Treatment Concepts Research Articles

Amino Acid Double-Passivation-Enhanced Quantum Dot Coupling for High-Efficiency FAPbI3 Perovskite Quantum Dot Solar Cells.

Formamidinium lead triiodide (FAPbI3) perovskite quantum dot has outstanding durability, reasonable carrier lifetime, and long carrier diffusion length for a new generation of highly efficient solar cells. However, ligand engineering is a dilemma because of the highly ionized and dynamic characteristics of quantum dots. To circumvent this issue, herein, we employed a mild solution-phase ligand-exchange approach through adding short-chain amino acids that contain amino and carboxyl groups to modify quantum dots and passivate their surface defects during the purification process. As a result, the photoelectric conversion efficiency of FAPbI3 perovskite quantum dot solar cells (PQDSCs) increased from 11.23 to 12.97% with an open-circuit voltage of 1.09 V, a short-circuit current density of 16.37 mA cm-2, and a filling factor of 72.13%. Furthermore, the stability of the device modified by amino acids retains over 80% of the initial efficiency upon being exposed to 20-30% relative humidity for 240 h of aging treatment. This work may offer an innovative concept and approach for surface ligand treatment to improve the photovoltaic performance of PQDSCs toward large-scale manufacture.

P915 Multi-Omics Biomarkers for the Prediction of Response to Biologics in Patients with Inflammatory Bowel Disease

Abstract Background The treatment concept for inflammatory bowel disease (IBD) has been transformed with biologics now recommended as the first-line therapy for moderate-to-severe patients. However, the significant heterogeneity among IBD patients has limited the efficacy of selected biologics based on traditional clinical factors. Therefore, it is imperative to molecularly stratify patients to match them with the most appropriate biologics. In this study, we systematically reviewed baseline omics biomarkers that have the potential to predict response to biological therapies, aiming to facilitate precision medicine in IBD. Methods We conducted a comprehensive literature search using PubMed by which we included studies that explore the role of omics biomarkers in predicting the efficacy of various biologics including anti-TNFα, anti-integrin, anti-IL-12/23P40 and anti-IL-23 P19 in patients with IBD. Results Our review included 110 studies. Of these, 86 studies focused on anti-TNFα, 17 focused on anti-integrin and 7 focused on anti-IL-12/23P40 and/or anti-IL-23P19. These studies investigated multi-levels baseline biomarkers, including genomics, transcriptomics (bulk RNA and sc-RNA sequence), proteomics, microbiome, and metabolomics (derived from serum, urine, or stool). Furthermore, recent studies already focused on integrating multiple omics analysis and showed that the predictive model based on multi-omics data could significantly enhance their performance. Among the available biomarkers, mucosal transcription of OSM (AUROC = 0.83), IL-13RA2 (AUROC = 0.90), and TREM-1 transcription in mucosal biopsy (AUROC = 0.77) as well as in PBMC ( AUROC varies between 0.78 and 0.94) could accurately predict the response to anti-TNFα. The mucosal IL-23A transcription could discriminate responders from non-responders to anti-IL-12/23P40 with an AUROC of 0.90. OSM, biomarkers of intestinal collagen turnover like C4M, IL-17, IL-22, and TNFα in serum also showed significant potential in predicting the response to anti-TNFα, anti-integrin and anti-IL-12/23P40. In addition, single-cell molecular signatures with sc-RNA sequencing provided more profound insights into predicting the response to biologics. The lack of reproducibility in results across different groups may be due to the disparity in patient selection, methodology, and study designs among different investigations. Conclusion Numerous omics markers have shown great potential in predicting the efficacy of biologics. However, it is crucial to explore and validate these novel biomarkers in larger cohorts using harmonized protocols to facilitate their evaluation into actual clinical practice, especially for newer biologics like anti-IL-12/23P40 and anti-IL-23P19.

Photodynamic Therapy as a Desirable Approach in the Treatment of Colorectal Cancer, with Special Focus on Photodynamic Nanotherapeutics in Immunotherapy.

Colorectal cancer (CRC) is one of the most prevalent malignancies worldwide; however, there is not a convincing treatment for this disease. Limitations of conventional CRC therapies force scientists to develop novel treatment concepts for both primary care alongside adjuvant therapy. Photodynamic therapy (PDT) has been introduced as a promising therapeutic procedure for CRC mediated through theranostic principle in which special dyes, photosensitizers (PSs), are excited by near-infrared (NIR) and visible light. Recent studies showed that PDT has synergistic effects in combination with chemotherapy or immunotherapy in the treatment of CRC patients. Of note, nanoformulation of PS or immunotherapeutic agents could augment the PDT effectiveness. In this review, we summarize PDT application in CRC management with a special focus on the nanoparticles-based delivery system from the perspective of targeting deeper CRC and increased PDT efficiency, which could provide a desirable approach for clinical translation.

