Violência contra a criança: indicadores dermatológicos e diagnósticos diferenciais Child abuse: skin markers and differential diagnosis

As denúncias de abuso contra a criança têm sido frequentes e configuram grave problema de saúde pública. O tema é desconfortável para muitos médicos, seja pelo treinamento insuficiente, seja pelo desconhecimento das dimensões do problema. Uma das formas mais comuns de violência contra a criança é o abuso físico. Como órgão mais exposto e extenso, a pele é o alvo mais sujeito aos maustratos. Equimoses e queimaduras são os sinais mais visíveis. Médicos (pediatras, clínicos-gerais e dermatologistas) costumam ser os primeiros profissionais a observar e reconhecer sinais de lesões não acidentais ou intencionais. Os dermatologistas podem auxiliar na distinção entre lesões traumáticas intencionais, acidentais e doenças cutâneas que mimetizam maus-tratos<br>Reports of child abuse have increased significantly. The matter makes most physicians uncomfortable for two reasons: a) Little guidance or no training in recognizing the problem; b - Not understanding its true dimension. The most common form of child violence is physical abuse. The skin is the largest and frequently the most traumatized organ. Bruises and burns are the most visible signs. Physicians (pediatricians, general practitioners and dermatologists) are the first professionals to observe and recognize the signs of intentional injury. Dermatologists particularly, can help distinguish intentional injury from accidental, or from skin diseases that mimic maltreatmen

Searches for Gravitational Waves from Known Pulsars at Two Harmonics in the Second and Third LIGO-Virgo Observing Runs

We present a targeted search for continuous gravitational waves (GWs) from 236 pulsars using data from the third observing run of LIGO and Virgo (O3) combined with data from the second observing run (O2). Searches were for emission from the l = m = 2 mass quadrupole mode with a frequency at only twice the pulsar rotation frequency (single harmonic) and the l = 2, m = 1, 2 modes with a frequency of both once and twice the rotation frequency (dual harmonic). No evidence of GWs was found, so we present 95% credible upper limits on the strain amplitudes h (0) for the single-harmonic search along with limits on the pulsars' mass quadrupole moments Q (22) and ellipticities epsilon. Of the pulsars studied, 23 have strain amplitudes that are lower than the limits calculated from their electromagnetically measured spin-down rates. These pulsars include the millisecond pulsars J0437-4715 and J0711-6830, which have spin-down ratios of 0.87 and 0.57, respectively. For nine pulsars, their spin-down limits have been surpassed for the first time. For the Crab and Vela pulsars, our limits are factors of similar to 100 and similar to 20 more constraining than their spin-down limits, respectively. For the dual-harmonic searches, new limits are placed on the strain amplitudes C (21) and C (22). For 23 pulsars, we also present limits on the emission amplitude assuming dipole radiation as predicted by Brans-Dicke theory