Surveillance Report of the Prevalence and Risk Factors of Chronic Non-Communicable Diseases in Tinghu District,Yancheng City,2021

Objective:To comprehensively understand the changes and prevalence of major chronic diseases among residents of Tinghu District,Yancheng City,in 2021,and to analyze the trends of the major risk factors for the onset of chronic diseases in the region.Methods:Chronic diseases and their risk factors in Tinghu District in 2021 were monitored among the resident population who had lived in the district for five years or more and were aged 18 years or older.The survey was conducted using random cluster sampling,with 7,130 questionnaires collected.After data processing,7,012 valid questionnaires were obtained,resulting in a qualification rate of 98.35%.Results:Among the chronic diseases reported in the survey population,hypertension had the highest prevalence at 37.61%,followed by dyslipidemia at 37.19%.Other chronic diseases were ranked in order of prevalence from highest to lowest.Regardless of gender,the top three chronic diseases were hypertension,diabetes,and hyperlipidemia.Multifactorial regression analysis identified both non-preventable risk factors(such as family history,gender,and age)and preventable risk factors(such as smoking,sedentary behavior,overweight,and obesity)as significant contributors to the major chronic diseases in Tinghu District.Conclusion:Analyzing the trends in the main risk factors for chronic disease incidence in Tinghu District,Yancheng City,provides a basis for developing a new comprehensive chronic disease prevention and control plan to address chronic disease prevention and management.

Prevalence of Risk Factors for Chronic Non-Communicable Diseases to the National Teaching Hospital “HKM” of Cotonou

Background: In 2008 Non-communicable diseases (NCDs) were responsible for 63% of deaths worldwide and 80% of these deaths occurred in developing countries. Four of them were responsible for more than 80% of mortality from NCDs, which were cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. They shared the same risk factors. Objective: To determine the prevalence of NCD risk factors in patients admitted to consult in the outpatient unit of the National Teaching Hospital of Cotonou. Patients and Methods: This was a transversal, descriptive and analytical study which took place from 15 June 2011 to 16 September 2011. It focused on 1000 subjects found after a recruitment of all patients coming to consult during the study period. The collection technique was a questionnaire followed by physical measures (weight, height, blood pressure and waist) and biological measures (fasting glucose and cholesterol). The data were analyzed with the software Epi-3.3.2 info. Results: The mainly prevalent behavioural risk factors were smoking (10.2%), alcohol consumption (60.3%), insufficient intake of fruits and vegetables (84.2%), and physical inactivity (57.6%). The prevalent physical risk factors were hypertension (47.4%), obesity (27.5%), and overweight (35.3%). The prevalent biological risk factors were diabetes (28.5%), and hypercholesterolemia (10.4%). The level of cardiovascular risk was higher than 40% in 81 people (8.1%). Conclusion: This study shows the importance of risk factors for NCDs in outpatient Unit in the National Teaching Hospital of Cotonou.

Chronic Non-Communicable Diseases in College Students in the Brazilian Western Amazon Region

The objective of this study was to analyze the prevalence of chronic non-communicable diseases (CNCDs) and associated lifestyle factors in college students in Rio Branco, Acre, Brazilian Western Amazon region. A cross-sectional study was conducted in 874 undergraduate students from a public university. The general prevalence of CNCDs was 15.6%. After adjusting for sex and age, the CNCD-associated lifestyle factors included the following: sedentary during leisure time (prevalence ratio (PR): 1.67;95% confidence interval (CI): 1.12 - 2.48), sedentary in locomotion by walking (PR: 1.34;95% CI: 1.00 - 1.79), current smoker (PR: 1.66;95% CI: 1.07 - 2.58), unsatisfactory self-rated health status (PR: 2.31;95% CI: 1.84 - 2.88), overweight (PR: 1.67;95% CI: 1.14 - 2.46) and obese (PR: 3.30;95% CI: 2.18 - 5.01). The high prevalence of CNCDs identified in this group of college students highlights the need for swift action to promote healthy lifestyles among youth.

