Development of the Low-Pressure Die Casting Process for an Aluminium Alloy Part.

The low-pressure die casting (LPDC) process was experimentally and numerically studied to produce AlSi7Mg0.3 components such as steering knuckles. Steering knuckles are important safety components in the context of a vehicle's suspension system, serving as the mechanical interface that facilitates the articulation of the steering to control the front wheel's orientation, while simultaneously bearing the vertical load imposed by the vehicle's weight. This work focuses on the development of a numerical model in ProCAST®, replicating the production of the aforementioned part. The model analyses parameters such as the filling dynamics, solidification process, and presence of shrinkage porosities. For the purpose of evaluating the quality of the castings, six parts were produced and characterised, both mechanically (tensile and hardness tests) and microstructurally (porosity and optical microscopy analysis). When correlating simulation results with the available experimental data, it is possible to conclude that the usage of the LPDC process is a viable alternative to the use of steels and other metals for the production of very high-quality castings while using lighter alloys such as aluminium and magnesium in more demanding applications.

Wear Rate, Tribo-Corrosion, and Plastic Deformation Values of Co-Cr-Mo Alloy in Ringer Lactate Solution.

This study investigates the tribocorrosion performance of a cast Co-Cr-Mo alloy prepared using casting and electromagnetic stirring (EMS) at specific frequencies. The tribocorrosion behaviour of the alloy was evaluated when exposed to Ringer's lactate solution to optimize the EMS parameters and improve its properties. The research focuses on biomedical implant applications and explores how EMS affects alloy wear and corrosion resistance. As did the friction coefficient and wear volume, the wear rate of samples produced with EMS frequencies of 75 Hz and 150 Hz decreased. These improvements are attributed to the ability of EMS to refine grain size and homogenize the microstructure, thereby increasing the resistance to tribocorrosion. Techniques such as scanning electron microscopy (SEM) and profilometry were used for surface and wear analysis, while mechanical properties were evaluated through instrumented indentation tests. The findings confirm that EMS improves the alloy's durability and tribocorrosion resistance, making it highly suitable for demanding biomedical applications such as joint replacements. This highlights the importance of advanced manufacturing techniques in optimizing biomedical alloys for simulated body conditions.

Scratch and Wear Behaviour of Co-Cr-Mo Alloy in Ringer's Lactate Solution.

Cobalt-chromium-molybdenum (Co-Cr-Mo) alloy is a material recommended for biomedical implants; however, to be suitable for this application, it should have good tribological properties, which are related to grain size. This paper investigates the tribological behaviour of a Co-Cr-Mo alloy produced using investment casting, together with electromagnetic stirring, to reduce its grain size. The samples were subjected to wear and scratch tests in simulated body fluid (Ringer's lactate solution). Since a reduction in grain size can influence the behaviour of the material, in terms of resistance and tribological response, four samples with different grain sizes were produced for use in our investigation of the behaviour of the alloy, in which we considered the friction coefficient, wear, and scratch resistance. The experiments were performed using a tribometer, with mean values for the friction coefficient, normal load, and tangential force acquired and recorded by the software. Spheres of Ti-6Al-4V and 316L steel were used as counterface materials. In addition, to elucidate the influence of grain size on the mechanical properties of the alloy, observations were conducted via scanning electron microscopy (SEM) with electron backscatter diffraction (EBSD). The results showed changes in the structure, with a reduction in grain size from 5.51 to 0.79 mm. Using both spheres, the best results for the friction coefficient and wear volume corresponded to the sample with the smallest grain size of 0.79 mm. The friction coefficients obtained were 0.37 and 0.45, using the Ti-6Al-4V and 316L spheres, respectively. These results confirm that the best surface finish for Co-Cr-Mo alloy used as a biomedical implant is one with a smaller grain size, since this results in a lower friction coefficient and low wear.

Relative age effects on speed trials in Brazilian athletics.

