The in vitro activity of Bay 09867, a new quinoline derivative, was compared with those of norfloxacin, nalidixic acid, ceftazidime, cefaclor, cefuroxime, gentamicin, and other antimicrobial agents, when appropriate, against 410 A new cluinoline derivative, 1-cyclopropyl-6-fluro-1, 4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic acid hydrochloride (Bay 09867) (Fig. 1 Inocula were prepared in the following manner. For all strains except those of B. fragilis, streptococci (including pneumococci), N. gonorrhoeae, and H. influenzae, the organisms were grown overnight in nutrient broth yielding a viable count of about 109 CFU/ml. H. influenzae, B. fragilis, and streptococcal strains were grown overnight in Levintal broth, thioglycolate broth, and Todd-Hewitt broth, respectively, yielding comparable viable counts. Pneumococci were also grown in Todd-Hewitt broth, and the viable count was 108 CFU/ml. N. gonorrhoeae strains were grown overnight on a chocolate agar plate, and the growth was removed just before use and suspended in peptone water to yield a viable count of 106 and 107 CFU/ml. Two inocula of 104 and 106 CFU, respectively, were used to test all the strains except N. gonorrhoeae and the pneumococci and were obtained by transferring 1 ,ul of an appropriate dilution of the overnight culture to the surface of the antibiotic-containing agar by a multipoint inoculating device (Denley-Tech Ltd., Billingshurst, England

Approximately 1800 children between the ages of 5 and 12 years were randomly selected and asked whether they had present or past experiences of imaginary companions. It was found that 829 (46.2%) children reported experiences of imaginary companions. These findings were unexpected as previous studies had suggested that imaginary companions are generally experienced by fewer, much younger children. There were no significant differences in creativity scores between children who reported imaginary companions compared with those who did not. Imaginary companions were reported by more girls than boys, and were not restricted to very young children.

A case of fever, sepsis, and chest lesions evident on a computed tomography scan of an indigenous man in northern Australia following burns to the feet is described. Sputum PCR testing revealed Mycobacterium leprae, and a fine-needle aspirate of the chest lesions demonstrated Cryptococcus coinfection. CASE REPORTA 47-year-old indigenous man from East Arnhem, northern Australia, was referred with painful burns to the right foot, having recently stepped on a burning log from a campfire. He reported a cough productive of white sputum for 1 week and weight loss for several months. Medical history included chronic bilateral peripheral neuropathy, iron deficiency anemia, and chronic hepatitis B virus infection. He had a history of heavy alcohol and kava use but denied recent intake. There was no known history of contact with leprosy.On examination he was febrile (40.8°C), tachycardic (heart rate, 130 beats/min), and hypotensive (blood pressure 85/45 mm Hg). His oxygen saturation was 100% on room air with a respiratory rate of 22. Respiratory examination revealed decreased breath sounds and crepitations bilaterally. He had full-thickness burns to the plantar aspect of the right great, second, and third toes and reduced sensation of the whole right foot in a stocking distribution. Laboratory investigations revealed a hemoglobin level of 93 g/liter (reference range [RR],135 to 185) and a white blood cell count of 3.6 ϫ 10 9 /liter (RR, 4.0 to 11.0), with 2.9 ϫ 10 9 neutrophils/liter (RR, 2.0 to 7.5) and 0.6 ϫ 10 9 lymphocytes/liter (RR, 1.5 to 4.0). He had a platelet count of 139 ϫ 10 9 /liter (RR, 150 to 450) and a normal blood glucose level. Chest X-ray demonstrated opacification of the apical segment of the right lower lobe.He was started on meropenem and azithromycin and placed in respiratory isolation. A computed tomography (CT) scan of the chest revealed two lesions of soft-tissue density within the right lower lobe (maximum diameters, 48 mm and 19 mm) but no lymphadenopathy (Fig. 1). A serum cryptococcal antigen test was positive (titer, 1:64; Remel, Lenexa, KS). Microscopy of a fineneedle aspiration biopsy specimen from one of the chest lesions showed numerous fungal organisms consistent with Cryptococcus species.One of three sputum specimens demonstrated scanty acid-fast bacilli (AFB) by Ziehl-Neelsen staining. PCR for Mycobacterium tuberculosis complex was negative on this sample. A subsequent generic PCR for mycobacteria yielded a 220-bp product; restriction digestion of the amplified product using HaeIII and CfoI gave a differential identification of Mycobacterium kansasii, Mycobacterium celatum, orMycobacterium leprae (1). Sequencing of the amplified product resulted in a 100% match with the internal transcribed spacer (ITS) region of M. leprae.On further clinical review, leonine facies and thinning eyebrows were noted (Fig. 2), but there was no evidence of dermatological hypopigmentation. The left greater auricular, right median, bilateral ulnar, and bilateral popliteal nerves were enlarged, and there was s...

During summer in early 2016, over 70 landscape fires in Tasmania (Australia) caused several severe episodes of fire smoke across the island state. To assess the health impact of the fire smoke, a case crossover analysis was performed, which measured the association between increased concentrations of PM 2.5 and emergency ambulance dispatches (EAD) from 1 January to 31 March 2016. Control days were matched by latitude and longitude, day of the week and calendar month. Exposure data were obtained from air quality monitoring stations at lag times of 1-48 h and for the 24-h mean on the same day and 1-day lag. Positive associations were observed between an increase of 10 µg/m 3 in PM 2.5 and EAD for stroke on the same day (OR 1.10, 95% CI 1.02-1.19) and at 1-day lag (OR 1.10, 95% CI 1.02-1.18). Furthermore, there were non-significant increases in breathing problems (OR 1.04, 95% CI 1.00-1.08) and diabetic problems (OR 1.11,) at 1-day lag. The EAD for all causes were not increased. These findings will be used for ambulance service planning and public health risk communication in future landscape fire events.