CHIEF COMPLAINT: Shortness of breath and leg edema

PRESENT ILLNESS: 72 year old male with history of DM, RA, prostate cancer s/p
prostatectomy only who presents with 7 days L>R LE edema and
dyspnea on exertion.  Symptoms began insidiously, used to walk
up stairs with [**Last Name **] problem, now only [**4-21**] stairs before SOB.  Also
noted 2 days erythematous papular rash on LLE (does have hx of
asteatotic eczema of the lower extremities with stasis
dermatitis).  He is s/p left TKR (from RA) and has always had
scant edema in that leg.  He has not noticed any CP,
palpitations, cough, orthopnea, PND, hemoptysis, trauma, weight
loss.  He was recently treated with cipro for cystitis (he
self-caths s/p prostate surgery).  Per pt, normal PSA last
month.  Recieved lasix 40mg IV in the ED.  Of note, he went to a
[**Hospital 11074**] clinic 7 days ago and was found to have "water on my
lungs."  His lasix dose was doubled to 40 [**Hospital1 **] and his actos and
lisinopril were stopped.

MEDICAL HISTORY: 1.  Prostate Cancer:  Diagnosed by rapid PSA velocity.  S/P
prostatectomy.  Normal recent PSA by report.
2.  RA:  Mainly affecting bilateral shoulders.  Tried
methotrexate and vioxx in past.  Now only on tylenol.
3.  DMI:  Diagnosed 20 years ago.  Was on actos until 7 days ago
when he was told to d/c at the walk in clinic.  Now only on
insulin.

MEDICATION ON ADMISSION: 1.  lasix 40 mg [**Hospital1 **]
2.  crestor 5 daily
3.  insulin

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 97.9   66    121/33    19     98%RA
Gen:  NAD, A&0X3, non-toxic, comfortable at 20degrees
Heent: EOMI, PERRL, MMM, anicteric sclera
Neck:  No JVD or LAD
Heart:  RRR no mrg.  PMI non-displaced.
Lungs:  Clear. No wheezes or rales.
Abd:  Soft, nt/nd.  Enlarged liver to 4 finger breaths beneath
CPM, nontender.  NABS
Ext:  No c/c.  2+ L>R (slightly) peripheral edema to knees.
+Palmar erythema

FAMILY HISTORY: None for heart or liver disease.

SOCIAL HISTORY: Lives in [**Location 40609**].  Retired barber.  No bad habits X 3.  No
tatoos.  + Blood transfusion.
Acute diastolic heart failure,Septicemia due to escherichia coli [E. coli],Septic shock,Severe sepsis,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled,Acute kidney failure, unspecified,Pernicious anemia,Insulins and antidiabetic agents causing adverse effects in therapeutic use,Long-term (current) use of insulin,Rheumatoid arthritis,Personal history of malignant neoplasm of prostate,Knee joint replacement,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere
Ac diastolic hrt failure,E coli septicemia,Septic shock,Severe sepsis,Hyp kid NOS w cr kid V,DMI renl nt st uncntrld,Acute kidney failure NOS,Pernicious anemia,Adv eff insulin/antidiab,Long-term use of insulin,Rheumatoid arthritis,Hx-prostatic malignancy,Joint replaced knee,Nephritis NOS in oth dis
Admission Date:  [**2169-3-24**]              Discharge Date:   [**2169-4-3**]

Date of Birth:  [**2096-12-1**]             Sex:   M

Service: MEDICINE

Allergies:
Patient recorded as having No Known Allergies to Drugs

Attending:[**First Name3 (LF) 613**]
Chief Complaint:
Shortness of breath and leg edema

Major Surgical or Invasive Procedure:
Exercise MIBI
Cardiac catheterization
Right Subclavian Line placement


