Effect of Aspirin or Resistant Starch on Colorectal Neoplasia in the Lynch Syndrome
Identifieur interne : 008D71 ( Main/Exploration ); précédent : 008D70; suivant : 008D72Effect of Aspirin or Resistant Starch on Colorectal Neoplasia in the Lynch Syndrome
Auteurs : John Burn [Royaume-Uni] ; D. Timothy Bishop [Royaume-Uni] ; Jukka-Pekka Mecklin [Finlande] ; Finlay Macrae [Australie] ; Gabriela Möslein [Allemagne] ; Sylviane Olschwang [France] ; Marie-Luise Bisgaard [Danemark] ; Raj Ramesar [Afrique du Sud] ; Diana Eccles [Royaume-Uni] ; Eamonn R. Maher [Royaume-Uni] ; Lucio Bertario [Italie] ; Heikki J. Jarvinen [Finlande] ; Annika Lindblom [Suède] ; D. Gareth Evans [Royaume-Uni] ; Jan Lubinski ; Patrick J. Morrison ; Judy W. C. Ho ; Hans F. A. Vasen ; Lucy Side ; Huw J. W. Thomas ; Rodney J. Scott ; Malcolm Dunlop ; Gail Barker [Royaume-Uni] ; Faye Elliott [Royaume-Uni] ; Jeremy R. Jass ; Ricardo Fodde ; Henry T. Lynch ; John C. MathersSource :
- The New England journal of medicine [ 0028-4793 ] ; 2008.
Descripteurs français
- Pascal (Inist)
- Wicri :
English descriptors
- KwdEn :
Abstract
BACKGROUND Observational and epidemiologic data indicate that the use of aspirin reduces the risk of colorectal neoplasia; however, the effects of aspirin in the Lynch syndrome (hereditary nonpolyposis colon cancer) are not known. Resistant starch has been associated with an antineoplastic effect on the colon. METHODS In a randomized, placebo-controlled trial, we used a two-by-two design to investigate the effects of aspirin, at a dose of 600 mg per day, and resistant starch (Novelose), at a dose of 30 g per day, in reducing the risk of adenoma and carcinoma among persons with the Lynch syndrome. RESULTS Among 1071 persons in 43 centers, 62 were ineligible to participate in the study, 72 did not enter the study, and 191 withdrew from the study. These three categories were equally distributed across the study groups. Over a mean period of 29 months (range, 7 to 74), colonic adenoma or carcinoma developed in 141 participants. Of 693 participants randomly assigned to receive aspirin or placebo, neoplasia developed in 66 participants receiving aspirin (18.9%), as compared with 65 receiving placebo (19.0%) (relative risk, 1.0; 95% confidence interval [CI], 0.7 to 1.4). There were no significant differences between the two groups with respect to the development of advanced neoplasia (7.4% and 9.9%, respectively; P=0.33). Among the 727 participants receiving resistant starch or placebo, neoplasia developed in 67 participants receiving starch (18.7%), as compared with 68 receiving placebo (18.4%) (relative risk, 1.0; 95% CI, 0.7 to 1.4). Advanced adenomas and colorectal cancers were evenly distributed in the two groups. The prevalence of serious adverse events was low, and the events were evenly distributed. CONCLUSIONS The use of aspirin, resistant starch, or both for up to 4 years has no effect on the incidence of colorectal adenoma or carcinoma among carriers of the Lynch syndrome.
