We find that veridical perceptions can be driven to extinction by

We find that veridical perceptions can be driven to extinction by non-veridical strategies that are tuned to utility rather than objective reality. This suggests that natural selection need not favor veridical perceptions, and that the effects of selection on sensory perception deserve further study. (c) 2010 Elsevier Ltd. All rights

“Introduction: L-Amino acid-based tracers have established their important role as tumor metabolic imaging agents. Recently, a number of studies demonstrated that D-amino acids may have improved imaging properties than their corresponding L-isomers. We synthesized and evaluated the D-isomer of a new phenylalanine derivative, p-(2-[F-18]fluoroethyl)-phenylalanine ([F-18]FEP), in comparison to its L-isomer and previously Belnacasan mw reported the L- and D-isomers of O-(2-[F-18]fluoroethyl)-tyrosine ([F-18]FET).

Methods: L- and D-Isomers of [F-18]FET and [F-18]FEP were successfully synthesized via a rapid and efficient two-step nucleophilic fluorination and deprotection reaction. In vitro studies SU5402 manufacturer were carried out

in 9L glioma cells. In in vivo studies, Fisher 344 rats bearing the 9L tumor model were used.

Results: L- and D-Isomers of F-18-fluoroalkyl tyrosine and phenylalanine derivatives were efficiently labeled with high enantiomeric purity (>95%), good yield (11-45%) and high specific activity (21-75 GBq/mu mol). D-[F-18]FEP showed a similar linear time-dependent uptake as D-[F-18]FET, while their corresponding L-isomers had much faster and higher uptake (4.3- to 16.0-fold at maximum uptake). The maximum Buparlisib nmr uptake of the new compounds, L- and D-[F-18]FEP, was 1.4- and 5.2-fold of that reported for L- and D-[F-18]FET, respectively. Transport characterization studies indicated that both L- and D-[F-18]FEP

were selective substrates for system L. While L-[F-18]FEP exhibited preference towards one subtype of system L, LATI, D-[F-18]FEP did not exhibit the same preference. Small animal PET imaging studies showed that both L- and D-[F-18]FEP had higher uptake in 9L tumor compared to surrounding tissues, but D-isomer had lower tumor-to-muscle ratio in comparison with its L.-isomer.

Conclusion: Both L- and D-[F-18]FEP are substrates for system L amino acid transporter with different preference toward its subtypes. Small animal imaging studies of 9L tumor showed that D-[F-18]FEP did not show better imaging properties than their corresponding L-isomer. (C) 2011 Published by Elsevier Inc.”
“Mechanical stiffness of bio-adhesive substrates is one of the major regulators of the cell adhesion and migration. In this study, we propose a theoretical model for the spontaneous growth of focal adhesion (FA) sites, on compliant elastic substrates, at the early stages of cellular adhesion. Using a purely thermodynamic approach, we demonstrate that the rate of membrane-substrate association decreases with increasing the compliance of the substrate.

Results – AD patients showed significantly reduced rMT, aMT and

Results. – AD patients showed significantly reduced rMT, aMT and shorter MEP onset latency; in addition there was a prolongation of both CSP and TI. There was a significant positive correlation between the MMSE and CDR, on the one hand, and aMT and rMT, on the other hand, whereas the correlation was negative with CSP and TI durations.

Conclusion. – AD is associated with hyperexcitability of the motor cortex, which supports the hypothesis that changes in GABAb and glutamate function are important factors in cognitive impairment. (C) 2011 Elsevier Masson SAS. All rights reserved.”
“Purpose: We explored the structural relationship find more between enzymes producing prostaglandin (cyclooxygenase I)

and 1 of the receptor families that respond to prostaglandin (prostaglandin E receptor 1) in the bladder muscle.

Materials and Methods: Nine male guinea pigs were sacrificed by cervical dislocation. Bladders were removed and fixed in 4% paraformaldehyde in phosphate buffered saline. Frozen sections (10 mu m) were cut and stained with antibodies to prostaglandin E receptor type 1, cyclooxygenase I and vimentin.

