Main description:

In the Western world, alcohol is the most abused drug. recognized that a majority of patients with cirrhosis do For all the attention being directed toward heroin, co admit to excessive alcohol consumption. Other tissues caine, and marijuana, the favorite mood-altering drug in can also be severely affected, including brain, gut, the United States, as in almost every human society, is heart, endocrine systems, bone, blood, and muscle. A question often raised is, "In what way does an alcoholic alcohol. In nature, the fermentation of sugars is the differ from a nonalcoholic?" Inquiries have focused on major source of ethanol, but how humans first encoun tered it is unclear. It most likely occurred in either psychological make-up, behavioral differences, and socio fermented fruit juices (wine), fermented grain (beer), or economic factors. More recently, however, physical dif fermented honey (mead). Whether the Paleolithic Stone ferences have been delineated. Prior to the development Age man knew of ethanol is undetermined, but it is of various disease entities, chronic ethanol exposure abundantly clear that his Neolithic descendants were results in profound biochemical and morphological familiar with the product of fermentation. With the changes. Consequently, an alcoholic does not respond exception of the original inhabitants of Tierra del Fuego, normally to alcohol, other drugs, or even other toxic the Australian aborigines, and some polar tribes, all agents.

Contents:

1. Metabolism of Ethanol.- 1.1. Pathways of Ethanol Oxidation.- 1.2. Alteration in the Metabolism of Ethanol after Chronic Ethanol Consumption.- 1.3. Effects of Liver Disease, Blood Flow, Circadian Rhythm, Gender, and Other Factors on Hepatic Alcohol Metabolism.- 1.4. Effects of Other Drugs on Ethanol Metabolism.- 1.5. Ethnic and Genetic Factors in Ethanol Metabolism.- 1.6. Extrahepatic Ethanol Metabolism.- 1.7. Summary.- References.- 2. Acetaldehyde and Acetate.- 2.1. Pathways of Acetaldehyde and Acetate Metabolism.- 2.2. Effect of Chronic Ethanol Consumption on Acetaldehyde and Acetate Metabolism.- 2.3. Effect of Liver Injury on Acetaldehyde Metabolism.- 2.4. Effects Attributable to Acetaldehyde and Acetate after Acute and Chronic Ethanol Consumption.- 2.5. Summary.- References.- 3. Alcohol, Hormones, and Metabolism.- 3.1. Hypothalamic-Pituitary-Thyroidal Axis.- 3.2. Parathormone and Calcitonin.- 3.3. Adrenocortical Function: Glucocorticoid Secretion.- 3.4. Adrenocortical Function: Mineralocorticoid Secretion.- 3.5. Adrenal Medullary Function.- 3.6. Growth Hormone.- 3.7. Antidiuretic Hormone and Oxytocin.- 3.8. Pancreatic and Gastrointestinal Hormones.- 3.9. Alteration of Carbohydrate Metabolism by Alcohol.- 3.10. Effects of Ethanol on Ketone Metabolism.- 3.11. Alcoholic Ketoacidosis.- 3.12. Hyperlactacidemia and Lactic Acidosis.- 3.13. Alcoholic Hyperuricemia and Its Relationship to Gouty Attacks.- References.- 4. Ethanol and Lipid Disorders, Including Fatty Liver, Hyperlipemia, and Atherosclerosis.- 4.1. Interaction of the Metabolism of Ethanol and Lipids.- 4.2. Pathogenesis of the Alcoholic Fatty Liver.- 4.3. Agents and Procedures that Prevent the Alcoholic Fatty Liver.- 4.4. Effects of Ethanol on Blood Lipids: Characteristics and Pathogenesis of Alcoholic Hyperlipemia.- 4.5. Ethanol, Atherosclerosis, and High-Density Lipoproteins.- 4.6. Interaction of Ethanol with Vascular Prostacyclin Production.- 4.7. Summary.- References.- 5. Effects of Ethanol on Amino Acid and Protein Metabolism.- 5.1. Effects of Ethanol on Nitrogen Balance and Body Protein Composition.- 5.2. Effects of Ethanol on Amino Acids.- 5.3. Effects of Ethanol on Hepatic Protein Synthesis.- 5.4. Effects of Ethanol on Hepatic Protein Secretion.- 5.5. Effects of Ethanol on Hepatic Protein Catabolism.- 5.6. Hepatic Accumulation of Protein after Chronic Ethanol Feeding.- 5.7. Dietary Requirements for Protein in the Alcoholic.- 5.8. Summary.- References.- 6. Interaction of Ethanol with Other Drugs.- 6.1. Interaction with Drug Absorption.- 6.2. Interaction with Plasma Protein Binding.- 6.3. Interaction with Hepatic Blood Flow.- 6.4. Interaction with Hepatic Cell Uptake.- 6.5. Interaction with Hepatic Metabolism.- 6.6. Pharmacological Interactions.- 6.7. Summary and Therapeutic Guidelines.- References.- 7. Alcohol and the Liver.- 7.1. Epidemiology of Alcoholic Liver Disease.- 7.2. Pathology and Symptomatology of the Various Stages of Alcoholic Liver Injury.- 7.3. Pathogenesis of Alcoholic Liver Injury.