CHIEF COMPLAINT: 

PRESENT ILLNESS: [**Known lastname **] [**Known lastname 74377**] is the former
2.050 kg product of a 30 [**12-24**] week gestation, born to a 27 year-
old, G2, P0 woman. Prenatal screens:  Mat Blood type AB positive,
antibody negative, Rubella immune, RPR nonreactive, hepatitis B
surface antigen negative.  Group beta strep status unknown.
This infant was born at [**Hospital1 18**] following a pregnancy notable
for fetal ascites. He was transferred to [**Hospital3 1810**]
on the day of birth for further management of his suspected
posterior urethral valve. He was treated for respiratory
distress syndrome with surfactant. He underwent paracentesis
times two for removal of peritoneal fluid. He was transferred
to [**Hospital1 69**] to continue to
grow, pending planned surgical repair of his posterior
urethral valve.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY: 
Other specified anomalies of bladder and urethra,Respiratory distress syndrome in newborn,Mechanical complication due to urethral (indwelling) catheter,Other preterm infants, 2,000-2,499 grams,Other "heavy-for-dates" infants,Other specified conditions originating in the perinatal period,Urinary tract infection of newborn,Undiagnosed cardiac murmurs,Urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in residential institution,Need for prophylactic vaccination and inoculation against viral hepatitis
Cystourethral anom NEC,Respiratory distress syn,Malfunc urethral cath,Preterm NEC 2000-2499g,Heavy-for-date infan NEC,Perinatal condition NEC,NB urinary tract infectn,Cardiac murmurs NEC,Abn react-urinary cath,Accid in resident instit,Need prphyl vc vrl hepat
Admission Date: [**2148-6-20**]        Discharge Date: [**2148-8-6**]

Date of Birth:  [**2148-5-30**]        Sex:  M

Service:  NICU

HISTORY OF PRESENT ILLNESS:  [**Known lastname **] [**Known lastname 74377**] is the former
2.050 kg product of a 30 [**12-24**] week gestation, born to a 27 year-
old, G2, P0 woman. Prenatal screens:  Mat Blood type AB positive,
antibody negative, Rubella immune, RPR nonreactive, hepatitis B
surface antigen negative.  Group beta strep status unknown.
This infant was born at [**Hospital1 18**] following a pregnancy notable
for fetal ascites. He was transferred to [**Hospital3 1810**]
on the day of birth for further management of his suspected
posterior urethral valve. He was treated for respiratory
distress syndrome with surfactant. He underwent paracentesis
times two for removal of peritoneal fluid. He was transferred
to [**Hospital1 69**] to continue to
grow, pending planned surgical repair of his posterior
urethral valve.

HOSPITAL COURSE BY SYSTEMS:  Respiratory:  [**Known lastname **] readmitted to
[**Hospital1 18**] on nasal cannula 02 at 1 liter per minute flow. He
was able to wean gradually on his flow through the next few
weeks of his Neonatal Intensive Care Unit admission. He began
to only need oxygen with p.o. feeds and he was then in room
air full time since [**2148-8-3**]. His apnea of prematurity that has
resolved.  At the time of discharge to CHB for PUV, he is
breathing comfortably, 30 to 60 breaths per minute, maintaining
oxygen saturations greater than 94%.

Cardiovascular:  [**Known lastname **] had an initial echocardiogram performed
at [**Hospital3 1810**] showed a small PDA and PFO. His murmur
persisted during admission at [**Hospital1 18**] NICU. A repeat echocardiogram
on [**2148-7-24**] showed no PDA. Murmur thought to be flow murmur. He
has normal heart rates (140s-180s) and blood pressures (e.g.
88/42 mmHg,mean 50 mmHg.

Fluids, electrolytes and nutrition: full enteral feedings of
breast milk 28 cal or premature formula upon readm to [**Hospital1 18**]. At
the time of this preoperative dictation ([**2148-8-5**]), he is p.o.
feeding, 120 to 140 ml/kg per day of breast milk or Enfamil 26
calories per ounce. He has had clear fluids since midnight on
[**2148-8-5**], n.p.o. since [**46**]:00 on [**2148-8-5**].  Weight on [**2148-8-5**]
is 3.22 kg, L=48 cm and HC=36.5 cm.  Serum electrolytes have been
normal during this admission.

