CHIEF COMPLAINT: Shortness of breath, requiring NRB

PRESENT ILLNESS: [**Age over 90 **] male with h/o CAD, HTN, CHF presented with gradually
increasing SOB/DOE over past few months and for the past week
has worsened to the point where he could not put on his
socks/ADL's. At baseline, he walks about 1 block before getting
short of breath.

MEDICAL HISTORY: CAD s/p CABG [**11**] y ago
HTN
DMII
DMII nephropathy
TURP
rectal bleeding

MEDICATION ON ADMISSION: ASA 325 QD
Procardia 90 CR QD
Protonix 40 QD
Nitro PRN
Cozaar 100 mg QD
Lasix 80 [**Hospital1 **]
Metoprolol 25 [**Hospital1 **]
Lisinopril 5 mg QD
Prandin 2mg Qbreakfast, 1mg Qdinner

ALLERGIES: Lipitor

PHYSICAL EXAM: In the ICU on admission:
VS- 95.4 127/75 48-69 24 99%NRB
GEN- lying in bed, breathing slightly labored using abd muscles

FAMILY HISTORY: not elicted

SOCIAL HISTORY: no tob/ ETOH or IVDU
Acute on chronic combined systolic and diastolic heart failure,Subendocardial infarction, initial episode of care,Atrial flutter,Acute kidney failure, unspecified,Urinary tract infection, site not specified,Unspecified pleural effusion,Mitral valve disorders,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Bacterial pneumonia, unspecified,Other primary cardiomyopathies,Hypoxemia,Legal blindness, as defined in U.S.A.,Aortocoronary bypass status,Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Esophageal reflux,Anemia of other chronic disease,Other chronic pulmonary heart diseases
Ac/chr syst/dia hrt fail,Subendo infarct, initial,Atrial flutter,Acute kidney failure NOS,Urin tract infection NOS,Pleural effusion NOS,Mitral valve disorder,Hyp kid NOS w cr kid V,Bacterial pneumonia NOS,Prim cardiomyopathy NEC,Hypoxemia,Legal blindness-usa def,Aortocoronary bypass,DMII renl nt st uncntrld,Nephritis NOS in oth dis,Neuropathy in diabetes,Esophageal reflux,Anemia-other chronic dis,Chr pulmon heart dis NEC
Admission Date:  [**2103-12-13**]              Discharge Date:   [**2103-12-28**]


Service: MEDICINE

Allergies:
Lipitor

Attending:[**First Name3 (LF) 2160**]
Chief Complaint:
Shortness of breath, requiring NRB

Major Surgical or Invasive Procedure:
Thoracentesis


History of Present Illness:
[**Age over 90 **] male with h/o CAD, HTN, CHF presented with gradually
increasing SOB/DOE over past few months and for the past week
has worsened to the point where he could not put on his
socks/ADL's. At baseline, he walks about 1 block before getting
short of breath.

In addition, he notes that for the past few weeks, he has been
experiencing some chest pressure, which is worse when lying
flat. He saw his cardiologist in the week before admission,
noted to have CHF on CXR, PCP called him to increase his Lasix
dose from 60 [**Hospital1 **] to 80 [**Hospital1 **]; however, he was noted to have no
significant increase in urine output. On the morning of
admission, he saw his PCP and was sent to ED.
.
ED COURSE: He was given 40mg IV lasix to which he did not
respond. He was subsequently given 100mg IV lasix, to which he
had good urine output.
.
ROS: +orthopnea, no sick contacts, no fever, chills, nausea,
vomiting. He does note an occasional mild non-productive cough.
He denies any large, salty meals, no palpitations, no pleuritic
chest pain, no lightheadedness, dizziness.


Past Medical History:
CAD s/p CABG [**11**] y ago
HTN
DMII
DMII nephropathy
TURP
rectal bleeding


Social History:
no tob/ ETOH or IVDU

Patient never married, no children. He lived with his brother in
an apartment until recently when his brother died. [**Name2 (NI) **] does have
2 friends who help him at home with meds, etc.


