ORCID Profile
0000-0002-8351-1978
Current Organisation
Flinders Medical Centre
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Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.JOCN.2022.03.026
Abstract: Cutibacterium acnes, formerly known as Propionibacterium acnes, is increasingly recognized as a cause of surgical site infection and implant failure despite the use of prophylactic antibiotics and antiseptic surgical preparations. The aim of this study was to investigate whether C. acnes persists in the dermal layer of the skin after standard perioperative antibiotics and skin prepping with alcoholic betadine solution in consecutive patients undergoing a craniotomy. A single centre prospective observational study was performed at Flinders Medical Centre. Adult patients undergoing a cranial neurosurgical intervention between October 2019 to March 2021 were eligible for inclusion. After administration of standard preoperative antibiotics (Cefazolin), three swabs were taken for each patient: one before prepping the skin with alcoholic betadine, one after prepping the skin and a dermal swab once the skin was incised. 73 patients were included. Cutibacterium acnes cultures were positive in 61 patients of the "pre-prep" group (83.6%), 12 (16.4%) in the "post-prep" group, and 53 (72.6%) were from dermal swabs There was a significant reduction of positive cultures of the skin after surgical preparation was applied (p < 0.00001). There was a non-significant reduction of positive cultures in the dermal swabs after skin preparation (p = 0.068) CONCLUSIONS: Cutibacterium acnes persists within the dermis of the scalp despite standard prophylactic measures using alcoholic betadine solution and cefazolin.
Publisher: Wiley
Date: 27-09-2021
DOI: 10.1111/ANS.17242
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJNO-2019-000017
Abstract: Large fat embolus is a rare but potential reversible cause of ischaemic stroke. We describe the neurosurgical management of a complete right internal carotid artery occlusion due to a large fat embolus, caused by a mitral valve replacement. Knowledge of acute cerebral ischaemia due to large fat embolism and its hallmark ‘hypodense artery’ is mandatory. Extracranial to intracranial bypass is a feasible rescue treatment after failure of endovascular embolectomy.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-05-2022
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.WNEU.2022.04.053
Abstract: Ventricular catheter placement can be a challenging procedure when treating patients with slit ventricles, despite the use of a neuronavigation system. We report the case of 3 patients with idiopathic intracranial hypertension who had required revision of their ventricular catheter due to malpositioning, despite initial placement using neuronavigation. Owing to the absence of intraoperative computed tomography in our center, we used the O-arm imaging system to confirm placement of the optimal ventricular tip position intraoperatively. Optimal ventricular drain position was achieved in all 3 patients. This short technical note describes an easy technique for using the O-arm to confirm the optimal ventricular drain position.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-07-2021
DOI: 10.1093/ONS/OPAB267
Publisher: Korean Society of Cerebrovascular Surgeons/Korean Society of Endovascular Surgery
Date: 30-06-2021
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JOCN.2022.05.010
Abstract: Smoking and hypertension are prevalent among Indigenous Australians (Aboriginal and Torres Strait Islanders). We investigated if these risk factors suggest a greater rate of aneurysmal subarachnoid haemorrhage in Indigenous Australians (IA) compared to non-IA. A retrospective cross-sectional study was performed on data retrieved from the Nationwide Hospital Morbidity Database for all aSAH cases in Australia between 2012 and 2018. Patient characteristics, radiological findings, aneurysm characteristics, treatment characteristics and discharge outcomes were assessed. Crude and age-adjusted incidences, trends of aSAH and case fatality rate over time were calculated. A total of 12,286 patients were included (285 IA, 12,001 non-IA). Indigenous aSAH patients were significantly younger than non-IA, with 89.8 percent of IA younger than 65 years old (p < 0.001). Crude annual incidences were similar between the 2 cohorts, however age-adjusted incidence shows a RR = 1.4 at 45-59 years in IA patients, compared with their non-IA counterparts. 30-day mortality was similar between the two groups, at 25.3 and 26.9% for IA and non-IA groups, respectively. This 10 year nationwide retrospective study highlights a disparity between the crude and age-adjusted incidence of aSAH in IA compared to non-IA.
Publisher: Elsevier BV
Date: 11-2014
Publisher: Springer Science and Business Media LLC
Date: 20-11-2022
Publisher: Springer Science and Business Media LLC
Date: 18-04-2022
Publisher: Springer Science and Business Media LLC
Date: 06-02-2020
Publisher: Georg Thieme Verlag KG
Date: 22-04-2022
DOI: 10.1055/A-1832-3158
Abstract: Superficial temporal artery (STA) to middle cerebral artery (MCA) bypass surgery for internal carotid artery (ICA) occlusive disease necessarily requires sufficient external carotid artery (ECA) blood flow. Surgical bypass is therefore precluded if there is common carotid artery (CCA) occlusion. Here we present two such cases: one patient had a CCA occlusion and the other had an ICA occlusion and ECA stenosis. Both had failed medical management, and were therefore treated with angioplasty and stenting of the ECA, followed by STA-MCA bypass. We describe the clinical and radiologic outcomes of these cases, and remark on the potential pitfalls associated with this novel approach.
