Currently Available Treatment Modalities for Uterine Fibroids.

Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. OBJECTIVES: In this review we present all currently available treatment modalities for uterine fibroids. METHODS: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. REVIEW: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient's age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. CONCLUSIONS: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient's desire for definitive treatment or fertility preservation.

Complications of Preterm Birth-The Importance of Care for the Outcome: A Narrative Review.

Preterm-born children are susceptible to problems of adaptation in the early neonatal period, as well as the emergence of consequences due to the immaturity of the respiratory, cardiovascular, and especially cerebrovascular systems. The authors searched PubMed, Scopus, the Cochrane Library, and Web of Science for articles that were available in their entirety and published in English between 1990 and 2024 in peer-reviewed journals using keywords relevant to the manuscript topic. Analyzing the requested studies and manuscripts, adequate articles describing the stated problem were used. The last trimester of pregnancy is the most important period in brain development. Brain growth is at its most intense, and nerve cells are created, multiply, and migrate, creating numerous connections between them and receptors. During this period, the baby is protected from the influence of external environmental factors. When a baby is born, it leaves its protected environment and very often requires intensive treatment to survive. In these circumstances, the immature nervous system, which is in a sensitive stage of development, is overloaded with numerous external stimuli, continuous light, noise, inappropriate positioning, and repeated painful reactions due to necessary diagnostic and therapeutic procedures and the unavoidable absence of the mother and the family, which cause stress that threatens proper programmed development. Minimally invasive therapeutic procedures and the presence of parents during hospitalization play a significant role in reducing the consequences for a premature child.

Simultaneous determination of macrolides in water samples by solid-phase extraction and capillary electrophoresis.

Solid-phase extraction (SPE) coupled with capillary electrophoresis (CE) for the determination of macrolide antibiotics (azithromycin, clarithromycin, roxithromycin, tylosin) and tiamulin in water samples was described in this article. These compounds were extracted with different types of sorbents ( Oasis HLB, C18, C8, SDB, and Strata-X) and different masses of sorbents (60 mg, 200 mg, and 500 mg) using different organic solvents (methanol, ethanol, and acetonitrile) and different pH values of water samples (pH 7.00, 8.00, and 9.00). It was found that the highest extraction efficiency of the studied compounds was obtained with 200 mg/3 mL C18 cartridges with methanol as eluent at pH 9.00 of the water sample. The developed SPE-CE method for macrolide antibiotics and tiamulin was validated for linearity, precision, repeatability, the limit of detection (LOD), the limit of quantification (LOQ), and recovery. Good linearity was obtained in the range of 0.3-30 mg L-1 depending on the drug, with correlation coefficients higher than 0.9958 in all cases except clarithromycin (0.9873). Expanded measurement uncertainties were calculated for each pharmaceutical, accounting for 20.31 % (azithromycin), 38.33 % (tiamulin), 28.95 % (clarithromycin), 26.99 % (roxithromycin), and 21.09 % (tiamulin). Uncertainties associated with precision and calibration curves contributed the most to the combined measurement uncertainty. The method was successfully applied to the analysis of production waste-water from the pharmaceutical industry.

Impact of Polymer Chain Rearrangements in the PA Structure of RO Membranes on Water Permeability and N-Nitrosamine Rejection.

