RESUMO
BACKGROUND: Although covered stents (CS) represent a potentially life-saving intervention for coronary perforation (CAP), their application has expanded to other contexts, including coronary aneurysms (CAA). However, data regarding mid- and long-term outcomes of CS in these settings scenarios remains limited. AIMS: This meta-analysis aims to evaluate major adverse cardiac events (MACE) from discharge through long-term follow-up in patients undergoing percutaneous coronary intervention with the new generation polyurethane-covered cobalt-chromium PK Papyrus CS. METHODS: We conducted a meta-analysis of data from three observational trials that included long-term follow-up of patients who underwent PK Papyrus CS implantation: Papyrus-Spain, SOS PK Papyrus, and PAST-PERF registry. RESULTS: 332 patients underwent PK Papyrus CS implantation, 236 (71.1%) for CAP, 70 (21.1%) for CAA and 26 (7.8%) for other indications. After a mean follow-up of 16.2 months, the MACE was 14.3%, with Target Lesion Revascularization (TLR) being the most frequent (8.5%), followed by stent thrombosis (ST), 3.3% and cardiac death (CD), 2.6%. Comparing CAP and CAA subgroups, the MACE rate in CAA was significantly higher than CAP (21.4% vs 9.7%, p < 0.01), primary driven by ST (CAA: 8.6% vs CAP: 1.3%; p = 0.0015). CONCLUSIONS: The clinical outcomes following PK Papyrus CS implantation are deemed acceptable, considering the challenging scenarios and the existing alternative treatments. However, MACE rates in patients with CAA who received Papyrus PK CS were significantly higher than in those with CAP, underscoring the importance of meticulous patient selection and optimization of CS in these complex patients and coronary anatomies.
RESUMO
While the Ebers Papyrus is understood to be one of the oldest and most complete contemporaneous perspectives on Ancient Egyptian healing practices, nothing has yet been said about the biography of its first English-language translator, Dr. Carl H. von Klein. A German immigrant and surgeon in the American Midwest, von Klein spent twenty-some years meticulously translating and annotating the Papyrus, but ultimately his manuscript was destroyed. In this paper, we examine the societal- and personal-scale forces that thwarted his efforts to transform our understanding of the history of medicine.
Assuntos
História da Medicina , História Antiga , Egito , TraduçõesRESUMO
Modeling is an essential and challenging activity in any engineering environment. It implies some hard-to-train skills such as abstraction and communication. Teachers, project leaders, and tool vendors have a hard time teaching or training their students, co-workers, or users. Gamification refers to the exploitation of gaming mechanisms for serious purposes, like promoting behavioral changes, soliciting participation and engagement in activities, etc. We investigate the introduction of gaming mechanisms in modeling tasks with the primary goal of supporting learning/training. The result has been the realization of a gamified modeling environment named PapyGame. In this article, we present the approach adopted for PapyGame implementation, the details on the gamification elements involved, and the derived conceptual architecture required for applying gamification in any modeling environment. Moreover, to demonstrate the benefits of using PapyGame for learning/training modeling, a set of user experience evaluations have been conducted. Correspondingly, we report the obtained results together with a set of future challenges we consider as critical to make gamified modeling a more effective education/training approach.
RESUMO
Kawasaki disease (KD) is an acute vasculitis that can cause coronary artery inflammation and aneurysm formation leading to early obstructive disease. We describe the use of PK Papyrus covered stents (Biotronic, Inc.) in three pediatric patients to exclude coronary artery aneurysms (CAA) from the circulation and relieve aneurysm associated stenoses. Follow-up angiography at 11-17 months postprocedure demonstrated persistent exclusion of CAA and varying degrees of in-stent restenosis (ISR). Two patients required percutaneous coronary intervention with drug eluting stent (DES) implantation to relieve in-stent stenosis. Our findings suggest that CAA exclusion with the PK Papyrus stent is possible and may be a valuable tool in simultaneously treating stenotic and thrombogenic CAA in pediatric KD patients. ISR of these non-DES remains an issue and may require additional interventions within the short-term to maintain vessel patency.
