Are All Stent Bearers Equal? Ureteral Stent Symptoms in Kidney Transplant Patients: A Case-Control Prospective Study.

Purpose: The aim of this study is to conduct a prospective, controlled single-center study to determine the prevalence and types of ureteral stent symptoms in kidney transplant (KTx) recipients and compare them with nontransplant subjects. Materials and Methods: From December 2012 to June 2019, a total of 102 patients having undergone a KTx and Double-J stent (DJS) placement and 88 patients having undergone endourological lithotripsy and DJS placement were enrolled. The Ureteral Stent Symptom Questionnaire (USSQ) was administered to patients with a median of 25 (KTx) and 31 (urolithiasis) days after stent placement. USSQ scores were used to compare symptoms between the two groups. Results: Of the 190 patients enrolled, 88 belonged to the lithotripsy group (control group) and 102 to the KTx recipients' group. Mean score for urinary symptoms was 21.42 for KTx patients vs 27.53 for control patients with statistical significance (p < 0.001, CI -7.792 to -4.433). The visual analog scale, overall bother, pain at voiding, flank pain at voiding, and frequency of painkiller use scores were significantly higher for control patients than for KTx patients (p = 0.024, <0.001, <0.001, <0.001, and 0.014, respectively). Frequency of rest, changes in work duration, work domain score, suspicion of urinary tract infection (UTI), and need for professional assistance scores were significantly lower for KTx patients than the control. There were no significant differences in general health and sexual domains between groups. Conclusions: KTx recipients have significantly fewer urinary symptoms, pain, work-related disturbances, suspected UTIs, and hospitalizations associated with stent placement than urolithiasis patients.

Randomized trial comparing pegylated interferon alpha-2b versus pegylated interferon alpha-2a, both plus ribavirin, to treat chronic hepatitis C in human immunodeficiency virus patients.

UNLABELLED: Although two pegylated interferons (Peg-IFN) are available to treat chronic hepatitis C virus (HCV) infection, no head-to-head comparative studies have been published. We aim to compare the efficacy and safety of PEG IFN alfa-2b (PEG 2b) versus PEG IFN alfa-2a (PEG 2a), plus ribavirin (RBV). A prospective, randomized, multi-center, open-label clinical trial including 182 human immunodeficiency virus (HIV)-hepatitis C virus (HCV) patients naïve for HCV therapy was performed. Patients were assigned to PEG 2b (80-150 mug/week; n = 96) or PEG 2a (180 mug/week; n = 86), plus RBV (800-1200 mg/day) for 48 weeks. The primary endpoint was sustained virological response (SVR: negative HCV-RNA 24 weeks after completion of treatment). At baseline, both groups were well balanced: 73% male; 63% HCV genotype 1 or [corrected] 4; 29% had fibrosis index of 3 or greater. The overall SVR was 44% (42% PEG 2b versus 46% PEG 2a, P = 0.65). Among genotypes 1 or [corrected] 4, SVRs were 28% versus 32% (P = 0.67) and 62% versus 71% (P = 0.6) in genotypes 2 or [corrected] 3 for PEG 2b and PEG 2a, respectively. Early virological response (EVR; >or=2 log reduction from baseline or negative HCV-RNA at week 12) was 70% in the PEG 2b group and 80% in the PEG 2a group (P = 0.13), reaching a positive predictive value of SVR of 64% and a negative predictive value of 100% in both arms. Side effects were present in 96% of patients but led to treatment discontinuation in 10% of patients (8% on PEG 2b and 13% on PEG 2a, P = 0.47). CONCLUSION: In patients with HIV, HCV therapy with PEG 2b or PEG 2a plus RBV had no significant differences in efficacy and safety.