A case of Capnocytophaga canimorsus meningitis and bacteraemia.

Capnocytophaga canimorsus is a commonly detectable commensal in the oral flora of dogs and cats, found in 25.5% and 15%, respectively, by culture and 70% and 55%, respectively, by molecular methods [1]. Formerly known as dysgonic fermenter 2 (DF-2), it was first reported in 1976 as a Gram-negative bacillus causing septicaemia and meningitis following dog bites [2]. It causes a spectrum of clinical syndromes from wound infections to bacteraemia and meningitis, especially in those with hyposplenism and alcoholism. We report a case of C. canimorsus meningitis and bacteraemia, and give a review of the relevant literature.

Metastatic uterine leiomyosarcoma presenting as a breast lump.

BACKGROUND: It is uncommon to encounter a breast metastasis from an extramammary malignancy and even rarer from a uterine leiomyosarcoma. AIMS: We describe the third case report in the medical literature of a breast metastasis from a uterine leiomyosarcoma. METHODS: We report the management of a 56-year-old patient who presented with a breast lump 3 years after hysterectomy for a fibroid uterus. We conducted a literature review of breast leiomyosarcomas. RESULTS: The excision of the breast mass revealed a low-grade leiomyosarcoma. Radiographic examinations demonstrated metastases to the lung, liver, pelvis and bone. Retrospective pathology review of her uterus identified a small focus of leiomyosarcoma. She received chemotherapy and palliative radiotherapy but passed away within few months. CONCLUSION: Metastasis to the breast from a non-breast primary is generally a sign of disseminated disease and; thus, a poor prognostic indicator.

Intrauterine programming of urinary calcium and magnesium excretion in children born to mothers with insulin dependent diabetes mellitus.

BACKGROUND: Offspring of diabetic rats have reduced urinary calcium and magnesium excretion compared with offspring of controls; these differences persist up to 16 weeks after birth, a time equivalent to young adulthood in humans. OBJECTIVES: To test the hypothesis that urinary calcium and magnesium excretion would be lower in children born to mothers with insulin dependent diabetes mellitus (ChMIDDM) than those born to non-diabetic mothers. METHODS: Concentrations of calcium, magnesium, sodium, and creatinine were measured in first void spot urine samples collected from 45 (28 male; median age 9.6 years) ChMIDDM and 127 (58 male; median age 11.3 years) controls. Analysis of covariance was used to test for differences in urinary calcium to creatinine ratios (UCa/Cr), magnesium to creatinine ratios (UMg/Cr), and log sodium to creatinine ratios (logUNa/Cr) between controls and ChMIDDM after allowing for the effects of sex and age. RESULTS: UCa/Cr (difference -0.10, 95% confidence interval (CI) -0.19 to -0.01; p = 0.03) and UMg/Cr (difference -0.15, 95% CI -0.22 to -0.08; p<0.0001) were lower in ChMIDDM than controls. However, logUNa/Cr did not differ between ChMIDDM and controls (difference -0.14, 95% CI -0.33 to 0.05; p = 0.1). The daily estimated intake of magnesium, sodium, and protein were significantly higher and that of calcium non-significantly higher in ChMIDDM than controls. In ChMIDDM, UCa/Cr and UMg/Cr were not related to diabetic control of mothers. CONCLUSIONS: Results of this study provide the first evidence that in humans, as in rats, there is modification of renal Ca and Mg handling in ChMIDDM, which persists well into childhood.