Search Results (1,012)

Background/Objectives: Renal artery stenosis (RAS) is associated with coronary artery disease (CAD), exacerbation of arterial hypertension, and progression to heart failure, but remains frequently unrecognized in clinical practice. Methods: We conducted a systematic review and meta-analysis of studies by pooling data of patients undergoing CAG due to suspected or stable CAD that received a bilateral renal artery angiography. Results: A total of 31 studies with 31,689 patients were included (mean age 63.2 ± 8.7 years, 20.9% were female). Overall, 13.4% (95%CI 10.5–16.7%) of patients undergoing coronary angiography had significant RAS, with 6.5% (95% CI 4.5–8.9%) and 3.7% (95%CI 2.5–5.2%) having severe and bilateral RAS. The mean weighted proportion of patients with three-vessel coronary disease (3VD) was 25.1 (95%CI 19.6–30.9%) while 4.2% (95%CI 2.6–6.2%) had left main (LM) coronary disease. Patients with RAS compared to those without RAS were significantly older (mean difference, MD 4.2 years (95%CI 3.8–4.6)). The relative risk of RAS was greater for the female sex (risk ratio, 95%CI; RR 1.3, 1.03–1.57), presence of diabetes (RR 1.2, 1.10–1.36), arterial hypertension (RR 1.3, 1.21–1.46), dyslipidemia (RR 1.1, 1.06–1.14), peripheral artery disease (PAD) (RR 2.1, 1.40–3.16), chronic kidney disease (CKD) (RR 2.6, 2.04–3.37), 3VD (RR 1.6, 1.30–1.87), and LM disease (RR 1.8, 1.28–2.47). Smoking had a neutral effect on the risk of RAS occurrence (RR 1.0, 0.94–1.06). Conclusions: RAS is common in patients undergoing coronary angiography. CKD, PAD, older age, and severe CAD were among the strongest predictors for the presence of significant RAS. Full article

Patellar sleeve fractures, though relatively rare, present unique challenges in diagnosis and management. This review aims to provide a comprehensive overview of the current understanding of patellar sleeve fractures, focusing on their epidemiology, clinical presentation, imaging, and management strategies. Epidemiologically, these fractures are uncommon, representing approximately 1% of all fractures in pediatric patients, yet they account for 50% of all patella fractures in this population. They predominantly affect adolescents, with a peak incidence around 12.7 years of age, and are more common in boys, occurring at a ratio of 3 to 5:1. Understanding these demographic patterns is crucial for early recognition and appropriate management. Clinically, patellar sleeve fractures typically present with the sudden onset of severe pain, often associated with explosive activities such as jumping. However, diagnosis can be challenging, particularly in cases with minimal displacement or where alternative muscle groups compensate for the injury. Differential diagnosis is essential, and clinicians should be vigilant for signs such as palpable gaps at the lower pole of the patella and patella alta. Imaging modalities play a vital role in diagnosis, with plain X-rays often revealing no bony damage. Ultrasonography may offer a cost-effective alternative, especially in cases where radiographic findings are inconclusive. Advanced imaging techniques such as MRI can assist in characterizing the extent of the injury and assessing for associated complications. Management strategies encompass a spectrum of approaches, ranging from conservative measures such as immobilization and physical therapy to surgical interventions, including open reduction and internal fixation or arthroscopic surgery. The choice of treatment depends on various factors, including the fracture pattern, displacement, patient age, activity level, and associated injuries. Despite advancements in diagnosis and treatment, the optimal management of patellar sleeve fractures remains a clinical challenge. Further research is warranted to elucidate optimal algorithms for diagnosis and treatment, with the ultimate goal of improving outcomes and reducing the risk of long-term complications associated with this rare but clinically significant knee injury. Full article

