Chronic degeneration of connective tissue components can be produced by a variety of autoimmune mechanisms. The designations connective tissue disease and collagen-vascular disease are commonly used to describe such conditions when a patient exhibits chronic, immune-mediated deterioration of connective tissue structures in a systemic distribution. Recognized conditions that fit this definition include rheumatoid arthritis, lupus erythematosus, progressive systemic sclerosis, CREST syndrome, and mixed connective tissue disease. Several characteristic oral manifestations of these conditions are recognized. Xerostomia associated with any of these conditions in addition to dryness of the eyes is the definition of secondary Sjögren's syndrome. Fibrosis of facial skin and the resulting limited jaw opening are diagnostic features of progressive systemic sclerosis. Several periodontal manifestations are associated with these connective tissue disorders. Dramatic periodontal ligament space widening that is associated with some cases of progressive systemic sclerosis has been appreciated for more than five decades. However, it has been more recently reported that the majority of progressive systemic sclerosis patients exhibit at least subtle generalized periodontal ligament widening when intraoral radiographs are carefully evaluated. This finding is, however, of limited periodontal significance because the teeth are typically not mobile. Comparisons of periodontitis indices such as pocket depth between healthy subjects and patients with progressive systemic sclerosis do not reveal significant differences (21). In addition, recent evidence suggests a tendency for more severe or progressive manifestations of periodontitis as a consequence of xerostomia that may result from these diseases.
op-performing global companies, much like their competitors, are banking on innovation to drive growth. But, unlike their competitors, they are investing in the product development capabilities, the supply chain process infrastructure, and the sophisticated information systems needed to support and synchronize innovation across the value chain. In stark contrast, most companies betting their future on their current innovation projects are not prioritizing investments in the supporting processes and infrastructure. Our research shows why this is a bad gamble.Over the last two years, we have studied the growth strategies and the supporting operations of nearly 650 companies around the world. From the executives participating in this research it is evident that for most companies today innovation is seen as the chief source of growth. Despite this expectation that innovation will drive corporate fortunes, our research also makes it clear that building or restructuring business operations to profitably bring new products and services to market is near the bottom of most companies' priorities.Our research shows this disparity between goals and infrastructure investment to hold true in just about every industry we have analyzed -for example, consumer products, automotive, chemicals, and process, pharmaceuticals, high technology and telecommunications equipment. However, overcoming this ''innovation contradiction'' is crucial to survival and success in increasingly complex global markets. The challenge becomes more formidable because companies continue to increase the complexity of their operations by globalizing sourcing, manufacturing, engineering, and marketing/sales operations. This growing complexity makes it ever more difficult to manage product lifecycles optimally.Of the nearly 650 companies from North America and Europe in our study, few have invested adequate resources in infrastructure to support innovation [1]. However, those making significant investment have generated far better business performance, with profit levels up to 70 percent higher than other groups of companies studied[2] (see Box 1). As we see from our research across leading companies -such as Mondi, Samsung Electronics, Porsche AG, and Rohm & Haas -a key factor to success in global markets is the ability to coordinate innovation across their global, complex operations.'' Of the nearly 650 companies from North America and Europe in our study . . . those making significant investment [in innovation infrastructure] have generated far better business performance, with profit levels up to 70 percent or higher compared to other groups of companies studied. ''
lobal manufacturers are focused intently on the opportunities to develop and sell their products in emerging markets. But long-term success will take far more than simply making minor adjustments to existing products, lowering prices, and developing new sales channels.Companies will need to acquire a new set of competencies and organizational structures to generate a continuing stream of innovative products tailored to the needs of consumers and industrial buyers in emerging markets. They will need to allow for local autonomy, for example local R&D and local commercial operations, while taking advantage of their parent company's governance, business processes, and management expertise to offer these products at dramatically lower prices that match the lower purchasing power of most buyers in emerging markets.By creating markets for their products among more than three billion people and numerous companies in emerging markets (according to 2005 estimates of the United Nations Population Division), many of whom are not currently being effectively served in many categories, manufacturers have the ability to drive sustainable, profitable growth. They also have the potential to develop products and skills that can be used to change the competitive landscape of developed markets as well.These are some of the preliminary findings emerging from research by Member Firms of Deloitte Touche Tohmatsu (''Deloitte'') on what is required for global manufacturers to realize the enormous market potential of the emerging economies of Asia, Eastern Europe, and Latin America. The research includes a survey that has been completed so far by more than 200 executives, in-depth case studies, and the extensive experience of Deloitte Member Firms in advising major manufacturers operating in emerging markets.
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