Healthcare: Research Pathophysiology, Research Paper Example

Risk factors for disease (Smoking, high fat diets, and alcohol abuse)

Introduction

Different behaviours may be highly addictive and may contribute to poor health outcomes in many individuals. These behaviours often serve as risk factors for many types of disease that may contribute to poor quality of life and even a shortened life span. Therefore, determining risk factors for disease is a critical component of disease prevention methods, particularly when multiple risk factors are present.

For example, three common risk factors for disease include smoking, a high-fat diet, and alcohol use/abuse. Each factor represents a high level of risk for patients who face serious challenges relative to their health. Therefore, these changes that occur within organs and systems must be evaluated in greater detail with regards to common lifestyle risk factors; epidemiology/prevalence of smoking, high-fat diet, and alcohol abuse; patient response to pathophysiology and risk factors and  analysis of pathophysiology and pathology

Background

Smoking, high fat diets, and alcohol abuse all contribute to a number of health concerns that cause serious problems for many adults (George, 2007) (Swinburn, Sacks, Hall, McPherson, Finegood, Moodie, Gordmaker, 2011). The origins of these risk factors and their impact on health and wellbeing will be addressed in the following paragraphs.

Common lifestyle risk factors

Smoking, a high-fat diet, and alcohol abuse are significant risk factors that often contribute to significant challenges for many people. These factors create significant cost concerns for the healthcare system; however, many individuals are unwilling to adjust their behaviours in order to reduce the risks of illness or disease (Prochaska et al., 2008). For patients who engage in multiple risk behaviours, there is a critical need to establish protocols to address these behaviours and their impact on health and wellbeing, as multiple risk factors contributes to a much higher rate of disease in many patients (Prochaska et.al., 2008). Therefore, it is important to address the concerns associated with properly allocating resources in order to accomplish the desired objectives and to demonstrate the significance of addressing multiple behaviours simultaneously (Prochaska & Prochaska, 2008).

Epidemiology/prevalence of smoking, high-fat diet, and alcohol abuse

Smoking is a key cause of up to six million deaths per year throughout the world, many of which are attributed to cardiovascular disease (World Health Organization, 2013). Furthermore, 80 percent of these smokers currently reside in low or middle-income nations (World Health Organization, 2013). Tobacco is expected to kill up to one billion people in the 21st Century (Action on Smoking & Health, 2014). Tobacco use is highly addictive and has both stimulant and depressant properties, thereby creating a serious health problem for many people (Prasad, et al., 2009). Smoking has many systemic effects that include cancers, cardiovascular disease and stroke, and pulmonary complications (Prasad, et al., 2009).

High-fat diets are key contributors to obesity, which is a serious epidemic throughout the world that contributes to more serious conditions such as cardiovascular disease, diabetes, and hypertension. Alcohol abuse is prevalent in many people and contributes to almost 30,000 deaths per year due to cirrhosis of the liver (Gao & Bataller, 2011), not to mention other complications such as motor vehicle accidents.

Patient response to pathophysiology and risk factors

Some patients who possess significant lifestyle risk factors may be likely to adjust their behaviours if they recognize these risks. However, in some cases, patients may be unwilling to modify their behaviours, in spite of the potential impact on their health (Swinburn et.al, 2011). This is a critical factor because it demonstrates the importance of new perspectives to encourage patients regarding the reality of continuing to enforce negative lifestyle habits that could ultimately reduce their quality of life over time (Swinburn et.al, 2011) (Prasad et.al, 2009). This is an ongoing process that requires many patients to experience a significant event within their own lives to be receptive to reducing these risk factors, perhaps a heart attack, a cancer scare, or another life-changing event that plays a role in shifting the mindset towards a different set of lifestyle behaviours that will reduce the risk of disease or other complications. These efforts require a greater understanding of addictive behaviours and the difficulties of refraining from alcohol or smoking as addictive substances (Prasad et.al, 2009; George et.al, 2007).