BACKGROUND: Relative age effect (RAE) is a concept related to the possible advantage that older athletes would have over younger ones within the same category. Although many studies have approached this subject in individual sports, there are few clippings by events within the sport. More detailed analyses are necessary for a better understanding of how RAE behaves in sports, especially in athletics, the subject of this study. The objective of this study was to analyze the RAE on speed in track and field events as a whole, separating the flat races from the hurdles races. METHODS: The Brazilian Ranking of Brazilian Athletics Confederation was used for data analysis, and the sample was composed of the 50 best-placed marks in the ranking of speed events in athletics in the categories Under(U)-16 and U-18 (female and male). Statistical analysis was calculated by chi-square, and the effect size was checked by Cramer's V. Likelihood-ratio test (L-Ratio) assessed the probability of the RAE occurring in the total sample and by age groups. RESULTS: In the total sample the results pointed to the emergence of RAE in males in both categories (U-16: p < 0.001; V: 0.13; L-Ratio: 3.64, U-18: p < 0.001; V: 0.13; L-Ratio: 3.80), whereas in females no such effect was found in any category (U-16: p = 0.6; V: 0.09; L-Ratio: 0.09, U-18: p = 0.6; V: 0.07; L-Ratio: 0.12). When the results were separated by type of event, there was only a RAE in the shallow event in the U-18 female category (p = 0.3; V: 0.11; L-Ratio: 8.72). CONCLUSION: The results allow us to conclude that there is a RAE in the speed trials of Brazilian athletics in the U16 and U18 categories for men, while this effect appears only in the shallow trials of the U18 category for women, indicating that the RAE has incidence when there is more participation and competition in the sport.

A cloth facemask increased ratings of perceived exertion and reduced affect, without affecting sprint or muscular performance.

We determined the effects of wearing a cloth facemask on exercise performance and subjective responses during training of track and field athletes. Track and field athletes (n = 10, sprinters and long jumpers) performed two training sessions with and without a three-layered antiviral cloth facemask. The training session simulated the specific demands of the sport, consisting of five 30-m sprints, interspersed with passive 4-min intervals. Countermovement jump performance was assessed pre- and post-sprints, and ratings of perceived exertion (RPE) and affect were collected throughout. There was no evidence of condition*time interactions for sprint time (P = 0.21) or acceleration (P = 0.47). There was weak evidence of a condition effect on RPE (P = 0.05), though no condition*time interaction (P = 0.35). There was moderate evidence of a condition*time interaction for affect (P = 0.02), with lower ratings following sprints 3, 4 and 5 when using the mask. These findings suggest that wearing a mask may negatively impact subjective feelings of training without necessarily harming sprint performance.

Relative age effect in elite Brazilian athletes in different combat sports: an observational study.

Background: The relative age effect (RAE) suggests that, due to maturity, young athletes born in the first quartiles of the year may have advantages over those born in the last quartiles of the year. Thus, it is important to evaluate the RAE in different sports and to consider the particularities of the subdivisions of the sports categories. Objective: To analyze the RAE in the top 20 of the Brazilian rankings in different combat sports. Methods: Observational study that analyzed the national databases for the year 2019 (from categories U-11 to U-18) made publicly available by the Brazilian confederations of karate, taekwondo and fencing. We obtained data on date of birth, age category and body weight of all modalities, type of fencing competition weapon (Epee, Foie and Saber) and type of karate modality (kumite and kata) from the top 20 places in each ranking. The final sample consisted of 1,486 athletes (Age: 14.2 ± 2.3. Male-53.2%. Female-46.8%). To identify the RAE, we performed a contingency analysis and compared the results between the sexes within the same sport. Results: There was RAE in the U-11, U-12, U-15 and U-17 fencing categories (p < 0.05), being higher in the female categories (p < 0.05). The RAE was higher for males in the Epee test, and similar between the sexes for the Saber and Foie tests. In karate, RAE occurred in categories U-14 and U-16 (p < 0.05), being higher in males (p < 0.05). The RAE was similar between the sexes in the kumite modality (p < 0.05). There was no RAE for the kata modality in karate (p > 0.05) and for the Taekwondo categories (p > 0.05). Conclusion: The results showed the existence of a relative age effect in elite athletes ranked (top 20 places in each ranking) only for the sport of fencing and karate kumite.