Results: IWP-2 Prostaglandin E receptors 1 was identified on smooth muscle cells, and vimentin positive surface muscle and intramuscular interstitial

cells. Muscle staining was less intense than on interstitial cells and had a punctuate appearance. Prostaglandin E receptor 1 expression on interstitial cells was highly localized. Discrete regions of intense staining were noted on interstitial cell processes. Cyclooxygenase

I was this website also expressed in muscle interstitial cells. Cyclooxygenase I positive interstitial cells were more prevalent in the muscle bundles of the inner muscle than in the outer muscle layers. Cyclooxygenase I staining was noted on discrete regions of the cell or cell processes. Double staining with prostaglandin E receptor 1 and cyclooxygenase I suggested that cell regions expressing the former are different from those expressing the latter.

Conclusions: The discovered arrangement of prostaglandin E receptor 1 and cyclooxygenase I may have the potential to facilitate the propagation of signals in the interstitial cell network. Such a signaling system may have a role in coordinating events, as in bladder pathology, facilitating the global coordinated changes associated with bladder wall remodeling.”
“Alcohol dependence constitutes a serious worldwide public health problem. The last few decades have seen many pharmacological studies devoted to the improvement of alcoholism treatment. Although psychosocial treatments (e.g. individual or group therapy) have historically been the mainstay of alcoholism treatment, a successful approach for alcohol dependence consists in associating pharmacologic medications with therapy, as 40-70% of patients following only psychosocial therapy typically resume alcohol use within a year of post-detoxification treatment.

Results: Hospital survival was 100% Overall survival after 5 yea

Results: Hospital survival was 100%. Overall survival after 5 years was 92.7% (38/41 patients). Three (7.3%) patients died of noncardiac causes. Freedom from reintervention of the left anterior descending

artery after a mean of 69 6 AZD3965 research buy +/- 7.4 months was 87.2% (36/41 patients). Freedom from any major adverse events during the whole follow-up was 75.7% (31/41 patients).

Conclusion: Endoscopic surgery on the beating heart remains the ultimate goal for minimally invasive coronary artery surgery. The clinical outcomes and need for reintervention of the target vessel leave room for improvement and may be considered reflective of early experiences typically associated with dramatic departure from conventional therapy. Moving forward, advances in instrumentation and anastomotic technology seem to be essential for reproducible and reliable coronary anastomosis in a totally endoscopic approach.”
“Objectives: We sought Tubastatin A to assess

the clinical and survival benefit of atrial fibrillation surgery in patients submitted to mitral valve surgery after stabilization of postoperative rhythm at 1 year.

Methods: One thousand seven hundred twenty-three patients were enrolled. Patients with follow-up of longer than 1 year (n = 972) were divided into 3 groups according to surface electrocardiographic rhythm during follow-up visits: stable sinus rhythm, stable atrial fibrillation, and intermittent rhythms. Adverse cardiac

event incidence and predictors of long-term outcome were compared among the 3 groups.

Results: In-hospital mortality was 2.6%. Risk factors for mortality were the cut-and-sew technique (odds ratio, 8.92; 95% confidence interval, 1.71-46.50; P = .009) and isolated left atrial procedure (odds ratio, 0.16; 95% confidence interval, 0.04-0.56; P = .004). At 1 year, 63.4% patients were in stable sinus rhythm. Stable sinus rhythm was found to be associated with early and late survival (P Tozasertib research buy = .01, log-rank analysis). Multivariate binary logistic regression analysis found that left atrial dimension (odds ratio, 0.97; 95% confidence interval, 0.96-0.99; P = .005) and concomitant coronary revascularization (odds ratio, 0.48; 95% confidence interval, 0.25-0.92; P = .027) were independent predictors of stable sinus rhythm at 1 year after surgical intervention. At 48 months’ follow-up, predictors for stable sinus rhythm were biatrial surgical approach and absence of preoperative permanent atrial fibrillation (odds ratio, 3.56; 95% confidence interval, 1.62-7.83; P < .002). Left atrial size (each millimeter) has a borderline statistical significance (odds ratio, 0.97; 95% confidence interval, 0.93-1.00; P < .065). Thromboembolic events were found to be associated with absence of stable sinus rhythm (P < .010, log-rank analysis).