Family History:
not elicted

Physical Exam:
In the ICU on admission:
VS- 95.4 127/75 48-69 24 99%NRB
GEN- lying in bed, breathing slightly labored using abd muscles

HEENT- MMM, PERRL, conjunctivae normal, sclerae anicteric
NECK- JVP at 8cm
CV- bradycardic, regular, III/VI systolic murmur at LLSB
CHEST- sternum separated, poor airflow, rare rhonchi and
crackles
ABD- +BS, soft, NT, ND
EXT- 1+ pitting edema 1/4 up tibia bilaterally
NEURO- oriented X 3
SKIN- seborheic keratosis, no rashes
MSK- deferred


Pertinent Results:
[**2103-12-26**] 06:45AM BLOOD WBC-9.7 RBC-3.38* Hgb-10.3* Hct-31.2*
MCV-92 MCH-30.4 MCHC-33.0 RDW-15.8* Plt Ct-349
[**2103-12-25**] 07:10AM BLOOD WBC-8.4 RBC-3.50* Hgb-10.4* Hct-32.2*
MCV-92 MCH-29.7 MCHC-32.3 RDW-15.8* Plt Ct-338
[**2103-12-15**] 06:38PM BLOOD Neuts-84.6* Lymphs-8.5* Monos-6.5 Eos-0.4
Baso-0.1
[**2103-12-13**] 01:00PM BLOOD Neuts-79.9* Lymphs-12.7* Monos-6.9
Eos-0.3 Baso-0.2
[**2103-12-25**] 11:00AM BLOOD PT-13.9* PTT-61.1* INR(PT)-1.2*
[**2103-12-20**] 07:25AM BLOOD PT-14.1* PTT-34.9 INR(PT)-1.2*
[**2103-12-26**] 06:45AM BLOOD Glucose-62* UreaN-111* Creat-3.1* Na-144
K-4.4 Cl-106 HCO3-22 AnGap-20
[**2103-12-22**] 06:55AM BLOOD Glucose-119* UreaN-131* Creat-3.5* Na-138
K-3.8 Cl-95* HCO3-29 AnGap-18
[**2103-12-15**] 06:38PM BLOOD Glucose-159* UreaN-87* Creat-3.6* Na-140
K-4.5 Cl-102 HCO3-24 AnGap-19
[**2103-12-13**] 01:00PM BLOOD Glucose-209* UreaN-80* Creat-3.2* Na-140
K-4.8 Cl-103 HCO3-23 AnGap-19
[**2103-12-14**] 04:45AM BLOOD CK(CPK)-67
[**2103-12-13**] 01:00PM BLOOD CK-MB-NotDone proBNP-[**Numeric Identifier **]*
[**2103-12-13**] 01:00PM BLOOD cTropnT-0.28*
[**2103-12-13**] 06:47PM BLOOD CK-MB-13* MB Indx-16.0* cTropnT-0.30*
[**2103-12-14**] 04:45AM BLOOD CK-MB-12* MB Indx-17.9* cTropnT-0.34*
[**2103-12-26**] 06:45AM BLOOD Calcium-9.2 Phos-4.5 Mg-2.3
[**2103-12-14**] 04:45AM BLOOD Albumin-4.2 Calcium-9.8 Phos-4.8* Mg-2.6
Iron-45 Cholest-161
[**2103-12-14**] 04:45AM BLOOD calTIBC-273 VitB12-1026* Folate-GREATER
TH Ferritn-155 TRF-210
[**2103-12-14**] 04:45AM BLOOD Triglyc-94 HDL-52 CHOL/HD-3.1 LDLcalc-90
[**2103-12-22**] 06:55AM BLOOD Osmolal-338*
[**2103-12-25**] 07:10AM BLOOD Osmolal-332*

Pleural fluid:
[**2103-12-25**] 01:54PM  pH-7.54* Comment-PLEURAL FL
[**2103-12-25**] 12:58PM PLEURAL WBC-125* RBC-950* Polys-17* Lymphs-19*
Monos-2* Meso-14* Macro-48*
[**2103-12-25**] 12:58PM PLEURAL TotProt-1.6 Glucose-190 LD(LDH)-93
[**2103-12-25**] 12:58 pm PLEURAL FLUID

   GRAM STAIN (Final [**2103-12-26**]):
      3+  (5-10 per 1000X FIELD):   POLYMORPHONUCLEAR
LEUKOCYTES.
      NO MICROORGANISMS SEEN.