The use of solvents is overall recognized as an efficient method to improve the water permeability of polyamide thin film composite membranes (PA-TFC). The objective of this work was to test the performance of the membranes after exposing them to n-propanol (n-PrOH) to improve the permeability of the membranes while maintaining the rejection factor for small uncharged organic molecules, namely N-nitrosamines (NTRs). After the membranes were exposed to n-PrOH, the water permeability of the UTC73AC membrane increased by 98%, with minimal change in rejection. N-nitrosodiethylamine (NDEA) rejection decreased (3.4%), while N-nitrosodi-n-propylamine (NDPA) and N-nitrosodi-n-butylamine (NDBA) rejection increased by 0.9% and 2.8%, respectively. In contrast, for the BW30LE membrane, water permeability decreased (by 38.7%), while rejection factors increased by 14.5% for NDEA, 6.2% for NDPA, and 15.0% for NDBA. In addition, the morphology of the membrane surface before and after exposure to n-PrOH was analyzed. This result and the pore size distribution (PSD) curves obtained indicate that the rearrangement of polymer chains affects the network or aggregate pores in the PA layer, implying that a change in pore size or a change in pore size distribution could improve the permeability of water molecules, while the rejection factor for NTRs is not significantly affected.

The Importance of Metabolic and Environmental Factors in the Occurrence of Oxidative Stress during Pregnancy.

Metabolic changes in pregnant women begin in the first weeks after conception under the influence of placental hormones that affect the metabolism of all nutrients. An increased concentration of total lipids accompanies pregnancy and an increased accumulation of triglycerides in low-density lipoproteins (LDL) particles. Lipids in small dense LDL particles are more susceptible to oxidative modification than normal-density LDL particles. Unlike LDL high-density lipoproteins (HDL), lipoprotein particles have an atheroprotective role in lipid metabolism. The very growth of the fetus depends on the nutrition of both parents, so obesity is not only in the mother but also in the father. Nutritional programming of the offspring occurs through changes in lipid metabolism and leads to an increased risk for cardiometabolic diseases. Pregnancy is accompanied by an increased need for oxygen in the mitochondria of the placenta and a tendency to develop oxidative stress. Oxidative stress represents a disturbance in the balance of oxidation-reduction processes in the body that occurs due to the excessive production of free oxygen radicals that cellular homeostatic mechanisms are unable to neutralize. When the balance with the antioxidant system is disturbed, which happens when free oxygen radicals are in high concentrations, serious damage to biological molecules occurs, resulting in a series of pathophysiological and pathological changes, including cell death. Therefore, oxidative stress plays a significant role in the pathogenesis of many complications that can occur during pregnancy. The oxidative status of pregnant women is also influenced by socioeconomic living conditions, lifestyle habits, diet, smoking, and exposure to environmental air pollution. During a healthy pregnancy, the altered lipid profile and oxidative stress create an increased risk for premature birth and pregnancy-related diseases, and a predisposition to adult diseases.

Programming Factors of Neonatal Intestinal Dysbiosis as a Cause of Disease.

The intestinal microbiota consists of trillions of bacteria, viruses, and fungi that achieve a perfect symbiosis with the host. They perform immunological, metabolic, and endocrine functions in the body. The microbiota is formed intrauterine. Dysbiosis is a microbiome disorder characterized by an imbalance in the composition of the microbiota, as well as changes in their functional and metabolic activities. The causes of dysbiosis include improper nutrition in pregnant women, hormone therapy, the use of drugs, especially antibiotics, and a lack of exposure to the mother's vaginal microbiota during natural birth. Changes in the intestinal microbiota are increasingly being identified in various diseases, starting in the early neonatal period into the adult period. Conclusions: In recent years, it has become more and more obvious that the components of the intestinal microbiota are crucial for the proper development of the immune system, and its disruption leads to disease.

The Significance of COVID-19 Diseases in Lipid Metabolism Pregnancy Women and Newborns.

Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2. Elderly people, people with immunodeficiency, autoimmune and malignant diseases, as well as people with chronic diseases have a higher risk of developing more severe forms of the disease. Pregnant women and children can becomesick, although more often they are only the carriers of the virus. Recent studies have indicated that infants can also be infected by SARS-CoV-2 and develop a severe form of the disease with a fatal outcome. Acute Respiratory Distress Syndrome (ARDS) ina pregnant woman can affect the supply of oxygen to the fetus and initiate the mechanism of metabolic disorders of the fetus and newborn caused by asphyxia. The initial metabolic response of the newborn to the lack of oxygen in the tissues is the activation of anaerobic glycolysis in the tissues and an increase in the concentration of lactate and ketones. Lipid peroxidation, especially in nerve cells, is catalyzed by iron released from hemoglobin, transferrin and ferritin, whose release is induced by tissue acidosis and free oxygen radicals. Ferroptosis-inducing factors can directly or indirectly affect glutathione peroxidase through various pathways, resulting in a decrease in the antioxidant capacity and accumulation of lipid reactive oxygen species (ROS) in the cells, ultimately leading to oxidative cell stress, and finally, death. Conclusion: damage to the mitochondria as a result of lipid peroxidation caused by the COVID-19 disease can cause the death of a newborn and pregnant women as well as short time and long-time sequelae.

Neonatal Pneumothorax Outcome in Preterm and Term Newborns.

Background and Objectives: Pneumothorax implies the presence of air in the pleural space between the visceral and parietal pleura. The aim of this study was to investigate the incidence, clinical characteristics, risk factors, therapy and perinatal outcome in neonates with pneumothorax in a tertiary care center. Materials and Methods: A retrospective study based on a five-year data sample of neonates with pneumothorax was conducted in a Maternity Hospital with a tertiary NICU from 2015 to 2020. We included all neonates with pneumothorax born in our hospital and compared demographic characteristics, perinatal risk factors, anthropometric parameters, comorbidities, clinical course and method of chest drainage between term (≥37 GW) and preterm (<37 GW) neonates. Results: The study included 74 newborns with pneumothorax, of which 67.6% were male and 32.5% were female. The majority of women (59.5%) had no complications during pregnancy. Delivery was mainly performed via CS (68.9%). Delivery occurred on average in 34.62 ± 4.03 GW. Significantly more (p = 0.001) children with pneumothorax were born prematurely (n = 53; 71.6%) than at term (n = 21; 28.4%). Most of the neonates had to be treated with ATD (63.5%) and nCPAP (39.2%), but less often they were treated with surfactant (40.5%) and corticosteroids (35.1%). O2 therapy lasted an average of 8.89 ± 4.57 days. Significantly more (p = 0.001) neonates with pneumothorax had additional complications, pneumonia, sepsis, convulsions and intraventricular hemorrhage (68.9%). However, most children had a good outcome (83.8%) and were discharged from the clinic. Fatal outcomes occurred in six cases, while another six neonates had to be transferred to referral neonatal centers for further treatment and care. Conclusion: Significantly more children with pneumothorax were born prematurely than at term. With adequate therapy, even premature newborns can successfully recover from pneumothorax.

Trends of the Prevalence of Pre-gestational Diabetes in 2030 and 2050 in Belgrade Cohort.

The aim of this study was to analyze the trends in diabetes in pregnancy in Belgrade, Serbia for the period of the past decade and forecast the number of women with pre-gestational diabetes for the years 2030 and 2050. The study included the data on all pregnant women with diabetes from the registry of the deliveries in Belgrade, by the City Institute of Public Health of Belgrade, Serbia for the period between 2010 and 2020 and the published data on the deliveries on the territory of Belgrade. During the examined period the total number of live births in Belgrade was 196,987, and the prevalence of diabetes in pregnancy was 3.4%, with the total prevalence of pre-gestational diabetes of 0.7% and overall prevalence of GDM of 2.7%. The average age of women in our study was significantly lower in 2010 compared to 2020. The forecasted prevalence of pre-gestational diabetes among all pregnant women for 2030 is 2% and 4% for 2050 in our cohort. Our study showed that the prevalence of pre-gestational diabetes has increased both among all pregnant women and among women with diabetes in pregnancy in the past decade in Belgrade, Serbia and that it is expected to increase further in the next decades and to further double by 2050.

Importance of Staphylococcus epidermidis findings in the blood and cerebrospinal fluid of a full-term newborn: a case report.

