CHIEF COMPLAINT: 

PRESENT ILLNESS: Baby [**Name (NI) **] [**Known lastname **] [**Known lastname 74435**] is the
former 2.345 kg product of a 34 and [**3-15**] week gestation
pregnancy born to a 34 year-old, G2, P1 now 2 woman. Prenatal
screens:  Blood type AB positive, antibody negative, Rubella
immune, RPR nonreactive.  Hepatitis B surface antigen
negative.  Group beta strep status unknown. Mother's
obstetrical history was notable for a Cesarean section at 36
weeks due to breech presentation. This pregnancy was
uncomplicated. She presented in preterm labor and was taken
to elective repeat Cesarean section.  This infant emerged
with spontaneous respirations, required blow-by oxygen, in
the delivery room had Apgars of 8 at 1 minute and 8 at 5
minutes.  He was admitted to the NICU for treatment of
prematurity. The intrapartum sepsis risk factors were a
temperature of 99.6 degrees Fahrenheit.  Rupture of membranes
occurred at delivery. There was no intrapartum antibiotic
treatment.  The infant had a prenatal amniocentesis performed
showing chromosomes of 46XY.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Transitory tachypnea of newborn,Meconium obstruction in fetus or newborn,Undescended testis,Routine or ritual circumcision,Need for prophylactic vaccination and inoculation against viral hepatitis,Observation for suspected infectious condition
NB transitory tachypnea,Meconium obstruction,Undescended testis,Routine circumcision,Need prphyl vc vrl hepat,NB obsrv suspct infect
Admission Date: [**2147-11-8**]        Discharge Date: [**2147-11-26**]

Date of Birth:  [**2147-11-8**]        Sex:  M

Service:  NBB


HISTORY OF PRESENT ILLNESS:  Baby [**Name (NI) **] [**Known lastname **] [**Known lastname 74435**] is the
former 2.345 kg product of a 34 and [**3-15**] week gestation
pregnancy born to a 34 year-old, G2, P1 now 2 woman. Prenatal
screens:  Blood type AB positive, antibody negative, Rubella
immune, RPR nonreactive.  Hepatitis B surface antigen
negative.  Group beta strep status unknown. Mother's
obstetrical history was notable for a Cesarean section at 36
weeks due to breech presentation. This pregnancy was
uncomplicated. She presented in preterm labor and was taken
to elective repeat Cesarean section.  This infant emerged
with spontaneous respirations, required blow-by oxygen, in
the delivery room had Apgars of 8 at 1 minute and 8 at 5
minutes.  He was admitted to the NICU for treatment of
prematurity. The intrapartum sepsis risk factors were a
temperature of 99.6 degrees Fahrenheit.  Rupture of membranes
occurred at delivery. There was no intrapartum antibiotic
treatment.  The infant had a prenatal amniocentesis performed
showing chromosomes of 46XY.

PHYSICAL EXAMINATION:  Upon admission to the Neonatal
Intensive Care Unit, anthropometric measurements revealed a
weight of 2.345 kg, length 44 cm, head circumference 32 cm,
all 50th percentile for gestational age. Physical examination
upon discharge:  Weight 2.765 kg.  Length 48 cm, head
circumference 33 cm.  General:  Alert, active infant in room
air. Skin warm and dry. Color pink.  Diaper rash.  Head,
eyes, ears, nose and throat: Anterior fontanel open and flat.
Sutures apposed. Positive red reflex bilaterally. Neck
supple. Chest: Breath sounds clear and equal, easy
respirations.  Cardiovascular:  Regular rate and rhythm, no
murmur.  Normal S1 and S2. Femoral pulses +2.  Abdomen soft,
nontender, nondistended.  No masses.  Cord on and drying.
Genitourinary:  Normal male phallus. Testes palpable
bilaterally, high in the canal. Patent anus.
Musculoskeletal:  Spine straight, normal sacrum. Hips stable.
Moves all extremities.  Neuro:  Alert, nonfocal, symmetric
tone and reflexes.

HOSPITAL COURSE BY SYSTEMS INCLUDING PERTINENT LABORATORY
DATA:  System 1:  Respiratory.  This infant required
treatment with oxygen and continuous positive airway
pressure. After admission to the NICU, a chest x-ray was
remarkable for 9 rib expansion, some streaking perihilar
densities, consistent with transient tachypnea of the
newborn. He was able to wean off of C-pap to room air by day
of life. He continued in room air for the rest of his
Neonatal Intensive Care Unit admission. He did not have any
episodes of spontaneous apnea and bradycardia.  At the time
of discharge, he is breathing comfortably in room air with a
respiratory rate of 40 to 60 breaths per minute with oxygen
saturations greater than 97%.