   FLUID CULTURE (Preliminary):    NO GROWTH.

   ANAEROBIC CULTURE (Pending):

Pleural fluid cytology - pending

[**2103-12-14**] 01:44AM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.010
[**2103-12-14**] 01:44AM URINE Blood-LGE Nitrite-NEG Protein-30
Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-NEG
[**2103-12-14**] 01:44AM URINE RBC-89* WBC-2 Bacteri-NONE Yeast-NONE
Epi-0
[**2103-12-14**] 01:44AM URINE CastHy-2*
[**2103-12-16**] 08:14PM URINE Color-Straw Appear-Clear Sp [**Last Name (un) **]-1.015
[**2103-12-16**] 08:14PM URINE Blood-LGE Nitrite-NEG Protein-30
Glucose-NEG Ketone-NEG Bilirub-NEG Urobiln-NEG pH-5.0 Leuks-MOD
[**2103-12-16**] 08:14PM URINE RBC-0-2 WBC-[**4-8**] Bacteri-FEW Yeast-NONE
Epi-0
[**2103-12-16**] 08:14PM URINE AmorphX-OCC
[**2103-12-23**] 09:12AM URINE Hours-RANDOM Creat-54 Na-36
[**2103-12-22**] 10:29AM URINE Hours-RANDOM UreaN-415
[**2103-12-22**] 10:29AM URINE Osmolal-352

[**2103-12-16**] 8:14 pm URINE

                            **FINAL REPORT [**2103-12-18**]**

   URINE CULTURE (Final [**2103-12-18**]):
      ESCHERICHIA COLI.    >100,000 ORGANISMS/ML..
         PRESUMPTIVE IDENTIFICATION.
         Trimethoprim/Sulfa sensitivity testing confirmed by
[**First Name8 (NamePattern2) 3077**] [**Last Name (NamePattern1) 3060**].

                              SENSITIVITIES: MIC expressed in
MCG/ML

_________________________________________________________
                             ESCHERICHIA COLI
                             |
AMPICILLIN------------  =>32 R
AMPICILLIN/SULBACTAM--  =>32 R
CEFAZOLIN-------------   <=4 S
CEFEPIME--------------   <=1 S
CEFTAZIDIME-----------   <=1 S
CEFTRIAXONE-----------   <=1 S
CEFUROXIME------------     4 S
CIPROFLOXACIN---------<=0.25 S
GENTAMICIN------------   <=1 S
IMIPENEM--------------   <=1 S
LEVOFLOXACIN----------<=0.25 S
MEROPENEM-------------<=0.25 S
NITROFURANTOIN--------  <=16 S
PIPERACILLIN---------- =>128 R
PIPERACILLIN/TAZO-----   <=4 S
TOBRAMYCIN------------   <=1 S
TRIMETHOPRIM/SULFA----   <=1 S

ECHO:
Conclusions:
The left atrium is moderately dilated. No atrial septal defect
is seen by 2D
or color Doppler. There is mild symmetric left ventricular
hypertrophy. The
left ventricular cavity is mildly dilated. There is mild
regional left
ventricular systolic dysfunction with mid antero-septal
hypokinesis. The right
ventricular cavity is mildly dilated. Right ventricular systolic
function is
borderline normal. There is abnormal septal motion/position
consistent with
right ventricular pressure/volume overload and superimposed
conduction delay.
The ascending aorta is mildly dilated. 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.
Moderate to severe (3+) mitral regurgitation is seen. The left
ventricular
inflow pattern suggests a restrictive filling abnormality, with
elevated left
atrial pressure. The tricuspid valve leaflets are mildly
thickened. Severe
[4+] tricuspid regurgitation is seen. There is severe pulmonary
artery
systolic hypertension. There is no pericardial effusion.

Compared with the report of the prior study (images unavailable
for review) of
[**2102-3-31**], the severity of mitral and tricuspid regurgitation
has increased.
The degree of pulmonbary hypertension detected has also
increased. Overall
regional LVEF may appear better, however, intrinsic forward EF
may be reduced
secondary to valvular regurgitation.