Lifestyle behaviors, defined as a combination of dietary behavior, physical activity (PA), screen time (ST), and sleep duration indicators, are strongly associated with blood pressure (BP) in students. Our aim was to characterize the joint trajectories of lifestyle behaviors among middle school students and evaluate their association with BP. Data were obtained from the monitoring dataset on common diseases and health factors among students in Jiading District, Shanghai, China, conducted from 2019 to 2023. Lifestyle behavior data were collected annually from middle school students aged 12–18 years through questionnaires covering dietary behavior score, PA, ST, and sleep duration. Students’ BP was measured in 2023. Joint trajectories of lifestyle behaviors were determined using group-based multi-trajectory modeling. Associations between lifestyle trajectories and students’ BP were examined using multiple linear regression and modified Poisson regression. A total of 1378 middle school students (759 [58.98%] boys, median age 14.36 years [IQR: 13·30–13.28]) with lifestyle behaviors data assessed at least three times were included, and they were categorized into four joint lifestyle trajectories as follows: “remain unhealthy with low PA and increasing ST” (n = 141, 10.46%), “remain unhealthy with only low PA” (n = 305, 22.63%), “change towards unhealthy with decreasing sleep duration” (n = 776, 57.57%), and “relatively healthy” (n = 126, 9.35%). After adjusting for important confounders, the “remain unhealthy with low PA and increasing ST” group was associated with higher diastolic BP (DBP) [β: 3.49, 95% CI: 0.55–6.44] and higher mean arterial pressure (MAP) [β: 3.19, 95% CI: 0.37–6.01] in students compared with the “relatively healthy” group. Additionally, compared with the “relatively healthy” group, students in the “remain unhealthy with low PA and increasing ST” group had a 1.12-fold increase in the risk of hypertension (risk ratios: 1.12, 95% CI: 1.03–1.24). All trend p values in DBP, MAP, and hypertension from the “relatively healthy” group to the “remain unhealthy with low PA and increasing ST” group were less than 0.05. Four distinct lifestyle trajectories were identified among middle school students. Students who remained in the “unhealthy with low PA and increasing ST” lifestyle trajectory were associated with later elevations in BP. Full article

Dairy and soy products are healthy food. However, studies have reported conflicting results associating their intake with coronary heart disease (CHD). Thus, this study determined the association between intake of dairy or soy products and 10-year CHD risk. Participants aged 40~69 years were grouped into those who consumed dairy products (more or less than twice a week) and those who consumed soy products (more or less than twice a week). Ten-year CHD risk (%), atherogenic index (AI), and atherogenic index of plasma (AIP) were calculated. The CHD risk, according to the level of dairy and soy product intake, was expressed as an odds ratio (OR) and a confidence interval (CI). Significant differences were observed in sex, age, education, income, and living area according to dairy intake frequencies, whereas only age showed significant differences according to soy products’ intake frequencies. Relative effects of Framingham Risk Score (FRS) factors on 10-year CHD risk in Korean adults were found to be significant in the order of age, high-density lipoprotein cholesterol (HDL-C), smoking, blood total cholesterol (TC), systolic blood pressure (SBP), diabetes, and sex. Overall, participants who consumed dairy products ≥2/week had a significantly lower OR of 10-year CHD risk compared to those who consumed dairy products <2/week after adjusting for confounding factors (OR: 0.742, 95% CI: 0.619 to 0.890). Otherwise, intake of soy products ≥2/week tended to decrease the OR of 10-year CHD risk, although the decrease was not statistically significant. In conclusion, Korean adults who consumed dairy products ≥2/week had higher HDL-C and lower 10-year CHD risk than those who consumed dairy products <2/week. However, these results did not appear when consuming soy products. Full article

Background/objectives: To compare the prevalence of intra-ocular inflammation (IOI) between brolucizumab and aflibercept in neovascular age-related macular degeneration (nAMD) after intra-vitreal injections (IVI) and to compare the IOI odds ratios (ORs) of both therapies with the prevalence of septic endophthalmitis after IVI that was previously reported in the literature. Methods: A total of 468 IVI of brolucizumab (117 eyes) were compared with 2884 IVI of aflibercept (305 eyes) regarding IOI and occlusive retinal vasculitis (RV) from December 2021 to June 2023 in this retrospective study. The OR was calculated for both anti-VEGF agents and was compared with the relative risk of septic endophthalmitis after IVI. Results: There were four eyes with unilateral IOI related to brolucizumab (3.42%), one presenting uveitis (0.85%), two vitritis (1.71%) and the last one presenting occlusive RV (0.85%), compared with two eyes presenting unilateral IOI (anterior uveitis, 0.66%) and none with RV from the aflibercept cohort. The incidence of IOI per injection with brolucizumab (0.855%) was significantly higher compared with aflibercept (0.069%, p = 0.004). The OR of IOI related to brolucizumab IVI compared with septic endophthalmitis was 20 times greater (1.49 for aflibercept, p = 0.646, versus 20.15 for brolucizumab, p < 0.001). The OR of RV with brolucizumab compared with septic endophthalmitis was 4.6. Conclusion: Data from our department suggest a much higher risk of IOI and occlusive retinal vasculitis after brolucizumab when compared with aflibercept. The risk of IOI and severe sight-threatening complications related to brolucizumab is greater than the risk of septic endophthalmitis after any IVI. Full article

