Physician CME

Upon completion of this activity, learners will be able to:

• Implement routine OSA screening for patients with obesity and other OSA risk factors.
• Identify tools that can aid in screening patients for OSA.
• Initiate diagnostic workups for patients with suspected OSA.
• Evaluate results from OSA diagnostic studies.
• Implement multidisciplinary approaches to formulate tailored management strategies for OSA that account for patient preferences and new therapeutic options.

In this online, self-learning activity: Blepharitis is a condition characterized by inflammation of the eyelids, resulting in discomfort, redness, irritation, and the appearance of dandruff-like flakes on eyelashes. Demodex blepharitis is a specific subtype of blepharitis, where blepharitis is caused by an overgrowth of Demodex mites, which are normal facial skin flora. In other forms of blepharitis, the etiology may be bacterial colonization, allergies, or seborrheic dermatitis, whereas in Demodex blepharitis, the excessive growth of Demodex folliculorum or Demodex brevis is the driver of inflammation. Research suggests that Demodex blepharitis represents three out of five cases of blepharitis.

In this 1-hour (chapter-based) presentation, join a primary care practitioner and an obesity specialist as they navigate real-world conversations about weight management. Explore effective pharmacologic options and gain confidence in initiating weight loss discussions.

In this accredited activity, expert faculty, Adjoa Anyane‐Yeboa, MD, MPH, and Ugo Iroku, MD, MHS, dive into the issue of healthcare disparities in inflammatory bowel disease (IBD).

Healthcare disparities disproportionately affect minoritized and low-income groups, contributing to poor health outcomes. Patient-provider distrust, knowledge gaps, and lack of shared decision making contribute to health disparities in these patient groups and influence disease outcomes. It is critical for clinicians to understand the social determinants of health impacting IBD patient care and develop strategies to reduce disparities. In addition, implicit bias significantly affects clinician-patient interaction, as well as diagnosis and treatment decisions. Once clinicians are made aware of their implicit biases, they must work to overcome them and foster open communication with patients to reduce disparities and improve patient care.

In this accredited CME/CNE activity, cardiologist Dr. Matthew Martinez reviews key considerations and updates in the diagnosis and management of hypertrophic cardiomyopathy (HCM). Specifically, he explores the disease burden and the dire consequences of undiagnosed HCM, the difficulty in diagnosing HCM including lack of symptoms or presence of nonspecific symptoms, best practices for ordering echocardiograms, and guideline recommendations for treatment, including mavacamten. The informational session also discusses communicating with patients and caregivers/families.

Early identification of atypical motor patterns is crucial for timely intervention and optimizing developmental outcomes in infants. A simple yet effective method for assessing these patterns involves observing the baby during a 30-second, 4-position exam. This examination includes careful observation of the infant in the following positions:

* Supine: Note posture, spontaneous movements, and interaction with the environment.

* Horizontal Suspension: Observe head control, trunk extension, and limb movements against gravity.

* Pull to Sit: Assess head lag, trunk activation, and ability to assist with the movement.

* Prone: Evaluate head lifting, weight-bearing through the arms, and early mobility attempts. Gain valuable insights and download resources through this complimentary CME/CE course

Primary care clinicians and endocrinologists play a critical role in identifying and managing metabolic dysfunction-associated steatohepatitis (MASH) before it progresses. Results from a Med-IQ survey, however, revealed that approximately half of the respondents screen only 50% or fewer of their patients with obesity or type 2 diabetes. Patients with these conditions or other risk factors, such as metabolic syndrome, dyslipidemia, or elevated liver enzymes, should be screened using noninvasive tools like FIB-4, transient elastography (FibroScan), ELF, or VCTE.

Although lifestyle modification remains the cornerstone of treatment, pharmacologic options such as GLP-1 receptor agonists, pioglitazone, and resmetirom may be appropriate based on individual risk profiles. Most patients can be effectively managed in primary care or endocrinology settings, with hepatology referral recommended for patients with a high risk of advanced fibrosis.

In this online, self-learning activity:

Over the past few decades, cultural competence has been defined in a variety of ways, including in the recent appearance of the closely related terms, cultural humility and cultural competemility. According to the Centers for Disease Control and Prevention, cultural competence is a “set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enables effective work in cross-cultural situations.” In the setting of healthcare, practicing cultural competence can improve the ability of HCPs to meet the social, cultural, and linguistic needs of patients, which may ultimately improve provider competence and health outcomes among diverse groups of patients with unique sociocultural identities, including race, ethnicity, gender, and sexual orientation.

Primary care clinicians have many functions in emergency medicine. These include providing emergency care themselves, especially in rural areas, identifying patients who require immediate referral to an emergency department, and care coordination with emergency room physicians. Learn how to improve the care of your patients with one of the emergency medicine CME/CE courses provided by Pri-Med.

Pediatric and adult infectious diseases, vaccines, and vaccine hesitancy have always been an integral component of primary care practice, and the need for to remain up to date on these topics has increased tremendously since the advent of COVID-19.

