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

L'infiltration dans les cônes de déjection : la basse vallée de la Tarentaise, Savoie - Alpes françaises

Dans les grandes vallées alpines, les cônes de déjection tiennent une place importante. De nombreuses études ponctuelles ont montré leur rôle dans l'alimentation des nappes alluviales. Le but de cette étude est d'analyser les facteurs qui influent sur l'infiltration dans les cône s de déjection. Une connaissance correcte de ces facteurs doit permettre d'agir de façon artificielle sur l'infiltration lorsque le besoin s'en fait sentir. Cette étude a été menée en Tarentaise, entre Albertville et Aigueblanche, car en raison de la position relative des éléments structuraux des Alpes et de la vallé e de l'Isère, les cônes de déjection que l'on y trouve sont tous différents les uns des autres.pas de résum

Etude rétrospective de 100 prothèses totales de hanche non cimentées à couple de frottement céramique/céramique (résultats à 9 ans)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Etude de l'ostéo-intégration des prothèses totales de hanche sans ciment chez les patients greffés d'organes (à propos de 20 cas)

LYON1-BU Santé (693882101) / SudocSudocFranceF

Chirurgie conservatrice et chirurgie prothétique de l'acetabulum dans les dysplasies de hanche chez l'adulte

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Fibrome desmoplastique (fibrome desmoïde osseux) (tumeur osseuse rare de l'appareil locomoteur : à propos de deux cas et revue de la littérature)

LYON1-BU Santé (693882101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Dual mobility design socket use in preventing total hip replacement dislocation following tumor resection

An overall rate of 9.8% dislocation was observed, taking into account all etiologies and contexts together. More precisely, this rate resulted from a compound figure of 5.2% in bone metastasis and 15% in primitive bone tumor. Dislocation risk depended less on etiology than on the surgical management of the abductor system, being 3.5% in the case of abductor conservation, 9.5% in the case of abductor sectioning/reinsertion, and 18% in case of gluteus medius muscle or nerve resection. Functional improvement was consistently observed, especially in bone metastasis. At the maximal follow-up, 32 patients were not using analgesics, six were taking WHO class III analgesics, 10 class II and 23 class I. Mean MSTS score was 68.1% ± 23.5% in bone metastasis and 59.6% ± 17.5% in primary bone tumor. Fourteen patients could walk without assistance, 33 with a single cane, 15 with two canes and eight with a walker; one patient had not been able to resume walking

Limb salvage in proximal humerus malignant tumors: the place of free vascularized fibular graft

Limb-salvage surgery has become a safe and well-established alternative to amputations for malignant tumors of the proximal humerus. The authors describe six cases with favorable restoration of the upper limb following tumor resection type IB Malawer and proximal humeral reconstruction by vascularized fibula graft (VFG) as a primary or secondary procedure. A scapulofibular arthrodesis was elected in all cases. A special custom-made plate was used in four cases. One patient required a latissimus dorsi musculocutaneous flap for better coverage. Serial x-rays assessed the bone union. Neither flap necrosis nor sepsis phenomena were noted. Stress fracture was the only complication. This was encountered in two cases. Every patient was reviewed and assessed by the Enneking score. The average score was 21.8. The average follow-up was 5-years. A good quality of life was preserved due to reliable mobility of the elbow and the hand

Nine years follow-up of 100 ceramic-on-ceramic total hip arthroplasty

The aim of this study was to evaluate the first 100 cementless ceramic-on-ceramic total hip arthroplasty (THA) performed at our institution with more than nine years of follow-up. Clinical evaluation was performed using Harris hip score. Radiological evaluation was performed by two surgeons. Four patients were lost to follow-up. Harris hip score significantly improved at latest follow-up. Radiological analysis showed calcar osteolysis for 75 patients and one cup loosening. One patient required a revision five years postoperatively for cup loosening. Based on these results and the routine use of a navigation system to optimise positioning of the implants, we advocate the use of uncemented hydroxyapatite coated ceramic-onceramic THA in young and active patients in our current practice

Hip Squeaking: A 10-Year Follow-Up Study

The aim of the study was to analyze the incidence of squeaking with ceramic-onceramic total hip arthroplasty (THA) after 10 years of follow-up and the potential complications that could occur related to this phenomenon. One hundred THAs implanted between November 1999 and December 2000 were evaluated. Incidence of squeaking was investigated clinically with a questionnaire. Implant positioning was analyzed on x-rays and computer tomography. Of the 100 THAs, 5 patients presented with squeaking. All of them were active, sporty, and heavy men. Functional scores were comparable with nonsqueaking patients. There was no malpositioning on the x-ray analysis, no wear, and no loosening. We could not demonstrate any relation between squeaking and ceramic fracture. Squeaking noise appeared at a mean of 66 months postsurgery. It appears to be an isolated phenomenon without any consequences at 10-year follow-up