Assuntos
Aneurisma Coronário , Reestenose Coronária , Stents Farmacológicos , Síndrome de Linfonodos Mucocutâneos , Intervenção Coronária Percutânea , Humanos , Criança , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Stents Farmacológicos/efeitos adversos , Vasos Coronários , Resultado do Tratamento , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/etiologia , Aneurisma Coronário/terapia , Stents , Intervenção Coronária Percutânea/efeitos adversos , Reestenose Coronária/etiologia , Angiografia CoronáriaRESUMO
OBJECTIVES: To evaluate the rate of procedural success and long-term outcomes of the PK Papyrus (PKP) covered stent (CS). BACKGROUND: CS are essential in the treatment of coronary artery perforation (CAP). They have also been used to treat coronary artery aneurysms. Limited evidence is available on clinical outcomes with the PKP. METHODS: This was a multicenter, observational, retrospective, and prospective study. Consecutive patients undergoing intentional PKP implantation in 22 centers in France were included. The primary endpoint was the rate of procedural success. Secondary endpoints included rates of death, myocardial infarction (MI), target lesion revascularization (TLR), in-stent restenosis (ISR), and stent thrombosis (ST). RESULTS: Data from 130 patients were analyzed (mean age 72.5 ± 10.5 years; 71% men). The main indication for PKP was CAP, in 84 patients (65%). Delivery success was achieved in 95% and procedural success in 91%. During the in-hospital stay, 15 patients died (12%) and 7 (5%) presented with ST. Data from 127 patients were available at 19.2 ± 12.8 month follow-up. Thirty-three patients died (26%), 15 (12%) had an MI and 21 (17%) presented with TLR. TLR was due to ISR in 12 patients (9%), 10 had definite ST (8%) and 1 patient for stent under-expansion. CONCLUSIONS: The principal indication for PKP was CAP. PKP had high rates of delivery and procedural success. At long-term follow-up, there was a high rate of TLR, mainly due to ISR and ST. These results are consistent with previously reported data in these clinical settings.
Assuntos
Reestenose Coronária , Intervenção Coronária Percutânea , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Desenho de Prótese , Sistema de Registros , Estudos Retrospectivos , Stents , Resultado do TratamentoRESUMO
Papyri belong to the oldest writing grounds in history. Their conservation is of the highest importance in preserving our cultural heritage, which is best achieved based on an extensive knowledge of the materials' constituents to choose a tailored conservation approach. Thermogravimetric Analysis (TGA) has been widely employed to quantify cellulose and lignin in papyrus sheets, yielding reported lignin contents of 25% to 40%. In this work, the TGA method conventionally used for papyrus samples was repeated and compared to other lignin determination approaches (Klason-lignin and acetyl bromide-soluble lignin). TGA can lead to a large overestimation of the lignin content of commercial papyrus sheets (~27%) compared to the other methods (~5%). A similar overestimation of the lignin content was found for the pith and rind of the native papyrus plant. We concluded that the TGA method should, therefore, not be used for lignin quantification.
Assuntos
Lignina/análise , Extratos VegetaisRESUMO
Coronary artery perforation is a rare complication of percutaneous coronary intervention (PCI). Covered stents have been successfully used in these situations. We report a case of ostial left circumflex (LCx) artery perforation during rotablation PCI of left main coronary artery (LMCA) and LCx artery. After failed attempts to balloon tamponade the perforation, a PK Papyrus covered stent was deployed from proximal LCx into LMCA. This resulted in acute exclusion of the left anterior descending (LAD) artery from coronary circulation. Using a dual lumen catheter, a stiff wire was advanced through the side port toward the occluded LAD to fenestrate the membrane of the covered stent. A series of balloons were used to dilate the fenestration in the covered stent to restore a normal flow into the LAD.
Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Angioplastia Coronária com Balão/instrumentação , Aterectomia Coronária/efeitos adversos , Doença da Artéria Coronariana/terapia , Estenose Coronária/terapia , Vasos Coronários/lesões , Stents Farmacológicos , Traumatismos Cardíacos/terapia , Idoso de 80 Anos ou mais , Doença da Artéria Coronariana/diagnóstico por imagem , Estenose Coronária/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Traumatismos Cardíacos/diagnóstico por imagem , Traumatismos Cardíacos/etiologia , Humanos , Masculino , Desenho de Prótese , Resultado do TratamentoRESUMO
Species-focused conservation planning is often based on reducing local extinction risk at key sites. However, with increasing levels of habitat fragmentation and pressures from climate change and overexploitation, surrounding landscapes also influence the persistence of species populations, and their effects are increasingly incorporated in conservation planning and management for both species and communities. Here, we present a framework based on metapopulation dynamics in fragmented landscapes, for quantifying the survival (resistance) and reestablishment of species populations following localized extinction events (resilience). We explore the application of this framework to guide the conservation of a group of threatened bird species endemic to papyrus (Cyperus papyrus) swamps in East and Central Africa. Using occupancy data for five species collected over two years from a network of wetlands in Uganda, we determine the local and landscape factors that influence local extinction and colonization, and map expected rates of population turnover across the network to draw inferences about the locations that contribute most to regional resistance and resilience for all species combined. Slight variation in the factors driving extinction and colonization between individual papyrus birds led to species-specific differences in the spatial patterns of site-level resistance and resilience. However, despite this, locations with the highest resistance and/or resilience overlapped for most species and reveal where resources could be invested for multispecies persistence. This novel simplified framework can aid decision making associated with conservation planning and prioritization for multiple species residing in overlapping, fragmented habitats; helping to identify key sites that warrant urgent conservation protection, with consideration of the need to adapt and respond to future change.
Assuntos
Conservação dos Recursos Naturais , Ecossistema , Animais , Aves , Mudança Climática , Extinção Biológica , Áreas AlagadasRESUMO
OBJECTIVES: To compare outcomes in patients receiving polytetrafluoroethylene (PTFE) and polyurethane (PL) covered stents (CS) after coronary artery perforation (CAP). BACKGROUND: The prognosis of CAP has improved with the advent of CSs. Information is scarce about the outcomes of new-generation CSs. METHODS: Sixty-one patients were treated with CSs in a 5-years period (age = 77 ± 8.75% males). Procedural and clinical data were retrospectively collected. The primary endpoint was procedural success. Secondary endpoints included death and major adverse cardiac events (MACE) defined as a composite of death, myocardial infarction, target vessel, and lesion revascularization and need for surgical repair). RESULTS: Twenty-two (36%) received PL-CSs and 39 (65%) PTFE-CSs. There were no differences in procedural success (86% vs 69%, P = 0.216). Time to deliver was shorter with PL-CS despite larger length of stents (8[11] vs 15[16] min, P = 0.001; 20[5] vs 16[3] mm, P < 0.001). This group had lower rate of pericardial effusion and cardiac arrest (41% vs 72%, P = 0.028; 5% vs 26%, P = 0.045). At 1-year follow-up, MACE rates were similar (58% vs 56%, P = 1.000) with atrend toward TVR in the PL-CS arm (21% vs 5%, P = 0.083). No differences were found in mortality (26% vs 41%, P = 0.385). Each group had 1 stent thrombosis and in-stent restenosis trended higher in the PL-CS group (12% vs 3%, P = 0.223). CONCLUSIONS: Time to deliver was shorter with the PL-CS and resulted in lower rate of pericardial effusion and cardiac arrest. However, there were no significant differences in procedural success and 1-year follow-up MACE in patients treated with PL-CS or PTFE-CS.