The obesity epidemic continues to escalate at a dramatic pace. Primary care clinicians stand at the front lines of obesity diagnosis and management. Earn obesity medicine CME/CE credits with one of the free courses provided by Pri-Med.

Acromegaly is an endocrine disorder characterized by dysregulated hypersecretion of growth hormone (GH), usually caused by a GH-secreting, pituitary adenoma and leading to an overproduction of insulin-like growth factor 1 (IGF-1). Estimated to have a prevalence of 2.8 to 13.7 cases per 100,000, acromegaly is not as common as other endocrine disorders. However, its incidence is increasing, and it has a significant impact on patient quality of life, with clinical features that include: acral enlargement; facial feature and oral changes; headache; significant fatigue, including daytime sleepiness; hyperhidrosis; oily and thicker skin; weight gain; and arthralgia. Approximately 25 percent of people with acromegaly have elevated blood pressure, and 50 percent have evidence of insulin resistance, putting them at risk of developing type 2 diabetes in future. The mortality rates of acromegaly patients are three times higher than the general population, with most dying from respiratory or cardiac complications.

In this online, self-learning activity:

Sickle cell disease (SCD) is the most common monogenic blood disorder, affecting millions of people worldwide and approximately 100,000 Americans. Although it may be found in various areas of the world, SCD predominantly affects individuals of African or Hispanic heritage. It is caused by the inheritance of b-globin alleles that code for hemoglobin S, resulting in an amino acid substitution in hemoglobin’s b chain and clinical disease. Patients with SCD have impaired circulation, and lysis of the erythrocytes contributes to a chronic inflammatory response, causing severe pain and less efficient oxygen delivery. The hallmark clinical features of SCD are hemolytic anemia and painful vaso-occlusive crises (VOCs), which may lead to emergency department (ED) visits, hospitalization, and potentially fatal complications. In one US study, 45% of deaths among people with SCD were related to cardiopulmonary causes, and VOCs alone have been shown to increase the risk of death by 50%. SCD also imposes other significant health burdens on patients: it is associated with a significant reduction in quality of life, malnutrition, the development of mental health disorders like depression and anxiety, loss of work or school days, frequent antibiotic use leading to higher rates of antimicrobial resistance, acute chest syndrome, and stroke.

In this online, self-learning activity:

Prostate cancer (PC) is the most common form of malignancy among men in the U.S. with close to 314,000 new cases and over 35,000 deaths from PC annually. Over the past few decades, the death rates associated with PC have declined, likely due to changes in screening practices and improved treatment options. However, the incidence of PC overall has increased in recent years, and the incidence of mPC at the time of diagnosis is on the rise, accounting for about 8% of those diagnosed. And while patients with local or regional disease have 5-year survival rates close to 100%, that number decreases to 37% for patients with metastatic disease (mPC). Mortality aside, as mPC advances, patients often experience increasing symptom burden, such as persistent fatigue and bone pain, both of which can severely impact their overall quality of life (QoL).

In this online, self-learning activity:

Lung cancer is the leading cause of cancer-related death in the United States, with more than 236,000 new cases diagnosed and over 124,000 deaths annually. The most common type of lung cancer, non–small cell lung cancer (NSCLC), accounts for about 85% of cases and has seen steady declines in mortality over the past several years as improvements have been made in diagnosis, staging, and treatment. In contrast, outcomes for the less prevalent small cell lung cancer (SCLC), which is neuroendocrine in nature and accounts for about 14% of all lung cancer cases, have remained poor in recent years despite improvement in those for NSCLC.

In this online, self-learning activity:

Cervical dystonia is the most common focal dystonia, characterized by involuntary muscular contractions resulting in abnormal head, neck, and shoulder movements in addition to posture that can cause tremor and pain. Early-onset dystonia can begin in infancy, childhood, or adolescence, and it generally progresses from focal to generalized. Adult-onset dystonia usually affects the upper part of the body; the origin of the dystonia determines the risk of spread. Cervical dystonia may appear as torticollis, laterocollis, anterocollis, or retrocollis. It may be distinguished from nondystonic hand tremor and essential tremor by the absence of limb tremor and the manner of neck movement. However, it is more difficult to distinguish from pseudodystonias, resulting in misdiagnosis, inappropriate treatment, and treatment delay.

In this online, self-learning activity:

Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus (SLE), affecting over 40% of patients with lupus. It is a major contributor to morbidity, healthcare utilization, and progression to end-stage renal disease (ESRD). The prevalence of LN has increased significantly over time, from 16.8 per 100,000 in 1985 to 21.2 per 100,000 more recently. The mortality rate associated with LN remains high with a standardized mortality ratio of 6.33 compared to the general population. Despite increased advances in treatments, long-term survival rates have not improved significantly over the past four decades. The 10-year survival rate is around 70%, while the incidence of progression in ESRD in LN patients affects up to 13% of patients over time.