Infectious disease:  [**Known lastname **] was treated with amoxicillin
for urinary tract infection prophylaxis for his urinary
catheter. A urine culture < [**2148-7-29**] grew Klebsiella. Abx
changed to intravenous Ceftazidime and [**2148-8-6**] is day 7 of his
intravenous course. Repeat U/C during ceftazidime Rx pending
since [**2148-8-4**].

Hematologic:  No blood transfusions. His most recent Hct=28.3%
([**2148-7-29**]) ( compared to 27.4%,[**2148-7-1**]); Retic= 3.6%.

Renal:  [**Known lastname **] has had an indwelling urinary catheter to
prevent bladder distention during admission. It is thought
that [**Known lastname **] had a ureteral rupture due to his posterior
urethral valve. He has been followed by the renal service at
[**Hospital3 1810**].  His weekly BUN and creatinine have remained
within normal limits: most recent [**2148-7-19**], BUN=8 and Cr=
Parathyroid hormone level was 33 (range 15 to 65).

Genetics:  Chromosome analysis =wnl (performed at CHB) [**Hospital1 **]
Due to the constellation of findings, there is a recommendation
for genetics follow-up as an outpatient when he is older.

Neurology:  [**Known lastname **] has had 2 normal head ultrasounds on [**5-31**]
and [**2148-6-28**].  He has maintained a normal neurologic exam
during admission and there are no neurologic concerns at the
time of discharge.

Sensory:  Hearing screening= not performed.
Ophthalmology: [**2148-7-22**]: mature retinas OU. Recommended
ophthalmology follow-up is at 9 months of age.

Psychosocial:  Parents are married, recent move to
[**Location (un) 1456**]; very involved with [**Known lastname **] care.
CONDITION ON DISCHARGE to CHB for PUV repair:  Good.

DISCHARGE DISPOSITION:  Transfer to [**Hospital3 1810**] for
repair of posterior urethral valve.

PRIMARY PEDIATRICIAN:  [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 8071**], MD, [**Street Address(2) 46314**],
[**Hospital1 3597**], [**Numeric Identifier 70818**]; phone number [**Telephone/Fax (1) 43314**].

CARE AND RECOMMENDATIONS:  At discharge to CHB [**2148-8-6**]:
1. [**Known lastname **] is n.p.o. with intravenous fluids pending surgery.
2. Medications: Ceftazidime 90 mg IV q. 8 hours.
3. State newborn screens were sent on [**2148-6-20**] with all
    results within normal limits.
3. Immunizations: Hepatitis B vaccine was administered on
    [**2148-7-5**].
4. Needs hearing screen and Carseat screen.

DISCHARGE DIAGNOSES:
1. Prematurity at 30 and 1/7 weeks gestation.
2. Status post respiratory distress syndrome.
3. Status post apnea of prematurity.
4. Posterior urethral valve.
5. Status post urinary ascites.
6. Klebsiella urinary tract infection.
7. Cardiac murmur.

                        [**First Name8 (NamePattern2) 1154**] [**Last Name (NamePattern1) **], MD [**MD Number(2) 56585**]

Dictated By:[**Last Name (Titles) **]
MEDQUIST36
D:  [**2148-8-6**] 03:18:37
T:  [**2148-8-6**] 05:02:06
Job#:  [**Job Number 74378**]





Admission Date: [**2148-6-20**]        Discharge Date: [**2148-8-9**]

Date of Birth:  [**2148-5-30**]        Sex:  M

Service:  NBB


HISTORY OF PRESENT ILLNESS:  [**Known lastname **] [**Known lastname 74377**] is a former 2.050
kg product of a 30 and [**12-24**] week gestation, born to a 27 year-
old, G2, P1 woman.  Prenatal screens:  Maternal blood type is
AB positive, antibody negative, Rubella immune, RPR
nonreactive, hepatitis B surface antigen negative.  Group B
beta strep status is unknown.  This infant was born at [**Hospital1 18**]
following a pregnancy notable for fetal ascites. He was
transferred to [**Hospital3 1810**] on day of birth for
further management of a suspected posterior urethral valve.
He was treated for respiratory distress syndrome with
Surfactant.  He underwent paracentesis times two for removal
of peritoneal fluid. He was transferred to [**Hospital1 18**] to continue
to grow and pending planned surgical repair of his posterior
urethral valve.