CHEST, PA AND LATERAL: Bilateral pleural effusions likely
slightly worse when compared to the previous exam. There is an
increased retrocardiac left lower lobe collapse. There are
increased perihilar interstitial opacities consistent with
slight worsening in CHF. There is unfolding of the aorta with
wall calcifications. The cardiac contour remains enlarged.

IMPRESSION:
1. Slight worsening of interstitial pulmonary edema.
2. Slight increase in size of bilateral pleural effusions with
left lower lobe atelectasis.
Approved: FRI [**2103-12-14**] 3:21 PM

Cardiology Report ECG Study Date of [**2103-12-16**]  4:15:42 PM


Since the previous tracing of [**2103-12-13**] there is a regular
supraventricular
rhythm. This is possibly sinus with first degree A-V block,
although a
junctional rhythm cannot be entirely excluded. Other than
rhythm, there is no
significant change compared to the previous tracing of [**2103-12-13**].
TRACING #1


Read by: [**Last Name (LF) **],[**First Name3 (LF) **] B.

  Intervals Axes
Rate PR QRS QT/QTc P QRS T
66 0 148 434/447 0 98 116

CT CHEST WITHOUT IV CONTRAST: There are moderate-sized bilateral
pleural effusions, left greater than right. There is associated
atelectasis of the left lower lobe. The combination of the left-
sided pleural effusion and left lower lobe atelectasis apparntly
accounts for the retrocardiac opacity seen on chest x- ray. The
patient is status post median sternotomy with no evidence of
sternal wires. There are extensive atherosclerotic coronary
artery and aortic wall calcifications. There are dense
calcifications involving the mitral annulus. The airways are
patent down the segmental bronchi. There is no significant
intrathoracic lymphadenopathy.

Imaging of the upper abdomen shows multiple cystic renal
lesions, which appear unchanged dating back to [**2101-6-4**],
compatible with multiple hyperdense renal cysts. The adrenal
glands are nodular and prominent, without evidence of focal
mass. There are tiny gallstones. A small amount of fluid is seen
anterior to the liver.

IMPRESSION: Moderate-sized bilateral pleural effusions. Left
lower lobe collapse. The combination of the pleural fluid and
left lower lobe collapse account for the retrocardiac left lower
lobe opacity on chest x-ray.
Approved: MON [**2103-12-17**] 9:40 PM

CXR:
IMPRESSION:

1. Improved CHF with resolving perihilar haziness.

2. Slight improvement in left lower lobe opacity, corresponding
to a combination of atelectasis and effusion on recent CT.

3. Slight decrease in small right pleural effusion.
Approved: [**Doctor First Name **] [**2103-12-20**] 4:07 PM

CXR:
History of shortness of breath.

There is cardiomegaly with pulmonary vascular engorgement and
probable small left pleural effusion consistent with CHF. In
addition, there is opacity at the left base obscuring the left
hemidiaphragm likely due to a combination of
atelectasis/consolidation in the left lower lobe and left
pleural effusion.

IMPRESSION: CHF with atelectasis/consolidation left lower lobe
and left pleural effusion. The left basilar opacity is possibly
slightly increased since yesterday's film of [**2103-12-23**].
Approved: MON [**2103-12-24**] 9:56 PM


Brief Hospital Course:
CHF (systiolic and diastolic) exacerbation was felt to be the
mostly likely cause of his progressive dyspnea given
radiographic findings, elevated BNP, and physical exam. The CHF
may have been triggered by the bradycardia/junctional escape
rhythm seen on EKG.

NSTEMI
Also had a Non-STEMI with elevated troponins. Started initially
on heparin gtt for one night; given his DNR/DNI status, he
preferred noninvasive medical management only. Repeat echo
revealed worsening MR [**First Name (Titles) **] [**Last Name (Titles) **], and it was felt that a large
component of his symtpoms of failure were due to poor forward
flow.

He was started on an ACEI for afterload reduction and he was
gently diuresed daily. Chest CT was obtained to further evaluate
retrocardiac opacification for malignancy, pneumonia. CT
revealed atelectasis and pleural effusions. It was decided not
to tap the effusions in the ICU given his clinical improvement.

