Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis?
Identifieur interne : 000148 ( Main/Exploration ); précédent : 000147; suivant : 000149Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis?
Auteurs : Vincent M. Brandenburg [Allemagne] ; Pieter Evenepoel [Belgique] ; Jürgen Floege [Allemagne] ; David Goldsmith [Royaume-Uni] ; Rafael Kramann [Allemagne] ; Ziad Massy [France] ; Sandro Mazzaferro [Italie] ; Leon J. Schurgers [Pays-Bas] ; Smeeta Sinha [Royaume-Uni] ; Vicens Torregrosa [Espagne] ; Pablo Ure A-Torres [France] ; Marc Vervloet [Pays-Bas] ; Mario Cozzolino [Italie]Source :
- Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association [ 1460-2385 ] ; 2016.
Abstract
Calcific uraemic arteriolopathy (CUA), or calciphylaxis, is a rare disease predominantly occurring in comorbidity with dialysis. Due to the very low frequency of CUA, prospective studies on its management are lacking and even anecdotal reports on treatment remain scarce. Therefore, calciphylaxis is still a challenging disease with dismal prognosis urgently requiring adequate strategies for diagnosis and treatment.In an attempt to fill some of the current gaps in evidence on various, highly debated and controversial aspects of dialysis-associated calciphylaxis, 13 international experts joined the 1st Consensus Conference on CUA, held in Leuven, Belgium on 21 September 2015. The conference was supported by the European Calciphylaxis Network (EuCalNet), which is a task force of the ERA-EDTA scientific working group on Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD). After an intense discussion, a 9-point Likert scale questionnaire regarding 20 items on calciphylaxis was anonymously answered by each participant. These 20 items addressed unsolved issues in terms of diagnosis and management of calciphylaxis. On the one hand, the analysis of the expert opinions identified areas of general consensus, which might be a valuable aid for physicians treating such a disease with less experience in the field. On the other hand, some topics such as the pertinence of skin biopsy and administration of certain treatments revealed divergent opinions. The aim of the present summary report is to provide some guidance for clinicians who face patients with calciphylaxis in the current setting of absence of evidence-based medicine.
DOI: 10.1093/ndt/gfw025
PubMed: 27005994
Affiliations:
- Allemagne, Belgique, Espagne, France, Italie, Pays-Bas, Royaume-Uni
- Angleterre, Catalogne, District de Cologne, Grand Est, Grand Londres, Hollande-Septentrionale, Latium, Lombardie, Lorraine (région), Rhénanie-du-Nord-Westphalie, Île-de-France
- Aix-la-Chapelle, Amsterdam, Barcelone, Londres, Milan, Nancy, Paris, Rome
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: 000011
- to stream PubMed, to step Curation: 000011
- to stream PubMed, to step Checkpoint: 000017
- to stream Ncbi, to step Merge: 000233
- to stream Ncbi, to step Curation: 000225
- to stream Ncbi, to step Checkpoint: 000225
- to stream Main, to step Merge: 000134
- to stream Main, to step Curation: 000148
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis?</title><author><name sortKey="Brandenburg, Vincent M" sort="Brandenburg, Vincent M" uniqKey="Brandenburg V" first="Vincent M" last="Brandenburg">Vincent M. Brandenburg</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, University Hospital RWTH Aachen, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Cardiology, University Hospital RWTH Aachen, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Evenepoel, Pieter" sort="Evenepoel, Pieter" uniqKey="Evenepoel P" first="Pieter" last="Evenepoel">Pieter Evenepoel</name><affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine, Division of Nephrology, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Internal Medicine, Division of Nephrology, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Floege, Jurgen" sort="Floege, Jurgen" uniqKey="Floege J" first="Jürgen" last="Floege">Jürgen Floege</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology, RWTH University of Aachen, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Nephrology, RWTH University of Aachen, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Goldsmith, David" sort="Goldsmith, David" uniqKey="Goldsmith D" first="David" last="Goldsmith">David Goldsmith</name><affiliation wicri:level="3"><nlm:affiliation>Renal and Transplantation Department, Guy's and St Thomas' Hospitals, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Renal and Transplantation Department, Guy's and St Thomas' Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Kramann, Rafael" sort="Kramann, Rafael" uniqKey="Kramann R" first="Rafael" last="Kramann">Rafael Kramann</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology, RWTH University of Aachen, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Nephrology, RWTH University of Aachen, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Massy, Ziad" sort="Massy, Ziad" uniqKey="Massy Z" first="Ziad" last="Massy">Ziad Massy</name><affiliation wicri:level="3"><nlm:affiliation>Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt, Paris