National Medical Organizations Research Articles

An Exploration of Contraceptive Choice Pathways in Adolescents and Young Adults

To visualize contraceptive choice pathways among adolescent and young adults (AYA) designated female at birth (DFAB) as a means of exploring the relationships between current contraceptive use, desired contraceptive, and ultimately, chosen contraceptive method. A retrospective cross-sectional study was conducted of AYA DFAB (N=2369), aged 14-24 years, presenting for initial visit at a contraceptive clinic with standardized efficacy-based counseling. Sankey diagrams were utilized to visualize patient flow through the contraceptive decision-making process. Outcomes of interest were current contraceptive method, desired contraceptive prior to contraceptive counseling, and then chosen contraception. Chi-Square tests were conducted to quantify the strength of the relationships identified by the Sankey diagrams. Sankey diagrams demonstrated a fair amount of change from current contraceptive to desired contraceptive and from current contraceptive to chosen contraceptive. A stronger relationship was evident between desired contraceptive method and chosen method; most patients did not change their desired contraceptive after receiving counseling except AYA who were undecided about their desired contraceptive who flowed variably into all available methods. Chi-Square test assessing the association between desired and chosen contraceptive method was significant at p-value <0.001, validating the patterns identified with the Sankey diagrams. We identified distinct contraceptive decision-making pathways among AYA which could inform the framework for a more tailored counseling approach. These findings are aligned with national medical organizations' recommendations for provision of non-coercive, patient-centered contraceptive counseling to promote adolescent reproductive autonomy.

Heart failure with preserved ejection fraction management: a systematic review of clinical practice guidelines and recommendations.

Multiple guidelines exist for the diagnosis and management of heart failure with preserved ejection fraction (HFpEF). We systematically reviewed current guidelines and recommendations, developed by national and international medical organizations, on the management of HFpEF in adults to aid clinical decision-making. We searched MEDLINE and EMBASE on 28 February 2024 for publications over the last 10 years as well as websites of organizations relevant to guideline development. Of the ten guidelines and recommendations retrieved, seven showed considerable rigour of development and were subsequently retained for analysis. There was consensus on the definition of HFpEF and the diagnostic role of serum natriuretic peptides and resting transthoracic echocardiography. Discrepancies were identified in the thresholds of serum natriuretic peptides and transthoracic echocardiography parameters used to diagnose HFpEF. There was agreement on the general pharmacological and supportive management of acute and chronic HFpEF. However, differences exist in strategies to identify and address specific phenotypes. Contemporary guidelines for HFpEF management agree on measures to avoid its development and the consideration of cardiac transplantation in advanced disease. There were discrepancies in recommended frequency of surveillance for patients with HFpEF and sparse recommendations on screening for HFpEF in the general population, use of diagnostic scoring systems, and the role of newly emerging therapies.

Breast and cervical cancer screenings across gender identity: results from the Behavioral Risk Factor Surveillance System before and during the COVID-19 pandemic.

Although national medical organizations often neglect to include trans and gender diverse (TGD) people in their breast and cervical cancer screening recommendations, the World Profession Association of Transgender Health recommends that TGD people who are at risk for these cancers follow existing guidelines for cisgender women. Despite WPATH's recommendations, TGD people are less likely to get screened in large part due to discrimination. The COVID-19 pandemic has limited access to cancer screenings among cisgender people, but it is unknown how this has impacted TGD people. Using national survey data from the Behavioral Risk Factors Surveillance System (BRFSS), we examined differences in cervical and breast cancer screening noncompliance across gender identity at two time points: before and during the COVID-19 pandemic. Screening noncompliance increased during the COVID-19 pandemic among cisgender and TGD people (e.g., transgender men, gender non-conforming people). Compared to cisgender women, transgender men and gender non-conforming respondents had higher odds of breast cancer screening noncompliance before and during COVID-19. Transgender men had lower odds of cervical cancer screening noncompliance than cisgender women before COVID-19, but higher odds during the pandemic. Gender non-conforming respondents also had lower odds of cervical cancer screening noncompliance during COVID-19 compared to cisgender women. Screening noncompliance for breast and cervical cancer was more common among TGD people than cisgender women; while these disparities existed before the COVID-19 pandemic, they were exacerbated during the pandemic. Future work should move beyond descriptive statistics and elucidate underlying causes to inform interventions.