New atrial flutter: was noted with a slow rate in the 60s
ventricular and 150's atrial. This is new compared to EKGs in
[**2102**]. Cardiology/EP felt that he would not benefit from pacer at
this time, and nothing active to do for the atrial flutter.
Specifically EP recs: "no pacer at this point but could consider
if clinically improves. Age and comorbidities make BiV not
indicated. Could have EPS for flutter but too sick for this now
and would likely necessitate pacer".

After stabilization of CHF and MI the patient was tranferred  to
the floor from the ICU.

Due to overdiuresis, the BUN went upto >130. After few IVF
boluses and holding lasix, BUN decreased. Patients renal
function was almost at baseline for him. Low dose lasix was
restarted. The continuing need for lasix and the dose should be
determined by PCP in response to his symptoms.

# UTI: Patient had a foley catheter in for the first few days of
admission. He developed a burning sensation with urination,
urine culture revealed E.coli and he was started on
ciprofloxacin for 7 day course for complicated UTI.


# Pleural effusions: 2 days prior to discharge, the patient
developed dyspnea requiring oxygen. Not much improvement with
nebs. CXR showed a large left pleural effusion and retrocardiac
infiltrate. Given the concern that this could have been a
parapneumonic effusion, thoracentesis was performed. Pleural
fluid was serous yellow in colour and a transudate suggestive of
CHF or renal failure. 1300 ml of fluid was drained and cytology
was sent for and pending at discharge.

#Pneumonia, bacterial - ciprofloxacin (for UTI) was changed to
levofloxacin to complete the 14 day course.

With Rx of pneumonia and thoracentesis, hypoxia and dyspnea both
resolved.
.
# DM: Patient had hx of diabetes, type II on prandin at home.
After initial insulin, started on home regimen.
.
# Acute on chronic renal failure: Has CKD from diabetes.
Baseline creatinine 3.5 in 11/[**2102**].  All meds were dosed
renally.

Due to overdiuresis, the BUN went upto >130. After few IVF
boluses and holding lasix, BUN decreased. Patient's renal
function was almost at baseline for him. Low dose lasix was
restarted. As stated above, the continuing need for lasix and
the dose should be determined by PCP in response to his
symptoms.
.
# Anemia: HCT baseline is ~30. Likely [**3-8**] chronic renal disease.
He is normocytic. Iron studies, B12, folate were normal
suggesting anemia of chronic disease (most likey renal disease)

.
# GERD: continued PPI
.
# CODE: dnr/dni

To be discharged to [**Hospital3 **].

Medications on Admission:
ASA 325 QD
Procardia 90 CR QD
Protonix 40 QD
Nitro PRN
Cozaar 100 mg QD
Lasix 80 [**Hospital1 **]
Metoprolol 25 [**Hospital1 **]
Lisinopril 5 mg QD
Prandin 2mg Qbreakfast, 1mg Qdinner


Discharge Medications:
1. Aspirin 325 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).
2. Pantoprazole 40 mg Tablet, Delayed Release (E.C.) Sig: One
(1) Tablet, Delayed Release (E.C.) PO Q24H (every 24 hours).
3. Docusate Sodium 100 mg Capsule Sig: One (1) Capsule PO BID (2
times a day).
4. Senna 8.6 mg Tablet Sig: One (1) Tablet PO BID (2 times a
day) as needed.
5. Losartan 50 mg Tablet Sig: Two (2) Tablet PO DAILY (Daily).
6. Nifedipine 90 mg Tablet Sustained Release Sig: One (1) Tablet
Sustained Release PO DAILY (Daily).
7. Lisinopril 20 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

8. Repaglinide 2 mg Tablet Sig: One (1) Tablet PO DAILY (Daily).

9. Repaglinide 0.5 mg Tablet Sig: Two (2) Tablet PO DINNER
(Dinner).
10. Albuterol Sulfate 0.083 % Solution Sig: One (1)  Inhalation
Q4H (every 4 hours) as needed for shortness of breath or
wheezing.
11. Acetaminophen 325 mg Tablet Sig: One (1) Tablet PO Q4-6H
(every 4 to 6 hours) as needed.
12. Insulin Lispro (Human) 100 unit/mL Solution Sig: One (1)
Subcutaneous ASDIR (AS DIRECTED).
13. Levofloxacin 250 mg Tablet Sig: One (1) Tablet PO Q48H
(every 48 hours) for 10 days.
14. Furosemide 20 mg Tablet Sig: One (1) Tablet PO DAILY
(Daily).