Educação sexual: dificuldades dos pais de jovens com síndrome de down / Sex education: difficulties for parents of young people with down syndrome / Educación sexual: dificultades para los padres de jóvenes con síndrome de down

Com este estudo buscou-se conhecer as dificuldades e barreiras de pais na educação sexual de jovens com Síndrome de Down, a partir de uma pesquisa descritiva e de natureza qualitativa, utilizando-se o conceito das representações sociais como referencial teórico-metodológico. O estudo foi conduzido em uma Organização Não Governamental (ONG), localizada em Recife (PE), após aprovação do Comitê de Ética e Pesquisa, sob parecer consubstanciado 3.558.587. A amostra do estudo envolveu 11 pais de jovens com Síndrome de Down com idades entre 15 e 24 anos. A coleta de dados foi realizada por meio de entrevistas semiestruturadas. A abordagem escolhida para a interpretação desses dados foi a análise de conteúdo proposta por Bardin. Pode-se elencar como principais dificuldades enfrentadas pelos pais ao conversarem com seus filhos sobre sexualidade: a infantilização do jovem com Síndrome de Down, julgando-o incapaz de experienciar tais fenômenos e compreender a orientação que pudesse ser repassada; o medo em ultrapassar etapas e, de repente, "estimular" o filho a viver sua sexualidade de maneira "precoce"; e o fato de os pais também terem recebido pouca ou nenhuma orientação sexual por parte de suas famílias. Diante das narrativas dos pais, é possível perceber que ainda são muitos os mitos, tabus e preconceitos que permeiam a sexualidade dos jovens com Síndrome de Down, demonstrando que os responsáveis estão despreparados para dar as devidas orientações.(AU)

This study sought to know the difficulties and barriers of parents in the sexual education of young people with Down Syndrome, from a descriptive, qualitative study, using the concept of social representations as a theoretical-methodological framework. The study was conducted in a Non-Governmental Organization (NGO), located in Recife (PE) after approval by the Ethics and Research Committee, under substantiated opinion 3,558,587. The study sample involved 11 parents of young people with Down Syndrome aged between 15 and 24 years. The data collection was carried out by using semi-structured interviews. The approach chosen for interpretation of these data was the content analysis proposed by Bardin. The main difficulties faced by parents in talking with their children about sexuality can be listed as: the infantilization of young persons with Down Syndrome, deeming them incapable of experiencing such phenomena and understanding the guidance that could be given; the fear of overshooting the stages and, suddenly, "stimulating" the child to live their sexuality in an "early" way; and the facts of the parents also having received little or no sexual guidance from their families. Given the parents' narratives, it is possible to realize that there are still many myths, taboos, and prejudices that permeate the sexuality of young people with Down Syndrome, demonstrating that parents were unprepared to provide the right guidance.(AU)

Este estudio buscó conocer las dificultades y barreras de los padres en la educación sexual de los jóvenes con síndrome de Down a partir de un estudio descriptivo, cualitativo, que utilizó el concepto de representaciones sociales como marco teórico-metodológico. La investigación se llevó a cabo en una Organización No Gubernamental (ONG), ubicada en la ciudad de Recife (Pernambuco, Brasil), después de la aprobación del Comité de Ética e Investigación, bajo la opinión fundamentada 3.558.587. La muestra del estudio incluyó a 11 padres de jóvenes con síndrome de Down con edades comprendidas entre 15 y 24 años. La recolección de datos se realizó mediante entrevista semiestructurada. El enfoque elegido para la interpretación de los datos fue el análisis de contenido propuesto por Bardin. Pueden enumerarse como las principales dificultades que enfrentan los padres para hablar sobre la sexualidad con sus hijos: la infantilización del joven con síndrome de Down, considerándolo incapaz de experimentar tales fenómenos y comprender la orientación que se le puede dar; el miedo de ir más allá de las etapas y, de repente, "estimular" al niño a vivir su sexualidad de una manera "temprana"; y el hecho de que los padres también habían recibido poca o ninguna orientación sexual de sus familias. Dadas las narraciones de los padres, es posible darse cuenta de que todavía hay muchos mitos, tabúes y prejuicios sobre la sexualidad de los jóvenes con síndrome de Down, lo que muestra que los padres no estaban preparados para brindarles este tipo de orientación.(AU)

