Multistage Treatment Research Articles

Urinary System Iatrogenic Injuries: Problem Review

Introduction: From May to December 2019, a literature review of the urinary system iatrogenic injury problem was performed. The most cited, representative articles in PubMed, Scopus, and WoS databases dedicated to this problem were selected. Urinary system iatrogenic injuries include ureter, bladder, urethra, and kidney traumas. It is widely thought that the main causes of such injuries are urological, obstetric, gynecological, and surgical operations on the retroperitoneal space, pelvis, or perineum. Methods: The purpose of the study is to describe all aspects of the iatrogenic injure problem, under the established scheme and for each of the most damaged organs: the urethra, bladder, kidney, and ureter. The treatment of confirmed iatrogenic injuries largely depends on the period of its detection. Modern medical procedures provide conservative or minimally invasive treatment. An untimely diagnosis worsens the treatment prognosis. “Overlooked” urinary system trauma is a serious threat to society and a particular patient. Thus, incorrect or traumatic catheterization can lead to infection (RR 95%) and urethral stricture (RR ≥11–36%), and percutaneous puncture nephrostomy can cause the risk of functional renal parenchyma loss (median 5%), urinary congestion (7%), or sepsis (0.6–1.5%). Results: Lost gain, profits, long-term and expensive, possibly multistage treatment, stress and depression, and the risks of suicide put a heavy financial, moral, and ethical burden on a person and society. Also, iatrogenic injury might have legal consequences. Discussion/Conclusion: Thus, the significant problem of urinary tract iatrogenic injuries is still difficult to solve. There is a need to implement mandatory examining algorithms for patients at risk, as well as the multidisciplinary principle for all pelvic surgery.

Multistage Surgical Treatment of Multisystem Closed Abdominal Trauma: Standardization of the Approach

Introduction. The multisystem closed abdominal trauma is accompanied by a high mortality rate, and exceeding the minimum required volume of surgery in an extremely difficult patient’s condition often leads to an unfavorable outcome.Aim of study. Standardization of staged treatment of patients with severe concomitant closed abdominal trauma.Material and methods. This review presents the latest information obtained as a result of studying domestic and foreign literature on the issue of multistage surgical treatment of severe multisystem closed abdominal trauma. The concept of damage control, its stages are described step by step, indications for types of surgical interventions are specified. The literature data on the results of clinical application of the technique from the standpoint of evidence-based medicine are presented.Conclusion. A clear knowledge of the required volume of surgical intervention at each stage of treatment of patients with severe concomitant closed abdominal trauma, the main points of intensive care, the criteria for patient stabilization and indications for relaparotomy improve the treatment results for this category of victims.

Multistage heat treatment and the development of a protective oxide-scale layer on the surface of FeCrAl sintered-metal-fibers

This study investigates the effects of Multistage Heat Treatment (MSHT) on the development of an oxide-scale layer on the surface of FeCrAl sintered-metal-fibers. The oxide-scale layer was developed using an MSHT cycle at 930 °C for 1 h, followed by 960 °C for 1 h, and finally at 990 °C for 2 h. In this study, three samples were considered: Sample 1 was kept without thermal oxidation, while Samples 2 and 3 were exposed to one and eighteen MSHT cycles. Thermo-gravimetric analyses show that the weight gain of the heat-treated sample slows with time, confirming the growth of the protective oxide-scale layer. Scanning electron microscope images, after one MSHT cycle, reveal nonuniform oxide-scale growth with platelet-like on the surface. After eighteen MSHT cycles, however, clumped particles formed on the surface of the fibers. Atomic force microscopy was utilized to study the surface topography of the fibers. The results show that MSHT increases the surface roughness, where the surface roughness of one and eighteen MSHT cycles are the same. The x-ray diffraction analyses of the baseline sample and the sample with one MSHT cycle show pattern peaks of crystalline Fe2CrAl. In contrast, the results of eighteen MSHT cycles displayed diffraction pattern peaks of crystalline Cr and stable α-Al2O3. In summary, the results of this study reveal the changing nature of the oxide-scale layer. The findings of this study form the foundation for new techniques to protect and prepare the FeCrAl fibers as a support for catalysts.

