Cover	1421	1404

	Articles
1371	Problem-Oriented Diagnosis Abnormal Uterine Bleeding KATHLEEN A. ORIEL, M.D., and SARINA SCHRAGER, M.D. Determining the cause of abnormal uterine bleeding requires a systematic approach based on the most probable differential diagnosis for premenopausal, perimenopausal and postmenopausal age groups.
	Patient information: "When You Have Abnormal Uterine Bleeding," p. 1381
1387	Cover Article: Clinical Pharmacology Drug Treatment of Common STDs: Part I. Herpes, Syphilis, Urethritis, Chlamydia and Gonorrhea CAROL WOODWARD, PHARM.D., and MELANIE A. FISHER, M.D., M.SC. This two-part article reviews Centers for Disease Control and Prevention guidelines for the treatment of sexually transmitted diseases. In part I, recommendations for treatment of genital ulcer diseases, urethritis and cervicitis are discussed.
1404	Radiologic Decision-Making Pigmented Villonodular Synovitis of the Hip and Knee FRANK J. FRASSICA, M.D., MEENESH A. BHIMANI, M.D., EDWARD F. MCCARTHY, M.D., and JAMES WENZ, M.D. Pigmented villonodular synovitis is an uncommon disease process characterized by joint effusion, elevation of the capsule, hyperplastic synovium and low signal intensity on magnetic resonance imaging. The diagnosis is confirmed through biopsy.
	Patient information: "Pigmented Villonodular Synovitis," p. 1415
1421	An Approach to Diagnosis and Initial Management of Systemic Vasculitis DOUGLAS W. ROANE, MAJ, USAF, MC, and DONALD R. GRIGER, MAJ, USAF, MC Clinical features of systemic vasculitis depend on the organs involved and, in turn, organ involvement is largely influenced by the size of the affected blood vessels.
1431	Chronic Insomnia: A Practical Review VIJAY RAJPUT, M.D., and STEVEN M. BROMLEY, M.D. Chronic insomnia often has multiple concurrent causes. Most patients benefit from behavioral approaches that focus on good sleep habits.
	Patient information: "When You Can't Sleep," p. 1441
1443	Clinical Utility of the Erythrocyte Sedimentation Rate MALCOLM L. BRIGDEN, M.D. The erythrocyte sedimentation rate remains useful in the diagnosis and monitoring of a few conditions but should not be used as a general screening tool or as an indicator of occult disease in the absence of clinical evidence.
1455	Parvovirus B19 Infections CAMILLE SABELLA, M.D., and JOHANNA GOLDFARB, M.D. Although parvovirus B19 infection usually causes only mild illness, it can cause arthropathy, aplastic anemia, hydrops fetalis and fetal death.
1462	Issues in Newborn Screening for Phenylketonuria RICHARD K. KOCH, M.D The blood sample for phenylketonuria (PKU) screening should be obtained at least 12 hours after delivery.
1468	Diabetes Care Update Management of the Hyperosmolar Hyperglycemic Syndrome ROBERT MATZ, M.D. In patients with uncontrolled diabetes, an altered state of consciousness is almost always due to severe hyperosmolar hyperglycemia. Treatment is the prompt, rapid administration of crystalloids, with tonicity appropriate to the level of hyperosmolarity.
1481	Practical Therapeutics The Home Visit BRIAN K. UNWIN, MAJ, MC, USA, and ANTHONY F. JERANT, M.D. Well-planned home visits can lead to improved medical care through the discovery of unmet health care needs. A simple mnemonic device can help physicians remember the areas to assess during these visits.

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	Departments
1297	Inside AFP
1305	Newsletter
1309	Quantum Sufficit
1313	Clinical Quiz
1318	Letters to the Editor Clinical Criteria as a Preliminary Screen for Cervical Spine Injury Speech and Language Problems in International Adoptees
1335	Editorials Thinking About Sexually Transmitted Diseases Medical Care in the Home
1345	CME Calendar
1367	Diary from a Week in Practice
1489	Photo Quiz
1492	Tips from Other Journals
1555	Family Practice International
1556	Curbside Consultation
1564	Special Medical Reports ACC, AHA, and ACP-ASIM Develop Guidelines for Angina
1570	Clinical Briefs
1576	Resident and Student Voice
1580	Physician's Bookshelf
1585	Information for Authors
1588	Medical Products and Services
1589	Classified Information

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Copyright © 1999 by the American Academy of Family Physicians.
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