The role of calcium supplementation in healthy musculoskeletal ageing: An Experts consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF)
Identifieur interne : 001554 ( Main/Exploration ); précédent : 001553; suivant : 001555The role of calcium supplementation in healthy musculoskeletal ageing: An Experts consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF)
Auteurs : Nicholas C. Harvey [Royaume-Uni] ; Emmanuel Biver [Suisse] ; Jean-Marc Kaufman [Belgique] ; Jürgen Bauer [Allemagne] ; Jaime Branco [Portugal] ; Maria Luisa Brandi [Italie] ; Olivier Bruyère [Belgique] ; Veronique Coxam [France] ; Alfonso Cruz-Jentoft [Espagne] ; Edward Czerwinski [Pologne] ; Hans Dimai [Autriche] ; Patrice Fardellone [France] ; Francesco Landi [Italie] ; Jean-Yves Reginster [Belgique] ; Bess Dawson-Hughes [États-Unis] ; John A. Kanis [Royaume-Uni, Australie] ; Rene Rizzoli [Suisse] ; Cyrus Cooper [Royaume-Uni]Source :
- Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA [ 0937-941X ] ; 2016.
Abstract
The place of calcium supplementation, with or without concomitant vitamin D supplementation, has been much debated in terms of both efficacy and safety. There have been numerous trials and meta-analyses of supplementation for fracture reduction, and associations with risk of myocardial infarction have been suggested in recent years. In this report, the product of an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF), we review the evidence for the value of calcium supplementation, with or without vitamin D supplementation, for healthy musculoskeletal ageing. We conclude that: 1) calcium and vitamin D supplementation leads to a modest reduction in fracture risk, although population-level intervention has not been shown to be an effective public health strategy; 2) supplementation with calcium alone for fracture reduction is not supported by the literature; 3) side effects of calcium supplementation include renal stones and gastrointestinal symptoms; 4) vitamin D supplementation, rather than calcium supplementation, may reduce falls risk; and 5) assertions of increased cardiovascular risk consequent on calcium supplementation are not convincingly supported by current evidence. In conclusion, we recommend, on the basis of the current evidence, that calcium supplementation, with concomitant vitamin D supplementation, is supported for patients at high risk of calcium and vitamin D insufficiency, and in those who are receiving treatment for osteoporosis.
Url:
DOI: 10.1007/s00198-016-3773-6
PubMed: 27761590
PubMed Central: 5274536
Affiliations:
- Allemagne, Australie, Autriche, Belgique, Espagne, France, Italie, Pologne, Portugal, Royaume-Uni, Suisse, États-Unis
- Angleterre, Auvergne (région administrative), Auvergne-Rhône-Alpes, Communauté de Madrid, Lombardie, Oxfordshire, Province de Flandre-Orientale, Province de Liège, Région flamande, Région wallonne, Victoria (État)
- Clermont-Ferrand, Clermonth-Ferrand, Gand, Liège, Madrid, Melbourne, Milan, Oxford
- Université d'Oxford, Université de Gand, Université de Liège
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Foundation for Osteoporosis (IOF)</title><author><name sortKey="Harvey, Nicholas C" sort="Harvey, Nicholas C" uniqKey="Harvey N" first="Nicholas C" last="Harvey">Nicholas C. Harvey</name><affiliation wicri:level="1"><nlm:aff id="A1">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation></author><author><name sortKey="Biver, Emmanuel" sort="Biver, Emmanuel" uniqKey="Biver E" first="Emmanuel" last="Biver">Emmanuel Biver</name><affiliation wicri:level="1"><nlm:aff id="A3">Service of Bone Diseases, University Hospitals Geneva, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Service of Bone Diseases, University Hospitals Geneva, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Kaufman, Jean Marc" sort="Kaufman, Jean Marc" uniqKey="Kaufman J" first="Jean-Marc" last="Kaufman">Jean-Marc Kaufman</name><affiliation wicri:level="4"><nlm:aff id="A4">Dept of Internal Medicine, section Endocrinology, Ghent University, Ghent, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Dept of Internal Medicine, section Endocrinology, Ghent University, Ghent</wicri:regionArea><orgName type="university">Université de Gand</orgName><placeName><settlement type="city">Gand</settlement><region>Région flamande</region><region type="district" nuts="2">Province de Flandre-Orientale</region></placeName></affiliation></author><author><name sortKey="Bauer, Jurgen" sort="Bauer, Jurgen" uniqKey="Bauer