Decontamination and toxicity removal of an industrial effluent containing pesticides via multistage treatment: Coagulation-flocculation-settling and photo-Fenton process

This paper evaluates the combination of coagulation-flocculation-settling and photo-Fenton for the decontamination of a real effluent containing ametrine ([AMT]=403mg L−1), atrazine ([ATZ]=2153mg L−1), imidacloprid ([IMD]=2936mg L−1) and tebuthiuron ([TBT]=3354mg L−1) and which is generated during the manufacturing process of pesticides. Physicochemical treatment (coagulation-flocculation-settling) was tested using different concentrations of Al(NO3)3 and Fe(NO3)3. No significant removal was achieved using Al(NO3)3 as coagulant while best results were obtained via coagulation with Fe(NO3)3 (99 % removal of color and turbidity). Pesticides remaining in the supernatant after coagulation-flocculation-settling stages were removed via photo-Fenton under black-light or solar irradiation. 82–95 % removal of target pesticides were obtained after photo-Fenton treatment (2mmol L−1 of FeOx, 5463mgL−1 of H2O2) using black-light lamps (400kJ m−2). Solar irradiation improved the degradation of target pesticides (>99 %) leading to concentrations below quantification limits (<0.1mg L−1; 400kJ m−2). Effluent acute toxicity (Vibrio fischeri) was reduced from 100 % to 43 % after solar photo-Fenton. Highly oxidized compounds were formed as confirmed by an increase in average and carbon oxidation states. Preliminary costs calculated for the proposed treatment indicated that $ 349 may be saved per m3 of treated effluent when compared to costs associated to the conventional treatment for this effluent (incineration).

Investigation of surface morphology of thin metal films with magnetic layers Fe-Cr-Co

Films containing layers of dispersion-hardening alloys (LDHA) based on the Fe-Cr-Co system were obtained by magnetron sputtering. LDHA acquire the properties of film permanent magnets after a single-stage «fast» high-vacuum annealing. Bulk materials acquire such properties only after many hours of multi-stage heat treatment. The film samples acquire these properties in tens of seconds. The morphology of their surface was studied to determine the origin of the coercive force of film samples. The surface morphology was studied using high resolution scanning electron microscopy and atomic force microscopy. We studied two compositions that, in bulk, have a different tendency to form many phases during crystallization. In magnetron sputtering, the alloy in which a multiphase state is easily formed is polycrystalline. The antipode alloy in magnetron sputtering is realized in an amorphous state. After annealing, both alloys are in a polycrystalline state. Electron microscopic examination showed that as a result of annealing, crystallites are formed with a large projection onto the substrate plane, which grow due to the nearest neighbors. Moreover, these crystallites have not only a large area, but also a height. After annealing, both alloys are in a polycrystalline state. Electron microscopic examination showed that as a result of annealing, crystallites are formed with a large projection onto the substrate plane, which grow due to the nearest neighbors. Moreover, these crystallites have not only a large area, but also a height. What is determined by atomic force microscopy. High crystallites are also faceted. This may indicate that the composition of these crystallites differs from the composition of the surrounding layer, which may be the reason for the increase in coercive force as a result of annealing.

Влияние дополнительной имплантации ионов кислорода на дислокационную люминесценцию кремния, содержащего кислородные преципитаты

Dislocation-related photoluminescence is studied in unimplanted and implanted with oxygen ions silicon wafers after multistage heat treatment, used for the formation of internal getter in microelectronics, and final annealing at 1000°С in a chlorine-containing atmosphere. In unimplanted sample, the dislocation-related luminescence line D1 dominates and its intensity is more than one order of magnitude in comparison with another dislocation-related luminescence line D2. With increasing temperature, an intensity of the D1 line increases and then decreases. In implanted sample, the intensities of the D1 and D2 lines increase. For both the lines, temperature quenching of their intensities is observed only. The energies of quenching and increase of the intensities of dislocation-related photoluminescence lines are determined. Possible reasons of observed effects are discussed.

