The likelihood of rupture of unruptured intracranial aneurysms that were less than 10 mm in diameter was exceedingly low among patients in group 1 and was substantially higher among those in group 2. The risk of morbidity and mortality related to surgery greatly exceeded the 7.5-year risk of rupture among patients in group 1 with unruptured intracranial aneurysms smaller than 10 mm in diameter.

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The cholinergic receptor, nicotinic, alpha 4 (CHRNA4) gene encodes the neuronal nicotinic acetylcholine receptor alpha-4 subunit. Recent research has shown that a variation in CHRNA4 (rs1044396) affects attention and negative emotionality in normal adults. To determine the link between CHRNA4 variation and cognitive function/depressed mood, this study conducted a genotype-phenotype correlation analysis between the common CHRNA4:rs1044396 variant and several baseline parameters of cognition and depressed mood in 192 elderly male subjects without major psychiatric disorders or dementia. Study findings identified a significant link between the CHRNA4:rs1044396 polymorphism and depression and loneliness in the aged. Compared to carriers of at least one T-allele, carriers of the homozygous C/C genotype described themselves as more depressed and lonely. This is the first evidence which may implicate CHRNA4 in depressed emotions in the elderly.

Background: Depression and loneliness are prevalent and highly correlated phenomena among the elderly and influence both physical and mental health. Brain functional connectivity changes associated with depressive symptoms and loneliness are not fully understood.Methods: A cross-sectional functional MRI study was conducted among 85 non-demented male elders. Geriatric depression scale-short form (GDS) and loneliness scale were used to evaluate the severity of depressive symptoms and loneliness, respectively. Whole brain voxel-wise resting-state functional connectivity density (FCD) mapping was performed to delineate short-range FCD (SFCD) and long-range FCD (LFCD). Regional correlations between depressive symptoms or loneliness and SFCD or LFCD were examined using general linear model (GLM), with age incorporated as a covariate and depressive symptoms and loneliness as predictors.Results: Positive correlations between depressive symptoms and LFCD were observed in left rectal gyrus, left superior frontal gyrus, right supraorbital gyrus, and left inferior temporal gyrus. Positive correlations between depressive symptoms and SFCD were observed in left middle frontal gyrus, left superior frontal gyrus, bilateral superior medial frontal gyrus, left inferior temporal gyrus, and left middle occipital region. Positive correlations between SFCD and loneliness were centered over bilateral lingual gyrus.Conclusion: Depressive symptoms are associated with FCD changes over frontal and temporal regions, which may involve the cognitive control, affective regulation, and default mode networks. Loneliness is associated with FCD changes in bilateral lingual gyri that are known to be important in social cognition. Depressive symptoms and loneliness may be associated with different brain regions in non-demented elderly male.

Wound necrosis and secondary infection are common complications after Naja atra bites. Clinical tools to evaluate the infection risk after Taiwan cobra bites are lacking. In this Cobra BITE study, we investigated the prevalence of wound infection, bacteriology, and corresponding antibiotic usage in patients presenting with Taiwan cobra snakebites. Patients with wound infection lacking tissue necrosis were included in developing Cobra BITE score utilizing univariate and multiple logistic regression, as patients with wound necrosis require antibiotics for infection treatment. 8,295,497 emergency department visits occurred in the span of this study, with 195 of those patients being diagnosed as having cobra bites. Of these patients, 23 had wound necrosis, and 30 had wound infection, resulting in a wound infection rate of 27.2% (53/195). Enterococcus faecalis and Morganella morganii were the main bacteria identified in the culture report regardless of whether patients’ wounds had necrosis. As per our Cobra BITE score, the three factors predicting secondary wound infection after cobra bites are hospital admission, a white blood cell count (in 103/µL) × by neu-trophil-lymphocyte ratio value of ≥114.23, and the use of antivenin medication. The area under the receiver operating characteristic curve for the Cobra BITE score system was 0.88; ideal sensitivity and specificity were 0.89 and 0.76. This scoring system enables the assessment of wound infections after N. atra bites, and it could be modified and improved in the future for other Naja spp. bites.

