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Paediatric hydrocephalus. 小儿脑积水。
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-05-16 DOI: 10.1038/s41572-024-00527-9
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引用次数: 0
Glioma. 胶质瘤
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-05-09 DOI: 10.1038/s41572-024-00524-y
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引用次数: 0
Glioma. 胶质瘤
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-05-09 DOI: 10.1038/s41572-024-00516-y
Michael Weller, Patrick Y Wen, Susan M Chang, Linda Dirven, Michael Lim, Michelle Monje, Guido Reifenberger

Gliomas are primary brain tumours that are thought to develop from neural stem or progenitor cells that carry tumour-initiating genetic alterations. Based on microscopic appearance and molecular characteristics, they are classified according to the WHO classification of central nervous system (CNS) tumours and graded into CNS WHO grades 1-4 from a low to high grade of malignancy. Diffusely infiltrating gliomas in adults comprise three tumour types with distinct natural course of disease, response to treatment and outcome: isocitrate dehydrogenase (IDH)-mutant and 1p/19q-codeleted oligodendrogliomas with the best prognosis; IDH-mutant astrocytomas with intermediate outcome; and IDH-wild-type glioblastomas with poor prognosis. Pilocytic astrocytoma is the most common glioma in children and is characterized by circumscribed growth, frequent BRAF alterations and favourable prognosis. Diffuse gliomas in children are divided into clinically indolent low-grade tumours and high-grade tumours with aggressive behaviour, with histone 3 K27-altered diffuse midline glioma being the leading cause of glioma-related death in children. Ependymal tumours are subdivided into biologically and prognostically distinct types on the basis of histology, molecular biomarkers and location. Although surgery, radiotherapy and alkylating agent chemotherapy are the mainstay of glioma treatment, individually tailored strategies based on tumour-intrinsic dominant signalling pathways have improved outcome in subsets of patients.

胶质瘤是一种原发性脑肿瘤,被认为是由携带肿瘤诱发基因改变的神经干细胞或祖细胞发展而来。根据显微镜下的外观和分子特征,胶质瘤按照世界卫生组织(WHO)中枢神经系统(CNS)肿瘤分类法进行分类,从低度恶性到高度恶性分为 CNS WHO 1-4 级。成人弥漫浸润性胶质瘤包括三种肿瘤类型,其自然病程、对治疗的反应和预后各不相同:异柠檬酸脱氢酶(IDH)突变型和1p/19q编码缺失型少突胶质瘤预后最好;IDH突变型星形细胞瘤预后中等;IDH-Wild型胶质母细胞瘤预后较差。嗜酸性粒细胞星形细胞瘤是儿童中最常见的胶质瘤,其特点是呈环状生长、经常发生 BRAF 改变和预后良好。儿童弥漫性胶质瘤分为临床症状不明显的低级别肿瘤和具有侵袭性的高级别肿瘤,其中组蛋白3 K27改变的弥漫性中线胶质瘤是儿童胶质瘤相关死亡的主要原因。根据组织学、分子生物标志物和位置的不同,表皮神经胶质瘤在生物学和预后上被细分为不同的类型。虽然手术、放疗和烷化剂化疗是胶质瘤治疗的主要手段,但基于肿瘤内在主导信号通路的个体化治疗策略改善了部分患者的预后。
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引用次数: 0
Shared decision-making to design care that fits for each patient 共同决策,设计适合每位患者的护理方案
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-05-02 DOI: 10.1038/s41572-024-00522-0
Marleen Kunneman
In shared decision-making, patients and clinicians work together to make care decisions. This method of care is ethically desirable and practically feasible and may be effective in making care fit: forming plans of care that maximally respond to the patient’s situation and priorities while minimally disrupting their lives.
在共同决策中,患者和临床医生共同做出护理决定。这种护理方法在道德上是可取的,在实践中也是可行的,而且可以有效地使护理符合病人的需要:制定护理计划,最大限度地满足病人的情况和优先事项,同时尽量减少对病人生活的干扰。
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引用次数: 0
Severe cutaneous adverse reactions 严重皮肤不良反应
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-04-25 DOI: 10.1038/s41572-024-00520-2
This PrimeView highlights the epidemiology of severe cutaneous adverse reactions, and summarizes the mechanisms, diagnosis and management of this disorder. It accompanies the Primer article on this topic by Hung et al.
本报告重点介绍了严重皮肤不良反应的流行病学,并概述了这种疾病的机制、诊断和管理。它与 Hung 等人撰写的有关这一主题的入门文章配套。
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引用次数: 0
Severe cutaneous adverse reactions 严重皮肤不良反应
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-04-25 DOI: 10.1038/s41572-024-00514-0
S. Hung, Maja Mockenhaupt, Kimberly G. Blumenthal, Riichiro Abe, Mayumi Ueta, Saskia Ingen-Housz-Oro, Elizabeth J. Phillips, Wen-Hung Chung
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引用次数: 0
Polycystic ovary syndrome 多囊卵巢综合征
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-04-18 DOI: 10.1038/s41572-024-00517-x
the epidemiology, pathophysiology, diagnosis, management and quality of life of patients with polycystic ovary syndrome
多囊卵巢综合征患者的流行病学、病理生理学、诊断、管理和生活质量
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引用次数: 0
Polycystic ovary syndrome 多囊卵巢综合征
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-04-18 DOI: 10.1038/s41572-024-00511-3
Elisabet Stener-Victorin, Helena Teede, Robert J. Norman, Richard Legro, Mark O. Goodarzi, Anuja Dokras, Joop Laven, Kathleen Hoeger, Terhi T. Piltonen

