COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Les bonnes pratiques de distribution (BPD) dans la répartition pharmaceutique (application à un nouvel établissement)

La répartition pharmaceutique, maillon de la chaîne de distribution des produits de santé le moins connu du grand public, en est pourtant un acteur essentiel. Pour préserver l'intégrité des produits de santé jusqu'à leur lieu de dispensation final, l'Union Européenne a adopté en 1994 une directive visant à instaurer dans chaque pays membre une réglementation sur la distribution des produits pharmaceutiques destinés à l'usage humain. C'est la naissance du guide des Bonnes Pratiques de Distribution (BPD). La mise en place de ces BPD et la mise en conformité de leurs étblissements a été un véritable défi stratégique pour les répartiteurs, leur permettant de prouver qu'ils restent le moyen le plus sûr de garantir l'accès au médicament de l'ensemble des citoyens, en toute sécurité. Confrontés à la baisse de leur marge et à de nouvelles formes de concurrence, ils doivent désormais accéder à un niveau encore plus élevé d'assurance qualité par la certification de l'ensemble de leurs établissements aux normes NF EN ISO 9000.GRENOBLE1-BU Médecine pharm. (385162101) / SudocSudocFranceF

Etude biomécanique de la récupération fonctionnelle des réparations du nerf fibulaire du chien, à l'aide d'un conduit de régénération nerveuse

LYON1-BU Santé (693882101) / SudocTOULOUSE-EN Vétérinaire (315552301) / SudocSudocFranceF

Unified semi-analytical wall boundary conditions in SPH: analytical extension to 3-D

International audienc

Unsteady open boundaries for SPH using semi-analytical conditions and Riemann solver in 2D

Due to the Lagrangian nature of SPH, treating inlet/outlet boundaries (that are intrinsically Eulerian) is a challenging issue. An extension to the Unified Semi-Analytical boundary conditions is presented to deal with unsteady open boundaries in confined and free-surface flows. The presented method uses Riemann invariants to calculate flow properties near the open boundaries, thus allowing the possibility to treat complex shapes. Furthermore, details are presented for a parallel implementation of this method, including particle creation and deletion , updating properties of vertices and segments, and additional constraints on the time step. Simple validation cases are then displayed to illustrate the performance of the proposed method as well as the ability to deal with complex problems such as generation of water waves and free outlets

Additional file 1: of Thoracolumbar partial lateral corpectomy for the treatment of chronic intervertebral disc disease in 107 dogs

Questionnaire sent to owners to evaluate medium-term neurological status of the dogs after treating ventral chronic thoracolumbar IVDD by TLPLC, as well as the owner’s satisfaction. (PDF 48 kb