Addiction interprofessional experiences of care: Stress, coping and transformation.

This study aimed to explore healthcare professionals' attribution of meaning to the concept of addiction, treatment and recovery. The study was conducted through semi-structured interviews with 18 healthcare professionals in the field of addiction: nine nurses, six psychologists, a psychiatrist, a social worker and a psychosocial technician. Based on a qualitative methodology, a thematic analysis was performed using the NVivo software. Regarding professional stress, the results revealed several stress factors related to the intervention (e.g. strategic powerlessness and uncertainty of intervention's effectiveness), the addicted individuals (e.g. motivation, difficulties in adhering to treatment, patient behaviour, negative patient emotionality and lack of socio-economic resources) as well as the healthcare services (e.g. team stress). Adaptive coping strategies were reported, both used in the work context (e.g. cognitive coping strategies and acceptance) and in personal life (e.g. work-family boundaries and family support and closeness). Despite the professional stress experienced, the participants' narratives indicated positive transformations of the self, which suggests resilient professional trajectories.

Concept of Parental Treatment in Surah Luqman Verses 13-19

Concept of Parental Treatment in Surah Luqman Verses 13-19

Current Aspects of Regenerative Endodontics: A Systematic Review

Relevance. The modern concept of endodontic treatment in most clinical cases involves extirpation of the pulp with the loss of its plastic, trophic, sensory, and protective functions. In this regard, the search for ways to recreate lost cells and the main substance of the pulp and periodontium to replace the intraradicular space with “vital” tissue. Regenerative endodontics based on the principles of tissue engineering and offers techniques for restoring damaged tissues of the pulp-dentin complex based on the use of stem cells, growth factors, and an organic matrix. Aim. Systematize information presented in scientific articles about research conducted, opportunities and development prospects in the field of regenerative endodontics. Materials and methods. A search of literature sources was carried out in the PubMed, dissercat.com, elibrary database.ru, cyberleninka.ru, by keywords, “regenerative endodontics”, “stem cells”, “growth factors”, “pulp-dentin complex” with a choice of article types “Clinical Trial”, “Meta-Analysis”, “Review”, "Systematic Review". Results. After analyzing the literature review, an idea was obtained about the current stage of development of regenerative endodontics, preclinical and clinical studies on the restoration of the pulp-dentin complex. Clinical cases based on the triad of regenerative endodontics are presented, as well as an algorithm for performing these therapeutic procedures. Conclusions. Regenerative endodontics is a rapidly developing discipline whose clinical advances are primarily related to the treatment of immature tooth roots, which results in continued root development. Subsequent scientific research is aimed at obtaining significant results in the treatment of a fully formed permanent tooth, which will ensure a unique restoration of the immunological, sensory and protective properties of the pulp-dentine complex.

Evidence and emerging trends in local therapy for metastatic hormone-sensitive prostate cancer: a narrative review.

Metastatic hormone-sensitive prostate cancer (mHSPC) displays both simultaneous and sequential patterns of metastasis, emphasizing a comprehensive treatment approach that integrates both local therapy and systemic treatment strategies. The increasing use of molecular imaging has led to a rise in mHSPC diagnoses, underscoring the importance of identifying the right patient population and effective treatment concepts for this disease state. Two prospective trials, HORRAD and STAMP EDE, investigated prostate radiotherapy (RT) for mHSPC; however, they did not show an overall survival (OS) benefit in the unselected cohort. Nonetheless, RT showed favorable outcomes in patients with fewer than five bone metastases, resulting in a 7% 3-year survival improvement and supporting the integration of RT in multimodal treatment for men with oligometastatic mHSPC. Regarding cytoreductive prostatectomy (cRP), the TRoMbone Trial confirmed its feasibility and safety. In addition, findings from the FUSCC-OMPCa Trial demonstrated improved 3-year radiographic progression-free survival and OS rates with acceptable rates of complications and incontinence. Recent data from the LoMP registry have further supported superior OS and cancer-specific survival (CSS) in patients undergoing cRP compared to systemic therapy alone. Notably, no significant differences in OS and CSS were observed between the cRP and RT groups. However, cRP-treated patients exhibited superior 2-year local event-free survival when compared to those treated with RT. RT in combination with systemic therapy remains the established first-line treatment for low-burden mHSPC, though the exact definition of low metastatic burden remains contentious. Precise assessment of metastatic burden is vital to identify patients who would derive the greatest benefit from RT. As treatment paradigms evolve, embracing multimodal approaches holds potential for optimizing outcomes in patients with mHSPC. Further research is needed to solidify the role of cRP as a standard therapeutic approach and to refine treatment strategies for improved patient outcomes.