The brain-derived neurotrophic factor (BDNF) Val66Met polymorphism is common and influences the activity-dependent secretion of BDNF, which is critical for neuronal plasticity and survival. This study investigated the genetic effect of the BDNF Val66Met polymorphism on cognitive function and regional gray matter (GM) volume in a healthy Chinese population (n = 330). Voxel-based morphometry (VBM)-optimized analysis was used. There was no significant difference in the neuropsychological performances among the three BDNF genotypic groups. VBM analyses demonstrated that Met homozygotes had greater GM volumes than Val homozygotes in the left medial frontal gyrus, the left middle temporal gyrus, the left cerebellum, and the right middle temporal gyrus, and had larger GM volumes than Val/Met heterozygotes in the left middle temporal gyrus, the left inferior temporal gyrus, and the right superior frontal gyrus. Our findings suggest that the presence of two Met alleles has a protective effect on regional GM volumes in the Chinese population.

83:735-743. 5. Albala C, Lebrã o ML, Leó n Díaz EM et al. Encuesta Salud, Bienestar y Envejecimiento (SABE): Metodología de la encuesta y perfil de la població n estudiada. Rev Panam Salud Publica 2005;17:307-322. 6. Bartali B, Frongillo EA, Bandinelli S et al. Low nutrient intake is an essential component of frailty in older persons.To the Editor: We read with great interest the recent article by Yaffe and colleagues 1 that stated that poorer cognitive function was associated with poorer kidney function in a large sample of older adults with chronic kidney disease (CKD). In light of that and other reports, 2-6 CKD has been linked to the risk of cognitive decline in middle-aged and older adults, although the presence of cognitive impairment (or clinical dementia) could result in decline in ability to perform activities of daily living and thus poor physical condition (e.g., dehydration). It remains unclear whether kidney function may affect cognitive performance in older people without dementia. Therefore, we would like to add our data to the association of medical confounders with cognitive performance based on an older community-dwelling sample without dementia. We also tested whether renal function was associated with specific domains of aging cognition. We analyzed 228 subjects (100% male; aged 79.4 AE 4.9, range 63-98; 5.8 AE 4.7 years of education, range 0-16) derived from our previously published works regarding the analysis of the genetic association of cognitive function 7 and cardiovascular physiology 8 in older Chinese men without dementia and with normal function of daily activities. These subjects had full physical and laboratory profiles available, including body mass index, heart rate, blood pressure, hemoglobin, fasting blood sugar, lipid, liver, and kidney function tests.Cognitive functions were assessed using the Cognitive Abilities Screening Instrument (CASI; mean AE SD 84.7 AE 9.1, range 54-100). 9 The CASI is a 100-point cognitive test that provides quantitative assessment in nine domains of cognitive function (long-term memory, short-term memory, attention, concentration and mental manipulation, orientation, abstraction and judgment, language, visual construction, and list-generating fluency). Multiple linear regression analysis with a forward stepwise method was used to identify significant predictors of cognitive performance, using the CASI assessment as a dependent variable and age, education duration, and physical and laboratory data as predictors. A general linear model was used to assess the difference in cognitive performance between subgroups with and without CKD, controlling for predictors identified in the regression model.According to the estimated glomerular filtration rate (eGFR) data, 117 (51.3%) subjects had normal kidney function (eGFR460 mL/min per 1.73 m 2 ), 104 (45.6%) had Stage 3 CKD, six (2.6%) had Stage CKD 4, and one (0.4%) had Stage 5 CKD. Table 1 summarizes the significant predictors accounting for the total CASI score and its component scores. Total CASI score cor...

Aims: Aging is associated with cognitive deterioration, and genetic factors are implicated in individual cognitive differences in the aged. The C677T mutation in the 5,10-methylenetetrahydrofolate reductase gene (MTHFR) yields a common thermolabile variant (T) with reduced enzyme activity and consequent elevation of serum homocysteine concentrations. We designed the present study to investigate whether this functional polymorphism may affect global and specific cognitive functions in older Chinese males without dementia. Methods: The subjects included 356 elderly males without major psychiatric disorders or dementia, who were assessed by the Cognitive Abilities Screening Instruments (CASI) and the Wechsler Digit Span Task tests. Results: A significant association was found between the MTHFR C677T polymorphism and total CASI scores (p = 0.012), particularly in short-term memory (p = 0.002) and concentration/mental manipulation (p = 0.007). Post hoc tests indicated that the C/T heterozygotes achieved better cognitive function test results than C/C or T/T carriers. No association was found between the MTHFR genotype and the Wechsler Digit Span Task tests. Conclusion: These results suggest that a heterozygote advantage exists for the MTHFR C677T polymorphism in specific cognitive functions in elderly Chinese males without dementia.