TY  - CHAP
M1  - Book, Section
TI  - Precision Medicine and Clinical Care
A1  - Editors, The
A2  - Loscalzo, Joseph
A2  - Fauci, Anthony
A2  - Kasper, Dennis
A2  - Hauser, Stephen
A2  - Longo, Dan
A2  - Jameson, J. Larry
PY  - 2022
T2  - Harrison's Principles of Internal Medicine, 21e
AB  - Modern  disease  nosology  arose  in  the  late  nineteenth  century  and  represented  a  clear  departure  from  the  holistic,  limited  descriptions  of  disease  dating  to  Galen.  In  this  rubric,  the  definition  of  any  disease  is  largely  based  on  clinicopathologic  observation.  As  the  correlation  between  clinical  signs  and  symptoms  with  pathoanatomy  required  autopsy  material,  diseases  tended  to  be  characterized  by  the  end  organ  in  which  the  primary  syndrome  was  manifest  and  by  late-stage  presentations.  Morgagni  institutionalized  this  framework  with  the  publication  of  De  Sedibus  et  Causis  Morborum  per  Anatomen  Indagatis  in  1761,  in  which  he  correlated  the  clinical  features  of  patients  with  more  than  600  autopsies  at  the  University  of  Padua,  demonstrating  an  anatomic  basis  for  disease  pathophysiology.  Clinicopathologic  observation  served  as  the  basis  for  inductive  generalization  coupled  with  the  application  of  Occam’s  razor  in  which  disease  complexity  was  reduced  to  its  simplest  possible  form.  While  this  approach  to  defining  human  disease  has  held  sway  for  over  a  century  and  facilitated  the  conquest  of  many  diseases  previously  considered  incurable,  overly  inclusive  and  simplified  Oslerian  diagnostics  suffer  from  significant  shortcomings.  These  include,  but  are  not  limited  to,  failure  to  distinguish  the  underlying  etiology  of  different  diseases  with  common  pathophenotypes.  For  example,  many  different  diseases  can  cause  end-stage  kidney  disease  or  heart  failure.  Over  time,  the  classification  of  neurodegenerative  disorders  or  lymphomas,  as  well  as  many  other  diseases,  is  becoming  more  refined  and  precise  as  the  underlying  etiologies  are  identified.  These  distinctions  are  important  for  providing  predictable  prognostic  information  for  individual  patients  with  even  highly  prevalent  diseases.  Additionally,  therapies  may  be  ineffective  owing  to  a  lack  of  understanding  of  the  often  subtle  molecular  complexities  of  specific  disease  drivers.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accesspharmacy.mhmedical.com/content.aspx?aid=1190470675
ER  -