A recent study suggests the use of antegrade flexible ureteroscopy-assisted percutaneous nephrolithotomy (aPNL) led to an increased stone-free rate (SFR) in cases of staghorn calculi, necessitated fewer percutaneous tracts, decreased the necessity for staged surgery, and resulted in a shorter operative duration compared to single percutaneous nephrolithotomy (sPNL ). The study findings were published in the journal, Urolithiasis.

A total of 160 patients were included in this prospective randomized controlled study, with 81 patients in the sPNL group and 79 patients in the aPNL group. Initially, the study focused on comparing the overall differences between sPNL and aPNL. Subsequently, the patients were categorized into two subgroups: Group 1 (patients with < 5 stone branches) and Group 2 (patients with ≥ 5 stone branches). The differences between these two subgroups were analyzed.

The study results revealed that aPNL exhibited a higher SFR and required fewer percutaneous tracts, with a shorter operation time compared to sPNL. Additionally, aPNL reduced the need for staged surgery, especially in patients with ≥ 5 stone branches. There were no significant variances in hemoglobin level changes and the requirement for blood transfusions between the sPNL and aPNL groups, and the frequency of multiple tracts was lower in the aPNL group.

Thus, it can be concluded that aPNL led to an increased SFR in staghorn calculi, necessitated fewer percutaneous tracts, minimized the requirement for staged surgery, and had a shorter operative duration compared to PNL alone. This was particularly notable in patients with ≥ 5 stone branches.

A recent study has shown that adjuvant intravenous tirofiban before stenting may lead to a decreased likelihood of acute stent thrombosis (AST) during stent angioplasty in patients experiencing symptomatic high-grade intracranial atherosclerotic stenosis (ICAS). This study’s findings were published in the journal, Neurology.

In this prospective, multicenter, randomized clinical trial, patients with symptomatic high-grade ICAS scheduled for stent angioplasty were randomly assigned to either receive intravenous tirofiban before stenting or not, in a 1:1 ratio. The study included 100 participants in the tirofiban group and 100 participants in the control group. Primary outcomes measured were the incidence of AST within 30 minutes post-stenting, periprocedural new-onset ischemic stroke, and symptomatic intracranial hemorrhage.

At the end of the study, there was a lower incidence of AST in the tirofiban group when compared to the control group (4.0% vs 14.0%).

The above study demonstrated that the use of adjuvant intravenous tirofiban prior to stenting could potentially reduce the occurrence of AST in patients with symptomatic high-grade ICAS undergoing stent angioplasty.

According to a recent study, the utilization of tamsulosin therapy and semirigid ureteroscopy for dilation prior to flexible ureteroscopy enhanced the success of primary flexible ureteroscopy advancement to the renal collecting system. This study's findings were published in the World journal of urology.

This prospective study included 170 patients who were randomly divided into two groups who had renal stones < 2 cm and underwent retrograde flexible ureteroscopy and laser lithotripsy. Group A (n=85), was administered a placebo for a duration of one week before the flexible ureteroscopy. On the other hand, group B (n=85), received a daily dosage of 0.4 mg tamsulosin for one week prior to the surgery. Additionally, they underwent active dilatation using semirigid ureteroscopy before the flexible ureteroscopy procedure. The ability of the flexible ureteroscope to reach the collecting system in both groups was evaluated during the same operative session. The operative outcomes and complications for both groups were also collected and analyzed.

The flexible ureteroscope demonstrated successful access to the kidney in 61 patients within group B, while in group A, it was only successful in 28 cases (71.4% vs 32.9%). Within group A, 33 patients (38.8%) reported lower urinary tract symptoms, while only 17 patients (20.2%) in group B experienced the same.

It can be concluded that using tamsulosin therapy and semirigid ureteroscopy as dilatation methods prior to flexible ureteroscopy may improve the success of primary flexible ureteroscopy in advancing to the renal collecting system.

A recent study demonstrated that the ileal bile acid transporter inhibitor maralixibat improves health-related quality of life (HRQoL) in children with Alagille syndrome. This study was published in The Journal of Pediatrics.

The ICONIC trial was a phase 2 study, having a 4-week double-blind, placebo-controlled, randomized drug withdrawal period. The study included 27 children having Alagille syndrome with moderate-to-severe pruritus. From baseline to week 48, the treatment response to maralixibat was noted using Itch-Reported Outcome (Observer) score. The HRQoL was assessed based on the certain scale scores that included Pediatric Quality of Life Inventory Generic Core, Family Impact, and Multidimensional Fatigue scale scores.

At week 48, twenty patients attained an Itch-Reported Outcome (Observer) treatment score response. The mean (SD) change in Multidimensional Fatigue score was higher was higher for responders over non-responders. The Pediatric Quality of Life Inventory Generic Core and Multidimensional Fatigue scores showed smaller and non-statistically significant point estimates.

Based on the results of the study, it can be concluded that maralixibat shows significant improvement in pruritis, thereby enhancing the quality of life in the affected children.