CZ:Featured article/Current: Difference between revisions

From Citizendium
Jump to navigation Jump to search
imported>Chunbum Park
imported>John Stephenson
(template)
 
(83 intermediate revisions by 5 users not shown)
Line 1: Line 1:
== '''[[Pulmonary embolism]]''' ==
{{:{{FeaturedArticleTitle}}}}
----
<small>
'''Pulmonary embolism''' (PE) is form of [[embolism and thromboembolism]] in which a blockage of the [[pulmonary artery]] (or one of its branches), usually when a [[deep vein thrombosis]] (blood clot from a vein), becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs.<ref name="pmid18322285">{{cite journal |author=Tapson VF |title=Acute pulmonary embolism |journal=N. Engl. J. Med. |volume=358 |issue=10 |pages=1037–52 |year=2008 |month=March |pmid=18322285 |doi=10.1056/NEJMra072753 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=18322285&promo=ONFLNS19 |issn=}}</ref> This process is termed ''thromboembolism''.
==Footnotes==
{{TOC|right}}
===Pathophysiology===
The development of thrombosis is classically due to a group of causes named [[Virchow's triad]] (alterations in blood flow, factors in the vessel wall and factors affecting the properties of the blood). Often, more than one risk factor is present.
* ''Alterations in blood flow'': immobilization (after surgery, [[Physical trauma|injury]] or [[Economy class syndrome|long-distance air travel]]), [[pregnancy]] (also procoagulant), [[obesity]] (also procoagulant)
* ''Factors in the vessel wall'': of limited direct relevance in VTE
* ''Factors affecting the properties of the blood'' (procoagulant state):
** [[Estrogen]]-containing [[hormonal contraception]]
** Genetic thrombophilia ([[factor V Leiden]],  [[protein C deficiency]], [[protein S deficiency]], [[antithrombin]] deficiency, [[hyperhomocysteinemia]] and [[plasminogen]]/[[fibrinolysis]] disorders). The role of [[prothrombin]] mutation G20210A, is  unclear.<ref name="pmid19531787">{{cite journal |author=Segal JB, Brotman DJ, Necochea AJ, ''et al.'' |title=Predictive value of factor V Leiden and prothrombin G20210A in adults with venous thromboembolism and in family members of those with a mutation: a systematic review |journal=JAMA |volume=301 |issue=23 |pages=2472–85 |year=2009 |month=June |pmid=19531787 |doi=10.1001/jama.2009.853 |url=http://jama.ama-assn.org/cgi/pmidlookup?view=long&pmid=19531787 |issn=}}</ref>
** Acquired thrombophilia (malignancy, [[antiphospholipid syndrome]], [[nephrotic syndrome]], [[paroxysmal nocturnal hemoglobinuria]])
===Diagnosis===
The diagnosis of PE is based primarily on validated clinical criteria combined with selective testing because the typical clinical presentation ([[shortness of breath]], [[chest pain]]) cannot be definitively differentiated from other causes of chest pain and shortness of breath.<ref name="pmid14657070">{{cite journal |author=Chunilal SD, Eikelboom JW, Attia J, ''et al'' |title=Does this patient have pulmonary embolism? |journal=JAMA |volume=290 |issue=21 |pages=2849–58 |year=2003 |pmid=14657070 |doi=10.1001/jama.290.21.2849 |issn=}}</ref> Patients can present with atypical syndromes such as unexplained exacerbations of chronic obstructive pulmonary disease.<ref name="pmid16549851">{{cite journal |author=Tillie-Leblond I, Marquette CH, Perez T, ''et al'' |title=Pulmonary embolism in patients with unexplained exacerbation of chronic obstructive pulmonary disease: prevalence and risk factors |journal=Ann. Intern. Med. |volume=144 |issue=6 |pages=390–6 |year=2006 |month=March |pmid=16549851 |doi= |url= |issn=}}</ref>
''[[Pulmonary embolism|.... (read more)]]''
 
{| class="wikitable collapsible collapsed" style="width: 90%; float: center; margin: 0.5em 1em 0.8em 0px;"
|-
! style="text-align: center;" | &nbsp;[[Pulmonary embolism#References|notes]]
|-
|
{{reflist|2}}
{{reflist|2}}
|}
</small>

Latest revision as of 10:19, 11 September 2020

In computational molecular physics and solid state physics, the Born-Oppenheimer approximation is used to separate the quantum mechanical motion of the electrons from the motion of the nuclei. The method relies on the large mass ratio of electrons and nuclei. For instance the lightest nucleus, the hydrogen nucleus, is already 1836 times heavier than an electron. The method is named after Max Born and Robert Oppenheimer[1], who proposed it in 1927.

Rationale

The computation of the energy and wave function of an average-size molecule is a formidable task that is alleviated by the Born-Oppenheimer (BO) approximation.The BO approximation makes it possible to compute the wave function in two less formidable, consecutive, steps. This approximation was proposed in the early days of quantum mechanics by Born and Oppenheimer (1927) and is indispensable in quantum chemistry and ubiquitous in large parts of computational physics.

In the first step of the BO approximation the electronic Schrödinger equation is solved, yielding a wave function depending on electrons only. For benzene this wave function depends on 126 electronic coordinates. During this solution the nuclei are fixed in a certain configuration, very often the equilibrium configuration. If the effects of the quantum mechanical nuclear motion are to be studied, for instance because a vibrational spectrum is required, this electronic computation must be repeated for many different nuclear configurations. The set of electronic energies thus computed becomes a function of the nuclear coordinates. In the second step of the BO approximation this function serves as a potential in a Schrödinger equation containing only the nuclei—for benzene an equation in 36 variables.

The success of the BO approximation is due to the high ratio between nuclear and electronic masses. The approximation is an important tool of quantum chemistry, without it only the lightest molecule, H2, could be handled; all computations of molecular wave functions for larger molecules make use of it. Even in the cases where the BO approximation breaks down, it is used as a point of departure for the computations.

Historical note

The Born-Oppenheimer approximation is named after M. Born and R. Oppenheimer who wrote a paper [Annalen der Physik, vol. 84, pp. 457-484 (1927)] entitled: Zur Quantentheorie der Molekeln (On the Quantum Theory of Molecules). This paper describes the separation of electronic motion, nuclear vibrations, and molecular rotation. A reader of this paper who expects to find clearly delineated the BO approximation—as it is explained above and in most modern textbooks—will be disappointed. The presentation of the BO approximation is well hidden in Taylor expansions (in terms of internal and external nuclear coordinates) of (i) electronic wave functions, (ii) potential energy surfaces and (iii) nuclear kinetic energy terms. Internal coordinates are the relative positions of the nuclei in the molecular equilibrium and their displacements (vibrations) from equilibrium. External coordinates are the position of the center of mass and the orientation of the molecule. The Taylor expansions complicate the theory tremendously and make the derivations very hard to follow. Moreover, knowing that the proper separation of vibrations and rotations was not achieved in this work, but only eight years later [by C. Eckart, Physical Review, vol. 46, pp. 383-387 (1935)] (see Eckart conditions), chemists and molecular physicists are not very much motivated to invest much effort into understanding the work by Born and Oppenheimer, however famous it may be. Although the article still collects many citations each year, it is safe to say that it is not read anymore, except maybe by historians of science.

Footnotes

  1. Wikipedia has an article about Robert Oppenheimer.