Pathophysiology and Pathology

Behaviours such as smoking, high-fat dietary intake, and alcohol abuse may lead to detrimental consequences for individual patients. A greater understanding of these events is required in order to determine how they impact individuals directly.  In order to recognize the possible disease states that might occur proper evaluation. These  health conditions include   cancer, respiratory irregularities, cardiovascular conditions, liver dysfunctions, and other complications. All of these dysfunctions  can contribute to higher mortality rates in some patient populations, particularly those with multiple risk factors (Prasad et.al, 2009) (Prochaska & Prochaska, 2008).

Part 1: Smoking

Impact of smoking

Smoking is a key contributor to many significant patient concerns including higher cholesterol levels, platelet aggregation, and coronary vasomotor reactivity (Prasad et.al, 2009) (Tonnesen et.al, 2009). Smoking also leads to atherosclerosis, thrombosis, and impacts on endothelial tissues (Prasad et.al, 2009). It is also evident that smoking may cause insulin resistance, which is critical factor in diabetes and cardiovascular disease, as well as artery re-occlusion post-myocardial infarction (Prasad et.al, 2009). These factors ultimately pose serious health dangers, which reduce life expectancy greatly. The pathogenesis will be discussed in the following sections.

Pathogenesis/mechanisms

Smoking impacts many organs and systems through pathogenic mechanisms, including the development of cardiovascular disease, stroke, and peripheral artery disease, all of which are manifested through a cardiotoxic impact of chemicals in cigarette smoke, accompanied by nicotinic effects such as catecholamine and neurotransmitter release (Pyrgakis, 2009).

Key manifestations/clinical characteristics

There are considerable challenges associated with cigarette smoking that impact organs and systems in debilitating ways and that influence negative quality of life in most patients, particularly those who have smoked for significant periods of time. The following diagram demonstrates the impact of tobacco on human health, created by Prasad et.al, 2009, which describes how tobacco chemicals initiate different responses that impact organs/system.

Body systems

It is known that cigarettes contain many different types of chemicals and carcinogens; furthermore, cigarette smoke is highly toxic for users (Prasad et.al, 2009). The number of carcinogens poses a potentially devastating risk to patients in many ways. In general, smoking does not discriminate and is attributed to cancer in many different body organs and systems that go beyond the lungs and that may cause irreversible harm and higher mortality rates in many people (Centers for Disease Control and Prevention, 2014).

Part 11: High fat diet

Impact of high-fat diet

A continuous diet that includes high-foods may contribute to a higher risk of obesity in many adults (Buettner et.al., 2007). This type of diet is likely to exacerbate a condition known as hyperglycaemia, as well as whole-body insulin resistance, thereby increasing the risk for other conditions such as type 2 diabetes, dyslipidaemia, and metabolic syndrome (Buettner et.al. 2007).

Pathogenesis/mechanisms

When high-fat diets are consumed, there is an ever-increasing presence of risk factors that stimulate poor gastrointestinal function and related complications (Little et.al, 2007). This system is likely to speed up gastric emptying and hormone secretion, as well as a higher intake of energy (Little et.al, 2007). The regular consumption of a high-fat diet further exacerbates the risks associated with excess fat in and surrounding the organs and tissues, thereby placing a greater strain on the heart muscle and cardiovascular system.

Key manifestations/clinical characteristics

High-fat diets contribute to obesity and higher basal and postprandial values for blood sugar (Buettner et.al. 2007). These factors may impact individuals in different ways and pose a challenge to individual patients that may also contribute to a reduction in insulin delivered to skeletal muscle, as well as an increase in adipocytes (Buettner et.al. 2007) (Little et.al, 2007).

Body systems

This poses a greater risk of myocardial infarction, stroke, diabetes, hypertension, and other activities. The figure below demonstrates the significance of obesity as related to different steps involving the environment and behaviors, of which high-fat diets are a critical component of this state, created by Swinburn et.al, 2011, which provides a summary of the environmental, behavioural, and physiological events that take place with respect to obesity.

