Corticosteroids in sepsis: an updated systematic review and meta-analysis (protocol).
Identifieur interne : 000A92 ( PubMed/Corpus ); précédent : 000A91; suivant : 000A93Corticosteroids in sepsis: an updated systematic review and meta-analysis (protocol).
Auteurs : Bram Rochwerg ; Simon Oczkowski ; Reed Alexander Siemieniuk ; Kusum Menon ; Wojciech Szczeklik ; Shane English ; Thomas Agoritsas ; Emilie Belley-Cote ; Frédérick D'Aragon ; Waleed Alhazzani ; Erick Duan ; Kira Gossack-Keenan ; Jon Sevransky ; Per Vandvik ; Bala Venkatesh ; Gordon Guyatt ; Djillali AnnaneSource :
- BMJ open [ 2044-6055 ] ; 2017.
Abstract
Sepsis is associated with a dysregulated host response to infection and impaired endogenous corticosteroid metabolism. As such, therapeutic use of exogenous corticosteroids is a promising adjunctive intervention. Despite a large number of trials examining this research question, uncertainty persists regarding the effect of corticosteroids on survival in sepsis. Several large randomised controlled trials have been published recently prompting a re-evaluation of the available literature.
DOI: 10.1136/bmjopen-2017-016847
PubMed: 28667229
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University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Menon, Kusum" sort="Menon, Kusum" uniqKey="Menon K" first="Kusum" last="Menon">Kusum Menon</name><affiliation><nlm:affiliation>Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Szczeklik, Wojciech" sort="Szczeklik, Wojciech" uniqKey="Szczeklik W" first="Wojciech" last="Szczeklik">Wojciech Szczeklik</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="English, Shane" sort="English, Shane" uniqKey="English S" first="Shane" last="English">Shane English</name><affiliation><nlm:affiliation>Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Agoritsas, Thomas" sort="Agoritsas, Thomas" uniqKey="Agoritsas T" first="Thomas" last="Agoritsas">Thomas Agoritsas</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Belley Cote, Emilie" sort="Belley Cote, Emilie" uniqKey="Belley Cote E" first="Emilie" last="Belley-Cote">Emilie Belley-Cote</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="D Aragon, Frederick" sort="D Aragon, Frederick" uniqKey="D Aragon F" first="Frédérick" last="D'Aragon">Frédérick D'Aragon</name><affiliation><nlm:affiliation>Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke et Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Alhazzani, Waleed" sort="Alhazzani, Waleed" uniqKey="Alhazzani W" first="Waleed" last="Alhazzani">Waleed Alhazzani</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Duan, Erick" sort="Duan, Erick" uniqKey="Duan E" first="Erick" last="Duan">Erick Duan</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Gossack Keenan, Kira" sort="Gossack Keenan, Kira" uniqKey="Gossack Keenan K" first="Kira" last="Gossack-Keenan">Kira Gossack-Keenan</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Sevransky, Jon" sort="Sevransky, Jon" uniqKey="Sevransky J" first="Jon" last="Sevransky">Jon Sevransky</name><affiliation><nlm:affiliation>Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Emory University, Atlanta, Georgia, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Vandvik, Per" sort="Vandvik, Per" uniqKey="Vandvik P" first="Per" last="Vandvik">Per Vandvik</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Venkatesh, Bala" sort="Venkatesh, Bala" uniqKey="Venkatesh B" first="Bala" last="Venkatesh">Bala Venkatesh</name><affiliation><nlm:affiliation>Department of Intensive Care, Wesley Hospital and Princess Alexandra Hospital, University of Queensland, St Lucia, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Guyatt, Gordon" sort="Guyatt, Gordon" uniqKey="Guyatt G" first="Gordon" last="Guyatt">Gordon Guyatt</name><affiliation><nlm:affiliation>University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Annane, Djillali" sort="Annane, Djillali" uniqKey="Annane D" first="Djillali" last="Annane">Djillali Annane</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28667229</idno><idno type="pmid">28667229</idno><idno type="doi">10.1136/bmjopen-2017-016847</idno><idno type="wicri:Area/PubMed/Corpus">000A92</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000A92</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Corticosteroids in sepsis: an updated systematic review and meta-analysis (protocol).