Genetic factors play a significant role in the pathogenesis of mitral valve diseases, including mitral valve prolapse (MVP) and mitral valve regurgitation. Genes like Fibrillin-1 (FBN1), Filamin A (FLNA), matrix metalloproteinase 2 (MMP2), and SRY-box transcription factor 9 (SOX9) are known to influence mitral valve pathology but knowledge of the exact mechanism is far from clear. Data regarding serum parameters, transesophageal echocardiography, and genetic and histopathologic parameters were investigated in 54 patients who underwent cardiovascular surgery for mitral valve regurgitation. The possible association between Fibrillin-1, Filamin A, MMP2, and SOX9 gene expressions was checked in relationship with the parameters of systemic inflammatory response. The mRNA expression levels (RQ—relative quantification) were categorized into three distinct groups: low (RQ < 1), medium/normal (RQ = 1–2), and high (RQ > 2). Severe fibrosis of the mitral valve was reflected by high expression of FBN1 and low expression of MMP2 (p < 0.05). The myxoid degeneration level was associated with the mRNA expression level for FBN1 and a low lymphocyte-monocyte ratio was associated with an increased mRNA expression of FBN1 (p < 0.05). A high number of monocytes was associated with high values of FBN1 whereas the increase in the number of lymphocytes was associated with high levels of MMP2. In addition, we observed that the risk of severe hyalinization was enhanced by a low mRNA expression of FLNA and/or SOX9. In conclusion, a lower FLNA mRNA expression can reflect the aging process that is highlighted in mitral valve pathology as a higher risk for hyalinization, especially in males, that might be prevented by upregulation of the SOX9 gene. FBN1 and MMP2 influence the inflammation-related fibrotic degeneration of the mitral valve. Understanding the genetic base of mitral valve pathology can provide insights into disease mechanisms, risk stratification, and potential therapeutic targets. Full article

The risk of occupational exposure to organic solvents varies across industries due to factors such as processing materials, ventilation conditions, and exposure duration. Given the dynamic nature of organic solvent use and occupational exposures, continuous monitoring and analysis are essential for identifying high-risk hazards and developing targeted prevention strategies. Therefore, this study aims to analyze the use of organic solvents and volatile organic compounds (VOCs) in different industries in Bao’an District, Shenzhen, China, from 2018 to 2023, to understand their temporal variation and industry-specific differences and to identify high-risk occupational hazards. This study includes 1335 organic solvent samples, used by 414 different industry enterprises, and 1554 air samples. The result shows that the usage of organic solvents in various industries decreased with the outbreak of the pandemic and, conversely, increased as the situation improved. The most frequently detected volatile components in organic solvents were alkanes, followed by aromatic hydrocarbons. The ratios of the detection frequency of VOCs to the total number of detected categories increased year by year after 2020, indicating a tendency towards reduction and concentration of the types of organic solvents used in industrial production. Among the 8 high-risk VOCs, toluene (22.5%), n-hexane (22.0%), xylene (16.1%), and ethylbenzene (15.3%) have relatively high detection rates, suggesting that they need to be focused on in occupational health. Through air samples, the results show that trichloroethylene and xylene pose a high risk to human health (HQ > 1). We recommend that industry should strengthen monitoring of these two VOCs. Full article

