Acta medica academica最新文献

{"title":"Benchmarking European Nursing Research Published in 2020 in Leading Nursing Journals: A Bibliometric Study.","authors":"Marija Janeš, Daniel Rehlicki, Andrea Vukša, Josip Strčić, Livia Puljak","doi":"10.5644/ama2006-124.518","DOIUrl":"https://doi.org/10.5644/ama2006-124.518","url":null,"abstract":"<p><strong>Objective: </strong>Nursing research plays a critical role in advancing evidence-based practice and improving patient outcomes. This study analysed the geographical distribution, methodological characteristics, reporting practices, and funding patterns of European nursing research published in Q1 nursing journals in 2020.</p><p><strong>Materials and methods: </strong>A bibliometric analysis was conducted on original articles published in the first quartile (Q1) of the 2020 Journal Impact Factor. Inclusion required at least one author to be affiliated with an institution in one of the 46 Council of Europe member states. The study assessed author affiliations, units of analysis, participant types, research design, reporting, and funding.</p><p><strong>Results: </strong>Of the 4911 identified records, 1618 articles met the inclusion criteria. The United Kingdom had the most author affiliations (N=420; 20%). Seven countries appeared in at least 5% of the articles, whereas 15 out of 46 European countries were not represented at all. Most studies focused on people (N=1236; 76%) and were primary research (N=1304; 81%), with observational designs being the most common. Only 38% of articles mentioned a reporting guideline, with PRISMA cited most frequently (N=220; 14%). Funding was predominantly non-commercial (N=739; 46%).</p><p><strong>Conclusion: </strong>The study revealed notable geographic imbalances in European nursing research and a strong reliance on observational designs, highlighting the need for methodological diversity and more inclusive research participation across Europe.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of Lower Respiratory Tract Infections in Hospitalized Patients Using Multiplex PCR in Central Greece.","authors":"Ioanna Argyrakouli, Georgios Meletis, Sofia Argyrakouli, Efthymia Protonotariou, Melania Kachrimanidou","doi":"10.5644/ama2006-124.517","DOIUrl":"https://doi.org/10.5644/ama2006-124.517","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the epidemiology of LRTIs using multiplex Polymerase Chain Reaction (mPCR) at the General Hospital of Larissa.</p><p><strong>Methods: </strong>This retrospective observational study was conducted from January 2021 to June 2024 and included 210 patients with suspected LRTIs. Respiratory specimens, comprising bronchoalveolar lavage and sputum samples, were analyzed using the Biofire Filmarray Pneumonia Panel Plus (BFPP; Biofire, bioMérieux), which detects a wide spectrum of bacterial, viral, and atypical respiratory pathogens.</p><p><strong>Results: </strong>The most frequently detected pathogens were Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, predominantly in patients admitted to the Intensive Care Unit. In contrast, specimens from the Department of Internal Medicine most often yielded Haemophilus influenzae, Staphylococcus aureus, and human rhinovirus/enterovirus. Overall, bacterial pathogens were more prevalent than viral pathogens. The use of mPCR enabled the rapid detection of respiratory pathogens and provided critical epidemiological insights into LRTI distribution across hospital departments.</p><p><strong>Conclusions: </strong>mPCR is a useful adjunctive tool for the detection of respiratory pathogens in patients with LRTIs and may support clinical decision-making if interpreted in the clinical context. The integration of molecular diagnostics into routine clinical practice may improve infection management and surveillance. Further multicenter studies and comparisons with conventional diagnostic methods are warranted to evaluate its impact on antimicrobial stewardship, clinical decision-making, and patient outcomes.