Полная пенильная реабилитация пациента с микрофаллией после коррекции экстрофии мочевого пузыря

Bladder exstrophy is a complex of urogenital malformations, varying in severity from epispadias to classical bladder exstrophy. The main aim of correcting bladder exstrophy in childhood is to achieve urine continence with the prevention of upper urinary tract disorders and to provide penile reconstruction. However, by the time of puberty, it is not always possible to achieve optimal anatomical features of the penis, and usually, by the end of puberty, the penile length is no more than 7 cm, which subsequently leads to psychosocial and sexual problems during puberty. Neither patient, nor urologist in most cases do not satisfy final result of the treatment of exstrophy and a number of epispadias forms. A clinical case of the surgical rehabilitation of a patient after undergoing multi-stage surgical treatment for a congenital malformation of the genitourinary system is presented in the article. MATERIALS AND METHODS: At the admission, the size of the penis was 3 cm (microfallia), urethral meatus was located in the area of the penoscrotal junction. From 2016 to 2019, the patient underwent neofallos formation, urethroplasty, and implantation of prostheses in the neophallos. RESULTS: According to the results, urinary and sexual function was completely restored, as well as anatomical relationships and dimensional parameters of the genitals.

STRATEGY OF EARLY DIFFERENTIATED TRAUMATOLOGICAL CARE IN TREATMENT OF VICTIMS WITH SEVERE COMBINED TRAUMA AND POLYTRAUMA WITH LONG TUBULAR BONES FRACTURES

Introduction. With the new organizational system, victims with severe concomitant trauma (TCT) and political injuries are allocated to a separate stream upon admission to the hospital, undergo damage diagnostics in the anti-shock ward, after which they are sent either to the anti-shock operating room when indications for an emergency operation are established or to the intensive care unit and intensive care for prolonged diagnosis and intensive care. Materials and methods. The analysis of the methods of treatment of 413 patients with fractures of long bones with severe concomitant trauma (TCT) and polytrauma, who received treatment using the strategy of "Differentiated early trauma care" and in relation to the treatment of fractures of long tubular bones with TCT and polytrauma of three tactics: 1 ) tactics of early (within 24 hours from the moment of injury) full volume of trauma care "Early total care" (ETC); 2) tactics of programmed multistage surgical treatment of fractures of the DTC "Damage control orthopedics" (DCO); 3) tactics of early individualized volume of trauma care "Early appropriate care" (EAC). Results. In the present study, 189 victims approached the third stage of DCO tactics: of all 413 patients studied with TST and polytrauma of the main array, 158 were performed ETC, 66 victims died - 189 remained. Of these 189 victims, the third stage of DCO tactics was performed by 116 (61.4%), and in 73 patients (38.6%) the third stage of DCO tactics was not performed due to a serious condition or long-term infectious complications. Long-term results of treatment were assessed as positive

Possibilities and prospects in early orthopaedic rehabilitation of children with ectodermal dysplasia and congenital edentulism. clinical features and practical experience

The article is devoted to the issue of early orthopaedic rehabilitation of youngest preschool children with ectodermal dysplasia and congenital edentulism. The essence and details of children’s psychophysiological development at this age are revealed, as well as main pedagogical tools making it possible to adapt the children to the specific environment of the dental clinic and motivate them for undergoing long-term multistage orthopaedic dental treatment. Clinical approaches and peculiarities in the dentist’s work with children of different psychological types as well as particular aspects in their adaptation to removable dentures are described. Two clinical cases of effective orthopaedic rehabilitation of 3-years-old children with ectodermal dysplasia and congenital edentulism using full removable lamellar dentures.

Errors in microseismic events locations introduced by neglecting anisotropy during velocity model calibration in downhole monitoring

Microseismic monitoring is the only tool to provide locations of microseismic events induced e.g. during hydraulic fracturing of unconventional reservoirs. Obtained locations become a baseline for the evaluation of stimulation effectiveness. However, due to several factors, they can be different from the true ones and lead to misinterpretation. Most important is the inaccuracy of the velocity model used in the location procedure, which is often amplified by seismic anisotropy. Even though the anisotropy is a common feature of organic-rich mudrocks, it is often neglected in the current industry practice. The usual approach is to produce a set of isotropic models, valid for the limited subsurface area only, which compensate for anisotropy effects. Here we explore how the accuracy of microseismic events' locations is affected when neglecting the anisotropy during velocity model building using traveltimes of calibration shots. We analyse events' mislocations using the synthetic modelling that simulates an ongoing multi-stage treatment in a vertically-transverse isotropic (VTI) media, monitored with a single vertical borehole. Finally, we provide a quantitative interpretation of location errors expected to be present when VTI anisotropy is being neglected. The most important result is the demonstration of how spatially limited are single-stage isotropic models in terms of correct event locations, despite performing an accurate calibration. Also, we show the limited gain in terms of location accuracy when multi-stage isotropic velocity models are constructed. As the ultimate solution to reduce location errors, we propose to account for anisotropy by inverting VTI anisotropy model parameters even when only part of calibration data is available.

