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The Health Information Management (HIM) department is responsible for the inspection, processing, filing and maintenance of patient clinical records, and for providing maximum confidentiality of such records for the benefit and protection of the patient.
A clinical record is maintained for each patient admitted to the facility, in accordance with accepted professional principles, and according to standards as set forth by federal and state regulations and accrediting agencies.
All routine requests for release of Protected Healthcare Information (PHI) are handled by the HIM department.
The HIM department is also responsible for the assignment of diagnosis and procedure codes and the transcription of all dictated reports.
Please contact 535-6247 with questions in regards to your Health Information.
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If you think you may be depressed, do not suffer in silence. Depression is not a sign of personal weakness. Tell your doctor how you are feeling so that you can start feeling like yourself again.
Depression and anxiety: Psychological factors may be responsible for erectile dysfunction. These factors include stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure. For more information, please visit the Depression Center.
The investigators found that the erectile dysfunction rate was 93 cases per 1000 persons per year among NSAID users compared with just 35 cases among nonusers.
The small percent of women who rate their partner's penis size as small, also report less sexual satisfaction
is a staff family physician at the Branch Medical Clinic, Naval Weapons Station, China Lake, Calif. Dr. Clenney is a graduate of the University of South Florida College of Medicine, Tampa.
Are you experiencing a lot of stress?
Men usually experience erectile dysfunction more than three years before coronary heart disease rears it head. Diabetes, erectile dysfunction, and heart disease are all related to damage of the blood vessels caused by high blood sugar levels. Men should be aware that if the blood flow required for maintaining an erection isn't happening, this could mean even more severe consequences for the heart.
Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are medicines prescribed for erection difficulties caused by either physical or psychological problems. The drugs work only when the man is sexually aroused. The effect is usually seen within 15 - 45 minutes.
The experiments described thus far demonstrate the ability of PDE5 inhibition to prime/augment antitumor immunity. Yet the mechanisms resulting in T cell activation are unknown. Because PDE5 is expressed in various cells of the immune system (including DCs, macrophages, and T cells ), PDE5 inhibitors could putatively target these various populations. Furthermore, numerous factors are present in tumor-bearing hosts that could impair the generation of an effective immune response such as the defective maturation of DCs (7), the accumulation of suppressive MDSCs (4), T cell anergy (27), and/or the accumulation of T reg cells (28). These populations were, therefore, examined separately. Flow cytometric analysis of sildenafil-treated or untreated mice failed to reveal important differences in DC maturation, CD4+Foxp3+ T reg cells, or CD11b+/Gr-1+ MDSC accumulation (unpublished). We evaluated the effect of in vitro PDE5 inhibition on purified CD11c+, CD11b+, CD4+, and CD8+ cells isolated from C26GM tumor-bearing mice. This enabled us to examine purified populations, thereby eliminating the potential for exogenous influences. Although sildenafil treatment increased the intracellular concentration of cGMP in all the populations examined (Fig. 5 A), it had no effect on the proliferation of purified CD4+ and CD8+ T cells stimulated with either ConA (Fig. 5 B) or anti-CD3/CD28 beads (Fig. S5, available at http://www.jem.org/cgi/content/full/jem.20061104/DC1), nor on CD11c maturation (Fig. 5 C) as determined by B7.2 or MHC class II up-regulation. It did, however, demonstrate the ability to reverse the suppressive phenotype of MDSCs. In light of recent data identifying IL-4R as a functional suppressive marker for MDSCs (29), we examined IL-4R expression on CD11b+ cells cultured in the presence or absence of sildenafil. Fig. 5 D shows that sildenafil significantly decreases IL-4R expression on MDSCs, suggesting a down-regulation of their suppressive pathways.
Patient history A diagnosis of erectile dysfunction is made in men who have repeated inability to achieve and/or maintain an erection for satisfactory sexual performance for at least 3 months. Candid communication between the patient and the doctor is important in establishing the diagnosis of erectile dysfunction, assessing its severity, and determining the cause. During patient interviews, doctors try to answer the following questions:
The experimental drug bremelanotide (formerly PT-141) does not act on the vascular system like the former compounds but allegedly increases sexual desire and drive in males as well as females. It is applied as a nasal spray. Bremelanotide allegedly works by activating melanocortin receptors in the brain. It is currently in Phase IIb trials.
ViagraŽ dosages are usually 25mg to 100mg (50mg doses being the average), taken up to one hour before sexual intercourse. These dosages have produced side effects such as headache, flushing and dyspepsia. There have been some reports of disturbances, dizziness, and nasal congestion. Other rarer adverse effects reported include diarrhea, muscle pain, skin rashes, and urinary or respiratory-tract infection. (2)
Sildenafil is used for the treatment of erectile dysfunction of either physical or psychological cause. It has been found to be effective in treating erectile dysfunction in men with coronary artery disease, diabetes mellitus, hypertension, depression, coronary artery bypass surgery, and men who are taking antidepressants and several classes of anti-hypertensives.
The researchers, led by Constance Bacon, a former post-doctoral fellow at HSPH, and Eric Rimm , associate professor of epidemiology and nutrition at HSPH, surveyed 22,086 healthy subjects between the ages of 40 and 75 from the Health Professionals Follow-up Study who reported good or very good erectile function and no major chronic disease before 1986. Among the participants, 17.7 percent (3,905) reported new onset of ED between 1986 and 2000. The researchers adjusted the results to take into account those with and without prostate cancer during the follow-up period, since prostate cancer treatments, such as radiation or surgery, may lead to ED.
Often there can be a psychological or relational problem. Psychological impotence is where erection or penetration fails due to thoughts or feelings (psychological reasons) rather than physical impossibility; this can often be helped. Notably in psychological impotence, there is a strong response to placebo treatment. Erectile dysfunction, tied closely as it is to cultural notions of potency, success and masculinity, can have severe psychological consequences.
Erectile dysfunction. This inflatable penile prosthesis has 3 major components. The 2 cylinders are placed within the corpora cavernosa, a reservoir is placed beneath the rectus muscle, and the pump is placed in the scrotum. When the pump is squeezed, fluid from the reservoir is transferred into the 2 cylinders, producing a firm erection. Squeezing the top of the pump causes a reversal of flow of the fluid from the cylinders back into the reservoir.
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