Methicillin-resistant Staphylococcus epidermidis (MRS) predominantly colonizes the skin and mucous membranes of humans and other animals. We describe the case of a male newborn of gestational age 39 weeks whose primary and repeated blood cultures and cerebrospinal fluid samples isolated MRS. The choice and duration of antibiotic therapy were determined by the clinical presentation, infection parameters, and results of bacteriological analyses of blood and cerebrospinal fluid samples obtained from the newborn on the day 5 of life. After 28 days of antibiotic therapy for sepsis accompanied by meningitis, the newborn was discharged home without sequelae.

The Effect of Glucose Metabolism and Breastfeeding on the Intestinal Microbiota of Newborns of Women with Gestational Diabetes Mellitus.

Gestational diabetes mellitus (GDM) is a pregnancy complication in which women without previously diagnosed diabetes develop chronic hyperglycemia during gestation. The diet and lifestyle of the mother during pregnancy as well as lactation have long-term effects on the child's health and development. Detection of early risk markers of adult-age chronic diseases that begin during prenatal life and the application of complex nutritional interventions at the right time may reduce the risk of these diseases. Newborns adapt to the ectopic environment by developing intestinal immune homeostasis. Adequate initial colonization of bacteria is necessary for sufficient development of intestinal immunity. The environmental determinant of adequate colonization is breast milk. Although a developing newborn is capable of producing an immune response, the effector immune component requires bacterial stimulation. Breast milk stimulates the proliferation of a well-balanced and diverse microbiota, which initially influences the switch from an intrauterine TH2 predominant to a TH1/TH2 balanced response and the activation of T-regulatory cells by breast milk-stimulated specific organisms (Bifidobacteria, Lactobacillus, and Bacteroides). Breastfeeding in newborns of mothers with diabetes mellitus regulates the adequate immune response of the newborn and prevents diseases of the neonatal and postnatal period.

Maternal and Fetal Outcomes among Pregnant Women with Diabetes.

The aim of this study was to examine the differences in pregnancy complications, delivery characteristics, and neonatal outcomes between women with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM). This study included all pregnant women with diabetes in pregnancy in Belgrade, Serbia, between 2010 and 2020. The total sample consisted of 6737 patients. In total, 1318 (19.6%) patients had T1DM, 138 (2.0%) had T2DM, and 5281 patients (78.4%) had GDM. Multivariate logistic regression with the type of diabetes as an outcome variable showed that patients with T1DM had a lower likelihood of vaginal delivery (OR: 0.73, 95% CI: 0.64-0.83), gestational hypertension (OR: 0.47, 95% CI: 0.36-0.62), higher likelihood of chronic hypertension (OR: 1.88, 95% CI: 1.55-2.29),and a higher likelihood ofgestational age at delivery before 37 weeks (OR: 1.38, 95% CI: 1.18-1.63) compared to women with GDM. Multivariate logistic regression showed that patients with T2DM had a lower likelihood ofgestational hypertension compared to women with GDM (OR: 0.37, 95% CI: 0.15-0.92).Our results indicate that the highest percentage of diabetes in pregnancy is GDM, and the existence of differences in pregnancy complications, childbirth characteristics, and neonatal outcomes are predominantly between women with GDM and women with T1DM.

Performance of TiO2/UV-LED-Based Processes for Degradation of Pharmaceuticals: Effect of Matrix Composition and Process Variables.

