Vertigo returning to the sitting position after the Semont manoeuvre. Is it a prognostic symptom?
Identifieur interne : 000073 ( Main/Exploration ); précédent : 000072; suivant : 000074Vertigo returning to the sitting position after the Semont manoeuvre. Is it a prognostic symptom?
Auteurs : A. Albera [Italie] ; M. Boldreghini [Italie] ; A. Canale [Italie] ; R. Albera [Italie] ; C F Gervasio [Italie]Source :
- Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale [ 1827-675X ] ; 2018.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Femelle (MeSH), Humains (MeSH), Jeune adulte (MeSH), Mâle (MeSH), Position assise (MeSH), Pronostic (MeSH), Récidive (MeSH), Résultat thérapeutique (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Vertige positionnel paroxystique bénin (thérapie), Études de cohortes (MeSH), Études rétrospectives (MeSH).
- MESH :
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Benign Paroxysmal Positional Vertigo (therapy), Cohort Studies (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Prognosis (MeSH), Recurrence (MeSH), Retrospective Studies (MeSH), Sitting Position (MeSH), Treatment Outcome (MeSH), Young Adult (MeSH).
- MESH :
Abstract
SUMMARY
Benign paroxysmal positional vertigo (BPPV) is a frequent benign vestibular condition usually managed with particle repositioning manoeuvres, such as Semont manoeuvre (SM). Since few authors have described prognostic aspects of liberatory manoeuvres, the purpose of the present study was to investigate the possibility of considering vertigo in the final sitting position of the SM as a prognostic symptom in the outcome of posterior BPPV. One hundred and thirteen patients with diagnosis of unilateral posterior BPPV were taking into account in our retrospective cohort study: 41 men and 72 women, aged 22 to 85 years. All were submitted to one repositioning SM and afterwards controlled 3 to 5 days later by means of an additional Dix-Hallpike manoeuvre. The main outcomes investigated were the occurrence of Ny and vertigo in the different phases of the SM, as well as their characteristics in relation to outcome of the disease. Among all patients, 75 (66%) presented both orthotropic Ny and vertigo in the second SM position and 72% obtained a complete resolution of the disease after the liberatory manoeuvre. Contrarily, 17 subjects (15%) manifested vertigo in the final sitting position of the SM and among these, only 7 (41%) completely recovered from BPPV. According to our data, in case of sudden vertigo returning to the final sitting position of the SM, the failure rate of the liberatory manoeuvre was higher, even though not statistically significant: therefore, it can be considered as a negative prognostic factor of posterior BPPV after SM.
DOI: 10.14639/0392-100X-1815
PubMed: 29967559
PubMed Central: PMC6028822
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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Is it a prognostic symptom?</title><author><name sortKey="Albera, A" sort="Albera, A" uniqKey="Albera A" first="A" last="Albera">A. Albera</name><affiliation wicri:level="1"><nlm:affiliation>Department of Otolaryngology, San Giuseppe Hospital, University of Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Otolaryngology, San Giuseppe Hospital, University of Milan</wicri:regionArea><wicri:noRegion>University of Milan</wicri:noRegion></affiliation></author><author><name sortKey="Boldreghini, M" sort="Boldreghini, M" uniqKey="Boldreghini M" first="M" last="Boldreghini">M. Boldreghini</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgical Sciences, Otolaryngology Unit, University of Turin</wicri:regionArea><wicri:noRegion>University of Turin</wicri:noRegion></affiliation></author><author><name sortKey="Canale, A" sort="Canale, A" uniqKey="Canale A" first="A" last="Canale">A. Canale</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgical Sciences, Otolaryngology Unit, University of Turin</wicri:regionArea><wicri:noRegion>University of Turin</wicri:noRegion></affiliation></author><author><name sortKey="Albera, R" sort="Albera, R" uniqKey="Albera R" first="R" last="Albera">R. Albera</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgical Sciences, Otolaryngology Unit, University of Turin</wicri:regionArea><wicri:noRegion>University of Turin</wicri:noRegion></affiliation></author><author><name sortKey="Gervasio, C F" sort="Gervasio, C F" uniqKey="Gervasio C" first="C F" last="Gervasio">C F Gervasio</name><affiliation wicri:level="1"><nlm:affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Surgical