J" first="Jürgen" last="Bauer">Jürgen Bauer</name><affiliation wicri:level="1"><nlm:aff id="A5">Department of Geriatric Medicine, Klinikum, Carl von Ossietzky University, Ammerländer Heerstrasse 114-118, 26129 Oldenburg, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Geriatric Medicine, Klinikum, Carl von Ossietzky University, Ammerländer Heerstrasse 114-118, 26129 Oldenburg</wicri:regionArea><wicri:noRegion>26129 Oldenburg</wicri:noRegion><wicri:noRegion>26129 Oldenburg</wicri:noRegion><wicri:noRegion>26129 Oldenburg</wicri:noRegion></affiliation></author><author><name sortKey="Branco, Jaime" sort="Branco, Jaime" uniqKey="Branco J" first="Jaime" last="Branco">Jaime Branco</name><affiliation wicri:level="1"><nlm:aff id="A6">CEDOC - NOVA Medical School, UNL and Rheumatology Department, CHLO/Hospital Egas Moniz, Lisbon, Portugal</nlm:aff><country xml:lang="fr">Portugal</country><wicri:regionArea>CEDOC - NOVA Medical School, UNL and Rheumatology Department, CHLO/Hospital Egas Moniz, Lisbon</wicri:regionArea><wicri:noRegion>Lisbon</wicri:noRegion></affiliation></author><author><name sortKey="Brandi, Maria Luisa" sort="Brandi, Maria Luisa" uniqKey="Brandi M" first="Maria Luisa" last="Brandi">Maria Luisa Brandi</name><affiliation wicri:level="1"><nlm:aff id="A7">Head, Bone and Mineral Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Head, Bone and Mineral Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence</wicri:regionArea><wicri:noRegion>Florence</wicri:noRegion></affiliation></author><author><name sortKey="Bruyere, Olivier" sort="Bruyere, Olivier" uniqKey="Bruyere O" first="Olivier" last="Bruyère">Olivier Bruyère</name><affiliation wicri:level="4"><nlm:aff id="A8">Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Public Health, Epidemiology and Health Economics, University of Liège</wicri:regionArea><placeName><settlement type="city">Liège</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province de Liège</region></placeName><orgName type="university">Université de Liège</orgName></affiliation></author><author><name sortKey="Coxam, Veronique" sort="Coxam, Veronique" uniqKey="Coxam V" first="Veronique" last="Coxam">Veronique Coxam</name><affiliation wicri:level="3"><nlm:aff id="A9">INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermonth-Ferrand, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 Clermonth-Ferrand</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Auvergne (région administrative)</region><settlement type="city">Clermonth-Ferrand</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:aff id="A10">Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 Clermont-Ferrand</wicri:regionArea><placeName><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Auvergne (région administrative)</region><settlement type="city">Clermont-Ferrand</settlement></placeName></affiliation></author><author><name sortKey="Cruz Jentoft, Alfonso" sort="Cruz Jentoft, Alfonso" uniqKey="Cruz Jentoft A" first="Alfonso" last="Cruz-Jentoft">Alfonso Cruz-Jentoft</name><affiliation wicri:level="3"><nlm:aff id="A11">Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (Irycis), Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Czerwinski, Edward" sort="Czerwinski, Edward" uniqKey="Czerwinski E" first="Edward" last="Czerwinski">Edward Czerwinski</name><affiliation wicri:level="1"><nlm:aff id="A12">Department of Bone and Joint Diseases, Jagiellonian University, Faculty of Health Sciences, Krakow Medical Centre, Krakow, Poland</nlm:aff><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Bone and Joint Diseases, Jagiellonian University, Faculty of Health Sciences, Krakow Medical Centre, Krakow</wicri:regionArea><wicri:noRegion>Krakow</wicri:noRegion></affiliation></author><author><name sortKey="Dimai, Hans" sort="Dimai, Hans" uniqKey="Dimai H" first="Hans" last="Dimai">Hans Dimai</name><affiliation wicri:level="1"><nlm:aff id="A13">Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria</nlm:aff><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz</wicri:regionArea><wicri:noRegion>Graz</wicri:noRegion></affiliation></author><author><name sortKey="Fardellone, Patrice" sort="Fardellone, Patrice" uniqKey="Fardellone P" first="Patrice" last="Fardellone">Patrice Fardellone</name><affiliation wicri:level="1"><nlm:aff id="A14">CHU Amiens, Université Picardie - Jules Verne, INSERM U 1088, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>CHU Amiens, Université Picardie - Jules Verne, INSERM U 1088</wicri:regionArea><wicri:noRegion>INSERM U 