History of Present Illness:
72 year old male with history of DM, RA, prostate cancer s/p
prostatectomy only who presents with 7 days L>R LE edema and
dyspnea on exertion.  Symptoms began insidiously, used to walk
up stairs with [**Last Name **] problem, now only [**4-21**] stairs before SOB.  Also
noted 2 days erythematous papular rash on LLE (does have hx of
asteatotic eczema of the lower extremities with stasis
dermatitis).  He is s/p left TKR (from RA) and has always had
scant edema in that leg.  He has not noticed any CP,
palpitations, cough, orthopnea, PND, hemoptysis, trauma, weight
loss.  He was recently treated with cipro for cystitis (he
self-caths s/p prostate surgery).  Per pt, normal PSA last
month.  Recieved lasix 40mg IV in the ED.  Of note, he went to a
[**Hospital 11074**] clinic 7 days ago and was found to have "water on my
lungs."  His lasix dose was doubled to 40 [**Hospital1 **] and his actos and
lisinopril were stopped.


Past Medical History:
1.  Prostate Cancer:  Diagnosed by rapid PSA velocity.  S/P
prostatectomy.  Normal recent PSA by report.
2.  RA:  Mainly affecting bilateral shoulders.  Tried
methotrexate and vioxx in past.  Now only on tylenol.
3.  DMI:  Diagnosed 20 years ago.  Was on actos until 7 days ago
when he was told to d/c at the walk in clinic.  Now only on
insulin.


Social History:
Lives in [**Location 40609**].  Retired barber.  No bad habits X 3.  No
tatoos.  + Blood transfusion.


Family History:
None for heart or liver disease.

Physical Exam:
97.9   66    121/33    19     98%RA
Gen:  NAD, A&0X3, non-toxic, comfortable at 20degrees
Heent: EOMI, PERRL, MMM, anicteric sclera
Neck:  No JVD or LAD
Heart:  RRR no mrg.  PMI non-displaced.
Lungs:  Clear. No wheezes or rales.
Abd:  Soft, nt/nd.  Enlarged liver to 4 finger breaths beneath
CPM, nontender.  NABS
Ext:  No c/c.  2+ L>R (slightly) peripheral edema to knees.
+Palmar erythema


Pertinent Results:
[**2169-3-24**]
11:25a
ADDED BNP ON [**2169-3-23**] AT 12:54PM
Trop-*T*: <0.01
Comments: Ctropnt > 0.10 Ng/Ml Suggests Acute Mi
Other Blood Chemistry:
proBNP: 772
Reference Values Vary With Age, Sex, And Renal Function;At 35%
Prevalence, Ntprobnp Values; < 450 Have 99% Neg Pred Value;
>1000 Have 78% Pos Pred Value;See Online Lab Manual For More
Detailed Information
138  105  46 /     AGap=14
------------- 172
4.8  24  1.7 \
CK: 88  MB: Notdone
ALT: 13 AP: 61 Tbili: 0.3 Alb: 4.2
AST: 18 LDH: 221 Dbili: 0.1 TProt:
[**Doctor First Name **]:  Lip:
Vit-B12:214
Other Blood Chemistry:
Iron: 25
calTIBC: 293
TRF: 225

 98
6.7 \ 9.7 / 174
    / 29.4\

 N:79.7 L:12.6 M:5.4 E:2.0 Bas:0.4
Macrocy: 1+

PT: 13.0  PTT: 27.1  INR: 1.1


[**2169-4-3**] 06:05AM BLOOD WBC-7.0 RBC-3.08* Hgb-9.8* Hct-29.0*
MCV-94 MCH-31.7 MCHC-33.7 RDW-14.3 Plt Ct-150
[**2169-4-2**] 05:45AM BLOOD Neuts-83.8* Bands-0 Lymphs-10.5*
Monos-2.4 Eos-2.9 Baso-0.3
[**2169-4-3**] 06:05AM BLOOD Glucose-84 UreaN-44* Creat-1.4* Na-142
K-3.8 Cl-107 HCO3-25 AnGap-14
[**2169-4-1**] 04:37AM BLOOD ALT-17 AST-22 LD(LDH)-186 AlkPhos-44
TotBili-0.4
[**2169-4-3**] 06:05AM BLOOD Calcium-8.6 Phos-2.7 Mg-2.1
[**2169-3-25**] 06:00AM BLOOD Ferritn-255
[**2169-3-24**] 11:25AM BLOOD calTIBC-293 VitB12-214* TRF-225
[**2169-3-28**] 06:11AM BLOOD Triglyc-83 HDL-42 CHOL/HD-2.8 LDLcalc-57
[**2169-3-30**] 04:15PM BLOOD Cortsol-24.9*
[**2169-3-30**] 04:15PM BLOOD CRP-24.14*
[**2169-3-31**] 08:15PM BLOOD Type-ART Temp-37.0 pO2-104 pCO2-35
pH-7.43 calHCO3-24 Base XS-0 Intubat-NOT INTUBA
[**2169-3-29**] 04:24PM BLOOD Type-ART pO2-81* pCO2-46* pH-7.47*
calHCO3-34* Base XS-8 Intubat-NOT INTUBA

