Search Results (775)

Background/Objectives: Patient experience is increasingly recognised as a key dimension of healthcare quality, yet most tools fail to capture its temporal and processual nature, limiting its contribution to system improvement. This study aimed to demonstrate how a biographical approach to patient experience can generate actionable insights for improving care pathways. Specifically, we sought to: (i) identify and characterise distinct types of prehospital care pathways among patients hospitalised for COVID-19; (ii) identify patient-perceived significant events and safety issues; and (iii) generate structured variables to inform a subsequent quantitative phase. Methods: We conducted semi-structured biographical interviews with 31 patients hospitalised for COVID-19 in two French university hospitals. Data were collected using a life-events calendar (LEC), enabling day-by-day reconstruction of symptoms, healthcare contacts, and decision-making processes. Thematic analysis was performed with multidisciplinary triangulation. The qualitative phase identified three pathway types and the key mechanisms underlying each; these patterns were subsequently confirmed in a separate quantitative follow-up study (n = 312) using state sequence analysis. Results: Three distinct pathway types emerged: short (≤3 days), intermediate (4–9 days), and long (≥10 days). Delayed pathways were associated with repeated false-negative tests, underestimation of severity, and silent hypoxaemia. Across all pathways, patient experience suggested critical system-level failures, including diagnostic delays and inadequate escalation of care. Notably, in many cases, hospitalisation was triggered by a relative rather than a healthcare professional. These findings highlight the role of patient and social context as key components of care pathways. Conclusions: When captured longitudinally, patient experience may provide actionable insights into healthcare system functioning, suggesting structural mismatches between clinical trajectories and care responses. The life-events calendar method offers a replicable framework for transforming patient experience data into clinically and organisationally relevant knowledge. Integrating such approaches into healthcare evaluation could enhance patient safety, improve care coordination, and support more responsive care systems beyond COVID-19. Full article

Background: Stroke significantly increases morbidity and mortality in patients receiving extracorporeal membrane oxygenation (ECMO). This study evaluates the prognostic impact of stroke subtypes, acute ischemic stroke (AIS) and hemorrhagic stroke (HS), and neurologic injury severity in a contemporary adult population. Methods: We conducted a retrospective cohort study using the TriNetX federated electronic health record network, including adult patients who underwent ECMO between 1 October 2015 and 31 December 2025. Stroke was defined as a first-instance diagnosis of AIS, HS, or unspecified cerebrovascular event occurring within 24 h of ECMO cannulation during the index hospitalization. Propensity score matching (1:1 nearest neighbor) was performed to balance baseline demographics, comorbidities, anticoagulant use, and ECMO modality between the stroke and non-stroke cohorts. Primary outcomes included all-cause mortality at 30 days, 90 days, and 1 year. Secondary outcomes included cardiac arrest, seizures, palliative care utilization, and hospital readmission. Kaplan–Meier survival analysis and multivariable Cox proportional hazards modeling were performed. Results: Among 18,981 ECMO patients, 1481 (7.8%) developed a stroke within 24 h of ECMO cannulation, including 814 AIS (54.9%), 454 HS (30.6%), and 213 unspecified cerebrovascular events (14.4%). After propensity score matching, stroke was associated with significantly higher all-cause mortality at 30 days (RR 1.16), 90 days (RR 1.18), and 1 year (RR 1.18), all p < 0.05. Stroke was also associated with higher rates of cardiac arrest, seizures, hospital readmission, and palliative care utilization (all p < 0.001). AIS was associated with significantly lower mortality than HS at 30 days, 90 days, and 1 year (all p < 0.0001). In multivariable Cox regression, only HS was independently associated with increased 30-day mortality compared with no stroke. Markers of neurologic injury severity, including cerebral edema, brain compression, and coma, were among the strongest independent predictors of mortality. Conclusions: Stroke occurring early after ECMO cannulation is associated with substantially worse short- and long-term survival, with hemorrhagic subtype and markers of neurologic injury severity driving the strongest prognostic signals. These findings support early stroke recognition and subtype-informed prognostic discussions in ECMO patients. Full article

