October 2024

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img-src="/content/dam/brand/aafp/pubs/afp/issues/2024/1000/cover.jpg.169.resized/cover.jpg"> </aafp-journal-issue-title-and-image> </div>  <div class="adl-layout__sm-only adl-space__sm__m-t-sm adl-space__sm__m-b-md"> <aafp-cme-quiz-card card-title="CME Quiz" auth-endpoint="https://www.aafp.org/jsparse/AAFPUser.js" credit-reporting-endpoint="https://www.aafp.org/credit-reporting-api/assessment/journal/credit" issue-identifier="AFP11004"> </aafp-cme-quiz-card> </div> <div><div class="aafp-xfpage xfpage page basicpage"> <div class="xf-content-height"> <div class="aem-Grid aem-Grid--12 aem-Grid--default--12 "> <div class="aafp-table-of-contents aem-GridColumn aem-GridColumn--default--12"> <section> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Articles </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/diagnosing-benign-skin-tumors.html">Diagnosing Common Benign Skin Tumors</a> </h3> <p>Joy Shen-Wagner, Joel Amidon, Stephen Carek</p> <p> Patients commonly present to family physicians with skin findings, and distinguishing common benign skin tumors from potentially malignant tumors is important. Benign skin tumors can often be diagnosed by their history, distribution, and characteristic morphology. </p> <aafp-journal-article-tag-list tags='[{"text":"Skin Conditions"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/melanoma.html">Melanoma: Diagnosis and Treatment</a> </h3> <p>Rebecca Lauters, Ashley Dianne Brown, Kari-Claudia Allen Harrington</p> <p> Risk factors for cutaneous malignant melanoma include increased exposure to ultraviolet radiation from indoor tanning and sun exposure and genetic susceptibility. Clinical tools, such as mnemonics and the ugly duckling sign, and dermoscopy aid in the diagnosis. All suspicious... </p> <aafp-journal-article-tag-list tags='[{"text":"Skin Cancer"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME","Alg"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/late-term-postterm-pregnancy-management.html">Management of Late-Term and Postterm Pregnancy</a> </h3> <p>Breanna Gawrys, Diana Trang, Whay Cheng</p> <p> Postterm pregnancy starts at 42 weeks' gestation and late-term pregnancy is between 41 weeks' and 0 days' and 41 weeks' and 6 days' gestation. Accurate first-trimester dating is essential for determining or verifying gestational age. Ideal management of late-term and postterm... </p> <aafp-journal-article-tag-list tags='[{"text":"Prenatal Care"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME","Alg"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/obsessive-compulsive-disorder.html">Diagnosis and Management of Obsessive-Compulsive Disorder in the Primary Care Setting</a> </h3> <p>Afi M. Semenya, Prakhya Bhatnagar</p> <p> Early recognition and proper diagnosis of obsessive-compulsive disorder can improve outcomes. First-line treatment includes exposure and response therapy, a selective serotonin reuptake inhibitor, or both. </p> <aafp-journal-article-tag-list tags='[{"text":"Psychologic"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/injections-hand-wrist-part-1.html">Injections of the Hand and Wrist: Part I. Trigger Finger, First Carpometacarpal Joint Osteoarthritis, and Palmar Fibromatosis</a> </h3> <p>George G. A. Pujalte, Rock Vomer, Neil Shah</p> <p> Family physicians are well-positioned to provide injections to help alleviate pain from hand and finger conditions, especially when conservative treatments are ineffective. Techniques vary, and ultrasound guidance can be helpful. </p> <aafp-journal-article-tag-list tags='[{"text":"Musculoskeletal Care"},{"text":"Office Procedures"},{"text":"Sports Medicine"},{"text":"Hand, Finger, and Wrist Disorders"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/injections-hand-wrist-part-2.html">Injections of the Hand and Wrist: Part II. Carpal Tunnel Syndrome, Ganglion Cyst, Intersection Syndrome, Triangular Fibrocartilage Complex Injury, and de Quervain Tenosynovitis</a> </h3> <p>George G. A. Pujalte, Rock Vomer, Neil Shah</p> <p> Several common wrist pathologies are suitable for therapeutic injection, and family physicians are well-positioned to provide these injections, especially when conservative treatments are ineffective. Techniques vary, and ultrasound guidance can be helpful. </p> <aafp-journal-article-tag-list tags='[{"text":"Musculoskeletal Care"},{"text":"Office Procedures"},{"text":"Sports Medicine"},{"text":"Hand, Finger, and Wrist Disorders"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Editorials </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/editorial-doxycycline-sti-postexposure-prophylaxis.html">Practice Alert: CDC Guidelines on Doxycycline for STI Postexposure Prophylaxis</a> </h3> <p>Doug Campos-Outcalt</p> <p> The CDC recently released guidelines on the use of doxycycline for postexposure prophylaxis of gonorrhea, chlamydia, and syphilis. </p> <aafp-journal-article-tag-list tags='[{"text":"Sexually Transmitted Infections"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/editorial-glp-1-agonists-weight-loss.html">Prescribing GLP-1 Agonists for Weight Loss: Wrestling With Our