Publisher: Springer Science and Business Media LLC
Date: 11-03-2014
DOI: 10.1007/S00701-014-2042-8
Abstract: The incidence of chronic subdural hematoma (CSDH) is increasing, but optimal treatment remains controversial. Recent meta-analyses suggest burr hole (BH) drainage is the best treatment because it provides optimal balance between recurrence and morbidity. Mini-craniotomy may offer supplementary technical advantages while maintaining equal or better outcomes. This study investigates the outcome of mini-craniotomy as the sole treatment in patients with CSDH. We analyzed all patients operated on for CSDH with mini-craniotomy in our neurosurgical center between 2005-2010. Baseline patient characteristics (age, sex, comorbidities, imaging characteristics, known risk factors for development of CSDH and neurological examination at presentation) and outcomes (mortality, complications, recurrence and neurological examination at discharge) were recorded. One hundred twenty-six adult patients were included, mean age was 73.9 (range 18 to 95) years old, and the sex ratio (M:F) was 2:1. Eighty-four percent of the patients showed clinical improvement at discharge, as shown by a decrease in the Markwalder score postoperatively (with 57 % Markwalder 0 and 23 % Markwalder 1). Recurrence rate was 8.7 %. Overall complication rate was 34.1 % (27.8 % medical complications and 6.3 % surgical complications). In-hospital mortality was 13.5 % (8.7 % due to pulmonary infections and 1.6 % to surgical complications). Preoperative Markwalder grade correlated significantly with complication rate, as did the presence of a neurodegenerative disease (p = 0.018). Factors significantly related to mortality in univariate analysis were arterial hypertension (p = 0.038), heart failure (p = 0.02), renal failure (p = 0.017), neurodegenerative disease (p = 0.001), cerebrovascular accident (p = 0.008) and coagulopathy (p = 0.019). Multivariate analysis was not able to confirm any significant relationship. This is the first published series of CSDH in which all consecutive patients were operated on by mini-craniotomy. The invasiveness and complication rate of mini-craniotomy are equal to those of burr hole treatment, but visualization is superior, resulting in lower recurrences. A randomized controlled trial is indicated to identify the best surgical strategy for the treatment of CSDH.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Springer Science and Business Media LLC
Date: 15-10-2021
DOI: 10.1186/S12711-021-00674-7
Abstract: The domestication of wild animals has resulted in a reduction in effective population sizes, which can affect the deleterious mutation load of domesticated breeds. In addition, artificial selection contributes to the accumulation of deleterious mutations because of an increased rate of inbreeding among domesticated animals. Since founder population sizes and artificial selection differ between cattle breeds, their deleterious mutation load can vary. We investigated this question by using whole-genome data from 432 animals belonging to 54 worldwide cattle breeds. Our analysis revealed a negative correlation between genomic heterozygosity and nonsynonymous-to-silent ersity ratio, which suggests a higher proportion of single nucleotide variants (SNVs) affecting proteins in low- ersity breeds. Our results also showed that low- ersity breeds had a larger number of high-frequency (derived allele frequency (DAF) 0.51) deleterious SNVs than high- ersity breeds. An opposite trend was observed for the low-frequency (DAF ≤ 0.51) deleterious SNVs. Overall, the number of high-frequency deleterious SNVs was larger in the genomes of taurine cattle breeds than of indicine breeds, whereas the number of low-frequency deleterious SNVs was larger in the genomes of indicine cattle than in those of taurine cattle. Furthermore, we observed significant variation in the counts of deleterious SNVs within taurine breeds. The variations in deleterious mutation load between taurine and indicine breeds could be attributed to the population sizes of the wild progenitors before domestication, whereas the variations observed within taurine breeds could be due to differences in inbreeding level, strength of artificial selection, and/or founding population size. Our findings imply that the incidence of genetic diseases can vary between cattle breeds.
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.WNEU.2019.05.131
Abstract: Adverse outcomes after aneurysm clipping can be potentially reversible, when managed appropriately. This is a case report describing kinking of a perforator due to clipping of parent vessel aneurysm. Complete recovery of a high-grade motor deficit was achieved after instant reintervention with application of smaller clips in combination with gelfoam soaked in papaverine. Use of evoked potentials and intraoperative digital subtraction angiography are recommended and may help in preclinical diagnosis. Knowledge of delayed perforator kinking as a complication may lead to a more rapid diagnosis and management.
No related grants have been discovered for Jorn Van Der Veken.