Radioisotopic techniques provide powerful tools for reconstructing the history of lake sediments, offering critical insights into past environmental changes and human impacts. These techniques have contributed significantly to our understanding of past environmental change and have implications for current environmental management practices. This review comprehensively examines various radiometric dating techniques used for lake sediments, with a focus on natural, cosmogenic, and artificial radionuclides, including ²¹⁰Pb, ¹³⁷Cs, ²⁴¹Am, ⁷Be, ³H, and ¹⁴C. The review highlights the widespread use of radionuclides in establishing sediment chronologies across different time scales, from short-term processes (days to decades) to long-term environmental reconstructions spanning thousands of years. Moreover, applications in limnological research are explored, including sedimentation rate estimation, reconstruction of pollution history of trace elements, nutrients, microplastics, and organic compounds, and assessment of anthropogenic impacts and catchment changes. The integration of radioisotopic methods with multiproxy paleolimnological approaches is emphasized as a powerful framework for reconstructing past environmental and ecological conditions. Despite their effectiveness, radioisotopic methods are exposed to several sources of uncertainty, including dispersion in atmospheric isotope flux, post-depositional processes, reservoir effects, and model assumptions. These challenges highlight the importance of careful methodological selection, site-specific evaluation, and rigorous uncertainty assessment in radioisotopic studies of lake sediments. Future research should emphasize refining sediment age-model calibration using region-specific sedimentation parameters and standardized validation procedures, and integrating radiometric techniques with geochemical, biological, and paleolimnological proxies to improve the reconstruction of environmental change in lacustrine systems. Such developments would enhance the interpretation of historical pollution records, sediment accumulation patterns, eutrophication history, and ecological variability, thereby providing scientifically robust information to support evidence-based lake management, restoration programs, and long-term conservation strategies. Full article

Objectives: This study aimed to evaluate the impact of thoracic endovascular aortic repair (TEVAR) on aortic remodeling using CT angiography-based morphometric measurements and to examine associated mid-term clinical outcomes in patients with acute Stanford type B aortic dissection. Methods: This retrospective, single-center observational cohort study included 33 consecutive patients who underwent TEVAR for acute Stanford type B aortic dissection between January 2020 and January 2025. Preoperative and postoperative true lumen (TL), false lumen (FL), and descending aorta (DA) diameters were compared using paired t-tests after Shapiro–Wilk normality testing. Endoleak, reintervention, FL thrombosis, and mortality were analyzed. Univariable analyses identified factors associated with endoleak and reintervention. Spearman’s correlation assessed factors associated with morphometric remodeling response. Results: All 33 patients had acute Stanford type B dissection (mean time to intervention: 2.73 ± 3.86 days). Among 33 patients (81.8% male; mean age 53.6 ± 12.1 years), mean follow-up was 4.08 ± 1.66 years. TEVAR induced a significant aortic remodeling response: TL diameter increased from 9.55 ± 5.91 mm to 28.30 ± 5.49 mm (+18.76 ± 8.83 mm; p < 0.001) and FL diameter decreased from 33.39 ± 6.76 mm to 11.48 ± 8.97 mm (−21.91 ± 9.53 mm; p < 0.001), while DA diameter remained stable (42.94 ± 6.90 vs. 42.03 ± 9.46 mm; p = 0.323). Complete FL thrombosis was achieved in 19 patients (57.6%). Endoleak occurred in nine patients (27.3%); Zone 2 landing was significantly associated with endoleak (54.5% vs. 13.6%, p = 0.033). Secondary intervention was required in 13 patients (39.4%). Overall mortality was 12.1%. Narrower preoperative TL was strongly associated with greater TL expansion (Spearman r = −0.724, p < 0.001); longer stent–graft coverage was associated with greater TL gain (r = +0.522, p = 0.002). Conclusions: TEVAR induced clinically meaningful aortic remodeling in acute Stanford type B dissection without progressive aortic enlargement. A narrower baseline TL and longer stent–graft coverage were associated with greater remodeling benefit. Zone 2 deployment was significantly associated with higher endoleak rates, underscoring the value of careful preprocedural planning and systematic long-term imaging surveillance. Full article

