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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Natalia Jaimes, Michael A. Marchetti
Mucous membranes are epithelial surfaces with mucus-secreting cells that form the lining of body cavities; for example, the mucosa of the mouth lines the oral cavity, including the gingivae, palate, lips, buccal surfaces, and floor of the mouth.1 Mucous membranes are generally nonkeratinized stratified squamous epitheliums, although different sites demonstrate varying degrees of keratinization. Examples of mucosal surfaces include the conjunctivae, oral mucosa, nasal mucosa, and anogenital mucosa.
Viral infections
Published in Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald, Principles of Mucosal Immunology, 2020
Sarah Elizabeth Blutt, Mary K. Estes, Satya Dandekar, Phillip D. Smith
Mucosal surfaces of the genital and gastrointestinal tracts play fundamental roles in the pathogenesis of HIV-1 infection. First, these surfaces are the major route through which HIV-1 enters the body. Second, the intestinal mucosa is the site of the earliest and most intense viral replication, leading to profound local and systemic CD4+ T-cell depletion. Third, as a consequence of compromised immunity, the mucosa is a site of disabling infections due to opportunistic viral, parasitic, bacterial, and fungal pathogens. Consequently, HIV-1 disease may be viewed as a mucosal infection with systemic manifestations. Accordingly, in this section of the chapter, we discuss the role of the mucosal surfaces of the genital and gastrointestinal tracts in HIV-1 pathogenesis.
Enteral nutrition
Published in David Westaby, Martin Lombard, Therapeutic Gastrointestinal Endoscopy A problem-oriented approach, 2019
Occasionally, there are problems entering the stomach with the trochar needle because of excessive ‘tenting’ of the gastric mucosa. An additional risk in this situation is that the needle may puncture the posterior wall of the stomach. This is most likely to happen if the insertion site is at the inscisura or high in the gastric body where rugal folds are prominent and more readily stretched. If possible, a different insertion site should be found. Alternatively, gentle pressure can be applied with an open snare to oppose elongation of the fold. Great care is needed to avoid damaging the mucosa.
Current status and advances in esophageal drug delivery technology: influence of physiological, pathophysiological and pharmaceutical factors
Published in Drug Delivery, 2023
Ai Wei Lim, Nicholas J. Talley, Marjorie M. Walker, Gert Storm, Susan Hua
The average thickness of the esophageal wall is approximately 1.87 to 2.70 mm in the dilated state and 4.05 to 5.68 mm in the contracted state (Xia et al., 2009). The thickness of the esophageal wall has also been reported to be slightly larger in males (5.26 mm) compared to females (4.34 mm) (Xia et al., 2009). The wall of the esophagus is comprised of the mucosa, submucosa, and muscularis propria (Figure 1). In healthy individuals, the mucosa is composed of three layers – non-keratinized, stratified squamous epithelium; lamina propria (composed of connective tissue); and muscularis mucosa (Scott-Brown et al., 2008; Orlando, 2010; Standring, 2020). The muscularis mucosa is composed primarily of smooth muscle, with a combination of striated muscles at the upper part of the esophagus. The submucosa layer consists of predominantly blood vessels, lymphatic vessels, minor salivary glands, connective tissues, and autonomic nerve plexus (i.e. submucosal plexus). The muscularis propria is formed by a mixture of striated and smooth muscles and is responsible for motor functions of the esophagus.
An HIV-positive man with painless ulcer and pustules: mpox, syphilis, or both?
Published in Baylor University Medical Center Proceedings, 2023
Ian Thien Bui, Benjamin Sloan, Marc Tribble, Angela Yen Moore
Mpox can have cutaneous manifestations similar to other STIs but is differentiated based on the timeline of exposure and clinical manifestations. Mpox has an incubation period of 5 to 13 days prior to symptom onset, with or without flulike prodromes. Once cutaneous lesions are present, transmission of mpox can occur through direct contact of infectious lesions and bodily fluid. Lesions progress through several stages beginning with the presence of small macules (2–5 mm), which develop into shiny umbilicated papules or pseudopustules before crusting over 7 to 14 days after onset, indicating the lesions are no longer infectious.8 Physical examination should include visualization of the patient’s external lesions but also a thorough evaluation of the mucosa. With an adequate light source, clinicians should ask the patient to elevate the palate and uvula, depress and elevate the tongue, evaluate the upper and lower gingiva, and ensure a patent airway. Abnormalities should be noted on physical exam, as mpox is a reported cause of pharyngitis/ tonsillitis that can result in airway obstruction and respiratory distress.9,10
Lactobacillus complex capsules ameliorate aspirin-related small intestinal mucosal injury: a prospective, randomized, controlled clinical trial
Published in Scandinavian Journal of Gastroenterology, 2022
With the aging population, the use of aspirin has continued to increase. In this study, we found that the incidence of small intestinal mucosal injury was 84.1% (58/69 patients) in patients using aspirin for >1 month. The characteristics of capsule endoscopy include red spots, loss of villi, scars, erosions, and ulcers [17]. Our results showed that a majority of aspirin-related small intestinal mucosal injuries were red spots and erosions, and the incidence of small bowel ulcers was low. A significant proportion of patients with aspirin-related small intestinal mucosal injuries do not typically have any specific symptoms or laboratory abnormalities [18]. Small intestinal mucosal injury can easily be ignored until serious complications, such as acute bleeding, occult gastrointestinal bleeding, and obstruction, develop. In this study, we attempted to prescribe interventional treatment before patients develop complications.