942 resultados para genesis
Resumo:
La presente ricerca affronta lo studio della formazione delle realtà urbane nell'area dell'antico Ager Gallicus, grossomodo corrispondente all'attuale territorio delle Marche settentrionali. Nel quadro della colonizzazione romana il fenomeno urbano rappresenta, infatti, l'elemento cardine nell'organizzazione di un territorio. Per tale ragione, si è scelto di condurre un lavoro finalizzato alla comprensione dei tempi e dei modi che portarono alla formazione dei municipi e delle colonie nella strutturazione romana del territorio, cercando anche di comprendere le scelte insediative alla base delle singole forme strutturali. L'analisi della genesi e dello sviluppo del fenomeno urbano nell'ager Gallicus ha come obiettivo ultimo l'approfondimento della conoscenza sulla colonizzazione e romanizzazione in area medio adriatica. La ricerca si articola in: uno stato dell'arte delle più recenti interpretazioni storiografiche; una sintesi sulle cosiddette “forme della conquista” (frequentazioni “precoloniali”, realtà santuariali, fondazioni coloniarie, realtà proto-urbane legate all'agro); una dettagliata e aggiornata schedatura storico-archeologica e urbanistico-topografica delle singole realtà urbane dell'ager Gallicus (le colonie di Sena Gallica, Pisaurum, Fanum Fortunae e Aesis, e i municipi di Forum Sempronii, Suasa e Ostra, e Sentinum); una parte conclusiva dove, mettendo a confronto gli elementi alla base della definizione urbana delle realtà esaminate, vengono delineati e sintetizzati i principali modelli di formazione delle città nell'ager Gallicus così individuati (fondazione coloniaria; fondazione coloniaria preceduta da una fase precoloniale nella forma di conciliabulum; nucleo di aggregazione precedente (conciliabulum) scelto quale polo di riferimento del popolamento sparso nel territorio al momento delle distribuzioni viritane; centro di servizio creato in funzione di assegnazioni di terre ai coloni). Infine, viene tracciato un quadro complessivo della romanizzazione dell'ager Gallicus, che, in estrema sintesi, si configura come un processo progressivo di occupazione del territorio rispecchiato dallo sviluppo stesso del fenomeno urbano, ma che si differenzia dalle aree limitrofe o dall'area cisalpina per alcune importanti dinamiche etnico-demografiche.
Resumo:
La ricerca consiste nell’edizione e traduzione del trattato ‘Practica musice’ di Franchino Gaffurio corredata da apparati critici e storico-contestuali. Si inizia con la biografia dell’autore redatta secondo gli ultimi dati disponibili e si presenta una esposizione del contenuto del trattato con proposte di chiarimenti dei passi più oscuri. Segue quindi uno studio dei cambiamenti intercorsi tra le parti del trattato come trasmesse nei manoscritti preparatori e la sua versione finale a stampa, seguito da una indagine sulle edizioni successive all’editio princeps, con tabelle sulle varianti tra le edizioni. Vengono quindi offerte la trascrizione interpretativa del testo latino del trattato (che può essere considerata la più corretta attualmente disponibile ed è l’unica a riportare numeri di partizione testuale) seguita dalla sua traduzione in italiano, con trascrizione degli esempi musicali. Il trattato, diviso in quattro libri, ha per argomenti rispettivamente il cantus planus e le scale modali gregoriane, la musica misurata e le figure della notazione, l’arte del contrappunto e la più ampia casistica disponibile sulle proporzioni ritmiche.
