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Certain organic substances change color in dilute solution when the hydronium ion concentration reaches a particular value. For example, phenolphthalein is a colorless substance in any aqueous solution with a hydronium ion concentration greater than 5.0 × 10−9 M (pH < 8.3). In more basic solutions where the hydronium ion concentration is less than 5.0 × 10−9 M (pH > 8.3), it is red or pink. Substances such as phenolphthalein, which can be used to determine the pH of a solution, are...
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Related Experiment Video

Updated: Feb 1, 2026

Comparing Eye-tracking Data of Children with High-functioning ASD, Comorbid ADHD, and of a Control Watching Social Videos
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Comorbidities as an Indication for Metabolic Surgery.

Anne-Catherine Schwarz1, Adrian T Billeter1, Katharina M Scheurlen1

  • 1Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany.

Visceral Medicine
|December 1, 2018
PubMed
Summary

Metabolic surgery offers significant benefits for type 2 diabetes mellitus (T2DM) and non-alcoholic steatohepatitis (NASH), improving survival and reversing complications. The Edmonton Obesity Staging System (EOSS) helps identify patients who will benefit most from these procedures.

Keywords:
Bariatric surgeryDiabetesEdmonton Obesity Staging System, EOSSGastric bypassMetabolic surgeryNon-alcoholic steatohepatitis, NASHRoux-en-Y gastric bypass, RYGBSleeveType 2 diabetes mellitus, T2DM

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Area of Science:

  • Metabolic diseases
  • Bariatric surgery
  • Hepatology

Background:

  • Metabolic diseases like type 2 diabetes mellitus (T2DM), dyslipidemia, and non-alcoholic steatohepatitis (NASH) are increasing globally.
  • Current medical therapies for these conditions have limited efficacy in improving survival or preventing complications.
  • NASH progression to cirrhosis and hepatocellular carcinoma remains a significant concern despite available treatments.

Purpose of the Study:

  • To propose evidence-based indications for metabolic surgery in patients with T2DM and NASH.
  • To highlight the effectiveness of metabolic surgery beyond BMI-based criteria.
  • To introduce a disease-specific staging system for patient selection.

Main Methods:

  • Review of current literature on metabolic surgery outcomes for T2DM and NASH.
  • Application of the Edmonton Obesity Staging System (EOSS) as a clinical staging tool.
  • Analysis of metabolic surgery's impact on mortality, complications, and disease remission.

Main Results:

  • Metabolic surgery significantly reduces overall and cardiovascular mortality in T2DM patients, independent of BMI.
  • It effectively reduces micro- and macrovascular complications and achieves T2DM remission with targeted glycemic control.
  • Metabolic surgery can reverse existing diabetic complications like nephropathy and features of NASH.

Conclusions:

  • Metabolic surgery is a highly effective treatment for T2DM and NASH, offering survival benefits and disease reversal.
  • The Edmonton Obesity Staging System (EOSS) provides an objective, BMI-independent method for identifying suitable surgical candidates.
  • Indications for metabolic surgery should be based on disease-specific staging to maximize patient benefit.