No abstract

To review the evidence for risk factors of Creutzfeldt-Jakob disease (CJD), we pooled and reanalyzed the raw data of three case-control studies. The pooled data set comprised 178 patients and 333 control subjects. The strength of association between CJD and putative risk factors was assessed by computing the odds ratio as estimate of the relative risk. The risk of CJD was statistically significantly increased for subjects with a family history of CJD (odds ratio = 19.1; 95% CI 1.1 to 348.0). Further, there was a significant association between the risk of CJD and a history of psychotic disease (odds ratio = 9.9; 95% CI 1.1 to 86.1). Although not significantly increased, there was an elevated risk of CJD for subjects with a family history of dementia, a history of poliomyelitis, subjects employed as health professionals, and subjects ever exposed to cows and sheep. No association could be shown with organ meat consumption, including brain. The negative results of this reanalysis reassures the absence of a common risk factor in all CJD patients. However, the ongoing epidemiologic surveillance of CJD in several European countries may provide more evidence to exclude any environmental exposure early in childhood.

Summary. The efficacy of 1% ketoconazole shampoo in the treatment of dandruff was tested in a double‐blind, placebo‐controlled trial with 176 patients. The application of the shampoo twice weekly gave a good or excellent result in 74% of the patients treated with ketoconazole versus 20% of the patients treated with placebo after 2 weeks. After 4 weeks these results were 80% versus 23%. The shampoo was well tolerated. Only one patient in the ketoconazole group stopped treatment because of greasy hair. Zusammenfassung. Die Wirksamkeit eines 1%igen Ketoconazol‐Shampoos zur Behandlung von Kopfschuppen wurde in einer Placebokontrollierten Doppelblindstudie an 176 Patienten untersucht. Die wöchentlich zweimalige Anwendung des Shampoos ergab nach zwei Wochen gute bis ausgezeichnete Resultate an 74% der Ketoconazol‐behandelten gegenüber 20% der Placebo‐behandelten Patienten. Nach vier Wochen betrugen die Ergebnisse 80% gegenüber 23%. Der Shampoo wurde gut vertragen. Nur ein Patient in der Ketoconazol‐Gruppe gab die Behandlung wegen fettigen Haars auf.

Objective: In 1991, a Dutch patient who had been treated from 1963 to 1969 with human-derived growth hormone died of Creutzfeldt-Jakob disease (CJD). This study was performed to investigate whether among other Dutch human growth hormone recipients there were clinically suspected cases of iatrogenic CJD. Methods: In a retrospective cohort study, all patients (n = 564) treated with human-derived growth hormone before May 1985 and recorded in the Dutch National Growth Registry were followed up until January 1995 for a clinical diagnosis of CJD. For this purpose, all human growth hormone recipients were linked to a database of the Foundation for Health Care Information comprising hospital discharges with a clinical diagnosis of iatrogenic CJD. Linkage of the two databases was performed on the basis of date of birth and gender. Subsequently, verification of patient’s name and initials of the positively matched pairs took place. Results: Linkage provided 37 positively matched pairs concerning 29 individual patients. After verification, no name from the hospital discharge records corresponded to the names of the human growth hormone recipients. Conclusion: The follow-up of 564 Dutch human growth hormone recipients, who had been treated with human growth hormone until 1985 did not establish any clinically suspected case of iatrogenic CJD. Future cases, however, can still emerge due to the potentially long incubation period of prion diseases.