Deep-sea Ordovician lingulide brachiopods and their associated burrows suggest an early colonization of proximal turbidite systems.

Trace fossils from Ordovician deep-marine environments are typically produced by a shallow endobenthos adapted to live under conditions of food scarcity by means of specialized grazing, farming, and trapping strategies, preserved in low-energy intermediate to distal zones of turbidite systems. High-energy proximal zones have been considered essentially barren in the early Paleozoic. We report here the first trace and body fossils of lingulide brachiopods in deep-marine environments from an Upper Ordovician turbidite channel-overbank complex in Asturias, Spain. Body and trace fossils are directly associated, supporting the interpretation of a lingulide tracemaker. Ellipsoidal cross-section, cone-in-cone spreite, and spade morphologies suggest the specimens belong to Lingulichnus verticalis. The oblique orientation in both trace and body fossils is the result of tectonic deformation. The organisms were suspension feeders showing escape, dwelling, and equilibrium behaviours controlled by sedimentation rates associated with turbidite deposition. These trace fossils and their in situ producers represent the oldest evidence of widespread endobenthos colonization in high-energy, proximal areas of turbidite systems, expanding the bathymetric range of Lingulichnus and the variety of behaviours and feeding styles in early Paleozoic deep-marine environments.

Complicaciones en accesos venosos vasculares: estudio descriptivo de catéteres venosos centrales y catéteres de línea media / Complications in vascular venous access: descriptive study of central venous catheters and midline catheters

[RESUMEN]. Los accesos vasculares venosos son dispositivos elementales para el tratamiento hospitalario de diversas condiciones. Está bien documentada la tasa de complicaciones para catéteres venosos centrales (CVC) y catéteres de línea media (MD), pero existe un solo trabajo que los compara directamente. Por ello realizamos el presente trabajo con el objetivo de establecer las tasas generales y comparativas de complicaciones en ambos tipos de catéteres. Se realizo un estudio descriptivo retrospectivo donde se reclutaron 168 pacientes, los cuales recibieron 268 catéteres (120 accesos venosos centrales y 148 midline), con una media de edad de 45 años, con leve predominio del sexo femenino (51,2%). De estos, la principal comorbilidad fue neoplasia (57,1%). En el 29,8% el principal motivo de colocación fue la infusión de quimioterapia. Como resultados, la prevalencia de complicaciones fue del 19%: infecciosas en el 7,5% de los casos (con una tasa de infecciones asociadas a catéter de 4.9/1000 días catéter), 1,9% trombóticas y 9,7% mecánicas. La tasa de complicaciones fue mayor para los catéteres venosos centrales, no alcanzando una diferencia estadísticamente significativa: infecciosas (10.8% vs. 4,7%; p: 0,059; OD: 2.47; IC 95%: 0.94 - 6.34) y mecánicas (5.8% vs. 12,8%; p: 0,054; OD: 0.42; IC 95%: 0.17 ­ 1.03) para CVC y MD, respectivamente. Las complicaciones trombóticas fueron similares en ambos (1,6% en CVC y 2% en MD, p: 0,82).

[ABSTRACT]. Venous vascular accesses are fundamental devices for in hospital treatment of various conditions. Complication rates for central venous catheters (CVC) and midline catheters (MD) are well-documented, but there is only one study in wich both devices were compared. Therefore, we conducted the present study with the aim of establishing the overall and comparative complication rates of both types of catheters. We conducted a retrospective descriptive study recruiting 168 patients who received 268 catheters (120 central venous accesses and 148 midlines). The mean age was 45 years, with a slight predominance of females (51.2%). Among these, the main comorbidity was neoplasia (57.1%). In 29.8% of cases, the main reason for catheter placement was chemotherapy infusion. As a result, the prevalence of complications was 19%: infectious complications in 7.5% of cases (with a catheter-associated infection rate of 4.9/1000 catheter days), thrombotic 1,9%, and mechanical 9,7%. Complication rate were higher for central venous accesses, although the difference did not reach statistical significance: infectious (10.8% vs. 4.7%; p: 0.059; OR: 2.47; 95% CI: 0.94 - 6.34) and mechanical (5.8% vs. 12.8%; p: 0.054; OR: 0.42; 95% CI: 0.17 ­ 1.03) for CVC and MD, respectively.Thrombotic complications were similar in both (1.6% in CVC and 2% in MD, p: 0.82).

The Chengjiang Biota inhabited a deltaic environment.