The more distal drivers are to the left and the environmental moderators that have an attenuating or accentuating effect are shown, along with some examples. The usual interventions for environmental change are policy based, whereas health promotion programs can affect environments and behaviors. Drugs and surgery operate at the physiological level. The framework shows that the more upstream interventions that target the systemic drivers might have larger effects, but their political implementation is more difficult than health promotion programs and medical services.

Part 111:  Alcohol Abuse

Impact of alcohol abuse

Alcohol abuse affects many people in different ways, and the addictive nature of this problem makes it extremely difficult to overcome (Wackernah et.al, 2014). Alcohol addiction may be treated with medications; however, these medications have limited and inconsistent results (Wackernah et.al, 2014). Therefore, it is important to identify other types of treatment that support long-term recovery and support for patients (Wackernah et.al, 2014).

Pathogenesis/mechanisms

Patients who abuse alcohol experience many cardio toxic effects that contribute to a higher risk of heart failure (Laonigro et.al, 2009). This state influences higher levels of norepinephrine and epinephrine, along with higher levels of oxidative stress in patients (Laonigro et.al, 2009). Other factors to consider include malnutrition, genetic concerns, and a negative influence on the rennin-angiotensin system (Laonigro et.al, 2009). In relation to heart function, alcohol may influence blood pressure and the risk of stroke, in addition to conduction and cardiac rhythm (Laonigro et.al, 2009).

Key manifestations/clinical characteristics

Individuals who abuse alcohol face a much greater risk of alcoholic liver disease, a contributing factor of cirrhosis and fibrosis (Gao & Bataller, 2011) (Laonigro et.al, 2009). In 2007, 29,925 persons died from cirrhosis, with 48 percent of cases attributed to alcohol use (Gao & Bataller, 2011). In particular, fatty liver is the precursor to other possible complications of alcohol abuse, including cirrhosis, alcoholic hepatitis, and hepatocellular carcinoma (Gao & Bataller, 2011) ( Laonigro et.al, 2009). Alcohol abuse also impairs cognitive abilities in some patients so that they are unable to perform effectively in routine tasks (Gao & Battaler, 2011).

Body systems

Research shows that modest alcohol use may impact heart rhythmic activities for patients who have used alcohol regularly in the past (Laonigro et.al, 2009). These concerns contribute to a much greater potential for sudden cardiac death in some patients who consume high levels of alcohol on a regular basis (Laonigro et.al, 2009). Therefore, these factors are instrumental in reducing the quality of life and routine function of the cardiac system in many ways (Laonigro et.al, 2009). The extent of alcohol abuse is characterized in the following figure, created by Gao & Bataller, 2011, which provides a visual depiction of the type of cell changes that occur in the liver resulting from alcohol abuse.

Part 1V: Analysis

Mechanisms contributing to pathophysiology

The pathophysiology of symptoms and responses to smoking, high-fat diets, and alcohol abuse varies from person to person, depending on other factors, such as genetics and pre-existing health concerns. However, there are general factors to consider that must be addressed in a larger context, given the potential number of changes to organs and systems that might occur. It is evident that pathophysiological responses follow a general path, but the level and severity of exacerbation is different in all persons, thereby creating a significant response in patients that may be difficult to treat (George, 2007; Laonigro et.al, 2009; Prasad et.al, 2009). Furthermore, if other clinical issues have been identified, there is an even greater risk of complications for these patients.

