Percutaneous balloon mitral valvuloplasty with shockwave lithotripsy for the treatment of calcific mitral valve stenosis.

Background: Calcific mitral stenosis (calcific MS) presents a challenge for surgical treatment and is a contraindication for most contemporary transcatheter mitral valve replacement devices (TMVR), rendering patients with very limited therapeutic options.

Aims: This study aims to assess the clinical and hemodynamic follow-up after mitral valve lithotripsy (MVL).

Methods: All consecutive patients who underwent MVL to treat symptomatic calcific MS at St Michael's Hospital, Toronto, Canada, were included.

Transcatheter Treatment of Native Aortic Valve Regurgitation: The North American Experience With a Novel Device.

Background: Transcatheter treatment of patients with native aortic valve regurgitation (AR) has been limited by anatomical factors. No transcatheter device has received U.S.

Clinical Presentation and Outcome of Patients Experiencing Homelessness Presenting With ST-Segment Elevation Myocardial Infarction.

Background: Cardiovascular disease remains a major cause of morbidity and mortality among homeless adults. Despite major advances in the management of ST elevation myocardial infarction (STEMI), limited information is available for the clinical presentation and management and outcome of STEMI among patients experiencing homelessness (PEH).

Methods: All patients presenting with STEMI between January 1, 2008 and December 31, 2017 at a PCI capable STEMI network inner city hospital comprised the study population.

Global Health Education at Home: Canadian Medical Students' Perspectives After Learning Alongside Haitian Peers.

Purpose: To explore how host medical students learn from visiting foreign students, by reporting on a global health program that has invited two or three Haitian medical students each year since 2013 to a Canadian medical school for a summer anatomy program.

Method: In 2017, the authors conducted a qualitative descriptive study that collected data through one-on-one, semistructured interviews with 10 Canadian students, who participated in the Université Quisqueya-McGill University collaborative, a bidirectional global health education initiative, 2013-2016. The authors' critical constructivist thematic analysis, while exploratory, was sensitized by their knowledge of contemporary frameworks of global health competencies, a postcolonial understanding of power relations, and three key concepts (agency, cultural humility, and reflexivity).

Cardiovascular Disease and Homelessness.

Cardiovascular disease (CVD) is a major cause of death among homeless adults, at rates that exceed those in nonhomeless individuals. A complex set of factors contributes to this disparity. In addition to a high prevalence of cigarette smoking and suboptimal control of traditional CVD risk factors such as hypertension and diabetes, a heavy burden of nontraditional psychosocial risk factors like chronic stress, depression, heavy alcohol use, and cocaine use may confer additional risk for adverse CVD outcomes beyond that predicted by conventional risk estimation methods.

The association between childhood adversity and components of metabolic syndrome in adults with mood disorders: results from the international mood disorders collaborative project.

Objective: We sought to determine whether a reported history of childhood adversity is associated with components of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP-III)-defined metabolic syndrome in adults with mood disorders.

Method: This was a cross-sectional analysis of adult outpatients (N = 373; n = 230 female, n = 143 male; mean age [SD] = 42.86 [14.

Aripiprazole for the maintenance treatment of bipolar disorder: a review of available evidence.

We aimed to review and synthesize results reporting on the maintenance efficacy of Aripiprazole in adults with bipolar I disorder. Aripiprazole is FDA approved for the acute and maintenance treatment of bipolar I disorder. Aripiprazole's efficacy during the long-term treatment of bipolar disorder is supported by extension of acute phase studies and long-term (ie, 100-week) double-blind placebo controlled recurrence prevention registration trials.

Depression in the workforce: the intermediary effect of medical comorbidity.

Background: It is amply documented that mood disorders adversely affect job satisfaction, workforce productivity, and absenteeism/presenteeism. It is also well documented that mood disorders are an independent risk factor for several chronic medical disorders (e.g.

Mood disorders and obesity: understanding inflammation as a pathophysiological nexus.

The aim of this review is to evaluate the evidentiary base supporting the hypothesis that the increased hazard for obesity in mood disorder populations (and vice versa) is a consequence of shared pathophysiological pathways. We conducted a PubMed search of all English-language articles with the following search terms: obesity, inflammation, hypothalamic-pituitary-adrenal axis, insulin, cognition, CNS, and neurotransmitters, cross-referenced with major depressive disorder and bipolar disorder. The frequent co-occurrence of mood disorders and obesity may be characterized by interconnected pathophysiology.

Aerobic physical exercise as a possible treatment for neurocognitive dysfunction in bipolar disorder.

Background: Neurocognitive dysfunction associated with bipolar disorder (BD) is pervasive, persistent across illness phases, and is demonstrated to predispose and portend psychosocial impairment. Moreover, no approved therapies for various phases of BD have been shown to reliably improve any dimension of neurocognitive performance. In this article, we emphasize that aerobic physical exercise is a viable neurocognitive-enhancing adjunctive treatment for patients with BD.

The rate of metabolic syndrome in euthymic Canadian individuals with bipolar I/II disorder.

Objective: To report on the rate of metabolic syndrome, as defined by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III), in asymptomatic adults with bipolar I/II disorder evaluated at the Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto. To our knowledge, this is the first study reporting on the rate of metabolic syndrome in a Canadian clinical sample and exclusively evaluating asymptomatic individuals.

Methods: This was a post-hoc, cross-sectional analysis of adult bipolar subjects who were primarily enrolled in a clinical intervention study.

Atypical antipsychotic tolerability and switching strategies in bipolar disorder.

Importance To The Field: Atypical antipsychotics have unequivocally advanced the pharmacotherapy of bipolar disorders. These broad-spectrum treatments offer efficacy against core symptoms of acute mania, mixed state, depressed and maintenance phases of the disorder. Atypical antipsychotics are not, however, a panacea and are associated with several problematic tolerability and safety concerns.

Bipolar disorder and metabolic syndrome: an international perspective.

Introduction: The ubiquity and hazards posed by abnormal body composition and metabolic parameters in the bipolar population are a priority research and clinical issue. Herein, we summarize and synthesize international studies describing the rate of US National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III [ATP III])- and International Diabetes Federation (IDF)-defined metabolic syndrome and its criterion components in individuals with bipolar disorder.

Methods: We conducted a PubMed search of all English-language articles published between January 2005 and July 2009 with the following search terms: metabolic syndrome and bipolar disorder, mania and manic-depression.