Basingstoke and North Hampshire Hospital (BNHH) is a 450-bed National Health Service (NHS) hospital in Basingstoke, Hampshire, England run by Hampshire Hospitals NHS Foundation Trust. It employs around 2,800 staff. Each year it has around 47,000 admissions, sees 43,000 patients in the Emergency Department, sees around 175,000 outpatients and delivers over 2,800 babies.
Objectives:Antibiotic susceptibility testing (AST) results are needed more rapidly to support antimicrobial stewardship and improve patient outcomes. Diagnostic microbiology laboratories receive hundreds of urine samples daily from patients with suspected urinary tract infection (UTI) in both community and inpatient settings. Bacteriostatic boric acid preserves microbial contents during transport but may interfere with rapid AST methods. This study aimed to assess the accuracy of rapid microcapillary direct-from-urine (RMD) AST with suspected UTI patient urine, and to determine whether RMD AST is affected by boric acid. Methods:The overall accuracy of RMD AST was assessed with 352 diagnostic remnant urine samples collected with boric acid, for seven first-line antibiotics (ampicillin, amoxicillin/clavulanic acid, trimethoprim, nitrofurantoin, ciprofloxacin, cefalexin and cefoxitin). A further 90 urine samples were tested in duplicate with or without addition of bacteriostatic. Results:RMD AST showed a concordance with the reference method of 572/590 bacteria/antibiotic combinations (96.95%) for urine samples containing a single organism. The mean time to AST result was 5.85 h. When duplicate samples with or without boric acid were directly compared there was a categorical agreement of 158/160 (98.75%). Conclusions:The overall high accuracy of RMD AST for determining antimicrobial susceptibility to seven first-line antibiotics for UTI shows this method can deliver rapid results-without requiring additional processing-for urine samples routinely collected with boric acid from suspected UTI patients. The close agreement between duplicates with or without boric acid confirms this rapid direct method is unaffected by bacteriostatic collection.
The knee is a frequently injured joint, and the incidence of injury is increasing. Young adults are most likely to injure their knee through sports participation, and this can result in long-term debility without appropriate early and deferred management. A detailed history and clinical examination, supplemented with radiographic evaluation of the joint and magnetic resonance imaging, assist in the diagnosis and can guide acute and definitive management. Early clinical assessment by an appropriately trained clinician is recommended. Fractures should be managed through orthopaedic trauma services, and soft tissue injuries are often best triaged into specialist acute knee clinics. Early management includes the use of plaster casts, splints or braces according to the injury pattern, and the principles or rest, ice, compression and elevation are followed. Early functional motion should be instituted when safe to do so to prevent arthrofibrosis and secondary complications. Fractures, including osteochondral lesions are typically best dealt with acutely, along with disruptions of the extensor mechanism and displaced meniscal tears causing locking. Non-acute surgical management of other soft tissue injuries is generally preferred, allowing the joint to recover before additional operative insult. Appropriate early intervention by specialist knee services is associated with improved long-term outcomes.
There is an increasing interest in functional food formulations with added bioactive compounds, such as vitamins, probiotics, polyphenols and bioactive peptides, specifically in dairy and plant-based foods, bakery, and beverages. However, their stability in the food system, release rates and biological activity after consumption/digestion play an important role in the effectiveness of functional foods. There are technical challenges in maintaining the stability and acceptability of added compounds in the formulation design of food items. A novel approach to delivering bioactive compounds in functional foods is their microencapsulation, where stability-sensitive compounds are protected against their degradation during processing and physiological digestion, with targeted release in the gastrointestinal tract (GIT) and elicited cellular responses. Microencapsulation of bioactive compounds has been proven to be beneficial in in vitro models for the stability, antioxidant and immunomodulatory action, and acceptability compared to free (non-capsulated) forms. This technology is worth considering relative to the protection of health benefits of compounds used in food products, with their necessary bioactivity after physiological digestion in GIT. This article reviews important bioactive compounds, challenges, and strategies in the development of functional foods to ensure the required stability for the bioavailability of added compounds.
Abstract BackgroundCardiac myxomas (CMs) are the commonest benign primary cardiac tumors, most frequently originating from the left atrium and occasionally from the right atrium. Despite being histologically benign, CMs can cause myriad serious embolic complications, including stroke, acute coronary syndrome, limb ischemia, and visceral infarction. While previous studies have explored risk factors for embolization, there is a lack of papers comprehensively summarizing the frequency, anatomical distribution, clinical patterns, and management of CM-related embolization. ObjectiveThis review aims to provide a comprehensive synthesis of embolic complications associated with CMs, highlighting patterns, management strategies, and gaps in the current literature. MethodsA systematic review will be conducted in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. MEDLINE, Embase, Scopus, CINAHL, the Cochrane Library, and PubMed will be searched for studies reporting embolic complications in patients with histologically or radiologically confirmed CMs. Eligible study designs include large case series, cohort studies, and registries. Six reviewers will independently perform title and abstract and full-text screening in pairs across 3 screening groups, with disagreements resolved through discussion and senior reviewer adjudication where necessary. Data will be extracted by 3 reviewers, with the extracted data independently verified for accuracy. Discrepancies will be resolved through discussion or third-party adjudication. Risk of bias will be assessed using the Joanna Briggs Institute tools. ResultsThe review will summarize reported frequencies and anatomical distribution of embolic events, clinical presentations, associations with tumor characteristics, and management strategies. Title and abstract screening were completed in early April 2026, and full-text screening commenced in late April 2026. Data extraction and synthesis were completed in May 2026. We anticipate publication of the findings in September 2026. ConclusionsThis review aims to provide a comprehensive synthesis of embolic complications associated with CMs, highlighting patterns, management strategies, and gaps in the current literature. The findings aim to improve clinical recognition, inform clinical management, and guide future research.