Risk-benefit analysis of surgical treatment strategies for cystic craniopharyngioma in children and adolescents.

Treatment strategies for craniopharyngiomas are still under debate particularly for the young population. We here present tumor control and functional outcome data after surgical treatment focusing on stereotactic and microsurgical procedures for cystic craniopharyngiomas in children and adolescents. From our prospective institutional database, we identified all consecutive patients less than 18 years of age who were surgically treated for newly-diagnosed cystic craniopharyngioma between, 2000 and, 2022. Treatment decisions in favor of stereotactic treatment (STX) or microsurgery were made interdisciplinary. STX included aspiration and/or implantation of an internal shunt catheter for permanent cyst drainage. Microsurgery aimed for safe maximal tumor resections. Study endpoints were time to tumor recurrence (TTR) and functional outcome including ophthalmological/perimetric, endocrinological, and body-mass index (BMI) data. 29 patients (median age 9.9 yrs, range 4-18 years) were analyzed. According to our interdisciplinary tumor board recommendation, 9 patients underwent stereotactic treatment, 10 patients microsurgical resection, and 10 patients the combination of both. Significant volume reduction was particularly achieved in the stereotactic (p=0.0019) and combined subgroups (p<0.001). Improvement of preoperative visual deficits was always achieved independent of the applied treatment modality. Microsurgery and the combinational treatment were associated with higher rates of postoperative endocrinological dysfunction (p<0.0001) including hypothalamic obesity (median BMI increase from 17.9kg/m2 to 24.1kg/m2, p=0.019). Median follow-up for all patients was 93.9 months (range 3.2-321.5 months). Recurrent tumors were seen in 48.3% and particularly concerned patients after initial combination of surgery and STX (p=0.004). In here, TTR was 35.1 ± 46.9 months. Additional radiation therapy was found indicated in 4 patients to achieve long-lasting tumor control. In children and adolescents suffering from predominantly cystic craniopharyngiomas, stereotactic and microsurgical procedures can improve clinical symptoms at low procedural risk. Microsurgery, however, bears a higher risk of postoperative endocrine dysfunction. A risk-adapted surgical treatment concept may have to be applied repeatedly in order to achieve long-term tumor control even without additional irradiation.

Needle-Free Jet Injection of Poly-(Lactic Acid) for Atrophic Acne Scars: Literature Review and Report of Clinical Cases.

Acne scars, particularly atrophic ones, present a persistent challenge in cosmetic medicine and surgery, requiring extended and multifaceted treatment approaches. Poly-(lactic acid) injectable fillers show promise in managing atrophic acne scars by stimulating collagen synthesis. However, the utilization of needle-free injectors for delivering poly-(lactic acid) into scars remains an area requiring further exploration. In this article, a summary of the latest advancements in needle-free jet injectors is provided, specifically highlighting the variations in jet-producing mechanisms. This summary emphasizes the differences in how these mechanisms operate, offering insights into the evolving technology behind needle-free injection systems. The literature review revealed documented cases focusing on treating atrophic acne scars using intralesional poly-(lactic acid) injections. The results of these clinical studies could be supported by separate in vitro and animal studies, elucidating the feasible pathways through which this treatment operates. However, there is limited information on the use of needle-free jet injectors for the intradermal delivery of poly-(lactic acid). Clinical cases of atrophic acne scar treatment are presented to explore this novel treatment concept, the needle-free delivery of poly-(lactic acid) using a jet pressure-based injector. The treatment demonstrated efficacy with minimal adverse effects, suggesting its potential for scar treatment. The clinical efficacy was supported by histological evidence obtained from cadaver skin, demonstrating an even distribution of injected particles in all layers of the dermis. In conclusion, we suggest that novel needle-free injectors offer advantages in precision and reduce patient discomfort, contributing to scar improvement and skin rejuvenation. Further comprehensive studies are warranted to substantiate these findings and ascertain the efficacy of this approach in scar treatment on a larger scale.

