Beruflich Dokumente
Kultur Dokumente
2009/2010
BIBLIOGRAFIA INDICADA PARA O TED 2011
Arch Dermatol. 2009 Jan;145(1):18-24. Topical tretinoin therapy and all-cause mortality.
Weinstock MA, Bingham SF, Lew RA, Hall R, Eilers D, Kirsner R, Naylor M, Kalivas J, Cole G,
Marcolivio K, Collins J, Digiovanna JJ, Vertrees JE; Veterans Affairs Topical Tretinoin
Chemoprevention (VATTC) Trial Group. Comment in: Arch Dermatol. 2009 Jan;145(1):76.
Abstract - OBJECTIVE: To evaluate the relation of topical tretinoin, a commonly used retinoid
cream, with all-cause mortality in the Veterans Affairs Topical Tretinoin Chemoprevention Trial
(VATTC). The planned outcome of this trial was risk of keratinocyte carcinoma, and systemic
administration of certain retinoid compounds has been shown to reduce risk of this cancer but has
also been associated with increased mortality risk among smokers. DESIGN: The VATTC Trial
was a blinded randomized chemoprevention trial, with 2- to 6-year follow-up. Oversight was
provided by multiple independent committees. SETTING: US Department of Veterans Affairs
medical centers. Patients A total of 1131 veterans were randomized. Their mean age was 71
years. Patients with a very high estimated short-term risk of death were excluded. Interventions
Application of tretinoin, 0.1%, or vehicle control cream twice daily to the face and ears. MAIN
OUTCOME MEASURES: Death, which was not contemplated as an end point in the original study
design. RESULTS: The intervention was terminated 6 months early because of an excessive
number of deaths in the tretinoin-treated group. Post hoc analysis of this difference revealed
minor imbalances in age, comorbidity, and smoking status, all of which were important predictors of
death. After adjusting for these imbalances, the difference in mortality between the
randomized groups remained statistically significant. CONCLUSIONS: We observed an
association of topical tretinoin therapy with death, but we do not infer a causal association that
current evidence suggests is unlikely.
Arch Dermatol. 2009 Jan;145(1):38-45. Non-sexually related acute genital ulcers in 13 pubertal
girls: a clinical and microbiological study. Farhi D, Wendling J, Molinari E, Raynal J, Carcelain
G, Morand P, Avril MF, Francès C, Rozenberg F, Pelisse M, Dupin N.
Abstract - OBJECTIVE: To describe the clinical and microbiological features of acute genital ulcers
(AGU), which have been reported in virgin adolescents, predominantly in girls. DESIGN:
Descriptive study. We collected data on the clinical features, sexual history, blood cell count,
biochemistry, microbiological workup, and 1-year follow-up. SETTING: Departments of dermatology
of 3 university hospitals in Paris. Patients Thirteen immunocompetent female patients with a first
flare of non-sexually transmitted AGU. MAIN OUTCOME MEASURES: Clinical and microbiological
data, using a standardized form. RESULTS: Mean age was 16.6 years (range, 11-19 years). Eleven
patients denied previous sexual contact. A fever or flulike symptoms preceded AGU in 10 of the 13
patients (77%), with a mean delay of 3.8 days before the AGU onset (range, 0-10 days). The genital
ulcers were bilateral in 10 patients. The final diagnosis was Epstein-Barr virus primary infection
in 4 patients (31%) and Behçet disease in 1 patient (8%). No other infectious agents were
detected in this series. CONCLUSIONS: We recommend serologic testing for Epstein-Barr virus
with IgM antibodies to viral capsid antigens in non-sexually related AGU in immunocompetent
patients. Further microbiological studies are required to identify other causative agents.