1088</wicri:noRegion><wicri:noRegion>INSERM U 1088</wicri:noRegion></affiliation></author><author><name sortKey="Landi, Francesco" sort="Landi, Francesco" uniqKey="Landi F" first="Francesco" last="Landi">Francesco Landi</name><affiliation wicri:level="3"><nlm:aff id="A15">Geriatric Department, Catholic University of Sacred Heart, Milan, Italy</nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea>Geriatric Department, Catholic University of Sacred Heart, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Reginster, Jean Yves" sort="Reginster, Jean Yves" uniqKey="Reginster J" first="Jean-Yves" last="Reginster">Jean-Yves Reginster</name><affiliation wicri:level="4"><nlm:aff id="A16">Director, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium</nlm:aff><country xml:lang="fr">Belgique</country><wicri:regionArea>Director, Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège</wicri:regionArea><orgName type="university">Université de Liège</orgName><placeName><settlement type="city">Liège</settlement><region type="region" nuts="1">Région wallonne</region><region type="province" nuts="1">Province de Liège</region></placeName></affiliation></author><author><name sortKey="Dawson Hughes, Bess" sort="Dawson Hughes, Bess" uniqKey="Dawson Hughes B" first="Bess" last="Dawson-Hughes">Bess Dawson-Hughes</name><affiliation wicri:level="1"><nlm:aff id="A17">Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA, US</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston MA</wicri:regionArea><wicri:noRegion>Boston MA</wicri:noRegion></affiliation></author><author><name sortKey="Kanis, John A" sort="Kanis, John A" uniqKey="Kanis J" first="John A" last="Kanis">John A. Kanis</name><affiliation wicri:level="1"><nlm:aff id="A18">Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield</wicri:regionArea><wicri:noRegion>Sheffield</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:aff id="A19">Institute for Health and Ageing, Catholic University of Australia, Melbourne</nlm:aff><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName><wicri:orgArea>Institute for Health and Ageing, Catholic University of Australia</wicri:orgArea></affiliation></author><author><name sortKey="Rizzoli, Rene" sort="Rizzoli, Rene" uniqKey="Rizzoli R" first="Rene" last="Rizzoli">Rene Rizzoli</name><affiliation wicri:level="1"><nlm:aff id="A3">Service of Bone Diseases, University Hospitals Geneva, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Service of Bone Diseases, University Hospitals Geneva, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><affiliation wicri:level="1"><nlm:aff id="A1">MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="A2">NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton</wicri:regionArea><wicri:noRegion>Southampton</wicri:noRegion></affiliation><affiliation wicri:level="4"><nlm:aff id="A20">Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, The Botnar Research Centre, University of Oxford, Oxford</wicri:regionArea><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author></analytic><series><title level="j">Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA</title><idno type="ISSN">0937-941X</idno><idno type="eISSN">1433-2965</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p id="P3">The place of calcium supplementation, with or without concomitant vitamin D supplementation, has been much debated in terms of both efficacy and safety. There have been numerous trials and meta-analyses of supplementation for fracture reduction, and associations with risk of myocardial infarction have been suggested in recent years. In this report, the product of an expert consensus meeting of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the International Foundation for Osteoporosis (IOF), we review the evidence for the value of calcium supplementation, with or without vitamin D supplementation, for healthy musculoskeletal ageing. We conclude that: 1) calcium and vitamin D supplementation leads to a modest reduction in fracture risk, although population-level intervention has not been shown to be an effective public health strategy; 2) supplementation with calcium alone for fracture reduction is not supported by the literature; 3) side effects of calcium supplementation include renal stones and gastrointestinal symptoms; 4) vitamin D supplementation, rather than calcium supplementation, may reduce falls risk; and 5) assertions of increased cardiovascular risk consequent on calcium supplementation are not convincingly supported by current evidence. In conclusion, we recommend, on the basis of the current evidence, that calcium supplementation, with concomitant vitamin D supplementation, is supported for patients at high risk of calcium and vitamin D insufficiency, and in those who are receiving treatment for osteoporosis.