Search Results (472)

Background: Deep vein thrombosis (DVT) is a serious thromboinflammatory complication of acute ischemic stroke (AIS). The true incidence, mechanistic risk factors, and optimal prophylactic strategies remain uncertain, particularly in the era of reperfusion therapy. Methods: This systematic review and meta-analysis (IRIS-DVT) searched PubMed, Embase, Cochrane, Scopus, and Web of Science for studies reporting DVT incidence, risk factors, or prophylaxis in AIS (2004–2025). Random-effects models were used to generate pooled prevalence and effect estimates, and the certainty of evidence was graded using the GRADE framework. Results: Forty-two studies (n = 6,051,729 patients) were included. The pooled prevalence of DVT was 7% (95% CI, 6–9%), approximately seventy-fold higher than in the general population, with wide heterogeneity influenced by screening timing and diagnostic modality. Pathophysiological risk factors included higher stroke severity (NIHSS; SMD 0.41; 95% CI, 0.38–0.43), older age (SMD 0.32; 95% CI, 0.18–0.46), elevated D-dimer (SMD 0.55; 95% CI, 0.38–0.72), female sex (OR 1.33; 95% CI, 1.19–1.50), and malignancy (OR 2.69; 95% CI, 1.56–5.22), supported by moderate-certainty evidence. Respiratory infection and admission hyperglycemia showed weaker, low-certainty associations. Traditional vascular risk factors (hypertension, diabetes, atrial fibrillation, dyslipidemia) were not significantly related to DVT risk. Evidence for prophylaxis with low-molecular-weight heparin, direct oral anticoagulants, or intermittent pneumatic compression was limited and graded very low certainty. Conclusions: DVT complicates approximately one in fourteen AIS cases, reflecting a distinct thromboinflammatory process driven more by acute neurological severity, systemic hypercoagulability, and malignancy than by conventional vascular risk factors. Early systematic screening (≤72 h) and consistent use of mechanical prophylaxis are warranted. Dedicated AIS-specific mechanistic and interventional trials are urgently needed to refine prevention strategies and improve post-stroke outcomes. Full article

Dry eye disease (DED) is a multifactorial condition characterized by insufficient tear film stability and ocular discomfort. Conventional artificial tears offer limited efficacy due to short precorneal residence time. This study aimed to develop and optimize ion-sensitive in situ gelling formulations based on low-acyl gellan gum (GG) and arabinogalactan (AG) to enhance retention and therapeutic efficacy in DED. Various buffer systems were screened to identify optimal gelation conditions upon interaction with artificial tear fluid (ATF). Formulations were characterized by pH, osmolality, wettability, thermal behavior, viscosity, and viscoelastic properties. A Design of Experiments (DoE) approach was employed to understand the influence of GG and AG concentrations on rheological behavior. The selected formulation, GG(0.1%)/AG(0.2%), demonstrated a significant viscosity increase upon ATF dilution, suitable viscoelastic properties, enhanced mucoadhesion compared to hyaluronic acid, improved ferning patterns, no cytotoxic effects, and stability over time. In vivo studies in rabbits confirmed prolonged precorneal retention of the fluorescently labeled formulation. These results suggest that the GG/AG-based hydrogel is a promising strategy for improving the performance of artificial tears in DED treatment. Full article

Background/Objectives: Dutch newborn screening is an important public health program designed to detect conditions early in life, enabling timely interventions that can prevent mortality, morbidity, and long-term disabilities. However, the program also faces certain challenges. One such issue is obtaining and maintaining a high positive predictive value (PPV); another is that newborn screening (NBS) in the Netherlands is intended for all newborn babies until the age of six months. This means comparing infants at different ages may introduce variability that complicates data interpretation. To support the optimization of the program, we systematically analyzed population-level tandem mass spectrometry (MS/MS) data to explore postnatal metabolic changes. Methods: We evaluated the impact of covariates—including birth weight, gestational age, age at blood collection, and biological sex—on metabolite profiles using retrospective newborn screening (NBS) data. Special emphasis was placed on the combined effects of these covariates. The analysis was based on data from 985,629 newborns collected between 2018 and 2024. Results: Specifically, (extremely) preterm infants exhibit altered levels of several amino acids and acylcarnitines. Moreover, we observed multiplicative effects of gestational age and birth weight on several metabolic markers. Biological sex however, does not have an impact. The largest impact of the age of sampling was observed on the C0/C16+C18 ratio, which may impact screening performance for CPT1 deficiency. Conclusions: Covariate-adjusted reference values could improve the performance of the Dutch newborn screening. Full article

