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J Valeriano

Publications and source records attributed to J Valeriano.

16 recordsLinked to original sources

The effect of a low-carbohydrate diet on bone turnover.

INTRODUCTION: Low-carbohydrate diets have become popular as weight loss techniques. These diets are high in protein, saturated fats, and omega-6 fatty acids. They also lead to a ketogenic state. These factors could lead to increased bone turnover. This study was designed to see whether a low-carbohydrate diet would lead to increased bone turnover in humans. METHODS: Thirty patients (15 study subjects and 15 controls) were recruited for this 3-month study. The 15 patients on the diet were instructed to consume less than 20 g of carbohydrates per day for the 1st month and then less than 40 g per day for months 2 and 3. Control subjects had no restrictions on their diet. The primary end point was urinary N-telopeptide (UNTx) at 3 months. Secondary end points included UNTx at 1 month, bone-specific alkaline phosphatase (BSAP) at 1 month, bone turnover ratio (BSAP/UNTx) at 1 month, and weight loss. RESULTS: The mean UNTx in the study subjects increased by 1.6 [95% confidence interval (CI) +/-22.8] compared with an increase of 1.9 (95% CI +/-17.6) in the controls at 3 months (p=0.86). The mean UNTx decreased by 2.2 (95% CI +/-27.2) and 3.1 (95% CI +/-17.6) at 1 month in the dieters and controls, respectively (p=0.36). The mean BSAP decreased by 0.53 (95% CI +/-2.96) in the dieters and increased by 0.34 (95% CI +/-2.92) in the controls at 1 month (p=0.27). The bone turnover ratio increased by 0.08 (95% CI +/-0.81) in the dieters and by 0.05 (95% CI +/- 0.27) in the controls at 1 month (p=0.78). The dieters lost 6.39 kg versus 1.05 kg for the controls at 3 months (p=0.0008). CONCLUSIONS: Although the patients on the low-carbohydrate diet did lose significantly more weight than the controls did, the diet did not increase bone turnover markers compared with controls at any time point. Further, there was no significant change in the bone turnover ratio compared with controls.

Adult↗

V2 regions of 16S ribosomal RNA used as a molecular marker for the species identification of streptococci in peripheral blood and synovial fluid from patients with psoriatic arthritis.

OBJECTIVE: To detect the 16S ribosomal RNA (rRNA) of 3 streptococcal species in the peripheral blood and synovial fluid of patients with psoriatic arthritis (PsA). METHODS: Reverse transcription-polymerase chain reaction (RT-PCR) detection targets bacterial 16S rRNA, which is present in bacteria at high copy numbers. The 3 species-specific primers for group A streptococci (GAS; Streptococcus pyogenes), group B streptococci (GBS; Streptococcus agalactiae), and Streptococcus pneumoniae were designed from the fragments of highly variable V2 regions of 16S rRNA. Total RNA was prepared from whole peripheral blood and joint fluid obtained from patients with PsA and rheumatoid arthritis (RA). All positive PCR reactions were then sequenced with a Pharmacia ALF DNA sequencing system. RESULTS: Our data in 19 PsA patients showed that 7 peripheral blood samples were positive for GAS (P = 0.006 versus GAS-positive RA patients [n = 0], by Fisher's exact test), and 2 were also positive for GBS. One synovial fluid sample from a PsA patient was positive for GAS. S pneumoniae was absent from all specimens. Seventeen patients with RA were PCR negative for the 3 streptococcal species. Peripheral blood from a patient with inflammatory bowel disease was positive for GAS. CONCLUSION: The presence of GAS 16S rRNA in the peripheral blood and synovial fluid of patients with PsA supports the concept that PsA is a reactive arthritis to certain streptococci.

Arthritis, Psoriatic↗

Isolated straight sinus thrombosis: clinical and neuroradiologic correlates.

A rare case of straight sinus thrombosis in a 36-year-old female with sudden onset of status migrainosus is presented. This condition was demonstrated by a linear density in the midline on a noncontrast computed tomography scan, as a filling defect at the location of straight sinus on magnetic resonance imaging, and by the inability to visualize blood flow in the straight sinus on magnetic resonance venography, with a similar demonstration on a 4-vessel digital subtraction angiography.

Adult↗

Malignancy and Rheumatic Disease.

BACKGROUND: A wide variety of clinically significant interactions occur between neoplastic and rheumatic diseases, and many are clinically significant. METHODS: The types of interactions between rheumatologic and neoplastic diseases and their clinical manifestations are reviewed and described. RESULTS: Several diseases included in the classic definition of rheumatology are associated with an increased incidence of specific neoplasms. Conversely, many neoplasms, by a variety of mechanisms, can cause or simulate many rheumatic diseases. CONCLUSIONS: Knowledge of the increased propensity for neoplasia in certain conditions and of the possibility that cancer may be the cause of specific rheumatologic syndromes will assist the physician in providing optimal clinical care to affected patients.

Journal Article↗

Neuropsychiatric side effects related to treatment with felbamate.

Seven patients with refractory seizure disorders and neuropsychiatric symptoms believed secondary to felbamate are presented. Five were on concomitant valproic acid (and other agents). Anergia, apathy, bradyphrenia, and increased irritability were prominent. One patient on felbamate monotherapy had a new-onset psychosis. Felbamate's NMDA receptor antagonism and GABA potentiation (perhaps enhanced by valproic acid use) are discussed as possible mechanisms of these side effects.

Adult↗

Prenuptial seizures: a report of five cases.

The cases of 5 patients with seizures occurring the day of or shortly before their weddings are presented. Major life events may precipitate or exacerbate epileptic or nonepileptic seizures as a result of 1) missed medications, 2) sleep deprivation, 3) alcohol or concomitant medications, 4) hyperventilation, or 5) the emotional state directly or stress indirectly. Seizures occurring at times of psychological stress may be either neurological or psychiatric in origin. The physician treating patients with a new onset or exacerbation of seizures around a major life event must consider all of these factors in the evaluation.

Adult↗

Reactive arthritis.

Explore the source record for details and available documents.

Arthritis, Reactive↗

The diagnosis of skull base metastases by radionuclide bone scan.

The differential diagnosis of multiple cranial nerve palsies in patients with cancer includes meningeal infections, meningeal carcinomatosis, and skull base metastases. In distinguishing these, spinal fluid analysis and skull base tomography should be helpful in most cases. In circumstances when results of skull base tomography are negative, radionuclide bone scans can demonstrate metastatic disease in the base of the skull, and it should be obtained in all patients who are highly suspicious for having skull base metastasis with negative skull base tomography, including computed tomography (CT).

Aged↗

An unusual cause of hypokalemic muscle weakness.

A 36-year-old woman presented with proximal muscle weakness, cramps, and a serum potassium level of 2.7 mEq/l. During her hospitalization she was noted to use excessive quantities of a snuff preparation containing glycyrrhizinic acid, a potent mineralocorticoid analogue. With discontinuation of this substance, her potassium returned to normal values and her strength improved. This case is submitted as a hypokalemia myopathy induced by snuff dipping.

Adult↗