System 2:  Cardiovascular:  This infant has maintained normal
heart rates and blood pressures. A soft intermittent murmur
was noted during admission but was not audible at the time of
discharge. Baseline heart rate is 140 to 160 beats per minute
with a recent blood pressure of 72/31 mmHg, mean arterial
pressure of 46 mmHg.

System 3:  Fluids, electrolytes and nutrition.  The infant
was initially n.p.o. and maintained on IV fluids.  Enteral
feeds were started on day of life one.  On day of life 2, he
was noted to have thick, bilious green aspirate with
abdominal distention and an abdominal x-ray showing dilated
bowel loops. He was transferred to [**Hospital3 1810**] where
he underwent upper gastrointestinal and enema studies. These
were normal and he was returned to the [**Hospital1 **]
Hospital and feedings were resumed. He has tolerated feedings
well since that time.  At the time of discharge, he is taking
a minimum of 130 mm/kg per day of Enfamil 24 calorie per
ounce formula all by mouth.  Weight on the day of discharge
is 2.765 kg.  Serum electrolytes were sent 3 times in the
first week of life and were all within normal limits.

System 4:  Infectious disease.  Due to the unknown etiology
of preterm labor and unknown group beta strep status of his
mother, this infant was evaluated for sepsis upon admission
to the Neonatal Intensive Care Unit.  A white blood cell
count and differential were within normal limits.  A blood
culture was obtained prior to starting IV ampicillin and
gentamycin. The blood culture was no growth at 48 hours and
the antibiotics were discontinued.

System 5:  Hematological.  Hematocrit at birth was 49.4%.
This infant did not receive any transfusions of blood
products.

System 6:  Gastrointestinal.  As previously mentioned, this
infant had upper gastrointestinal and enema contrast studies
done at [**Hospital3 1810**]. Both studies were within normal
limits.  The infant had not passed stool prior to the enema
but has maintained normal stooling patterns since that time.
Enteral feeds have been well tolerated.  The peak serum
bilirubin was noted on day of life #5, total of 11.2 mg/dl.
A recheck level on [**2147-11-15**] was 9 mg/dl.  He did not require
any treatment.  This infant will require follow-up with
pediatric surgery 2 to 3 weeks after discharge.

System 7:  Endocrine. This infant was noted to have
undescended testes bilaterally upon admission to the Neonatal
Intensive Care Unit. He was evaluated by the urology team
from [**Hospital3 1810**]. An abdominal ultrasound was
performed on [**2147-11-10**] and the testes were not visualized.
At the recommendation of the consult service, a serum
testosterone level was sent and was 151 ng/dl and well above
the normal range.  During his admission, both testes have
been noted high in the canals and are undescended but
palpable at the time of discharge. This infant should follow-
up with urology consult team with the attending Dr. [**First Name4 (NamePattern1) **]
[**Last Name (NamePattern1) 64463**] 4 to 6 weeks after discharge.

System 8:  Neurology.  This infant has maintained a normal
neurologic examination and there are no neurologic concerns
at the time of discharge.

System 10:  Sensory
Audiology: Hearing screening was performed with automated
auditory brain stem responses. This infant passed in both
ears.

System 11: Psychosocial.  [**Hospital1 188**] social work has been involved with this family. The
contact social worker is [**Name (NI) 4457**] [**Name (NI) 36244**] and she can be
reached at [**Telephone/Fax (1) 8717**].

CONDITION ON DISCHARGE:  Good.

DISCHARGE DISPOSITION:  Home with the parents.

PRIMARY CARE PHYSICIAN:  [**First Name8 (NamePattern2) 40133**] [**Last Name (NamePattern1) 311**], [**Apartment Address(1) 76003**], [**Location (un) **], [**Numeric Identifier 68635**], telephone number [**Telephone/Fax (1) 76004**].

