IMRCDP5 ;HCIOFO/NCA - Display CDC Form (Cont.) ;7/16/97 08:57 ;;2.1;IMMUNOLOGY CASE REGISTRY;;Feb 09, 1998 Q:IMRUT W !,"| * Other (specify): " S X=$S(IMRPT:$$FIELD^IMRCDCPX(158,IMRPT,111.13,"E"),1:"") W X_$P(UNDR,"_",1,(30-$L(X)))," ",$S(IMRPT:$$DAT^IMRCDCPX(111.14),1:"__ __")," | * CD4 Percent ......... " S X=$S(IMRPT:$$FIELD^IMRCDCPX(158,IMRPT,111.08,"E"),1:"") S X=$S(X'="":$J(X,2),1:"__") W X," % ",$S(IMRPT:$$DAT^IMRCDCPX(111.09),1:"__ __")," |" W !,"==================================================================================================================================" W @IOF W !," ================================================= VIII. CLINICAL STATUS ======================================================" W !,"| CLINICAL YES NO | ENTER DATE PATIENT Asymptomatic Mo. Yr. Symptomatic Mo. Yr. |" W !,"| RECORD REVIEWED |",$S(IMRPT:$$VAL^IMRCDCPX(110.04,1),1:1),"| |",$S(IMRPT:$$VAL^IMRCDCPX(110.04,0),1:0) W "| | WAS DIAGNOSED AS: (including acute retroviral syndrome and |" W !,"| | persistant generalized lymphadenopathy): ",$S(IMRPT:$$DAT^IMRCDCPX(112.07),1:"__ __")," (not AIDS): ",$S(IMRPT:$$DAT^IMRCDCPX(112.08),1:"__ __")," |" W !,"|--------------------------------------------------------------------------------------------------------------------------------|" W !,"| Initial Initial | Initial Initial |" W !,"| Diagnosis Date | Diagnosis Date |" W !,"| AIDS INDICATOR DISEASES Def. Pres. Mo. Yr. | AIDS INDICATOR DISEASES Def. Pres. Mo. Yr. |" W !,"|---------------------------------------------------------------|----------------------------------------------------------------|" W !,"|Candidiasis, bronchi, trachea, or lungs |",$S(IMRPT:$$VAL^IMRCDCPX(7,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.01),1:"__ __")," |" W "Lymphoma, Burkitt's (or equivalent term) |",$S(IMRPT:$$VAL^IMRCDCPX(8.2,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.14),1:"__ __")," |" W !,"|Candidiasis, esophageal |",$S(IMRPT:$$VAL^IMRCDCPX(7.1,1),1:1),"| |",$S(IMRPT:$$VAL^IMRCDCPX(7.1,2),1:2),"| ",$S(IMRPT:$$DAT^IMRCDCPX(108.02),1:"__ __")," |" W "Lymphoma, Immunoblastic (or equivalent |" W !,"|Carcinoma, invasive cervical |",$S(IMRPT:$$VAL^IMRCDCPX(102.15,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.03),1:"__ __")," |" W " term) |",$S(IMRPT:$$VAL^IMRCDCPX(8.3,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.15),1:"__ __")," |" W !,"|Coccidioidomycosis, disseminated or |Lymphoma, primary in brain |",$S(IMRPT:$$VAL^IMRCDCPX(8.4,1),1:1),"| NA " W $S(IMRPT:$$DAT^IMRCDCPX(108.16),1:"__ __")," |" W !,"| extrapulmonary |",$S(IMRPT:$$VAL^IMRCDCPX(7.2,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.04),1:"__ __")," |" W "Mycobacterium avium complex or |" W !,"|Cryptococcosis, extrapulmonary |",$S(IMRPT:$$VAL^IMRCDCPX(7.3,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.05),1:"__ __")," |" W " M. kansasii, disseminated or |" W !,"|Cryptosporidiosis, chronic intestinal | extrapulmonary |",$S(IMRPT:$$VAL^IMRCDCPX(8.5,1),1:1),"| |" W $S(IMRPT:$$VAL^IMRCDCPX(8.5,2),1:2),"| ",$S(IMRPT:$$DAT^IMRCDCPX(108.17),1:"__ __")," |" W !,"| (> 1 month duration) |",$S(IMRPT:$$VAL^IMRCDCPX(7.4,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.06),1:"__ __")," |" W "M. tuberculosis, pulmonary * |",$S(IMRPT:$$VAL^IMRCDCPX(102.16,1),1:1),"| |",$S(IMRPT:$$VAL^IMRCDCPX(102.16,2),1:2),"| " W $S(IMRPT:$$DAT^IMRCDCPX(108.18),1:"__ __")," |" D HDR^IMRCDCPR Q