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E Saltzman

Publications and source records attributed to E Saltzman.

31 records · Page 2Linked to original sources
PubMed1997

Dietary vitamin K1 and stability of oral anticoagulation: proposal of a diet with constant vitamin K1 content.

Case reports cited in Medline or Biological Abstracts (1966-1996) were reviewed to evaluate the impact of vitamin K1 dietary intake on the stability of anticoagulant control in patients using coumarin derivatives. Reported nutrient-drug interactions cannot always be explained by the vitamin K1 content of the food items. However, metabolic data indicate that a consistent dietary intake of vitamin K is important to attain a daily equilibrium in vitamin K status. We report a diet that provides a stable intake of vitamin K1 equivalent to the current U.S. Recommended Dietary Allowance, using food composition data derived from high-performance liquid chromatography. Inconsistencies in the published literature indicate that prospective clinical studies should be undertaken to clarify the putative dietary vitamin K1-coumarin interaction. The dietary guidelines reported here may be used in such studies.

Administration, Oral↗
PubMed1996

Effects of energy imbalance on energy expenditure and respiratory quotient in young and older men: a summary of data from two metabolic studies.

The roles of energy expenditure and substrate oxidation in energy regulation, and the effects of factors such as aging on these parameters, remain uncertain. A re-analysis of data from two studies involving overfeeding or underfeeding in young men (22.7 +/- 0.6 [SEM] years) and older men (68.0 +/- 1.50 years) was conducted to further evaluate the adaptive capacity of energy expenditure and respiratory quotient to an increase or a decrease in energy intake. Changes in total energy expenditure (TEE) and resting energy expenditure (REE) and respiratory quotient (RQ) in response to energy imbalance were compared between subjects undergoing overfeeding by 4.1 MJ/day for 21 days, or underfeeding by 3.2 MJ/day for 21 days. Comparing responses to overfeeding or underfeeding, there was a significant TEE response to energy imbalance averaging 1.39 MJ/day and equivalent to 19% of the alteration in energy intake (p < 0.05). There was also a significant REE response to energy imbalance averaging 0.45 MJ/day (p < 0.001), and a significant RQ response in both fasting and fed states (p < 0.01). There was no significant difference between young and older men in their TEE, energy deposition or RQ responses to energy imbalance, but older men did have significantly diminished REE response to energy imbalance (p < 0.05) and a significantly delayed thermic response to a standard meal (p < 0.05). These data indicate that energy expenditure plays a significant role in attenuating the effects of alterations in energy intake on body energy stores and that, based on some measures of energy expenditure, aging is associated with a reduction in the adaptive capacity of energy expenditure to participate in energy regulation.

Adult↗
PubMed1996

Evaluation of four methods for determining energy intake in young and older women: comparison with doubly labeled water measurements of total energy expenditure.

The accuracy and precision of four different food intake assessment methods were evaluated in young and older women by comparing reported energy intakes with doubly labeled water measurements total energy expenditure (TEE). A study lasting 8 d was conducted in 10 young women aged 25.2+/-1.1 y (-x+/-SEM) and in 10 older women aged 74.0+/-1.4 y. Free-living TEE was measured over 7 d and food consumption was determined from weighed food intake data (7 d), a 24-h food recall (in duplicate), and two different food-frequency questionnaires [Fred Hutchinson Cancer Research Center (FHCRC)/Block and Willett, both in duplicate]. In addition, body composition was determined by using hydrodensitometry, and strenuous physical activity and the extent of dietary restraint were determined by questionnaire. In young women, 24-h recall gave mean energy intakes that were closest to measures of TEE (-0.34+/-3.71 MJ/d compared with TEE, P=0.178), and energy intakes by food-frequency questionnaires were the only intake data that correlated significantly with individual values for TEE (P<0.05). In older women, food-frequency questionnaires gave mean energy intakes that were closest to measured TEE (+0.53+/-2.95 MJ/d with the Willett questionnaire and -1.19+/-3.02 MJ/d with FHCRC/Block questionnaire). No energy intake data from this group correlated significantly with values for TEE. The 7-d weighed dietary intakes were significantly lower than measured TEE in both young and older women (-2.0 MJ/d in young and older women combined, P<0.001), and did not correlate significantly with values for TEE, although they did most closely mirror the mean difference in TEE between the young and older women (2.30 MJ/d for TEE and 2.11 MJ/d for 7-d weighed intake). These data suggest that none of the methods studied gave accurate estimates of the usual energy requirements of individual subjects. In addition, the results suggest that for some types of studies, simple methods for assessing group mean dietary intake may actually give more accurate information than weighed dietary intakes.

Adult↗
PubMed1996

Postabsorptive and postprandial energy expenditure and substrate oxidation do not change during the menstrual cycle in young women.

