Application of HPLC-UV combined with chemometrics for the detection and quantification of 'true cinnamon' adulteration.

Cinnamon is one of the most popular spices used in cuisines worldwide. Among its different species, Ceylon cinnamon ("true cinnamon") is the one with the most health benefits due to its high concentration in the antioxidant eugenol and the ultra-low content of the hepatotoxic compound coumarin. However, the higher price of Ceylon cinnamon makes it vulnerable to fraudulent adulteration with more economic species of cinnamon, such as Cassia and Saigon. Thus, for the detection of frauds in cinnamon samples, a HPLC-UV method was developed for the determination of 4 characteristic cinnamon compounds: eugenol, cinnamaldehyde, coumarin and cinnamic acid. The obtained data were analyzed by PLS to attain not only the authentication of cinnamon species but also the detection and quantification of partial adulterations. Several mixtures prepared in the laboratory using different cinnamon powder samples considered 'pure' Ceylon, Cassia or Saigon were tested, concluding that the proposed approach allows a clear identification of Ceylon cinnamon and a suitable quantification of the Ceylon: non-Ceylon ratio regardless of the commercial sample selected (RMSE <0.06 for both training and test sets).

Evolving mortality and clinical outcomes of hospitalized subjects during successive COVID-19 waves in Catalonia, Spain.

BACKGROUND: The changes in shield strategies, treatments, emergence variants, and healthcare pathways might shift the profile and outcome of patients hospitalized with COVID-19 in successive waves of the outbreak. METHODS: We retrospectively analysed the characteristics and in-hospital outcomes of all patients admitted with COVID-19 in eight university hospitals of Catalonia (North-East Spain) between Feb 28, 2020 and Feb 28, 2021. Using a 7-joinpoint regression analysis, we split admissions into four waves. The main hospital outcomes included 30-day mortality and admission to intensive care unit (ICU). FINDINGS: The analysis included 17,027 subjects admitted during the first wave (6800; 39.9%), summer wave (1807; 10.6%), second wave (3804; 22.3%), and third wave (4616; 27.1%). The highest 30-day mortality rate was reported during the first wave (17%) and decreased afterwards, remaining stable at 13% in the second and third waves (overall 30% reduction); the lowest mortality was reported during the summer wave (8%, 50% reduction). ICU admission became progressively more frequent during successive waves. In Cox regression analysis, the main factors contributing to differences in 30-day mortality were the epidemic wave, followed by gender, age, diabetes, chronic kidney disease, and neoplasms. INTERPRETATION: Although in-hospital COVID-19 mortality remains high, it decreased substantially after the first wave and is highly dependent of patient's characteristics and ICU availability. Highest mortality reductions occurred during a wave characterized by younger individuals, an increasingly frequent scenario as vaccination campaigns progress. FUNDING: This work did not receive specific funding.

Effectiveness of an intervention to optimise the use of mirabegron for overactive bladder: a quasi-experimental study in primary care.

BACKGROUND: Overactive bladder is a composite of lower urinary tract storage symptoms. Pharmacological treatment is widely employed despite markedly modest efficacy data, adverse effects, and costs for the health system. AIM: To determine the 12-month efficacy of an intervention delivered by GPs on mirabegron revision and, if appropriate, discontinuation of treatment. DESIGN AND SETTING: Multicentre, quasi-experimental study in Barcelona (Catalonia), Spain. METHOD: Two groups composed of 17 intervention and 34 control practices were formed. The follow-up period was 12 months, from 1 January to 31 December 2017. A structured intervention was designed consisting of initiatives with GPs and urology/gynaecology specialists. The primary outcome was mirabegron use at 12 months. RESULTS: Of the 1932 patients, a significant discontinuation in treatment was observed at 12 months' follow-up in the intervention group (IG) (n = 433 out of 762, 56.8%), in contrast with the control one (CG) (n = 484 out of 1170, 41.4%) (P<0.001). There was also a reduced incorporation of new treatments in the IG (n = 214 out of 762, 28.1%) compared with the CG (n = 595 out of 1170, 50.9%) (P<0.001). In relation to patients with treatment at the beginning and end of the period, there was a decrease of 219 (28.7%) patients in the IG and an increase of 111 (9.5%) in the CG (P<0.001). CONCLUSION: The structured intervention showed optimisation in the use of mirabegron. When considering discontinuation it is necessary to provide clear data on the benefits and/or risks for patients and their caregivers, as such information is a precondition for shared decision making.

Satisfacción de los usuarios de un servicio de urgencias: comparación de resultados / No disponible

Fundamentos: Después de la aplicación de medidas de calidad se comparó la calidad percibida por los usuarios del servicio de urgencias de nuestro hospital en el año 2000 con la percibida por los usuarios en el año 1998. A su vez se compararon los datos globales de los servicios de urgencias del grupo de hospitales del Institut Català de la Salut (ICS) con los de nuestro centro. Material y métodos: Se realizaron dos encuestas telefónicas centralizadas desde el ICS a los usuarios del servicio de urgencias, la primera en el año 1998 y la segunda en el año 2000. Sobre una muestra de 3.811 pacientes, a nuestro centro le correspondieron 218 en el año 1998 y 213 en el 2000. Las dimensiones valoradas fueron: accesibilidad, trato, información, confort, competencia profesional, confianza y satisfacción global. Resultados: Al comparar los resultados de nuestro centro del año 2000 con los del año 1998, se observó que en sólo 2 preguntas (información del tiempo de espera y confort del lugar de las exploraciones) se obtuvieron mejoras estadísticamente significativas, y en una pregunta se observó un empeoramiento. En relación con el global de hospitales del ICS, en 11 preguntas se obtuvieron mejores puntuaciones estadísticamente significativas, entre ellas la de satisfacción global, destacando como la mejor la dimensión trato. Conclusiones: En todos los aspectos relevantes se obtuvieron mejores resultados que en el global de los hospitales del ICS, pero con capacidad de mejora en aspectos informativos a los pacientes. A pesar de la introducción de aspectos de mejora de la calidad, los resultados obtenidos en la encuesta del año 2000 no muestran una mejora significativa en la mayoría de las dimensiones valoradas en relación con la encuesta del año 1998 (AU)

Background: Users’ perception of quality of the Emergency Room service in our hospital in 2000 was compared with that in 1998 after the application of quality measures. Global data on the Emergency Room services of the Catalan Health Institute [Institut Català de la Salut (ICS)] hospital division were compared with those from our center. Material and methods: Two telephone surveys, centralized by the ICS, of users of Emergency Room services were performed. The first survey was performed in 1998 and the second in 2000. Of a sample of 3811 patients, 218 patients received medical assistance in our center in 1998 and 213 in 2000. The dimensions evaluated were: accessibility, dealings with staff, verbal and written information, comfort, professional competence, confidence, and global satisfaction. Results: Comparison of the results of the 2000 survey with those for 1998 in our center revealed that statistically significant improvements were obtained in only two items (information on waiting times and comfort) and that in one item a lowering of standards was observed. The hospitals of the ICS obtained statistically significant improvements in scores of eleven questions, among them, global satisfaction. The item receiving the highest score was that concerning dealings with staff. Conclusions: In all salient aspects, the results obtained in our center were better than the global score for the ICS hospital division. The information given to patients could be improved. Despite quality improvement, the results obtained in the 2000 survey were not significantly better than those obtained in most of the dimensions evaluated in the 1998 survey (AU)