Behavioral Risk Factors for Chronic Non-Communicable Diseases in Adults and Elderly People in the City of Ribeirão Preto—SP

Aims: to analyze the presence and simultaneity of behavioral risk factors for chronic non-communicable disease (NCD) in adults and the elderly. Methods: quantitative, cross-sectional and observational study. Healthy and unhealthy eating are classified according to the frequency of food consumption. Smoking is expressed by the percentage of smokers. Harmful alcohol consumption by the percentage of individuals who consumed alcoholic beverages at least once in the last 30 days. Classification of the level of physical inactivity required to practice at least 150 minutes of physical activity. Results: the sample constituted 719 people, 535 adults and 184 elderly. The behavioral risk factor reported by most adults 499 (93.3%) and elderly 156 (84.8%) was unhealthy eating. Frequency 72% higher of smoking, four times higher of harmful alcohol consumption and 10% higher of unhealthy food among adults when compared to the elderly. The simultaneity between risk factors was 39% greater in adults than in the elderly. Discussion: risk factors evaluated in this study are key aspects of the development of NCDs. Adults have 2.43 times the chance of presenting two risk factors and 7.73 times the chance of presenting three in relation to the elderly. Conclusion: To achieve more effective and differentiated results, knowing and directing measures to control behavioral risk factors, whether isolated or concurrent, requires specific knowledge.

Research progress of 24-hour movement behaviors in chronic non-communicable disease

Chronic non-communicable diseases(NCDs)represent a significant impediment to improve life expectancy and remain a focal point in global public health and disease prevention efforts.24-hour movement behaviors,which include sleep,sedentary behavior(SED),and physical activity,underscore the inherent connections between different daily activities and the comprehensive impact of overall movement patterns on health.Evidence suggested that modifying patterns of 24-hour movement behaviors can aid in preventing and attenuating the progression of NCDs.This study systematically delineated the concept,evolution,analytical methods,and intrinsic associations of 24-hour movement behaviors,emphasizing their pivotal role in the prevention and management of NCDs such as obesity,mental disorders,cardiovascular diseases,diabetes,and renal diseases.Future research endeavors should focus on refining methodologies,broadening study populations,developing research tools,and exploring precise intervention strategies and interdisciplinary approaches to comprehensively enhance the effectiveness of NCDs prevention and management from a temporal perspective.Such efforts are poised to provide substantive guidance and support for public health practices.

New perspectives on the therapeutic potential of quercetin in non-communicable diseases:Targeting Nrf2 to counteract oxidative stress and inflammation

Non-communicable diseases(NCDs),including cardiovascular diseases,cancer,metabolic diseases,and skeletal diseases,pose significant challenges to public health worldwide.The complex pathogenesis of these diseases is closely linked to oxidative stress and inflammatory damage.Nuclear factor erythroid 2-related factor 2(Nrf2),a critical transcription factor,plays an important role in regulating antioxidant and anti-inflammatory responses to protect the cells from oxidative damage and inflammation-mediated injury.Therefore,Nrf2-targeting therapies hold promise for preventing and treating NCDs.Quercetin(Que)is a widely available flavonoid that has significant antioxidant and anti-inflammatory properties.It modulates the Nrf2 signaling pathway to ameliorate oxidative stress and inflammation.Que modulates mitochondrial function,apoptosis,autophagy,and cell damage biomarkers to regulate oxidative stress and inflammation,highlighting its efficacy as a therapeutic agent against NCDs.Here,we discussed,for the first time,the close association between NCD pathogenesis and the Nrf2 signaling pathway,involved in neurodegenerative diseases(NDDs),cardiovascular disease,cancers,organ damage,and bone damage.Furthermore,we reviewed the availability,pharmacokinetics,pharmaceutics,and therapeutic applications of Que in treating NCDs.In addition,we focused on the challenges and prospects for its clinical use.Que represents a promising candidate for the treatment of NCDs due to its Nrf2-targeting properties.

The Interventional Capacity of Community Health Volunteers for Screening and Linkages of Non-Communicable Diseases in Nyeri County, Kenya

Non-communicable diseases (NCDs) account for 63% of mortalities. Approximately 80% of these NCD-related deaths occur in LMICs. A quasi-experimental study utilizing a non-equivalent pre-and post-test was conducted from May 2022 to March 2023 with 370 study participants. Multistage cluster and random sampling were used to select ten community units, and therefore, 150 CHVs were chosen for the control unit, and 150 were used to form the interventional group. Data was collected from the KOBO app. Six (6) homogenous FGDs comprised ten members, and 10 KII were conducted across study sites. Quantitative data was analyzed using SPSS version 28.0, and qualitative data was audio-recorded, transcribed, and analyzed via N-Vivo 12. The study shows that 59.3% of respondents have minimal information, and 92.7% (n = 139) have no clear understanding of NCDs, with a pre-intervention capacity of 48.8%. Independent sample t-test showed a significant difference in capacity from a pre-intervention average of 48.75 (SD ± 5.7)%, which increased to 68.28 (SD ± 7.6)%, p < 0.001. A well-designed community interventional model plays a pivotal role in grassroots healthcare delivery but requires optimization for NCD management.

Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.