“Piezocision assisted orthodontics: Already 14 years…”

Piezocision™ assisted orthodontics as a technique was first published 14 years ago. This technique has evolved into a treatment concept that allows the orthodontist to treat successfully challenging cases by creating differential anchorage in three planes while maintaining or enhancing the patients’ periodontal phenotype. Technical advances in digital dentistry over the past 10 years have brought some important innovations to Piezocision™ assisted orthodontic surgery. Dynamic Navigated Piezocision™ allows the surgeon to see the corticotomies in REAL TIME on the monitor screen, thus avoiding roots, anatomical structures and getting to proper depth. Piezocision™ allows for Precision orthodontics. In the past 10 years it has helped in distalization mechanics, bite opening, severe torque issues, treatment of posterior crossbites in adults, posterior open bites, anterior open bites, alveolar insufficiencies and impacted teeth eruption.

New concept of etiopathogenesis and treatment of primary open-angle glaucoma

Primary open-angle glaucoma (POAG) is one of the main causes of irreversible blindness. There is no single theory of POAG development. The trigger of the disease is unknown. Treatment is ineffective. The author's concept: the trigger of the glaucomatous process is a genetically programmed small distance between the ciliary body and the lens equator (less than the age-related norm) in the presbyopic period of life. This causes weakness of accommodation and triggers further pathological changes in the eye. For proof of concept, large-scale studies of the anterior segment of the eye (ultrasound biomicroscopy) should be performed in presbyopes with ophthalmic hypertension, with and without POAG, with measurement of the distance "ciliary body - lens equator". Objective acomodometry is also necessary to determine the volume of accommodation in the above patients. In case of confirmation of the author's concept, a 3-component phased treatment of POAG is proposed: 1. Surgical expansion of the ciliary body ring (scleral thinning) - non-penetrating supraciliary sclerectomy or application of antimetabolites to the supraciliary sclera; 2. Phaco emulsification of the lens with implantation of an IOL model that maximizes the volume of pseudo - accommodation; 3. antiglaucomatous microinvasive surgery.

Understanding health care pathways of patients with sepsis: protocol of a mixed-methods analysis of health care utilization, experiences, and needs of patients with and after sepsis

BackgroundSepsis is associated with about 20% of deaths worldwide. It often presents with non-specific initial symptoms, making its emergency treatment an interdisciplinary and cross-sectoral challenge. Three in four sepsis survivors suffers from new cognitive, psychological, or physical sequelae for which specific treatment concepts are scarce. The AVENIR project aims to improve the understanding of patient pathways, and subjective care experiences and needs along the entire healthcare pathway before, with and after sepsis. Based on this, concrete recommendations for the organization of care and patient information materials will be developed with close patient participation.MethodsMixed-methods study including (1) analysis of anonymized nationwide health claims data from Germany, (2) linkage of health claims data with patient care reports (PCR) of emergency medical services from study regions in two federal states within Germany, and (3) qualitative exploration of the patient, relative, and care provider perspective on sepsis care. In (1), we analyze inpatient and outpatient health care utilization until 30 days pre-sepsis; clinical sepsis care including intra- and inter-hospital transfers; and rehabilitation, inpatient and outpatient aftercare of sepsis survivors as well as costs for health care utilization until 24 months post-sepsis. We attempt to identify survivor classes with similar health care utilization by Latent Class Analyses. In (2), PCR are linked with health claims data to establish a comprehensive database outlining care pathways for sepsis patients from pre-hospital to follow-up. We investigate e.g., whether correct initial assessment is associated with acute (e.g., same-day lethality) and long-term (e.g., new need for care, long-term mortality) outcomes of patients. We compare the performance of sepsis-specific screening tools such as qSOFA, NEWS-2 or PRESEP in the pre-clinical setting. In (3), semi-structured interviews as well as synchronous and asynchronous online focus groups are conducted and analyzed using qualitative content analyses techniques.DiscussionThe results of the AVENIR study will contribute to a deeper understanding of sepsis care pathways in Germany. They may serve as a base for improvements and innovations in sepsis care, that in the long-term can contribute to reduce the personal, medical, and societal burden of sepsis and its sepsis sequelae.Trial registrationRegistered at German Clinical Trial Register (ID: DRKS00031302, date of registration: 5th May 2023).