</title><author><name sortKey="Rochwerg, Bram" sort="Rochwerg, Bram" uniqKey="Rochwerg B" first="Bram" last="Rochwerg">Bram Rochwerg</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Oczkowski, Simon" sort="Oczkowski, Simon" uniqKey="Oczkowski S" first="Simon" last="Oczkowski">Simon Oczkowski</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Siemieniuk, Reed Alexander" sort="Siemieniuk, Reed Alexander" uniqKey="Siemieniuk R" first="Reed Alexander" last="Siemieniuk">Reed Alexander Siemieniuk</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Menon, Kusum" sort="Menon, Kusum" uniqKey="Menon K" first="Kusum" last="Menon">Kusum Menon</name><affiliation><nlm:affiliation>Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Szczeklik, Wojciech" sort="Szczeklik, Wojciech" uniqKey="Szczeklik W" first="Wojciech" last="Szczeklik">Wojciech Szczeklik</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="English, Shane" sort="English, Shane" uniqKey="English S" first="Shane" last="English">Shane English</name><affiliation><nlm:affiliation>Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Agoritsas, Thomas" sort="Agoritsas, Thomas" uniqKey="Agoritsas T" first="Thomas" last="Agoritsas">Thomas Agoritsas</name><affiliation><nlm:affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Belley Cote, Emilie" sort="Belley Cote, Emilie" uniqKey="Belley Cote E" first="Emilie" last="Belley-Cote">Emilie Belley-Cote</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="D Aragon, Frederick" sort="D Aragon, Frederick" uniqKey="D Aragon F" first="Frédérick" last="D'Aragon">Frédérick D'Aragon</name><affiliation><nlm:affiliation>Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke et Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Alhazzani, Waleed" sort="Alhazzani, Waleed" uniqKey="Alhazzani W" first="Waleed" last="Alhazzani">Waleed Alhazzani</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Duan, Erick" sort="Duan, Erick" uniqKey="Duan E" first="Erick" last="Duan">Erick Duan</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Gossack Keenan, Kira" sort="Gossack Keenan, Kira" uniqKey="Gossack Keenan K" first="Kira" last="Gossack-Keenan">Kira Gossack-Keenan</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Sevransky, Jon" sort="Sevransky, Jon" uniqKey="Sevransky J" first="Jon" last="Sevransky">Jon Sevransky</name><affiliation><nlm:affiliation>Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Emory University, Atlanta, Georgia, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Vandvik, Per" sort="Vandvik, Per" uniqKey="Vandvik P" first="Per" last="Vandvik">Per Vandvik</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Venkatesh, Bala" sort="Venkatesh, Bala" uniqKey="Venkatesh B" first="Bala" last="Venkatesh">Bala Venkatesh</name><affiliation><nlm:affiliation>Department of Intensive Care, Wesley Hospital and Princess Alexandra Hospital, University of Queensland, St Lucia, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Guyatt, Gordon" sort="Guyatt, Gordon" uniqKey="Guyatt G" first="Gordon" last="Guyatt">Gordon Guyatt</name><affiliation><nlm:affiliation>University of Sydney, Sydney, Australia.</nlm:affiliation></affiliation></author><author><name sortKey="Annane, Djillali" sort="Annane, Djillali" uniqKey="Annane D" first="Djillali" last="Annane">Djillali Annane</name><affiliation><nlm:affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMJ open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Sepsis is associated with a dysregulated host response to infection and impaired endogenous corticosteroid metabolism. As such, therapeutic use of exogenous corticosteroids is a promising adjunctive intervention. Despite a large number of trials examining this research question, uncertainty persists regarding the effect of corticosteroids on survival in sepsis. Several large randomised controlled trials have been published recently prompting a re-evaluation of the available literature.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28667229</PMID><DateCreated><Year>2017</Year><Month>07</Month><Day>01</Day></DateCreated><DateRevised><Year>2017</Year><Month>07</Month><Day>01</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">2044-6055</ISSN><JournalIssue CitedMedium="Internet"><Volume>7</Volume><Issue>6</Issue><PubDate><Year>2017</Year><Month>Jun</Month><Day>30</Day></PubDate></JournalIssue><Title>BMJ open</Title><ISOAbbreviation>BMJ Open</ISOAbbreviation></Journal><ArticleTitle>Corticosteroids in sepsis: an updated systematic review and meta-analysis (protocol).</ArticleTitle><Pagination><MedlinePgn>e016847</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1136/bmjopen-2017-016847</ELocationID><Abstract><AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Sepsis is associated with a dysregulated host response to infection and impaired endogenous corticosteroid metabolism. As such, therapeutic use of exogenous corticosteroids is a promising adjunctive intervention. Despite a large number of trials examining this research question, uncertainty persists regarding the effect of corticosteroids on survival in sepsis. Several large randomised controlled trials have been published recently prompting a re-evaluation of the available literature.