PHYSICAL EXAMINATION:  At discharge, current weight is 3.275
kg which is 50th percentile.  His head circumference is 36.5
cm which is greater than 90th percentile and his length is 48
cm which is 25th percentile.  General appearance:  Well-
appearing PMA 40 and 2/7 weeks male infant with normal tone.
Head, eyes, ears, nose and throat demonstrates nondysmorphic
infant.  Anterior fontanel is open and soft. Normal ears,
normal nose and positive bilateral red reflex.  Chest is
symmetric.  Respiratory:  Breath sounds are equal and clear.
CV:  Soft, audible murmur.  Regular rate and rhythm.  Pulses
palpable and equal.  Capillary refill was less than 3
seconds.  Abdomen:  Soft and round, positive bowel sounds. No
hepatosplenomegaly.  Anus is patent.  Genitourinary:  Normal
male genitalia. Testes are descended bilaterally.
Extremities:  Clavicles are intact. Hips are intact. No click
and no clunk on exam.  Neuro:  Positive root, positive suck
and positive Moro reflex present.

HOSPITAL COURSE BY SYSTEMS:  Respiratory:  [**Known lastname **] was admitted
to [**Hospital1 18**] on nasal cannula 02 at 1 liter per minute flow. He
was able to wean gradually on his flow through the next few
weeks of his NICU admission. He began to only need oxygen
with p.o. feeds and he was then transitioned to room air on
[**2148-8-3**]. His apnea of prematurity has resolved and he
is breathing comfortably, 30 to 60 breaths per minute, and
maintaining his oxygen saturation greater than 94 percentile.

Cardiovascular:  Even has had initial echocardiogram
performed at [**Hospital3 1810**] which showed a small PDA and
a PFO. His murmur persisted during admission at [**Hospital1 18**] NICU.
A repeat echocardiogram on [**2148-7-24**] showed no PDA.
Murmur was thought to be a flow murmur. He has a normal heart
rate which is 140s to 180s and a blood pressure of 82/42 with
a mean of 50.

Fluids, electrolytes and nutrition:  Full enteral feeds of
breast milk 28 calories of premature formula upon readmission
to [**Hospital1 18**].  At the time of discharge, he is taking Enfamil 20
calls ad lib and his current weight is 3.275 kg with a length
of 48 cm and with a head circumference of 36.5 cm.
Serum electrolytes have been normal throughout this
admission.

Infectious disease:  [**Known lastname **] was treated with amoxicillin for
urinary tract infection. Prophylaxis for his urinary
catheter.  A urine culture on [**2148-7-29**] grew
Klebsiella.  Antibiotic was changed to intravenous
Ceftazidime on [**2148-8-6**]. He had a 7 day course of this
antibiotic.  Repeat cultures done on [**2148-8-4**] is
negative.  His Ceftazidime was discontinued on [**2148-8-7**] after a VCUG.

Hematologic:  No blood transfusion. His most recent
hematocrit is 28.3 with a retic count of 3.6% which was done
on [**2148-7-29**] and compared to 27.4% which was done on
[**2148-7-1**].

Renal:  [**Known lastname **] has had indwelling urinary catheter to prevent
bladder distention during admission. It was felt that [**Known lastname **]
had a urethral rupture due to his posterior urethral valve.
He has been followed by the renal service at [**Hospital3 18242**]. He has had weekly BUN and creatinine which has
remained normal. The most recent one was on [**2148-7-29**].
He had BUN of 3 and creatinine of 0.3.  parathyroid hormone
was done on [**2148-7-19**] which was 33 and the range is 15
to 65.  [**Known lastname **] is status post posterior urethral valve repair
on [**8-6**]. He has had a normal VCUG on [**8-7**] and his
[**Known lastname 8389**] catheter has been removed.  [**Known lastname **] is voiding on his own.

Genetics:  Chromosome analysis were within normal limits,
performed at [**Hospital3 1810**]. Due to the constellation of
findings, there is recommendation for genetic follow-up as an
outpatient when he is older.

Neurology:  [**Known lastname **] has had 3 normal head ultrasounds on [**5-31**]
and [**2148-6-28**].  He has maintained a normal neurologic
exam during admission and there are no neurologic concerns at
the time of discharge.

Sensory:  Audiology hearing screening was performed with
automatic auditory brain stem response and results are
pending.

Ophthalmology:  [**2148-7-22**] mature retina both eyes;
recommend ophthalmology follow-up is at 9 months of age.

Psychosocial:  [**Hospital1 18**] social worker is involved with family.
The contact number for the social worker can be reached at
[**Telephone/Fax (1) 8717**].  Parents are married and recently moved to
[**Location (un) 1456**] and are very involved with [**Known lastname **] care.

