CHIEF COMPLAINT: Shortness of breath

PRESENT ILLNESS: 52 y/o M with PMHx of CHF (EF 20%), crack pneumonitis, COPD,
HTN, HLD, HCV, who is presenting with shortness of breath.
Reports that shortness of breath began 2-3 days ago and is worse
with exertion. Also endorses some intermittent orthopnea. During
this time, he has had a cough productive of white frothy sputum.
Endorses pleuritic chest pain but no heart palpitations.
Endorses chills, but no fevers or night sweats. No worsened LE
edema. He also endorses some nausea, heart palpitations,
lightheadedness, and headaches. He has had some sick contacts
recently.

MEDICAL HISTORY: Crack pneumonitis
Type I Diabetes
Hyperlipidemia
HTN
Nonischemic dilated cardiomyopathy (EF 20% [**2-/2196**])
mild to moderate MR
moderate pHTN
Hepatitis C antibody positive
MRSA pneumonia (requiring trach)
COPD
Substance abuse (cocaine)
Tobacco abuse
Schizophrenia

MEDICATION ON ADMISSION: ALBUTEROL SULFATE - 2.5 mg/3 mL (0.083 %) Solution for
Nebulization - 1 Solution(s) inhaled every six (6) hours
ALBUTEROL SULFATE [PROAIR HFA] - 90 mcg HFA Aerosol Inhaler -
[**12-21**]
puffs inhaled q4-6h as needed for shortness of breath, wheezing.

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Admission:
PHYSICAL EXAM:
VS - Temp 98.3 F, BP 110/60, HR 100, RR 18, O2-sat 94%4L
GENERAL - Alert, interactive, mildly dyspneic
HEENT - EOMI, sclerae anicteric, MMM, OP clear
NECK - Supple, JVP ~9cm
HEART - RRR, nl S1-S2, no MRG
LUNGS - faint diffuse crackles R>L, mildly labored respirations

FAMILY HISTORY: Father: pacemaker, deceased.  No family history of pulmonary
disease.

SOCIAL HISTORY: - history of multiple incarcerations (>6 months in [**2193**])
- lives with sister and [**Name2 (NI) 802**].  Collects disability for
shizophrenia.
- walks w/ cane due to right sided foot drop
- Tobacco history: current smoker, a few cig per day [**12-21**]
- ETOH: 2-3 beers three times per week
- Illicit drugs: last IVDU [**2166**], last crack cocaine [**2196-3-24**].
Used MJ [**2196-4-9**].
Acute on chronic systolic heart failure,Other primary cardiomyopathies,Schizophrenic disorders, residual type, chronic,Chronic airway obstruction, not elsewhere classified,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Long-term (current) use of insulin,Carrier or suspected carrier of Methicillin resistant Staphylococcus aureus,Tobacco use disorder,Other acquired deformities of ankle and foot,Other chronic pulmonary heart diseases,Chronic hepatitis C without mention of hepatic coma
Ac on chr syst hrt fail,Prim cardiomyopathy NEC,Schizophr dis resid-chr,Chr airway obstruct NEC,Hypertension NOS,Hyperlipidemia NEC/NOS,DMII wo cmp nt st uncntr,Long-term use of insulin,Meth resis Staph carrier,Tobacco use disorder,Acq ankle-foot def NEC,Chr pulmon heart dis NEC,Chrnc hpt C wo hpat coma
Admission Date:  [**2196-4-11**]              Discharge Date:   [**2196-4-15**]

Date of Birth:  [**2143-6-4**]             Sex:   M

Service: MEDICINE

Allergies:
No Known Allergies / Adverse Drug Reactions

Attending:[**First Name3 (LF) 1943**]
Chief Complaint:
Shortness of breath

Major Surgical or Invasive Procedure:
None

History of Present Illness:
52 y/o M with PMHx of CHF (EF 20%), crack pneumonitis, COPD,
HTN, HLD, HCV, who is presenting with shortness of breath.
Reports that shortness of breath began 2-3 days ago and is worse
with exertion. Also endorses some intermittent orthopnea. During
this time, he has had a cough productive of white frothy sputum.
Endorses pleuritic chest pain but no heart palpitations.
Endorses chills, but no fevers or night sweats. No worsened LE
edema. He also endorses some nausea, heart palpitations,
lightheadedness, and headaches. He has had some sick contacts
recently.

