Archives curieuses de l'histoire de France.... 1re série. Tome 8e

Comprend : Histoire contenant un abrégé de la vie, moeurs et vertus du roy... Charles IX... ; La Prinse du Comte de Montgommery, dedans le chasteau de Donfron, par monsieur de Matignon, lieutenant en la basse Normandie, en l'absence du Duc de Bouillon, le Ieudy XXVII de May, mil cinq cens soixante et quatorze. A Paris, pour Nicolas du Mont demeurant auprès le Collège de Reims 1574 ; Arrest contre Geoffroy Vallée. 8 février 1574. (Extrait des Registres du Parlement) ; Discours de la mort et exécution de Gabriel Comte de Montgommery, par arrest de la Court, pour les conspirations et menées par luy commises, contre le Roy et son estat, qui fut à Paris, le vingsixième de Iuing, 1574. A Paris, par Michel Buffet... 1574 ; Choses notables et qui semblent digne de l'histoire, advenues aux premiers troubles et qui peuvent estre adjoustées aux discours qui en on esté escrits ; Histoire de Charles IX ; Le Tumulte de Bassigni... ; Discours de la famine de Sancerre. Mars 1573 ; Lettre... au roy, 27 septembre 1572 ; Des mines d'argent trouvées en France, ouvrage et police d'icelles... ; Ordonnances... sur la discipline militaire

Reaudit report on the Collins-Maxwell Community School District for the period July 1, 2005 through June 30, 2006

Reaudit report on the Collins-Maxwell Community School District for the period July 1, 2005 through June 30, 2006

Implementation study of a clinical prediction score to rule out cardiogenic chest pain in community: Cluster randomized trial

1.1 Fundamentals Chest pain is a common complaint in primary care patients (1 to 3% of all consultations) (1) and its aetiology can be miscellaneous, from harmless to potentially life threatening conditions. In primary care practice, the most prevalent aetiologies are: chest wall syndrome (43%), coronary heart disease (12%) and anxiety (7%) (2). In up to 20% of cases, potentially serious conditions as cardiac, respiratory or neoplasic diseases underlie chest pain. In this context, a large number of laboratory tests are run (42%) and over 16% of patients are referred to a specialist or hospitalized (2).¦A cardiovascular origin to chest pain can threaten patient's life and investigations run to exclude a serious condition can be expensive and involve a large number of exams or referral to specialist -­‐ often without real clinical need. In emergency settings, up to 80% of chest pains in patients are due to cardiovascular events (3) and scoring methods have been developed to identify conditions such as coronary heart disease (HD) quickly and efficiently (4-­‐6). In primary care, a cardiovascular origin is present in only about 12% of patients with chest pain (2) and general practitioners (GPs) need to exclude as safely as possible a potential serious condition underlying chest pain. A simple clinical prediction rule (CPR) like those available in emergency settings may therefore help GPs and spare time and extra investigations in ruling out CHD in primary care patients. Such a tool may also help GPs reassure patients with more common origin to chest pain.

Efficacy of clinical guideline implementation to improve the appropriateness of chest physiotherapy prescription among inpatients with community-acquired pneumonia

BACKGROUND: Although there is no strong evidence of benefit, chest physiotherapy (CP) seems to be commonly used in simple pneumonia. CP requires equipment and frequently involves the assistance of a respiratory therapist, engendering a significant medical workload and cost. AIM: To measure and compare the efficacy of two modalities of chest physiotherapy (CP) guideline implementation on the appropriateness of CP prescription among patients hospitalised for community-acquired pneumonia (CAP). PATIENTS AND METHODS: We measured the CP prescription rate and duration in all consecutive CAP inpatients admitted in a division of general internal medicine at an urban teaching community hospital during three consecutive one-year time periods: (1) before any guideline implementation; (2) after a passive implementation by medical grand rounds and guideline diffusion through mailing; (3) after adding a one-page reminder in the CAP patient's medical chart highlighting our recommendations. Death and recurrent hospitalisation rates within one year after hospitalisation were recorded to assess whether CP prescription reduction, if any, impaired patient outcomes. RESULTS: During the three successive phases, 127, 157, and 147 patients with similar characteristics were included. Among all CAP inpatients, the CP prescription rate decreased from 68% (86/127) to 51% (80/157), and to 48% (71/147), respectively (P for trend <0.01 for trend). A significant reduction in CP duration was observed after the active guideline implementation (12.0, 11.0, 7.0days, respectively) and persisted after adjustment for length of stay. Reductions in CP prescription rate and duration were also observed among CAP patients with COPD CP prescription rate: 97% (30/31), 67% (24/36), 75% (35/47), respectively (P<0.01 for trend). The mean cost of CP per patient was reduced by 56%, from $709 to $481, and to $309, respectively. Neither the in-hospital deaths, the one-year overall recurrent hospitalisation nor the one-year CAP-specific recurrent hospitalisation significantly differed between the three phases. CONCLUSION: Both passive and active implementation of guidelines appear to improve the appropriateness of CP prescription among inpatients with CAP without impairing their outcomes. Restricting CP use to patients who benefit from this treatment might be an opportunity to decrease CAP medical cost and workload.