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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The current COVID-19 pandemic has completely transformed the care of rheumatology patients in outpatient clinics&#44; including paediatric rheumatology&#46; Telemedicine has been mandatory during the worst moments of the health crisis&#44; and will be maintained once normality returns&#44; because in every crisis there is an opportunity&#46; Teleconsultation in adult rheumatology<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and to a lesser extent in paediatric rheumatology<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> has occasionally involved telematic communication with primary care&#46; Current teleconsultation involves patients directly and this method appears to have been well received&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In this letter we show our results from paediatric rheumatology teleconsultation during the pandemic&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">During the months of March&#44; April and May 2020 we provided telephone support to the vast majority of patients who were given an appointment using a semi-structured interview&#46; During each call we asked the patients&#8217; parents&#44; or the patients themselves if they were over 14 years of age&#44; about symptoms of joint pain or inflammation and any symptoms related to their underlying disease&#46; In the case of juvenile idiopathic arthritis &#40;JIA&#41;&#44; the child was considered to be in remission if they answered that they were living a normal life without pain&#44; swelling or limping&#46; If they reported pain or swelling or for any other justified cause&#44; the patient was given an appointment to attend the next available consultation in person&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There was a total of 147 consultations&#44; of which 110 &#40;75&#37;&#41; were by telephone&#46; The diagnoses of the patients seen and their demographic data are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; Only nine patients &#40;8&#46;2&#37;&#41; reported feeling unwell and a face-to-face consultation was required in 13 cases &#40;11&#46;8&#37;&#41;&#46; The mean time from the previous consultation &#40;10&#46;7 weeks&#41; was similar to that of the next telephone appointment &#40;11&#46;5 weeks&#41;&#46; In JIA there were 34 telephone consultations and 14 face-to-face check-ups&#46; In 32 cases &#40;94&#46;1&#37;&#41; the children were asymptomatic&#44; however&#44; eight patients &#40;23&#46;6&#37;&#41; required a face-to-face consultation in the following eight weeks&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The vast majority of patients were grateful for the teleconsultation and reported that they were well or very well&#46; However&#44; after one or two calls some parents expressed the need to be seen in person&#44; even if the child was asymptomatic&#46; In the paediatric rheumatology practice we propose a format of face-to-face consultations interspersed with non-face-to-face consultations&#46; This will allow us to distance face-to-face consultations from each other&#44; avoiding patients crowding together in the waiting room without having to reduce the number of patients seen per consultation&#46; Face-to-face consultations should not be neglected&#44; especially in the follow-up of JIA&#44; where systematic joint examination is essential as inflammation may go unnoticed by patients and parents&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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Letter to the Editor
Teleconsultation of infant rheumatology in Covid-19 time
Teleconsulta de reumatología infantil en tiempo de COVID-19
Juan Carlos Nieto-González
Corresponding author
juancarlos.nietog@gmail.com

Corresponding author.
, Indalecio Monteagudo
Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;9 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female gender &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">92 &#40;62&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">JIA n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;32&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SLE&#47;Sj&#246;gren&#8217;s&#47;JDM n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Arthralgias n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;19&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other diagnoses n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36 &#40;24&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Face-to-face consultation n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Telephone consultation n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110 &#40;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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Article information
ISSN: 21735743
Original language: English
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Idiomas
Reumatología Clínica (English Edition)
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