Gender disparities in pulmonary hypertension at a tertiary centre in Cameroon

Background. Pulmonary hypertension (PH) is a potent cause of heart failure and has been little investigated in the African setting. Objective. To investigate the effects of gender on the clinical presentation, echocardiographic features and outcomes of patients with PH in Douala, Cameroon. Methods. A prospective cohort study was conducted from March 2012 to December 2013 as part of the Pan African Pulmonary Hypertension Cohort study. PH was diagnosed by echocardiography and defined as a right ventricular systolic pressure >35 mmHg in the absence of acute right heart failure. Patients were followed up for a maximum of 12 months for primary endpoint mortality. Results. In total, 130 patients with PH were recruited; 71 (54.6%) were women. The median age was 59.2 years for men and 58.3 years for women (p=0.76). Active smoking and alcohol use were more frequent in men than women (both p<0.001), but women had greater exposure to indoor cooking fumes than men (p<0.001). Previous tuberculosis infection (11.3% v. 1.7%) and S3 gallop rhythm (30.9% v. 11.9%) were more common in women (both p<0.03). Women had a significantly higher mean systolic blood pressure (134 mmHg v. 125 mmHg; p=0.04) and pulse pressure (53.8 mmHg v. 44.9 mmHg; p=0.01) and a lower mean haemoglobin concentration (10.4 g/dL v. 12.4 g/dL; p<0.05) compared with men. Echocardiographic left ventricular (LV) systolic dysfunction was more frequent in men: mean LV ejection fraction 42.6% v. 51.5% (p=0.01) and mean fractional shortening 21.4% v. 28.6% (p=0.01). The overall mortality rate was 20.3%, and rates were similar in the two groups (Kaplan-Meier log rank 1.1; p=0.30). Conclusions. Despite differences in baseline characteristics including cardiovascular risk factors, mortality rates on follow-up were similar in men and women in this study. However, these different baseline characteristics probably suggest differences in the pathogenesis of PH in men and women in our setting that need further investigation.S Afr Med J 2017;107(10):892-89

Enhancing carbon sequestration in soil with coal combustion products: a technology for minimising carbon footprints in coal-power generation and agriculture

Coal-fired power generation and agriculture account for more than half of global greenhouse gas emissions, but the coal fly ash (CFA) produced in the former can be a resource for reducing emissions from agriculture to minimise environmental footprints in both industries. Our aim in this study was to test how acidic and alkaline CFA addition could minimise loss of C and N from acidic soil, with or without added manure. We determined composition and structural characteristics of acidic and alkaline CFA for their capacity to adsorb organic carbon, but observed poor adsorption because of low concentrations of cenospheres and unburnt carbon as the primary absorbents in the ash. Addition of CFA had no impact on the loss of carbon or nitrogen from unmanured soil in which concentrations of these nutrients were low. Loss of carbon from manured soil was reduced by 36% with alkaline ashes and by 3-fold with acidic ashes; while loss of N was 30–50% lower with acidic ashes, but 28% higher with alkaline ashes, compared with no ash treatment. The increases in C sparing with CFA addition were achieved not by direct C absorption but by restraining microbial population and respiration, and potentially emissions. Alkaline CFA increased soil pH and if used to substitute just 10% of lime for ameliorating soil acidity would reduce CO2 emission associated with the mining of the lime and its eventual dissolution in soil by ~ 2.66 Tg or 2.8% of Australia’s annual agricultural emissions. High concentrations of oxides of phosphorus, silicon, titanium and clay particles in acidic ashes, and oxides of cations in alkaline ashes, were associated with potential for promoting C storage and acidity amelioration in soil

ESICM LIVES 2016: part two : Milan, Italy. 1-5 October 2016.

Meeting abstrac