There is little information on the effects of the menstrual cycle on the thermic effect of feeding (TEF) and postprandial substrate oxidation. To address these issues, a dose-response study was conducted in eight young women to whom test meals containing 0, 1046, 2092 and 4148 kJ were administered on nonconsecutive days, once each during the follicular phase and once during the luteal phase of the menstrual cycle. Postprandial energy expenditure was measured until it returned to base line (test duration for the 0 kJ meal was matched to duration of 4184 kJ meal). There was no significant difference between menstrual cycle phases in the duration of the thermogenic response to any size meal. TEF, calculated by four different methods, did not differ between follicular and luteal phases, and a comparable dose-response was observed in both phases. Similarly, there was no effect of menstrual cycle phase on postabsorptive or postprandial protein, fat, or carbohydrate oxidation. In conclusion, postabsorptive and postprandial energy expenditure and substrate oxidations did not differ in young women during the follicular and luteal phases of the menstrual cycle.

Adult↗
PubMed1996

Accurate recovery of articulator positions from acoustics: new conclusions based on human data.

Vocal tract models are often used to study the problem of mapping from the acoustic transfer function to the vocal tract area function (inverse mapping). Unfortunately, results based on vocal tract models are strongly affected by the assumptions underlying the models. In this study, the mapping from acoustics (digitized speech samples) to articulation (measurements of the positions of receiver coils placed on the tongue, jaw, and lips) is examined using human data from a single speaker: Simultaneous acoustic and articulator measurements made for vowel-to-vowel transitions, /g/ closures, and transitions into and out of /g/ closures. Articulator positions were measured using an EMMA system to track coils placed on the lips, jaw, and tongue. Using these data, look-up tables were created that allow articulator positions to be estimated from acoustic signals. On a data set not used for making look-up tables, correlations between estimated and actual coil positions of around 94% and root-mean-squared errors around 2 mm are common for coils on the tongue. An error source evaluation shows that estimating articulator positions from quantized acoustics gives root-mean-squared errors that are typically less than 1 mm greater than the errors that would be obtained from quantizing the articulator positions themselves. This study agrees with and extends previous studies of human data by showing that for the data studied, speech acoustics can be used to accurately recover articulator positions.

Humans↗
PubMed1995

Dietary energy requirements of young and older women determined by using the doubly labeled water method.

There is little information on the effects of age on energy requirements in women. This issue was investigated in a cross-sectional study of 10 normal-weight young women aged 25.2 +/- 1.1 y (mean +/- SEM) and 10 normal-weight older women aged 74.0 +/- 1.4 y. In a 9-d study, measurements were made of free-living total energy expenditure (TEE) by using the doubly labeled water technique, body composition by using hydrodensitometry, and resting energy expenditure (REE) by using indirect calorimetry. Mean values for reported levels of strenuous activity were within the expected range in both groups (31 +/- 13 min/d in the young group and 7 +/- 2 min/d in the older group). Energy requirements expressed as the ratio of TEE to REE were 1.80 +/- 0.10 and 1.62 +/- 0.06 (P < 0.01) in the young and older group, respectively. When values for REE predicted from body weight (pREE) were used, as suggested in the current recommended dietary allowances (RDAs), the ratios of TEE to pREE in the two groups were 1.85 +/- 0.10 and 1.54 +/- 0.04 (P < 0.05). The RDAs significantly under-predicted the energy requirements of the young group (P < 0.05), but there was no significant underprediction in the older group. Although obtained in a relatively small number of subjects, these results provide no evidence to indicate that the current RDAs underestimate the energy requirements of older women, in contrast with previous observations of an underestimation of energy requirements by the RDAs in older men.

Adult↗
PubMed1995

The role of energy expenditure in energy regulation: findings from a decade of research.

The role of energy expenditure in energy regulation remains a subject of continuing controversy. New data have emerged from studies conducted over the last decade demonstrating that energy expenditure is a critical factor contributing to successful energy regulation in normal individuals, as well as to the disregulation of energy balance that characterizes obesity. Reduced energy expenditure appears to facilitate weight gain in individuals susceptible to obesity and also appears to reduce the extent of body energy loss during undereating in both lean and obese individuals. The magnitude of the reduction in energy expenditure during, and perhaps after, weight loss is greater than expected on the basis of the reduction in body weight and appears to occur in response to undefined underlying determinants of energy regulation. In addition, exercise intervention studies and cross-sectional investigations of the relationship between energy expenditure for physical activity and body composition demonstrate an apparent equilibration between physical activity and body fat content. This equilibration is suggestive of a direct influence of physical activity on the underlying metabolic determinants of energy balance.

Body Mass Index↗
PubMed1993

Infected urachal remnants in the adult: case report and review.