Healthcare-associated infections (HAIs) in long-term care facilities (LTCFs) are a public health problem worldwide. The aim of this narrative review is to summarize and to provide a comprehensive overview of the current surveillance methods used in LTCFs. We conducted a search of the PubMed database starting from 2000 onward. We found 324 articles that were systematically evaluated by the titles, abstracts, and full texts, and we selected 42 records. These articles were dispersed across North America, Europe, Australia, and Asia. We identified articles describing the results from active or passive surveillance and from a point prevalence study (PPS). The most frequently used method was PPSs in 30 studies, followed by 12 articles reporting active surveillance results and 3 articles describing active surveillance findings. The case definitions applied in 16 articles were those provided by the Centers for Disease Control and Prevention, followed by the McGeer and European Centre for Disease Prevention and Control definitions in 15 and 13, respectively. Twenty-six studies described the method used to calculate the HAI indicator (incidence, incidence density, or prevalence). The articles on PPSs reported prevalence per 100 patients (22 articles), whereas those on active and passive surveillance reported the incidence density per 1000 patient-days. PPSs effectively identified HAIs in LTCFs through standardized data collection and essential interpretive information. The variability in surveillance methods, case definitions, HAI types, and indicator calculation approaches highlights the need for standardized surveillance protocols and methodologies in LTCFs worldwide. Furthermore, these findings emphasize the importance of implementing appropriate surveillance systems and targeted public health measures to effectively address the specific needs and vulnerabilities of the LTCF population in our country. Full article

Background: Antimicrobial resistance, driven by inappropriate use and overuse of antibiotics, is a major public health threat. Diarrhea and respiratory illness are the leading causes of pediatric healthcare visits in low- and middle-income countries like Bangladesh. Despite clear WHO guidelines recommending limited use of antibiotics for these conditions, potentially inappropriate or non-prescription antibiotic use remains a concern. Methods: We interviewed caregivers of 3025 under-5 children via cellphones to assess common illnesses, associated care-seeking practices, and antibiotic use for diarrhea and respiratory illnesses experienced by their children in the prior 14 days. Caregivers were identified through hospital outpatient screening and were contacted over the phone for the interview at least two months after that hospital visit. Results: Among the participants, 116 (3.8%) reported diarrheal disease and 570 (18.8%) experienced respiratory illness during the preceding 2-week recall period. Among the children with diarrhea, 52.6% received antibiotics, and 73.8% obtained them over the counter from pharmacies. Among those with respiratory illness, 26.3% received antibiotics, and 58% procured them from local drugstores without a prescription from a registered physician. For diarrhea, azithromycin and metronidazole were the commonly used antibiotics, while for respiratory illness, cefixime and azithromycin were frequently used. Notably, 68% of the diarrheal children either sought care from local drugstores, were self-medicated, or did not receive any formal treatment. Conventional practice, long wait times at healthcare facilities, distance, and poverty were the main reasons for not seeking care from a registered healthcare provider. Conclusions: Understanding community-level antibiotic use and care-seeking behavior is essential to strengthening antibiotic stewardship and child health programs. Our findings suggest the need for context-sensitive community education, improved access to appropriate care, and enforcement of regulations restricting the over-the-counter sale of antibiotics to curb irrational and excessive antibiotic use. Full article

Traditional solid-contact ion-selective electrodes (SC-ISEs) are severely constrained by a long-standing thermodynamic bottleneck, which requires hours of pre-conditioning and stabilization to establish a stable phase-boundary potential. To fundamentally bypass this limitation, we present a paradigm shift in electrochemical ion sensing that exploits dynamic kinetics rather than waiting for thermodynamic equilibrium. In this paper, we report a transient potential profiling method that eliminates the need for equilibration by analyzing the open-circuit voltage decay during the first 60 s of polarization. A discharge step on indicator electrode returns the membrane to a reproducible initial state, allowing for the extraction of a concentration correlated coefficient. Using a calcium ISE with an optimized membrane, the early-stage polarization dynamics were fitted to a single exponential saturation model, predicting the steady state response with an average error of 1.6%. The method achieved high repeatability (intra-day RSD 3.22%), batch to batch reproducibility (4.57%), and recovery rates from 90.7% to 115.0% in real water samples. Validation against ion chromatography showed high agreement (R² = 0.997). This strategy enabled conditioning free, disposable ISEs for point of care and environmental monitoring. Full article