Resumo:
Das menschliche Gen human giant larvae (hugl) ist ein Homolog des hochkonservierten Drosophila Gens lethal giant larvae (lgl), welches in Epithelzellen die Funktion eines neoplastischen Tumorsuppressors und Polaritätsregulators einnimmt. Ein Verlust oder eine verminderte Expression beider Homologe des Gens, hugl-1 und hugl-2, geht einher mit dem Auftreten und der Progression verschiedener epithelialer Tumorerkrankungen wie malignen Melanomen und Brust-, Kolon- oder Lungentumoren. Die exakte Funktion der Homologe Hugl-1 und Hugl-2 bezüglich der Regulation und Aufrechterhaltung der epithelialen Zellpolarität sowie ihre Rolle in der Genese humaner Tumore ist jedoch weitgehend unbekannt. Gänzlich unbekannt ist auch die Bedeutung von Hugl-1 und Hugl-2 als Polaritätsregulatoren für die Ausbildung und den Erhalt der T-Zellmorphologie und -funktion. Ziel der vorliegenden Arbeit war es daher, die Polaritäts- und Tumorsuppressorgene hugl-1 und hugl-2 in funktionellen Analysen mittels siRNA-vermitteltem Gen-Silencing in Epithelzellen und T-Lymphozyten zu charakterisieren. Darüber hinaus wurden die Funktionen und Eigenschaften von mgl-2, dem murinen Homologen von hugl-2, im Cre/loxP-vermittelten konditionalen Knockout Mausmodell in vivo analysiert.rnrnZur Charakterisierung der biologischen Effekte von Hugl-1 und Hugl-2 auf das Wachstumsverhalten, Migration und Invasion von Epithelzellen wurden in dieser Arbeit erfolgreich unterschiedliche shRNA-Expressionskonstrukte generiert sowie Hugl-supprimierte Zelllinien etabliert. In vitro Studien sowie in vivo Tumorigenizitätsanalysen lieferten übereinstimmend Hinweise darauf, dass verminderte Hugl-1- und Hugl-2-Expressionsspiegel eine signifikante Rolle in der Vermittlung invasiver und tumorigener Eigenschaften von Epithelzellen spielen. Dabei rief der Verlust beider Homologe deutlich stärkere Reaktionen hervor als die Suppression eines einzelnen Homologen. Zudem wiesen die Überexpression des Zellzyklusregulators Cyclin D1 sowie die Hyperproliferation von Hugl-1- und/oder Hugl-2-depletierten Epithelzellen auf eine wichtige Rolle der beiden Homologe in der Zellzyklusprogression und Zellproliferation hin. Ein geringer Expressionsstatus von Hugl-1 und -2 schien darüber hinaus mit einer verstärkten Resistenzbildung gegenüber Chemotherapeutika zu korrelieren. Im Rahmen dieser Arbeit konnte weiterhin gezeigt werden, dass die untersuchten T-Lymphozyten nur Hugl-1 exprimieren und dass letzteres notwendig für den F-Aktin-vermittelten Erhalt der T-Zellpolarität und -morphologie ist. Hugl-1-supprimierte, über voneinander unabhängige Signalwege (TCR- oder Chemokinrezeptor) stimulierte T-Lymphozyten wiesen eine bedeutende Störung der Lamellipodien- und Uropodausbildung auf und ließen eine Interaktion von Hugl-1 auf Ebene des F Aktins vermuten. Des Weiteren zeigte sich, dass der Polaritätsregulator Hugl-1 die CD3/TCR-induzierte Zelladhäsion positiv beeinflusst. Die Analyse der T-Zellmigration und -motilität offenbarte in Übereinstimmung dazu die Wichtigkeit von Hugl-1 für die Polarisierung und Migration der T-Zellen sowohl im Chemokingradienten als auch auf mDCs. rnrnFür die Aufklärung der funktionellen Rolle von mgl-2 in vivo wurde in dieser Arbeit eine Tamoxifen-induzierbare, Cre/loxP-vermittelte konditionale Mauslinie generiert und analysiert. Die mgl-2-deletierten Tiere wiesen weder signifikante phänotypische Unterschiede noch Abweichungen in der Organanatomie auf und ließen daher auf eine Kompensation durch das im Darmepithel koexprimierte und möglicherweise funktionell redundante mgl-1 Gen schließen.rn
Resumo:
Der Wilms-Tumor ist eine embryonale Tumorerkrankung der Niere, als deren Ursprung Nierenvorläuferzellen des metanephrischen Mesenchyms gelten, deren Differenzierung während der frühen Nephrogenese ausbleibt und aus denen nachfolgend durch eine maligne Transformation Wilms-Tumore entstehen. Zwei Gene, die an der Wilms-Tumorgenese beteiligt zu sein scheinen, sind WT1 (Wilms-Tumorgen 1) und CTNNB1 (Catenin, cadherin-associated protein, beta 1). Während WT1 u.a. die Differenzierung des metanephrischen Mesenchyms steuert, begünstigen aktivierende Mutationen von CTNNB1 und eine dadurch bedingte Akkumulation seines Proteins β-Catenin die Tumorgenese vieler Organe. So verwundert es nicht, dass eine alleinige heterozygote Keimbahnmutation von WT1, die einen dominant-negativen Effekt auf funktionsfähiges WT1 ausübt, häufig zur Entstehung von Wilms-Tumoren in Patienten mit Denys-Drash-Syndrom (DDS) führt, sowie in etwa 15 % aller sporadischen Wilms-Tumore WT1 und CTNNB1 mutiert sind.rnDer Mechanismus der Entstehung von Wilms-Tumoren ist weitgehend unbekannt, was u.a. daran liegt, dass homozygote Wt1-Mutationen in der Maus embryonal (~ Tag 13,5 d.p.c.) letal sind. In der vorliegenden Arbeit sollten daher mit Hilfe einer Wt1 k.o.-Effektormaus (WE2) vier murine konditional reversible Wilms-Tumor-Modelle auf Basis des Tet off-Systems hergestellt werden. Dadurch lag in den zu generierenden Tieren Wt1 durch die Integration des WE2-Transgens zwar nur heterozygot mutiert vor, doch durch den endogenen Wt1-Promotor des Transgens sollte es zur zeitlichen und räumlichen Wt1-analogen Expression eines tetrazyklinabhängigen Transaktivators (tTA) kommen, der ohne die Gabe von Doxycyclin Tet-regulierbare Transgene in Wt1-exprimierenden Zellen aktivieren kann, die einen positiven Einfluss auf die Wilms-Tumorgenese haben könnten. So sollte durch das WE2 DDS-Modell ein DDS simuliert werden und es in Tieren der Modelle WE2 TC bCat∆Ex3, WE2 LC bCat∆Ex3 und WE2 Wnt1 zur Akkumulation von β-Catenin in Wt1-exprimierenden Nierenvorläuferzellen kommen, so dass deren Differenzierung ausbleibt und es durch eine maligne Transformation zur Entstehung eines Wilms-Tumors kommt.rnrnMit Hilfe von histologischen Analysen an entsprechenden Responder-Linien konnte zunächst gezeigt werden, dass die embryonale und adulte Expressionsdomäne des WE2-Effektors mit der von endogenen Wt1 übereinstimmt. Gleichzeitig wurden aber auch neue Expressionsorte von Wt1 nachgewiesen. So konnte die Expression des WE2-Effektors z.B. im Endothel der dorsalen Aorta detektiert werden, der als Entstehungsort von hämatopoetischen Stammzellen gilt. Anschließende hier vorgestellte Experimente zeigten, dass Wt1 direkt an diesem Prozess beteiligt ist und belegten eine noch nicht beschriebene Funktion von Wt1 in der frühen Hämatopoese.rnEs war jedoch mit keinem System möglich, eine Wilms-Tumorerkrankung zu simulieren. Während Tiere des WE2 DDS-Modells trotz nachweisbarer Induktion keinen Phänotyp aufwiesen, war wohl in den anderen Modellen eine konstitutive β-Catenin-Aktivierung in der Frühschwangerschaft nicht mit dem embryonalen Überleben vereinbar. Dabei schienen alle tripeltransgenen bzw. doppeltransgenen Embryonen, in denen durch einen frühen Doxycyclinentzug die Entstehung von Wilms-Tumoren möglich gewesen wäre, intrauterin zu sterben. Wurde dagegen Doxycyclin erst in der dritten Lebenswoche entzogen, so entwickelten die Tiere durch eine Wt1-vermittelte β-Catenin-Aktivierung Granulosazelltumore, polyzystische Nieren und Veränderungen der Hoden. Da alle diese organischen Veränderungen während der prä- bis frühen postnatalen Phase induziert wurden, schien die Doxycyclinmenge nicht auszureichen, um eine β-Catenin-Aktivierung zu verhindern. Es hätte also auch zur Entstehung von Wilms-Tumoren kommen können, so dass diese Ergebnisse darauf hinweisen, dass eine β-Catenin-Aktivierung wahrscheinlich nicht der physiologisch entscheidende Schritt bei der Entstehung eines Wilms-Tumors ist.rnrnDie Charakterisierung der WE2-Effektormaus und die Herstellung und Analysen der Systeme geben damit Einblick in die WT1- bzw. WT1/CTNNB1-assoziierte Wilms-Tumorgenese und ermöglichen die weitere Erforschung von Granulosazelltumoren, polyzystsischen Nieren, Veränderungen von Hoden und der Rolle von WT1 in der frühen Hämatopoese.rn
Potential vorticity and moisture in extratropical cyclones : climatology and sensitivity experiments
Resumo:
The development of extratropical cyclones can be seen as an interplay of three positive potential vorticity (PV) anomalies: an upper-level stratospheric intrusion, low-tropospheric diabatically produced PV, and a warm anomaly at the surface acting as a surrogate PV anomaly. In the mature stage they become vertically aligned and form a “PV tower” associated with strong cyclonic circulation. This paradigm of extratropical cyclone development provides the basis of this thesis, which will use a climatological dataset and numerical model experiments to investigate the amplitude of the three anomalies and the processes leading in particular to the formation of the diabatically produced low-tropospheric PV anomaly.rnrnThe first part of this study, based on the interim ECMWF Re-Analysis (ERA-Interim) dataset, quantifies the amplitude of the three PV anomalies in mature extratropical cyclones in different regions in the Northern Hemisphere on a climatological basis. A tracking algorithm is applied to sea level pressure (SLP) fields to identify cyclone tracks. Surface potential temperature anomalies ∆θ and vertical profiles of PV anomalies ∆PV are calculated at the time of the cyclones’ minimum SLP and during the intensification phase 24 hours before in a vertical cylinder with a radius of 200 km around the surface cyclone center. To compare the characteristics of the cyclones, they are grouped according to their location (8 regions) and intensity, where the central SLP is used as a measure of intensity. Composites of ∆PV profiles and ∆θ are calculated for each region and intensity class at the time of minimum SLP and during the cyclone intensification phase.rnrnDuring the cyclones’ development stage the amplitudes of all three anomalies increase on average. In the mature stage all three anomalies are typically larger for intense than for weak winter cyclones [e.g., 0.6 versus 0.2 potential vorticity units (PVU) at lower levels, and 1.5 versus 0.5 PVU at upper levels].rnThe regional variability of the cyclones’ vertical structure and the profile evolution is prominent (cyclones in some regions are more sensitive to the amplitude of a particular anomaly than in other regions). Values of ∆θ and low-level ∆PV are on average larger in the western parts of the oceans than in the eastern parts. In addition, a large seasonal variability can be identified, with fewer and weaker cyclones especially in the summer, associated with higher low-tropospheric PV values, but also with a higher tropopause and much weaker surface potential temperature anomalies (compared to winter cyclones).rnrnIn the second part, we were interested in the diabatic low-level part of PV towers. Evaporative sources were identified of moisture that was involved in PV production through condensation. Lagrangian backward trajectories were calculated from the region with high PV values at low-levels in the cyclones. PV production regions were identified along these trajectories and from these regions a new set of backward trajectories was calculated and moisture uptakes were traced along them. The main contribution from surface evaporation to the specific humidity of the trajectories is collected 12-72 hours prior to therntime of PV production. The uptake region for weaker cyclones with less PV in the centre is typically more localized with reduced uptake values compared to intense cyclones. However, in a qualitative sense uptakes and other variables along single trajectories do not vary much between cyclones of different intensity in different regions.rnrnA sensitivity study with the COSMO model comprises the last part of this work. The study aims at investigating the influence of synthetic moisture modification in the cyclone environment in different stages of its development. Moisture was eliminated in three regions, which were identified as important moisture source regions for PV production. Moisture suppression affected the cyclone the most in its early phase. It led to cyclolysis shortly after its genesis. Nevertheles, a new cyclone formed on the other side of a dry box and developed relatively quickly. Also in other experiments, moisture elimination led to strong intensity reduction of the surface cyclone, limited upper-level development, and delayed or missing interaction between the two.rnrnIn summary, this thesis provides novel insight into the