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International Primary Care Association

Clinical Focus Primary Care

Volume 11 Issue 3 - 2017

It has been an odd summer, and autumn has already and will usher in further calamities. On the home front, the Brexit debate has moved from the extreme hardline exit to a softer approach now that that the consequences of the simple IN or OUT vote have been gradually unveiled by a much-divided government and a slightly less divided opposition. I note a that May et al have subtly indicated changes in their stance, with a wish to continue membership of Research organisations (UK has awards of ~ 1 billion Euros per annum from the EU), Security organisations, there has been a shift on immigration………the list goes on. Strangely, as far as the NHS is concerned, NHS England are looking to attract 1000s of doctors, from the EU, to fill the deficit in GPs! I am not entirely certain they will be able to fulfil the need, as EU healthcare professionals are leaving the UK, rather than flocking to it. We shall probably have to turn to the Commonwealth, India, Australia, Canada….to fill the gaps left and additionally to make up deficits from poor workforce planning.  

Increasing levels of antimicrobial resistance are currently a big problem in the management of Gram negative infections caused by enterobacteriaceae. This article reviews resistance mechanisms, focusing on a management approach relevant to primary care.

The Female lower urinary tract symptoms (FLUTS) are a collection of symptoms akin to the wellknown lower urinary tract symptoms (LUTS) in male counterparts. It is a common presentation in primary care consultations, particularly in women of middle to late age. Awareness of risk factors and actively looking out for these cases may be worthwhile particularly as patients may not be very forthcoming with this problem. Careful history taking, examination and assessment of its impact on quality of life (QOL) are of paramount importance. There is a need to carry out holistic assessment of these patients prior to offering management plan, which can include self-help measures, behavioural treatment, medications and surgical treatment.

This article illustrates the magnitude of the problem and will assist clinicians in primary care to identify, diagnose and manage patients with FLUTS in an evidence-based manner.


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