Key manifestations/clinical characteristics

It is known that cardiovascular disease is exacerbated by the intake of saturated fat; therefore, LDL cholesterol will increase and promote a greater risk of coronary heart disease (Merchant et.al, 2008). Therefore, high-fat diets may contribute to higher cholesterol levels, which thereby contribute to a higher risk of heart attack and stroke (Merchant et.al, 2008). Therefore, patients often face considerable risks that require further evaluation and consideration in a health setting. For example, patients who drink high amounts of alcohol on a regular basis are likely to experience more complex symptoms and negative behaviours, such as a greater potential for violence and motor vehicle impairment (Merchant et.al, 2008; Matsumoto, 2009). These observations also demonstrate that patients face considerable risks in the face of alcohol intake. However, some studies argue that moderate alcohol intake may be effective in counteracting the effects of a diet that is high in saturated fats, although this does not at all discount the risks associated with alcohol use and misuse in some patients (Merchant et.al, 2008; Matsumoto, 2009).

Critical review/comparison of risk factors and impact

Smoking, high-fat diets, and alcohol abuse pose serious challenges for patients and may serve as a primary cause of many different conditions. Therefore, it is important to identify how these factors impact organs and systems through a complex series of events. Each risk factor may have an influence on a variety of conditions that are overlapping, such as cardiovascular disease, diabetes, cancer, hypertension, and epithelial complications, amongst others. Therefore, each risk factor represents a unique focus and representation in each individual patient. Nonetheless, standard pathophysiologic patterns exist that pose a challenge to all patients who participate in one or more of these behaviours (Prasad et.al, 2009; Gao et.al, 2011; Laonigro et.al, 2009). In the event that all three behaviours are evident, patients face an almost certain risk of serious health complications in the future. Patients who smoke continuously take in carcinogens and nicotine that impact organs and systems, including the heart and lungs (Prasad et.al, 2009). Patients who consume high-fat diets are likely to experience a much greater risk of cardiovascular disease and related complications, including atherosclerosis, myocardial infarction, and stroke (Merchant et.al, 2008). Patients who abuse alcohol face a much higher risk of liver-related complications, including cirrhosis and hepatitis, as well as diabetes (George, 2007). It is important to recognize these overlapping risk factors and the options that are available to conduct assessments regarding these risk factors and the options that are available to medical professionals in order to minimize these risks, including rehabilitation, therapy, and abstinence if at all possible.

Paramedic Pre-Hospital/Medical Management

 Chronic Obstructive pulmonary disease (COPD)

Signs and symptoms

• Shortness of breath
• Cough with mucus
• Tightness in chest

Intervention

• Airway clearance
• Breathing maintenance
• Improving pulmonary circulation

Acute myocardial infarction (AIM)

Signs and symptoms

• Chest pain
• Chest tightness
• Lightheadedness
• Profuse sweating
• Nausea, vomiting

Intervention

• Secure airway patency
• Assess breathing and administer appropriate

Intervention

• Ensure that extremities are perfused and blood circulation is active

For patients who smoke, consume high-fat diets, and/or abuse alcohol, there are significant health risks that pose a threat to human health on many levels. These include chronic obstructive pulmonary disease and acute myocardial infarction. Therefore, paramedics must evaluate patients using expert knowledge to address immediate concerns. Common patient presentations/conditions influenced by smoking, alcohol abuse and high-fat diets include cardiovascular disease, hypertension, and diabetes (George, 2007).

These conditions are attributed to any number of factors. However, they are further exacerbated by one or more the aforementioned risk factors. Managing these risks to prevent even larger complications is ideal, yet this is sometimes difficult because treatment may not begin until a larger event occurs (George, 2007). Thus, it is important that Paramedic Pre-Hospital/Medical Management be efficient and paramedics capable of executing such interventions.

Pre-hospital management practices/therapies

Patients should be examined by their primary physicians on a regular basis in order to screen for possible risk factors and underlying complications. If patients require an ambulance, initial evaluation should include blood pressure, heart rate, and other critical vital signs in order to prepare patients for emergency care and treatment. Many patients may be resistant to medical care; however, this is a critical component of their routine so that they are able to identify any serious health risks in a timely manner. This will also enable patients to receive the attention that is necessary to address problems and to consider treatments to manage smoking and/or alcohol addictions once they are transferred out of paramedic care.