[**2169-3-30**] 8:02 pm URINE

                            **FINAL REPORT [**2169-4-3**]**

   URINE CULTURE (Final [**2169-4-3**]):
      ESCHERICHIA COLI.    >100,000 ORGANISMS/ML..
         OF TWO COLONIAL MORPHOLOGIES.  PRESUMPTIVE
IDENTIFICATION.
         Trimethoprim/sulfa sensitivity confirmed by
[**Doctor Last Name 3077**]-[**Doctor Last Name 3060**].

                              SENSITIVITIES: MIC expressed in
MCG/ML

_________________________________________________________
                             ESCHERICHIA COLI
                             |
AMPICILLIN------------  =>32 R
AMPICILLIN/SULBACTAM--    16 I
CEFAZOLIN-------------   <=4 S
CEFEPIME--------------   <=1 S
CEFTAZIDIME-----------   <=1 S
CEFTRIAXONE-----------   <=1 S
CEFUROXIME------------    16 I
CIPROFLOXACIN---------   =>4 R
GENTAMICIN------------  =>16 R
IMIPENEM--------------   <=1 S
LEVOFLOXACIN----------   =>8 R
MEROPENEM-------------<=0.25 S
NITROFURANTOIN--------  <=16 S
PIPERACILLIN----------    32 I
PIPERACILLIN/TAZO-----   <=4 S
TOBRAMYCIN------------     8 I
TRIMETHOPRIM/SULFA----  =>16 R

[**2169-3-29**] 10:00 pm BLOOD CULTURE

                            **FINAL REPORT [**2169-4-1**]**

   AEROBIC BOTTLE (Final [**2169-4-1**]):
      ESCHERICHIA COLI.
         IDENTIFICATION AND SENSITIVITIES PERFORMED ON CULTURE #
[**Numeric Identifier 40610**]
         ([**2169-3-29**]).

   ANAEROBIC BOTTLE (Final [**2169-4-1**]):
      ESCHERICHIA COLI.
         IDENTIFICATION AND SENSITIVITIES PERFORMED ON CULTURE #
[**Numeric Identifier 40610**]
         ([**2169-3-29**]).

[**2169-3-27**] Cardiology ECHO
Conclusions:
The left atrium is mildly dilated. The right atrium is
moderately dilated.
Left ventricular wall thicknesses are normal. The left
ventricular cavity size
is normal. Due to suboptimal technical quality, a focal wall
motion
abnormality cannot be fully excluded. Overall left ventricular
systolic
function is normal (LVEF 60-70%). No masses or thrombi are seen
in the left
ventricle. There is no ventricular septal defect. Right
ventricular chamber
size and free wall motion are normal. The aortic root is
moderately dilated.
The aortic arch is mildly dilated. There are focal
calcifications in the
aortic arch. The aortic valve leaflets (3) are mildly thickened
but aortic
stenosis is not present. Mild (1+) aortic regurgitation is seen.
The mitral
valve leaflets are mildly thickened. There is no mitral valve
prolapse. Mild
(1+) mitral regurgitation is seen. The estimated pulmonary
artery systolic
pressure is normal. There is no pericardial effusion.

Compared with the findings of the prior report (tape unavailable
for review)
of [**2167-11-26**], no major change is evident.

EXERCISE MIBI  [**2169-3-28**]
IMPRESSION: 1. Reversible, mild myocardial perfusion defect
involving the
inferolateral wall at the level of exercise achieved. 2. Normal
left
ventricular cavity size and function.