Grain Refinement of Inconel 718 Superalloy-The Effect of Rotating Magnetic Field.

The effect of the application of a rotating magnetic field on the average grain size of IN718 castings was experimentally studied. For the purpose, four parts were produced by investment casting and characterized. The first casting was produced without application of RMF for comparison. The remaining ones were submitted to different RMF frequencies for 15 min and subsequently to the pouring of the nickel-based superalloy. In these three castings, the RMF frequencies applied were, respectively, 15 Hz, 75 Hz and 150 Hz. All the other process parameters were kept constant during the execution of the experimental procedure. The average grain size of the samples was determined according to the ASTM E112-13 standard, using intercept methods. Macro hardness measurements, tensile testing and SEM-EDS analysis were conducted in order to evaluate the casting's mechanical properties and microstructures. The results demonstrate a noticeable grain size reduction in the samples submitted to rotating magnetic field. An average grain area reduction, greater than 96%, was achieved in the castings where RMF frequencies of 75 Hz and 150 Hz were applied. The application of RMF also caused a morphological change in the casting's dendrites from cellular to almost equiaxed. Additionally, it originated the decrease of the size and amount of needle-like δ phase. Regarding mechanical properties of the cast parts, no major differences were verified.

Equation for analyzing the peak power in aquatic environment: An alternative for olympic rowing athletes.

PURPOSE: To develop an equation to provide the peak power (PP) through a specific stimulus performed in an aquatic environment, as well as to correlate morphological, anthropometric and strength variables with rowing performance. METHODS: The sample consisted of 16 elite young rowing athletes of both sexes (15.7 ± 1.21 years). The strength of upper limbs and lower limbs was verified. To analyze the PP, a 100-m Sprint test was performed on an indoor rowing type ergometer, and after a 72-hour wash-out, the test was repeated in an aquatic environment on a vessel equipped with a global position system. Body composition was analyzed by examining bone densitometry with an X-ray source and maturation was verified by anthropometry. RESULTS: The tests for water sprint and indoor rowing showed significant reliability (ICC = 0.695; p = 0.0007). The PP aquatic showed reliability with that acquired in indoor rowing (ICC = 0.897; p<0.0001) and was related to maturation (p<0.05). The morphology, anthropometry and strength of the upper limbs were related to the sprint and peak strength in both tests (p<0.05). CONCLUSION: The equation for the PP in aquatic environment presented by the present study is highly reliable with an indoor ergometer digital ergometer.

Relato de caso: tomografia computadorizada cardíaca no diagnóstico de miocárdio não-compactado / Case report: cardiac computed tomography in the diagnosis of non-compacted myocardium