structure of different intensity categories of extratropical cyclones from a PV perspective, which corroborates the findings from a series of previous case studies. It reveals that all three PV anomalies are typically enhanced for more intense cyclones, with important regional differences concerning the relative amplitude of the three anomalies. The moisture source analysis is the first of this kind to study the evaporation-condensation cycle related to the intensification of extratropical cyclones. Interestingly, most of the evaporation occurs during the 3 days prior to the time of maximum cyclone intensity and typically extends over fairly large areas along the track of the cyclone. The numerical model case study complements this analysis by analyzing the impact of regionally confined moisture sources for the evolution of the cyclone.
Resumo:
Data sets describing the state of the earth's atmosphere are of great importance in the atmospheric sciences. Over the last decades, the quality and sheer amount of the available data increased significantly, resulting in a rising demand for new tools capable of handling and analysing these large, multidimensional sets of atmospheric data. The interdisciplinary work presented in this thesis covers the development and the application of practical software tools and efficient algorithms from the field of computer science, aiming at the goal of enabling atmospheric scientists to analyse and to gain new insights from these large data sets. For this purpose, our tools combine novel techniques with well-established methods from different areas such as scientific visualization and data segmentation. In this thesis, three practical tools are presented. Two of these tools are software systems (Insight and IWAL) for different types of processing and interactive visualization of data, the third tool is an efficient algorithm for data segmentation implemented as part of Insight.Insight is a toolkit for the interactive, three-dimensional visualization and processing of large sets of atmospheric data, originally developed as a testing environment for the novel segmentation algorithm. It provides a dynamic system for combining at runtime data from different sources, a variety of different data processing algorithms, and several visualization techniques. Its modular architecture and flexible scripting support led to additional applications of the software, from which two examples are presented: the usage of Insight as a WMS (web map service) server, and the automatic production of a sequence of images for the visualization of cyclone simulations. The core application of Insight is the provision of the novel segmentation algorithm for the efficient detection and tracking of 3D features in large sets of atmospheric data, as well as for the precise localization of the occurring genesis, lysis, merging and splitting events. Data segmentation usually leads to a significant reduction of the size of the considered data. This enables a practical visualization of the data, statistical analyses of the features and their events, and the manual or automatic detection of interesting situations for subsequent detailed investigation. The concepts of the novel algorithm, its technical realization, and several extensions for avoiding under- and over-segmentation are discussed. As example applications, this thesis covers the setup and the results of the segmentation of upper-tropospheric jet streams and cyclones as full 3D objects. Finally, IWAL is presented, which is a web application for providing an easy interactive access to meteorological data visualizations, primarily aimed at students. As a web application, the needs to retrieve all input data sets and to install and handle complex visualization tools on a local machine are avoided. The main challenge in the provision of customizable visualizations to large numbers of simultaneous users was to find an acceptable trade-off between the available visualization options and the performance of the application. Besides the implementational details, benchmarks and the results of a user survey are presented.