The Case for Advocacy Curricula and Opportunities in Medical Education: Past Examples to Inform Future Instruction.

With recent advances in understanding racial, socioeconomic, and mental health issues in medicine and their relation to policy and legislation, medical professionals are increasingly involved in local and national advocacy efforts. At the frontlines of these initiatives are medical students who, in addition to completing required coursework and clinical training, devote themselves to serving patients through civic participation. The burgeoning evidence concerning health care disparities and inequity, along with greater awareness of racial and socioeconomic discrimination, have made advocacy an essential aspect of many students' medical training. Every year, thousands of medical students join national medical advocacy organizations, in addition to regional, state, and local groups. Despite the rich history of medical student involvement in advocacy, there remains much speculation and skepticism about the practice as an essential component of the medical profession. From early initiatives pushing for national health insurance after World War II to encouraging anti-discrimination policies and practices, medical students have been collectively working to create change for themselves and their patients. Through efforts such as banning smoking on airplanes, creating safe syringe programs, and protesting against police brutality, many medical students work tirelessly in advocacy despite minimal educational support or guidance about the advocacy process. Given that medical student advocacy continues to grow and has shown measurable successes in the past, the authors believe that these efforts should be rewarded and expanded upon. The authors examine historical examples of medical student advocacy to suggest ways in which advocacy can be integrated into core medical school curricula and activities. They call attention to opportunities to support students' development of knowledge and skills to facilitate legislative change, expansion of interprofessional collaborations and credit, and curricular updates to promote social and health equity.

National groups unite in unprecedented effort to ban conversion therapy

Leaders of national medical and mental health organizations publicly joined together last week in observance of National Coming Out Day, Oct. 11, to end conversion therapy — calling such efforts “unscientific” and “ineffective” — and to affirm LGBTQ+ health care. The pioneering partnership is working to escalate awareness about how harmful conversion efforts are to a national level, organizers stated.

Underrepresentation of African Americans in Plastic Surgery: Examining Demographics, Specialty Factors, and Medical School Experiences

Racial representation among medical trainees translates into physicians that are able to communicate with diverse patient populations and are perceptive to health disparities. This is important within plastic surgery where an optimal physicianpatient relationship is essential to health outcomes. The purpose of this study is to address underrepresentation of African Americans (AA) in plastic surgery through improving understanding of factors that may contribute to AA medical student interest in plastic surgery. This was a voluntary, cross-sectional survey. An online survey was designed to collect information on demographics, specialty factor importance, medical school experiences, and plastic surgery interest among medical students. The survey was distributed to medical students within three national medical organizations between August 2018 and February 2019. The following groups of respondents were statistically COMPARED: AAs interested vs. AAs not interested in plastic surgery and AA vs. Caucasian medical students both interested in plastic surgery. Online survey for medical students in the United States. All 428 participants were medical students that belonged to at least 1 of the 3 national medical organizations between August 2018 and February 2019. The survey was completed by 428 participants of which 142 were excluded for incomplete surveys, leaving 286 (66.8%) participants to be included in the study. Among AA medical students, 128 (75.3%) were not interested in Plastic Surgery and 42 (24.7%) were interested. The 2 groups were similar demographically but differed significantly across multiple specialty factors and medical school experiences (p < 0.05). When compared to interested Caucasian medical students (n = 30), interested AA medical students differed significantly in demographics, specialty factors, and medical school experiences (p < 0.05). This study supports the implementation of medical school interventions emphasizing specialty factors and medical school experiences unique to AA medical students interested in plastic surgery to promote their application into the specialty.