</AbstractText><AbstractText Label="METHODS AND ANALYSIS" NlmCategory="UNASSIGNED">A rigorous and reproducible search and screening process from a Cochrane review on the same topic was comprehensive to October 2014. We will search MEDLINE, EMBASE, LILACS, the Cochrane trial registry and clinicaltrials.gov for eligible randomised controlled trials investigating the use of corticosteroids in patients with sepsis from September 2014. Outcomes have been chosen by a semi-independent guideline panel, created in the context of a parallel BMJ Rapid Recommendation on the topic. This panel includes clinicians, content experts, methodologists and patient representatives, who will help identify patient-important outcomes that are critical for deciding whether to use or not use corticosteroids in sepsis. Two reviewers will independently screen and identify eligible studies; a third reviewer will resolve any disagreements. We will use RevMan to pool effect estimates from included studies for each outcome using a random-effect model. We will present the results as relative risk with 95% CI for dichotomous outcomes and as mean difference or standardised mean difference for continuous outcomes with 95% CI. We will assess the certainty of evidence at the outcome level using the Grading of Recommendations, Assessment, Development and Evaluation approach. We will conduct a priori subgroup analyses, which have been chosen by the parallel BMJ Rapid Recommendation panel.</AbstractText><AbstractText Label="ETHICS AND DISSEMINATION" NlmCategory="UNASSIGNED">The aim of this systematic review is to summarise the updated evidence on the efficacy and safety of corticosteroids in patients with sepsis.</AbstractText><AbstractText Label="TRIAL REGISTRATION NUMBER" NlmCategory="BACKGROUND">CRD42017058537.</AbstractText><CopyrightInformation>© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Rochwerg</LastName><ForeName>Bram</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oczkowski</LastName><ForeName>Simon</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Siemieniuk</LastName><ForeName>Reed Alexander</ForeName><Initials>RA</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Menon</LastName><ForeName>Kusum</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Szczeklik</LastName><ForeName>Wojciech</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>English</LastName><ForeName>Shane</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Medicine (Critical Care), University of Ottawa, Ottawa, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agoritsas</LastName><ForeName>Thomas</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of General Internal Medicine & Division of Clinical Epidemiology, University Hospitals of Geneva, Geneva, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Belley-Cote</LastName><ForeName>Emilie</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>D'Aragon</LastName><ForeName>Frédérick</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke et Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Alhazzani</LastName><ForeName>Waleed</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duan</LastName><ForeName>Erick</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gossack-Keenan</LastName><ForeName>Kira</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sevransky</LastName><ForeName>Jon</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Pulmonary, Allergy and Critical Care, Department of Medicine, Emory University, Atlanta, Georgia, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vandvik</LastName><ForeName>Per</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medicine, Innlandet Hospital Trust-Division Gjøvik, Norway.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Venkatesh</LastName><ForeName>Bala</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Department of Intensive Care, Wesley Hospital and Princess Alexandra Hospital, University of Queensland, St Lucia, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guyatt</LastName><ForeName>Gordon</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>University of Sydney, Sydney, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Annane</LastName><ForeName>Djillali</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Department of Medicine, McMaster University, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Hôpital Raymond Poincaré, Laboratory of Infection and Inflammation, University of Versailles, Garches, France.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>06</Month><Day>30</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Open</MedlineTA><NlmUniqueID>101552874</NlmUniqueID><ISSNLinking>2044-6055</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Sepsis</Keyword><Keyword MajorTopicYN="N">corticosteroids</Keyword><Keyword MajorTopicYN="N">intensive care</Keyword><Keyword MajorTopicYN="N">meta-analysis</Keyword><Keyword MajorTopicYN="N">shock</Keyword><Keyword MajorTopicYN="N">systematic review</Keyword></KeywordList><CoiStatement>Competing interests: BR and SO are supported by McMaster University Department of Medicine early career research awards.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>7</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>7</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>7</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28667229</ArticleId><ArticleId IdType="pii">bmjopen-2017-016847</ArticleId><ArticleId IdType="doi">10.1136/bmjopen-2017-016847</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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