Affiliations:
- Afrique du Sud, Allemagne, Australie, Danemark, Finlande, France, Italie, Royaume-Uni, Suède
- Angleterre, Grand Manchester, Lombardie, Midlands de l'Ouest, Provence-Alpes-Côte d'Azur, Svealand, Victoria (État)
- Birmingham, Manchester, Marseille, Melbourne, Milan, Stockholm
- Université de Birmingham
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Jass</name></author><author><name sortKey="Fodde, Ricardo" sort="Fodde, Ricardo" uniqKey="Fodde R" first="Ricardo" last="Fodde">Ricardo Fodde</name></author><author><name sortKey="Lynch, Henry T" sort="Lynch, Henry T" uniqKey="Lynch H" first="Henry T." last="Lynch">Henry T. Lynch</name></author><author><name sortKey="Mathers, John C" sort="Mathers, John C" uniqKey="Mathers J" first="John C." last="Mathers">John C. Mathers</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0060867</idno><date when="2008">2008</date><idno type="stanalyst">PASCAL 09-0060867 INIST</idno><idno type="RBID">Pascal:09-0060867</idno><idno type="wicri:Area/PascalFrancis/Corpus">003048</idno><idno type="wicri:Area/PascalFrancis/Curation">002F69</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">003282</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">003282</idno><idno type="wicri:doubleKey">0028-4793:2008:Burn J:effect:of:aspirin</idno><idno type="wicri:Area/Main/Merge">009696</idno><idno type="wicri:Area/Main/Curation">008D71</idno><idno type="wicri:Area/Main/Exploration">008D71</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Effect of Aspirin or Resistant Starch on Colorectal Neoplasia in the Lynch Syndrome</title><author><name sortKey="Burn, John" sort="Burn, John" uniqKey="Burn J" first="John" last="Burn">John Burn</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Human Genetics</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Institute of Human Genetics</wicri:noRegion></affiliation></author><author><name sortKey="Bishop, D Timothy" sort="Bishop, D Timothy" uniqKey="Bishop D" first="D. Timothy" last="Bishop">D. Timothy Bishop</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Leeds Institute of Molecular Medicine, Leeds University</s1><s2>Leeds</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>24 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds</wicri:noRegion></affiliation></author><author><name sortKey="Mecklin, Jukka Pekka" sort="Mecklin, Jukka Pekka" uniqKey="Mecklin J" first="Jukka-Pekka" last="Mecklin">Jukka-Pekka Mecklin</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Jyväskylä Central Hospital</s1><s2>Jyväskylä</s2><s3>FIN</s3><sZ>3 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Jyväskylä Central Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Macrae, Finlay" sort="Macrae, Finlay" uniqKey="Macrae F" first="Finlay" last="Macrae">Finlay Macrae</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Royal Melbourne Hospital</s1><s2>Melbourne</s2><s3>AUS</s3><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Melbourne</settlement><region type="état">Victoria (État)</region></placeName></affiliation></author><author><name sortKey="Moslein, Gabriela" sort="Moslein, Gabriela" uniqKey="Moslein G" first="Gabriela" last="Möslein">Gabriela Möslein</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>St. Josefs-Hospital</s1><s2>Bochum-Linden</s2><s3>DEU</s3><sZ>5 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Bochum-Linden</wicri:noRegion><wicri:noRegion>St. Josefs-Hospital</wicri:noRegion><wicri:noRegion>St. Josefs-Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Olschwang, Sylviane" sort="Olschwang, Sylviane" uniqKey="Olschwang S" first="Sylviane" last="Olschwang">Sylviane Olschwang</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Institut Paoli-Calmettes</s1><s2>Marseille</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Bisgaard, Marie Luise" sort="Bisgaard, Marie Luise" uniqKey="Bisgaard M" first="Marie-Luise" last="Bisgaard">Marie-Luise Bisgaard</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>University of Copenhagen, Danish Hereditary Non-Polyposis Colon Cancer Register</s1><s2>Hvidovre</s2><s3>DNK</s3><sZ>7 aut.