Current Treatment Concepts for Extra-Abdominal Desmoid-Type Fibromatosis: A Narrative Review.

Extra-abdominal desmoid-type fibromatosis (EADTF) is a rare neoplastic condition of monoclonal fibroblastic proliferation characterized by local aggressiveness with a distinct tendency to recur. Although EADTF is a benign disease entity, these tumors have a tendency to infiltrate surrounding normal tissues, making it difficult to completely eliminate them without adjacent healthy tissue injury. Surgical excision of these locally aggressive tumors without clear resection margins often leads to local recurrence. The aim of this thorough review was to assess the current treatment concepts for these rare tumors. A comprehensive search of articles published in the Cochrane Library, MEDLINE (PubMed), and EMBASE databases between January 2008 and February 2023 was conducted. Surgical intervention is no longer the first-line approach for most cases; instead, strategies like active surveillance or systemic therapies are used as initial treatment options. With the exception of EADTFs situated near vital structures, a minimum of 6-12 months of active surveillance is currently advocated for, during which some disease progression may be considered acceptable. Non-surgical interventions such as radiation or cryoablation may be employed in certain patients to achieve local control. The currently preferred systemic treatment options include tyrosine kinase inhibitors, low-dose chemotherapy, and gamma-secretase inhibitors, while hormone therapy is not advised. Nonsteroidal anti-inflammatory drugs are utilized primarily for pain management.

Concept for the treatment of periprosthetic proximal femoral fractures

Due to demographic changes and increased survival rates of total hip arthroplasties, the incidence of periprosthetic proximal femoral fractures is increasing. The current treatment concept requires accurate preoperative planning. Besides patient-related risk factors, fracture type, prosthesis stability, and bone quality influence whether osteosynthesis or arevision arthroplasty is required.

Multiparametric Monitoring of Disease Progression in Contemporary Patients with Wild-Type Transthyretin Amyloid Cardiomyopathy Initiating Tafamidis Treatment.

Recently, a disease modifying therapy has become available for transthyretin amyloid cardiomyopathy (ATTR-CM). A validated monitoring concept of treatment is lacking, but a current expert consensus recommends three clinical domains (clinical, biomarker and ECG/imaging) assessed by several measurable features to define disease progression. We retrospectively analyzed data of wild-type ATTR-CM patients initiating tafamidis therapy assessed within our local routine protocol at baseline and 6-months follow-up with respect to the frequency of values beyond the proposed thresholds defining disease progression. Additionally, associations of cardiac magnetic resonance (CMR) tomography with clinical domains were examined within a subgroup. Sixty-two ATTR-CM patients were included (88.7% male, mean age 79 years). In total, 16.1% of patients had progress in the clinical and functional domain, 33.9% in the biomarker domain and 43.5% in the imaging/electrocardiography (ECG) domain, with the latter driven by deterioration of the diastolic dysfunction grade and global longitudinal strain. In total, 35.5% of patients showed progress in none, 35.5% in one, 29.0% in two and no patient in three domains, the latter indicating overall disease progression. A subgroup analysis of twenty-two patients with available baseline and follow-up CMR data revealed an increase in CMR-based extracellular volume by more than 5% in 18.2% of patients, with no significant correlation with progress in one of the clinical domains. We provide first frequency estimates of the markers of disease progression according to a recent expert consensus statement, which might help refine the multiparametric monitoring concept in patients with ATTR-CM.

Risk factors for multimodal conservative approach failure before bariatric surgery.

A multimodal conservative approach (MCA) is internationally recommended prior to bariatric surgery for the majority of patients. This research aimed to identify risk factors for therapy failure within the MCA. This study was conducted in a German bariatric obesity centre. Patients who underwent a 3- to 6-month preoperative MCA from November 2019 to October 2020 were prospectively recorded and analysed. MCA included dietary and movement therapy, psychological and endocrinological referral and connection to a patient support group. The change in BMI was considered the main parameter for therapeutic success. Explanatory factors were evaluated for this outcome of interest and included physical and mental well-being (SF-36), perceived stress (DASS-21), social and economic situation and educational background (SOEP). Out of 413 eligible patients, 209 were analysed. Overall, patients gained BMI (average gain 0.23 kg/m² (s.d. 1.44 kg/m²)) during the preoperative MCA. Diverse social, demographic and economic and health properties did not influence the course of the therapy. There was a significant positive correlation between successful loss of BMI and physical well-being (β = 0.03, 95% c.i. 0.01 to 0.04, P < 0.0001) and a negative correlation between mental well-being (β = -0.02, 95% c.i. -0.004 to -0.001, P = 0.001) as well as self-perceived stress (β = -0.05, 95% c.i. -0.09 to -0.01, P = 0.019), although these effects were small and did not affect the overall trend of gaining BMI during MCA. The current therapeutic approach of preoperative conservative treatment within the multimodal concept of bariatric treatment fails to achieve its intended outcome. A different conservative weight loss programme from the pre-bariatric setting, which should focus on a surgical preparation, is therefore recommended.