The Chengjiang Biota is the earliest Phanerozoic soft-bodied fossil assemblage offering the most complete snapshot of Earth's initial diversification, the Cambrian Explosion. Although palaeobiologic aspects of this biota are well understood, the precise sedimentary environment inhabited by this biota remains debated. Herein, we examine a non-weathered core from the Yu'anshan Formation including the interval preserving the Chengjiang Biota. Our data indicate that the succession was deposited as part of a delta influenced by storm floods (i.e., produced by upstream river floods resulting from ocean storms). Most Chengjiang animals lived in an oxygen and nutrient-rich delta front environment in which unstable salinity and high sedimentation rates were the main stressors. This unexpected finding allows for sophisticated ecological comparisons with other Burgess Shale-type deposits and emphasizes that the long-held view of Burgess Shale-type faunas as snapshots of stable distal shelf and slope communities needs to be revised based on recent sedimentologic advances.

Percepción de la familia del paciente crítico sobre enfermería, en el horario de visita en un Hospital de Alta Complejidad / Perception of Nurses by the Critical Patient's Family during Visit Time in a High-Complexity Hospital

OBJETIVOS: El estudio se inicio durante el mes de septiembre de 2017 con los familiares de los pacientes críticos de la unidad de terapia intensiva adultos en el Hospital de Alta Complejidad El Cruce. Teniendo en cuenta que no solo el paciente critico requiere cuidados por parte de la disciplina profesional, sino también la familia, cuidados asociados a la seguridad, comunicación en el tiempo adecuado en base a lo que ve y observa de su familiar; lleno de dispositivos invasivos en todo el cuerpo, catéteres, sondas, monitores. Los familiares expresan Angustia, llanto, hostilidad, emociones involuntarias, porque no todos los días de su vida se encuentran en ese escenario. Por tal motivo hemos decido investigar que percepción tienen los familiares al quinto día de internación sobre enfermería tomando como variables, aspectos de percepción, comunicación, apoyo emocional, anticiparnos a las alertas de alarma, realmente saber cuál es nuestra atención frente al familiar ya que a este lo consideramos una extensión de paciente y por lo tanto experimenta el proceso de la enfermedad al igual que ellos. MATERIALES Y MÉTODOS: Se trabajo con un diseño descriptivo de corte transversal, cualicuantitativo. Se elaboro como instrumento una escala Likert modificada, se tuvo en cuenta consideraciones éticas, siendo una encuesta voluntaria y anónima. Ya que tiene valor conocer las manifestaciones de la experiencia vivida por estos familiares como planteamiento de un problema, para buscar soluciones y estrategias de apoyo. RESULTADOS: En este estudio la percepción del familiar fue satisfactoria y productiva, lo que nos permite seguir trabajando y mejorando para la elaboración de pautas que contribuyan a mejorar la calidad y calidez del cuidado que se brindan en las instituciones de salud a los familiares de los pacientes críticos. Esta investigación nos permitió seguir aportando datos propios a la dinámica de nuestro servicio y poder intervenir como disciplina profesional y equipo de trabajo.

OBJECTIVE: The study was started in September 2017, with family members of critical patients in the adult intensive care unit in the high-complexity hospital EL CRUCE. Considering that professional careis required not only by the critical patient but also by the family, safety-related care and timely communication based on what they see and observe in their patient whose body is full of invasive devices, like catheters, probes and monitors, are provided. Family members express anguish, cry, hostility, involuntary emotions, because they do not find themselves in that setting every day of their lives. This is why we have decided to research on what family members perceive in nurses on the fifth hospitalization day taking these variables, perception aspects, communication, emotional support, anticipating alarm alerts, in order to really know how we provide care to the family member, since we regard them as an extension of the patient and, therefore, they experiment the illness process just like the patient. MATERIALS AND METHODS: The design used was applicative, descriptive, cross-sectional and qualitative-quantitative. A modified Likert scale was developed as an instrument and ethical considerations were taking into account in a voluntary anonymous survey. Since manifestations of the experience lived by these family members were worth knowing, as the presentation of a problem, aiming at finding solutions and support strategies. RESULTS: In this study, the family member's perception was satisfactory and productive, which allows us to continue working and improving in developing guidelines that help to improve the quality and warmth of the care provided to critical patients' family members in health care centers. This research has allowed us to continue contributing with our own data to the dynamics of our service and to be able to intervene as a profesional discipline and work team.