CONDITION ON DISCHARGE:  Good.

DISCHARGE DISPOSITION:  To home with parents.

PRIMARY PEDIATRICIAN:  [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 8071**], MD.  His address is [**Street Address(2) 74379**], [**Hospital1 3597**], [**Numeric Identifier 70818**].  Phone number is [**Telephone/Fax (1) 74380**].

CARE AND RECOMMENDATIONS:  Feeds at discharge:  Enfamil 20
calories ad lib demand.
Medications:  None at this time.
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.
Car seat position screening:  Infant has passed.
State newborn screen was sent on [**2148-6-20**] with all
results within normal limits.
Immunizations:  [**Known lastname **] has received his hepatitis B vaccine
which was administered on [**2148-7-5**].
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:  Follow-up appointment with [**First Name8 (NamePattern2) 449**] [**Last Name (NamePattern1) 8071**], MD [**First Name (Titles) **]
[**Last Name (Titles) 766**], [**8-12**].
[**Hospital1 **] nephrology, Dr. [**First Name8 (NamePattern2) **] [**Last Name (NamePattern1) **] (Fellow); parents to
schedule appt ([**Telephone/Fax (1) 50498**]).
[**Hospital1 **] urology, Dr. [**Last Name (STitle) **] on [**9-6**] at 1:30 p.m.
Phone number [**Telephone/Fax (1) 54579**].
[**Hospital1 **] genetics (nl chromosomes): parents to schedule appt
([**Telephone/Fax (1) 46938**]).

DISCHARGE DIAGNOSES:
1. Prematurity at 30 and 1/7 weeks gestation.
2. Status post respiratory distress syndrome.
3. Status post apnea of prematurity.
4. Status post posterior urethral valve repair.
5. Status post urinary ascites.
6. Status post Klebsiella urinary tract infection.
7. Cardiac murmur. [**7-24**] ECHO: no PDA.

                        [**First Name8 (NamePattern2) 1154**] [**Last Name (NamePattern1) **], MD [**MD Number(2) 56585**]

Dictated By:[**Last Name (NamePattern1) 70824**]
MEDQUIST36
D:  [**2148-8-9**] 00:01:22
T:  [**2148-8-9**] 08:55:48
Job#:  [**Job Number 74381**]
{'Other specified anomalies of bladder and urethra,Respiratory distress syndrome in newborn,Mechanical complication due to urethral (indwelling) catheter,Other preterm infants, 2,000-2,499 grams,Other "heavy-for-dates" infants,Other specified conditions originating in the perinatal period,Urinary tract infection of newborn,Undiagnosed cardiac murmurs,Urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in residential institution,Need for prophylactic vaccination and inoculation against viral hepatitis'}


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: [**Known lastname **] [**Known lastname 74377**] is the former
2.050 kg product of a 30 [**12-24**] week gestation, born to a 27 year-
old, G2, P0 woman. Prenatal screens:  Mat Blood type AB positive,
antibody negative, Rubella immune, RPR nonreactive, hepatitis B
surface antigen negative.  Group beta strep status unknown.
This infant was born at [**Hospital1 18**] following a pregnancy notable
for fetal ascites. He was transferred to [**Hospital3 1810**]
on the day of birth for further management of his suspected
posterior urethral valve. He was treated for respiratory
distress syndrome with surfactant. He underwent paracentesis
times two for removal of peritoneal fluid. He was transferred
to [**Hospital1 69**] to continue to
grow, pending planned surgical repair of his posterior
urethral valve.

MEDICAL HISTORY: 

MEDICATION ON ADMISSION: 

ALLERGIES: 

PHYSICAL EXAM: 

FAMILY HISTORY: 

SOCIAL HISTORY:  

### Response:
{'Other specified anomalies of bladder and urethra,Respiratory distress syndrome in newborn,Mechanical complication due to urethral (indwelling) catheter,Other preterm infants, 2,000-2,499 grams,Other "heavy-for-dates" infants,Other specified conditions originating in the perinatal period,Urinary tract infection of newborn,Undiagnosed cardiac murmurs,Urinary catheterization as the cause of abnormal reaction of patient, or of later complication, without mention of misadventure at time of procedure,Accidents occurring in residential institution,Need for prophylactic vaccination and inoculation against viral hepatitis'}
