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Introduction: Vitamin D deficiency, a reversible cause of osteoporosis, is increasingly prevalent, showing varying degrees of severity that are notably pronounced among the growing population of multimorbid elderly patients. Given that the aging pancreas undergoes senescent processes leading to impaired function—which negatively impacts enteral vitamin D absorption and, consequently, elderly bone metabolism—a specific diagnostic and treatment approach is crucial. Our study aimed to determine the prevalence of vitamin D deficiency and exocrine pancreatic insufficiency (EPI) in orthogeriatric patients. We also evaluated differences in vitamin D deficiency severity between patients with normal and impaired pancreatic function. Furthermore, a short-term monitoring of vitamin D level increases after 12 days of substitution therapy in both groups aimed to inform osteoanabolic therapy for specific high-fracture-risk patients, assessing the influence of pancreatic function on substitution efficacy. Methods: We conducted a retrospective, monocentric cohort study, evaluating data from all patients hospitalized with manifest osteoporosis in an orthogeriatric department during a six-month spring/summer period. Demographic data, relevant comorbidities, the type of fracture, the amount of faecal elastase 1 (CALEX^® Cap Bühlmann), and the serum levels of 25-hydroxyvitamin D (25(OH)D) were assessed. Results: We found a high prevalence (70.6%) of vitamin D deficiency (25(OH)D < 30 µg/L) among all orthogeriatric patients. Of these, 16% met the criteria for mild to severe EPI. The group with normal exocrine pancreatic function showed a higher average vitamin D value, and their increase in vitamin D levels following short-term substitution was up to 100% greater compared to the group with impaired pancreatic function. Notably, 69% of women and 20% of men met the therapeutic threshold for specific osteoanabolic osteoporosis therapy, even without a T-score. Conclusions: Our findings reveal a very high prevalence of vitamin D deficiency and a high prevalence of EPI in orthogeriatric patients. Those with impaired exocrine pancreatic function exhibit lower baseline vitamin D levels and a diminished capacity for vitamin D absorption during short-term monitoring. These results have significant clinical implications for osteoporotic therapy, given that a substantial proportion of patients, particularly women, meet the criteria for specific osteoanabolic treatment. Full article

Background: Disruptions in the mesh of the ecosystem come with implications that severely harm the sustainability and the equilibrium of life. Interactions of humans, animals, and many other organisms, along with the whole ecological complex, have given birth to zoonotic diseases, which can vary in type and burden. Collaborative efforts put into the prioritization of environmental, animal, and human health are envisioned as “One Health”. Understanding vector ecology and the varying mechanistic ways of transmission is crucial for constructing effective One Health surveillance tools and warning systems. Methods: We identified the literature available concerning the subject matter. We utilized scholarly databases to gather research for the last 10 years using predefined keywords. Objectives: This review aims to synthesize current knowledge on the interconnection between climate discrepancies, ecological alarms, and the emergence and spread of zoonotic diseases. We attempted to provide recommendations for future research and policy interventions. Results: Human activities have significantly impacted disease-carrying vectors and wildlife habitats, aiding their proliferation and the spillover of diseases. Global frameworks incorporating One Health principles enhance global preparedness for future health threats. Applying the integrated One Health Surveillance has strengthened early warning systems. Interdisciplinary collaborations and tools like OH-EpiCap, a comprehensive tool that assesses and enhances the capacities of One Health surveillance systems, have significantly contributed to responding to infectious disease outbreaks, as seen in the Netherlands, reducing the risk of tick-borne diseases. Conclusions: Strides have been made with comprehensive processes that identify and prioritize zoonotic diseases of most significant concern and burden, such as OHZDP, approaches like One Health, and other theories considered. A proactive and integrated approach will build resilience against potential outbreaks and ensure a healthier future for our planet and its inhabitants. Full article

We evaluated the One Health-ness (OH-ness) of the surveillance system for antimicrobial resistance (AMR) in Norway by using the recently developed “Evaluation tool for One Health epidemiological surveillance capacities and capabilities” (OH–EpiCap tool). First, we defined the Norwegian AMR surveillance system that we would evaluate. The tool was applied by a group of stakeholders (key persons in the Norwegian AMR surveillance programmes and authors of this paper). The evaluation was performed using a consensus approach. The evaluation resulted in an overall OH-ness score of 68% across all three dimensions included in the tool: Organisation, Operation, and Impact. Suggestions for improvement were only indicated within the areas of internal evaluation and operational costs, whereas most of the indicators included in the tool showed good adherence to the One Health principles. By performing this internal evaluation, we recognized that AMR surveillance in the environment needs to be included in a more systematic and standardized way to improve the OH-ness as defined by the quadripartite organisations. Last but not least, it was beneficial to bring key stakeholders together to conduct the evaluation. It increased a joint perception of the OH-ness of AMR surveillance in Norway and encouraged further collaboration in the future. Full article