Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial
Identifieur interne : 006C60 ( Main/Exploration ); précédent : 006C59; suivant : 006C61Single-point acupuncture and physiotherapy for the treatment of painful shoulder: a multicentre randomized controlled trial
Auteurs : J. Vas [Espagne] ; C. Ortega [Espagne] ; V. Olmo [Espagne] ; F. Perez-Fernandez [Espagne] ; L. Hernandez [Espagne] ; I. Medina [Espagne] ; J. M. Seminario [Espagne] ; A. Herrera [Espagne] ; F. Luna [Espagne] ; E. Perea-Milla [Espagne] ; C. Mendez [Espagne] ; F. Madrazo [Espagne] ; C. Jimenez [Espagne] ; M. A. Ruiz [Espagne] ; I. Aguilar [Espagne]Source :
- Rheumatology [ 1462-0324 ] ; 2008-06.
Abstract
Objective. Evaluate the efficacy of acupuncture associated with physiotherapy for patients with painful shoulder. Methods. In a multicentre controlled randomized study, participants were recruited with a clinical diagnosis of unilateral subacromial syndrome from six rehabilitation medicine departments belonging to the Public Health System in two Spanish regions. All participants received 15 sessions of physiotherapy during the 3 weeks that the treatment lasted and were randomized to additionally receive, once a week, acupuncture or mock TENS (transcutaneous electrical nerve stimulation). The primary outcome measure was the change in the Constant–Murley Score (CMS) for functional assessment of the shoulder, at 4 weeks after randomization. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN28687220. Results. A total of 425 patients were recruited. The mean score (s.d.) on the CMS had increased by 16.6 (15.6) points among the acupuncture group, compared with 10.6 (13.5) points in the control group, and the mean difference between the two groups was statistically significant (6.0 points; 95% CI 3.2, 8.8 points; P < 0.001). By the end of the treatment, 53% of the patients in the acupuncture group had decreased their consumption of analgesics, compared with a corresponding 30% among the control group (P < 0.001). Conclusions. Single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of analgesic medicaments.
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DOI: 10.1093/rheumatology/ken040
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Vas</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Espagne</country></affiliation></author><author><name sortKey="Ortega, C" sort="Ortega, C" uniqKey="Ortega C" first="C." last="Ortega">C. Ortega</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Olmo, V" sort="Olmo, V" uniqKey="Olmo V" first="V." last="Olmo">V. Olmo</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Perez Fernandez, F" sort="Perez Fernandez, F" uniqKey="Perez Fernandez F" first="F." last="Perez-Fernandez">F. Perez-Fernandez</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Hernandez, L" sort="Hernandez, L" uniqKey="Hernandez L" first="L." last="Hernandez">L. Hernandez</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Medina, I" sort="Medina, I" uniqKey="Medina I" first="I." last="Medina">I. Medina</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Seminario, J M" sort="Seminario, J M" uniqKey="Seminario J" first="J. M." last="Seminario">J. M. Seminario</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Herrera, A" sort="Herrera, A" uniqKey="Herrera A" first="A." last="Herrera">A. Herrera</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Luna, F" sort="Luna, F" uniqKey="Luna F" first="F." last="Luna">F. Luna</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Perea Milla, E" sort="Perea Milla, E" uniqKey="Perea Milla E" first="E." last="Perea-Milla">E. Perea-Milla</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Mendez, C" sort="Mendez, C" uniqKey="Mendez C" first="C." last="Mendez">C. Mendez</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Madrazo, F" sort="Madrazo, F" uniqKey="Madrazo F" first="F." last="Madrazo">F. Madrazo</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Jimenez, C" sort="Jimenez, C" uniqKey="Jimenez C" first="C." last="Jimenez">C. Jimenez</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Ruiz, M A" sort="Ruiz, M A" uniqKey="Ruiz M" first="M. A." last="Ruiz">M. A. Ruiz</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author><author><name sortKey="Aguilar, I" sort="Aguilar, I" uniqKey="Aguilar I" first="I." last="Aguilar">I. Aguilar</name><affiliation wicri:level="4"><country xml:lang="fr">Espagne</country><wicri:regionArea>Pain Treatment Unit, Healthcare Centre Doña Mercedes, Dos Hermanas, Seville, Rehabilitation Medicine Department, Infanta Elena Hospital, Huelva, Rehabilitation Medicine Department, Infanta Margarita Hospital, Cabra, Cordoba, Rehabilitation Medicine Department, Military General Hospital, Cartagena, Physiotherapy Department, University of Malaga, Malaga, Anaesthesia