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American Family Physician
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1307 1380 1339
Articles
1307 Evidence-Based Prenatal Care: Part I. General Prenatal Care and Counseling Issues
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COLLEEN KIRKHAM, M.D., SUSAN HARRIS, M.D., and STEFAN GRZYBOWSKI, M.D.
Routine prenatal interventions are controversial, but fetal heart auscultation, urinalysis, and assessment of maternal weight, blood pressure, and fundal height generally are recommended. Women should be offered screening for anemia and ABO and Rh blood typing during the first prenatal visit. All women should be offered prenatal serum marker screening for neural tube defects and aneuploidy. Folic acid supplementation is recommended to prevent neural tube defects. CME

Patient information: "Pregnancy: Keeping Yourself and Your Baby Healthy,” p. 1321

Editorial: "Prenatal Care: Examining the Evidence for an Evolving Paradigm,” p. 1264

    
1327 Evaluation of the Patient with Muscle Weakness
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AARON SAGUIL, CPT (P), MC, USA
A comprehensive evaluation of patients with muscle weakness includes a thorough examination and coordinated laboratory, radiologic, electrodiagnostic, and pathologic studies. CME
    
1339 Diagnosis of Gastrointestinal Bleeding in Adults
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LINDA L. MANNING-DIMMITT, D.O., STEVEN G. DIMMITT, D.O., and GEORGE R. WILSON, M.D.
The clinical evaluation of gastrointestinal bleeding depends on the hemodynamic status of the patient and the suspected source of the bleed. Several diagnostic tools are available depending on these variables. CME
   
1353 Methadone Treatment for Pain States
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JAMES D. TOOMBS, M.D., and LEE A. KRAL, PHARM.D.
Methadone may be used to treat cancer and neuropathic pain states. It may be an appropriate replacement for other opioids when side effects have limited further use. CME
   


Departments
  
Keeping Up to Date
1365 Clinical Evidence Concise

• Venous Leg Ulcers

1386 POEMs and Tips from Other Journals
1429 Practice Guidelines
   
  
Answering Clinical Questions
1301 Cochrane for Clinicians
1369 Putting Prevention into Practice

• Screening for Thyroid Disease

1375 FPIN's Clinical Inquiries

• St. John's Wort for Depression

1380 Photo Quiz
   
  
Commentary
1239 Inside AFP
1261 Letters to the Editor

online letters
Available online only:

1264 Editorials

• Prenatal Care: Examining the Evidence for an Evolving Paradigm

   
  
Medicine and Society
1249 Newsletter
1253 Quantum Sufficit
1294 Diary from a Week in Practice
   
 
Readers Services
1245 Strength of Recommendation Taxonomy in AFP
1257 Clinical Quiz
1269 CME Calendar
1363 Change-of-Address Form
1385 Levels-of-Evidence Labels in AFP
1388 Definition of POEMs
1435 Classified Information
   Information for Authors

CME This article is included as part of this issue's continuing medical education (CME) activity. See "Clinical Quiz," p. 1257.

EB CME This logo designates clinical content that conforms to AAFP criteria for evidence-based continuing medical education (EB CME). EB CME is clinical content presented with practice recommendations supported by evidence that has been systematically reviewed by an AAFP-approved source.


Cover illustration © 2005 Bert Oppenheim, Medway, Mass., and Chris Scalici, Boston, Mass.



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