Asymmetric Pulmonary Hypermetabolism on 18F-FDG PET/CT Caused by Pulmonary Embolism

We present a case of diffuse and moderately increased F-FDG uptake in the entire left lung on F-FDG PET without any morphological parenchymal abnormalities in a patient with recent history of esophageal adenocarcinoma treated by minimal invasive surgery and adjuvant chemotherapy. Contrast-enhanced CT revealed a large embolism in the left pulmonary artery with near total occlusion. In the absence of parenchymal lesions, the increased F-FDG uptake is most likely an inflammatory response to a recent ischemic insult. This case illustrates that asymmetric lung hypermetabolism in the absence of parenchymal disease can be caused by a central pulmonary embolism.status: publishe

Can a ratio between medial and lateral meniscal volumes be calculated to determine critical meniscal volume in view of post-meniscectomy symptoms?

Partial meniscectomy is a frequently performed treatment strategy for non-suturable meniscal tears. However, the meniscal volume which can be resected without compromising the load-bearing, shock-absorbing function of the meniscus remains a topic of ongoing research. The aim of this study was to calculate the medio-lateral meniscal volume ratio to estimate this volume. In 90 patients (98 pairs of menisci) without meniscal injury, medial and lateral menisci were segmented on MRI imaging and 3D surface models were created to calculate volume. The mean medial meniscal volume was 1928,9mm3 and the mean lateral meniscal volume was 1681,7mm3. A fixed ratio of the medial over the lateral meniscal volume was calculated to be 1,16. The standard deviation of the prediction errors based on this ratio equals 217mm³. This ratio seems a useful parameter in follow-up research to determine whether there is a critical volume which can be resected without post-operative pain and osteoarthritis.status: accepte

Can a ratio between medial and lateral meniscal volumes be calculated to determine critical meniscal volume in view of post-meniscectomy symptoms?

Partial meniscectomy is a frequently performed treatment strategy for non-suturable meniscal tears.  However, the meniscal volume which can be resected without compromising the load-bearing, shock-absorbing function of the meniscus remains a topic of ongoing research. The aim of this study was to calculate the medio-lateral meniscal volume ratio to estimate this volume.In 90 patients (98 pairs of menisci) without meniscal injury, medial and lateral menisci were segmented on MRI imaging and 3D surface models were created to calculate volume.The mean medial meniscal volume was 1928,9mm3 and the mean lateral meniscal volume was 1681,7mm3. A fixed ratio of the medial over the lateral meniscal volume was calculated to be 1,16. The standard deviation of the prediction errors based on this ratio equals 217mm³.This ratio seems a useful parameter in follow-up research to determine whether there is a critical volume which can be resected without post-operative pain and osteoarthritis

Tailor-made coaching for antimicrobial reduction in pig farms within the Belgium-Dutch cross border project; i-4-1-Health

Introduction Antimicrobial use in pigs (AMU) has led to an increase in antimicrobial resistance (AMR). This has prompted measures to reduce AMU, which has been associated with AMR reduction on national level. However, it remains unclear how on-farm dynamics of AMU and its effects on AMR are exactly related. Moreover, it is challenging to influence farmers’ behavior towards increased infection prevention and AMU reduction. In this project we use specific coaching skills to reduce AMU and evaluate the effects on AMR. Material and Methods The i-4-1-health project started in 2017. In Flanders as well as in The Netherlands, 15 pig farms with an above average AMU are visited four times in 1.5 year. During the first visit, an assessment is made of e.g. biosecurity, technical performance, AMU and AMR. AMR is determined in faecal samples phenotypically in Enterobacteriaceae. The results of the assessment are evaluated using a designated new tool (V-iris) to start coaching four weeks later. In the coaching process, farmers and veterinarians reflect upon their own perceived behavior. A tailor-made action plan will be developed together with the farmer and veterinarian. After 6 and 12 months the farm is revisited to evaluate implementation and reinforce compliance to the action plan. At the 2nd and 3rd visit faecal samples are obtained for analysis of AMR development. Results Preliminary results indicate presence of AMR for ciprofloxacin as well as ESBL-producing Enterobacteriaceae. In addition a difference in prevalence between Belgium and Dutch farms is observed. Discussion and conclusion In both countries veterinarians and farmers face the challenge to reduce AMR. Preliminary experiences indicate that there is not a one-size-fits-all approach within, nor between countries. To increase knowledge and awareness during the project, knowledge sharing sessions are organized for people working in public health, human medicine and veterinary medicine

Tailor-made coaching for antimicrobial reduction in pig farms within the Belgium-Dutch cross border project; i-4-1-Health

