Clinical management of nausea and vomiting in pregnancy and hyperemesis gravidarum across primary and secondary care: a population-based study.

Objectives: To assess how nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) are managed and treated across primary and secondary care.

Design: Population-based pregnancy cohort.

Setting: Medical records (CPRD-GOLD) from England.

Varenicline induces manic relapse in bipolar disorder.

Varenicline (Chantix) is commonly used to assist individuals with smoking cessation. This medication is known to affect mood and behavior. We report a patient with bipolar disorder who developed manic relapse after starting treatment with varenicline for tobacco dependence.

Non-fundholding in Nottingham: a vision of the future.

The 1991 health service reforms introduced the internal market and grave individual fundholding practices budgets with which they could attempt to secure preferential access to secondary health care for their patients. In the view of many doctors this undermined the principle of equity on which the NHS was founded. In Nottingham 200 non-fundholding general practitioners have joined together to act in liaison with their purchasing health authority.