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dc.contributor.authorPedro-Cuesta, Jesus de 
dc.contributor.authorMahillo-Fernandez, Ignacio 
dc.contributor.authorRábano, Alberto
dc.contributor.authorCalero, Miguel 
dc.contributor.authorCruz, Mabel
dc.contributor.authorSiden, Ake
dc.contributor.authorLaursen, Henning
dc.contributor.authorFalkenhorst, Gerhard
dc.contributor.authorMølbak, Kåre
dc.date.accessioned2019-05-30T09:47:31Z
dc.date.available2019-05-30T09:47:31Z
dc.date.issued2011-02
dc.identifier.citationJ Neurol Neurosurg Psychiatry. 2011; 82(2):204-12es_ES
dc.identifier.urihttp://hdl.handle.net/20.500.12105/7697
dc.description.abstractOBJECTIVES: Evidence of surgical transmission of sporadic Creutzfeldt-Jakob disease (sCJD) remains debatable in part due to misclassification of exposure levels. In a registry-based case-control study, the authors applied a risk-based classification of surgical interventions to determine the association between a history of surgery and sCJD. DESIGN: Case-control study, allowing for detailed analysis according to time since exposure. SETTING: National populations of Denmark and Sweden. PARTICIPANTS: From national registries of Denmark and Sweden, the authors included 167 definite and probable sCJD cases with onset during the period 1987-2003, 835 age-, sex- and residence-matched controls and 2224 unmatched. Surgical procedures were categorised by anatomical structure and presumed risk of transmission level. The authors used logistic regression to determine the odds ratio (OR) for sCJD by surgical interventions in specified time-windows before disease-onset. RESULTS: From comparisons with matched controls, procedures involving retina and optic nerve were associated with an increased risk at a latency of ≥1 year OR (95% CI) 5.53 (1.08 to 28.0). At latencies of 10 to 19 years, interventions on peripheral nerves 4.41 (1.17 to 16.6) and skeletal muscle 1.58 (1.01 to 2.48) were directly associated. Interventions on blood vessels 4.54 (1.01 to 20.0), peritoneum 2.38 (1.14 to 4.96) and skeletal muscle 2.04 (1.06 to 3.92), interventions conducted by vaginal approach 2.26 (1.14 to 4.47) and a pooled category of lower-risk procedures 2.81 (1.62 to 4.88) had an increased risk after ≥20 years. Similar results were found when comparing with unmatched controls. INTERPRETATION: This observation is in concordance with animal models of prion neuroinvasion and is likely to represent a causal relation of surgery with a non-negligible proportion of sCJD cases.es_ES
dc.description.sponsorshipFunding was obtained from The Research Commission EU, Concerted Action QLRG3-CT-2002-81223, NEUROPRION, and the Spanish RECSP C03-09, CIEN C03-06 and CIBERNED networks.es_ES
dc.language.isoenges_ES
dc.publisherBMJ Publishing Group es_ES
dc.type.hasVersionVoRes_ES
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/*
dc.subject.meshCase-Control Studies es_ES
dc.subject.meshCreutzfeldt-Jakob Syndrome es_ES
dc.subject.meshCross Infection es_ES
dc.subject.meshData Interpretation, Statisticales_ES
dc.subject.meshDenmark es_ES
dc.subject.meshHospitals es_ES
dc.subject.meshHumans es_ES
dc.subject.meshLogistic Models es_ES
dc.subject.meshOdds Ratio es_ES
dc.subject.meshOphthalmologic Surgical Procedures es_ES
dc.subject.meshRegistries es_ES
dc.subject.meshRisk Assessment es_ES
dc.subject.meshSurgical Procedures, Operativees_ES
dc.subject.meshSweden es_ES
dc.titleNosocomial transmission of sporadic Creutzfeldt-Jakob disease: results from a risk-based assessment of surgical interventionses_ES
dc.typejournal articlees_ES
dc.rights.licenseAtribución-NoComercial-CompartirIgual 4.0 Internacional*
dc.identifier.pubmedID20547628es_ES
dc.format.volume82es_ES
dc.format.number2es_ES
dc.format.page204-12es_ES
dc.identifier.doi10.1136/jnnp.2009.188425es_ES
dc.contributor.funderFundación Centro De Investigación De Enfermedades Neurológicas 
dc.contributor.funderCentro de Investigación Biomédica en Red - CIBERNED (Enfermedades Neurodegenerativas) 
dc.contributor.funderUnión Europea. Comisión Europea 
dc.description.peerreviewedes_ES
dc.identifier.e-issn1468-330Xes_ES
dc.relation.publisherversionhttps://doi.org/10.1136/jnnp.2009.188425es_ES
dc.identifier.journalJournal of neurology, neurosurgery, and psychiatryes_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.repisalud.institucionISCIIIes_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/QLRG3-CT-2002-81223es_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/RECS/PC03-09es_ES
dc.relation.projectIDinfo:eu-repo/grantAgreement/ES/CIEN/C03-06es_ES
dc.rights.accessRightsopen accesses_ES


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