Stroke is a leading cause of morbidity and long-term disability worldwide. This study evaluated the feasibility, safety, and preliminary clinical effects of phonotherapy (PHT) as an adjunct to standard care in patients with acute ischemic stroke. This prospective observational study enrolled 140 patients, who were assigned to receive either phonotherapy in addition to standard care (PHT group, n = 70) or standard care alone (control group, n = 70). Phonotherapy consisted of twice-daily 528 Hz sound stimulation administered for 3 months. Neurological (NIHSS), functional (mRS), and cognitive (MoCA) outcomes were assessed at days 10 and 90. At day 10, patients receiving PHT showed significantly better neurological, functional, and cognitive outcomes compared to the controls. However, these differences were not sustained at 90 days. Phonotherapy was not an independent predictor of favorable functional outcome at 90 days. Recurrent stroke occurred in three patients (4.3%) in the PHT group and nine (12.9%) in the control group (p = 0.07). No intervention-related adverse events were observed. Phonotherapy appears to be a safe adjunct intervention in acute ischemic stroke and may be associated with short-term improvements in selected outcomes. Overall, phonotherapy appeared safe as an adjunctive intervention in patients with acute ischemic stroke and showed possible short-term associations with improvements in selected outcomes, although these preliminary findings require confirmation in randomized controlled trials. Full article

Background/Objectives: Reliable quality control (QC) materials are essential for maintaining the analytical performance of hepatitis C virus (HCV) screening assays. Rapid diagnostic tests (RDTs) are widely used for point-of-care HCV screening; however, standardized plasma-based internal quality control (IQC) materials compatible with both rapid tests and automated immunoassays remain limited. This study aimed to develop and evaluate plasma-based QC materials applicable to multiple anti-HCV RDTs and automated immunoassays. Methods: QC materials were prepared from pooled HCV-positive plasma at strong-positive, weak-positive, and negative levels in liquid and lyophilized formats. Lyophilized preparations were produced with and without trehalose, while liquid samples were prepared with and without a stabilizer. Performance was evaluated using five anti-HCV RDT kits and the Elecsys Anti-HCV II automated immunoassay platform. Stability was assessed under accelerated temperature conditions (45 °C for 28 days) and long-term storage (2–8 °C and 20–30 °C for six months). Signal trends were analyzed using linear regression (p > 0.05), and homogeneity was evaluated using one-way analysis of variance and Cochran’s C test. Results: All QC formulations demonstrated consistent qualitative reactivity across the evaluated RDT kits and stable responses on the automated immunoassay platform. Lyophilized plasma containing trehalose maintained stable cut-off index (COI) values during accelerated and long-term storage, with no significant time-dependent trends (p > 0.05). Conclusions: Trehalose-stabilized lyophilized materials demonstrated enhanced stability and acceptable homogeneity, supporting practical applicability under the tested storage conditions across the evaluated rapid tests, and within the evaluated moderate-to-high positive analytical ranges on the automated anti-HCV immunoassay platform. Full article

Background: A previous short-term retrospective analysis from our center suggested early improvement in pain, function, and sleep outcomes after fixed-dose tramadol/paracetamol therapy in patients with early-stage symptomatic knee osteoarthritis (KOA). However, the durability of these outcomes beyond the initial treatment phase remains insufficiently described in routine clinical practice. Objective: To describe short- and mid-term patient-reported outcomes and safety during extended follow-up in adults with symptomatic KOA treated with fixed-dose tramadol/paracetamol in routine outpatient care. Methods: This single-center retrospective observational extension study analyzed a fixed cohort of 30 adults with symptomatic knee osteoarthritis and Kellgren–Lawrence grade I–II treated with fixed-dose tramadol/paracetamol in routine outpatient care. Patients were evaluated at baseline (T0), 15 days (D15), 3 months (M3), and 6 months (M6), where evaluable follow-up data were available. The primary outcome was change in pain intensity measured by the Numeric Rating Scale (NRS). Secondary outcomes included WOMAC total and subscale scores, Pittsburgh Sleep Quality Index (PSQI) score, adverse events, and treatment discontinuation. Results: Patients had a mean age of 64.8 ± 9.6 years and a mean BMI of 27.3 ± 5.0 kg/m². NRS pain improved from a median of 6.0 (5.0–7.0) at baseline to 4.0 (2.0–5.3) at D15 and 3.0 (2.0–5.0) at both M3 and M6. WOMAC total score improved from 47.8 ± 12.8 at baseline to 35.6 ± 13.8 at D15, 33.8 ± 13.6 at M3, and 33.9 ± 13.5 at M6. Sleep score improved from 9.5 (7.0–15.0) at baseline to 7.0 (5.0–9.0) at D15 and remained improved at M3 and M6. Mild adverse events were reported in 10.0% of patients, and discontinuation occurred in 6.7%. Conclusions: In this small, uncontrolled, single-center retrospective cohort of adults with early-stage symptomatic KOA, fixed-dose tramadol/paracetamol was associated with early improvement in pain, WOMAC outcomes, and sleep, with group-level benefits remaining evident through 6 months. These findings should be considered exploratory and hypothesis-generating rather than comparative evidence of effectiveness. Larger controlled studies are needed to confirm durability, comparative benefit, and long-term safety. Full article

