Cover	1472	1514

	Articles
1455	Primary Prevention of CHD: Nine Ways to Reduce Risk EDWARD P. HAVRANEK, M.D. Control of hypertension, increased physical activity and smoking cessation should be goals for all patients. Patients who are at high risk for coronary heart disease should also undergo therapy aimed at reducing cholesterol levels.
	Patient information: "Reducing Your Risk of Coronary Heart Disease," p. 1466
1472	Pediatric Urinary Tract Infection and Reflux JONATHAN H. ROSS, M.D., and ROBERT KAY, M.D. Current recommendations for the diagnosis, evaluation and management of urinary tract infections and vesicoureteral reflux in children are reviewed.
	Patient information: "Urinary Tract Infections in Children," p. 1485
1489	Amyotrophic Lateral Sclerosis: Lou Gehrig's Disease ANNE D. WALLING, M.D. Amyotrophic lateral sclerosis is an idiopathic, progressive neuromuscular disease that usually presents with minor problems in gait, dexterity, speech or swallowing.
1500	Evaluation and Treatment of Patients with Suicidal Ideation MICHAEL F. GLIATTO, M.D., and ANIL K. RAI, M.D. Although most patients with suicidal ideation do not ultimately commit suicide, the family physician must determine the extent of ideation, including the presence of a plan and the means to commit suicide.
1514	Adult Circumcision JOHN R. HOLMAN, CDR, MC, USN, and KEITH A. STUESSI, LT, MC, USNR Adult circumcision is generally performed in an outpatient setting under local anesthesia. Two common techniques include the dorsal slit and the sleeve method.
1521	Taking a Nutrition History: A Practical Approach for Family Physicians LISA HARK, PH.D., R.D., and DARWIN DEEN, JR., M.D., M.S. Taking a nutrition history is essential for improving patients' dietary habits and offering nutritional guidance. The practical approach outlined here helps physicians incorporate nutrition into a standard medical history and raise their patients' awareness of the importance of nutritional health.
	Patient information: "Tips for Improving Your Nutritional Health," p. 1531
1537	Flexible Sigmoidoscopy: Screening for Colorectal Cancer* BRETT ANDREW JOHNSON, M.D. Flexible sigmoidoscopy is a valuable screening procedure that family physicians can perform in their practices. * The article by Johnson is being republished in the printed version of AFP, with corrected photographs, from the January 15, 1999 issue. The corrections have been made to the online article as well. The link above will take you to the corrected article, which remains part of the January 15, 1999 online issue.
1547	Vulvodynia and Vulvar Vestibulitis: Challenges in Diagnosis and Management JULIUS F. METTS, M.D. Vulvodynia is a syndrome of unexplained vulvar pain frequently accompanied by physical disabilities, limitation of daily activities, sexual dysfunction and psychologic distress. The pain has an acute onset and usually becomes a chronic problem lasting months to years.
	Patient information: "Vulvodynia," p. 1561
1565	Classification of Tremor and Update on Treatment P. DAVID CHARLES, M.D., GREGORY J. ESPER, B.S., THOMAS L. DAVIS, M.D., ROBERT J. MACIUNAS, M.D., and DAVID ROBERTSON, M.D. If drug therapy fails to control tremor, thalamic stimulation may be a consideration in patients with essential tremor, as well as patients with Parkinson's disease.
1577	Primary Prevention of Child Abuse LESA BETHEA, M.D. Strategies to reduce the occurrence of child abuse that may be implemented by family physicians include helping parents meet their basic needs, identifying problems of substance abuse and spousal abuse, and educating parents about childhood behavior, discipline, safety and development.
	Patient information: "Tips for Better Parenting," p. 1591
1598	Practical Therapeutics Ambulatory Management of Common Forms of Anemia DAVID R. LITTLE, M.D., M.S. Deficiencies of iron, vitamin B12 and folic acid are among the most common causes of anemia. Once a definitive diagnosis is made, patients with these forms of anemia can be readily managed in the ambulatory setting.
1607	Clinical Pharmacology Low-Molecular-Weight Heparin in Preventing and Treating DVT ERIC J. RYDBERG, M.D., JOHN M. WESTFALL, M.D., M.P.H., and RICHARD A. NICHOLAS, M.D. Low-molecular-weight heparin has been determined to be as effective as standard heparin or warfarin for prophylaxis and treatment of deep venous thrombosis. It does not require monitoring of the activated partial thromboplastin time or International Normalized Ratio and can be administered on an outpatient basis.

---

	Departments
1358	Inside AFP
1375	Newsletter
1379	Quantum Sufficit
1383	Clinical Quiz
1388	Editorials End-of-Life Care and Family Practice
1402	Letters to the Editor Use of Breakfast Cereals for Constipation in Elderly Persons Increased Incidence of Prostate Cancer in Black Patients The Hospitalist Debate
1415	CME Calendar
1451	Diary from a Week in Practice
1617	Conference Highlights
1623	Tips from Other Journals
1679	Family Practice International
1681	Special Medical Reports New Guidelines Offer Recommendations for Women with Epilepsy CDC Calls for Tuberculosis Screening and Treatment for All Patients with HIV Infection ACOG Releases a Statement on Identification and Treatment of Adolescent Victims of Sexual Assault
1690	Clinical Briefs
1698	Information for Authors
1700	Medical Services
1701	Classified Information

---

Copyright © 1999 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.