[**2169-3-29**] Cardiology C.CATH
COMMENTS:     1. Selective coronary angiography demonstrated no
angiographically apparent flow limiting disease in this left
dominant
circulation. The LMCA was without flow limiting disease. The LAD
and its
diagonal branches had minimal luminal irregularities without
obstructive
disease. The LCX was a dominant vessel without flow limiting
disease in
the OM branches. The RCA was without flow limiting disease.
2. Right heart catheterization demonstrated normal right and
left sided
filling pressures (RVEDP=8mmHg, PCWP=11mmHg). Cardiac output and
index
were preserved at 9.0 L/min and 4.0 L/min/m2 respectively. No
aortic
stenosis gradient seen.
3. Left ventriculogram deferred to reduce constrast load.

FINAL DIAGNOSIS:
1. Coronary arteries without flow limiting disease.
2. Preseved cardiac output and index.
3. Normal left and right sided filling pressures.

[**2169-3-24**] Radiology CHEST (PA & LAT)
PA AND LATERAL VIEWS OF THE CHEST: When compared with prior PA
and lateral views of the chest dated [**2166-4-1**], there is an
interval development of a new right-sided pleural effusion. The
cardiac, mediastinal, and hilar silhouettes are normal.
Pulmonary vasculature is prominent. The remainder of both lungs
are clear without infiltrates, or consolidations. There is no
left-sided pleural effusion. Surrounding soft tissue and osseous
structures reveal degenerative changes within bilateral
shoulders, and along the thoracic spine.
IMPRESSION: Moderate, asymmetric CHF. No infiltrates or
consolidations.

MRA KIDNEY W&W/O CONTRAST  [**2169-4-1**] 7:17 PM
IMPRESSION:
No abnormal mass or inflammatory process.
Widely patent venous system from the right atrium down to the
external iliac arteries. More distal venous anatomy was obscured
from view. If this is important, ultrasound could be obtained.
Third spacing of fluid as described above.


Brief Hospital Course:
1) Peripheral Edema: The patient presented with lower extremity
edema of unclear etiology. It may be related to the patient
taking pioglitazone (Actos) which has been found to cause
peripheral edema in 10% of individuals who take the drug
concurrently with insulin. Because it was bilateral it was felt
to be unlikely due to DVT. Heart failure was ruled out as a
cause with normal ECHO [**3-27**] (LVEF=60-70%), normal R and L heart
cath, and low pro-BNP with absent pulmonary edema. MRI/MRV was
done on [**4-1**] and negative for vascular/lymphatic obstruction.
Labs were negative for proteinuria. Liver synthetic function was
intact. The patient was taken off Actos and aggressively
diuresed on lasix 20-60mg IV BID with a goal I/O of negative 1.5
to 2L daily. He was discharged on a low-salt (<2g/day) diet as
well as lasix and HCTZ. He still had some edema at discharge
which was improved since admission. He should be evaluated as an
outpatient with regard to lasix dose and potassium repletion.

2) Gram negative Urosepsis: The patient had a traumatic foley
placement during cath and subsequently became hypotensive and
febrile. He was transferred to the MICU and required on
neosynephrine for ~22 hours. Urine and blood cultures grew out
E.coli. He was put on cefpodoxime due to resistance of the E
coli. He returned to the floor 2 days later once he was
hemodynamically stable off pressors.

3) rule out CAD - A stress MIBI was done which showed a
reversible inferolateral defect. During exercise the pt
experienced a flat SBP response with a 12mmHg drop at peak
exertion.  Cardiac catheterization was done which was negative
for CAD or heart failure. He was discharged on aspirin for
primary prevention for CAD which can be discontinued at the
PCP's discretion. Crestor was given for LDL goal < 70.

4) Dyspnea on exertion: The patient had a normal 02 sat, normal
CXR except for small effusions, normal EKG, and normal ECHO, and
normal cath pressures which made a cardiac etiology unlikely.
He may have primary lung disease, although it is more likely
attributable to the extra weight gain from his edema, bibasilar
atelectasis, advanced age, and severe deconditioning.  Therefore
the DOE of unclear etiology but was somewhat improved at
discharge.