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The following thesis attempts to study and analyse the geomorphological evolution of a relatively small coastal area located to the North of Syracuse (Southeastern Sicily). The presently inactive Palombara Cave is located in this area. The 800 metres of passages in this cave show an evolution in some way linked to the local topographic and environmental changes. This portion of coastline was affected more or less constantly by the tectonic uplift during the Pleistocene, which simultaneously to the eustatic variations have played a key role in the genesis of the marine terraces and the cave. Starting from a DTM made from Lidar data, using a GIS procedure several marine terraces have been mapped. These informations combinated with a geomorphological study of the area, allowed to identify and recognise the different orders of the Middle Pleistocene terraced surfaces. Four orders of terraces between 180-75 m a.s.l have been observed, illustrated and described. Furthermore, two other supposed terrace edges located respectively at 60 and 35 m, which would indicate the presence of two more orders, have been recognised. All these marine terraces appear to have formed in the last million years. The morphological data of the Palombara cave, highlights a genesis related to the rising of CO2 rich waters coming from the depths through the fractures of the rock mass, that ranks it as a hypogenic cave. The development has been influenced by the changes in the water table, in turn determined by the fluctuations in the sea level. In fact, the cave shows a speleogenetic evolution characterised by phases of karstification in phreatic and epiphreatic environment and fossilization stages of the upper branches in vadose conditions. These observations indicate that the cave probably started forming around 600 Ky ago, contemporary to the start of volcanic processes in the area.
Resumo:
This dissertation is aimed at analysing deeply and thoroughly the most significant topics and features reflected in the Latin American literary work of Alberto Manzi. His almost thirty years of travelling and volunteering in the indigenous communities of South America formed a background of knowledge and experiences, which turned out to be crucial for the genesis of his Latin American trilogy. In the light of this, not only are ‘La luna nelle baracche’, ‘El loco’ and ‘E venne il sabato’ a speaking testimony of Manzi’s life and inner development, but they also offer a privileged perspective on the social, historical and religious situation of the people of Latin America. For a better understanding of the books, chapter one provides an extensive historical and economic commentary stretching over a century, from the collapse of the Spanish Empire to the rise of modern dictatorships in the late ‘70s, and the long democratic transition of the ‘80s. As far as the religious background is concerned, it is important to mention the influence of the liberation theology in the shaping of Manzi’s revolutionary thought. Indeed, chapter two identifies the precursors of the liberation theology, considers the effects of the Second Vatican Council on Latin America’s Catholic Church, and presents the methodology and the most powerful intuitions of the liberation theology. Finally, chapter three employs a critical analysis of Manzi’s Latin American trilogy, which focuses on his personal journal of his time in the austral continent, and Sonia and Giulia Manzi’s testimony published in a book entitled ‘Non è mai troppo tardi’. Chapter three provides an in-depth analysis of the evolution of the author’s revolutionary thought and plot dynamics; it discusses the psychological profile of the characters, the cultural features of the indigenous traditions, and the author’s urge to involve the readership in a permanent process of self-questioning.
Resumo:
Heschl's gyrus (HG) is functionally involved in the genesis of auditory verbal hallucinations (AVH). This dysfunction seems to be structurally facilitated. The aim of the study was to analyze macrostructural features of HG in a group of patients reporting AVH who demonstrated white matter diffusion tensor imaging abnormalities reported previously.
Resumo:
Pulse-wave velocity (PWV) is considered as the gold-standard method to assess arterial stiffness, an independent predictor of cardiovascular morbidity and mortality. Current available devices that measure PWV need to be operated by skilled medical staff, thus, reducing the potential use of PWV in the ambulatory setting. In this paper, we present a new technique allowing continuous, unsupervised measurements of pulse transit times (PTT) in central arteries by means of a chest sensor. This technique relies on measuring the propagation time of pressure pulses from their genesis in the left ventricle to their later arrival at the cutaneous vasculature on the sternum. Combined thoracic impedance cardiography and phonocardiography are used to detect the opening of the aortic valve, from which a pre-ejection period (PEP) value is estimated. Multichannel reflective photoplethysmography at the sternum is used to detect the distal pulse-arrival time (PAT). A PTT value is then calculated as PTT = PAT - PEP. After optimizing the parameters of the chest PTT calculation algorithm on a nine-subject cohort, a prospective validation study involving 31 normo- and hypertensive subjects was performed. 1/chest PTT correlated very well with the COMPLIOR carotid to femoral PWV (r = 0.88, p < 10 (-9)). Finally, an empirical method to map chest PTT values onto chest PWV values is explored.