Philosophical Angst</a> </h3> <p>Madhuri Rao, Allen Shaughnessy, Randi Sokol</p> <p> Although patients will likely continue to request GLP-1 agonists and other weight-loss remedies, we do not have to embrace a weight-centric approach. </p> <aafp-journal-article-tag-list tags='[{"text":"Weight Loss"},{"text":"Diabetes"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> AFP Clinical Answers </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/afp-clinical-answers.html">RSV, Testosterone Therapy, Prenatal Medication Risk, Obstructive Sialadenitis, Conjunctivitis, Gout</a> </h3> <p> Key clinical questions and their evidence-based answers directly from the journal’s content, written by and for family physicians. </p> <aafp-journal-article-tag-list tags='[{"text":"Endocrinology"},{"text":"Gout"},{"text":"Upper Respiratory Infections"},{"text":"Immunizations"},{"text":"Autism"},{"text":"Vision Disorders"},{"text":"Oral and Dental Conditions"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Cochrane for Clinicians </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/cochrane-laba-lama-uncontrolled-asthma.html">Adding a LABA or LAMA to Current ICS Therapy for Uncontrolled Asthma</a> </h3> <p>Kyle Jordan Fletke, Nel Trasybule</p> <p> Adding a LABA to a medium- or high-dose ICS likely reduces the frequency of moderate to severe asthma exacerbations compared with continuing a medium-dose ICS alone. </p> <aafp-journal-article-tag-list tags='[{"text":"Asthma"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/cochrane-disulfiram-cocaine-dependence-treatment.html">Disulfiram for the Treatment of Cocaine Dependence</a> </h3> <p>Madhavi Singh, Gretchen Maurer, Sophia Smithbauer</p> <p> Disulfiram appears to increase point abstinence (i.e., the number of abstinent participants at completion of treatment) compared with placebo. </p> <aafp-journal-article-tag-list tags='[{"text":"Substance Abuse"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Graham Center Policy One-Pager </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/graham-center-deaf-community-health-care-needs.html">Understanding the Health Care Needs of the Deaf Community Through Medical Interpreters</a> </h3> <p>Chandra A. Char, Michael McKee</p> <p> For approximately 500,000 Deaf people in the United States who use American Sign Language (ASL), accessing quality health care is challenging. Deaf people are more likely to have been admitted to a hospital in the past 12 months and have a history of chronic illness (e.g.,... </p> <aafp-journal-article-tag-list tags='[{"text":"Family Medicine"},{"text":"Hearing Disorders"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> U.S. Preventive Services Task Force </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/uspstf-high-body-mass-index-children-adolescents.html">Interventions for High Body Mass Index in Children and Adolescents</a> </h3> <p> The USPSTF recommends that clinicians provide or refer children and adolescents 6 years or older with a high body mass index (BMI) (≥95th percentile for age and sex) to comprehensive, intensive behavioral interventions. </p> <aafp-journal-article-tag-list tags='[{"text":"Obesity"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Medicine by the Numbers </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/mbtn-psychological-therapy-older-adults-depression.html">Psychological Therapy for Older Adults in Long-Term Care Who Have Depression</a> </h3> <p>Russell S. Blackwelder, Victoria A. Sullivan</p> <p> A color recommendation of yellow (more data are needed) has been assigned for psychological therapies in long-term care residents with depression. </p> <aafp-journal-article-tag-list tags='[{"text":"Geriatric Care"},{"text":"Psychologic"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Photo Quiz </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/photo-quiz-lung-lesions.html">Lung Lesions Discovered Incidentally in an Older Patient</a> </h3> <p>Takahiko Nagamine</p> <p> Chest radiography revealed a shadow in the upper lung field of an 82-year-old man. </p> <aafp-journal-article-tag-list tags='[{"text":"Pulmonary Medicine"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/photo-quiz-rash-school-aged-child.html">Rash in a School-Aged Child</a> </h3> <p>Ramona Sharma</p> <p> A 10-year-old boy presented with a rash on his lower extremities. </p> <aafp-journal-article-tag-list tags='[{"text":"Skin Infections"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> FPIN's Clinical Inquiries </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/fpin-ci-degenerative-meniscal-tears.html">Arthroscopic Surgery vs. Physical Therapy for Degenerative Meniscal Tears</a> </h3> <p>Jason W. Deck, Lamont Cavanagh, William Dudney, Joshua Hansen, Thomas Kern, Emrys Moreau</p> <p> Arthroscopic surgery, PT, and exercise can be offered to patients with degenerative meniscal tears; none of these is considered superior. Compared with PT, arthroscopic surgery does not result in any clinically significant differences in pain, symptoms, function, activities... </p> <aafp-journal-article-tag-list tags='[{"text":"Musculoskeletal Care"},{"text":"Knee