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INTRODUCTION: Lung cancer continues to be the leading cause of death among cancer patients worldwide. This study aimed to estimate the clinical, economic, and social burdens of stage IV non-small cell lung cancer (NSCLC) in private and public healthcare centers in Mexico, utilizing real-world evidence. METHODS: The study population included patients >18 years of age diagnosed with stage IV NSCLC who received cancer treatment at the Centro Médico Nacional Siglo XXI (IMSS), the Centro Médico Nacional "20 de Noviembre" (ISSSTE), the Mexican Institute of Respiratory Diseases (INER), and the Medical Center ABC (American British Cowdray) from 1 January 2019 to 31 December 2020. The analysis included evaluation of epidemiological data, treatment regimens, and clinical outcomes, and emphasized pharmacological and non-pharmacological treatments, including detailed follow-up investigations, as part of comprehensive clinical management. Additionally, the study assessed the social burden through variables such as working-age absenteeism and presenteeism and caregiver productivity loss, as well as economic burden, considering both clinical and social components, with costs adjusted to 2022 Mexican pesos (MXN) values. RESULTS: A total of 188 patients with metastatic NSCLC were studied. The main type of NSCLC tumor found in the sample was adenocarcinoma (81%). Treatment regimens included pharmacological treatments (78%), non-pharmacological treatments (25%), and palliative care (24%). Complications were present in 73% of the cohort, while 60% presented adverse events. Clinical management costs of up to MXN1,001,579 per patient in the public sector and MXN2,140,604 in the private sector were reported. It was estimated that working-age patients lose 84-335 days yearly due to absenteeism and presenteeism, while caregivers report a productivity loss equivalent to 13-30 days due to the management of NSCLC patients. These indirect costs of NSCLC contribute to the social burden. A working-age patient with stage IV disease is associated with an average indirect cost of MXN49,731-178,287 in public institutions, while in private institutions, the cost elevates to MXN438,103. CONCLUSIONS: This study highlights the substantial clinical, economic, and social burdens of stage IV NSCLC in Mexico, revealing significant disparities between public and private healthcare sectors. It underscores the urgent need for standardized practices and equitable care across all systems.

This study examined the effects of advanced lung cancer (stage IV non-small cell lung cancer [NSCLC]) on patients in Mexico, focusing on the health, financial, and caregiver burdens. Researchers studied adults over 18 years of age undergoing cancer treatment at four medical centers across Mexico, analyzing treatment costs and time lost due to illness. All costs were updated to 2022 Mexican pesos (MXN) values. Treating one patient for 1 year can cost up to MXN 1 million in public hospitals and more than MXN 2 million in private hospitals. Patients might lose about 84­335 days of work annually, with caregivers losing 13­30 days. These lost workdays significantly impact finances, costing approximately MXN50,000­178,000 per patient per year in public hospitals and MXN438,000 in private hospitals. The study concludes that understanding these costs can help create better treatment plans, improving patient care and reducing financial burdens. By aligning treatment strategies across public and private healthcare settings, patients could benefit from more consistent and effective care, potentially leading to better health outcomes and reducing the overall impact of the disease on their lives and the broader healthcare system.

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La neumonía intersticial con características autoinmunes por sus siglas en inglés, es una entidad en la que existe un compromiso pulmonar intersticial y hallazgos clínicos y paraclínicos que sugieren una enfermedad del tejido conectivo, aunque no cumplen criterios diagnósticos para ninguna de estas. Con fines de investigación, en el 2015 se describieron criterios para esta entidad, en los que se incluyeron características de los dominios clínicos, serológicos y morfológicos, con diversos patrones de compromiso pulmonar. En la actualidad, hay un aumento en el interés de esta entidad, pues algunos autores sugieren que se pueda tratar de una enfermedad autoinmune per se, cuyo órgano blanco principal sería el pulmón. Dado su reciente reconocimiento, son pocos los casos descritos en la literatura. Con el propósito de contribuir a la mejor identificación de esa entidad, presentamos el caso de una paciente de 68 años con afectación pulmonar en quien después de descartar otras causas se llegó al diagnóstico de neumonía intersticial con características autoinmunes al cumplir los criterios de cada dominio requerido. Se inició tratamiento con micofenolato mofetilo a dosis de 2,5 mg/día. En su evolución clínica, la paciente presentó mejoría y fue dada de alta con tratamiento ambulatorio(AU)