Sciences, Otolaryngology Unit, University of Turin</wicri:regionArea><wicri:noRegion>University of Turin</wicri:noRegion></affiliation></author></analytic><series><title level="j">Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale</title><idno type="eISSN">1827-675X</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>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Benign Paroxysmal Positional Vertigo (therapy)</term><term>Cohort Studies (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Prognosis (MeSH)</term><term>Recurrence (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Sitting Position (MeSH)</term><term>Treatment Outcome (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Mâle (MeSH)</term><term>Position assise (MeSH)</term><term>Pronostic (MeSH)</term><term>Récidive (MeSH)</term><term>Résultat thérapeutique (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Vertige positionnel paroxystique bénin (thérapie)</term><term>Études de cohortes (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Benign Paroxysmal Positional Vertigo</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Vertige positionnel paroxystique bénin</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prognosis</term><term>Recurrence</term><term>Retrospective Studies</term><term>Sitting Position</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Position assise</term><term>Pronostic</term><term>Récidive</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>SUMMARY</b></p><p>Benign paroxysmal positional vertigo (BPPV) is a frequent benign vestibular condition usually managed with particle repositioning manoeuvres, such as Semont manoeuvre (SM). Since few authors have described prognostic aspects of liberatory manoeuvres, the purpose of the present study was to investigate the possibility of considering vertigo in the final sitting position of the SM as a prognostic symptom in the outcome of posterior BPPV. One hundred and thirteen patients with diagnosis of unilateral posterior BPPV were taking into account in our retrospective cohort study: 41 men and 72 women, aged 22 to 85 years. All were submitted to one repositioning SM and afterwards controlled 3 to 5 days later by means of an additional Dix-Hallpike manoeuvre. The main outcomes investigated were the occurrence of Ny and vertigo in the different phases of the SM, as well as their characteristics in relation to outcome of the disease. Among all patients, 75 (66%) presented both orthotropic Ny and vertigo in the second SM position and 72% obtained a complete resolution of the disease after the liberatory manoeuvre. Contrarily, 17 subjects (15%) manifested vertigo in the final sitting position of the SM and among these, only 7 (41%) completely recovered from BPPV. According to our data, in case of sudden vertigo returning to the final sitting position of the SM, the failure rate of the liberatory manoeuvre was higher, even though not statistically significant: therefore, it can be considered as a negative prognostic factor of posterior BPPV after SM.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29967559</PMID><DateCompleted><Year>2019</Year><Month>02</Month><Day>28</Day></DateCompleted><DateRevised><Year>2019</Year><Month>02</Month><Day>28</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1827-675X</ISSN><JournalIssue CitedMedium="Internet"><Volume>38</Volume><Issue>2</Issue><PubDate><Year>2018</Year><Month>Apr</Month></PubDate></JournalIssue><Title>Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale</Title><ISOAbbreviation>Acta Otorhinolaryngol Ital</ISOAbbreviation></Journal><ArticleTitle>Vertigo returning to the sitting position after the Semont manoeuvre. Is it a prognostic symptom?</ArticleTitle><Pagination><MedlinePgn>145-150</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.14639/0392-100X-1815</ELocationID><Abstract><AbstractText Label="SUMMARY" NlmCategory="CONCLUSIONS">Benign paroxysmal positional vertigo (BPPV) is a frequent benign vestibular condition usually managed with particle repositioning manoeuvres, such as Semont manoeuvre (SM). Since few authors have described prognostic aspects of liberatory manoeuvres, the purpose of the present study was to investigate the possibility of considering vertigo in the final sitting position of the SM as a prognostic symptom in the outcome of posterior BPPV. One hundred and thirteen patients with diagnosis of unilateral posterior BPPV were taking into account in our retrospective cohort study: 41 men and 72 women, aged 22 to 85 years. All were submitted to one repositioning