Kamagra enthält Sildenafilcitrat als pharmakologisch aktiven Bestandteil. Dieser hemmt selektiv die Phosphodiesterase-5 und erhöht dadurch die Konzentration von cGMP im Corpus cavernosum. Der Effekt ist zeitlich begrenzt, da die Halbwertszeit von Sildenafil etwa vier Stunden beträgt. In der galenischen Form als Mundgel erfolgt die Resorption besonders rasch, was zu einem schnelleren Wirkeintritt führt. Der Abbau erfolgt überwiegend hepatisch über CYP3A4, wobei ein aktiver Metabolit entsteht, der zur Gesamtwirkung beiträgt. Typische Nebenwirkungen ergeben sich aus der Vasodilatation, darunter leichte Kopfschmerzen und nasale Kongestion. In klinischen Beschreibungen wird kamagra oral jelly im Zusammenhang mit der schnelleren Absorption erwähnt.
Patient history form
RAO V.SUNKAVALLY M.D.,F.A.C.S. PATIENT HISTORY FORM UROLOGY (Sheet 1/5 of NewPt H&P Revised 2/2011) LAST NAME_________________________________ FIRST NAME_____________________ TODAY’S DATE__________TIME_____ DATE OF BIRTH__________________ REFERRING DOCTOR_____________________________ LAST EXAM DATE ____________ CHIEF COMPLAINT: What is the main reason for your visit today? ( Describe your problem in detail including duration) ______________________________________________________________________________________________________________ _____________________________________________________________________________________________________________ HISTORY OF PRESENT ILLNESS: ♦Note: Please answer the following questions in detail! 1.Location of the problem: Other____________________________________ 2.Quality: Is the problem Constant or Variable? Dull, then Sharp Very Sharp then leaves Always there Other_______________________________________________ 3.Severity: On a Scale of 1-10, with 10 being the most severe, Check the number that best describes the severity of problem? 4.Duration: When did you first notice the problem? Two days ago 2 weeks ago 2 months ago Other___________________________________________________________ 5.Timing: How long does the problem last? It is always there Other______________________________ 6.Context: Does the problem interfere with your normal functions? No If Yes, please explain_______________________________________________________________________________ 7.Modifying Factors: Does anything help or make the problem worse? Moving around Standing up Lying on my side Other______________________________________________________ 8.Associated Signs & Symptoms: Is there anything else occurring at the same time? No. If Yes please explain below: Headaches Other________________________________________________________________________ PAST, FAMILY & SOCIAL HISTORY
♦Medications: Please list all medications you are currently taking. DRUG NAMES DOSE START DATE DRUG NAMES DOSE START DATE ________________________ _____________ ____________ _______________________ _____________ ______________ ________________________ _____________ ____________ _______________________ _____________ ______________ ________________________ _____________ ____________ _______________________ _____________ ______________ ________________________ _____________ ____________ _______________________ _____________ ______________ PAST MEDICAL HISTORY:♦List any personal past Illnesses and or Surgeries and when they occurred.
ILLNESS OR SURGERY DATE ILLNESS OR SURGERY DATE Hypertension. High cholesterol. ____________ ___________________________________ ____________ ___________________________________________ ____________ ___________________________________ ____________ ___________________________________________ ____________ ___________________________________ ____________ ♦ALLERGIES: Do you have any allergies to medicines or food ? No Yes. IF YES, PLEASE LIST BELOW: PENICILLIN. MACRODANTIN. OTHER: _____________________________________________________ FAMILY HISTORY: ♦List all serious Illnesses in your Immediate family.
