CARCINOMA EPIDERMOIDE ASOCIADO A LA INFESTACIÓN CRÓNICA POR HABRONEMA MUSCAE EN UN CABALLO DE RAZA PINTO: REGISTRO DE UN CASO EN VENEZUELA

An 8 year old male Pinto horse (Equus caballus) had a history of chronic exudative nodular balanopostitis complicated by secondary bacterial infection dating back to 4 years. Severe chronic wasting, oliguria, stranguria, polydipsia and lymphoadenomegaly of bubos femurales and pre-scapular areas were noted. Euthanasia was performed. Later necropsy was performed systematically by the techniques described for horses. Tissue sections were taken for histopathological examination and were processed by conventional methods. Fecal samples were taken for parasitological studies. Gross examination revealed severe chronic wasting, and exudative balanoposthitis with severe chronic secondary bacterial infection. Evidenced hydroperitoneum lymphoadenomegaly of mesenteric nodes were also observed. Histological sections showed severe chronic balanoposthitis, with focal cell proliferation of squamous cell with abundant spin cells acanthosis, pleomorphism, nuclear hyperchromasia, anaplasia, typical mitotic figures, and atypical consistant presence of abundant pearls corneas. In some areas, granulomas were observed with parasite forms of the genus Habronema. Parasitological results were consistent with eggs of Habronema muscae. In conclusion, the clinical history, and macroscopic and histological findings demonstrate a syndrome of chronic balanopostitis and metastatic squamous cell carcinoma.Se remite un caballo (Equus caballus), sexo macho, de raza Pinto y 8 años de edad. Con historia de balanopostitis nodular exudativa crónica complicada con infección bacteriana secundaria data de 4 años. Emaciación crónica severa. Oliguria, estranguria y polidipsia. Linfadenomegalia de nódulos linfáticos inguinales y femurales preescapulares. Se le practicó eutanasia. Posteriormente se le prácticó necropsia por las técnicas sistemáticas descritas para equinos. Se tomaron secciones de tejido para estudio histopatológico y fueron procesadas por los métodos convencionales de procesamiento histológico. Fueron tomadas muestras de heces para estudios parasitológicos. El examen macroscópico reveló emaciación crónica severa. Balanopostitis exudativa crónica severa con infección bacteriana secundaria. Se evidencio hidroperitoneo marcado. Linfadenomegalia de nódulos mesentéricos. Los cortes histológicos evidenciaron: Balanopostitis crónica severa, con focos de proliferación de células escamosas espinocelulares con abundante acantosis, pleomorfismo, hipercromasia nuclear, anaplasia, figuras mitóticas típicas y atípicas constantes, presencia de perlas corneas abundantes. En algunas zonas se observaron granulomas con formas parasitarias tipo Habronema. Los resultados del estudio coprológico fueron consistentes con huevos de Habronema muscae. En conclusión: la historia clínica, los hallazgos macroscópicos e histológicos evidencian un síndrome de balanopostitis crónica y carcinoma epidermoide metastásico

InterMiG: international differences in the therapeutic approach to migraine patients in specialized headache centers

Antidepressiu; Migranya; Tractament preventiuAntidepresivo; Migraña; Tratamiento preventivoAntidepressant; Migraine; Preventive treatmentBackground There is currently a wide therapeutic arsenal for migraine patients, without a single first-line preventive drug and we choose the different available alternatives taking into account comorbidities, national guidelines, previous treatments and personal experiences. Our objective was to evaluate the differences in the use of migraine treatments between neurologists from different countries. Methods This is a multi-centre observational study carried out by neurologists from specialized headache units in seven countries, retrospective with consecutive inclusion of all patients presenting with a migraine diagnosis, over a period of three months. Results A total of 734 patients were recruited but only 600 were considered in the analysis in order to homogenize the patient cohorts from countries: 200 Spain (ES), 100 Italy (IT), 85 Russia (RUS), 80 Germany (DE), 60 Portugal (PT), 45 Poland (PL) and 30 Australia (AU). 85.4 % of patients were women with a mean age of 42.6 ± 11.8 years. Considering previous and current preventive treatment, the order of use was: antidepressants (69.3 %), antiepileptic drugs (54.7 %), beta-blockers and antihypertensive drugs (49.7 %), OnabotulinumtoxinA (44.0 %) and others (36.2 %). Statistically significant differences were found between all pharmacological classes: antidepressants were commonly used in all countries, with the exception of Poland (AU: 76.7 %, IT: 71.0 %, DE: 60.0 %, PL: 31.1 %, PT: 71.7 %, RUS: 70.6 %, ES: 78.5 %; p < 0.0001); antiepileptic drugs were more frequently prescribed in Portugal, Australia and Spain (AU: 73.3 %, IT: 40.0 %, DE: 37.5 %, PL: 48.9 %, PT: 85.0 %, RUS: 29.4 % and ES: 69.0 %; p < 0.0001); beta-blockers and antihypertensive drugs were frequently used in all countries except Italy (AU: 60.0 %, IT: 14.0 %, DE: 53.8 %, PL: 48.9 %, PT: 68.3 %, RUS: 49.4 % and ES: 59.0 %; p < 0.0001); BTX-A were predominately used in Spain, Italy and Australia (AU:56.7 %, IT:58.0 %, DE:20.0 %, PL: 42.2 %, PT: 26.7 %, RUS: 24.7 % and ES: 58.5 %; p < 0.0001) and others were most frequently used in Poland (AU: 0.0 %, IT: 19.0 %, DE: 42.5 %, PL: 95.6 %, PT: 31.7 %, RUS: 3.5 % and ES: 49.5 %; p < 0.0001). If only patients without comorbidities are considered (200/600), statistically differences between countries persist in all preventive treatments. Conclusions There is heterogeneity in the choice of preventive treatment between different countries. Prospective comparative studies of the different oral and subcutaneous alternatives would help to create a global therapeutic algorithm that would guarantee the best option for our patients.This work did not receive any funds