Ultra-violet light-emitting diode (UV-LED)-based processes for water treatment have shown the potential to surpass the hurdles that prevent the adoption of photocatalysis at a large scale due to UV-LEDs' unique features and design flexibility. In this work, the degradation of five EU Watch List 2020/1161 pharmaceutical compounds was comprehensively investigated. Initially, the UV-A and UV-C photolytic and photocatalytic degradation of individual compounds and their mixtures were explored. A design of experiments (DoE) approach was used to quantify the effects of numerous variables on the compounds' degradation rate constant, total organic carbon abatement, and toxicity. The reaction mechanisms of UV-A photocatalysis were investigated by adding different radical scavengers to the mix. The influence of the initial pH was tested and a second DoE helped evaluate the impact of matrix constituents on degradation rates during UV-A photocatalysis. The results showed that each compound had widely different responses to each treatment/scenario, meaning that the optimized design will depend on matrix composition, target pollutant reactivity, and required effluent standards. Each situation should be analyzed individually with care. The levels of the electrical energy per order are still unfeasible for practical applications, but LEDs of lower wavelengths (UV-C) are now approaching UV-A performance levels.

Photodegradation, toxicity and density functional theory study of pharmaceutical metoclopramide and its photoproducts.

Pharmaceuticals as ubiquitous organic pollutants in the aquatic environment represent substances whose knowledge of environmental fate is still limited. One such compound is metoclopramide, whose direct and indirect photolysis and toxicological assessment have been studied for the first time in this study. Experiments were performed under solar radiation, showing metoclopramide as a compound that can easily degrade in different water matrices. The effect of pH-values showed the faster degradation at pH = 7, while the highly alkaline conditions at pH = 11 slowed photolysis. The highest value of quantum yield of metoclopramide photodegradation (ϕ = 43.55·10-4) was obtained at pH = 7. Various organic and inorganic substances (NO3-, Fe(III), HA, Cl-, Br-, HCO3-, SO42-), commonly present in natural water, inhibited the degradation by absorbing light. In all experiments, kinetics followed pseudo-first-order reaction with r2 greater than 0.98. The structures of the photolytic degradation products were tentatively identified, and degradation photoproducts were proposed. The hydroxylation of the aromatic ring and the amino group's dealkylation were two major photoproduct formation mechanisms. Calculated thermochemical quantities are in agreement with the experimentally observed stability of different photoproducts. Reactive sites in metoclopramide were studied with conceptual density functional theory and regions most susceptible to •OH attack were characterized. Metoclopramide and its degradation products were neither genotoxic for bacteria Salmonella typhimurium in the SOS/umuC assay nor acutely toxic for bacteria Vibrio fischeri.

Effects of environmental factors on nitrofurantoin photolysis in water and its acute toxicity assessment.

Pharmaceuticals have special attention of researchers over the world due to their possible effect on the environment and humans. This paper focuses on the photolysis of nitrofurantoin in different water matrices. Nitrofurantoin photodegradation has been indicated as a pseudo-first order photoreaction. The indirect photodegradation rate of nitrofurantoin (river water, k1 = 0.0088 min-1 and synthetic wastewater, k1 = 0.0154 min-1) was slower than its direct photolysis rate (ultrapure water, k1 = 0.0176 min-1). The highest value of quantum yield of nitrofurantoin photodegradation (ϕ = 0.2047) was observed at pH = 4, while at higher pH-values it decreased. Furthermore, the mechanism of nitrofurantoin photodegradation is proposed. Heterocyclic ring opening and further hydrolysis, nucleophilic aromatic photosubstitution and homolytic N-N bond cleavage are suggested as three main initial processes of nitrofurantoin photodegradation. Acute toxicity study of nitrofurantoin and its photoproducts with regard to luminescence inhibition of Vibrio fischeri showed that the toxic effect of nitrofurantoin (EC50 = 4.0 mg L-1) decreases by photolysis.

Development of an analytical method for the determination of pimavanserin and its impurities applying analytical quality by design principles as a risk-based strategy.

