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Team-Based Primary Care for the Multimorbid Patient: Matching Complexity With Complexity

Complex, multimorbid patients are individuals within whom multiple chronic diagnoses (usually, more than two)1intersect additional complications—diminished function, cognitive impairment, homelessness, or substance abuse, for example. As many as one third of patients are multimorbid, with correlates of socioeconomic deprivation, increasing health services utilization, and mental health comorbidity.2 The growing scope and scale of care for complex, […]

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Annals of Communication: ’Giving a Patient a Diagnosis‘ and Other Idioms in Development

Communication is at the heart of the medical enterprise. We doctors share our research and our interpretations of that research in words. We use words to learn about the concerns of our patients and record our impressions, our findings, and our plans; words to share with patients and families what we have discovered, how we […]

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doctor shaking hands with female patient

Coaching Patients Saves Lives and Money (video)

The Coaching On Achieving Cardiovascular Health (COACH) Program has been proven to improve biomedical and lifestyle cardiovascular disease (CVD) risk factors. The objective of this study was to evaluate the long-term impact of The COACH Program on overall survival, hospital utilization, and costs from the perspective of a private health insurer (payor), in patients with […]

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Mandibular arch showing bilateral torus mandibularis on lingual side (black arrows).

Torus Mandibularis

A 34-year-old male patient presented with asymptomatic bony overgrowth in his mandibular arch. The overgrowth started 5 years back and gradually kept on increasing to its present size. On intraoral examination, the bony overgrowth was present bilaterally on the lingual surface of the mandible from canine to first molar region, measuring about 1.4 cm × 1 […]

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Skin examination was remarkable for multiple diffusely distributed erythematous patches with central clearing, consistent with erythema chronicum migrans.

Case of Reversible Complete Heart Block

    A previously healthy Caucasian 22-year-old man presented to a southern Quebec community hospital with syncopal episodes for 1 week. He was found to be hypotensive and bradycardic (heart rate 36 beats per minute), owing to third-degree atrioventricular (AV) block, which did not respond to atropine. A perfusion of isoprenaline was started, and the […]

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Hemispheric Cerebral Edema

  A 67-year-old previously healthy man was admitted in November after a seizure. Examination showed normal vital signs, right hemiparesis and facial palsy, global aphasia, and right upper motor neuron signs but no meningeal irritation. Results from chest X-ray, electrocardiogram, and laboratory tests were normal. Neuromaging revealed left hemispheric cerebral edema without evidence of vascular […]

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