The Irrelevance of Harm for a Theory of Disease

Abstract Normativism holds that there is a close conceptual link between disease and disvalue. We challenge normativism by advancing an argument against a popular normativist theory, Jerome Wakefield’s harmful dysfunction account. Wakefield maintains that medical disorders are breakdowns (dysfunctions) in evolved mechanisms that cause significant harm to the organism. We argue that Wakefield’s account is not a promising way to distinguish between disease and health because being harmful is neither necessary nor sufficient for a dysfunction to be a disorder. Counterexamples to the harmful dysfunction account are considered, such as mild infections, perceptual deficits, and beneficial illnesses. Then we consider two ways of amending the harmful dysfunction account to address these cases and argue that the proposed amendments raise even more serious problems for this account. These problems apply generally to any normativist theory and raise doubts about the entire normative approach to the philosophy of health and disease.

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Can Relational Problems be Genuine Medical Disorders? A Harmful Dysfunction Perspective

PsycEXTRA Dataset ◽

10.1037/e601312007-009 ◽

2006 ◽

Author(s):

Jerome Wakefield

Keyword(s):

Medical Disorders ◽

Harmful Dysfunction

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Modifying muscle mass – the endocrine perspective

Journal of Endocrinology ◽

10.1677/joe.1.06837 ◽

2006 ◽

Vol 191 (2) ◽

pp. 349-360 ◽

Cited By ~ 101

Author(s):

A M Solomon ◽

P M G Bouloux

Keyword(s):

Molecular Mechanisms ◽

Negative Regulator ◽

Specific Reference ◽

Exciting Field ◽

Medical Disorders ◽

Age Related ◽

Health And Disease ◽

Endocrine Factors ◽

Atrophy And Hypertrophy

This review describes the major hormonal factors that determine the balance between human skeletal muscle anabolism and catabolism in health and disease, with specific reference to age-related muscle loss (sarcopenia). The molecular mechanisms associated with muscle hypertrophy are described, and the central role of the satellite cell highlighted. The biological dynamics of satellite cells, varying between states of quiescence, proliferation and differentiation are strongly influenced by local endocrine factors. The molecular mechanisms of muscle atrophy are examined focussing on the causes of sarcopenia and associations with systemic medical disorders. In addition, evidence is provided that the mechanisms of atrophy and hypertrophy are unlikely to be simple opposites. Novel endocrine mechanisms underpinning mechano-transduction include IGF-I subtypes that may differentiate between endocrine and mechanical signals; their interaction with classical endocrine factors is an active area of translational research. Recently acquired knowledge on the mechanism of anabolic effects of androgens is also reviewed. The increasingly recognised role of myostatin, a negative regulator of muscle function, is described, as well as its potential as a therapeutic target. Strategies to counter age-related sarcopenia thus represent an exciting field of future investigation.

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LTBP4 in Health and Disease

Genes ◽

10.3390/genes12060795 ◽

2021 ◽

Vol 12 (6) ◽

pp. 795

Author(s):

Chi-Ting Su ◽

Zsolt Urban

Keyword(s):

Growth Factor ◽

Cancer Progression ◽

Calcium Binding ◽

Autosomal Recessive ◽

Transforming Growth Factor ◽

Structural Homology ◽

Medical Disorders ◽

Domain Composition ◽

Health And Disease ◽

Epidermal Growth

Latent transforming growth factor ꞵ (TGFꞵ)-binding protein (LTBP) 4, a member of the LTBP family, shows structural homology with fibrillins. Both these protein types are characterized by calcium-binding epidermal growth factor-like repeats interspersed with 8-cysteine domains. Based on its domain composition and distribution, LTBP4 is thought to adopt an extended structure, facilitating the linear deposition of tropoelastin onto microfibrils. In humans, mutations in LTBP4 result in autosomal recessive cutis laxa type 1C, characterized by redundant skin, pulmonary emphysema, and valvular heart disease. LTBP4 is an essential regulator of TGFꞵ signaling and is related to development, immunity, injury repair, and diseases, playing a central role in regulating inflammation, fibrosis, and cancer progression. In this review, we focus on medical disorders or diseases that may be manipulated by LTBP4 in order to enhance the understanding of this protein.

