RESUMO
Empyema necessitans (EN) is a rare long-term sequela of poorly or untreated empyema thoracis, characterized by the dissection of pus through the soft tissues and skin of the chest wall, ultimately forming a fistula between skin and pleural cavity. We herein present a male patient in his late 30s, a known case of tuberculosis (TB) on anti-tubercular therapy (ATT) under directly observed treatment short-course (DOTS), who recently came with complaints of backache for 3 days. Chest X-ray showed a massive pleural effusion, in view of which an intercostal drainage tube (ICD) was inserted and 1.5 L of pleural fluid was drained. An ultrasound (USG) back done revealed subcutaneous collection with communication to pleural space, which resolved after pleural fluid drainage. As there was a persistent communication between pleural space and right-sided subcutaneous plane with a massive effusion i.e., EN, he was advised to undergo thoracotomy with decortication and resection of communication which he underwent successfully. This case is presented for its rarity with atypical presentation.
RESUMO
Empty Sella syndrome is an uncommon condition characterized by the shrinking or flattening of the pituitary gland, resulting in the filling of the Sella turcica with cerebrospinal fluid rather than the normal pituitary gland. In this report, we present a case of undiagnosed partial empty Sella syndrome, which was found to be caused by pituitary hypophysitis with an idiopathic etiology. The patient, a middle-aged individual, presented atypically with acute adrenal insufficiency induced by a lower respiratory tract infection. The diagnosis was made following an investigative work-up that took into consideration the presence of hypotension, electrolyte imbalances, and a history of two post-partum lactational failures. Hormonal supplements were used to manage the patient conservatively, and no significant complications were observed.
RESUMO
Empty Sella syndrome is an uncommon condition characterized by the shrinking or flattening of the pituitary gland, resulting in the filling of the Sella turcica with cerebrospinal fluid rather than the normal pituitary gland. In this report, we present a case of undiagnosed partial empty Sella syndrome, which was found to be caused by pituitary hypophysitis with an idiopathic etiology. The patient, a middle-aged individual, presented atypically with acute adrenal insufficiency induced by a lower respiratory tract infection. The diagnosis was made following an investigative work-up that took into consideration the presence of hypotension, electrolyte imbalances, and a history of two post-partum lactational failures. Hormonal supplements were used to manage the patient conservatively, and no significant complications were observed.
RESUMO
Objetivou-se estimar as exigências energéticas de borregas mestiças confinadas, alimentadas com níveis crescentes de concentrado na dieta. Foram avaliadas 36 borregas, com peso corporal inicial de 23,7±3,67kg. Seis animais foram abatidos no início do experimento para obtenção dos valores do grupo referência. Os demais (30 animais) foram distribuídos em cinco tratamentos: mantença (alimentação restrita com feno de capim Tifton) e suplementados com níveis crescentes de concentrado (20, 40, 60 e 80%) em base de matéria seca (seis animais por tratamento). As borregas foram abatidas quando atingiram 37,70±9,89kg. Os níveis de concentrado influenciaram a eficiência de utilização da energia metabolizável para mantença (km) e consequentemente as exigências diárias de energia metabolizável para mantença. A exigência de energia líquida para mantença de borregas mestiças em crescimento é 57 kcal/PCJ0,75/dia, em que PCJ é o peso corporal em jejum. As borregas com 20kg apresentaram exigência de energia líquida para 100g de ganho de peso diário de 465kcal/dia. As borregas com 40kg de peso corporal exigiram 930kcal/dia de energia líquida para o mesmo ganho. A exigência líquida para mantença de borregas pode ser estimada pela equação: ELm (Mcal/dia) = 0,057* PCJ0,75. A exigência líquida de energia para ganho de borregas mestiças (Mcal/dia) pode ser estimada a partir da equação: ELg = 0,524 x PVJ0,75 x GPCVZ1,21, em que GPCVZ é o ganho de peso do corpo vazio. As dietas influenciam as eficiências de usos da energia metabolizável para mantença (km) e ganho (kg).(AU)
The aim of this study was to estimate the energy requirements of crossbreed ewe lambs in a feedlot fed with increasing levels of concentrate in the diet. 36 ewe lambs were evaluated with initial body weight of 23.7±3.67kg. Six animals were slaughtered at the beginning of the experiment to obtain the reference group values. Animals (30) were distributed in five treatments: maintenance (feed restricted with Tifton grass hay) and those supplemented with increasing dietary levels of concentrate (20, 40, 60 and 80%) on a dry matter basis (six animals per treatment). The ewe lambs were slaughtered when they reached 37.70±9.89kg. The concentrate levels influenced the utilization efficiency of metabolizable energy for maintenance (km) and consequently the daily requirements of metabolizable energy for maintenance. The net energy requirements for maintenance of crossbred lambs in growth is 57kcal/FCW 0.75/day, where FCW is body weight on fasting. The ewe lambs with 20kg presented net energy requirement for 100g daily weight gain of 465kcal/day. The ewe lambs with 40kg of body weight required 930 kcal/day of net energy for the same gain. The net energy requirement for maintenance of ewe lambs can be estimated by the equation: NEm (Mcal/day) = 0.057 * FCW0.75. The net energy requirement for crossbred ewe lambs gain (Mcal/day) can be estimated from the equation: NEg (Mcal/day) = 0.524*FCW 0.75*GEBW1.21, where GEBW represented gain empty body weight. Diets affect the efficiencies of uses of metabolizable energy for maintenance (km) and gain (kg).(AU)