In the ED, initial VS: 98.5 108 105/72 22. [**Name8 (MD) **] RN report, he was
tachypneic with an SaO2 of 88% on RA, 2LNC placed and SaO2
increased to 95%. Labs significant for BNP of 4905 (up from
prior values), Tn 0.03. CXR showed diffuse airspace opacities
c/w infection. EKG was c/w prior. He was given
vanc/levofloxacin, duonebs, 500 cc IVFs. Bedside echo by ED
reportedly showed no effusion, "plump" RV with no focal WMAs. VS
prior to transfer 98.4 70 25 102/54 97%2L.
On arrival to the floor, the patient reported that his breathing
was much improved.
Of note, pt was recently admitted with dyspnea in 3/[**2195**]. At
that time, it was felt that his symptoms were likely related to
fluid overload and hypersensitivity pneumonitis [**1-21**] crack
cocaine. He was diureses, his carvedilol was increased, and he
was started on a prednisone taper.

REVIEW OF SYSTEMS:
Denies fever, night sweats, rhinorrhea, congestion, sore throat,
abdominal pain, vomiting, diarrhea, constipation, BRBPR, melena,
hematochezia, dysuria, hematuria.

Past Medical History:
Crack pneumonitis
Type I Diabetes
Hyperlipidemia
HTN
Nonischemic dilated cardiomyopathy (EF 20% [**2-/2196**])
mild to moderate MR
moderate pHTN
Hepatitis C antibody positive
MRSA pneumonia (requiring trach)
COPD
Substance abuse (cocaine)
Tobacco abuse
Schizophrenia

Social History:
- history of multiple incarcerations (>6 months in [**2193**])
- lives with sister and [**Name2 (NI) 802**].  Collects disability for
shizophrenia.
- walks w/ cane due to right sided foot drop
- Tobacco history: current smoker, a few cig per day [**12-21**]
- ETOH: 2-3 beers three times per week
- Illicit drugs: last IVDU [**2166**], last crack cocaine [**2196-3-24**].
Used MJ [**2196-4-9**].

Family History:
Father: pacemaker, deceased.  No family history of pulmonary
disease.

Physical Exam:
Admission:
PHYSICAL EXAM:
VS - Temp 98.3 F, BP 110/60, HR 100, RR 18, O2-sat 94%4L
GENERAL - Alert, interactive, mildly dyspneic
HEENT - EOMI, sclerae anicteric, MMM, OP clear
NECK - Supple, JVP ~9cm
HEART - RRR, nl S1-S2, no MRG
LUNGS - faint diffuse crackles R>L, mildly labored respirations

ABDOMEN - NABS, soft/NT/ND, no masses or HSM
EXTREMITIES - WWP, edema R>L (baseline per pt), no calf
tenderness
NEURO - awake, A&Ox3, nonfocal

Discharge:
Weight: 193 Lbs.
Vitals: 98.5, BP 98/56, HR 94, 95 RA rr 20.
GENERAL - Alert, interactive, breathing slightly labored.
HEENT - EOMI, sclerae muddy but anicteric, MMM, OP clear
NECK - Supple, No JVD
HEART - tachycardic, nl S1-S2, no MRG
LUNGS - distant breath sounds throughout.  No wheezes or
crackles appreciated.
ABDOMEN - NABS, soft/NT/ND, no masses or HSM
EXTREMITIES - WWP, no lower extremity edema ,2+ pulses
NEURO - awake, A&Ox3, nonfocal

Pertinent Results:
I) ADMISSION LABORATORY DATA

[**2196-4-11**] 01:20AM [**Month/Day/Year 3143**] WBC-9.4 RBC-4.22* Hgb-11.2* Hct-37.2*
MCV-88 MCH-26.5* MCHC-30.0* RDW-16.7* Plt Ct-182

[**2196-4-11**] 09:10AM [**Month/Day/Year 3143**] PT-12.4 PTT-37.4* INR(PT)-1.1

[**2196-4-11**] 01:20AM [**Month/Day/Year 3143**] Glucose-69* UreaN-17 Creat-1.0 Na-142
K-3.9 Cl-107 HCO3-23 AnGap-16