Background: Malnutrition is highly prevalent in hospitalized older adults and is associated with adverse clinical outcomes. However, the extent to which nutritional care is systematically implemented and its relationship with outcomes remains unclear. Methods: We conducted a retrospective analysis of 4963 patients aged ≥65 years who were admitted to the National Institute for Health and Scientific Research for the Elderly (IRCCS INRCA, Ancona, Italy) between 2012 and 2020 and received at least one nutritional consultation. We examined associations between timing and type of nutritional interventions, the Geriatric Nutritional Risk Index (GNRI), and clinical outcomes, including in-hospital mortality and length of hospital stay (LOS). We also analyzed the prevalence of different complications during Medical Nutritional Therapy (MNT). Results: Only 11% of hospitalized patients received a nutritional consultation. Among them, in-hospital mortality was 35.8%. The Geriatric Nutritional Risk Index was a significant predictor of mortality (HR 1.89; 95% CI: 1.55–2.31; p < 0.001) and inversely associated with LOS, reflecting a frail subset of patients with complex clinical conditions. The timing of nutritional consultation showed no significant association with mortality or LOS, possibly due to relatively prompt intervention (median 4 days). Enteral (EN) and parenteral nutrition (PN) were more frequently prescribed to non-survivors. Medical nutrition therapy-related complications were also more common in non-survivors (22.3% vs. 14%, p < 0.001). Artificial nutrition (AN) was not associated with increased mortality, but it was associated with prolonged hospital stays both in survivors and in non-survivors. Conclusions: Our findings highlight the limited use of nutritional consultations in hospitalized elderly patients despite the high prevalence of malnutrition and its prognostic relevance. The GNRI is a valuable tool for early risk stratification and clinical decision-making. Systematic screening and timely nutritional intervention, integrated with broader therapeutic goals, may improve care and optimize outcomes even in this vulnerable population. Full article

Car wash wastewaters (CWW) bring growing environmental challenges due to the increasing number of vehicles worldwide and they require novel, optimized and sustainable treatment methods. They are highly heterogenous, typically containing complex mixtures of detergents, waxes, oils, petroleum derivatives, corrosion inhibitors and salts, with the composition depending on installation age, geographic location, season, and weather. This study aimed to select bacteria resistant to variable and potentially toxic CWW, capable of biodegrading organic pollutants. A total of 81 strains isolated from various environmental sites were screened for tolerance to CWW environments by performing growth inhibition tests in 20 real wastewater samples with chemical oxygen demand (COD) ranging from 122 to 2267 mg O₂/dm³. Seventeen strain candidates were chosen, identified with molecular proteomics, and further evaluated for biodegradation potential. Based on the most robust isolates, six microbial consortia were developed and examined. Biodegradation experiments were conducted at ambient temperature without active pH control and nutrient supplementation to reflect real conditions occurring in wastewater treatment practice. The best-performing consortium reduced COD by 86% within 7 days. These findings should help improve the treatment of complex CWW by highlighting the potential of thoroughly selected bacteria as effective tools for bioremediation of extremely harsh environments. Full article

Background and Objectives: Vitamin D deficiency affects bone health and immune function, especially in children. While universal screening is not cost-effective, targeted screening and supplementation strategies have proven effective. This study evaluates the effectiveness of Romania’s National Vitamin D Screening Programme in detecting vitamin D deficiency in paediatric patients, while also accounting for the impact of the COVID-19 pandemic. Materials and Methods: This retrospective observational study assessed the effectiveness of Romania’s National Vitamin D Screening Initiative in detecting vitamin D deficiency among children admitted to the Clinical Emergency Hospital for Children “Louis Țurcanu”, Timișoara, from January 2018 to December 2024. Serum 25-hydroxyvitamin D levels were analysed in 3596 tested patients out of 22,353 total admitted patients, to evaluate trends from before, during, and after the COVID-19 pandemic. Patients aged 0–18 with at least one admission were included, regardless of diagnosis. Patients in ICU, surgical departments, non-Romanian citizens, and those with life-threatening conditions were excluded. Logistic regression analysis was used to assess programme impact and risk factors for vitamin D insufficiency. Results: The study population had a mean age of 5.36 years, with 53.57% male patients. Patient admissions dropped significantly during pandemic years (mean of 2057 annually in 2020–2022 vs. 4045.5 in pre-/post-pandemic years). Vitamin D insufficiency (<20 ng/mL) peaked at 33.3% in 2020 and 32.5% in 2023, with lowest rates in 2019 (17.2%) and 2021 (16.5%). The National Screening Programme implementation resulted in 57.1% higher odds of vitamin D testing in 2023–2024 compared with 2018–2019 (adjusted OR = 1.571, 95% CI: 1.429–1.726, p < 0.001), with testing rates increasing from 12.6% to 17.5%. Age emerged as the strongest predictor of vitamin D insufficiency, with each additional year associated with 8–9% increased odds of deficiency. Conclusions: The National Vitamin D Screening Programme significantly enhanced detection of vitamin D insufficiency in paediatric populations, despite pandemic-related disruptions. An optimal testing rate of approximately 17% was identified for balancing detection efficiency with resource utilisation. These findings underscore the need for sustained risk-based screening programmes and public health education initiatives to address vitamin D insufficiency in children, particularly in developing countries with limited healthcare resources. Full article