Resveratrol combats chronic diseases through enhancing mitochondrial quality

Resveratrol(RSV),as a functional food component extracted from natural plants,has been widely studied and recognized in preventing and treating various diseases,with major mechanisms including executing anti-inflammation and anti-oxidation functions,and improving mitochondrial quality.Chronic diseases as non-communicable diseases are mainly caused by multiple factors,such as physiological decline and dysfunction in the body,and have become a significant challenge on public health worldwide.It is worth noting that chronic diseases such as Alzheimer's disease(AD),Parkinson's disease(PD),muscle atrophy,cardiovascular disease,obesity,and cancer are accompanied by abnormal mitochondrial function.Therefore,targeted regulation of mitochondria may be a meaningful way to prevent and treat chronic diseases.Increasing evidence has confirmed that RSV is actively involved in regulating mitochondria,and it has become an essential consideration to prevent and treat chronic diseases through targeting mitochondria and improving corresponding functions.In this article,current studies on RSV to optimize mitochondrial quality for preventing and alleviating chronic disease are systematically summarized,which can provide a theoretical reference for the development of functional foods or drugs to combat chronic diseases.

Seasonal variation in dietary intake and its association with obesity-related chronic diseases in northeast China

Objective:The objective of this study was to assess seasonal changes in dietary and nutrient intake of residents(18-75 years old)in Northeast China during summer and winter,and to explore the associations between fatty acids,phytosterols,and the prevalence of obesity-related chronic diseases,particularly obesity,hyperlipidemia,and NAFLD.Methods:A total of 4773 participants from the Internet-based Dietary Questionnaire for Chinese(IDQC)were included in this study.Dietary intake information was collected using a validated food frequency questionnaire.Student's t-test or Mann-Whitney U-test was used to analyze continuous variables,while Chi-squared tests were used to compare categorical variables.Multivariable logistic regression was employed to assess the relationship between fatty acids,phytosterols,and obesity-related chronic diseases.Results:The mean consumption of legumes,vegetables,fruits,nuts,dairy products,fish,condiments,energy,protein,fat,and carbohydrate differed significantly between summer and winter(P<0.05).Significant inverse associations were found between both fatty acids and phytosterols and obesity-related chronic diseases in multivariate adjusted models.Summer polyunsaturated fatty acid(PUFA)intake was negatively associated with the prevalence of hyperlipidemia(Q4,OR,0.515;95%CI,0.283-0.921;P<0.05)and non-alcoholic fatty liver disease(NAFLD)(Q4,OR,0.331;95%CI,0.176-0.599;P<0.001).Phytosterols intake was negatively associated with the prevalence of obesity(Q4,OR,0.603;95%CI,0.414-0.873;P<0.05),hyperlipidemia(Q4,OR,0.420;95%CI,0.233-0.731;P<0.001),and NAFLD(Q4,OR,0.206;95%CI,0.111-0.360;P<0.001)during the summer.Conclusions:Higher PUFA intake was associated with a lower prevalence of obesity,hyperlipidemia,and NAFLD.Phytosterol intake was inversely associated with the prevalence of hyperlipidemia and NAFLD.These findings suggest that the associations between PUFA and phytosterols and the prevalence of obesity-related chronic diseases may be influenced by seasonal differences in food intake.

Perceptions of Patients with Chronic Diseases on Telenursing in Selected Hospitals of Shandong Province, China: A Comparative Study

Objectives:To explore the perception of telenursing among patients with chronic diseases in the selected community hospitals only in Shandong Province,China,and to compare the differences in perception of telenursing among patients with different chronic diseases.Methods:The purpose sampling method was adopted in this study,and questionnaires were distributed to 324 chronic disease patients in OPD hospitals.Results:Patients with chronic diseases have higher awareness and acceptance of telenursing,and there are significant differences in their cognition of telenursing needs.Conclusion:The disease characteristics of patients with different chronic diseases and their different needs for telenursing require more considerations in the design and use of telenursing services.

Economic and Social Impact Assessment of Chronic Diseases Among the Low-Income Population in Southern Punjab,Pakistan

Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.

Opportunity and challenge of big data in improving chronic non-communicable diseases： by health system engineering approaches

Chronic non-communicable diseases （NCDs） is a sick- state in the complex system of human body. Healthsystems engineering approach can be used to recover health state by many different ways of system adjustments, including physical exercises, nutrition and psychological intervention, and drug therapies. To evaluate and assess the effects of these adjustments, many parameters of the system states have to be monitored （such as molecular high- throughput technologies, physiological, image, etc.）, and estimated at the different levels （such as molecular, cellular, tissue, organ, and system levels） and on the different dimensions （such as metabolic, immune, neural, etc.） for human system. Huge data have been produced during the whole process, and health systems engineering approach will model health and sick state in the human system by detecting and analyzing these multi-dimension and multi- level big-data in order to find personal suitable adjustment method.