INSERM U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, Villejuif, France F-CRIN-INI-CRCT, Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt, Paris INSERM U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, Villejuif, France F-CRIN-INI-CRCT, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author><author><name sortKey="Mazzaferro, Sandro" sort="Mazzaferro, Sandro" uniqKey="Mazzaferro S" first="Sandro" last="Mazzaferro">Sandro Mazzaferro</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiovascular, Respiratory, Nephrologic, Geriatric Sciences, Sapienza University of Rome, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Cardiovascular, Respiratory, Nephrologic, Geriatric Sciences, Sapienza University of Rome, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Schurgers, Leon J" sort="Schurgers, Leon J" uniqKey="Schurgers L" first="Leon J" last="Schurgers">Leon J. Schurgers</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biochemistry, Faculty of Medicine, Health and Life Science, Maastricht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Biochemistry, Faculty of Medicine, Health and Life Science, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Sinha, Smeeta" sort="Sinha, Smeeta" uniqKey="Sinha S" first="Smeeta" last="Sinha">Smeeta Sinha</name><affiliation wicri:level="1"><nlm:affiliation>Department of Renal Medicine, Manchester Academic Health Sciences Centre, Salford Royal NHS Foundation Trust, Salford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Renal Medicine, Manchester Academic Health Sciences Centre, Salford Royal NHS Foundation Trust, Salford</wicri:regionArea><wicri:noRegion>Salford</wicri:noRegion></affiliation></author><author><name sortKey="Torregrosa, Vicens" sort="Torregrosa, Vicens" uniqKey="Torregrosa V" first="Vicens" last="Torregrosa">Vicens Torregrosa</name><affiliation wicri:level="3"><nlm:affiliation>Nephrology and Renal Transplantation Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Nephrology and Renal Transplantation Department, Hospital Clinic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Ure A Torres, Pablo" sort="Ure A Torres, Pablo" uniqKey="Ure A Torres P" first="Pablo" last="Ure A-Torres">Pablo Ure A-Torres</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology and Dialysis, Clinique du Landy, Saint-Ouen, France Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Nephrology and Dialysis, Clinique du Landy, Saint-Ouen, France Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Vervloet, Marc" sort="Vervloet, Marc" uniqKey="Vervloet M" first="Marc" last="Vervloet">Marc Vervloet</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Nephrology, VU University Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Cozzolino, Mario" sort="Cozzolino, Mario" uniqKey="Cozzolino M" first="Mario" last="Cozzolino">Mario Cozzolino</name><affiliation wicri:level="3"><nlm:affiliation>Department of Health Sciences, University of Milan, Renal Division, San Paolo Hospital, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Sciences, University of Milan, Renal Division, San Paolo Hospital, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="doi">10.1093/ndt/gfw025</idno><idno type="RBID">pubmed:27005994</idno><idno type="pmid">27005994</idno><idno type="wicri:Area/PubMed/Corpus">000011</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000011</idno><idno type="wicri:Area/PubMed/Curation">000011</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">000011</idno><idno type="wicri:Area/PubMed/Checkpoint">000017</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">000017</idno><idno type="wicri:Area/Ncbi/Merge">000233</idno><idno type="wicri:Area/Ncbi/Curation">000225</idno><idno type="wicri:Area/Ncbi/Checkpoint">000225</idno><idno type="wicri:Area/Main/Merge">000134</idno><idno type="wicri:Area/Main/Curation">000148</idno><idno type="wicri:Area/Main/Exploration">000148</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis?</title><author><name sortKey="Brandenburg, Vincent M" sort="Brandenburg, Vincent M" uniqKey="Brandenburg V" first="Vincent M" last="Brandenburg">Vincent M. Brandenburg</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiology, University Hospital RWTH Aachen, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Cardiology, University Hospital RWTH Aachen, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Evenepoel, Pieter" sort="Evenepoel, Pieter" uniqKey="Evenepoel P" first="Pieter" last="Evenepoel">Pieter Evenepoel</name><affiliation wicri:level="1"><nlm:affiliation>Department of Internal Medicine, Division of Nephrology, University Hospitals Leuven, Leuven, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>Department of Internal Medicine, Division of Nephrology, University Hospitals Leuven, Leuven</wicri:regionArea><wicri:noRegion>Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Floege, Jurgen" sort="Floege, Jurgen" uniqKey="Floege J" first="Jürgen" last="Floege">Jürgen Floege</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology, RWTH University of