The natural wound healing process is often insufficient to restore tissue integrity in the case of chronic wounds, particularly when skin disruption is accompanied by pathological complications. The severity of these wounds is frequently exacerbated by persistent inflammation and the formation of bacterial biofilms, which significantly hinder skin regeneration. In this study, a pharmaceutical hydrogel-based wound dressing was developed and evaluated, incorporating silver nanoparticles synthesized with cinnamon essential oil that serves as both a stabilizer and antimicrobial agent, polymeric beta-carotene nanoparticles, and Centella asiatica extract. The work details the synthesis of both types of nanoparticles, their integration into an alginate-based matrix, and the subsequent formulation of composite dressings. The influence of each therapeutic agent on the morphology and structural characteristics of the dressings was demonstrated, along with the evaluation of their antimicrobial performance against both Gram-positive and Gram-negative bacterial strains. The antimicrobial effects observed within the first 24 h, critical for wound dressing application, highlight the potential of the developed materials for effective chronic wound management. A comprehensive set of analyses was performed to characterize the synthesized nanostructures and the final dressings. These included XRD, FTIR, SEM, EDS, and DLS. Additionally, swelling and degradation tests were conducted to assess hydrogel performance, while antimicrobial and antibiofilm activities were tested against Staphylococcus aureus and Escherichia coli over a 24-h period. The biocompatibility screening of the alginate-based wound dressings was performed on human keratinocyte cells and revealed that the incorporation of beta-carotene and Centella asiatica into alginate-based wound dressings effectively mitigates silver-induced cytotoxicity and oxidative stress and determines the development of highly biocompatible wound dressings. This paper presents an alginate hydrogel co-loaded with Ag nanoparticles, BC@PVP, and Centella asiatica extract that balances antimicrobial efficacy with cytocompatibility. Pairing silver with natural antioxidant/anti-inflammatory components mitigates cell stress while retaining broad activity, and the nanoparticle choice tunes pore architecture to optimize moisture and exudate control in chronic wounds. Full article

The renal vessels are known to exhibit variations in different populations. The present retrospective cross-sectional study aimed to evaluate the radiological anatomy of renal arteries and veins in the Omani population. Computed tomography angiography scans were used to assess diameter, laterality, and vascular branching patterns in adults (aged ≥ 18 years) who underwent contrast-enhanced CT angiography of the abdomen and pelvis between 1 January 2023, and 31 December 2024. Normal CT angiograms of cases performed for vascular pathology screening, renal transplant workup, or trauma evaluation with normal findings were included. Measurements included diameters, anatomical course, and vascular variations in the renal arteries and veins. Accessory renal arteries were defined as any additional arteries arising from the aorta supplying the kidney, regardless of the entry point. The mean diameters of the right and left renal arteries were significantly higher in males (p = 0.020 and 0.026, respectively). The right renal vein was significantly larger in females (p = 0.020). Accessory renal arteries were identified in 24.22% (n = 31 patients), including two cases with unilateral double accessory arteries. The right and left RA diameters were 4.51 ± 0.91 mm and 4.95 ± 0.98 mm, respectively, both significantly larger in males (p = 0.020 and 0.026). Supernumerary renal veins were observed in 21 patients; retroaortic and circumaortic left RVs were found in seven and one case(s), respectively. Venous variations were present in 17.2% of the Omani subjects. The findings may enhance preoperative planning, especially in renal transplantation and urologic surgery, by increasing awareness of anatomical variants. This region-specific dataset supports the development of optimized imaging protocols and surgical strategies for better patient care. Full article