Paramedics’ responsibility

Paramedics are responsible for treating patients in urgent situations, using clinical inquiry tools to accomplish these objectives (Lynagh et.al, 2009). In particular, patients may experience common clinical symptoms that paramedics are likely to recognize; therefore, this supports proper service referrals as necessary (Lynagh et.al, 2009). In other cases involving overweight or obese patients, paramedics may face challenges that impact their responsibilities, such as lifting patients and transporting them to hospitals (Cataldo Ambulance Service, 2009). For patients requiring emergency care, there is a need to develop protocols to ensure that these patients receive the necessary care and treatment, using paramedic and EMT knowledge and experience in this manner (Smith et.al, 2013). The patient assessment process is essential to the success of paramedic practice, thereby enabling patients with any of the aforementioned conditions to receive treatment in a timely and effective manner (Thompson & Drummond, 2013).

In spite of the warnings posed throughout society regarding smoking, high-fat diets, and alcohol abuse, many patients are unwilling to change their behaviours and seek guidance in the event of addiction. This places many patients in serious jeopardy of other risks that could continue to create new complications for patients on many levels (George, 2007).

Therefore, patients may be subject to any number of common complications, including changes in cognitive behaviours, obesity, respiratory problems, cardiovascular concerns, heart attacks, strokes, diabetes, high cholesterol, and hypertension, among others. It is important to recognize that many of these complications are caused by numerous risk factors; as a result, proper evaluation of patients is essential to identify a possible treatment plan. It is imperative for patients to be provided with the tools and support that are required to overcome these negative behaviours in order to minimize complications as best as possible (George, 2007).

Critical review/comparison of risk factors and impact on mortality

Patients who require surgery and who also smoke and drink alcohol are significantly more likely to experience complications and/or side effects after surgical procedures (Tonnesen et.al, 2009). This includes patients who do not face a debilitating end-stage disease that is likely to increase mortality rates; in other words, patients who also receive elective surgeries are at a much higher risk (Tonnesen et.al, 2009). It is likely that patients in this category may experience even greater complications if they smoke and drink more frequently than the average person (Tonnesen et.al, 2009) (Swinburn et.al, 2011).

For example, poor tissue healing and wound infections may be exacerbated, along with an increased risk of bleeding and cardiopulmonary effects (Tonnesen et.al, 2009; Swinburn et.al, 2011). Therefore, it is essential to establish a greater understanding of these challenges so that surgical interventions are conducted in order to achieve the best possible outcomes (Tonnesen et.al, 2009). Furthermore, patients should strongly consider abstinence for a number of weeks prior to surgery in order to alleviate or minimize some of the possible complications that may occur (Tonnesen et.al, 2009; Swinburn et.al, 2011).

Summary and Conclusions

The health risks contained in smoking, high fat diets, and alcohol abuse are immense.  quality of life  is reduce significant when people develop diabetes, chronic obstructive pulmonary disease and coronary heart disease. In developed nations heart disease is the leading cause of death. Therefore, it is highly likely that heart disease will be the first cause of death resulting from these three risk factors (Prochaska & Prochaska, 2008).

It is the responsibility of healthcare providers to inform patients of their risk factors and the potential complications that exist. This practice will ensure that patients possess the knowledge and resources that are necessary to ensure that if they possess complications as a result of the aforementioned risk factors, they will obtain treatment in a timely manner (Prochaska & Prochaska, 2008). At the same time, education must be provided to patients so that they are able to make possible lifestyle changes that will have a positive impact on their wellbeing. This is a continuous process of education and guidance that requires patients to address alcohol abuse, smoking, and high-fat food consumption in a timely manner to prevent further complications (Prochaska & Prochaska, 2008).

Patients who face these risks must be provided with the information and resources that are necessary to make informed decisions regarding their health and current behaviours as early as possible before any complications are observed that could increase mortality rates in these population groups, using interventions as a primary alternative.

References

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