Aachen, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Nephrology, RWTH University of Aachen, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Goldsmith, David" sort="Goldsmith, David" uniqKey="Goldsmith D" first="David" last="Goldsmith">David Goldsmith</name><affiliation wicri:level="3"><nlm:affiliation>Renal and Transplantation Department, Guy's and St Thomas' Hospitals, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Renal and Transplantation Department, Guy's and St Thomas' Hospitals, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Kramann, Rafael" sort="Kramann, Rafael" uniqKey="Kramann R" first="Rafael" last="Kramann">Rafael Kramann</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology, RWTH University of Aachen, Aachen, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Nephrology, RWTH University of Aachen, Aachen</wicri:regionArea><placeName><region type="land" nuts="1">Rhénanie-du-Nord-Westphalie</region><region type="district" nuts="2">District de Cologne</region><settlement type="city">Aix-la-Chapelle</settlement></placeName></affiliation></author><author><name sortKey="Massy, Ziad" sort="Massy, Ziad" uniqKey="Massy Z" first="Ziad" last="Massy">Ziad Massy</name><affiliation wicri:level="3"><nlm:affiliation>Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt, Paris INSERM U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, Villejuif, France F-CRIN-INI-CRCT, Nancy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Division of Nephrology, Ambroise Paré University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne-Billancourt, Paris INSERM U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, Villejuif, France F-CRIN-INI-CRCT, Nancy</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Lorraine (région)</region><settlement type="city">Nancy</settlement></placeName></affiliation></author><author><name sortKey="Mazzaferro, Sandro" sort="Mazzaferro, Sandro" uniqKey="Mazzaferro S" first="Sandro" last="Mazzaferro">Sandro Mazzaferro</name><affiliation wicri:level="3"><nlm:affiliation>Department of Cardiovascular, Respiratory, Nephrologic, Geriatric Sciences, Sapienza University of Rome, Rome, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Cardiovascular, Respiratory, Nephrologic, Geriatric Sciences, Sapienza University of Rome, Rome</wicri:regionArea><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Schurgers, Leon J" sort="Schurgers, Leon J" uniqKey="Schurgers L" first="Leon J" last="Schurgers">Leon J. Schurgers</name><affiliation wicri:level="1"><nlm:affiliation>Department of Biochemistry, Faculty of Medicine, Health and Life Science, Maastricht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Biochemistry, Faculty of Medicine, Health and Life Science, Maastricht</wicri:regionArea><wicri:noRegion>Maastricht</wicri:noRegion></affiliation></author><author><name sortKey="Sinha, Smeeta" sort="Sinha, Smeeta" uniqKey="Sinha S" first="Smeeta" last="Sinha">Smeeta Sinha</name><affiliation wicri:level="1"><nlm:affiliation>Department of Renal Medicine, Manchester Academic Health Sciences Centre, Salford Royal NHS Foundation Trust, Salford, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Renal Medicine, Manchester Academic Health Sciences Centre, Salford Royal NHS Foundation Trust, Salford</wicri:regionArea><wicri:noRegion>Salford</wicri:noRegion></affiliation></author><author><name sortKey="Torregrosa, Vicens" sort="Torregrosa, Vicens" uniqKey="Torregrosa V" first="Vicens" last="Torregrosa">Vicens Torregrosa</name><affiliation wicri:level="3"><nlm:affiliation>Nephrology and Renal Transplantation Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Nephrology and Renal Transplantation Department, Hospital Clinic, University of Barcelona, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Ure A Torres, Pablo" sort="Ure A Torres, Pablo" uniqKey="Ure A Torres P" first="Pablo" last="Ure A-Torres">Pablo Ure A-Torres</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology and Dialysis, Clinique du Landy, Saint-Ouen, France Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Nephrology and Dialysis, Clinique du Landy, Saint-Ouen, France Department of Renal Physiology, Necker Hospital, University of Paris Descartes, Paris</wicri:regionArea><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Vervloet, Marc" sort="Vervloet, Marc" uniqKey="Vervloet M" first="Marc" last="Vervloet">Marc Vervloet</name><affiliation wicri:level="3"><nlm:affiliation>Department of Nephrology, VU University Medical Center, Amsterdam, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Nephrology, VU University Medical Center, Amsterdam</wicri:regionArea><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Cozzolino, Mario" sort="Cozzolino, Mario" uniqKey="Cozzolino M" first="Mario" last="Cozzolino">Mario Cozzolino</name><affiliation wicri:level="3"><nlm:affiliation>Department of Health Sciences, University of Milan, Renal Division, San Paolo Hospital, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Health Sciences, University of Milan, Renal Division, San Paolo Hospital, Milan</wicri:regionArea><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author></analytic><series><title