Cover	2791	2703

	Articles
2667	Cover Article: Practical Therapeutics Identification and Management of Tuberculosis ANTHONY F. JERANT, M.D., MICHELLE BANNON, P.A.-C, M.P.H., and STEPHEN RITTENHOUSE, CPT, MC, USA A high index of suspicion is required to identify patients who require purified protein derivative skin testing for possible tuberculosis infection. In patients with a positive skin test whose clinical history or sputum smear is consistent with active disease, prompt initiation of a four-drug antimycobacterial regimen minimizes the spread of infection and the emergence of antimicrobial resistance.
	Patient information: "Questions and Answers About TB," p. 2681
2683	Problem-Oriented Diagnosis The Preparticipation Athletic Evaluation KURT KUROWSKI, M.D., and SANGILI CHANDRAN, M.D. An appropriately structured preparticipation athletic examination improves a physician's ability to detect patients at risk for sudden exercise-related death, as well as conditions susceptible to rehabilitation.
	Appendix: "Preparticipation Examination," p. 2696
2703	Treatment of Seborrheic Dermatitis BETTY ANNE JOHNSON, M.D., PH.D., and JULIA R. NUNLEY, M.D. A number of genetic, hormonal and environmental factors may contribute to the development of seborrheic dermatitis. Many topical agents are available to control this inflammatory disorder.
	Patient information, "Seborrhea: What It Is and How to Treat It," p. 2713
2719	Practical Use of the Pessary ANTHONY J. VIERA, LT, MC, USNR, and MARGARET LARKINS-PETTIGREW, LCDR, MC, USNR The pessary is an effective nonsurgical way to treat a variety of gynecologic problems, such as pelvic support defects and stress urinary incontinence.
	Patient information handout: "How to Use a Pessary," p. 2729
2731	Bisphosphonates: Safety and Efficacy in the Treatment and Prevention of Osteoporosis SUSAN L. GREENSPAN, M.D., STEVEN T. HARRIS, M.D., HENRY BONE, M.D., PAUL D. MILLER, ERIC S. ORWOLL, M.D., NELSON B. WATTS, M.D., and CLIFFORD J. ROSEN, M.D. Osteoporosis affects more than 28 million Americans. One class of agents used to treat osteoporosis is the bisphosphonates, which have been shown to have a strong safety and tolerability profile.
2741	New Classification and Update on the Quinolone Antibiotics DANA E. KING, M.D., ROBB MALONE, PHARM.D., and SANDRA H. LILLEY, PHARM.D. The new classification of quinolone antibiotics takes into account the expanded antimicrobial spectrum of the newer fluoroquinolones and their clinical indications. This classification can help family physicians prescribe quinolones appropriately and evaluate new drugs as they are introduced.
2749	Noise-Induced Hearing Loss PETER M. RABINOWITZ, M.D., M.P.H. Hearing loss caused by occupational or recreational exposure to noise is virtually 100 percent preventable. Family physicians can educate patients to avoid potentially damaging noise, to use adequate hearing protection and to seek treatment for an existing hearing deficit.
	Patient information: "How to Prevent Noise-Induced Hearing Loss," p. 2759
2763	An Approach to Drug Abuse, Intoxication and Withdrawal A. JAMES GIANNINI, M.D. By identifying the effects of the six neurotransmitters on which drugs of abuse act, family physicians can make accurate diagnoses and institute appropriate interventions.
2785	Medical Surveillance in Work-Site Safety and Health Programs JAMES C. WESDOCK, M.D., M.P.H., and ROSEMARY K. SOKAS, M.D., M.O.H. Family physicians who perform employee medical surveillance must visit the work site. Many resources are available to help physicians design a comprehensive surveillance program.
2791	Radiologic Decision-Making Bilious Vomiting in the Newborn: Rapid Diagnosis of Intestinal Obstruction KEN KIMURA, M.D., and VERA LOENING-BAUCKE, M.D. Bilious vomiting, with or without abdominal distention, is the initial sign of intestinal obstruction in newborns. Duodenal atresia, midgut malrotation and volvulus, jejunoileal atresia, meconium ileus and necrotizing enterocolitis are the most common causes.

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