Objective: The aim of this work is to provide evidence for the relationship between suspicion and diagnosis of cases of child abuse and fractures, since, in national literature, studies are still scarce on the subject. Methods: Retrospective study involving electronic medical records of a public reference hospital, in a city of the state of São Paulo, in a 8-year period (2010 to 2018). Cases involving children up to 12 years of age were selected when notified as abuse and presenting fractures; data were statistically analyzed. Results: Among 83 cases of abuse, 19 patients (20.5%) had 23 different fractures. The victims were mainly boys (68.42%) with a mean age of 5 years old, who suffered physical aggression (79%). The majority had no identified aggressor (52%) and 21% were related to the mother. The fracture patterns found involved, mostly, skull fractures (43.48%) and diaphysary fractures (34.78%). Seven patients (30.43%) had other associated lesions and four patients died (21%). Conclusion: Despite the number of cases, it was possible to identify relevant characteristics and patterns. These data indicate that the diagnosis is underestimated and show small epidemiological differences compared with international literature. Level of Evidence II, Retrospective study.

Objective: Evaluate risk factors related to clinical evolution and dedifferentiation of parosteal (juxtacortical) osteosarcoma to high-grade osteosarcoma. Methods: Retrospective cohort study performed over a period of 25 years, using data from medical records of patients diagnosed with parosteal osteosarcoma. The data were submitted to statistical analysis by Fisher’s exact test and Student’s t-test. Results: Of the 326 patients treated for osteosarcoma, we identified 17 patients diagnosed with parosteal osteosarcoma. Of these, 4 (23.5%) were not actually diagnosed with parosteal osteosarcoma and 4 did not have the minimum data required for analysis, being excluded from the study. Of the 9 patients studied, we observed that 3 (33.3%) evolved with tumor dedifferentiation to high-grade osteosarcoma. Moreover, 2 (66.7%) had local recurrence and 2 (66.7%) metastases. Conclusion: Age, sex, and the tumor size were not directly related to the dedifferentiation from parosteal osteosarcoma to high-grade osteosarcoma. The most aggressive clinical evolution - presence of local recurrences and metastasis - in parosteal osteosarcoma occurred in tumors with dedifferentiation, however, we cannot associate each other as cause and effect, but as related factors. Level of Evidence IV, Case Series.

As enteroparasitoses acometem grande número de pessoas, e sua frequência está associada a condições socioeconômicas e de saneamento básico, representando um problema de saúde pública. Apesar da transição epidemiológica mundial, muitos países, como o Brasil, ainda mantêm nas doenças parasitárias importante causa de morbimortalidade. Este artigo tem como objetivo descrever a prevalência de enteroparasitos em exames parasitológicos de fezes em uma unidade laboratorial de um distrito de Feira de Santana, Bahia, Brasil. Foram incluídos 2.304 pacientes que realizaram exames parasitológicos de fezes, entre março de 2011 e junho de 2013, e excluídos os sem dados. As variáveis foram obtidas da base de dados do laboratório local e os dados foram analisados utilizando o software SPSS, versão 17.0. Os pacientes estudados foram com frequência mulheres (59,0%) e com idade inferior a 40 anos (66,2%). Parasitos intestinais foram encontrados em 1.112 pacientes (48,3%). Protozoários representaram 93,3%, e helmintos, 10,3%. O monoparasitismo foi predominante (72,2%). Os parasitos mais frequentes foram Giardia lamblia (8,7%), seguido de Entamoeba histolytica (6,6%), Ancylostomideo SP (4,6%), Ascaris lumbricoides (2,0%), Hymenolepis SP (1,7%) e Schistosoma mansoni (1,6%). A prevalência de enteroparasitos foi elevada, com predominância de protozoários e monoparasitoses, e o perfil da população estudada caracterizou-se por maior frequência de mulheres e adultos jovens.