Metabolic syndrome (MetS) is a worldwide public health challenge. Accumulating evidence implicates elevated serum ferritin and disruptions in iron metabolism as potential elements linked to an increased risk of MetS. This study investigates the relationship between iron homeostasis—including hepcidin levels, serum iron concentration, unsaturated iron-binding capacity (UIBC), and the hepcidin/ferritin (H/F) ratio—and MetS. In this descriptive cross-sectional study, 209 participants aged 24–70 were categorized into two groups: 103 with MetS and 106 without MetS. All participants underwent medical assessment, including anthropometric measures, indices of glycemic control, lipid profiles, and iron-related parameters. Participants were further stratified by the Homeostasis Model Assessment—Insulin Resistance index into three subgroups: insulin-sensitive (IS) (<1.9), early insulin resistance (EIR) (>1.9 to <2.9), and significant insulin resistance (SIR) (>2.9). Notable increments in serum ferritin and hepcidin were observed in the SIR group relative to the IS and EIR groups, with a significant association between metabolic parameters. The UIBC and serum ferritin emerged as significant predictors of MetS, particularly in men, with an area under the curve (AUC) of 0.753 and 0.792, respectively (p ≤ 0.001). In contrast, hepcidin was notably correlated with MetS in women, with an AUC of 0.655 (p = 0.007). The H/F ratio showed superior predictive capability for MetS across both sexes (at cutoff level = 0.67). Among women, this ratio had an AUC of 0.639 (p = 0.015), and for men, it had an AUC of 0.792 (p < 0.001). Hypertension proved an independent risk factor for MetS, affirming its role in metabolic dysregulation. The findings highlight a significant interconnection between iron homeostasis parameters and MetS, with sex-specific variations underscoring the importance of personalized diagnostic criteria. The crucial role of the H/F ratio and the UIBC as emerging predictive markers for MetS indicates their potential utility in identifying at-risk individuals. Further longitudinal research is essential to establish causality and explore the interplay between these biomarkers and MetS. Full article

Background: The prognostic significance of liver dysfunction in COVID-19 patients remains unclear. In this study, we investigated the association between liver function test results and severe disease progression in COVID-19 patients. Methods: This retrospective study included consecutive Japanese COVID-19 patients admitted between February 2020 and July 2021. Predictive variables for severe disease progression were identified by multivariate logistic regression analysis. Severe disease-free survival was estimated with the Kaplan–Meier method and Cox regression analysis. Aspartate aminotransferase (AST) was divided into three grades: grade 1, AST < 30 U/L; grade 2, 30 U/L ≤ AST < 60 U/L; and grade 3, AST > 60 U/L. Results: Among 604 symptomatic patients, 141 (23.3%) developed severe disease at a median of 2 days postadmission. The median hospital stay was 10 days, and 43 patients (7.1%) died during hospitalization. Multivariate regression analysis revealed that hypertension, decreased lymphocyte count, and elevated LDH, CRP, and AST levels (grade 2 and grade 3 relative to grade 1) were the significant predictive variables. Severe disease-free survival time was significantly different between the different AST grades (hazard ratio (HR): grade 2 vs. grade 1, 4.07 (95% confidential interval (CI): 2.06–8.03); grade 3 vs. grade 1, 7.66 (95% CI: 3.89–15.1)). Conclusions: The AST level at admission was an independent risk factor for severe disease in hospitalized Japanese patients with COVID-19. Full article

Background: Indocyanine Green (ICG) is a promising technique for the assessment of gastric conduit and anastomosis perfusion during esophagectomy. ICG integration may be helpful in minimizing the risk of anastomotic leak (AL). Literature evidence is sparse, while the real effect of ICG assessment on AL minimization remains unsolved. The aim of this systematic review and meta-analysis was to compare short-term outcomes between ICG-guided and non-ICG-guided (nICG) esophagogastric anastomosis during esophagectomy for cancer. Materials and Methods: PubMed, MEDLINE, Scopus, Web of Science, Cochrane Central Library, and ClinicalTrials.gov were queried up to 25 April 2024. Studies that reported short-term outcomes for ICG versus non-ICG-guided (nICG) anastomosis in patients undergoing esophagectomy were considered. Primary outcome was AL. Risk ratio (RR) and standardized mean difference (SMD) were utilized as effect size measures, whereas to assess relative inference we used 95% confidence intervals (95% CI). Results: Overall, 1399 patients (11 observational studies) were included. Overall, 576 (41.2%) underwent ICG gastric conduit assessment. The patients’ ages ranged from 22 to 91 years, with 73% being male. The cumulative incidence of AL was 10.4% for ICG and 15.4% for nICG. Compared to nICG, ICG utilization was related to a reduced risk for postoperative AL (RR 0.48; 95% CI 0.23–0.99; p = 0.05). No differences were found in terms of pulmonary complications (RR 0.83), operative time (SMD −0.47), hospital length of stay (SMD −0.16), or 90-day mortality (RR 1.70). Conclusions: Our study seems to indicate a potential impact of ICG in reducing post-esophagectomy AL. However, because of limitations in the design of the included studies, allocation/reporting bias, variable definitions of AL, and heterogeneity in ICG use, caution is required to avoid potential overestimation of the ICG effect. Full article