Resumo:
The development of imaging technologies has contributed to the understanding of the genesis and pathophysiological mechanisms of geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Fundus autofluorescence (FAF) imaging allows accurate discrimination of the boundaries of atrophic patches. Furthermore, predictive markers for disease progression can be identified. Non-invasive FAF imaging now represents the gold standard for evaluating progressive enlargement of atrophic areas. By means of high resolution optical coherence tomography (OCT) microstructural retinal changes in GA can be identified. Anatomical endpoints are now being used in interventional GA trials and represent meaningful outcome parameters as surrogate markers in an overall slowly progressive disease which may not affect the fovea until later stages of the disease.
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Earth is the name of our planet and of an element from which we emerge. Pre-modern and non-modern traditions show us how to live at this conjunction better than many modern simulacra. This reflection examines in particular early medieval Christian tradition, set in dialogue with the emerging twenty-first-century field of ecosemiotics, while wandering from the Susquehanna Valley to Middle-earth.
Resumo:
Auditory hallucinations (AH) occur in various neurological and psychiatric disorders. In psychosis, increased neuronal activity in the primary auditory cortex (PAC) contributes to AH. We investigated functional neuroanatomy of epileptic hallucinations by measuring cerebral perfusion in three patients with AH during simple partial status epilepticus. Hyperperfusion in the temporal lobe covering the PAC occurred in all patients. Our perfusion data support the hypothesis of PAC being a constituting element in the genesis of AH independent of their aetiology.
Resumo:
In the recent years, for oral care in general, both improving oral hygiene and tobacco use cessation have been identified as necessary measures to gain and maintain long-term periodontal health. This growing evidence has given the dental team a whole new task to tackle when achieving and maintaining oral health with their patients. In order to support dental patients to quit tobacco use, it is helpful for the clinician to have a clear understanding of the genesis of 'tobacco use disease' in general. At present, the evidence-based method for tobacco use cessation consists of professional counselling on behavioural change using the so called "5A Method" (Ask, Advise, Assess, Assist and Arrange") in combination with pharmacotherapy. A suitable model for behavioural support in tobacco use cessation would help patients to move from one stage to the next. People who want to quit the smoking habit do not always participate in carefully controlled nicotine withdrawal programs, e.g. in linear fashion and from start to finish. Nevertheless, simple instructions - like those offered in the "Assist" (to help) and "Arrange" (to organize follow-up visits) - can be valuable tools for dental professionals supporting their patients to quit smoking. On the basis of significant evidence on the recovery of the oral mucosa and the periodontal tissue following tobacco use cessation, a new task has been emerged in dentistry: the role of oral health professionals providing counselling for patients who ought to quit tobacco use.
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The development of pulmonary edema is divided in cardiogenic and non-cardiogenic. Cardiogenic edema pathogenically is caused by elevated hydrostatic pressure in the pulmonary capillaries due to left sided congestive heart failure. Non-cardiogenic pulmonary edema is categorized depending on the underlying pathogenesis in low-alveolar pressure, elevated permeability or neurogenic edema. Some important examples of causes are upper airway obstruction like in laryngeal paralysis or strangulation for low alveolar pressure, leptospirosis and ARDS for elevated permeability, and epilepsy, brain trauma and electrocution for neurogenic edema. The differentiation between cardiogenic versus non-cardiogenic genesis is not always straightforward, but most relevant, because treatment markedly differs between the two. Of further importance is the identification of the specific underlying cause in non-cardiogenic edema, not only for therapeutic but particularly for prognostic reasons. Depending on the cause the prognosis ranges from very poor to good chance of complete recovery.