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypersensitivity to PEG-Asparaginase and Desensitization Strategies in Pediatric Acute Lymphoblastic Leukemia: A Narrative Review.","authors":"Tomaž Prelog, Marko Kavčič, Simona Ivancan, Neža Salobir, Janez Jazbec","doi":"10.5644/ama2006-124.516","DOIUrl":"https://doi.org/10.5644/ama2006-124.516","url":null,"abstract":"<p><p>This narrative review synthesizes current evidence on incidence, the immunologic basis of hypersensitivity-including the recently clarified role of anti-PEG (rather than anti-protein) antibodies-genetic predisposition, differential diagnosis from asparaginase-associated hyperammonemia, therapeutic drug monitoring (TDM), and desensitization. Hypersensitivity to PEG-asparaginase is a frequent, clinically consequential complication of pediatric acute lymphoblastic leukemia therapy that can compromise treatment exposure and survival. Recombinant Erwinia asparaginase (crisantaspase) is now licensed in the United States (2021) and the European Union (2023) for hypersensitive patients; however, cost, reimbursement, and local availability continue to limit access in many settings. Therefore, strategies for the safe continuation of PEG-asparaginase remain clinically relevant for reasons other than supply shortages alone. Using Ponte di Legno Toxicity Working Group definitions, reactions are classified as clinical allergy, allergic-like reaction, or silent inactivation, each requiring a different response; TDM is central to making this distinction. Genetic susceptibility loci (HLA class II haplotypes, CNOT3, GRIA1) remain investigational, with moderate effect sizes and inconsistent replication, and are not yet suitable for clinical decision-making. An adapted multi-step desensitization protocol can preserve therapeutic enzyme activity in appropriately selected patients; however, tolerance is temporary and dose-specific and requires repeat TDM after every dose. Conclusion. A personalized, multidisciplinary approach-integrating TDM, realistic assessment of access to alternative formulations, and (where available) genetic data-is recommended to optimize treatment safety and antileukemic efficacy.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Euglycemic Ketoacidosis: An Overlap of Diabetic and Non-diabetic Causes.","authors":"Alpha Madu, Himanshi Garg","doi":"10.5644/ama2006-124.513","DOIUrl":"10.5644/ama2006-124.513","url":null,"abstract":"<p><strong>Objective: </strong>Ketoacidosis is the most common cause of high anion gap metabolic acidosis in acute medical settings. Although bedside detection is straightforward, identifying the underlying aetiology may be challenging, particularly in patients with diabetes, in whom multiple mechanisms may coexist.</p><p><strong>Case report: </strong>We report a case of a middle-aged woman with type 1 diabetes who presented with vomiting and reduced oral intake. Initial investigations demonstrated high anion gap metabolic acidosis with severe ketoacidosis (ketones 4.8 mmol/L), hypoglycaemia (glucose 3.3 mmol/L), and profound acute kidney injury (eGFR 5 ml/min/1.73 m² from a baseline of 47 ml/min/1.73 m²). She was initially managed for diabetic ketoacidosis (DKA) with hypoglycaemia using a fixed-rate insulin infusion; however, no clinical or biochemical improvement was observed. Re-evaluation of her clinical presentation and investigations by the multidisciplinary team prompted consideration of other differential diagnoses, such as euglycemic DKA, starvation ketosis, and metabolic acidosis secondary to acute tubular necrosis. Targeted treatment for these causes of metabolic acidosis was initiated, and remarkable clinical and biochemical improvements were noted within 48 hours, suggesting an overlapping metabolic pathophysiology. The patient made a full recovery and was discharged after 10 days.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic complexities that may be encountered in managing ketoacidosis, especially in patients with diabetes, and underscores the importance of correctly identifying the different causes of ketoacidosis. It draws the attention of acute and general physicians to the possibility of overlapping metabolic processes in the aetiology of ketoacidosis and that successful treatment often targets all identified causes, rather than a single cause. Additionally, other causes of metabolic acidosis, such as lactic acidosis and acute kidney injury, should be identified and treated.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"202-207"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Neutropenia in Children: A Single-Center Experience.","authors":"Jelena Roganović, Martina Zubović, Ana Đorđević, Silvije Šegulja","doi":"10.5644/ama2006-124.510","DOIUrl":"10.5644/ama2006-124.510","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the characteristics, etiology, diagnostic evaluation, management, follow-up, and outcomes of children with chronic neutropenia treated at a tertiary care pediatric hospital in Croatia.