Whose Life Is It Anyway? Medical Aid in Dying and Its Legal, Medical, and Ethical Conundrums

Whose Life Is It Anyway? Medical Aid in Dying and Its Legal, Medical, and Ethical Conundrums

Determinants of Meningococcal Vaccination Coverage and Adherence: A Targeted Literature Review Supporting a 16-year-old Healthcare Visit.

We conducted a targeted literature review to understand the determinants of meningococcal serogroups A, C, W, and Y (MenACWY) and meningococcal serogroup B (MenB) vaccination coverage and adherence to vaccination schedules in the USA, and to identify evidence to support improvement of MenACWY and MenB vaccination coverage and adherence in older adolescents. Sources published since 2011 were considered, with sources published since 2015 given preference. Out of 2355 citations screened, 47 (46 studies) were selected for inclusion. Determinants of coverage and adherence ranging from patient-level sociodemographic factors to policy-level factors were identified. Four determinants identified were associated with improved coverage and adherence: (1) well-child, preventive, or vaccination-only appointments (particularly for older adolescents); (2) provider-initiated, provider-driven vaccine recommendations; (3) provider education about meningococcal disease and vaccine recommendations; and (4) state-level school-entry immunization policies. This robust review of the literature sheds light on the continued low MenACWY and MenB vaccination coverage and adherence among older adolescents (16-23years of age) compared with that of younger adolescents (11-15years of age) in the USA. The evidence supports a renewed call to action by local and national health authorities and medical organizations urging healthcare professionals to implement a healthcare visitfor 16-year-olds and focus on vaccination as a key component of the visit.

From the national to the local: Issues of trust and a model for community-academic-engagement.

Inequities in health and health care in the United States have persisted for decades, and the impacts on equity from the COVID-19 pandemic were no exception. In addition to the disproportionate burden of the disease across various populations, the pandemic posed several challenges, which exacerbated these existing inequities. This has undoubtedly contributed to deeply rooted public mistrust in medical research and healthcare delivery, particularly among historically and structurally oppressed populations. In the summer of 2020, given the series of social injustices posed by the pandemic and highly publicized incidents of police brutality, notably the murder of George Floyd, the Association of American Medical Colleges (AAMC) enlisted the help of a national collaborative, the AAMC Collaborative for Health Equity: Act, Research, Generate Evidence (CHARGE) to establish a three-way partnership that would gather and prioritize community perspectives and lived experiences from multiple regions across the US on the role of academic medicals centers (AMCs) in advancing health and social justice. Given physical gathering constraints posed by the pandemic, virtual interviews were conducted with 30 racially and ethnically diverse community members across the country who expressed their views on how medical education, clinical care, and research could or did impact their health experiences. These interviews were framed within the context of the relationship between historically oppressed groups and the COVID-19 vaccine clinical trials underway. From the three-way partnership formed with the AAMC, AAMC CHARGE participants, and 30 community members from racially and ethnically diverse groups, qualitative methods provided lived experiences supporting other literature on the lack of trust between oppressed communities and AMCs. This led to the development of the Principles of Trustworthiness (PoT) Toolkit, which features ten principles inspired by community members' insights into how AMCs can demonstrate they are worthy of their community's trust. In the end, the three-way partnership serves as a successful model for other national medical and health organizations to establish community engaged processes that elicit and prioritize lived experiences describing relationships between AMCs and oppressed communities.

Resilience-Related Resources Predict Physicians' Fatigue, Job Search Behavior, and Productivity Outcomes.

The objective of this research was to assess the relative contribution of three resilience-related dispositional resources (trait mindfulness, core self-evaluations, and optimism) to emergency medicine physicians' fatigue, retention, and productivity. We surveyed emergency physicians employed by a national (US) medical staffing organization. The survey included measures of work stressors, resilience resources, job search behavior, and fatigue. We linked the survey responses to objective demographic and productivity measures from the organization's records. A total of 371 respondents completed the survey. Multiple regression analyses demonstrated support for each of the three resilience-related resources as predictors. Relative weights analyses showed that resilience accounted for 14% and 62% of the outcome variance, whereas work demands accounted for between 32% and 56%. Multiple facets of dispositional resilience are important predictors of emergency medicine physicians' occupational health, retention, and productivity.