[**2196-4-11**] 01:20AM [**Month/Day/Year 3143**] proBNP-4905*

[**2196-4-11**] 01:20AM [**Month/Day/Year 3143**] cTropnT-0.03*
[**2196-4-11**] 09:10AM [**Month/Day/Year 3143**] CK-MB-6 cTropnT-0.04*
[**2196-4-11**] 01:30PM [**Month/Day/Year 3143**] CK-MB-5 cTropnT-0.04*

[**2196-4-11**] 09:10AM [**Month/Day/Year 3143**] Calcium-8.7 Phos-2.8 Mg-1.7

[**2196-4-11**] 01:29AM [**Month/Day/Year 3143**] Lactate-1.2

II) Microbiology:

--HCV VIRAL LOAD (Final [**2196-4-15**]): 7,331,998 IU/mL.

 --Legionella Urinary Antigen  (Final [**2196-4-12**]): Negative


III) IMAGING:
Chest XRAY:
FINDINGS:

Frontal and lateral views of the chest demonstrate low lung
volumes. Diffuse bilateral consolidate opacities with have
recurred since prior exam, but are in different distribution.
There is no pleural effusion or pneumothorax.
Hilar and mediastinal silhouettes are unremarkable. Heart size
is top normal.

IMPRESSION:
Diffuse bilateral consolidative opacities have recurred in
different
distribution since prior exams, likely due to interval
environmental
exposures.

IV) Discharge Labs:

[**2196-4-15**] 06:50AM [**Month/Day/Year 3143**] WBC-5.9 RBC-4.19* Hgb-11.0* Hct-35.3*
MCV-84 MCH-26.3* MCHC-31.3 RDW-15.6* Plt Ct-259

[**2196-4-15**] 06:50AM [**Month/Day/Year 3143**] Glucose-101* UreaN-21* Creat-0.9 Na-142
K-3.7 Cl-103 HCO3-32 AnGap-11

[**2196-4-13**] 07:35AM [**Month/Day/Year 3143**] ALT-53* AST-18 AlkPhos-78 TotBili-0.2

[**2196-4-15**] 06:50AM [**Month/Day/Year 3143**] Calcium-9.5 Phos-4.3 Mg-2.0

V) PENDING AT DISCHARGE:
[**Month/Day/Year 3143**] CULTURES [**2196-4-11**]: Pending

Brief Hospital Course:
52 year old man with schizophrenia, multiple admissions for
inhaled freebase-cocaine pneumonitis, non-ischemic dilated
cardiomyopathy with left ventricular ejection fraction of 20%
who presented in the setting of volume overload secondary to
dietary indiscretions and was admitted for treatment of acute on
chronic systolic congestive heart failure.

# Acute on chronic systolic heart failure with a LVEF of 20%:
Upon arrival to the floor ~8am [**2196-4-11**], Mr. [**Known lastname 10794**] was in florid
heart failure. He had 2+ lower extremity edema. His JVD was
elevated to the angle of the mandible. He his respiratory rate
was in the low 30's, heavily labored with a saturation of 94% on
5L facemask. His pulmonary exam notable for diffuse inspiratory
rales. His BNP was elevated to 5000. He was given IV lasix 40mg
after which he made approximately 2L of urine. He was
re-evaluated two hours later and his clinically he appeared to
be as volume overloaded as before. He was given 80mg of IV lasix
and he made another 3L of urine. Despite brisk diureisis, his
respirations were labored with respiratory rates in the 30s and
oxygen saturation in the 90's on 6L facemask. At that time, he
noted left sided chest cramps. An EKG was performed which showed
no dynamic changes concerning for ischemia. His cardiac enzymes
were negative. Due to concern for impending respiratory failure
secondary to volume overload, he was transferred to the medical
ICU for overnight monitoring. In the ICU he received additional
lasix, but did not require mechanical ventilation. The following
day, the patient returned to the floor breathing comfortably on
4L NC. He was actively diuresed with IV lasix to 193 lbs from an
admission weight of 201 lbs. He responded very well to the
diuretics and upon discharge had an ambulatory saturation in the
mid 90's on room air, no JVD, and no lower extremity edema. Of
note during diuresis his carvedilol was decreased to 3.125mg [**Hospital1 **]
from 12.5mg [**Hospital1 **] secondary to [**Hospital1 **] pressures in the high 90s.
The patient
was counseled extensively on the importance of a low sodium diet
after the patient admitted to eating foods high in salt like
ramen and BBQ.

