isolating features and the RH focuses on conjoining features. It is suggested that each hemisphere utilizes efficient (apparently parallel) processing when stimuli are congruent with its preferred processing style and inefficient (apparently serial) processing when they are not, resulting in the typical left-lateralization for orthographic analysis and right-lateralization for face analysis. (C) 2008 Elsevier Ltd. All rights reserved.”
“It has been shown that visual stimulation can activate cortical regions normally devoted to auditory processing in deaf individuals.

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To determine if clofibrate affects blood pressure regulation we s

To determine if clofibrate affects blood pressure regulation we studied mice with DOCA-salt induced hypertension in wild-type and PPAR alpha knockout mice. Wild-type

mice treated with DOCA-salt had higher mean arterial pressures and higher cumulative sodium balance, but lower renal 20-HETE production than did vehicle-treated mice. Treating DOCA-salt mice with clofibrate attenuated the increase in mean arterial pressure and cumulative sodium balance while increasing 20-HETE production and renal Cyp4a expression. In contrast the PPAR alpha knockout mice treated with clofibrate and DOCA- salt showed no attenuation in the increase of blood pressure, cumulative selleck chemicals sodium balance, renal 20-HETE production or Cyp4a protein expression. Expression of the PPAR alpha protein was greater in proximal tubules than in renal microvessels. Our results show that PPARa pathway induces renal tubular 20-HETE production which affects sodium retention and blood pressure regulation in DOCA- salt-treated Saracatinib purchase mice.”
“Several studies have demonstrated that cortical inhibition (CI) can be recorded by paired transcranial magnetic stimulation (TMS) of the motor cortex and recorded by surface electromyography (EMG). However, recording CI from other cortical regions that are more closely associated with the pathophysiology of some neurological

and psychiatric disorders (eg, dorsolateral prefrontal cortex (DLPFC) in schizophrenia) was previously unattainable. This study, therefore, was designed to investigate whether CI could be measured Non-specific serine/threonine protein kinase directly from the motor cortex and DLPFC by combining TMS with electroencephalography ( EEG).

Long-interval CI ( LICI) is a TMS paradigm that was used to index CI in the motor cortex and DLPFC in healthy subjects. In the motor cortex, LICI resulted in significant suppression (32.8 +/- 30.5%) of mean cortical evoked activity on EEG, which was strongly correlated with LICI recorded by EMG. In the DLPFC, LICI resulted in significant suppression (30.1 +/- 26.9%) of mean cortical evoked activity and also correlated with LICI in the motor cortex. These data suggest that CI can be recorded by combining TMS with EEG and may facilitate future research attempting to ascertain the role of CI in the pathophysiology of several neurological and psychiatric disorders.”
“Transgenic mouse models of HIV-associated nephropathy (HIVAN) show that expression of HIV-1 genes in kidney cells produces collapsing focal segmental glomerulosclerosis and microcystic tubular disease typical of the human disease. HIV-1 vpr plays an important role in the glomerulosclerosis of HIVAN, especially when it is associated with nef expression in podocytes. Further, Vpr is reported to exacerbate tubular pathology. Here we determined effects of vpr expression on renal tubular epithelial cell function by transducing them with a pseudotyped lentivirus vector carrying HIV-1 vpr and control genes.

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Subintimal BTSA1 angioplasty was first described in 1987 as a method of performing an endovascular

arterial bypass. The subintimal space at the start of the occlusion is entered with a catheter and a wire loop is used to cross the occlusion and reenter the vessel lumen distally. In patients with critical limb ischemia, there is high quality evidence demonstrating that the limb salvage rate and amputation-free survival rates for surgery and endovascular treatment are similar, but surgery is more expensive than angioplasty in the short term. In patients with intermittent claudication, surgical bypass using an autologous saphenous vein graft is currently believed to be the gold standard, but this is increasingly questioned in the light of recent advances in endovascular techniques. Surgical bypass with vein graft offers a 2-year patency of 81%, compared with 67% for a polytetrafluoroethylene (PTFE) graft and at best 67% for subintimal angioplasty. The better patency offered by surgery must be balanced against a higher morbidity and mortality. To conclude, subintimal angioplasty is an extremely valuable technique