YES NO RELATION YES NO RELATION YES NO RELATION/ TYPE OF CANCER Heart Disease ____________ Diabetes ____________ Cancer _____________________________ High Blood Pressure ____________ Stroke ____________ Other _____________________________
♦Do you Drink Alcohol? No Yes. What do you drink?_________________ How much?______________ Quit Date:__________
♦Do you Smoke Cigarettes? No Yes.How much?______________ Quit date:_________ How long were you smoking?______ PHYSICIAN USE ONLY:(Comment/Notes)____________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ NEW PATIENT HISTORY OF PRESENT ILLNESS (1-3 = 1 or 2; 4+ = 3-5)PFSH ( 0 = 1 or 2; 1-2 = 3; 3 = 4 or 5) Page 1 OVER RAO V.SUNKAVALLY M.D.,F.A.C.S. REVIEW OF SYSTEMS UROLOGY (sheet 2/5 of NewPt H&P Revised 2/2011)
♦Do you now have or have you had any of the following problems? Please explain any “Yes” answer CONSTITUTIONAL SYMPTOMS: 1.Fever Y 2.Chills Y 3.Weight loss Y 4.Headaches Y 5.Other __________________________________ _____________________________________________________________________________________________________________ EYES: 1.Blurred Vision Y 2.Double Vision Y 4.Other _____________________________________________ _____________________________________________________________________________________________________________ EARS/NOSE/MOUTH/THROAT: 1.Hearing loss Y 2.Hay fever Y 3.Loss of Smell Y 4.Sinus Problem Y 5.Other__________________ _____________________________________________________________________________________________________________ CARDIOVASCULAR: 1.Chest Pains Y 2.Irregular Heart Beat Y 3.Varicose Veins Y 4.Other _________________________________ _____________________________________________________________________________________________________________ RESPIRATORY: 1.Wheezing Y 2.Frequent Cough Y 3.Shortness of Breath Y 4.Other ________________________________ _____________________________________________________________________________________________________________ GASTROINTESTINAL: 1.Abdominal Pain Y 2.Nausea/Vomiting Y 3.Constipation Y 4.Other_________________________________ _____________________________________________________________________________________________________________ GENITOURINARY: 1.Urine Retention Y 2.Painful Urination Y 3.Blood in Urine Y 4.Other_________________________________ _____________________________________________________________________________________________________________ MUSCULSKELETAL: 1.Joint Pain Y 2.Neck Pain Y 3.Back Pain Y 4.Back Injury Y 5.Other___________________________ _____________________________________________________________________________________________________________ INTEGUMENTARY: 1.Skin Rash Y 2.Persistant Itch Y 3.Boils Y 4.Other______________________________________________ _____________________________________________________________________________________________________________ NEUROLOGICAL: 1.Tremors Y 2.Dizziness Y 3.Numbness/Tingling Y 4. Other_______________________________________ _____________________________________________________________________________________________________________ PSYCHIATRIC: 1.Depression Y 2.Anxiety Y 3.Suicidal Tendencies Y 4.Other______________________________________ _____________________________________________________________________________________________________________ ENDOCRINE: 1.Excessive Thirst Y 2.Too Hot/Cold Y 3.Tired/sluggish Y 4.Other___________________________________ _____________________________________________________________________________________________________________ HEMATOLOGIC/LYMPHATIC: 1.Swollen Glands Y 2.Blood clotting Problem Y 3.Anemia Y 4.Other________________________________ _____________________________________________________________________________________________________________ ALLERGIC/IMMUNOLOGIC: 1.Hay Fever Y 2.Other____________________________________________________________________________________ PHYSICIAN USE ONLY: (Comments/Notes)____________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________ NEW PATIENT REVIEW OF SYSTEMS (0-1 = 1 or 2; 2-9 = 3; 10+ = 4 or 5 ) PHYSICIAN SIGNATURE OR INITIALS______________ DATE:______________
Application of Case Based Reasoning to Legacy System Migration J. Grimson, B. Wu, J. Bisbal, and D. Lawless 1. Introduction Systems migration is now a major issue in established IT departments, [Bene95, Wins94]. Typically the information systems of these organisations are large, old, mission critical, and have minimal, if any, documentation. These information systems define what we today ca