Epidemiology of transfusion-transmitted infections among multi-transfused patients in seven hospitals in Peru.

BACKGROUND: Transfusion-transmitted infections (TTIs) constitute a major health problem worldwide where routine screening of blood or blood products is improperly done, and where non-medical injecting medications and/or drug use are prevalent. Prevalence and risk factors vary by geographic location and by the specific TTI (including HIV-1, HBV, HCV and HTLV-I). OBJECTIVE: To determine the prevalence and risk factors associated with TTIs among a sample of multi-transfused adult patients in Peru. STUDY DESIGN: A cross-sectional multi-center study was conducted across seven major hospitals in Peru from February 2003 to September 2004. Self-reported behavior information (medical procedures, number of sexual partners, and drug use history) was analyzed, along with a review of exposure history from hospital medical records. Prevalences were calculated by TTI for different exposures, along with unadjusted and adjusted odds ratios for infection risk. RESULTS: Overall, 192 (54.7%) of 351 multi-transfused patients were found infected with one or more TTIs. Number of transfusion units, years of transfusion history (6 or more), and number of treatment facilities (2 or more) were associated with HCV infection. Hemodialysis history was a common risk factor associated with HBV, HCV and HTLV-I infection. HIV infection was associated only with total number of transfusion units received. CONCLUSIONS: High prevalences of HBV and HCV infection were found among Peruvian multi-transfused patients and were associated with a past history and number of blood transfusions, as well as with past hemodialysis procedures. TTIs continue to represent a significant public health problem in Peru. Continued vigilant attention to blood safety procedures, including universal screening and health care provider education, is recommended.

Effects of spaced retrieval training (SRT) on cognitive function in Alzheimer's disease (AD) patients.

Among the non-pharmacological treatments of dementia, SRT is a good candidate strategy for rehabilitating the cognition of AD patients. This study investigates the efficacy of SRT on the cognition of AD patients with very mild to mild disease. We administered 24-session SRT to 13 very mild and 6 mild AD patients. To assess the change of the neuropsychological performance after SRT, we performed the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery (CERAD-K), the logical memory test (LMT), the Benton visual retention test A (BVRT-A), and the digit span test (DST). All tests were administered both before and after SRT. Retention spans were significantly increased up to 24 min after SRT in both very mild and mild AD patients (p<0.05), and this improvement was maintained for different sets of target information. Retainable words were also significantly increased after SRT in the very mild AD patients (p=0.007). However, we observed no changes in neuropsychological performance after SRT. Although we did not observe improvements in the neuropsychological tests following SRT, our results suggest that the treatment was an effective intervention for improving the memory of very mild to mild AD patients, and could potentially improve learning and retention outside the training session.