Cover	177	109

	Articles
99	Common Causes of Vision Loss in Elderly Patients DAVID A. QUILLEN, M.D. The principal causes of loss of vision in elderly patients (age-related macular degeneration, glaucoma, cataract and diabetic retinopathy) may be detected and monitored with careful annual eye examinations that include dilation.
109	Ludwig's Angina in Children RICHARD W. HARTMANN, JR., M.D. Ludwig's angina is a potentially life-threatening diffuse inflammation of the submandibular and sublingual spaces. Following treatment with high doses of penicillin, most patients recover without complications.
119	Prevention and Treatment of Traveler's Diarrhea GREGORY JUCKETT, M.D. Judicious eating and drinking to avoid contaminated foodstuffs is essential in preventing traveler's diarrhea. The condition can usually be treated initially with loperamide; a fluoroquinolone can be added if loperamide fails to stop the diarrhea. Because drug resistance is widespread, the usefulness of trimethoprim-sulfamethoxazole and doxycycline for the treatment of traveler's diarrhea is increasingly limited.
	Patient information: "Preventing and Treating Traveler's Diarrhea," p. 135
137	Vasectomy Techniques TIMOTHY L. CLENNEY, LCDR, MC, USN, and JAMES C. HIGGINS, CDR, MC, USN Isolation of the vas is key to a successful vasectomy. Techniques for managing the vasal ends include surgical clipping, cautery, fascial interposition and the open-ended technique.
	Patient information: "Having a Vasectomy," p. 151
156	Cardiovascular Medicine Update A Rational Approach to the Treatment of Hypertension in Special Populations W. DALLAS HALL, M.D. Hypertension in black patients is usually characterized by a low-renin, volume-expanded and salt-sensitive state. Isolated systolic hypertension and combined systolic and diastolic hypertension are common in older patients. Diuretics and calcium channel antagonists are the usual therapies.
167	Special Article Responses to Questions About the Specialty of Family Practice as a Career JULEA G. GARNER, M.D., JOSEPH E. SCHERGER, M.D., M.P.H., JOHN W. BEASLEY, M.D., WM. MACMILLAN RODNEY, M.D., DAVID E. SWEE, M.D., ELIZABETH A. GARRETT, M.D., M.S.P.H., and NORMAN B. KAHN, JR., M.D. Updated information is presented on a variety of subjects about family practice, including income, scope of the specialty, continuing medical education, board certification and residency training.
177	Radiologic Decision-Making Screening for Developmental Dysplasia of the Hip LINDA M. FRENCH, M.D., and FREDERICK R. DIETZ, M.D. Ultrasound imaging may have a role in the surveillance of mild hip abnormalities in infants and possibly in selective screening for developmental dysplasia.
	Patient information: "Infant Hip Problems," p. 187
194	Prevention of Osteoporosis and Fractures PAUL ULLOM-MINNICH, M.D., M.P.H. Some risk factors for fractures can be modified or eliminated. Based on cost-effectiveness and clinical efficacy, combined calcium and vitamin D supplementation should be first-line therapy in patients at risk for osteoporotic fractures.
209	Disorders of Puberty RICHARD D. BLONDELL, M.D., MICHAEL B. FOSTER, M.D., and KAMLESH C. DAVE, M.B.B.S. If the clinician has an adequate working knowledge of the hypothalamic-pituitary-gonadal axis, the cause of aberrant puberty can often be identified with a focused medical history, a directed physical examination and selected diagnostic testing.
	Patient information: "When Your Child Is Close to Puberty," p. 223
225	Depression in Women: Diagnostic and Treatment Considerations SUBHASH C. BHATIA, M.D., and SHASHI K. BHATIA, M.D. In evaluating and treating depression in women, family physicians should consider gender-related biopsychosocial differences, as well as phases of the reproductive cycle.
	Patient information: "Depression in Women," p. 239

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	Departments
13	Inside AFP
21	Newsletter
25	Quantum Sufficit
29	Clinical Quiz
38	Editorials Family Practice as a Career Choice Pain, Depression and Survival
53	Letters to the Editor Physician Reimbursement Issues in Home Health Care Male Dyspareunia in the Uncircumcised Patient Hypnosis in the Treatment of Hyperemesis Gravidarum
68	CME Calendar
93	Diary from a Week in Practice
245	Photo Quiz
251	Conference Highlights
253	Tips from Other Journals
298	Family Practice International
300	Curbside Consultation
305	Core Educational Guidelines
309	Special Medical Reports Advisory Committee on Immunization Practices Issues Recommendations for the 1999-2000 Influenza Season National Stroke Association Develops a Consensus Statement on Prevention of Stroke
319	Clinical Briefs
329	Resident and Student Voice
332	Subscription Change of Address Form
335	Information for Authors Author statements form: p. 338
341	Physician's Bookshelf
344	Medical Services
345	Classified Information

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