</p></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pologne</li><li>Portugal</li><li>Royaume-Uni</li><li>Suisse</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Auvergne (région administrative)</li><li>Auvergne-Rhône-Alpes</li><li>Communauté de Madrid</li><li>Lombardie</li><li>Oxfordshire</li><li>Province de Flandre-Orientale</li><li>Province de Liège</li><li>Région flamande</li><li>Région wallonne</li><li>Victoria (État)</li></region><settlement><li>Clermont-Ferrand</li><li>Clermonth-Ferrand</li><li>Gand</li><li>Liège</li><li>Madrid</li><li>Melbourne</li><li>Milan</li><li>Oxford</li></settlement><orgName><li>Université d'Oxford</li><li>Université de Gand</li><li>Université de Liège</li></orgName></list><tree><country name="Royaume-Uni"><noRegion><name sortKey="Harvey, Nicholas C" sort="Harvey, Nicholas C" uniqKey="Harvey N" first="Nicholas C" last="Harvey">Nicholas C. Harvey</name></noRegion><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><name sortKey="Cooper, Cyrus" sort="Cooper, Cyrus" uniqKey="Cooper C" first="Cyrus" last="Cooper">Cyrus Cooper</name><name sortKey="Harvey, Nicholas C" sort="Harvey, Nicholas C" uniqKey="Harvey N" first="Nicholas C" last="Harvey">Nicholas C. Harvey</name><name sortKey="Kanis, John A" sort="Kanis, John A" uniqKey="Kanis J" first="John A" last="Kanis">John A. Kanis</name></country><country name="Suisse"><noRegion><name sortKey="Biver, Emmanuel" sort="Biver, Emmanuel" uniqKey="Biver E" first="Emmanuel" last="Biver">Emmanuel Biver</name></noRegion><name sortKey="Rizzoli, Rene" sort="Rizzoli, Rene" uniqKey="Rizzoli R" first="Rene" last="Rizzoli">Rene Rizzoli</name></country><country name="Belgique"><region name="Région flamande"><name sortKey="Kaufman, Jean Marc" sort="Kaufman, Jean Marc" uniqKey="Kaufman J" first="Jean-Marc" last="Kaufman">Jean-Marc Kaufman</name></region><name sortKey="Bruyere, Olivier" sort="Bruyere, Olivier" uniqKey="Bruyere O" first="Olivier" last="Bruyère">Olivier Bruyère</name><name sortKey="Reginster, Jean Yves" sort="Reginster, Jean Yves" uniqKey="Reginster J" first="Jean-Yves" last="Reginster">Jean-Yves Reginster</name></country><country name="Allemagne"><noRegion><name sortKey="Bauer, Jurgen" sort="Bauer, Jurgen" uniqKey="Bauer J" first="Jürgen" last="Bauer">Jürgen Bauer</name></noRegion></country><country name="Portugal"><noRegion><name sortKey="Branco, Jaime" sort="Branco, Jaime" uniqKey="Branco J" first="Jaime" last="Branco">Jaime Branco</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Brandi, Maria Luisa" sort="Brandi, Maria Luisa" uniqKey="Brandi M" first="Maria Luisa" last="Brandi">Maria Luisa Brandi</name></noRegion><name sortKey="Landi, Francesco" sort="Landi, Francesco" uniqKey="Landi F" first="Francesco" last="Landi">Francesco Landi</name></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Coxam, Veronique" sort="Coxam, Veronique" uniqKey="Coxam V" first="Veronique" last="Coxam">Veronique Coxam</name></region><name sortKey="Coxam, Veronique" sort="Coxam, Veronique" uniqKey="Coxam V" first="Veronique" last="Coxam">Veronique Coxam</name><name sortKey="Fardellone, Patrice" sort="Fardellone, Patrice" uniqKey="Fardellone P" first="Patrice" last="Fardellone">Patrice Fardellone</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Cruz Jentoft, Alfonso" sort="Cruz Jentoft, Alfonso" uniqKey="Cruz Jentoft A" first="Alfonso" last="Cruz-Jentoft">Alfonso Cruz-Jentoft</name></region></country><country name="Pologne"><noRegion><name sortKey="Czerwinski, Edward" sort="Czerwinski, Edward" uniqKey="Czerwinski E" first="Edward" last="Czerwinski">Edward Czerwinski</name></noRegion></country><country name="Autriche"><noRegion><name sortKey="Dimai, Hans" sort="Dimai, Hans" uniqKey="Dimai H" first="Hans" last="Dimai">Hans Dimai</name></noRegion></country><country name="États-Unis"><noRegion><name sortKey="Dawson Hughes, Bess" sort="Dawson Hughes, Bess" uniqKey="Dawson Hughes B" first="Bess" last="Dawson-Hughes">Bess Dawson-Hughes</name></noRegion></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Kanis, John A" sort="Kanis, John A" uniqKey="Kanis J" first="John A" last="Kanis">John A. Kanis</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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