ERIKA L. RAGER, M.D., M.P.H., EDWARD P. BRIDGEFORD, M.D., and DAVID W. OLLILA, M.D.

Survival is influenced strongly by the stage at diagnosis, making selective screening for melanoma important, especially in persons with more than one risk factor. The best evidence supports preventing intermittent sunburn in childhood and practicing sun avoidance. Patients with melanoma require close follow-up because they are at risk for recurrence and diagnosis of a second primary tumor.

DANIEL J. WATTENDORF, MAJ, MC, USAF, and MAXIMILIAN MUENKE, M.D.

Fetal alcohol spectrum disorders are caused by the effects of maternal alcohol consumption during pregnancy. Fetal alcohol syndrome is a specific, clinically identifiable disorder characterized by a pattern of minor facial anomalies, prenatal and postnatal growth retardation, and structural brain anomalies. Behavioral and learning difficulties are often greater than the degree of neurocognitive impairment.

MONTE C. UYEMURA, M.D.

Physicians must be alert for a variety of symptoms of foreign body ingestion. Many ingested foreign bodies pass spontaneously, but serious complications, such as bowel perforation and obstruction, can occur.

Patient information: "What to Do If Your Child Swallows Something," p. 292

DANIEL L. DEPIETROPAOLO, M.D., JOHN H. POWERS, M.D., JAMES M. GILL, M.D., M.P.H., and ANDREW J. FOY

The use of serologic testing in the diagnosis of Lyme disease varies depending on the stage and the probability of Lyme disease based on endemicity and clinical findings.

Patient information: "Lyme Disease: What You Should Know," p. 309