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Oral Nutritional Supplements and Appetite Stimulation Therapy
Published in Michael M. Rothkopf, Jennifer C. Johnson, Optimizing Metabolic Status for the Hospitalized Patient, 2023
Michael M. Rothkopf, Jennifer C. Johnson
Our sense of taste is derived from three types of papillae on the surface of the tongue, soft palate, cheeks, epiglottis and upper esophagus (see Figure 16.3). These chemosensory organs are able to detect sweet, salt, sour and bitter tastes. A fifth taste called umami has been described, which refers to a savory or meaty flavor. Umami receptors respond to glutamates and nucleotides.
Acute erythematous rash on the trunk and limbs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
This disease may be confused with measles, but must be recognised because of the potentially serious association with myocarditis. It occurs in young children under the age of 5 (50% under 2 years of age). The onset is acute with fever, red eyes, dry lips and prominent papillae on the tongue. The most characteristic signs are the large glands in the neck, the rash on the trunk and limbs, and the red palms and soles, which later peel. A similar illness is seen rarely in young children with Covid-19 infection.
Looking at the Tongue
Published in K. Gupta, P. Carmichael, A. Zumla, 100 Short Cases for the MRCP, 2020
K. Gupta, P. Carmichael, A. Zumla
The filiform papillae are markedly overgrown (x4); the precise cause is unclear though it may be associated with a fungal infection. It tends to develop in individuals who are heavy smokers, or either on steroids or on broad spectrum antibiotics.
Critical roles of adherens junctions in diseases of the oral mucosa
Published in Tissue Barriers, 2023
Christina Kingsley, Antonis Kourtidis
Situated in the central portion of the oral cavity, the tongue is important in mastication, or chewing to form a bolus of food, and also assists in swallowing. The tongue consists of stratified squamous epithelium and is attached to the floor of the mouth via a folded structure, called the frenulum.4 The ventral portion of the tongue consists of stratified squamous, non-keratinized epithelium, while the dorsum of the tongue is covered by a specialized mucosa that can be either keratinized or non-keratinized2 (Figure 1). Taste bud papillae are found predominantly on the tongue and palate. There are three types of papillae: a) fungiform located on the anterior portion; b) circumvallate, which are located on the posterior part of the tongue; and c) foliate papillae located on the lateral sides of the tongue.5
Efficacy of 2% Rebamipide Suspension for Vernal Keratoconjunctivitis: A Clinical Comparison with Topical Immune Modulators Cyclosporine and Tacrolimus
Published in Ocular Immunology and Inflammation, 2022
Chintan Malhotra, Himanshi Singh, Arun Kumar Jain, Amit Gupta, Jagat Ram
Baseline examination included a detailed systemic history, uncorrected and corrected distance visual acuity, intraocular pressure measurement with noncontact tonometry, slit lamp biomicroscopy for ocular surface and anterior segment evaluation and a dilated fundus examination with indirect ophthalmoscopy. All recruited patients were administered a questionnaire at baseline and on subsequent visits at the 2nd, 6th and 12th week regarding the presence and severity of 7 ocular symptoms (itching, tearing, stinging, burning, foreign body sensation, discharge and photophobia)14 . Each symptom was scored from 0 to 3 in order of increasing severity and the total symptom score (range 0–21) recorded at every visit for each eye. This was followed by slit lamp biomicroscopy for the presence and severity of 10 clinical signs of VKC as previously described by Uchio et al.26These included signs of the palpebral conjunctiva (hyperemia, edema, follicles, papillae and giant papillae i.e. papillae size > 1 mm), bulbar conjunctiva (hyperemia, edema), limbus (Horner Tranta’s dots, swelling) and corneal epithelial signs (superficial punctate keratitis, shield ulcer or corneal erosion). Each sign was scored from 0 to 3 in order of increasing severity by a single observer. The total sign score (range 0–30) was tabulated and documented at each visit.
Revisiting Ocular Allergy: Evaluating Symptoms, Benzalkonium Chloride and Efficacy of Topical Ketotifen 0.025%
Published in Ocular Immunology and Inflammation, 2020
Kostas G. Boboridis, Nikolaos Kozeis, Anastasios GP. Konstas
Most importantly, the toxic effect of preservatives, mainly benzalkonium chloride (BAK), but also of active ingredients in prolonged topical treatment as in glaucoma therapy may involve an initial allergic reaction and ocular itching. However, in chronic cases, ocular surface toxicity prevails presenting as a type IV delayed inflammation mediated by T lymphocytes. This important drug adverse event manifests as chronic inflammatory reaction, which if untreated may eventually lead to conjunctival fibrosis and scar formation. Toxic conjunctivitis with initial follicular response which later can also involve papillae is frequently misdiagnosed as simple allergic conjunctivitis due to possible early mast cell and histamine involvement. It requires cessation or replacement of the offending topical medication and commencement of unpreserved anti-inflammatory treatment. Advanced cases or prolonged treatment of persistent OS inflammation would require beyond topical steroids, which due to side effects can only be administered for a short course, drugs with immunomodulatory action on T-cells such as topical cyclosporine or lifitegrast.2