Assuntos
Implante de Prótese Vascular/instrumentação , Vasos Coronários , Stents Farmacológicos/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Politetrafluoretileno/uso terapêutico , Poliuretanos/uso terapêutico , Ferida Cirúrgica/cirurgia , Lesões do Sistema Vascular , Idoso , Idoso de 80 Anos ou mais , Materiais Revestidos Biocompatíveis/uso terapêutico , Vasos Coronários/lesões , Vasos Coronários/cirurgia , Feminino , Humanos , Masculino , Desenho de Prótese , Estudos Retrospectivos , Resultado do Tratamento , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/cirurgiaRESUMO
The effect of hydraulic loading rate (HLR) and hydraulic retention time (HRT) on the bioremediation of municipal wastewater using a pilot scale subsurface horizontal flow constructed treatment wetland (HFCTW) vegetated with Cyprus papyrus was investigated. Different HLRs were applied to the treatment system namely 0.18, 0.10, and 0.07 m3/m2. d with corresponding HRTs of 1.8, 3.2, and 4.7 days, respectively. The flow rate was 8 m3/d, and the average organic loading rate (OLR) was 0.037 kg BOD/m3/d. Results showed that the performance of the HFCTW was linearly affected by decreasing the HLR and increasing the HRT. The highest treatment efficiency was achieved at HRT (4.7 days) and HLR (0.07 m3/m2. d). The percentage reductions of chemical oxygen demand (COD), biochemical oxygen demand (BOD), and total suspended solids (TSS) were 86%, 87%, and 80%, respectively. Satisfactory nutrient removal was obtained. Also, removal of 2-3 logs of bacterial indicators of pollution was achieved. The dry biomass of Cyperus was 7.7 kg/m2 and proved to be very efficient in nitrification processes due to high diversity of the roots that increase the treatment surface area.
Assuntos
Biodegradação Ambiental , Cyperus , Águas Residuárias , Áreas Alagadas , BiomassaRESUMO
A constructed wetland (CW) in arid areas requires special knowledge given the particular climatic conditions. Among other aspects, the Hydraulic Retention Time (HRT) and plant species may be two important design parameters in hyper- and super-arid areas. Therefore, the study aimed to evaluate the influence of both variables in the application of CW in super-arid areas. Two HRT, 3.5 d and 7 d, and plant species classified by their origin: (a) native, Festuca Orthopylla, Cortaderia atacamensis and Schoenoplectus americanus, and (b) foreign, Cyperus papyrus, were evaluated in four Mesocosm Constructed Wetlands (MCW) operated in a super-arid area. The results showed that the HRT significantly increased (α < 0.05) in more than 10% the removal efficiency of nitrogen and phosphorus forms (TN, NH4+-N, TP, PO4-3-P). These results were the same for the two groups of plants assessed. Moreover, Cyperus papyrus significantly increased (α < 0.05) above 30% the removal efficiency, but only for nitrogen and phosphorus forms. MCW with this plant species showed a water loss above 25% and significantly increased (α < 0.05) the Electrical Conductivity (EC) of effluents. MCW planted with Schoenoplectus americanus showed water losses of around 25% for the both HRT evaluated, and its influence was not significant (α > 0.05) on the EC of the effluents. These results suggest that Schoenoplectus americanus would be an ideal candidate species for use in CW with subsurface flow in super-arid areas, with HRT varying between 3.5 d and 7 d.
