981	981	981

	Articles
981	Cover Article Initial management of Breastfeeding KEITH SINUSAS, M.D., and AMY GAGLIARDI, M.A., I.B.C.L.C. Proper support, hospital policies and education improve rates of successful breastfeeding.
	Patient information: "Tips for Breastfeeding Success" p. 991
	Editorial: "Promoting and Supporting Breastfeeding," p. 931
999	Appropriate Antimicrobial Prescribing: Approaches that Limit Antibiotic Resistance RICHARD COLGAN, M.D., and JOHN H. POWERS, M.D. Illnesses related to antibiotic-resistant organisms are on the rise as a result of indiscriminate prescribing. Physicians should evaluate patients carefully to determine if antibiotics are necessary.
1007	Concussion in Sports: Minimizing the Risk for Complications DAVID S. KUSHNER, M.D. Concussions may be complicated by cerebral edema related to the second impact syndrome, cumulative neuropsychologic deficits, intracranial bleeding or the postconcussion syndrome. An athlete should not be allowed to resume play until all symptoms of a concussion have resolved.
	Editorial: "Concussion in Sports," p. 938
1019	End-of-Life Care Management of Common Symptoms in Terminally Ill Patients: Part II. Constipation, Delirium and Dyspnea DOUGLAS D. ROSS, M.D., PH.D., and CARLA S. ALEXANDER, M.D. With appropriate diagnosis and management, most end-of-life symptoms can be alleviated. Management of constipation involves manipulation of the components required for a normal bowel movement. Haloperidol is the pharmaceutical agent of choice for the management of delirium. Dyspnea is often treated by titration of an opioid until the symptom is relieved.
1031	Practical Therapeutics Health Care Management of Adults with Down Syndrome DAVID S. SMITH, M.D. Adults with Down syndrome need to have routine health screening and monitoring for special medical conditions that are more common in persons with this syndrome, such as thyroid disease, cervical spine disease and hearing loss.
	Patient information: "Health Issues for Adults with Down Syndrome," p. 1039
1045	Cardiovascular Medicine Update Guideline for the Management of Heart Failure Caused by Systolic Dysfunction: Part II. Treatment WILLIAM E. CHAVEY II, M.D., M.S., CAROLINE S. BLAUM, M.D., M.S., BARRY E. BLESKE, PHARM.D., RICHARD VAN HARRISON, PH.D., SEAN KESTERSON, M.D., and JOHN M. NICKLAS, M.D. Based on the University of Michigan guideline, patients with heart failure resulting from ventricular systolic dysfunction should be treated with the following, if tolerated and not contraindicated: an angiotensin-converting enzyme inhibitor in all patients; a beta blocker in all patients except those with symptoms at rest; and spironolactone in patients with symptoms at rest or a history of such symptoms during the past six months. Diuretics and digoxin are reserved for symptomatic management.
	Editorial: "The ABCs of Treating Congestive Heart Failure," p. 934

Cover Illustration © 2001 Marcia Hartsock, Cincinnati Ohio
Copyright © 2001 by the American Academy of Family Physicians.
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