SM and afterwards controlled 3 to 5 days later by means of an additional Dix-Hallpike manoeuvre. The main outcomes investigated were the occurrence of Ny and vertigo in the different phases of the SM, as well as their characteristics in relation to outcome of the disease. Among all patients, 75 (66%) presented both orthotropic Ny and vertigo in the second SM position and 72% obtained a complete resolution of the disease after the liberatory manoeuvre. Contrarily, 17 subjects (15%) manifested vertigo in the final sitting position of the SM and among these, only 7 (41%) completely recovered from BPPV. According to our data, in case of sudden vertigo returning to the final sitting position of the SM, the failure rate of the liberatory manoeuvre was higher, even though not statistically significant: therefore, it can be considered as a negative prognostic factor of posterior BPPV after SM.</AbstractText><CopyrightInformation>Copyright © 2018 Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Albera</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Otolaryngology, San Giuseppe Hospital, University of Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boldreghini</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Canale</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Albera</LastName><ForeName>R</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gervasio</LastName><ForeName>C F</ForeName><Initials>CF</Initials><AffiliationInfo><Affiliation>Department of Surgical Sciences, Otolaryngology Unit, University of Turin, Italy.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Italy</Country><MedlineTA>Acta Otorhinolaryngol Ital</MedlineTA><NlmUniqueID>8213019</NlmUniqueID><ISSNLinking>0392-100X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D065635" MajorTopicYN="N">Benign Paroxysmal Positional Vertigo</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></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="D011379" MajorTopicYN="N">Prognosis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012008" MajorTopicYN="N">Recurrence</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000077708" MajorTopicYN="Y">Sitting Position</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList><OtherAbstract Type="Publisher" Language="ita"><AbstractText>La comparsa di vertigine al ritorno nella posizione seduta della manovra di Semont può esser considerata un fattore prognostico?</AbstractText><AbstractText Label="RIASSUNTO" NlmCategory="UNASSIGNED">La vertigine parossistica posizionale benigna (BPPV) è la patologia che più frequentemente colpisce il labirinto e si manifesta con crisi di vertigine parossistiche, ovvero intense e di breve durata. Poiché la BPPV, provocata da un disturbo meccanico dell’organo dell’equilibrio, è considerata una patologia ad andamento benigno, viene normalmente gestita con manovre di riposizionamento degli otoliti chiamate manovre liberatorie: tra queste vi è la manovra di Semont (SM). L’obiettivo del presente studio è indagare se vi sia la possibilità di considerare la vertigine che talvolta insorge al ritorno nella posizione seduta finale della SM come un fattore prognostico riguardo l’esito della manovra stessa e quindi la risoluzione della patologia. Sono stati presi in considerazione per questo studio retrospettivo 113 pazienti con diagnosi di BPPV unilaterale posteriore: 41 uomini e 72 donne, di età compresa tra 22 e 85 anni. Tutti sono stati sottoposti a una SM liberatoria e in seguito controllati dopo 3-5 giorni mediante una nuova manovra Dix-Hallpike diagnostica. Tra le diverse variabili indagate, il principale dato preso in considerazione è stato il verificarsi di nistagmo (Ny) e/o vertigine nelle diverse posizioni della SM, nonché le loro caratteristiche in funzione dell’evoluzione della malattia. Tra tutti i campioni, 75 pazienti (66%) presentavano sia vertigine che Ny nella seconda posizione della SM ed il 72% di essi ha ottenuto una completa risoluzione della malattia dopo tale manovra liberatoria. Al contrario, 17 soggetti (15%) hanno manifestato esclusivamente vertigini al ritorno nella posizione seduta finale della SM e tra di essi solo 7 pazienti (41%) hanno ottenuto una completa remissione della BPPV. Secondo i dati in nostro possesso si può pertanto affermare che, in caso di insorgenza di vertigini nella posizione seduta finale della SM, il tasso di fallimento della manovra liberatoria è risultato molto più elevato, anche se non statisticamente significativo: tale risultato può essere considerato un fattore prognostico negativo nell’outcome della BPPV posteriore dopo SM.