Despite affecting ~11–13% of women globally, polycystic ovary syndrome (PCOS) is a substantially understudied condition. PCOS, possibly extending to men’s health, imposes a considerable health and economic burden worldwide. Diagnosis in adults follows the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, requiring two out of three criteria — clinical or biochemical hyperandrogenism, ovulatory dysfunction, and/or specific ovarian morphological characteristics or elevated anti-Müllerian hormone. However, diagnosing adolescents omits ovarian morphology and anti-Müllerian hormone considerations. PCOS, marked by insulin resistance and hyperandrogenism, strongly contributes to early-onset type 2 diabetes, with increased odds for cardiovascular diseases. Reproduction-related implications include irregular menstrual cycles, anovulatory infertility, heightened risks of pregnancy complications and endometrial cancer. Beyond physiological manifestations, PCOS is associated with anxiety, depression, eating disorders, psychosexual dysfunction and negative body image, collectively contributing to diminished health-related quality of life in patients. Despite its high prevalence persisting into menopause, diagnosing PCOS often involves extended timelines and multiple health-care visits. Treatment remains ad hoc owing to limited understanding of underlying mechanisms, highlighting the need for research delineating the aetiology and pathophysiology of the syndrome. Identifying factors contributing to PCOS will pave the way for personalized medicine approaches. Additionally, exploring novel biomarkers, refining diagnostic criteria and advancing treatment modalities will be crucial in enhancing the precision and efficacy of interventions that will positively impact the lives of patients.

尽管多囊卵巢综合症(PCOS)影响着全球约 11-13% 的女性,但对它的研究却远远不够。多囊卵巢综合症在全球范围内造成了相当大的健康和经济负担,并可能影响男性健康。成人多囊卵巢综合症的诊断遵循《多囊卵巢综合症评估和管理国际循证指南》,需要满足三个标准中的两个标准,即临床或生化高雄激素、排卵功能障碍和/或特定卵巢形态特征或抗穆勒氏激素升高。然而,青少年的诊断则省略了卵巢形态学和抗苗勒氏管激素的考虑。以胰岛素抵抗和高雄激素为特征的多囊卵巢综合症会导致早发的 2 型糖尿病,并增加心血管疾病的发病几率。与生殖相关的影响包括月经周期不规律、无排卵性不孕、妊娠并发症和子宫内膜癌的风险增加。除生理表现外,多囊卵巢综合征还与焦虑、抑郁、饮食失调、性心理障碍和负面身体形象有关,共同导致患者健康相关生活质量下降。尽管多囊卵巢综合征的发病率一直持续到绝经期,但诊断多囊卵巢综合征往往需要较长的时间和多次就医。由于对其潜在机制的了解有限,治疗仍然是临时性的,这突出表明需要对该综合征的病因和病理生理学进行研究。找出导致多囊卵巢综合症的因素将为个性化医疗方法铺平道路。此外,探索新型生物标志物、完善诊断标准和改进治疗方法对于提高干预措施的精确性和有效性至关重要,这将对患者的生活产生积极影响。
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引用次数: 0
Author Correction: Attention-deficit/hyperactivity disorder. 作者更正:注意缺陷/多动症。
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-04-15 DOI: 10.1038/s41572-024-00518-w
Stephen V Faraone, Mark A Bellgrove, Isabell Brikell, Samuele Cortese, Catharina A Hartman, Chris Hollis, Jeffrey H Newcorn, Alexandra Philipsen, Guilherme V Polanczyk, Katya Rubia, Margaret H Sibley, Jan K Buitelaar
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引用次数: 0
Gastric neuroendocrine neoplasms 胃神经内分泌肿瘤
IF 81.5 1区 医学 Q1 Medicine Pub Date : 2024-04-11 DOI: 10.1038/s41572-024-00515-z
the epidemiology, mechanisms, diagnosis, management and the quality of life of patients with gastric neuroendocrine neoplasms.
胃神经内分泌肿瘤患者的流行病学、发病机制、诊断、管理和生活质量。
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引用次数: 0
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Nature Reviews Disease Primers
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