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Background: Patients with inflammatory bowel disease (IBD) are vulnerable to some psychological disorders. Here we describe the psychological impact of a COVID-19 pandemic lockdown in patients with IBD., Methods: This multicenter prospective cohort study included 145 patients recently diagnosed with IBD. Data on clinical and demographic characteristics, anxiety and depression scales, and IBD activity were collected in two telephone surveys, during and after the first COVID-19 lockdown in Spain. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated., Results: During lockdown, 33.1% and 24.1% scored high on the anxiety and depression scales, respectively. Independent factors related to anxiety (all values ORs; 95% CIs) during lockdown were female sex (2; 1.2-5.4) and IBD activity (4.3; 1.8-10.4). Factors related to depression were comorbidity (3.3; 1.1-9.8), IBD activity (6; 1.9-18.1), use of biologics (2.9; 1.1-7.6), and living alone or with one person (3.1; 1.2-8.2). After lockdown, anxiety and depression symptoms showed significant improvement, with 24.8% and 15.2% having high scores for anxiety and depression, respectively. Factors related to post-lockdown anxiety were female sex (2.5; 1.01-6.3), Crohn's disease (3.3; 1.3-8.5), and active IBD (4.1; 1.2-13.7). Factors associated with depression were previous history of mood and/or anxiety disorders (6.3; 1.6-24.9), active IBD (7.5; 2.1-26.8), and steroid use (6.4; 1.4-29)., Conclusions: Lockdown during the COVID-19 pandemic had a significant psychological impact in patients with IBD. Disease activity was related to the presence of anxiety and depression symptoms during and after lockdown., (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)

Background/objectives: To analyze mortality, costs, residents and personnel characteristics, in six long-term care facilities (LTCF) during the outbreak of COVID-19 in Spain., Design: Epidemiological study., Setting: Six open LTCFs in Albacete (Spain)., Participants: 198 residents and 190 workers from LTCF A were included, between 2020 March 6 and April 5. Epidemiological data were also collected from six LTCFs of Albacete for the same period of time, including 1,084 residents., Measurements: Baseline demographic, clinical, functional, cognitive and nutritional variables were collected. 1-month and 3-month mortality was determined, excess mortality was calculated, and costs associated with the pandemics were analyzed., Results: The pooled mortality rate for the first month and first three months of the outbreak were 15.3% and 28.0%, and the pooled excess mortality for these periods were 564% and 315% respectively. In facility A, the percentage of probable COVID-19 infected residents were 33.6%. Probable infected patients were older, frail, and with a worse functional situation than those without COVID-19. The most common symptoms were fever, cough and dyspnea. 25 residents were transferred to the emergency department, 21 were hospitalized, and 54 were moved to the facility medical unit. Mortality was higher upon male older residents, with worse functionality, and higher comorbidity. During the first month of the outbreak, 65 (24.6%) workers leaved, mainly with COVID-19 symptoms, and 69 new workers were contracted. The mean number of days of leave was 19.2. Costs associated with the COVID-19 in facility A were estimated at € 276,281/month, mostly caused by resident hospitalizations, leaves of workers, staff replacement, and interventions of healthcare professionals., Conclusion: The COVID-19 pandemic posed residents at high mortality risk, mainly in those older, frail and with worse functional status. Personal and economic costs were high., Competing Interests: The authors have declared that no competing interests exist.

Objectives: The purpose of this document is to establish practical recommendations on neurogenic bladder (NB) management based on scientific evidence and medical and nursing perspective in Spinal Cord Injury (SCI) Units as a first multidisciplinary consensual approach in Spain. METHODS: This paper reports results from the first modified Delphi consensus building exercise on this procedure. A committee of recognised opinion-leaders in rehabilitation and urology with special interest in NB was constituted. A working group formed by rehabilitation doctors, urologists and nursing staff of SCI and Neurorehabilitation Units of a number of Spanish hospitals and specialised centres associated with the panel of NB experts have prepared this document. RESULTS: This review provided an overview of the main aspects described by the different clinical guidelines already available and highlighted the need to focus on recommendations in special priority situations in which there was no consensus. In view of the considerable impact this condition has on quality of life, patients should be offered help to better understand the disorder and they should be taught how to use the treatment techniques to obtain satisfactory results and promote their autonomy. CONCLUSIONS: This article presents a version of guidelines for patients with NB. The guidelines define the clinical profile of patients to provide the best evidence- based care and also an overview of the current drug and surgical treatments of NB.

Objectives: To examine whether there is adequate available information in hospital discharge records (HDR) to retrospectively evaluate the adequacy of medical care to patients suffering from ischemic heart disease (IHD) and to relate care quality to physicians' decisions., Material and Methods: Cross-sectional study in which a total of 690 HDRs of patients admitted to three university teaching hospitals in Seville, Spain, on account of ischemic heart disease. The fulfillment of 15 parameters representing an adaptation to the CMBD regulation to IHD. The criterion of adequate information was set at 80% of data., Results: Only 2.8% of HDRs contains adequate information. According to the analysed data, relevant fulfillment variability was observed. There were significant differences in fulfillment depending upon hospital and type of patient, with more information among younger patients and comorbidity., Conclusions: HDRs contain inadequate information to evaluate medical care.

Objective: To examine the availability of information in the clinical records (CR) to evaluate care quality in ischemic heart disease., Material and Methods: A total of 722 clinical records of patients admitted because of ischemic heart disease were evaluated. Based upon a bibliographic review and the criteria of an expert panel necessary data to evaluate care quality were selected. A CR was considered adequate when at least 80% of data considered necessary by the expert panel were available., Results: 78.5% of CR had adequate data. The elderly, clinical presentation as ischemic equivalent and one of the hospitals studied had most deficient CR., Conclusions: The CR is valid to retrospectively evaluate medical care. Differences between hospitals were important and should be taken into consideration before studies on clinical quality are performed.

Objectives: To describe a systematic procedure for exhaustive retrieval of Spanish articles about evaluation or health information systems (1983-1992); to analyze the useful terms, the item contribution and the retrieval failures of the sources., Methods: As sources for identification of articles, data base Indice Médico Español (IME), contents of journals and references of the retrieved items have been used. As analysis variables, coincidence of terms in search profile, item's titles and key words; item contribution, specific contribution and overlap indexes; hindsight analysis of failures., Results: 94 items have been retrieved, 83 of them have, at least one term related with the subject. Referred to sources contribution, IME gives 74 items; journal contents 75 and references 33. Specific contribution of IME was 16 items, contents 12 and references 2. Overlap between sources was 25.5%., Conclusion: The three sources are complementary. Complete retrieval of the literature requires systematic use of the abstracts and references of the papers, where the perception of its contents are less dependent of the terms used in the titles.