INTRODUÇÃO: O Miocárdio Não-Compactado (MNC) é uma cardiomiopatia de fenótipo distinto caracterizada por proeminentes trabéculas e recessos do ventrículo esquerdo. É usualmente diagnosticado usando critérios diagnósticos morfológicos no ecocardiograma transtorácico (ECO). A ressonância magnética cardíaca (RCM), além de fornecer informações estruturais adicionais, é indicada para casos inconclusivos. Com critérios morfológicos atualizados, a tomografia computadorizada cardíaca (TCC) pode ser utilizada em casos inconclusivos ou na impossibilidade da realização de RMC. RELATO DE CASO: Paciente, sexo feminino, história de dispneia aos moderados esforços desde os 23 anos. Antecedente pessoal de hipertensão arterial desde os 30 anos. Aos 38 anos iniciou segmento em serviço terciário de cardiologia, realizando ECO e teste ergométrico sem alterações. Manteve segmento da hipertensão. Aos 52 anos foi internada por síndrome coronariana aguda e bloqueio de ramo esquerdo intermitente. Realizou coronariografia com ausência de processo ateromatoso coronariano e ventriculografia com hipocinesia difusa. ECO da ocasião com queda da fração de ejeção do ventrículo esquerdo (40%) e hipocinesia difusa. Evoluiu com bloqueio de ramo esquerdo fixo e piora progressiva de dispneia, até aos mínimos esforços. Aos 58 anos realizou novo ECO para avaliação de dissincronia ventricular, porém foram verificados critérios morfológicos sugestivos de MNC. Não disponível RMC no serviço, foi solicitada TCC, que demonstrou trabeculção miocárdica difusa com relação de espessura miocárdio não-compacta do/compactado de 5,2. Aos 62 anos realizou implante de ressincronizador cardíaco com cardioversores desfibriladores implantável, inviabilizando realização futura de RMC. Hoje com 69 anos, apresenta recuperação de função ventricular e dispneia aos moderados esforços. CONCLUSÃO: O relato de caso é importante para o auxílio na atualização dos critérios morfológicos da TCC para o diagnóstico do MNC. O MNC tem manifestações clínicas variadas e complicações potencialmente graves, tais como insuficiência cardíaca, tromboembolismo e arritmias. Seus critérios diagnósticos são exclusivamente por exames de imagem e estão em constante desenvolvimento e atualização, com baixa especificidade, pois outras patologias podem cursar com aumento de trabeculação, como cardiomiopatia dilatada. São consagrados o uso do ECO e da RMC, contudo deve-se atentar para utilização da TCC como auxílio diagnóstico, principalmente para ocasiões em que a RMC é indisponível ou contra-indicada.

An engineering-based approach for design and fabrication of a customized nasal prosthesis.

BACKGROUND AND AIM: Facial defects (from neoplasms, trauma, etc.) can be functionally and emotionally devastating. A non-invasive treatment for these defects is the application of external prostheses. Conventionally, these prostheses are fabricated by an anaplastologist through a manual procedure, which is an expensive and time-consuming approach. Current advances in computational and engineering tools report an improvement in design and manufacturing of silicone prostheses. This demand motivated this study that aims to develop a methodology for fabricating customized nasal prostheses. TECHNIQUE: In this study, an 80-year-old woman with a total defect of the nose is considered as case-study. The proposed methodology entails six tasks: (a) data acquisition, (b) three-dimensional reconstruction, (c) prosthesis design, (d) moulds fabrication, (e) prosthesis manufacturing and (f) final fittings. DISCUSSION: The presented approach showed encouraging outcomes since it saves time, reduces costs and allows the achievement of prosthesis with the minimum contact and discomfort to the patient, disclosing excellent aesthetic and functional results. CLINICAL RELEVANCE: Custom-made nasal prostheses with minimum contact and discomfort for the patient can be achieved using an engineering approach based on digital technologies and additive manufacturing that is cost-effective and less time-consuming than the manual procedure.

Ruídos na unidade de terapia intensiva: quantificação e percepção dos profissionais de saúde / Noise in the intensive care unit: quantification and perception by healthcare professionals

