[Functional assessment of patients with vertigo and dizziness in occupational medicine].
Identifieur interne : 000332 ( Main/Exploration ); précédent : 000331; suivant : 000333[Functional assessment of patients with vertigo and dizziness in occupational medicine].
Auteurs : Ewa Zamysłowska-Szmytke [Pologne] ; Sylwia Szostek-Rogula [Pologne] ; Mariola Liwi Ska-Kowalska [Pologne]Source :
- Medycyna pracy [ 0465-5893 ] ; 2018.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Enquêtes et questionnaires (MeSH), Femelle (MeSH), Humains (MeSH), Indice de gravité de la maladie (MeSH), Mâle (MeSH), Médecine du travail (méthodes), Sensation vertigineuse (diagnostic), Vertige (diagnostic), Vertige positionnel paroxystique bénin (diagnostic), Épreuves vestibulaires (MeSH), Équilibre postural (MeSH), Évaluation de l'invalidité (MeSH).
- MESH :
- diagnostic : Sensation vertigineuse, Vertige, Vertige positionnel paroxystique bénin.
- méthodes : Médecine du travail.
- Adulte, Adulte d'âge moyen, Enquêtes et questionnaires, Femelle, Humains, Indice de gravité de la maladie, Mâle, Épreuves vestibulaires, Équilibre postural, Évaluation de l'invalidité.
English descriptors
- KwdEn :
- Adult (MeSH), Benign Paroxysmal Positional Vertigo (diagnosis), Disability Evaluation (MeSH), Dizziness (diagnosis), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Occupational Medicine (methods), Postural Balance (MeSH), Severity of Illness Index (MeSH), Surveys and Questionnaires (MeSH), Vertigo (diagnosis), Vestibular Function Tests (MeSH).
- MESH :
Abstract
BACKGROUND
Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations.
MATERIAL AND METHODS
A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients' symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography.
RESULTS
The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall's W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08-0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI - 46% and 57%, respectively.
CONCLUSIONS
The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179-189.
DOI: 10.13075/mp.5893.00645
PubMed: 29493628
Affiliations:
Links toward previous steps (curation, corpus...)
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Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic). ewa.zamyslowska@imp.lodz.pl.</nlm:affiliation><country wicri:rule="url">Pologne</country></affiliation></author><author><name sortKey="Szostek Rogula, Sylwia" sort="Szostek Rogula, Sylwia" uniqKey="Szostek Rogula S" first="Sylwia" last="Szostek-Rogula">Sylwia Szostek-Rogula</name><affiliation wicri:level="1"><nlm:affiliation>Górnośląskie Centrum Rehabilitacji "Repty" / Upper-Silesian Centre of Rehabilitation "Repty", Tarnowskie Góry, Poland. sylszo@op.pl.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Górnośląskie Centrum Rehabilitacji "Repty" / Upper-Silesian Centre of Rehabilitation "Repty", Tarnowskie Góry</wicri:regionArea><wicri:noRegion>Tarnowskie Góry</wicri:noRegion></affiliation></author><author><name sortKey=" Liwi Ska Kowalska, Mariola" sort=" Liwi Ska Kowalska, Mariola" uniqKey=" Liwi Ska Kowalska M" first="Mariola" last=" Liwi Ska-Kowalska">Mariola Liwi Ska-Kowalska</name><affiliation wicri:level="1"><nlm:affiliation>Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic). msliwinska@imp.lodz.pl.</nlm:affiliation><country wicri:rule="url">Pologne</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2018">2018</date><idno type="RBID">pubmed:29493628</idno><idno type="pmid">29493628</idno><idno type="doi">10.13075/mp.5893.00645</idno><idno type="wicri:Area/Main/Corpus">000422</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000422</idno><idno type="wicri:Area/Main/Curation">000422</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000422</idno><idno type="wicri:Area/Main/Exploration">000422</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Functional assessment of patients with vertigo and dizziness in occupational medicine].