Pimavanserin is an atypical antipsychotic indicated for the treatment of hallucinations and delusions associated with Parkinson's disease psychosis. As it is a relatively new drug on the market, limited number of pharmacokinetic information and analytical methods are available. This paper presents an ultra-high performance chromatography for the simultaneous determination of pimavanserin and its four process impurities. The method was developed applying analytical quality by design (AQbD) principles as a risk-based approach. Critical method attributes (CMAs) were selected as a resolution between the worst separated compounds (impurity B and impurity C), a duration of analysis defined by the retention time of the last eluting peak (impurity D), a capacity factor of the first eluted impurity (impurity A), a tailing factor and a theoretical plate number. Risk assessment in the early stage of method development pointed out critical method parameters (CMPs): column temperature, gradient time and pH-value of the mobile phase (water phase, eluent A). Design of experiments (DoE), using DryLab®4 software, was applied to evaluate the influence of CMPs on CMAs and to determine method operable design region (MODR). Based on the risk assessment and the results of robustness and precision tests, a control strategy with system suitability criteria was proposed. Developed method was validated according to ICH Q2 (R1) guideline with respect to the selectivity, LOD, LOQ, linearity, precision, accuracy, robustness and stability. A forced degradation study was performed to provide an evidence of the stability-indicating property of the method. Degradation products of pimavanserin were identified using ultra high-performance liquid chromatography coupled to high resolution mass spectrometry (UHPLC-qTOF). Additionally, potential degradation products were assessed in silico with the help of Zeneth® software and good agreement with experimentally identified degradation products was achieved. Main degradation products were formed during acid and base hydrolysis (m/z 223.16 [M+H]+ at RRT 0.37) and under oxidative stress conditions (m/z 444.26 [M+H]+ at RRT 0.57). The results revealed that the pimavanserin undergoes degradation through acid and base hydrolysis of urea and N-oxidation of aliphatic tertiary amine.

UV filters as a driver of the antibiotic pollution in different water matrices.

Antibiotic pollution is frequently detected in fresh waters and wastewaters where they represent an environmental risk for the development of global antibiotic resistance. Due to their excessive use in personal care products, UV filters have also been found to be pseudo-persistent in the aquatic environment. In contrast to antibiotics, which can undergo photodegradation, UV filters are compounds designed to stably absorb UV radiation. This study explored the light based remediation of representative antibiotics from seven classes of antibiotics (fluoroquinolones, tetracyclines, penicillins, macrolide, glycolpeptide, sulphonamides and trimethoprim) in order to assess whether antibiotic pollution persists longer in the presence of organic UV filters. We show that the presence of UV filters either completely supresses or significantly alters the photodegradation of antibiotics in water. Advanced technologies in wastewater treatment, such as the use of UV C radiation, both effectively minimise the effect of UV filters and degrade most of the tested antibiotics proving to be effective management strategy. However, the half-life of erythromycin and amoxicillin, widely used antibiotics from macrolide- and penicillin-like classes, is extended in the presence of UV filters, even during UV C irradiation. Overall, the UV filters present within environmental mixtures are identified as important drivers of mixture toxicity, as they prolong antibiotic contamination of aquatic and engineered environments. The ramification of such finding is that inadequate consideration of UV filters may result in an imperfect prediction of the solar and UV light-based remediation of antibiotics, lead to improper classification of antibiotics persistence in the environment and cause non-optimal chemical fate and transport model performance. Use of the more benign compounds and assessment of the UV filters were identified as feasible management options in minimizing the influence of UV filters onto the remediation of antibiotics in aquatic environments.

State-of-the-art and current challenges for TiO2/UV-LED photocatalytic degradation of emerging organic micropollutants.