Vaccine knowledge, attitudes, and recommendation practices among health care providers in New York State

ABSTRACT Community-wide vaccine uptake remains sub-optimal. Healthcare provider (HCP) vaccine recommendations influence patient vaccination; however, provider vaccine recommendation behavior is highly influenced by one’s own vaccine attitudes and/or knowledge. We aim to describe vaccine knowledge, attitudes, and recommendation practices (KAP) among New York State HCPs. A survey to assess HCP KAP was developed and electronically distributed to NYS members of national medical organizations via their local chapter administrators. Descriptive statistical methods were used to define provider KAP. A total of 864 surveys were included, 500 (60%) and 336 (40%) primary and specialty care providers, respectively. Eighty-one percent (402/499) of primary care providers (PCPs) report encountering vaccine hesitant patients daily or weekly. Of the 500 PCPs who responded, only 204 (41%) stated strong agreement with confidence in their communications with vaccine hesitant patients. HCPs who correctly answered all four knowledge questions were more likely to self-report routine recommendations of standard vaccines to all patients when compared to those who correctly answered fewer questions (489/588 (83%) vs 135/241 (56%), p < .05). HCPs were more likely to routinely recommend standard vaccines to all patients if they also report initiating vaccine discussion (476/485 (98%) vs 148/344 (43%), p < .05) and reviewing and recommending vaccinations at each encounter (315/320 (98%) vs 308/508 (61%), p < .05). Vaccine hesitancy exists across healthcare specialties and provider roles. Focused interventions should include reaching all HCPs to promote vaccinations for disease prevention, tailoring messages to reduce HCP vaccine misperceptions, and increasing awareness of evidence-based office strategies known to facilitate immunizations.

587. Vaccine knowledge, attitudes, and practices among New York State healthcare providers

Abstract Background Vaccine attitudes of healthcare providers (HCPs) influence patient vaccine acceptance. We sought to characterize vaccine knowledge, attitudes, and practices (KAP) among HCPs in NYS. Methods An electronic survey was developed to assess vaccine KAP among HCPs. The questionnaires were sent to members of various national medical organizations via local chapter administrators. Results 864 surveys were returned from 672 (78%) physicians and 192 (22%) mid-level practitioners (MLPs). 624/724 (86%) of HCPs report always recommending routine vaccines to eligible patients, yet only 76% recommend influenza vaccine (IV) and 77% strongly recommend HPV vaccine at 11-12 yrs. MLPs had a higher mean agreement level that recommending vaccines (4.6 vs 4.2 p &amp;lt; 0.01) or promoting HPV vaccine (4.2 vs. 3.9 p &amp;lt; 0.05) is within their scope of practice. Physicians had a higher mean agreement level that: vaccine benefits outweigh risks (4.9 vs 4.6 p &amp;lt; 0.01), HPV vaccine prevents cancer (4.7 vs 4.5 p &amp;lt; 0.01), and COVID-19 vaccine is safe (4.8 vs 4.5 p &amp;lt; 0.01) and effective (4.8 vs 4.7 p &amp;lt; 0.01). 82% (680/825) of HCPs knew that vaccines should not be deferred for mild illness. 14/836 (2%) believed that HPV vaccine could increase sexual activity, while 273/705 (39%) knew that the most common HPV associated malignancy is oropharyngeal cancer. HCPs who correctly answered ≥ 5/7 questions (462/507 91%) were more likely to recommend all vaccines to eligible patients than HCPs with lower scores (22/40 50% p &amp;lt; 0.05). Routine IV recommendation was more likely among HCPs who: strongly disagree that influenza is not serious enough for vaccination (292/397 (74%) vs 137/249 (55%) p &amp;lt; 0.01), strongly agree that it prevents severe disease (267/352 (76%) vs 162/294 (55%) p &amp;lt; 0.01), and receive annual IV (423/629 (67%) vs 6/17 (35%)) p &amp;lt; 0.01). HPV vaccine recommendation at 11-12 years was more likely among HCPs who strongly agree that the vaccine prevents cancer (273/326 (84%) vs 48/86, 56% p &amp;lt; 0.01) and those who stated that vaccination does not increase risk of unprotected sex (316/392 (79%) vs 3/12 (25%) p &amp;lt; 0.01). Conclusion Vaccine recommendation practices are influenced by HCP vaccine misperceptions and hesitancy. Interventions to reduce misperceptions and improve vaccine confidence are needed. Disclosures Manika Suryadevara, MD, Janssen: Grant/Research Support|Merck: Grant/Research Support|Roche: Grant/Research Support.