</sZ></inist:fA14><country>Danemark</country><wicri:noRegion>Hvidovre</wicri:noRegion></affiliation></author><author><name sortKey="Ramesar, Raj" sort="Ramesar, Raj" uniqKey="Ramesar R" first="Raj" last="Ramesar">Raj Ramesar</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>University of Cape Town</s1><s2>Observatory</s2><s3>ZAF</s3><sZ>8 aut.</sZ></inist:fA14><country>Afrique du Sud</country><wicri:noRegion>University of Cape Town</wicri:noRegion></affiliation></author><author><name sortKey="Eccles, Diana" sort="Eccles, Diana" uniqKey="Eccles D" first="Diana" last="Eccles">Diana Eccles</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Princess Anne Hospital</s1><s2>Southampton</s2><s3>GBR</s3><sZ>9 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Princess Anne Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Maher, Eamonn R" sort="Maher, Eamonn R" uniqKey="Maher E" first="Eamonn R." last="Maher">Eamonn R. Maher</name><affiliation wicri:level="4"><inist:fA14 i1="10"><s1>Medical and Molecular Genetics, University of Birmingham</s1><s2>Birmingham</s2><s3>GBR</s3><sZ>10 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region><settlement type="city">Birmingham</settlement></placeName><orgName type="university">Université de Birmingham</orgName></affiliation></author><author><name sortKey="Bertario, Lucio" sort="Bertario, Lucio" uniqKey="Bertario L" first="Lucio" last="Bertario">Lucio Bertario</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Istituto Nazionale per lo Studio e la Cura dei Tumori</s1><s2>Milan</s2><s3>ITA</s3><sZ>11 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Jarvinen, Heikki J" sort="Jarvinen, Heikki J" uniqKey="Jarvinen H" first="Heikki J." last="Jarvinen">Heikki J. Jarvinen</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Helsinki University Central Hospital</s1><s2>Helsinki</s2><s3>FIN</s3><sZ>12 aut.</sZ></inist:fA14><country>Finlande</country><wicri:noRegion>Helsinki University Central Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Lindblom, Annika" sort="Lindblom, Annika" uniqKey="Lindblom A" first="Annika" last="Lindblom">Annika Lindblom</name><affiliation wicri:level="3"><inist:fA14 i1="13"><s1>Karolinska Institutet</s1><s2>Stockholm</s2><s3>SWE</s3><sZ>13 aut.</sZ></inist:fA14><country>Suède</country><placeName><settlement type="city">Stockholm</settlement><region nuts="2">Svealand</region></placeName></affiliation></author><author><name sortKey="Evans, D Gareth" sort="Evans, D Gareth" uniqKey="Evans D" first="D. Gareth" last="Evans">D. Gareth Evans</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>St. Mary's Hospital</s1><s2>Manchester</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Lubinski, Jan" sort="Lubinski, Jan" uniqKey="Lubinski J" first="Jan" last="Lubinski">Jan Lubinski</name></author><author><name sortKey="Morrison, Patrick J" sort="Morrison, Patrick J" uniqKey="Morrison P" first="Patrick J." last="Morrison">Patrick J. Morrison</name></author><author><name sortKey="Ho, Judy W C" sort="Ho, Judy W C" uniqKey="Ho J" first="Judy W. C." last="Ho">Judy W. C. Ho</name></author><author><name sortKey="Vasen, Hans F A" sort="Vasen, Hans F A" uniqKey="Vasen H" first="Hans F. A." last="Vasen">Hans F. A. Vasen</name></author><author><name sortKey="Side, Lucy" sort="Side, Lucy" uniqKey="Side L" first="Lucy" last="Side">Lucy Side</name></author><author><name sortKey="Thomas, Huw J W" sort="Thomas, Huw J W" uniqKey="Thomas H" first="Huw J. W." last="Thomas">Huw J. W. Thomas</name></author><author><name sortKey="Scott, Rodney J" sort="Scott, Rodney J" uniqKey="Scott R" first="Rodney J." last="Scott">Rodney J. Scott</name></author><author><name sortKey="Dunlop, Malcolm" sort="Dunlop, Malcolm" uniqKey="Dunlop M" first="Malcolm" last="Dunlop">Malcolm Dunlop</name></author><author><name sortKey="Barker, Gail" sort="Barker, Gail" uniqKey="Barker G" first="Gail" last="Barker">Gail Barker</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Institute of Human Genetics</s1><s3>GBR</s3><sZ>1 aut.</sZ><sZ>23 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Institute of Human Genetics</wicri:noRegion></affiliation></author><author><name sortKey="Elliott, Faye" sort="Elliott, Faye" uniqKey="Elliott F" first="Faye" last="Elliott">Faye Elliott</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Leeds Institute of Molecular Medicine, Leeds University</s1><s2>Leeds</s2><s3>GBR</s3><sZ>2 aut.