Answering medical questions at the point of care: a cross-sectional study comparing rapid decisions based on PubMed and Epistemonikos searches with evidence-based recommendations developed with the GRADE approach.

Introduction: Using the best current evidence to inform clinical decisions remains a challenge for clinicians. Given the scarcity of trustworthy clinical practice guidelines providing recommendations to answer clinicians' daily questions, clinical decision support systems (ie, assistance in question identification and answering) emerge as an attractive alternative. The trustworthiness of the recommendations achieved by such systems is unknown.

[In vivo measurement of the mineral content of renal calculi by dual-photon absorptiometry. Correlation with its fragility to extracorporeal shockwave lithotripsy].

After a few years of experience with extracorporeal shock wave lithotripsy (ESWL) and other fragmentation techniques, it has become apparent that stone fragility is a significant clinical distinction that should be taken into consideration when selecting a treatment program. In 30 unselected patients, stone mineral content, density and area were measured in vivo by dual-photon absorptiometry prior to perform ESWL treatment. Stone area determinations showed a median of 4.

[Staghorn renal lithiasis treated with shock waves. Bacteriologic aspects].

Struvite renal stones are caused by infection of the urine with bacteria that synthesize the enzyme urease. Ammonium is released by the breakdown of urea by urease, the urine becomes highly alkaline, and magnesium ammonium phosphate (struvite) and carbonate apatite crystallize. Incorporation of the infecting bacteria within the developing stone, results in a focus of infection that is resistant to conventional antimicrobial therapy, and which is manifested clinically by repeated urinary tract infection caused by persistent bacteriuria.