5) Acute renal insufficiency: The patient was admitted with Cr
1.8 which peaked at 3.2 likely secondary to overly aggressive
diuresis as it preceded contrast administration and sepsis. His
creatinine returned to baseline at discharge, which is likely
from longstanding diabetes nephropathy. An MRA of the kidney
from [**4-1**] showed no abnormal masses or inflammatory processes.

6) Diabetes: Mr. [**Known lastname 131**] has longstanding diabetes.  His Actos was
discontinued and he was kept on Lantus with a Humalog SS.  The
patient was instructed to follow up with his primary care
provider.

7) Pernicious anemia (new diagnosis): While working up a
consistently low hematocrit, Mr. [**Known lastname 131**] was found to have a
Vitamin B12 level of 214 ([**2169-3-24**]).  He subsequently tested
positive for intrinsic factor antibodies.  100 mcg IM
cyanocobalimin was given QD x 3 days.  The patient should get
another 100 mcg IM cyanocobalimin injection this week and every
month hereafter for life. Alternatively, Mr. [**Known lastname 131**] could take
high-dose 1mg tablets of cyanocobalimin QD, though considering
the possible consequences of non-compliance, it may be
preferable to have monthly IM injections of B12 to ensure
compliance.

8) History of Prostate Cancer: Mr. [**Known lastname **] PSA level was normal
throughout the duration of his hospital stay.  An ultrasound
study of his liver showed no masses consistent with metastases.

Medications on Admission:
1.  lasix 40 mg [**Hospital1 **]
2.  crestor 5 daily
3.  insulin


Discharge Medications:
1. Rosuvastatin Calcium 5 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
[**Hospital1 **]:*30 Tablet(s)* Refills:*2*
2. Bimatoprost 0.03 % Drops Sig: One (1) drop Ophthalmic  qhs
().
[**Hospital1 **]:*qs drop* Refills:*2*
3. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
4. Bimatoprost 0.03 % Drops Sig: [**12-18**]  Ophthalmic  at bedtime.
5. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).
6. Lasix 40 mg Tablet Sig: One (1) Tablet PO once a day.
[**Month/Day (2) **]:*30 Tablet(s)* Refills:*0*
7. Cyanocobalamin 1,000 mcg Tablet Sig: One (1) Tablet PO once a
day.
[**Month/Day (2) **]:*30 Tablet(s)* Refills:*6*
8. Cefpodoxime Proxetil 100 mg Tablet Sig: One (1) Tablet PO
Q12H (every 12 hours) for 11 days.
[**Month/Day (2) **]:*22 Tablet(s)* Refills:*0*
9. Potassium Chloride 20 mEq Tab Sust.Rel. Particle/Crystal Sig:
One (1) Tab Sust.Rel. Particle/Crystal PO once a day: please
discontinue if you stop lasix.
[**Month/Day (2) **]:*30 Tab Sust.Rel. Particle/Crystal(s)* Refills:*0*
10. Insulin Glargine 100 unit/mL Solution Sig: 24  units
Subcutaneous at bedtime: or as directed by your doctor.
[**Last Name (Titles) **]:*1 bottle* Refills:*6*
11. Humalog 100 unit/mL Solution Sig: as directed units
Subcutaneous as directed: please check your sugars 4 times daily
and use sliding scale as indicated on the accompanying sheet. .
[**Last Name (Titles) **]:*1 bottle* Refills:*6*
12. Hydrochlorothiazide 25 mg Tablet Sig: One (1) Tablet PO once
a day.
[**Last Name (Titles) **]:*30 Tablet(s)* Refills:*2*


Discharge Disposition:
Home

Discharge Diagnosis:
Bilateral Pedal Edema
gram negative urosepsis
hypertension
diabetes mellitus
pernicious anemia


Discharge Condition:
Good, patient still had some lower extremity edema but his
shortness of breath was improved.

Discharge Instructions:
Please take all your medications as outlined below.

Please follow up with your primary care physician.