level="j">Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association</title><idno type="eISSN">1460-2385</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Calcific uraemic arteriolopathy (CUA), or calciphylaxis, is a rare disease predominantly occurring in comorbidity with dialysis. Due to the very low frequency of CUA, prospective studies on its management are lacking and even anecdotal reports on treatment remain scarce. Therefore, calciphylaxis is still a challenging disease with dismal prognosis urgently requiring adequate strategies for diagnosis and treatment.In an attempt to fill some of the current gaps in evidence on various, highly debated and controversial aspects of dialysis-associated calciphylaxis, 13 international experts joined the 1st Consensus Conference on CUA, held in Leuven, Belgium on 21 September 2015. The conference was supported by the European Calciphylaxis Network (EuCalNet), which is a task force of the ERA-EDTA scientific working group on Chronic Kidney Disease-Mineral and Bone Disorders (CKD-MBD). After an intense discussion, a 9-point Likert scale questionnaire regarding 20 items on calciphylaxis was anonymously answered by each participant. These 20 items addressed unsolved issues in terms of diagnosis and management of calciphylaxis. On the one hand, the analysis of the expert opinions identified areas of general consensus, which might be a valuable aid for physicians treating such a disease with less experience in the field. On the other hand, some topics such as the pertinence of skin biopsy and administration of certain treatments revealed divergent opinions. The aim of the present summary report is to provide some guidance for clinicians who face patients with calciphylaxis in the current setting of absence of evidence-based medicine.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Belgique</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Catalogne</li><li>District de Cologne</li><li>Grand Est</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Latium</li><li>Lombardie</li><li>Lorraine (région)</li><li>Rhénanie-du-Nord-Westphalie</li><li>Île-de-France</li></region><settlement><li>Aix-la-Chapelle</li><li>Amsterdam</li><li>Barcelone</li><li>Londres</li><li>Milan</li><li>Nancy</li><li>Paris</li><li>Rome</li></settlement></list><tree><country name="Allemagne"><region name="Rhénanie-du-Nord-Westphalie"><name sortKey="Brandenburg, Vincent M" sort="Brandenburg, Vincent M" uniqKey="Brandenburg V" first="Vincent M" last="Brandenburg">Vincent M. Brandenburg</name></region><name sortKey="Floege, Jurgen" sort="Floege, Jurgen" uniqKey="Floege J" first="Jürgen" last="Floege">Jürgen Floege</name><name sortKey="Kramann, Rafael" sort="Kramann, Rafael" uniqKey="Kramann R" first="Rafael" last="Kramann">Rafael Kramann</name></country><country name="Belgique"><noRegion><name sortKey="Evenepoel, Pieter" sort="Evenepoel, Pieter" uniqKey="Evenepoel P" first="Pieter" last="Evenepoel">Pieter Evenepoel</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Goldsmith, David" sort="Goldsmith, David" uniqKey="Goldsmith D" first="David" last="Goldsmith">David Goldsmith</name></region><name sortKey="Sinha, Smeeta" sort="Sinha, Smeeta" uniqKey="Sinha S" first="Smeeta" last="Sinha">Smeeta Sinha</name></country><country name="France"><region name="Grand Est"><name sortKey="Massy, Ziad" sort="Massy, Ziad" uniqKey="Massy Z" first="Ziad" last="Massy">Ziad Massy</name></region><name sortKey="Ure A Torres, Pablo" sort="Ure A Torres, Pablo" uniqKey="Ure A Torres P" first="Pablo" last="Ure A-Torres">Pablo Ure A-Torres</name></country><country name="Italie"><region name="Latium"><name sortKey="Mazzaferro, Sandro" sort="Mazzaferro, Sandro" uniqKey="Mazzaferro S" first="Sandro" last="Mazzaferro">Sandro Mazzaferro</name></region><name sortKey="Cozzolino, Mario" sort="Cozzolino, Mario" uniqKey="Cozzolino M" first="Mario" last="Cozzolino">Mario Cozzolino</name></country><country name="Pays-Bas"><noRegion><name sortKey="Schurgers, Leon J" sort="Schurgers, Leon J" uniqKey="Schurgers L" first="Leon J" last="Schurgers">Leon J. Schurgers</name></noRegion><name sortKey="Vervloet, Marc" sort="Vervloet, Marc" uniqKey="Vervloet M" first="Marc" last="Vervloet">Marc Vervloet</name></country><country name="Espagne"><region name="Catalogne"><name sortKey="Torregrosa, Vicens" sort="Torregrosa, Vicens" uniqKey="Torregrosa V" first="Vicens" last="Torregrosa">Vicens Torregrosa</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Lorraine/explor/InforLorV4/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000148 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 000148 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Lorraine
|area= InforLorV4
|flux= Main
|étape= Exploration
|type= RBID
|clé= pubmed:27005994
|texte= Lack of evidence does not justify neglect: how can we address unmet medical needs in calciphylaxis?
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:27005994" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a InforLorV4
| This area was generated with Dilib version V0.6.33. |  |