Repeated successful surgical rescues of early and delayed multiple ruptures of ventricular septum, right ventricle and aneurysmal left ventricle following massive biventricular infarction

A 58 year old man underwent 6 surgical interventions for various complications of massive biventricular myocardial infarction over a period of 2 years following acute occlusion of a possibly "hyperdominant" left anterior descending coronary artery. These included concomitant repair of apicoanterior post-infarction VSD and right ventricular free wall rupture, repeat repair of recurrent VSD following inferoposterior extension of VSD in the infarcted septum 5 weeks later, repair of delayed right ventricular free wall rupture 4 weeks subsequently, repair of a bleeding left ventricular aneurysm eroding through left chest wall 16 months thereafter, repair of right upper lobe lung tear causing massive anterior mediastinal haemorrhage, mimicking yet another cardiac rupture, 2 months later, followed, at the same admission, 2 weeks later, by sternal reconstruction for dehisced and infected sternum using pedicled myocutaneous latissimus dorsi flap. 5 years after the latissimus myoplasty, the patient remains in NYHA class 1 and is leading a normal life

Nutrition and Central Nervous System

Clinical studies have revealed that depression is accompanied by impaired brain function and cognitive performances or neurodegenerative processes. Moreover, accumulation of oxidative damage has been implicated in aging and various neurological disorders. This chapter aims to integrate the current knowledge on the relation between brain and diverse alterations in nutrition. The mammalian brain is a lipid-rich organ, where lipids content in gray matter is 36–40% lipid. However, the regulation of cholesterol transport from astrocytes to neurons still remains unclear, among other things. In addition to that, micronutrient status can affect cognitive function at all ages. Vitamin deficiency could influence memory function, and might contribute to cognitive impairment and dementia. Deficiency of vitamin A, folate, vitamins B6, B12, and minerals such as Fe and Zn are associated with prevalence of depressive symptoms according to several epidemiological studies. Experimental evidence suggests that resveratrol, vitamins A, C, E, D and folate may block oxidative stress and promote clearance of Aβ peptides. An adequate intake of fruit, nuts, vegetables, cereals, legumes, or fish can prevent the depletion. High dietary intake of saturated fat and low intake of vegetables may be associated with increased risk of Alzheimer’s disease. Supplementation of diets with omega-3 has been shown to have positive effects on cognitive function. The biochemical and molecular mechanism of these alterations of normal brain function has been described. Future studies should also examine how DNA repair deficiency occurs and affects the nervous system, because this could provide a rational basis for therapies in neurodegenerative diseases.Fil: Alvarez, Silvina Monica. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Gomez, Nidia Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Navigatore Fonzo, Lorena Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Sanchez, Emilse Silvina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; ArgentinaFil: Gimenez, Maria Sofia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Luis. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis. Universidad Nacional de San Luis. Facultad de Ciencias Físico Matemáticas y Naturales. Instituto Multidisciplinario de Investigaciones Biológicas de San Luis; Argentin