Hydrolyzed polyacrylamide-containing wastewater treatment using ozone reactor-upflow anaerobic sludge blanket reactor-aerobic biofilm reactor multistage treatment system.

Polymer flooding is one of the most important enhanced oil recovery techniques. However, a large amount of hydrolyzed polyacrylamide (HPAM)-containing wastewater is produced in the process of polymer flooding, and this poses a potential threat to the environment. In this study, the treatment of HPAM-containing wastewater was analyzed in an ozonic-anaerobic-aerobic multistage treatment process involving an ozone reactor (OR), an upflow anaerobic sludge blanket reactor (UASBR), and an aerobic biofilm reactor (ABR). At an HPAM concentration of 500mgL-1 and an ozone dose of 25g O3/g TOC, the HPAM removal rate reached 85.06%. With fracturing of the carbon chain, high-molecular-weight HPAM was degraded into low-molecular-weight compounds. Microbial communities in bioreactors were investigated via high-throughput sequencing, which revealed that norank_c_Bacteroidetes_vadinHA17, norank_f_Cytophagaceae, and Meiothermus were the dominant bacterial groups, and that Methanobacterium, norank_c_WCHA1-57, and Methanosaeta were the key archaeal genera. To the best of our knowledge, this is the first study in which HPAM-containing wastewater is treated using an ozonic-anaerobic-aerobic multistage treatment system. The ideal degradation performance and the presence of keystone microorganisms confirmed that the multistage treatment process is feasible for treatment of HPAM-containing wastewater.

Magnetic Properties of Nanocrystalline (Nd,R)-(Fe,Co)-B (R = Pr, Ho) Alloys after Melt Spinning, Severe Plastic Deformation and Heat Treatment

Magnetic force microscopy (MFM) and magnetometry, scanning electron microscopy (SEM) and atomic force microscopy (AFM) are used to study the magnetic and structural properties of the (Nd,Pr)-Fe–B and (Nd,Ho)-(Fe,Co)-B alloys. The alloys are synthesized using an arc or induction furnaces. The nanocrystalline state of the (Nd,Ho)-(Fe,Co)-B alloys is reached by two techniques, namely, melt spinning (MS) and severe plastic deformation (SPD). Hydrogenation and multistage treatment of (Nd,Ho)-(Fe,Co)-B alloys, which includes severe plastic deformation of melt-quenched ribbons and subsequent heat treatment, is also used. The surface morphology and domain structure of samples are studied. These pictures are used to interpret the observed magnetic hysteresis loops of the samples. It was found that multistage treatment allows one to obtain samples with higher values of coercivity due to the formation of a special microstructure with oval grain (the aspect ratio equal to ∼ 3).

The case of the multistage treatment of acute pancreatitis using a variety of minimally invasive techniques

Treatment of acute pancreatitis and infectious complications is a complex multidisciplinary task. The use of traditional surgical procedures for the rehabilitation of foci of pancreatogenic infection often aggravates the course of the disease, leads to the development of postoperative complications, does not improve the results of treatment. On the contrary, the use of minimally invasive techniques avoids additional surgical injury. The case of stage treatment of acute pancreatitis and its purulent-septic complications with the use of minimally invasive technologies is presented to the readers.

Multistage Treatment of a Class II Division 1 Malocclusion With Severe Crowding

The improvement of facial aesthetics is one of the main reasons why patients with a class II division 1 malocclusion seek orthodontic treatment. There are various techniques available to treat class II malocclusions, one of which is a two-phase approach that includes functional jaw orthopedics as well as fixed orthodontic treatment. The following case report describes the case of a 12-year-old growing female patient AK with a severe class II division 1 malocclusion. The patient was treated initially with Haas-type rapid maxillary expansion. Pre-functional orthodontics was followed with a removable twin block functional appliance and a combination pull headgear for growth modification and correction of her overjet and profile. Thereafter, a fixed, pre-adjusted MBT (McLaughlin Bennet Trevsi) prescription orthodontic appliance was utilized following the extractions of the maxillary first premolars and two lower incisors in the final phase, to ensure well-aligned arches and improved aesthetics and function.

