An overview of health risks and benefits of alcohol consumption.

This article provides an overview of the most recent evidence on health risks and benefits of alcohol consumption. Not only different types of dose-response curves but also other factors are important to consider when balancing health risks and benefits of alcohol consumption. The association between alcohol exposure and the risk of developing alcohol-related harm is multifactorial; there is a considerable individual variation in risk and a particular female susceptibility. Guidelines on drinking published over the last decade have become successively more restrictive. Whereas guidelines in the 1980s referred to "sensible drinking" or "responsible drinking," more recent guidelines refer to "low-risk drinking." For an increasing number of groups, the recommendation is to avoid alcohol entirely. The need to consider individual risk factors and specific risk situations is increasingly emphasized. The possible net beneficial health effects of moderate drinking may be achieved in less risky ways by refraining from smoking, eating less dietary fat, and doing regular exercise. A number of health risks of moderate drinking have been demonstrated. Yet, for the moderate drinker, various psychosocial problems--especially in the area of productivity and relations--are more likely to develop than organ damage. Also, the risks involved in giving general guidelines on drinking have been widely discussed. If these guidelines were generally accepted and followed, it could have negative consequences on public health.

[How can primary health care influence patients' alcohol drinking habits. "Simple intervention" results in a new therapeutic perspective]. / Så kan primärvården påverka patientens alkoholvanor. "Enkel intervention" ger nytt perspektiv på behandlingen.

A review of findings in randomised trials with at least one-year follow-up suggests that primary care physicians can intervene briefly and successfully for patients manifesting symptoms of excessive drinking but no serious dependence. The risk level can be assessed by summing the preceding week's intake of spirits, wine and beer in standard measures and then convert it into grams of pure alcohol. Denial is minimised by using a non-judgmental lifestyle approach, and defining problems in terms of lifestyle habits and its consequences. Nervous problems, hypertension and dyspepsia are the most common diagnoses in the target group. Measurement of biochemical markers can be used, the serum gamma-glutamyl transpeptidase (GGT) level being still the most useful. Questionnaires are of limited value as they are associated with high false-positive rates. To motivate patients to reduce alcohol consumption, an intervention strategy with feedback is proposed, mainly based on the monitoring of symptoms and clinical findings including biochemical markers, and a self-help pamphlet is recommended. It is emphasised that the goal should be realistic to the patient, and that controlled drinking is an acceptable goal even in cases of mild dependence.

Purity profiles of pteroylglutamate reference substances by high-performance liquid chromatography.

High-performance liquid chromatography (HPLC) in the reversed-phase mode was used for the purity analysis of three pteroylglutamic acid-type reference substances (folic acid, leucovorin calcium, and methotrexate). The influence of the pH of the mobile phase on the separation of an artificial mixture of six pteroylglutamic acid derivatives and three potential impurities was studied. Results of purity analysis of current lots of USP reference standards are reported. A better separation of methotrexate from its major impurities was achieved by using a standard buffer, rather than an ion-pairing mobile phase. A separation of methotrexate and its biologically inactive 7-isomer is reported.

Stability of solid drugs: degradation of ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3) at high humidities and elevated temperatures.

Ergocalciferol and cholecalciferol powders were studied at 25 and 40 degrees and at different humidities. Ergocalciferol decomposed rapidly at 25 and 40 degrees when stored in dry air. Decomposition of ergocalciferol led to the formation of products of higher polarity. Cholecalciferol was not as labile under dry conditions, but decomposed rapidly at high temperature.

Loss of hydrophobic amine from solution by adsorption onto container surfaces.

The apparent loss of the hydrophobic amine drug alpha-[(dibutylamino)methyl]-6,8-dichloro-2-(3',4'-dichlorophenyl)-4-quinoline-methanol monohydrochloride from solution due to its adsorption onto the surface of its storage container was studied. The drug appeared to be adsorbed only as the free base. Therefore, any perturbations to the solution phase that will help solubilize the drug and thus lower its chemical potential will minimize adsorption. Multilayer drug adsorption to the container surfaces appeared to take place, with some evidence of a highly organized system in the adsorbed phase. Adsorption was minimized when the heterogenous polar functionalities on glass surfaces were covered by a layer of silicone or methacrylate polymer, which yielded less reactive, more hydrophobic surfaces. Loss was also minimized when the environment was kept acidic (pH less than or equal to 4,8), the drug was dissolved in a proton-donating solvent (e.g., chloroform), and an ion-pairing agent (e.g., trichloroacetate) was present to solubilize further the monocationic form of the drug in organic media.