Investigating College Students’ Diet and Physical Activity Behaviors Regarding Non-Communicable Diseases Prevention in China

We aimed to investigate if college students’ dietary and physical activity adhered to the Chinese Dietary Guidelines, the Composing Editorial Board of Physical Activity Guidelines, and WHO recommendation for NCDs prevention. Methods: A 3-day (2 weekdays and 1 weekend day) 24-hour (24-HRs) dietary recall was conducted to record details of participants’ food consumption. One-way analysis of variance (ANOVA) was applied to examine the influence of the identified demographic variables (including BMI, gender, major, family monthly income, and place of household registration) on the 8 food groups’ consumption. We analyzed the effect of the various demographic variables on sodium intake by the student’s t-test. The questionnaire, International Physical Activity Questionnaire (IPAQ)-Short Form, was utilized to assess participants’ physical activity (PA) level. The Wilcoxon-Mann-Whitney was applied to analyze participants’ physical activity. Results: Our research indicated participants consumed much fewer fruits and vegetables and excessive meats on average for both males and females regarding NCDs prevention. Conclusion: Participants’ dietary intake did not comply with the Chinese Dietary Guide-lines recommendation for chronic diseases prevention. Nutrition knowledge and health education are needed for college students. .

Impact of sepsis and non-communicable diseases on prognostic models to predict the outcome of hospitalized chronic liver disease patients

AIM To evaluate the impact of sepsis and non-communicable diseases(NCDs) on the outcome of decompensated chronic liver disease(CLD) patients.METHODSIn this cross-sectional study, medical records of patients with CLD admitted to the Gastroenterology unit at the Aga Khan University Hospital were reviewed.Patients older than 18 years with decompensation of CLD(i.e., jaundice, ascites,encephalopathy, and/or upper gastrointestinal bleed) as the primary reason for admission were included, while those who were admitted for reasons other than decompensation of CLD were excluded. Each patient was followed for 6 wk after index admission to assess mortality, prolonged hospital stay(> 5 d), and early readmission(within 7 d).RESULTS A total of 399 patients were enrolled. The mean age was 54.3 ± 11.7 years and64.6%(n = 258) were male. Six-week mortality was 13%(n = 52). Prolonged hospital stay and readmission were present in 18%(n = 72) and 7%(n = 28) of patients, respectively. NCDs were found in 47.4%(n = 189) of patients. Acute kidney injury, sepsis, and non-ST elevation myocardial infarction were found in41%(n = 165), 17.5%(n = 70), and 1.75%(n = 7) of patients, respectively. Upon multivariate analysis, acute kidney injury, non-ST elevation myocardial infarction, sepsis, and coagulopathy were found to be statistically significant predictors of mortality. While chronic kidney disease(CKD), low albumin, and high Model for End-Stage Liver Disease(MELD)-Na score were found to be statistically significant predictors of morbidity. Addition of sepsis in conventionalMELD score predicted mortality even better than MELD-Na(area under receiver operating characteristic: 0.735 vs 0.686; P < 0.001). Among NCDs, CKD was found to increase morbidity independently.CONCLUSION Addition of sepsis improved the predictability of MELD score as a prognostic marker for mortality in patients with CLD. Presence of CKD increases the morbidity of patients with CLD.

Association of physical activity with risk of chronic kidney disease in China:A population-based cohort study

Background:Information on the association between physical activity(PA)and the risk of chronic kidney disease(CKD)is limited.We aimed to explore the associations of total,domain-specific,and intensity-specific PA with CKD and its subtypes in China.Methods:The study included 475,376 adults from the China Kadoorie Biobank aged 30-79 years during 2004-2008 at baseline.An interviewer-administered questionnaire was used to collect the information about PA,which was quantified as metabolic equivalent of task hours per day(MET-h/day)and categorized into 4 groups based on quartiles.Cox regression was used to analyze the association between PA and CKD risk.Results:During a median follow-up of 12.1 years,5415 incident CKD cases were documented,including 1159 incident diabetic kidney disease(DKD)cases and 362 incident hypertensive nephropathy(HTN)cases.Total PA was inversely associated with CKD risk,with an adjusted hazard ratio(HR,95%confidence interval(95%CI))of 0.83(0.75-0.92)for incident CKD in the highest quartile of total PA as compared with participants in the lowest quartile.Similar results were observed for risk of DKD and HTN,and the corresponding HRs(95%CIs)were 0.75(0.58-0.97)for DKD risk and 0.56(0.37-0.85)for HTN risk.Increased nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA were significantly associated with a decreased risk of CKD,with HRs(95%CIs)of 0.80(0.73-0.88),0.85(0.77-0.94),and 0.85(0.76-0.95)in the highest quartile,respectively.Conclusion:PA,including nonoccupational PA,low-intensity PA,and moderate-to-vigorous-intensity PA,was inversely associated with the risk of CKD,including DKD,HTN,and other CKD,and such associations were dose dependent.