Discharge Disposition:
Extended Care

Facility:
[**Hospital6 85**]  - [**Location (un) 86**]

Discharge Diagnosis:
Congestive heart failure (systolic and diastolic)
Coronary artery disease
Non ST-elevation MI
Atrial flutter
Acute on chronic renal failure
Pneumonia, bacterial
Urinary tract infection (E.Coli)


Discharge Condition:
Stable


Discharge Instructions:
The doctor at the rehab will take care of your further medical
needs.

Please make a follow up appointment with your primary doctor in
next 10 days.

Your medications have been changed. Please refer to the details
attached.

Return to the emergency room or call your doctor if you notice
increasing shortness of breath, cougf, fever, chest pain or any
other symtpoms concerning  to you.

Followup Instructions:
Make a follow up appointment with your doctor [**First Name8 (NamePattern2) **] [**Last Name (Titles) 58**]
[**Telephone/Fax (1) 3329**] in the 7 to 10 days.  [**Last Name (LF) **],[**First Name3 (LF) **] D.
[**Telephone/Fax (1) 3329**]. (to follow cytology results of pleural fluid)
{'Acute on chronic combined systolic and diastolic heart failure,Subendocardial infarction, initial episode of care,Atrial flutter,Acute kidney failure, unspecified,Urinary tract infection, site not specified,Unspecified pleural effusion,Mitral valve disorders,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Bacterial pneumonia, unspecified,Other primary cardiomyopathies,Hypoxemia,Legal blindness, as defined in U.S.A.,Aortocoronary bypass status,Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Esophageal reflux,Anemia of other chronic disease,Other chronic pulmonary heart diseases'}


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, requiring NRB

PRESENT ILLNESS: [**Age over 90 **] male with h/o CAD, HTN, CHF presented with gradually
increasing SOB/DOE over past few months and for the past week
has worsened to the point where he could not put on his
socks/ADL's. At baseline, he walks about 1 block before getting
short of breath.

MEDICAL HISTORY: CAD s/p CABG [**11**] y ago
HTN
DMII
DMII nephropathy
TURP
rectal bleeding

MEDICATION ON ADMISSION: ASA 325 QD
Procardia 90 CR QD
Protonix 40 QD
Nitro PRN
Cozaar 100 mg QD
Lasix 80 [**Hospital1 **]
Metoprolol 25 [**Hospital1 **]
Lisinopril 5 mg QD
Prandin 2mg Qbreakfast, 1mg Qdinner

ALLERGIES: Lipitor

PHYSICAL EXAM: In the ICU on admission:
VS- 95.4 127/75 48-69 24 99%NRB
GEN- lying in bed, breathing slightly labored using abd muscles

FAMILY HISTORY: not elicted

SOCIAL HISTORY: no tob/ ETOH or IVDU 

### Response:
{'Acute on chronic combined systolic and diastolic heart failure,Subendocardial infarction, initial episode of care,Atrial flutter,Acute kidney failure, unspecified,Urinary tract infection, site not specified,Unspecified pleural effusion,Mitral valve disorders,Hypertensive chronic kidney disease, unspecified, with chronic kidney disease stage V or end stage renal disease,Bacterial pneumonia, unspecified,Other primary cardiomyopathies,Hypoxemia,Legal blindness, as defined in U.S.A.,Aortocoronary bypass status,Diabetes with renal manifestations, type II or unspecified type, not stated as uncontrolled,Nephritis and nephropathy, not specified as acute or chronic, in diseases classified elsewhere,Polyneuropathy in diabetes,Esophageal reflux,Anemia of other chronic disease,Other chronic pulmonary heart diseases'}
