Health Hazards of Binge Drinking and Chronic Alcoholism

Chapter 4: Cellular Biology This chapter explores altered cellular and tissue biology, focusing on cellular adaptation, injury, manifestations of cellular injury, cellular death, aging, and the various types of cell death such as necrosis and apoptosis. Cellular adaptation allows cells to respond to physiological and pathological conditions, but severe or prolonged stressors can lead to cellular injury or death. Common sources of cell injury include lack of oxygen, free radicals, infections, inflammation, and metabolic derangements. Cellular aging also contributes to changes in structure and function. Bullet points Health hazards of binge drinking and chronic alcoholism: ● Binge drinking (four standard alcoholic drinks for women, five drinks for men on one occasion) has significant health hazards. ● Chronic drinking and binge drinking can cause alcoholic liver disease, ranging from fatty change to cirrhosis of the liver. ● Alcohol can induce damage to mitochondrial DNA, lipid accumulation, and oxidative stress. ● Adolescent alcohol drinking, especially binge drinking, can result in neurocognitive changes and risk-taking behaviors. ● Chronic alcoholism affects multiple organs and tissues, with significant changes in the liver. ● Alcohol is the leading cause of liver-related morbidity and mortality. ● Other disorders associated with chronic alcoholism include alcoholic cardiomyopathy, increased risk of hypertension, gastritis, pancreatitis, regressive changes in skeletal muscle, and increased risk for oral, liver, esophageal, and breast cancer. ● Alcohol is implicated in immune defects, including cytokine production, inflammation, increased susceptibility to infection, and enhanced progression of human immunodeficiency disease. Alcohol and Pregnancy ● Alcohol ingestion during pregnancy can lead to cognitive deficiencies and neurobehavioral disorders ● Fetal alcohol syndrome (FAS) is a severe disorder associated with prenatal alcohol exposure ● FAS is characterized by growth retardation, facial anomalies, cognitive impairment, and ocular malformations ● Alcohol readily crosses the placenta and reaches the fetus, causing equivalent blood levels as the mother ● Alcohol-induced epigenetic alterations may be carried through the male germline for multiple generations Social or Street Drugs ● The recreational use of psychoactive and narcotic drugs is a major problem worldwide ● Popular drugs include methamphetamine, marijuana, cocaine, heroin, and fentanyl ● These drugs have a high risk for addiction, dependence, and can cause respiratory distress and death ● Opiates, both prescription and illicit, are the main causes of drug overdose deaths Unintentional and Intentional Injuries ● Injuries, both unintentional and intentional, are a significant health problem in the United States ● In 2016, there were 231,991 injury deaths, with rates varying for different causes (poisoning, motor vehicle accidents, firearms) ● Drug overdose deaths, including opioids and stimulants, continue to increase ● Falls caused by accidents have led to increased death rates, especially in older adults ● Sexual violence affects millions of people each year in the United States Unintentional injuries ● Account for 3.2 million visits to emergency rooms each year for children aged 5-14 ● Injuries from sports account for 775,000 emergency room visits annually for this age group ● Sports-related injuries are the leading cause of emergency room visits in 12to 17-year-olds ● Death from all injuries is more common among men than women ● Significant racial differences in mortality rates ● Bimodal age distribution for injury-related deaths, with peaks in young adults and elderly ● Unintentional injuries are the leading cause of death among those aged 1-34 years Injuries from medical care ● 44,000 to 98,000 unnecessary deaths per year in hospitals due to errors by healthcare professionals ● Hospital-acquired infections alone account for more than 90,000 deaths per year ● Estimate of more than 400,000 premature deaths per year associated with preventable harm ● Approximately 75,000 preventable hospital deaths occurred in 2013 due to hospital-acquired conditions Types of unintentional and intentional injuries ● Blunt-force injuries: caused by blows or impacts, most common type seen in healthcare settings ● Sharp-force injuries: cutting and piercing injuries ● Descriptions and examples of contusion, laceration, and fracture Gunshot wounds ● Accounted for > 33,636 deaths in the United States in 2015 ● Men more likely to die compared with women (18.16 vs. 3/100,000) ● Black men ages 15 to 24 years have the greatest death rate (86.95/100,000) ● Gunshot wounds can be penetrating (bullet remains in the body) or perforating (bullet exits the body) ● The appearance of the wound is affected by the range of fire Entrance wounds ● Contact range entrance wound: When the gun is in contact with the skin surface, searing of edges of the wound from flame and soot or smoke on edges of wound occurs ● Intermediate (distance) range entrance wound: Surrounded by gunpowder tattooing or stippling ● Indeterminate range entrance wound: Occurs when flame, soot, or gunpowder does not reach the skin surface but the bullet does Exit wounds ● Size cannot be used to determine whether a hole is an exit or entrance wound ● Usually has clean edges that can often be reapproximated to cover the defect Wounding potential of bullets ● The damage done by a bullet is a result of the amount of energy transferred to tissue impacted ● Speed of the bullet has a greater effect than increased size ● Some bullets are designed to expand or fragment when striking an object Lethality of a wound ● Lethality of a wound depends on what structures are damaged ● Wounds of the brain may not be lethal, but they are usually immediately incapacitating and lead to significant long-term disability ● A person with a "lethal" injury such as a wound of the heart or aorta may not be immediately incapacitated Asphyxiation ● Asphyxial injuries are caused by the failure of cells to receive or use oxygen ● Deprivation of oxygen may be partial (hypoxia) or total (anoxia) Categories of asphyxiation ● Suffocation: Lack of oxygen in the environment or blockage of respiratory airways ● Strangulation: Caused by external pressure on the neck ● Chemical asphyxiants: Exposure to substances that interfere with oxygen utilization ● Drowning: Involves the inhalation of liquid preventing oxygen intake Suffocation ● Can occur from lack of oxygen or displacement of oxygen by another gas in the environment ● Examples include being trapped in an enclosed space or exposure to gases like methane or carbon dioxide Choking asphyxiation ● Occurs when there is an obstruction of the pulmonary airways ● An object or swelling may block the airway, leading to asphyxiation ● Treatment involves removing the obstructing object or reversing airway swelling Compressional asphyxiation ● Occurs when mechanical compression of the chest or abdomen prevents normal respiratory movements ● Signs and symptoms include facial congestion and petechiae (pinpoint bleeding)