Objective: The present study aimed to determine clinical and surgical variables associated with postoperative morbidity and 10-year mortality in isolated mitral valve replacement (MVR) and to assess the association between sex and postoperative outcomes. Materials and Methods: A total of 1629 patients undergoing isolated MVR in one center during the period between January 2000 and December 2015 were retrospectively analyzed. Hospital records provided demographic, clinical, echocardiographic, and operative data. Cox regression analyses were used to determine factors associated with postoperative morbidity and long-term mortality. The Kaplan–Meier method was used to analyze long-term survival, and the log-rank test was used to compare the groups. Results: A total of 866 (53.1%) patients were male and 763 (46.9%) were female, and the average age was 63.8 ± 10.9 years. There were no significant differences in female and male patients regarding basic demographic and clinical characteristics. The first 30-day in-hospital morbidity rate was also significantly greater in women than in men (25.7% vs. 20.6%; p = 0.015). The in-hospital mortality was more prevalent among women (5.0% vs. 3.0%; p = 0.043). Age, sex (female), diabetes mellitus, pulmonary hypertension, chronic obstructive pulmonary disease, critical preoperative condition, high body mass index, longer cardiopulmonary bypass time, and low left ventricular functioning were significantly associated with postoperative morbidity in multivariable analysis. The total mortality rate during a 10-year follow-up was 33.2%, which was considerably higher among women compared to men (36.3 vs. 30.5; p = 0.013). Kaplan–Meier analysis demonstrated significantly lower long-term survival in female patients (log-rank p = 0.011). Conclusions: Morbidity and mortality following isolated MVR are closely related to patient-related factors. Female sex showed a significant adjusted association with higher 10-year mortality in multivariable analysis, warranting careful long-term risk assessment in female patients. Full article

Background: Acute malignant colorectal obstruction requires urgent management, traditionally by emergency resection or stoma formation. Colonic stenting as a bridge to surgery (BTS) has emerged as an alternative, but concerns persist regarding oncologic safety. This systematic review evaluates short-term and long-term outcomes of BTS with self-expanding metal stents (BTS-stent) compared with acute resection (AR). Methods: A systematic review was conducted on multiple databases. PubMed, Cochrane Library, and Google Scholar were searched for studies published between 2015 and 2025 reporting surgical management of obstructive colon cancer. Outcomes included perioperative morbidity and mortality, laparoscopic conversion, stoma formation, stent-related complications, and long-term overall survival (OS) and disease-free survival (DFS). Data were synthesized descriptively with reference to reported comparative effects and prior meta-analyses. Results: Fifteen studies published between 2015 and 2025 were included, encompassing 6999 patients (AR: 4944; BTS-stent: 1739; other BTS: 311). BTS was associated with higher rates of laparoscopic surgery (57% vs. 14%) and primary anastomosis, and significantly reduced stoma formation (27% vs. 60%). Postoperative morbidity and 30-day mortality were lower or comparable in BTS cohorts (4.9% vs. 7.8%). SEMS technical success ranged from 78 to 97%, with perforation rates of 0–15%, representing the main adverse event. Long-term outcomes were comparable between groups. Five-year OS ranged from 46 to 75% (BTS) and 46 to 74% (AR), with similar DFS. Subgroup data suggested possible worse outcomes in T4 tumors and improved results in selected stage III patients. Delayed surgery (>4 weeks) may improve survival, but increases complication risk. Conclusions: BTS with SEMS improves short-term outcomes without compromising long-term survival. Careful selection and avoidance of perforation are essential. Full article