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed the demographic, clinical, and laboratory data of 48 children (23 males and 25 females; median age 7.75 months [IQR 5.13-11.75]) diagnosed with chronic neutropenia between 2013 and 2021.</p><p><strong>Results: </strong>The median absolute neutrophil count (ANC) at presentation was 487/μL (IQR 198.5-837.5), and 52% of the patients had severe neutropenia. Autoimmune neutropenia (AIN) was diagnosed in 21 cases, chronic idiopathic neutropenia (CIN) in 26 cases, and neutropenia in the context of a genetic syndrome in one case. Antineutrophil antibodies were detected in 47% of the children tested. During follow-up, 23% received granulocyte-colony-stimulating factor (G-CSF), and 21% received antibiotics. The median follow-up duration was 21 months (IQR 12-32.75), during which 83% achieved spontaneous remission, with a median time to remission of 13.5 months. Lower ANC at diagnosis was associated with more frequent rehospitalizations, longer time to remission, and longer follow-up. No significant differences were found between AIN and CIN in terms of age, ANC at diagnosis, time to referral, or time to remission, although AIN cases were followed for a longer period.</p><p><strong>Conclusion: </strong>Pediatric chronic isolated neutropenia, including AIN and CIN, generally follows a mild clinical course with a low incidence of severe infection. Most children achieve spontaneous remission within one year. Comprehensive genetic testing is essential in children with suspected congenital neutropenia and those with features suggestive of an underlying genetic syndrome. Adherence to European guidelines supports standardized diagnosis, follow-up, and management, thereby improving patient care.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"134-144"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the Spine: A Rare Case of Myxopapillary Ependymoma With Extraneural Metastases.","authors":"Areti Kalfoutzou, Cleopatra Rapti, Spyros Sfikas, Eleftheria Bagiokou, Nikolaos Chaleplidis, Vasileios Kolintzikis, Vasileios Ramfidis","doi":"10.5644/ama2006-124.514","DOIUrl":"10.5644/ama2006-124.514","url":null,"abstract":"<p><strong>Objective: </strong>Myxopapillary ependymoma (MPE) is a rare tumor of ependymal origin that commonly arises within the spinal canal. It is rather benign and slow-growing; however, it tends to recur along the central nervous system (CNS), usually after incomplete resection or tumor seeding due to surgical manipulation. Extraneural metastases of MPE are extremely rare, with only a few documented cases in the literature.</p><p><strong>Case report: </strong>We describe a case of a middle-aged female patient with sacrococcygeal MPE, which was initially misdiagnosed as a pilonidal cyst and subjected to surgical excision. Over the following years, she experienced three local recurrences in the sacrococcygeal region, which were treated with surgery and radiotherapy. Ten years after the initial excision, the patient complained of dyspnea and hemoptysis, and imaging studies revealed multiple right lung nodules. A core biopsy of a lung lesion was performed, and histopathology was consistent with metastatic MPE. The patient was started on chemotherapy with per os temozolomide and has not experienced disease progression for nearly 3 years.</p><p><strong>Conclusion: </strong>Extraneural metastases of MPE represent an exceptionally rare and diagnostically challenging entity and should be considered in patients with a history of MPE who present with distant lesions, even years after the initial diagnosis.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"208-215"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guidelines for Adult MASLD in Bosnia and Herzegovina: National Recommendations for Diagnosis, Risk Stratification, and Treatment.","authors":"Enver Zerem, Azra Husić, Maja Karin, Tanja Glamočanin, Mirela Bašić Denjagić, Emil Babić, Zumreta Bihorac-Kučuk, Goran Bokan, Nerma Čustović, Aida Dumpor, Belma Hadžiselimović, Admir Kurtcehajic, Ljubica Jovandić, Predrag Jovanović, Amila Mehmedović, Nataša Pilipović-Broćeta, Dženita Salihefendić, Nadža Zubčević","doi":"10.5644/ama2006-124.515","DOIUrl":"10.5644/ama2006-124.515","url":null,"abstract":"<p><p>Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading cause of chronic liver disease in Bosnia and Herzegovina and a major contributor to liver- and cardiovascular-related morbidity and mortality. These national guidelines provide the first country-specific, evidence-based recommendations for the diagnosis, risk stratification, and