A systematic review on the current situation of emerging pollutants in Mexico: A perspective on policies, regulation, detection, and elimination in water and wastewater.

Emerging pollutants (EPs) emerged as a group of new compounds whose presence in the environment has been widely detected in Mexico. In this country, different concentrations of pharmaceutical compounds, pesticides, dyes, and microplastics have been reported, which vary depending on the region and the analyzed matrix (i.e., wastewater, surface water, groundwater). The evidence of the EPs' presence focuses on the detection of them, but there is a gap in information regarding is biomonitoring and their effects in health in Mexico. The presence of these pollutants in the country associated with lack of proper regulations in the discharge and disposal of EPs. Therefore, this review aims to provide a comprehensive view of the current environmental status, policies, and frameworks regarding Mexico's situation. The review also highlights the lack of information about biomonitoring since EPs are present in water even after their treatment, leading to a critical situation, which is high exposure to humans and animals. Although, technologies to efficiently eliminate EPs are available, their application has been reported only at a laboratory scale thus far. Here, an overview of health and environmental impacts and a summary of the research works reported in Mexico from 2014 to 2023 were presented. This review concludes with a concrete point of view and perspective on the status of the EPs' research in Mexico as an alert for government entities about the necessity of measures to control the EPs disposal and treatment.

Intranasal dexamethasone: a new clinical trial for the control of inflammation and neuroinflammation in COVID-19 patients.

BACKGROUND: By end December of 2021, COVID-19 has infected around 276 million individuals and caused over 5 million deaths worldwide. Infection results in dysregulated systemic inflammation, multi-organ dysfunction, and critical illness. Cells of the central nervous system are also affected, triggering an uncontrolled neuroinflammatory response. Low doses of glucocorticoids, administered orally or intravenously, reduce mortality among moderate and severe COVID-19 patients. However, low doses administered by these routes do not reach therapeutic levels in the CNS. In contrast, intranasally administered dexamethasone can result in therapeutic doses in the CNS even at low doses. METHODS: This is an approved open-label, multicenter, randomized controlled trial to compare the effectiveness of intranasal versus intravenous dexamethasone administered in low doses to moderate and severe COVID-19 adult patients. The protocol is conducted in five health institutions in Mexico City. A total of 120 patients will be randomized into two groups (intravenous vs. intranasal) at a 1:1 ratio. Both groups will be treated with the corresponding dexamethasone scheme for 10 days. The primary outcome of the study will be clinical improvement, defined as a statistically significant reduction in the NEWS-2 score of patients with intranasal versus intravenous dexamethasone administration. The secondary outcome will be the reduction in mortality during hospitalization. CONCLUSIONS: This protocol is currently in progress to improve the efficacy of the standard therapeutic dexamethasone regimen for moderate and severe COVID-19 patients. TRIAL REGISTRATION: ClinicalTrials.gov NCT04513184 . Registered November 12, 2020. Approved by La Comisión Federal para la Protección contra Riesgos Sanitarios (COFEPRIS) with identification number DI/20/407/04/36. People are currently being recruited.