Notice bibliographique
Résumé
SEVERE OBESITY is associated with a large number of comorbid diseases. These start at the head (stroke, diabetic retinopathy, pseudotumor cerebri, tinnitus) and go to the toes (diabetic neuropathy, foot ulcers, venous stasis disease) and affect almost every organ in between: lungs, heart, liver, spleen, gall bladder, esophagus, intestines, colon, kidneys, bladder, ovaries, prostate, breast, kidneys, bladder, legs, etc. Many of these comorbidities can be divided into two major groups: the metabolic syndrome (also known as Syndrome X) and comorbidities secondary to an increased intra-abdominal pressure (1). Metabolic syndrome comorbidities include type 2 diabetes mellitus (T2DM), hypercholesterolemia, hypertriglyceridemia, non-alcoholic liver disease (NALD) or steatohepatitis (NASH), polycystic ovary syndrome, hypertension, and gallstones. The comorbidities associated with an increased intra-abdominal pressure include pseudotumor cerebri, obesity hypoventilation, venous stasis disease (venous thrombosis, venous stasis ulcers, pulmonary embolism), gastroesophageal reflux disease (GERD), urinary stress incontinence, abdominal hernias (inguinal, umbilical, incisional), hypertension, and the nephrotic syndrome. Other problems such as sleep apnea, diverticulitis, necrotizing pancreatitis, and musculoskeletal disorders (low back, hip, and knee pain), as well as depression and quality of life (QoL) issues are unrelated to either the metabolic syndrome or increased intra-abdominal pressure. Severe obesity also increases the risk of developing cancer (esophagus, liver, pancreas, kidney, colon, breast, uterus, ovary, prostate, leukemias, lymphomas), some of which are associated with the metabolic syndrome (e.g., breast, uterus, prostate) and some secondary to an increased intra-abdominal pressure (e.g., esophagus). Severe obesity is also associated with severe discrimination, problems with employability, and absenteeism, as well as presenteeism (limited quality and quantity of work when employed).Unfortunately, dietary management with or without pharmaceutical therapy has not been effective over the long term (three to five years) for severely obese individuals. Weight loss peaks at approximately 10% of weight, but recidivism is almost invariable. Bariatric surgery is associated with the loss of approximately one-third of pre-operative weight or two-thirds of excess weight, and this weight loss is reasonably stable over ten years, with a relatively small degree of recidivism (2-4). In 1991 the National Institutes of Health Consensus Conference supported bariatric surgery in patients with a body mass index (BMI) of 35 kg/m2 and obesity-related comorbidities or a BMI of 40 kg/m2 regardless of comorbidity status (5).The current operations for severe obesity include Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric band (LAGB), biliopancreatic diversion (BPD) with or without a sleeve gastrectomy (SG), and an SG by itself (figs. 1-4) (6-9).Surgically induced weight loss is associated with a significant improvement in or remission of all obesity-related comorbidities. In a study by Christou et al. there were significant improvements after RYGB in patients from Quebec, Canada, in musculoskeletal disorders, infectious complications, endocrinological problems, cardiovascular complications (myocardial infarction, peripheral vascular disease), respiratory problems (sleep apnea, obesity hypoventilation), mental problems, genitourinary problems, and, for the first time, a significant decrease in cancer care (10). In a meta-analysis with 22,094 patients, Buchwald et al. found a significant improvement in T2DM (86%), hyperlipidemia (70%), hypertension (62%), and sleep apnea (86%) following bariatric surgery (11). In that study, there was significantly more weight loss with the RYGB and BPD than with the LAGB, and these were associated with a better improvement in T2DM than the LAGB. The LAGB had the lowest mortality risk (0. …
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,019 | 0,007 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».