If you have these symptoms, call your doctor:
- shortness of breath with exertion or rest
- orthopnea (worse breathing when you lie down compared to
sitting)
- light-headedness
- visual change
- palpitations
- chest pain
- nausea/vomiting
- fevers/chills

Followup Instructions:
Provider: [**Name8 (MD) 17291**], MD Where: [**Hospital6 29**] [**Hospital **] Phone:[**Telephone/Fax (1) 250**] Date/Time:[**2169-4-7**] 2:30

Please have labs drawn at this visit. Your lasix and potassium
dose may be changed.


                             [**First Name5 (NamePattern1) **] [**Last Name (NamePattern1) **] MD [**MD Number(2) 617**]

Completed by:[**2169-4-5**]
{'Acute diastolic heart failure,Septicemia due to escherichia coli [E. coli],Septic shock,Severe sepsis,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled,Acute kidney failure, unspecified,Pernicious anemia,Insulins and antidiabetic agents causing adverse effects in therapeutic use,Long-term (current) use of insulin,Rheumatoid arthritis,Personal history of malignant neoplasm of prostate,Knee joint replacement,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere'}


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 and leg edema

PRESENT ILLNESS: 72 year old male with history of DM, RA, prostate cancer s/p
prostatectomy only who presents with 7 days L>R LE edema and
dyspnea on exertion.  Symptoms began insidiously, used to walk
up stairs with [**Last Name **] problem, now only [**4-21**] stairs before SOB.  Also
noted 2 days erythematous papular rash on LLE (does have hx of
asteatotic eczema of the lower extremities with stasis
dermatitis).  He is s/p left TKR (from RA) and has always had
scant edema in that leg.  He has not noticed any CP,
palpitations, cough, orthopnea, PND, hemoptysis, trauma, weight
loss.  He was recently treated with cipro for cystitis (he
self-caths s/p prostate surgery).  Per pt, normal PSA last
month.  Recieved lasix 40mg IV in the ED.  Of note, he went to a
[**Hospital 11074**] clinic 7 days ago and was found to have "water on my
lungs."  His lasix dose was doubled to 40 [**Hospital1 **] and his actos and
lisinopril were stopped.

MEDICAL HISTORY: 1.  Prostate Cancer:  Diagnosed by rapid PSA velocity.  S/P
prostatectomy.  Normal recent PSA by report.
2.  RA:  Mainly affecting bilateral shoulders.  Tried
methotrexate and vioxx in past.  Now only on tylenol.
3.  DMI:  Diagnosed 20 years ago.  Was on actos until 7 days ago
when he was told to d/c at the walk in clinic.  Now only on
insulin.

MEDICATION ON ADMISSION: 1.  lasix 40 mg [**Hospital1 **]
2.  crestor 5 daily
3.  insulin

ALLERGIES: Patient recorded as having No Known Allergies to Drugs

PHYSICAL EXAM: 97.9   66    121/33    19     98%RA
Gen:  NAD, A&0X3, non-toxic, comfortable at 20degrees
Heent: EOMI, PERRL, MMM, anicteric sclera
Neck:  No JVD or LAD
Heart:  RRR no mrg.  PMI non-displaced.
Lungs:  Clear. No wheezes or rales.
Abd:  Soft, nt/nd.  Enlarged liver to 4 finger breaths beneath
CPM, nontender.  NABS
Ext:  No c/c.  2+ L>R (slightly) peripheral edema to knees.
+Palmar erythema

FAMILY HISTORY: None for heart or liver disease.

SOCIAL HISTORY: Lives in [**Location 40609**].  Retired barber.  No bad habits X 3.  No
tatoos.  + Blood transfusion. 

### Response:
{'Acute diastolic heart failure,Septicemia due to escherichia coli [E. coli],Septic shock,Severe sepsis,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Diabetes with renal manifestations, type I [juvenile type], not stated as uncontrolled,Acute kidney failure, unspecified,Pernicious anemia,Insulins and antidiabetic agents causing adverse effects in therapeutic use,Long-term (current) use of insulin,Rheumatoid arthritis,Personal history of malignant neoplasm of prostate,Knee joint replacement,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere'}
