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      Integration and utilization of modern technologies in nephrolithiasis research

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          Abstract

          Nephrolithiasis, or stones, is one of the oldest urological diseases, with descriptions and treatment strategies dating back to ancient times. Despite the enormous number of patients affected by stones, a surprising lack of conceptual understanding of many aspects of this disease still exists. This lack of understanding includes mechanisms of stone formation and retention, the clinical relevance of different stone compositions and that of formation patterns and associated pathological features to the overall course of the condition. Fortunately, a number of new tools are available to assist in answering such questions. New renal endoscopes enable kidney visualization in much higher definition than was previously possible, while micro-CT imaging is the optimal technique for assessment of stone microstructure and mineral composition in a nondestructive fashion. Together, these tools have the potential to provide novel insights into the aetiology of stone formation that might unlock new prevention and treatment strategies, and enable more effective management of patients with nephrolithiasis.

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          Most cited references57

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          Anterior cruciate ligament injury and radiologic progression of knee osteoarthritis: a systematic review and meta-analysis.

          Knee osteoarthritis after anterior cruciate ligament (ACL) injury has previously been reported. However, there has been no meta-analysis reporting the development and progression of osteoarthritis.
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            Risk assessment scales for pressure ulcer prevention: a systematic review.

            This paper reports a systematic review conducted to determine the effectiveness of the use of risk assessment scales for pressure ulcer prevention in clinical practice, degree of validation of risk assessment scales, and effectiveness of risk assessment scales as indicators of risk of developing a pressure ulcer. Pressure ulcers are an important health problem. The best strategy to avoid them is prevention. There are several risk assessment scales for pressure ulcer prevention which complement nurses' clinical judgement. However, some of these have not undergone proper validation. A systematic bibliographical review was conducted, based on a search of 14 databases in four languages using the keywords pressure ulcer or pressure sore or decubitus ulcer and risk assessment. Reports of clinical trials or prospective studies of validation were included in the review. Thirty-three studies were included in the review, three on clinical effectiveness and the rest on scale validation. There is no decrease in pressure ulcer incidence was found which might be attributed to use of an assessment scale. However, the use of scales increases the intensity and effectiveness of prevention interventions. The Braden Scale shows optimal validation and the best sensitivity/specificity balance (57.1%/67.5%, respectively); its score is a good pressure ulcer risk predictor (odds ratio = 4.08, CI 95% = 2.56-6.48). The Norton Scale has reasonable scores for sensitivity (46.8%), specificity (61.8%) and risk prediction (OR = 2.16, CI 95% = 1.03-4.54). The Waterlow Scale offers a high sensitivity score (82.4%), but low specificity (27.4%); with a good risk prediction score (OR = 2.05, CI 95% = 1.11-3.76). Nurses' clinical judgement (only considered in three studies) gives moderate scores for sensitivity (50.6%) and specificity (60.1%), but is not a good pressure ulcer risk predictor (OR = 1.69, CI 95% = 0.76-3.75). There is no evidence that the use of risk assessment scales decreases pressure ulcer incidence. The Braden Scale offers the best balance between sensitivity and specificity and the best risk estimate. Both the Braden and Norton Scales are more accurate than nurses' clinical judgement in predicting pressure ulcer risk.
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              THE ORIGIN AND GROWTH OF RENAL CALCULI.

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                Author and article information

                Contributors
                Journal
                101500082
                35766
                Nat Rev Urol
                Nat Rev Urol
                Nature reviews. Urology
                1759-4812
                1759-4820
                25 March 2018
                23 August 2016
                September 2016
                02 April 2018
                : 13
                : 9
                : 549-557
                Affiliations
                Department of Urology, Indiana University Health at Methodist Hospital, 1801 Senate Boulevard #220, Indianapolis, Indianapolis 46202, USA
                Department of Urology, Indiana University Health at Methodist Hospital, 1801 Senate Boulevard #220, Indianapolis, Indianapolis 46202, USA
                Department of Urology, University of Chicago Hospital, 5841 S Maryland Avenue, Mc 6038, Chicago, Illinois 60637, USA
                Department of Anatomy and Cell Biology, Indiana University School of Medicine, 635 Barnhill Drive, VanNuys Medical Science Building, Indianapolis, Indiana 46202, USA
                Department of Anatomy and Cell Biology, Indiana University School of Medicine, 635 Barnhill Drive, VanNuys Medical Science Building, Indianapolis, Indiana 46202, USA
                Department of Urology, Indiana University Health at Methodist Hospital, 1801 Senate Boulevard #220, Indianapolis, Indianapolis 46202, USA
                Author notes
                Correspondence to J.E.L. jlinaeman@ 123456iuhealth.ora
                Article
                PMC5880530 PMC5880530 5880530 nihpa954055
                10.1038/nrurol.2016.148
                5880530
                27549355
                56ef95d0-adb4-48c6-93b2-d99f58d6a0bd
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