Bladder and genitourinary tumours

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1 Oxford Scholarship Online You are looking at of 3042 items for: keywords : stasis pubepi Bladder and genitourinary tumours Claudio Pelucchi and Carlotta Galeone Published in print: Published Online: May acprof:oso/ This chapter reviews studies on the link between alcohol consumption and the genitourinary cancers. No material association emerged between alcohol drinking and bladder cancer in a revision of about forty epidemiological investigations. This conclusion is further supported by two meta-analyses that recently provided definite quantitative evidence on the issue. Results were somewhat inconsistent between studies, possibly because of different drinking patterns and correlates mainly tobacco smoking among different populations. However, residual confounding by smoking might explain the moderate increase in risk of bladder cancer reported in some studies. Increasing evidence from large cohort studies indicates a protective role of moderate alcohol drinking on kidney cancer. This has been attributed to the effects of alcohol on insulin sensitivity, or through a role of fluid and/or antioxidants intake contained in alcoholic drinks. The risk appears to level-off in heavy drinkers. Results for prostate cancer are somewhat heterogeneous. Overall, the available evidence suggests no meaningful role of alcohol consumption. Cardiac disease William H. Frishman Published in print: Published Online: May acprof:oso/ This chapter discusses the link between alcohol consumption and cardiovascular disease. Over the past twenty years, alcohol has Page 1 of 6

2 increasingly been viewed as a potential ally in the war against coronary heart disease. Many investigators have reported on the beneficial effects of routine alcohol intake, and non-scientific journals have provided these data to the lay public. Therefore, the positive effects of alcohol are also considered. Alcohol has been linked to some specific detrimental effects on the cardiovascular system. These include alcoholic cardiomyopathy, systemic hypertension, and arrhythmia. Vascular disease Kenneth J. Mukamal Published in print: Published Online: May acprof:oso/ This chapter discusses the link between alcohol consumption and vascular diseases. These include hypertension, cerebrovascular disease (including ischaemic and haemorrhagic stroke), peripheral arterial disease (PAD), abdominal aortic aneurysm (AAA), and venous thromboembolism (VTE). There are complex relationships between moderate and heavy alcohol consumption and vascular disease, reflecting their heterogeneity and the multiple mechanisms by which alcohol consumption can influence vascular disease. Heavy alcohol consumption increases risk of hypertension, all forms of stroke, and probably AAA. For moderate alcohol consumption, relationships differ. It has a less pronounced effect on blood pressure and appears to be associated with a lower risk of ischaemic stroke, at least among light drinkers, and possibly a lower risk of PAD and VTE. Benign diseases of the gastrointestinal tract Julia B. Greer and Dhiraj Yadav Published in print: Published Online: May acprof:oso/ This chapter discusses the effects of alcohol consumption on the gastrointestinal (GI) tract. Alcohol lowers oesophageal sphincter pressure, reduces acid clearance, and alters oesophageal epithelial function, contributing to an increased incidence of gastro-oesophageal reflux disease. Dyspepsia, chronic atrophic gastritis, and delayed gastric Page 2 of 6

3 emptying are characteristic of chronic alcoholics. Upper GI bleeding in heavy drinkers is more commonly a consequence of variceal bleeding due to portal hypertension than to gastritis, while peptic ulcer disease and H. pylori infection have been shown to have a lower incidence in individuals who consume alcohol than abstainers. Finally, malnutrition in heavy drinkers is common and is due to the combined effects of diminished intake, decreased digestion, bacterial overgrowth and bile salt diarrhoea. Immunological effects of heavy alcohol consumption, such as delayed or deficient healing from colorectal surgery, should also be a major concern for health care providers. Liver disease Michael H. Miller, Frank Sullivan, and John F. Dillon Published in print: Published Online: May acprof:oso/ Alcohol-related liver disease (ALD) represents a spectrum of liver damage caused by excessive alcohol consumption. The spectrum ranges from reversible fatty liver through to alcoholic hepatitis, alcoholrelated cirrhosis, and hepatocellular carcinoma. The majority of heavy drinkers will not develop ALD despite apparently consuming similar amounts of alcohol in similar circumstances. The cause of this variation is probably multifactorial, and the combinations of factors differ between individuals, but accumulate to cross a threshold of response. This chapter discusses the mechanisms of alcohol-related liver damage and the clinical consequences this leads to. Pancreatitis Dhiraj Yadav Published in print: Published Online: May acprof:oso/ Alcohol has been linked to pancreatitis for over a century. Unlike many chronic diseases (e.g., heart disease) where alcohol is considered to be a risk factor, it is implicated as a direct aetiological factor for pancreatitis. This chapter discusses emerging data on the disease burden, the association and risk of pancreatitis with alcohol consumption, disease Page 3 of 6