Objectives: Clear cell renal cell carcinoma (ccRCC) may later metastasize despite curative surgery. This study asked whether transcriptomic alterations detectable at nephrectomy are associated with subsequent metastatic progression, and whether such signals retain prognostic relevance in overt metastatic disease. Methods: Bulk RNA sequencing was performed in 30 ccRCC patients without metastasis at surgery; 4 developed distant metastasis during follow-up. Differential expression, enrichment, and network analyses identified hub genes, which were screened by ROC analysis with bootstrap optimism correction. External validation used TCGA-KIRC focusing on patients metastatic at baseline (M1) to evaluate overall and disease-specific survival with multivariable Cox models (per-SD expression, adjusted for age, sex, and stage); Kaplan–Meier curves were shown for visualization only. Results: Fifty-nine DEGs distinguished patients who later metastasized from those who remained metastasis-free, with enrichment in mitotic and chromosomal-segregation pathways. Five hub genes (BASP1, CDCA8, KIF2C, LMNB1, TROAP) showed high discrimination in the discovery set (optimism-corrected AUC ~0.92–0.93). In TCGA-M1, CDCA8, and TROAP were consistently associated with worse survival and remained significant in multivariable models. Conclusions: Dysregulation of mitotic control may underlie latent metastatic competence in ccRCC. CDCA8 and TROAP emerge as candidate prognostic biomarkers, linking postoperative metastatic progression in an initially M0 cohort with survival in metastatic disease. These hypothesis-generating findings warrant validation in larger, prospective cohorts. Full article

Depression, stress, and anxiety are mental health disorders that are increasingly becoming a huge challenge in the digital age; at the same time, it is critical that they are detected early. Social media is a rich and complex source of emotional expressions that requires intelligent systems that can decode subtle psychological states from natural language. This paper presents RAMHA (RoBERTa with Adapter-based Mental Health Analyzer), a hybrid deep learning model that combines RoBERTa, parameter-efficient adapter layers, BiLSTM, and attention mechanisms and is further optimized with focal loss to address the class imbalance problem. When tested on three filtered versions of the GoEmotions dataset, RAMHA shows outstanding results, with a maximum accuracy of 92% in binary classification and 88% in multiclass tasks. A large number of experiments are performed to compare RAMHA with eight standard baseline models, including SVM, LSTM, and BERT. In these experiments, RAMHA is able to consistently outperform the other models in terms of accuracy, precision, recall, and F1-score. Ablation studies further confirm the contributions of the individual components of the architecture, and comparative analysis demonstrates that RAMHA outperforms the best previously reported F1-scores by a substantial margin. The results of our study not only indicate the potential of the adapter-enhanced transformer in emotion-aware mental health screening but also establish a solid basis for its use in clinical and social settings. Full article

Background and Objectives: Third-trimester screening is widely used to identify small for gestational age (SGA) and fetal growth restriction (FGR), but optimal models and timing remain under investigation. This study aimed to assess the performance of combined maternal factors and biomarkers, including ultrasound estimated fetal weight (EFW), Doppler indices, mean arterial pressure (MAP), and angiogenic biomarkers, for predicting SGA neonates after a routine 35–36 weeks’ scan in an unselected population. Materials and Methods: We conducted a retrospective cohort study in three Spanish centers offering universal third-trimester ultrasound. Logistic regression analyses were carried out to predict birthweight < 10th and <5th percentile using maternal characteristics and medical history, EFW, MAP, Doppler indices, and the angiogenic biomarkers placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1). Using a 10-fold cross-validation, we estimated the area under the receiver operating characteristic curve (AUC), detection rates (DRs), false-positive rates (FPRs), and their corresponding screen-positive rates (SPRs). External validation was performed using an independent cohort. Results: Among 3992 pregnancies, the DR of ultrasound alone for birthweight <10th percentile was 47.9% (95% CI: 44.0 to 51.9), with an FPR of 7.3%. Adding maternal factors increased DR to 57.0% (95% CI: 53.0 to 60.9) at 10% FPR and to 83.0% (95% CI: 79.9 to 85.9) at 30% FPR. Similarly, the DR of ultrasound alone for birthweight < 5th percentile was 48.4% (95% CI: 43.1 to 53.6), with an FPR of 4.5%. Adding maternal factors increased DR to 65.7 (95% CI: 60.5 to 70.5) at 10% FPR and to 88.2 (95% CI: 84.4 to 91.3) at 30% FPR. The inclusion of MAP, Doppler, and biomarkers provided marginal additional gains, particularly for <5th percentile prediction. To achieve a DR > 80%, an SPR of approximately 40% was required. Performance improved when focusing on neonates born before 38 weeks, with a DR of 77.5 (95% CI: 68.6 to 84.9) at 10% FPR for SGA < 10th percentile. However, less than 40% of screen-positive women remained undelivered by 40 weeks, limiting the number requiring further surveillance. Conclusions: A third-trimester screening at 35–36 weeks using maternal characteristics and EFW identifies most SGA neonates, particularly those delivering before 38 weeks. Even including other biomarkers, an SPR of about 40% should be necessary to achieve a high DR. However, less than 40% of the women would remain undelivered before a subsequent follow-up is required. Full article

