Pub Date : 2024-05-09DOI: 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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Pub Date : 2024-05-02DOI: 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.
{"title":"Shared decision-making to design care that fits for each patient","authors":"Marleen Kunneman","doi":"10.1038/s41572-024-00522-0","DOIUrl":"https://doi.org/10.1038/s41572-024-00522-0","url":null,"abstract":"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.","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":null,"pages":null},"PeriodicalIF":81.5,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140828003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-25DOI: 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.
{"title":"Severe cutaneous adverse reactions","authors":"","doi":"10.1038/s41572-024-00520-2","DOIUrl":"https://doi.org/10.1038/s41572-024-00520-2","url":null,"abstract":"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.","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":null,"pages":null},"PeriodicalIF":81.5,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-18DOI: 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
{"title":"Polycystic ovary syndrome","authors":"","doi":"10.1038/s41572-024-00517-x","DOIUrl":"https://doi.org/10.1038/s41572-024-00517-x","url":null,"abstract":"the epidemiology, pathophysiology, diagnosis, management and quality of life of patients with polycystic ovary syndrome","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":null,"pages":null},"PeriodicalIF":81.5,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140609944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-18DOI: 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.
{"title":"Polycystic ovary syndrome","authors":"Elisabet Stener-Victorin, Helena Teede, Robert J. Norman, Richard Legro, Mark O. Goodarzi, Anuja Dokras, Joop Laven, Kathleen Hoeger, Terhi T. Piltonen","doi":"10.1038/s41572-024-00511-3","DOIUrl":"https://doi.org/10.1038/s41572-024-00511-3","url":null,"abstract":"<p>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.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":null,"pages":null},"PeriodicalIF":81.5,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140610223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-15DOI: 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
{"title":"Author Correction: Attention-deficit/hyperactivity disorder.","authors":"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","doi":"10.1038/s41572-024-00518-w","DOIUrl":"https://doi.org/10.1038/s41572-024-00518-w","url":null,"abstract":"","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":null,"pages":null},"PeriodicalIF":81.5,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-11DOI: 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。
{"title":"Gastric neuroendocrine neoplasms","authors":"","doi":"10.1038/s41572-024-00515-z","DOIUrl":"https://doi.org/10.1038/s41572-024-00515-z","url":null,"abstract":"the epidemiology, mechanisms, diagnosis, management and the quality of life of patients with gastric neuroendocrine neoplasms.","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":null,"pages":null},"PeriodicalIF":81.5,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140584740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}