Abnormalities of the urachus in adults are uncommon. Urachal tract remnants that abnormally remain patent are subject to infection. Urachal infection is frequently confused with a wide spectrum of midline intraabdominal or pelvic inflammatory disorders. Because the literature on urachal infection is primarily limited to articles in urology and surgical specialty journals, many physicians may not be familiar with the varied clinical manifestations. We describe a case of infection of a patent urachus in an adult and review the embryology and anatomy of the urachus as it relates to clinical presentation, evaluation, and management. Infection of a urachal remnant should be included in the broad differential diagnosis of omphalitis and midline abdominal or pelvic infections. Rarely, it may be a cause of recurrent urinary tract infection. Definitive management consists of surgical excision after the institution of antimicrobial therapy.

Adult↗
PubMed1990

Intraoperative pathologic diagnosis of thyroid neoplasms. Report on experience with 504 specimens.

Intraoperative pathologic examination with frozen section (FS) was performed on 504 specimens of thyroid tissue obtained from 457 patients over a period of 9 years. After examination of permanent sections (PS) a malignant neoplasm was diagnosed in 57 specimens (11.3%); 50 (87%) of these were primary thyroid carcinoma, four (8%) metastatic carcinoma, and three (5%) malignant lymphoma. The FS diagnosis was "benign" in 448 (88.9%), "malignant" in (30) 5.9%, and "deferred" in 26 (5.2%). The sensitivity of FS diagnosis of malignancy was 53% and the specificity and positive predictive value 100%. The negative predictive value was 97.8% and overall accuracy 97.9%. The PS disclosed a malignant neoplasm in 62% of specimens in which FS diagnosis was "deferred." Sixty-eight percent of papillary carcinomas, 87% of undifferentiated carcinomas, and a single case of medullary carcinoma were diagnosed with FS examination. A FS diagnosis of malignancy was not made in any of the ten specimens containing follicular carcinoma; in all ten the neoplasms were well-differentiated and eight were encapsulated and minimally invasive. The inability to diagnose follicular carcinoma intraoperatively with FS is the most significant factor accounting for the relatively low sensitivity of FS diagnosis of malignant thyroid neoplasms.

Carcinoma↗
PubMedDate not supplied

Nonsurgical factors that influence the outcome of bariatric surgery: a review.

OBJECTIVE: Severe obesity (ie, at least 100% overweight or body mass index > or =40 kg/m2) is associated with significant morbidity and increased mortality. It is apparently becoming more common in this country. Conventional weight-loss treatments are usually ineffective for severe obesity and bariatric surgery is recommended as a treatment option. However, longitudinal data on the long-term outcome of bariatric surgery are sparse. Available data indicate that the outcome of bariatric surgery, although usually favorable in the short term, is variable and weight regain sometimes occurs at 2 years after surgery. The objective of this study is to present a review of the outcome of bariatric surgery in three areas: weight loss and improvement in health status, changes in eating behavior, and psychosocial adjustment. The study will also review how eating behavior, energy metabolism, and psychosocial functioning may affect the outcome of bariatric surgery. Suggestions for additional research in these areas are made. METHOD: Literature review. RESULTS: On average, most patients lose 60% of excess weight after gastric bypass and 40% after vertical banded gastroplasty. In about 30% of patients, weight regain occurs at 18 months to 2 years after surgery. Binge eating behavior, which is common among the morbidly obese, may recur after surgery and is associated with weight regain. Energy metabolism may affect the outcome of bariatric surgery, but it has not been systematically studied in this population. Presurgery psychosocial functioning does not seem to affect the outcome of surgery, and psychosocial outcome is generally encouraging over the short term, but there are reports of poor adjustment after weight loss, including alcohol abuse and suicide. CONCLUSIONS: Factors leading to poor outcome of bariatric surgery, such as binge eating and lowered energy metabolism, should be studied to improve patient selection and outcome. Long-term outcome data on psychosocial functioning are lacking. Longitudinal studies to examine the long-term outcome of bariatric surgery and the prognostic indicators are needed.

Feeding Behavior↗
PubMedDate not supplied

Coordination and coarticulation in speech production.

In this article, we consider the concepts of coordination and coarticulation in speech production in the context of a task-dynamic model. Coordination reflects the transient establishment of constrained relationships among articulators that jointly produce linguistically significant actions of the vocal tract--that is phonetic gestures--in a flexible, context-sensitive manner. We ascribe the need for these constraints in part to the requirement of coarticulatory overlap in speech production. Coarticulation reflects temporally staggered activation of coordinative constraints for different phonetic gestures. We suggest that the anticipatory coarticulatory field for a gesture is more limited than look-ahead models have suggested, consistent with the idea that anticipatory coarticulation is the onset of activation of coordinative constraints for a forthcoming gesture. Finally, we ascribe much of the context-sensitivity in the anticipatory or carryover fields of a gesture (variation due to "coarticulation resistance") to low-level (below the speech plan) interactions among the coordinative constraints for temporally overlapping gestures.

Female↗