Phillipa Hay, Jose C Appolinario, Katrin E Giel, Aaron Keshen, Deborah Mitchison, Ulrike Schmidt, Trevor Steward, Eric Stice
{"title":"Bulimia nervosa.","authors":"Phillipa Hay, Jose C Appolinario, Katrin E Giel, Aaron Keshen, Deborah Mitchison, Ulrike Schmidt, Trevor Steward, Eric Stice","doi":"10.1038/s41572-026-00726-6","DOIUrl":"https://doi.org/10.1038/s41572-026-00726-6","url":null,"abstract":"<p><p>Bulimia nervosa (BN) is common and has a global presence and burden. BN shares features with anorexia nervosa and binge eating disorder, but its cardinal feature is recurrent binge eating followed by extreme weight control or compensatory behaviours in association with high levels of weight and shape, and other body image and eating, preoccupations. The last three decades have seen advances in understanding the risk factors and psychobehavioural mechanisms of BN. These advances have informed primary prevention programmes that are effective in preventing the onset of risk factors and, in one selective programme, the onset of BN itself. First-line treatment for BN is psychological therapy, namely cognitive behaviour therapy for eating disorders. However, the challenge of a large treatment gap and the need to improve prevention and early detection of BN remains. Adaptations of treatments to increase their accessibility and reduce cost, alongside the growth of co-design and incorporation of lived experience expertise in research, are assisting in developing programmes that may effectively close this treatment gap. An increasingly sophisticated approach to understanding the neuroscience of BN has the potential to inform novel treatments in both psychological and biological spheres.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":79.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630935","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}
Marco Vincenzo Lenti, Carlo Maria Rossi, Evan S Dellon, Alfredo J Lucendo, Akinari Sawada, Antonella Cianferoni, Usha Krishnan, Margaret H Collins, Edoardo Vincenzo Savarino, Antonio Di Sabatino
{"title":"Eosinophilic gastrointestinal diseases.","authors":"Marco Vincenzo Lenti, Carlo Maria Rossi, Evan S Dellon, Alfredo J Lucendo, Akinari Sawada, Antonella Cianferoni, Usha Krishnan, Margaret H Collins, Edoardo Vincenzo Savarino, Antonio Di Sabatino","doi":"10.1038/s41572-026-00723-9","DOIUrl":"https://doi.org/10.1038/s41572-026-00723-9","url":null,"abstract":"<p><p>Eosinophilic gastrointestinal diseases (EGID) are characterized by abnormal and prominent eosinophilic inflammation of the gastrointestinal mucosa, associated with symptoms related to the segment involved, in the absence of secondary causes of eosinophilia. EGID may affect different parts of the gastrointestinal tract, causing eosinophilic oesophagitis (EoE), eosinophilic gastritis, eosinophilic enteritis and eosinophilic colitis either individually or in combination. Secondary causes of eosinophilic infiltration of the gastrointestinal tract include parasitic infections, the use of certain medications, vasculitis, allergic syndromes, haematological conditions and other inflammatory diseases. The incidence of EGID is increasing globally. EoE is the most reported form, with a prevalence of ~1 in 700 individuals. Several pathogenetic mechanisms are being investigated, in particular, the crosstalk between aeroallergens and mucosal inflammatory cell activation, which leads to a T helper 2 cell inflammatory response and disruption of epithelial barrier integrity. EGID is frequently associated with other T helper 2 cell-driven disorders, such as atopic dermatitis, allergic rhinitis and asthma. EGID is diagnosed through histological assessment, with biopsy samples of affected areas typically showing increased eosinophils, after excluding secondary causes of eosinophilia. For EoE, new treatments, including biologic therapies, are now available, whereas therapeutic options for non-EoE EGID remain limited. Patients' quality of life may be impaired owing to social and functional limitations from symptoms, such as dysphagia and food impaction in EoE, or diarrhoea and abdominal pain in eosinophilic colitis.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":79.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148579501","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}
Frédéric B Piel, Mariane de Montalembert, Reena Das, Kevin H M Kuo, Ali T Taher, Khaled M Musallam, Marsha Treadwell, Suthat Fucharoen, Michael Angastiniotis, Douglas Higgs, Elliott Vichinsky, Maria Domenica Cappellini, Lucia De Franceschi
{"title":"Thalassaemia.","authors":"Frédéric B Piel, Mariane de Montalembert, Reena Das, Kevin H M Kuo, Ali T Taher, Khaled M Musallam, Marsha Treadwell, Suthat Fucharoen, Michael Angastiniotis, Douglas Higgs, Elliott Vichinsky, Maria Domenica Cappellini, Lucia De Franceschi","doi":"10.1038/s41572-026-00722-w","DOIUrl":"https://doi.org/10.1038/s41572-026-00722-w","url":null,"abstract":"<p><p>The thalassaemia syndromes, which primarily include α-thalassaemia and β-thalassaemia, are a complex group of inherited disorders affecting haemoglobin production. They are prevalent throughout the most populated parts of the world and span a wide range of severity from mild to fatal. Advances in the management of these syndromes, including blood transfusion and iron chelation, have led to substantial improvements in the life expectancy and quality of life of many patients worldwide. Nevertheless, major forms of thalassaemia are still associated with chronic comorbidities and remain an important but neglected global health burden. Prevention and advances in the treatment and management of the thalassaemia syndromes rely on the early identification of people affected, either through prenatal or premarital screening or through newborn screening or testing at later stages in life. This depends on the availability of expertise, facilities and treatment options for patients. Fast and groundbreaking developments in disease-modifying and curative gene editing therapies are promising, but not without challenges in terms of costs, accessibility and uncertainties around their long-term benefits and safety. Better awareness, patient-centred approaches and coordinated strategies are needed to reduce current inequalities.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":79.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148422713","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}