</AbstractText></OtherAbstract><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">BPPV</Keyword><Keyword MajorTopicYN="N">BPPV outcomes</Keyword><Keyword MajorTopicYN="N">Positional vertigo</Keyword><Keyword MajorTopicYN="N">Semont manoeuvre •Semont prognostic factors</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year><Month>06</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>12</Month><Day>22</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>7</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>7</Month><Day>4</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2019</Year><Month>3</Month><Day>1</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">29967559</ArticleId><ArticleId IdType="pmc">PMC6028822</ArticleId><ArticleId IdType="doi">10.14639/0392-100X-1815</ArticleId></ArticleIdList><ReferenceList><Reference><Citation>N Engl J Med. 1998 Sep 3;339(10):680-5</Citation><ArticleIdList><ArticleId IdType="pubmed">9725927</ArticleId></ArticleIdList></Reference><Reference><Citation>Acta Otolaryngol. 2017 Jan;137(1):63-70</Citation><ArticleIdList><ArticleId IdType="pubmed">27683970</ArticleId></ArticleIdList></Reference><Reference><Citation>Otol Neurotol. 2012 Sep;33(7):1127-30</Citation><ArticleIdList><ArticleId IdType="pubmed">22892804</ArticleId></ArticleIdList></Reference><Reference><Citation>Neurology. 2007 Apr 10;68(15):1219-22</Citation><ArticleIdList><ArticleId IdType="pubmed">17420406</ArticleId></ArticleIdList></Reference><Reference><Citation>J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):710-5</Citation><ArticleIdList><ArticleId IdType="pubmed">17135456</ArticleId></ArticleIdList></Reference><Reference><Citation>Laryngoscope. 1992 Sep;102(9):988-92</Citation><ArticleIdList><ArticleId IdType="pubmed">1518363</ArticleId></ArticleIdList></Reference><Reference><Citation>Adv Otorhinolaryngol. 1988;42:290-3</Citation><ArticleIdList><ArticleId IdType="pubmed">3213745</ArticleId></ArticleIdList></Reference><Reference><Citation>J Neurol. 2012 May;259(5):882-5</Citation><ArticleIdList><ArticleId IdType="pubmed">22008871</ArticleId></ArticleIdList></Reference><Reference><Citation>Acta Otorhinolaryngol Ital. 2003 Jun;23(3):161-7</Citation><ArticleIdList><ArticleId IdType="pubmed">14677308</ArticleId></ArticleIdList></Reference><Reference><Citation>ScientificWorldJournal. 2012;2012:162123</Citation><ArticleIdList><ArticleId IdType="pubmed">22973168</ArticleId></ArticleIdList></Reference><Reference><Citation>Acta Otolaryngol. 2017 May;137(5):490-494</Citation><ArticleIdList><ArticleId IdType="pubmed">27841050</ArticleId></ArticleIdList></Reference><Reference><Citation>Otolaryngol Head Neck Surg. 1992 Sep;107(3):399-404</Citation><ArticleIdList><ArticleId IdType="pubmed">1408225</ArticleId></ArticleIdList></Reference><Reference><Citation>Otol Neurotol. 2014 Jul;35(6):1105-10</Citation><ArticleIdList><ArticleId IdType="pubmed">24853239</ArticleId></ArticleIdList></Reference><Reference><Citation>Otolaryngol Head Neck Surg. 2008 Nov;139(5 Suppl 4):S47-81</Citation><ArticleIdList><ArticleId IdType="pubmed">18973840</ArticleId></ArticleIdList></Reference><Reference><Citation>Ann Otol Rhinol Laryngol. 1952 Dec;61(4):987-1016</Citation><ArticleIdList><ArticleId IdType="pubmed">13008328</ArticleId></ArticleIdList></Reference><Reference><Citation>Otol Neurotol. 2011 Aug;32(6):1008-11</Citation><ArticleIdList><ArticleId IdType="pubmed">21725255</ArticleId></ArticleIdList></Reference><Reference><Citation>J Neurophysiol. 2007 Mar;97(3):2355-63</Citation><ArticleIdList><ArticleId IdType="pubmed">17229824</ArticleId></ArticleIdList></Reference><Reference><Citation>N Engl J Med. 1999 Nov 18;341(21):1590-6</Citation><ArticleIdList><ArticleId IdType="pubmed">10564690</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>Italie</li></country></list><tree><country name="Italie"><noRegion><name sortKey="Albera, A" sort="Albera, A" uniqKey="Albera A" first="A" last="Albera">A. Albera</name></noRegion><name sortKey="Albera, R" sort="Albera, R" uniqKey="Albera R" first="R" last="Albera">R. Albera</name><name sortKey="Boldreghini, M" sort="Boldreghini, M" uniqKey="Boldreghini M" first="M" last="Boldreghini">M. Boldreghini</name><name sortKey="Canale, A" sort="Canale, A" uniqKey="Canale A" first="A" last="Canale">A. Canale</name><name sortKey="Gervasio, C F" sort="Gervasio, C F" uniqKey="Gervasio C" first="C F" last="Gervasio">C F Gervasio</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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