The No Surprises Act: What Do Plastic Surgeons Need to Know?

Background:Out-of-network, or “surprise” bills, have grown common in recent years and have raised substantial concern for patients. Congress recently enacted the No Surprises Act, effective on January 1, 2022, ending the majority of out-of-network bills for privately insured patients. The aim of this review is to briefly summarize the history of surprise billing, describe the regulations of the No Surprises Act, and examine the impact this legislation will have on the field of plastic surgery.Methods:A PubMed and Google Scholar literature search was conducted on out-of-network billing, or surprise bills, and the No Surprises Act. Media outlets, governmental agencies, and local and national medical organizations were additionally queried for surprise billing and the No Surprises Act.Results:Under the No Surprises Act, privately insured patients are protected from surprise medical bills in emergency and nonemergency settings, and uninsured or self-pay patients must be provided a good faith estimate of service fees before receiving nonemergent care. Plastic surgeons may consent patients to receive out-of-network bills if consent is obtained at least 72 hours before rendering a nonemergency service. Despite these patient protections, this act may influence plastic surgeons’ reimbursement rates and incentivize surgeons to alter their network status.Conclusions:The No Surprises Act provides significant protections for patients. However, it may have adverse effects for plastic surgeons. Plastic surgeons will only get paid in-network fees while providing care to patients unless consent is properly obtained in a nonemergent setting.

Critical Implications of IVDR for Innovation in Diagnostics: Input From the BioMed Alliance Diagnostics Task Force.

Critical Implications of IVDR for Innovation in Diagnostics: Input From the BioMed Alliance Diagnostics Task Force.

Experiences of Discrimination, Institutional Responses to Seminal Race Events, and Depressive Symptoms in Black U.S. Medical Students.

To examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students. This study collected data from a convenience sample of Black U.S. medical students via an anonymous electronic questionnaire in August 2020 that was distributed through the Student National Medical Association and Organization of Student Representatives listservs and an author's social media accounts. It included questions on demographics, institutional responses to seminal race events, experiences of discrimination, and symptoms of depression. Path models were used to examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students. Of the 750 students completing the survey, 733 (97.7%) were Black. Experiences of discrimination and a lack of institutional responses to seminal race events were associated with more depressive symptoms (b = 0.19, 95% CI: 0.11, 0.26; P < .001 and b = 0.12, 95% CI: 0.04, 0.20; P = .01). After controlling for gender and clinical diagnosis of depression or anxiety before medical school, there was a relationship between experiences of discrimination and institutional responses to seminal race events such that students who reported more experiences of discrimination were more likely to report that their institution did not respond to seminal race events (b = 0.41, 95% CI: 0.34, 0.48; P < .001). Experiences of discrimination moderated the relationship between institutional responses to seminal race events and depressive symptoms (i.e., the relationship between a lack of institutional responses to seminal race events and depressive symptoms was stronger among students who reported more frequent experiences of discrimination). Institutions dedicated to supporting Black medical student wellness must be diligent in cultivating a culture intolerant of discrimination and deft in their responses to seminal race events in the larger culture.