A total of 228 BPD patients participated in the study In

A total of 228 BPD patients participated in the study. In selleck inhibitor addition, 236 healthy blood donors, who frequency matched with the patients according to age and gender, were also studied as a control group. Statistical analysis revealed that polymorphisms of neither GSTM1 (OR = 0.73, 95% CI: 0.50-1.05) nor GSTT1 (OR = 0.98, 95% Cl: 0.65-1.47) were associated with risk of BPD. Patients were stratified according to their age

of onset into early onset (below 19 years old) and late onset (more than 19 years old) groups. Among the early onset group, the GSTM1 null genotype decreases the risk of BPD (OR = 0.43, 95% Cl: 0.24-0.79). Further analysis showed that a combination of “”GSTM1 positive genotype and GSTT1 null genotype”" versus “”positive genotypes of GSTM1 and GSTT1″” increased the risk of BPD (OR = 2.28, 95% Cl: 1.07-4.85). However, there was no significant association between the study polymorphisms and risk of BPD among the late onset group.

The present finding indicated that GSTM1 and GSTT1 are candidate polymorphisms for susceptibility to BDP among adolescents. (C) 2010 AZD5363 clinical trial Elsevier Ireland Ltd. All rights reserved.”
“To the Editor: A 48-year-old woman presented with nonbloody diarrhea 9 months after cord-blood transplantation. Her condition was caused by colitis and met the criteria for cord colitis syndrome.(1) Two courses of metronidazole were administered and were followed by clinical and endoscopically confirmed remission. Colonoscopy was performed during active colitis and at the end of antibiotic therapy. Colonic biopsies were performed on both OSI-027 concentration occasions, and specimens were frozen and were analyzed by means of 16S rDNA-based microbial community profiling with the use of high-throughput pyrosequencing.(2) In contrast with the findings of Bhatt et al. (Aug. 8 issue),(3) we were unable …”
“Purpose: Studies of the outcome of hypospadias repair must document quality, including assessment of complications and appraisal of appearance.

To our knowledge the Pediatric Penile Perception Score is the first validated instrument for the outcome assessment of hypospadias repair in prepubertal males by surgeons and patients. We validated the instrument for adult genitalia.

Materials and Methods: Standardized photographic documentation was prepared for 19 men after hypospadias repair and 3 with normal genitalia after circumcision. This was sent to 21 urologists, who rated the outcome with a questionnaire comprising items on the penile meatus, glans, shaft skin and general appearance. Each item was rated with a 4-point Likert scale. The Penile Perception Score is a sum score of all items. Patients were asked to provide a self-assessment with the same instrument.

Samples containing unusual profiles were sequenced for identifica

Samples containing unusual profiles were sequenced for identification. In addition, a subset of samples with two common

variants, 23 reference and 34 E6-350G variants, was also sequenced to confirm the findings of high resolution melting. Concordance between the melting analysis and sequencing was 93.9%, while HRM sensitivity and specificity were 92.9% and 94.7%, respectively.

This study showed that SRT1720 order HRM analysis can be useful for the identification of HPV 16 variants. The HRM method will be useful in low resource settings as it saves considerable time and resources compared to sequencing. (C) 2009 Elsevier B.V. All rights reserved.”
“Whether emotional distracters call for attentional resources has been discussed in several studies. We have earlier shown that brief unpleasant distracters captured right hemisphere (RH) attentional resources as evidenced with reduced event-related potential responses and increased reaction times to nonemotional left visual field/RH targets. The aim of this study

was to investigate whether emotional distracters selectively interfere with processes predominantly relying on the RH such as processing global visual features. Evoked potentials were recorded from 18 participants carrying out a visual discrimination task engaging global RH and local left hemisphere-dependent processes. Unpleasant distracters reduced global target detection-related right parietal activity. Foretinib in vivo We conclude that brief unpleasant distracters compete for RH attentional resources with global level processing. NeuroReport 21:344-348 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.”
“Simian betaretroviruses (formerly Type D retroviruses; SRV) are a group of closely related retroviruses for which the natural host species are Asian monkeys of the genus Macaca. Five serotypes have been identified by classical

neutralization assays and three additional untyped variants have been reported (SRV(Tsukuba), SRV-6, SRV-7). These viruses may be significant pathogens in macaque colonies, causing a broad spectrum of clinical disease secondary to viral-induced INCB018424 clinical trial immune suppression. Undetected SRV infections in research macaques also represent a potential confounding variable in research protocols and a concern for human caretakers. Intensive testing efforts have been implemented to identify infected animals in established colonies. A real-time quantitative generic multiplex PCR assay was developed that is capable of simultaneous detection of proviral DNA of SRV serotypes 1, 2, 3, 4 and 5. This assay incorporates amplification of the oncostatin M (OSM) gene for confirmation of amplifiable DNA and allows quantitation of the number of proviral copies per cell analyzed in each multiplex reaction. Detection of multiple serotypes by PCR increases the efficiency and cost-effectiveness of SRV screening programs.