</title><author><name sortKey="Zamyslowska Szmytke, Ewa" sort="Zamyslowska Szmytke, Ewa" uniqKey="Zamyslowska Szmytke E" first="Ewa" last="Zamysłowska-Szmytke">Ewa Zamysłowska-Szmytke</name><affiliation wicri:level="1"><nlm:affiliation>Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic). ewa.zamyslowska@imp.lodz.pl.</nlm:affiliation><country wicri:rule="url">Pologne</country></affiliation></author><author><name sortKey="Szostek Rogula, Sylwia" sort="Szostek Rogula, Sylwia" uniqKey="Szostek Rogula S" first="Sylwia" last="Szostek-Rogula">Sylwia Szostek-Rogula</name><affiliation wicri:level="1"><nlm:affiliation>Górnośląskie Centrum Rehabilitacji "Repty" / Upper-Silesian Centre of Rehabilitation "Repty", Tarnowskie Góry, Poland. sylszo@op.pl.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Górnośląskie Centrum Rehabilitacji "Repty" / Upper-Silesian Centre of Rehabilitation "Repty", Tarnowskie Góry</wicri:regionArea><wicri:noRegion>Tarnowskie Góry</wicri:noRegion></affiliation></author><author><name sortKey=" Liwi Ska Kowalska, Mariola" sort=" Liwi Ska Kowalska, Mariola" uniqKey=" Liwi Ska Kowalska M" first="Mariola" last=" Liwi Ska-Kowalska">Mariola Liwi Ska-Kowalska</name><affiliation wicri:level="1"><nlm:affiliation>Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic). msliwinska@imp.lodz.pl.</nlm:affiliation><country wicri:rule="url">Pologne</country></affiliation></author></analytic><series><title level="j">Medycyna pracy</title><idno type="ISSN">0465-5893</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Benign Paroxysmal Positional Vertigo (diagnosis)</term><term>Disability Evaluation (MeSH)</term><term>Dizziness (diagnosis)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Occupational Medicine (methods)</term><term>Postural Balance (MeSH)</term><term>Severity of Illness Index (MeSH)</term><term>Surveys and Questionnaires (MeSH)</term><term>Vertigo (diagnosis)</term><term>Vestibular Function Tests (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Mâle (MeSH)</term><term>Médecine du travail (méthodes)</term><term>Sensation vertigineuse (diagnostic)</term><term>Vertige (diagnostic)</term><term>Vertige positionnel paroxystique bénin (diagnostic)</term><term>Épreuves vestibulaires (MeSH)</term><term>Équilibre postural (MeSH)</term><term>Évaluation de l'invalidité (MeSH)</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term><term>Dizziness</term><term>Vertigo</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Sensation vertigineuse</term><term>Vertige</term><term>Vertige positionnel paroxystique bénin</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Occupational Medicine</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Médecine du travail</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Disability Evaluation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Postural Balance</term><term>Severity of Illness Index</term><term>Surveys and Questionnaires</term><term>Vestibular Function Tests</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Mâle</term><term>Épreuves vestibulaires</term><term>Équilibre postural</term><term>Évaluation de l'invalidité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations.</p></div><div type="abstract" xml:lang="en"><p><b>MATERIAL AND METHODS</b></p><p>A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients' symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall's W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08-0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI - 46% and 57%, respectively.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179-189.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29493628</PMID><DateCompleted><Year>2018</Year><Month>06</Month><Day>25</Day></DateCompleted><DateRevised><Year>2018</Year><Month>06</Month><Day>25</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0465-5893</ISSN><JournalIssue CitedMedium="Print"><Volume>69</Volume><Issue>2</Issue><PubDate><Year>2018</Year><Month>Mar</Month><Day>09</Day></PubDate></JournalIssue><Title>Medycyna pracy</Title><ISOAbbreviation>Med Pr</ISOAbbreviation></Journal><ArticleTitle>[Functional assessment of patients with vertigo and dizziness in occupational medicine].