Diversity, equity, and inclusion in presidential leadership of academic medical and surgical societies

BackgroundOur aim was to identify gender and racial disparities in presidential leadership for national medical and surgical organizations. MethodsWe located publicly sourced information on national medical organizations. Years between or since the first diverse presidents were analyzed using descriptive statistics and Mann Whitney U tests. ResultsSixty-seven national medical and surgical organizations were surveyed. 70.8% (n = 34) diversified via gender first (White-female), whereas 26.1% (n = 14) had racial diversity first. Organizations with gender diversity first followed with an African American male president sooner than organizations who first diversified by race (14.7 ± 11.8 v. 27.6 ± 11.3 years, p = 0.018). No significant difference was observed for the third tier of diversification. ConclusionsSignificant gender and racial leadership disparities in national medical organizations are still present. It is notable that organizations with female leaders had a shorter timeline to racial diversity. These findings help to inform strategies to promote and increase diversity, equity, and inclusion in national leadership.

Первый опыт применения технологий телемедицины в офтальмологии Дальневосточного федерального округа

Purpose. Evaluation of the first experience in organizing systematic telemedicine consultations/conciliums between the national medical research center and medical organizations in the territory of the Far Eastern Federal District (FEFD) of the Russian Federation. Material and methods. The analysis of organizational and technical difficulties in creating of stable system of planned and unscheduled telecommunication events between the Khabarovsk branch of the Fyodorov Eye Microsurgery Federal State Institution (Khabarovsk branch) and assigned to it medical organizations of the 3rd level, providing ophthalmological care for patients from 8 administrative territories of the FEFD. Results. Organizational and methodological department was created in the Khabarovsk branch, which clarified and eliminated the factors that impeded of telemedicine consultations/conciliums for ophthalmologists of medical organizations of the 3rd level; a set of organizational measures was taken to register these medical organizations in the Federal Register of Medical Organizations, in the Unified State Information System in the Field of Healthcare; the equipment necessary for communication was purchased and technically prepared; methodological assistance was provided in setting up equipment in the regions, including on-site visits; backup connections of several providers have been created; an algorithm for preliminary notification of regional ophthalmologists about the knowledge transmission has been worked out; an organizational algorithm for forming a request for telemedicine consultations has been tested. For 2019–2020 the Khabarovsk branch conducted 32 knowledge transmissions, 560 telemedicine consultations on patients living in the FEFD. Conclusion. The introduction into the daily clinical ophthalmologists practice in the FEFD of system of periodic telecommunication events between the Khabarovsk branch and assigned medical organizations of the 3rd level after the elimination of organizational and technical difficulties showed a high demand, allowing consultations on patient management in accordance with modern standards of ophthalmological care. Key words: telemedicine, teleophthalmology, Far Eastern Federal District, knowledge transmission, telemedicine consultations

Being an excellent scientist is not enough to succeed! Soft skills for medical physicists

PurposeTo provide a review of the literature and commentary regarding soft skills for Medical Physicists. MethodA comprehensive search in PubMed was carried out using the searchwords ‘medical physics’ coupled separately (‘AND’, both in Title) with each of the following terms: leadership, teamwork, communication, pedagog*, teach*, marketing, conflict resolution, negotiat*, qualitative research, organizational psychology. ResultsThe total number of PubMed references was extremely low (total 6 relevant articles for all of leadership, communication, pedagog*, teach*, with the rest of the searchwords giving zero hits) which is quite disturbing. For an improved perspective, we compared the search for ‘leadership AND medical physics’ to ‘leadership AND medical’ and ‘leadership AND nursing’ we only had 4 hits for Medical Physics as opposed to 564 for ‘leadership AND medical’ and 1419 for ‘leadership AND nursing’. ConclusionsIt seems that Medical Physicists give an extremely low priority to soft skills as opposed to scientific skills. In a world of austerity economics and sometimes over commoditization such a situation is not only disturbing it is actually very risky for the profession. Medical Physicists must learn to provide strategic and robust leadership, be able to market their profession to all stakeholders (in particular to decision makers, other health care professions and the general public), be able to communicate their role, negotiate effectively for their profession, and boost their abilities for teambuilding and conflict resolution. The setting up of education programmes to overcome this soft skill deficit among medical physicists by national, regional and international medical physics organizations must be given priority.