(C) 2008 IBRO Published by Elsevier Ltd All

rights rese

(C) 2008 IBRO. Published by Elsevier Ltd. All

rights reserved.”
“Epstein-Barr virus (EBV) is an important human pathogen that establishes a life-long persistent Tideglusib cell line infection and for which no precise animal model exists. In this paper, we describe in detail an agent-based model and computer simulation of EBV infection. Agents representing EBV and sets of B and T lymphocytes move and interact on a three-dimensional grid approximating Waldeyer’s ring, together with abstract compartments for lymph and blood. The simulation allows us to explore the development and resolution of virtual infections in a manner not possible in actual human experiments. Specifically, we identify parameters capable of inducing clearance, persistent infection, or death. (C) 2008 Elsevier Ltd. All rights reserved.”

this report a series of six in vitro experiments in which reserpine-evoked dopamine output and two in vivo experiments in which the effects of reserpine injections upon dopamine content from striatal tissue of female ZD1839 manufacturer and male mice were performed as a means to assess possible sex differences in vesicular monoamine transporter 2 (VMAT2) function. Significantly greater amounts of dopamine were obtained from striatal tissue of female mice in response to either a brief (experiment 1) or continuous (experiment 2) infusion of reserpine. Similarly, reserpine-evoked dopamine output from striatal tissue of gonadectomized females was significantly greater that that of gonadectomized males (experiment 3). When reserpine-evoked dopamine responses were compared directly between intact versus gonadectomized females (experiment 4) or males (experiment 5) no statistically significant differences were obtained. Finally, comparisons

YAP-TEAD Inhibitor 1 in vitro of gonadectomized females treated or not with estrogen revealed no statistically significant differences in reserpine-evoked dopamine output (experiment 6). Injections of reserpine produced significantly greater depletions of striatal dopamine content within intact female versus male mice (experiment 7). Dopamine contents of gonadectomized females treated or not with estrogen did not differ following treatment with reserpine, but were significantly greater than that of gonadectomized males (experiment 8). Taken together, these results show that female striatal tissue is more responsive to reserpine-evoked dopamine output, and this sex difference appears to be estrogen independent. Similarly, the dopamine depleting effects of reserpine are greater in intact female mice, however, gonadectomy reverses this effect in an estrogen independent manner. The data suggest that female mice may have a greater amount/activity of VMAT2 function as revealed by the increased responsiveness to the VMAT2 blocking drug, reserpine. Such differences in VMAT2 function may be related to the gender differences observed in conditions like Parkinson’s disease and drug addiction.

Because ADO effects in standard solution occurred at doses that a

Because ADO effects in standard solution occurred at doses that are notably higher than those occurring in vivo, we hypothesize that newborn rat locomotor networks are rather insensitive to this GSK461364 datasheet neuromodulator. (C) 2012 IBRO. Published by Elsevier Ltd. All rights reserved.”
“Background Moderate differences in efficacy between adjuvant chemotherapy regimens for breast cancer are plausible, and could affect treatment choices. We sought any such differences.

Methods We undertook individual-patient-data meta-analyses of the randomised trials comparing: any taxane-plus-anthracycline-based regimen versus

the same, or more, non-taxane chemotherapy (n=44 000); one anthracycline-based regimen versus another (n=7000) or versus cyclo phosphamide, methotrexate,

and fluorouracil (CMF; n=18 000); and polychemotherapy PLX-4720 chemical structure versus no chemotherapy (n=32 000). The scheduled dosages of these three drugs and of the anthracyclines doxorubicin (A) and epirubicin (E) were used to define standard CMF, standard 4AC, and CAF and CEF. Log-rank breast cancer mortality rate ratios (RRs) are reported.