Chronic Issues:

#Chronic obstructive pulmonary disease:
Pulmonary function testing from 4 months ago show that Mr. [**Known lastname 10794**]
has an FEV1 ~50% predicted and a FVC ~65% predicted. These
values are suggestive of both a component of restrictive and
obstructive lung disease. Given his previous admissions for
respiratory failure induced by pneumonia and crack-cocaine
pneumonitis combined with his chest xray which showed diffuse
infiltrates concerning for possible pneumonia. The patient was
treated empirically with antibiotics and steroids upon initial
presentation. Given his dramatic improvement with lasix and no
signs of underlying infection (no leukocytosis, left shift) and
no signs of an acute COPD flare, his steroids and antibiotics
were discontinued on hospital day two with no adverse affect. No
changes were made to his outpatient COPD treatment.

# Diabetes Mellitus: The patient was maintained on his
outpatient regimen of [**Hospital1 **] lantus with a sliding scale with [**Hospital1 **]
sugars ranging in the 160s to low 200s.

# HCV: Given his history of HCV, his LFT's were checked upon
admission and were found to be moderately elevated. His viral
load was found to be 7 million copies. He is currently being
followed as an outpatient by Dr. [**Last Name (STitle) **]. Given his
cardiopulmonary status he is not currently a candidate for IFN
per OMR note.

Medication Changes:
Lasix INCREASED to 40mg PO BID.
Carvedilol decreased to 3.25mg [**Hospital1 **].

Transitional Issues:
1. Close monitoring of volume status and titration of lasix
dosing.
2. Encourage enrollment in cardiopulmonary rehabilitation.
3. Follow up with liver center in 3 months with Dr. [**Last Name (STitle) **] for
hep c management.
4. Consider ICD placement for prevention of SCD with Dr. [**Last Name (STitle) **].
5. Follow up pending [**Last Name (STitle) **] cultures.

Medications on Admission:
ALBUTEROL SULFATE - 2.5 mg/3 mL (0.083 %) Solution for
Nebulization - 1 Solution(s) inhaled every six (6) hours
ALBUTEROL SULFATE [PROAIR HFA] - 90 mcg HFA Aerosol Inhaler -
[**12-21**]
puffs inhaled q4-6h as needed for shortness of breath, wheezing.

ATORVASTATIN [LIPITOR] - 20 mg Tablet - 1 Tablet(s) by mouth hs
-
No Substitution
CARVEDILOL - (Prescribed by Other Provider) - 12.5 mg Tablet - 1

Tablet(s) by mouth twice a day
FLUTICASONE-SALMETEROL [ADVAIR DISKUS] - 250 mcg-50 mcg/Dose
Disk
with Device - 1 puff inhaled twice a day
FUROSEMIDE - 40 mg Tablet - 1 (One) Tablet(s) by mouth daily
INSULIN ASPART [NOVOLOG] - 100 unit/mL Solution - As directed
per
sliding scale tid with meals
INSULIN GLARGINE [LANTUS] - (Prescribed by Other Provider; Dose

adjustment - no new Rx) - 100 unit/mL Solution - 50 units twice
a
day (***states he's currently using 40 units in AM, 50 units in
PM)
IPRATROPIUM BROMIDE - 0.2 mg/mL (0.02 %) Solution - 1
Solution(s) inhaled every six (6) hours as needed for wheeze
IPRATROPIUM BROMIDE [ATROVENT HFA] - 17 mcg/Actuation HFA
Aerosol
Inhaler - 1-2 puffs inhaled every six (6) hours as needed for
shortness of breath, wheezing
LISINOPRIL - (Dose adjustment - no new Rx) - 5 mg Tablet - 1
Tablet(s) by mouth once a day
OMEPRAZOLE - 20 mg Capsule, Delayed Release(E.C.) - 1 Capsule(s)

by mouth twice a day
QUETIAPINE [SEROQUEL] - 100 mg Tablet - 1/2-1 Tablet(s) by mouth

hs
TRAMADOL - 50 mg Tablet - 1 Tablet(s) by mouth twice a day as
needed for severe pain only