Risk factors for cognitive impairment in patients with chronic kidney disease

BACKGROUND Chronic kidney disease(CKD)patients have been found to be at risk of concurrent cognitive dysfunction in previous studies,which has now become an important public health issue of widespread concern.AIM To investigate the risk factors for concurrent cognitive dysfunction in patients with CKD.METHODS This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023.A questionnaire was formulated by literature review and expert consultation and included questions about age,sex,education level,per capita monthly household income,marital status,living condition,payment method,and hypertension.RESULTS Logistic regression analysis showed that patients aged 60-79 years[odds ratio(OR)=1.561,P=0.015]and≥80 years(OR=1.760,P=0.013),participants with middle to high school education(OR=0.820,P=0.027),divorced or widowed individuals(OR=1.37,P=0.032),self-funded patients(OR=2.368,P=0.008),and patients with hypertension(OR=2.011,P=0.041)had a higher risk of cognitive impairment.The risk of cognitive impairment was lower for those with a college degree(OR=0.435,P=0.034)and married individuals.CONCLUSION The risk factors affecting cognitive dysfunction are age,60-79 years and≥80 years;education,primary school education or less;marital status,divorced or widowed;payment method,selffunded;hypertension;and CKD.

Heat exposure and hospitalizations for chronic kidney disease in China: a nationwide time series study in 261 major Chinese cities

Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.

Clinical features of chronic kidney disease in dogs with the serological presence of Leptospira spp.,Ehrlichia canis,and Anaplasma phagocytophilum

Chronic kidney disease is commonly diagnosed in dogs,and clinical signs may be aggravated when infected agents are involved.In this case report,33 dogs with chronic kidney disease were clinically evaluated and serologically tested for Leptospira spp.,Ehrlichia canis,and Anaplasma phagocytophilum.The seroprevalence for Leptospira spp.was 39.4%.The most frequent serovars found were Pyrogenes,Canicola,Bratislava and Australis,with serological titers between 1:100 to 1:800.Clinical signs included fever,depression,decreased body condition,vomiting and hema‑turia.Signifcant laboratory fndings were anemia,leukocytosis,thrombocytopenia,increased liver enzymes,urea and creatinine,hyperbilirubinemia and hyperphosphatemia.All leptospira seronegative dogs were positive for one or both monitored homoparasites(i.e.,E.canis and A.phagocytophilum);only three leptospira seropositive dogs were positive for one or both hemoparasites.Findings also suggest that endemic hemoparasites of dogs should be moni‑tored in dogs with a kidney condition for a better clinical picture of the patients and therapeutic approach.

Bone loss in chronic liver diseases:Could healthy liver be a requirement for good bone health?

Given that the liver is involved in many metabolic mechanisms,it is not surprising that chronic liver disease(CLD)could have numerous complications.Secondary osteoporosis and increased bone fragility are frequently overlooked complications in CLD patients.Previous studies implied that up to one-third of these individuals meet diagnostic criteria for osteopenia or osteoporosis.Recent publications indicated that CLD-induced bone fragility depends on the etiology,duration,and stage of liver disease.Therefore,the increased fracture risk in CLD patients puts a severe socioeconomic burden on the health system and urgently requires more effective prevention,diagnosis,and treatment measures.The pathogenesis of CLD-induced bone loss is multifactorial and still insufficiently understood,especially considering the relative impact of increased bone resorption and reduced bone formation in these individuals.It is essential to note that inconsistent findings regarding bone mineral density measurement were previously reported in these individuals.Bone mineral density is widely used as the“golden standard”in the clinical assessment of bone fragility although it is not adequate to predict individual fracture risk.Therefore,microscale bone alterations(bone microstructure,mechanical properties,and cellular indices)were analyzed in CLD individuals.These studies further support the thesis that bone strength could be compromised in CLD individuals,implying that an individualized approach to fracture risk assessment and subsequent therapy is necessary for CLD patients.However,more well-designed studies are required to solve the bone fragility puzzle in CLD patients.