OBJETIVO: Em uma unidade de terapia intensiva, a circulação de pessoas da equipe multidisciplinar e o número considerável de equipamentos e alarmes sonoros deixam o ambiente ruidoso. O objetivo desta pesquisa foi mensurar os níveis de ruídos de uma unidade de terapia intensiva da cidade de Recife e avaliar sua percepção pelos profissionais da unidade. MÉTODOS: Durante uma semana, 24 horas por dia, foi utilizado um decibelímetro para realizar mensurações a cada cinco segundos. Após as aferições, foi aplicado um questionário aos profissionais sobre sua percepção e incômodo causados pelo ruído, e se eles achavam possível reduzir o barulho. RESULTADOS: A média de ruído verificada foi de 58,21 ± 5,93 dB. O período diurno apresentou maiores níveis de ruídos que o noturno (60,86 ± 4,90 vs 55,60 ± 5,98 dB; p < 0,001), assim como os dias úteis quando comparados ao final de semana (58,77 ± 6,05 vs 56,83 ± 5,90 dB; p < 0,001) e a passagem de plantão noturna quando comparada a diurna (62,31 ± 4,70 vs 61,35 ± 5,08 dB; p < 0,001). Dos 73 profissionais que responderam o questionário, 97,3 por cento acham que a unidade de terapia intensiva tem ruído de moderado a intenso, 50,7 por cento se sentem prejudicados pelo barulho e 98,6 por cento acham que é possível reduzir o nível de ruídos. CONCLUSÃO: Os níveis de ruídos encontrados estavam acima dos recomendados. Programas preventivos e educativos conscientizando da importância da redução do nível de ruído devem ser estimulados, envolvendo todos os profissionais que compõem a equipe da unidade de terapia intensiva.

OBJECTIVE: The several multidisciplinary team personnel and device alarms make intensive care units noisy environments. This study aimed to measure the noise level of a medical-surgical intensive care unit in Recife, Brazil, and to assess the noise perception by the unit's healthcare professionals. METHODS: A decibel meter was used for continuous every five seconds one week noise levels recording. After this measurement, an interview shaped noise perception questionnaire was applied to the healthcare professionals, approaching the discomfort level and noise control possibilities. RESULTS: Mean 58.21 ± 5.93 dB noise was recorded. The morning noise level was higher than at night (60.85 ± 4.90 versus 55.60 ± 5.98, p <0.001), as well as work-days versus weekend (58. 77 ± 6.05 versus 56.83 ± 5.90, p <0.001). The evening staff shift change noise was louder than by daytime change (62.31 ± 4.70 versus 61.35 ± 5.08 dB; p < 0.001). Of the 73 questionnaire respondents, 97.3 percent believe that the intensive care unit has moderate or intense noise levels; 50.7 percent consider the noise harmful; and 98.6 percent believe that noise levels can be reduced. CONCLUSION: The measured noise levels were above the recommended. Preventive and educational programs approaching the importance of noise levels reduction should be encouraged in intensive care units.

Tecnologia assistencial na promoção da saúde: cuidado e autocuidado do idoso insulino-dependente / Assistance technology in health promotion: care and selfcare of insulin dependent elderly / Tecnología asistencial en la promoción de la salud: cuidado y autocuidado del anciano dependiente de insulina

Objetivou-se relatar a experiência vivida pelos profissionais de enfermagem em um grupo de pacientes idosos insulino-dependentes com a prática da tecnologia assistencial. Participaram do grupo doze pacientes, oito cuidadores, um médico, um enfermeiro e um interno de medicina. O encontro apresentou quatro momentos distintos. No primeiro momento, o usuário participou apenas como observador, aprendendo como fazer a manipulação correta do material, como aplicar a medicação e como deve ser o acondicionamento dos frascos. No segundo momento, passou a ser agente de transformação do próprio cuidado. No terceiro momento, foram expostas as dificuldades e dúvidas e o quarto momento resultou na avaliação do encontro. A convocação dos pacientes para uma orientação coletiva resultou, após avaliação do encontro, na criação de um novo grupo de convivência, para que temas diversos relacionados ao cotidiano de ter diabetes e fazer uso de insulina pudessem ser abordados.

This article aimed to report the experience lived by the nursing professionals in a group of insulin-dependent elderly patients with theassistance technology practice. Twelve patients participated in the group, eight caregivers, a doctor, a nurse a one medical student. Theencounter presented four different moments. In the first moment the user participated only as an observer, learning how to manipulatecorrectly the material, how to apply the medication and how to storage the bottles. In the second moment the user became agent oftransformation of his own care. In the third moment the difficulties and doubts were exposed and in the fourth moment the encounterwas evaluated. Those professionals’ attitude of summoning the insulin patients for a collective orientation resulted, after the encounterevaluation, in the creation of a new support group, so that several themes concerning the daily life of having diabetes and using insulin could be approached.