Interstitial pneumonia with autoimmune features is a condition in which patients can have clinical and serological findings suggesting of a connective tissue disease associated with an interstitial lung disease, nonetheless no criteria for an specific connective tissue disease are meeting. In 2015 classification criteria where proposed, the diagnosis is made in the presence of a combination of features from clinical, serological and morphological domain with various patterns of pulmonary involvement. Currently there is an increase in the interest of this condition, as some authors suggest that it can be an autoimmune pathology per se, whose main target organ would be the lung. Given its recent recognition, there are few cases described in the literature and therefore in order to contribute to the better identification of that entity, we present the case of a 65 year old patient with lung involvement in whom after ruling out other etiological causes reached the diagnosis of I Interstitial pneumonia with autoimmune by meeting criteria of each required domain(AU)

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La mastitis granulomatosa idiopática es una enfermedad inflamatoria crónica de causa desconocida y presentación infrecuente, que afecta a mujeres en edad reproductiva. Su presentación clínica similar al carcinoma de mama, sumada al desconocimiento de esta entidad, genera confusión, errores y retrasos en el diagnóstico en gran proporción de los casos, por lo que la histopatología es un requisito fundamental para el diagnóstico correcto de esta enfermedad. Presentamos dos casos de pacientes femeninas con cuadro clínico de mastitis crónica en quienes, tras descartar causas infecciosas y neoplásicas, se estableció el diagnóstico de mastitis granulomatosa idiopática. Se administró terapia inmunosupresora con prednisolona, metotrexate y ácido fólico. Las pacientes tuvieron una adecuada respuesta y se evidenció la resolución del cuadro clínico a las 3 semanas de tratamiento(AU)

Idiopathic granulomatous mastitis is a chronic inflammatory disease of unknown etiology and infrequent presentation. Confusion, delayed and mistaken in diagnosis has been atribuided to the similar clinical manifestation with breast carcinoma, added to the ignorance of this entity, that's why histopathology is a fundamental requirement for the correct diagnosis of this disease. We present two cases of female patients with clinical symptoms of chronic mastitis, in whom a diagnosis of idiopathic granulomatous mastitis was made after ruling out infectious and neoplastic causes(AU)

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The anteromedial extrastriate complex has been proposed to play an essential role in a spatial orientation system in rats. To gain more information about that possible role, in the present work, two questions were addressed: 1. Are allocentric visual cues relevant for acquisition of the orientation task in the Lashley III maze? 2. Is this integration of allocentric inputs in the anteromedial visual complex relevant in the retention of this test? While a control group of rats was trained keeping the maze in the same position, the experimental group was trained with the maze rotated counterclockwise by 144 degrees from session to session. Control rats reached learning criterion significantly earlier and with less errors than the experimental ones (p<.05). After 11 sessions, rats of both groups received stereotaxic injections of ibotenic acid in the anteromedial complex. In the retention test one week after surgery, the control group, which had been able to learn using egocentric and allocentric visual cues, showed a greater deficit than the experimental animals (p<.05). These results confirm the role of the anteromedial complex in the processing of visuospatial orientation tasks and demonstrate the integration of allocentric visual cues in the solution of those tasks.

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The anteromedial extrastriate complex has been proposed to play an essential role in a spatial orientation system in rats. To gain more information about that possible role, in the present work, two questions were addressed: 1. Are allocentric visual cues relevant for acquisition of the orientation task in the Lashley III maze? 2. Is this integration of allocentric inputs in the anteromedial visual complex relevant in the retention of this test? While a control group of rats was trained keeping the maze in the same position, the experimental group was trained with the maze rotated counterclockwise by 144 degrees from session to session. Control rats reached learning criterion significantly earlier and with less errors than the experimental ones (p<.05). After 11 sessions, rats of both groups received stereotaxic injections of ibotenic acid in the anteromedial complex. In the retention test one week after surgery, the control group, which had been able to learn using egocentric and allocentric visual cues, showed a greater deficit than the experimental animals (p<.05). These results confirm the role of the anteromedial complex in the processing of visuospatial orientation tasks and demonstrate the integration of allocentric visual cues in the solution of those tasks.

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