management of MASLD, covering the full disease spectrum from steatosis to cirrhosis and its complications. MASLD management is based on a coordinated, stepwise model across primary, secondary, and tertiary healthcare levels, with primary healthcare serving as the central gatekeeper and coordinator of care. Active case-finding of clinically significant fibrosis is emphasized, particularly in high-risk populations, such as individuals with type 2 diabetes mellitus or obesity. Primary healthcare plays a key role in early risk assessment through systematic evaluation of metabolic risk factors and first-line use of simple non-invasive tools, notably the FIB-4 index. A stepwise non-invasive diagnostic algorithm is recommended, with elastography (preferably vibration-controlled transient elastography or 2D shear wave elastography where available) used for further assessment in patients with indeterminate or high-risk results. Lifestyle modification and optimal management of cardiometabolic comorbidities remain the foundations of MASLD treatment. In eligible patients with type 2 diabetes mellitus and/or overweight or obesity, glucagon-like peptide-1 receptor agonists may be considered, while bariatric surgery represents an option for selected individuals with persistent obesity. Advanced MASLD, including cirrhosis, requires multidisciplinary management, surveillance for hepatocellular carcinoma, and evaluation for liver transplantation in cases of decompensation. These guidelines aim to standardize MASLD care in Bosnia and Herzegovina and strengthen the pivotal role of primary healthcare within the national MASLD care pathway.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"111-133"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic and Molecular Characterisation of Respiratory Syncytial Virus in the National SARI Surveillance System Across Three Consecutive Seasons in North Macedonia (2022-2025).","authors":"Teodora Karevska, Golubinka Boshevska, Elizabeta Jancheska, Maja Vukovikj, Senada Karishik, Gala Matevska, Gordana Nikolovska, Aneta Peshnachka, Dragan Kochinski, Kristina Stavridis, Enkela Polozhani, Milica Simova, Marija Andonovska, Gorica Popova, Icko Gjorgoski","doi":"10.5644/ama2006-124.508","DOIUrl":"10.5644/ama2006-124.508","url":null,"abstract":"<p><strong>Objective: </strong>To describe the epidemiological, molecular, and genomic characteristics of respiratory syncytial virus (RSV) detected through the national severe acute respiratory infection (SARI) surveillance system in North Macedonia across three consecutive seasons (2022/2023-2024/2025).</p><p><strong>Materials and methods: </strong>This study analysed SARI surveillance data from seven hospital-based sentinel sites. RSV detection and subgroup determination were performed using reverse transcription quantitative polymerase chain reaction (RT-qPCR), following season-specific testing strategies, which should be considered when interpreting seasonal differences in RSV positivity. Consensus genomes were generated, and phylogenetic analyses were performed using contemporaneous European reference sequences. Amino acid substitutions in the G and F proteins were assessed descriptively.</p><p><strong>Results: </strong>Among 1,899 laboratory-tested SARI cases, 53.3% were tested for RSV, of which 24.8% were positive. RSV-A predominated overall, although seasonal shifts in subgroup dominance were observed. RSV infections were concentrated among young children, particularly those aged 0-2 years. Whole-genome sequencing of 85 RSV-positive samples revealed a dynamic seasonal turnover of RSV-A lineages, whereas RSV-B circulation remained largely confined to a single dominant lineage across seasons. Analysis of antigenically important genes showed greater variability in the G gene compared with the more conserved F gene in both subgroups.</p><p><strong>Conclusion: </strong>The integration of epidemiological, molecular, and whole-genome data within routine SARI surveillance provides a comprehensive overview of RSV circulation and evolution in North Macedonia. These findings contribute genomic data from an under-represented region and provide a foundation for future evaluation of RSV vaccination and monoclonal antibody effectiveness by detecting viral genetic changes, should such measures be implemented in North Macedonia.