Medical and Nutritional Complications of Alcoholism: Mechanisms and Management

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...