Disorders"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> FPIN's Help Desk Answers </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/fpin-hda-pet-therapy-anxiety.html">Pet Therapy as a Treatment for Anxiety</a> </h3> <p>Mark Zawisa, Urchit Bhatiya, Ian Andrew</p> <p> Pet therapy is used to treat anxiety because it notably reduces self-reported anxiety across multiple age groups. Most pet therapy studies involve dogs, but cats and horses also have been studied. In patients with dementia, animal-assisted therapy reduces behavioral and... </p> <aafp-journal-article-tag-list tags='[{"text":"Anxiety Disorders"},{"text":"Psychologic"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Diagnostic Tests </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/diagnostic-tests-acute-coronary-syndrome.html">High-Sensitivity Troponin in the Diagnosis of Acute Coronary Syndrome</a> </h3> <p>Michael T. Partin, Nathan J. Hemerly, Karl T. Clebak</p> <p> Compared with conventional assays, hs-cTn assays have a lower limit of detection and a good overall negative predictive value at certain levels in diagnosing acute MI in patients presenting with cardiac symptoms. </p> <aafp-journal-article-tag-list tags='[{"text":"Coronary Heart Disease"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Curbside Consultation </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/curbside-contraceptive-counseling.html">Patient-Centered Contraceptive Counseling: A Reproductive Justice–Informed Shift to Shared Decision-Making</a> </h3> <p>David A. Klein, Ryan L. Williamson, Emily A. 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Ebell</p> <p> </p> <aafp-journal-article-tag-list tags='[{"text":"Influenza"},{"text":"Upper Respiratory Infections"},{"text":"COVID"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/poems-scabies-treatment.html">Benzyl Benzoate 25% Is More Effective Than Permethrin 5% for the Treatment of Scabies</a> </h3> <p>Mark H. Ebell</p> <p> </p> <aafp-journal-article-tag-list tags='[{"text":"Skin Conditions"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/poems-umbilical-hernias.html">89% of Umbilical Hernias Spontaneously Close by 5 Years of Age</a> </h3> <p>Henry C. Barry</p> <p> </p> <aafp-journal-article-tag-list tags='[{"text":"Hernias"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Diary of a Family Physician </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='[]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/diary.html">Diary of a Family Physician</a> </h3> <p>Megan Bradley</p> <p> First-person accounts from the front lines of family medicine. </p> <aafp-journal-article-tag-list tags='[{"text":"Family Medicine"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Practice Guidelines </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/practice-guidelines-concussion-in-sport.html">Concussion in Sport: Recommendations From the 6th International Conference on Concussion in Sport</a> </h3> <p>Kyle Lau</p> <p> The Concussion in Sport Group created the 6th International Conference on Concussion in Sport consensus statement to provide updated recommendations on concussion care for athletes at any level of sport. </p> <aafp-journal-article-tag-list tags='[{"text":"Sports Medicine"},{"text":"Concussion"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["CME"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/practice-guidelines-atopic-dermatitis.html">Atopic Dermatitis: Updated Guidelines From the AAAAI/ACAAI Joint Task Force on Practice Parameters</a> </h3> <p>Winfred Frazier, Lynda Schneider, Derek K. Chu</p> <p> The American Academy of Allergy, Asthma and Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters updated guidelines for managing atopic dermatitis (eczema). </p> <aafp-journal-article-tag-list tags='[{"text":"Dermatitis"}]'></aafp-journal-article-tag-list> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-section-heading journal="afp" class="adl-gutter-breakout"> Letters to the Editor </aafp-journal-issue-toc-section-heading> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/letter-gender-disparities-medicine.html">Examining Gender Disparities in Medicine</a> </h3> <p>Francis X. Brickfield</p> <p> Reply: Grace Walter, Anam Siddiqi, Alison Huffstetler </p> </aafp-journal-issue-toc-article> <aafp-journal-issue-toc-article> <aafp-journal-article-icon-list icons='["FREE"]'></aafp-journal-article-icon-list> <h3 class="adl-h3"> <a href="/pubs/afp/issues/2024/1000/letter-allergic-rhinitis-during-breastfeeding.html">Treatment of Allergic Rhinitis During Breastfeeding</a> </h3> <p>Bryce Ringwald</p> <p> </p> </aafp-journal-issue-toc-article> </section> </div> <div class="aafp-horizontal-line aem-GridColumn aem-GridColumn--default--12"> <hr class="adl-horizontal-line adl-horizontal-line--solid adl-space__sm__m-t-md adl-space__sm__m-b-md"/> </div> <div class="aafp-reader-services aem-GridColumn aem-GridColumn--default--12"> <aafp-link-pile class="adl-space__sm__m-b-md adl-space__md__m-b-lg adl-space__lg__m-b-xl" data-linked-list-type="TEXT" create-links-from-json="true" data-linked-list='[{"text":"CME Course 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