Screening for diabetes-specific distress should be considered a standard component of diabetes management. This study aimed to evaluate the psychometric properties of the Serbian adaptation of the Problem Areas in Diabetes—Teen Version (PAID-T). Methods: A multicentre, validation, cross-sectional study was conducted with 374 adolescents (aged 13–18 years) diagnosed with type 1 diabetes (T1D), all of whom completed the Serbian version of the PAID-T. The psychometric evaluation included assessments of construct validity through exploratory (EFA, first subsample, n = 140) and confirmatory (CFA, second subsample, n = 234) factor analyses, as well as examinations of concurrent and convergent validity. Reliability was evaluated using measures of internal consistency and test–retest stability (n = 289). Results: Factor analyses indicated some multidimensionality; however, the high correlations between factors in the three-factor model and the optimal fit of the hierarchical three-factor model with a single second-order factor supported the interpretation that the PAID-T measures a unified construct, with satisfactory fit indices (CFI = 0.95; TLI = 0.93; RMSEA = 0.08; SRMR = 0.05). Concurrent validity testing demonstrated gender-based differences in adolescents’ perceptions of the emotional burden of diabetes (W = 19.718, p = 0.03, small effect size = 0.11). Convergent validity analyses showed that adolescents who were non-adherent to treatment (W = 11.390, p = 0.01, small effect size = 0.13) or experienced difficulties managing diabetes at school (W = 16.333, p < 0.001, small effect size = 0.16) reported significantly higher levels of diabetes-specific distress. A significant negative correlation was also observed between PAID-T scores and perceived social support (ρ = −0.24, p < 0.001). Importantly, Serbian adolescents with T1D reported mean PAID-T scores close to the cutoff point of 44, indicating clinically relevant levels of distress. The Serbian version demonstrated strong internal consistency (Cronbach’s α = 0.92; McDonald’s ω = 0.93) and excellent test–retest reliability (ICC = 0.99, 95% CI), confirming stability over time. Conclusions: The Serbian adaptation of the PAID-T demonstrated strong validity and reliability, supporting its use as a robust tool for assessing self-reported diabetes-specific distress in adolescents. Notably, the mean PAID-T scores in Serbian adolescents with T1D were close to the established cutoff point of 44, underscoring the clinical relevance of routine screening in this population. The early identification of diabetes distress can enable nurses and other members of the multidisciplinary healthcare team to deliver tailored interventions, ultimately improving psychological well-being and health outcomes. Full article

Objective: The study aimed to analyze the relationship between screen time (ST) duration, body weight status (BWS), and selected lifestyle behaviors in children aged 10–12. Methods: A cross-sectional study of 7763 (50.8% girls) Polish schoolchildren was conducted in 2023–2024. Data on ST, physical activity (PA), sleep duration (SD), frequency of consumption of unhealthy foods, family meals (FM), and sociodemographic data were collected using a paper questionnaire. Anthropometric data were obtained from measurements; body mass index (BMI) was used to assess BWS, and the waist-to-height ratio to measure central obesity. A logistic regression model was performed to assess the effect of unhealthy food consumption, FM, BWS, PA level, and SD on the odds of excessive ST (>2 h/day). Results: Girls were less likely to extend ST than boys (OR: 0.78; 95% CI: 0.70–0.86). Increased PA had a limiting effect on the dependent variable (moderate OR: 0.64; 95% CI: 0.53–0.77; vigorous OR: 0.37; 95% CI: 0.31–0.45). Sleeping 6–8 h per day was associated with a 41.6% increase in prolonged ST (OR: 1.42; 95% CI: 1.27–1.57). Overweight/obese individuals were 39.6% more likely to exceed ST compared to normal-weight peers (OR: 1.40; 95% CI: 1.16–1.68). Living in a village and a smaller city increased the odds of excessive ST (OR: 1.12; 95% CI: 1.07–1.41 and OR: 1.18; 95% CI: 1.03–1.34). Conclusions: Excessive body mass and unhealthy dietary habits, particularly sugary beverages, have been identified as significant risk factors for excessive ST. Optimal SD, high PA, and regular FM might have a protective effect on ST. This knowledge will contribute to designing more tailored and effective educational interventions promoting healthy lifestyles in children. Full article