Influence of multi-stage heat treatment on the microstructure and mechanical properties of TC21 titanium alloy

Duplex-structured TC21 alloy samples were first solution-treated at a higher temperature in the α + β region (940°C) with furnace cooling (FC), air cooling (AC), and water cooling (WC), followed by a second-stage solution treatment at a lower temperature in the α + β region (900°C), and then finally aged at 590°C. The effects of the morphology and quantity of α phases on the structure and properties of the TC21 alloy after the different heat treatments were analyzed. The in-situ tensile deformation process and crack propagation behavior were observed using scanning electron microscopy (SEM). The quantity of equiaxed α phases as well as the thickness of lamellar α phases reduced, the tensile strength increased firstly and then decreased, the elongation decreased with the increasing cooling rate after the first-stage solution treatment. The amount and size of lamellar α phases increased after the second-stage solution treatment because of sufficient diffusion of the alloying elements, thereby leading to increased tensile strength. The amount of dispersed α phases increased after the third-stage aging treatment owing to the increase in the nucleation rate, resulting in a noteworthy strengthening effect. After the third-stage aging treatment, the first-stage FC sample exhibited better mechanical properties because it contained more equiaxed α and βtrans phases than the first-stage AC and WC samples.

Aortic Arch Hypoplasia in Infants: Algorithm of Diagnosis and Treatment

&#x0D; Background. Aortic arch hypoplasia is a congenital anomaly of the development of the aortic arch characterized by hemodynamically significant narrowing of one or more segments of the aortic arch. Despite the great interest in the problem of aortic arch hypoplasia, there are many contradictions in terms of terminology and classification. It is quite difficult to draw a clear line between normal physiology and pathology to determine in which cases there is a true hypoplasia, so, from a practical standpoint, the fundamental issue is the selection of criteria with reference to which we can talk about clinically and prognostically significant aortic arch hypoplasia. Important and yet controversial are the issues of multi-stage treatment of aortic arch hypoplasia and concomitant congenital heart diseases (CHD), and, in case of the isolated variant of hypoplasia, the choice of surgical approach.&#x0D; The aim of the study was to discuss different strategies and surgical approaches for patients with aortic arch hypoplasia, with an emphasis on surgical solutions and based on many years of experience, to develop an algorithm for diagnostic and surgical treatment of the aortic arch hypoplasia in infants.&#x0D; Conclusions. Aortic arch hypoplasia in infants remains a complicated issue in pediatric cardiac surgery. The variety of anatomical forms of isolated aortic arch hypoplasia and common overlap with other CHD raises many questions for the cardiac surgeon. Decisions concerning diagnosis and choice of further treatment tactics made in the neonatal period will affect not only the immediate but also the long-term outcome in the future. The algorithm of diagnostic and patient management with aortic arch hypoplasia allows to make the right timely decision which will affect the outcome of surgical treatment of this complex pathology.

SOFIA: Selection of Medical Features by Induced Alterations in Numeric Labels

This work deals with the improvement of multi-target prediction models through a proposed optimization called Selection Of medical Features by Induced Alterations in numeric labels (SOFIA). This method performs a data transformation when: (1) weighting the features, (2) performing small perturbations on numeric labels and (3) selecting the features that are relevant in the trained multi-target prediction models. With the purpose of decreasing the computational cost in the SOFIA method, we consider those multi-objective optimization metaheuristics that support parallelization. In this sense, we propose an extension of the Natural Optimization (NO) approach for Simulated Annealing to support a multi-objective (MO) optimization. This proposed extension, called MONO, and some multiobjective evolutionary algorithms (MOEAs) are considered when performing the SOFIA method to improve prediction models in a multi-stage migraine treatment. This work also considers the adaptation of these metaheuristics to run on GPUs for accelerating the exploration of a larger space of solutions and improving results at the same time. The obtained results show that accuracies close to 88% are obtained with the MONO metaheuristic when employing eight threads and when running on a GPU. In addition, training times have been decreased from more than 8 h to less than 45 min when running the algorithms on a GPU. Besides, classification models trained with the SOFIA method only require 15 medical features or fewer to predict treatment responses. All in all, the methods proposed in this work remarkably improve the accuracy of multi-target prediction models for the OnabotulinumtoxinA (BoNT-A) treatment, while selecting those relevant features that allow us to know in advance the response to every stage of the treatment.

