Key PointsQuestionAre lower (worse) left atrial (LA) function and greater LA size associated with increased risk of subsequent dementia?FindingsIn this retrospective cohort study that included 4096 participants, there were statistically significant associations between measures of lower LA function and incident dementia comparing the lowest vs highest quintile for LA reservoir strain (HR, 1.98), conduit strain (HR, 1.50), contractile strain (HR, 1.57), emptying fraction (HR, 1.87), and active emptying fraction (HR, 1.43). Measures of LA size were not significantly associated with incident dementia.MeaningThe findings suggest that impaired LA function may be a risk factor associated with dementia.

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Background Patients with polycythemia vera with high hematocrit have increased risk of venous thromboembolism (VTE). Objective To determine whether high hematocrit in the general population is also associated with elevated VTE risk. Methods The prospective Atherosclerosis Risk in Communities Study performed a complete blood count in 13 891 adults aged 45 to 64 in 1987 to 1989. We identified incident hospitalized VTEs through 2015 and performed proportional hazards regression analyses using race‐sex–specific categorization of hematocrit percentiles (ie, <5th, 5th to <25th, 25th to <75th, 75th to <95th, and 95th‐100th percentiles, with the 25th to <75th percentile serving as the reference). Results Over a median follow‐up of 26 years, 800 participants had an incident venous thrombosis of the leg and/or a pulmonary embolism. There was a nonlinear association of hematocrit with VTE incidence, with risk elevated 72% for participants above the 95th percentile of hematocrit compared with the reference. Specifically, hazard ratios (95% confidence intervals) of incident VTE were 1.27 (0.91‐1.76), 1.06 (0.87‐1.28), 1 (reference), 1.17 (0.98‐1.40) and 1.72 (1.30‐2.27) across the 5 hematocrit percentiles, adjusted for age, race, sex, body mass index, smoking status and pack‐years, and other confounding variables. The association of high hematocrit with VTE was limited to provoked VTE, with little evidence for unprovoked VTE. Hemoglobin above the 95th percentile also was associated with an increased risk of VTE. In contrast, there were no significant associations of platelet, leukocyte, neutrophil, or lymphocyte counts with VTE incidence. Conclusion High hematocrit and hemoglobin in a general middle‐aged population sample were associated with increased long‐term risk of VTE, particularly provoked VTE.

BackgroundSome of the relatively newer, more efficacious, and potent topical wound dressing solutions include tetrachlorodecaoxide and super-oxidised solution. This study compares the efficacy and safety of these two drugs.MethodsThis is a block-randomised, double blind, parallel-arm, post-marketing study. One hundred fifty patients with ulcers (75 blocks uniform for sex, ulcer aetiology, diabetes mellitus, and wound area score) were randomised into the two treatment arms. Patients were observed for eight weeks with weekly assessments. One hundred and twenty patients completed the study. Wound healing was objectively assessed by measurement of wound area, scoring of wound exudation and tissue type, and using the pressure ulcer scale of healing Tool (validated for multiple wound aetiologies). Subjective improvement in pain was noted using a visual analogue scale. Both groups were compared using Mann–Whitney U test on all indicators.ResultsDifference in change in wound tissue type in the two groups was significant (α=0.05) by intention-to-treat (ITT) and per-protocol (PP) analysis at the end of week two (ITT and PP, P<0.001) and week four (ITT, P=0.010; PP, P=0.009). P-values for other comparisons were not significant (P>0.05). No study-related adverse events were observed.ConclusionsBoth drugs are efficacious. Tetrachlorodecaoxide yields healthy granulation tissue earlier. Both drugs appear to be safe for application.