</ArticleTitle><Pagination><MedlinePgn>179-189</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">78186</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.13075/mp.5893.00645</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Balance assessment relies on symptoms, clinical examination and functional assessment and their verification in objective tests. Our study was aimed at calculating the assessment compatibility between questionnaires, functional scales and objective vestibular and balance examinations.</AbstractText><AbstractText Label="MATERIAL AND METHODS" NlmCategory="METHODS">A group of 131 patients (including 101 women; mean age: 59±14 years) of the audiology outpatient clinic was examined. Benign paroxysmal positional vertigo, phobic vertigo and central dizziness were the most common diseases observed in the study group. Patients' symptoms were tested using the questionnaire on Cawthworne-Cooksey exercises (CC), Dizziness Handicap Inventory (DHI) and Duke Anxiety-Depression Scale. Berg Balance Scale (BBS), Dynamic Gait Index (DGI), the Tinetti test, Timed Up and Go test (TUG), and Dynamic Visual Acuity (DVA) were used for the functional balance assessment. Objective evaluation included: videonystagmography caloric test and static posturography.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">The study results revealed statistically significant but moderate compatibility between functional tests BBS, DGI, TUG, DVA and caloric results (Kendall's W = 0.29) and higher for posturography (W = 0.33). The agreement between questionnaires and objective tests were very low (W = 0.08-0.11).The positive predictive values of BBS were 42% for caloric and 62% for posturography tests, of DGI - 46% and 57%, respectively.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The results of functional tests (BBS, DGI, TUG, DVA) revealed statistically significant correlations with objective balance tests but low predictive values did not allow to use these tests in vestibular damage screening. Only half of the patients with functional disturbances revealed abnormal caloric or posturography tests. The qualification to work based on objective tests ignore functional state of the worker, which may influence the ability to work. Med Pr 2018;69(2):179-189.</AbstractText><CopyrightInformation>This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Zamysłowska-Szmytke</LastName><ForeName>Ewa</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic). ewa.zamyslowska@imp.lodz.pl.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Szostek-Rogula</LastName><ForeName>Sylwia</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Górnośląskie Centrum Rehabilitacji "Repty" / Upper-Silesian Centre of Rehabilitation "Repty", Tarnowskie Góry, Poland. sylszo@op.pl.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Śliwińska-Kowalska</LastName><ForeName>Mariola</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Klinika Audiologii i Foniatrii / Audiology and Phoniatrics Clinic). msliwinska@imp.lodz.pl.</Affiliation></AffiliationInfo></Author></AuthorList><Language>pol</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Badanie czynnościowe osób z zawrotami głowy i zaburzeniami równowagi dla potrzeb medycyny pracy.</VernacularTitle><ArticleDate DateType="Electronic"><Year>2018</Year><Month>02</Month><Day>28</Day></ArticleDate></Article><MedlineJournalInfo><Country>Poland</Country><MedlineTA>Med Pr</MedlineTA><NlmUniqueID>0376642</NlmUniqueID><ISSNLinking>0465-5893</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D065635" MajorTopicYN="N">Benign Paroxysmal Positional Vertigo</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004185" MajorTopicYN="Y">Disability Evaluation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004244" MajorTopicYN="N">Dizziness</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009787" MajorTopicYN="N">Occupational