El objetivo fue relatar la experiencia de los profesionales de enfermería en un grupo de pacientes ancianos dependientes de insulina conla práctica de la tecnología de asistencia. Participaron del grupo doce pacientes, ocho cuidadores, un médico, un enfermero y un residentede medicina. La reunión presentó cuatro momentos. distintos. En el primer momento, el usuario sólo participó como observador,aprendiendo cómo hacer la manipulación correcta del material, cómo aplicar la medicación y cómo se deben acondicionar los frascos.En el segundo momento, pasó a ser agente de transformación del propio autocuidado. En el tercer momento, se expusieron las dificultadesy dudas y el cuarto momento resultó en la evaluación del encuentro. La convocación de los pacientes para una orientación colectivaresultó, tras la evaluación del encuentro, en la creación de un nuevo grupo de convivencia, a fin de que temas diversos relacionados alhecho cotidiano de tener diabetes y hacer uso de insulina pudieran ser planteados.

Noise in the intensive care unit: quantification and perception by healthcare professionals. / Ruídos na unidade de terapia intensiva: quantificação e percepção dos profissionais de saúde.

OBJECTIVE: The several multidisciplinary team personnel and device alarms make intensive care units noisy environments. This study aimed to measure the noise level of a medical-surgical intensive care unit in Recife, Brazil, and to assess the noise perception by the unit's healthcare professionals. METHODS: A decibel meter was used for continuous every five seconds one week noise levels recording. After this measurement, an interview shaped noise perception questionnaire was applied to the healthcare professionals, approaching the discomfort level and noise control possibilities. RESULTS: Mean 58.21 ± 5.93 dB noise was recorded. The morning noise level was higher than at night (60.85 ± 4.90 versus 55.60 ± 5.98, p <0.001), as well as work-days versus weekend (58. 77 ± 6.05 versus 56.83 ± 5.90, p <0.001). The evening staff shift change noise was louder than by daytime change (62.31 ± 4.70 versus 61.35 ± 5.08 dB; p < 0.001). Of the 73 questionnaire respondents, 97.3% believe that the intensive care unit has moderate or intense noise levels; 50.7% consider the noise harmful; and 98.6% believe that noise levels can be reduced. CONCLUSION: The measured noise levels were above the recommended. Preventive and educational programs approaching the importance of noise levels reduction should be encouraged in intensive care units.

Adenoid cystic carcinoma of the external auditory canal.

Adenoid cystic carcinoma is a rare tumor originating from the salivary glands, especially when arise the external auditory canal. This tumor has high rate of perineural invasion and metastasis, then must be treated with aggressive surgery combined with postoperative radiation. We report a case of an adenoid cystic carcinoma arising the external auditory canal of 77 years old female patient, who complained hypoacusis and pain. She was treated by radical mastoidectomy and radiotherapy.

Carcinoma adenóide cístico de conduto auditivo externo / Adenoid cystic carcinoma of the external auditory canal

O carcinoma adenóide cístico é um raro tumor originado das glândulas salivares, principalmente quando se localiza no conduto auditivo externo. Apresenta alta taxa de invasão perineural e metástases, devendo ser tratado com combinação de cirurgia agressiva seguida de radioterapia. Relatamos um caso de carcinoma adenóide cístico de conduto auditivo externo em paciente de 77 anos com queixa de hipoacusia e otalgia. A mesma foi tratada com mastoidectomia radical e radioterapia.

Adenoid cystic carcinoma is a rare tumor originating from the salivary glands, especially when arise the external auditory canal. This tumor has high rate of perineural invasion and metastasis, then must be treated with aggressive surgery combined with postoperative radiation. We report a case of an adenoid cystic carcinoma arising the external auditory canal of 77 years old female patient, who complained hypoacusis and pain. She was treated by radical mastoidectomy and radiotherapy.