</sZ><sZ>24 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Leeds</wicri:noRegion></affiliation></author><author><name sortKey="Jass, Jeremy R" sort="Jass, Jeremy R" uniqKey="Jass J" first="Jeremy R." last="Jass">Jeremy R. Jass</name></author><author><name sortKey="Fodde, Ricardo" sort="Fodde, Ricardo" uniqKey="Fodde R" first="Ricardo" last="Fodde">Ricardo Fodde</name></author><author><name sortKey="Lynch, Henry T" sort="Lynch, Henry T" uniqKey="Lynch H" first="Henry T." last="Lynch">Henry T. Lynch</name></author><author><name sortKey="Mathers, John C" sort="Mathers, John C" uniqKey="Mathers J" first="John C." last="Mathers">John C. Mathers</name></author></analytic><series><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">The New England journal of medicine</title><title level="j" type="abbreviated">N. Engl. j. med.</title><idno type="ISSN">0028-4793</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acetylsalicylic acid</term><term>Analgesic</term><term>Antiplatelet agent</term><term>Antipyretic</term><term>Colorectal cancer</term><term>Hereditary nonpolyposis colorectal cancer</term><term>Medicine</term><term>Non steroidal antiinflammatory agent</term><term>Resistance</term><term>Starch</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Cancer colorectal</term><term>Acide acétylsalicylique</term><term>Résistance</term><term>Cancer colorectal héréditaire non polyposique</term><term>Amidon</term><term>Médecine</term><term>Antipyrétique</term><term>Analgésique</term><term>Antiinflammatoire non stéroïde</term><term>Inhibiteur thromboagrégation</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Amidon</term><term>Médecine</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND Observational and epidemiologic data indicate that the use of aspirin reduces the risk of colorectal neoplasia; however, the effects of aspirin in the Lynch syndrome (hereditary nonpolyposis colon cancer) are not known. Resistant starch has been associated with an antineoplastic effect on the colon. METHODS In a randomized, placebo-controlled trial, we used a two-by-two design to investigate the effects of aspirin, at a dose of 600 mg per day, and resistant starch (Novelose), at a dose of 30 g per day, in reducing the risk of adenoma and carcinoma among persons with the Lynch syndrome. RESULTS Among 1071 persons in 43 centers, 62 were ineligible to participate in the study, 72 did not enter the study, and 191 withdrew from the study. These three categories were equally distributed across the study groups. Over a mean period of 29 months (range, 7 to 74), colonic adenoma or carcinoma developed in 141 participants. Of 693 participants randomly assigned to receive aspirin or placebo, neoplasia developed in 66 participants receiving aspirin (18.9%), as compared with 65 receiving placebo (19.0%) (relative risk, 1.0; 95% confidence interval [CI], 0.7 to 1.4). There were no significant differences between the two groups with respect to the development of advanced neoplasia (7.4% and 9.9%, respectively; P=0.33). Among the 727 participants receiving resistant starch or placebo, neoplasia developed in 67 participants receiving starch (18.7%), as compared with 68 receiving placebo (18.4%) (relative risk, 1.0; 95% CI, 0.7 to 1.4). Advanced adenomas and colorectal cancers were evenly distributed in the two groups. The prevalence of serious adverse events was low, and the events were evenly distributed. CONCLUSIONS The use of aspirin, resistant starch, or both for up to 4 years has no effect on the incidence of colorectal adenoma or carcinoma among carriers of the Lynch syndrome.