RESUMO
Australopithecus bahrelghazali, its origin and palaeobiology are not well understood. Reported from only one location some several thousand kilometres away from East African Pliocene hominin sites, it appears to have predominantly fed on C4 sources. Yet, it lacks the morphological adaptations of other primate C4 consumers like Paranthropus boisei and Theropithecus oswaldi. Furthermore, although considered to belong to Australopithecus afarensis by most researchers, A. bahrelghazali appears to differ from the former in a key aspect of its morphology: enamel thickness. To assess the phylogeny and palaeobiology of A. bahrelghazali, I first evaluate the dietary adaptations and energetics of A. bahrelghazali using empirical data of the feeding ecology of extant baboons, Papio cynocephalus. Information published on A. bahrelghazali morphology and habitat preference is used to select C4 foods with the appropriate mechanical properties and availability within the environment to create the models. By altering the feeding time on various food categories, I then test whether A. bahrelghazali could have subsisted on a C4 diet, thus accounting for the δ(13)C composition of its dental tissue. The effects of body mass on the volume of food consumed are taken into account. The outcomes of these simulations indicate that A. bahrelghazali could have subsisted on a diet of predominantly sedges, albeit with limitations. At higher energy requirements, i.e., above 3.5 times the BMR, it would be difficult for a medium-sized primate to obtain sufficient energy from a sedge-based diet. This is apparently due to constraints on foraging/feeding time, not because of the nutritional value of sedges per se. These results are discussed against the backdrop of A. bahrelghazali biogeography, palaeoenvironment, and phylogeny. The combined evidence makes it plausible to suggest that Northern Chad may have been a refugium for migrating mammals, including hominins, and throws new light on the deep history of A. bahrelghazali.
Assuntos
Distribuição Animal , Dieta , Hominidae/fisiologia , Animais , Chade , Ecossistema , Meio Ambiente , Modelos Biológicos , PaleontologiaRESUMO
Significant percentage of today's knowledge of ancient Egyptian medicine has been acquired from papyri left behind from various periods of Egyptian history. The longest and the most comprehensive is the Ebers papyrus, kept at the University Museum of Leipzig, which was written more than one thousand years before Hippocrates (c. 460-377 BC). One of the riddles among the prescriptions of the Ebers papyrus Eb20 has been used in order to remove the so called "wemyt" weremit from the abdomen with the help of a drink, which consists of "jnnk", Conyza dioscoridis in milk or sweet beer. The authors assume that the disease could be an infection of Schistosoma haematobium and/or Schistosoma mansoni. Nowadays the tea of Conyza dioscoridis is widely used as an important part of traditional medicine against rheumatism, intestinal distention and cramps, as well as an antiperspirant, and with external use for wound healing. The authors' intent is to interpret the efficacy of the above-mentioned ancient prescription with the help of modern medical and pharmaceutical knowledge.
Assuntos
Conyza , Medicina Tradicional/história , Schistosoma/efeitos dos fármacos , Esquistossomose/tratamento farmacológico , Esquistossomose/história , Animais , Prescrições de Medicamentos/história , Antigo Egito , História Antiga , Humanos , Medicina Tradicional/métodos , Schistosoma haematobium/efeitos dos fármacos , Schistosoma mansoni/efeitos dos fármacos , Esquistossomose Urinária/história , Esquistossomose mansoni/históriaRESUMO
MOTIVATION: Giant unilamellar vesicles (GUVs), cell-like synthetic micrometer size structures, assemble when thin lipid films are hydrated in aqueous solutions. Quantitative measurements of static yields and distribution of sizes of GUVs obtained from thin film hydration methods were recently reported. Dynamic data such as the time evolution of yields and distribution of sizes, however, is not known. Dynamic data can provide insights into the assembly pathway of GUVs and guidelines for choosing conditions to obtain populations with desired size distributions. APPROACH: We develop the 'stopped-time' technique to characterize the time evolution of the distribution of sizes and molar yields of populations of free-floating GUVs. We additionally capture high resolution time-lapse images of surface-attached GUV buds on the lipid films. We systematically study the dynamics of assembly of GUVs from three widely used thin film hydration methods, PAPYRUS (Paper-Abetted amPhiphile hYdRation in aqUeous Solutions), gentle hydration, and electroformation. FINDINGS: We find that the molar yield versus time curves of GUVs demonstrate a characteristic sigmoidal shape, with an initial yield, a transient, and then a steady state plateau for all three methods. The population of GUVs showed a right-skewed distribution of diameters. The variance of the distributions increased with time. The systems reached steady state within 120 min. We rationalize the dynamics using the thermodynamically motivated budding and merging (BNM) model. These results further the understanding of lipid dynamics and provide for the first-time practical parameters to tailor the production of GUVs of specific sizes for applications.