Introduction Antimicrobial use in pigs (AMU) has led to an increase in antimicrobial resistance (AMR). This has prompted measures to reduce AMU, which has been associated with AMR reduction on national level. However, it remains unclear how on-farm dynamics of AMU and its effects on AMR are exactly related. Moreover, it is challenging to influence farmers’ behavior towards increased infection prevention and AMU reduction. In this project we use specific coaching skills to reduce AMU and evaluate the effects on AMR. Material and Methods The i-4-1-health project started in 2017. In Flanders as well as in The Netherlands, 15 pig farms with an above average AMU are visited four times in 1.5 year. During the first visit, an assessment is made of e.g. biosecurity, technical performance, AMU and AMR. AMR is determined in faecal samples phenotypically in Enterobacteriaceae. The results of the assessment are evaluated using a designated new tool (V-iris) to start coaching four weeks later. In the coaching process, farmers and veterinarians reflect upon their own perceived behavior. A tailor-made action plan will be developed together with the farmer and veterinarian. After 6 and 12 months the farm is revisited to evaluate implementation and reinforce compliance to the action plan. At the 2nd and 3rd visit faecal samples are obtained for analysis of AMR development. Results Preliminary results indicate presence of AMR for ciprofloxacin as well as ESBL-producing Enterobacteriaceae. In addition a difference in prevalence between Belgium and Dutch farms is observed. Discussion and conclusion In both countries veterinarians and farmers face the challenge to reduce AMR. Preliminary experiences indicate that there is not a one-size-fits-all approach within, nor between countries. To increase knowledge and awareness during the project, knowledge sharing sessions are organized for people working in public health, human medicine and veterinary medicine

Tailor-made coaching for antimicrobial reduction in pig farms within the Belgium-Dutch cross border project; i-4-1-Health

Introduction Antimicrobial use in pigs (AMU) has led to an increase in antimicrobial resistance (AMR). This has prompted measures to reduce AMU, which has been associated with AMR reduction on national level. However, it remains unclear how on-farm dynamics of AMU and its effects on AMR are exactly related. Moreover, it is challenging to influence farmers’ behavior towards increased infection prevention and AMU reduction. In this project we use specific coaching skills to reduce AMU and evaluate the effects on AMR. Material and Methods The i-4-1-health project started in 2017. In Flanders as well as in The Netherlands, 15 pig farms with an above average AMU are visited four times in 1.5 year. During the first visit, an assessment is made of e.g. biosecurity, technical performance, AMU and AMR. AMR is determined in faecal samples phenotypically in Enterobacteriaceae. The results of the assessment are evaluated using a designated new tool (V-iris) to start coaching four weeks later. In the coaching process, farmers and veterinarians reflect upon their own perceived behavior. A tailor-made action plan will be developed together with the farmer and veterinarian. After 6 and 12 months the farm is revisited to evaluate implementation and reinforce compliance to the action plan. At the 2nd and 3rd visit faecal samples are obtained for analysis of AMR development. Results Preliminary results indicate presence of AMR for ciprofloxacin as well as ESBL-producing Enterobacteriaceae. In addition a difference in prevalence between Belgium and Dutch farms is observed. Discussion and conclusion In both countries veterinarians and farmers face the challenge to reduce AMR. Preliminary experiences indicate that there is not a one-size-fits-all approach within, nor between countries. To increase knowledge and awareness during the project, knowledge sharing sessions are organized for people working in public health, human medicine and veterinary medicine

Tailor-made coaching for antimicrobial reduction in pig farms within the Belgium-Dutch cross border project; i-4-1-Health

Introduction Antimicrobial use in pigs (AMU) has led to an increase in antimicrobial resistance (AMR). This has prompted measures to reduce AMU, which has been associated with AMR reduction on national level. However, it remains unclear how on-farm dynamics of AMU and its effects on AMR are exactly related. Moreover, it is challenging to influence farmers’ behavior towards increased infection prevention and AMU reduction. In this project we use specific coaching skills to reduce AMU and evaluate the effects on AMR. Material and Methods The i-4-1-health project started in 2017. In Flanders as well as in The Netherlands, 15 pig farms with an above average AMU are visited four times in 1.5 year. During the first visit, an assessment is made of e.g. biosecurity, technical performance, AMU and AMR. AMR is determined in faecal samples phenotypically in Enterobacteriaceae. The results of the assessment are evaluated using a designated new tool (V-iris) to start coaching four weeks later. In the coaching process, farmers and veterinarians reflect upon their own perceived behavior. A tailor-made action plan will be developed together with the farmer and veterinarian. After 6 and 12 months the farm is revisited to evaluate implementation and reinforce compliance to the action plan. At the 2nd and 3rd visit faecal samples are obtained for analysis of AMR development. Results Preliminary results indicate presence of AMR for ciprofloxacin as well as ESBL-producing Enterobacteriaceae. In addition a difference in prevalence between Belgium and Dutch farms is observed. Discussion and conclusion In both countries veterinarians and farmers face the challenge to reduce AMR. Preliminary experiences indicate that there is not a one-size-fits-all approach within, nor between countries. To increase knowledge and awareness during the project, knowledge sharing sessions are organized for people working in public health, human medicine and veterinary medicine