Control de la hiperglucemia con la solución de glucosa-insulina-potasio en pacientes no diabéticos en cirugía cardíaca / Hyperglycemia controlled with GIK solution in non-diabetic patients subjected to heart surgery

We prospectively compared, the glucose-insulin-potassium (GIK) solution 1,000 mL 10% glucose, 20 units of fast acting insulin and 60 mEq of potassium chloride, against a GIK solution with 1,000 mL of glucose, 40 units of fast acting insulin an 120 mEq of chloride, in the hyperglycemic control of non-diabetic patient subjected to cardiac surgery. We divided 40 patients in four groups ten patients each. Group A was the control they received 1,000 mL of 10% glucose in water, 20 units of fast acting insulin and 60 mEq of potassium chloride in a drops/ hour dose without an infusion pump. Group B received the same solution in a 50 mL/hour dose. Group C received 1,000 mL of 10% glucose in water, 40 units of fast acting insulin plus, 120 mEq of potassium chloride at the same infusion rate as Group A. Group D 2 1,000 mL of 10% of glucose in water, 40 units of fast acting insulin in the same rate as Group B. The GIK solution was started after anesthesia induction and maintained all along the extracorporeal circulation, the study continued until the patient was transferred to the intensive care unit. We measured blood glucose, circulating insulin and seric levels of potassium three times; basal before the anesthetic induction, during the extracorporeal circulation and at the intensive care unit arrival. The data were analyzed with measure of central tendency, dispersion and multivariate analysis. RESULTS: Among the four groups no statistically significant differences existed in demographic data. In Group A, glucose and potassium levels were higher as compared with the rest of the groups (p <0.05) in all measurements; Group D was less hyperglycaemic as compared with Groups A, B, and C. CONCLUSION: The solution with low insulin dose does useful plasmatic insulin levels in the hyperglycemia in non diabetic patients subjected to cardiac surgery.

Adhesión de composites a esmalte y dentina con adhesivos mono y multienvase / Bonding of composite to enamel and dentin using multi and single-bottle adhesives

Se evaluó la resistencia adhesiva de composites a esmalte y dentina, utilizando adhesivos multi y monoenvase. Se usaron los adhesivos monofrasco (con grabado ácido previo o sin él): Syntac Sprint (SS), Optibond Solo (OS) y Single Bond (SB), y los multicomponente (utilizando o no el Primer respectivo con acondicionamiento ácido dentinario o sin él); Syntac (SY), Optibond FL(OF) y Scotchbond Multipropósito Plus (SBM). Posteriormente, se fijaron probetas de composite que fueron sometidas a ensayo de resistencia adhesiva. En ambos tejidos se observaron diferencias significativas (P menor 0,001) respecto del factor tratamiento. Los sistemas SBM, SY, SS y SB fueron los que obtuvieron el mejor comportamiento adhesivo a esmalte. Evitar el uso de grabado ácido disminuyó los valores alcanzados, mientras que no ocurrió lo mismo sin aplicar Primer. Los sistemas adhesivos monofrasco lograron un mejor comportamiento cuando la dentina fue acondicionada previamente con ácido

Agentes estressores no trabalho e sugestões para amenizá-los: opiniões de enfermeiros de pós-graduação / Stressors agents in workplace and sugestions to soften its: opinions of the post graduation's nurses

A sobrecarga de trabalho, relacionamento e comunicação, características da Instituição e poluição ambiental foram os agentes estressores organizacionais mais citados neste estudo composto por 30 enfermeiras, sendo que a melhoria no planejamento do trabalho, o aspecto de humanização, adequação dos recursos humanos, melhora na comunicação e educação continuada, dentre outras, foram as sugestões identificadas para melhorar estes agentes estressores. Como agentes estressores extra organizacionais, os mais citados foram problemas econômicos e familiares e distância do trabalho/transporte.

The work overload, relationship and comunication problems, institution's characteristics and ambiental pollution were the stressing organization agents with the greatest pontuation in this study composed by 30 nurses. The work planning, work humanization, suitable human resourses, improving comunication and continued education were the suggestions given by nurses to minimize these stressing organizational agents. Analysing the stressing extra organizational agents, economic and familiar problems, work distance and transportation to work , were the most pointed.