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Thyroid Disease: A Guide for the Head and Neck Surgeon

Annals of Otology Rhinology & Laryngology ◽

10.1177/00034894800894s301 ◽

1980 ◽

Vol 89 (4_suppl3) ◽

pp. 1-16 ◽

Cited By ~ 1

Author(s):

Robert M. Bumsted

Keyword(s):

Thyroid Gland ◽

Head And Neck ◽

Thyroid Function ◽

Surgical Therapy ◽

Thyroid Disease ◽

Surgical Techniques ◽

Basic Knowledge ◽

Laboratory Findings ◽

Medical Disorders ◽

Health And Disease

Head and neck surgeons are involved in the diagnosis and therapy of thyroid disease with increasing frequency. The surgical techniques utilized for the management of thyroid disease are well known by most head and neck surgeons and will not be discussed in this paper. It is the head and neck surgeons' knowledge of the physiology, medical disorders, and the proper evaluation of the patient with thyroid disease that is most open to criticism. This paper reviews thyroid physiology, basic tests used to assess thyroid function in health and disease, thyroiditis, thyroid carcinomas, and nodules of the thyroid gland. The signs, symptoms, laboratory findings, and the methods of medical and surgical therapy are discussed for each of these disorders. The supplement is not intended to provide expertise, but will provide a general and basic knowledge of thyroid disease.

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Medicine in Ethiopia

Proceedings of the Royal Society of London Series B Biological Sciences ◽

10.1098/rspb.1976.0064 ◽

1976 ◽

Vol 194 (1114) ◽

pp. 49-56

Keyword(s):

Oxygen Tension ◽

Personal Experience ◽

Addis Ababa ◽

Medical Disorders ◽

Ethiopian Plateau ◽

Parenchymal Liver ◽

Health And Disease ◽

Alveolar Oxygen ◽

The Tropics ◽

Inspired Oxygen

The medical school in Addis Ababa is situated 9° N of the Equator at an altitude of about 2500 m, the average for the greater part of Central Ethiopian plateau. This altitude corresponds to an inspired oxygen tension of 14.2 kPa (107 mmHg) and an alveolar oxygen tension of around 9.3 kPa (70 mmHg). Clinical practice in Addis Ababa is conducted therefore at medium altitude and within the tropics. To date, no clinical studies have been made of altitude effects on health and disease. This paper will present the personal experience of the author of ten years and of approximately 30 000 patients presenting with ‘medical’ disorders at the Princess Tsehai Memorial Hospital, which has been throughout the principal teaching hospital in Addis Ababa. The diseases encountered have been above all those of poverty and to a lesser extent of tropical parasitisms. A unique feature has been an overwhelming burden of parenchymal liver disease of uncertain pathogenesis. The influence of altitude on heart and lung disease is considered, but the consideration is necessarily speculative rather than factual.

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Drug Induced Changes in Cell Organelles

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100100299 ◽

1968 ◽

Vol 26 ◽

pp. 110-111

Author(s):

Sarah A. Luse

Keyword(s):

Clinical Medicine ◽

Cell Organelles ◽

Riboflavin Deficiency ◽

Drug Induced ◽

New Era ◽

Health And Disease ◽

In The Beginning ◽

Cellular Pathology ◽

Induced Changes ◽

The Impact

In the mid-nineteenth century Virchow revolutionized pathology by introduction of the concept of “cellular pathology”. Today, a century later, this term has increasing significance in health and disease. We now are in the beginning of a new era in pathology, one which might well be termed “organelle pathology” or “subcellular pathology”. The impact of lysosomal diseases on clinical medicine exemplifies this role of pathology of organelles in elucidation of disease today.Another aspect of cell organelles of prime importance is their pathologic alteration by drugs, toxins, hormones and malnutrition. The sensitivity of cell organelles to minute alterations in their environment offers an accurate evaluation of the site of action of drugs in the study of both function and toxicity. Examples of mitochondrial lesions include the effect of DDD on the adrenal cortex, riboflavin deficiency on liver cells, elevated blood ammonia on the neuron and some 8-aminoquinolines on myocardium.

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The Laryngeal Epithelium in Reflux

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd21.3.112 ◽

2011 ◽

Vol 21 (3) ◽

pp. 112-117 ◽

Cited By ~ 2

Author(s):

Elizabeth Erickson-Levendoski ◽

Mahalakshmi Sivasankar

Keyword(s):

Laryngopharyngeal Reflux ◽

Critical Role ◽

Structure And Function ◽

Laryngeal Disease ◽

Health And Disease ◽

And Function ◽

The Impact

The epithelium plays a critical role in the maintenance of laryngeal health. This is evident in that laryngeal disease may result when the integrity of the epithelium is compromised by insults such as laryngopharyngeal reflux. In this article, we will review the structure and function of the laryngeal epithelium and summarize the impact of laryngopharyngeal reflux on the epithelium. Research investigating the ramifications of reflux on the epithelium has improved our understanding of laryngeal disease associated with laryngopharyngeal reflux. It further highlights the need for continued research on the laryngeal epithelium in health and disease.

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