</div></front></TEI><affiliations><list><country><li>Afrique du Sud</li><li>Allemagne</li><li>Australie</li><li>Danemark</li><li>Finlande</li><li>France</li><li>Italie</li><li>Royaume-Uni</li><li>Suède</li></country><region><li>Angleterre</li><li>Grand Manchester</li><li>Lombardie</li><li>Midlands de l'Ouest</li><li>Provence-Alpes-Côte d'Azur</li><li>Svealand</li><li>Victoria (État)</li></region><settlement><li>Birmingham</li><li>Manchester</li><li>Marseille</li><li>Melbourne</li><li>Milan</li><li>Stockholm</li></settlement><orgName><li>Université de Birmingham</li></orgName></list><tree><noCountry><name sortKey="Dunlop, Malcolm" sort="Dunlop, Malcolm" uniqKey="Dunlop M" first="Malcolm" last="Dunlop">Malcolm Dunlop</name><name sortKey="Fodde, Ricardo" sort="Fodde, Ricardo" uniqKey="Fodde R" first="Ricardo" last="Fodde">Ricardo Fodde</name><name sortKey="Ho, Judy W C" sort="Ho, Judy W C" uniqKey="Ho J" first="Judy W. C." last="Ho">Judy W. C. Ho</name><name sortKey="Jass, Jeremy R" sort="Jass, Jeremy R" uniqKey="Jass J" first="Jeremy R." last="Jass">Jeremy R. Jass</name><name sortKey="Lubinski, Jan" sort="Lubinski, Jan" uniqKey="Lubinski J" first="Jan" last="Lubinski">Jan Lubinski</name><name sortKey="Lynch, Henry T" sort="Lynch, Henry T" uniqKey="Lynch H" first="Henry T." last="Lynch">Henry T. Lynch</name><name sortKey="Mathers, John C" sort="Mathers, John C" uniqKey="Mathers J" first="John C." last="Mathers">John C. Mathers</name><name sortKey="Morrison, Patrick J" sort="Morrison, Patrick J" uniqKey="Morrison P" first="Patrick J." last="Morrison">Patrick J. Morrison</name><name sortKey="Scott, Rodney J" sort="Scott, Rodney J" uniqKey="Scott R" first="Rodney J." last="Scott">Rodney J. Scott</name><name sortKey="Side, Lucy" sort="Side, Lucy" uniqKey="Side L" first="Lucy" last="Side">Lucy Side</name><name sortKey="Thomas, Huw J W" sort="Thomas, Huw J W" uniqKey="Thomas H" first="Huw J. W." last="Thomas">Huw J. W. Thomas</name><name sortKey="Vasen, Hans F A" sort="Vasen, Hans F A" uniqKey="Vasen H" first="Hans F. A." last="Vasen">Hans F. A. Vasen</name></noCountry><country name="Royaume-Uni"><noRegion><name sortKey="Burn, John" sort="Burn, John" uniqKey="Burn J" first="John" last="Burn">John Burn</name></noRegion><name sortKey="Barker, Gail" sort="Barker, Gail" uniqKey="Barker G" first="Gail" last="Barker">Gail Barker</name><name sortKey="Bishop, D Timothy" sort="Bishop, D Timothy" uniqKey="Bishop D" first="D. Timothy" last="Bishop">D. Timothy Bishop</name><name sortKey="Eccles, Diana" sort="Eccles, Diana" uniqKey="Eccles D" first="Diana" last="Eccles">Diana Eccles</name><name sortKey="Elliott, Faye" sort="Elliott, Faye" uniqKey="Elliott F" first="Faye" last="Elliott">Faye Elliott</name><name sortKey="Evans, D Gareth" sort="Evans, D Gareth" uniqKey="Evans D" first="D. Gareth" last="Evans">D. Gareth Evans</name><name sortKey="Maher, Eamonn R" sort="Maher, Eamonn R" uniqKey="Maher E" first="Eamonn R." last="Maher">Eamonn R. Maher</name></country><country name="Finlande"><noRegion><name sortKey="Mecklin, Jukka Pekka" sort="Mecklin, Jukka Pekka" uniqKey="Mecklin J" first="Jukka-Pekka" last="Mecklin">Jukka-Pekka Mecklin</name></noRegion><name sortKey="Jarvinen, Heikki J" sort="Jarvinen, Heikki J" uniqKey="Jarvinen H" first="Heikki J." last="Jarvinen">Heikki J. Jarvinen</name></country><country name="Australie"><region name="Victoria (État)"><name sortKey="Macrae, Finlay" sort="Macrae, Finlay" uniqKey="Macrae F" first="Finlay" last="Macrae">Finlay Macrae</name></region></country><country name="Allemagne"><noRegion><name sortKey="Moslein, Gabriela" sort="Moslein, Gabriela" uniqKey="Moslein G" first="Gabriela" last="Möslein">Gabriela Möslein</name></noRegion></country><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Olschwang, Sylviane" sort="Olschwang, Sylviane" uniqKey="Olschwang S" first="Sylviane" last="Olschwang">Sylviane Olschwang</name></region></country><country name="Danemark"><noRegion><name sortKey="Bisgaard, Marie Luise" sort="Bisgaard, Marie Luise" uniqKey="Bisgaard M" first="Marie-Luise" last="Bisgaard">Marie-Luise Bisgaard</name></noRegion></country><country name="Afrique du Sud"><noRegion><name sortKey="Ramesar, Raj" sort="Ramesar, Raj" uniqKey="Ramesar R" first="Raj" last="Ramesar">Raj Ramesar</name></noRegion></country><country name="Italie"><region name="Lombardie"><name sortKey="Bertario, Lucio" sort="Bertario, Lucio" uniqKey="Bertario L" first="Lucio" last="Bertario">Lucio Bertario</name></region></country><country name="Suède"><region name="Svealand"><name sortKey="Lindblom, Annika" sort="Lindblom, Annika" uniqKey="Lindblom A" first="Annika" last="Lindblom">Annika Lindblom</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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