In recent years, global climate change has become more and more obvious, and extreme rainfall weather has occurred frequently, which has a serious impact on people’s life and property safety. In order to reduce the risk of urban flooding and contribute to the sustainable development of the urban economy, society, and environment, this study takes Zhengzhou City as the study area. The surface runoff during extreme rainfall events from 2005 to 2023 was simulated using the SCS-CN model, and the spatiotemporal patterns of surface runoff during extreme rainfall conditions and their influencing factors were investigated. The results showed that (1) the average annual extreme rainfall in the study area was 95.6 mm, and the average annual surface runoff was 76.5 mm, with cultivated land contributing the most to surface runoff, accounting for more than 50%. The annual average frequency of extreme rainfall in the study area ranged from 0 to 3 times. (2) During the extreme rainfall events in 2021 and 2023, the surface runoff of the main urban area was relatively great. Under the influence of impermeable surfaces, the surface runoff of the main urban area was greater than that of the surrounding area, even when the rainfall in the main urban area was less than that in the surrounding urban area. In addition, during these two extreme rainfall events, the surface runoff in the slight slope (<5°) area was the greatest; overall, the larger the slope was, the smaller the surface runoff. (3) Differences between rainfall and surface runoff (DRS) of the different administrative districts in the study area showed three trends from 2005 to 2020, with those of most areas showing a clear decreasing trend, which was affected mainly by the surface runoff potential of the land use type. Under the same rainfall conditions (110 mm), the surface runoff of urban land and construction land was 1.4–2.5 times that of various types of woodland and grassland. From 2005 to 2020, the area of urban land and other construction land increased by 104.13%, the coverage area of woodland and grassland decreased by 35.90%, and the surface runoff potential increased in most areas of the study area. To reduce the risk of urban waterlogging, most areas of Zhengzhou, especially the main urban area and slight slope areas, need to rationally regulate land use and increase the coverage ratio of woodland and grassland. Full article

Studying efficient and accurate soil heavy-metal detection technology is of great significance to establishing a modern system for monitoring soil pollution, early warning and risk assessment, which contributes to the continuous improvement of soil quality and the assurance of food safety. Laser-induced breakdown spectroscopy (LIBS) is considered to be an emerging and effective tool for heavy-metal detection, compared with traditional detection technologies. Limited by the soil matrix effect, the LIBS signal of target elements for soil heavy-metal detection is prone to interference, thereby compromising the accuracy of quantitative detection. Thus, a series of signal-enhancement methods are investigated. This study aims to explore the effect of conductive materials of NaCl and graphite on the quantitative detection of lead (Pb) in soil using LIBS, seeking to find a reliable signal-enhancement method of LIBS for the determination of soil heavy-metal elements. The impact of the addition amount of NaCl and graphite on spectral intensity and parameters, including the signal-to-background ratio (SBR), signal-to-noise ratio (SNR), and relative standard deviation (RSD), were investigated, and the mechanism of signal enhancement by NaCl and graphite based on the analysis of the three-dimensional profile data of ablation craters and plasma parameters (plasmatemperature and electron density) were explored. Univariate and multivariate quantitative analysis models including partial least-squares regression (PLSR), least-squares support vector machine (LS-SVM), and extreme learning machine (ELM) were developed for the quantitative detection of Pb in soil with the optimal amount of NaCl and graphite, and the performance of the models was further compared. The PLSR model with the optimal amount of graphite obtained the best prediction performance, with an Rp that reached 0.994. In addition, among the three spectral lines of Pb, the univariate model of Pb I 405.78 nm showed the best prediction performance, with an Rp of 0.984 and the lowest LOD of 26.142 mg/kg. The overall results indicated that the LIBS signal-enhancement method based on conductive materials combined with appropriate chemometric methods could be a potential tool for the accurate quantitative detection of Pb in soil and could provide a reference for environmental monitoring. Full article

