Diagnosis

Pneumonia is suspected based on a constellation of symptoms and signs, but individual symptoms and clinical findings lack accuracy for precise diagnosis. 13 Attempts have been made to combine some of the symptoms and signs into a scoring system that predicts the probability of pneumonia, and four different decision rules were compared in a study of adult outpatients (Table59-2). The results of these attempts indicate that clinical criteria are most useful for "ruling out" pneumonia; that is, if a patient has none of the positive predictors, the probability of pneumonia is very low, from 1 to 4 percent. However, clinical criteria are inaccurate for "ruling in" pneumonia; even if a patient has all of the positive clinical predictors, these scoring systems predict pneumonia with a maximal probability of 40 to 50 percent. 13 Thus, for accurate diagnosis, a chest radiograph is required.

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Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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