in the management of critical limb ischemia. Based on the evidence to date, this technique is likely to have an increasing role in the management of intermittent claudication over the coming years, particularly if the risk of general anaesthesia is high or there is no suitable vein. (J Vase Surg 2010;52:1410-6.)”
“Prion disorders occur when endogenous prion protein Selleckchem Rapamycin (PrP(C)) undergoes a conformational change from a predominantly a-helix-rich structure to an insoluble 3-mercaptopyruvate sulfurtransferase beta-sheet-rich structure (PrP(Sc)). The resulting PrP(Sc) then in some way facilitates the progressive transformation of nearby PrP(C) to PrP(Sc). In time this results in the deposition of insoluble PrP(Sc) aggregates in the brain; aggregate deposition is irreversible and is ultimately fatal. Prion diseases are transmissible orally or through transplantation (including blood transfusion). Current diagnostic methods are limited in that they lack the ability to distinguish qualitatively

between PrP(C) and PrP(Sc). PrP has been shown to bind divalent cations including copper and zinc, these cations are toxic and thus of limited use in the removal of PrP from solutions destined for administration to subjects. We have immobilised Fe(3+) to an inert Sepharose resin; this resin was capable of quantitatively removing endogenous and recombinant PrP(C) and recombinant beta PrP from complex solutions. The low toxicity of Fe(3+) suggests that the resin described in this report may be of practical use in the depletion of PrP from blood products destined for human use. (C) 2010 Elsevier B.V. All rights reserved.”
“Rift Valley fever virus (RVFV) is an arthropod-borne pathogen that often results in severe morbidity and mortality in both humans and livestock.

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Seasonal TIV was also effective in protecting against the lung in

Seasonal TIV was also effective in protecting against the lung infection and severe lung pathology associated with 1918 virus infection. Our data demonstrate that prior immunization

with contemporary TIV provides cross-protection against the 1918 virus in ferrets. These findings suggest that exposure to A(H1N1)pdm09 through immunization may provide protection against the reconstructed SB431542 supplier 1918 virus which, as a select agent, is considered to pose both biosafety and biosecurity threats.”
“The study of the total serum N-glycome during liver cirrhosis has demonstrated numerous alterations. The identification of the glycoproteins carrying these modifications and their relative contribution to the modification of the total serum N-glycome has shown the important role of IgA and IgG. The possible mechanisms of glycosylation alteration of the Igs and of liver secreted glycoproteins, the consequences LY3023414 in the pathophysiology of cirrhosis and their relation to the biomarkers of liver diseases are also discussed in the present review.”
“The cholinergic system plays important roles in neurotransmission in both the peripheral and central nervous systems. The cholinergic neurotransmitter acetylcholine is synthesized by choline acetyltransferase (ChAT) and its action terminated by acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). The predominance of AChE has focused much attention on understanding

the relationship of this enzyme to ChAT-positive cholinergic neurons. However, there is ample evidence that BuChE also plays an important role in cholinergic regulation. To elucidate the relationship of BuChE to neural elements that are producing acetylcholine, the distribution of this enzyme was compared to that of ChAT in the mouse CNS. Brain tissues from 129S1/SvImJ mice were stained for BuChE and ChAT using histochemical, immunohistochemical and immunofluorescent techniques. Both BuChE and ChAT were found in neural elements throughout the CNS. BuChE staining with histochemistry and immunohistochemistry produced the same distribution of labeling throughout the brain and spinal cord. Immunofluorescent

Edoxaban double labeling demonstrated that many nuclei in the medulla oblongata, as well as regions of the spinal cord, had neurons that contained both BuChE and ChAT. BuChE-positive neurons without ChAT were found in close proximity with ChAT-positive neuropil in areas such as the thalamus and amygdala. BuChE-positive neuropil was also found closely associated with ChAT-positive neurons, particularly in tegmental nuclei of the pons. These observations provide further neuroanatomical evidence of a role for BuChE in the regulation of acetylcholine levels in the CNS. (C) 2013 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Human immunodeficiency virus type 1 (HIV-1) Nef downregulates major histocompatibility complex class I (MHC-I), impairing the clearance of infected cells by CD8(+) cytotoxic T lymphocytes (CTLs).

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This resulted in a number of recommendations that should improve

This resulted in a number of recommendations that should improve the recognition and management of inflammation-associated symptoms in medically ill patients. (C) 2007 Elsevier Ltd. All rights reserved.”
“Purpose: Nocturnal enuresis is a common, Buparlisib molecular weight genetically heterogeneous disorder. Family, twin and segregation analyses have demonstrated a high heritability. Molecular genetic linkage studies have identified several loci on different chromosomes. Much less is known about the genetics of daytime urinary

incontinence. In this study we identify familial patterns in a large, representative sample of children with nocturnal enuresis and daytime urinary incontinence.