Black infertility and social media engagement: a mixed methodology analysis

ObjectiveTo study social media engagement on Black infertility to better understand why there is lower utilization of in vitro fertilization by Black women despite higher infertility rates.DesignThe online analytics module BuzzSumo was used to quantify total engagements with the search term “Black infertility” across the commonly used social media platforms. The 10 article links with the highest engagement were selected from periods in 2020 and 2021. Sources cited in each article were reviewed to identify those that had citations of scientific peer-reviewed journals or national medical organizations. The contents of each article were reviewed for accuracy by comparing the article information against available scientific research and consensus data.Patient(s)Not applicable.Intervention(s)Not applicable.Main Outcome Measure(s)Not applicable.Result(s)After applying the exclusion criteria, nine article links remained in each date range. The highest engagement with the term “Black infertility” was found on Facebook for both 2020 and 2021. Ten percent of content regarding Black infertility in 2020 compared with 50% of content regarding Black infertility in 2021 referenced original studies in peer-reviewed journals. Links with greater social engagement were more likely to have academic sources in 2021 than in 2020 (odds ratio, 1.30). The highest user engagement was found for articles discussing the emotional toll of Black infertility.Conclusion(s)Social media users encounter misleading or inaccurate information regarding Black fertility at similar rates to accurate content. Social media can propagate misinformation, and this study identifies social media as an opportunity to improve education directed toward Black women to increase the utilization of in vitro fertilization services.

Integrated-electrochemical Approaches Powered by Photovoltaic Energy for Detecting and Treating Hydroxychloroquine in Water

Hydroxychloroquine (HCQ), a derivative of 4-aminoquinolone, is prescribed as an antimalarial prevention drug and to treat diseases such as rheumatoid arthritis, and systemic lupus erythematosus. Recently, the treatment of Coronavirus (COVID-19) was authorized by national and international medical organizations in certain hospitalized patients by chloroquine and hydroxychloroquine. However, its use for treating COVID-19 is only an unproven hypothesis still being investigated. Consequently, the high risk of natural water contamination due to the large production and utilization of HCQ is a key issue to overcome urgently. For this reason, the monitoring its concentration in water and the treatment of polluted effluents with HCQ are needed to minimize its hazardous effects. Then, in this study, an electrochemical measuring device and electrochemical water treatment are integrated for their environmental application on HCQ control. In the former, raw cork-graphite electrochemical sensor was prepared and a simple differential pulse voltammetric (DPV) method was developed for the quantitative determination of HQC. Meanwhile, the degradation of HCQ was carried out with BDD anode by applying 15, 30, and 60 mA cm-2 over 90 min of treatment, in the latter. The decay and degradation of HCQ were monitored by DPV, and HPLC measurements. Results indicated that, the electrochemical device exhibited a clear current response, allowing to quantify the analyte in the 2.5–25 ppm range. Alternatively, BDD-electrolysis demonstrated to be an efficient process for removing organic matter from the drug compound effluent via the production of strong oxidizing species. Lower HCQ concentrations were detected, using the electrochemical sensor, when higher current densities and sulfate concentrations were used in BDD-electrolysis, demonstrating the applicability of integrated-technologies. The evolution of short-carboxylic acids (oxalic, formic, oxamic, maleic, acetic, and glycoxylic) was observed at 15 mA cm-2 but all of them were eliminated after 120 min. Inorganic ions (NH4 + and NO3 -) were also detected under these experimental conditions, confirming that the pollutant was mineralized. Finally, lower energy requirements were estimated for all experimental conditions; however, solar photovoltaic (PV) renewable energy has been utilized to power these electrochemical technologies, decreasing the investment cost.