4 recurrence, progression, and opportunities for altering the natural course of disease. Diabetes Dolly Baliunas Published in print: Published Online: May acprof:oso/ This chapter reviews evidence on the link between alcohol consumption and the risk for type 2 diabetes. The results of individual studies vary. Some studies have found a linear inverse relationship association between alcohol consumption and incidence of type 2 diabetes. In the Nurses Health Study, alcohol consumption was associated with a lower risk of type 2 diabetes compared to abstention. The Health Professionals Follow-Up Study in males found a similar inverse association between alcohol consumption and type 2 diabetes. The Physician s Health Study corroborates that consumption of alcohol in men has an inverse linear association with type 2 diabetes. In contrast, Holbrook et al. found a positive association between alcohol consumption and incidence of type 2 diabetes in men. A study in middle-aged men who consumed a substantial amount of alcohol (greater than 21 drinks per week) found a 50% increase in relative risk of type 2 diabetes compared with their counterparts who drank up to one drink per week. Neurological and mental disorders Tarakad S. Ramachandran Published in print: Published Online: May acprof:oso/ This chapter examines the link between alcohol consumption and neurological and mental disorders. The deleterious effect of alcohol on the nervous system and psyche is diffuse and very pervasive. Associated with disability and early mortality, alcohol use mental disorders are frequently comorbid with other psychiatric disorders, and play an aetiological role in other mental diseases. The following disorders are discussed: acute alcoholic intoxication, amnestic syndromes, chronic ethanolism, mental disorders, alcohol withdrawal seizures, delirium, Page 4 of 6

5 alcohol hallucinosis, Wernicke s encephalopathy, Korsakoff s syndrome, central pontine myelinolysis, Marchiafava Bignami disease, alcoholic dementia, alcoholic cerebellar degeneration, peripheral neuropathy, myopathy, and pellagra. Infectious disease Andriy V. Samokhvalov, Paul A. Shuper, and Jürgen Rehm Published in print: Published Online: May acprof:oso/ This chapter discusses the link between alcohol consumption and infectious disease. Alcohol consumption impacts on a variety of biological and social factors including general health, immune system functioning, socio-economic status, and the behaviour of a drinker that, in turn, lead to increased exposure to infectious agents, increased susceptibility to acquiring infectious diseases, and a number of complications slowing down recovery or even promoting disease progression. The most recent epidemiological evidence demonstrates significantly higher incidence and prevalence rates of the most common forms of infectious diseases in drinkers compared to abstainers, but especially high for heavy drinkers and alcohol use disorders. Alcohol and pregnancy: fetal alcohol spectrum disorders and the fetal alcohol syndrome Kenneth R. Warren and Margaret M. Murray Published in print: Published Online: May acprof:oso/ Today, alcohol is recognized as one of the leading preventable causes of birth defects and developmental disorders. It is now established that there are a range of effects on the developing foetus and that the severity of these effects are the result of timing and amount of alcohol exposure, as well as genetic vulnerabilities, environmental factors such as nutrition, and epigenetic changes. This chapter discusses foetal alcohol spectrum disorders (FASD); alcohol-related birth defects and alcohol-related neurodevelopmental disorders; intervention strategies for FASD; incidence and prevalence of foetal alcohol syndrome and FASD; Page 5 of 6

6 and maternal risk factors for FASD and the need for effective prevention strategies. Page 6 of 6