Background: Depression is the most common mental illness worldwide and generates an enormous health and economic burden. Furthermore, it is known to be associated with an elevated risk of arteriosclerotic cardiovascular diseases (ASCVD), particularly stroke. However, it is not a factor reflected in many ASCVD risk models, including SCORE2. Thus, we analysed the relationship between depression, ASCVD and SCORE2 in our cohort. Methods: We analysed 9350 subjects from the Paracelsus 10,000 cohort, who underwent both a carotid artery ultrasound and completed a Beck Depression Inventory (BDI) screening. Patients were categorised binomially based on the BDI score. Atherosclerotic carotid plaque or absence was dichotomised for logistic regression modelling. Odds ratios and adjusted relative risks were calculated using Stata. Results: Subjects with an elevated BDI (≥14) had higher odds for carotid plaques compared to subjects with normal BDI, especially after adjusting for classical risk factors included in SCORE2 (1.21; 95%CI 1.03–1.43, p = 0.023). The adjusted relative risk for plaques was also increased (1.09; 95%CI 1.01–1.18, p = 0.021). Subgroup analysis showed an increased odds of plaques with increases in depressive symptoms, particularly in women and patients ≤55 yrs. Conclusions: In our cohort, the BDI score is associated with subclinical atherosclerosis beyond classical risk factors. Thus, depression might be an independent risk factor which may improve risk stratification if considered in ASCVD risk prediction models, such as SCORE2. Furthermore, reminding clinicians to take mental health into consideration to identify individuals at increased atherosclerosis risk may provide added opportunities to address measures which can reduce the risk of ASCVD. Full article

Beach morphology can be observed over large spatio-temporal scales, and future shoreline positions can be predicted and coastal risk indicators can be derived by measuring satellite-derived instantaneous waterlines. Long-term satellite missions, such as Landsat and Sentinel-2, provide decades of freely available, high-resolution optical measurement datasets, enabling large-scale data collection and relatively high-frequency monitoring of sandy beaches. Satellite-Derived Shoreline (SDS) extraction methods are emerging and are increasingly being applied over large spatio-temporal scales. SDS generally consists of two steps: a mathematical relationship is applied to obtain a ratio index or pixel classification by machine-learning algorithms, and the land/sea boundary is then determined by edge detection. Indexes from lake waterline detection, such as AWEI or NDWI, are often transferred towards the shore without taking into account that these indexes are inherently affected by wave breaking. This can be overcome by using pixel classification to filter the indices, but this comes at a computational cost. In this paper, we carry out a thorough evaluation of the relationship between scene-dependent variables and waterline extraction accuracy, as well as a robust and efficient thresholding method for coastal land–water classification that optimises the index to satellite radiometry. The method developed for sandy beaches combines a new purpose-built multispectral index (SCoWI) with a refinement method of Otsu’s threshold to derive sub-pixel waterline positions. Secondly, we present a waterline extraction pipeline, called Shoreliner, which combines the SCoWI index and the extraction steps to produce standardised outputs. Implemented on the CNES High Performance Cluster (HPC), Shoreliner has been quantitatively validated at Duck, NC, USA, using simultaneous Sentinel-2 acquisitions and in situ beach surveys over a 3-year period. Out of six dates that have a satellite acquisition and an in situ survey, five dates have a sub-pixel RMS error of less than 10 m. This sub-pixel performance of the extraction processing demonstrates the ability of the proposed SDS extraction method to extract reliable, instantaneous and stable waterlines. In addition, preliminary work demonstrates the transferability of the method, initially developed for Sentinel-2 Level1C imagery, to Landsat imagery. When evaluated at Duck on the same day, Sentinel-2 and Landsat imagery several minutes apart provide similar results for the detected waterline, within the method’s precision. Future work includes global validation using Landsat’s 40 years of data in combination with the higher resolution Sentinel-2 data at different locations around the world. Full article

Toxoplasmosis, caused by the protozoan Toxoplasma gondii, is a zoonotic disease that affects various animal species, including dogs, that can serve as sentinels for indirectly estimating the environmental contamination. The current study aimed to determine the seroprevalence of T. gondii IgG and IgM antibodies in dogs across different regions of Greece and assess their living area as a potential risk factor. In total, 1282 blood samples were collected from dogs in urban and rural areas of Greece, including Attica and Thessaloniki. Serum samples were tested for T. gondii-specific IgG and IgM antibodies using an indirect immunofluorescent antibody test. A chi-square test was performed to assess the association between seropositivity for T. gondii and geographical location (urban/rural). The overall T. gondii seroprevalence was 47.6%, while the seroprevalence of IgG and IgM antibodies was 34.3% and 22.2%, respectively. Dogs from rural areas exhibited a significantly higher seroprevalence (53.8%) than those from urban areas (43.9%) (p < 0.001), with the estimated odds ratio being equal to 1.49 (95% CI, 1.18 to 1.65) and the relative risk increased by 22.4%. Dogs in Greece are highly exposed to T. gondii, particularly in rural areas. Measures to prevent canine infections are necessary, and basic hygiene practices, such as hand washing after petting dogs, are required to reduce human infection risk and safeguard public health. Full article