RESUMO
With the ongoing rapid growth of publicly available ligand-protein bioactivity data, there is a trove of valuable data that can be used to train a plethora of machine-learning algorithms. However, not all data is equal in terms of size and quality and a significant portion of researchers' time is needed to adapt the data to their needs. On top of that, finding the right data for a research question can often be a challenge on its own. To meet these challenges, we have constructed the Papyrus dataset. Papyrus is comprised of around 60 million data points. This dataset contains multiple large publicly available datasets such as ChEMBL and ExCAPE-DB combined with several smaller datasets containing high-quality data. The aggregated data has been standardised and normalised in a manner that is suitable for machine learning. We show how data can be filtered in a variety of ways and also perform some examples of quantitative structure-activity relationship analyses and proteochemometric modelling. Our ambition is that this pruned data collection constitutes a benchmark set that can be used for constructing predictive models, while also providing an accessible data source for research.
RESUMO
Plant combination and rhizobacterial bioaugmentation are the modification of constructed wetlands (CWs) to promote the detoxification of leachate. In this study, characterization of leachate was carried out to ensure the maximum concentration of leachate that did not affect the plant's growth. Herein, the identification of leachate-resistant rhizobacteria is used to determine the type of bacteria that is resistant and has the potential for leachate processing in the next step. The phytodetoxification test is carried out by comparing the addition of rhizobacteria and without the addition of rhizobacteria to detox leachate parameter Chemical Oxygen Demand (COD), Biological Oxygen Demand (BOD), Total Suspended Solid (TSS), Total Nitrogen (TN), Cadmium (Cd), and Mercury (Hg). Results showed that used plants could still live in the largest leachate concentration of 100%. The rhizobacteria that were identified and bioaugmented in the reactor were Bacillus cereus, Nitrosomonas communis, and Pseudomonas aeruginosa. Phytodetoxification test by a single plant showed the efficiency ranged between 40% and 70%. The addition of rhizobacterial bioaugmentation and plant combination can improve the percentage of COD 80.47%, BOD 84.05%, TSS 80.05%, TN 75.58%, Cd 99.96%, and Hg 90%. These modifications are very influential for leachate detoxification through plant uptake and rhizodegradation processes.
RESUMO
Acinetobacter baumannii is a leading cause of biofilm-associated infections, particularly catheter-related bloodstream infections (CRBSIs) that are mostly recalcitrant to antimicrobial therapy. One approach to reducing the burden of CRBSIs is inhibiting biofilm formation on catheters. Owing to their prodigious microbial diversity, bacterial endophytes might be a valuable source of biosurfactants, which are known for their great capacity to disperse microbial biofilms. With this in mind, our study aimed to screen bacterial endophytes from plants growing on the banks of the River Nile for the production of powerful biosurfactants capable of reducing the ability of A. baumannii to form biofilms on central venous catheters (CVCs). This was tested on multidrug- and extensive drug-resistant (M/XDR) clinical isolates of A. baumannii that belong to high-risk global clones and on a standard strain of A. baumannii ATCC 19606. The drop collapse and oil dispersion assays were employed in screening the cell-free supernatants (CFS) of all endophytes for biosurfactant activity. Of the 44 bacterial endophytes recovered from 10 plants, the CFS of Bacillus amyloliquefaciens Cp24, isolated from Cyperus papyrus, showed the highest biosurfactant activity. The crude biosurfactant extract of Cp24 showed potent antibacterial activity with minimum inhibitory concentrations (MICs) ranging from 0.78 to 1.56 mg/ml. It also showed significant antibiofilm activity (p-value<0.01). Sub-MICs of the extract could reduce biofilm formation by up to 89.59%, while up to 87.3% of the preformed biofilms were eradicated by the MIC. A significant reduction in biofilm formation on CVCs impregnated with sub-MIC of the extract was demonstrated by CV assay and further confirmed by scanning electron microscopy. This was associated with three log10 reductions in adhered bacteria in the viable count assay. GC-MS analysis of the crude biosurfactant extract revealed the presence of several compounds, such as saturated, unsaturated, and epoxy fatty acids, cyclopeptides, and 3-Benzyl-hexahydro-pyrrolo [1, 2-a] pyrazine-1,4-dione, potentially implicated in the potent biosurfactant and antibiofilm activities. In the present study, we report the isolation of a B. amyloliquefaciens endophyte from the plant C. papyrus that produces a biosurfactant with potent antibiofilm activity against MDR/XDR global clones of A. baumannii. The impregnation of CVCs with the biosurfactant was demonstrated to reduce biofilms and, hence, proposed as a potential strategy for reducing CRBSIs.