Amphotericin B (AmB) is a broad-spectrum antifungal agent and a long-standing standard of care; however, its clinical use is compromised by poor solubility, off-target tissue distribution and severe dose-limiting toxicity. AmB-loaded poly (D, L-lactide-co-glycolide) nanoparticles (PLGA-AmB-NPs) were developed and characterized with respect to their physicochemical properties, antifungal activity against A. fumigatus biofilms, in vivo efficacy in the Galleria mellonella infection model, and hemolytic toxicity in vitro. Blank PLGA nanoparticles (PLGA-NPs) and PLGA-AmB-NPs exhibited mean diameters of 165 nm (PDI 0.075) and 120 nm (PDI 0.210), respectively, with negative zeta potential values consistent with colloidal stability in aqueous media. PLGA-AmB-NPs showed significantly enhanced activity against 24 h A. fumigatus biofilms compared with free AmB at concentrations of 5 and 10 µg/mL, while unloaded PLGA-NPs were inactive. Infected G. mellonella larvae treated with PLGA-AmB-NPs displayed markedly improved survival over a 5-day period relative to those receiving equivalent doses of free AmB. Furthermore, PLGA-AmB-NPs induced substantially lower hemolysis of human red blood cells than free AmB across all tested concentrations (5–20 µg/mL). PLGA-AmB-NPs represent a promising polymeric platform for the treatment of A. fumigatus infections. Full article

In this paper, we propose an outcome-based contrastive loss for imbalanced binary classification to alert to next-day health deterioration using care records and meteorological data. Long-term care facilities maintain daily care and observation records to monitor the health of older adults. Such objective records are particularly valuable when sudden deterioration occurs, enabling timely coordination with medical institutions. Predicting deterioration one day in advance could provide care staff with an actionable window to intensify observation and adjust care plans (e.g., scheduling additional vital checks or increasing fluid intake monitoring). This could potentially reduce emergency transports and ease the burden on already understaffed care facilities. However, for such predictions to be useful in practice, false positives must be suppressed. Because deterioration events are rare, class imbalance generates an excess of false positives, causing alert fatigue and increasing the risk that actual events go unnoticed. To address these challenges, we propose an outcome-based contrastive loss that contrasts actual deteriorating samples against false alarms conditioned on mini-batch prediction outcomes. The proposed loss contracts same-label pairs to shape local structure within each ground-truth label. The loss also separates actual deteriorating samples from false alarms among samples predicted as deteriorating, thereby directly reducing unnecessary alerts. As a result, compared with random oversampling with standard cross-entropy, the proposed model improved precision from 3.97% to 12.94% (+8.97 percentage points), while limiting the F1-score decrease to 0.71 percentage points (from 7.28% to 6.57%). Pair-design ablations and UMAP projections supported this mechanism by indicating clearer separation between actually deteriorating and false-alarm samples in the learned representation space. These results suggest a viable direction for alert systems that produce fewer unnecessary alerts, reducing alert fatigue and supporting more reliable deterioration detection in care settings. Full article

Background: Staphylococcus aureus neonatal osteomyelitis (SA-NOm) is a rare condition with the potential for lifelong skeletal morbidity. Available evidence remains scarce and inconsistent, with notable differences in clinical presentation, therapeutic regimens, and reported outcomes, underscoring the need for a systematic evaluation combining clinical experience with existing literature. Methods: We retrospectively reviewed data from all neonates admitted to Regina Margherita Children’s Hospital, Turin, Italy, between 2017 and 2024 with a diagnosis of SA-NOm. A structured narrative review of the pertinent literature published over the past 25 years was conducted to identify additional cases and compare management approaches. Results: Four neonates with SA-NOm were identified at our center (institutional cohort) while a literature review retrieved 38 additional cases (literature cohort) to establish a combined cohort (n = 42). Of these, 78% were born at term, with a male-to-female ratio of 1.6:1 (26 males, 16 females). Approximately half of the combined cohort presented identifiable risk factors for SA-NOm, including neonatal intensive care unit admission, prematurity, sepsis, or maternal complications. Across the combined cohort, the mean age at presentation was 19 days. The most common presenting signs were local swelling and reduced mobility of the affected limb, although systemic symptoms often complicated early recognition. Long bones were most frequently involved—particularly the femur, humerus, and tibia—with equal distribution between upper and lower extremities. The mean intravenous antibiotic duration for the combined cohort was 31.6 days, followed by two to three weeks of oral therapy. Empiric regimens varied, including glycopeptides alone or combined with second- or third-generation cephalosporins, anti-staphylococcal penicillins, or carbapenems. Sequelae rates were rarely reported in the literature, likely due to limited follow-up, whereas extended surveillance in our cohort revealed substantial long-term morbidity, including restricted joint mobility, limb length discrepancy, and persistent radiographic abnormalities. Conclusions: SA-NOm, due to its rarity and potential for long-term skeletal sequelae, requires early diagnosis and timely empiric antibiotic therapy based on local resistance data. Prospective multicenter studies are needed to define standardized diagnostic and therapeutic protocols. Full article