Findings In trials adding four separate cycles of a taxane to a fixed anthracycline-based control regimen, extending treatment duration, breast cancer mortality was reduced (RR 0.86, SE 0.04, two-sided significance [2p]=0.0005). In trials with four such extra cycles of a taxane counterbalanced in controls by extra cycles of other cytotoxic

drugs, roughly doubling non-taxane dosage, there was no significant difference (RR 0.94, SE 0.06, 2p=0.33). Trials with CMF-treated controls showed that standard 4AC and standard CMF were equivalent (RR 0.98, SE 0.05, 2p=0.67), but that anthracycline-based regimens with substantially higher cumulative dosage than standard 4AC (eg, CAF or CEF) were superior to standard CMF (RR 0.78, SE 0.06, 2p=0.0004). Trials versus no chemotherapy also suggested greater mortality reductions with CAF (RR 0.64, SE 0.09, 2p<0.0001) than with standard 4AC (RR 0.78, SE 0.09, 2p=0.01) or standard CMF (RR 0.76, SE 0.05, 2p<0.0001). In all meta-analyses involving taxane-based selleck products or anthracycline-based regimens, proportional risk reductions were little affected by age, nodal status, tumour diameter or differentiation (moderate or poor; few were well differentiated), oestrogen receptor status, or tamoxifen use. Hence, largely independently of age (up to at least 70 years) or the tumour characteristics currently available to us for the patients selected to be in these trials, some taxane-plus-anthracycline-based or higher-cumulative-dosage anthracycline-based regimens (not requiring stem cells) reduced breast cancer mortality by, on average, about one-third. 10-year overall mortality differences paralleled breast cancer mortality differences, despite taxane, anthracycline, and other toxicities.

3 years (+72%, p < 05) but were significantly

lower f

3 years (+72%, p < .05) but were significantly

lower following 6 years of high-fat diet (-77%, p < .05). Associations with glucose also switched from being positive (r = .44, p = .03) to strikingly negative (r = -.84, p < .001) with increasing insulin resistance. In conclusion, a low-fat diet may preserve tissue HSP70 and health with aging, whereas high-fat diets, insulin resistance, and genetic factors may be more important than age for determining HSP70 levels.”
“Patients and Methods: We recruited 572 patients (356 South Asian and 216 Blacks) epsilon 45 years as a sub-study to a community screening project, the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) study. All subjects 3-Methyladenine datasheet c-Met inhibitor completed an interviewer-led

questionnaire, anthropometric measurements and blood sampling. Ankle brachial pressure index (ABPI) was calculated and intermittent claudication was assessed using the Edinburgh Claudication Questionnaire. The presence of PAD was defined as ABPI < 0.9.

Results: The mean age was 62 years overall with no difference between the two ethnic groups. The prevalence of PAD was 13.2% [95% confidence interval (CI) 9.7-16.7] in South Asians and 10.2% (95% CI 6.2-14.2) in Blacks with no significant difference between the two ethnic groups. The prevalence of PAD was higher in South Asian women than Black women (16.3 vs. 6.1%; P = 0.011). No difference in prevalence was found in men (11 vs. 14% P = 0.47, in South Asians and Blacks, respectively). The prevalence of intermittent claudication was 0.9% (95% CI 0.11-1.63). On multivariate logistic regression, mean systolic blood pressure, diabetes, smoking and male sex were independently

associated with PAD in South Asians (P = 0.016, 0.022, 0.037and 0.008, respectively). In Blacks, only age remained independently associated with PAD on multivariate logistic regression (P = 0.003).

Conclusion: The prevalence Avapritinib of PAD is similar in South Asians and Blacks, and similar to levels reported in pre-dominantly White populations. South Asian women had a higher prevalence of PAD than Black women, which is not explained by traditional cardiovascular risk factors.”
“There is accumulating evidence that mitochondrial respiratory malfunction is associated with aging-associated complex diseases. However, progress in our understanding of these diseases has been hampered by the sensitivity and throughput of systems employed to quantify dysfunction and inherent limitations of the biological systems studied. In this review, we describe and contrast two methodologies that have been developed for measuring mitochondrial function to address the need for improved sensitivity and increased throughput. We then consider the utility of each methodology in studying three biological systems: isolated mitochondria, cultured cells, and cell fibers and tissues.