RESUMO
BACKGROUND: Data on the mechanisms of failure of covered coronary stents [Graftmaster, PK Papyrus] are limited. METHODS: We queried the "Manufacturer and User Facility Device Experience" (MAUDE) database between August 2018 (when the PK Papyrus stent was FDA approved) and December 2020 for reports on covered coronary stents. RESULTS: We identified 299 reports in the MAUDE database (after excluding duplicates, peripheral vascular reports, and incomplete records) (Graftmaster n = 225, PK Papyrus n = 74). The most common mechanism of failure of covered stents was failure to deliver the stent (46.2%), followed by stent dislodgement (22.4%) and failure to seal the perforation (19.7%). Failure to deliver the stent was more often reported with Graftmaster compared with PK Papyrus (59.1% vs. 6.8%, p < 0.001). Stent dislodgement was more often reported with PK Papyrus compared with Graftmaster (75.7% vs. 4.9%, p < 0.001) and was managed by device retrieval or by crushing the stent. CONCLUSIONS: The most common failure mechanisms of covered stents are failure of delivery, stent dislodgement, and failure to seal the perforation. Failure of delivery was more common with Graftmaster, while stent dislodgement was more common with PK Papyrus. Further improvements in covered stent design are needed to optimize deliverability and minimize the risk of complications.
Assuntos
Intervenção Coronária Percutânea , Bases de Dados Factuais , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Desenho de Prótese , Stents , Resultado do TratamentoRESUMO
Papyrus (Cyperus papyrus L.) is a sedge plant with a high rate of biomass productivity that represents an interesting raw material to produce chemicals, materials and fuels, which are currently still obtained from fossil resources, in the context of a lignocellulosic biorefinery. In this work, the content and chemical composition of the lipids present in papyrus stems were thoroughly studied. For this, the papyrus stems were separated into the rind and the pith. The lipid content accounted for 4.1% in the rind and 4.9% in the pith (based on dry matter). The main compounds identified in both parts of the papyrus stem were hydrocarbons, n-fatty acids, 2-hydroxyfatty acids, alcohols, alkylamides, mono- and diglycerides, steroids (sterols, ketones, hydrocarbons, esters and glycosides), tocopherols, tocopherol esters, phytol, phytol esters, alkyl ferulates, ω-carboxyalkyl ferulates (and their monoglycerides), and acylglycerol glycosides. The rind presented a predominance of n-fatty acids (6790 mg/kg; that represented 28.6% of all identified compounds), steroid compounds (6255 mg/kg; 26.3%), phytol and phytol esters (4985 mg/kg; 21.0%), and isoprenoid hydrocarbons, namely phytadiene and squalene (2660 mg/kg; 11.2%), while the most abundant lipids in the pith were steroids (8600 mg/kg; 44.4% of all identified compounds) and fatty acids (6245 mg/kg; 32.2%). Due to the great diversity and significant abundance of the compounds identified in papyrus, it can be considered as a potential raw material for biorefineries to obtain valuable phytochemicals of interest to various industrial sectors.