The Belfast City Hospital (Irish: Ospidéal Chathair Bhéal Feirste) in Belfast, Northern Ireland, is a 900-bed modern university teaching hospital providing local acute services and key regional specialities. Its distinctive orange tower block dominates the Belfast skyline being the third tallest storeyed building in Ireland (after Windsor House and Obel Tower, both in Belfast). It has a focus on the development of regional cancer and renal services. It is managed by Belfast Health and Social Care Trust and is the largest general hospital in the United Kingdom. In April 2020, due to the global coronavirus pandemic, the tower block was designated one of the UK's Nightingale Hospitals.
Antimicrobial resistance (AMR) has caused a global public health crisis, contributing to approximately five million deaths in 2019 and predicted deaths of approximately ten million annually by 2050. This equates to approximately 1.4-fold more deaths annually from AMR in 2050 than the entire COVID-19 pandemic to date. To tackle this AMR pandemic, regulatory and policy frameworks have been prepared at local, national and international levels with multi-faceted proposals and advances encompassing surveillance, diagnostics, infection prevention, antibiotic prescribing and variation of existing and novel treatment approaches. This narrative review primarily focuses on research and development which have been documented over the last five years in relation to therapeutic approaches at various stages in clinical development and the potential role that vaccines can play in the fight against AMR. This review provides an overview on antibacterial drugs, including novel classes of antibiotics, which have been recently approved, as well as combination antibiotic therapy and the potential of repurposed drugs. The potential role of novel antimicrobial, antibiofilm and quorum sensing inhibitors, such as antimicrobial peptides, nanomaterials and compounds from the extreme and natural environments, as well as ethnopharmacology including the antimicrobial effects of plants, spices, honey and venoms are explored. Novel therapeutic approaches are critically discussed in terms of their realistic clinical potential, detailing recent and ongoing trials to highlight the current interest of these approaches, including immunotherapy, bacteriophage therapy, antimicrobial photodynamic therapy (aPDT), antimicrobial sonodynamic therapy (aSDT), nitric oxide therapy and microbiome manipulation including faecal microbiota transplantation (FMT). The potential of predatory bacteria as living antimicrobial agents is also discussed. Importantly, there have been many technological developments which have enhanced bioprospecting and research and development of novel antimicrobials which this review draws attention to, including artificial intelligence, machine learning and Organ-on-a-Chip devices. Finally, key messages from the recent World Health Organization report into the role of vaccines against AMR provides an interesting perspective relating to prevention which can be of significance in tackling the AMR burden.
Dental sinus tracts can present as persistent cutaneous lesions on the lower face, often misdiagnosed as dermatological conditions such as squamous cell carcinoma. This case series describes four patients with extraoral lesions initially suspected to be of dermatological origin. Detailed assessment, imaging and histopathology confirmed a dental source in each case. Treatment included root canal treatment, tooth extraction and cyst enucleation, resulting in lesion resolution.