Discharge Medications:
1. albuterol sulfate 2.5 mg /3 mL (0.083 %) Solution for
Nebulization Sig: One (1) solution
solution Inhalation Q6H (every 6 hours) as needed for shortness
of breath or wheezing.
2. albuterol sulfate 90 mcg/actuation HFA Aerosol Inhaler Sig:
[**12-21**] puff Inhalation every 4-6 hours as needed for shortness of
breath or wheezing.
3. atorvastatin 20 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
4. fluticasone-salmeterol 250-50 mcg/dose Disk with Device Sig:
One (1) Disk with Device Inhalation [**Hospital1 **] (2 times a day).
5. Novolog 100 unit/mL Solution Sig: As directed unit
Subcutaneous TID w/meals : Per home sliding scale .
6. Lantus 100 unit/mL Solution Sig: Fifty (50) units
Subcutaneous at bedtime.
7. ipratropium bromide 0.02 % Solution Sig: One (1) solution
Inhalation Q6H (every 6 hours) as needed for shortness of breath
or wheezing.
8. lisinopril 5 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

9. omeprazole 20 mg Capsule, Delayed Release(E.C.) Sig: One (1)
Capsule, Delayed Release(E.C.) PO BID (2 times a day).
10. quetiapine 50 mg Tablet Sig: One (1) Tablet PO HS (at
bedtime).
11. aspirin 81 mg Tablet, Chewable Sig: One (1) Tablet, Chewable
PO DAILY (Daily).
12. tramadol 50 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed for pain.
13. ferrous sulfate 300  mg (60 mg iron) Tablet Sig: One (1)
Tablet PO BID (2 times a day).
14. Lasix 40 mg Tablet Sig: One (1) Tablet PO twice a day.
Disp:*60 Tablet(s)* Refills:*2*
15. Lantus 100 unit/mL Solution Sig: Forty (40) units
Subcutaneous qAM.
16. ipratropium bromide 17 mcg/actuation HFA Aerosol Inhaler
Sig: 1-2 puffs Inhalation every six (6) hours as needed for
shortness of breath or wheezing.
17. carvedilol 3.125 mg Tablet Sig: One (1) Tablet PO twice a
day.
Disp:*60 Tablet(s)* Refills:*2*

Discharge Disposition:
Home

Discharge Diagnosis:
Primary Diagnosis:
- Acute on chronic systolic heart failure - left ventricular
ejection fraction of 20%.

Secondary Diagnosis:
- Chronic obstructive pulmonary disease
- Insulin dependent diabetes mellitus

Discharge Condition:
Mental Status: Clear and coherent.
Level of Consciousness: Alert and interactive.
Activity Status: Ambulatory - Independent.s

Discharge Instructions:
Mr. [**Known lastname 10794**],
You were admitted to [**Hospital1 69**]
because of difficulty breathing.  This is because you were
retaining too much fluid, most likely because of salt intake.
We gave you diuretics to help you get ride of some of these
fluids.  When you go home, you will be on a slightly increased
dose of lasix.  It will be very important to watch your diet and
your salt intake.  Please weigh yourself daily.  If you find
that you have gained more than 3 lbs, please call your doctor.

The following medications have changed:
- Please INCREASE your Lasix to 40 mg twice a day
- Please DECREASE your Carvedilol to 3.125 mg twice a day

The rest of your medications have not changed.  Please continue
to take them as originally prescribed

Followup Instructions:
Department: [**Hospital 7975**] [**Hospital **] HEALTH CENTER
When: MONDAY [**2196-4-18**] at 9:45 AM
With: [**Name6 (MD) **] [**Last Name (NamePattern4) 8268**], MD [**Telephone/Fax (1) 7976**]
Building: [**Hospital1 7977**] ([**Location (un) 686**], MA) [**Location (un) **]
Campus: OFF CAMPUS     Best Parking: Free Parking on Site
***At this appt, please discuss if its still necessary to see Dr
[**First Name (STitle) 31365**] on [**4-20**] as well