CARE AND RECOMMENDATIONS:
1. Feeding ad lib:  Enfamil 24 calorie per ounce formula
    with a minimum of 130 ml/kg per day intake.
2. No medications.
3. Iron and vitamin D supplementation:  Iron
    supplementation is recommended for preterm and low birth
    weight infants until 12 months corrected age.  All
    infants fed predominantly breast milk should receive
    Vitamin D supplementation at 200 i.u. (may be provided
    as a multi-vitamin preparation) daily until 12 months
    corrected age.
4. Car seat position screening was performed. This infant
    was evaluated in his car seat for 90 minutes without any
    episodes of desaturation or bradycardia.
5. State newborn screens were sent on [**11-11**] and [**2147-11-26**]
    with no notification of abnormal results to date.
6. Immunizations:  Hepatitis B vaccine was administered on
    [**2147-11-24**].
7. Immunizations recommended:
Synagis RSV prophylaxis should be considered from [**Month (only) **]
through [**Month (only) 958**] for infants who meet any of the following four
criteria:  (1) Born at less than 32 weeks; (2) Born between
32 weeks and 35 weeks with two of the following:  Day care
during RSV season, a smoker in the household, neuromuscular
disease, airway abnormalities or school age siblings; (3)
chronic lung disease or (4) hemodynamically significant
congenital heart disease.
Influenza immunization is recommended annually in the Fall
for all infants once they reach 6 months of age.  Before this
age, and for the first 24 months of the child's life,
immunization against influenza is recommended for household
contacts and out-of-home caregivers.
This infant has not received ROTA virus vaccine. The American
Academy of Pediatrics recommends initial vaccination of
preterm infants at or following discharge from the hospital
if they are clinically stable or at least 6 weeks but fewer
than 12 weeks of age.

FOLLOWUP:
1. Pediatric surgery with Dr. [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], 2 to 3 weeks
    after discharge.  Phone number [**Telephone/Fax (1) 76005**].
2. Pediatric urology:  Attending [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) 64463**] 4 to 6 weeks
    after discharge.  Phone number [**Telephone/Fax (1) 45268**].

DISCHARGE DIAGNOSES:
1. Prematurity at 34 and 3/7 weeks gestation.
2. Respiratory distress, consistent with transient
    tachypnea of the newborn.
3. Suspicion for sepsis ruled out.
4. Undescended testicles.
5. Suspicion for bowel obstruction ruled out.



                        [**First Name8 (NamePattern2) 73452**] [**First Name4 (NamePattern1) **] [**Last Name (NamePattern1) **], M.D. [**MD Number(2) 73453**]

Dictated By:[**Last Name (Titles) **]
MEDQUIST36
D:  [**2147-11-26**] 00:49:42
T:  [**2147-11-26**] 15:28:59
Job#:  [**Job Number 76006**]
{'Transitory tachypnea of newborn,Meconium obstruction in fetus or newborn,Undescended testis,Routine or ritual circumcision,Need for prophylactic vaccination and inoculation against viral hepatitis,Observation for suspected infectious condition'}


You are an AI assistant analyzing clinical admission notes from the MIMIC III dataset. Your task is to map symptoms mentioned in the notes to a list of provided ICD-9 LONG_TEXT.



### Clinical text :
CHIEF COMPLAINT: 

PRESENT ILLNESS: Baby [**Name (NI) **] [**Known lastname **] [**Known lastname 74435**] is the
former 2.345 kg product of a 34 and [**3-15**] week gestation
pregnancy born to a 34 year-old, G2, P1 now 2 woman. Prenatal
screens:  Blood type AB positive, antibody negative, Rubella
immune, RPR nonreactive.  Hepatitis B surface antigen
negative.  Group beta strep status unknown. Mother's
obstetrical history was notable for a Cesarean section at 36
weeks due to breech presentation. This pregnancy was
uncomplicated. She presented in preterm labor and was taken
to elective repeat Cesarean section.  This infant emerged
with spontaneous respirations, required blow-by oxygen, in
the delivery room had Apgars of 8 at 1 minute and 8 at 5
minutes.  He was admitted to the NICU for treatment of
prematurity. The intrapartum sepsis risk factors were a
temperature of 99.6 degrees Fahrenheit.  Rupture of membranes
occurred at delivery. There was no intrapartum antibiotic
treatment.  The infant had a prenatal amniocentesis performed
showing chromosomes of 46XY.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Transitory tachypnea of newborn,Meconium obstruction in fetus or newborn,Undescended testis,Routine or ritual circumcision,Need for prophylactic vaccination and inoculation against viral hepatitis,Observation for suspected infectious condition'}