Immunotherapy against gliomas

Gliomas represent the most frequent malignant primary brain tumors in adults. Despite multimodal treatment concepts involving surgery, irradiation and chemotherapy, the prognosis remains poor and they are incurable. Recent insights into the interactions between the immune system and the central nervous system as well as breakthroughs in the results of other cancer types have led to the fact that various immunotherapeutic approaches against gliomas have also been investigated and in some cases specifically developed. This article provides an overview of the current status of different immunotherapeutic concepts against gliomas, highlighting the advantages, disadvantages, and challenges. Additionally, it provides an overview of currently ongoing immunotherapeutic clinical trials in Germany and neighboring countries. Previous randomized studies on antibodies against programmed cell death protein1 (anti-PD1) immune checkpoint inhibition, viral treatment and peptide vaccination targeting the variantIII of the epidermal growth factor receptor (EGFRvIII) in glioblastomas were negative with respect to survival benefits. Conversely, other immunotherapeutic approaches, such as multivalent or driver mutation-based vaccinations, cytokine-based therapy and cell therapy, demonstrated arobust scientific foundation, with at least early studies showing promising safety and pharmacodynamic effects on the tumors. Currently, immunotherapies against gliomas should only be applied within the framework of well-designed clinical studies. There are still many knowledge gaps regarding the mechanisms of action and resistance of various immunotherapies. Accompanying translational research is essential to address these gaps and develop more effective therapies.

Evaluation of edentulous maxillary and mandibular full arch implant supported rehabilitation using All-on-four treatment concept -A 8-year follow-up retrospective study.

Evaluation of edentulous maxillary and mandibular full arch implant supported rehabilitation using All-on-four treatment concept -A 8-year follow-up retrospective study.

The effect of posterior dental implant angulations in all-on-four treatment concept on the stresses induced at implant/crystal bone interface using glass fiber reinforced composite framework: Three‑dimensional finite element analysis

The effect of posterior dental implant angulations in all-on-four treatment concept on the stresses induced at implant/crystal bone interface using glass fiber reinforced composite framework: Three‑dimensional finite element analysis

What is the agreement between principles and practice of antibiotic stewardship in the management of diabetic foot infection: an in-hospital quality control study.

Introduction: Standardization of diagnostic and treatment concepts in diabetes-related foot infection (DFI) is challenging. In 2019, specific recommendations regarding diagnostic principles and antibiotic therapy (ABT) for DFI, including the one for osteomyelitis (DFO), were introduced in our institution. In this study, we assessed the adherence to these in-house guidelines 2 years after their implementation. Methods: Adult patients with DFI with and without DFO who underwent surgical intervention between 2019 and 2021 were included. Patients' charts were retrospectively reviewed. Accordance to recommendations regarding biopsy sampling, labeling, requesting microbiological and histopathological examinations, and treatment duration were assessed. Results: A total of 80 patients with 117 hospital episodes and 163 surgical interventions were included; 84.6 % required an amputation. Patients with HbA1c levels of % more often required a revision during the same hospitalization than those with HbA1c levels of % (29.4 % vs.12.1 %, respectively, ). Specimens were obtained in 71.8 % of operations and sent for histological examination in 63.2 %. The mean duration of ABT was 9 (interquartile range (IQR) 5-15) d in macroscopically surgically cured episodes and 40.5 (IQR 15-42) d in cases with resection margins in non-healthy bone ( ). Treatment duration results were similar when using histological results: 13 (IQR 8-42) d for healthy bone vs.29 (IQR 13-42) d for resection margins consistent with osteomyelitis ( ). Conclusion: The adherence to recommendations in terms of biopsy sampling was good, moderate for histopathological analysis and poor for labeling the anatomic location. Adherence to recommendations for ABT duration was good, but further shortening of treatment duration for surgically cured cases is necessary.