Department: [**Hospital1 7975**] INTERNAL MEDICINE
When: WEDNESDAY [**2196-4-20**] at 3:00 PM
With: [**First Name11 (Name Pattern1) **] [**Last Name (NamePattern4) 63642**], MD [**Telephone/Fax (1) 7976**]
Building: [**Hospital1 7977**] ([**Location (un) 686**], MA) [**Location (un) **]
Campus: OFF CAMPUS     Best Parking: Free Parking on Site
{'Acute on chronic systolic heart failure,Other primary cardiomyopathies,Schizophrenic disorders, residual type, chronic,Chronic airway obstruction, not elsewhere classified,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Long-term (current) use of insulin,Carrier or suspected carrier of Methicillin resistant Staphylococcus aureus,Tobacco use disorder,Other acquired deformities of ankle and foot,Other chronic pulmonary heart diseases,Chronic hepatitis C without mention of hepatic coma'}


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: Shortness of breath

PRESENT ILLNESS: 52 y/o M with PMHx of CHF (EF 20%), crack pneumonitis, COPD,
HTN, HLD, HCV, who is presenting with shortness of breath.
Reports that shortness of breath began 2-3 days ago and is worse
with exertion. Also endorses some intermittent orthopnea. During
this time, he has had a cough productive of white frothy sputum.
Endorses pleuritic chest pain but no heart palpitations.
Endorses chills, but no fevers or night sweats. No worsened LE
edema. He also endorses some nausea, heart palpitations,
lightheadedness, and headaches. He has had some sick contacts
recently.

MEDICAL HISTORY: Crack pneumonitis
Type I Diabetes
Hyperlipidemia
HTN
Nonischemic dilated cardiomyopathy (EF 20% [**2-/2196**])
mild to moderate MR
moderate pHTN
Hepatitis C antibody positive
MRSA pneumonia (requiring trach)
COPD
Substance abuse (cocaine)
Tobacco abuse
Schizophrenia

MEDICATION ON ADMISSION: ALBUTEROL SULFATE - 2.5 mg/3 mL (0.083 %) Solution for
Nebulization - 1 Solution(s) inhaled every six (6) hours
ALBUTEROL SULFATE [PROAIR HFA] - 90 mcg HFA Aerosol Inhaler -
[**12-21**]
puffs inhaled q4-6h as needed for shortness of breath, wheezing.

ALLERGIES: No Known Allergies / Adverse Drug Reactions

PHYSICAL EXAM: Admission:
PHYSICAL EXAM:
VS - Temp 98.3 F, BP 110/60, HR 100, RR 18, O2-sat 94%4L
GENERAL - Alert, interactive, mildly dyspneic
HEENT - EOMI, sclerae anicteric, MMM, OP clear
NECK - Supple, JVP ~9cm
HEART - RRR, nl S1-S2, no MRG
LUNGS - faint diffuse crackles R>L, mildly labored respirations

FAMILY HISTORY: Father: pacemaker, deceased.  No family history of pulmonary
disease.

SOCIAL HISTORY: - history of multiple incarcerations (>6 months in [**2193**])
- lives with sister and [**Name2 (NI) 802**].  Collects disability for
shizophrenia.
- walks w/ cane due to right sided foot drop
- Tobacco history: current smoker, a few cig per day [**12-21**]
- ETOH: 2-3 beers three times per week
- Illicit drugs: last IVDU [**2166**], last crack cocaine [**2196-3-24**].
Used MJ [**2196-4-9**]. 

### Response:
{'Acute on chronic systolic heart failure,Other primary cardiomyopathies,Schizophrenic disorders, residual type, chronic,Chronic airway obstruction, not elsewhere classified,Unspecified essential hypertension,Other and unspecified hyperlipidemia,Diabetes mellitus without mention of complication, type II or unspecified type, not stated as uncontrolled,Long-term (current) use of insulin,Carrier or suspected carrier of Methicillin resistant Staphylococcus aureus,Tobacco use disorder,Other acquired deformities of ankle and foot,Other chronic pulmonary heart diseases,Chronic hepatitis C without mention of hepatic coma'}