Materials and Methods: Participants were a cohort of more than 8,000 children enrolled in the population based Avon Longitudinal Study of Parents and Children, a prospective longitudinal study of an original birth cohort of nearly 14,000 children. Parents completed postal questionnaires asking about their own nocturnal enuresis and urinary incontinence.

At the age of 7 1/2 years extensive data on nocturnal enuresis and urinary incontinence of their children were obtained.

Results: At the age of 7 1/2 years the prevalence of nocturnal enuresis was 15.5%. Infrequent nocturnal enuresis affected 12.8% of children and severe nocturnal enuresis (2 or more episodes weekly) affected 2.6%. The prevalence of urinary incontinence was 7.8%, and 6.8% had infrequent and 1.0% had severe

daytime urinary KU55933 cell line incontinence. Of the 11,650 mothers who provided data on their own nocturnal enuresis and urinary incontinence 8.8% had nocturnal enuresis and 0.7% had daytime urinary incontinence. Of the 7,897 fathers 9.6% had nocturnal enuresis and 0.3% had Tenofovir manufacturer daytime urinary incontinence. There were significant associations between parental and child nocturnal enuresis, and parental and child urinary incontinence. Specifically the odds ratios for severe child nocturnal enuresis were 3.63 times higher in maternal and 1.85 times higher in paternal nocturnal enuresis. The odds ratios for severe child urinary incontinence were 3.28 times higher in maternal and 10.1 times higher in paternal urinary incontinence. The associations were less pronounced between parental nocturnal enuresis and child urinary incontinence, as well as between parental urinary incontinence and child nocturnal enuresis.

Conclusions: Formal genetic risks exist for nocturnal enuresis and urinary incontinence, especially in severe incontinence. The magnitude of effects for child nocturnal enuresis and urinary incontinence is comparable. While the heritability of nocturnal enuresis is well-known, the familiarity of urinary incontinence has been underestimated.

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This network involves a set of regulated transcription factors th

This network involves a set of regulated transcription factors that crosstalk with physiological signaling. The knowledge thus acquired paves the way for the genetic engineering of oilseed crops dedicated to food applications or green chemistry. (C) 2010 Elsevier Ltd. All rights reserved.”
“Objectives: learn more Thoracic endovascular aortic repair (TEVAR) has been gaining popularity for the treatment of thoracoabdominal aortic aneurysm (TAAA). We used a nonvoluntary database to examine national trends and regional/hospital variations in the use of TEVAR and open thoracic aortic repair (OTAR) for TAAA.

Methods: From the 2005-2008 Nationwide

Inpatient Sample database, we identified all patients with the diagnosis of TAAA who were treated with TEVAR or OTAR. Rates of these procedures were compared between years, across geographic regions, and between hospitals of various bed sizes.

Results: Over the study period, the rate of OTAR remained relatively stable TPX-0005 manufacturer (range, 7.5/100 patients in 2005 to 10.1/100 patients in 2008; P = .26), whereas the rate of TEVAR increased dramatically (range, 1.4/100 patients in 2005 to 6.3/100 patients in 2008; P<.0001). In 2008, 29%(211) of all TEVAR procedures and 11%(130) of all OTAR

procedures were performed in western regions of the United States (P = .03). Additionally, 13%(95) of all TEVAR procedures and 3%(35) of all OTAR procedures were performed in smaller hospitals (P<.0001).

Conclusions: The use of TEVAR for TAAA repair increased significantly over the study period, whereas OTAR rates remained relatively stable. Our findings suggest that more patients who were otherwise not surgical candidates or did not have traditional

surgical indications for OTAR were treated with TEVAR, most commonly in regions or hospitals where OTAR is less often performed. Given the complexity of TAAA cases, these results may have significant Lumacaftor price implications for patient safety in the current era of heightened health care scrutiny. (J Thorac Cardiovasc Surg 2012;144:612-6)”

Survivors of sexual violence have high rates of depression, anxiety, and post-traumatic stress disorder (PTSD). Although treatment for symptoms related to sexual violence has been shown to be effective in high-income countries, evidence is lacking in low-income, conflict-affected countries.


In this trial in the Democratic Republic of Congo, we randomly assigned 16 villages to provide cognitive processing therapy (1 individual session and 11 group sessions) or individual support to female sexual-violence survivors with high levels of PTSD symptoms and combined depression and anxiety symptoms. One village was excluded owing to concern about the competency of the psychosocial assistant, resulting in 7 villages that provided therapy (157 women) and 8 villages that provided individual support (248 women).

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