PrimeViews in 2016

Aortic dissection is a medical emergency that requires prompt diagnosis and treatment to ensure patient survival. This PrimeView highlights the mechanisms and risk factors that contribute to aortic dissection, including hypertension, connective tissue disorders, inflammation and atherosclerosis.

Measles is caused by a highly infectious, airborne pathogen: measles virus. This PrimeView focuses on the transmission of this virus and explains how cheap and safe vaccines can be used to prevent transmission and eliminate measles globally.

Sjögren syndrome (SjS) is an autoimmune disease that is characterized by the development of sicca symptoms and, in some patients, systemic disease. This PrimeView focuses on the aetiopathogenetic mechanisms of SjS and also discusses the epidemiology, diagnosis and management of this disease.

This PrimeView highlights the three main components of managing patients with sepsis: infection control, haemodynamic stabilization and modulation of the septic response.

Uterine fibroids are common neoplasms of the uterus and can cause heavy or prolonged menstrual bleeding, as well as pain and urinary and gastrointestinal problems. This PrimeView focuses on the mechanisms underlying the development of uterine fibroids.

Systemic lupus erythematosus (SLE) is a potentially fatal, chronic autoimmune disorder. This PrimeView illustrates that SLE is heterogeneous with considerable variability in clinical manifestations and disease severity. Early diagnosis and prevention of flares is important to reduce long-term morbidity and mortality.

This PrimeView highlights the pathophysiology of acute-on-chronic liver failure in cirrhosis. In patients with cirrhosis, triggers of inflammation, such as sepsis and alcoholic hepatitis, can cause acute liver decompensation and organ failure, resulting in high short-term mortality.

Disseminated intravascular coagulation (DIC) is a medical emergency that can be caused by infectious or non-infectious conditions. The mechanisms underlying DIC — highlighted in this PrimeView — are an imbalance in the factors that control haemostasis.

This PrimeView highlights the mechanisms underlying tuberous sclerosis complex (TSC), a lifelong chronic disease caused by mutations in either TSC1 or TSC2. These mutations lead to signalling changes that promote the growth of benign tumours in various organs.

Primary hyperparathyroidism (PHPT) is a common disorder characterized by an excessive secretion of parathyroid hormone. This PrimeView accompanies the Primer by Bilezikian and colleagues and shows that PHPT can be caused by a single benign adenoma, multiglandular disease and parathyroid carcinoma.

Meniere's disease is a multifactorial disorder of the inner ear. This PrimeView highlights its common symptoms including tinnitus (continuous ringing noise), aural fullness (feeling of pressure in the ear), vertigo (a spinning sensation) and fluctuating hearing loss.

Benign prostatic hyperplasia, in which the prostate gland becomes enlarged, is a major cause of lower urinary tract symptoms in ageing men. This PrimeView highlights the available treatment options for this condition.

10–20% of adults will develop gallstones in their lifetime, and >20% of those will develop symptoms or complications. This PrimeView focuses on the most common risk factors, which include genetics, ethnicity, sex, age, drugs, parasites, overnutrition and pregnancy.

This PrimeView highlights the interplay between genetic mutations, signalling pathway aberrations, microenvironmental disturbances and metabolic reprogramming that underlie the development of pancreatic cancer.

Common risk factors for developing hepatocellular carcinoma (HCC) include cirrhosis, excessive alcohol consumption and viral hepatitis. This PrimeView highlights the management of HCC, for which there is only one systemic therapy and front-line treatment remains liver transplantation.

Clostridium difficile infection is an increasingly common infective healthcare-associated diarrhoea. This PrimeView highlights how the bacterium causes disease, which typically emerges after antibiotic-mediated dysbiosis of the gut.

Atrial fibrillation results from the disorganized propagation of electrical impulses in the heart. The subsequent ineffective pumping of blood increases the risk of coagulation and thrombosis, and stroke prevention is therefore the most important management priority for these patients.

Irritable bowel syndrome is a gastrointestinal disorder that can be mild in some patients, but debilitating in others. This PrimeView focuses on the complex aetiology and current understanding of the molecular pathophysiology, involving intestinal permeability, microbiota, inflammation and visceral sensitivity, among other factors.

One-third of people with diabetes develop diabetic retinopathy (DR). This PrimeView focuses on the pathophysiology of the different stages of DR, ranging from mild to severe non-proliferative DR and proliferative DR, with or without diabetic macular oedema.

Acute myeloid leukaemia is a malignant disorder that leads to an expansion of immature myeloid precursors at the expense of their differentiated counterparts. This PrimeView highlights how the disease can occur at all ages, but predominantly affects the elderly (>60 years of age).