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.