Department, Serrania Hospital, Ronda, Malaga, Rehabilitation Medicine Department, Carlos Haya Hospital, Malaga, Rehabilitation Medicine Department, Serrania Hospital, Ronda, Malaga, Research Unit (CIBERESP.Spain), Costa del Sol Hospital, Marbella, Malaga, Information and Assessment Service, Department of Health, Seville and Rehabilitation Medicine Department, Valme Hospital, Seville</wicri:regionArea><orgName type="university">Université de Malaga</orgName><placeName><settlement type="city">Malaga</settlement><region nuts="2" type="region">Andalousie</region></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Rheumatology</title><idno type="ISSN">1462-0324</idno><idno type="eISSN">1462-0332</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2008-06">2008-06</date><biblScope unit="volume">47</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="887">887</biblScope><biblScope unit="page" to="893">893</biblScope></imprint><idno type="ISSN">1462-0324</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1462-0324</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Objective. Evaluate the efficacy of acupuncture associated with physiotherapy for patients with painful shoulder. Methods. In a multicentre controlled randomized study, participants were recruited with a clinical diagnosis of unilateral subacromial syndrome from six rehabilitation medicine departments belonging to the Public Health System in two Spanish regions. All participants received 15 sessions of physiotherapy during the 3 weeks that the treatment lasted and were randomized to additionally receive, once a week, acupuncture or mock TENS (transcutaneous electrical nerve stimulation). The primary outcome measure was the change in the Constant–Murley Score (CMS) for functional assessment of the shoulder, at 4 weeks after randomization. This study is registered as an International Standard Randomized Controlled Trial, number ISRCTN28687220. Results. A total of 425 patients were recruited. The mean score (s.d.) on the CMS had increased by 16.6 (15.6) points among the acupuncture group, compared with 10.6 (13.5) points in the control group, and the mean difference between the two groups was statistically significant (6.0 points; 95% CI 3.2, 8.8 points; P < 0.001). By the end of the treatment, 53% of the patients in the acupuncture group had decreased their consumption of analgesics, compared with a corresponding 30% among the control group (P < 0.001). Conclusions. Single-point acupuncture in association with physiotherapy improves shoulder function and alleviates pain, compared with physiotherapy as the sole treatment. This improvement is accompanied by a reduction in the consumption of analgesic medicaments.</div></front></TEI><affiliations><list><country><li>Espagne</li></country><region><li>Andalousie</li></region><settlement><li>Malaga</li></settlement><orgName><li>Université de Malaga</li></orgName></list><tree><country name="Espagne"><region name="Andalousie"><name sortKey="Vas, J" sort="Vas, J" uniqKey="Vas J" first="J." last="Vas">J. Vas</name></region><name sortKey="Aguilar, I" sort="Aguilar, I" uniqKey="Aguilar I" first="I." last="Aguilar">I. Aguilar</name><name sortKey="Hernandez, L" sort="Hernandez, L" uniqKey="Hernandez L" first="L." last="Hernandez">L. Hernandez</name><name sortKey="Herrera, A" sort="Herrera, A" uniqKey="Herrera A" first="A." last="Herrera">A. Herrera</name><name sortKey="Jimenez, C" sort="Jimenez, C" uniqKey="Jimenez C" first="C." last="Jimenez">C. Jimenez</name><name sortKey="Luna, F" sort="Luna, F" uniqKey="Luna F" first="F." last="Luna">F. Luna</name><name sortKey="Madrazo, F" sort="Madrazo, F" uniqKey="Madrazo F" first="F." last="Madrazo">F. Madrazo</name><name sortKey="Medina, I" sort="Medina, I" uniqKey="Medina I" first="I." last="Medina">I. Medina</name><name sortKey="Mendez, C" sort="Mendez, C" uniqKey="Mendez C" first="C." last="Mendez">C. Mendez</name><name sortKey="Olmo, V" sort="Olmo, V" uniqKey="Olmo V" first="V." last="Olmo">V. Olmo</name><name sortKey="Ortega, C" sort="Ortega, C" uniqKey="Ortega C" first="C." last="Ortega">C. Ortega</name><name sortKey="Perea Milla, E" sort="Perea Milla, E" uniqKey="Perea Milla E" first="E." last="Perea-Milla">E. Perea-Milla</name><name sortKey="Perez Fernandez, F" sort="Perez Fernandez, F" uniqKey="Perez Fernandez F" first="F." last="Perez-Fernandez">F. Perez-Fernandez</name><name sortKey="Ruiz, M A" sort="Ruiz, M A" uniqKey="Ruiz M" first="M. A." last="Ruiz">M. A. Ruiz</name><name sortKey="Seminario, J M" sort="Seminario, J M" uniqKey="Seminario J" first="J. M." last="Seminario">J. M. Seminario</name><name sortKey="Vas, J" sort="Vas, J" uniqKey="Vas J" first="J." last="Vas">J. Vas</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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