The reaction of acrylamide with amines, amino acids, and polypeptides was studied in an attempt to understand the role of amino compounds on acrylamide fate. The obtained results showed that amino compounds are added to acrylamide by means of a Michael addition to produce the corresponding 3-(alkylamino)propionamides. Although 3-(alkylamino)propionamides can also be added to a new molecule of acrylamide to produce a new adduct, this last adduct was not detected under the employed conditions in which the concentration of acrylamide was much lower than the concentration of the amino compounds. The produced 3-(alkylamino)propionamides were not stable, and the addition reaction was easily reversed by heating. Thus, acrylamide was produced from 3-(alkylamino)propionamides by means of an elimination reaction. However, the activation energies (E(a)) of both reactions are not the same. In fact, acrylamide seems to be converted into its Michael adduct with a lower activation energy than the elimination reaction of the Michael adduct. For this reason, when acrylamide was stored in the presence of glycine at 60 degrees C, acrylamide disappeared after 14 days. However, when these samples were heated again for 20 min at 180 degrees C, the equilibrium was reestablished and a significant amount of acrylamide was detected. All of these results suggest that amino compounds may play a significant role in the changes observed in acrylamide content in foods upon storage. In addition, they also point to 3-(alkylamino)propionamides as possible compounds in which acrylamide might be potentially hidden.

To improve the efficiency and effectiveness of care and optimize healthcare resources, a home healthcare program was created for individuals with multiple chronic conditions. Demographic and clinical characteristics of the 261 individuals (mean age 84) included in the program from its inception in 2011 through 2013 (mean stay in the program 203±192 days) were prospectively analyzed. The number of hospital admissions, length of stay, and costs for individuals admitted to the program were compared for two time periods: the 6 months before admission to the program and their stay in the program. After admission to the program, the number of hospital admissions and the hospital length of stay per person per month decreased from 0.36±0.21 to 0.19±0.52 (P<.001) and from 3.5 to 1 day (P<.001), respectively. Surveys of randomly selected patients and caregivers showed high satisfaction with the program. Costs per person per day decreased from €54.65 (US$73.12) to €17.91 (US$23.96), a reduction of 67.1%. Fewer admissions and shorter hospital stays enabled the hospital to eliminate one acute bed for every 50 individuals admitted to the program. In conclusion, home care for individuals with chronic illness with multimorbidity reduced the number of hospital admissions and length of stay, resulting in good patient satisfaction and lower costs.

The ability of 20 phenolic derivatives to produce the Strecker-type degradation of phenylalanine and phenylglycine methyl ester was studied to investigate both the direct degradation of amino acids and amines by phenolic compounds in the absence of added oxidants and the effect of the number and positions of hydroxyl groups in the aromatic ring of the phenolic compound in relation to its ability to produce carbonyl derivatives from amino compounds. The obtained results showed that polyphenols can produce the Strecker degradation of amino acids and amines in the absence of added oxidants. The only requisite for producing the reaction is the presence of two hydroxyl groups in ortho or para positions. However, the presence of two hydroxyl groups in meta position in an additional aromatic ring can inhibit the Strecker-degrading ability of the hydroxyl groups in ortho or para positions. A reaction pathway that explains all of these findings is proposed. In addition, the effect of reaction conditions on the obtained reaction yields was studied. Activation energies (Ea) for phenylacetaldehyde formation from phenylalanine in the presence of hydroquinone, 1,2,4-trihydroxybenzene, and benzoquinone were 32.9, 31.5, and 28.8 kJ/mol, respectively.

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