Introduction: Overuse injuries are a growing concern among adolescent soccer players, with the repetitive nature of the sport placing significant physical demands on young athletes. These injuries can have long-term implications for physical development, performance, and overall well-being. This narrative synthesis aimed to evaluate the existing literature on the epidemiology, risk factors, and management strategies for overuse injuries in adolescent soccer players. Methods: A comprehensive literature search was conducted using PubMed and Embase. A total of 123 articles were identified, 27 of which met the inclusion criteria after screening. Studies focusing on overuse injuries in adolescent soccer players aged 10–18 years were included, while those addressing acute injuries, non-soccer populations, or adult athletes were excluded. Relevant quantitative and qualitative data were extracted and evaluated. Due to heterogeneity in study designs and outcomes, findings were narratively synthesized rather than meta-analyzed. Results: The period around peak height velocity (PHV: 11.5 years in girls, 13.5 years in boys) was consistently identified as a high-risk window, with seven studies demonstrating a significantly increased incidence of overuse injuries. Additional risk factors included leg length asymmetry, truncal weakness, early sport specialization, high ratios of organized-to-free play, and increased body size. Injury burden was greatest for hamstring and groin injuries, often leading to prolonged time lost from play. Preventive interventions such as plyometric training, trunk stabilization, and structured load monitoring demonstrated reductions in injury incidence in several prospective studies, though protocols varied widely. Conclusion: This narrative synthesis highlights PHV as the most consistent risk factor for overuse injuries in adolescent soccer players, alongside modifiable contributors such as training load, sport specialization, and free play balance. Evidence supports neuromuscular training and structured monitoring as promising preventive strategies, but there remains a lack of standardized, evidence-based protocols. Future research should focus on optimizing and validating interventions, integrating growth and load monitoring, and leveraging emerging approaches such as machine learning-based risk prediction. Full article

Background and Objectives: Pyogenic spondylodiscitis (SD) is a severe spinal infection involving the intervertebral disc and adjacent vertebrae and is often associated with significant morbidity. Identifying the causative microorganism is crucial for targeted treatment; however, the microbiological yield from blood or tissue cultures varies widely due to factors such as prior antibiotic use and biopsy technique. In this study, we aimed to investigate the clinical, laboratory, and radiological predictors of microbiological yield, particularly from tissue biopsy specimens. Materials and Methods: This retrospective cohort study included adult patients diagnosed with pyogenic SD between January 2023 and July 2025 at a tertiary care hospital. Demographics, comorbidities, laboratory markers (CRP, ESR, ALP, albumin), radiological findings (abscess presence, anatomical location, claw sign), prior antibiotic use, and microbiological results were analyzed. Tissue specimens were obtained through either surgical sampling or needle biopsy. Univariable and multivariable logistic regression were performed to determine the predictors of positive tissue cultures. Results: Of the 159 patients screened, 55 met our inclusion criteria. The mean age was 63.9 ± 13.5 years, 80% had lumbar involvement, and 58.2% had abscesses, primarily paravertebral or psoas in location. Microorganisms were isolated in 65.5% of the cases, with Staphylococcus aureus being the most common (41.7%). The blood culture positivity was 55.5%, while tissue culture positivity was 40.4%. Logistic regression revealed that lower albumin (p = 0.046) and higher ALP levels (p = 0.045) were independent predictors of a positive microbial yield from tissue biopsies. Conclusions: Serum albumin and ALP levels may aid clinical decision-making regarding invasive sampling in SD. When blood cultures are negative and albumin is low while ALP is elevated, clinicians should consider prioritizing tissue biopsy. These findings may help optimize diagnostic strategies and should be validated in larger, prospective studies. Full article