Tomasz Darocha, Mathieu Pasquier, Konrad Mendrala, Michał Pluta, Kazue Oshiro, Justyna Swol, Silvia Mariani, Alice Hutin, Paweł Podsiadło, Sylweriusz Kosiński
{"title":"Accidental hypothermia.","authors":"Tomasz Darocha, Mathieu Pasquier, Konrad Mendrala, Michał Pluta, Kazue Oshiro, Justyna Swol, Silvia Mariani, Alice Hutin, Paweł Podsiadło, Sylweriusz Kosiński","doi":"10.1038/s41572-026-00717-7","DOIUrl":"10.1038/s41572-026-00717-7","url":null,"abstract":"<p><p>Accidental hypothermia is an unintentional drop in core body temperature below 35 °C. It can occur at any time of year and in any climate, and can affect all age groups. The epidemiology of accidental hypothermia reflects the interaction between biological susceptibility, social conditions and exposure to environmental factors. As core temperature falls and thermoregulation mechanisms become insufficient, the metabolism slows, consciousness deteriorates and the hypothermic myocardium becomes increasingly prone to arrhythmias and cardiac arrest. The prognosis is variable, and treatment outcomes are dependent on multiple factors, with cardiac arrest being the decisive determinant, carrying an in-hospital mortality rate of up to 50%. Diagnosis relies on accurate core temperature measurement whenever possible, together with clinical staging when measurement is unavailable. The management of accidental hypothermia should follow the hypothermic chain of survival: prevent further cooling, handle the patient gently, provide airway, breathing and circulatory support, choose the correct destination hospital, and rewarm the patient using passive, active external, active internal or extracorporeal techniques according to severity. Extracorporeal life support is crucial for patients with hypothermic cardiac arrest. Most survivors of hypothermic cardiac arrest have excellent neurological outcomes. Effective prevention and education, together with well-organized regional pathways of care and personalized strategies to prevent cardiac arrest, are needed to improve outcomes.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":79.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376266","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}
{"title":"Buruli ulcer in Africa: between innovation and pragmatism.","authors":"Karl N Fai, Lucrece Eteki, Eric Youm, Yap Boum","doi":"10.1038/s41572-026-00720-y","DOIUrl":"https://doi.org/10.1038/s41572-026-00720-y","url":null,"abstract":"","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":79.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148331404","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}
Anand Vaidya, Gregory A Kline, Paolo Mulatero, Adina F Turcu, Tracy Ann Williams, Vin-Cent Wu, Jun Yang, Maria-Christina Zennaro, André Lacroix
{"title":"Primary aldosteronism.","authors":"Anand Vaidya, Gregory A Kline, Paolo Mulatero, Adina F Turcu, Tracy Ann Williams, Vin-Cent Wu, Jun Yang, Maria-Christina Zennaro, André Lacroix","doi":"10.1038/s41572-026-00714-w","DOIUrl":"10.1038/s41572-026-00714-w","url":null,"abstract":"<p><p>Primary aldosteronism (PA) results from excessive aldosterone production by one or both adrenal glands and is an important cause of hypertension, leading to increased cardiovascular and renal morbidities. PA is primarily caused by a spectrum of somatic or germline mutations in aldosterone-driver genes and superimposed aberrant adrenal expression of various G-protein-coupled receptors and their ligands, leading to dysregulated aldosterone production. PA remains underdiagnosed, and simplified testing by measuring renin and aldosterone is recommended in all people with hypertension to maximize the diagnosis of PA. Some individuals with PA may also have co-secretion of cortisol, which contributes to cardiometabolic morbidities. Adrenal vein sampling, emerging functional imaging and novel biomarkers can identify whether a unilateral source of PA can be treated with surgical adrenalectomy. However, the majority of patients with PA have bilateral disease, warranting medical therapy with dietary sodium restriction and mineralocorticoid receptor antagonists, and aldosterone synthase inhibitors in the near future. Medical therapy objectives are to normalize blood pressure and serum potassium; a rise in renin can serve as a biomarker of adequate therapy and reduced risk for adverse cardio-renal outcomes. Patients with PA should be monitored longitudinally for disease progression or recurrence, to manage potential adverse effects of treatment, and to optimize therapy of cardiovascular and other co-morbidities.</p>","PeriodicalId":18910,"journal":{"name":"Nature Reviews Disease Primers","volume":"12 1","pages":""},"PeriodicalIF":79.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148331448","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}
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