The development of ultraviolet light-emitting diodes (UV-LED) opens new possibilities for water treatment and photoreactor design. TiO2 photocatalysis, a technology that has been continuously drawing attention, can potentially benefit from LEDs to become a sustainable alternative for the abatement of organic micropollutants (OMPs). Recently reported data on photocatalytic degradation of OMPs and their parameters of influence are here critically evaluated. The literature on OMP degradation in real water matrices, and at environmentally relevant concentrations, is largely missing, as well as the investigations of the impact of photoreactor design in pollutant degradation kinetics. The key factors for reducing UV-LED treatment technology costs are pointed out, like the increase in external quantum and wall-plug efficiencies of UV-LEDs compared to other technologies, as well as the need for an appropriate design optimizing light homogeneity in the reactor. Controlled periodic illumination, wavelength coupling and H2O2 addition are presented as efficiency enhancement options. Although electrical energy per order (EEO) values for UV-LED photocatalysis have decreased to the range of traditional mercury lamps, values are still not low enough for practical employment. Moreover, due to the adoption of high initial OMP concentration in most experiments, it is likely that most literature EEO values are overestimated. Given the process characteristics, which are favoured by translucent matrices and small diameters for more homogenous light distribution and better transportation of radicals, innovative reactor designs should explore the potential of point-of-use applications to increase photocatalysis applicability at large scale.

The role of photodegradation in the environmental fate of hydroxychloroquine.

For many organic pollutants present in surface waters, photolysis is considered as a major abiotic degradation process. The present study aimed to explore the role of photolysis in the environmental fate of hydroxychloroquine (HCQ) for the first time. The photolytic degradation of HCQ was investigated under simulated solar radiation (300-800 nm) in ultrapure, spring, river, and sea water. The effect of pH on the photodegradation rate was substantial and it was observed that degradation was faster at higher pH-values. Obtained half-lives ranged from 5.5 min at pH 9 to 23.1 h at pH 4. Humic acids, nitrate and iron(III) enhanced photodegradation of HCQ due to formation of hydroxyl radicals and its attack on HCQ molecule. In contrast, chloride, sulfate and bromide inhibited photodegradation. Additionally, the humic acids exhibited a dual role, photosensitization and inner filter effect. The study of the reaction kinetics was performed with HPLC-PDA, while the identification of degradation products formed during photolytic degradation was carried out using HPLC-MS/MS and NMR spectroscopy. The hydroxylation was recognized as the dominant path of photoproducts formation. The results of this research reveal the importance of photolytic degradation in environmental fate of HCQ and enable a better understanding of its behavior in the environment. Moreover, the results showing the significant effect of pH on the photodegradation of HCQ can be very useful in water treatment processes.

Photocatalytic Degradation of Azithromycin by Nanostructured TiO2 Film: Kinetics, Degradation Products, and Toxicity.

In this paper, nanostructured TiO2 film was prepared by the by sol-gel process and dip-coating technique with titanium tetraisopropoxide as a precursor. After heat treatment at 550 °C, the deposited film was characterized by means of micro-Raman spectroscopy and atomic force microscopy (AFM). It was found that the TiO2 film consisted of only the TiO2 anatase phase and showed a granular microstructure. Photocatalytic degradation of azithromycin by using sol-gel nanostructured TiO2 film was studied to define the most effective degradation process for potential use in wastewater treatment. Different factors were evaluated during photocatalysis, such as pH (3, 7, and 10), water matrix (ultrapure water and synthetic municipal waste water effluent), influence of another pharmaceutically active compound (sulfamethoxazole, one of the most often detected pharmaceutic compounds in waste waters), and radiation sources (low pressure ultraviolet (UV) mercury lamps with a UV-A and UV-C range; a light-emitting diode (LED) lamp with a radiation peak at 365 nm). The most effective degradation process was achieved with the UV-C irradiation source in matrices at pH 10. The water matrix had little effect on the photocatalytic degradation rates of azithromycin. The presence of sulfamethoxazole in the water matrix decreased the degradation rate of azithromycin, however, only in matrices with a pH level adjusted to 10. During the experiments, five azithromycin degradation products were identified and none of them showed toxic properties, suggesting effective removal of azithromycin. LED 365 nm as the irradiation source was not as effective as the UV-C lamp. Nevertheless, considering the cost, energy efficiency, and environmental aspects of the irradiation source, the LED lamp could be a "real-life" alternative.