Medicine</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004856" MajorTopicYN="Y">Postural Balance</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014717" MajorTopicYN="N">Vertigo</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014724" MajorTopicYN="N">Vestibular Function Tests</DescriptorName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="pol"><AbstractText Label="WSTĘP" NlmCategory="UNASSIGNED">W ocenie układu równowagi istotne znaczenie mają objawy, zaburzenia w badaniu klinicznym i czynnościowym oraz ich weryfikacja w testach obiektywnych. Celem pracy było określenie zgodności oceny kwestionariuszowej i funkcjonalnej z badaniami obiektywnymi.</AbstractText><AbstractText Label="MATERIAŁ I METODY" NlmCategory="UNASSIGNED">Badaniem objęto 131 pacjentów poradni audiologicznej (średni wiek: 59±14 lat), w tym 101 kobiet. Wśród rozpoznań klinicznych dominowały łagodne położeniowe zawroty głowy, zawroty psychogenne i zawroty pochodzenia ośrodkowego. Objawy oceniano, korzystając z kwestionariusza dotyczącego ćwiczeń Cawthworne’a-Cookseya (CC), kwestionariusza DHI (Dizziness Handicap Inventory) i Skali Lęku-Depresji Duke’a. Do oceny czynnościowej zastosowano Skalę Równowagi Berg (Berg Balance Scale – BBS), dynamiczny indeks chodu (dynamic gait index – DGI), test Tinetti, test TUG (Timed Up and Go – „wstań i idź”) oraz test dynamicznej ostrości wzroku (DOW). Badania laboratoryjne obejmowały próbę kaloryczną i posturografię statyczną.</AbstractText><AbstractText Label="WYNIKI" NlmCategory="UNASSIGNED">Wyniki BBS, DGI, TUG i DOW wykazały istotną statystycznie, lecz umiarkowaną zgodność z wynikami badań obiektywnych – zarówno próby kalorycznej (W Kendalla = 0,29), jak i posturografii statycznej (W = 0,33). Dla badań kwestionariuszowych zgodność ta była bardzo niska (W = 0,08–0,11). Wartości predykcyjne dodatnie dla skali BBS wynosiły 42% (próba kaloryczna) i 62% (posturografia), dla DGI odpowiednio: 46% i 57%.</AbstractText><AbstractText Label="WNIOSKI" NlmCategory="UNASSIGNED">Wyniki testów czynnościowych BBS, DGI, TUG i DOW wykazują istotną statystycznie zależność od badań obiektywnych, jednak niskie wartości predykcyjne nie pozwalają na zastosowanie tych testów jako screeningowych dla zaburzeń przedsionkowych. Jedynie połowa osób, u których stwierdzono zaburzenia funkcji układu równowagi w testach czynnościowych, ma nieprawidłowe wyniki próby kalorycznej i/lub posturografii statycznej. Kwalifikując do pracy na podstawie wyników badań obiektywnych, pomija się zaburzenia funkcjonalne, które mogą wpływać na zdolność do wykonywania pracy. Med. Pr. 2018;69(2):179–189.</AbstractText></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Berg Balance Scale</Keyword><Keyword MajorTopicYN="N">dynamic gait index</Keyword><Keyword MajorTopicYN="N">posturography</Keyword><Keyword MajorTopicYN="N">unbalance</Keyword><Keyword MajorTopicYN="N">vertigo</Keyword><Keyword MajorTopicYN="N">videonystagmography</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>3</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>6</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>3</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29493628</ArticleId><ArticleId IdType="pii">78186</ArticleId><ArticleId IdType="doi">10.13075/mp.5893.00645</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Pologne</li></country></list><tree><country name="Pologne"><noRegion><name sortKey="Zamyslowska Szmytke, Ewa" sort="Zamyslowska Szmytke, Ewa" uniqKey="Zamyslowska Szmytke E" first="Ewa" last="Zamysłowska-Szmytke">Ewa Zamysłowska-Szmytke</name></noRegion><name sortKey=" Liwi Ska Kowalska, Mariola" sort=" Liwi Ska Kowalska, Mariola" uniqKey=" Liwi Ska Kowalska M" first="Mariola" last=" Liwi Ska-Kowalska">Mariola Liwi Ska-Kowalska</name><name sortKey="Szostek Rogula, Sylwia" sort="Szostek Rogula, Sylwia" uniqKey="Szostek Rogula S" first="Sylwia" last="Szostek-Rogula">Sylwia Szostek-Rogula</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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