| 1 | IMRCDP5 ;HCIOFO/NCA - Display CDC Form (Cont.) ;7/16/97 08:57
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| 2 | ;;2.1;IMMUNOLOGY CASE REGISTRY;;Feb 09, 1998
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| 3 | Q:IMRUT
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| 4 | W !,"| * Other (specify): "
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| 5 | S X=$S(IMRPT:$$FIELD^IMRCDCPX(158,IMRPT,111.13,"E"),1:"")
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| 6 | W X_$P(UNDR,"_",1,(30-$L(X)))," ",$S(IMRPT:$$DAT^IMRCDCPX(111.14),1:"__ __")," | * CD4 Percent ......... "
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| 7 | S X=$S(IMRPT:$$FIELD^IMRCDCPX(158,IMRPT,111.08,"E"),1:"")
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| 8 | S X=$S(X'="":$J(X,2),1:"__") W X," % ",$S(IMRPT:$$DAT^IMRCDCPX(111.09),1:"__ __")," |"
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| 9 | W !,"=================================================================================================================================="
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| 10 | W @IOF
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| 11 | W !," ================================================= VIII. CLINICAL STATUS ======================================================"
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| 12 | W !,"| CLINICAL YES NO | ENTER DATE PATIENT Asymptomatic Mo. Yr. Symptomatic Mo. Yr. |"
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| 13 | W !,"| RECORD REVIEWED |",$S(IMRPT:$$VAL^IMRCDCPX(110.04,1),1:1),"| |",$S(IMRPT:$$VAL^IMRCDCPX(110.04,0),1:0)
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| 14 | W "| | WAS DIAGNOSED AS: (including acute retroviral syndrome and |"
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| 15 | W !,"| | persistant generalized lymphadenopathy): ",$S(IMRPT:$$DAT^IMRCDCPX(112.07),1:"__ __")," (not AIDS): ",$S(IMRPT:$$DAT^IMRCDCPX(112.08),1:"__ __")," |"
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| 16 | W !,"|--------------------------------------------------------------------------------------------------------------------------------|"
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| 17 | W !,"| Initial Initial | Initial Initial |"
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| 18 | W !,"| Diagnosis Date | Diagnosis Date |"
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| 19 | W !,"| AIDS INDICATOR DISEASES Def. Pres. Mo. Yr. | AIDS INDICATOR DISEASES Def. Pres. Mo. Yr. |"
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| 20 | W !,"|---------------------------------------------------------------|----------------------------------------------------------------|"
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| 21 | W !,"|Candidiasis, bronchi, trachea, or lungs |",$S(IMRPT:$$VAL^IMRCDCPX(7,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.01),1:"__ __")," |"
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| 22 | W "Lymphoma, Burkitt's (or equivalent term) |",$S(IMRPT:$$VAL^IMRCDCPX(8.2,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.14),1:"__ __")," |"
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| 23 | W !,"|Candidiasis, esophageal |",$S(IMRPT:$$VAL^IMRCDCPX(7.1,1),1:1),"| |",$S(IMRPT:$$VAL^IMRCDCPX(7.1,2),1:2),"| ",$S(IMRPT:$$DAT^IMRCDCPX(108.02),1:"__ __")," |"
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| 24 | W "Lymphoma, Immunoblastic (or equivalent |"
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| 25 | W !,"|Carcinoma, invasive cervical |",$S(IMRPT:$$VAL^IMRCDCPX(102.15,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.03),1:"__ __")," |"
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| 26 | W " term) |",$S(IMRPT:$$VAL^IMRCDCPX(8.3,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.15),1:"__ __")," |"
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| 27 | W !,"|Coccidioidomycosis, disseminated or |Lymphoma, primary in brain |",$S(IMRPT:$$VAL^IMRCDCPX(8.4,1),1:1),"| NA "
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| 28 | W $S(IMRPT:$$DAT^IMRCDCPX(108.16),1:"__ __")," |"
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| 29 | W !,"| extrapulmonary |",$S(IMRPT:$$VAL^IMRCDCPX(7.2,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.04),1:"__ __")," |"
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| 30 | W "Mycobacterium avium complex or |"
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| 31 | W !,"|Cryptococcosis, extrapulmonary |",$S(IMRPT:$$VAL^IMRCDCPX(7.3,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.05),1:"__ __")," |"
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| 32 | W " M. kansasii, disseminated or |"
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| 33 | W !,"|Cryptosporidiosis, chronic intestinal | extrapulmonary |",$S(IMRPT:$$VAL^IMRCDCPX(8.5,1),1:1),"| |"
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| 34 | W $S(IMRPT:$$VAL^IMRCDCPX(8.5,2),1:2),"| ",$S(IMRPT:$$DAT^IMRCDCPX(108.17),1:"__ __")," |"
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| 35 | W !,"| (> 1 month duration) |",$S(IMRPT:$$VAL^IMRCDCPX(7.4,1),1:1),"| NA ",$S(IMRPT:$$DAT^IMRCDCPX(108.06),1:"__ __")," |"
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| 36 | W "M. tuberculosis, pulmonary * |",$S(IMRPT:$$VAL^IMRCDCPX(102.16,1),1:1),"| |",$S(IMRPT:$$VAL^IMRCDCPX(102.16,2),1:2),"| "
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| 37 | W $S(IMRPT:$$DAT^IMRCDCPX(108.18),1:"__ __")," |"
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| 38 | D HDR^IMRCDCPR
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| 39 | Q
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