This effect is thought to reflect category-specific adaptation pr

This effect is thought to reflect category-specific adaptation processes. Similarly, presenting two faces concurrently also reduces

the N170, suggesting that stimuli compete for neural representations in the occipito-temporal cortex as early as 170 ms. Here we compared the ERPs obtained for two faces or for a face and a phase-scrambled face in three selleck products different conditions: (1) a first stimulus (Si) followed by a second one (S2), similarly to previous adaptation paradigms; (2) S1 remaining on screen when S2 appeared, as previously used in studies of competition; (3) or S1 and S2 having simultaneous onset and offset as well. We found a significant and stimulus specific reduction of the N170 in both conditions where the onset of S1 preceded the onset of S2. In contrast, simultaneous presentation of the two stimuli had no specific effect on the ERPs at least until 200 ms post-stimulus onset. This suggests either that competition does not lead to early repetition suppression or that the absence of a larger N170 response to two simultaneously presented GSK621 face stimuli compared to a single stimulus reflects competition between overlapping representations. Overall, our results show that the asynchronous presentation

of S1 and S2 is critical to observe stimulus specific reduction of the N170, presumably reflecting adaptation-related processes.

selleckchem (C) 2013 Elsevier Ltd. All rights reserved.”
“Background. Certain parenting styles are influential in the emergence of later mental health problems, but less is known about the relationship between parenting style and later psychological well-being. Our aim was to examine the association between well-being in midlife and parental behaviour during childhood and adolescence, and the role of personality as a possible mediator of this relationship.

Method. Data from 984 women in the 1946 British birth cohort study were analysed using structural equation modelling. Psychological well-being was assessed at age 52 years using Ryff’s scales of psychological well-being. Parenting practices were recollected at age 43 years using the Parental Bonding Instrument. Extraversion and neuroticism were assessed at age 26 years using the Maudsley Personality Inventory.

Results. In this sample, three parenting style factors were identified : care; non-engagement; control. Higher levels of parental care were associated with higher psychological well-being, while higher parental non-engagement or control were associated with lower levels of psychological well-being. The effects of care and non-engagement were largely mediated by the offspring’s personality, whereas control had direct effects on psychological well-being.

Data indicate, however, that it is underdosed with this dosing sc

Data indicate, however, that it is underdosed with this dosing schedule. A prospective, randomized study comparing intermittent versus

loading dose plus continuous infusion for the same total dose of cefazolin was performed to assess which modality is pharmacokinetically and pharmacodynamically advantageous.

Methods: Patients received 2 g cefazolin as a starting dose and then were divided into an intermittent group (receiving another 1 g at 3, 9, and 15 hours after the first dose) and a continuous group (continuous infusion started after the first dose, providing 1 g every 6 hours for 18 hours). Cefazolin levels were measured in blood and atria.

Results: Mean total and calculated free trough concentrations in blood Veliparib varied greatly among patients in

the intermittent group and were lower than those in the continuous group (P<.05 at 15, 18 and 24 hours). For 9 of 10 (90%) patients in the continuous infusion group, the targeted pharmacokinetic and pharmacodynamic goal (time above minimal inhibitory concentration >90%) was achieved, whereas the goal was met for only 3 of 10 (30%) in the intermittent group (P<.05). AG-014699 clinical trial The mean atrial tissue concentration was also higher with continuous infusion (P<.05).

Conclusions: Administration of cefazolin as bolus plus continuous infusion has pharmacokinetic and pharmacodynamic advantages relative to intermittent administration. It provides more stable serum levels, lower interpatient variability, and higher myocardial tissue penetration. (J Thorac Cardiovasc Surg 2010; 140: 471-5)”

Recommendations vary regarding immediate antimicrobial treatment versus watchful waiting for children younger than 2 years

of age with acute otitis media.


We randomly assigned 291 children Barasertib manufacturer 6 to 23 months of age, with acute otitis media diagnosed with the use of stringent criteria, to receive amoxicillin-clavulanate or placebo for 10 days. We measured symptomatic response and rates of clinical failure.


Among the children who received amoxicillin-clavulanate, 35% had initial resolution of symptoms by day 2, 61% by day 4, and 80% by day 7; among children who received placebo, 28% had initial resolution of symptoms by day 2, 54% by day 4, and 74% by day 7 (P = 0.14 for the overall comparison). For sustained resolution of symptoms, the corresponding values were 20%, 41%, and 67% with amoxicillin-clavulanate, as compared with 14%, 36%, and 53% with placebo (P = 0.04 for the overall comparison). Mean symptom scores over the first 7 days were lower for the children treated with amoxicillin-clavulanate than for those who received placebo (P = 0.02).