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"145-165"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147989443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of the Russo‑Ukrainian War on Ukrainian Scholarly Publishing and Research Directions: A Bibliometric Analysis.","authors":"Maryna Kreslova, Livia Puljak, Damir Sapunar","doi":"10.5644/ama2006-124.507","DOIUrl":"10.5644/ama2006-124.507","url":null,"abstract":"<p><strong>Objective: </strong>Russia's aggression against Ukraine has unfolded in two phases: the onset of the Donbas war and the annexation of Crimea in 2014, and the full-scale invasion in 2022. We examined the changes in Ukrainian scholarly publishing across these disruption periods.</p><p><strong>Methods: </strong>Using Web of Science Core Collection and InCites data (1991-2024), we analyzed publication trends in Ukraine and Croatia, disciplinary composition, leading universities, city-level output in occupied territories, and international collaboration. Interrupted time series (ITS) models were specified with breakpoints at 2014 and 2022.</p><p><strong>Results: </strong>Ukraine's output increased from 331 articles in 1991 to 12,475 in 2021, then declined by 14.6% to 10,649 in 2024, whereas Croatia's output remained comparatively stable. The segmented ITS showed significant growth before 2014, a steeper upward trend after 2014, and a decline after 2022. Croatia showed continued growth with a smaller, non-significant post-2022 slowdown. In Ukraine, the largest post-2022 declines were observed in Physical Sciences and Social Sciences, while Engineering and Technology appeared more resilient. City-level analyses in occupied territories showed an early break in 2014 in Donetsk and Luhansk, while output linked to Simferopol and Sevastopol was rapidly reclassified after 2014, with records increasingly indexed under Russia. After 2022, collaboration with Russia collapsed, whereas partnerships with Poland, Germany, and the USA expanded.</p><p><strong>Conclusion: </strong>Ukrainian scholarly publishing showed phase-specific shifts in output and collaboration patterns that coincided with major geopolitical disruptions.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"174-185"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Meta-Analysis of Whole Blood Cholinesterase Activity in Healthy Ruminants Using a Modified Electrometric Measurement Method.","authors":"Fouad Kasim Mohammad, Maha Ahmed Ramadhan","doi":"10.5644/ama2006-124.506","DOIUrl":"10.5644/ama2006-124.506","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aimed to compile and analyze WBChE activity using the modified electrometric method to establish normal or baseline enzyme activity values in ruminants (sheep, goats, cattle, and buffalo).</p><p><strong>Materials and methods: </strong>This is a one-group randomized-effect-size meta-analysis model applied to the mean ± SD of WBChE activities in sheep, goats, cattle, and buffaloes.</p><p><strong>Results: </strong>Using PRISMA selection, we identified 16 records from five studies that measured WBChE activity in sheep (N=267), goats (N=165), cattle (N=197), and buffaloes (N=31) using a modified electrometric method. The studies included both sexes and were published between 2007 and 2025. The forest plot showed that the WBChE activities of sheep, goats, cattle, and buffaloes were 0.40, 0.32, 0.51, and 0.42 Δ pH/enzymatic reaction incubation time, respectively. Their 95% CI were 0.19-0.60, 0.16-0.49, 0.31-0.70, and 0.39-45, respectively. The weights of the individual records across the four species varied from 0.91% to 14.77%. The I2 heterogeneity index of 61% was moderate and significant (Q=38.35; P=0.001). Despite the low pseudo-R2 value (24.24%), the I2 of subgroup analysis was significant only in sheep (64.2%, Q=14, P=0.016). The funnel plot showed the possibility of publication bias in five imputed studies. However, Egger's regression analysis was not statistically significant (t=1.91, P=0.077). The overall risk of bias in the studies was low.</p><p><strong>Conclusion: </strong>This study is the first meta-analysis to establish the reference WBChE activity in healthy ruminants, including sheep, goats, cattle, and buffaloes. This is an additional contribution to the existing literature, as the modified electrometric method is recommended for measuring blood or tissue ChE activity in various animal species. These findings provide valuable reference points for the clinical and toxicological assessment of poisoning by cholinesterase-inhibiting pesticides in these species.</p>","PeriodicalId":38313,"journal":{"name":"Acta medica academica","volume":" ","pages":"216-225"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}