Femicide trends in Brazil: relationship between public interest and mortality rates.

In this information epidemiology (infodemiology) study, we describe the online public interest about the issue of femicide in Brazil and analyze the relationship between search queries and femicide trends from 2004 to 2015. We showed that information-seeking behavior for femicide in the Brazilian states has been strongly influenced by female homicide rates. Educational and policy-related interventions are needed to improve the population's knowledge and attitude toward femicide.

Topical application of tranexamic acid in anticoagulated patients undergoing minor oral surgery: A systematic review and meta-analysis of randomized clinical trials.

PURPOSE: To perform a systematic review and meta-analysis of randomized clinical trials (RCTs) investigating the efficacy and safety of topical tranexamic acid (TXA) to prevent postoperative bleeding in anticoagulated patients undergoing minor oral surgery. MATERIAL AND METHODS: We analyzed RCTs comparing the use of topical TXA versus other topical hemostatic agents or placebo solutions for minor oral surgeries. We assessed the risk of bias and strength of evidence according to the Cochrane guidelines and GRADE rating system, respectively. The pooled relative risk (RR) was calculated for the effect of topical application of TXA on postsurgical bleeding. RESULTS: Five RCTs were included in the study. The combined RR for the number of patients receiving TXA in comparison to the control group was 0.13 (95% CI 0.05-0.36; P = 0.01), indicating a protective effect of topical TXA on bleeding after minor oral surgeries. Subgroup analysis revealed that topical TXA was effective in preventing postsurgical bleeding compared to placebo and epsilon-aminocaproic acid. No cases of thromboembolic events were reported. CONCLUSIONS: Currently available evidence suggests that surgical site irrigation with TXA followed by mouthwash during the first postoperative week is safe and may reduce the risk of bleeding after minor oral surgeries in anticoagulated patients.

Importância do cirurgião-dentista no diagnóstico precoce do pênfigo vulgar / Importance of the dentist in early diagnosis of pemphigus vulgaris

O pênfigo vulgar é uma doença vésico-bolhosa crônica, rara, de natureza autoimune e com possibilidade de seguir um curso clínico preocupante, quando não diagnosticada e tratada na sua fase inicial. Usualmente, acomete indivíduos entre quarenta e sessenta anos de idade, sendo raro seu aparecimento em crianças. As manifestações bucais são, na maioria das vezes, os primeiros sinais da doença, tendo o cirurgião-dentista um papel fundamental no seu diagnóstico precoce. Os autores apresentam um caso clínico de pênfigo vulgar, em uma paciente de 17 anos de idade, atendida no Serviço de Cirurgia Buco-Maxilo-Facial da Fundação de Beneficência Hospital de Cirurgia em Aracaju, Sergipe. A paciente deu entrada queixando-se da presença de numerosas úlceras dolorosas espalhadas na cavidade bucal, com evolução de aproximadamente dois meses, e relatou que, primeiramente, surgiram bolhas que se romperam rapidamente, dando lugar a ulcerações extremamente dolorosas. Foram realizadas biópsias incisionais das regiões de mucosa jugal e retromolar, além de hemograma completo, para se descartar a hipótese de um quadro de leucemia. Diante dos achados clínicos e histopatológicos, chegou-se ao diagnóstico definitivo de pênfigo vulgar. Antes de receber tratamento especializado, a paciente apresentou piora acentuada do quadro, com exacerbação dos sinais e sintomas intrabucais e desenvolvimento de lesões cutâneas ao redor da superfície corporal. Foi internada no Hospital Universitário da Universidade Federal de Sergipe e medicada com prednisona, cimetidina e nistatina, apresentando melhora significante do quadro clínico em aproximadamente duas semanas. Atualmente, está sob os cuidados de uma equipe interdisciplinar, que inclui dermatologista e cirurgião-dentista

The vulgar pemphigus is a chronic, rare, vesicle-bubble disease of autoimmune origin and with a possibility of following a dangerous clinical course when it is not diagnosed and treated in its initial stage. It usually affects people from 40 to 60 years old, being rare in children. In the majority of cases, oral manifestations are the first signs of the disease, so that dentists play an important rol in its early diagnosis. The authors present a case report of vulgar pemphigus in a 17 year-old patient, attended by the Bucco-Maxillo-Facial Surgery Service of the "Fundação de Beneficência Hospital de Cirurgia" in Aracaju-SE, Brazil. The patient was admitted with a complaint of the presence of numerous scattered painful ulcers in the mouth that had developed in approximately two months, and reported that at first, blisters that broke quickly appeared, leading to extremely painful ulcerations. Incisional biopsies were performed in the jugal mucosa and retromolar regions, and also a complete hemogram to discard the hypothesis of leukemia. In view of the clinical and histopathological findings, the final diagnosis of pemphigus vulgaris was made. Before receiving specialized treatment, the patient presented marked worsening of the clinical condition, with exacerbation of intraoral signs and symptoms and development of skin lesions around the body surface. The patient was hospitalized in the "Hospital Universitário da Universidade Federal de Sergipe" and treated with prednisone, cimetidine and nystatin, showing significant improvement of symptoms in approximately two weeks. At present, the patient is under the care of an interdisciplinary team that includes dermatologists and dentists.