Simultaneous Stripping of Ammonia from Leachate: Experimental Insights and Key Microbial Players

Air stripping is commonly used to remove the ammonia in multistage treatment systems for municipal landfill leachate (LFL). This paper proposes a novel approach combining the process of stripping with biological removal of ammonia, based on simultaneous nitrification and denitrification (SND) in a single hybrid sequencing batch reactor (HSBR). To avoid the accumulation of free ammonia (N-FAN), the shallow aeration system was used for the treatment of raw LFL with N-TAN level of 1520 mg/L and pH 9.24. The mean N-FAN removal efficiency of 69% with the reaction rate of 55 mg L−1 h−1 and mean ammonium (N-NH4+) removal efficiency of 84% with the reaction rate of 44 mg L−1 h−1 were achieved within a month in such an HSBR (R1). The comparative HSBR (R2), with conventional aeration system maintaining the same concentration of dissolved oxygen (DO ≤ 1 mg/L), was removing only trace amounts of N-FAN and 48% of N-NH4+. The quantitative analysis of 16S rRNA genes indicated that the number of total bacteria, Actinobacteria, Bacteroidetes, Firmicutes, and Beta- and Gammaproteobacteria increased during the operation of both HSBRs, but was always higher in R1. Moreover, the bacterial community shift was observed since the beginning of the experiment; the relative abundance of Firmicutes, and Beta- and Gammaproteobacteria increased by 5.01, 3.25 and 9.67% respectively, whilst the abundance of Bacteroidetes and Actinobacteria decreased by 15.59 and 0.95%. All of the surveyed bacteria groups, except Gammaproteobacteria, correlated significantly negatively (p &lt; 0.001) with the concentrations of N-NH4+ in the outflows from R1. The results allow us to suppose that simultaneous stripping and SND in a single reactor could be a promising, cost-effective and easy-to-operate solution for LFL treatment.

Multi-stage treatment of esophago-tracheal injury after button battery ingestion

Abstract The aspiration of the foreign body is a common problem in any pediatric specialization. We present a case of a 3-year-old boy admitted to the hospital after the button battery ingestion. In diagnostic imaging, a bronchoesophageal fistula was found. Gastrostomy and ileostomy were obtained. Due to increasing respiratory failure, the tracheotomy was made and the patient was intubated with the bilateral bronchopulmonary tube. On the 25th day, an attempt to reconstruct the esophagus and trachea was taken. During the operation, the surgery team took the cartilage lobe of the left ear, then switched to the extracorporeal circulation and finally made the esophagus end to end anastomosis and reconstruction of the tracheal loss with cartilage. On the 45th day, the communication between the esophagus and the trachea was found. A esophagostomy was made, and salivary glands were injected with botulinum toxin. The tightness of the anastomosis was confirmed. The patient in the favorable general condition left the ward on the 103rd day of stay. In cases of the trachea, bronchus, or esophagus damages, the prognosis is very serious. The therapeutic success depends on the cooperation of many specialists, both the non-surgical and operational specializations.

Treatment of hospital wastewater by supercritical water oxidation process

Hospital wastewater contains several micro and macro pollutants that cannot be removed efficiently by conventional treatment processes. Thus, generally hybrid and multistage treatment methods are suggested for the treatment of hospital wastewater. Supercritical water oxidation (SCWO) is a promising method for the removal of emerging organic pollutants from hospital wastewater in one step and a very short reaction time. In this study, supercritical water oxidation (SCWO) process was used for the removal of pharmaceuticals in addition to conventional pollutants from real hospital wastewater. As a result of a series of preliminary studies, the optimum conditions were selected as 450 °C, 60 s, and 1:1 for temperature, reaction time, and oxidant ratio (H2O2/COD), respectively, for the treatment of hospital wastewater at 25 ± 1 MPa. The removal rates were determined above 90% for COD, BOD, TOC, TN, and SS from hospital wastewater. Phosphorus removal was greater than 90%, while the removal rates were around 80% for phenol, AOX, and surfactants in hospital wastewater. A total of 9 pharmaceuticals were observed in the real hospital wastewater samples. The highest removal rate was obtained for Paracetamol as 99.9%, while the lowest removal rate was obtained for Warfarin as 72% after SCWO treatment of hospital wastewater. As a result, it can be concluded that SCWO process is sufficient for the treatment of hospital wastewater without the need of additional treatment steps, with high removal rates in a short reaction time.