- 7.4. Diagnosis of Alcoholic Liver Injury.- 7.5. Prognosis and Treatment of Alcholic Liver Injury.- References.- 8. Alcohol and the Hematologic System.- 8.1. Red Cells.- 8.2. Platelets.- 8.3. Granulocytes.- 8.4. Monocytes and Macrophages.- 8.5. Lymphocytes.- 8.6. Other Factors Favoring Infection.- 8.7. Summary.- References.- 9. Immunologic Reactions in Alcoholic Liver Disease.- 9.1. Morphological Considerations.- 9.2. Genetic Factors.- 9.3. Immunoglobulins, Antibodies, and Immune Complexes.- 9.4. Hepatitis B Virus (HBV).- 9.5. Hepatitis C Virus (HCV).- 9.6. Serum Factors and Cytokine Activity.- 9.7. Cell-Mediated Alterations.- 9.8. Abnormal Antigen Expression on Liver Cells.- 9.9. Alcohol and Alteration of the Immune Response in Alcoholics without ALD.- 9.10. Summary.- References.- 10. Alcohol and the Digestive Tract.- 10.1. Introduction.- 10.2. Oropharynx and Salivary Glands.- 10.3. Esophagus.- 10.4. Stomach.- 10.5. Effect of Alcohol on the Small Intestine.- 10.6. Effects of Alcohol on the Colon.- References.- 11. Ethanol and the Pancreas.- 11.1. Introduction.- 11.2. Epidemiology of Alcoholic Pancreatitis.- 11.3. The Pathology of Alcoholic Pancreatitis.- 11.4. Pathogenesis of Alcoholic Pancreatitis.- 11.5. Nutrition.- 11.6. Summary: Pathogenesis of Alcoholic Pancreatitis.- 11.7. Clinical Aspects of Alcoholic Pancreatitis.- References.- 12. Cardiovascular Effects of Ethanol.- 12.1. Acute Hemodynamic Effects of Ethanol.- 12.2. The Acute Metabolic Effects of Ethanol on the Heart.- 12.3. Changes in Regional Blood Flow Caused by Ethanol.- 12.4. Alcoholic Cardiomyopathy.- 12.5. Effects of Prolonged Alcohol Exposure in Experimental Animals.- 12.6. Holiday Heart.- 12.7. Hypertension.- 12.8. Stroke.- 12.9. Relationship of Alcohol Use to Coronary Artery Disease.- References.- 13. Effects of Alcohol Abuse on Skeletal Muscle.- 13.1. Introduction.- 13.2. Clinicopathological Classification.- 13.3. Clinicopathological Features of Acute Myopathy.- 13.4. Clinicopathological Features of Chronic Myopathy.- 13.5. Prevalence of Alcoholic Myopathy.- 13.6. Pathogenesis of Alcoholic Myopathy.- 13.7. Treatment and Prognosis.- References.- 14. The Effects of Alcohol on the Nervous System: Clinical Features, Pathogenesis, and Treatment.- 14.1. Alcoholic Intoxication.- 14.2. Alcohol Withdrawal Syndrome.- 14.3. Nutritional Diseases of the Nervous System Secondary to Alcoholism.- 14.4. Alcoholic Cerebellar Degeneration.- 14.5. Alcoholic Neuropathy.- 14.6. Alcohol (Tobacco-Alcohol) Amblyopia.- 14.7. Pellagra.- 14.8. Central Pontine Myelinolysis.- 14.9. Marchiafava-Bignami Disease (Primary Degeneration of the Corpus Callosum).- 14.10. Alcoholic Dementia.- 14.11. Alcoholic Cerebral Atrophy.- 14.12. Hepatic Encephalopathy.- References.- 15. Alcohol Abuse: Carcinogenic Effects and Fetal Alcohol Syndrome: Description, Diagnosis, and Prevention.- 15.1. Alcohol and Cancer.- 15.2. Ethanol as a Cocarcinogen.- 15.3. Animal Studies.- 15.4. Biochemical Bases for Ethanol's Activity as a Cocarcinogen.- 15.5. Hepatitis B Virus and Hepatocellular Carcinoma.- 15.6. Dietary Deficiencies and Alcohol Abuse.- 15.7. Fetal Alcohol Syndrome: Description, Diagnosis, and Prevention.- References.- 16. Alcohol and the Kidney.- 16.1. Changes in Renal Anatomy.- 16.2. Renal Hemodynamics.- 16.3. Renal Sodium Handling.- 16.4. Hypophosphatemia in the Alcoholic.- 16.5. Effects on Renal Calcium Handling.- 16.6. Effects on Renal Magnesium Handling.- 16.7. Renal Water Handling.- 16.8. Chronic Effects of Ethanol.- 16.9. Hyponatremia in Alcoholics without Cirrhosis.- 16.10. Acid-Base Disturbances Induced by Alcohol.- 16.11. Acidosis Caused by Toxin Ingestion.- 16.12. Abnormalities of Acid-Base Status in Liver Disease.- 16.13. Renal Tubular Acidosis.- 16.14. Effects on the Renin-Aldosterone System and Adrenocortical Function.- 16.15. Effects on Blood Pressure.- 16.16. Summary.- References.- 17. Nutrition: Medical Problems of Alcoholism.- 17.1. General Nutritional Status in the Alcoholic Including Disorders of Minerals and Vitamins.- 17.2. Nutritive Aspects of Alcohol and Alcoholic Beverages.- 17.3. Nutritional Status of Alcoholics.- 17.4. Water-Soluble Vitamins.- 17.5. Fat-Soluble Vitamins.- 17.6. Minerals and Electrolytes.- 17.7. Nutritional Therapy.- References.- 18. Biological Markers of Alcoholism.- 18.1. Utility of a Biological Marker of Alcoholism.- 18.2. Currently Available Markers.- 18.3. Special Laboratory Markers.- 18.4. Biological Markers of a Predisposition to Alcoholism.- 18.5. Combination of Markers.- 18.6. Summary.- References.